Women’s autonomy in refusing risky sex and associated factors in Ethiopia: evidence from 2011 to 2016 EDHS data

Background Risky sexual behavior is a major public health concern of Ethiopians. Although studying the autonomy of women in refusing risky sex is significant to take proper actions, the issue is not yet studied. Accordingly, this population-based nationwide study was aimed at assessing women’s autonomy in refusing risky sex and its associated factors in Ethiopia. Method The sample was limited to married women of 2011 (n = 8369) and 2016 (n = 8403) Ethiopian Demographic and Health Survey data. Women's autonomy in refusing risky sex was measured based on wives' response to 'not having sex because husbands have other women. To examine associated factors, socio-demographic variables were computed using binary logistic regression. Result The finding revealed that the trend of women’s autonomy in refusing risky sex had declined from 78.9% in 2011 to 69.5% in 2016. Women aged from 25 to 34 were less likely autonomous in refusing sex compared to those who aged less than 24 years old (AOR = .7064; 95% CI 0.605, 0.965). The autonomy of women with higher educational status was three times more likely higher than those who have no formal education (AOR = 3.221; 95% CI 1.647, 6.300 respectively. The autonomy of women who are from rich households was more likely higher in comparison to women from poor households (AOR = 1.523; 95% CI 1.28, 1.813). The autonomy of women those who live in Tigray 2.9 times (AOR = 2.938; 95% CI 2.025, 4.263), Amhara 4.8 times (AOR = 4.870; 95% CI 3.388, 7.000), SNNP 1.9 times (AOR = 1.900; 95% CI 1.355, 2.664), and Addis Ababa 3.8 times (AOR = 3.809; 95% CI 2.227, 6.516) more likely higher than those who reside in Dire Dawa. Conclusion The autonomy of women in refusing risky sex has declined from 2011 to 2016. This infers that currently, women are more victimized than previously. Hence, possible interventions like empowering women shall be taken to protect women from certain health problems of risky sexual behavior.

Online Sex-Seeking Among Chinese Heterosexual Men Who Seek Care in Stis Clinics: A Cross-Sectional Study

Background: The Internet has become an important virtual venue for men who have sex with men to seek sexual partners, with a high potential threat to spread sexually transmitted infections (STIs). However,the onlinesex-seeking use and its risk causing STIs spread remain unclear among heterosexual men. We conducted a cross-sectional study to investigate the use of online sex-seeking venues and the related risky sex activities (e.g. condomless sex, quick sex) in STIs clinics in Guangdong, China. Methods: These STIs clinics were involved in the Guangdong governmental sentinel network and we recruited heterosexual men (age >= 18) between March and August 2018. Multivariable logistic regression models were used to identify the factors associated with online sex-seeking use and risky sex activities with online sex partners. Results: 191 of 2,154 participants (8.9%) ever sought sex online. Among users,16.8% met their partners in-person within 24 hours, 31.4% engaged in condomless sex with their last online partner. Online sex-seeking was positively associated with a) previous STIs diagnosis (aOR=3.0, 95%CI:2.0-4.6), and b)having casual partners in the last three months (aOR=3.3, 95%CI 2.4-4.6). Condomless sex with the last online partner was negatively associated with the correct answer of “having only one partner can reduce the risk to infect HIV” (aOR=0.3, 95%CI:0.1-0.8). Conclusion:In China, online sex-seeking and its related risky sexual activities are not rare among heterosexual men. Future prevention strategies to reduce STIs incidence should especially target heterosexual men engaging in online sex-seeking.

Examining HIV Risk and Exchange Sex Among Current and Formerly Homeless Young Adults

This study investigated HIV risk among homeless and formerly homeless young adults by examining risky sex behaviors (e.g., condomless sex, exchange sex, and sex with multiple persons) using 90-day and daily recall methods. Data came from a sample of young adults (aged 18–27) with current (n = 101) or past (n = 109) homelessness experience in Los Angeles, California, recruited between 2017 and 2019. Baseline surveys queried demographics and sexual history. Daily retrospective surveys queried sexual events. Multiple logistic regressions were used to test the effects of demographic characteristics including homelessness history, relationship status, substance use, and sexual history on risky sex outcomes. In this sample, 26% reported never using a condom during anal or vaginal sex in the past 90 days, 5% reported testing positive for HIV, 82% had limited to no knowledge of preexposure prophylaxis, and 8% reported having had exchange sex during a 7-day measurement period, with those experiencing homelessness more likely to report. The study suggests supportive housing can reduce the occurrence of exchange sex but that HIV prevention services are still needed in homeless and housing programs to promote safe sexual practices.

The Perceived Need To Be Hot: An Investigation Of The Relationship Between Belief In Sexual Stereotypes And Erectile Dysfunction In Gay Men Using Thermal Imaging

Erectile dysfunction (ED) has been associated with considerable mental health and interpersonal problems, an increase in risky sex, and is particularly prevalent among gay and bisexual men. Psychological treatment protocols for sexual dysfunctions often aim at challenging beliefs and cognitions about the importance of a “perfect sexual performance,” known as sexual stereotypes. However, to date, little empirical evidence exists for the relationship between ED and belief in sexual stereotypes (BSS). To address this gap, 70 gay men were recruited; 30 with ED and 40 healthy controls. Participants completed a battery of questionnaires, including a measure of BSS, followed by having their genital temperature measured using a thermal imaging camera, while viewing a sexually explicit film. The study had four main objectives: (1) to evaluate between group differences in subjective sexual arousal and physiological arousal; (2) to examine within group differences in the effects of BSS on physiological and self-reported sexual arousal; (3) to evaluate the relationship between BSS, negative automatic thoughts during sex, and ED; and (4) to evaluate the relationship between ED and risky sex among gay men. Results revealed significant between-group differences in physiological arousal, but not in subjective sexual arousal. While between-group differences were found in BSS, no within-group differences were found in the relation of BSS on physiological and self-reported sexual arousal. No significant relationships were found between BSS, negative automatic thoughts, and ED. Participants with ED were found to be significantly more likely to use erectile enhancing drugs, but no significant differences in condom removal were found between groups; however, substantially more individuals with ED (23.3%) reported removing condoms prior to the completion of sexual activity, as compared to healthy controls (5%). Findings of this study contribute to improving psychological treatments for gay men with ED, as well as better understanding pathways leading to risky sex in gay men.

The Perceived Need To Be Hot: An Investigation Of The Relationship Between Belief In Sexual Stereotypes And Erectile Dysfunction In Gay Men Using Thermal Imaging

Erectile dysfunction (ED) has been associated with considerable mental health and interpersonal problems, an increase in risky sex, and is particularly prevalent among gay and bisexual men. Psychological treatment protocols for sexual dysfunctions often aim at challenging beliefs and cognitions about the importance of a “perfect sexual performance,” known as sexual stereotypes. However, to date, little empirical evidence exists for the relationship between ED and belief in sexual stereotypes (BSS). To address this gap, 70 gay men were recruited; 30 with ED and 40 healthy controls. Participants completed a battery of questionnaires, including a measure of BSS, followed by having their genital temperature measured using a thermal imaging camera, while viewing a sexually explicit film. The study had four main objectives: (1) to evaluate between group differences in subjective sexual arousal and physiological arousal; (2) to examine within group differences in the effects of BSS on physiological and self-reported sexual arousal; (3) to evaluate the relationship between BSS, negative automatic thoughts during sex, and ED; and (4) to evaluate the relationship between ED and risky sex among gay men. Results revealed significant between-group differences in physiological arousal, but not in subjective sexual arousal. While between-group differences were found in BSS, no within-group differences were found in the relation of BSS on physiological and self-reported sexual arousal. No significant relationships were found between BSS, negative automatic thoughts, and ED. Participants with ED were found to be significantly more likely to use erectile enhancing drugs, but no significant differences in condom removal were found between groups; however, substantially more individuals with ED (23.3%) reported removing condoms prior to the completion of sexual activity, as compared to healthy controls (5%). Findings of this study contribute to improving psychological treatments for gay men with ED, as well as better understanding pathways leading to risky sex in gay men.

The Trend of Women’s Autonomy in Refusing Risky Sex and Associated Factors in Ethiopia: Evidence From 2011 & 2016 EDHS Data

Background: Risky sexual behavior is a major public health concern of Ethiopians. Although studying the autonomy of women in refusing risky sex is significant to take proper actions, the issue is not yet studied. Accordingly, this population-based nationwide study was aimed at assessing the trends of women’s autonomy in refusing risky sex and its associated factors in Ethiopia.Method: The sample was limited to married women of 2011 (n=8369) and 2016 (n=8403) Ethiopian Demographic and Health Survey (EDHS) data. Women's autonomy in refusing risky sex was measured based on wives' response to 'not having sex because of husbands have other women. To examine associated factors, sociodemographic variables were computed using binary logistic regression. Result: The finding revealed that the trend of women’s autonomy in refusing risky sex had declined from 78.9% in 2011 to 69.5% in 2016. Women aged from 25-34 were less likely autonomous in refusing sex (AOR=.764;95%CI=.605,.965), in comparison with women aged less than 24 years old. The autonomy of women with primary, secondary, and higher educational status were AOR=1.607;95%CI:1.379,1.874, AOR=2.208;95%CI:1.639,2.975, and AOR=3.221;95%CI:1.647,6.300 respectively. The autonomy of women from rich households was more likely higher (AOR=1.523;95%CI:1.28,1.813) in comparison to women from poor households. The autonomy of women in Tigray, (AOR=2.938;95%CI:2.025,4.263), Afar (AOR=1.497;95%CI:1.111,2.017), Amhara (AOR=4.870;95%CI:3.388,7.000), Benishangul Gumuz (AOR=.568;95%CI:.406,.796), SNNP (AOR=1.900;95%CI:1.355,2.664), Harari (AOR=.516;95%CI:.372,.716), and Addis Ababa (AOR=3.809;95%CI:2.227,6.516) when compared with autonomy of women who resides Dire Dawa.Conclusion: The autonomy of women in refusing risky sex has declined from 2011 to 2016. This infers that currently, women are more victimized than previously. Hence, possible interventions like empowering women shall be taken to protect women from certain health problems of risky sexual behavior.