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1.
Medicine (Baltimore) ; 99(35): e21360, 2020 Aug 28.
Artigo em Inglês | MEDLINE | ID: mdl-32871863

RESUMO

HIV prevalence is higher among Men who have Sex with Men (MSM), owing to their unsafe sexual behavior. Further, MSM indulge in behaviors such as consumption of alcohol/oral drugs and/or injecting during/before sex that poses the risk of unsafe behaviors, thereby increasing their vulnerability to HIV. The study aims to analyze the factors associated with HIV infection among the multi-risk MSM using any substances with those MSM who do not use substances.Community-based cross-sectional survey design using probability-based sampling between October 2014 and November 2015.For the nation-wide Integrated Biological and Behavioral Surveillance (IBBS), 23,081 MSM were recruited from 4067 hotspots in 108 districts across India. Information on demographics, sexual behaviors, substance use, sexual partners, and awareness on HIV and its management was collected from the consented respondents using computer-assisted personal interview (CAPI) by trained personnel. Blood samples were tested for HIV. Statistical analyses were done, to study the associations between substance use and its influence on high-risk sexual behaviors and HIV infection.One in 3 MSM (33.88%) in India were substance users, thus exhibiting "multi-risk" (MR) behaviors. Significantly higher HIV prevalence (3.8%, P < .05) was reported among MR-MSM, despite 97.2% of them being aware of HIV. Higher HIV prevalence among MSM exhibiting homosexual behavior for ≤1 year is of specific concern, as this accounts to recent infections and indicates the increased vulnerability of the infection among the new entrants.Substance-use resulting in high-risk sexual behavior was significantly associated with higher HIV prevalence among MR-MSM. Integrated targeted interventions focusing on safe sex and safe-IDU practices among MR-MSM are required to end the disease transmission.


Assuntos
Infecções por HIV/epidemiologia , Infecções por HIV/transmissão , Homossexualidade Masculina/estatística & dados numéricos , Comportamento Sexual/etnologia , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Adolescente , Adulto , Consumo de Bebidas Alcoólicas/epidemiologia , Conscientização , Estudos Transversais , Usuários de Drogas/estatística & dados numéricos , Infecções por HIV/psicologia , Homossexualidade Masculina/etnologia , Humanos , Índia/epidemiologia , Masculino , Prevalência , Assunção de Riscos , Comportamento Sexual/psicologia , Parceiros Sexuais/classificação , Adulto Jovem
3.
BMC Infect Dis ; 20(1): 591, 2020 Aug 10.
Artigo em Inglês | MEDLINE | ID: mdl-32778057

RESUMO

BACKGROUND: Men who have sex with men (MSM) bear a disproportionate burden of HIV in Malawi. Early prevention efforts in Malawi have been largely focused on preventing heterosexual and vertical transmission of HIV, and MSM have rarely been the specific benefactors of these efforts, despite facing both higher prevalence of HIV coupled with multiple barriers to prevention and care. To better facilitate the design of culturally relevant HIV prevention programs and prioritize resources among MSM in resource limited settings, the objective of this analysis was to estimate the relationship between social factors and HIV related risk behaviors and mental health. METHODS: 338 MSM were recruited using respondent-driven sampling in Blantyre, Malawi from April 2011 to March 2012. Structural equation models were built to test the association between six latent factors: participation in social activities, social support, stigma and human rights violations, depression symptomatology, condom use, and sexual risk behaviors, including concurrent sexual partnerships and total number of partners. RESULTS: The mean age of participants was 25 years old. Almost 50% (158/338) of the participants were unemployed and 11% (37/338) were married or cohabiting with women. More than 30% (120/338) of the participants reported sexual behavior stigma and 30% (102/338) reported depression symptomatology. Almost 50% (153/338) of the participants reported any kind of HIV-related risk behaviors and 30% (110/338) participated in one of the recorded social activities. Significant associations were identified between stigma and risk behaviors (ß = 0.14, p = 0.03); stigma and depression symptomatology (ß = 0.62, p = 0.01); participation in social activities and depression symptomatology (ß = 0.17, p = 0.01). CONCLUSION: Results suggest MSM reporting stigma are more likely to report sexual risk practices associated with HIV/STI transmission and depressive symptoms, while those reporting participation in social activities related to HIV education are less likely to be depressed. Furthermore, interventions at the community level to support group empowerment and engagement may further reduce risks of HIV transmission and improve mental health outcomes. Taken together, these results suggest the potential additive benefits of mental health services integrated within comprehensive HIV prevention packages to optimize both HIV-related outcomes and general quality of life among MSM in Malawi.


Assuntos
Infecções por HIV/patologia , Homossexualidade Masculina/psicologia , Modelos Teóricos , Adulto , Depressão/patologia , Infecções por HIV/epidemiologia , Humanos , Malaui , Masculino , Saúde Mental , Prevalência , Assunção de Riscos , Comportamento Sexual , Estigma Social , Adulto Jovem
4.
Urologe A ; 59(9): 1095-1106, 2020 Sep.
Artigo em Alemão | MEDLINE | ID: mdl-32803406

RESUMO

His contemporaries described Hermann Rohleder, a physician from Leipzig, as a pioneer of sexual medicine. His career led him from treating patients with venereal diseases to urology and sexology. Rohleder worked for the institutionalization of sexology in Germany, but his attempts to establish a professorship at the University of Leipzig remained unsuccessful. Rohleder's life and work illustrate how closely the disciplines of urology and sexology were connected in the early 20th century.


Assuntos
Sexologia/história , Urologia/história , Venereologia/história , Alemanha , História do Século XIX , História do Século XX , Humanos , Masculino , Comportamento Sexual , Urologistas
5.
Lancet Child Adolesc Health ; 4(9): 699-708, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32827491

RESUMO

Sexual and reproductive health is an important aspect of human development, but discussions with adolescents and young adults on this topic are often challenging for health-care providers. As a result, many adolescents and young adults do not receive appropriate, comprehensive sexual education, despite recognition from WHO and the UN that access to this education is a human right. Adolescents and young adults with mild to moderate intellectual or developmental disability, or both, are just as likely to be sexually active as are their peers without disability; however, these individuals are less likely to receive comprehensive sexual education. To ensure adequate comprehensive sexual education for adolescents and young adults with intellectual and developmental disabilities, sexual health educators should facilitate conversations about sexual and reproductive health that are non-judgmental and sexually inclusive. Such initiatives should use an educational framework grounded in universal design for learning, including use of multiple media types with clear, concise language and images.


Assuntos
Educação Sexual/métodos , Comportamento Sexual , Saúde Sexual/educação , Adolescente , Deficiências do Desenvolvimento/psicologia , Deficiências do Desenvolvimento/terapia , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Deficiência Intelectual/psicologia , Deficiência Intelectual/terapia , Masculino , Medição de Risco , Adulto Jovem
6.
Soins Gerontol ; 25(144): 12-16, 2020.
Artigo em Francês | MEDLINE | ID: mdl-32792235

RESUMO

Negative stereotypes are often conveyed in the area of older adults' sexuality. Contrary to popular belief, sexual desire persists in elderly. Sexual activity has a positive impact on psychological well-being but it must be adapted to the elderly body because it can be hindered by somatic pathologies or medications. In this article we emphasize the rights to privacy and to sex life in the elderly.


Assuntos
Sexualidade , Idoso , Humanos , Privacidade , Comportamento Sexual
7.
Eur J Obstet Gynecol Reprod Biol ; 252: 622-623, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32778481

RESUMO

Covid-19 is not transmitted by sex but close proximity during the act could aide in spread of the disease. Health care workers by virtue of the nature of their work have higher chances of exposure to the virus and them indulging in sex needs risk reduction strategies.


Assuntos
Betacoronavirus , Infecções por Coronavirus/prevenção & controle , Transmissão de Doença Infecciosa/prevenção & controle , Pessoal de Saúde/psicologia , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Comportamento Sexual , Coito , Infecções por Coronavirus/transmissão , Feminino , Humanos , Masculino , Pneumonia Viral/transmissão , Fatores de Risco , Comportamento de Redução do Risco , Doenças Virais Sexualmente Transmissíveis/transmissão
8.
BMC Infect Dis ; 20(1): 577, 2020 Aug 05.
Artigo em Inglês | MEDLINE | ID: mdl-32758172

RESUMO

BACKGROUND: Despite the significant decline in the prevalence of HIV in Tanzania, the prevalence rates in Mbeya, Iringa, and Njombe regions are higher than the national average and have remained stable for years. The current stable HIV prevalence may be driven by factors such as a high incidence of sexually transmitted infections (STIs) and high-risk behaviours. In sub-Saharan Africa, it has previously been observed that up to 50% of HIV cases were attributed to herpes simplex type 2 (HSV-2) among low-risk populations. Because the proportion of sexually transmitted HSV-1 is rising, it is essential to study the interaction between HSV-1 and HIV infections. METHODS: We conducted a study in Mbeya region using the archived blood sera of participants from the recently completed EU-funded EMINI project. A specially designed questionnaire was used to obtain the social and demographic characteristics of the study participants in the database. We tested archived participants' sera for herpes simplex virus type 1 using Virotech HSV-1 (gG1) IgG ELISA (Enzygnost, Behring, Germany). Univariate and multivariate Poisson regression models were used to identify factors associated with HSV-1. RESULTS: A total of 640 adults were randomly recruited after stratification by HIV status (318 were HIV positive), age, and sex. The overall seroprevalence of HSV-1 in the study population was 92.1%. The extrapolated seroprevalence estimate of herpes simplex virus type 1 in the general population was 95.0% (96.0% in males versus 94.0% in females). Males and females were equally affected by HSV-1. HSV-1 was less prevalent in HIV-positive individuals than in HIV-negative individuals. CONCLUSION: People living with HIV were less likely to be HSV-1 seropositive. Further prospective studies are necessary to conclude a causal association.


Assuntos
Infecções Oportunistas Relacionadas com a AIDS/epidemiologia , HIV-1 , Herpes Simples/epidemiologia , Herpesvirus Humano 1/imunologia , Doenças Sexualmente Transmissíveis/epidemiologia , Infecções Oportunistas Relacionadas com a AIDS/sangue , Infecções Oportunistas Relacionadas com a AIDS/virologia , Adolescente , Adulto , Anticorpos Antivirais/sangue , Estudos de Coortes , Estudos Transversais , Feminino , Herpes Simples/sangue , Herpes Simples/virologia , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Prevalência , Fatores de Risco , Estudos Soroepidemiológicos , Comportamento Sexual , Doenças Sexualmente Transmissíveis/sangue , Doenças Sexualmente Transmissíveis/virologia , Tanzânia/epidemiologia , Adulto Jovem
11.
JAMA ; 324(7): 682-699, 2020 08 18.
Artigo em Inglês | MEDLINE | ID: mdl-32809007

RESUMO

Importance: Increasing rates of preventable sexually transmitted infections (STIs) in the US pose substantial burdens to health and well-being. Objective: To update evidence for the US Preventive Services Task Force (USPSTF) on effectiveness of behavioral counseling interventions for preventing STIs. Data Sources: Studies from the previous USPSTF review (2014); literature published January 2013 through May 31, 2019, in MEDLINE, PubMed (for publisher-supplied records only), PsycINFO, and Cochrane Central Register of Controlled Trials. Ongoing surveillance through May 22, 2020. Study Selection: Good- and fair-quality randomized and nonrandomized controlled intervention studies of behavioral counseling interventions for adolescents and adults conducted in primary care settings were included. Studies with active comparators only or limited to individuals requiring specialist care for STI risk-related comorbidities were excluded. Data Extraction and Synthesis: Dual risk of bias assessment, with inconsistent ratings adjudicated by a third team member. Study data were abstracted into prespecified forms. Pooled odds ratios (ORs) were estimated using the DerSimonian and Laird method or the restricted maximum likelihood method with Knapp-Hartung adjustment. Main Outcomes and Measures: Differences in STI diagnoses, self-reported condom use, and self-reported unprotected sex at 3 months or more after baseline. Results: The review included 37 randomized trials and 2 nonrandomized controlled intervention studies (N = 65 888; 13 good-quality, 26 fair-quality) recruited from primary care settings in the US. Study populations were composed predominantly of heterosexual adolescents and young adults (12 to 25 years), females, and racial and ethnic minorities at increased risk for STIs. Nineteen trials (n = 52 072) reported STI diagnoses as outcomes (3 to 17 months' follow-up); intervention was associated with reduced STI incidence (OR, 0.66 [95% CI, 0.54-0.81; I2 = 74%]). Absolute differences in STI acquisition between groups varied widely depending on baseline population STI risk and intervention effectiveness, ranging from 19% fewer to 4% more people acquiring STI. Thirty-four trials (n = 21 417) reported behavioral change outcomes. Interventions were associated with self-reported behavioral change (eg, increased condom use) that reduce STI risk (OR, 1.31 [95% CI, 1.10-1.56; I2 = 40%, n = 5253). There was limited evidence on persistence of intervention effects beyond 1 year. No harms were identified in 7 studies (n = 3458) reporting adverse outcomes. Conclusions and Relevance: Behavioral counseling interventions for individuals seeking primary health care were associated with reduced incidence of STIs. Group or individual counseling sessions lasting more than 2 hours were associated with larger reductions in STI incidence, and interventions of shorter duration also were associated with STI prevention, although evidence was limited on whether the STI reductions associated with these interventions persisted beyond 1 year.


Assuntos
Terapia Comportamental , Aconselhamento , Comportamento Sexual , Doenças Sexualmente Transmissíveis/prevenção & controle , Adolescente , Adulto , Fatores Etários , Terapia Comportamental/métodos , Aconselhamento/métodos , Feminino , Humanos , Masculino , Razão de Chances , Guias de Prática Clínica como Assunto , Gravidez , Atenção Primária à Saúde , Comportamento de Redução do Risco , Adulto Jovem
12.
JAMA ; 324(7): 674-681, 2020 08 18.
Artigo em Inglês | MEDLINE | ID: mdl-32809008

RESUMO

Importance: Approximately 20 million new cases of bacterial or viral sexually transmitted infections (STIs) occur each year in the US, and about one-half of these cases occur in persons aged 15 to 24 years. Rates of chlamydial, gonococcal, and syphilis infection continue to increase in all regions. Sexually transmitted infections are frequently asymptomatic, which may delay diagnosis and treatment and lead persons to unknowingly transmit STIs to others. Serious consequences of STIs include pelvic inflammatory disease, infertility, cancer, and AIDS. Objective: To update its 2014 recommendation, the US Preventive Services Task Force (USPSTF) commissioned a review of the evidence on the benefits and harms of behavioral counseling interventions for preventing STI acquisition. Population: This recommendation statement applies to all sexually active adolescents and to adults at increased risk for STIs. Evidence Assessment: The USPSTF concludes with moderate certainty that behavioral counseling interventions reduce the likelihood of acquiring STIs in sexually active adolescents and in adults at increased risk, including for example, those who have a current STI, do not use condoms, or have multiple partners, resulting in a moderate net benefit. Recommendation: The USPSTF recommends behavioral counseling for all sexually active adolescents and for adults at increased risk for STIs. (B recommendation).


Assuntos
Terapia Comportamental , Aconselhamento , Comportamento Sexual , Doenças Sexualmente Transmissíveis/prevenção & controle , Adolescente , Adulto , Terapia Comportamental/métodos , Aconselhamento/métodos , Feminino , Humanos , Masculino , Atenção Primária à Saúde , Comportamento de Redução do Risco
13.
Artigo em Inglês | MEDLINE | ID: mdl-32796759

RESUMO

This study used data collected from an online survey study on coronavirus disease 2019 (COVID-19) in Taiwan to examine changes in sex life during the pandemic and the factors affecting such changes. In total, 1954 respondents were recruited from a Facebook advertisement. The survey inquired changes in sex life during the pandemic, including satisfaction with the individual's sex life, frequency of sexual activity, frequency of sex-seeking activity, and frequency of using protection for sex. The associations of change in sex life with risk perception of COVID-19, general anxiety, gender, age, and sexual orientation were also examined. For each aspect of their sex life, 1.4%-13.5% of respondents reported a decrease in frequency or satisfaction, and 1.6%-2.9% reported an increase in frequency or satisfaction. Risk perception of COVID-19 was significantly and negatively associated with frequencies of sexual and sex-seeking activities. Higher general anxiety was significantly and negatively associated with satisfaction of sex life and frequencies of sexual and sex-seeking activities. Sexual minority respondents were more likely to report decreased satisfaction with sex life and frequencies of sexual activity and sex-seeking activities during COVID-19. Health care providers should consider these factors when developing strategies for sexual wellness amid respiratory infection epidemics.


Assuntos
Ansiedade/epidemiologia , Infecções por Coronavirus/epidemiologia , Pneumonia Viral/epidemiologia , Comportamento Sexual/psicologia , Fatores Socioeconômicos , Adulto , Fatores Etários , Idoso , Betacoronavirus , Coronavirus , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pandemias , Medição de Risco , Fatores Sexuais , Minorias Sexuais e de Gênero/psicologia , Inquéritos e Questionários , Taiwan/epidemiologia , Adulto Jovem
14.
BMC Infect Dis ; 20(1): 563, 2020 Aug 01.
Artigo em Inglês | MEDLINE | ID: mdl-32738895

RESUMO

BACKGROUND: Despite several intervention programmes in South Africa, risky sexual behaviours among women of reproductive age remain a public health concern, making them vulnerable to unintended pregnancies and/or sexually transmitted infections (STIs), including human immunodeficiency virus (HIV) infection. The aim of this study was to investigate the predictors of risky sexual behaviours among women of reproductive age in a high HIV-burden township in KwaZulu-Natal, South Africa. METHODS: In a cross-sectional study, 471 women of reproductive age (18-49 years, mean: 25.83) in 10 public health clinics in Umlazi Township, responded to a structured questionnaire. Data were coded, entered into Epi Data Manager and exported to Stata for analysis. A Pearson Chi-square tests and logistic regression models (bivariate and multivariate) were employed to assess the level of the association between the predictor and outcome variables and the p-value < 0.05 was considered statistically significant. RESULTS: More than half (51.80%) of the women were aged 18-24 years and only a handful (18.26%) had a tertiary qualification. The majority were single (88.96%) and the unemployed accounted for 53.50%. This study found that women who had talked about condoms with their partner in the past 12 months were more likely (p = < 0.0001) to have used condoms during their last sexual intercourse. Older women (p = 0.035) were more likely to have used a condom at last sex, compared to younger women. However, women who were exposed to physical partner violence (hitting and/or slapping), those who had been diagnosed with HIV and those whose sexual partners were diagnosed with HIV, did not show a significant association with condom use at last sex. CONCLUSION: Exposure to physical partner violence and poor partner discussions about condoms are key deterrents to condom usage. Holistic interventions are required in order to address the risky behaviours, and consequently reduce sexually transmitted infections and/or unintended pregnancies.


Assuntos
Infecções por HIV/patologia , Comportamento Sexual , Adolescente , Adulto , Fatores Etários , Preservativos/estatística & dados numéricos , Estudos Transversais , Feminino , Infecções por HIV/epidemiologia , Humanos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Razão de Chances , Delitos Sexuais , África do Sul/epidemiologia , Inquéritos e Questionários , Adulto Jovem
15.
Epidemiol Infect ; 148: e185, 2020 08 24.
Artigo em Inglês | MEDLINE | ID: mdl-32829742

RESUMO

During the last months and following the implementation of containment measures in the context of coronavirus disease 2019 (COVID-19) pandemic, the number of new human immunodeficiency virus (HIV) diagnoses radically decreased in Liege AIDS Reference Center, Belgium. The number of HIV screening tests has also dramatically dropped down to an unprecedented level. This decline of HIV diagnosis is caused by missed diagnoses of individuals infected before the establishment of such measures and to the reduction of high-risk sexual behaviours during the COVID-19 pandemic.


Assuntos
Infecções por Coronavirus/prevenção & controle , Infecções por HIV , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Bélgica , Betacoronavirus , Infecções por HIV/diagnóstico , Infecções por HIV/epidemiologia , Infecções por HIV/transmissão , Humanos , Programas de Rastreamento/estatística & dados numéricos , Comportamento Sexual/estatística & dados numéricos
16.
Zhonghua Liu Xing Bing Xue Za Zhi ; 41(7): 1081-1085, 2020 Jul 10.
Artigo em Chinês | MEDLINE | ID: mdl-32741175

RESUMO

Objective: To analyze the prevalence of anal sex and related factors in low-tier female sex workers (FSWs) in the demonstration areas of comprehensive AIDS responses (DACAR) in Zhejiang province. Method: In 2013, a survey on low-tier FSWs was carried out in 21 Demonstration Areas of AIDS Responses in Zhejiang. Experience of having anal sex with clients in the last month was taken as dependent variable while independent variables would include perception and characteristics related to behavior of the FSWs. The multivariate logistic regression analyses were conducted to identify the factors related to anal sex in low-tier FSWs. Results: A total of 2 645 low-tier FSWs were interviewed. Among these FSWs, 67.9% (1 796/2 645) were over 26 years old, 89.9% (2 378/2 645) were with education level of junior high school or below, 58.4% (1 546/2 645) were married, 78.2% (2 068/2 645) were from other provinces, 68.6% (1 814/2 645) had income level less than 4 000 Yuan, and rates of anal sex with client in the last month were 5.03% (133/2 645). Results from the multivariate logistic regression analysis of related factors of anal sex with client in the last month showed that among the low-tier FSWs, the venues of having commercial sex were in hair salons/massage parlors (OR=7.31, 95%CI: 2.27-23.59), roadside shops (OR=7.89, 95%CI: 2.27- 27.40) or other places (OR=4.65, 95%CI: 1.23-17.53), when compared with the street-women service. FSWs often engaged in commercial sex business in three or more counties (OR=1.68, 95%CI: 1.01-2.81), when compared with FSWs often engaged in commercial sex business just one county. FSWs had sex with only middle-aged and the elderly clients (OR=0.45, 95%CI: 0.30-0.66), when compared with FSWs had sex with young or middle-aged and the elderly clients. FSWs had risk perception for sexually transmitted disease (STD) (OR=2.00, 95%CI: 1.20-3.32), when compared with FSWs with no risk perception. FSWs had oral sex experience with their clients in the last month (OR=7.29, 95%CI: 4.78-11.12), when compared with the ones without oral sex. The above said factors were all related to the incidence of anal sex. Conclusions: Certain numbers of low-tier FSWs had anal sex experiences with their clients, especially those who had oral sex were more likely to have anal sex in DACAR in Zhejiang province. Attention should be paid to anal sex behavior when conducting behavior-related intervention programs, targeting on the low-tier FSWs.


Assuntos
Síndrome de Imunodeficiência Adquirida/prevenção & controle , Profissionais do Sexo/psicologia , Comportamento Sexual/estatística & dados numéricos , Síndrome de Imunodeficiência Adquirida/epidemiologia , Adulto , China/epidemiologia , Feminino , Humanos , Prevalência , Fatores de Risco , Profissionais do Sexo/estatística & dados numéricos , Fatores Socioeconômicos
17.
Pediatrics ; 146(2)2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32636237

RESUMO

OBJECTIVE: The Centers for Disease Control and Prevention recommend testing for Chlamydia trachomatis in sexually active female patients <25 years old using nucleic-acid amplification tests (NAAT) from a vaginal swab. Our providers were typically testing using the less sensitive urine NAATs. We aimed to increase the percentage of urogenital C trachomatis NAATs performed by using vaginal swabs in adolescent female patients ages 10 through 20 years from 1.4% to 25%. METHODS: We implemented 3 interventions at 3 pediatric practices over 12 months including education, process standardization, and cross-training. We used statistical process control to analyze the effect of interventions on our primary outcome: the percentage of urogenital C trachomatis tests performed with a vaginal swab. Our balance measure was the total number of urogenital C trachomatis tests. RESULTS: There were 818 urogenital C trachomatis tests performed: 289 before and 529 after the first intervention. Of urogenital C trachomatis tests in the preintervention time period, 1.4% were performed by using vaginal swabs. We surpassed our aim of 25% 6 weeks after the first intervention. We noted sustained improvement after the second intervention, with an average of 68.3% of tests performed by using vaginal swabs for the remaining postintervention period. There was no difference in the overall number of urogenital C trachomatis tests pre- and postintervention. CONCLUSIONS: Using quality improvement methodology and implementing easily replicable interventions, we significantly and sustainably increased use of vaginal swabs. The interventions standardizing processes were associated with a higher impact than the educational intervention.


Assuntos
Infecções por Chlamydia/diagnóstico , Chlamydia trachomatis/isolamento & purificação , Técnicas de Amplificação de Ácido Nucleico/métodos , Pediatras/educação , Padrões de Prática Médica/tendências , Vagina/microbiologia , Esfregaço Vaginal/tendências , Adolescente , Criança , Infecções por Chlamydia/epidemiologia , Feminino , Humanos , Massachusetts/epidemiologia , Técnicas de Amplificação de Ácido Nucleico/estatística & dados numéricos , Folhetos , Guias de Prática Clínica como Assunto , Padrões de Prática Médica/estatística & dados numéricos , Utilização de Procedimentos e Técnicas/tendências , Avaliação de Programas e Projetos de Saúde , Melhoria de Qualidade , Comportamento Sexual , Adulto Jovem
18.
PLoS One ; 15(7): e0235608, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32639994

RESUMO

Sex is an important factor in mental health, and a non-binary view of how variation in sex and gender influence mental health represents a new research frontier that may yield new insights. The recent acceleration of research into sexual orientation, gender identity, and mental health has generally been conducted without sufficient understanding of the opinions of sexual and gender minorities (SGM) toward this research. We surveyed 768 individuals, with an enrichment of LGBTQ+ stakeholders, for their opinions regarding genetic research of SGM and mental health. We found that the key predictors of attitudes toward genetic research specifically on SGM are 1) general attitudes toward genetic and mental health research 2) tolerance of SGM and associated behaviors and 3) age of the participant. Non-heterosexual stakeholder status was significantly associated with increased willingness to participate in genetic research if a biological basis for gender identity were discovered. We also found that heterosexual, cisgender participants with a low tolerance for SGM indicated their SGM views would be positively updated if science showed a biological basis for their behaviors and identities. These findings represent an important first step in understanding and engaging the LGBTQ+ stakeholder community in the context of genetic research.


Assuntos
Atitude , Identidade de Gênero , Pesquisa em Genética , Saúde Mental , Características de Residência/estatística & dados numéricos , Comportamento Sexual , Adolescente , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Minorias Sexuais e de Gênero/psicologia , Participação dos Interessados/psicologia , Inquéritos e Questionários , Adulto Jovem
19.
PLoS One ; 15(7): e0235601, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32649697

RESUMO

INTRODUCTION: Given the social, economic, and health consequences of early parenthood, unintended pregnancy, and the risks of HIV infection and subsequent transmission, there is an urgent need to understand how adolescents make sexual and reproductive decisions regarding contraceptive use. This study sought to assess the association between female adolescents' reproductive health decision-making capacity and their contraceptive usage. MATERIALS AND METHODS: Data was obtained from pooled current Demographic and Health Surveys (DHS) conducted in 32 countries in sub-Saharan Africa (SSA). The unit of analysis for this study was adolescents in sexual unions [n = 15,858]. Bivariate and multivariable analyses were conducted using Pearson chi-square tests and binary logistic regression respectively. All analyses were performed using STATA version 14.2. Results were presented using Odds Ratios [OR] and adjusted Odds Ratios [AOR]. Statistical significance was set at p<0.05. RESULTS: The results showed that 68.66% of adolescents in SSA had the capacity to make reproductive health decisions. The overall prevalence of contraceptive use was 18.87%, ranging from 1.84% in Chad to 45.75% in Zimbabwe. Adolescents who had the capacity to take reproductive health decisions had higher odds of using contraceptives [AOR = 1.47; CI = 1.31-1.65, p < 0.001]. The odds of contraceptive use among female adolescents increased with age, with those aged 19 years having the highest likelihood of using contraceptives [AOR = 3.12; CI = 2.27-34.29, p < 0.001]. Further, the higher the level of education, the more likely female adolescents will use contraceptives, and this was more predominant among those with secondary/higher education [AOR = 2.50; CI = 2.11-2.96, p < 0.001]. Female adolescents who were cohabiting had higher odds of using contraceptives, compared to those who were married [AOR = 1.69; CI = 1.47-1.95, p < 0.001]. The odds of contraceptive use was highest among female adolescents from the richest wealth quintile, compared to those from the poorest wealth quintile [AOR = 1.65; CI = 1.35-2.01, p<0.001]. Conversely, female adolescents in rural areas were less likely to use contraceptives, compared to those in urban areas [AOR = 0.78; CI = 0.69-0.89, p < 0.001]. CONCLUSION: The use of general and modern contraceptives among adolescents in SSA remains low. Therefore, there is a need to strengthen existing efforts on contraceptives usage among adolescents in SSA. This goal can be achieved by empowering these young females, particularly those in the rural areas where the level of literacy is very low to take positive reproductive health decisions to prevent unintended teenage pregnancy, HIV/AIDs and other sexually transmitted infections. This approach would help reduce maternal mortality and early childbirth in studied SSA countries.


Assuntos
Comportamento Contraceptivo/psicologia , Comportamento Contraceptivo/estatística & dados numéricos , Tomada de Decisões , Inquéritos Epidemiológicos , Saúde Reprodutiva/estatística & dados numéricos , Adolescente , África ao Sul do Saara , Demografia , Feminino , Humanos , Modelos Logísticos , Comportamento Sexual , Adulto Jovem
20.
Pediatrics ; 146(2)2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32690805

RESUMO

Rates of sexual activity, pregnancies, and births among adolescents have continued to decline during the past decade to historic lows. Despite these positive trends, many adolescents remain at risk for unintended pregnancy and sexually transmitted infections (STIs). This technical report discusses the new data and trends in adolescent sexual behavior and barrier protection use. Since 2017, STI rates have increased and use of barrier methods, specifically external condom use, has declined among adolescents and young adults. Interventions that increase availability of or accessibility to barrier methods are most efficacious when combined with additional individual, small-group, or community-level activities that include messages about safer sex. Continued research informs public health interventions for adolescents that increase the consistent and correct use of barrier methods and promote dual protection of barrier methods for STI prevention together with other effective methods of contraception.


Assuntos
Preservativos Femininos , Preservativos , Comportamento Sexual , Adolescente , Fatores Etários , Preservativos/estatística & dados numéricos , Preservativos Femininos/estatística & dados numéricos , Comportamento Contraceptivo/estatística & dados numéricos , Pessoas com Deficiência/estatística & dados numéricos , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Relações Interpessoais , Profilaxia Pré-Exposição , Gravidez , Gravidez na Adolescência/estatística & dados numéricos , Gravidez não Planejada , Fatores Raciais , Sexo Seguro , Autoimagem , Educação Sexual , Minorias Sexuais e de Gênero/estatística & dados numéricos , Doenças Sexualmente Transmissíveis/epidemiologia , Doenças Sexualmente Transmissíveis/prevenção & controle , Apoio Social
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