Safer sex negotiation and parity among women in sub-Saharan Africa

Women’s ability to negotiate for safer sex has effects on their sexual and reproductive health. This study investigated the association between safer sex negotiation and parity among women in sub-Saharan Africa. The data were sourced from the Demographic and Health Surveys of 28 sub-Saharan African countries conducted from 2010 to 2019. A total of 215,397 women aged 15–49 were included in the study. Multilevel logistic analysis was conducted to examine the association between safer sex negotiation and parity among women in sub-Saharan Africa. The results were presented as adjusted odds ratios (aOR) and the significance level set at p<0.05. The overall prevalences of safer sex negotiation and high parity among women in sub-Saharan Africa were 82.7% and 52.1%, respectively. The prevalence of high parity ranged from 32.3% in Chad to 72.1% in Lesotho. The lowest prevalence of safer sex negotiation was in Chad (16.8%) while the highest prevalence was recorded in Rwanda (99.7%). Women who had the capacity to negotiate for safer sex were less likely to have high parity compared with those who had no capacity to negotiate for safer sex (aOR = 0.78, CI: 0.75–0.81). Other factors that were associated with high parity were age, educational level, marital status, exposure to media, contraceptive use, religion, wealth quintile, sex of household head, and place of residence. The study identified significant association between safer sex negotiation and high parity among women of reproductive age in sub-Saharan Africa. It is worth noting that women’s ability to negotiate for safer sex could reduce high parity among women in sub-Saharan Africa. Therefore, policies and programmes aimed at birth control or reducing high parity among women could be targeted at improving their capacity to negotiate for safer sex through education.

Sex, Digital Devices, Social Media, and Social Isolation: A Study on Sexual Behavioral During COVID -19 Pandemic

Introduction: Coronavirus (COVID-19) pandemic has caused social and economic damages. People have adapted to a new reality of physical distance. Objective: The study aimed to assess the use of digital devices and social media, focusing on psychosocial and demographic factors of people´s sexual behavior during the pandemic. Methods: A total of 1,357 Brazilian adults participated in a cross-sectional online survey. They were recruited through social media to obtain information regarding sexual behavior and the use of digital devices and social media. Results: Digital devices and social media were used by 38.8% of the participants. Among the group that used technological devices, most claimed to have changed their sexual behavior, with 76.9% consuming more sexual content through movies or series. Conclusion: In a smaller group, technological resources appeared as an alternative for safer sex, reducing the risks of COVID-19 transmission.

An Assessment of an Educational Intervention Program Based on the Health Belief Model for Safer Sex Among Female Sex Workers in Selected Districts of Northern Region of Malawi

Background: Pregnant women are at risk of pregnancy if they have unprotected sex, do not use or poorly use contraceptives in the context of penile-vaginal sex. We therefore developed an educational toolkit based on the Health Belief Model (HBM) to assist FSWs to make informed sexual and reproductive decision for safer sex before and/or after heterosexual encounter with their clients. We evaluated the educational intervention programme among FSWs and other stakeholders (nurses and clinicians).Methods:This was a qualitative operational research. We developed an educational tool kit based on the HBM to aid FSWs to make informed decision for safer sex behaviour. We conducted 10 in-depth interviews (IDIs) to identify the components of the educational tool kit, 5 IDIs for modification and refining the tool, and consequently two Focus Group Discussions (FGDs) for consensus building. This process was done in Mzimba North. After the intervention we conducted 6 FGDs with FSWs and 10 IDIs with nurses and clinicians to evaluate the applicability and feasibility of the intervention among female sex workers (FSWs) in Mzimba North, and Nkhata Bay located in Northern region of Malawi.Results:We observed mixed opinions on the components of the educational toolkit. Female sex workers were eager to understand misinformation and misconceptions on contraceptives, right to justice, effectiveness of contraceptives. Female sex workers requested the inclusion of STIs and HIV prevention and economic empowerment in the toolkit. Overall the toolkit and the educational intervention were relevant, feasible, and applicable among the study participants. Conclusion:While several strategies can be used to facilitate the implementation of the evidence based intervention to improve health, our educational intervention program based on the Health Belief Model for safer sex behaviour among female sex workers was found to be feasible and applicable in our study settings. We believe that the intervention may be helpful to address sexual and reproductive health challenges encountered by FSWs in the study sites and elsewhere.

Dream It, Do It? Associations between Pornography Use, Risky Sexual Behaviour, Sexual Preoccupation and Sexting Behaviours among Young Australian Adults

While sexting behaviours have attracted increasing research focus over the last decade as both normative and deviant forms of sexual activity, little attention has been paid to their potential associations with sexual preoccupation and heightened interest in sex. The current study sought to identify whether sexual preoccupation significantly predicts sending, receiving, and disseminating sexts, after controlling for pornography use and risky sexual behaviours. Young Australian adult participants (N = 654, 78.8% women) aged 18 to 34 (M = 19.78, SD = 1.66) completed an anonymous online self-report questionnaire regarding their engagement in sexting behaviours (sending, receiving, and dissemination), pornography use, risky sexual behaviours, and sexual preoccupation. Results showed that individuals with higher sexual preoccupation were more likely to engage in pornography use and risky sexual behaviours. Binary hierarchical logistic regressions revealed that sexual preoccupation predicted higher rates of sending and receiving sexts. However, sexual preoccupation did not significantly contribute to increased rates of sext dissemination. Our study illustrates the need to incorporate pornography viewing and sexting into the promotion of safe sexual behaviours in online and offline contexts, and the potential to utilise modern technology to negotiate safer sex practices.

Male Sex Workers Selling Physical Sex during the COVID-19 Pandemic in Portugal: Motives, Safer Sex Practices, and Social Vulnerabilities

The purpose of this research was to assess the motives, safer sex practices, and vulnerabilities of male sex workers who sold physical sex during the COVID-19 pandemic. This study used a mixed strategy, utilizing purposive sampling techniques to conduct 13 online surveys with male sex workers working in Portugal during the COVID-19 pandemic. Participants were aged between 23 and 47 years old and mostly provided their services to other men. Additionally, half of the participants were immigrants. Participants mentioned paying for essential expenses (rent, food, phone, etc.), having money for day-to-day expenses, wanting to, and enjoying it, as their main motives for engaging in sex work. Regarding sexual practices, 3 to 11 participants did not always or did not consistently use condoms during penetrative sex with their clients. Thematic analysis was used to identify the following repeated patterns of meaning regarding COVID-19-related vulnerabilities, encompassing a loss of clients and income, increased work availability, price reductions and negotiation difficulties, emotional functioning, health care access, safer sex negotiations, age, and immigration status. The findings serve as a basis for recommendations regarding social policies aimed at male sex workers who sell physical sex in Portugal.

Comprehensive HIV/AIDS knowledge and safer sex negotiation among adolescent girls and young women in sub-Saharan Africa

Globally, HIV/AIDS remains a public health issue, especially in sub-Saharan Africa (SSA). Despite the increased advocacy and dissemination of comprehensive HIV/AIDS information in SSA, it appears that little progress has been made to reduce the incidence of HIV/AIDS in the sub-region. This study, therefore, examined the association between comprehensive HIV/AIDS knowledge and safer sex negotiation among adolescent girls and young women in SSA. Data were taken from the Demographic and Health Surveys conducted between 2010 and 2019 in 30 countries in SSA. The study sample comprised 37,364 adolescent girls and young women aged 15–24. A multivariable binary logistic regression analysis was done to test the hypothesis that there is a positive association between comprehensive HIV/AIDS knowledge and safer sex negotiation. Adolescent girls and young women who had comprehensive knowledge on HIV/AIDS were more likely to negotiate for safer sex compared with those who had no comprehensive knowledge on HIV/AIDS (AOR=1.31, 95% CI: 1.22–1.41). At the country level, the positive association between comprehensive knowledge on HIV/AIDS and safer sex negotiation was significant in Chad, Congo DR, Gambia, Guinea, Liberia, Ethiopia and Malawi. On the other hand, in Togo, adolescent girls and young women who had comprehensive HIV/AIDS knowledge were less likely to negotiate for safer sex. These findings can inform policies and programmes on the crucial role of comprehensive HIV/AIDS education and knowledge in increasing safer sex negotiation among adolescent girls and young women in SSA. The study recommends that Togo needs to address certain practices such as intimate partner violence against adolescent girls and young women, which prevent them from negotiating for safer sex, despite their higher knowledge on comprehensive HIV/AIDS. Lessons can be learnt from Chad, Congo DR, Gambia, Guinea, Liberia, Ethiopia and Malawi about the scale-up of programmes and interventions targeted at young women.

Promiske Sexualität oder monogame Beziehung?

A question that was and remains central to the history of homosexualities is how relationships and sexuality are interlinked. Through discussions around heteronormative relationship norms, the West German gay1 (liberation/rights) movement engaged in heated debates around the question of how sexuality could and should be lived out. This article outlines that debate, starting with the release of Rosa von Praunheim’s film »Nicht der Homosexuelle ist pervers, sondern die Situation, in der er lebt« (»It Is Not the Homosexual Who Is Perverse, But the Society in Which He Lives«; 1971) and proceeding to examine the convulsions of the AIDS crisis. As the debate went on, its focus shif ted from morality to responsibility as the central topic. The increasing visibility of lived sexuality brought about by AIDS and the development of safer sex in reaction to HIV/AIDS in particular contributed to establishing the concept of responsible sexuality. This concept could in turn be positioned against a coupling of relationship and sexuality predicated on moral imperatives.