الملخص
Durante la última década, presenciamos en Argentina un aumento de la incidencia de infecciones de transmisión sexual(ITS) vinculado con una disminución en el uso de métodos de barrera (MB). De acuerdo a la bibliografía, existen varias categorías de obstáculos para el uso de MB: desigualdades de género, dificultades económicas y/o de accesibilidad, desconfianza respecto de los MB provistos por el Estado respecto de su calidad y/o fecha de vencimiento, o bien, creencias acerca de que la utilización de MB disminuye el placer sexual o que no es necesario su uso cuando la relación de pareja es estable y/o basada en la confianza, el amor y/o la fidelidad. A partir de esta problemática, los autores de este artículo realizamos una búsqueda bibliográfica y revisamos cual es la evidencia que respalda diferentes intervenciones para promover el uso de MB. Encontramos evidencia de moderada calidad que avala la eficacia de intervenciones a nivel comunitario basadas en la teoría sociocognitiva y en el aumento de la oferta y la disponibilidad de preservativos para mejorar el conocimiento sobre el HIV y el uso de estos métodos, sin impacto sobre la incidencia de ITS a nivel poblacional. (AU)
Over the last decade, Argentina has shown an increase in the incidence of sexually transmitted infections (STIs) linked to a decrease in the use of barrier methods (BM). According to the literature, there are several categories of obstacles for the use of BM: gender inequalities, economic and/or accessibility difficulties, mistrust regarding the quality and/or expiry date of state-provided BMs, as well as beliefs that the use of BMs reduces sexual pleasure or that their use is not necessary when the couple's relationship is stable and/or based on trust, love and/or fidelity. In light of this issue, the authors of this article conducted a literature search and reviewed the evidence supporting different interventions to promote the use of BM. They found moderate quality evidence that supports the efficacy of community-level interventions based on socio-cognitive theory and on increasing the supply and availability of condoms to improve knowledge about HIV and the use of these methods, with no impact on the incidence of STIs at the population level. (AU)
الموضوعات
Humans , Male , Female , Contraception, Barrier/trends , Unsafe Sex/statistics & numerical data , Evaluation of the Efficacy-Effectiveness of Interventions , Argentina , Syphilis/prevention & control , Syphilis/epidemiology , Sexually Transmitted Diseases/prevention & control , Sexually Transmitted Diseases/epidemiology , Condoms/trends , Coitus , Contraception, Barrier/statistics & numerical data , Systematic Reviews as Topic , Health Promotion/trendsالملخص
RESUMEN Objetivo Evaluar la efectividad de las intervenciones de tipo estructural o multicomponente dirigidas al incremento del uso del preservativo en adolescentes y jóvenes, identificar las estrategias que conforman las intervenciones evaluadas y reconocer los modelos teóricos que sustentan dichas intervenciones. Metodología Diseño: revisión sistemática de la literatura. Fuente de datos: se consultaron las bases de datos MEDLINE vía OVID, Embase y CENTRAL para buscar estudios sobre intervenciones dirigidas al incremento del uso del preservativo en adolescentes y jóvenes. Selección de estudios: se seleccionaron un total de 7 investigaciones primarias donde se evaluaba el efecto de una intervención estructural o multicomponente para incrementar el uso del preservativo en adolescentes y jóvenes. La calidad de los estudios fue evaluada usando la herramienta para valoración de riesgo de sesgos de Cochrane. Resultados Cinco investigaciones mostraron cambios en los porcentajes del uso del preservativo con valores entre 53 % y el 68 %. Las intervenciones planteadas orientaban sus acciones más a nivel individual con estrategias como: educación sobre salud sexual, consejería en salud reproductiva, conocimientos acerca del preservativo, conocimientos acerca de las ITS/VIH. A nivel organizacional y del entorno iban dirigidas a la provisión de preservativos. Los modelos teóricos planteados en los estudios están centrados en la conducta humana, comportamiento del individuo y el aprendizaje social. Discusión Las intervenciones de tipo estructural que tienen como fin el incremento del uso del preservativo en adolescentes y jóvenes parecen mostrar cambios significativos a nivel individual, pero se desconocen los posibles cambios generados a nivel de la organización y del entorno.(AU)
ABSTRACT Objective Evaluate the effectiveness of structural or multicomponent interventions aimed at increasing the use of condoms in adolescents and young adults, identifying the strategies that form the interventions evaluated, and recognizing the theoretical models that support these interventions. Methodology Design: Systematic review of literature. Data source: MEDLINE databases were consulted via OVID, Embase, and CENTRAL in order to search for studies on interventions aimed at increasing the use of condoms in adolescents and young adults. Selection of studies: A total of 7 primary investigations were selected, in which the effect of a structured or multicomponent intervention to increase the use of condoms in adolescents and young adults was evaluated. The quality of the studies was evaluated using the Cochrane bias risk assessment. Results Five investigations show changes in the percentages of condom use with values between 53% and 68%. The interventions targeted guided their actions more at individual level with strategies such as sexual health education, reproductive health counseling, knowledge about the condom, knowledge about STIs / HIV, than at organizational and environ-mental levels, which were aimed at the provision of condoms. The theoretical models proposed in the studies are focused on human behavior, individual behavior, and social learning. Conclusion Structural interventions that aim to increase the use of condoms in adolescents and young adults seem to show significant changes at individual level, but possible changes generated at both organization and environment levels are unknown.(AU)
الموضوعات
Humans , Adolescent , Adult , Condoms/trends , Evaluation of the Efficacy-Effectiveness of Interventions , Health Promotion/methodsالملخص
Resumen: Objetivo: Caracterizar el uso de condón en la primera y última relación sexual en diferentes cohortes para observar posibles diferencias entre grupos generacionales. Material y métodos: Mediante la Encuesta Nacional de Niños, Niñas y Mujeres 2015, representativa a nivel nacional, se ajustaron modelos de regresión Poisson para buscar asociación de variables de interés con el uso del condón en la primera y última relación sexual. Resultados: Las cohortes más jóvenes, con mayor educación y riqueza tienen mayores posibilidades de usar condón en su primera y última relación sexual; hablar lengua indígena se asocia con menores posibilidades de uso en ambos eventos. El uso de condón en el debut sexual incrementa la posibilidad de uso en la última relación sexual. Conclusiones: Existe un cambio generacional en el uso del condón en la primera y última relación sexual entre las más jóvenes. La utilización del condón en el debut sexual favorece su uso posterior.
Abstract: Objective: Characterize the use of condoms in the first and last sexual intercourse in different birth cohorts, to observe possible differences among generations. Materials and methods: Using the National Survey of Boys, Girls and Women, 2015, representative at the national level, we adjust Poisson regression models to find associations between variables of interest and the use of condoms in first and last intercourse. Results: Women from younger cohorts, with higher education and wealth are more likely to use a condom in their first and last sexual intercourse; speaking an indigenous language is associated with a lower likelihood of condom use at both events. Using condom in sexual debut increases the likelihood of using in last intercourse. Conclusions: There is a generational change in condom use at first and last sex among younger cohorts. The use of the condom in sexual debut favors its later use.
الموضوعات
Adolescent , Adult , Female , Humans , Middle Aged , Young Adult , Condoms/trends , Coitus , Rural Population/statistics & numerical data , Urban Population/statistics & numerical data , Poisson Distribution , Surveys and Questionnaires , Cohort Studies , Negotiating , Condoms/statistics & numerical data , Educational Status , Economic Status , Languageالملخص
El uso del condón es un método eficaz para prevenir enfermedades venéreas y un embarazo no deseado. Años atrás se puede apreciar cómo se debate dónde y cómo los llamados dispositivos intrauterinos fueron utilizados por primera vez. La siguiente investigación se realizó con el objetivo de explicar el surgimiento y la evolución del condón y otros métodos anticonceptivos, para ello se utilizaron un total de 15 referencias bibliográficas. Es indudable que la anticoncepción tiene que figurar como elemento básico de la atención en medicina, el conocimiento de sus orígenes, historia y evolución es fundamental. (AU)
The use of the condom is an effective method to prevent venereal diseases and an unwanted pregnancy. Years ago you can see how it is discussed where and how the so-called intrauterine devices were used for the first time. The following investigation was carried out with the objective of explaining the emergence and evolution of the condom and other contraceptive methods, for which a total of 15 bibliographical references were used. Undoubtedly, contraception must figure as a basic element of medical care, knowledge of its origins, history and evolution is fundamental. (AU)
الموضوعات
Humans , History, 16th Century , Sex Education/history , Sex Education/trends , Condoms/history , Condoms/trends , Contraceptive Devices/history , Contraceptive Devices/trends , Social Marketing , Health Promotion/history , Health Promotion/trends , Pregnancy in Adolescence/prevention & control , Sexually Transmitted Diseases/prevention & controlالملخص
Objetivo: analisar os fatores sociodemográficos relacionados ao não uso do preservativo nas relações sexuais e a prevalência de infecções sexualmente transmissíveis (IST) em comunidades rurais de Ouro Preto, Minas Gerais, Brasil, entre 2014 e 2016. Métodos: foram coletados dados de entrevista individual e realizados testes rápidos; as associações foram testadas pelo modelo de regressão de Poisson, com intervalo de confiança de 95% (IC95%). Resultados: foram detectados 3,8 casos/10 mil habitantes de hepatite B e sífilis, e 1,3/10 mil hab. de hepatite C; não foram detectados casos de HIV; na análise multivariada, foram encontradas maiores prevalências de não uso de preservativos entre indivíduos casados/em união estável/viúvos (RP=1,20 - IC95% 1,06;1,36). Conclusão: o grupo com maior prevalência de não uso de preservativo é o de pessoas com relacionamento fixo; novos casos de sífilis e de hepatites virais foram detectados pelo teste rápido, aplicado no inquérito.
Objetivo: investigar el perfil sociodemográfico asociado al no uso del preservativo en las relaciones sexuales y describir la prevalencia de infecciones de transmisión sexual (ITS) en comunidades rurales de Ouro Preto, Minas Gerais, Brasil, entre 2014 y 2016. Métodos: se recolectaron datos en entrevista individual y se realizaron pruebas rápidas; las asociaciones fueron analizadas por la regresión de Poisson, con intervalo de confianza de 95% (IC95%). Resultados: se detectaron 3,8 casos/10 mil habitantes de hepatitis B y sífilis, y 1,3/10 mil habitantes de hepatitis C; no se detectaron casos de VIH; el análisis multivariado mostró mayor prevalencia de no uso del preservativo para personas casadas /en unión estable/viudos (RP=1,20 - IC95% 1,06;1,36). Conclusión: se detectaron nuevos casos de sífilis y hepatitis virales por las pruebas rápidas en esta investigación; el grupo de mayor riesgo de no usar preservativo fue de personas casadas/con relación fija.
Objective: to investigate socio-demographic factors associated with non-use of condoms, and to describe the prevalence of sexually transmitted infections (STI) in rural communities of Ouro Preto, Minas Gerais, Brazil, 2014 to 2016. Methods: data were gathered from individual interviews and rapid tests were performed; associations were tested using Poisson regression, with a 95% confidence interval (95%CI). Results: we detected 3.8 cases/10,000 inhabitants for hepatitis B and syphilis, and 1.3 cases/10,000 inhabitants for hepatitis C; no HIV cases were detected; in the multivariate analysis we found higher prevalence rates of condom non-use among the group of individuals who were married, had common law partners or were widowed (PR=1.20 - 95%CI 1.06;1.36). Conclusion: individuals in a stable relationship formed the group with the highest prevalence rate of condom non-use; new syphilis and viral hepatitis cases were detected using rapid tests during the survey.
الموضوعات
Humans , Male , Female , Adult , Middle Aged , Aged , Young Adult , Syphilis Serodiagnosis , AIDS Serodiagnosis , Syphilis/epidemiology , Sexually Transmitted Diseases/epidemiology , HIV Infections/epidemiology , Hepatitis C/diagnosis , Hepatitis C/epidemiology , Hepatitis B/diagnosis , Hepatitis B/epidemiology , Sexual Behavior/statistics & numerical data , Socioeconomic Factors , Brazil/epidemiology , Serologic Tests/methods , Rural Health/statistics & numerical data , Prevalence , Cross-Sectional Studies , Condoms/trendsالملخص
Objective: To investigate the changes of proportion on both consistent condom use and syphilis infection among low-fee female sex workers aged 35 and above (LFSW), in order to provide evidence for targeted intervention strategies. Methods: A total of six cities-Liuzhou city and Pingnan couty of Guigang city of Guangxi Zhuang Autonomous Region, Jinghong city of Xishuangbanna Dai autonomous prefecture and Dali city of Dali Bai autonomous prefecture of Yunnan province, Zhangjiajie city and Jianghua Yao autonomous county of Yongzhou city Hunan province were involved in this study, with 60 eligible participants needed in each city, estimated through a pre-study. The first cross-sectional survey was completed from October 2012 to January 2013. Face-to-face questionnaire interview was carried out to collect information on socio-demography, work-related information and condom use situation. Blood was collected for syphilis testing. The second cross-sectional survey was carried out from June to September, 2015 under the same procedure. Results: A total of 371 and 403 eligible participants were included in the first and second survey, respectively. When comparing the two surveys, we noticed that the average age showed a slight change, from 42.4 years to 43.8 years old (t=3.537, P<0.001) and the average price for every commercial sex exchange increased from 36.8 RMB to 49.5 RMB (t=11.961, P<0.001). In the first survey, 46.9% (174/371) of the participants had more than two years of experience working as LFSW, compared to 61.3% (247/403) in the second survey (χ(2)=16.125, P<0.001). Also, 46.9% (174/371) of the participants consistently used condoms with clients in the past month in the first survey versus 64.3% (259/403) (χ(2)=23.641, P<0.001) in the second one. Rates of syphilis infection were found from 15.9% (59/371) in the first survey reduced to 7.2% (29/403) in the second survey (χ(2)=14.533, P<0.001). Conclusion: Compared with the first survey, the proportion of consistent condoms use showed an increase. Although the proportion of syphilis infection decreased in the second survey, the scope did not meet the criteria on syphilis, set by the government. Targeted intervention strategies on condom promotion and syphilis control should be implemented consistently in this population.
الموضوعات
Adult , Female , Humans , China/epidemiology , Condoms/trends , Cross-Sectional Studies , Prevalence , Risk Factors , Safe Sex , Sex Work , Sex Workers , Sexually Transmitted Diseases/epidemiology , Surveys and Questionnaires , Syphilis/prevention & control , Syphilis Serodiagnosisالملخص
RESUMEN Objetivo Investigar los factores socioeconómicos, demográficos y culturales que influyen en la adherencia al uso del condón en población abierta. Métodos Estudio transversal, con un enfoque cuantitativo, por medio de una encuesta de hogares de carácter explicativa, en el municipio de Caraúbas, Oeste medio de Potiguar, con 3 482 individuos mayores de 18 años. Se aplicó cuestionario en formato Likert en el entorno doméstico, por parte de trabajadores sanitarios de la comunidad. Se utilizó estadística descriptiva, análisis univariado y bivariado, y la prueba de Chi-cuadrado. Resultados Los grupos más receptivos al uso de preservativos fueron los más jóvenes, los hombres, los participantes que no tenían una relación estable y los que tenían un nivel de educación superior. Se encontró menor uso del condón en los estratos de mayores ingresos. Las razones planteadas en el estudio para el abandono de los condones fueron la preferencia de otro método anticonceptivo y la confianza en la pareja. La principal razón aducida para su uso fue la prevención de enfermedades de transmisión sexual. Discusión Sin embargo, se concluyó que la adhesión al condón era frágil en cualquiera de los grupos considerados y se debe popularizar la efectividad individual y colectiva del uso del condón, por medio de la información, la educación sexual y la superación de los conflictos de género.(AU)
RESUMO Objetivo Objetivou-se investigar os elementos socioeconômicos, demográficos e culturais que interferem na adesão ao uso da camisinha em população aberta. Métodos Realizou-se estudo transversal, com abordagem quantitativa, através de inquérito domiciliar de natureza explicativa, no município de Caraúbas, mesorregião oeste potiguar, com 3 482 indivíduos maiores de 18 anos. Foi aplicado questionário em formato Likert, por agentes comunitários de saúde, em ambiente domiciliar. Realizou-se estatística descritiva, seguida de análises univariada e bivariada, com uso do teste de Qui-quadrado. Resultados Os grupos mais receptivos ao uso do condom dizem respeito às faixas etárias mais precoces, indivíduos do sexo masculino, participantes que não declararam estar em relacionamento estável e aqueles com grau de instrução mais elevado. A associação entre renda e adoção da camisinha revelou que os estratos mais abastados representaram menor adoção do preservativo. Os motivos levantados no estudo para o abandono do preservativo foram a preferência por outro método anticoncepcional e a confiança no parceiro e a principal justificativa declarada para sua utilização foi a prevenção contra as doenças sexualmente transmissíveis. Discussão Entretanto, concluiu-se que a adesão à camisinha foi frágil em quaisquer dos grupos considerados e que a popularização do método deve perpassar por medidas de efetivação individuais e coletivas que considerem o uso da dupla finalidade do condom, pela ampliação das informações através de educação sexual formalizada e indistinta e pela superação dos conflitos de gênero.(AU)
ABSTRACT Objective To investigate the socioeconomic, demographic and cultural elements that interfere in the adherence to the use of condoms in an open population. Methodology A cross-sectional study with a quantitative approach was conducted through an explanatory household survey, in the municipality of Caraúbas, West Potiguar mesoregion, with 3 482 individuals older than 18. A Likert questionnaire was administered by community health agents in a household setting. Descriptive statistics were performed, followed by univariate and bivariate analyzes, using the Chi-square test. Results The most receptive groups to condom use are the earliest age groups, male subjects, participants who do not have a stable relationship, and those with a higher education level. The association between condom and condom use showed that the more affluent strata represented less condom adoption. The reasons for condom abandonment were the preference for another contraceptive method and the confidence in the partner, and the main reason for its use was prevention against sexually transmitted diseases. Discussion Adherence to condom use is scarce in all the groups considered. The popularization of the method must be fostered by individual and collective measures directed to consider the use of condoms for a dual purpose, by expanding information through sex education campaigns and overcoming gender conflicts.(AU)
الموضوعات
Humans , Socioeconomic Factors , Sexually Transmitted Diseases/prevention & control , Condoms/trends , Safe Sex , Brazil/epidemiology , Cross-Sectional Studies/instrumentationالموضوعات
Humans , Demography , Reproductive Health , Abortion, Induced , Sexual Abstinence , Contraception/trends , Sexual Behavior , Health Status Disparities , Population Studies in Public Health , Health of Ethnic Minorities , Medical Examination , Pregnancy in Adolescence , HIV Infections/epidemiology , Parturition , Condoms/trends , Acquired Immunodeficiency Syndrome/epidemiologyالموضوعات
Humans , Male , Female , HIV , Contraceptive Agents, Male/administration & dosage , Contraceptive Agents, Male/supply & distribution , Condoms/supply & distribution , Condoms/trends , Sexually Transmitted Diseases/prevention & control , Social Marketing , Reproductive Health , Reproductive Health Services/supply & distributionالملخص
Busca atingir um dos grupos mais afetados pela epidemia da aids, que são os jovens. pioneiro no conceito de vulnerabilidade, destina-se a promover o encontro de educadores e adolescentes em torno da proposta de construção de uma resposta efetiva e solidária a expansão da doença.
الموضوعات
Humans , Adolescent , Adolescent , Disaster Vulnerability , Social Vulnerability , Acquired Immunodeficiency Syndrome/prevention & control , Disease Outbreaks , Condoms/trends , Socioeconomic Factors , Illicit Drugs , Violenceالملخص
O objetivo deste trabalho foi analisar alguns aspectos acerca do "condom" e sua influência no exercício da sexualidade. Depreende-se que, na sua história secular, a finalidade inicial foi de prevençäo contras as doenças sexualmente transmissíveis (DST) (século XVI) e, posteriormente no século XVIII, sua ênfase foi na contracepçäo. A partir dos anos 80, curiosamente, o condom volta a assumir importante papel nas tentativas de prevençäo das doenças transmitidas, por via sexual, apresentando como principal objetivo o controle da expansäo da epidemia, provocada pelo vírus da imunodeficiência humana.