Your browser doesn't support javascript.
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 17.108
Filtrar
1.
Artículo en Inglés | MEDLINE | ID: mdl-32418513

RESUMEN

Background: Notification rates of gonorrhoea in Australia for heterosexual young adults rose by 63% between 2012 and 2016. In Western Australian major cities, there was a 612% increase among non-Aboriginal females and a 358% increase in non-Aboriginal males in the ten-year period 2007-2016. A qualitative public health investigation was initiated to inform appropriate action. Methods: Eighteen semi-structured telephone interviews were conducted with non-Aboriginal heterosexual young adults aged 18-34 years living in Perth, Western Australia, who had recently been notified to the Department of Health with gonorrhoea, to explore the context of their sexual interactions and lifestyles which could have predisposed them to contracting gonorrhoea. Data were thematically analysed. Results: Common themes were having several casual sexual partners, limited communication between sexual partners about condom use or sexual history prior to engaging in sexual activity, inconsistent condom use, normalisation of some sexually transmissible infections amongst young people, and poor understandings and assessment of sexually transmissible infection risk. Conclusion: The findings support public health interventions that focus on communication between sexual partners and shifting of risk perceptions in sexual health education programs, ensuring accessibility of quality sexual health information, increasing condom accessibility and acceptability, and on strategies for addressing misperceptions of young people in relation to sexually transmitted infections.


Asunto(s)
Gonorrea/epidemiología , Conducta Sexual , Adulto , Femenino , Heterosexualidad , Humanos , Masculino , Salud Pública , Factores de Riesgo , Salud Sexual , Parejas Sexuales , Australia Occidental/epidemiología , Adulto Joven
2.
Wiad Lek ; 73(3): 551-554, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32285832

RESUMEN

OBJECTIVE: The aim: To study the psychological peculiarities of relationships in families of women with neurotic disorders. PATIENTS AND METHODS: Materials and methods: 30 women who received treatment in the neurotic unit of the A.F. Maltsev Poltava Regional Clinical Psychiatric Hospital and 30 mentally healthy women have been examined. In the research the authors used a complex of interrelated and complementary general scientific and specific methods based on the systematic approach. RESULTS: Results: There was a tendency for following types of marital interactions: dependent - 58% of couples, intermediate - 35% of couples. The emotionally-metaphorical type of interpreting life events is inherent for 89% of women with neurotic disorders. Studying the types of relationships with a husbands demonstrated that women with neurotic disorders perform 'the role of victim' - 30% (1,7689) and 'the role of 'burden'' - 40% (1,7689) in their relationships. CONCLUSION: Conclusions: The types of relationships with a partner of women with neurotic disorders are partly determined by the specifics of early parenting experiences.


Asunto(s)
Matrimonio , Trastornos Neuróticos , Femenino , Humanos , Parejas Sexuales
3.
J Glob Health ; 10(1): 010406, 2020 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-32257154

RESUMEN

Background: There is considerable interest in community organising and activism as a strategy to shift patriarchal gender norms, attitudes and beliefs and thus reduce intimate partner violence (IPV). Yet there is limited insight into how activism actually translates into reduced violence, including how aspects of programme implementation or cultural context may affect impact. This study evaluates the community activism/mobilisation portion of Indashyikirwa, a multi-component, IPV prevention programme implemented in rural Rwanda. The activism part of Indashyikirwa was based on SASA!, a promising program model from Uganda with demonstrated effectiveness. Methods: We implemented two separate cross-sectional surveys as part of a larger community randomised controlled trial to assess the impact of the community portion of Indashyikirwa on preventing physical and/or sexual IPV and other secondary outcomes at a community level. The survey consisted of a random household-based sample of 1400 women and 1400 men at both waves. Surveys were conducted before community-level activities commenced and were repeated 24 months later with a new cross-sectional sample. Longitudinal, qualitative data were collected as part of an embedded process evaluation. Results: There was no evidence of an intervention effect at a community level on any of the trial's primary or secondary outcomes, most notably women's experience of physical and/or sexual IPV from a current male partner in the past 12 months (adjusted odds ratio (aOR) = 1.25; 95% confidence interval (CI) = 0.92-1.70, P = 0.16), or men's perpetration of male-to-female physical and/or sexual IPV (aOR = 1.02; 95% CI = 0.72-1.45, P = 0.89). Process evaluation data suggest that delays due to challenges in adapting and implementing SASA!-style activites in rural Rwanda may account for the trial's failure to measure an effect. Additionally, the intervention strategy of informal activism was not well suited to the Rwandan context and required considerable modification. Conclusions: Failure to reduce violence when implementing an adaptation of SASA! in rural Rwanda highlights the importance of allowing sufficient time for adapting evidence-based programming (EBP) to ensure cultural appropriateness and fidelity. This evaluation held little chance of demonstrating impact since the project timeline forced endline evaluation only months after certain elements of the programme became operational. Donors must anticipate longer time horizons (5 to 7 years) when contemplating evaluations of novel or newly-adapted programmess for reducing IPV at a population level. These findings also reinforce the value of including embedded process evaluations when investing in rigorous trials of complex phenomena such as community activism. Trial registration: ClinicalTrials.gov, NCT03477877.


Asunto(s)
Participación de la Comunidad , Violencia de Pareja/prevención & control , Población Rural , Parejas Sexuales , Adolescente , Adulto , Servicios de Salud Comunitaria , Estudios Transversales , Composición Familiar , Femenino , Humanos , Violencia de Pareja/etnología , Violencia de Pareja/estadística & datos numéricos , Masculino , Persona de Mediana Edad , Factores de Riesgo , Rwanda , Maltrato Conyugal/etnología , Maltrato Conyugal/prevención & control , Maltrato Conyugal/estadística & datos numéricos
4.
J Glob Health ; 10(1): 010707, 2020 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-32257164

RESUMEN

Background: Intimate partner violence (IPV) is a multi-national problem with many health consequences. Some research suggests that reducing rates of child marriage can improve gender norms and health outcomes related to IPV. Here, we examine whether changes in national child marriage laws can improve attitudes about domestic violence and reduce intimate partner violence at scale. Methods: Data on attitudes towards violence and violence experienced were obtained from the Demographic and Health Surveys (DHS) and longitudinal data on child marriage policy from WORLD and MACHEquity databases (1995-2012). Treatment countries were included if they improved their national child marriage policies from harmful (under 18) to more protective and control countries were included if they had a constant child-marriage policy that allowed girls to marry under the age of 18. Our final data set included 5 treatment and 14 control countries for women's outcomes, 2 treatment and 9 control countries for men's outcomes and 2 treatment and 7 control countries for IPV outcomes (for which fewer countries collect data). We combined individual level responses to five questions on attitudes about domestic violence to create a scale from 0 (always unacceptable) to 5 (always acceptable). All analyses employed a difference-in-differences approach adjusting for individual and country level predictors. Results: Data were available for 532 255 women, of which 96 414 also completed the domestic violence modules, and 104 704 men. National changes to a protective child marriage policy were associated with improved attitudes towards violence among women (-0.21 points, 95% confidence interval (CI) = -0.28, -0.14) and men (-0.98 points, 95% CI = -1.13, -0.83). Additionally, the risk of women experiencing physical and sexual abuse reduced by a greater proportion in treatment compared to control countries (odds ratio OR = 0.65, 95% CI = 0.50, 0.84; OR = 0.63, 95% CI = 0.45, 0.88, respectively). Conclusions: Our large multi-national study is the first of its kind to critically evaluate the role of national policy on attitudes towards and experiences of IPV among both men and women, and finds that these laws have protective outcomes. Our results are consistent with the hypothesis that gender egalitarian laws positively influence norms and health at the national level.


Asunto(s)
Violencia de Pareja/estadística & datos numéricos , Matrimonio/estadística & datos numéricos , Parejas Sexuales/psicología , Maltrato Conyugal/estadística & datos numéricos , Violencia/estadística & datos numéricos , Adolescente , Adulto , Actitud , Niño , Comparación Transcultural , Estudios Transversales , Demografía , Femenino , Humanos , Violencia de Pareja/etnología , Masculino , Matrimonio/etnología , Normas Sociales , Maltrato Conyugal/etnología , Adulto Joven
5.
RECIIS (Online) ; 14(1): 212-224, jan.-mar. 2020.
Artículo en Portugués | LILACS | ID: biblio-1087309

RESUMEN

A pegação masculina em espaços públicos da cidade é um fenômeno plural, rico em experiências instauradoras de práticas e modos de ocupar o mundo dissidentes da heteronorma. Não por acaso, foi submetido a muitos registros de infâmia. Dos antigos crimes jurídico-religiosos de sodomia forjados na Europa, que colonizaram, inclusive, os prazeres nas Américas, até sua inscrição patológico-criminal apoiada pela ciência do século XIX, a pegação tornou-se um atentado ao pudor, uma afronta à moral pública. Contudo, as figuras anônimas homoeróticas que circulam oscilantes pela urbe, instauradoras de territórios de prazer em meio ao espaço público, nos ajudam a entender, através de seus rastros, muitas vezes captados pelos aparelhos de poder, justamente suas histórias de repressão.


The cruising gay men in public spaces of the city is a plural phenomenon, rich in experiences instituting dissident practices and lifestyle of the heteronormativity. It is not by chance that this phenomenon was subjected to many registers of infamy. From the ancient juridical religious sodomy crimes established in Europe that even colonized the pleasures in the Americas to their pathological criminal inscription supported by nineteenth-century science, the cruising gay men became an indecent assault, an affront to the public moral principles. However, the anonymous homoerotic figures that circulate around the city, establishing pleasure territories in the midst of public space, help us to understand through their traces often captured by the power apparatus, precisely their stories of repression.


La práctica del cruising en los espacios públicos de la ciudad es un fenómeno plural, rico en experiencias que establecen prácticas y formas de ocupar el mundo disidentes de la heteronorma. No por casualidad, el fenómeno fue sometido a muchos registros de infamia. Desde los antiguos crimenes jurídico-religiosos de sodomía, establecidos en Europa y que incluso colonizaron los placeres en las Américas, hasta la inscripción criminal patológica apoyada por la ciencia del siglo XIX, la práctica del cruising se convirtió en un atentado contra el pudor, una afrenta a la moral pública. Sin embargo, las figuras anónimas homoeróticas que circulan alrededor de la ciudad, estableciendo territorios de placer en el espacio público, nos ayudan a comprender, a través de sus rastros, a menudo capturadas por los aparatos del poder, precisamente sus historias de represión.


Asunto(s)
Humanos , Conducta Sexual , Parejas Sexuales , Homosexualidad/historia , Sexualidad , Sexo Inseguro , Sociedades , Ciudades , Placer
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 Infect Dis ; 20(1): 195, 2020 Mar 06.
Artículo en Inglés | MEDLINE | ID: mdl-32138673

RESUMEN

BACKGROUND: Antiretroviral therapy (ART) demonstrates high efficacy in reducing the risk of HIV transmission to sexual partners. However, it is not clear if the use of pre-exposure prophylaxis (PrEP) in HIV-1-serodiscordant couples is necessary during natural conception when the HIV-positive partner exhibits a suppressed viral load. The purpose of this study was to assess the role of PrEP during natural conception in this population. METHODS: A retrospective, multicenter study was conducted in a cohort of HIV-1-serodiscordant couples (positive man, negative woman) with childbearing desires. HIV-positive male partners were treated with ART and achieved viral suppression for more than half a year. The HIV-negative female partners were either treated with PrEP or not treated with PrEP, and outcomes were compared between the two treatment groups. RESULTS: Of 246 HIV-1-serodiscordant couples in whom the HIV-positive partner achieved viral suppression, 104 seronegative women were treated with PrEP during natural conception and 142 seronegative women were not treated with PrEP. There were 410 condom-less sexual acts in couples treated with PrEP and 615 condom-less sexual acts in couples not treated with PrEP. We observed no instances of HIV transmission in HIV-1-serodiscordant couples with or without the use of PrEP during the process of natural conception. CONCLUSIONS: Our results show that PrEP had minimal influence in reducing the risk of HIV transmission during natural conception in HIV-1-serodiscordant couples with a stably suppressed viral load. Thus, it may be an acceptable option for HIV-negative partners to not use PrEP during the process of natural conception if the HIV-positive partner has achieved viral suppression for more than half a year.


Asunto(s)
Fármacos Anti-VIH/uso terapéutico , Fertilización/fisiología , Infecciones por VIH/transmisión , Profilaxis Pre-Exposición , Carga Viral/efectos de los fármacos , Adulto , Condones/estadística & datos numéricos , Femenino , Infecciones por VIH/tratamiento farmacológico , Infecciones por VIH/prevención & control , Seropositividad para VIH/tratamiento farmacológico , Seropositividad para VIH/transmisión , VIH-1 , Humanos , Masculino , Estudios Retrospectivos , Parejas Sexuales
8.
Infect Dis Poverty ; 9(1): 28, 2020 Mar 10.
Artículo en Inglés | MEDLINE | ID: mdl-32169118

RESUMEN

BACKGROUND: By the end of October 2019, there were 958 thousand people were reported living with HIV/AIDS in China. Unhealthy lifestyle factors, such as smoking, drinking alcohol, using illicit drugs and no physical activity have been found to mitigate the positive impact of antiretroviral therapy (ART) on viral load and HIV-related quality of life. Moreover, risky sexual behavior among HIV-positive persons places their partners at risk for HIV transmission and other sexually transmitted infections. The aim of the study is to determine the prevalence of unhealthy behavior of people living with HIV/AIDS and related influencing factors, particularly those that are closely connected with HIV infection and ART effects. METHODS: An institutional based cross-sectional study design was used to collect data from people living with HIV/AIDS (PLWHA) in Beijing and Yunnan Province. The following information was included in the questionnaire survey: social-demographic characteristics, health behavior information, sexual risk behaviors. Binary logistic regression model was conducted to analyze the influencing factors of unhealthy general health behaviors and risky sexual behaviors. RESULTS: In total, 2575 PLWHA were included in the study and 78.3% (2017/2575) were male. For the general health behaviors, 34.2% (987/2544) smoke; 33.8% (870/2575) drank alcohol and 2.3% (49/2134) reported the use of illicit drugs in the previous 6 months. From the sexual behaviors perspective, 59.0% (1519/2575) had sex in the previous 6 months. Among people who had sex, 92.0% (1398/1519) had fixed sexual partners. Among those with no fixed sexual partner, 38.0% (46/121) had more than three partners. Among men who had sex, 34.7% (448/1292) reported having sex with men in the previous 6 months and 16.7% (75/448) of these had group sexual activity. Among participants, 72.2% (1053/1458) used condoms every time they had sex while 6.4% (94/1458) of people never used condom. Male people living with HIV/AIDS were more likely to have sexual risk behaviors (adjusted odds ratio [OR] = 2.208, 95% confidence interval [CI]: 1.147-4.252) and unhealthy general health behaviors (adjusted OR = 2.029, 95% CI: 1.480-2.783). The odds of higher risk sexual behaviors was 1.546 times (95% CI: 1.302-1.827, P = 0.001) greater among participants who drank alcohol compared with their non-drinking counterparts. CONCLUSIONS: PLWHA is a group that is vulnerable to problematic health behaviors, especially for men who were more likely to drink alcohol, have more sexual partners, more sexual risk behaviors including group sexual activity, not using condoms and using drugs. Therefore, interventions focusing on gender-specific risk behaviors reduction for people living with HIV/AIDS are now necessary to control the spread of HIV infection and improve the efficacy of antiviral treatment.


Asunto(s)
Fármacos Anti-VIH/uso terapéutico , Condones/estadística & datos numéricos , Infecciones por VIH/tratamiento farmacológico , Infecciones por VIH/psicología , Conductas Relacionadas con la Salud , Conducta Sexual , Adolescente , Adulto , Consumo de Bebidas Alcohólicas/epidemiología , China/epidemiología , Estudios Transversales , Femenino , Infecciones por VIH/epidemiología , Conocimientos, Actitudes y Práctica en Salud , Humanos , Masculino , Persona de Mediana Edad , Prevalencia , Calidad de Vida , Factores de Riesgo , Asunción de Riesgos , Parejas Sexuales , Fumar/epidemiología , Trastornos Relacionados con Sustancias/epidemiología
9.
Medicine (Baltimore) ; 99(12): e19490, 2020 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-32195948

RESUMEN

INTRODUCTION: Contraceptive use and sexual health behavior remain a prominent public health concern in South Africa (SA). Despite many government interventions, unintended pregnancies and termination of pregnancies remain relatively high. This review aimed to map evidence on factors influencing contraceptive use and sexual behavior in SA. METHODS: We conducted a scoping review guided by Arksey and O'Malley's framework. We searched for articles from the following databases: PubMed/MEDLINE, American Doctoral Dissertations via EBSCO host, Union Catalogue of Theses and Dissertations (UCTD) and SA ePublications via SABINET Online and World Cat Dissertations, Theses via OCLC and Google Scholar. Studies published from January 1990 to March 2018 were included. We used the Population, Concept, and Context (PCC) framework and the PRISMA chart to report the screening of results. The Mixed Method Appraisal Tool (MMAT) version 11 and ACCODS tools were used to determine the quality of the included studies. RESULTS: A total of 2030 articles were identified by our search criteria for title screening. Only 21 studies met our inclusion criteria and were included in quality assessment stage. We found that knowledge of a contraceptive method, length of a relationship, sexual debut, age difference between partners availability of a contraceptive method, long waiting hours, and nurse's attitudes toward human immunodeficiency virus (HIV) positive or younger clients predict whether or not women use a contraceptive method or improve sexual behavior. CONCLUSION: There remains a necessity for improving educational programs aimed at transferring knowledge on contraceptives and sexual behavior to both women and their male counterparts, alongside the public health systems' improvements.


Asunto(s)
Conducta Anticonceptiva/tendencias , Anticoncepción/psicología , Conocimiento de la Medicación por el Paciente/estadística & datos numéricos , Conducta Sexual/psicología , Aborto Inducido/estadística & datos numéricos , Adolescente , Adulto , Conducta Anticonceptiva/estadística & datos numéricos , Femenino , Conocimientos, Actitudes y Práctica en Salud , Humanos , Masculino , Tamizaje Masivo/normas , Persona de Mediana Edad , Embarazo , Embarazo no Planeado/psicología , Parejas Sexuales/psicología , Sudáfrica/epidemiología , Adulto Joven
10.
Zhong Nan Da Xue Xue Bao Yi Xue Ban ; 45(1): 55-60, 2020 Jan 28.
Artículo en Inglés, Chino | MEDLINE | ID: mdl-32132298

RESUMEN

OBJECTIVES: To explore the Impact of community subculture of men who have sex with men (MSM) on the occurrence of high-risk sexual behavior based on the health belief model. METHODS: A qualitative research method was used to conduct in-depth interviews with 17 MSM by one-to-one and half-structured way, and thematic analysis was used to analyze the data. RESULTS: There were several factors for high-risk sexual behavior in MSM subculture, such as trust, subjective assessment for partner or personal health status, the role in inserting, awareness of HIV infection among partners, perception of HIV and homosexual discrimination, difficulty in maintaining a fixed partner, family responsibility,and so on. Self-efficacy also affected MSM's high-risk sexual behavior. CONCLUSIONS: High-risk sexual behavior in MSM population is influenced by individual, group, and intra-circle subculture. Cognitive bias for HIV infection in MSMs can be intervened by constructing a preventive intervention model for high-risk sexual behavior.


Asunto(s)
Conducta Sexual , Minorías Sexuales y de Género , Infecciones por VIH , Homosexualidad Masculina , Humanos , Masculino , Asunción de Riesgos , Parejas Sexuales
11.
BMC Infect Dis ; 20(1): 129, 2020 Feb 11.
Artículo en Inglés | MEDLINE | ID: mdl-32046662

RESUMEN

BACKGROUND: Syphilis is a sexually transmitted infection (STI) transmitted from person to person mainly by sexual intercourse or through vertical transmission during pregnancy. Female sex workers (FSWs) are exposed especially to syphilis infection, and besides all the efforts to control the spread of STIs, syphilis prevalence is still rising, mainly occurring in low-income countries. This study aimed to investigate the syphilis prevalence, demographic characteristics and sexual habits among FSWs in the Amazon region of Brazil. METHODS: A cross-sectional study was carried out including 184 FSWs from 3 countryside cities of the state of Pará, Amazon region of Brazil. A venereal disease research laboratory test and an indirect immunoenzyme assay to test antibodies against Treponema pallidum were used for screening syphilis infection, while sexual habits and demographic data information were collected through a semi-structured questionnaire. Data was analyzed comparing groups with/without syphilis. Poisson regression models were used to estimate the reasons of prevalence (RP). RESULTS: The overall prevalence of syphilis was 14.1% (95% CI = 9.8-17.8). FSWs had between 15 and 56 years of age, most were unmarried (65.7%), had attended less than 8 years of formal education (64.1%), had between 10 and 20 partners per week (64.1%), and reported no previous history of STIs (76.1%) and regular use of condom (52.7%). Low level of education attending up to the primary school (RP adjusted = 3.8; 95% CI = 1.4-9.2) and high frequency of anal sex during the past year (RP adjusted = 9.3; 95% CI = 3.5-28.7) were associated with a higher prevalence of syphilis. CONCLUSIONS: A high prevalence of syphilis among FSWs in the Brazilian Amazon region was identified, showing that syphilis is more likely to be transmitted in FSW working in low-income areas, which is attributed to the low level of education. Anal intercourse was found as a risk factor associated with syphilis. Health programs focused on risk populations appear as a rational way to control syphilis spread, which is a rising problem in Brazil and in other several countries.


Asunto(s)
Trabajadores Sexuales/estadística & datos numéricos , Sífilis/epidemiología , Adolescente , Adulto , Brasil/epidemiología , Ciudades/estadística & datos numéricos , Condones/estadística & datos numéricos , Estudios Transversales , Escolaridad , Femenino , Humanos , Persona de Mediana Edad , Prevalencia , Factores de Riesgo , Conducta Sexual/estadística & datos numéricos , Parejas Sexuales , Sífilis/diagnóstico , Serodiagnóstico de la Sífilis , Treponema pallidum/inmunología , Adulto Joven
12.
PLoS One ; 15(2): e0228783, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32045460

RESUMEN

BACKGROUND: HIV counseling and testing are key to control and prevent the spread of the virus and improve the lives of people living with HIV. Although the risk of acquiring the virus is high, only 27% of young Ethiopian women age 15 to 24 years old were tested and counseled for HIV. This coverage is low to achieve the 90-90-90 goal. Identifying factors associated with low utilization of HIV testing and counseling services among young females (aged 15 to 24 years) is important to identify the barriers and improve uptake. Therefore, this analysis was done to identify factors associated with low utilization of HIV counseling and testing services among young Ethiopian women. METHODS: The study used the 2016 Ethiopian demographic and health survey data. The data was downloaded from The DHS program with permission. A total of 2661 young women (aged 15 to 24 years) were included in the final model. Data was weighted to consider disproportionate sampling and non-response. A Complex data management technique was applied to consider the complex sampling technique used in the DHS. Multivariable logistic regression was used to identify factors associated with HIV testing among young women. RESULT: Among sexually active young women, 33.5% (95%CI; 30.1, 37.1) were tested for HIV. Young women who attended primary ((AOR 2.8; (95% CI; 2.0, 3.9)), secondary (AOR 4.7; (95% CI; 3.1, 7.3)) or higher education (AOR; 5.6; 95% CI; 2.6, 12.0), those who had multiple sexual partners (AOR 5.5; 95% (CI; 1.3, 23.3)), young women who ever used alcohol (AOR 1.46; 95% (CI; 1.1, 2.0)) and young women who visited health care facilities (AOR 1.8; (95% CI; 1.4, 2.3)) had higher odds of being tested for HIV. On the other hand, young women from the rural areas had lower odds (AOR 0.5; (95% CI; 0.3, 0.7)) of being tested for HIV. CONCLUSION: HIV testing among sexually active young women in Ethiopia was low. Educational status, place of residence, alcohol intake, number of sexual partners and visiting health facility 12 months before the survey were found significant predictors of HIV testing. Therefore, the Ethiopian government should encourage girls to complete secondary education to improve HIV testing and counseling. Young women should be encouraged to visit health facilities to improve HIV testing service uptake.


Asunto(s)
Infecciones por VIH/diagnóstico , Encuestas Epidemiológicas , Tamizaje Masivo/estadística & datos numéricos , Adolescente , Consumo de Bebidas Alcohólicas , Escolaridad , Etiopía , Femenino , Infecciones por VIH/prevención & control , Instituciones de Salud , Humanos , Oportunidad Relativa , Población Rural , Parejas Sexuales , Adulto Joven
13.
BMC Health Serv Res ; 20(1): 92, 2020 Feb 05.
Artículo en Inglés | MEDLINE | ID: mdl-32024550

RESUMEN

BACKGROUND: Couples HIV Testing & Counselling (CHTC) service is an approach that may enable more people to be reached and tested for HIV. However, little is known about how couples may use this service and what they think about CHTC as an approach to finding out their HIV status. This study aimed to understand how individuals who had ever been in an ongoing heterosexual relationship for 6 months or more intended to use CHTC in Ethiopia and their beliefs about its benefits and potential harms. METHODS: Qualitative in-depth interviews were conducted in Addis Ababa, the capital city of Ethiopia, in 2017. Semi-structured interviews were undertaken with individuals who had ever been in an ongoing heterosexual relationship (n = 21) and key-informants (n = 11) including religious leaders, health care providers, and case managers. The interviews were transcribed verbatim, and an inductive thematic analysis was conducted. The data were coded to look for concepts and patterns across the interviews and relevant themes identified which captured key aspects related to the individual's views on undertaking HIV testing with a sexual partner. RESULTS: Most participants regarded CHTC as an important HIV testing approach for people who are in an ongoing heterosexual relationship and expressed the view that there was "nothing like testing together". However, many of the individual participants revealed they would prefer first to get tested alone to find out their own HIV status. They feared the consequences if they were HIV-positive, including accusations of infidelity, relationship break-up, and being exposed in the community. Many also reported being pressured to undertake CHTC before marriage by a third party, including religious institutions. Key informant interviews also discussed the requirements for CHTC before marriage. CONCLUSION: The findings of this study suggest that people may be concerned about undertaking couples HIV testing without prior individual HIV testing. The intention of many to first test alone has policy and cost implications and underscores the possible harms of the implementation of CHTC in Ethiopia. Future research should examine whether the views identified in this qualitative study are reflected more broadly among couples in the community.


Asunto(s)
Consejo , Infecciones por VIH/prevención & control , Conocimientos, Actitudes y Práctica en Salud , Heterosexualidad , Intención , Tamizaje Masivo/psicología , Parejas Sexuales/psicología , Adulto , Etiopía , Femenino , Humanos , Masculino , Investigación Cualitativa
15.
BMC Public Health ; 20(1): 188, 2020 Feb 06.
Artículo en Inglés | MEDLINE | ID: mdl-32028917

RESUMEN

BACKGROUND: Partner concurrency, (having sexual partnerships overlapping in time), especially when condoms are not used, can facilitate sexually transmitted infections (STI) transmission. In Britain, STI diagnoses rates and the reporting of concurrency are higher among black Caribbeans than other ethnic groups. We explored attitudes towards, drivers, characteristics, and contexts of concurrent partnerships, and their implications for STI risk among black Caribbeans in England. METHODS: Purposive sampling, by sex and age-groups, was used to recruit participants (overall n = 59) from five sexual health clinics and community settings in London and Birmingham, England. Audio-recorded four focus group discussions (n = 28 participants), and in-depth interviews (n = 31) were conducted (June 2014-December 2015). Transcribed data were thematically analysed using Framework Analysis. RESULTS: 'Main plus' and 'non-main' concurrency were identified in this population. Main plus concurrency involves an individual having a main partner with whom s/he has a "relationship" with, and the individual and/or their partner secretly or explicitly have other non-main partners. In contrast, non-main concurrency entails having multiple, non-committed partners overlapping in time, where concurrency is usually taken as a given, making disclosure to partners irrelevant. While main partnerships were usually long-term, non-main partnerships ranged in duration from a single event through to encounters lasting several months/years. Condomless sex was common with ex/long-term/married/cohabiting partners; whereas condoms were typically used with non-main partners. However, condom use declined with partnership duration and familiarity with partners. Awareness of partners' concurrency facilitated condom use, STI-testing, and partner notification. While unresolved feelings, or sharing children with ex-partners, usually facilitated main plus concurrency; non-main concurrency was common among young, and single people. Gender norms, notions of masculinity, and sexual desires influenced concurrency. Black Caribbean popular music, social media, peer pressure, and relationship norms among black Caribbeans were also perceived to encourage concurrency, especially among men and young people. CONCLUSIONS: Concurrency among black Caribbeans is shaped by a complex interaction between emotional/psychological, interpersonal, sociocultural, and structural factors. Concurrency type, its duration, and awareness influence sexual health choices, and thus STI risk in this population. Collecting these data during clinic consultations could facilitate offering partner notification methods tailored to concurrency type. Gender- and age-specific, culturally-sensitive interventions addressing STI risks associated with concurrency are needed.


Asunto(s)
Grupo de Ascendencia Continental Africana/psicología , Actitud/etnología , Conducta Sexual/etnología , Parejas Sexuales/psicología , Enfermedades de Transmisión Sexual/prevención & control , Adolescente , Adulto , Grupo de Ascendencia Continental Africana/estadística & datos numéricos , Región del Caribe/etnología , Inglaterra , Femenino , Humanos , Masculino , Persona de Mediana Edad , Investigación Cualitativa , Enfermedades de Transmisión Sexual/etnología , Adulto Joven
16.
BMC Public Health ; 20(1): 199, 2020 Feb 07.
Artículo en Inglés | MEDLINE | ID: mdl-32033544

RESUMEN

BACKGROUND: The impacts of interventions designed to change health behaviours are potentially affected by the complex social systems in which they are embedded. This study uses Scottish data to explore how men receive and utilise partner support when attempting to change dietary practices and physical activity within the context of Football Fans in Training (FFIT), a gender-sensitised weight management and healthy living programme for men who are overweight/obese. METHODS: Separate semi-structured face-to-face interviews were conducted with 20 men and their cohabiting female partners (total n = 40), 3-12 months after the men had completed FFIT. Data were thematically analysed and individual interviews were combined for dyadic analysis. RESULTS: Men's and women's accounts suggested variations in men's need for, and utilisation of, partner support in order to make changes to dietary practices and physical activity. There were also differences in descriptions of women's involvement in men's behaviour changes. Typologies were developed categorising men as 'resolute', 'reliant'/'receptive' and 'non-responsive' and women as 'very involved', 'partially involved' and 'not involved'. Men were more reliant, and women more involved, in changes to dietary practices compared to physical activity. The role of partner involvement in promoting men's behaviour change seemed contingent on men's resoluteness, or their reliance on the partner support. CONCLUSIONS: These results highlight how interactions between men's resoluteness/reliance on cohabiting female partners and the partners' involvement impact the extent to which female partners influence men's changes to dietary practices and physical activity following a weight loss intervention. Understanding this interaction could increase the impact of health interventions aimed at one individual's behaviour by considering other family members' roles in facilitating those changes. The typologies developed for this study might contribute towards the development of behaviour change theories within the cohabiting couple context.


Asunto(s)
Dieta/psicología , Ejercicio Físico/psicología , Hombres/psicología , Sobrepeso/prevención & control , Parejas Sexuales/psicología , Apoyo Social , Programas de Reducción de Peso , Adulto , Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Obesidad/epidemiología , Obesidad/prevención & control , Sobrepeso/epidemiología , Investigación Cualitativa , Escocia/epidemiología , Fútbol
17.
BMC Infect Dis ; 20(1): 110, 2020 Feb 07.
Artículo en Inglés | MEDLINE | ID: mdl-32033533

RESUMEN

BACKGROUND: Men who have sex with men (MSM) are disproportionally affected by sexually transmitted infections (STI). STI are often extragenital and asymptomatic. Both can delay diagnosis and treatment. Approval of HIV pre-exposure prophylaxis (PrEP) might have influenced sexual behaviour and STI-prevalence of HIV- MSM. We estimated STI-prevalence and risk factors amongst HIV- and HIV+ MSM in Germany to plan effective interventions. METHODS: We conducted a nationwide, cross-sectional study between February and July 2018. Thirteen MSM-friendly STI-practices screened MSM for Chlamydia trachomatis (CT), Mycoplasma genitalium (MG), Neisseria gonorrhea (NG), and Trichomonas vaginalis (TV) using self-collected rectal and pharyngeal swabs, and urine samples. APTIMA™ STI-assays (Hologic™ Inc., San Diego, USA) were used for diagnostics, and samples were not pooled. We collected information on socio-demographics, HIV-status, clinical symptoms, sexual behaviour within the last 6 months, and PrEP use. We combined HIV status and PrEP use for defining risk groups, and used directed acyclic graphs and multivariable logistic regression to identify risk factors for STI. RESULTS: Two thousand three hundred three MSM were included: 50.5% HIV+, median age 39 [18-79] years. Median number of male sex partners within the last 6 months was five. Sex without condom was reported by 73.6%, use of party drugs by 44.6%. 80.3% had a STI history, 32.2% of STI+ MSM reported STI-related symptoms. 27.6% of HIV- MSM used PrEP. Overall STI-prevalence was 30.1, 25.0% in HIV-/PrEP- MSM (CT:7.2%; MG:14.2%; NG:7.4%; TV:0%), 40.3% in HIV-/PrEP+ MSM (CT:13.8%; MG:19.4%; NG:14.8%; TV:0.4%), and 30.8% in HIV+ MSM (CT:10.1%; MG:18.4%; NG:8.6%; TV:0.1%). Being HIV+ (OR 1.7, 95%-CI 1.3-2.2), using PrEP (OR 2.0, 95%-CI 1.5-2.7), having > 5 sex partners (OR:1.65; 95%-CI:1.32-2.01.9), having condomless sex (OR:2.11.9; 95%-CI:1.65-2.86), and using party drugs (OR:1.65; 95%-CI:1.32-2.0) were independent risk factors for being tested positive for at least one STI. CONCLUSIONS: We found a high STI-prevalence in MSM in Germany, especially in PrEP users, frequently being asymptomatic. As a relevant proportion of PrEP users will not use a condom, counselling and comprehensive STI screening is essential and should be low threshold and preferably free of cost. Counselling of PrEP users should also address use of party drugs.


Asunto(s)
Infecciones por Chlamydia/epidemiología , Chlamydia trachomatis/genética , Gonorrea/epidemiología , Infecciones por VIH/epidemiología , Homosexualidad Masculina , Infecciones por Mycoplasma/epidemiología , Mycoplasma genitalium/genética , Neisseria gonorrhoeae/genética , Profilaxis Pre-Exposición , Minorías Sexuales y de Género , Adolescente , Adulto , Anciano , Chlamydia trachomatis/aislamiento & purificación , Condones , Consejo , Estudios Transversales , Alemania/epidemiología , Gonorrea/diagnóstico , Gonorrea/microbiología , Infecciones por VIH/prevención & control , Humanos , Masculino , Tamizaje Masivo , Persona de Mediana Edad , Mycoplasma genitalium/aislamiento & purificación , Neisseria gonorrhoeae/aislamiento & purificación , Prevalencia , Factores de Riesgo , Conducta Sexual , Parejas Sexuales , Adulto Joven
18.
BMC Infect Dis ; 20(1): 149, 2020 Feb 18.
Artículo en Inglés | MEDLINE | ID: mdl-32070297

RESUMEN

BACKGROUND: HIV testing plays a central role in the combat against HIV. We aimed to determine if the availability of HIV self-testing (HIVST) would increase the frequency of testing among men who have sex with men (MSM) attending university in China. METHODS: A stepped wedge randomized controlled trial will be conducted in 4 provinces in China: Chongqing, Guangdong, Shandong, and Tianjin. Eligibility assessment will include (1) male, aged 16 years or older, (2) university student (technical diploma and undergraduate students), (3) MSM (sexual behaviors including mutual masturbation, oral sex, and anal sex), (4) HIV negative, and (5) willing to provide informed consent. Participants will be randomly allocated to HIV self-testing intervention with free HIVST kits in every 30 days according to the intervention waiting lists with a computer-generated randomized sequence. All participants will complete a self-administrated online questionnaire onsite at baseline and 12-month follow-up and complete an online questionnaire at 4- and 8-month. The primary outcome is the effect of HIVST on HIV testing frequency. Secondary outcomes include the change in sexual behaviors and HIV incidence. DISCUSSION: No previous study had measured the effect of social media based HIVST intervention on the change in HIV testing behaviors, sexual behaviors and incident HIV infection among MSM attending university in China. Findings from this study will provide evidence for further interventional practice promotions and prevention strategies scale-up, including HIV testing, pre-exposure prophylaxis (PrEP) or post-exposure prophylaxis (PEP), and sexual partner serosorting. TRIAL REGISTRATION: Chinese Clinical Trial Registry: ChiCTR1900020645. Registered 11 January 2019.


Asunto(s)
Infecciones por VIH/diagnóstico , Homosexualidad Masculina , Autocuidado/métodos , Adolescente , Adulto , China/epidemiología , Infecciones por VIH/epidemiología , Seroclasificación por VIH , Conductas de Riesgo para la Salud , Humanos , Masculino , Ensayos Clínicos Controlados Aleatorios como Asunto , Conducta Sexual , Parejas Sexuales , Medios de Comunicación Sociales , Encuestas y Cuestionarios , Universidades , Adulto Joven
19.
PLoS One ; 15(2): e0228849, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32045444

RESUMEN

INTRODUCTION: As HIV is very effectively acquired during condomless receptive anal intercourse (AI) with serodiscordant and viremic partners, the practice could contribute to the high prevalence among female sex workers (FSW) in eSwatini (formerly known as Swaziland). We aim to estimate the proportion reporting AI (AI prevalence) among Swazi FSW and to identify the correlates of AI practice in order to better inform HIV prevention interventions among this population. METHODS: Using respondent-driven sampling (RDS), 325 Swazi FSW were recruited in 2011. We estimated the prevalence of AI and AI with inconsistent condom use in the past month with any partner type, and inconsistent condom use during AI and vaginal intercourse (VI) by partner type. Univariate and multivariable logistic regression models were used to identify behavioural and structural correlates associated with AI and AI with inconsistent condom use. RESULTS: RDS-adjusted prevalence of AI and AI with inconsistent condom use was high, at 44%[95% confidence interval (95%CI):35-53%]) and 34%[95%CI:26-42%], respectively and did not vary by partner type. HIV prevalence was high in this sample of FSW (70%), but knowledge that AI increases HIV acquisition risk low, with only 10% identifying AI as the riskiest sex act. Those who reported AI were more likely to be better educated (adjusted odds ratio(aOR) = 1.92[95%CI:1.03-3.57]), to have grown up in rural areas (aOR = 1.90[95%CI:1.09-3.32]), have fewer new clients in the past month (aOR = 0.33[95%CI:0.16-0.68]), and for last sex with clients to be condomless (aOR = 2.09[95%CI:1.07-4.08]). Although FSW reporting AI in past month were more likely to have been raped (aOR = 1.95[95%CI:1.05-3.65]) and harassed because of being a sex worker (aOR = 2.09[95%CI:1.16-3.74]), they were also less likely to have ever been blackmailed (aOR = 0.50[95%CI:0.25-0.98]) or been afraid to walk in public places (aOR = 0.46[95%CI:0.25-0.87]). Correlates of AI with inconsistent condom use were similar to those of AI. CONCLUSIONS: AI is commonly practised and condom use is inconsistent among Swazi FSW. Sex act data are needed to determine how frequently AI is practiced. Interventions to address barriers to condom use are needed, as are biomedical interventions that reduce acquisition risk during AI.


Asunto(s)
Trabajadores Sexuales/estadística & datos numéricos , Conducta Sexual/estadística & datos numéricos , Adolescente , Adulto , Condones/estadística & datos numéricos , Esuatini/epidemiología , Femenino , Infecciones por VIH/epidemiología , Infecciones por VIH/prevención & control , Infecciones por VIH/transmisión , Humanos , Modelos Logísticos , Masculino , Persona de Mediana Edad , Prevalencia , Trabajadores Sexuales/psicología , Parejas Sexuales , Encuestas y Cuestionarios , Adulto Joven
20.
BMC Public Health ; 20(1): 211, 2020 Feb 11.
Artículo en Inglés | MEDLINE | ID: mdl-32046686

RESUMEN

BACKGROUND: Voluntary Medical Male Circumcision (VMMC) is one of the strategies being promoted to prevent sexual heterosexual transmission of HIV. It has been adopted by 14 countries with high HIV prevalence and low circumcision rates. The 60.0% protective efficacy of VMMC has come with misconceptions in some societies in Malawi, hence VMMC clients may opt for risky sexual practices owing to its perceived protective effect. The study estimated proportion of circumcised men engaging in risky sexual behaviors post-VMMC, assessed knowledge on VMMC protective effect and identified socio-demographic factors associated with risky sexual practices. METHOD: A cross sectional study was conducted at two sites of Mzuzu city. Systematic random sampling was used to select 322 participants aged 18-49 who had undergone VMMC. The independent variables included age, location, occupation, religion, marital status and education. Outcome variables were non condom use, having multiple sexual partners and engaging in transactional sex. Data from questionnaires was analyzed using Pearson's chi square test and logistic regression. RESULTS: Out of 322 respondents, 84.8% (273) understood the partial protection offered by VMMC in HIV prevention. Ninety-six percent of the participants self-reported continued use of condoms post VMMC. Overall 23.7-38.3% participants self-reported engaging in risky sexual practices post VMMC, 23.7% (76) had more than one sexual partner; 29.2% (94) paid for sex while 39.9% (n = 187) did not use a condom. Residing in high density areas was associated with non-condom use, (p = 0.043). Being single (p < 0.001), and residing in low density areas (p = 0.004) was associated with engaging in transactional sex. CONCLUSION: Risky sexual practices are evident among participants that have undergone VMMC. Messages on safer sexual practices and limitations of VMMC need to be emphasized to clients, especially unmarried or single and those residing in low density areas.


Asunto(s)
Circuncisión Masculina/estadística & datos numéricos , Infecciones por VIH/prevención & control , Asunción de Riesgos , Conducta Sexual/psicología , Conducta Sexual/estadística & datos numéricos , Programas Voluntarios , Adolescente , Adulto , Condones/estadística & datos numéricos , Estudios Transversales , Infecciones por VIH/epidemiología , Humanos , Malaui/epidemiología , Masculino , Persona de Mediana Edad , Autoinforme , Trabajo Sexual/estadística & datos numéricos , Parejas Sexuales , Factores Socioeconómicos , Encuestas y Cuestionarios , Adulto Joven
SELECCIÓN DE REFERENCIAS
DETALLE DE LA BÚSQUEDA