Sexual and Gender Minorities and Risk Behaviours among University Students in Italy

Sexual and gender minorities (SGM) may experience stigma, discrimination and show higher prevalence of behavioural risk factors than heterosexual counterparts. In Italy, the information on SGM is scarce and outdated. The present cross-sectional study aims to provide a more up-to-date estimate of the SGM proportion in young adults and to assess differences in the adoption of risk behaviours compared to their heterosexual counterparts. The study involved university students aged 18–25. Information on socio-demographic and behavioural characteristics were collected. The effect of sexual orientation on risk behaviours was assessed with a multinomial single-step logistic regression analysis. A total of 9988 participants were included. Overall, 518 students (5.2%) self-identified as SGM. While lesbians showed significantly higher odds of only non-regular use of protective barriers (AOR: 11.16), bisexuals showed higher odds for frequent drinking (AOR: 2.67), smoking (AOR: 1.85), multiple sexual partnerships (AOR: 1.78) and non-regular use of protective barriers (AOR: 1.90) compared with heterosexual women. Gay men showed higher odds of multiple sexual partnerships compared with heterosexual males (AOR: 5.52). SGM accounted for 5.2% of the sample, slightly more than the proportion found in the general population, but substantially in line with similarly aged populations abroad. Our findings confirm that unhealthy risk behaviours are more frequent among LGBTQ+, in particular among bisexual women. Rather than targeting specific subpopulations, our study aims to show the need for health promotion interventions that aim at the empowerment of all students regardless of sexual orientation, being aware that SGMs can benefit to a relatively greater extent.

Neighbourhood Determinants of Early Sexual Debut and Multiple Sexual Partnerships: A cross-sectional Analysis of Adolescents in Rwanda, Ghana and South Africa.

Background: The relationship between neighbourhood characteristics and youth involvement in risky sexual behaviour such as early sexual debut and multiple sexual partnerships is well established in the literature. However, there are very few empirical studies using Demographic and Health Surveys to unpack the nature of this relationship in Africa. This study aims to identify the neighbourhood characteristics influencing young people's engagement in risky sexual behaviour in sub-Saharan Africa. Methods: Univariate, bivariate, and multivariate analyses on young people aged 15 to 24 years were conducted using the most recent Demographic and Health Survey Data (DHS 2014-2016) from Ghana, Rwanda, and South Africa to investigate the relationship between neighbourhood characteristics and youth risky sexual behaviour. Results: Individual and, in particular, neighbourhood characteristics (community poverty, community occupation, community media access, and community education) were found to be substantially linked with youth risky sexual behaviour. Conclusion: To lower the incidence of risky sexual behaviour in the community, programs aimed at appropriate policy options must be intensified. Adopting the implications of these findings is critical for a developmental approach aimed at reaching Africa’s long-term development goal of eliminating STIs among young people.

Age at Sexual Debut and Multiple Sexual Partnerships among Adolescents in Nigeria: An Assessment of the Mediating Role of the Knowledge of Sexually Transmitted Infections

Adolescents in Nigeria are at risk of plethora of ills arising from risky sexual behavior in the form of multiple sexual partnerships (MSP). Despite evidence linking MSPs to age at sexual debut, there is a dearth of research among adolescents and the mediating role of the knowledge of STIs has been ignored. Hence, we examined the association between age at sexual debut and MSP and the mediating role of the knowledge of STIs in the relationship among adolescents. We utilized data from the 2018 Nigeria Demographic and Health Survey (n = 3215), employing Chi square test of association and binary logistic regression to address the study objectives. We established strong inverse relationship between age at sexual debut and MSP among adolescents in Nigeria and additionally, found that its interaction with knowledge of HIV and STIs significantly reduced adolescents’ engagement in MSP, i.e., adolescents who first had sex in later years (15+ years) were significantly less likely to have multiple sexual partners compared to adolescents who had early sexual debut (≤14 years). Early, age-appropriate, continuous, and improved awareness campaigns and reproductive health services and interventions for this population subgroup are recommended.

Sociodemographic Characteristics, HIV-Related Risk Behaviors and HIV preva-lence of Vulnerable Men in Tehran, Iran

Background: Sexual minorities, such as men who have sex with men (MSM), are dis-proportionately impacted by HIV/AIDS compared to heterosexual men . The increased prevalence of HIV/AIDs among this group of individuals is associated with increased participation in HIV-related risk behavior, such as multiple sexual partnerships and in-jection drug use. However, very little is known about the prevalence of HIV and the risk behaviors related to HIV infection among MSM in Iran. This absence of data is due to the increased discrimination and stigmatization MSM, and other vulnerable popula-tions, face in Iran. This study was conducted to identify HIV-related risks, HIV preva-lence and sociodemographic characteristics of the MSM population in Iran. Method: A cross-sectional study was conducted among MSM attending the Sexual Health Clinic at Imam Khomeini Hospital in 2018. A sexual health screening question-naire was used to aid in identifying HIV-related risk behaviors. HIV status was deter-mined using an HIV rapid test and confirmed by an ELISA. Results: One hundred MSM enrolled in this study, from whom 41% aged 18-25 years old. The majorities were single; almost one-third had a diploma degree. Only a fifth were employed, and about a quarter (25%) reported substance abuse. Among eighty-three people (83%) reported having sex during the past three months, and only 27 (27.3%) of participants always used condoms for sex. Among 80 participants tested for HIV, two positive results were detected (2.5%). Conclusion: Data collected through a sexual health questionnaire indicate that the prevalence of HIV is increased among MSM in Iran. This finding sheds light on the urgent need for the implemenation of social programs providing counseling and healthcare to vulnerable populations in Iran.

Polyamory in Paris: A social network theory application

Multiple sexual partnerships can be viewed as networks in order to assess the nature of links between lovers and metamours (lover’s lovers) as well as the larger population. In such non-monogamous networks, where participants share sex, friendship, ideas, and economic resources, there exists a vast web of nodes connected in much more intimate and complex ways than one finds in the mono-normative landscape. This study explored gender dynamics in network centrality on a sample of 62 polyamorists in Paris, France using participant-observation, informal and structured interviews, and social network analysis. Though evolutionary psychology and pornographic film tend to reinforce heteronormative stereotypes of males as central social actors with multiple sexual partners and women as sexually passive, feminist theorists have argued for a more “agentic female sexual subjectivity”. My data showed that cis- and trans-women, with a strong sense of family and skills in interpersonal communication, score highest on network metrics of density/degree, homophily, indirectedness, and transitivity. The network data also indicate high modularity and endogamy with clustering tendencies for both cis-men and cis- and trans-women linked to kink, atypical intelligence, sexual and gender non-conformity, and mitigating factors of socioeconomic advantage and racial privilege.

Epidemiology and Natural History of HIV

The human immunodeficiency virus (HIV) is a member of the genus Lentivirus, a subgroup of retrovirus (Retroviridae), that causes HIV infection, which, if untreated, results in acquired immunodeficiency syndrome (AIDS) and death. It was first described in 1981 during an epidemic of a previously unknown immunodeficiency syndrome in the US. The term HIV was accepted in 1986. HIV is thought to originate from simian immune deficiency virus (SIV). HIV-1 was discovered first, with the epidemic of AIDS in the US in 1981. In 1986, a related virus subsequently known as HIV-2, was identified in West Africa. The viruses differ in several aspects; HIV-1 is found worldwide, whereas HIV-2 is predominantly found in West Africa. HIV-1 is a more virulent and rapidly progressive virus; HIV-2 tends to be present in lower viral quantities and progresses more slowly. The number of people living with HIV (PLWH) rose from an estimated 9.0 million in 1990 to 36.9 million in 2014, due in part to a substantial improvement in survival rates as a result of effective anti-retroviral treatment. By 2014, annual new HIV infections had dropped to 2.0 million, down from 3.1 million in 2000, representing a decline of about 35%, although there remain an estimated 5600 people newly infected with HIV every day. It is estimated that without the global response that was mounted in 2000, notably the ‘Combatting of HIV/AIDS’ (the 6th Millennium Development Goal, which focused on halting and reversing trends for HIV by the end of 2015) there would have been six million new infections in 2013 alone. The main driver of progress has been widespread roll-out of antiretroviral treatment (ART) and behavioural change interventions, resulting in increased condom use, fewer multiple sexual partnerships, and delayed sexual debut. HIV-related deaths peaked in 2004–2005, and deaths fell by 24% between 2000 and 2014 from 1.2 million (0.98–1.6 million) in 2014 compared to 1.6 million (1.3–2.1 million) in 2000. The drop in AIDS-related mortality has been even steeper among children aged under fifteen years of age due to the enormous progress made with prevention of mother-to-child transmission (PMTCT).

Vaginal practices among women at risk for HIV acquisition in Soweto, South Africa

Background: Vaginal practices (VP) may adversely affect normal vaginal flora and mucosal integrity, and increase acquisition risk of HIV and other genital tract infections.Objective: The aim of this study was to describe self-reported VP, changes in the reported number of VP over time and factors associated with VP in a cohort of young Sowetan women enrolled in the HVTN 915 observational study.Method: We longitudinally assessed self-reported VP in 50 young women at risk of HIV acquisition aged 18–25 years in a prospective study over 3 months in Soweto, South Africa. Interviewer-administered HIV behavioural risk questionnaires were completed. No intervention to reduce VP was specified per protocol, but clinicians provided education at their discretion. The generalised estimating equation with inverse probability weights assessed VP over time.Results: The mean age at screening was 22 years; women reported multiple sexual partnerships with a mean of one main and 2 casual partners in the last 30 days. Consistent condom use was 2% (n = 1), 25% (n = 12) and 43% (n = 3) with main, casual and new partners, respectively. Commonly reported VP included washing the vagina with water (44%) and using fingers (48%). VP decreased significantly over time (p < 0.001). Women who used condoms inconsistently or whose last sex was with a casual partner were 3 times more likely to report VP (p = 0.001).Conclusion: Despite the high incidence of HIV in our setting, VP are still common and are associated with other behavioural risks for HIV. Further study is needed to assess whether clinician education may reduce VP and therefore should be included in HIV risk reduction counselling.