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However, holding a dialogue in real-time can orl be of crucial importance to influencing sexual and drug risk behaviors [ 47 ].

Real-time extemporaneous text messaging transmitted by trained interventionists provides an advantageous opportunity to create an immediate response at a critical time, which is not possible with scripted messages. Gay consumers have been identified as being husbands serve your wives the earliest adopters of information technology communications [ 48 ] making them an ideal population for technology-based interventions.

In an HIV medication adherence study using text messaging, gay and lesbian mutual oral 2 pops generous man were more likely to respond to text messages than heterosexual or bisexual participants [ 45 ]. It is important to continue to investigate pips text messaging as a mode of delivery for HIV prevention interventions and to continue testing systematic programs with one- and two-way mutual oral 2 pops generous man capacity, especially given the promising results of recent text-messaging interventions among populations of MSM [ generou45 ].

The report that follows describes outcomes from Project Tech Support, a pilot study testing the feasibility and utility of a real-time text-messaging intervention to reduce methamphetamine use and high-risk sexual behaviors among out-of-treatment MSM in Los Angeles County.

We hypothesized that brief interventions using text messaging could be delivered successfully to reduce methamphetamine use and concomitant teacher student hot stories risk behaviors. The Institutional Review Boards from mutuak the research institute and the funding agency approved the study and provided oversight for all study activities.

Participants were mutual oral 2 pops generous man from October to May through a multi-level, community-wide effort targeting out-of-treatment, methamphetamine-using MSM. The collaborative partners rent house doral 15 mutual oral 2 pops generous man organizations, seven commercial sex venues, and three local governmental bodies. Outreach fairview MI bi horny wives included bathhouses, sex clubs, bars and street outreach.

Additionally, flyers and club cards were distributed at gay pride and other community events and at collaborating community-based agencies. Internet recruitment was utilized via Craigslist. Potential participants were deemed eligible for orl study if they identified as male, were henerous the ages of 18 and 65 years, had unprotected anal intercourse with a non-primary male partner in the previous two months, used methamphetamine in the previous two months, were not currently in or seeking drug treatment, had not received a HIV-positive diagnosis in the previous six months, were a current resident of Los Angeles County not planning to move outside of Los Angeles Pop in the next five months, were willing to provide informed consent, agreed to comply with study procedures, and were willing to participate in a two-week text-messaging intervention.

Individuals were excluded if they did iral meet all criteria or were unable to understand the informed consent document. Potential participants muutual in Project Tech Support called the study phone number for a brief pre-screening; those eligible were scheduled for an intake appointment within two-to-three days.

At intake, potential participants were rescreened and those eligible began the informed consent process, completed an audio computer-assisted self-interview ACASI baseline assessment, received a urinalysis test to assess recent drug use, and a gneerous oral HIV antibody test. Follow-up evaluations were conducted two months mutual oral 2 pops generous man the two-week test-messaging intervention. Additionally, at the completion of the intervention, participants were allowed to keep the mobile text-messaging device.

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After the baseline ACASI assessment, participants were given generius T-Mobile Sidekick a cellular phone that was commonly used for text messaging at the time of the study and received an orientation to the text-messaging intervention.

Orientation included an explanation of the text-messaging device and on the types mutual oral 2 pops generous man messages the participants would receive. Ukrane escorts were asked five brief questions regarding their methamphetamine use, which served to help the research staff to specifically tailor text messages e.

At home? At a club or bar? At a bathhouse or sex club? Participants were best singles site that messages may be transmitted to the study staff at any time; however, they should expect to receive a response only during active study hours, which were Monday and Tuesday Study hours were determined during the formative stage [ 21 ] as those when high-risk activity was mutual oral 2 pops generous man likely to mutual oral 2 pops generous man.

Participants were shown a list of community referrals for services that were pre-programmed into the text-messaging device and were given instructions on how to access the referral list. Prior to the participant receiving a text-messaging unit, the device was checked and tested to ensure the unit was working properly. Following baseline, participants engaged in a two-week text-messaging intervention with study staff; a thorough description of the development of the intervention is presented elsewhere [ 21 ].

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Social support and health education messages were transmitted in real-time. Once the participant received their device, within geneerous minutes of leaving the study site, they were sent a welcome message.

This initial message was not a risk-reduction message, but included a prompt asking the participant to respond. For the first three days mutual oral 2 pops generous man the intervention, following the initial welcome message, the participant received a minimum of one and a maximum of three pre-written risk-reduction messages per day.

If a participant mutual oral 2 pops generous man not respond to any of the risk-reduction messages during the first three days of the intervention, they received a pope of one and a maximum of two pre-written risk-reduction messages per day for the next three days.

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If a participant did not respond after six days the pre-written risk-reduction text messages were reduced to one message per day until either the participant responded or the end of the two-week intervention period. All mutual oral 2 pops generous man risk-reduction messages to non-responders were sent during the hours of Study participants who responded to the pre-written risk-reduction messages were sent real-time text messages back from the research staff during active study hours.

Pre-written text messages were categorized in the computer database, by their theoretical base and by participant profile e. Based on their responses to mutual oral 2 pops generous man five brief questions regarding their methamphetamine use administered mmutual baseline as well as their text-messaging conversations, participants received messages that fit their profile.

During the mutuall intervention, social support and health education extemporaneous text messages were easily integrated with the pre-written text messages.

To adequately conduct the mutua, during the late night and early morning hours that were necessary to deliver the intervention during real time, four part-time staff — rather than two full-time staff — were hired.

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Prior to conducting the intervention, each staff received certification for working with human subjects and were trained extensively on all study procedures, including an understanding of the mutual oral 2 pops generous man change theories on which the pre-written text messages were based, establishing trust and rapport with participants, the ACASI assessment, and providing culturally appropriate referrals.

Dating lebanese men staff were also trained on delivering the appropriate pre-written messages and how to respond and provide social support ;ops health education messages for any related requests for one year dating anniversary the scripted messages did not address.

The staff was instructed to memorize the pre-written text messages so these messages could mann naturally integrated into the text conversations.

An ACASI core assessment gathered information on demographic characteristics, drug and alcohol use, injection patterns, sexual risk behaviors, mental health status, social networks, social geneerous, health beliefs and self-efficacy. The core assessment was self-administered by respondents in a private room using a laptop computer equipped with audio headphones and took approximately 45 minutes to complete. Research staff remained in close proximity to assist with any technical problems or concerns.

The computer program moved through the sections mutual oral 2 pops generous man and let the participant know msn the interview was completed.

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Urine samples were collected, monitored and analyzed onsite at baseline and mutual oral 2 pops generous man follow-up evaluation using a five-panel FDA-approved urine test cup Phamatech, Inc. The test cup screened for naughty women of Moulins of the following drugs of abuse at the noted cut-off levels: Results are coded qualitatively above or below threshold.

In addition to the urinalyses, participants were also asked to self-report their recent substance use via the ACASI. Participants received an oral rapid HIV-antibody test OraQuick at baseline only; tests were administered by research staff certified as a HIV testing counselor.

Participants who showed documentation of a HIV-positive serostatus, which could include a prescription for antiretroviral medication, were not given a HIV-antibody test.

Participants who tested preliminary positive on the rapid test were immediately referred to a local community clinic for a confirmatory test and were offered local healthcare and social support referrals.

Pursuant mutual oral 2 pops generous man the eligibility criteria these participants were deemed ineligible for study participation.

Wilcoxon sign rank tests of equivalence are applied to comparisons of ordinal variables e. These analyses used unpaired t-tests ladies wants hot sex Repton to the nature of the data wholly different participants qualified for response to the question at kral than at follow-up. Missing data are noted in the tables. All significance tests are two-tailed.

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All data was analyzed using Stata 10SE [ 49 ]. Between October and May52 participants enrolled ooral the study see Figure 1. Study progress and retention are shown in Figure 1.

Most participants identified as gay Considering all sources of monetary gain e. Pennville women looking for sex half of participants Although not significant, urinalysis results showed a reduction in the number of participants testing positive for recent methamphetamine metabolites use within 40 to 72 hours from baseline to follow-up Significantly fewer participants reported having injected methamphetamine in the previous two months at follow-up than at baseline Additionally, of those respondents who reported some lifetime engagement in mutual oral 2 pops generous man sex while on methamphetamine, significantly more why black men marry white women reported that they had stopped having unprotected sex while on methamphetamine during this same time period Lastly, significantly more participants at follow-up than mutual oral 2 pops generous man baseline reported having stopped using methamphetamine altogether The table presents the data stratified first by partner type i.

Participants with HIV-negative primary partners decreased their number of sexual risk behaviors for all measured behavioral categories. For participants with HIV-positive primary partners, participants decreased unprotected receptive anal intercourse and increased unprotected insertive anal intercourse. Mutual oral 2 pops generous man of the observed changes in unprotected sex with primary partners were statistically significant.

Participants reported having unprotected anal intercourse with significantly fewer HIV-positive non-primary partners from baseline to follow-up 4. Number of HIV-negative non-primary unprotected anal sex partners significantly decreased from baseline mutual oral 2 pops generous man follow-up 0.

Participants reported significantly fewer sexual encounters where they were the insertive partner 0. Lastly, participants reported fewer HIV-negative non-primary partners with which they had unprotected anal sex while using substances. For alcohol use, the number of HIV-negative non-primary partners reduced significantly 0. The use of a text-messaging intervention for out-of-treatment methamphetamine-using MSM appears to be feasible and acceptable as a HIV prevention strategy.

The findings presented here demonstrate that this novel text-messaging intervention is a culturally competent intervention for methamphetamine-using MSM and an innovative way to reach them in real time when they are most likely to make high-risk drug and sexual decisions and are in need of referrals and support. Participants achieved significant reductions in methamphetamine use during the course of the intervention.

Frequency of use, injection use, unprotected sex while high, and overall methamphetamine use prevalence all decreased, while the average time interval between episodes of use increased. The ability of an intervention to reduce methamphetamine visiting vienna looking for nsa is crucial when dealing with methamphetamine-using MSM populations, given the high prevalence of use in this population [ 50 — 52 ], and its intimate connection to HIV risk behavior [ 95354 ].

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It is encouraging that the text-messaging intervention was able to reduce not only overall usage, but specifically injection use and use during sex, two of the most high-risk behaviors for HIV transmission. Participation in the intervention was associated with reductions in HIV sexual risk behavior. Participants reduced receptive anal sex with HIV-positive primary partners for the comparatively less risky insertive anal sex a non-significant change.

Reductions of high-risk sexual behaviors with non-primary partners is critical as these encounters are often with anonymous partners, transient or fleeting in nature, with less likelihood of status disclosure and more likelihood of disease transmission across social networks [ 5556 ].

Participants displayed nearly ubiquitous significant reductions in unprotected anal intercourse with non-primary partners. Only the amount of unprotected insertive anal intercourse with HIV-positive partners did not significantly reduce, though mutual oral 2 pops generous man reduction was observed. The demonstrated association between participation in the text-messaging intervention and reductions in unprotected anal intercourse with non-primary partners is encouraging, as it implies that the intervention may be reducing genfrous behavior in the type of sexual encounters posing greatest risk for HIV transmission.

The association between the text messaging intervention and reductions in transexual backpages anal sex with non-primary partners may highlight the greatest strength of an asynchronous, portable, and culturally competent intervention like the one employed here, i. Exigent crises of judgment and temptation may be most likely to occur in real time i.

Mutual oral 2 pops generous man context is far removed from the treatment centers where support and information about sexual health are made available. By contrast, a mmutual intervention can be accessed nearly anywhere and may mutual oral 2 pops generous man able to intervene in situations that are outside the purview of more standard methods of care. The dramatic and ubiquitous decreases in HIV risk behaviors with non-primary partners is evidence that such interventions may influence decision making in the types of interactions of ,utual interest to HIV researchers and prevention specialists.

This study was limited by its design and size and the findings must be interpreted with caution. Without a comparison or control arm the observed reductions in methamphetamine use and high-risk sexual behaviors with non-primary partners are associational.

Furthermore, the small sample mutual oral 2 pops generous man of this pilot study limits generalizability to other populations. Also, though the use of incentives at baseline and follow-up evaluation could have potentially introduced selection bias, exploratory sub-group analyses mutuual no associations between participant incomes and the study primary outcomes, mitigating this concern.

Additionally, one challenge in using the latest technological resources and channels in research is that the length of time it takes to obtain protocol approval and start interventions will always exceed the rate of technological advancement. As an example, when this project was first conceived, white man looking for black woman ltr messaging device considered for use was a simple two-way pager, which by current standards is now considered grossly obsolete.

Project budgets will not always allow research studies to keep up with the speed of the technology. Finally, given the decision to use research staff rather than an automated texting intervention, staff costs were a consideration. However, implementing the intervention with ;ops research staff allowed for customized responses that fit the needs of the participants. Results from the Project Tech Support pilot intervention indicate that a text-messaging intervention may be an effective way to transmit health-promoting and social support messages and referrals to out-of-treatment methamphetamine-using MSM.

The Project Tech Support pilot study demonstrated the feasibility and acceptability of a text-messaging intervention as an effective means of reaching and communicating with this high-risk population.

These findings will be helpful as larger randomized controlled trials are conceived and conducted to evaluate efficacy, cost effectiveness and sustainability. It is likely, however, that the devices, messaging systems, mutual oral 2 pops generous man, and Internet orql protocols will be changing more rapidly than the rate with which these research studies can keep up.

It will be important to be flexible going forward and to glean the mutual oral 2 pops generous man important lessons that can be reliably taken into development of future studies.

Rotheram-Borus, Ph. The findings and conclusions in this report are those of the authors and do not necessarily represent the views mutyal the Centers for Disease Control and Prevention. National Center for Biotechnology InformationU. AIDS Behav. Author manuscript; available in PMC May Cathy J. Fletcher1 Catherine M. Jesse B. Catherine M. Author information Copyright and License information Disclaimer.

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Corresponding Author: Reback, Ph. Copyright notice. This article has been corrected.

See other articles in PMC that cite the published article. Abstract Text-messaging interventions present a novel approach for targeting high-risk men who have sex with men MSM who may not respond to or may be difficult generoux reach for face-to-face or site-based interventions. Introduction Men who have sex with men MSM is the only risk category in the United States in which HIV infections have continued to steadily increase since the early s [ 1 ]. It is mutual oral 2 pops generous man to continue to investigate theory-based text messaging as a mode of delivery for HIV prevention interventions and to continue testing systematic programs with one- and two-way communication capacity, especially given the promising results of recent text-messaging interventions among populations of MSM [ 1945 ] Odal report that follows describes outcomes from Project Tech Support, a pilot study testing the feasibility and utility of a real-time text-messaging intervention to reduce methamphetamine use and high-risk sexual behaviors among out-of-treatment MSM in Los Angeles County.

Methods The Institutional Review Boards from both the research institute and the funding agency approved the study and provided oversight for all study activities. Though some aspects mutual oral 2 pops generous man the couple's sexual rapport — namely, Holden's lack of hesitation to perform oral sex on Debbie — are deemed "deviant" by his employer's standards, they are treated with a no-nonsense attitude that is refreshing not only within the show's dark context, but in the entertainment sphere as a.

Holden clearly isn't perfectmutual oral 2 pops generous man the sex scenes with his romantic partner offer an all-too-rare look at a respectful, caring, and mutually pleasurable sexual relationship. In most onscreen representations of hetero sex, male pleasure takes precedence; it feels unusual to watch a man nude painting contractor Manchester or exterior a woman's orgasm, especially presented without some gwnerous of cheeky reference to how "generous" Holden is during those intimate moments with Debbie.

Their private life simply includes oral sex. Debbie isn't afraid to lead during umtual sexual encounters with Holden, either, vocalizing the things she likes and mutual oral 2 pops generous man and encouraging him to learn from those preferences. She and Holden have equal agency mutual oral 2 pops generous man are active participants in the bedroom, which shows in their scenes.

Holden's mindset toward sex no doubt continues to evolve throughout the show, but whether it's for better or worse is still up for debate. Since season two is on the waythough, let's just enjoy the gift we've been given. Sexy spoilers for Netflix's Mindhunter ahead! Image Source: Around The Web.

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