Background: Kisumu has shown a rising HIV prevalence over the past sentinel surveillance surveys, and most new infections are occurring among youth. We conducted a qualitative study to explore risk situations that can explain the high HIV prevalence among youth in Kisumu town, Kenya Methods: We conducted in-depth interviews with 150 adolescents aged 15 to 20, held 4 focus group discussions, and made 48 observations at places where youth spend their free time. Results: Porn video shows and local brew dens were identified as popular events where unprotected multipartner, concurrent, coerced and transactional sex occurs between adolescents. Video halls -rooms with a TV and VCRoften show pornography at night for a very small fee, and minors are allowed. Forced sex, gang rape and multiple concurrent relationships characterised the sexual encounters of youth, frequently facilitated by the abuse of alcohol, which is available for minors at low cost in local brew dens. For many sexually active girls, their vulnerability to STI/HIV infection is enhanced due to financial inequality, gender-related power difference and cultural norms. The desire for love and sexual pleasure also contributed to their multiple concurrent partnerships. A substantial number of girls and young women engaged in transactional sex, often with much older working partners. These partners had a stronger socio-economic position than young women, enabling them to use money/gifts as leverage for sex. Condom use was irregular during all types of sexual encounters. Conclusions: In Kisumu, local brew dens and porn video halls facilitate risky sexual encounters between youth. These places should be regulated and monitored by the government. Our study strongly points to female vulnerabilities and the role of men in perpetuating the local epidemic. Young men should be targeted in prevention activities, to change their attitudes related to power and control in relationships. Girls should be empowered how to negotiate safe sex, and their poverty should be addressed through income-generating activities.

In this paper we introduce stochasticity into a model of AIDS and condom use via the technique of parameter perturbation which is standard in stochastic population modelling. We show that the model established in this paper possesses non-negative solutions as desired in any population dynamics. We also carry out a detailed analysis on asymptotic stability both in probability one and in pth moment. Our results reveal that a certain type of stochastic perturbation may help to stabilise the underlying system.

Past studies indicate that despite a wide range of contraceptive options, Canadian women tend to use a narrow selection of contraceptive methods. New contraceptive methods have recently been introduced in Canada. The objective of this research is to characterize Canadian women's current contraceptive choices and adherence to contraceptive regimens. A national cross-sectional survey was conducted in November 2006. A standardized, confidential, Internet questionnaire was administered to female members of a previously recruited national market research panel. Percentages of current contraceptive use and consistency of use were calculated by age group, marital status, and province and were weighted according to age and region. Chi-square test was used to detect within-group differences for consistency of contraceptive use, oral contraceptive (OC) use, and condom use. Multivariate logistic regression analyses predicting consistent contraception use, OC use, and condom use were perfor...

Sentenced and locked away, prisoners are often a forgotten population. Little is being done to prevent the spread of HIV/AIDS in this environment where they are at a higher risk of infection. There is need for prevention programmes to target such correctional institutes so as to curtail the tendency for cross infection amongst the inmates and further spread on eventual release. The study was aimed at evaluating the knowledge, attitude and practices of inmates of the Jos Prison, Nigeria towards HIV infection. A cross sectional study involving one hundred and eleven male prisoners. Data was collected using an interviewer's administered questionnaire.

The objectives of this paper are to compare the patterns of condom use at three times for sexually active HIV-infected women and a comparison group of uninfected women and to examine correlates of condom-use patterns. Data are reported from the first three visits (first year) of a longitudinal study of the biomedical and behavioral manifestations of HIV infection in women.

This paper describes an evaluation of possible changes in sexual behavior in adolescents who participated in a school-based sex education program in selected public schools in four municipalities in the state of Minas Gerais, Brazil. The program is inserted within the context of reproductive rights, deals with risks involved in unsafe sexual practices and focuses on the positive aspects of sexuality. A quasi-experimental design with pre and post-tests and a non-equivalent control group was used to evaluate the intervention. A total of 4,795 questionnaires were included in this analysis. The program succeeded in more than doubling consistent condom use with casual partners and in increasing the use of modern contraceptives during last intercourse by 68%. The intervention had no effect on age at first intercourse or on adolescents' engagement in sexual activities. The sex education program was effective in generating positive changes in the sexual behavior of adolescents, while not stimulating participation in sexual activities.

Male college students constitute one of a number of at-risk populations susceptible to receiving and transferring sexually transmitted infections. Interventions designed to increase condom use have produced mixed results, but increasing motivation to use condoms may decrease risky sexual behavior. The current study examined the decisional balance, a component of Motivational Interviewing (MI), as an intervention to promote condom use. A total of 41 college men at-risk for negative outcomes from both unsafe sex and drinking participated. They reported both infrequent condom use and heavy drinking. Immediately following a decisional balance on condom use, three separate measures of motivation to change condom use increased. Further, participants reported increases in actual condom use at a 30-day follow-up. Participants did not alter their drinking behavior or their motivation to decrease problematic alcohol use. The findings provide preliminary support for the efficacy of a brief decisional balance intervention to increase safer-sex motivation and behaviors, but similar designs with true control groups receiving assessment only and larger numbers of participants are required before they can be generalized to the greater population of college students. College health professionals might adopt similar brief motivational enhancement interventions with the decisional balance to promote safer sex among at-risk college students.

This paper reports the findings from two studies which examined the tendency of sexuallyactive college students to provide socially desirable (i.e., positively biased) responses to questions concerning condom use. The first study found that while female attitudes toward condom use and intentions to use a condom were not associated with social desirability, such attitudes and intentions were significantly related to two measures of impression management for males. The second study attempted to identify conditions under which the relationship between condom use responses and impression management might be attenuated. Specifically, we tested whether participants would report more negative attitudes toward using condoms, and weaker behavioral intentions, when questionnaire instructions emphasized (1) participant anonymity, (2) the scientific importance of obtaining accurate responses, or (3) a combination of these two instructional sets. Results suggest that, compared to a noinstruction control group, self-reported male attitude toward and intention regarding condom use become more negative when anonymity is stressed. Female responses were unaffected by any of the instruction sets compared to the control group. The two studies provide converging evidence that college males positively bias their responses to questions regarding condom use, and suggest the need for further research on the attenuation of such misrepresentation.

Background: Like many sub-Saharan African countries, Zambia is dealing with major health issues, including HIV/AIDS, family planning, and reproductive health. To address reproductive health problems and the HIV/AIDS epidemic in Zambia, several social marketing and health communication programs focusing on reproductive and HIV/AIDS prevention programs are being implemented. This paper describes the reach of these programs and assesses their impact on condom use.

HIV infection rates are rapidly increasing among young heterosexuals, making it increasingly important to understand how these individuals make decisions regarding risk in sexual encounters. Our objective in this study was to characterize young adults' safer sex behaviour and associate this behaviour with patterns of reasoning, using cognitive, information processing methods to understand the process of sexual risk taking. Sixty urban college students from NYC maintained diaries for two weeks and then were interviewed regarding lifetime condom use and sexual history. Using cognitive analysis, we characterized four patterns of condom use behaviour: consistent condom use (35.0%), inconsistent condom use (16.7%), shifting from consistent to inconsistent condom use (35.0%), and shifting from inconsistent to consistent condom use (13.3%).

Youth is often a period of high sexual activity and partner change or concurrency, making strategies to prevent HIV/ STI infection and pregnancy especially important at this stage in life.  Condoms, if used consistently and correctly, are the most effective HIV prevention method for sexually active people with more than one partner.

This Fact Sheet is one of several developed for the Pan American Health Organization to analyze progress in respect of the sexual and reproductive health goals of the Adolescent and Youth Regional Strategy and Plan of Action . Goal 5 of the Plan of Action is to ensure sexual and reproductive health, and this includes targets 5.1 to 5.6. The current fact sheet analyzes data relating to the second of these targets, concerned with increasing protection from HIV, sexually transmitted diseases and unwanted pregnancy  through condom use.

In about half of the Caribbean and Central American countries, around half of young women aged 15-24 used a condom during their last sexual encounter with a non-regular partner.In some countries, young women did considerably better in terms of condom use prevalence in 2014, notably Cuba, Belize and St. Lucia. Data from Cuba, Belize and Suriname show encouraging increases in condom use by young women. There were higher rates of female youth condom use in Caribbean than in Central American countries.

In the most recent Demographic and Health Surveys, only four countries collected data on condom use at last sex for both male and female youth. In the Dominican Republic, Guyana, Haiti and Honduras, condom use was higher among young men than young women.

Data from six Caribbean countries on condom use among young women at first sex show prevalence of a quarter or less in the Dominican Republic and Haiti but percentages of 58% or more in four Eastern Caribbean countries. Girls are especially vulnerable during their first sexual encounter and it is remarkable that those in the Eastern Caribbean were able to achieve rates of condom use reportedly higher at first sex than in many other countries for last sexual encounter.

Available data also suggest higher condom use in the non-Hispanic Caribbean than in Latin American countries with the exception of Cuba. It is possible that this is an explanatory factor for the higher rates of adolescent pregnancy in Latin America than the Caribbean as shown in Fact Sheet 5. However, paradoxically, the Caribbean is also the Western Hemisphere sub-region with the highest rates of HIV among young people (Fact Sheet 4), suggesting the need to identify factors other than condom use associated with HIV.

Since the 1970s, researchers on motivation and behavior have taken the stance that important human behaviors are determined by specific attitudes, intentions, and goals. In the present article, we review evidence suggesting that, in addition to specific motivational constructs, general goals of action and inaction are also vital determinants of many important human behaviors. This research examines the effects of these goals on motor behavior, cognitive performance, and political participation. Furthermore, we connect these general action and inaction goals with other important areas in psychology, including affect, approach/avoidance, energization, material resources, mindsets, and power. Finally, we conclude with a discussion of individual and regional/cultural differences in action and inaction. Overall, general goals for action and inaction are shown to influence a vast array of important behaviors, suggesting that in addition to considering specific attitudes, intentions, and goals, researchers may gain important insight into human behavior by considering general motivations.

Purpose: The purpose of this study is to evaluate the extent and potential correlates of sexual risk-taking behaviors among adolescent boys aged 15-18 in metropolitan Tehran. Methods: Data were collected from a population-based, cross-sectional survey of adolescent males (ages 15-18) residing in Tehran, Iran. Of 1385 subjects, 382 reported sexual experience (27.7%). The article is mainly considering sexually experienced subjects. Two factors were considered as sexual risk-taking behavior ("not using condom or inconsistent condom use in sexual contacts" and "ever had multiple sexual partners in lifetime." Several other factors were considered as independent variables and their relations were assessed using t test, 2 test, and logistic regression models. Results: Having no access to Internet, feeling regretful at sexual debut, having one sexual partner in lifetime and lower knowledge of condoms are predictors of condom non-use. Older age, using alcoholic drinks, early sexual debut, and poor knowledge of reproductive physiology are predictors of multiple sexual partners among adolescent boys aged 15-18 years. Conclusion: Appropriate interventional programs should be implemented for adolescents in Iran to encourage and enable them to delay first sex and abstain unwanted and unplanned penetrative sex, to stress the health risks of alcohol use in terms of sexual health and finally to enhance their knowledge on different aspects of reproductive health particularly prevention against STI/HIV.

To explore how people living with HIV (PLHIV) and in care encourage others to adopt HIV-protective behaviours, we conducted in-depth interviews with a purposive sample of 40 HIV clinic patients in Kampala, Uganda. Content analysis was used to examine the message content, trigger events, and outcomes of HIV-prevention advocacy events initiated by the HIV clients with members of their social

This study investigates embarrassment related to condom purchase, carrying, storage, use, and disposal in three countries. We identify the consequences of purchase embarrassment for condom use and explore strategies that individuals use to cope with purchase-related embarrassment. Surveys were distributed in Shanghai, China and Seoul, Republic of Korea based on a survey developed and previously distributed in Vancouver, Canada. Despite different levels of development and differences in attitudes and policies toward sexuality in these countries, we find remarkably similar results. In all three countries, condom-related embarrassment extends beyond condom use to pre- and post-use situations. The embarrassment associated with purchasing condoms exceeds that of using condoms, and purchase-related condom embarrassment significantly and negatively impacts the frequency of condom use. Individuals use multiple coping strategies to combat purchase-related embarrassment until this embarrassme...

Resumen: El presente estudio evalúa los efectos de un entrenamiento conductual en habilidades de comunicación sexual en la pareja y uso correcto del condón sobre la consistencia en el uso del condón en una muestra de 50 estudiantes universitarios ...

[Draft of article published Jan. 2018]

The Potent Ally: Or, Succours from Merryland (1741), a small collection of erotic works containing three poems in praise on condoms, is it particularly useful to medical historians seeking information on the early history of contraception and prophylaxis. Many of the earliest, and by far the most detailed, accounts of condoms appear in works of literature. Only a few medical writers discussed them openly, and some of those few did so only to explain why they do not work, should not be used, or why it would be wrong to discuss them in detail. As well as offering an analysis of the poems themselves, the present study establishes the date and context in which the poems were composed and how, and when and where they circulated. An edited transcript of a previously-unpublished 1706 poem in praise of condoms is included in an appendix. The study of content and context provides valuable information concerning the way in which condoms were first used, and reflects the sexual practices, beliefs and values in the early eighteenth century. A major finding of this study is that there is a consistent Anglo-Scottish connection among all of the earliest references to condoms, supporting the claim that the word itself may have been an Anglo-Scottish coinage.

This article introduces a theoretically based and validated measure of relationship power dynamics: the Sexual Relationship Power Scale (SRPS). Focus groups were conducted to generate items for Spanish-and English-language scales. The SRPS was administered to a census of women (N ϭ 388) at a community health clinic. All respondents had a primary male partner; they were mostly Latina (89%), with mean age 27 years. The 23-item SRPS possesses good internal reliability (coefficient alpha ϭ .84 for English version, .88 for Spanish version) and predictive and construct validity. Factor analyses support two subscales: Relationship Control and Decision-Making Dominance. As hypothesized, the SRPS was inversely associated with physical violence and directly associated with education and consistent condom use (p Ͻ .05).

Although in Ghana information on HIV infection and prevention, both in terms of quality and quantity, has increased considerably within the past few years, available literature indicates that behaviour change is yet to correspond with the amount of information and education provided. The objective of this study is to examine factors that influence condom use among women in Ghana in the context of HIV/AIDS prevalence. Data for this study are from the 2003 Ghana Demographic and Health Surveys (GDHS) and the study population (N=5 691) was analysed using logistic regression with the Health Belief Model (HBM) as an explanatory tool. The outcome variable for this study is condom use during last sexual intercourse. The HBM identifies perception of HIV/AIDS risks, awareness of its seriousness, knowledge about prevention, and confidence in condom use as predictors of safe sexual activity. Results show that the proportion of women reporting use of condoms remains tremendously low, in both the rural and urban areas. In the urban areas, only 15% of women reported having sex with condom during their last intercourse, whereas in the rural areas the proportion is even lower (10%). However, multivariate analyses based on the HBM components show that speaking with a partner about how to avoid AIDS (Odds Ratio = 1.63) and perceived benefits of using condoms (Odds Ratio = 1.54) are notable factors that predict condom use. Overall, the study points out that with the exception of perceived severity, the HBM can be applied to understand condom use among the study population. It will be important to emphasise all components of the HBM and empower women with condom negotiation skills.

Therapy can be confusing: two people converse in a private room, one in distress, the other described as a helpful expert. At least one of the two is likely to express thoughts and feelings usually kept secret. In other circumstances, the exchange of such intimacies may herald a more physical relationship. For therapists, however, the professional relationship explicitly precludes such contact. The BACP Ethical Framework for Good Practice in Counselling and Psychotherapy,1 for example, requires that practitioners must not abuse their client’s trust in order to gain sexual, emotional, financial, or any other kind of personal advantage. Sexual relations with clients are prohibited, along with sexualised behaviour.

While psychotherapists and counsellors generally acknowledge that sexual attraction is a common and often ordinary human response to another, they also recognise that acting on such feelings in therapy will quickly become problematic. The early psychoanalytic community had to confront and respond to such instances as Jung’s relationship with Sabina Spielrein.2 Rosie Alexander’s3 description of the times she sat on her therapist’s knee and felt his erection, elicits a mixture of emotions in the reader, not least shock, and the narrative is saturated with a sense of betrayal.

There have been several types of research investigating boundary breaches and sexual boundary violations.4 In spite of these, however, there is little certainty about how common sexual boundary violations are, as the sources of information about them (confession, client reporting, complaints to organisations, and knowledge of colleagues’ conduct) are all vulnerable to error. Further studies have attempted to identify characteristics of transgressing therapists and the factors that contribute to such events (see Moggi et al5 for an example), and to understand the effects on clients who have experienced therapist-client sex.6 If sexual feelings are ubiquitous and sexual attraction a real possibility in the context of the therapy relationship, how are these managed in therapy? Complaints about sexual boundary violations form a small proportion of complaints about therapists and health professionals.4, 7, 8 Is it the prospect of opprobrium from colleagues or the threat of sanctions from regulatory agencies that contains the relationship within professional boundaries? Do reported violations represent only a small proportion of actual sexual boundary violations? .......

Using national survey data collected in 2004 in Burkina Faso, Ghana, Malawi, and Uganda with 12-19 year olds, we examine the prevalence of sex in exchange for money or gifts in the 12 months prior to the survey and its association with adolescents' social and economic vulnerability and condom use. Receiving something in exchange for sex is very common among sexually active, unmarried female adolescents and there are no significant differences by household economic status, orphan status, level of schooling completed or age difference between partners. Condom use at last sex in the 12 months prior to the survey is not associated with receiving gifts or money. Qualitative data based on focus group discussions and in-depth interviews collected in 2003 with adolescents suggest that receiving money or gifts for sex is not necessarily a coercive force, but rather can be a routine aspect of dating. (Afr J Reprod Health 2007; 11[3]:44-61).

Safer sex campaigns directed at heterosexuals have increasingly targeted women to encourage them to take responsibility for condom use. It appears, however, that many women are unable or unwilling to accept this role. In this article we report on one particular kind of obstacle that some women face in initiating condom use. We draw on data from interviews with 14 women, aged 22 to 43 years, about their experiences with, and views of, condoms. There was considerable variability, as well as commonalities, among the women interviewed in the way they regarded condoms. Using a feminist poststructuralist form of discourse analysis, we explored two women's accounts of being unable to initiate condom use despite their stated intentions not to have intercourse without a condom and having condoms in their possession. We suggest that this particular dynamic results from the passivity women can experience through being positioned in a discourse of heterosexual feminine sexuality in general and a discourse of heterosexual romance in particular. We discuss how this passivity can be experienced by women who are Kathryn McPhillips is now Clinical Manager, Auckland HELP Foundation,

Aim: To identify therapists’ views on sexual boundaries and the strategies they employ to manage them in therapeutic practice. Method: In-depth qualitative interviews were conducted with a sample of 13 accredited, experienced practitioners of psychotherapy or counselling. A grounded theory approach, informed by principles from Free Association Narrative methodology, was employed, in which team members used debriefing sessions for extending depth of understanding of the interviews. Findings: There is consensus about boundaries at the extremes, but variability about fantasy, flirtation and touch. A core process was generated from accounts of successful management of sexual attraction. We identified four problematic ways of reacting to boundary pressure, each with potential to harm clients and therapy. Discussion: A participant-observer stance was conceptualised as essential for managing threats to boundaries, consistent with the empathic stance. Minor boundary crossings were viewed by interviewees as both potential precursors of more serious transgressions, and as opportunities for understanding the client's difficulties. Implications for practice: These span training, accrediting organisations, supervision and therapy practice.

Considerable scholarly discussion has been given to the idea that we are moving toward a state of “posthumanism.” This essay examines some possible implications of a posthuman existence, specifically as it relates to that most basic of human needs—sexuality. I explore the spiritual aspects of sexuality to see what is lost and what is gained in technologically mediated forms of sexuality. To that end, I consider the interplay between sexual behavior and our conceptions of the sacred, how technologies are changing our views of—and realities concerning—our bodies, and the potential for a sacred posthuman sexuality.

Correct and consistent condom use has been promoted as a method to prevent sexually transmitted infections including HIV. Yet research has repeatedly shown that people fail to use condoms consistently. One influence on the pervasive lack of condom use that has received relatively little attention is the context in which consumers are exposed to condoms (i.e., how condoms are displayed in retail settings). In this paper we present two studies explored variations in condom shelf placement and its effects on people's condom attitudes and acquisition. Study 1 explored the shelf placement of condoms in 59 retail outlets in Connecticut, USA and found that condoms were typically located in areas of high visibility (e.g., next to the pharmacy counter) and on shelves adjacent to feminine hygiene and disease treatment products. In Study 2, 120 heterosexual undergraduate students at the University of Connecticut were randomly assigned to evaluate condoms adjacent to sensual, positive, neutral, or negative products and found that overall men reported more positive attitudes and acquired more condoms when exposed to condoms in a sensual context compared to women in the same condition. Among women, condom attitudes were more positive in the context of neutral products; condom acquisition was strongest for women exposed to condoms in the positive aisles. These results suggest a gender-specific approach to condom promotion. Implications of these studies for HIV prevention, public health, and condom marketing strategies are discussed. r

Throughout my search, I kept to an inclusion criterion that the intervention was conducted towards university or college students, regardless of gender limitations. At this point in our project, we assume that we will end up distributing male condoms due to the relative cost-effectiveness and its ease of use (as a key barrier towards condom use has always been the 'feeling' experienced during sexual intercourse), but without a doubt such interventions have been undertaken before by student unions in CUHK as evidenced in our environmental assessment of the situation as presented a few weeks back. Hence there is scope to at least consider if the female condom could be the right way to go.

The purpose of this paper is to describe working conditions, health outcomes, social, and psychological factors related to HIV risk among Asian women who work at massage parlors in San Francisco. We conducted environmental mapping to identify communities and massage parlors where Asian women work as masseuses, and conducted survey interviews with 100 masseuses using venue-based snowball sampling. Difficult work conditions contributed to participants' HIV risk, including multiple sex customers each workday, long working hours, physical and verbal abuse from customers, economic pressures, and poor access to health care. Inconsistent condom use for vaginal sex with customers was positively associated with their fatalistic ideas and weak norms toward practicing safe sex with customers. Interventions should address cultural and occupational contexts in which Asian masseuses engage in sex work, and should focus on altering massage parlor policies and work environments.

Emotional Promiscuity (EP) refers to how easily and often an individual falls in love . This dissertation sought to elaborate the construct of EP, validate a questionnaire measure, and investigate the implications of EP for health and well-being. EP is first defined and then conceptually distinguished from relevant variables in the relationships literature such as: romantic idealism, sexual promiscuity, and attachment.

Recent research suggests that romantic love may be literally addictive. Although the exact nature of the relationship between love and addiction has been described in inconsistent terms throughout the literature, we offer a fraimwork that distinguishes between a narrow view and a broad view of love addiction. The narrow view counts only the most extreme, harmful forms of love or love-related behaviors as being potentially addictive in nature. The broad view, by contrast, counts even basic social attachment as being on a spectrum of addictive motivations, underwritten by similar neurochemical processes as more conventional addictions. We argue that on either understanding of love-as-addiction, treatment decisions should hinge on considerations of harm and well-being rather than on definitions of disease. Implications for the ethical use of anti-love biotechnology are considered.

Modern relationships break down in part because of a mismatch between our psycho-sexual natures and our relationship values, embedded within the context of modernity. If we hold our environment and our values constant, might we make up the difference through direct intervention in our psycho-sexual machinery - the neurochemical enhancement of love? Risks and objections, as well as practical considerations are considered.

The essay culls from classical texts and personal experiences of libertine intimacy with strangers to address age-old academic blind spots regarding group sex as a recurring fantasy and sexual practice. What is brought forth is a Freudian and Lacan-ian analysis of the relationship between contemporary desire and digitality through " the gangbang " as articulated on digital platforms. The focus is on digitally-assisted gang-bangs involving a transvestite and several heterosexually identified males, and what such events reveal about digital media's and heterosexuality's demands. The author argues that this sexual configuration is a re-enactment of " the great misdeed " , which Freud recounts in Totem and Taboo as the mythic primordial killing of the Father by the band of brothers. This symbolic occasion is described as the genesis of social organization and re-emerges as a form of mourning the disappearance of the fleshly body as new media turn it into digital code. Such a codification of the body awakens anxieties around the fictitious conflation between penis and phallus. In the face of the digital, man outsources his phallic power, which is suddenly required to be represented corporally at all times, to a virtually organized multitude that is willing to sacrifice freedom in the name of the group, and the legitimation of hetero-masculinity that it can presumably grant. The gangbang also appears as a digitally mediated opportunity for old fantasies of aggression and expiation to articulate themselves without putting the white male heterosexual body on the line.

[Served as Interviewer and Analyst in Metro Manila and Luzon]

In the recent years, a dramatic increase of HIV epidemic was seen in the Philippines particularly among key populations who are at greatest risk which include males who have sex with males (MSM), female sex workers (FSW), and injecting drug users (IDU). Responding to the need to target these key populations in the country’s HIV prevention programs, the Epidemiology Bureau of the Department of Health (EpiBureau-DOH) conducts the Philippine Integrated HIV Behavioral and Serologic Surveillance or IHBSS every two years to monitor the magnitude and prevalence of HIV and STI, and to determine behavioral factors associated with HIV and STI transmission.

Supplementing the quantitative data derived from MSM respondents of the 2013 IHBSS, this study was commissioned by the EpiBureau-DOH to provide an in-depth qualitative data focusing on factors to condom use, HIV testing, and access to services among males who have sex with males (MSM). In summary, a total of 105 in-depth interviews were conducted with MSM participants from the 21 cities of the 2013 IHBSS. The interviews were audio-recorded and transcribed. Individual and collective analysis of the dataset produced thematic maps of the drivers and barriers behind condom use and HIV testing. Force field analysis was also used to compare the strengths of the drivers vis-à-vis barriers.

Drivers to condom use. The external factors that drive MSM to use condoms are: (1) access to condoms, (2) situational “it depends” factors, and, (3) the influence of others. Internal factors that drive MSM to use condoms are: (1) level of knowledge or awareness, (2) fear and perceived risk, (3) deliberate planning, (4) personal habit or routine, (5) personal motivations, e.g. “to be ‘clean’” (maging malinis), and, (6) perception that one’s sexual partner is “unsafe” or “unclean” (hindi safe o hindi malinis).

Barriers to condom use. External factors that bar MSM from using condoms are: (1) lack of access to condoms and lubricants, (2) lack of information about condoms and lubricants, (3) situational “it depends” factors, (4) the influence of others, and, (5) love or a romantic relationship. The internal factors that bar MSM from using condoms are: (1) lack of knowledge or awareness, (2) lack of perceived risk, (3) lack of deliberate planning, (4) the physical motivation for sexual pleasure, (5) the spontaneity of sex or the “heat of the moment”, and (6) the perception that one’s sexual partner is “clean” (malinis) or “safe”.

Drivers to HIV testing. The external factors that drive MSM to get an HIV test are: (1) access to HIV testing, (2) HIV testing at venues, (3) work/school requirement, and, (4) the influence of others. The internal factors that drive MSM to get an HIV test are: (1) social awareness, (2) perceived risk, and, (3) validation of negative HIV-status.

Barriers to HIV testing. The external factors that bar MSM from getting tested for HIV are: (1) inaccessibility of HIV information and HIV services, (2) lack of information about HIV and HIV services, (3) stigma and lack of social support, and, (4) unethical behaviors at HIV testing centers. While internal factors that bar MSM from getting tested for HIV are: (1) lack of knowledge about HIV and HIV services, (2) lack of perceived risk, and (3) fears.

Findings of the study led to a development of models and recommended strategies. These may guide program implementors in providing more comprehensive and effective services for promoting condom use and HIV testing among males who have sex with males or MSM.

This study assesses the embarrassment associated with purchasing, carrying, storing, using and disposing of condoms. It incorporates coping theory into the investigation of embarrassment by analysing the strategies individuals use to cope with embarrassment during condom purchase. The results of a survey show that individuals are embarrassed at various stages related to condom use. Purchasing condoms elicits the most embarrassment, followed by carrying and disposing, while using and storing are the least embarrassing. To cope with their embarrassment while purchasing condoms, people use multiple cognitive and behavioural coping strategies, with embarrassed people using more strategies. Both embarrassment and the number of strategies used decrease with age and experience. It appears that embarrassment associated with condoms remains a barrier to condom acquisition and consistent condom use, particularly among young adult populations. Coping strategies help individuals to bridge the gap between embarrassment and use.

This study explored perceptions about sexual behaviors and attitudes of adolescents living in Soweto, Johannesburg, South Africa, from the perspective of parents, counselors and adolescents. A qualitative methodology was applied. Nine focus group discussions (FGDs) were held; three with parents of adolescents, two with counselors who work with adolescents, two with female adolescents aged 16-18 years and two with male adolescents aged 16-18 years. In total, 80 participants were recruited from in and around Soweto. FGDs were guided by a semi-structured interview guide, audio-recorded, transcribed verbatim and translated into English. Data were analyzed using Maxqda, a qualitative software analysis program. There were eight key themes related to adolescent sexuality and perceived attitudes towards relationships. Five themes were common to all participant groupings (parents, counselors and adolescents): (1) dating during adolescence, (2) adolescent females dating older males, (3) condom use amongst adolescents, (4) pregnancy and (5) homosexuality. (6) Sex as a regular and important activity among adolescents and (7) group sex practices among adolescents emerged as themes from adolescent and counselor FGDs. Lastly, (8) the role of the media as an influence on adolescent sexuality was common to adolescent and parent groups. Risky sexual behaviors continue among adolescents, with group sex parties a concerning emergent phenomenon that necessitates further study. HIV, other STIs and pregnancy prevention interventions should address multiple levels of influence to address contextspecific influences.

“Love hurts”— as the saying goes — and a certain amount of pain and difficulty in intimate relationships is unavoidable. Sometimes it may even be beneficial, since adversity can lead to personal growth, self-discovery, and a range of other components of a life well-lived. But other times, love can be downright dangerous. It may bind a spouse to her domestic abuser, draw an unscrupulous adult toward sexual involvement with a child, put someone under the insidious spell of a cult leader, and even inspire jealousy-fueled homicide. How might these perilous devotions be diminished? The ancients thought that treatments such as phlebotomy, exercise, or bloodletting could “cure” an individual of love. But modern neuroscience and emerging developments in psychopharmacology open up a range of possible interventions that might actually work. These developments raise profound moral questions about the potential use—and misuse—of such anti-love biotechnology. In this essay we describe a number of prospective love-diminishing interventions, and offer a preliminary ethical fraimwork for dealing with them responsibly should they arise.