Risky Sexual Behavior Profiles in Youth: Associations With Borderline Personality Features

Adolescence and young adulthood are peak periods for risky sexual behaviors (RSB) and borderline personality disorder (BPD) features. RSB is a major public health concern and adolescents with BPD may be particularly vulnerable to RSB, but this is understudied. The aim of this study was to identify distinct RSB profiles in youth and determine whether a specific profile was associated with BPD features. Participants were 220 adolescents and young adults (age 14–21) recruited from the community. To identify groups of adolescents and young adults who engage in similar RSB, a latent profile analysis (LPA) was conducted on sexually active youth (57%). Next ANOVA was used to identify how profiles differed in terms RSB dimensions and BPD features. We identified three distinct RSB profiles: (1) a Low RSB profile that was manifested by the majority (77.7%) of youth; (2) an Unprotected Sex in Relationships profile (13.3%) and; (3) an Impulsive Sex Outside Relationships profile (12%) which was manifested by youth with significantly higher BPD features. The findings shed light on the difficulties youth with BPD manifest around integrating sexuality, intimacy, fidelity, and love. This contrasts with the majority of youth who are sexually active in the context of relationships and engage in little or no RSB. The findings have important clinical implications. Adolescent sexuality is frequently in the blind spot of clinicians. To address the elevated risk of RSB in adolescents with BPD, interventions are needed to help adolescents navigate this period and improve their understanding of the reasons for RSB while addressing difficulties in establishing sexual and attachment relationships.

Integration of Sexual and Relational Mental Representations in Autobiographical Memories is Associated with Sexual Well-Being

Determinants of sexual well-being have often been identified as sexual and relational satisfaction, which both include a focus on partner relationship. Such a conceptualization excludes sexually active single individuals, while confusing sexual and relational satisfaction with sexual well-being as both determinant and outcome. In the present research, we propose an intrapersonal perspective focused on cognitive sexual and relational mental representations as determinants of sexual well-being. Based on behavioral systems theory, we suggest that a high level of integration of sexual and relational mental representations should be associated with sexual well-being indicators, whereas a weaker level of integration should correspond to a lower level of sexual well-being. We developed a novel codification scheme to measure the cognitive integration of sexual and relational mental representations in narratives of sexual autobiographical memories. We examined its associations with sexual well-being indicators (satisfaction, passion, and sociosexuality). In a sample of 142 students, results showed that integration of sexual and relational representations in memories was positively associated with sexual satisfaction and harmonious passion, and negatively with obsessive passion and sociosexual desire. Results suggest that an integrated cognitive organization of sexual and relational mental representations in autobiographical memories can reflect a greater sexual wellbeing. Clinical implications are discussed.

Knowledge of Family Planning and Access to Sexual and Reproductive Health Services by Immigrant Youth in Hillbrow, South Africa: A Cross-sectional Study.

Background: For countries to achieve the Sustainable Development Goals (SDGs) especially SDG3.7- universal access to Sexual and Reproductive Health (SRH) care services including information and education for family planning, immigrant youth must be ensured access to SRH services. This study examines the determinants of knowledge about family planning (KFP) and access to SRH services by sexually active immigrant youth in Hillbrow, South Africa.Methods: This cross-sectional study of 467 immigrant youth aged 18-34 years used a multistage-sampling technique. Data were collected using interviewer-administered questionnaires on socio-demographic, migration, KFP and access to SRH services from government health facilities. Unadjusted and adjusted logistic regression models were used to determine levels of KFP and access to SRH services among 437 sexually active youth. Results: The main sources of information on SRH issues were radio/television (38.7%) and friends (22.8%). Over half of the respondents have adequate KFP, while two out of five indicated a lack of access to SRH services from government health facilities. In the adjusted models, the determinants of having KFP were being a female (AOR= 3.85, CI: 2.33–6.35, belonging to the age groups 25–29 years (AOR=2.13, CI: 1.12–4.04; and 30–34 years (AOR=3.88, CI: 2.00–7.53); belonging to the middle and rich wealth index (AOR=1.84, CI: 1.05–3.20) and (AOR=2.61 (1.34–5.08) respectively. Not having received information about family planning (AOR=0.16, CI=0.09–0.28) and not using a contraceptive at the time of the survey (AOR=0.36, CI: 0.18–0.70) were associated with reduced odds of KFP. The determinants of having access to government health facility for SRH services were being a female (AOR=2.95, CI: 1.87–4.65), being 30–34 years of age (AOR=1.91, CI: 1.08–3.39), and not having received information about family planning (AOR=0.44, CI=0.27–0.73). Conclusion: Majority of the survey respondents lack access to information about family and SRH services provided by government health facilities, which resulted in them depending on unreliable sources of information about SRH issues. There is a need to advocate for universal access to SRH services, inclusive of immigrant youth in South Africa, to curb negative SRH outcomes and to achieve SDG 3.7.

Determinants of condom use during last sexual intercourse among male college youth of Kaski, Nepal: A cross-sectional survey

Background The National Family Planning program of Nepal has introduced the condom as an important family planning method. Despite the continuous effort from the public and private sectors at various levels, its use among youth remains low. Therefore, this study aimed to assess the factors associated with condom use during the last sexual intercourse among male college youth. Methods We conducted a cross-sectional study and analyzed the responses of 361 male college youth (aged 19 to 24 years who reported being sexually active preceding six months of the survey), among the 903 participants who reported being involved in vaginal and anal sexual intercourse. The chi-square test was primarily used to find the associated factors and then, stepwise logistic regression was performed by selecting the covariates after the multicollinearity test followed by adjustment of confounders. Results We found that more than one-fourth (27.4%) of the sexually active male youth had used the condoms during their last sexual intercourse. Postgraduate male youth were four times more likely to use the condoms during the last sexual intercourse than undergraduate male youth (AOR = 4.09, 95% CI; 2.08–8.06). Similarly, married youth were less likely to use the condoms during the last sexual intercourse with 95% lower odds than their counterparts (AOR = 0.05, 95% CI; 0.01–0.38). Male youth with adequate knowledge about the condoms were 8 times more likely to use them compared to those with inadequate knowledge (AOR = 8.42, 95% CI; 4.34–16.33). Likewise, male youth with favorable attitude towards the condoms were 2.5 times more likely to use them compared to their counterparts (AOR = 2.58, 95% CI; 1.23–5.42). Similarly, male youth having two or more sex partners were 4.5 times more likely to use the condoms than the youth having only a sex partner (AOR = 4.57, 95% CI; 2.38–8.76). Conclusion The study concluded that slightly more than one-fourth (27.4%) of male college youth in Kaski district used the condoms during their last sexual intercourse. Level of education, marital status, knowledge about condoms, attitude toward condoms, and number of sex partners are the determinants of condom use among male college youth so recommended for early behavioral interventions, especially in knowledge and attitude. Further studies focusing on including the rural youth and larger geography may help to reach a firmer conclusion.

Use of Moisturizers and Lubricants for Vulvovaginal Atrophy

The estrogen decrease in postmenopausal women results in functional and anatomical changes in the genitourinary tract. The most prevalent and bothersome symptoms are vaginal dryness, dyspareunia, and reduced lubrication, which can significantly affect the quality of life of these women, principally those who are sexually active. Hormonal therapy with local estrogens is generally considered the “gold standard.” However, there are cases in which there are clinical concerns about its use or women opt for non-hormonal options. Thus, safe and effective non-hormonal options are needed to improve symptoms in these women. Moisturizers and lubricants are first-line therapy for breast cancer survivors.

Adolescents and Young Adults: The Pediatrician’s Role in HIV Testing and Pre- and Postexposure HIV Prophylaxis

Most sexually active youth in the United States do not believe that they are at risk for contracting HIV and have never been tested. Creating safe environments that promote confidentiality and respect, obtaining an accurate sexual and reproductive health assessment, and providing nonstigmatizing risk counseling are key components of any youth encounters. Pediatricians can play a key role in preventing and controlling HIV infection by promoting risk-reduction counseling and offering routine HIV testing and prophylaxis to adolescent and young adult (youth) patients. In light of persistently high numbers of people living with HIV in the United States and documented missed opportunities for HIV testing, the Centers for Disease Control and Prevention and the US Preventive Services Task Force recommend universal and routine HIV screening among US populations, including youth. Recent advances in HIV diagnostics, treatment, and prevention help support this recommendation. This clinical report reviews epidemiological data and recommends that routine HIV screening be offered to all youth 15 years or older, at least once, in health care settings. After initial screening, youth at increased risk, including those who are sexually active, should be rescreened at least annually, and potentially as frequently as every 3 to 6 months if at high risk (male youth reporting male sexual contact, active injection drug users, transgender youth; youth having sexual partners who are HIV-infected, of both genders, or injection drug users; youth exchanging sex for drugs or money; or youth who have had a diagnosis of or have requested testing for other sexually transmitted infections). Youth at substantial risk for HIV acquisition should be routinely offered HIV preexposure prophylaxis, and HIV postexposure prophylaxis is also indicated after high-risk exposures. This clinical report also addresses consent, confidentiality, and coverage issues that pediatricians face in promoting routine HIV testing and HIV prophylaxis for their patients.