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1.
Rev. enferm. UERJ ; 28: e45752, jan.-dez. 2020.
Artículo en Inglés, Portugués | LILACS, BDENF - Enfermería | ID: biblio-1117683

RESUMEN

Objetivo: estimar a prevalência do uso do preservativo e os fatores associados em trabalhadores da construção civil. Método: estudo transversal, analítico, com 370 trabalhadores da grande João Pessoa, Paraíba. Considerou como variável de desfecho o uso do preservativo na última relação sexual. Utilizou-se questionário estruturado. Análise de regressão logística bivariada e múltipla foi utilizada para identificar associação entre as variáveis sociodemográficas e o uso do preservativo. Resultados: a maioria dos participantes é do sexo masculino, adultos jovens, casados e com baixa escolaridade. A prevalência estimada de uso do preservativo foi de 23,5% (IC 95%: 19,2% - 27,8%). Indivíduos com menos de 39 anos possuem 1,82 vezes mais chances de usar o preservativo e ser casado diminui (RC=0,26) as chances de uso. Conclusão: há baixa prevalência de uso do preservativo em trabalhadores da construção civil. A prevenção combinada é uma alternativa para controle das infecções transmissíveis, sendo o preservativo o principal coadjuvante.


Objective: to estimate the prevalence of condom use and the associated factors in construction workers. Method: in this crosssectional, analytical study with 370 workers from greater João Pessoa, Paraíba, Brazil, the outcome variable was condom use at last sexual intercourse. A structured questionnaire was used. Bivariate and multiple logistic regression analysis was used to identify associations between sociodemographic variables and condom use. Results: most participants were young, male adults, married and with little education. Estimated prevalence of condom use was 23.5% (95% CI; 19.2% - 27.8%). Individuals under 39 years old were found to be 1.82 times more likely to use condoms than individuals aged 40 years or older (OR = 1.82; 95% CI), while being married reduced the likelihood (OR = 0.26). Conclusion: prevalence of condom use is low among construction workers. Combined prevention is one option for controlling communicable diseases, with condoms as the main support.


Objetivo: estimar la prevalencia del uso de condón y los factores asociados en trabajadores de la construcción. Método: en este estudio transversal y analítico con 370 trabajadores del área metropolitana de João Pessoa, Paraíba, Brazil, la variable de resultado fue el uso de condón en la última relación sexual. Se utilizó un cuestionario estructurado y análisis de regresión logística bivariada y múltiple para identificar asociaciones entre las variables sociodemográficas y el uso del condón. Resultados: la mayoría de los participantes fueron jóvenes, varones adultos, casados y con poca educación. La prevalencia estimada del uso de condones fue del 23,5% (IC del 95%; 19,2% - 27,8%). Se encontró que las personas menores de 39 años tenían 1,82 veces más probabilidades de usar condones que las personas de 40 años o más (OR = 1,82; IC del 95%), mientras que estar casado redujo la probabilidad (OR = 0,26). Conclusión: la prevalencia del uso de condones es baja entre los trabajadores de la construcción. La prevención combinada es una opción para controlar las enfermedades transmisibles, con el condón como principal apoyo.


Asunto(s)
Humanos , Masculino , Femenino , Adolescente , Adulto , Persona de Mediana Edad , Adulto Joven , Conducta Sexual/estadística & datos numéricos , Salud Laboral , Condones/estadística & datos numéricos , Sexo Inseguro/estadística & datos numéricos , Brasil , Industria de la Construcción , Estudios Transversales , Prevención de Enfermedades , Correlación de Datos , Enfermería del Trabajo
2.
Medicine (Baltimore) ; 99(44): e22776, 2020 Oct 30.
Artículo en Inglés | MEDLINE | ID: mdl-33126316

RESUMEN

Based on the Theory of Health Action Process Approach (HAPA) Model, this study aimed to investigate factors associated with condom use intention in Chinese adolescents.In 2017, we conducted a cross-sectional study using stratified cluster, convenience sampling method to assess condom use intention among senior high school students in Tianjin, China. One thousand eighty two senior high school students were anonymously surveyed through self-administered questionnaires. Structural equation modelling was used to assess the pre-intentional phase of HAPA model.Among the participants, 41.5% (449/1082) were male, 54.1% (585/1082) were female, 4.4% (48/1082) were gender-deficient. The average age was 16.7 years. The final pre-intentional phase of HAPA model was acceptable (CFI = 0.95; GFI = 0.94; RMSEA = 0.06). Action self-efficacy (r = 0.60) had a strong direct effect on condom use intention.The pre-intentional phase of HAPA model is valid to assess condom use intention among Chinese senior high school students. The pre-intention phase of the HAPA model could be applied to guide AIDS health educations of students, and further research is needed to evaluate the effect.


Asunto(s)
Condones/estadística & datos numéricos , Conducta Anticonceptiva/psicología , Intención , Conducta Sexual/psicología , Estudiantes/psicología , Adolescente , China , Estudios Transversales , Femenino , Humanos , Análisis de Clases Latentes , Masculino , Autoeficacia , Encuestas y Cuestionarios
3.
S Afr Med J ; 110(7): 661-666, 2020 Jul 07.
Artículo en Inglés | MEDLINE | ID: mdl-32880344

RESUMEN

BACKGROUND: South African guidelines recommend a syndromic approach for the management of sexually transmitted infections (STIs), based on the presence of genital symptoms. However, the guidelines do not prescribe specific indications for microbiology testing for patients presenting with or without repeat genital symptoms. OBJECTIVES: To describe the prevalence of and factors associated with repeat genital symptoms among STI service attendees at primary care facilities. METHODS: This was a cross-sectional study at 7 STI primary care facilities participating in the aetiological surveillance of STIs between January 2015 and December 2016. Demographic and clinical information and appropriate genital specimens were collected from participants presenting with vaginal discharge syndrome (VDS), male urethral syndrome (MUS) and/or genital ulcer syndrome (GUS). Repeat genital symptoms were defined as self-reported history of the same STI-related genital symptoms in the preceding 12 months. Multivariable logistic regression identified factors associated with repeat genital symptoms. RESULTS: Of 1 822 eligible participants, 480 (30%) had repeat genital symptoms (25% and 75% in the preceding 3 months and 12 months, respectively). Of those with repeat genital symptoms, the median age was 28 (interquartile range (IQR) 24 - 32) years, and 54% were females. The most common aetiological agents among participants with VDS, MUS and GUS were bacterial vaginosis (n=132; 55%), Neisseria gonorrhoeae (n=172; 81%) and ulcers (n=67; 63%), respectively. One hundred and seven (20%) participants had no detectable common STI aetiology. In the multivariable analysis, repeat genital symptoms were associated with HIV co-infection (adjusted odds ratio (aOR) 1.43; 95% confidence interval (CI) 1.14 - 1.78), VDS diagnosis (aOR 1.39; 95% CI 1.10 - 1.76), self-reported condom use (aOR 1.56; 95% CI 1.20 - 2.03) and age 25 - 34 years (aOR 1.33; 95% CI 1.03 - 1.71). CONCLUSIONS: Our study found a high prevalence of repeat genital symptoms ‒ a significant proportion without STI aetiology. Identified factors of repeat genital symptoms highlight the need for improved integration of HIV and STI prevention and management. Further research is needed to determine the aetiology of repeat genital symptoms and the contribution of non-STI causes.


Asunto(s)
Enfermedades de los Genitales Femeninos/epidemiología , Enfermedades de los Genitales Masculinos/epidemiología , Úlcera/epidemiología , Excreción Vaginal/epidemiología , Adulto , Coinfección/epidemiología , Condones/estadística & datos numéricos , Estudios Transversales , Femenino , Infecciones por VIH/epidemiología , Humanos , Masculino , Vigilancia de la Población , Prevalencia , Atención Primaria de Salud , Sudáfrica/epidemiología
4.
PLoS Negl Trop Dis ; 14(9): e0008556, 2020 09.
Artículo en Inglés | MEDLINE | ID: mdl-32925964

RESUMEN

Sexual transmission of Ebola virus (EBOV) is well established and has been implicated in multiple resurgences during the West African Ebola epidemic. Given the persistence of viral RNA in semen, guidelines from the World Health Organization (WHO) recommend abstinence or condom use for at least 1 year or until two semen PCR tests are negative. To better understand the impact of semen testing on sexual behavior, male EVD survivors were surveyed regarding their sexual behavior before and after semen testing. Of the 171 men who enrolled, 148 reported being sexually active following discharge from an ETU with 59% reporting episodes of condomless sex. At least one semen sample for testing was provided by 149 men and 13 of these men had EBOV RNA detected in their semen. When comparing sexual behaviors before and after semen testing, a positive semen test result had limited impact on behavior. Of those with seminal EBOV RNA detected, 61% reported no change in behavior pre- and post-semen testing with 46% engaging in condomless sex before and after testing and only 1 adopted safer sex behaviors following receipt of a positive result. Similarly, among men with undetectable EBOV in their semen, 66% reported no change in sexual behaviors with semen testing, with 55% forgoing condoms during sex. In only 11% was a negative semen result followed by abandoning condoms. There were no known sexual transmission events of Ebola virus in this cohort despite viral presence in semen during periods of condomless sex. This highlights the need to better understand the infectious potential of viral RNA persistence and determine what constitutes effective counseling for survivors and their partners.


Asunto(s)
Consejo , ARN Viral/análisis , Semen/virología , Conducta Sexual/psicología , Adolescente , Adulto , Portador Sano , Niño , Condones/estadística & datos numéricos , Ebolavirus , Fiebre Hemorrágica Ebola/prevención & control , Fiebre Hemorrágica Ebola/transmisión , Humanos , Liberia/epidemiología , Masculino , Persona de Mediana Edad , Conducta Sexual/estadística & datos numéricos , Encuestas y Cuestionarios , Sobrevivientes
5.
BMC Infect Dis ; 20(1): 563, 2020 Aug 01.
Artículo en Inglés | MEDLINE | ID: mdl-32738895

RESUMEN

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.


Asunto(s)
Infecciones por VIH/patología , Conducta Sexual , Adolescente , Adulto , Factores de Edad , Condones/estadística & datos numéricos , Estudios Transversales , Femenino , Infecciones por VIH/epidemiología , Humanos , Modelos Logísticos , Masculino , Persona de Mediana Edad , Análisis Multivariante , Oportunidad Relativa , Delitos Sexuales , Sudáfrica/epidemiología , Encuestas y Cuestionarios , Adulto Joven
6.
PLoS One ; 15(8): e0236552, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32776965

RESUMEN

BACKGROUND: Paying for sex has often been associated with risky sexual behavior among heterosexual men, and men who pay for sex are considered as a bridging population for sexually transmitted infections. Consistent condom use during paid sex is essential for reducing sexually transmitted infections, including HIV/AIDS. In this study, we assessed the prevalence and predictors of consistent condom use among men who pay for sex in sub-Saharan Africa. MATERIALS AND METHODS: We pooled data from 29 sub-Saharan African countries' Demographic and Health Surveys. A total of 3,353 men in sub-Saharan Africa who had paid for sex in the last 12 months preceding the surveys and had complete information on all the variables of interest were used in this study. The outcome variable for the study was consistent condom use for every paid sex in the last 12 months. Both bivariate and multivariable logistic regression analyses were carried out. Results were presented as adjusted odds ratios with their corresponding 95% confidence intervals. Statistical significance was declared at p< 0.05. RESULTS: Overall, the prevalence of consistent condom use during paid sex in sub-Saharan Africa was 83.96% (CI = 80.35-87.56), ranging from 48.70% in Benin to 98% in Burkina Faso. Men aged 35-44 [AOR, 1.39 CI = 1.04-1.49], men in the richest wealth quintile [AOR, 1.96 CI = 1.30-3.00], men with secondary level of education [AOR, 1.69 CI = 1.17-2.44], and men in Burkina Faso [AOR = 67.59, CI = 8.72-523.9] had higher odds of consistent condom use during paid sex, compared to men aged 15-19, those in the poorest wealth quintile, those with no formal education, and men in Benin respectively. Conversely, Muslim men had lower odds [AOR = 0.71, CI = 0.53-0.95] of using condom consistently during paid sex, compared to Christian men. CONCLUSION: Empirical evidence from this study suggests that consistent condom use during paid sex encompasses complex social and demographic characteristics. The study also revealed that demographic characteristics such as age, wealth quintile, education, and religion were independently related to consistent condom use for paid sex among men. With sub-Saharan Africa having the highest sexual and reproductive health burden in the world, continuous application of evidence-based interventions (e.g., educational and entrepreneurial training) that account for behavioural and social vulnerabilities are required.


Asunto(s)
Condones/estadística & datos numéricos , Sexo Seguro/estadística & datos numéricos , Trabajo Sexual , Conducta Sexual/estadística & datos numéricos , Enfermedades de Transmisión Sexual/prevención & control , Adolescente , Adulto , África del Sur del Sahara , Encuestas Epidemiológicas , Heterosexualidad , Humanos , Masculino , Persona de Mediana Edad , Asunción de Riesgos , Adulto Joven
7.
PLoS One ; 15(8): e0236984, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32790677

RESUMEN

BACKGROUND: Understanding of the facilitators and challenges to female condom (FC) uptake has been limited due to lack of evaluation of national FC programmes. SETTING: The FC has been an integral component of South Africa's (SA) HIV prevention programme for 20 years and is the largest government-funded FC programme worldwide. METHODS: The national FC evaluation used a mixed-methods approach and consisted of key informant interviews and a telephone survey in a national sample of public and non-public sites. A sub-sample of sites participated in client and provider interviews, and a self-administered client survey. A review of distribution statistics from South Africa's District Health Information System was also conducted. RESULTS: All 256 public-sector and 28 non-public-sector facilities reported having ever distributed FCs. Less than 5% of these facilities reported stock-outs and less than 3% reported they had a supply of expired female condoms. Systems for male condom (MC) and FC distribution were complementary, with similar ordering, delivery and reporting processes. FC promotion by providers (n = 278) varied with regard to FC training, whether attitudes about FCs influenced providers offer of FCs, and how they counselled clients about FCs. Of the 4442 self-administered client surveys in 133 facilities, similar proportions of women (15.4%) and men (15.2%) had ever used FCs. Although FCs were available at almost all sites surveyed, only two-thirds of clients were aware of their availability. CONCLUSION: Data highlight the role of providers as gatekeepers to FC access in public and non-public sectors and provide support for further FC programme expansion in SA and globally.


Asunto(s)
Condones Femeninos , Adolescente , Adulto , Condones/estadística & datos numéricos , Condones/provisión & distribución , Condones Femeninos/estadística & datos numéricos , Condones Femeninos/provisión & distribución , Femenino , Infecciones por VIH/prevención & control , Conocimientos, Actitudes y Práctica en Salud , Política de Salud , Humanos , Masculino , Persona de Mediana Edad , Programas Nacionales de Salud , Sector Privado , Sector Público , Sudáfrica , Encuestas y Cuestionarios , Adulto Joven
9.
Artículo en Inglés | MEDLINE | ID: mdl-32664646

RESUMEN

Dual-method use is the most reliable form of protection against unintended pregnancies and human immunodeficiency virus/sexually transmitted infections (HIV/STIs). Although dual-method use remains uncommon among women in stable relationships, some women do practice it. In this study, we explored the barriers that make dual-method use rare and the behaviors of women who practice dual-method use using a positive deviance framework in Uganda. We screened 150 women using highly effective contraceptives at five health facilities. We identified nine women who practiced dual-method use and 141 women who did not. In a qualitative study, we conducted in-depth interviews with all nine women practicing dual-method use and 10 women randomly selected out of the 141 who did not. We performed a thematic analysis using the positive deviance framework. Regardless of practicing dual-method use or not, women faced perceived barriers against dual-method use, such as partner's objection, distrust, shyness about introducing condoms into marital relationships, and limited access to condoms. However, women practicing dual-method use had higher levels of risk perception about unintended pregnancies and HIV/STIs. They also engaged in unique behaviors, such as influencing their partners' condom use by initiating discussions, educating their partners on sexual risks and condom use, and obtaining condoms by themselves. These findings will be useful in developing effective community-led and peer-based interventions promoting dual-method use to reduce the dual burden of unintended pregnancies and HIV/STIs among women in Uganda.


Asunto(s)
Condones/estadística & datos numéricos , Conducta Anticonceptiva/etnología , Infecciones por VIH/prevención & control , Sexo Seguro/estadística & datos numéricos , Enfermedades de Transmisión Sexual/prevención & control , Niño , Femenino , Infecciones por VIH/etnología , Infecciones por VIH/transmisión , Humanos , Entrevistas como Asunto , Embarazo , Investigación Cualitativa , Conducta Sexual , Uganda/epidemiología
10.
Sex Transm Infect ; 96(6): 422-427, 2020 09.
Artículo en Inglés | MEDLINE | ID: mdl-32605930

RESUMEN

OBJECTIVES: Transgender men who have sex with men (TMSM) represent an understudied population in relation to screening for HIV and sexually transmitted infections (STIs). We examined HIV and STI testing prevalence among TMSM along with the factors associated with testing in a diverse US nationwide sample of TMSM. METHODS: Data from a cross-sectional online convenience sample of 192 TMSM were analysed using multivariable binary logistic regression models to examine the association between sociodemographic and behavioural factors and lifetime testing for HIV, bacterial STIs and viral STIs, as well as past year testing for HIV. RESULTS: More than two-thirds of TMSM reported lifetime testing for HIV (71.4%), bacterial STIs (66.7%), and viral STIs (70.8%), and 60.9% had received HIV testing in the past year. Engaging in condomless anal sex with a casual partner whose HIV status is different or unknown and having fewer than two casual partners in the past 6 months were related to lower odds of lifetime HIV, bacterial STI, viral STI and past year HIV testing. Being younger in age was related to lower probability of testing for HIV, bacterial STIs and viral STIs. Furthermore, TMSM residing in the South were less likely to be tested for HIV and viral STIs in their lifetime, and for HIV in the past year. Finally, lower odds of lifetime testing for viral STIs was found among TMSM who reported no drug use in the past 6 months. CONCLUSIONS: These findings indicate that a notable percentage of TMSM had never tested for HIV and bacterial and viral STIs, though at rates only somewhat lower than among cisgender MSM despite similar patterns of risk behaviour. Efforts to increase HIV/STI testing among TMSM, especially among those who engage in condomless anal sex, are needed.


Asunto(s)
Infecciones por VIH/diagnóstico , Tamizaje Masivo/estadística & datos numéricos , Conducta Sexual/estadística & datos numéricos , Enfermedades Bacterianas de Transmisión Sexual/diagnóstico , Enfermedades Virales de Transmisión Sexual/diagnóstico , Personas Transgénero , Adolescente , Adulto , Bisexualidad , Condones/estadística & datos numéricos , Estudios Transversales , Femenino , Homosexualidad Masculina , Humanos , Masculino , Persona de Mediana Edad , Minorías Sexuales y de Género , Enfermedades de Transmisión Sexual/diagnóstico , Estados Unidos , Sexo Inseguro/estadística & datos numéricos , Adulto Joven
11.
PLoS One ; 15(7): e0235094, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32609731

RESUMEN

INTRODUCTION: Between 2014 and 2017, a program aimed at reducing HIV risk and promoting safe sex through consistent use of condoms sought to work through addressing social and economic vulnerabilities and strengthening community-led organizations (COs) of female sex workers (FSWs). This study examines if the program was effective by studying relationship between strengthening of COs, vulnerability reduction, and sustaining of consistent condom use behavior among FSWs. METHODS: We used a longitudinal study design to assess the change in outcomes. A three-stage sampling design was used to select FSWs for the study. Panel data of 2085 FSWs selected from 38 COs across five states of India was used to examine the change in various outcomes from 2015 (Survey Round 1) to 2017 (Survey Round 2). The CO level program pillar measuring institutional development assessed performance of COs in six domains critical for any organization's functionality and sustainability: governance, project management, financial management, program monitoring, advocacy and networking, and resource mobilization. Overall, 32 indicators from all these domains were used to compute the CO strength score. A score was computed by taking mean of average dimension scores. The overall score was divided into two groups based on the median cutoff; COs which scored below the median were considered to have low CO strength, while COs which scored above or equal to median were considered to have high CO strength. Multivariable regression modeling techniques were used to examine the effect of program pillars on outcome measures. RESULTS: Analyses showed a significant improvement in the strength of the COs over time; percentage of COs having high strength improved from 50% in 2015 to 87% in Round 2. The improvement in CO's strength increased financial security (Adjusted Odds Ratio [AOR]: 2.18, p<0.01), social welfare security (AOR: 1.71, p<0.01), and socio-legal security (AOR: 2.20, p<0.01) among FSWs. Further, improvement in financial security led to significant increase in consistent condom use with client among FSWs (AOR: 1.69, p<0.01) who were members of COs having high strength. Sustained consistent condom use was positively associated with young age (<30 years), ability to negotiate with clients for condom use, membership in self-help groups, high self-efficacy, self-confidence, and client solicitation in streets and brothels. CONCLUSIONS: Improving financial security and strengthening FSW led CO can improve sustained and consistent condom use. In addition, the program should focus on enhancing ability of FSWs to negotiate with clients for condom use, promote membership in self-help groups and target FSWs who are 30 years or older, and soliciting from homes to sustain consistent condom use across all FSWs.


Asunto(s)
Sexo Seguro , Trabajo Sexual , Trabajadores Sexuales , Adulto , Condones/estadística & datos numéricos , Femenino , Humanos , India , Sexo Seguro/estadística & datos numéricos , Grupos de Autoayuda/estadística & datos numéricos , Trabajo Sexual/estadística & datos numéricos , Trabajadores Sexuales/estadística & datos numéricos , Poblaciones Vulnerables/estadística & datos numéricos
12.
Pediatrics ; 146(2)2020 08.
Artículo en Inglés | MEDLINE | ID: mdl-32690805

RESUMEN

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.


Asunto(s)
Condones Femeninos , Condones , Conducta Sexual , Adolescente , Factores de Edad , Condones/estadística & datos numéricos , Condones Femeninos/estadística & datos numéricos , Conducta Anticonceptiva/estadística & datos numéricos , Personas con Discapacidad/estadística & datos numéricos , Femenino , Conocimientos, Actitudes y Práctica en Salud , Humanos , Relaciones Interpersonales , Profilaxis Pre-Exposición , Embarazo , Embarazo en Adolescencia/estadística & datos numéricos , Embarazo no Planeado , Factores Raciales , Sexo Seguro , Autoimagen , Educación Sexual , Minorías Sexuales y de Género/estadística & datos numéricos , Enfermedades de Transmisión Sexual/epidemiología , Enfermedades de Transmisión Sexual/prevención & control , Apoyo Social
13.
PLoS One ; 15(7): e0236557, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32706840

RESUMEN

BACKGROUND: A systematic assessment was done to examine the effect of HIV interventions among MSM in Dhaka, Bangladesh. MSM were defined as males having sex with males but did not sell sex in the last year. MSM are hidden, marginalized and stigmatized population groups not only in Bangladesh but also globally. In 2010, HIV interventions for MSM were expanded in 40 districts of Bangladesh through 65 drop-in-centres (DICs) and peer outreach workers. METHODS: Data from two surveys on MSM in Dhaka in 2010 (baseline) and 2013 (midline) were used to analyse the effect of ongoing HIV prevention services. Both surveys used time location sampling to randomly select MSM for risk behaviour interviews. Two outcome variables were considered; condom use in the last anal sex act and consistent condom use during anal sex in the last month. Univariate and multivariate logistic regression methods were used to determine factors associated with condom use. RESULTS: Condom use significantly increased at the midline than baseline (p<0.001 for both). Multivariate analysis showed that having comprehensive knowledge of HIV and participation in HIV prevention programme were positively associated with both last time and consistent condom use. MSM who had comprehensive knowledge of HIV were 1.9 times (95% CI: 1.3-2.8, p = 0.002) and 2.1 times (95% CI: 1.4-3.2, p<0.001) more likely to use condoms than those who did not have comprehensive knowledge of HIV. The likelihood of using condoms among MSM was more than double at the midline than the baseline (p<0.01 for both). However, odds of condom use was significantly lower among those who perceived themselves to be at risk or were not able to assess their own risk of HIV. CONCLUSION: To sustain positive changes in HIV risk behaviours, HIV prevention programmes for MSM need to be continued and strengthened.


Asunto(s)
Condones/estadística & datos numéricos , Infecciones por VIH/prevención & control , Homosexualidad Masculina/psicología , Evaluación de Programas y Proyectos de Salud , Adolescente , Adulto , Bangladesh , Humanos , Entrevistas como Asunto , Conocimiento , Masculino , Oportunidad Relativa , Asunción de Riesgos , Encuestas y Cuestionarios , Adulto Joven
14.
PLoS One ; 15(6): e0233922, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32479519

RESUMEN

PURPOSE: To understand the characteristics of a minority of Australian gay and bisexual men (GBM) who, despite an increase in the number and availability of HIV risk reduction strategies, do not consistently use a strategy to protect themselves from HIV. METHODS: This analysis is based on data from 2,920 participants in a national, online, prospective observational cohort study. GBM who never or rarely used HIV risk reduction strategies (NRR) were compared with two groups using multivariate logistic regression: i) GBM using pre-exposure prophylaxis (PrEP) and ii) GBM frequently using risk reduction strategies (FRR) other than PrEP. RESULTS: Compared to PrEP users, NRR men were younger (p<0.0001), less socially engaged with gay men (p<0.0001) and less likely to have completed a postgraduate (p<0.05) or undergraduate degree (p<0.05). They were also less likely to have recently used amyl nitrite (p<0.05), erectile dysfunction medication (p<0.05) and cocaine (p<0.05) in the previous 6 months. Compared with FRR men, NRR men were less likely to have completed a postgraduate (p<0.0001) or undergraduate degree (p<0.05), scored higher on the sexual sensation-seeking scale (p<0.0001) and were more likely to identify as versatile (p<0.05), a bottom (p<0.05) or very much a bottom (p<0.05) during anal sex. CONCLUSIONS: NRR men were largely similar to other Australian GBM. However, our analysis suggests it may be appropriate to focus HIV prevention interventions on younger, less socially engaged and less educated GBM, as well as men who prefer receptive anal intercourse to promote the use of effective HIV risk reduction strategies.


Asunto(s)
Infecciones por VIH/prevención & control , Profilaxis Pre-Exposición/estadística & datos numéricos , Conducta de Reducción del Riesgo , Sexo Seguro/estadística & datos numéricos , Minorías Sexuales y de Género/estadística & datos numéricos , Adulto , Factores de Edad , Australia , Condones/estadística & datos numéricos , Escolaridad , Infecciones por VIH/transmisión , Humanos , Internet , Masculino , Persona de Mediana Edad , Estudios Prospectivos , Sexo Seguro/psicología , Minorías Sexuales y de Género/psicología , Adulto Joven
15.
Int J STD AIDS ; 31(7): 671-679, 2020 06.
Artículo en Inglés | MEDLINE | ID: mdl-32538329

RESUMEN

Early sex work initiation among female sex workers (FSWs) increases their vulnerabilities to high-risk sexual practices and sexually transmitted infections (STIs). We examined the association of early sex work with condomless sex indicators, HIV, and other STIs, including human papillomavirus, chlamydia, trichomoniasis, syphilis, and gonorrhea, among FSWs in Iran. We recruited 1347 FSWs from 13 cities in 2015, with 1296 participants (94.2%) reporting information about their age of sex work initiation. Early sex work was defined as the initiation of selling sex before 18 years of age. Adjusted odds ratios (aORs) and 95% confidence intervals (CIs) were reported using multivariable logistic regression. Overall, 10.1% of FSWs reported early sex work initiation. FSWs who initiated sex work earlier were more likely to report last-month inconsistent condom use (aOR = 3.31, 95% CI: 1.82, 6.02) and condomless sex with last client (aOR = 1.72, 95% CI: 1.15, 2.56). There was no statistically significant association between early sex work and HIV (aOR = 1.40, 95% CI: 0.43, 4.53) and any other STIs (aOR = 1.01, 95% CI: 0.69, 1.48), except for chlamydia (aOR = 2.09, 95% CI: 1.08, 4.04). These findings suggest that FSWs with early sexual debut would benefit from differentiated interventions including screening for STIs and enhanced counseling for condom use.


Asunto(s)
Condones/estadística & datos numéricos , Asunción de Riesgos , Trabajo Sexual/estadística & datos numéricos , Trabajadores Sexuales/psicología , Enfermedades de Transmisión Sexual/diagnóstico , Sexo Inseguro/estadística & datos numéricos , Adolescente , Adulto , Femenino , Humanos , Irán/epidemiología , Conducta Sexual , Parejas Sexuales , Enfermedades de Transmisión Sexual/epidemiología , Adulto Joven
16.
AIDS Patient Care STDS ; 34(5): 228-236, 2020 05.
Artículo en Inglés | MEDLINE | ID: mdl-32396478

RESUMEN

Consistent condom use is an inexpensive and efficacious HIV prevention strategy. Understanding factors associated with condom use and barriers to use can inform strategies to increase condom uptake. The ongoing African Cohort Study prospectively enrolls adults at 12 clinical sites in Uganda, Kenya, Tanzania, and Nigeria. At enrollment, participants are asked about condom use at last sex with a regular partner. Robust Poisson regression models were used to evaluate predictors of self-reported condom use. Participants who reported not using condoms were asked to provide reasons. From January 2013 to September 2019, 2482 participants reported having at least one regular sexual partner in the preceding 6 months. Of those, 1577 (63.5%) reported using a condom at last sex. Condom use was more common among older participants, males, HIV-infected participants, and those with an HIV-infected partner. Married participants, those with a partner of unknown HIV status, and those reporting alcohol use were less likely to report condom use at last sex. Condom use at last sex also varied significantly by clinical site. Partner disapproval or refusal to use a condom was a consistent driver of disparities in condom use among participants who were HIV infected, female, and aged 18-24 years. Effective HIV prevention programs should integrate condom education with the tools necessary to negotiate condom use with regular partners.


Asunto(s)
Condones/estadística & datos numéricos , Infecciones por VIH/prevención & control , Parejas Sexuales , Adolescente , Adulto , África , Estudios de Cohortes , Femenino , Humanos , Masculino , Estudios Prospectivos , Conducta Sexual , Adulto Joven
17.
AIDS Behav ; 24(7): 2024-2032, 2020 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-32350773

RESUMEN

The COVID-19 pandemic is reinforcing health inequities among vulnerable populations, including men who have sex with men (MSM). We conducted a rapid online survey (April 2 to April 13, 2020) of COVID-19 related impacts on the sexual health of 1051 US MSM. Many participants had adverse impacts to general wellbeing, social interactions, money, food, drug use and alcohol consumption. Half had fewer sex partners and most had no change in condom access or use. Some reported challenges in accessing HIV testing, prevention and treatment services. Compared to older MSM, those 15-24 years were more likely to report economic and service impacts. While additional studies of COVID-19 epidemiology among MSM are needed, there is already evidence of emerging interruptions to HIV-related services. Scalable remote solutions such as telehealth and mailed testing and prevention supplies may be urgently needed to avert increased HIV incidence among MSM during the COVID-19 pandemic era.


Asunto(s)
Condones/estadística & datos numéricos , Infecciones por Coronavirus , Coronavirus , Accesibilidad a los Servicios de Salud/estadística & datos numéricos , Homosexualidad Masculina/estadística & datos numéricos , Tamizaje Masivo/estadística & datos numéricos , Pandemias , Neumonía Viral , Parejas Sexuales , Adulto , Betacoronavirus , Infecciones por Coronavirus/epidemiología , Infecciones por VIH/prevención & control , Humanos , Incidencia , Masculino , Persona de Mediana Edad , Neumonía Viral/epidemiología , Trastornos Relacionados con Sustancias/epidemiología , Encuestas y Cuestionarios , Estados Unidos , Adulto Joven
18.
Einstein (Sao Paulo) ; 18: eAO4978, 2020.
Artículo en Portugués, Inglés | MEDLINE | ID: mdl-32428062

RESUMEN

Objective To determine the prevalence of syphilis and the associated risk factors in a female prison unit. Methods This was a cross-sectional study including 113 women whom data were collected in two stages: first, blood test to check for syphilis seropositivity; and then collection of information through a form to assess risk situations for sexually transmitted infections. Results Overall, syphilis prevalence was found to be 22.1% among the female prison population (n=25) and 28.6% among pregnant women. A statistically significant relationship was found between syphilis infection and previous history of sexually transmitted infections (p=0.04). However, most participants diagnosed with the disease were unaware of a history of sexually transmitted infection in the last 12 months (n=20/80.0%). The use of condom with fixed partners was considered to be a protective factor (odds ratio of 0.76; 95% of confidence interval 0.68-0.85). Conclusion The prevalence of syphilis among the female prison population was high, particularly among pregnant women. Preventive and therapeutic measures as well as appropriate prenatal care can minimize the impact of syphilis in prison systems and, consequently, improve such health outcomes nationwide.


Asunto(s)
Sífilis/epidemiología , Adolescente , Adulto , Brasil/epidemiología , Condones/estadística & datos numéricos , Estudios Transversales , Femenino , Humanos , Persona de Mediana Edad , Prevalencia , Factores de Riesgo , Sífilis/prevención & control , Adulto Joven
19.
Int J STD AIDS ; 31(7): 637-641, 2020 06.
Artículo en Inglés | MEDLINE | ID: mdl-32448077

RESUMEN

In Thailand, pre-exposure prophylaxis (PrEP) is recommended for human immunodeficiency virus (HIV) prevention among at-risk men who have sex with men (MSM). We modeled the impact of PrEP and condom use as independent and combined interventions on the estimated number of HIV infections among a hypothetical population of 10,000 MSM in Bangkok, Thailand. Our model demonstrated a 92% (95% confidence interval 89.7, 94.2) reduction in HIV infections among Thai MSM who took daily PrEP and self-reported using condoms correctly and consistently (100% condom use). Increased use of PrEP and condoms likely would have a substantial impact on the HIV epidemic in Thailand.


Asunto(s)
Condones/estadística & datos numéricos , Infecciones por VIH/prevención & control , Homosexualidad Masculina/estadística & datos numéricos , Profilaxis Pre-Exposición , Adulto , Fármacos Anti-VIH/administración & dosificación , Estudios de Cohortes , Infecciones por VIH/tratamiento farmacológico , Infecciones por VIH/epidemiología , Homosexualidad Masculina/psicología , Humanos , Masculino , Cumplimiento de la Medicación , Sexo Seguro , Conducta Sexual , Tailandia/epidemiología
20.
BMC Public Health ; 20(1): 756, 2020 May 24.
Artículo en Inglés | MEDLINE | ID: mdl-32448365

RESUMEN

BACKGROUND: Perceiving a personal risk for HIV infection is considered important for engaging in HIV prevention behaviour and often targeted in HIV prevention interventions. However, there is limited evidence for assumed causal relationships between risk perception and prevention behaviour and the degree to which change in behaviour is attributable to change in risk perception is poorly understood. This study examines longitudinal relationships between changes in HIV risk perception and in condom use and the public health importance of changing risk perception. METHODS: Data on sexually active, HIV-negative adults (15-54 years) were taken from four surveys of a general-population open-cohort study in Manicaland, Zimbabwe (2003-2013). Increasing condom use between surveys was modelled in generalised estimating equations dependent on change in risk perception between surveys. Accounting for changes in other socio-demographic and behavioural factors, regression models examined the bi-directional relationship between risk perception and condom use, testing whether increasing risk perception is associated with increasing condom use and whether increasing condom use is associated with decreasing risk perception. Population attributable fractions (PAFs) were estimated. RESULTS: One thousand, nine hundred eighty-eight males and 3715 females participated in ≥2 surveys, contributing 8426 surveys pairs. Increasing risk perception between two surveys was associated with higher odds of increasing condom use (males: adjusted odds ratio [aOR] = 1.39, 95% confidence interval [CI] = 0.85-2.28, PAF = 3.39%; females: aOR = 1.41 [1.06-1.88], PAF = 6.59%), adjusting for changes in other socio-demographic and behavioural factors. Those who decreased risk perception were also more likely to increase condom use (males: aOR = 1.76 [1.12-2.78]; females: aOR = 1.23 [0.93-1.62]) compared to those without change in risk perception. CONCLUSIONS: Results on associations between changing risk perception and increasing condom use support hypothesised effects of risk perception on condom use and effects of condom use on risk perception (down-adjusting risk perception after adopting condom use). However, low proportions of change in condom use were attributable to changing risk perception, underlining the range of factors influencing HIV prevention behaviour and the need for comprehensive approaches to HIV prevention.


Asunto(s)
Condones , Infecciones por VIH , Sexo Seguro , Conducta Sexual , Síndrome de Inmunodeficiencia Adquirida/prevención & control , Adolescente , Adulto , Estudios de Cohortes , Condones/estadística & datos numéricos , Femenino , Infecciones por VIH/epidemiología , Humanos , Modelos Logísticos , Masculino , Persona de Mediana Edad , Medición de Riesgo , Sexo Seguro/estadística & datos numéricos , Conducta Sexual/estadística & datos numéricos , Encuestas y Cuestionarios , Adulto Joven , Zimbabwe/epidemiología
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