Risky sexual behavior

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Risky sexual behavior is the description of the activity that will increase the probability that a person engaging in sexual activity with another person infected with a sexually transmitted infection will be infected [1] [2] [3] or become pregnant, or make a partner pregnant. It can mean two similar things: the behavior itself, and the description of the partner's behavior. [1]

Contents

The behavior could be unprotected vaginal, oral, anal, or non-penetrative manual intercourse. The partner could be a non-exclusive sexual partner, HIV-positive, and/or an intravenous drug user. [1] [2] [4] Illicit drug use is closely associated with risky sexual behaviors. [2] [5]

Factors

Risky sexual behaviors can include: [6]

Risky sexual behavior includes unprotected intercourse, multiple sexual partners, and illicit drug use. [1] [2] [11] The use of alcoholic drinks and illicit drugs greatly increases the risk of gonorrhea, chlamydia, trichomoniasis, hepatitis B, and HIV/AIDS. [2] Trauma from penile-anal sex has been identified as a risky sexual behavior. [12]

Risky sexual behaviors can lead to serious consequences both for person and their partner(s). This sometimes includes cervical cancer, ectopic pregnancy, and infertility. [4] An association exists between those with a higher incidence of body modifications (such as body piercings and tattoos) and risky sexual behaviors. [12]

Epidemiology

According to the National Youth Behavior Risk Survey, 19% of all sexually active adolescents in the US consumed alcohol or used other drugs before their last sexual intercourse. [13] In contrast, adolescents who reported no substance use were found to be the least likely to engage in sexual risk-taking. [14]

Most Canadian and American adolescents aged 15 to 19 years describe having had sexual intercourse at least one time. In the same population, 23.9% and 45.5% of young, adolescent females describe having sex with two or more sexual partners during the previous year. Of the males in the same population, 32.1% of Canadian males had two or more partners and 50.8% of American males also describe a similar experience. [4]

Alcohol is the most commonly used substance among youth aged 18–25 years. 10% of young adults had an alcohol use disorder in 2018, which is greater than the prevalence among all other age cohorts. [15] Research indicates that alcohol can lead to risky sexual behavior including lack of condom use, sexual intercourse with a non-primary partner, as well as lower likelihood of using contraception in general. [16]

Among older age cohorts, a similar positive trend can be observed in risky sexual behavior when combined with alcohol use. For instance, research on older men who have sex with men (MSM) showed that the likelihood of engaging in risky sexual activities increased with the use of alcohol and other drugs. [17]

Treatment and interventions

AIDS Prevention - Condom dispensers in toilets (4612444296).jpg

There are several factors linked to risky sexual behaviors. These include inconsistent condom use, alcohol use, polysubstance abuse, depression, lack of social support, recent incarceration, residing with a partner, and exposure to intimate partner violence and childhood sexual abuse. Further research is needed to establish the exact causal relationship between these factors and risky sexual behaviors. [18] [19] Sexual health risk reduction can include motivational exercises, assertiveness skills, educational and behavioral interventions. Counseling has been developed and implemented for people with severe mental illness, may improve participants' knowledge, attitudes, beliefs, behaviors or practices (including assertiveness skills) and could lead to a reduction in risky sexual behavior. [11]

There are several studies on the management of risky sexual behavior among youth, with most focusing on the prevention of sexually transmitted infections (STIs) such as HIV. [20] [21] [22] A meta-analysis evaluating prevention interventions among adolescents offers support for these programs in contributing to successful outcomes such as decreased incident STIs, increased condom use, and decreased or delayed penetrative sex. [21] The findings showed that most interventions were administered in a group format and involved psychoeducation on HIV/AIDS, active interpersonal skills-training with some additionally focusing on self-management skills-training and condom information/ demonstrations. Some evidence suggests that family interventions may be beneficial in preventing long-term risky sexual behavior in early adulthood. [23]

Related Research Articles

<span class="mw-page-title-main">Sexual intercourse</span> Penetrative sexual activity for reproduction or sexual pleasure

Sexual intercourse is sexual activity involving the insertion and thrusting of the male penis inside the female vagina for sexual pleasure, reproduction, or both. This is also known as vaginal intercourse or vaginal sex. Sexual penetration has been known by humans since the dawn of time, and has been an instinctive form of sexual behaviour and psychology among humans. Other forms of penetrative sexual intercourse include anal sex, oral sex, fingering and penetration by use of a dildo, and vibrators. These activities involve physical intimacy between two or more people and are usually used among humans solely for physical or emotional pleasure. They can contribute to human bonding.

<span class="mw-page-title-main">Sex worker</span> Person who works in the sex industry

A sex worker is a person who provides sex work, either on a regular or occasional basis. The term is used in reference to those who work in all areas of the sex industry.

<span class="mw-page-title-main">Safe sex</span> Ways to reduce the risk of acquiring STIs

Safe sex is sexual activity using methods or contraceptive devices to reduce the risk of transmitting or acquiring sexually transmitted infections (STIs), especially HIV. "Safe sex" is also sometimes referred to as safer sex or protected sex to indicate that some safe sex practices do not eliminate STI risks. It is also sometimes used colloquially to describe methods aimed at preventing pregnancy that may or may not also lower STI risks.

<span class="mw-page-title-main">Alcohol abuse</span> Substance abuse of alcoholic beverages

Alcohol abuse encompasses a spectrum of alcohol-related substance abuse, ranging from the consumption of more than 2 drinks per day on average for men, or more than 1 drink per day on average for women, to binge drinking or alcohol use disorder.

Men who have sex with men (MSM) refers to all men who engage in sexual activity with other men, regardless of sexual identity. The term was created by epidemiologists in the 1990s, to better study and communicate the spread of sexually transmitted infections such as HIV/AIDS between all sexually active males, not strictly those identifying as gay, bisexual, pansexual or various other sexualities, but also for example male prostitutes. The term is often used in medical literature and social research to describe such men as a group. It does not describe any specific kind of sexual activity, and which activities are covered by the term depends on context. An alternative term, males who have sex with males is sometimes considered more accurate in cases where those described may not be legal adults.

<span class="mw-page-title-main">Bareback (sexual act)</span> Sexual penetration without the use of a condom

Bareback sex is physical sexual activity, especially sexual penetration, without the use of a condom. The topic primarily concerns anal sex between men without the use of a condom, and may be distinguished from unprotected sex because bareback sex denotes the deliberate act of forgoing condom use.

Sex and drugs date back to ancient humans and have been interlocked throughout human history. Both legal and illegal, the consumption of drugs and their effects on the human body encompasses all aspects of sex, including desire, performance, pleasure, conception, gestation, and disease.

Comprehensive Sexuality Education (CSE) is a sex education instruction method based on a curriculum that aims to give students the holistic knowledge, attitudes, skills, and values to make healthy and informed choices in their sexual lives. The intention is that this understanding will help students understand their body and reproductive processes, engage in safer sex by reduce incidents of contracting sexually transmitted infections (STIs) such as HIV and HPV, reduce unplanned and unwanted pregnancies, as well as lowering rates of domestic and sexual violence.

Women who have sex with women (WSW) are women who engage in sexual activities with women, whether they identify as straight, lesbian, bisexual, pansexual, have other sexualities, or dispense with sexual identification altogether. The term WSW is often used in medical literature to describe such women as a group for clinical study, without needing to consider sexual self-identity.

<span class="mw-page-title-main">Substance abuse prevention</span> Measures to prevent the consumption of licit and illicit drugs

Substance abuse prevention, also known as drug abuse prevention, is a process that attempts to prevent the onset of substance use or limit the development of problems associated with using psychoactive substances. Prevention efforts may focus on the individual or their surroundings. A concept that is known as "environmental prevention" focuses on changing community conditions or policies so that the availability of substances is reduced as well as the demand. Individual Substance Abuse Prevention, also known as drug abuse prevention involves numerous different sessions depending on the individual to help cease or reduce the use of substances. The time period to help a specific individual can vary based upon many aspects of an individual. The type of Prevention efforts should be based upon the individual's necessities which can also vary. Substance use prevention efforts typically focus on minors and young adults – especially between 12–35 years of age. Substances typically targeted by preventive efforts include alcohol, tobacco, marijuana, inhalants, coke, methamphetamine, steroids, club drugs, and opioids. Community advocacy against substance use is imperative due to the significant increase in opioid overdoses in the United States alone. It has been estimated that about one hundred and thirty individuals continue to lose their lives daily due to opioid overdoses alone.

Adolescent health, or youth health, is the range of approaches to preventing, detecting or treating young people's health and well-being.

<span class="mw-page-title-main">HIV-affected community</span> Medical condition

The affected community is composed of people who are living with HIV and AIDS, plus individuals whose lives are directly influenced by HIV infection. This originally was defined as young to middle aged adults who associate with being gay or bisexual men, and or injection drug users. HIV-affected community is a community that is affected directly or indirectly affected by HIV. These communities are usually influenced by HIV and undertake risky behaviours that lead to a higher chance of HIV infection. To date HIV infection is still one of the leading cause of deaths around the world with an estimate of 36.8 million people diagnosed with HIV by the end of 2017, but there can particular communities that are more vulnerable to HIV infection, these communities include certain races, gender, minorities, and disadvantaged communities. One of the most common communities at risk is the gay community as it is commonly transmitted through unsafe sex. The main factor that contributes to HIV infection within the gay/bisexual community is that gay men do not use protection when performing anal sex or other sexual activities which can lead to a higher risk of HIV infections. Another community will be people diagnosed with mental health issues, such as depression is one of the most common related mental illnesses associated with HIV infection. HIV testing is an essential role in reducing HIV infection within communities as it can lead to prevention and treatment of HIV infections but also helps with early diagnosis of HIV. Educating young people in a community with the knowledge of HIV prevention will be able to help decrease the prevalence within the community. As education is an important source for development in many areas. Research has shown that people more at risk for HIV are part of disenfranchised and inner city populations as drug use and sexually transmitted diseases(STDs) are more prevalent. People with mental illnesses that inhibit making decisions or overlook sexual tendencies are especially at risk for contracting HIV.

HIV prevention refers to practices that aim to prevent the spread of the human immunodeficiency virus (HIV). HIV prevention practices may be undertaken by individuals to protect their own health and the health of those in their community, or may be instituted by governments and community-based organizations as public health policies.

Since reports of emergence and spread of the human immunodeficiency virus (HIV) in the United States between the 1970s and 1980s, the HIV/AIDS epidemic has frequently been linked to gay, bisexual, and other men who have sex with men (MSM) by epidemiologists and medical professionals. It was first noticed after doctors discovered clusters of Kaposi's sarcoma and pneumocystis pneumonia in homosexual men in Los Angeles, New York City, and San Francisco in 1981. The first official report on the virus was published by the Center for Disease Control (CDC) on June 5, 1981, and detailed the cases of five young gay men who were hospitalized with serious infections. A month later, The New York Times reported that 41 homosexuals had been diagnosed with Kaposi's sarcoma, and eight had died less than 24 months after the diagnosis was made.

Wendee M. Wechsberg is an American social science researcher. Wechsberg's research focuses on developing and testing the efficacy of HIV prevention interventions among key populations of substance abusers globally. She is a recognized expert in the fields of substance abuse, gender inequality, and HIV. She developed the Women's CoOp intervention, a woman-focused behavioral HIV intervention that incorporates gender- and culture-specific skills training. Wechsberg is a Principal Researcher and Director of the Substance Use, Gender, and Applied Research (SUGAR) Program at RTI International and Director of the RTI Global Gender Center. She is also adjunct professor at the University of North Carolina at Chapel Hill (UNC) Gillings School of Global Public Health, Adjunct Professor of Psychology at North Carolina State University (NCSU), and adjunct professor in Psychiatry and Behavioral Sciences at Duke University School of Medicine.

Multiple sex partners is the measure and incidence of engaging in sexual activities with two or more people within a specific time period. Sexual activity with MSP can happen simultaneously or serially. MSP includes sexual activity between people of a different gender or the same gender. A person can be said to have multiple sex partners, when the person have sex with more than one person at the same time. Another term, polyamorous, is a behavior and not a measure describing multiple romantically sexually or romantically committed relationships at the same time.

Jeffrey T. Parsons is an American psychologist, researcher, and educator; he was a Distinguished Professor of Psychology at Hunter College and The Graduate Center of the City University of New York (CUNY) and was the Director of Hunter College's Center for HIV/AIDS Educational Studies & Training, which he founded in 1996. Parsons was trained as a developmental psychologist and applied this training to understand health, with a particular emphasis on HIV prevention and treatment. He was known for his research on HIV risk behaviors of gay, bisexual, and other men who have sex with men (GBMSM), HIV-related syndemics, and sexual compulsivity. He resigned his positions at CUNY on July 3, 2019, following a year-long university investigation of misconduct allegations against him. In 2023, the U.S. Attorney's Office announced that he was required to pay a $375,000 settlement for engaging in fraud against the federal government for many years.

Human sexual promiscuity is the practice of having many different sexual partners. In the case of men, this behavior of sexual nondiscrimination and hypersexuality is referred to as satyriasis, while in the case of women, this behavior is conventionally known as nymphomania. Both conditions are regarded as possibly compulsive and pathological qualities, closely related to hyper-sexuality. The results of, or costs associated with, these behaviors are the effects of human sexual promiscuity.

Screening, Brief Intervention and Referral to Treatment (SBIRT) is a model that encourages mental health and substance use screenings as a routine preventive service in healthcare.

Angela Denise Bryan is a social psychologist known for her research on HIV/STD prevention, healthy eating habits, and use of legalized cannabis. She is Professor of Psychology and Neuroscience at the University of Colorado Boulder where she co-directs the Center for Health and Neuroscience, Genes, and Environment.

References

  1. 1 2 3 4 5 Eaton, A.D.; Scheadler, T.R.; Bradley, C.; McInroy, L.B. (September 2023). "Identity development, attraction, and behaviour of heterosexually identified men who have sex with men: scoping review protocol". Systematic Reviews . 12 (184). Springer Nature. doi: 10.1186/s13643-023-02355-6 . ISSN   2046-4053. PMC   10542689 . PMID   37777815. S2CID   263231942.
  2. 1 2 3 4 5 6 7 8 Wang, S.-C.; Maher, B. (December 2019). "Substance Use Disorder, Intravenous Injection, and HIV Infection: A Review". Cell Transplantation. 28 (12). SAGE Journals: 1465–1471. doi: 10.1177/0963689719878380 . ISSN   1555-3892. PMC   6923556 . PMID   31547679. S2CID   202746148.
  3. ↑ Dimbuene, Z.T.; Emina, J.B.; Sankoh, O. (March 2014). "UNAIDS 'multiple sexual partners' core indicator: promoting sexual networks to reduce potential biases". Global Health Action . 7 (1). Taylor & Francis: 23103. doi: 10.3402/gha.v7.23103 . ISSN   1654-9880. PMC   3955766 . PMID   24647127. S2CID   12815577.
  4. 1 2 3 Hall PA (2004). "Risky Adolescent Sexual Behavior: A Psychological Perspective for Primary Care Clinicians". Topics in Advanced Practice Nursing eJournal.
  5. ↑ Fryar CD, Hirsch R, Porter KS, Kottiri B, Brody DJ, Louis T (June 2007). "Drug use and sexual behaviors reported by adults: United States, 1999-2002" (PDF). Advance Data (384). Centers for Disease Control and Prevention, National Center for Health Statistics: 1–14. PMID   17668724 . Retrieved 21 April 2017.
  6. ↑ World Health Organization. Mental Health: Evidence and Research Team (2005). Alcohol Use and Sexual Risk Behaviour: A Cross-Cultural Study in Eight Countries. World Health Organization. hdl:10665/43122 . Retrieved 11 June 2022.
  7. ↑ "High Risk Sexual Behaviour". British Columbia, HealthLinkBC. 27 May 2016. Archived from the original on 21 March 2017. Retrieved 21 April 2017.
  8. ↑ Siegler AJ, Rosenthal EM, Sullivan PS, Christina Mehta C, Moore RH, Ahlschlager L, et al. (December 2019). "Levels of clinical condom failure for anal sex: A randomized cross-over trial". eClinicalMedicine. 17: 100199. doi:10.1016/j.eclinm.2019.10.012. PMC   6933145 . PMID   31891134.
  9. ↑ "Safe Sex". WebMD. Retrieved 26 February 2020.
  10. ↑ Henderson, Elena; Aaron, Sean; Blackhurst, Zachary; Maddock, Meghan; Fincham, Frank; Braithwaite, Scott R. (1 December 2020). "Is Pornography Consumption Related to Risky Behaviors During Friends with Benefits Relationships?". The Journal of Sexual Medicine. 17 (12): 2446–2455. doi:10.1016/j.jsxm.2020.08.017. ISSN   1743-6109.
  11. 1 2 Pandor A, Kaltenthaler E, Higgins A, Lorimer K, Smith S, Wylie K, Wong R (February 2015). "Sexual health risk reduction interventions for people with severe mental illness: a systematic review". BMC Public Health. 15 (1): 138. doi: 10.1186/s12889-015-1448-4 . PMC   4330652 . PMID   25886371.
  12. 1 2 Potter P (2013). Fundamentals of nursing. St. Louis, Mo: Mosby Elsevier. p. 386. ISBN   9780323079334.
  13. ↑ Kann L, McManus T, Harris WA, Shanklin SL, Flint KH, Queen B, et al. (June 2018). "Youth Risk Behavior Surveillance - United States, 2017". MMWR. Surveillance Summaries. 67 (8): 1–114. doi:10.15585/mmwr.ss6708a1. PMC   6002027 . PMID   29902162.
  14. ↑ Lowry R, Holtzman D, Truman BI, Kann L, Collins JL, Kolbe LJ (July 1994). "Substance use and HIV-related sexual behaviors among US high school students: are they related?". American Journal of Public Health. 84 (7): 1116–20. doi:10.2105/AJPH.84.7.1116. PMC   1614756 . PMID   8017535.
  15. ↑ Substance Abuse and Mental Health Services Administration. (2019). Key substance use and mental health indicators in the United States: Results from the 2018 National Survey on Drug Use and Health (HHS Publication No. PEP19-5068, NSDUH Series H-54). Rockville, MD: Center for Behavioral Health Statistics and Quality, Substance Abuse and Mental Health Services Administration. "Home Page | CBHSQ Data". www.samhsa.gov. Retrieved 21 October 2020.{{cite web}}: CS1 maint: multiple names: authors list (link) CS1 maint: numeric names: authors list (link)
  16. ↑ Weinhardt LS, Carey MP (2000). "Does alcohol lead to sexual risk behavior? Findings from event-level research". Annual Review of Sex Research. 11: 125–57. PMC   2426779 . PMID   11351830.
  17. ↑ Heath J, Lanoye A, Maisto SA (April 2012). "The role of alcohol and substance use in risky sexual behavior among older men who have sex with men: a review and critique of the current literature". AIDS and Behavior. 16 (3): 578–89. doi:10.1007/s10461-011-9921-2. PMC   3743230 . PMID   21390534.
  18. ↑ Engstrom M, Winham K, Gilbert L (2016). "Types and Characteristics of Childhood Sexual Abuse: How Do They Matter in HIV Sexual Risk Behaviors Among Women in Methadone Treatment in New York City?". Substance Use & Misuse. 51 (3): 277–94. doi:10.3109/10826084.2015.1058823. PMC   6385865 . PMID   26886405.
  19. ↑ Icard LD, Jemmott JB, Teitelman A, O'Leary A, Heeren GA (February 2014). "Mediation effects of problem drinking and marijuana use on HIV sexual risk behaviors among childhood sexually abused South African heterosexual men". Child Abuse & Neglect. 38 (2): 234–42. doi:10.1016/j.chiabu.2013.08.002. PMC   4075286 . PMID   24041455.
  20. ↑ Mullen PD, Ramírez G, Strouse D, Hedges LV, Sogolow E (July 2002). "Meta-analysis of the effects of behavioral HIV prevention interventions on the sexual risk behavior of sexually experienced adolescents in controlled studies in the United States". Journal of Acquired Immune Deficiency Syndromes. 30 (Suppl 1): S94–S105. doi: 10.1097/00126334-200207011-00009 . PMID   12107363.
  21. 1 2 Johnson BT, Scott-Sheldon LA, Huedo-Medina TB, Carey MP (January 2011). "Interventions to reduce sexual risk for human immunodeficiency virus in adolescents: a meta-analysis of trials, 1985-2008". Archives of Pediatrics & Adolescent Medicine. 165 (1): 77–84. doi:10.1001/archpediatrics.2010.251. PMC   4361805 . PMID   21199984.
  22. ↑ Pedlow CT, Carey MP (April 2003). "HIV sexual risk-reduction interventions for youth: a review and methodological critique of randomized controlled trials". Behavior Modification. 27 (2): 135–90. doi:10.1177/0145445503251562. PMC   2441937 . PMID   12705104.
  23. ↑ Caruthers AS, Van Ryzin MJ, Dishion TJ (February 2014). "Preventing high-risk sexual behavior in early adulthood with family interventions in adolescence: outcomes and developmental processes". Prevention Science. 15 Suppl 1 (S1): S59-69. doi:10.1007/s11121-013-0383-9. PMC   3749294 . PMID   23536124.
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