Beyond Vectors of Transmission Through Commercial Sex: Exploring Models of Sexual Risk Taking with Clients and Casual Partners Among Internet Based Male Sex Workers

Male sex workers (MSWs) have often been portrayed as vectors of disease although most published studies have reported high rates of condom use with clients in this population. Regardless, social psychological models of sexual behavior that have been widely utilized to examine sexual risk taking in the gay and bisexual male community have not been applied to research with MSWs. Further, sexual behaviors with casual sex partners among MSWs has been absent in most reported research. More recently, the rise of barebacking (unprotected anal sex) in the gay male community has challenged assumptions that most gay and bisexual men want to have protected anal sex which form the basis of the majority of previous sexual behavior research in this population. The theory of reasoned action (TRA) has been suggested as well suited to examine barebacking; however, this model may require adaptation. Within the TRA, behavioral intentions are theorized to mediate the relationship of peer norms and attitudes for behaviors, and are directed toward what Ajzen and Fishbein frame as reasonable behaviors. Examination of barebacking behavior may require inclusion of other factors as temptation to engage in unprotected anal sex. A sample of 50 Internet based MSWs were recruited in NYC for the present study. Results indicate that temptation for barebacking is the most significant predictor of barebacking when examined alongside intentions for barebacking and condom use self-efficacy. Attitudes toward barebacking were mediated by temptation across partner types (client or casual) and unprotected anal sex position (insertive or receptive). Peer norms were not predictive of behavior, however did bear a significant relationship to attitudes toward barebacking regardless of partner type or sexual position. As a result, a new theoretical model is proposed for future research: Norms-Attitudes-Temptation-Behavior (NATR)

Community Reactions to Campaigns Addressing Crystal Methamphetamine Use Among Gay and Bisexual Men In New York City

Crystal methamphetamine (aka “crystal meth”) use with high-risk sex has become an emerging health problem for gay and bisexual men in New York City since the late 1990s. Public health campaigns were eventually developed to encourage gay and bisexual men to avoid or reconsider using crystal meth. Reactions to three campaigns were measured with a cross-sectional survey administered in 2004. Among an ethnically-diverse sample of 971 gay and bisexual men, 61.8% reported seeing the campaigns. Those who reported ever using crystal meth, recent use, and recent use with sex were significantly more likely to have seen the campaigns. In general, white men, HIV-negative men, and men not currently using crystal meth responded more positively to the campaigns than their counterparts; yet, more men of color reported having discussions with partners and friends about their crystal use as a result of these campaigns. Implications for researchers and practitioners are discussed

Do we need a different organ allocation system for kidney transplants using donors after circulatory death?

There is no national policy for allocation of kidneys from Donation after circulatory death (DCD) donors in the UK. Allocation is geographical and based on individual/regional centre policies. We have evaluated the short term outcomes of paired kidneys from DCD donors subject to this allocation policy