RESUMEN
OBJECTIVES: Determination of the attitudes of individuals toward sexually transmitted infections (STIs) can also help identify barriers to health service-seeking behavior. Hence, this study aimed to develop a scale for determining the attitudes of individuals toward sexually transmitted diseases. STUDY DESIGN: This was a methodological study. The Health Belief Model (HBM) framework was used to elucidate the perceptions and interpretations of illnesses among individuals. After reviewing the relevant literature, an item pool was created to include 4 dimensions (perceived susceptibility (A), perceived severity (B), perceived benefit (C), and perceived barriers and self-efficacy (D)) about sexually transmitted diseases from the perspective of HBM. Exploratory factor analysis was conducted to evaluate the construct validity of the scale. Moreover, confirmatory factor analysis was used to examine the suitability of the items in terms of factor structures. RESULTS: The final version of the scale comprised 19 items and 4 subdimensions. The first subdimension of the scale accounted for 20.11% of the total variance, whereas the second, third, and fourth subdimensions accounted for 17.83%, 12.50%, and 8.75% of the total variance, respectively. Collectively, these four subdimensions accounted for 59.19% of the total variance. The Cronbach's alpha reliability coefficient of the scale was found to be 0.74. CONCLUSIONS: Briefly, the present study led to the development of a novel assessment tool, Attitude Toward Sexually Transmitted Infections Scale. Higher scores on the scale indicated higher likelihood of taking action for a possible STI treatment according to the HBM approach.
Asunto(s)
Modelo de Creencias sobre la Salud , Enfermedades de Transmisión Sexual , Humanos , Enfermedades de Transmisión Sexual/psicología , Femenino , Masculino , Adulto , Encuestas y Cuestionarios , Conocimientos, Actitudes y Práctica en Salud , Adulto Joven , Reproducibilidad de los Resultados , Análisis Factorial , Adolescente , Psicometría , Actitud Frente a la SaludRESUMEN
BACKGROUND: Maori and Pacific young people are disproportionately impacted by sexually transmitted infections (STIs). Access to STI screening is important to reduce transmission and reproductive health complications. METHODS: Between November 2022 and May 2023, we held four wananga (workshops) with Maori and Pacific participants (15-24years old) to find out what barriers they encounter to STI testing, and hear their ideas about how to overcome these. Participants were recruited via youth-focused community organisations in the Wellington region of Aotearoa New Zealand. Inductive thematic analysis was used to understand data generated from discussions, drawing on Maori and Pacific models of wellbeing to frame themes. RESULTS: Thirty-eight participants were involved in the wananga. Barriers to STI testing related to five themes: (1) differences in cultural values and expression; (2) family/friends; (3) educational gaps; (4) psychological factors; and (5) structural obstacles. Suggested strategies to improve access to sexual health care included the need for free, flexible services, education and health promotion activities to reach young people in their spaces (e.g. church, marae, social media). Participants stressed the need for approaches to be community-based, delivered by trusted individuals using culturally appropriate messages, and saw participation in STI testing as beneficial for whanau/family and communities. CONCLUSIONS: To improve access to STI testing, participants described the need for free services, together with education and health promotion to improve inter-generational sexual health knowledge. Reframing messages around STIs to align with Maori and Pacific models of wellbeing was identified as a way to normalise conversations, in turn reducing the stigma surrounding STI testing.
Asunto(s)
Salud Sexual , Enfermedades de Transmisión Sexual , Adolescente , Humanos , Pueblo Maorí , Conducta Sexual , Enfermedades de Transmisión Sexual/diagnóstico , Enfermedades de Transmisión Sexual/prevención & control , Enfermedades de Transmisión Sexual/psicología , Estigma Social , Pueblos Isleños del Pacífico , Adulto JovenRESUMEN
BACKGROUND: Sexually transmitted infections (STIs) impose burdens on individuals and communities, while their prevalence in young people has risen continually in recent years. Partner notification is an effective public health strategy which can limit STI transmission. AIMS: This study aimed to explore young adults' sexual health behaviours, attitudes toward STI testing, and feelings toward visiting a sexual health clinic. It also aimed to investigate preferences for partner notification and the role of self-efficacy in people's intentions to notify a partner for STIs including the human immunodeficiency virus (HIV). METHODS: A quantitative, cross-sectional design was applied. Participants were 400 adults aged 18-34 years (M = 23 years; SD = 4.27), recruited from the Republic of Ireland. RESULTS: Over half of the participants reported never being tested for STIs. These young people placed less importance on undergoing regular STI testing and testing after unprotected sex than their counterparts who had been tested for STIs. Self-efficacy was significantly associated with intentions to notify partner(s) for STIs including HIV. CONCLUSIONS: As STIs are becoming increasingly prevalent in young adults, it is important to gain a deeper understanding of the interventions used to break the transmission chain and how different beliefs and attitudes may affect them. Self-efficacy was a key component in PN intentions, suggesting that the belief in someone's ability or skillset to perform a sexual health behaviour is positively related to their intention to perform the behaviour.
Asunto(s)
Conducta Sexual , Salud Sexual , Enfermedades de Transmisión Sexual , Humanos , Enfermedades de Transmisión Sexual/transmisión , Enfermedades de Transmisión Sexual/prevención & control , Enfermedades de Transmisión Sexual/psicología , Enfermedades de Transmisión Sexual/epidemiología , Irlanda/epidemiología , Masculino , Femenino , Adulto , Adulto Joven , Estudios Transversales , Adolescente , Conducta Sexual/psicología , Trazado de Contacto/estadística & datos numéricos , Parejas Sexuales/psicología , Conocimientos, Actitudes y Práctica en Salud , Autoeficacia , Conductas Relacionadas con la SaludRESUMEN
Background and aims: Borderline personality disorder (BPD) is a complex mental health condition characterized by emotional dysregulation, impulsivity, and unstable interpersonal relationships. Some individuals with BPD regularly engage in sexual risk behavior such as unprotected sex and are at higher risk of contracting sexually transmitted infections. This study investigates discounting of condom- or dental dam-protected sex in women with BPD compared with a control group. Methods: Data were collected from 40 women diagnosed with BPD and 40 healthy controls with an average age of 27.28 years (SD = 6.14) using the Sexual Delay Discounting Task (SDT), the Borderline Symptom List-23 (BSL-23), and the Compulsive Sexual Behavior Disorder Scale-19 (CSBD-19). Results: Women with BPD were less likely to use an immediately available condom or dental dam and more likely to discount safer sex than controls. Partner desirability and the perceived STI risk influenced the participants' likelihood of having protected sex. Women with BPD showed more symptoms of compulsive sexual behavior (CSB) than controls. However, sexual delay discounting was not significantly correlated with borderline symptoms or CSB in the BPD group. Discussion and conclusions: These findings contribute to our understanding of sexual impulsivity in women with BPD and highlight the omission and delayed availability of safety measures as important contributors to sexual risk behavior and STI risk in women. Impulsive sexual behavior, as well as the accompanying sexual health concerns, should receive special attention in the treatment of women with BPD.
Asunto(s)
Trastorno de Personalidad Limítrofe , Descuento por Demora , Enfermedades de Transmisión Sexual , Adulto , Femenino , Humanos , Adulto Joven , Trastorno de Personalidad Limítrofe/psicología , Trastorno de Conducta Sexual Compulsivo , Conducta Impulsiva , Sexo Seguro/psicología , Conducta Sexual/psicología , Enfermedades de Transmisión Sexual/complicaciones , Enfermedades de Transmisión Sexual/psicología , Estudios de Casos y ControlesRESUMEN
Introducción: Las infecciones de transmisión sexual (ITS) se adquieren principalmente por el contacto sexual y pueden afectar a personas de cualquier edad, sin embargo los adolescentes son el grupo etario más afectado, por tanto es probable que sus conductas sean más de riesgo que protectoras. Objetivo: El objetivo de la investigación es determinar la relación entre el nivel de educación sexual y el conocimiento sobre ITS y las conductas de riesgo y protectoras en los jóvenes. Método: Investigación de diseño analítico, estudio de tipo descriptivo, transversal con datos de tipo cuantitativos, con una muestra de 130 hombres y mujeres, considerando 10 personas por edad desde los 18 a los 30 años. Resultados: No existe relación estadísticamente significativa entre la educación sexual y las conductas de riesgo y/o protectores (p > 0,05), ni tampoco entre la educación sexual y el uso del preservativo, tanto interno como externo (p > 0,05). Conclusión: A pesar de tener educación sexual, no todas las personas utilizan de forma frecuente los anticonceptivos de barrera y principalmente es sorprendente el poco uso del condón de vagina en la población en general, siendo las personas de orientación heterosexual las que lo utilizan menos.
Introduction: Sexually transmitted infections (STIs) are mainly acquired through sexual contact and can affect people of any age; however, adolescents are the most affected age group, therefore, it is likely that their behaviors are more risky than protective. Objective: The objective of the research is to determine the relationship between the level of sexual education and knowledge about STIs and risk and protective behaviors in young people. Method: Analytical design research, descriptive, cross-sectional study with quantitative data, with a sample of 130 men and women, considering 10 people by age from 18 to 30 years. Results: There is no statistically significant relationship between sexual education and risk and/or protective behaviors (p > 0.05) nor between sexual education and condom use, both internal and external (p > 0.05). Conclusion: Despite having sexual education, not all people use frequently barrier contraceptives and, mainly, the little use of the vaginal condom in the general population is surprising, with people of heterosexual orientation being those that use it less.
Asunto(s)
Humanos , Masculino , Femenino , Adolescente , Adulto , Educación Sexual/métodos , Enfermedades de Transmisión Sexual/psicología , Conocimientos, Actitudes y Práctica en Salud , Enfermedades de Transmisión Sexual/prevención & controlRESUMEN
BACKGROUND: Despite various strategies implemented to promote sexual education and prevent sexually transmitted infections (STIs), the 10th National Youth Survey revealed that slightly more than half of young people in Chile used a condom during their last sexual encounter. While several sociodemographic, cultural, and psychological predictors have been described, recent studies specific to Chile are scarce. AIM: To examine the relationship between social determinants, gender roles, and mental health symptoms with condom use in young Chileans. MATERIAL AND METHODS: Secondary data from the 10th National Youth Survey were analyzed. The analytical sample comprised 5,507 young people who had started their sexual life. Multiple binomial logistic regression models were run using survey-based data estimates. RESULTS: Older youth, women, people who identify with any ethnicity, those in a dating relationship, and those diagnosed with an STI are less likely to use a condom at last intercourse. CONCLUSION: Individual characteristics can explain adherence to preventive behaviors and may reflect underlying psychological and cultural factors. Identifying socio-structural, cultural, and psychological factors associated with preventive and protective sexual behaviors should be a health priority, as it enables the design and promotion of more effective social communication campaigns.
Asunto(s)
Condones , Salud Mental , Conducta Sexual , Factores Socioeconómicos , Humanos , Chile/epidemiología , Femenino , Masculino , Adolescente , Condones/estadística & datos numéricos , Adulto Joven , Salud Mental/estadística & datos numéricos , Conducta Sexual/psicología , Conducta Sexual/estadística & datos numéricos , Rol de Género , Determinantes Sociales de la Salud , Factores Sociodemográficos , Enfermedades de Transmisión Sexual/prevención & control , Enfermedades de Transmisión Sexual/psicología , Factores Sexuales , Pueblos SudamericanosRESUMEN
Due to its long-term longitudinal design, the National Longitudinal Study of Adolescent to Adult Health (Add Health) has provided numerous valuable insights into adolescent and young adult sexual behavior. Framed by a conceptual model of sexual behavior and health, I review research using Add Health data to study sexual behavior and health. In this paper, I review research examining both predictors (e.g., neighborhood, family, genetic, individual) and health outcomes (e.g., sexually transmitted infections, mental health) of sexual behavior in adolescents and young adults. Where possible, I focus on long-term longitudinal studies that make use of the unique strengths of the Add Health data. Existing Add Health research has provided considerable information about both the predictors and health consequences of adolescent and young adult sexual behavior. Factors ranging from neighborhoods to genetics predict whether adolescent and young adults engage in sexual behaviors. Findings on long-term outcomes of adolescent sexual behavior suggest that early sexual behavior predicts higher rates of sexually transmitted infections and pregnancy in young adulthood, but not long-term changes to mental health. Unique contributions of Add Health include the ability to examine multidimensional bio-ecological predictors of sexual behavior and to examine long-term effects of sexual behavior and how sexual behaviors and their correlates change across adolescence into adulthood. Future work can leverage these strengths, and in particular the long-term longitudinal nature of the data, to uncover new insights about the developmental course of sexual behavior and health.
Asunto(s)
Conducta del Adolescente , Enfermedades de Transmisión Sexual , Adulto Joven , Embarazo , Femenino , Adolescente , Humanos , Adulto , Estudios Longitudinales , Conducta Sexual/psicología , Enfermedades de Transmisión Sexual/prevención & control , Enfermedades de Transmisión Sexual/psicología , Conducta del Adolescente/psicología , Salud del AdolescenteRESUMEN
As the rates of sexually transmitted infections among Brazilian youth rise, college students present with low rates of condom use. Understanding which factors affect preventive behaviours may assist in promoting them. This study aimed to test the Theory of Planned Behaviour (TPB) as a model of condom use behaviour among young university students. Data on sexual behaviour, TPB, and personality variables were collected online with 343 sexually active students aged between 18 and 29. Seventy participants also provided follow-up data after 30 days. Structural equation models and ordinal regressions were used to analyse the effects of TPB variables on condom use behaviour. Attitude was the main predictor of behavioural intention in the cross-sectional and longitudinal models. Being in a relationship and lower age at sexual debut were also associated with less frequent condom use behaviour in the cross-sectional analysis. Behavioural intention and perceived control were associated with condom use behaviour. (AU)
Enquanto a incidência de infecções sexualmente transmissíveis cresce entre jovens brasileiros, universitários apresentam pouco uso de preservativos. Compreender quais fatores afetam a adoção de comportamentos preventivos pode auxiliar na sua promoção. Esse estudo testou a Teoria do Comportamento Planejado (TCP) como modelo de uso de camisinha entre jovens universitários. Foram coletados dados sobre comportamento sexual, TCP, e personalidade em questionário online com 343 estudantes sexualmente ativos entre 18 e 29 anos de idade. Setenta participantes também responderam ao follow-up após 30 dias. Modelos de equações estruturais e regressões ordinais foram usados para analisar os efeitos das variáveis da TCP no uso de preservativo. Atitude foi o principal preditor da intenção comportamental nos modelos transversal e longitudinal. Estar em um relacionamento e menor idade na primeira relação sexual também foram associados a uso menos frequente de preservativo na análise transversal. Intenção comportamental e controle percebido foram associados com uso de preservativo. (AU)
Mientras la incidencia de infecciones de transmisión sexual aumenta entre los jóvenes brasileños, los estudiantes universitarios reportan poco uso de preservativos. Comprender qué factores inciden en la adopción de conductas preventivas puede ayudar en su promoción. Este estudio probó la Teoría del Comportamiento Planeado (TCP) como modelo de uso de preservativos entre jóvenes universitarios. Los datos sobre comportamiento sexual, TCP y personalidad fueron recopilados en un cuestionario en línea con 343 estudiantes sexualmente activos entre 18 y 29 años. Setenta participantes también respondieron al seguimiento después de 30 días. Se utilizaron modelos de ecuaciones estructurales y regresiones ordinales para analizar los efectos de las variables de TCP sobre la utilización del condón. La actitud fue el principal predictor de la intención en los modelos transversal y longitudinal. Estar en una relación y una edad más temprana en la primera relación sexual se asociaron con el uso menos frecuente de preservativo en el análisis transversal. La intención conductual y el control percibido se asociaron con el uso de condones. (AU)
Asunto(s)
Humanos , Masculino , Femenino , Adolescente , Adulto , Adulto Joven , Conducta Sexual/psicología , Condones , Sexo Inseguro/psicología , Personalidad , Pruebas de Personalidad , Estudiantes/psicología , Universidades , Conductas Relacionadas con la Salud , Enfermedades de Transmisión Sexual/psicología , Proyectos Piloto , Estudios Transversales , Encuestas y Cuestionarios , Análisis de Regresión , Análisis Factorial , Estudios Longitudinales , Salud Sexual , Análisis de Clases Latentes , Correlación de Datos , Factores SociodemográficosRESUMEN
BACKGROUND: Sexually transmitted infections (STIs) among women have led to substantial public health and economic burdens in several low-middle-income countries. However, there is a paucity of scientific knowledge about the relationship between empowerment and symptoms of STIs among married Bangladeshi women. This article aimed to examine the association between women empowerment and symptoms of STIs among currently married Bangladeshi women of reproductive age. MATERIALS AND METHODS: We extracted data from the Bangladesh Demographic and Health Survey (BDHS), conducted from June 28, 2014, to November 9, 2014. We utilised cross-tabulation, the conceptual framework and multivariable multilevel mixed-effect logistics regression to explore the association between women's empowerment indicators and women's self-reported symptoms of genital sore and abnormal genital discharge. All of the analysis was adjusted using cluster weight. RESULTS: We found that among 16,858 currently married women, 5.59% and 10.84% experienced genital sores and abnormal genital discharge during the past 12 months, respectively. Women who depended on husbands to make decisions regarding their health care (AOR = 0.75, 95% CI = 0.67-0.84), significant household purchases (AOR = 0.79, 95% CI = 0.71-0.88), and visiting family or relatives (AOR = 0.72, 95% CI = 0.64-0.80) were less likely to report signs of abnormal genital discharge. Women who could make joint healthcare decisions with their husbands were also less likely to report genital sores (AOR = 0.78, 95% CI = 0.67-0.90). CONCLUSION: Genital sores and abnormal genital discharge were prevalent across all parameters of women empowerment among currently married women in Bangladesh. Our estimates show that the husband plays a significant role in decision-making about sexual and reproductive health. Efforts need to be invested in establishing culturally relevant gender policies which facilitate the involvement of women in joint decision-making.
Asunto(s)
Toma de Decisiones , Empoderamiento , Autonomía Personal , Conducta Sexual/psicología , Enfermedades de Transmisión Sexual/epidemiología , Esposos/psicología , Adolescente , Adulto , Bangladesh/epidemiología , Estudios Transversales , Femenino , Instituciones de Salud , Humanos , Incidencia , Masculino , Matrimonio , Persona de Mediana Edad , Enfermedades de Transmisión Sexual/psicología , Factores Socioeconómicos , Adulto JovenRESUMEN
Global health researchers often approach Traditional, Complementary, and Alternative Medicine (TCAM) from a health efficacy perspective, asking whether the presence of plural medical systems helps or hinders the uptake of biomedicine. Medical anthropologists, by contrast, typically emphasize how plural medical systems encourage us to rethink health ontologies-that is, who and what comes to constitute the experience of health and illness, and through which practices. Building on both approaches, we explore the role of "healers," a term we use to encompass several different kinds of TCAM providers, in the sexual and reproductive healthcare (SRH) of young people from southcentral Uganda, a region well known as an HIV/AIDS epicenter. Drawing from ethnographic data, we describe three reasons that young people seek SRH from healers. First, they associate stigma, scarcity, and high costs with biomedical SRH. Second, healers work across biomedical and non-biomedical therapeutic divides, prescribing herbs for sexually transmitted infections while simultaneously referring clients to biomedical HIV clinics. Third, healers provide counseling focused on pleasurable and economically-motivated sex. Because these therapies diverge from international and national HIV prevention messaging that frames non-marital and transactional sex in terms of danger and disease, healers' holistic approach to SRH may help to reconstitute the meaning, practice, and experience of "sexual health" in contemporary Uganda. This has important implications for improving global SRH programs and for understanding the continued appeal of TCAM more generally.
Asunto(s)
Síndrome de Inmunodeficiencia Adquirida , Infecciones por VIH , Enfermedades de Transmisión Sexual , Adolescente , Atención a la Salud , Infecciones por VIH/psicología , Humanos , Enfermedades de Transmisión Sexual/psicología , UgandaRESUMEN
Las estrategias preventivas para las enfermedades de transmisión sexual en poblaciones jóvenes, se han convertido en una prioridad de salud pública. Los adolescentes y adultos jóvenes, se han identificado como los que tienden a participar más frecuentemente, en actividades sexuales riesgosas; dentro este grupo de población, se encuentran en su mayoría los estudiantes universitarios, de ahí que no solo los sistemas de salud deben dar respuesta a esta situación, también las distintas organizaciones educativas. Por tanto, se realizó un estudio descriptivo de corte transversal en dos universidades peruanas, con el objetivo de evaluar la percepción de la participación en un programa de intervención lúdica sobre el conocimiento y actitudes preventivas hacia las enfermedades de infección sexual. La muestra estuvo conformada por 149 participantes, de ellos 51,68% masculinos y 43,28% femeninas. Se realizó la valoración de la intervención mediante la escala de Likert y la intencionalidad conductual a través de la prueba T de comparación de medias. Los resultados mostraron, luego de la aplicación de las 16 actividades lúdicas, significacia estadística sobre mejora del conocimiento y la intencionalidad de cambios conductuales positivos en torno a la práctica de sexualidad responsable, además de la importancia de abordar la temática con información clara y precisa. Se concluye que las estrategias lúdicas son efectivas para la concientización sobre la prevención de ETS y embarazos no deseados; además se puede utilizarse para reforzar conocimientos, prácticas e inducir mejoras en las actitudes contra la estimagtización de las personas que viven con ETS(AU)
Asunto(s)
Humanos , Masculino , Femenino , Juego e Implementos de Juego/psicología , Educación Sexual/métodos , Estudiantes/psicología , Universidades , Enfermedades de Transmisión Sexual/psicología , Conocimientos, Actitudes y Práctica en Salud , Perú , Enfermedades de Transmisión Sexual/prevención & control , Factores Sexuales , Estudios Transversales , Modelos EducacionalesRESUMEN
BACKGROUND: Sexually Transmitted Infections (STIs) increase the risk of contracting Human Immunodeficiency Virus (HIV). Hence, early screening and treatment of STIs as a behavioral practice will reduce the odds of HIV infection among at risk and vulnerable sub-populations. To that end, HIV prevention strategies need to design evidence-based interventions using behavioral models or theories to help at-risk individuals adopt early screening and treatment of STI as preventive health behavior. In this study, commercial sex workers were considered as HIV at-risk sub-populations. OBJECTIVE: Measuring to what extent that Integrated Behavioral Model constructs explain individuals' intention to practice early screening and treatment of sexually transmitted infections as healthy behavior of interest in HIV prevention. DESIGN: Integrated Behavioral Model (IBM) measurement survey was conducted using Respondent Driven Sampling (RDS) in six towns located in the main transport corridors of Ethiopia. Respondents' answers to model construct-based questions and intention to practice the health behavior of interest were measured using Likert Scale. Analysis was done to assess the correlation and level of association of model construct-based questions with intention to practice the preventive health behavior. RESULTS: Respondents' attitude explained 32%, perceived control 2%, normative influence 21%, and self-efficacy 53 % of their intention to get early screening and treatment of sexually transmitted infections. CONCLUSION: Self-efficacy explained the variability of respondents' intention to get early screening and treatment of STIs most, while perceived control was the least. Hence, HIV prevention behavioral interventions targeting early screening and treatment of STIs should give high emphasis to self-efficacy.
Asunto(s)
Infecciones por VIH/diagnóstico , Intención , Tamizaje Masivo/estadística & datos numéricos , Trabajadores Sexuales/psicología , Enfermedades de Transmisión Sexual/diagnóstico , Adulto , Etiopía , Femenino , Infecciones por VIH/psicología , Conductas Relacionadas con la Salud , Accesibilidad a los Servicios de Salud , Humanos , Autoeficacia , Enfermedades de Transmisión Sexual/psicologíaAsunto(s)
Enfermedades de Transmisión Sexual , Humanos , Centers for Disease Control and Prevention, U.S. , Guías de Práctica Clínica como Asunto , Conducta Sexual , Enfermedades de Transmisión Sexual/tratamiento farmacológico , Enfermedades de Transmisión Sexual/economía , Enfermedades de Transmisión Sexual/epidemiología , Enfermedades de Transmisión Sexual/psicología , Estados UnidosRESUMEN
OBJECTIVES: Patient and public involvement (PPI) in research priority-setting remains limited, especially for non-HIV STI. We identify and compare the top 10 patient and public STI research priorities with those of clinicians and STI stakeholders. METHODS: This two-stage study was conducted in May-August 2019. First, STI research priorities were canvassed through qualitative questionnaires issued to all patients attending a large sexual health clinic, all clinicians in region-wide mailing lists, all stakeholders identified through existing networks and the Charity Commission database, and to the Liverpool public. Raw responses were organised by theme into a shortlist of 25. In stage 2, these were ranked through priority-setting activities by telephone with patients and the public (n=8) and some clinicians (n=3), and in two workshops with clinicians (n=26) and stakeholders (n=5), respectively. The top 10 priorities were compared. RESULTS: Of 373 surveys submitted, 106 were analysed (83 patient and public; 23 clinician and stakeholder). Exclusions included lack of completion and responses out of scope. Among patient and public respondents, 55% (n=46) were aged 18-24 years, 51% (n=42) identified as heterosexual women and 23% (n=19) as men who have sex with men. Clinicians included all cadres; stakeholders were academics, commissioners and third sector representatives. In stage 2, 4 of 10 themes (STI education, targeted services for high-risk groups, antibiotic resistance and counselling for those with STI) were prioritised by all. Remote STI services and rapid diagnostics also ranked highly but the rationale differed between groups. CONCLUSION: This is the first non-HIV STI research priority-setting exercise to be reported in the UK. It identifies overlaps and differences between public and provider concerns, highlights gaps in the public understanding of STI research, and shows how PPI can promote research responsive to the concerns of both those who use and deliver services.
Asunto(s)
Personal de Salud/psicología , Aceptación de la Atención de Salud/psicología , Investigación , Enfermedades de Transmisión Sexual/psicología , Adolescente , Consejo , Femenino , Heterosexualidad , Homosexualidad Masculina , Humanos , Masculino , Salud Pública , Enfermedades de Transmisión Sexual/diagnóstico , Encuestas y Cuestionarios , Adulto JovenAsunto(s)
Servicios Preventivos de Salud , Conducta Sexual , Enfermedades de Transmisión Sexual , Determinantes Sociales de la Salud , Adolescente , Conducta del Adolescente , Salud del Adolescente/tendencias , Necesidades y Demandas de Servicios de Salud , Humanos , Servicios Preventivos de Salud/organización & administración , Servicios Preventivos de Salud/normas , Factores de Riesgo , Educación Sexual/métodos , Educación Sexual/normas , Enfermedades de Transmisión Sexual/diagnóstico , Enfermedades de Transmisión Sexual/epidemiología , Enfermedades de Transmisión Sexual/prevención & control , Enfermedades de Transmisión Sexual/psicología , Estados Unidos/epidemiologíaRESUMEN
HIV care provides an opportunity to integrate comprehensive sexual and reproductive healthcare, including sexually transmitted infection (STI) management. We describe STI prevalence and correlates among men living with HIV (MLWH) accessing safer conception care to conceive a child with an HIV-uninfected partner while minimizing HIV transmission risks. This study reflects an ongoing safer conception program embedded within a regional referral hospital HIV clinic in southwestern Uganda. We enrolled MLWH, planning for pregnancy with an HIV-uninfected partner and accessing safer conception care. Participants completed interviewer-administered questionnaires detailing socio-demographics, gender dynamics, and sexual history. Participants also completed STI laboratory screening for syphilis (immunochromatographic testing confirmed by rapid plasma reagin), and chlamydia, gonorrhea, trichomoniasis, and HIV-RNA via GeneXpert nucleic acid amplification testing. Bivariable associations of STI covariates were assessed using Fisher's exact test. Among the 50 men who completed STI screening, median age was 33 (IQR 31-37) years, 13/50 (26%) had ≥2 sexual partners in the prior three months, and 46/50 (92%) had HIV-RNA <400 copies/mL. Overall, 11/50 (22%) had STIs: 16% active syphilis, 6% chlamydia. All participants initiated STI treatment. STI prevalence was associated with the use of threats/intimidation to coerce partners into sex (27% vs 3%; p = 0.03), although absolute numbers were small. We describe a 22% curable STI prevalence among a priority population at higher risk for transmission to partners and neonates. STI screening and treatment as a part of comprehensive sexual and reproductive healthcare should be integrated into HIV care to maximize the health of men, women, and children.
Asunto(s)
Infecciones por VIH/epidemiología , Hombres/psicología , Conducta Reproductiva/psicología , Enfermedades de Transmisión Sexual/epidemiología , Adulto , Conocimientos, Actitudes y Práctica en Salud , Humanos , Educación del Paciente como Asunto , Prevalencia , Parejas Sexuales/clasificación , Enfermedades de Transmisión Sexual/tratamiento farmacológico , Enfermedades de Transmisión Sexual/psicología , Encuestas y Cuestionarios , Uganda/epidemiologíaRESUMEN
BACKGROUND: The use of mobile technologies to prevent STIs is recognised as a promising approach worldwide; however, evidence has been inconclusive, and the field has developed rapidly. With about 1 million new STIs a day globally, up-to-date evidence is urgently needed. OBJECTIVE: To assess the effectiveness of mobile health interventions delivered to participants for preventing STIs and promoting preventive behaviour. METHODS: We searched seven databases and reference lists of 49 related reviews (January 1990-February 2020) and contacted experts in the field. We included randomised controlled trials of mobile interventions delivered to adolescents and adults to prevent sexual transmission of STIs. We conducted meta-analyses and assessed risk of bias and certainty of evidence following Cochrane guidance. RESULTS: After double screening 6683 records, we included 22 trials into the systematic review and 20 into meta-analyses; 18 trials used text messages, 3 used smartphone applications and 1 used Facebook messages as delivery modes. The certainty of evidence regarding intervention effects on STI/HIV occurrence and adverse events was low or very low. There was moderate certainty of evidence that in the short/medium-term text messaging interventions had little or no effect on condom use (standardised mean differences (SMD) 0.02, 95% CI -0.09 to 0.14, nine trials), but increased STI/HIV testing (OR 1.83, 95% CI 1.41 to 2.36, seven trials), although not if the standard-of-care control already contained an active text messaging component (OR 1.00, 95% CI 0.68 to 1.47, two trials). Smartphone application messages also increased STI/HIV testing (risk ratio 1.40, 95% CI 1.22 to 1.60, subgroup analysis, two trials). The effects on other outcomes or of social media or blended interventions is uncertain due to low or very low certainty evidence. CONCLUSIONS: Text messaging interventions probably increase STI/HIV testing but not condom use in the short/medium term. Ongoing trials will report the effects on biological and other outcomes.