Evaluation of a behavior-centered design strategy for creating demand for oral PrEP among young women in Cape Town, South Africa

Background: There is an urgent need to find effective interventions that reduce young South African women’s vulnerability to HIV, and pre-exposure prophylaxis (PrEP) is highly effective when taken consistently. As national programs in Africa launch PrEP programs for young women, it is critical to understand how to effectively create awareness, stimulate interest, and increase uptake of PrEP. Methods: Behavior-centered design (BCD) guided the development of a PrEP social marketing campaign for young women. Ethnographic observations, in-depth interviews, and focus-group discussions with young South African women informed the content and design of a 90-second PrEP demand creation video and two informational brochures. A short survey was administered to young women at their homes after watching a video to evaluate PrEP interest. Of 800 households with a 16-25-year-old female identified from a Cape Town township census, 320 women in these households viewed the video and completed a survey about the video and their interest in PrEP. Results: In focus groups, young women from the township preferred local characters and messaging that was empowering, simple, and motivational. From the household survey of young women who viewed the video, most reported interest in learning more about PrEP (67.7% ‘definitely interested’ and 9.4% ‘somewhat interested’) and taking PrEP (56.4% ‘definitely interested’ and 12.5% ‘somewhat interested’). Factors significantly associated with interest in taking PrEP were having a primary partner with whom they regularly have sex (80.0% vs. 65.2% without a primary partner; adjusted odds ratio (AOR)=3.1, 95% CI: 1.3, 7.0) and being in a sexual partnership for <6 months (86.8% vs. 68.5% for >12 months; AOR=3.0, 95% CI: 1.2, 7.3). Conclusions: A positively framed PrEP demand creation video generated high interest in PrEP among young South African women, particularly among women with a primary partner and a shorter-term relationship. Registration: NCT03142256; registered on 5 May 2017.

A Prospective Investigation of the Decision to Open Up a Romantic Relationship

Consensual nonmonogamy (CNM) is an increasingly popular relationship option and a burgeoning topic within relationship science. However, retrospective designs have limited our ability to draw conclusions about the consequences of opening up a romantic relationship to other partners. In a longitudinal study, 233 individuals who were planning to engage in CNM, but who had not done so yet, were tracked over 2 months. We compared participants’ relational, sexual, and personal well-being before versus after opening up and between participants who did ( n = 155) versus did not ( n = 78) open up their relationships over the course of the study. Those who engaged in CNM experienced significant increases in sexual satisfaction, particularly if they did so with the explicit goal of addressing sexual incompatibilities within their relationships. We found no evidence that engaging in CNM impacted either life satisfaction or relationship quality with the primary partner.

Evaluation of a behavior-centered design strategy for creating demand for oral PrEP among young women in Cape Town, South Africa

Background: There is an urgent need to find effective interventions that reduce young South African women’s vulnerability to HIV, and pre-exposure prophylaxis (PrEP) is highly effective when taken consistently. As national programs in Africa launch PrEP programs for young women, it is critical to understand how to effectively create awareness, stimulate interest, and increase uptake of PrEP. Methods: Behavior-centered design (BCD) guided the development of a PrEP social marketing campaign for young women. Ethnographic observations, in-depth interviews, and focus-group discussions with young South African women informed the content and design of a 90-second PrEP demand creation video and two informational brochures. A short survey was administered to young women at their homes after watching a video to evaluate PrEP interest. Of 800 households with a 16-25-year-old female identified from a Cape Town township census, 320 women in these households viewed the video and completed a survey about the video and their interest in PrEP. Results: In focus groups, young women from the township preferred local characters and messaging that was empowering, simple, and motivational. From the household survey of young women who viewed the video, most reported interest in learning more about PrEP (67.7% ‘definitely interested’ and 9.4% ‘somewhat interested’) and taking PrEP (56.4% ‘definitely interested’ and 12.5% ‘somewhat interested’). Factors significantly associated with interest in taking PrEP were having a primary partner with whom they regularly have sex (80.0% vs. 65.2% without a primary partner; adjusted odds ratio (AOR)=3.1, 95% CI: 1.3, 7.0) and being in a sexual partnership for <6 months (86.8% vs. 68.5% for >12 months; AOR=3.0, 95% CI: 1.2, 7.3). Conclusions: A positively framed PrEP demand creation video generated high interest in PrEP among young South African women, particularly among women with a primary partner and a shorter-term relationship. Registration: NCT03142256; registered on 5 May 2017.

A Prospective Investigation of the Decision to Open Up a Romantic Relationship

Consensual non-monogamy (CNM) is an increasingly popular relationship option, and a burgeoning topic within relationship science. However, retrospective designs have limited our ability to draw conclusions about the consequences of opening up a romantic relationship to other partners. In a longitudinal study, 233 individuals who were planning to engage in CNM but who had not done so yet were tracked over two months. We compared participants’ relational, sexual, and personal wellbeing before versus after opening up, as well as between participants who did (n = 155) versus did not (n = 78) open up their relationships over the course of the study. Those who engaged in CNM experienced significant increases in sexual satisfaction, particularly if they did so with the explicit goal of addressing sexual incompatibilities within their relationships. We found no evidence that engaging in CNM impacted either life satisfaction or relationship quality with the primary partner.

Waterfront Toronto: Privacy or Piracy?

Toronto's Portlands neighborhood is the target of an enormous redevelopment effort that will infuse smart-city technologies into the urban morphology. The quasi-governmental Waterfront Toronto agency has partnered with the Alphabet subsidiary company Sidewalk Labs to plan and build out the neighborhood, essentially from the ground up, and embedded it with sophisticated technologies. The redevelopment plan details a digital layer made up of sensors that will collect and process locational information, tracking movement and usage patterns. Yet the project has been mired in controversy, mainly because of questions about data ownership and management. While there will be the amassing of an unfathomable amount of data, it is not clear who will control it and how it will be processed and used. Critics of the project have pointed out that the potential value of the data is enormous and if a private company has exclusive domain over it, that company could decide to sell it at will. Securely storing citizen’s data is another problem. This paper provides a description of the popular newspaper accounts of the Waterfront Toronto Project. It discusses how the project and redevelopment authority came to be, how Alphabet be-came the primary partner, the redevelopment vision, and controversy that has engulfed this smart-city project.

Eroticism Versus Nurturance

Romantic partners provide both erotic and nurturing experiences, though these may emerge more strongly in different phases of a relationship. Unlike individuals in monogamous relationships, those in polyamorous relationships can pursue multiple romantic relationships simultaneously, potentially allowing them to experience higher levels of eroticism and nurturance. This research examined eroticism and nurturance among individuals in polyamorous and monogamous relationships. As expected, polyamorous participants experienced less eroticism but more nurturance in their relationships with their primary partner compared to secondary. Furthermore, people in polyamorous relationships reported more nurturance with primary partners and eroticism with secondary partners compared to people in monogamous relationships. These findings suggest that polyamory may provide a unique opportunity for individuals to experience both eroticism and nurturance simultaneously.

Eroticism versus Nurturance: How Eroticism and Nurturance Differs in Polyamorous and Monogamous Relationships

Romantic partners provide both erotic and nurturing experiences, though these may emerge more strongly in different phases of a relationship. Unlike individuals in monogamous relationships, those in polyamorous relationships can pursue multiple romantic relationships simultaneously, potentially allowing them to experience higher levels of eroticism and nurturance. This research examined eroticism and nurturance among individuals in polyamorous and monogamous relationships. As expected, polyamorous participants experienced less eroticism but more nurturance in their relationships with their primary partner compared to secondary. Furthermore, people in polyamorous relationships reported more nurturance with primary partners and eroticism with secondary partners compared to people in monogamous relationships. These findings suggest that polyamory may provide a unique opportunity for individuals to experience both eroticism and nurturance simultaneously.Keywords: polyamory; monogamy; nurturance; eroticism; relationship length

Alcohol Use and Experiences of Partner Violence Among Female Sex Workers in Coastal Andhra Pradesh, India

This cross-sectional study describes the prevalence and context of violence by sexual partners against female sex workers (FSWs, N = 589) in Andhra Pradesh and its association with alcohol use by FSWs and abusive partners. In all, 84% of FSWs reported alcohol use; 65% reported lifetime physical abuse by a sexual partner. Most abused women suffered abuse from multiple partners, often triggered by inebriation or FSW’s defiance. In multivariate logistic regressions, frequency of FSW’s alcohol use was associated with abuse by clients and primary partner, whereas partner’s alcohol use was only significant for abuse by primary partner, not clients.