Purpose: Obtaining affirmative consent, a hallmark of sexual violence prevention education on college campuses, may influence sexual communication and behaviors such as condom use. This study examined the relationship between self-efficacy to obtain sexual consent with sexual health communication and behaviors among a sample of U.S. college students. Methods: Data were from 2,291 students enrolled in a cluster-randomized controlled trial conducted on 28 college campuses from 2015-2017. Students reported their self-efficacy to obtain sexual consent, communication about sexual health, and sexual health behaviors. Multivariable logistic regression, adjusted for school clustering, history of violence victimization, and STI history, estimated odds ratios (OR) and 95% confidence intervals (CI) for sexual consent self-efficacy and sexual health communication. Results: Females (n=1150) reported higher self-efficacy to obtain consent than males (b1=0.32, CI 95% 0.23, 0.41), but lower odds of communication about condom use (AOR 0.75, CI 95% 0.60, 0.96) and HIV prevention (AOR 0.63, CI 95% 0.48, 0.81). Black and other race students reported higher odds of HIV/STI prevention communication compared to White students. Odds of consistent condom use were highest among students reporting condom use communication and high self-efficacy to obtain sexual consent (AOR 1.99, CI 95% 1.58, 2.51). Conclusion: Campus sexual assault prevention education that focuses narrowly on obtaining sexual consent may be missing an opportunity to enhance sexual health communication broadly, including condom and contraceptive use discussion to promote overall sexual health.

<h4>Background</h4>Men who have sex with men (MSM) and transgender women experience high sexually transmitted infection (STI) rates. This study evaluated the feasibility of doxycycline pre-exposure prophylaxis (doxyPrEP) for STI prevention in these key populations.<h4>Methods</h4>Sexually-active MSM and transgender women without human immunodeficiency virus (HIV) with prior syphilis were recruited. Participants initiated HIV PrEP with tenofovir disoproxil fumarate/emtricitabine (TDF/FTC) daily for 48 weeks and were randomized 1:1 to daily doxyPrEP for 48 weeks (immediate arm), or doxyPrEP initiated at 24 weeks (deferred arm). Primary outcomes included adherence, measured using questionnaires, along with tolerability; STI incidence (chlamydia, gonorrhea, syphilis) was a secondary outcome. Nasal carriage of Staphylococccus aureus was assessed serially for doxycycline resistance.<h4>Results</h4>Fifty-two participants were enrolled into the immediate (n = 26) and deferred (n = 26) arms. At 48 weeks, self-reported adherence (≥95%) was 75.0% versus 66.7% (P = .538) for TDF/FTC, and 70.8% versus 61.9% (P = .526) for doxycycline in the immediate versus deferred arms, respectively. No doxyPrEP-related serious adverse events occurred. Incidence of any STI at 24 weeks was reduced in the immediate versus deferred arms, and over 48 weeks, being on doxycycline (vs being off; ie, first 24 weeks of deferred arm) was associated with STI reduction (adjusted odds ratio [aOR] 0.36; 95% confidence interval [CI]: .15-.89). Emergent doxycycline-resistant S. aureus was identified in six individuals, with five in the immediate arm (P = .077).<h4>Conclusions</h4>Dual HIV/doxyPrEP is feasible and associated with a significant reduction in incident STI. Further evaluation of dosing strategies, efficacy and impact on antimicrobial resistance is warranted.

Primary Prevention Methods Skip directly to site content Skip directly to search Español | Other Languages An official website of the United States government Here's how you know Official websites use .gov A .gov website belongs to an official government organization in the United States. Secure .gov websites use HTTPS A lock ( ) or https:// means you've safely connected to the .gov website. Share sensitive information only on official, secure websites. Primary Prevention Methods Print Related Pages On This Page Pre-exposure Vaccination Condoms Cervical Diaphragms Multipurpose Prevention Technologies Topical Microbicides and Spermicides Nonbarrier Contraception, Female Surgical Sterilization, and Hysterectomy Emergency Contraception Male Circumcision Pre-exposure Prophylaxis for HIV Pre-exposure Prophylaxis for STIs Postexposure Prophylaxis for HIV and STIs Doxy PEP as an STI Prevention Strategy HIV Treatment as Prevention HIV Seroadaptive Strategies Abstinence and Reduction of Number of Sex Partners Pre-exposure Vaccination Pre-exposure vaccination is one of the most effective methods for preventing transmission of HPV, HAV, and HBV, all of which can be sexually transmitted. HPV vaccination is recommended routinely for males and females aged 11 or 12 years and can be administered beginning at age 9 years. HPV vaccination is recommended through age 26 years for those not previously vaccinated ( 11 ). Sharing clinical decision-making about HPV vaccination is recommended for certain adults aged 27&ndash;45 years who are not adequately vaccinated in accordance with existing guidance ( https://www.cdc.gov/vaccines/hcp/acip-recs/vacc-specific/hpv.html ). Hepatitis B vaccination is recommended for all unvaccinated, uninfected persons who are sexually active with more than one partner or are being evaluated or treated for an STI ( 12 ). In addition, hepatitis A and B vaccines are recommended for MSM, persons who inject drugs, persons with chronic liver disease, and persons