Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 3.153
Filtrar
1.
Arch Ital Urol Androl ; 92(2)2020 Jun 23.
Artigo em Inglês | MEDLINE | ID: mdl-32597102

RESUMO

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the coronavirus that causes an infectious disease, called COVID-19, first detected in patients with pneumonia in Wuhan (People's Republic of China) on December 2019. Italy was the first European country to state the outbreak of the infection and its Council of Ministers declared the state of health emergency on 31.01.2020, then the World Health Organization ruled a global pandemic on 11.03.2020. The nasopharyngeal swab is based on the detection of virus RNA and is the only reliable one for declaring COVID-19 infection. The most common symptoms observed in COVID-19 patients before hospitalization may be fever, chills, cough, dyspnea, asthenia, myalgia and/or arthralgia. This symptomatology can be often complicated in a dramatically increasing manner such as to require hospitalization starting from the third-fourth week. COVID-19 outbreak has dramatically affected the quality of life by changing inter-personal relationships, community life and obviously sexual health. The purpose of this work, based on available evidence, is to provide recommendations to help the population to face their sexual life in this critical period.


Assuntos
Betacoronavirus , Infecções por Coronavirus/prevenção & controle , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Comportamento Sexual , Betacoronavirus/isolamento & purificação , Líquidos Corporais/virologia , Técnicas de Laboratório Clínico , Convalescença , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/transmissão , Transmissão de Doença Infecciosa/prevenção & controle , Medo , Feminino , Felicidade , Humanos , Itália , Masculino , Pneumonia Viral/diagnóstico , Pneumonia Viral/epidemiologia , Pneumonia Viral/transmissão , Qualidade de Vida , Quarentena , Sexo Seguro/psicologia , Comportamento Sexual/psicologia , Parceiros Sexuais/psicologia , Avaliação de Sintomas
2.
Pediatrics ; 145(Suppl 2): S219-S224, 2020 05.
Artigo em Inglês | MEDLINE | ID: mdl-32358214

RESUMO

Almost 1 in 4 adolescents have a sexually transmitted infection (STI). These infections are preventable through safe sexual practices and routine screening. Pediatricians are the first line of clinical care for adolescents and are well positioned to offer sexual and reproductive health care counseling and services to their patients; yet, there is a paucity of sexual health screening provided at routine health supervision visits. This article addresses the epidemiology of STIs in adolescents, reviews the evidence of current clinical practice, presents recommended STI screening from government and medical agencies, and offers strategies to address barriers to providing care for adolescents and for sexual health screening in primary care.


Assuntos
Assistência Ambulatorial , Programas de Rastreamento , Doenças Sexualmente Transmissíveis/epidemiologia , Adolescente , Estudos Transversais , Feminino , Humanos , Masculino , Pediatria , Sexo Seguro , Aconselhamento Sexual , Doenças Sexualmente Transmissíveis/diagnóstico , Doenças Sexualmente Transmissíveis/prevenção & controle , Estados Unidos
3.
PLoS One ; 15(4): e0231026, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32240244

RESUMO

BACKGROUND: Currently, human immunodeficiency virus (HIV) sentinel surveillance among men who have sex with men (MSM) in China conducted in large and medium-sized cities, and no HIV sentinel surveillance conducted in rural areas. HIV testing and intervention is predominantly conducted in urban areas, there have been a limited number of studies in rural areas MSM, it is necessary to conduct the investigation of HIV risk sexual behavior, HIV testing among rural and urban MSM. METHOD: Between December 2013 and August 2015, a cross-sectional study was conducted in rural and urban areas in Zhejiang Province using respondent-driven sampling (RDS). Participants completed face-to-face interviewer-administered questionnaire surveys and were tested for HIV. RESULTS: A total of 710 MSM participants were recruited, of whom 36.1% were from rural areas. The overall HIV prevalence was 16.6%, and was considerably lower among MSM living in rural areas (3.9%) than those living in urban areas (24.2%). 61.1% participants had not condom use with male sexual behavior in the past 6 months (86.7% in rural areas and 46.7% in urban areas). The social demographic and behavioral characteristics had significance difference among rural and urban MSM. Multivariate logistic regression revealed that, compared to men living in urban areas, MSM living in rural areas MSM were more likely to use dating apps to find sexual partners, were more likely to engage in bisexual behavior, and had lower condom use. 43.0% participants had been tested for HIV in the past year (41.8% in rural areas and 43.6% in urban areas). Multivariate logistic regression also revealed that among participants living in rural areas, having rural health insurance and not accepting HIV intervention were associated with lower HIV testing rates, while a higher monthly income and through use of internet to find sexual partner were associated with higher rates of HIV testing. CONCLUSION: High risk behavior was prevalent, and HIV testing rates were low among MSM living in rural areas compare to urban areas in Zhejiang Province, therefore, preventative intervention measures should be immediately among rural MSM urgently to reduce HIV transmission and to promote HIV testing.


Assuntos
Infecções por HIV/epidemiologia , Infecções por HIV/etiologia , Homossexualidade Masculina/estatística & dados numéricos , População Rural/estatística & dados numéricos , Adolescente , Adulto , Bissexualidade/estatística & dados numéricos , China , Estudos Transversais , Feminino , Humanos , Masculino , Programas de Rastreamento/métodos , Assunção de Riscos , Sexo Seguro/estatística & dados numéricos , Amostragem , Comportamento Sexual/estatística & dados numéricos , Parceiros Sexuais , Minorias Sexuais e de Gênero/estatística & dados numéricos , Adulto Jovem
5.
Pediatrics ; 145(5)2020 05.
Artigo em Inglês | MEDLINE | ID: mdl-32345685

RESUMO

OBJECTIVES: In this study, we evaluate the efficacy of Families Talking Together (FTT), a triadic intervention to reduce adolescent sexual risk behavior. METHODS: Adolescents aged 11 to 14 and their female caregivers were recruited from a pediatric clinic; 900 families were enrolled; 84 declined. Families were randomly assigned to FTT or 1 of 2 control conditions. The FTT triadic intervention consisted of a 45-minute face-to-face session for mothers, health care provider endorsement of intervention content, printed materials for families, and a booster call for mothers. The primary outcomes were ever having had vaginal intercourse, sexual debut within the past 12 months, and condom use at last sexual intercourse. Assessments occurred at baseline, 3 months post baseline, and 12 months post baseline. RESULTS: Of enrolled families, 73.4% identified as Hispanic, 20.4% as African American, and 6.2% as mixed race. Mean maternal age was 38.8 years, and mean adolescent grade was seventh grade. At the 12-month follow-up, 5.2% of adolescents in the experimental group reported having had sexual intercourse, compared with 18% of adolescents in the control groups (P < .05). In the experimental group, 4.7% of adolescents reported sexual debut within the past 12 months, compared with 14.7% of adolescents in the control group (P < .05). In the experimental group, 74.2% of sexually active adolescents indicated using a condom at last sexual intercourse, compared with 49.1% of adolescents in the control group (P < .05). CONCLUSIONS: This research suggests that the FTT triadic intervention is efficacious in delaying sexual debut and reducing sexual risk behavior among adolescents.


Assuntos
Comportamento do Adolescente/psicologia , Saúde do Adolescente/tendências , Relações Pais-Filho , Comportamento de Redução do Risco , Sexo Seguro/psicologia , Saúde Sexual/tendências , Adolescente , Comportamento do Adolescente/fisiologia , Adulto , Idoso , Criança , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Sexo Seguro/fisiologia , Adulto Jovem
6.
AIDS Care ; 32(sup2): 40-46, 2020 05.
Artigo em Inglês | MEDLINE | ID: mdl-32167374

RESUMO

In the U.S., HIV incidence is highest among Black men who have sex with men (MSM) but PrEP uptake is low, in part due to lack of normative support for using PrEP. This research pilot tested a social network-level intervention designed to increase PrEP use willingness, interest, and peer supports among Black MSM in Milwaukee. Five community social networks (n = 40 participants) of racial minority MSM were assessed at baseline with measures of PrEP knowledge, interest, attitudes, and action taking. Persons most interconnected with others in each network attended an intervention that provided training to increase knowledge about PrEPbenefits, address PrEP concerns, endorse PrEP use as a symbol of pride and health, and deliver these messages to others in their social networks. All network members were re-administered the same measures at 3-month followup. Significant increases over time were found in network members' PrEP knowledge, attitudes, norm perceptions, self-efficacy, and willingness to use PrEP. Participants more often talked with friends about HIV and with their health care providers about PrEP. The percentage of participants who reported using PrEP increased from 3% to 11%. Larger-scale evaluations of this intervention model are needed.


Assuntos
Afro-Americanos/psicologia , Fármacos Anti-HIV/administração & dosagem , Infecções por HIV/prevenção & controle , Conhecimentos, Atitudes e Prática em Saúde , Homossexualidade Masculina/psicologia , Aceitação pelo Paciente de Cuidados de Saúde , Profilaxia Pré-Exposição/métodos , Rede Social , Adulto , Fármacos Anti-HIV/uso terapêutico , Infecções por HIV/tratamento farmacológico , Homossexualidade Masculina/etnologia , Humanos , Masculino , Grupo Associado , Sexo Seguro , Wisconsin/epidemiologia
7.
AIDS Care ; 32(sup2): 32-39, 2020 05.
Artigo em Inglês | MEDLINE | ID: mdl-32174136

RESUMO

The ANRS-PREVENIR (2017-2020) prospective cohort study aims to reduce the number of new HIV infections in the "Ile-de-France" region in France, by enrolling individuals at high risk of HIV infection and proposing daily and on-demand pre-exposure prophylaxis (PrEP). The qualitative component of the ANRS-PREVENIR study aimed to investigate social and relational evolutions associated with PrEP use in men who have sex with men (MSM). In 2018, 12 focus groups with MSM (n = 68) were conducted by a social sciences researcher in Paris. A thematic analysis was performed. Results showed that stigma concerning PrEP use is a complex issue, with various kinds of stigmatization being practiced, sometimes even by the wider MSM population and PrEP users themselves. All types of stigma identified were expressed in forms of verbal abuse which made PrEP use taboo. Inside the wider MSM population a PrEP-user "community" was identified which shared a certain complicity in terms of values and a positive attitude towards PrEP. The emergence of new intragroup and intergroup social norms should be taken into account by policy makers to promote a more positive image of PrEP users.


Assuntos
Fármacos Anti-HIV/administração & dosagem , Infecções por HIV/prevenção & controle , Homossexualidade Masculina/psicologia , Profilaxia Pré-Exposição , Estigma Social , Estereotipagem , Adulto , Fármacos Anti-HIV/uso terapêutico , Grupos Focais , França , Infecções por HIV/tratamento farmacológico , Infecções por HIV/epidemiologia , Infecções por HIV/psicologia , Homossexualidade Masculina/estatística & dados numéricos , Humanos , Masculino , Estudos Prospectivos , Pesquisa Qualitativa , Assunção de Riscos , Sexo Seguro , Comportamento Sexual , Parceiros Sexuais , Normas Sociais
8.
AIDS Care ; 32(sup2): 23-31, 2020 05.
Artigo em Inglês | MEDLINE | ID: mdl-32178529

RESUMO

Over a third of new HIV infections occur in adolescents aged 10-19 globally. Pre-exposure prophylaxis (PrEP) could be a powerful tool for prevention. Understanding more about the drivers of PrEP interest could inform implementation strategies among this age group. Moreover, family dynamics may play a uniquely critical role for this younger age group, thus it is important to gauge whether caregivers would support their children's use of PrEP. We surveyed 2,089 adolescents (aged 10-16) and their caregivers in Malawi during 2017-2018. Data were collected on PrEP interest, factors that may facilitate PrEP use, and preferences for PrEP modality. We used multivariate logistic regression to estimate the association between the above characteristics and PrEP interest. We find that young adolescents are engaging in behaviors that would put them at substantial risk of acquiring HIV, would likely benefit from PrEP, are largely (82%) interested in using such, would prefer to get an injection over taking a daily pill, and are considerably discouraged by the prospect of side effects. Endorsement by caregivers was even greater (87%). Our findings demonstrate initial support for adolescent PrEP, and suggest parents may be a surprising advocate.


Assuntos
Grupo com Ancestrais do Continente Africano/estatística & dados numéricos , Fármacos Anti-HIV/administração & dosagem , Cuidadores/psicologia , Infecções por HIV/prevenção & controle , Pais/psicologia , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Profilaxia Pré-Exposição/métodos , Adolescente , Comportamento do Adolescente , Adulto , Fármacos Anti-HIV/uso terapêutico , Criança , Feminino , Infecções por HIV/tratamento farmacológico , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Malaui , Masculino , Sexo Seguro , Inquéritos e Questionários , Adulto Jovem
9.
AIDS Care ; 32(sup2): 170-176, 2020 05.
Artigo em Inglês | MEDLINE | ID: mdl-32156157

RESUMO

The expanding HIV risk reduction toolkit increases options for men who have sex men (MSM), but increasing options in combination with different preferences may complicate promoting risk reduction. To investigate what strategies MSM prefer, data of 3310 participants in the online survey "Men & Sexuality" (Median age = 37 years, 320 (9.7%) HIV positive) was analysed. Questions assessed attitudes towards HIV risk reduction strategies. Participants had the most positive attitudes regarding PrEP and HIV testing, while withdrawal and strategic positioning were least preferred (all p's < .001). Condoms were seen as acceptable to partners and effective but scored low on sexual pleasure. HIV-positive participants were more negative about condoms and more positive about viral load sorting than HIV-negative participants (F(12,3297) = 5.09, p < .001, [Formula: see text] = .02). Findings highlight a preference for HIV risk reduction strategies (PrEP and HIV testing) that do not diminish sexual pleasure and can be applied independent of sexual partners. A serological divide was apparent: HIV-negative MSM were less negative about condoms than HIV-positive MSM, suggesting that condom promotion remains a viable strategy for HIV-negative MSM. Taken together, results indicate a need for personalized approaches to the promotion of HIV risk reduction strategies, accounting for individual preferences and strategy effectiveness.


Assuntos
Preservativos/estatística & dados numéricos , Infecções por HIV/prevenção & controle , Seleção por Sorologia para HIV/estatística & dados numéricos , Conhecimentos, Atitudes e Prática em Saúde , Homossexualidade Masculina/psicologia , Comportamento de Redução do Risco , Sexo sem Proteção/prevenção & controle , Adolescente , Adulto , Infecções por HIV/psicologia , Homossexualidade Masculina/estatística & dados numéricos , Humanos , Masculino , Sexo Seguro/estatística & dados numéricos , Comportamento Sexual , Parceiros Sexuais , Inquéritos e Questionários , Carga Viral
10.
AIDS Care ; 32(sup2): 162-169, 2020 05.
Artigo em Inglês | MEDLINE | ID: mdl-32160761

RESUMO

This study measures the evolution in the overall level of protection against HIV by men who have sex with men (MSM) in France. Using data from the 2017 and 2019 editions of Rapport au Sexe - an online survey - we compared the use of HIV prevention tools by MSM during their most recent anal intercourse (MRAI) with a casual male partner. We developed a classification with five categories ordered according to the effectiveness of each tool method in reducing the risk of acquiring HIV: Treatment as prevention (TasP), Pre-exposure prophylaxis (PrEP), exclusive condom use, Post-exposure prophylaxis (PEP) or nothing (i.e., no tool used). The percentage of MSM who did not use any prevention tool decreased from 25.9% in 2017 to 23.5% in 2019 (aOR [95%CI] = 0.9 [0.8-0.9]). The proportion of MSM who took PrEP during the MRAI increased from 5.4% in 2017 to 14.0% in 2019 (aOR [95%CI] = 2.9[2.5-3.3]). The proportion of MSM who used condoms exclusively decreased from 67.5% in 2017 to 61.3% in 2019 (aOR [95%CI] = 0.8 [0.7-0.8]). We observed an increase in the rate of protected anal sex, and a decrease in the rate of condom use. The implementation of PrEP may be one of the main driving forces behind these changes.


Assuntos
Preservativos/estatística & dados numéricos , Infecções por HIV/prevenção & controle , Homossexualidade Masculina/estatística & dados numéricos , Profilaxia Pós-Exposição/estatística & dados numéricos , Profilaxia Pré-Exposição/estatística & dados numéricos , Sexo Seguro/estatística & dados numéricos , Adulto , Estudos Transversais , França , Humanos , Masculino , Profilaxia Pré-Exposição/métodos , Comportamento Sexual , Parceiros Sexuais , Inquéritos e Questionários
11.
AIDS Care ; 32(sup2): 148-154, 2020 05.
Artigo em Inglês | MEDLINE | ID: mdl-32189510

RESUMO

A mobile-based behavioural change program iloveLive.mobi was implemented to prevent HIV among young people (12-24 years) in South Africa. The mobile site offered access to sexual and reproductive health and psychosocial information through interactive learning. The site provided incentives for positive behaviour (such as HIV testing). The research aimed to evaluate the effectiveness of the iloveLife.mobi site in promoting protective behaviour of users. A mixed-methods approach was used, including document review, KAPB survey (n = 1882), group discussions (n = 68) and telephonic interviews (n = 175) with users and interviews with 46 project and community stakeholders. The SRH and psychosocial information on the site was age-appropriate and useful to young people (82.2%). The site reached young men who are generally difficult to reach with SRH information. High-frequency users reported more confidence related to condom use and HIV testing and more protective behaviour (condom use, VMMC) compared to low-frequency users. Users also reported more protective behaviour (HIV testing, VMMC, condom use) than a comparable national sample. iloveLife.mobi became a repository for learning to reach young people with health information. The research highlights key issues to consider when implementing an mHealth platform in a low- or middle-income country, where literacy levels and technical infrastructure may cause challenges.


Assuntos
Infecções por HIV/prevenção & controle , Conhecimentos, Atitudes e Prática em Saúde , Promoção da Saúde/métodos , Saúde Sexual , Telemedicina , Adolescente , Feminino , Infecções por HIV/psicologia , Humanos , Masculino , Avaliação de Programas e Projetos de Saúde , Saúde Reprodutiva , Sexo Seguro , Comportamento Sexual/psicologia , África do Sul , Adulto Jovem
12.
AIDS Educ Prev ; 32(1): 67-81, 2020 02.
Artigo em Inglês | MEDLINE | ID: mdl-32202920

RESUMO

We tested the acceptability, feasibility, and preliminary efficacy of Our Family Our Future, a resilience-oriented intervention engaging families in prevention of adolescent HIV and depression. South African adolescents, 13-15 years of age, with mild depressive symptoms, were randomized to intervention or wait-list using parallel assignment in a single-blind trial. HIV risk behavior and depression were evaluated at baseline, 1, and 3 months. We examined intervention satisfaction, fidelity, trial retention, and preliminary efficacy. One hundred-ninety-six adolescent-parent dyads completed eligibility screening and baseline, and n = 73 dyads were randomized. All families ranked intervention quality as good or excellent. Over 90% were satisfied with content. Facilitators were adherent to intervention protocol. All families were retained in post-intervention assessments. Intervention recipients reported diminished depressive symptoms, inconsistent condom use, and sexual activity, as well as increased HIV testing. Our Family Our Future is highly acceptable and feasible and should be tested in a future efficacy trial.


Assuntos
Depressão/prevenção & controle , Infecções por HIV/prevenção & controle , Programas de Rastreamento/métodos , Pais/psicologia , Aceitação pelo Paciente de Cuidados de Saúde , Resiliência Psicológica , Adolescente , Comportamento do Adolescente , Depressão/psicologia , Estudos de Viabilidade , Feminino , Infecções por HIV/psicologia , Humanos , Masculino , Projetos Piloto , Sexo Seguro , Comportamento Sexual , Método Simples-Cego , África do Sul
13.
PLoS One ; 15(2): e0228981, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32078662

RESUMO

PURPOSE: This paper examines condom use in penile-vaginal sexual intercourse among adults in Canada. DATA AND METHOD: The Sex in Canada survey is a national survey of Canadian adults, ages 18+ (N = 2,303). The online survey used quota-based population sample matching of 2016 census targets for gender, age, region, language, visible minority status, and education level. We report general patterns of self-reported condom use, as well as results from zero-inflated negative binomial regression models on the relationship between condom use and social location, relationship status, and sexual health. RESULTS: Condom use varies by gender, age, education, visible minority status, and relationship status. Use of condoms is related to the perception of risk of being diagnosed with a sexually transmitted infection in the next six months and to the experience of receiving lessons in condom use. No significant associations were found between condom use and region, rural/urban residence, income, or religion. Among men, but not women, condom use is associated with language preference, past diagnosis with a sexually transmitted infection, and self-reported sexual health. CONCLUSION: Canadian adults report using a condom in approximately 30% of their sexual encounters involving penile-vaginal sex. Condom use is highest among young adults. Single people use condoms more often than people with marital or common-law partners. Condom use is higher among those with higher levels of education, among people belonging to visible minorities relative to white people, and for men relative to women. People who think they are likely to be diagnosed with a sexually transmitted infection in the next six months are more likely to use condoms than those who do not.


Assuntos
Preservativos , Sexo Seguro , Adolescente , Adulto , Canadá , Feminino , Humanos , Masculino , Doenças Sexualmente Transmissíveis/prevenção & controle , Adulto Jovem
14.
J Acquir Immune Defic Syndr ; 83(2): 99-102, 2020 02 01.
Artigo em Inglês | MEDLINE | ID: mdl-31929399

RESUMO

BACKGROUND: Sexual mixing between HIV-positive, HIV-negative, and pre-exposure prophylaxis (PrEP) users among men who have sex with men (MSM) is an important determinant of the incidence of infection. There have been very limited studies examining the patterns of sexual mixing in relation to HIV status and PrEP use in the era of PrEP. SETTING: Melbourne Sexual Health Centre (MSHC), Australia. METHODS: We included all MSM partnerships attending MSHC on the same day between 2011 and 2018. A chi-square trend test was used to examine the changes in the annual proportion of partnerships by HIV serostatus in 2011-2018 and by PrEP use in 2016-2018. RESULTS: Of the 1765 MSM partnerships who attended MSHC between 2011 and 2018, 1.3% of the partnerships were concordant HIV-positive, 91.0% were concordant HIV-negative, and 7.6% were HIV-discordant. The proportion of HIV-discordant partnerships increased from 0% in 2011 to 12.5% in 2018 (ptrend < 0.001). In 2016-2018, only a small proportion (1.2%) of concordant HIV-negative partnerships involved both men taking PrEP, whereas 6.0% involved at least one man taking PrEP. Overall, 79.1% of concordant HIV-negative partnerships were not protected against HIV (ie, neither man taking PrEP), and this proportion declined significantly from 84.3% in 2016 to 74.0% in 2018 (ptrend = 0.001). CONCLUSIONS: The pattern of sexual mixing by HIV status and PrEP use among MSM partnerships has changed over time. PrEP use in both men within MSM partnerships is not common. About 79% of concordant HIV-negative partnerships were not protected against HIV as neither man taking PrEP.


Assuntos
Infecções por HIV/tratamento farmacológico , Infecções por HIV/prevenção & controle , Profilaxia Pré-Exposição , Comportamento Sexual , Parceiros Sexuais , Minorias Sexuais e de Gênero , Adulto , Austrália , Estudos Transversais , Infecções por HIV/epidemiologia , Homossexualidade Masculina , Humanos , Incidência , Masculino , Profilaxia Pré-Exposição/estatística & dados numéricos , Sexo Seguro/estatística & dados numéricos
15.
J Acquir Immune Defic Syndr ; 83(2): 111-118, 2020 02 01.
Artigo em Inglês | MEDLINE | ID: mdl-31929400

RESUMO

BACKGROUND: Male sex workers (MSWs) are at increased risk of HIV infection in the United States. Research is limited on sexual and drug use network characteristics of MSWs. SETTING: Community-based organization and health center in 2 US Northeast cities. METHODS: One hundred MSWs completed a behavioral assessment and sexual and drug network inventory. Using dyadic analyses, we assessed whether network characteristics, including sex worker-male client age, race, and HIV status homophily and risk multiplexity (ie, overlap in drug-use and sex networks), were associated with condom use. RESULTS: MSW participants' mean age was 33.6. Two-thirds identified as Black or Latino, 12% identified as heterosexual, and 90% reported recent drug use. Participants reported an average of 5.3 male clients in the past month (SD = 3.4), and having anal sex with 74% of these clients, at a rate of 2.2 times per month (SD = 4.6). Participants reported inconsistent condom use during anal sex with 53% of clients. In multivariable models, inconsistent condom use was more common in relationships with presumed HIV status homophily [odds ratio (OR): 1.25; 95% confidence interval (CI): 1.07 to 1.46] and sexual and drug network multiplexity (OR: 1.19; 95% CI: 1.09 to 1.30); and less common within relationships where the client is older than the MSW participant (OR: 0.83; 95% CI: 0.74 to 0.93). Number of multiplex relationships was positively associated with number of condomless anal sex acts with male clients (incidence rate ratio: 1.35; 95% CI: 1.19 to 1.54). CONCLUSIONS: Network characteristics may contribute to disproportionate HIV risk among MSWs. Modeling studies should include network characteristics when simulating HIV transmission, and future HIV interventions should address the role of networks.


Assuntos
Infecções por HIV/transmissão , Trabalho Sexual , Profissionais do Sexo , Adulto , Preservativos , Infecções por HIV/epidemiologia , Heterossexualidade , Homossexualidade Masculina , Humanos , Masculino , Pessoa de Meia-Idade , Razão de Chances , Fatores de Risco , Sexo Seguro , Trabalho Sexual/estatística & dados numéricos , Profissionais do Sexo/psicologia , Comportamento Sexual/estatística & dados numéricos , Parceiros Sexuais , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Estados Unidos , Adulto Jovem
18.
PLoS One ; 14(12): e0225406, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31834885

RESUMO

OBJECTIVES: Consistent condom use is essential to reducing heterosexual transmission of HIV. African Americans are disproportionately affected by HIV in the United States despite comprising a small percentage of the population. Our objectives were to evaluate factors associated with self-reported condom use in a cohort of predominantly African American women receiving HIV care in Atlanta, Georgia. METHODS: A cross-sectional study of reproductive knowledge, attitudes, and practices among adult, sexually-active, HIV-positive women attending the Grady Infectious Disease Clinic in Atlanta, Georgia was conducted from July, 2013 to November, 2014 to evaluate factors associated with self-reported condom use. Primary outcomes included: condom use at last vaginal intercourse and consistent condom use with vaginal intercourse over the last six months. Descriptive, bivariable, and multivariable logistic regression analyses were performed. RESULTS: Of 187 women enrolled, 170 reported having vaginal intercourse in the last six months. Seventy-four percent used condoms at last vaginal intercourse, whereas 53% reported consistent condom use over the last six months. In adjusted analyses, factors associated with condom use at last intercourse included decreased frequency of sex, no history of drug use, and confidence to discuss condom use with sexual partners (p<0.05). Factors associated with consistent condom use in the past six months were older age, being single/dating, and confidence to discuss condom use with sexual partners. History of drug use, having HIV-positive partners, and unprotected anal intercourse were associated with inconsistent use (p<0.05). CONCLUSIONS: Improved strategies are needed to educate women on the importance of safe sexual practices and condom negotiation. Healthcare providers should strive to have an open dialogue with patients about condom use, whether they engage in anal sex, and its risks.


Assuntos
Preservativos , Infecções por HIV/prevenção & controle , Soropositividade para HIV , Conhecimentos, Atitudes e Prática em Saúde , Sexo Seguro , Adulto , Estudos Transversais , Feminino , Georgia , Humanos , Pessoa de Meia-Idade , Comportamento Sexual , Parceiros Sexuais , Inquéritos e Questionários
19.
Acta Med Port ; 32(12): 776-781, 2019 Dec 02.
Artigo em Inglês | MEDLINE | ID: mdl-31851887

RESUMO

Over the last few decades, behavioral changes in sexual practices have made oral transmission of traditional sexually transmissible infections increasingly recognized. Patients harboring a sexually transmissible infection may first present lesions on the oral cavity, as these may be visible and interfere with basic functions such as speech or swallowing. Moreover, the oral cavity may function as a reservoir for future spread of these infections. In order to successfully control this problem, a greater focus on oral sex should be persued, along with promotion of the use of condom and education on safe oral sex practices. Furthermore, examination of the oral cavity should is essential when evaluating any patient suspected of harboring a sexually transmissible infection. In this article, oral transmission of several viral and bacterial infections is reviewed, including human papillomavirus infection, genital herpes, syphilis and gonorrhea, among others.


Assuntos
Doenças da Boca/complicações , Sexo Seguro , Comportamento Sexual , Doenças Sexualmente Transmissíveis/transmissão , Infecções por Chlamydia/diagnóstico , Infecções por Chlamydia/transmissão , Chlamydia trachomatis , Gonorreia/diagnóstico , Gonorreia/transmissão , Infecções por HIV/diagnóstico , Infecções por HIV/patologia , Infecções por HIV/transmissão , Herpes Simples/diagnóstico , Herpes Simples/transmissão , Humanos , Doenças da Boca/diagnóstico , Doenças da Boca/patologia , Infecções por Papillomavirus/diagnóstico , Infecções por Papillomavirus/patologia , Infecções por Papillomavirus/transmissão , Doenças Sexualmente Transmissíveis/diagnóstico , Doenças Sexualmente Transmissíveis/patologia , Sífilis/diagnóstico , Sífilis/patologia , Sífilis/transmissão
20.
PLoS One ; 14(11): e0217115, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31693669

RESUMO

Although the HIV epidemic is generalized in West Africa, some population groups such as men who have sex with men (MSM), especially those engaged in transactional sex (TS), are thought to be particularly more vulnerable to HIV than others. However, few data are available to help identify their health-related needs with a view to implementing targeted prevention interventions. To fill this knowledge gap, we aimed to characterize MSM reporting TS (MSM-TS) and to identify factors associated with their sexual practices using data from the prospective cohort study CohMSM, which was conducted in Burkina Faso, Côte d'Ivoire, Mali and Togo. Three stigmatization sub-scores were constructed (experienced, perceived and internalized). The generalized estimating equation method was used for data analysis. Of the total 630 HIV-negative MSM recruited in CohMSM, 463, 410 and 244 had a follow-up visit at 6, 12 and 18 months, respectively. In a total of 1747 follow-up visits, 478 TS encounters were reported by 289 MSM-TS (45.9%). Of the latter, 91 regularly reported TS (31.5%), 55 (19.0%) stopped reporting TS after baseline, and 53 (18.3%) reported TS after baseline and 90 (31.1%) occasionally reported TS. The following variables, regarding the previous 6 months, were positively associated with TS: being younger (aOR[95%CI]:1.86[1.39-2.50]), less educated (aOR[95%CI]:1.49[1.09-2.03]), unmarried status (aOR[95%CI]:1.79[1.10-2.93]), satisfaction with current sex life (aOR[95%CI]:1.41[1.06-1.88]), group sex with men (aOR[95%CI]:2.07[1.46-2.94]), multiple male sexual partners (aOR[95%CI]:1.85[1.40-2.44]), receptive or versatile anal sex with male partners (aOR [95%CI]:1.48[1.12-1.96]), giving benefits in exchange for sex with a man (aOR[95%CI]:2.80[1.97-3.98]), alcohol consumption (aOR[95%CI]:1.44[1.08-1.93]) and drug use (aOR[95%CI]:1.82[1.24-2.68]) during sex, and finally experiencing stigmatization (aOR [95%CI]:1.15[1.07-1.25]). Condom use during anal sex (aOR[95%CI]:0.73[0.53-0.99]) was negatively associated with TS.


Assuntos
Infecções por HIV/transmissão , Homossexualidade Masculina , Profissionais do Sexo , Adulto , África Ocidental/epidemiologia , Estudos de Coortes , Infecções por HIV/epidemiologia , Infecções por HIV/prevenção & controle , Humanos , Masculino , Estudos Prospectivos , Fatores de Risco , Sexo Seguro , Comportamento Sexual , Parceiros Sexuais , Adulto Jovem
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA