Human Papillomavirus Risk Perceptions Among Young Adult Sexual Minority Cisgender Women and Nonbinary Individuals Assigned Female at Birth

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/148405/1/psrh12087_am.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/148405/2/psrh12087.pd

Effects of 17-α-ethynylestradiol on Hybrid Striped Bass Sperm

Gemstone Team FISHOne of the most potent EDCs in the environment is 17-ethynylestradiol (EE2), the hormone in most birth control pills. EE2 is released into the ecosystem through human wastewater, affecting the environment and its inhabitants. Fish both live and reproduce in these affected ecosystems, which may make them particularly susceptible to the effects of EE2. This study investigates the impacts on reproductive efficacy of acute, direct exposure of male hybrid striped bass sperm cells to EE2. In the study, reproductive efficacy is measured by two endpoints: genetic integrity of sperm DNA and sperm cell viability. Genetic integrity and cell viability were assessed by the comet assay and SYBR-14/Propidium Iodide stains, respectively. The results concerning genetic integrity were not statistically significant, but the results of the sperm viability assay suggest that acute direct exposure to EE2 does not cause significant death within a population of sperm

Understanding the impact of multiple forms of violence on sexual and drug-related HIV risk in female sex workers

Background: Female sex workers (FSW) are a key population in the HIV epidemic and in many settings face high levels of violence from intimate partners, clients, police, and pimps. FSW are therefore at risk of polyvictimization, or experiencing multiple types of violence. Methods: Using respondent-driven sampling, 754 FSW from Russia were recruited. Participants self-reported lifetime exposure to client, police, intimate partner, and pimp violence, as well as recent injecting drug use, inconsistent condom use with intimate partners, and inconsistent condom use with clients. Results: Lifetime violence was prevalent, with 44.8% experiencing any violence, including 31.7% from clients, 16.0% from police, 15.7% from intimate partners, and 11.4% from pimps. One-fifth (20.4%) experienced polyvictimization. Client violence was one of the strongest independent correlates of the other three types of violence. Respondents reported prevalent recent injecting drug use (10.7%), inconsistent condom use with intimate partners (45.1%), and inconsistent condom use with clients (22.5%). Intimate partner violence was associated with all three risk behaviors, police violence was associated with both sexual risk outcomes, and client violence was associated with injecting drug use, while pimp violence was not associated with any of the three risk behaviors. Linear dose-response analyses standard to syndemics research demonstrated that the risk of injecting drug use (ARR=1.37, 95% CI 1.04, 1.81), inconsistent condom use with intimate partners (ARR=1.04, 95% CI 1.01, 1.08), and inconsistent condom use with clients (ARR=1.27, 95% CI 1.07, 1.49) rises as the number of types of violence experienced increases. We propose three novel analyses to measure whether these four types of violence synergistically increase HIV risk; none demonstrated synergism. Conclusions: The present study is unique for measuring four major types of violence against FSW and three major HIV risk pathways. All three pathways were associated with multiple types of violence; these results support the World Health Organization mandate that violence prevention needs to be integrated into HIV prevention programming for FSW, and demonstrates the importance of considering multiple forms of violence and of considering different types of violence for each specific HIV risk pathway. The novel synergism analyses proposed can be leveraged to advance syndemics research

Intimate Partner Violence (IPV) Screening and Referral Outcomes among Transgender Patients in a Primary Care Setting

Transgender patients are at elevated risk of intimate partner violence (IPV), but national guidelines do not recommend routine screening for this population. This paper explores the feasibility and effectiveness of routine IPV screening of transgender patients in a primary care setting by describing an existing screening program and identifying factors associated with referral and engagement in IPV-related care for transgender patients. An IPV referral cascade was created for 1,947 transgender primary care patients at an urban community health center who were screened for IPV between January 1, 2014 to May 31, 2016: (a) Of those screening positive, how many were referred? (b) Of those referred, how many engaged in IPV-specific care within 3 months? Logistic regression identified demographic correlates of referral and engagement. Of the 1,947 transgender patients screened for IPV, 227 screened positive. 110/227 (48.5%) were referred to either internal or external IPV-related services. Of those referred to on-site services, 65/103 (63.1%) had an IPV-related appointment within 3 months of a positive screen. IPV referral was associated with being assigned male at birth (AMAB) versus assigned female at birth (AFAB) (AOR = 2.69, 95% CI 1.52, 4.75) and with nonbinary, rather than binary, gender identity (AOR = 2.07, 95%CI 1.09, 3.73). Engagement in IPV-related services was not associated with any measured demographic characteristics. Similar to published rates for cisgender women, half of transgender patients with positive IPV screens received referrals and two-thirds of those referred engaged in IPV-specific care. These findings support routine IPV screening and referral for transgender patients in primary care settings. Provider training should focus on how to ensure referrals are made for all transgender patients who screen positive for IPV, regardless of gender identity, to ensure the benefits of screening accrue equally for all patients

Sexual Violence against Men Who Have Sex with Men and Transgender Women in Mongolia: A Mixed-Methods Study of Scope and Consequences.

The role of sexual violence in health and human rights-related outcomes, including HIV, is receiving increasing attention globally, yet the prevalence, patterns, and correlates of sexual violence have been little-studied among men who have sex with men (MSM) and transgender women in low and middle income countries. A mixed-methods study with quantitative and qualitative phases was conducted among MSM and transgender women in Ulaanbaatar, Mongolia. Methods included respondent-driven sampling (RDS) with structured socio-behavioral surveys (N = 313) as well as qualitative methods including 30 in-depth interviews and 2 focus group discussions. Forced sex in the last three years was reported by 14.7% of respondents (RDS-weighted estimate, 95%CI: 9.4-20.1; crude estimate 16.1%, 49/307) in the quantitative phase. A descriptive typology of common scenarios was constructed based on the specific incidents of sexual violence shared by respondents in the qualitative phase (37 incidents across 28 interviews and 2 focus groups). Eight major types of sexual violence were identified, most frequent of which were bias-motivated street violence and alcohol-involved party-related violence. Many vulnerabilities to and consequences of sexual violence described during the qualitative phase were also independently associated with forced sex, including alcohol use at least once per week (AOR = 3.39, 95% CI:1.69-6.81), and having received payment for sex (AOR = 2.77, 95% CI:1.14-6.75). Building on the promising strategies used in other settings to prevent and respond to sexual violence, similar strengthening of legal and social sector responses may provide much needed support to survivors and prevent future sexual violence

Intimate partner violence perpetration among adolescent males in disadvantaged neighborhoods globally

Purpose: Intimate partner violence (IPV) affects one in three women globally, with adolescent and young adult women at highest risk. Less is known about IPV perpetration. We compare the prevalence and correlates of IPV perpetration among 15- to 19-year-old adolescent males in Baltimore (United States), Johannesburg (South Africa), Delhi (India), and Shanghai (China). Methods: A cross-sectional survey was conducted in 2013 with males aged 15–19 recruited via respondent-driven sampling from disadvantaged neighborhoods in four cities: Baltimore (United States), New Delhi (India), Johannesburg (South Africa), and Shanghai (China); total n = 751 ever-partnered men. We describe the prevalence of past-year physical and sexual IPV perpetration and evaluate associations with gender norm attitudes, mental health, substance use, victimization experiences, and demographic factors. Results: Past-year physical or sexual IPV perpetration ranged from 9% in Shanghai to 40% in Johannesburg. Factors associated with past-year perpetration across multiple sites included: binge drinking (Johannesburg adjusted odds ratio [AOR] = 2.8, Baltimore AOR = 6.7, and Shanghai AOR = 3.2), depressive symptoms (Johannesburg AOR = 2.4 and Shanghai AOR = 2.2), victimization in the home (Baltimore AOR = 2.5, Shanghai AOR = 2.7, and Johannesburg AOR = 1.7), and community violence victimization (Baltimore AOR = 7.0, Delhi AOR = 4.1, and Johannesburg AOR = 2.8). Equitable gender norm attitudes were protective against IPV perpetration in Johannesburg and Shanghai. Demographic factors (e.g., age, employment, and education) were inconsistently associated with IPV perpetration across sites. Conclusions: Past-year IPV perpetration was prevalent with differences identified across settings. Findings suggest the need to scale up evidence-based interventions targeting adolescents in disadvantaged urban communities in order to address many modifiable factors associated with IPV perpetration in this study

Prevalence and health impact of intimate partner violence and non-partner sexual violence among female adolescents aged 15–19 years in vulnerable urban environments: A multi-country study

Purpose: Globally, adolescent women are at risk for gender-based violence (GBV) including sexual violence and intimate partner violence (IPV). Those in economically distressed settings are considered uniquely vulnerable. Methods: Female adolescents aged 15–19 from Baltimore, Maryland, USA; New Delhi, India; Ibadan, Nigeria; Johannesburg, South Africa; and Shanghai, China (n = 1,112) were recruited via respondent-driven sampling to participate in a cross-sectional survey. We describe the prevalence of past-year physical and sexual IPV, and lifetime and past-year non-partner sexual violence. Logistic regression models evaluated associations of GBV with substance use, sexual and reproductive health, mental health, and self-rated health. Results: Among ever-partnered women, past-year IPV prevalence ranged from 10.2% in Shanghai to 36.6% in Johannesburg. Lifetime non-partner sexual violence ranged from 1.2% in Shanghai to 12.6% in Johannesburg. Where sufficient cases allowed additional analyses (Baltimore and Johannesburg), both IPV and non-partner sexual violence were associated with poor health across domains of substance use, sexual and reproductive health, mental health, and self-rated health; associations varied across study sites. Conclusions: Significant heterogeneity was observed in the prevalence of IPV and non-partner sexual violence among adolescent women in economically distressed urban settings, with upwards of 25% of ever-partnered women experiencing past-year IPV in Baltimore, Ibadan, and Johannesburg, and more than 10% of adolescent women in Baltimore and Johannesburg reporting non-partner sexual violence. Findings affirm the negative health influence of GBV even in disadvantaged urban settings that present a range of competing health threats. A multisectoral response is needed to prevent GBV against young women, mitigate its health impact, and hold perpetrators accountable