Medical Institute for Sexual Health

The purpose of this review was to examine socioecological risk factors for substance use among sexually and gender diverse (SGD) Latine youth and young adults (YYA). We conducted a Preferred Reporting Items for Systematic Reviews and Meta-Analyses-guided search in PubMed, PsycInfo, Web of Science, and MEDLINE on July 16, 2025. Inclusion criteria were the following: (1) peer-reviewed journal article published on or after January 2014; (2) sample aged between 10 and 29 years old; (3) intersectional analysis of Latine and SGD subsample; (4) analysis for associative or predictive properties of individual-level, interpersonal-level, and/or structural-level risk factors with substance use. Studies that failed to meet all criteria were excluded. The quality of articles was assessed using the Appraisal tool for Cross-Sectional Studies and the Quality of Reporting of Observational Longitudinal Research tool. Twelve studies were included in the final synthesis, the majority being cross-sectional studies (9, 75%) with youth/adolescent samples (8, 67%). Outcomes from reviewed studies indicated that depression and psychological distress were associated with substance use among SGD Latine YYA. In addition, victimization, discrimination, and absence of social support contributed to substance use among SGD Latine YYA. Outcomes from reviewed studies prompt targeted consideration of individual-level mental health and interpersonal-level discrimination and support as it relates to substance use prevention and intervention among SGD Latine YYA. Future research should explore the intersecting cultural influences of being Latine and SGD on substance use and access to mental health and social support resources among SGD Latine YYA.

Objective: Inform the public that receptive anal intercourse (RAI) is a key transmission route of the human immunodeficiency virus (HIV) epidemic in the United States. Method: The role of receptive anal intercourse (RAI) in this epidemic will be examined using the following approach: 1) Risk comparison of HIV transmission via RAI to the other major routes of transmission. 2) HIV transmission risks of RAI using some of the present risk reduction techniques. 3) HIV infection via anal intercourse among male youth. 4) HIV infection via anal intercourse among women. Results: Of the major transmission routes of HIV, receptive anal intercourse has the highest transmission risk for acquiring HIV infection. RAI is 2 times the risk of needle-sharing during injection drug use (IDU) and 17 times the risk of receptive vaginal intercourse. The estimated per act probability of acquiring HIV from an infected source by the exposure route of RAI is high in most circumstances: 1) Condoms alone only partially reduce the high risk of RAI. With the addition of pre-exposure prophylaxis (PrEP), the risk is further reduced. 2) When one or both partners are infected with a sexually transmitted disease (STD), even with condom use, the risks are very high. With the addition of PrEP the risks are reduced, but RAI still carries significant risks. 3) With exposure to acute HIV (high viral load) the risks of RAI are very high and remain significant even with condom use and PrEP. Anal intercourse often begins in adolescence; both genders are at risk. Conclusion: Public knowledge of the high transmission risks of receptive anal intercourse may likely result in a downward trend of new HIV infections and contribute to ending the epidemic.

Condom use is a primary prevention strategy for sexually transmitted infections (STIs). Consistent condom use substantially reduces the risk of HIV infection. Similar levels of effectiveness for reducing the risk of other STIs have not been established. Differences in disease-specific infectivity and the number of exposures to an infected partner may explain differences in condom effectiveness. The goal was to examine the impact of differing infectivities and increasing numbers of exposures on theoretical condom effectiveness. Mathematical modeling using estimated disease-specific infectivities and condom failure rates. Condom effectiveness decreases as disease-specific infectivity and the number of exposures to infection risk increase. Condom effectiveness for decreasing STI risk is influenced by disease infectivity and the number of exposures. Generalizations from studies of relatively uninfectious STIs to highly infectious STIs or from short-term studies to longer-term situations will overestimate condom effectiveness.