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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.

Purpose: This chapter examines the implementation of lesbian, gay, bisexual, transgender, and queer (LGBTQ) health curricula in medical education, focusing on how this content is presented to students to understand if these curricula can fulfill goals of achieving healthcare equity for LGBTQ populations.

Methodology: This research draws on data from six months of participant observation of an academic medical center and school and 28 interviews with medical faculty, students, community members, administrators, and LGBTQ Health Center employees.

Findings: This research has three findings: (1) this medical school has variable definitions for LGBTQ health, making it a hybrid form of knowledge based in (a) understanding the unique health needs of; (b) being culturally competent to; and (c) being a (structural) advocate for LGBTQ patients; (2) LGBTQ health is integrated into multiple courses in the curriculum; and (3) LGBTQ health is becoming a medical specialty frequently delivered to students by LGBTQ health experts.

Research limitations and implications: This research used snowball sampling to recruit participants engaged in LGBTQ health at the institution; it therefore risks self-selection bias. Findings from this study are not generalizable.

Originality: This research argues that LGBTQ health experts engage in a new kind of diversity and inclusion work because (1) these health experts are not always LGBTQ identified; (2) this work is not necessarily unpaid or involuntary; and (3) it involves a hybrid knowledge requiring an understanding of LGBTQ identity, medical knowledge, and social science. Because these LGBTQ health experts opt into this work, and broadly define it, a message available to other physicians and students is that LGBTQ health remains elective.

This study investigates the relationship between being formerly incarcerated and the sexual health of African American and White men. It uses data from the 2011–2013 National Survey of Family Growth to compare the likelihoods of reporting sexually transmitted disease among African American and White men who were formerly incarcerated with those who were never incarcerated. The results show that having been incarcerated increases the likelihood of having sexually transmitted infections (STIs) for both African American men and White men. The results also reveal that, when controlling for sociodemographic and sexual network differences, White men maintain lower infection rates than do comparable African American men regardless of their former incarceration statuses. When several factors are taken into account, the likelihood of infections for African American men who have never been incarcerated are higher than those of White men who have been incarcerated. Racial disadvantage is a key determinant of disparities in STIs between formerly incarcerated White males and never incarcerated African American males. The implications of these results are discussed.

Older adults’ sexual health is becoming an increasingly important component of healthy aging in the wake of the HIV/AIDS epidemic and rising infection rates among this age cohort. The increase in HIV/AIDS diagnoses in the older adult population ignites the need to understand the reasons why older adults are omitted from HIV/AIDS prevention education policy.

This chapter examines the social forces that influence HIV/AIDS policy at the state and community levels. Through qualitative methodology and analysis, including interviews with state policymakers and managers of AIDS service organizations in four Midwestern states (n=31), I look for trends and patterns as to whether or not older adults are considered as an “at-risk” group for HIV infection.

Findings reveal that HIV/AIDS policy may be impacted by enduring sexual scripts about older adults. To some extent both state policymakers and AIDS service organization personnel adhere to stereotypes about older adults’ sexuality and sexual activity, which is then implemented in their health promotion activities. The result is that gaps exist in HIV/AIDS prevention education for older adults, despite the fact that current trends show an increase in new HIV infections and AIDS diagnoses among people over the age of 50.

While this is an exploratory study of the available HIV/AIDS prevention education and health promotion activities for older adults, as well as the viewpoints of state policymakers and AIDS service organization personnel, the findings do indicate the need for additional research on the potentially dangerous sexual behaviors – lack of HIV testing, low condom usage, multiple partners – exhibited by older adults. Future research involving interviews with older adults, physicians, and medical personnel may add new perspectives to the current research.

As the baby boomers continue to age and challenge cultural stereotypes of sexual behaviors among older adults, research in the area of sexual health and HIV/AIDS prevention education will remain an important component of healthy aging. This research begins what will ultimately be a necessary conversation.

The Russian Federation is the scene of one of the fastest-growing HIV epidemics in the world. In dialogue with the scholarship on gendered connections between migration and HIV/STIs, this study employs unique survey and qualitative data to examine HIV/STI-related risks and attitudes among working migrant women from three Central Asian countries and their native counterparts in three Russian cities. The analyses focus on involvement in risky sexual relationships, negotiation of trust and safer sexual practices in permanent partnerships, worries about HIV infection, and experience of HIV testing by comparing natives and migrants as well as migrants of different legal statuses. The results suggest that while migrant women are generally less likely to engage in risky behavior, they are also less able to establish trust and to negotiate safer sex within their permanent partnerships, compared to native women. Migrants are less worried about HIV risks than are native women. Finally, migrant women are less likely to get tested for HIV than natives, but the analyses also point to a particular disadvantage of migrants with temporary or irregular legal status. The findings are interpreted within the structural and cultural constraints that shape migrant women’s lives in Russia and similar migrant-receiving contexts.

The purpose of the study was to analyse approaches to HIV/AIDS education adopted by the Zambian Ministry of Education (MoE), using a holistic approach and focusing on the Zambian culture. This chapter reports on an explorative qualitative study involving focus group discussions and in-depth interviews with Ministry of Education and Health officials, pupils, students, and members of the community. Qualitative analysis was applied and themes from ecological theory were used to organise and discuss data. At the macro level, there was inadequate implementation of HIV/AIDS education in schools, very few handbooks, textbooks and learners’ reading materials, and no discussion of the Zambian cultural (sexual) practices in relation to HIV/AIDS education. Inadequate laws and policies on HIV/AIDS prevention, poverty, unemployment, lack of job creation, and lack of social security were blamed for the lack of positive sexual behaviour changes. Communities had strong theological and metaphysical beliefs including witchcraft and sex with a widow, a menstruating woman or a woman who had an abortion as possible causes of HIV and incurable diseases being a curse from God. At the individual level, the knowledge of HIV/AIDS was high with radio and television being sources of information. Respondents viewed sexual cultures in communities not to have significantly changed. A majority of respondents did not use condoms; most adults continued having multiple sexual partners and women were submissive in marriages. This chapter is useful to policy makers, teachers, pupils/students, and the community, and in understanding interactions and influences of cultures on HIV/AIDS education and government's role in creating an enabling environment to sustain desirable changes.

This paper, and the corresponding project, is motivated by the lack of qualitative research elucidating the voices of young Black women in Canada when it comes to their sexual health.

This paper draws from data produced in the Let’s Talk About Sex (LTAS) project – a Photovoice process held once a week for nine consecutive weeks in the Jane-Finch community, a low-income community in Toronto, Canada. This workshop was completed by 15 young African Caribbean and Black (ACB) women in the age group 14–18. These young women used photography and creative writing to express their opinions on the barriers and facilitators to making healthy sexual decisions.

A central finding was the existence of a subculture among youth in Toronto, where the exchange of sex for material resources was commonplace. Herein, we unpack the various forms of economically motivated relationships reported, which ranged from romantic relationships to sugar daddies and brothel-like sex dens. We also reflect on the discussions at community forums where the research findings were presented. From shock and outrage to a sly smile of knowing, the responses were often gendered, generational and reflective of a trend occurring across Toronto, not just in the Jane-Finch community, and not merely among the Black youth.

Effective interventions and youth programs should focus on the sexually transmitted infection (STI) and HIV risks that may result from transactional relationships, economic empowerment, and youth employment.

This is a novel arts-based study on youth engaged inthe exchange of sex for money, which has nuanced differences from survival sex.

Purpose – To examine and critique the research on HIV/AIDS health disparities among Black Americans.

Methodology – A selective investigation of quantitative research on HIV/AIDS health disparities from the 1980s to the present. Prevalence and incidence of HIV/AIDS in Black American communities and research targeting individual-level behaviors and their outcomes are presented. The impact of racialized discourses related to Black sexuality and its impact on research are discussed. Future policy and practice directions are offered.

Findings – This chapter notes the preponderance of studies at the individual level even in the face of null findings.

Research limitations/implications – This work is not an exhaustive examination of all the studies on HIV racial health disparity.

Practical implications – This chapter contributes to the literature that redirects HIV/AIDS research from focus on individual behaviors in the face of a population-level epidemic.

Social implications – This chapter demonstrates how research goals may be diverted by unacknowledged racialized assumptions.

Originality/value of chapter – This study is one of the few critiques of HIV/AIDS research on Black Americans.

Complex inequalities have shaped the trajectory of the HIV epidemic in South Africa. These include factors related to gender disempowerment, poverty, family disruption and violence – all of which have intensified the risk of HIV infection among the majority of South Africans, contributing to one of the most severe country-level HIV epidemics globally. Neo-liberal economic policies adopted in the post-apartheid period failed to address poverty and burgeoning urban migration – both of which were key factors exacerbating vulnerability to HIV. While there was, ostensibly, a strong commitment to addressing the HIV epidemic by the post-apartheid government, HIV prevalence among pregnant women quadrupled from 7.6% in 1994 to 30.2% in 2005. Contributing to this rise, was a series of missteps by the national Department of Health in the late 1990s, which constrained HIV prevention efforts and stifled HIV treatment. The mid-2000s saw a reprioritisation of the response to the epidemic, with international guidelines supported by biomedical and social research underpinning a rights- and evidence-based response. Multisectoral HIV prevention activities were complemented by high levels of investment in implementing prevention of mother to child HIV transmission and expanding access to antiretroviral therapy (ART) for HIV through the public sector. While these efforts contributed to stabilising the epidemic, stark inequalities in vulnerability and susceptibility to HIV infection continued – in particular, among youth. In this chapter, we draw on a review of the research literature to describe concerns and explore opportunities for a response.