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Older males having sex with younger females is known to increase unsafe sex practices, exacerbated by power and economic imbalances between partners. The purpose of this paper is to examine transactional sexual relationships (i.e. long-term relationships constructed as “girlfriends not ‘prostitutes’” based on the exchange of gifts and other obligations) among female students of University of Cape Coast, Ghana. It particularly explores the implications for HIV education in institutions of higher learning. HIV/AIDS has been labelled as a disease of the poor and the uneducated, and it might be expected university students would engage in safer sexual practices: if they do not it highlights the problem around gender and economic imbalances and their repercussions even more clearly.

Using snowballing, 40 university-educated female students engaged in transactional sex were interviewed using unstructured interview. The data were analysed thematically.

These young women were not simple victims, these relationships were the result of complex and conscious choices. They did not want to marry their partners and were clear that these were short-term relationships primarily for material gain, which they nevertheless kept secret from family and most friends for fear of stigma, particularly in blighting their future marriage prospects. They protected themselves from emotional involvement, although they often saw their partners as loving, taking the provision of gifts as a sign of affection and sometimes a replacement for parental love. Their motivation was primarily economic, to fulfil “wants” not survival “needs” – the relationships enabled them to purchase the trappings of affluent society such as clothes, hairstyles, fast food and gadgets. They were also motivated by the enhanced experiences these relationships allowed, such as feeling protected, respected, “high class”, part of a daring elite of women and being able to travel and continue their education. The unequal nature of the relationships (often described as “father-daughter”) in a society in which parents, older people and men are given unquestioning respect, reduced their abilities to negotiate safe sex practices. In so far as they practiced safer sex it was to avoid pregnancy rather than disease, believing they would be able to tell from physical signs if their partner was infected.

This study shows that the “privileged” status’ that higher education offers is no match for the socioeconomic and cultural factors which make female youths, whatever their educational background, compromise on safer sexual practices, rendering them vulnerable to STIs and particularly, HIV infection. It is also clear that students in higher education are nevertheless ignorant about the risk and invisible nature of sexually transmitted disease. Institutions of higher education need to do more to provide robust sex and relationship educational interventions for their students and faculty about HIV/AIDS, which take into account the complex and socially situated decisions that surround sexual relationships.

Most of the work on transactional sexual relationships has come from South Africa – this is the first study in a Ghanaian context and of educated young women.

With almost half of college undergraduates engaging in friends with benefits relationships (FWBRs), the current study sought to explore the sexual decision making strategies and potential physical and psychological health outcomes behind these relationships.

Using self-report measures, Study 1 asked 207 undergraduates to rate the importance of motivations, maintenance rules, and future outcomes of FWBRs in their own personal experience and for other men and women. Study 2 sampled 142 undergraduate women who were asked to indicate the percentage of time they engaged in sexual behavior under the influence of alcohol or marijuana and the frequency with which they used safe sex practices in an FWBR.

Both genders appeared equally motivated to begin an FWBR; however women reported establishing permanence rules and avoiding over-attachment in the relationship as significantly more important than men. Men were more likely to prefer that the FWBR remain unchanged, however both genders agreed that a transition to a committed relationship was unlikely. Alcohol use was not significantly more prevalent in an FWBR, nor was the likelihood of practicing safe sex.

Both studies employed the use of self-report surveys from a single university and were subject to social desirability.

Quantitatively examining young adults’ reasoning behind choosing to engage in FWBRs provided insight into their overarching fear of “being hurt” and their preference for “easy access” to sexual experiences. These trends may suggest a shift in dating patterns and a preference for avoiding the emotional complexities of a committed, monogamous relationship.

Sexual education in adolescence may represent the only formal sexual information individuals ever receive. It is unclear whether this early educational experience is sufficient to promote lifelong sexual health literacy. The purpose of this paper is to examine the influence of the timing and source of sexual knowledge on current safe sex knowledge and risky sexual behaviours among middle-aged and older adults in the USA.

Participants (n=410, mean age=53.9, 50.7 per cent female) reported whether and when they received sexual knowledge from various sources. They were asked about their current safe sex knowledge and their lifetime sexual risk behaviours.

Most of the participants (61.5 per cent) received formal sexual education in adolescence and 20.2 per cent reported formal sexual education post-adolescence. Across the life span, friends were the most common source of sexual information. The sample scored in the upper mid-range on the scale indexing safe sex knowledge (M=6.69, SD=1.64, range=0-8). Participants reported engaging in an average of approximately four (out of 16) risky sexual behaviours across their lifetime. Those with formal sex education in adolescence scored significantly higher on safe sex knowledge. However, they also engaged in more risky sex behaviours.

This study is among the first to situate the normative, formal sexual education experience of adolescence within a life span context that not only accounts for time, but also multiple sources of influence. It would appear that there are more things to learn about the long-term influence of sexual education programmes during the formative years by studying adult sexual health and knowledge.

To date, there is a gap in the literature exploring the perceptions and experiences of law enforcement regarding enforcement of online and offline prostitution. The purpose of this paper is to investigate the perceptions of law enforcement in the USA regarding the safety and mobility of individuals who prostitute online compared to those who sell sexual services offline. The next section will explain the methodology of the exploratory study, including the method of original data collection.

All police departments in the USA located in a jurisdiction of 50,000 people or more were requested participation in the study (n=689). Respondents were sent an initial mailing of a cover letter and survey, followed by an e-mail reminder and a second mailing of a cover letter and survey. Individual respondents were asked questions about their own perceptions of behaviors and lifestyles of offline vs online prostitutes.

The majority of law enforcement respondents did not feel as if online prostitutes were safer compared to offline prostitutes. However, the majority of respondents did believe that online prostitutes are afforded a better lifestyle and are more mobile.

The majority of the respondents were from the Northeast and Southwest may mean that their perceptions could be different from those that are not located within either region. In addition, since almost 80 percent of the agencies were in a jurisdiction with a population between 50,000 and 249,000, this too may have influenced their perceptions. Law enforcement in a smaller or larger area may have felt differently or have had different experiences to report.

This study is very unique as to date, another study with the same methodology and question content was not found.

Describes the development of teaching materials on sex education for young people which would enable them to become so familiar with the vocabulary of sex and sexuality that it would no longer cause them embarrassment or shyness. The aim of the materials is to empower young people to negotiate the kind of sex, including safe sex, that they want, and to be able to discuss sex openly with others. Summarizes a variety of exercises, including a statements game that helps to demonstrate the differing needs, wants, views, expectations and conditioning of the two sexes. Describes a “condom creativity” exercise designed to get young people used to the sight, smell and feel of condoms in order to reduce embarrassment by making things out of condoms. Outlines how to play the Hang‐up Game which encourages discussion on issues relevant to the age group taking part, and the use of sexual vocabulary.

Since the first case of AIDS was reported in 1986, several HIV/AIDS intervention program operates at the national and regional level in India, to control the spread of this epidemic. The purpose of this paper is to evaluate one intervention program in a major city of India – Kolkata that targets specifically the commercial sex-workers challenged with socio-economic-health disparities. This intervention program called the Durbar Mahila Samanwaya Committee (DMSC) is located in the Sonagachi area and nicknamed as the “Sonagachi Project.”

The behavioral change of about 500 sex-workers participating in the survey was studied in 2005. The data were collected from the focus groups of the sex-workers; official records and DMSC officials were also interviewed to collect data. The “short-term” outcome and the “long-term” impact of the program were compared with a baseline survey conducted in 1992 by another study.

Participants experienced increased awareness of the disease, increased literacy rate and increased social and economical empowerment. The incidence of HIV/AIDS has gone down significantly among this high-risk group due to safe-sex practice.

This community-based organization adopts a unique method of engaging the sex-workers as peer educators to train other sex-workers about safe-sex practices and has become the role model for sex-workers in other parts of the world to fight socio-economic-health disparities.

This research was conducted by directly contacting the program directors and members of the Sonagachi project and in that sense is first hand information. It gives valuable insights into the struggles these sex-workers had to go through to gain social and economic empowerment.

Sexual health promotion aimed at men who have sex with men (MSM) is not achieving its objective of reducing the incidence of new infections of sexually transmitted diseases, notably HIV/AIDS, in the MSM population. The paper aims to raise awareness of possible unintended consequences when using visual culture and advertising techniques in the field of sexual (and other) health promotion and public health messages.

Using critical textual analysis and drawing on visual culture methodology the approach is to critique current practice and suggest alternative ways to approach gay men's sexual health which are not predicated on a “model” gay man.

Men who have sex with men (MSM) are constructed through sexual health promotion (SHP) literature as young, hedonistic and irrational which may serve to distance the very audience it seeks to attract and address. What may at first appear to be a targeted and helpful initiative to raise awareness may inadvertently have the simultaneous and unanticipated effect of “selling” unsafe sex rather than promoting safe sex. This is because, first, the use of sexual imagery designed to attract attention works in unanticipated ways. Second, MSM are constructed through the images and language used in ways that may be at best unhelpful and potentially quite harmful.

There are many different approaches and interventions in this field and the criticisms here may not be applicable to many of the other sources of health promotion awareness campaigns. Future research could certainly be conducted in other fields of health promotion and public health issues such as obesity, drug and alcohol abuse and smoking cessation.

Health promotion practice should beware of depicting their audience in stereotypical ways. MSM could be constructed far more positively as role models to be followed instead of bad examples to be avoided.

The methodology is new to this field and the findings provide an original basis for criticism of advertising techniques which have until now formed the basis of this type of public awareness‐raising.

This project examines how queer and trans zines have complicated the notion of traditional patient narratives and provides insight into the issues that LGBTQ+ (lesbian, gay, bisexual, transgender, queer/questioning) populations face when accessing healthcare information and resources. Historically, information about queer and trans identities has been suppressed in the United States, reflecting dominant social values that pathologize queer identities. Using health-related zines housed at the Queer Zine Archive Project as a case study, this project investigates how queer and trans zines about healthcare have resisted these homophobic and transphobic ideologies. The analysis reveals that queer and trans zinesters use their feelings of impatience with the medical industry to fuel communal solutions to accessing and providing health care information.

The purpose of this paper is to examine a national sexual health and relationships education (SHARE) educational package for behaviour change techniques (BCTs) utilised in order to make recommendations for further improvements.

Using BCTs taxonomy (BCT V1), two coders independently examined the 22 session plans within SHARE for their utilisation of BCTs. All three authors then examined the results, and agreed on any discrepancies.

The SHARE package utilises only a small range of BCTs detailed in BCT V1. SHARE makes use of a range of techniques which may impact on the distal factors that influence sexual risk taking, such as self-esteem and building confidence to say “no” to sex.

SHARE – and perhaps other sexual health education programmes – may need to draw on more BCTs, particularly those supported by evidence, in order to effectively reduce risky sexual behaviours among young people. Programmes may also benefit from including broader elements around pleasure, self-examination and screening behaviour.

Sexual health packages rarely encounter such scrutiny, particularly being examined in relation to the BCTs. The new and rigorous way of rating the SHARE package has enabled a range of recommendations relating to BCTs to be made both for improving the package and other sexual health education programmes.

Radical feminists position any forms of sex work as gender violence against individuals and more broadly for all women in society. I argue against the ideological stance that sex work is inherently violent and as a result should be outlawed, setting out how this ideology and dogma has allowed structural factors to persist. In this paper, I argue that despite the unacceptable high levels of violence against sex workers across the globe, violence in sex work is not inevitable. Through a review of the literature as well as drawing on research from the United Kingdom, I deconstruct the myth of inevitable violence. In turn I argue that violence is dependent on three dynamics. First, environment: spaces in which sex work happens has an intrinsic bearing on the safety of those who work there. Second, the relationship to the state: how prostitution is governed in any one jurisdiction and the treatment of violence against sex workers by the police and judicial system dictates the very organization of the sex industry and the regulation, health and safety of the sex work communities. Third, I argue that social status and stigma have significant effects on societal attitudes toward sex workers and how they are treated. It is because of these interlocking structural, cultural, legal, and social dynamics that violence exists and therefore it is these exact dynamics that hold the solutions to preventing violence against sex workers. Toward the end of the paper, I examine the UK’s “Merseyside model” whereby police treat violence against sex workers as a hate crime. It is in these examples of innovative practice despite a national and international criminalization agenda against sex workers, that human rights against a sexual minority group can be upheld.