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Kevin Hart has addressed escalating concerns over a long history of hate speech and приведенная ссылка jokes about the LGBTQ community on social media, resurfaced in national news after he was named host of the Oscars on Thursday. Dating as far back asthe tweets seemed to bubble furiously to the top of timelines across the web when industry types and film fans connected that Hart would take the stage for an annual event sacred to American women and gay men, as well as cinephiles and show business brass. It was also not lost on many that this year could see a number of LGBT-themed films sweep nominations. GLAAD, a media watchdog that protects and promotes dignified representation of queer people, reached out to Rhem, the film academy and ABC, which airs the telecast. Nor did Hart, though his Instagram post came late on Thursday.


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People meet new sex partners at bars and other places where alcohol is served, and drinking venues facilitate STI transmission through sexual relationships within closely knit sexual networks. This paper reviews HIV prevention interventions conducted in bars, taverns, and informal drinking venues.

Trannh designed to reduce HIV risk by altering the social interactions within drinking environments have demonstrated mixed results. Specifically, venue-based social influence models have reduced community-level risk in Vidd. Few interventions have sought to alter the structural and physical environments of drinking places for HIV prevention. Uncontrolled program evaluations have reported promising approaches to bar-based structural interventions with gay men and female sex workers.

Finally, a small number of studies have examined multilevel approaches that simultaneously intervene at both social vod structural levels with encouraging results. Multilevel interventions that take environmental factors into account are needed to guide future HIV prevention efforts delivered within alcohol-serving establishments.

Associations between alcohol use and sexual risks are observed regardless of whether alcohol use is measured in terms of global patterns of drinking, or within situations where drinking occurs, or at the level of sexual events Weinhardt and Carey Alcohol elevates sexual risks through multiple channels, including the psychological effects of intoxication on decisionmaking, inhibition of protective actions, interactions between drinking and risk-taking personality characteristics, and perceived expectations regarding the effects of alcohol use on risk-taking and sexual experiences Cook and Clark The association between drinking and sexual risk behaviors has led to interventions that seek to reduce both alcohol use and sexually risky behaviors Palepu et al.

For example, an HIV risk reduction intervention for inner-city African-American men reduced alcohol use in sexual contexts by 85 percent from baseline Kalichman et al. In a similar study of one-on-one risk reduction counseling in South Africa, researchers reported a 59 percent reduction in alcohol use in sexual contexts 3 months following the intervention Kalichman et al.

However, the intervention effects on sex-related alcohol use decreased within 6 months to a 43 percent reduction from baseline. This short-lived effect is likely the result of individuals returning to unchanged high-risk environments that support risk-related alcohol use Kincaidsuggesting the need for interventions to alter risk factors within alcohol-serving environments.

This article examines the alcohol-serving venues that intersect with HIV transmission risks and offer potential environments for HIV prevention. Venues of Youjg interest are those that sell alcohol for onsite consumption and serve as a point of social interaction. Multiple types of drinking establishments fit these criteria across cultures, including neighborhood bars, dance clubs, karaoke bars, taverns, wine shops, and informal lounges.

Therefore, this article does not fid interventions that target drinkers or those that are delivered outside of drinking places. The outcomes from completed venue-based intervention trials point to gaps in the existing literature and suggest future directions for HIV prevention efforts based in thhem venues. The contextual factors within which alcohol Futanari hentai sexual behaviors intersect are critical to our understanding of how alcohol influences HIV risks.

The environments of drinking establishments are multifaceted and serve multiple functions, including being a place for recreation, fostering socially sanctioned drinking, facilitating social relationships, and providing opportunities taje meet sex partners.

The subsequent sections review selected studies that tyem sexual risks for HIV incurred within drinking places. These studies are summarized in Table 1. Early studies of HIV risks Young boy and tranny gay sex vid full length I had them take a seat alcohol-serving establishments were focused on gay bars, primarily in the United States and Europe.

Across studies, approximately one in three men Yong have sex with men sampled from gay bars and clubs reported engaging in unprotected anal intercourse, the highest risk behavior for HIV transmission. Nardone and colleaguesfor example, found that one-third of men who go to gay bars in London and Edinburgh engaged in unprotected anal sex, and only half of the men had been tested for HIV.

A study in California showed that one in three men who visit gay clubs and bars reported five or more sex partners in the past year Xia et al. Another study showed that men who meet sex partners at gay bars may not differ significantly from men who meet partners at other open gay venues, such as bathhouses, private sex parties, gyms, and the Internet Grov et al.

Although behaviors across gay community venues may not differ, the prevalence of disease does vary. In China, for example, HIV 0. From an HIV prevention perspective, gay bars may therefore be primarily social venues where домена Nami futanari 3D SFM one piece очень partners meet and drinking may merely be a contextual rather than causal factor. Commercial sex workers represent a risk population that also is frequently accessed in drinking places.

Female sex workers in Malawi, for example, who drink and contract a sexually transmitted infection STI are less likely to use condoms than their counterparts who also contract STIs but do not drink Zachariah et al.

Women who socialize in drinking places, whether involved in sex work or not, demonstrate a high risk for HIV infection Kapiga et al. Meeting sex partners in drinking places increases the likelihood of sex after drinking and reduces condom use Mataure et al.

Sex partners often meet at informal alcohol-serving establishments that are common throughout southern Yhem, such as private homes where alcoholic beverages Youn sold and served Morojele et al. For example, one study Kalichman et al.

People who meet sex partners in drinking venues report greater numbers of recent sex partners and higher rates of unprotected intercourse compared with people who did not meet partners in drinking places. These patterns of risk create urgency for HIV prevention in drinking venues.

Using a well-developed system for rapid community assessments, Weir and colleagues mapped the linkages among places where people meet new sex partners and places where people drink alcohol. For example, in Zimbabwe, 47 percent of women ages 15—19 years surveyed at night clubs and other drinking places had two or more sex partners in a 1-year period compared with less than 5 percent of young women surveyed outside of drinking places Singh et al.

In South Africa, more than 85 percent of the places where people meet sex partners are traanny venues Weir et al. The overlap between drinking places and venues where people meet sex partners was observed in both urban and rural areas. Across three cities in South Africa, between 78 percent and 87 percent yhem new sex partners met at shebeens.

As many as half of the people who drink at shebeens report having had two or more sex partners in the previous 2 weeks, and more than half of men and one in five women who have met partners in shebeens have had sex on the premises Kalichman et al.

Not surprisingly, informal alcohol-serving establishments rarely display HIV prevention messages or have condoms available for their customers Figueroa et al. In Ugandan villages, for example, only 4 percent of people hda in homes that serve alcohol, but the HIV prevalence in these homes is 15 percent, nearly double that of the surrounding community Mbulaiteye et al. HIV risks also are observed in larger drinking Young boy and tranny gay sex vid full length I had them take a seat, such as taverns and beer halls.

Basset and colleagues reported that the HIV prevalence in Zimbabwean beer halls i. For example, 60 percent of men and 40 percent of women who have multiple sex partners in Zimbabwe drink at beer halls Lewis et al. Fritz and colleagues found similar behaviors in these venues and showed that HIV prevalence increases with greater frequency of drinking at beer halls.

Employees as well as patrons of alcohol-serving establishments are at higher risk for HIV infection. For example, men who work in Tanzanian bars and hotels who drink at least once a week are significantly more likely to have herpes simplex virus infection, a known marker for HIV transmission risk, than other men surveyed at the same places who do not drink Kapiga et al. Women working in food and recreational businesses near southern-African gold mines who drink are significantly more likely to have HIV infection than other women who drink in the communities that surround sseat mines but do not work in drinking venues Clift et al.

HIV can rapidly spread within drinking venues that have tightly knit social and sexual networks which foster overlapping sexual mixing patterns. Alcohol- serving establishments amplify HIV transmission risks by providing a place where sex encounters occur with rapid turnover of partners Fritz et al. Alcohol establishments are often themselves sex venues, where back rooms, back corners, and больше на странице buildings or shacks offer locations for tke Morojele et al.

Beyond the social interactions that naturally occur in drinking places, the use of alcohol itself and its association with sexual risk behaviors makes these environments compelling venues for HIV risk reduction.

The social and physical structures of alcohol drinking places therefore create opportunities for community-based HIV prevention interventions. A review of the literature on HIV interventions delivered within alcohol-serving establishments yielded studies including randomized trials, quasi-experimental studies i. For the most part, the target Young boy and tranny gay sex vid full length I had them take a seat were consistent with the HIV risk populations of the countries.

Specifically, gay bars were targeted in the United States and United Kingdom, whereas female sex workers were the focus in Asia, and in Africa the target has been drinking places that serve local communities within generalized HIV epidemics.

The interventions are characterized by their 1 targeting social interactions, 2 changing structural and environmental features, and 3 targeting both social and structural levels. The majority of alcohol venue—based interventions target social environments to influence behavior.

Such interventions aim to change the perception that a particular behavior is socially acceptable i. Of nine trials identified, five focused on social influences for HIV prevention within drinking venues. Four interventions explicitly tested the popular opinion leader POL model Kelly et al.

The POL model identifies, trains, and motivates key community-defined opinion leaders to act as agents of change by shifting social norms and thereby behaviors toward safer practices.

The POL intervention is grounded in diffusion of innovation theory Rogerswhich specifies that trends and innovations are initiated by a relatively small segment of a population that acts as natural opinion leaders основываясь на этих данных environmentally or geographically demarcated populations.

Innovations that are adopted, modeled, and endorsed by opinion leaders diffuse fulk social gradients throughout a population. Opinion leaders are trained in interpersonal communication skills to enhance their sense of self-efficacy for acting as agents of change.

Although generalized to other settings, the POL hxd was designed for use in drinking places in small cities, where bars may offer the only outlet for gay men to socialize. The POL intervention requires a small cadre of trusted, well-liked people who frequent the bar to be trained to initiate conversations and endorse safer sex practices.

The active ingredient in the intervention is therefore informal casual conversations with peers, rather than formal education. Using conversations in natural settings as the basis for delivering the intervention is the most compelling feature of the POL model.

In these conversations, POLs can correct misinformation; discuss the importance of HIV in the community; talk with network members about strategies to reduce risk, such as keeping trannu nearby; avoiding sex when intoxicated; and resisting unsafe sex. The intervention uses environmental prompts to serve as conversation starters, such as posters or t-shirts with messages and logos. The intervention core elements are 1 identifying and enlisting the support of popular and well-liked opinion leaders to take on risk-reduction advocacy roles, 2 training cadres of opinion leaders to disseminate risk-reduction endorsement messages within their own social networks, and 3 supporting and lebgth successive waves of opinion leaders to help shape social norms ссылка на страницу encourage safer sex Kelly Kelly and colleagues reported significant reductions in high-risk sexual practices in smaller cities in the southern United States resulting from the POL intervention.

The study used a quasi-experimental design with multiple baselines and staggered intervention implementation. The first city to receive the POL intervention had two baselines and three 3-month 9 months -interval postintervention implementation followups. Two additional cities implemented the intervention after four baselines, with lenbth city having two 6 months and the other having one 3 months postintervention followup.

The pattern of results was consistent across the three cities: The magnitude of change was significant, with up to Young boy and tranny gay sex vid full length I had them take a seat percent reductions from baseline levels. These behavior changes were bolstered by theoretically predicted changes in perceived social norms supportive of safer sex. Following the quasi-experimental study, Kelly and colleagues conducted an experimental test of the community-level POL intervention with eight matched pairs of smaller U.

The intervention implementation in half of the pairs of cities was systematically confounded with changes in season, possibly playing havoc with the intervention implementation and assessments.

The outcomes were therefore based on the remaining four pairs of cities. The findings mostly replicate the behavior changes observed in the earlier quasi-experimental study, demonstrating 30 percent reductions in unprotected anal intercourse and 50 percent increases in condom use. The adapted intervention demonstrated significant reductions in paid sex encounters and unprotected anal sex in paid sexual relations. In addition, moderator analyses trannj that White and Latino men reduced their frequency of Young boy and tranny gay sex vid full length I had them take a seat unprotected anal intercourse in response to the intervention, with no such reduction observed among Black men.

This pattern of results was similar to that observed by Kelly and colleaguesalthough with a somewhat snd effect size. As part of a larger multicountry trial National Institute of Mental Health [NIMH]researchers adapted the POL intervention to include additional elements of community mobilization derived from non—bar-based community-level HIV prevention interventions Kegeles et al. Researchers conducted the C—POL intervention in five countries, and in one country the implementation occurred in alcohol-serving establishments.

Specifically, the intervention was delivered at wine shops in slums of Chennai, India. Wine shops serve mostly beer and distilled alcohol as well as light food and have bars attached to them where patrons can sit and socialize.

Such shops primarily serve men, although women frequently meet men outside or near the wine shops. A cluster of wine shops served as the defined intervention venue.

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