Non-parental Adults and Sexual Health Behaviors Among Young Minority Men: A Qualitative Examination

Young Black and Latino sexual minority men (YBLSM) exhibit disproportionately high rates of negative sexual health outcomes, including HIV and other sexually transmitted infections, compared to other groups, partly due to relatively higher rates of exposure to a host of socio-structural risk factors (e.g., unstable housing and under-employment). However, an under-studied interpersonal resource exists for many YBLSM, non-parental adults (NPAs, i.e., adults who act as role models and provide social support), who may be able to influence contextual (e.g., unemployment) and individual (e.g., reduced health expectations) factors underlying sexual health disparities.Aims: This study sought to examine the role of NPAs in factors that affect sexual health behaviors and in supporting those health behaviors directly, among YBLSM living in a mid-sized city in the southern United States. A total of n=20 participants, n=10 YBLSM (ages 16 to 22), and n=10 NPAs (ages 26 to 52) were interviewed using semi-structured guides to examine NPA involvement in the lives of YBLSM from both sides of the relationship. The research team used a framework analysis approach to iteratively identify and define meaningful codes and sub-codes. Both YBLSM and NPAs described NPAs helping YBLSM through role modeling and social support in a variety of areas found to affect sexual health behaviors, such as housing instability and psychological distress, as well as in specific behaviors, such as condom use and HIV medication adherence. Given the multiple socio-structural obstacles facing YBLSM and their multifaceted relationships with NPAs, NPAs may be a promising resource to help address these impediments to health. Partnering more intentionally with NPAs is a potentially promising strategy to help reduce HIV-related disparities affecting YBLSM that is worthy of additional empirical attention.

A Scoping Review on Access and Use of Technology in Youth Experiencing Homelessness: Implications for Healthcare

Introduction: Youth are among the fastest growing subset of the homeless population. Youth experiencing homelessness (YEH) face multiple barriers in accessing health information and health care services. As such, they may best be reached through information and communication technologies (ICTs); however, limited efforts have been made to synthesize literature on this topic. In this paper, we review studies on access and use of ICTs among YEH. We also discuss the implications of the review for healthcare.Methods: Using scoping review methodology, we searched four databases (Medline, Embase, PsycInfo, and CINAHL) for studies published between 2005 and 2019, screening 1,927 titles and abstracts.Results: We identified 19 articles reporting on studies with YEH between the ages of 12-30, the majority of which were published in the USA. On average, more than half of the samples owned smartphones, used social media, and accessed the internet weekly to search for housing, employment, health information, and to communicate with family, peers, and health workers; however, many youths faced barriers to sustaining their access to technology. Benefits of using ICTs were connecting with home-based peers, family, and case workers, which was associated with a reduction in substance use, risky sexual health behaviors, and severity of mental health symptoms. Connecting with negative, street-based social ties was identified as the most common risk factor to using ICTs due to its association with engaging in risky sex behaviors and substance abuse.Discussion: This review supports the advancement of research and practice on using ICTs to deliver public health information and health services to YEH, while also considering the health-related risks, benefits, and barriers that YEH face when accessing ICTs.

Sexual Health in Emerging Adulthood

Sexual health in emerging adulthood encompasses a wide spectrum of medical and mental health functioning and associated behaviors. This chapter addresses aspects of physical sexual health that are of concern to emerging adults, including prevalence rates, determinants, and consequences of sexually transmitted infections, including HIV, and unintended pregnancy among emerging adults. The chapter also discusses sexual dysfunction and its treatment. Whenever possible, the chapter highlights differences in prevalence, risk, and protective factors related to aspects of human diversity, guided by an intersectional approach based on the ADDRESSING framework. Both protective and risky sexual health behaviors and decision making about sexual behavior are discussed, with a focus on the role of substance use in sexual risk taking. The chapter concludes with implications for future research, particularly in the area of prevention.

Individual Motives for Security Influence Sexual Activity During the COVID-19 Pandemic

Amidst a global pandemic, people’ survival needs become salient and the ability for people to regulate feeling and actions might be particularly relevant to protecting oneself from harm. Regulatory Focus Theory (Higgins, 1998) proposes that people pursue their goals by having a focus on prevention (i.e., motivated by security) or promotion (i.e., motivated by pleasure). Prior research indicates that people focused on prevention (vs. promotion) are more likely to engage in health-protective behaviors, including sexual health behaviors, because they perceive more threats. Extending this reasoning to the sexual activity of single people during the COVID-19 pandemic, we conducted a pre-registered longitudinal study (N = 174) examining the role of regulatory focus on people’s sexual behaviors. As hypothesized, results showed that single people who reported having a more prevention focus at the onset of the pandemic perceived greater threats caused by the pandemic two weeks later, which, in turn, predicted less frequent sexual activity and engagement in sex with fewer sexual partners the following two weeks. These effects were consistent even when controlling for promotion (i.e., pleasure motivations), personality, gender, and sexual orientation. Findings are discussed considering their implications for the sexual functioning and sexual health of single people.

Sex in Late Life: Assessing Adults’ Expectations and the Role of Healthcare Professionals

Sexual activity contributes to quality of life throughout the lifespan. However, stigma about sex in late life influences older adults’ perceptions and healthcare professionals’ perceptions of older adults’ sexual health/behaviors. Using a multi-methods approach, we examined attitudes and knowledge about sexual health/behaviors in late life. Using longitudinal data from the Midlife in the US Study (Wave 1-3; N=7049), we ran age-based growth curve models to analyze changes in levels of optimism about sex in their future. We also piloted a survey with healthcare professionals assessing attitudes, knowledge, and awareness of policy about sexual health/behaviors among older adults. Adults’ expectations became less optimistic with increased age (β = -0.1, SE = 0.003, p < .0001). Men were more optimistic than women at age 20 (p = 0.016), but men’s optimism decreased over the life course at a faster rate than did women’s (p < .0001), so that from ages 40-93, men were less optimistic than women. Among healthcare professionals (N=21), the majority indicated never or rarely asking their clients about sexual history or health/behaviors; however, they indicated some knowledge about issues relevant to older adults (e.g., safe-sex practices, sexual dysfunction). Few indicated awareness about policies related to sexual behavior among residents (i.e., issues of consent, STIs). Among adults, there is a need to address declining optimism for expectations about sex in late life. Health professionals are well-situated to raise awareness and normalize discussions about sexual health, thus countering negative stigma and contributing to increasing optimism for expectations to remain sexually active.

Regulatory Focus and Perceived Security with Casual Partners: Implications for Sexual Behaviors During the COVID-19 Pandemic

Background: Fundamental motives for survival help people regulate their goal pursuit, by shaping perceptions, feelings and actions. Motives for security (i.e., prevention focus) are associated with risk awareness and risk avoidance, whereas motives for pleasure (i.e., promotion focus) are associated with risk taking. Purpose: During the COVID-19 pandemic, survival needs and health risks are particularly salient. Hence, people focused on prevention (vs. promotion) should be more aware of health risks, more careful in their sexual behaviors, and less likely to take sexual health risks with casual partners. However, feeling safer with casual partners might mitigate some of the risks associated with sexual behaviors during this pandemic. Methods: We administered an online survey in English, Spanish and German to 550 single participants (57.6% women; Mage = 24.72, SD = 5.75). Results: Prevention focused participants were less fearful of COVID-19 infection, perceived to be better informed, and retrieved their information from scientific sources. They were also less likely to have condomless sex with casual partners, regardless how safe they perceived to be with them. Promotion focused participants were more fearful of COVID-19 infection and perceived to be better informed, but retrieved their information from non-scientific sources. They were more willing to have sex with casual partners, and more likely to consider having condomless oral sex, but only if they felt safer (vs. less safe) with their casual partnersConclusions: Our findings show the importance of individual motivations and interpersonal dynamics for risk perception and sexual health behaviors.