Inconsistent condom use in young people is related to the perceived barriers to their use. The psychometric properties and factor structure of the new Condom Use Barriers Scale for Adolescents (CUBS-A) are analyzed. Concurrent validity was assessed by the Attitude towards condom use subscale of the validated HIV-AS test and the percentage of condom use variable. A total of 629 Spanish adolescents whose mean age was 15.17 (SD = 1.09; 51.5% boys) participated. Exploratory factor analysis supported a 15–item instrument with four factors: negotiation skills, perceived feelings, negative aspects of condoms, and disruption of the sexual experience, which explained 41.89% of the total variance (KMO = .84; χ2 = 1071.93; p < .001). The results show high internal consistency (α = .86) and a good fit of the data to the model (NNFI = .93; CFI = .95; IFI = .95; RMSEA = .04). Its total score and most of its factors show acceptable correlation with the percentage of condom use, values that support the criterial validity (p ≤ .05). Gender differences were found in most subscales (p ≤ .001). The CUBS-A is a valid and reliable new instrument for assessing perceived barriers in adolescents for using condoms to protect themselves during sexual intercourse.

Differences by ethnic group in STI diagnosis rates have long been recognized in England. We investigated whether these may be explained by ethnic disparities in socioeconomic deprivation (SED). Data on all diagnoses made in sexual health clinics in England in 2013 were obtained from the mandatory STI surveillance system. Poisson regression was used to calculate incidence rate ratios (IRRs) of STIs, by ethnicity, with and without adjustment for index of multiple deprivation (IMD) a measure of area-level deprivation. Unadjusted IRRs (95% confidence intervals) were highest for gonorrhoea [8·18 (7·77–8·61) and 5·76 (5·28–6·29)] and genital herpes [4·24 (3·99–4·51) and 3·58 (3·23–3·98)] for people of black Caribbean and non-Caribbean/non-African black ethnicity and IRRs were highest for syphilis [8·76 (7·97–9·63)] and genital warts [2·23 (2·17–2·29)] for people of non-British/non-Irish white ethnicity compared to white British ethnicity. After adjustment for IMD, IRRs for gonorrhoea [5·76 (5·47–6·07)] and genital herpes [3·73 (3·50–3·97)] declined but remained highest for black Caribbeans and IRRs for syphilis [7·35 (6·68–8·09)] and genital warts [2·10 (2·04–2·16)] declined but remained highest for non-British/non-Irish white compared to white British. In England, ethnic disparities in STI diagnosis rates are partially explained by SED, but behavioural and contextual factors likely contribute. Clinic and community-based interventions should involve social peer networks to ensure they are targeted and culturally sensitive.

In 2009, we examined HIV and sexually transmitted infections (STIs) in 750 female sex workers (FSWs) in Shanghai using a cross-sectional survey. Participants (mean age 27 years) were interviewed and tested for HIV and selected STIs. Prevalence was: HIV 0·13%, chlamydia 14·7%, gonorrhoea 3·5% and syphilis 1·3%. In a demographic multivariate model, younger age, higher income and originating from provinces other than Zhejiang and Shanghai were independently associated with STI. In a social and sexual behavioural model, women working in small venues with fewer clients per week, use of drugs, and higher price charged per sex act indicated a greater risk for STI. Although HIV appears rare in Shanghai FSWs, chlamydial infection is common, especially in women aged <25 years (prevalence 19·6%). Since STI and HIV share similar risk factors, preventive intervention measures should be implemented immediately based on the venues and characteristics of FSWs to prevent future spread of HIV.