Determinants Factors of High-risk Sexual Behavior Pregnancy among Adolescent in Indonesia

BACKGROUND: The vulnerability of adolescent lifestyles, especially sexual behavior among adolescents, which causes an increase in pregnancy and early marriage. AIM: This study aimed to analyze the determinants of high-risk sexual behavior among adolescents in Indonesia. METHODS: A correlational analytic research design was used with a cross-sectional approach using secondary data for the 2017 Indonesian demographic and health survey data (IDHS). The data collection was carried out through filling in the instruments developed by the 2017 IDHS. The data were analyzed using percentages, Chi-square test, and logistic regression. The study population was all adolescents, totaling 9,971 women and 12,612 single men aged 15–24 and living in Indonesia in the 2017 IDHS. The sampling technique used total sampling. Time of research: August-November 2020. Place: research locations in 34 provinces in Indonesia. RESULTS: In male respondents, it was shown that the factors most influencing high-risk sexual behavior in adolescents were age (p = 0.000), knowledge (p = 0.003), place of residence (p = 0.000), discussion before wet dreams (p = 0.000), age at first wet dream (p = 0.000), age at first dating (p = 0.019), and internet usage (p = 0.000). Meanwhile, female respondents indicated that the most influential factors were age (p = 0.000) and place of residence (p = 0.032). CONCLUSION: Boys have many factors that influence high-risk sexual behavior than girls. Information on determinant factors of high-risk adolescent sexual behavior can be used as a basis for developing policies for developing interventions in solving problems of premarital pregnancy due to high-risk sexual behavior among adolescents.

863. Pre-Exposure Prophylaxis (PrEP) Prescriptions among Individuals at High Risk for HIV in the United States, 2012-2018

Background To describe trends in emtricitabine and tenofovir disoproxil fumarate (FTC/TDF) PrEP uptake in 2012-2018 and characterize high risk individuals who use PrEP. Methods The study identified individuals aged ≥ 15 years old with claims suggesting high risk for HIV infection in the IBM MarketScan® Commercial Claims and Multi-state Medicaid Databases. High risk was defined using ICD codes indicating high risk sexual behavior or rectal/repeated bacterial sexually transmitted infection (STI). The index date was defined as the earliest of the first high risk sexual behavior diagnosis, the first rectal bacterial STI diagnosis, or the second non-rectal bacterial STI diagnosis within 12 months. Individuals were considered PrEP users if they had at least one FTC/TDF PrEP prescription within 12 months of index date. Individuals with evidence of HIV prior to or within 30 days after PrEP initiation/index date were excluded. Comorbidities were assessed using a modified Charlson Comorbidity Index that excluded HIV/AIDS. Results FTC/TDF PrEP uptake increased from 0.1% to 7.3% among commercially insured individuals between 2012-2018, and from 0.01% to 0.5% among Medicaid insured individuals between 2012-2017. Individuals ≥ 35 years old had the largest increase in PrEP uptake (0.1% to 13.0%), while those 16-25 years old had the smallest increase (0.03% to 2.3%). The largest proportion of PrEP users across all years were aged 25-34 while the largest proportion of non-PrEP users were aged 18-24. Compared to PrEP users, a larger proportion of PrEP non-users were female (62.9% vs. 1.4%, p < 0.05) and blacks/African American (49.1% vs. 40.3%, p < 0.05). A larger proportion of PrEP users had a risk status of homosexual (46.6% vs. 1.5%, p < 0.05) or bisexual (3.9% vs. 0.8%, p < 0.05) behavior than non-PrEP users. PrEP users also had more comorbidities than non-users among individuals with Medicaid and were less likely to have fee-for-service insurance plans overall (p < 0.05). Table 1. Characteristics of people at high-risk for HIV who do vs. do not use FTC/TDF PrEP measured during the follow-up period Conclusion Despite an increase in FTC/TDF PrEP initiations, uptake was low, especially among young adults, women, heterosexuals and blacks/African Americans. Low initiation rates in these groups may illustrate that FTC/TDF PrEP is not meeting the needs of all high-risk individuals. Disclosures Mo Zhou, PhD, Merck & Co., Inc. (Consultant) Yan Song, PhD, Merck & Co., Inc. (Consultant) Emily Gao, MS, MPH, Merck & Co., Inc. (Consultant) Yohance Whiteside, PhD, MSPH, Merck & Co., Inc. (Employee) Emma Billmyer, BA, Merck & Co., Inc. (Consultant) James Signorovitch, PhD, Merck & Co., Inc. (Consultant)

Hepatitis D: challenges in the estimation of true prevalence and laboratory diagnosis

Hepatitis delta virus (HDV) is a defective single negative chain RNA virus, as its envelope protein synthesis is dependent on hepatitis B virus (HBV). Studies have consistently shown that coinfection of HBV and HDV is the most serious form of viral hepatitis, with accelerated progression to liver cirrhosis and hepatocellular carcinoma. About 74 million of HBV surface antigen (HBsAg) positive patients worldwide are also co-infected with HDV. Besides, patients with intravenous drug use and high-risk sexual behavior are at higher risk of HDV infection. Therapeutic schedules for HDV are limited, and relapse of HDV has been observed after treatment with pegylated interferon alpha. To reduce the transmission of HDV, all people infected with HBV should be screened for HDV. At present, several serological and molecular detection methods are widely used in the diagnosis of HDV. However, due to the lack of international standards diagnostic results from different laboratories are often not comparable. Therefore, the true prevalence of HDV is still unclear. In this manuscript, we have analyzed various factors influencing the estimation of HDV prevalence. We have also discussed about the advantages and disadvantages of currently available HDV laboratory diagnostic methods, in order to provide some ideas for improving the detection of HDV.

Trichomonas Vaginalis Infection in Men with High-Risk Sexual Behaviors

Background: Trichomonas vaginalis is a protozoan pathogen of the human genitourinary tract, which is the cause of trichomoniasis. The disease is one of the most important non-viral sexually transmitted infections in the world. Many studies have been performed on the molecular identification of Trichomonas in men in different parts of the world, but in Iran, such a study has been very limited. We aimed to detect T. vaginalis in urine of men with unusual sexual behavior by wet mount microscopic observation, culturing in TYM-33 and molecular method in Tehran, Iran. Methods: Totally, 47 urine samples were collected from men with high-risk sexual behaviors referred to Health Care Centers in South of Tehran, Iran during 2017-2018. After urine centrifugation and wet mount sediment preparation, the samples were cultured in TYM-33 medium and examined microscopically. Then DNA was extracted from urine sediment samples and finally the 18srRNA gene was amplified by PCR. Results: Thirty-one (65.95%) urine samples were positive for T. vaginalis by PCR. Of these, only 6 (12.76%) were detected positive by wet mount method and 25 (53.19%) by culture and successive passages. Conclusion: The high prevalence of trichomoniasis among men with high-risk sexual behavior in Tehran indicates a potent health risk condition for families. Of course, this percentage is not the real infection rate in ordinary men in Tehran. This situation could be controlled by promoting concurrent diagnosis and treatment of T. vaginalis infection in men and women, as well as strengthening religious beliefs and health education in the individuals.

Socialization processes within adolescents’ relationships with parents and peers predicting couples’ intimate partner violence in adulthood: A social learning perspective

Previous studies have established that individual characteristics such as violent behavior, substance use, and high-risk sexual behavior, as well as negative relationships with parents and friends, are all risk factors for intimate partner violence (IPV). In this longitudinal prospective study, we investigated whether violent behavior, substance use, and high-risk sexual behavior in early adulthood (ages 22–23 years) mediated the link between family conflict and coercive relationship talk with friends in adolescence (ages 16–17 years) and dyadic IPV in adulthood (ages 28–30 years). A total of 998 individuals participated in multimethod assessments, including observations of interactions with parents and friends. Data from multiple reporters were used for variables of interest including court records, parental and self-reports of violence, self-reports of high-sexual-risk behaviors and substance use, and self- and romantic partner-reports of IPV. Longitudinal mediation analyses showed that violent behavior during early adulthood mediated the link between coercive relationship talk with friends in adolescence and dyadic IPV in adulthood. No other mediation paths were found and there was no evidence of gender differences. Results are discussed with attention to the interpersonal socialization processes by which IPV emerges relative to individual risk factors.

Analysis of High-Risk Sexual Behavior among Polish University Students

High-risk sexual behavior consists of activities and habits that put a person at increased risk of sexually transmitted infections (STIs) or unplanned pregnancy. Poland is currently experiencing a problem with increased STI rates, largely due to poor sexual education. Our exploratory study aims to evaluate the sexual behavior of students attending universities across Poland. The study covered 7678 students from 50 different faculties and universities across the country. The authors created an original questionnaire which consists of 31 questions which, among others, included demographic factors, sexual initiation, high-risk sexual behavior, STI’s and religious beliefs. 78% of students have participated in sexual activity, among them 19% of students had ‘casual sex’ consisting of intercourse without the use of a condom, 27% had participated in sexual intercourse after the consumption of alcohol. Our study found that students who are influenced by religious belief tend to engage in sexual activity into their later years. The groups most exposed to the consequences of risky sexual behavior are mostly homosexual men, bisexual women, art students, and military students. Alcohol consumption is a strong factor contributing to risky sexual behavior. Sexual education in Poland should be improved.

High-risk sexual behavior and HIV/STDs cascade of care in migrants: results from an Italian dedicated outpatient clinic

Introduction: Ethnical segregation and migration influence sexual health. Differences in sexual networks and the risk of sexually transmitted diseases (STDs) between racial/ethnic minorities and the native population have been described in the literature. Methodology: We collected data on sexual behavior and physical examination. Basing on CDC 2015 guidelines on STDs, anamnesis, and clinical features, screening for HIV/STDs was proposed. Results: We enrolled 209 migrants, the median age was 32.5 (26-40) years, and 146 (69.9%) were male. The most represented nationalities were Nigerian, Senegalese, and Somali, with 85 (40.7%), 68 (32.5%), and 16 (7.7%) people, respectively. Twenty-two (10.5%) patients referred perianal/genital lesions, 6 (2.9%) abdominal/pelvic discomfort, and 183 (87.6%) were asymptomatic. Almost all symptomatic patients accepted the tests. 52/183 (28.4%) asymptomatic subjects accepted the tests, and only 24/52(46.2%) performed them. Among symptomatic patients were 6 (24%) HBsAg positivities and one (4%) HCV infection. Four (16%) people had latent syphilis; in 12 (48%) people, HPV-related genital warts were present, 7 (28%) people had Molluscum contagiosum, and 6 (24%) women had pelvic inflammatory diseases. Among patients referring no symptoms, there were 10 (41.7%) HBsAg positivities, one (4.2%) HIV infection, four (16.7%) latent syphilis, one (4.2%) HPV-related genital infection, and one (4.2%) PID. Being Nigerian and having symptoms were associated with a more high acceptance of the STDs test. Having a high-risk behavior was significantly associated with the development of at least one STD. Conclusions: migrants have high-risk sexual behavior. Despite this, they have a low perception of HIV/STDs risk and healthcare needs. Particular attention should be given to improve access to HIV/STDs services that provide screening and treatment and increase the perception of healthcare needs.

Internet Survey of Awareness and Behavior Related to HPV Vaccination in Japan

Recommendations for HPV vaccines were suspended in 2013 due to unfounded safety fears in Japan. We aimed to clarify the differences between vaccinated and unvaccinated females in their awareness, knowledge, and behaviors toward cervical cancer, HPV vaccination and sex. Questionnaires were administered online to women aged 16 to 20. We conducted investigations for the following: awareness, knowledge, and actions for cervical cancer, HPV vaccination, and sexual activity, as well as items related to participants’ social background. The survey in 828 girls revealed three points. The first is that more than half of the surveyed Japanese girls had poor knowledge about cervical cancer screening, HPV, or HPV vaccines. The second is that those in the unvaccinated group had a particularly poor knowledge of the subject and tended to have higher sexual activity. The final is that only 0.5% of the girls experienced changes in awareness about sexual activity after vaccination. In conclusion, this is the first large-scale survey analyzing the association between HPV vaccination and sexual activity in Japanese girls. Not only do unvaccinated girls not benefit from vaccines, but they also tend to engage in high-risk sexual behavior, and thus it is even more important to provide information on the effectiveness of vaccines and the usefulness of cancer screening.

Are Swedish swingers a risk group for sexually transmitted infections?

The aim of this study was to investigate whether Swedish swingers constitute a risk group for sexually transmitted infections (STIs). Two swinger clubs were invited to participate. At swinger meetings, members were offered an STI sampling kit and a questionnaire. Samples were analyzed for Chlamydia trachomatis, Neisseria gonorrhoeae, Mycoplasma genitalium, and Trichomonas vaginalis using a multiplex real-time polymerase chain reaction assay. In total, 235 swingers participated (118 women and 117 men). Urogenital C. trachomatis prevalence was 1.7%. Urogenital M. genitalium prevalence was 7.6% for women and 4.3% for men. No one tested positive for N. gonorrhoeae or T. vaginalis. For women, the mean number of unprotected temporary sex partners within the last 12 months was four men (range 0–35) and three women (range 0–50). Among men, the mean number of unprotected temporary sex partners within the last 12 months was five women (range 0–50) and 0 men (range 0–10). During vaginal sex, 46.6% women and 38.5% men always used protection with a temporary sex partner. Swedish swingers did not seem to have an increased prevalence of STIs. However, there was high-risk sexual behavior with unprotected sex and multiple sex partners, thereby making them a vulnerable group for acquiring STIs.