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1.
Can Bull Med Hist ; 37(2): 319-359, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32822549

RESUMEN

Hypochondriac or phobic reactions to venereal disease, specifically syphilis, have invited over three centuries of medical reification and nosological reframing. This bibliographic overview establishes that the early specification and psychiatricization of early modern concepts of melancholy and hypochondriasis, imaginary syphilis or syphilophobia, animated the early respective territorializations of venereology, infectiology more broadly, neurology, and mental medicine. Together with mercuriophobia and a wider emergent clinical sensitivity to sexual angst, the diagnosis, while evidently only sporadically made, functioned as a durable soundboard in the confrontation of emergent medical rationale with various confounders and contenders: medically literate and increasingly mobile but possibly deluded patients; charlatans and putative malpractitioners; self-referral laboratory serology (after 1906); and eventually, through psychoanalysis, the patient's unconscious. Requiring medical psychology early on, syphilology became and remained self-conscious and circumspect, attentive to the casualties of overdiagnosis, overtreatment, and iatrogenesis. Finally, patient apprehension led to makeshift forms of "moral treatment," including fear-instilling and placebos.


Asunto(s)
Hipocondriasis/historia , Trastornos Fóbicos/historia , Sífilis/historia , Historiografía , Historia del Siglo XVII , Historia del Siglo XVIII , Historia del Siglo XIX , Historia del Siglo XX , Humanos , Trastornos Fóbicos/terapia , Enfermedades de Transmisión Sexual/historia , Enfermedades de Transmisión Sexual/psicología , Sífilis/psicología
2.
AIDS Educ Prev ; 32(2): 117-136, 2020 04.
Artículo en Inglés | MEDLINE | ID: mdl-32539477

RESUMEN

Very few studies have been conducted to investigate HIV risk and protective behaviors in relation to psychosocial factors among Asian and Pacific Islander (API) MSM whose HIV/AIDS prevalence is lower than those of other racial/ethnic groups. This study, based on an online survey targeting API MSM in California revealed that API MSM often met sex partners online and that psychosocial factors (e.g., homophobia and identity with API gay community) were correlated with condomless receptive anal sex (RAS) with casual partners. In particular, an Asian cultural construct, interdependency, was correlated with condom use for RAS; that is, those who consider sex partners' health and value harmony tend to engage in safe sex. This finding sheds light on re-thinking the current over-emphasis on assertiveness and self-responsibility to keep free from HIV/STIs during negotiation with partners. Future STI prevention programs for API MSM should incorporate Asian cultural constructs and target specific risk groups.


Asunto(s)
Americanos Asiáticos/estadística & datos numéricos , Infecciones por VIH/epidemiología , Homosexualidad Masculina/psicología , Internet , Grupo de Ascendencia Oceánica/estadística & datos numéricos , Sexo Seguro/estadística & datos numéricos , Enfermedades de Transmisión Sexual/epidemiología , Adolescente , Adulto , Americanos Asiáticos/psicología , California/epidemiología , Infecciones por VIH/psicología , Homosexualidad Masculina/etnología , Humanos , Masculino , Persona de Mediana Edad , Grupo de Ascendencia Oceánica/psicología , Prevalencia , Asunción de Riesgos , Sexo Seguro/psicología , Parejas Sexuales , Enfermedades de Transmisión Sexual/psicología , Encuestas y Cuestionarios , Adulto Joven
3.
Int J STD AIDS ; 31(7): 613-618, 2020 06.
Artículo en Inglés | MEDLINE | ID: mdl-32366180

RESUMEN

The sexual health services in the Birmingham and Solihull area of the United Kingdom, called Umbrella, has been offering home-based testing for sexually transmitted infections to patients since August 2015. The aim of this service evaluation was to evaluate the uptake, return rate and new diagnosis rates of home-based testing in comparison with clinic-based testing for human immunodeficiency virus (HIV), syphilis (STS) and hepatitis B. Home-based testing, although popular, had low uptake amongst high-risk groups such as men who have sex with men (MSM), compared to the clinic-based group (1% versus 11%, p < 0.001). This resulted in low positivity rates for HIV (0.02%) and STS (0.17%) and no new cases of hepatitis B in the home-based group. Therefore, our results show that home-based testing is not a cost-effective method of testing for HIV and likely this is also the case for hepatitis B and STS. Our recommendation would be to encourage uptake of home-based testing in high-risk groups such as MSM and Black Africans to improve the diagnosis rates of HIV, STS and hepatitis B. Alternatively, the continuation of home-based blood testing in the Birmingham and Solihull area will need to be reviewed by Umbrella as a cost-saving strategy for the service in the future.


Asunto(s)
Instituciones de Atención Ambulatoria/estadística & datos numéricos , Prestación de Atención de Salud/estadística & datos numéricos , Infecciones por VIH/diagnóstico , Infecciones por VIH/prevención & control , Hepatitis B/diagnóstico , Hepatitis B/prevención & control , Tamizaje Masivo/métodos , Autocuidado/estadística & datos numéricos , Enfermedades de Transmisión Sexual/diagnóstico , Enfermedades de Transmisión Sexual/prevención & control , Sífilis/diagnóstico , Sífilis/prevención & control , Adolescente , Adulto , Autoevaluación Diagnóstica , Femenino , Infecciones por VIH/psicología , Hepatitis B/psicología , Virus de la Hepatitis B , Humanos , Masculino , Estudios Retrospectivos , Enfermedades de Transmisión Sexual/psicología , Sífilis/psicología , Serodiagnóstico de la Sífilis , Treponema pallidum , Reino Unido , Adulto Joven
4.
BMC Public Health ; 20(1): 616, 2020 May 04.
Artículo en Inglés | MEDLINE | ID: mdl-32366241

RESUMEN

BACKGROUND: Men who have sex with men (MSM) globally have a high burden of curable sexually transmitted infections (STIs). MSM do not frequently receive rectal STI testing because of several barriers, such as not being out (disclosure of sexual behavior). We evaluate whether Chinese MSM select an STI test (rectal vs urethral) appropriate for their sexual behavior (insertive and/or receptive), and the interactions with being out. METHODS: This was a secondary analysis of data from a cross sectional MSM survey conducted at a multisite randomized controlled trial (RCT) (December 2018 to January 2019) around uptake of gonorrhea and chlamydia testing among Chinese MSM (N = 431). We collected socio demographics, relevant medical and sexual history, and disclosure of sexual behavior (outness). We estimated the decision to test and test choice, and the extent to which disclosure plays a role in decision making. RESULTS: Among 431 MSM, mean age was 28 years (SD = 7.10) and 65% were out to someone. MSM who indicated versatile sexual behavior and were out to someone had a 26.8% (95%CI = 6.1, 47.5) increased likelihood for selecting the rectal test vs the ure thral test, compared to those versatile and not out. Versatile MSM out to their health provider outside of the study context had a 29.4% (95%CI = 6.3, 52.6) greater likelihood for selecting the rectal STI test vs the urethral test, compared to versatile MSM not out to their health provider. CONCLUSIONS: Sexual behavior and outness may affect gonorrhea and chlamydia testing provision. Apart from clinicians, community based efforts may reduce stigma based barriers to testing.


Asunto(s)
Revelación/estadística & datos numéricos , Homosexualidad Masculina/estadística & datos numéricos , Conducta Sexual/estadística & datos numéricos , Enfermedades de Transmisión Sexual/diagnóstico , Enfermedades de Transmisión Sexual/psicología , Estigma Social , Adulto , China/epidemiología , Estudios Transversales , Humanos , Masculino , Prevalencia , Enfermedades de Transmisión Sexual/epidemiología , Adulto Joven
5.
BMC Public Health ; 20(1): 717, 2020 May 19.
Artículo en Inglés | MEDLINE | ID: mdl-32429891

RESUMEN

BACKGROUND: Premarital sex can increase the risk of sexually transmitted diseases (STDs) in adolescents, and lack of premarital sex can be considered as a reliable policy for STD prevention, which is used by some countries such as Iran. Since the success of this policy is related to the concept of virginity, the present study was conducted to determine the concept of virginity from the perspective of Iranian adolescents. METHODS: In this qualitative study with phenomenological approach, the research team visited public places, including parks and coffee shops, and interviewed a number of 15-19-year-old adolescents. The data were collected using in-depth interviews with semi-structured questions and analysed using thematic analysis method. RESULTS: Several themes, including virginity as the lack of emotional relationship with the opposite sex, lack of physical contact, nonpenetrative relationship, virginity as a myth, virginity as a commitment, having an intact hymen, and not knowing the meaning of virginity, were extracted from the data. CONCLUSION: The most reliable policy on STD prevention is the lack of premarital sex. The success of this policy is related to the concept of virginity. The findings of this study showed that the participants did not consider physical contact as the breach of virginity. This may indicate that the policy of not having sex before marriage or lack of premarital sex is not enough and Iranian adolescents are at risk of STDs. Therefore, policymakers must take steps towards modifying the concept of virginity in the adolescents' value system and provide and implement educational programs on sexual health for adolescents.


Asunto(s)
Conducta del Adolescente/psicología , Abstinencia Sexual/psicología , Adolescente , Femenino , Conocimientos, Actitudes y Práctica en Salud , Humanos , Irán , Masculino , Matrimonio/psicología , Investigación Cualitativa , Enfermedades de Transmisión Sexual/psicología , Adulto Joven
6.
Rev Saude Publica ; 54: 41, 2020.
Artículo en Inglés, Portugués | MEDLINE | ID: mdl-32321057

RESUMEN

OBJECTIVE: To describe the sexual behavior of freshmen undergraduate students according to demographic, economic, psychosocial and behavioral characteristics, and evaluate the prevalence of risky sexual behavior and its associated factors. METHODS: A cross-sectional study of the census type with undergraduate students over 18 years old of 80 undergraduate courses of the Universidade Federal de Pelotas (UFPel), in Rio Grande do Sul (RS), who entered in the first semester of 2017 and remained enrolled in the second semester. Undergraduate students who reported having had sex were evaluated. We considered as risky sexual behavior having more than one sexual partner within the last three months and not having used condoms in the last sexual intercourse. RESULTS: The prevalence of risky sexual behavior was 9% (95%CI 7.6-10.5). Men presented more risky behavior than women, with a prevalence of 10.8% and 7.5%, respectively. Of the undergraduate students, 45% did not use condoms in the last sexual intercourse, and 24% had two partners or more within three months before the survey. Smartphone applications for sexual purposes were used by 23% of students within three months before the survey. Risky sexual behavior was associated with gender, age at first sexual intercourse, frequency of alcohol consumption, consumption of psychoactive substances before the last sexual intercourse and use of smartphone applications for sexual purposes. CONCLUSION: Although undergraduate students are expected to be an informed population, the prevalence of risky sexual behavior was important, indicating the need to expand public investment in sexual education and awareness actions.


Asunto(s)
Censos , Conductas de Riesgo para la Salud , Conducta Sexual/estadística & datos numéricos , Estudiantes/estadística & datos numéricos , Adolescente , Adulto , Consumo de Bebidas Alcohólicas/epidemiología , Consumo de Bebidas Alcohólicas/psicología , Brasil/epidemiología , Coito/psicología , Estudios Transversales , Femenino , Humanos , Masculino , Prevalencia , Factores Sexuales , Conducta Sexual/psicología , Parejas Sexuales/psicología , Enfermedades de Transmisión Sexual/epidemiología , Enfermedades de Transmisión Sexual/psicología , Factores Socioeconómicos , Estudiantes/psicología , Adulto Joven
7.
BMC Public Health ; 20(1): 577, 2020 Apr 28.
Artículo en Inglés | MEDLINE | ID: mdl-32345293

RESUMEN

BACKGROUND: Sexually transmitted infections (STIs) during pregnancy result in neonatal morbidity and mortality, and may increase mother-to-child-transmission of HIV. Yet the World Health Organization's current syndromic management guidelines for STIs leaves most pregnant women undiagnosed and untreated. Point-of-care (POC) diagnostic tests for STIs can drastically improve detection and treatment. Though acceptable and feasible, poor medication adherence and re-infection due to lack of partner treatment threaten the programmatic effectiveness of POC diagnostic programmes. METHODS: To engender patient-provider trust, and improve medication adherence and disclosure of STI status to sexual partners, we trained study nurses in compassionate care, good clinical practices and motivational interviewing. Using qualitative methods, we explored the role patient-provider communications may play in supporting treatment adherence and STI disclosure to sexual partners. Nurses were provided training in motivational interviewing, compassionate care and good clinical practices. Participants were interviewed using a semi-structured protocol, with domains including STI testing experience, patient-provider communication, and HIV and STI disclosure. Interviews were audio-recorded, transcribed and analyzed using a constant comparison approach. RESULTS: Twenty-eight participants treated for Chlamydia trachomatis (CT), Trichomonas vaginalis (TV), and/or Neisseria gonorrhea (NG) were interviewed. Participants described strong communications and trusting relationships with nurses trained in patient-centered care training and implementing POC STI diagnostic testing. However, women described a delayed trust in treatment until their symptoms resolved. Women expressed a limited recall of their exact diagnosis, which impacted their ability to fully disclose their STI status to sexual partners. CONCLUSIONS: We recommend implementing patient health literacy programmes as part of POC services to support women in remembering and disclosing their specific STI diagnosis to sexual partners, which may facilitate partner treatment uptake and thus decrease the risk of re-infection.


Asunto(s)
Relaciones Enfermero-Paciente , Aceptación de la Atención de Salud/psicología , Pruebas en el Punto de Atención , Mujeres Embarazadas/psicología , Diagnóstico Prenatal/psicología , Adulto , Femenino , Infecciones por VIH/enfermería , Infecciones por VIH/psicología , Infecciones por VIH/transmisión , Alfabetización en Salud , Humanos , Transmisión Vertical de Enfermedad Infecciosa/prevención & control , Embarazo , Complicaciones Infecciosas del Embarazo/diagnóstico , Complicaciones Infecciosas del Embarazo/enfermería , Complicaciones Infecciosas del Embarazo/psicología , Diagnóstico Prenatal/métodos , Diagnóstico Prenatal/enfermería , Enfermedades de Transmisión Sexual/diagnóstico , Enfermedades de Transmisión Sexual/enfermería , Enfermedades de Transmisión Sexual/psicología , Sudáfrica , Confianza
8.
PLoS One ; 15(4): e0232218, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32339212

RESUMEN

Stigma has significant detrimental health outcomes for those affected. This study examined socio-demographic characteristics that were associated with stigmatising attitudes among the general population towards people who inject drugs, and people living with blood borne viruses or sexually transmissible infections. Questions were included in the Australian Survey of Social Attitudes (total sample = 1,001). Attitudes towards each of the target populations were measured by 5-item stigma scales. Bivariate analyses and multiple regression analyses were conducted to identify socio-demographic characteristics associated with stigmatising attitudes. Knowing a person affected by a stigmatised attribute was associated with reduced stigmatising attitudes, while voting for a conservative political party was associated with increased stigmatising attitudes. Age, gender, education, income, and marital status were each related to some stigmatising attitudes. Results also highlight differences between attitudes towards a stigmatised behaviour (i.e., injecting drug use) and stigmatised conditions (i.e., blood borne viruses and sexually transmissible infections). Identifying socio-demographic characteristics that are associated with stigmatising attitudes may have global implications for informing stigma reduction interventions, in order to promote positive health outcomes for affected communities.


Asunto(s)
Enfermedades de Transmisión Sexual/psicología , Abuso de Sustancias por Vía Intravenosa/psicología , Virosis/psicología , Adulto , Anciano , Australia , Femenino , Conocimientos, Actitudes y Práctica en Salud , Humanos , Masculino , Persona de Mediana Edad , Estigma Social , Estereotipo , Encuestas y Cuestionarios , Virus/patogenicidad
9.
BMC Public Health ; 20(1): 521, 2020 Apr 19.
Artículo en Inglés | MEDLINE | ID: mdl-32306942

RESUMEN

BACKGROUND: In Perú, HIV disproportionately affects men who have sex with men (MSM). Despite widespread access to treatment, the high rate of new HIV infections has remained unchanged over the last decade. Low knowledge of HIV status associated with late diagnosis is a key factor underlying the high HIV incidence observed in this setting, creating conditions for efficient onward transmission. Improving access to HIV testing and prevention services for those at highest risk is an important public health priority. Sex-on-premise venues (SOPVs) - saunas, sex clubs, pornographic movie theaters, hourly hotels, and bars/discos with areas where sex is permitted - may be opportune sites for outreach; however, further research on SOPVs and the populations who frequent them is needed to inform such efforts. METHODS: We conducted a cross-sectional online survey of adult MSM in Lima, Perú to evaluate patterns of SOPV attendance, associated sexual risk behaviors, and attitudes toward SOPV-based interventions. Participants were recruited through outreach to social media networks affiliated with local LGBTQ-aligned community groups. Our primary analytic objective was to estimate the association of HIV-related sexual risk behaviors and SOPV attendance. Additionally, we performed exploratory analyses to describe risk behavior stratified by SOPV category and to examine the relationship between SOPV attendance and the use of online platforms to meet sex partners. RESULTS: Overall, 389 MSM completed the survey from November 2018 through May 2019, of whom 68% reported attending an SOPV in the last 3 months. SOPV attendance was associated with multiple sexual risk behaviors, including transactional sex, group sex, substance use around the time of sex, and higher number of partners. Over two thirds of SOPV attendees indicated they would accept HIV testing if offered at SOPVs. CONCLUSIONS: SOPV attendance was common among MSM in Lima who participated in our survey, and SOPV attendees reported significantly greater engagement in sexual risk behaviors related to HIV transmission. Attitudes toward hypothetical SOPV-based interventions were generally favorable. These findings suggest that outreach at SOPVs may be an effective mechanism for reaching a particularly high-risk sub-population of MSM in Perú to deliver targeted HIV testing and prevention interventions.


Asunto(s)
Infecciones por VIH/psicología , Tamizaje Masivo/psicología , Conducta Sexual/psicología , Minorías Sexuales y de Género/psicología , Enfermedades de Transmisión Sexual/psicología , Adolescente , Adulto , Estudios Transversales , VIH , Infecciones por VIH/epidemiología , Conocimientos, Actitudes y Práctica en Salud , Humanos , Masculino , Persona de Mediana Edad , Perú/epidemiología , Factores de Riesgo , Asunción de Riesgos , Conducta Sexual/estadística & datos numéricos , Parejas Sexuales/psicología , Minorías Sexuales y de Género/estadística & datos numéricos , Enfermedades de Transmisión Sexual/epidemiología , Enfermedades de Transmisión Sexual/virología , Red Social , Trastornos Relacionados con Sustancias/epidemiología , Trastornos Relacionados con Sustancias/psicología , Trastornos Relacionados con Sustancias/virología , Encuestas y Cuestionarios , Adulto Joven
10.
BMC Public Health ; 20(1): 434, 2020 Apr 03.
Artículo en Inglés | MEDLINE | ID: mdl-32245375

RESUMEN

BACKGROUND: Lack of knowledge about sexual violence, its consequences, substance use and homelessness are major problems that make street dwellers susceptible to sexually transmitted diseases. Hence, this study assessed knowledge, attitudes and treatment-seeking behaviors related to sexually transmitted diseases among street dwellers in southern Ethiopia. METHODS: An explanatory sequential mixed-methods study design was conducted among 842 respondents. A simple random sampling technique was used to select seven cities among fourteen major cities of the region. The sample was allocated proportionally to each selected city. In order to identify and fill in the required sample size, a snowball sampling technique was used. A pre-tested and structured interviewer-administered questionnaire was used to collect quantitative data. The collected data were entered using Epidata and exported to SPSS version 23.0 for further analysis. Unstructured questionnaires were also used to collect 21 in-depth interviews and 10 key informants' interviews. Respondents for in-depth interviews were selected purposively during quantitative data collection. RESULTS: Most street dwellers were aware of (86.7%) and had a favourable attitude towards (84.4%) prevention and management of sexually transmitted diseases. A portion of respondents experienced bad-smelling genital discharge (13.8%), genital ulcers (11.2%) and a burning sensation (14.5%) during urination, in the previous year. Among those who experienced symptoms of sexually transmitted disease, only 15.3% of them received treatment from a health care provider. Fear of questions raised by providers was one of the reasons for not seeking care according to our qualitative findings. CONCLUSIONS: In this study, a significant number of street dwellers reported experiencing symptoms of a sexually transmitted disease. Despite having awareness about sexually transmitted diseases, seeking treatment from a health center was found to be low based on both quantitative and qualitative findings. We recommend that health care providers should undergo special training to address the sexual and reproductive health problems of street dwellers.


Asunto(s)
Conocimientos, Actitudes y Práctica en Salud , Personas sin Hogar/psicología , Aceptación de la Atención de Salud/psicología , Enfermedades de Transmisión Sexual/psicología , Trastornos Relacionados con Sustancias/psicología , Adolescente , Adulto , Etiopía/epidemiología , Femenino , Humanos , Masculino , Investigación Cualitativa , Proyectos de Investigación , Enfermedades de Transmisión Sexual/epidemiología , Enfermedades de Transmisión Sexual/etiología , Trastornos Relacionados con Sustancias/complicaciones , Trastornos Relacionados con Sustancias/epidemiología , Encuestas y Cuestionarios , Adulto Joven
11.
AIDS Care ; 32(sup2): 193-197, 2020 05.
Artículo en Inglés | MEDLINE | ID: mdl-32193964

RESUMEN

Women, and specifically, adolescents, are at high risk of HIV and STIs during the postpartum period. Biological and behavioral factors contribute to adolescents' susceptibility. However, the influence of behavioral factors, like intimate partner violence (IPV), on postpartum STI acquisition has been understudied. The study's purpose is to determine whether IPV victimization during pregnancy predicts incident STIs in the first 6 months postpartum. Adolescent mothers (14-19 years) were recruited at a township hospital's maternity ward near Durban. Adolescent mothers who were HIV-negative and had no laboratory-diagnosed STIs at baseline (6 weeks postpartum) were included in the analysis (n = 61). We used a modified Poisson regression with robust standard errors to assess differences in postpartum STI risk by IPV victimization during pregnancy controlling for covariates. At baseline, 25 (41%) adolescent mothers reported IPV victimization during pregnancy. Adolescent mothers who reported IPV during pregnancy were at higher risk of receiving an STI diagnoses at 6 months postpartum (aRR: 4.43; 95% CI: 1.31-14.97). Our findings heighten understanding of HIV risk among a vulnerable subset of adolescent girls: adolescent mothers. Non-combined interventions that help young mothers and their partners navigate partnership dynamics to reduce IPV and STIs are needed to reduce HIV risk.


Asunto(s)
Víctimas de Crimen/psicología , Violencia de Pareja/estadística & datos numéricos , Madres/psicología , Parejas Sexuales/psicología , Enfermedades de Transmisión Sexual/epidemiología , Adolescente , Adulto , Víctimas de Crimen/estadística & datos numéricos , Femenino , Humanos , Incidencia , Violencia de Pareja/psicología , Madres/estadística & datos numéricos , Periodo Posparto , Embarazo , Embarazo en Adolescencia , Enfermedades de Transmisión Sexual/psicología , Sudáfrica/epidemiología , Adulto Joven
13.
J Youth Adolesc ; 49(5): 991-1004, 2020 May.
Artículo en Inglés | MEDLINE | ID: mdl-32096008

RESUMEN

Adolescent risky sexual behaviors can result in negative consequences such as sexually transmitted infection. However, much research effort has been placed on understanding individual characteristics, rather than the role of neighborhood environment. This study addressed the prospective effects of neighborhood and family functioning in preadolescence on risky sexual behaviors. Participants included 4179 youth (Mage = 11.01 years, range 8.64-13.83; 51% female) and their caregivers. Using objective and self-reported measures of neighborhood and family functioning, results from multilevel regression analyses indicated that youth residing in disordered neighborhoods or had poorer family functioning in preadolescence were more likely to initiate sexual intercourse at younger ages 5 years later. Specifically, neighborhood poverty and decay were linked to early sexual initiation, whereas neighborhood social and family processes were protective against early sexual initiation. Males were more likely to engage in risky sexual behaviors in neighborhoods with greater poverty or decay; neighborhood poverty was linked with sexual initiation in White but not African American youth. Finally, parental monitoring moderated relationships between neighborhood social resources and contraceptive use, with neighborhood social resources linked with greater contraceptive use at low levels of parental monitoring, but lower contraceptive use at high levels of parental monitoring. These findings underscore the importance of neighborhood and family contexts in adolescents' risky sexual behavior, suggesting that males and White youth are more vulnerable to the effects of neighborhood poverty and that more research is needed on the possible counterproductive function of parental monitoring in neighborhoods with greater social resources.


Asunto(s)
Conducta del Adolescente/psicología , Características de la Residencia/estadística & datos numéricos , Asunción de Riesgos , Conducta Sexual/psicología , Adolescente , Niño , Coito/psicología , Recolección de Datos , Femenino , Humanos , Masculino , Relaciones Padres-Hijo , Estudios Prospectivos , Enfermedades de Transmisión Sexual/psicología
15.
Sex Transm Infect ; 96(1): 62-66, 2020 02.
Artículo en Inglés | MEDLINE | ID: mdl-30696753

RESUMEN

OBJECTIVES: Men who have sex with men (MSM) are a highly neglected population in the current recommendation of girls-only human papillomavirus (HPV) vaccination programmes in many countries. To better assess the cost effectiveness of HPV vaccination among men requires data on the prevalence of HPV infection in MSM using a community sample, which is still sparse in several regions. We examined the prevalence of and factors associated with anogenital HPV infection among MSM in Taiwan. METHODS: MSM 20 years of age and older were recruited from the community and social media in Taiwan in 2015-2016 and screened for HPV infection to detect 37 genotypes. MSM were seen at baseline and were/will be seen at 6, 12, 24 and 36 months. Men completed a questionnaire regarding their sexual experiences. Multivariable regression analyses were conducted to identify associated behavioural risk factors using the baseline data. RESULTS: A total of 253 MSM were recruited; 87 % were below 35 years of age. Diagnosis of HIV was reported in 4% of men; just over 20% had three or more anal sex partners in the past year. The prevalence of any tested HPV type was 29.4% at the anal site and 11% at the penile site. One quarter of MSM were infected with any of the 9-valent vaccine HPV types. Anal HPV detection was associated with having three or more receptive anal sex partners in the past year (adjusted odds ratio (aOR)=2.92, 95% CI 1.29 to 6.61) and having older sex partners (aOR=2.51, 95% CI 1.07 to 5.90). CONCLUSIONS: Our data provide the base to calculate the reproductive rate for HPV transmission in a low-risk community sample and cost-effectiveness to include men in HPV vaccination policies. Adding evidence from a community sample adds comprehensiveness for future estimates of disease transmission and vaccine effectiveness.


Asunto(s)
Enfermedades del Ano/virología , Homosexualidad Masculina/estadística & datos numéricos , Infecciones por Papillomavirus/epidemiología , Adulto , Canal Anal/virología , Enfermedades del Ano/epidemiología , Enfermedades del Ano/psicología , Estudios de Cohortes , Homosexualidad Masculina/psicología , Humanos , Masculino , Persona de Mediana Edad , Papillomaviridae/clasificación , Papillomaviridae/genética , Papillomaviridae/aislamiento & purificación , Infecciones por Papillomavirus/psicología , Infecciones por Papillomavirus/virología , Prevalencia , Características de la Residencia/estadística & datos numéricos , Factores de Riesgo , Conducta Sexual , Parejas Sexuales , Enfermedades de Transmisión Sexual/epidemiología , Enfermedades de Transmisión Sexual/psicología , Enfermedades de Transmisión Sexual/virología , Taiwán , Adulto Joven
16.
Sex Transm Infect ; 96(1): 40-46, 2020 02.
Artículo en Inglés | MEDLINE | ID: mdl-31406001

RESUMEN

OBJECTIVES: Drug use during sex has been associated with sexually transmitted infections (STI). While a growing body of research has investigated drug use during sex among men who have sex with men, data in swingers is limited. Swingers are heterosexual couples who have sex with others and singles who have sex with these couples. Our study assessed the prevalence of drug use during sex and perceived benefits and risks among swingers. METHODS: In 2018, 1005 swingers completed an online questionnaire that was advertised at Dutch swinger-websites. We assessed the associations between drug use during sex <6 months (any drug use excluding alcohol and erection medicines) and sociodemographic characteristics, alcohol use and condomless sex using backward multivariable logistic regression analysis. We compared drug use, motives, beliefs and experienced effects between heterosexual male, bisexual male and female drug-using swingers using χ2-tests. RESULTS: Drug use during sex was reported by 44% (443/1005): 51% in women, 44% in bisexual men and 39% in heterosexual men (P<0.01). Condomless vaginal (46%) and anal sex (22%) was higher in drug-using swingers (vs 34% and 13% in non-drug-using swingers, P<0.001). Among drug-using swingers, XTC (92%), GHB (76%) and laughing gas (69%) were mostly used. Prolonging sex (68%) and increasing arousal (66%) were the most reported motives. Most reported positive effects were feeling happy (78%) and increasing energy (78%). Ninety-four per cent considered drug use to be pleasurable. The most reported negative effect was feeling tired (53%), 7% reported that they might become addicted or felt uncomfortable having sex without drugs. CONCLUSION: This study among a large group of swingers shows that drug use during sex is highly prevalent. STI clinics should discuss drug use during sex among swingers and provide information on safer sex and drug use, while acknowledging the perceived benefits, such as the increased quality of sex.


Asunto(s)
Consumidores de Drogas/psicología , Enfermedades de Transmisión Sexual/psicología , Adulto , Estudios Transversales , Consumidores de Drogas/estadística & datos numéricos , Femenino , Heterosexualidad/psicología , Heterosexualidad/estadística & datos numéricos , Humanos , Masculino , Persona de Mediana Edad , Países Bajos/epidemiología , Prevalencia , Parejas Sexuales/psicología , Minorías Sexuales y de Género/psicología , Minorías Sexuales y de Género/estadística & datos numéricos , Enfermedades de Transmisión Sexual/epidemiología , Sexo Inseguro/psicología , Sexo Inseguro/estadística & datos numéricos , Adulto Joven
17.
J Pediatr Adolesc Gynecol ; 33(1): 45-52, 2020 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-31585164

RESUMEN

STUDY OBJECTIVE: The purpose of this study was to understand the factors and influences that affect dual-method contraception in adolescent and young adult women using long-acting reversible contraception (LARC) and whether these are unique to LARC users. DESIGN: Qualitative semistructured interview study. SETTING AND PARTICIPANTS: Adolescents and young women aged 14-24 years using LARC methods, adolescents and young women aged 14-24 years using short-acting reversible contraception (SARC), and men aged 14-30 years. INTERVENTIONS: Interviews were conducted until thematic saturation was reached. MAIN OUTCOME MEASURES: The team used a grounded theory approach to identify common themes relating to dual-method contraception. RESULTS: Interviews were conducted with 20 LARC users, 26 SARC users, and 13 men. There were no differences in dual-method contraception use between LARC users and SARC users. Most participants used condoms primarily for pregnancy prevention rather than sexually transmitted infection (STI) prevention. Relationship context played an important role in dual-method contraception among all 3 groups; participants were less likely to use condoms in a long-term or monogamous relationship than with new or casual partners. Most participants perceived themselves to be at low risk for STI acquisition, although even those who identified themselves to be at risk did not consistently use condoms. Immediate availability of condoms was a determinant of condom use in all 3 groups, whereas knowledge, access, and negotiation of condom use were not. CONCLUSION: LARC users are similar to SARC users in their decision-making about condom use. Relationship factors and STI risk assessment are important components to be included in contraceptive counseling.


Asunto(s)
Condones/estadística & datos numéricos , Conducta Anticonceptiva/psicología , Anticoncepción Reversible de Larga Duración/estadística & datos numéricos , Enfermedades de Transmisión Sexual/prevención & control , Adolescente , Adulto , Toma de Decisiones , Femenino , Teoría Fundamentada , Humanos , Masculino , Embarazo , Investigación Cualitativa , Parejas Sexuales/psicología , Enfermedades de Transmisión Sexual/psicología , Adulto Joven
18.
AIDS Care ; 32(5): 567-571, 2020 05.
Artículo en Inglés | MEDLINE | ID: mdl-31248272

RESUMEN

The knowledge of sexual practices of heterosexual males (HM) in Israel is limited despite the increase inthe incidence of sexually transmitted diseases (STI). This study assessed sexual practices among Israeli HM and the associations between demographic characteristics and sexual risk behaviors. The Cross-sectional study included a representative sample of 913 Jewish HM aged 18-44, which completed a questionnaire including their demographics, sexual practices, and risky sexual behavior. Of all participants, 66.8% had monogamous sex with their steady partner. These participants were more likely to be older, religious, involved ina limited repertoire of sexual practices, and less likely to engage in risky sexual behavior. Of the participants, 9.6% were in steady relationships but had concomitant sexual casual partner/s. They were more likely to be secular, paid for sex, and had more lifetime sexual partners. Of all the participants, 23.6% were singles and had sex with casual partner/s. They were more likely to be younger and engage in risky sexual behavior. Of all participants, 10.3% were involved in risky sexual behavior. These men were more likely to be singles, pay for sex and have more lifetime sexual partners. We conclude that preventive interventions aimed to prevent STI-infections should target HM who are in singles and those in steady relationships and have concomitant sex partners.


Asunto(s)
Condones/estadística & datos numéricos , Infecciones por VIH , Heterosexualidad/estadística & datos numéricos , Asunción de Riesgos , Conducta Sexual/psicología , Adolescente , Adulto , Estudios Transversales , Humanos , Israel/epidemiología , Masculino , Conducta Sexual/etnología , Parejas Sexuales , Enfermedades de Transmisión Sexual/epidemiología , Enfermedades de Transmisión Sexual/prevención & control , Enfermedades de Transmisión Sexual/psicología , Adulto Joven
19.
Sex Transm Infect ; 96(1): 33-39, 2020 02.
Artículo en Inglés | MEDLINE | ID: mdl-31221743

RESUMEN

OBJECTIVES: Continuing high STI positivity among men who have sex with men (MSM) attending centres for sexual health (CSH) indicates that high-risk behaviour is ongoing. The objective of this study was to gain a better insight into risk behaviours among MSM attending CSH and to explore STI and HIV positivity by subgroups. METHODS: We used national data routinely collected during CSH consultations for this study. From September to December 2017, questions on group sex, substance use and sex with HIV-positive partners were asked at each CSH consultation. We analysed latent classes of client-related factors and sexual risk behaviour among MSM attending CSH in this period. We examined STI positivity and prevalence ratios by latent classes. RESULTS: A total of six classes were identified in order of increasing risk: 'overall low-risk behaviour' (n=2974; 22.0%), 'Western origin and multiple sex partners' (MSP) (n=4182; 30.9%), 'Non-Western origin and MSP' (n=2496; 18.5%), 'living with HIV' (n=827; 6.1%), 'group sex and HIV-positive partners' (n=1798; 13.3%) and 'group sex and chemsex' (n=1239; 9.2%). The any STI positivity ranged from 14.0% in the overall low-risk behaviour class to 35.5% in the group sex and chemsex class. HIV positivity did not differ significantly between classes. The Western origin and MSP class was largest and accounted for the majority of STI and HIV infections. CONCLUSIONS: Although STI positivity increased with increased risky behaviours, considerable STI positivity was found in all six latent classes. Comparable HIV positivity between classes indicates risk reduction strategies among subgroups engaged in risky behaviours. The differences in risk behaviour and STI positivity require preventive strategies tailored to each subgroup.


Asunto(s)
Centros Comunitarios de Salud/estadística & datos numéricos , Homosexualidad Masculina/estadística & datos numéricos , Enfermedades de Transmisión Sexual/epidemiología , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Infecciones por VIH/epidemiología , Infecciones por VIH/psicología , Homosexualidad Masculina/psicología , Humanos , Masculino , Persona de Mediana Edad , Países Bajos/epidemiología , Conducta Sexual , Salud Sexual/estadística & datos numéricos , Enfermedades de Transmisión Sexual/psicología , Sexo Inseguro , Adulto Joven
20.
AIDS Behav ; 24(3): 724-737, 2020 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-31093819

RESUMEN

Drug use during sex increases risks for HIV acquisition. Male clients of female sex workers (FSW) represent both a key population at risk for HIV as well as a transmission bridge population. In Tijuana, Mexico, drug use is prevalent and there is a need to understand male clients' drug use during sex with FSW. Characteristics of sex work venues may confer higher risks for drug use, risky sex, and HIV/STI. It is essential to understand the venue-related social and structural factors associated with drug use during sex in order to inform HIV prevention interventions with male clients in this region. We used a Mixed-Methods Sequential Explanatory Design to conduct an enriched examination of drug use during sex among male clients of FSW in Tijuana. Findings from logistic regression analysis showed that drug use during sex was significantly correlated with police harassment (AOR = 4.06, p < .001) and methamphetamine use (AOR = 33.77, p < .001). In-depth interview data provided rich meaning behind and context around the quantitative associations. Social and structural interventions to reduce police harassment, methamphetamine use, and promote condom availability are needed to reduce risks for HIV among male clients of FSW in Tijuana.


Asunto(s)
Infecciones por VIH/transmisión , Trabajo Sexual/estadística & datos numéricos , Trabajadores Sexuales , Enfermedades de Transmisión Sexual/transmisión , Trastornos Relacionados con Sustancias/epidemiología , Sexo Inseguro/psicología , Adolescente , Adulto , Condones , Femenino , Infecciones por VIH/epidemiología , Infecciones por VIH/psicología , Humanos , Masculino , México/epidemiología , Prevalencia , Medición de Riesgo , Factores de Riesgo , Asunción de Riesgos , Enfermedades de Transmisión Sexual/epidemiología , Enfermedades de Transmisión Sexual/psicología , Trastornos Relacionados con Sustancias/complicaciones , Sexo Inseguro/estadística & datos numéricos , Adulto Joven
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