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1.
BMC Infect Dis ; 21(1): 1, 2021 Jan 04.
Artigo em Inglês | MEDLINE | ID: mdl-33390160

RESUMO

BACKGROUND: Undernutrition is one of the most common problems among people living with HIV, contributing to premature death and the development of comorbidities within this population. In Sub-Saharan Africa (SSA), the impacts of these often inter-related conditions appear in a series of fragmented and inconclusive studies. Thus, this review examines the pooled effects of undernutrition on mortality and morbidities among adults living with HIV in SSA. METHODS: A systematic literature search was conducted from PubMed, EMBASE, CINAHL, and Scopus databases. All observational studies reporting the effects of undernutrition on mortality and morbidity among adults living with HIV in SSA were included. Heterogeneity between the included studies was assessed using the Cochrane Q-test and I2 statistics. Publication bias was assessed using Egger's and Begg's tests at a 5% significance level. Finally, a random-effects meta-analysis model was employed to estimate the overall adjusted hazard ratio. RESULTS: Of 4309 identified studies, 53 articles met the inclusion criteria and were included in this review. Of these, 40 studies were available for the meta-analysis. A meta-analysis of 23 cohort studies indicated that undernutrition significantly (AHR: 2.1, 95% CI: 1.8, 2.4) increased the risk of mortality among adults living with HIV, while severely undernourished adults living with HIV were at higher risk of death (AHR: 2.3, 95% CI: 1.9, 2.8) as compared to mildly undernourished adults living with HIV. Furthermore, the pooled estimates of ten cohort studies revealed that undernutrition significantly increased the risk of developing tuberculosis (AHR: 2.1, 95% CI: 1.6, 2.7) among adults living with HIV. CONCLUSION: This review found that undernutrition has significant effects on mortality and morbidity among adults living with HIV. As the degree of undernutrition became more severe, mortality rate also increased. Therefore, findings from this review may be used to update the nutritional guidelines used for the management of PLHIV by different stakeholders, especially in limited-resource settings.


Assuntos
Infecções por HIV/epidemiologia , Desnutrição/epidemiologia , Tuberculose/epidemiologia , Infecções Oportunistas Relacionadas com a AIDS/epidemiologia , Adulto , África ao Sul do Saara/epidemiologia , Comorbidade , Infecções por HIV/mortalidade , Humanos , Morbidade , Prevalência , Tuberculose/etiologia
2.
Artigo em Inglês | MEDLINE | ID: mdl-33252815

RESUMO

OBJECTIVES: Sexual minority young people (SMYP) show higher levels of substance use than their heterosexual counterparts. This study aims to test potential LGBT community-specific reasons assumed to affect substance use and their relationships to LGBT community participation/connectedness and substance use behaviour. METHODS: Eight LGBT community-specific reasons for substance use were tested in an online survey with 1,556 SMYP. RESULTS: Respondents agreed that the LGBT community had liberal attitudes towards substance use (80.5%, n=1,079) and that the media portrayed substance use as a part of the community culture (66.5%, n=904). Participants disagreed that excessive partying is a part of the community (34.7%, n=470). Significant but weak correlations between reasons and community participation/connectedness or personal substance use behaviour were found. Subgroup analyses indicated male and gay/lesbian participants showed differential agreement levels to some of the reasons. CONCLUSION: Young people's perceptions of substance use within the LGBT community are not associated with community participation/connectedness or personal substance use. Implications for public health: Further research is needed to better understand what factors lead to elevated levels of substance use in SMYP. This may assist in the development of adequate public health responses. Targeting problematic beliefs may have little impact on substance use in SMYP.

3.
Public Health ; 179: 18-26, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31715550

RESUMO

OBJECTIVES: The literature suggests that sexual minority young people (SMYP) use alcohol at disproportionate levels when compared with their heterosexual counterparts. Little is known about alcohol dependency symptoms and correlations between high-risk alcohol use/dependency symptoms and minority stress in this population in general and between subgroups. STUDY DESIGN: Cross-sectional study. METHODS: Descriptive statistics, adjusted odds ratios, and analysis of covariance were used to determine high-risk alcohol use, dependency symptoms, differences between subgroups, and correlations between alcohol use, dependency symptoms, and minority stress. RESULTS: A total of 1556 Australian SMYPs aged 18 to 35 years completed the survey. Fifty percent of the participants reported high-risk alcohol consumption with significant differences between subgroups. Typical dependency symptoms such as 'health, social, legal or financial problems due to alcohol consumption' (16.8%, n = 247) were identified in large parts of the sample. High-risk consumption and dependency symptoms were significantly correlated with minority stress. CONCLUSION: High levels of high-risk alcohol use and dependency symptoms were found, largely consistent with existing literature. However, disparities are not distributed equally in this population, suggesting that future health promotion interventions should focus on SMYP subgroups. Significant correlations between minority stress and dependency symptoms/high-risk use suggest a potential route for future interventions in these populations.


Assuntos
Alcoolismo/epidemiologia , Bebedeira/epidemiologia , Grupos Minoritários/estatística & dados numéricos , Minorias Sexuais e de Gênero/psicologia , Estresse Psicológico/epidemiologia , Adolescente , Adulto , Consumo de Bebidas Alcoólicas/epidemiologia , Alcoolismo/psicologia , Austrália/epidemiologia , Estudos Transversais , Feminino , Disparidades nos Níveis de Saúde , Inquéritos Epidemiológicos , Humanos , Masculino , Grupo com Ancestrais Oceânicos , Minorias Sexuais e de Gênero/estatística & dados numéricos , Estresse Psicológico/psicologia , Adulto Jovem
4.
Drug Alcohol Rev ; 38(5): 465-472, 2019 07.
Artigo em Inglês | MEDLINE | ID: mdl-31209963

RESUMO

INTRODUCTION AND AIMS: Poppers (alkyl nitrites) are recreational substances commonly used during sexual activity. The current legal status of poppers is complex and wide-ranging bans are increasingly under discussion. Research has identified disproportionate levels of poppers use in sexual minority men. While research on poppers use among sexual minority men exists, little is known about poppers use patterns and correlations with psychosocial and other factors among gay and bisexual young men. DESIGN AND METHODS: A cross-sectional survey was conducted with 836 Australian gay and bisexual young men aged 18 to 35 years. Descriptive statistics and hierarchical segmentation analyses were conducted to identify poppers use patterns, and correlates of recent poppers use (past 3 months) with personal characteristics, use of other substances, as well as mental and psychosocial health including minority stress, LGBT-community connectedness and participation. RESULTS: High levels of lifetime (38%, n = 315) and recent (24%, n = 204) poppers use were reported. However, few participants reported dependency symptoms, risky consumption or problems arising from using poppers. The final model included three variables (visiting sex-on-premises venues, licensed LGBT venues, and using other substances) and predicted 85% (n = 174) of recent poppers use. No correlations with other concepts or characteristics could be identified. CONCLUSION: This analysis further supports the hypothesis that poppers may be substances with a comparably low-risk profile. A regulation of poppers with a harm reduction approach may present a valuable public health intervention.


Assuntos
Nitritos , Assunção de Riscos , Comportamento Sexual/psicologia , Transtornos Relacionados ao Uso de Substâncias/psicologia , Adolescente , Adulto , Austrália , Estudos Transversais , Redução do Dano , Humanos , Masculino , Medição de Risco , Minorias Sexuais e de Gênero , Adulto Jovem
5.
Front Psychiatry ; 10: 105, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30914975

RESUMO

Rapid technological innovations over the past few years have led to dramatic changes in today's mobile phone technology. While such changes can improve the quality of life of its users, problematic mobile phone use can result in its users experiencing a range of negative outcomes such as anxiety or, in some cases, engagement in unsafe behaviors with serious health and safety implications such as mobile phone distracted driving. The aims of the present study are two-fold. First, this study investigated the current problem mobile phone use in Australia and its potential implications for road safety. Second, based on the changing nature and pervasiveness of mobile phones in Australian society, this study compared data from 2005 with data collected in 2018 to identify trends in problem mobile phone use in Australia. As predicted, the results demonstrated that problem mobile phone use in Australia increased from the first data collected in 2005. In addition, meaningful differences were found between gender and age groups in this study, with females and users in the 18-25 year-old age group showing higher mean Mobile Phone Problem Use Scale (MPPUS) scores. Additionally, problematic mobile phone use was linked with mobile phone use while driving. Specifically, participants who reported high levels of problem mobile phone use, also reported handheld and hands-free mobile phone use while driving.

6.
Asia Pac J Public Health ; 30(7): 655-665, 2018 10.
Artigo em Inglês | MEDLINE | ID: mdl-30288986

RESUMO

Streamed and recorded lectures as well as audience response technology are increasingly used in public health tertiary education, to train practitioners to address Asia-Pacific region's rapidly changing health needs. However, little is known about the impact on student performance, satisfaction, and understanding. This study aimed to assess postgraduate students' perceptions and their use of technology in a large epidemiology subject at an Australian university in internal and external modes. The study used both routinely collected student data (n = 453) and survey data (n = 88). Results indicate that students accept and use technology-based learning tools, and perceive audience response technology as well as streamed and recorded lectures as useful for their learning (96.6%). Students have shown a preference to review recorded lectures rather than viewing streamed lectures. Analyses further suggest that the use of recorded and streamed lectures may be linked to better student performance for external students (passing, any use odds ratio = 3.32). However, these effects are not consistent across all student subgroups and externally enrolled students may profit more than those enrolled internally.


Assuntos
Educação de Pós-Graduação , Tecnologia Educacional/estatística & dados numéricos , Saúde Pública/educação , Estudantes de Saúde Pública/psicologia , Austrália , Epidemiologia/educação , Humanos , Aprendizagem , Inquéritos e Questionários , Universidades
7.
PLoS One ; 13(9): e0204730, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30261052

RESUMO

Sexual minority young people use licit and illicit substances at disproportionate levels. However, little is known about the perceptions of substance use among members of LGBT communities. This paper reports the results of a content analysis of 45 semi-structured interviews about substance use in LGBT communities with sexual minority young people (n = 31) and community stakeholders (n = 14). Results indicated both sexual minority youth and community stakeholders perceived the use and acceptance of substances to be higher in LGBT communities compared to the general population. Participants identified a range of characteristics potentially leading to higher levels of substance use including peer pressure, high exposure to substance use, and the high concentrations of licensed venues in LGBT communities. Marginalisation, discrimination and mental health were also perceived as important reasons for these disparities. Community stakeholders identified a range of potential interventions including legislation to address discrimination and substance use, increased services and activities, advertising in commercial LGBT venues and social media, and reinvigorating community cohesion.


Assuntos
Saúde Mental , Sexismo , Minorias Sexuais e de Gênero , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Adolescente , Adulto , Feminino , Humanos , Masculino , Queensland/epidemiologia , Transtornos Relacionados ao Uso de Substâncias/psicologia
8.
PLoS One ; 13(5): e0196421, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29718971

RESUMO

OBJECTIVE: Drowning claims 7% of the global burden of injury-related deaths. Lifejackets are routinely recommended as a drowning prevention strategy; however, a review of related factors regarding lifejacket wear has not previously been investigated. METHODS: This systematic review examined literature published from inception to December 2016 in English and German languages. The personal, social, and environmental factors associated with lifejacket wear among adults and children were investigated, a quantitative evaluation of the results undertaken, and gaps in the literature identified. RESULTS: Twenty studies, with sample sizes of studies ranging between 20 and 482,331, were identified. Fifty-five percent were cross-sectional studies. All studies were scored IV or V on the Australian National Health and Medical Research Council (NHMRC) grading system indicating mostly descriptive and cross-sectional levels of evidence. Factors associated with increased wear included age (mostly children), gender (mostly female), boat type (non-motorised), boat size (small boats), role modelling (children influenced by adult lifejacket wear), and activity (water-skiing, fishing). Factors not associated or inconsistent with lifejacket wear included education, household income, ethnicity, boating ability, confidence in lifejackets, waterway type, and weather and water conditions. Factors associated with reduced lifejacket wear included adults, males, discomfort, cost and accessibility, consumption of alcohol, and swimming ability. Three studies evaluated the impact of interventions. CONCLUSION: This review identified factors associated with both increased and decreased lifejacket wear. Future research should address the motivational factors associated with individuals' decisions to wear or not wear lifejackets. This, combined with further research on the evaluation of interventions designed to increase lifejacket wear, will enhance the evidence base to support future drowning prevention interventions.


Assuntos
Afogamento/prevenção & controle , Navios , Natação , Adolescente , Adulto , Criança , Emergências , Feminino , Humanos , Masculino , Adulto Jovem
9.
Int J Public Health ; 63(5): 621-630, 2018 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-29605878

RESUMO

OBJECTIVES: We examined protective and non-protective effects of disadvantaged social identities and their intersections on lifetime substance use and risky alcohol consumption. METHODS: Data from 90,941 participants of the Global Drug Survey 2015 were analysed. Multivariable logistic regressions were used to calculate adjusted odds ratios for lifetime use of nine psychoactive substances, as well as high-risk/harmful alcohol use. Disadvantaged identities from three categories (ethnicity, sexual identity, gender), and interactions between these were compared. RESULTS: Findings indicate that participants with disadvantaged ethnic and sexual minority identities are more likely to use psychoactive substances compared to their counterparts. The intersecting identity 'disadvantaged ethnic identity and sexual minority' appears to be protective compared to those with just one of these identities. While female gender appears to be highly protective in general, it is not protective among females with disadvantaged social identities. CONCLUSIONS: Stark disparities in substance use between different social identities and their intersections emphasise the importance of intersectionality theories in public health research intervention design. Future research on health equity, particularly substance use, should target individuals with intersecting identities.


Assuntos
Grupos Étnicos/estatística & dados numéricos , Identidade de Gênero , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Adulto , Alcoolismo/epidemiologia , Feminino , Humanos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Razão de Chances , Saúde Pública , Projetos de Pesquisa , Fatores Sexuais , Fatores Socioeconômicos , Transtornos Relacionados ao Uso de Substâncias/etnologia , Inquéritos e Questionários , Populações Vulneráveis
10.
Addict Behav ; 81: 167-174, 2018 06.
Artigo em Inglês | MEDLINE | ID: mdl-29395187

RESUMO

INTRODUCTION: Research shows disproportionate levels of substance use among sexual minority young people. A range of reasons for these disparities have been suggested, including connectedness to and participation in the LGBT community. Little is known about how these constructs are related to substance use involvement in sexual minority (sub)groups or how these relationships are affected by other factors. METHODS: 1266 young sexual minority Australians completed a cross-sectional online survey. Multiple regressions were conducted to assess associations between connectedness to and participation in the LGBT community on substance use involvement, before and after controlling for other factors such as substance use motives, psychological distress, wellbeing, resilience, minority stress, and age. RESULTS/CONCLUSION: Most participants identified as homosexual (57%, n=726) and male (54%, n=683). In the overall sample, participation in and connectedness the LGBT community were significantly associated with increased substance use involvement before (F(2,1263)=35.930, p≤0.001, R2=0.052) and after controlling for other variables (F(8,1095)=33.538, p≤0.001, R2=0.191), with meaningfully higher effect sizes for participation than for connectedness. After controlling for other variables, connectedness only remained significant for homosexuals. Effect sizes for participation were higher for females than males, and bisexuals than homosexuals. However, participation in the LGBT Community was not associated with substance use in participants identifying with a non-binary gender identity. In conclusion, substance use involvement was associated with participation in the LGBT community, but connectedness to the LGBT community only had a weak association with substance use involvement in the homosexual subgroup.


Assuntos
Minorias Sexuais e de Gênero/estatística & dados numéricos , Comportamento Social , Participação Social , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Austrália/epidemiologia , Estudos Transversais , Feminino , Humanos , Masculino , Análise de Regressão , Características de Residência , Fatores Sexuais , Adulto Jovem
11.
J Public Health (Oxf) ; 39(3): 532-541, 2017 09 01.
Artigo em Inglês | MEDLINE | ID: mdl-27519959

RESUMO

Background: This study examines substance use disparities among homosexual, bisexual and heterosexual adolescents and young adults from nine countries. Methods: Data from 58 963 respondents (aged 16 and 35 years) to the 2015 'Global Drug Survey' were utilized. Rates of lifetime, last-year, last-month use and age of onset of 13 different substances were compared across sexual identity subgroups. Results: Adolescents and young adults with a sexual minority identity generally reported higher rates of substance use and an earlier age of onset compared to their heterosexual counterparts. Differences in substance use were larger among female groups than male groups, and rates of substance use were generally higher among bisexuals than homosexuals of both genders. Conclusion: Higher rates of substance use in bisexuals compared with homosexuals among both genders and larger differences between female groups highlight the importance of differentiating between sexual minority identities in substance use research, and in designing substance misuse interventions for people with a sexual minority identity.


Assuntos
Comportamento Sexual/psicologia , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Adolescente , Adulto , Feminino , Inquéritos Epidemiológicos , Heterossexualidade/psicologia , Heterossexualidade/estatística & dados numéricos , Humanos , Masculino , Comportamento Sexual/estatística & dados numéricos , Minorias Sexuais e de Gênero/psicologia , Minorias Sexuais e de Gênero/estatística & dados numéricos , Transtornos Relacionados ao Uso de Substâncias/psicologia , Adulto Jovem
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