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BMC Infect Dis ; 20(1): 299, 2020 Apr 22.
Artículo en Inglés | MEDLINE | ID: mdl-32321442


BACKGROUND: Sexualized drug use (SDU) refers to use of any psychoactive substance before/during sexual intercourse. Chemsex is a subset of SDU, which is defined as the use of some specific psychoactive substances (methamphetamine, mephedrone, γ-hydroxybutyrate, ketamine and cocaine) before/during sexual intercourse. SDU and chemsex are prevalent among gay, bisexual and other men who have sex with men (GBMSM). This study investigated uptake and willingness to use pre-exposure prophylaxis (PrEP) among a sample of GBMSM in Hong Kong with experience of SDU in the past year. METHODS: A total of 600 GBMSM were recruited by convenient sampling through outreaching in gay venues, online recruitment and peer referral. Participants completed a cross-sectional anonymous telephone interview. This study was based on a subsample of 580 GBMSM self-reported as HIV negative/unknown sero-status. RESULTS: Of the participants, 82 (14.1%) and 37 (6.4%) had experience of SDU and chemsex in the past year. The prevalence of PrEP uptake was 4.0% among all participants and 14.6% among those with experience of SDU in the past year. Among GBMSM with experience of SDU in the past year who were not on PrEP (n = 70), 67.1% were willing to use daily oral PrEP in the next 6 months. Multivariate logistic regression models showed that positive attitudes toward PrEP (AOR: 2.37, 95%CI: 1.47, 3.82), perceived support from significant others to use PrEP (AOR: 9.67, 95%CI: 2.95, 31.71), and perceived behavioral control of using PrEP (AOR: 19.68, 95%CI: 5.44, 71.26) were significantly associated with higher willingness to use PrEP. CONCLUSION: GBMSM with experience of recent SDU are potentially good candidates of PrEP implementation. This group of GBMSM reported high prevalence of uptake and willingness to use PrEP. Perceptions related to PrEP based on the Theory of Planned Behavior were significantly associated with willingness to use PrEP.

Homosexualidad Masculina/estadística & datos numéricos , Participación del Paciente/estadística & datos numéricos , Profilaxis Pre-Exposición/métodos , Psicotrópicos/uso terapéutico , Minorías Sexuales y de Género/estadística & datos numéricos , Enfermedades de Transmisión Sexual/prevención & control , Trastornos Relacionados con Sustancias/epidemiología , Volición , Adolescente , Adulto , Actitud Frente a la Salud , Bisexualidad/psicología , Bisexualidad/estadística & datos numéricos , China/epidemiología , Estudios Transversales , Infecciones por VIH/epidemiología , Infecciones por VIH/prevención & control , Conocimientos, Actitudes y Práctica en Salud , Homosexualidad Masculina/psicología , Hong Kong/epidemiología , Humanos , Entrevistas como Asunto , Masculino , Persona de Mediana Edad , Profilaxis Pre-Exposición/estadística & datos numéricos , Prevalencia , Conducta Sexual/fisiología , Conducta Sexual/estadística & datos numéricos , Minorías Sexuales y de Género/psicología , Enfermedades de Transmisión Sexual/epidemiología , Encuestas y Cuestionarios , Volición/fisiología , Adulto Joven
BMJ ; 369: m1043, 2020 04 02.
Artículo en Inglés | MEDLINE | ID: mdl-32241761


OBJECTIVES: To outline which infectious diseases in the pre-covid-19 era persist in children and adolescents in China and to describe recent trends and variations by age, sex, season, and province. DESIGN: National surveillance studies, 2008-17. SETTING: 31 provinces in mainland China. PARTICIPANTS: 4 959 790 Chinese students aged 6 to 22 years with a diagnosis of any of 44 notifiable infectious diseases. The diseases were categorised into seven groups: quarantinable; vaccine preventable; gastrointestinal and enteroviral; vectorborne; zoonotic; bacterial; and sexually transmitted and bloodborne. MAIN OUTCOME MEASURES: Diagnosis of, and deaths from, 44 notifiable infectious diseases. RESULTS: From 2008 to 2017, 44 notifiable infectious diseases were diagnosed in 4 959 790 participants (3 045 905 males, 1 913 885 females) and there were 2532 deaths (1663 males, 869 females). The leading causes of death among infectious diseases shifted from rabies and tuberculosis to HIV/AIDS, particularly in males. Mortality from infectious diseases decreased steadily from 0.21 per 100 000 population in 2008 to 0.07 per 100 000 in 2017. Quarantinable conditions with high mortality have effectively disappeared. The incidence of notifiable infectious diseases in children and adolescents decreased from 280 per 100 000 in 2008 to 162 per 100 000 in 2015, but rose again to 242 per 100 000 in 2017, largely related to mumps and seasonal influenza. Excluding mumps and influenza, the incidence of vaccine preventable diseases fell from 96 per 100 000 in 2008 to 7 per 100 000 in 2017. The incidence of gastrointestinal and enterovirus diseases remained constant, but typhoid, paratyphoid, and dysentery continued to decline. Vectorborne diseases all declined, with a particularly noticeable reduction in malaria. Zoonotic infections remained at low incidence, but there were still unpredictable outbreaks, such as pandemic A/H1N1 2009 influenza. Tuberculosis remained the most common bacterial infection, although cases of scarlet fever doubled between 2008 and 2017. Sexually transmitted diseases and bloodborne infections increased significantly, particularly from 2011 to 2017, among which HIV/AIDS increased fivefold, particularly in males. Difference was noticeable between regions, with children and adolescents in western China continuing to carry a disproportionate burden from infectious diseases. CONCLUSIONS: China's success in infectious disease control in the pre-covid-19 era was notable, with deaths due to infectious diseases in children and adolescents aged 6-22 years becoming rare. Many challenges remain around reducing regional inequalities, scaling-up of vaccination, prevention of further escalation of HIV/AIDS, renewed efforts for persisting diseases, and undertaking early and effective response to highly transmissible seasonal and unpredictable diseases such as that caused by the novel SARS-CoV-2 virus.

Control de Enfermedades Transmisibles , Programas de Inmunización , Vacunación , Enfermedades Prevenibles por Vacunación , Adolescente , Betacoronavirus , Niño , China/epidemiología , Control de Enfermedades Transmisibles/métodos , Control de Enfermedades Transmisibles/normas , Infecciones por Coronavirus , Brotes de Enfermedades , Femenino , Humanos , Incidencia , Subtipo H1N1 del Virus de la Influenza A , Gripe Humana/prevención & control , Malaria/economía , Malaria/prevención & control , Masculino , Pandemias , Neumonía Viral , Estudios Retrospectivos , Escarlatina/epidemiología , Escarlatina/prevención & control , Enfermedades de Transmisión Sexual/epidemiología , Enfermedades de Transmisión Sexual/prevención & control , Tuberculosis/epidemiología , Tuberculosis/prevención & control , Enfermedades Prevenibles por Vacunación/prevención & control
Clin Ter ; 171(2): e130-e136, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32141484


AIMS: Evaluation of the knowledge and behavioral risks related to sexually transmitted infections (STIs) among the student population of the degree course in nursing at the University of Palermo. MATERIAL AND METHODS: An anonymous online a survey was provided to students that investigate to socio-demographic information, sexual habits and the level of knowledge of the STIs. Multivariable logistic regression was performed, considering it as a dependent variable "Do you permanently have unprotected sex (without a condom)? Yes", in order to evaluate the role of the variables of the questionnaire. Results are expressed as adjusted Odds Ratio (aOR). RESULTS: The sample size consists of 405. The average age of the sample is 21.65 years (standard deviation±3.24). The analysis shows that the risk of having permanently unprotected sex (without condom) is significantly associated with the following variables: "Are you engaged or single? Engaged" (aOR 3.24, 95% CI 1.66 - 6.33); "Sexual orientation. Homosexual or Bisexual (aOR 4.45, 95% CI 1.30 - 15.29); "Have you occasionally had unprotected sex (without a condom)? Yes" (aOR 5.09, 95% CI 2.69 - 9.62); "How would you define your knowledge of sexually transmitted diseases? Good" (aOR 2.07, 95% CI 1.05 - 4.08); "How would you define your knowledge about contraceptive methods? Good" (aOR 2.51, 95% CI 1.23 - 5.15); "Have you or have you ever had a sexually transmitted disease? Yes (aOR 4.43, 95% CI 1.71 - 11.53); "Do you know that men can also undergo HPV vaccination? Yes" (aOR 2.57, 95% CI 1.03 - 6.40); "Age. As the unit increase" (aOR 1.14, 95% CI 1.02 - 1.26). CONCLUSIONS: These results highlight the importance of involving university students in programs aimed at improving the knowledge in terms of STIs and increase of Sexual and reproductive health. Further, because STIs prevention is based mainly on human behavior, tailored intervention is needed especially because behavior change remains a complex challenge.

Condones , Estudiantes de Enfermería/psicología , Sexo Inseguro/estadística & datos numéricos , Condones/estadística & datos numéricos , Estudios Transversales , Femenino , Humanos , Masculino , Conducta Sexual , Enfermedades de Transmisión Sexual/prevención & control , Encuestas y Cuestionarios , Sexo Inseguro/psicología , Adulto Joven
Sex Reprod Health Matters ; 28(1): 1731296, 2020 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-32202220


Extramarital sexual relations are forbidden in Islam, and sexual health information is not readily available in Islamic communities, especially for women. This review aimed to explore sexually transmitted infection (STI) knowledge and attitudes among Muslim women worldwide. A systematic review was conducted on seven electronic databases. We included qualitative and quantitative studies of female Muslim participants of reproductive age, focusing on STI knowledge and attitudes. A narrative synthesis approach was used with thematic analysis methods. Eighteen studies conducted in 13 countries were included. Three main themes were identified: poor knowledge and misconceptions; sources of sexual health information and information needs; and cultural influences on STI knowledge and attitudes. Generally, Muslim women had poor knowledge regarding STI signs and symptoms, prevention, diagnosis and treatment, in addition to many misconceptions. Negative attitudes towards people infected with HIV/AIDS were common, and attitudes were highly influenced by misconceptions and insufficient knowledge. Infected women tended to be subjected to more blame and judgement compared to men. While the review summarises knowledge and attitudes of Muslim women worldwide, we excluded studies that did not clearly state that the study participants were Muslim women, hence many countries with Muslim populations are not represented in this review. Negative attitudes towards STIs make it harder for women to access sexual health information, STI prevention and treatment. This review highlights the need for culturally sensitive sexual health education for Muslim women. Future sex education interventions would benefit from considering the wider personal and external barriers.

Conductas Relacionadas con la Salud/etnología , Conocimientos, Actitudes y Práctica en Salud/etnología , Islamismo , Enfermedades de Transmisión Sexual , Cultura , Femenino , Infecciones por VIH/etnología , Infecciones por VIH/prevención & control , Humanos , Religión , Conducta Sexual/etnología , Salud Sexual , Enfermedades de Transmisión Sexual/diagnóstico , Enfermedades de Transmisión Sexual/etnología , Enfermedades de Transmisión Sexual/prevención & control
AIDS Patient Care STDS ; 34(2): 72-80, 2020 02.
Artículo en Inglés | MEDLINE | ID: mdl-32049557


Justice-involved youth (JIY) are at considerable risk for human immunodeficiency virus (HIV), but are disconnected from treatment and prevention. Juvenile justice agencies providing community supervision (CS) are well positioned to provide HIV prevention, testing, and prompt referral to treatment for JIY. However, we lack an understanding of juvenile CS agency responses to HIV/sexually transmitted infection (STI) needs among JIY. We conducted a nationwide systematic assessment of how juvenile CS agencies identify, refer, and move youth through the HIV care cascade using a nationally representative sample of 195 juvenile CS agencies across 20 states. Two-thirds of CS agencies did not offer any HIV-/STI-related services, and 82% reported no collaboration with health agencies. Screening or referral for HIV risk behaviors was reported by 32% of the CS agencies and 12% for any intervention or prevention for HIV/STI risk behaviors. Between 21% and 30% of agencies were unaware of the location of local HIV/STI services. HIV/STI prevention training was not a priority for directors and was ranked second to last out of 16 training topics. Agencies where staff expressed need for HIV risk training and where specific court programming was available were more likely to provide or refer for HIV/STI screening and/or testing. Agencies were more likely to provide or refer for services if they provided pre-trial/pre-adjudication supervision, parole, or court programming. Considering the low provision of HIV/STI-related services and limited collaboration between health and justice agencies, interventions that promote cross-system collaboration designed to minimize barriers and facilitate identification, referral, and linkage to HIV services for JIY are necessary.

Servicios de Salud del Adolescente/organización & administración , Prestación de Atención de Salud/organización & administración , Infecciones por VIH/prevención & control , Delincuencia Juvenil , Tamizaje Masivo/métodos , Enfermedades de Transmisión Sexual/prevención & control , Adolescente , Niño , Servicios de Salud Comunitaria , Continuidad de la Atención al Paciente , Femenino , Infecciones por VIH/epidemiología , Infecciones por VIH/terapia , Accesibilidad a los Servicios de Salud , Humanos , Prevalencia , Derivación y Consulta , Retención en el Cuidado , Asunción de Riesgos , Conducta Sexual , Enfermedades de Transmisión Sexual/epidemiología , Enfermedades de Transmisión Sexual/terapia , Estados Unidos , Adulto Joven
PLoS One ; 15(2): e0228981, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32078662


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.

Condones , Sexo Seguro , Adolescente , Adulto , Canadá , Femenino , Humanos , Masculino , Enfermedades de Transmisión Sexual/prevención & control , Adulto Joven
FP Essent ; 488: 11-15, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-31894950


Circumcision is the surgical removal of some or all of the foreskin (ie, prepuce) of the penis. Among high-resource countries, the United States is the only country in which the majority of newborns are circumcised for nonreligious reasons. The rate of circumcision in the United States has been decreasing. Circumcised males have a lower risk of urinary tract infections, penile cancer, and several sexually transmitted infections. The benefit of circumcision is greater for males with certain urologic conditions, such as isolated hydronephrosis, vesicoureteral reflux, and ureteropelvic junction obstruction. Complications develop in approximately 1 of every 200 procedures. The American Academy of Pediatrics and the American Academy of Family Physicians recommend continued access to circumcision on an elective basis and conclude that the benefits outweigh the risks. However, they do not endorse routine neonatal circumcision. Local anesthesia should be used to decrease pain during the procedure. Three devices commonly are used. Each has risks and benefits, and no one device has been proven to be superior to another.

Circuncisión Masculina , Neoplasias del Pene , Enfermedades de Transmisión Sexual , Infecciones Urinarias , Niño , Humanos , Lactante , Recién Nacido , Masculino , Neoplasias del Pene/prevención & control , Enfermedades de Transmisión Sexual/prevención & control , Estados Unidos , Obstrucción Ureteral , Infecciones Urinarias/prevención & control
BMC Health Serv Res ; 20(1): 42, 2020 Jan 16.
Artículo en Inglés | MEDLINE | ID: mdl-31948452


BACKGROUND: The youths in Zambia have limited access to information concerning Sexual Reproductive Health (SRH) and this puts them at risk of unwanted pregnancies. Talking about other methods of preventing pregnancy or sexually transmitted infections than abstinence is regarded as culturally unacceptable. The Research Initiative to Support the Empowerment of Girls (RISE) is a cluster randomised controlled trial testing the effectiveness of different support packages on teenage pregnancies, early marriages and school drop-out rates. One of the support packages included youth clubs focusing on Comprehensive Sexual and Reproductive Health Education (CSRHE). Although similar interventions have been implemented in other settings, their integration process has been complex and comprehensive assessments of factors shaping acceptability of CSRHE are lacking. This article qualitatively aimed at identifying factors that shaped the acceptability of CSRHE youth clubs in rural schools in Central Province. METHOD: A qualitative case study was conducted after the youth clubs had been running for a year. Data were gathered through eight focus group discussions with grade eight pupils and eight individual interviews with teachers. Data were analysed using thematic analysis. RESULTS: The perceived advantage and simplicity of the clubs related to the use of participatory learning methods, films and role plays to communicate sensitive reproductive health information made the learners like the youth clubs. Further, the perceived compatibility of the content of the sessions with the science curriculum increased the learners' interest in the youth clubs as the meetings also helped them to prepare for the school examinations. However, cultural and religious beliefs among teachers and parents regarding the use of contraceptives complicated the delivery of reproductive health messages and the acceptability of youth clubs' information among the learners. CONCLUSION: The study indicated that CSRHE youth clubs may be acceptable in rural schools if participatory learning methods are used and head-teachers, teachers as well as parents appreciate and support the clubs.

Aceptación de la Atención de Salud/psicología , Salud Reproductiva/educación , Población Rural , Servicios de Salud Escolar/organización & administración , Salud Sexual/educación , Adolescente , Adulto , Femenino , Grupos Focales , Humanos , Masculino , Persona de Mediana Edad , Embarazo , Embarazo en Adolescencia/prevención & control , Investigación Cualitativa , Población Rural/estadística & datos numéricos , Enfermedades de Transmisión Sexual/prevención & control , Zambia
Health Psychol ; 39(3): 169-171, 2020 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-31886692


Rates of sexually transmitted infections (STIs) declined over several decades and reached historic lows by 2009. Unfortunately, STIs have resurged since then. Adolescents and young adults comprise approximately half of the new cases, and up to two thirds are youth of color. We briefly review the emergence of this new STI epidemic and offer several recommendations to prevent transmission of STIs in youth. (PsycINFO Database Record (c) 2020 APA, all rights reserved).

Enfermedades de Transmisión Sexual/prevención & control , Adolescente , Femenino , Humanos , Masculino , Estados Unidos , Adulto Joven
Am J Public Health ; 110(2): 145-148, 2020 02.
Artículo en Inglés | MEDLINE | ID: mdl-31855482


Sex education in the United States is limited in both its content and the measures used to collect data on what is taught. The risk-reduction framework that guides the teaching of sex education in the United States focuses almost exclusively on avoiding unintended pregnancy and sexually transmitted diseases, overlooking other critical topics such as the information and skills needed to form healthy relationships and content related to sexual pleasure.Young people express frustration about the lack of information on sexuality and sexual behavior that is included in sex education programs; sexual and gender minority youths, in particular, feel overlooked by current approaches.International guidance provides a more robust framework for developing and measuring sex education and suggests a number of areas in which US sex education can improve to better meet the needs of youths.

Placer , Educación Sexual , Conducta Sexual , Adolescente , Bienestar del Niño/psicología , Humanos , Conducta de Reducción del Riesgo , Enfermedades de Transmisión Sexual/prevención & control , Estados Unidos
Rev. enferm. UERJ ; 27: e40203, jan.-dez. 2019.
Artículo en Portugués | LILACS, BDENF - Enfermería | ID: biblio-1005371


Objetivo: analisar ações de prevenção e enfrentamento das IST/AIDS em mulheres encarceradas, considerando as dimensões de vulnerabilidade. Método: pesquisa qualitativa com aporte teórico-metodológico da Narrativa de Vida de Bertaux. Teve como cenário de estudo o Conjunto Penal de Jequié-BA. Os dados foram coletados através da entrevista aberta com 15 mulheres encarceradas. Estudo aprovado POR Comitê de Ética em Pesquisa. Dados tratados por meio da análise temática de Bertaux. Resultados: a utilização de preservativo, seguindo critérios pessoais e culturais, e acesso aos serviços de saúde e insumos proporcionados pelo presídio constituem ações preventivas que as mulheres não teriam fora dele. Contudo, práticas sexuais desprotegidas prevalecem sobre a decisão em utilizar medidas protetivas, pois é fortemente determinada pela cultura e hábitos pregressos, bem como pela dinâmica do presídio. Conclusão: as ações de prevenção podem reduzir a vulnerabilidade das mulheres encarceradas, porém medidas individuais e institucionais voltadas para estas práticas preventivas efetivas permanecem como desafio dentro do sistema prisional.

Objective: to examine STI/AIDS prevention and coping measures for women in prison, considering the dimensions of vulnerability. Method: this qualitative study drew theoretically and methodologically on Bertaux's Life Narrative. The study setting was the penal facility at Jequié, Bahia. Data were collected through an open interviews of 15 women inmates. The study was approved by the research ethics committee. Data were analyzed by Bertaux thematic analysis. Results: condom use, on personal and cultural criteria, and access to health services and materials provided by the prison are preventive measures that women would not have on the outside. Nonetheless, unprotected sex practices prevail over the decision to use protective measures, which is strongly determined by culture and past habits, as well as by the dynamics of the prison. Conclusion: preventive measures can reduce vulnerability of women in prison, but individual and institutional measures directed to these effective preventive practices remain a challenge within the prison system.

Objetivo: analizar acciones de prevención y enfrentamiento de las IST/SIDA en mujeres encarceladas, considerando las dimensiones de vulnerabilidad. Método: investigación cualitativa con aporte teórico-metodológicamente de las Narrativa de Vida de Bertaux. El escenario de estudio fue el Conjunto Penal de Jequié-BA. Los datos han sido recolectados a través de la entrevista abierta con 15 mujeres encarceladas. Estudio aprobado por el Comité de Ética en Investigación. Los datos han sido tratados por el análisis temático de Bertaux. Resultados: la utilización del preservativo, siguiendo criterios personales y culturales, y el acceso a los servicios de salud e insumos proporcionados por la prisión, constituyen acciones preventivas que las mujeres no tendrían fuera de ella. Sin embargo, las prácticas sexuales desprotegidas prevalecen por encima de la decisión de utilizar medidas protectoras, pues son fuertemente determinadas por la cultura y los hábitos pasados, así como por la dinámica de la cárcel. Conclusión: las acciones de prevención pueden reducir la vulnerabilidad de las mujeres encarceladas, pero medidas individuales e institucionales volcadas a estas prácticas preventivas efectivas permanecen como desafío dentro del sistema penitenciario.

Humanos , Femenino , Prisioneros/psicología , Enfermedades de Transmisión Sexual , Salud de la Mujer , Prevención de Enfermedades , Enfermedades de Transmisión Sexual/prevención & control , Investigación Cualitativa , Vulnerabilidad en Salud
Rev. enferm. UERJ ; 27: e34262, jan.-dez. 2019.
Artículo en Portugués | LILACS, BDENF - Enfermería | ID: biblio-1005414


Objetivo: descrever e analisar o cuidado às lésbicas, por enfermeiras e médicos, no campo da saúde sexual e reprodutiva. Método: pesquisa descritiva, qualitativa. Participaram do estudo 24 enfermeiras e 21 médicos atuantes na atenção primária, no município do Rio de Janeiro. Pesquisa aprovada por Comitê de Ética em Pesquisa. Os dados foram coletados em 2014, por meio da entrevista semiestruturada. Desenvolveu-se análise de conteúdo temático-categorial. Resultados: os esquemas de percepção e apreciação de enfermeiras e médicos sobre as lésbicas apresentam um conteúdo fortemente normativo e os profissionais apresentam defasagem de conhecimento, inabilidade de comunicação e omissão em relação às demandas de saúde dessas mulheres. Conclusão: o cuidado às lésbicas é permeado por rotinas heteronormativas e a omissão de enfermeiras e médicos frente às demandas de saúde de lésbicas opera como uma violência simbólica, sendo condicionante do menor acesso à saúde.

Objective: to describe and analyze care by nurses and physicians for lesbians' sexual and reproductive health. Method: in this qualitative, descriptive study, data were collected in 2014, by semi-structured interviews of 24 nurses and 21 physicians working in primary care in Rio de Janeiro city. Thematic category content analysis was applied. The study was approved by the research ethics committee. Results: nurses' and doctors' perceptions and understandings of lesbians are strongly normative in content and personnel display knowledge deficits, inability to communicate and omission in relation to these women's health demands. Conclusion: care for lesbians is permeated by heteronormative routines, while nurses' and physicians' omissions in response to lesbian health demands operates as symbolic violence, and is a condition in their more restricted access to health.

Objetivo: describir y analizar el cuidado a las lesbianas, por parte de enfermeras y médicos, en el campo de la salud sexual y reproductiva. Método: investigación descriptiva, cualitativa. Participaron del estudio 24 enfermeras y 21 médicos que trabajan en la atención primaria, en el municipio de Río de Janeiro. Investigación aprobada por el Comité de Ética en Investigación. Los datos fueron recolectados en 2014, a través de la entrevista semiestructurada. Se desarrolló el análisis de contenido temáticocategorial. Resultados: los esquemas de percepción y apreciación de enfermeras y médicos sobre las lesbianas presentan un contenido fuertemente normativo y los profesionales presentan desfase de conocimiento, inhabilidad de comunicación y omisión en relación a las demandas de salud de esas mujeres. Conclusión: el cuidado a las lesbianas se hace a través de rutinas heteronormativas y la omisión de enfermeras y médicos ante las demandas de salud de lesbianas se muestra como una violencia simbólica y limita el acceso a la salud.

Humanos , Femenino , Violencia , Enfermedades de Transmisión Sexual , Enfermedades de Transmisión Sexual/prevención & control , Salud Sexual y Reproductiva , Género y Salud , Minorías Sexuales y de Género , Mujeres , Estudios de Evaluación como Asunto , Epidemiología Descriptiva , Relaciones Enfermero-Paciente , Atención de Enfermería
Reprod Health ; 16(1): 179, 2019 Dec 16.
Artículo en Inglés | MEDLINE | ID: mdl-31842904


BACKGROUND: Evaluating progress towards the Sustainable Development Goal of universal access to sexual and reproductive (SRH) services requires an understanding of the health needs of individuals and what constitutes access to services. We explored women's costs of accessing SRH services in Johannesburg, South Africa and contextualized costs based on estimates of household income. METHODS: We conducted an observational study of women aged 18-49 at a public HIV treatment site and two public primary health care facilities from June 2015 to August 2016. Interviews assessed women's SRH needs (for contraception, fertility problems, menstrual problems, menopause symptoms, sexually transmitted infections (STI), experiences of intimate-partner violence (IPV), and cervical and breast cancer screening) and associated costs. We calculated average and total costs (including out-of-pocket spending, lost income, and estimated value of time spent) for women who incurred costs. We also estimated the total and average costs of meeting all SRH needs in a hypothetical "full needs met" year. Finally, we contextualize SRH spending against a measure of catastrophic expenditure (> 10% of household income). RESULTS: Among the 385 women who participated, 94.8% had at least one SRH need in the prior 12 months; 79.7% incurred costs for accessing care. On average, women spent $28.34 on SRH needs during the prior year. Excluding one HIV-negative woman who spent 112% of her annual income on infertility treatment, HIV-positive women spent more on average annually for SRH care than HIV-negative women. Sixty percent of women reported at least one unmet SRH need. If all participants sought care for all reported needs, their average annual cost would rise to $52.65 per woman. Only two women reported catastrophic expenditure - for managing infertility. CONCLUSIONS: SRH needs are constants throughout women's lives. Small annual costs can become large costs when considered cumulatively over time. As South Africa and other countries grapple with increasing access to SRH services under the rubric of universal access, it is important to remember that individuals incur costs despite free care at the point of service. Policies that address geographic proximity and service quality would be important for reducing costs and ensuring full access to SRH services. Literature on women's financial and economic costs for accessing comprehensive sexual and reproductive health care in low- and middle-income countries is extremely limited, and existing literature often overlooks out-of-pocket costs associated with travel, child care, and time spent accessing services. Using data from a survey of 385 women from a public HIV treatment site and two public primary health care facilities in Johannesburg, we found nearly all women reported at least on sexual and reproductive health need and more than 75% of women incurred costs related to those needs. Furthermore, more than half of women surveyed reported not accessing services for their sexual and reproductive health needs, suggesting a total annual cost of more than $50 USD, on average, to access services for all reported needs. While few women spent more than 10% of their total household income on sexual and reproductive health services in the prior year, needs are constant and costs incur throughout a woman's life suggesting accessing services to meet these needs might still result in financial burden. As South Africa grapples with increasing access to sexual and reproductive health services under the rubric of universal access, it is important to remember that individuals incur costs despite free care at the point of service. Policies that address geographic proximity and service quality would be important for reducing costs and ensuring full access to services.

Accesibilidad a los Servicios de Salud/economía , Necesidades y Demandas de Servicios de Salud , Servicios de Salud Reproductiva/economía , Conducta Sexual , Enfermedades de Transmisión Sexual/prevención & control , Adolescente , Adulto , Anticoncepción , Femenino , Humanos , Persona de Mediana Edad , Sudáfrica , Adulto Joven
Artículo en Inglés | MEDLINE | ID: mdl-31842473


Industrial workers or factory workers, especially migrant workers, have been found to be vulnerable populations at risk of sexually transmitted infections (STIs). However, there has been a gap in literature regarding health behaviors of migrant factory workers. We conducted a cross-sectional study among 230 factory workers in Hanoi and Bac Ninh cities in Northern Vietnam from July to September 2018 to identify sexual risk practices and related factors among migrant and nonmigrant factory workers. Information collected regarding sexual behavior included the number of sexual partners in the previous 12 months and whether they used condoms in their last sexual intercourse. Two-thirds of participants reported having no sexual activity in the last 12 months, and there was a low percentage of participants using condoms in their last sexual intercourse. Being female, living with spouses/partners, and being a nonimmigrant had a negative association with the lack of using condoms in the last sexual intercourse with casual partners/sex workers, as opposed to having mobility and self-care problems and identifying as a binge drinker. Therefore, workplace-based prevention programs focusing on providing tailored sexual health education and promoting condom use among industrial workers, especially those who are immigrant or migrant workers, in Vietnam should be emphasized.

Conductas Relacionadas con la Salud , Conducta Sexual , Migrantes , Adulto , Condones , Estudios Transversales , Femenino , Humanos , Desarrollo Industrial , Industrias , Masculino , Parejas Sexuales , Enfermedades de Transmisión Sexual/prevención & control , Vietnam , Poblaciones Vulnerables
Rev. Pesqui. (Univ. Fed. Estado Rio J., Online) ; 11(5): 1135-1141, out.-dez. 2019. tab
Artículo en Inglés, Portugués | LILACS, BDENF - Enfermería | ID: biblio-1021916


Objetivo: Identificar e avaliar as práticas, o conhecimento e comportamento dos estudantes universitários em relação às Infecções Sexualmente Transmissíveis. Método: Estudo descritivo, quantitativo, realizado em universidade pública, no Rio de Janeiro com 255 estudantes que responderam a um questionário. Os dados foram analisados com aplicação da estatística descritiva. Resultados: Entre os jovens investigados 181 (71%) eram mulheres e 74 (29%) homens; (93,7%) tinham idades entre 18-24 anos; 194 (76%) eram sexualmente ativos; 110 (43,1%) adotam o preservativo em todos os intercursos sexuais. Os jovens consideram possuir todo conhecimento sobre as Infecções Sexualmente Transmissíveis (87/34,1%); acreditam que a infecção por gonorreia pode ocorrer ao utilizar banheiros públicos (80/31,7%), e que existe cura para hepatite (102/40%). Conclusão: Os achados evidenciam que os estudantes assumem comportamento de risco e demonstram fragilidades no conhecimento sobre a prevenção e transmissão das Infecções Sexualmente Transmissíveis

Objective: The study's purpose has been to identify and assess the practices, knowledge, and behavior of college students vis-à-vis Sexually Transmitted Diseases. Methods: It is a descriptive study with a quantitative approach, which was performed at a Public University in the Rio de Janeiro city with 255 students who answered a questionnaire. Data were analyzed using descriptive statistics. Results: Among the young investigated, 181 (71%) were women and 74 (29%) were men; 93.7% were within the age group from 18 to 24 years old; 194 (76%) were sexually active; 110 (43.1%) adopt the condom in all sexual intercourse. Young people consider that they have all the knowledge about Sexually Transmitted Diseases (87/34.1%); Believe that gonorrhea infection can occur when using public restrooms (80/31.7%), and that there is a cure for hepatitis (102/40%). Conclusion: The findings show that college students assume risky behavior and demonstrate lack of knowledge concerning both prevention and transmission of Sexually Transmitted Diseases

Objetivo: Identificar y evaluar las prácticas, el conocimiento y el comportamiento de los estudiantes universitarios en relación a las Infecciones Sexualmente Transmisibles. Método: Estudio descriptivo, cuantitativo, realizado en una universidad pública, en Río de Janeiro con 255 estudiantes que respondieron a un cuestionario. Los datos fueron analizados con aplicación de la estadística descriptiva. Resultados: Entre los jóvenes investigados 181 (71%) eran mujeres y 74 (29%) hombres; (93,7%) tenían edades entre 18-24 años; 194 (76%) eran sexualmente activos; 110 (43,1%) adopta el preservativo en todos los intercursos sexuales. Los jóvenes consideran poseer todo conocimiento sobre las Infecciones Sexualmente Transmisibles (87 / 34,1%); Creen que la infección por gonorrea puede ocurrir al utilizar baños públicos (80 / 31,7%), y que existe cura para hepatitis (102/40%). Conclusión: Los hallazgos evidencian que los estudiantes asumen comportamiento de riesgo y demuestran fragilidades en el conocimiento sobre la prevención y transmisión de las Infecciones Sexualmente Transmisibles

Humanos , Masculino , Femenino , Adulto Joven , Enfermedades de Transmisión Sexual/prevención & control , Conocimientos, Actitudes y Práctica en Salud , Salud del Estudiante , Factores de Riesgo , Brasil
Bull Soc Pathol Exot ; 112(2): 90-95, 2019.
Artículo en Francés | MEDLINE | ID: mdl-31478618


Schools are considered as one of the most effective vectors for education on sexually transmitted diseases among young people. We report here the results of a study of HIV infection as presented in school textbooks in Ivory Coast, conducted in June 2018 as part of the development of a communication strategy to increase demand for HIV infection testing, especially among young people. Surprisingly, even though the textbooks studied were published between 2007 and 2017, almost all of them stated that HIV infection leads to death, with no mention of the existence of treatments that make it possible to live in good health. Some textbooks even stated that no treatment is available. These findings highlight one cause - perhaps major - for the reluctance of young people to get tested. The misrepresentation of HIV infection, reinforced by education, hampers incentive campaigns for HIV testing, for which the best argument is that awareness of a positive HIV status makes it possible to benefit from treatment. The present study included textbooks from the French educational program, used throughout French-speaking Africa, and from the Ivory Coast program. It would be interesting to conduct a similar study in other French-speaking and English-speaking African countries. Adapting the presentation of HIV in school textbooks to reflect the current situation in the fight against HIV infection should be a priority.

Comunicación , Infecciones por VIH , Servicios de Salud Escolar , Libros de Texto como Asunto , Síndrome de Inmunodeficiencia Adquirida/diagnóstico , Síndrome de Inmunodeficiencia Adquirida/prevención & control , Síndrome de Inmunodeficiencia Adquirida/transmisión , Actitud Frente a la Salud , Costa de Marfil/epidemiología , Infecciones por VIH/diagnóstico , Infecciones por VIH/prevención & control , Infecciones por VIH/transmisión , VIH-1/fisiología , VIH-2/fisiología , Promoción de la Salud/métodos , Promoción de la Salud/normas , Humanos , Conocimiento , Lenguaje , Tamizaje Masivo/psicología , Servicios de Salud Escolar/normas , Servicios de Salud Escolar/estadística & datos numéricos , Educación Sexual/normas , Educación Sexual/estadística & datos numéricos , Enfermedades de Transmisión Sexual/diagnóstico , Enfermedades de Transmisión Sexual/prevención & control , Enfermedades de Transmisión Sexual/transmisión , Libros de Texto como Asunto/normas
Emerg Med Clin North Am ; 37(4): 725-738, 2019 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-31563204


The diagnosis and treatment of sexually transmitted infections is a crucial component of providing evidence-based care in the emergency department. Understanding how to make the diagnosis and implement effective treatment is essential to maintaining and improving public health. Providers should also be adept at giving care to sexual assault survivors and seeking out the expertise of specially trained professionals within networks known as SANE, SAFE, or SART. These networks are critical to providing standardized care to sexual assault patients. Prophylaxis remains a key element for the prevention of sexually transmitted infections in all patients who are considered high risk.

Enfermedades de Transmisión Sexual/diagnóstico , Servicio de Urgencia en Hospital , Infecciones por VIH/prevención & control , Humanos , Profilaxis Posexposición , Profilaxis Pre-Exposición , Violación , Enfermedades de Transmisión Sexual/prevención & control , Enfermedades de Transmisión Sexual/terapia