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Whatever the intent behind many of his bills, this does seem to be their effect: to make life better for sexual predators. Consider the Wiener-authored SB 145, a 2020 measure that amended the sex-offender registration laws in California, so that an adult having anal or oral sex with a minor could avoid getting placed on the sex- offender registry, as long as the child was at least 14 and the adult was no more than a decade older.

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Wiener is correct on the history: California law did treat 25-year-old statutory rapists differently, depending on the manner of intercourse that they had with their victim. That discrepancy called out for remediation: the same treatment should apply to anal sex with a minor.

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Adolescents who engage in "high-risk" patterns of sexual behavior do not necessarily develop into young adults with poor sexual and reproductive health, Abigail A. Haydon and colleagues report in this issue of Perspectives on Sexual and Reproductive Health (see article). In analyses using three waves of data from the National Longitudinal Study of Adolescent Health, the researchers compared outcomes among five groups of young adults, defined by the sequence, spacing, timing and variety of their sexual experiences during adolescence. The most prevalent pattern of behavior was initiation of vaginal sex and then, within about two years, another sexual behavior (typically oral sex). Compared with young adults reporting this pattern, those who had begun having oral and vaginal sex in the same year were no more likely to have had an STD (ever or in the past year) or to have recently had concurrent partners or exchanged sex for money; those who had experienced both early first sex and anal sex by age 18 had elevated odds only of reporting concurrent partnerships. The small minority of respondents who had delayed their first sexual experience until late adolescence or beyond had reduced odds of all adverse outcomes.

IV. Perform gene expression array analysis comparing expression in anal cancer with HSIL overlying the cancer; perform gene expression array analysis comparing expression in HSIL biopsies that progressed to cancer with non-progressing HSIL biopsies at other locations; perform similar analyses comparing expression in HSIL biopsies that progressed to cancer with the same lesion at earlier time points prior to progression.

V. Characterize genetic changes in anal cancers compared with HSIL overlying the cancer; characterize genetic changes in HSIL biopsies that progressed to cancer compared with non-progressing HSIL biopsies at other locations; characterize genetic changes HSIL biopsies that progressed to cancer with the same lesion at earlier time points prior to progression.

ARM I: Patients are directed to receive either topical or ablative treatment at the discretion of the clinician. Patients receiving topical treatment apply imiquimod intra-anally, peri-anally or both thrice weekly for up to 16 weeks, fluorouracil twice daily for 5 days every 2 weeks for up to 16 weeks, or trichloroacetic acid every 3 weeks up to 12 weeks. Patients receiving ablative treatment using infrared coagulation, hyfrecation/electrocautery, or laser. Patients may undergo excision under anesthesia if the clinician believes none of the other treatment approaches will be effective. The number and timing of such treatments will be at the discretion of the investigator. Patients with persistent HSIL should continue a protocol-approved treatment or a new protocol treatment should be considered. 041b061a72