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1.
Zhonghua Liu Xing Bing Xue Za Zhi ; 40(10): 1197-1202, 2019 Oct 10.
Artigo em Chinês | MEDLINE | ID: mdl-31658516

RESUMO

Being a double-edged sword, Internet Plus not only increases the risk of HIV transmission, but also plays an positive role in programs regarding the control and prevention of HIV. Here, we introduced a special issue- "HIV Prevention among MSM in the Internet Era" , synthesizing both domestic and international evidence, and discussed the history and progress, strengths and effectiveness, problems and countermeasures, as well as the directions of the Internet Plus regarding the prevention programs of HIV/AIDS among MSM.


Assuntos
Infecções por HIV/prevenção & controle , Internet , Minorias Sexuais e de Gênero , Homossexualidade Masculina , Humanos , Masculino , Assunção de Riscos , Comportamento Sexual
2.
Zhonghua Liu Xing Bing Xue Za Zhi ; 40(10): 1206-1211, 2019 Oct 10.
Artigo em Chinês | MEDLINE | ID: mdl-31658518

RESUMO

Objective: To analyze the characteristics of the "Interner Plus-based AIDS Comprehensive Prevention Service System" among MSM who frequently using the Internet in Guangzhou. Methods: An online survey was conducted among MSM who were recruited through gay-website portals between August and September, 2018 in Guangzhou, to collect information regarding the use of and attitudes on the "Interner Plus-based AIDS Comprehensive Prevention Service System" . Logistic regression was used to explore the association between the use of Internet intervention tools and related behavioral characteristics. Information on the awareness of AIDS, HIV testing, and condomless anal sex behavior were compared between the core or non-core services users. Results: A total of 777 Internet-based MSM were recruited as participants including 638 men (82.1%) as core service users. MSM were satisfied in using the the "Interner Plus-based AIDS Comprehensive Prevention Service System" while more than 80.0% of the users felt that the tools were helpful in: increasing the HIV awareness, promoting test uptake, and reducing those related risk behavior. Comparing with those who did not use the tools, the users showed higher rates in practising condomless anal intercourse (1.50-1.86 times), commercial sex with men (11.60-21.21 times), and unprotected vaginal intercourse (13.62-20.67 times), in the last 6 months. Proportions of core service users appeared as: [96.6% vs. 74.8%, aOR (95%CI): 8.80 (4.85-15.97)] on HIV testing, [56.4% vs. 22.3%, aOR (95%CI): 4.54 (2.94-7.02)] on regular HIV testing and [86.2% vs. 80.6%, aOR (95%CI): 1.75 (1.06-2.89)] on awareness of HIV knowledge respectively, which were all significantly higher than the non-core service users. Conclusions: The frequent Internet using MSM in Guangzhou claimed to have had high acceptance and satisfaction on the local Internet HIV intervention service tools. The "Internet Plus-based AIDS Comprehensive Prevention Service System" had effectively reached the high-risk subgroups of MSM, increasing the awareness on related risk and promoting testing on HIV.


Assuntos
Síndrome de Imunodeficiência Adquirida/prevenção & controle , Infecções por HIV/prevenção & controle , Internet , Minorias Sexuais e de Gênero , China , Feminino , Homossexualidade Masculina , Humanos , Masculino , Assunção de Riscos , Trabalho Sexual , Comportamento Sexual
3.
Zhonghua Liu Xing Bing Xue Za Zhi ; 40(10): 1217-1221, 2019 Oct 10.
Artigo em Chinês | MEDLINE | ID: mdl-31658520

RESUMO

Objective: To analyze the characteristics of levels related to the risk through self-evaluation system, among MSM users in Guangzhou, between 2015 and 2017. Methods: Between 2015 and 2017, data was collected from the users of a self-evaluation system network related to HIV infection, based on the previous 'HIV health risk appraisal model'. Information on risk factors was collected to calculate the scores and levels of risks and to estimate the incidence of HIV. Taking the reference of R value on risks as (R=0.9-1.1) in general population. The ones with very low risk, with low risk, moderate risk, high risk and very high risk were set as R≤0.5, 0.52.0, respectively. The scores of modifiable risk factors were compared with different subgroups of MSM. Results: A total of 4 601 MSM were involved in this study, with the following features presented as: aged 16-64 (28.38±7.11) years, proportions of residence from Guangzhou, Guangdong province or other provinces as 38.6%(1 776/4 601)、35.4%(1 629/4 601) and 26.0%(1 197/4 601), 59.6%(2 742/4 601) received bachelor or above degrees. 81.3%(3 741/4 601) of them claimed as having homosexual orientation. R values of risk level on very low risk, low risk level, moderate risk, high risk and very high risk appeared as 12.9%(594/4 601), 50.9%(2 342/4 601), 17.0%(783/4 601), 14.8%(682/4 601) and 4.3%(200/4 601), respectively. Scores of modifiable risk factors decreased year by year (P<0.05), among MSM in this study. In either of the groups that experiencing insertive or receptive sex, the ones with heterosexual orientation presented the highest scores of modifiable risk factors (P<0.05). Conclusions: The risk levels on HIV infections called for special attention among the users of the self-evaluation network system. Among the MSM that carrying either insertive or receptive sex role, the ones with heterosexual orientation had the highest risk levels and scores of modifiable risk factors in Guangzhou. Further study should be explored to better understand the causes of related risks.


Assuntos
Infecções por HIV/epidemiologia , Medição de Risco , Minorias Sexuais e de Gênero , Adolescente , Adulto , China/epidemiologia , Homossexualidade Masculina , Humanos , Masculino , Pessoa de Meia-Idade , Assunção de Riscos , Comportamento Sexual , Adulto Jovem
4.
Zhonghua Liu Xing Bing Xue Za Zhi ; 40(10): 1227-1233, 2019 Oct 10.
Artigo em Chinês | MEDLINE | ID: mdl-31658522

RESUMO

Objective: To evaluate the effect of the "Interner Plus-based AIDS Comprehensive Prevention Service System" among MSM in Guangzhou, during 2010-2017, using a dynamic compartmental model. Methods: A dynamic compartmental model was developed to describe the HIV situation among MSM in Guangzhou. This model was parameterized on data from published literature or surveillance programs from the Guangzhou CDC. The Matlab 7.0 software was used for coding and analysis on collected data. HIV prevalence was analyzed among MSM under the status quo data and estimated the impact by the "Internet Plus" AIDS prevention services project. Results: HIV prevalence would have increased to 22.75% in 2017, and the total number of new HIV infections would have been 11 038, from 2010 to 2017, using the data status quo. Under the Guangzhou "Internet Plus" AIDS prevention services project, the prevalence of HIV among MSM from 2010 to 2017 was estimated to be 8.44%, 9.68%, 10.65%, 11.34%, 11.73%, 11.83%, 11.71% and 11.43% in Guangzhou, which were similar to the surveillance data. The total number of new infections in the past 8 years under the "Internet Plus" scenario was estimated to be 4 009. The "Internet Plus" program would have prevented 7 029 (63.68%) new infections during 2010-2017 as compared to the number, status quo. Conclusions: The fitting result of dynamic compartmental model seemed more reasonable, which was applicable to predict HIV epidemic among MSM in Guangzhou, suggesting that the increase of HIV prevalence had been curbed since the "Internet Plus" project which was launched in 2010, and the "Interner Plus-based AIDS Comprehensive Prevention Service System" had achieved the purpose as planned, epidemiologically.


Assuntos
Síndrome de Imunodeficiência Adquirida/diagnóstico , Infecções por HIV/diagnóstico , Internet , Serviços Preventivos de Saúde , Minorias Sexuais e de Gênero , Síndrome de Imunodeficiência Adquirida/prevenção & controle , China , Infecções por HIV/prevenção & controle , Homossexualidade Masculina , Humanos , Masculino , Modelos Teóricos , Assunção de Riscos
5.
Pan Afr Med J ; 33: 166, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31565127

RESUMO

With its number of employees ranging from 45,310 to 46,000, the textile and apparel industry is the main private sector employer of labour in Lesotho. It has been reported that a third (an estimated 34%) of these workers are living with HIV. There is perception that textile factory workers living with HIV (TFWLWH) in Lesotho indulge in HIV risk-taking behaviours. However, no study has yet investigated or documented factors that influence risk-taking behaviours amongst these workers. Transmitting the disease to others, treatment complications and death consequent to HIV reinfection are complications associated with HIV risk-taking behaviours by seropositive individuals. Using an in-depth, face-to-face, semi-structured interview, this study obtained the perspectives of ten factory workers from three randomly selected textile factories in Maseru, Lesotho on factors that influence HIV-risk taking behaviour amongst TFWLWH in Lesotho. Analysis of the comments given by workers revealed four core themes, namely, peer pressure, communication, cultural norms and societal norms. Determining the predictors of HIV risk-taking behaviours amongst these workers will inform both present and future interventions aimed at supporting textile factory workers living with HIV in Lesotho. This supports the need for continued research to identify HIV risk-taking behaviours by people living with HIV countrywide, to decrease the incidence of new infections and complications arising from reinfection.


Assuntos
Infecções por HIV/epidemiologia , Assunção de Riscos , Indústria Têxtil , Adolescente , Adulto , Comunicação , Cultura , Feminino , Humanos , Entrevistas como Assunto , Lesoto/epidemiologia , Masculino , Infuência dos Pares , Setor Privado , Normas Sociais , Adulto Jovem
6.
Medicine (Baltimore) ; 98(39): e17071, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31574806

RESUMO

Access to antiretroviral-based HIV prevention has been marked by sex asymmetries, and its effectiveness has been compromised by low clinical follow-up rates. We investigated risk profiles of women who received nonoccupational post-exposure prophylaxis (nPEP), as well as the rates and predictive factors of loss to follow-up after nPEP initiation.Retrospective study evaluating 501 women who received nPEP between 2014 and 2015 at 5 HIV centers (testing centers-VCT, outpatient clinics, and infectious diseases hospital). Risk profiles were drawn based on the characteristics of the women and their sexual partners, and then stratified by sociodemographic indicators and previous use of HIV prevention services. Loss to follow-up (LTFU) was defined as not presenting for follow-up visits or for HIV testing after nPEP initiation. Predictors of LTFU were analyzed by calculating adjusted prevalence ratios (aPRs).Approximately 90% of women had sexual encounters that met the criteria established in the Brazilian guidelines for nPEP. Those who declared to be sex workers (26.5%) or drug users (19.2%) had the highest social vulnerability indicators. In contrast, women who had intercourse with casual partners of unknown HIV risk (42.7%) had higher education and less experience with previous HIV testing (89.3%) or nPEP use (98.6%). Of the women who received nPEP after sexual intercourse with stable partners, 75.8% had HIV-infected partners. LTFU rate was 72.8% and predictors included being Black (aPR = 1.15, 95% confidence interval [CI]: 1.03-1.30), using drugs/alcohol (aPR = 1.15, 95% CI: 1.01-1.32) and having received nPEP at an HIV outpatient clinic (aPR = 1.35, 95% CI: 1.20-1.51) or at an infectious diseases hospital (aPR = 1.37, 95% CI: 1.11-1.69) compared with a VCT. The risk of LTFU declined as age increased (aPR 41-59 years = 0.80, 95% CI: 0.68-0.96).Most women who used nPEP had higher socioeconomic status and were not part of populations most affected by HIV. In contrast, factors that contribute to loss to follow-up were: having increased social vulnerability; increased vulnerability to HIV infection; and seeking nPEP at HIV treatment services as opposed to at a VCT.


Assuntos
Antirretrovirais/uso terapêutico , Infecções por HIV/prevenção & controle , Profilaxia Pós-Exposição , Sexo sem Proteção , Adolescente , Adulto , Brasil , Coito , Feminino , Seguimentos , Humanos , Adesão à Medicação , Pessoa de Meia-Idade , Estudos Retrospectivos , Assunção de Riscos , Trabalho Sexual , Classe Social , Transtornos Relacionados ao Uso de Substâncias/complicações , Adulto Jovem
7.
MMWR Morb Mortal Wkly Rep ; 68(40): 873-879, 2019 Oct 11.
Artigo em Inglês | MEDLINE | ID: mdl-31600183

RESUMO

Correct and consistent condom use and human immunodeficiency virus (HIV) preexposure prophylaxis (PrEP) are protective against sexual transmission of HIV (1,2). The incidence of HIV infection among Hispanic/Latino men who have sex with men (MSM) in the United States is increasing (3). HIV risk among Hispanic/Latino MSM differs based on their place of birth and years of U.S. residence (4). Data from CDC's National HIV Behavioral Surveillance (NHBS)* for 2011-2017 were analyzed to assess changes in sexual risk behaviors among Hispanic/Latino MSM by place of birth and years of U.S. residence. Overall, condomless anal sex during the previous 12 months increased from 63% in 2011 to 74% in 2017, and PrEP use during the previous 12 months increased from 3% in 2014 to 24% in 2017. Regardless of place of birth, nearly 75% of Hispanic/Latino MSM reported condomless anal sex during 2017. However, because of PrEP use, <60% of non-U.S.-born Hispanic/Latino MSM and <50% of U.S.-born Hispanic/Latino MSM reported unprotected anal sex (condomless anal sex and no PrEP use) during 2017. Results indicate that PrEP can be a vital tool for reducing HIV transmission among Hispanic/Latino MSM, especially those who have condomless anal sex. Interventions to prevent HIV acquisition, including increasing PrEP uptake, could address cultural and linguistic needs of Hispanic/Latino MSM, as well as other barriers to prevention of HIV infection typically faced by all MSM.


Assuntos
Hispano-Americanos/psicologia , Homossexualidade Masculina/etnologia , Assunção de Riscos , Sexo sem Proteção/etnologia , Adolescente , Adulto , Infecções por HIV/etnologia , Hispano-Americanos/estatística & dados numéricos , Homossexualidade Masculina/psicologia , Homossexualidade Masculina/estatística & dados numéricos , Humanos , Masculino , Estados Unidos/epidemiologia , População Urbana/estatística & dados numéricos , Adulto Jovem
8.
Pan Afr Med J ; 33: 135, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31558934

RESUMO

Introduction: The rate of sexually transmitted infection's, including HIV has increased in recent years in Ethiopia. Many adolescents and young people still do not protect themselves against unintended pregnancies and STIs. Therefore, this study was conducted to assess the predictors of risky sexual behavior among pre-college students in Adama Town, Ethiopia. Methods: School based cross-sectional study was employed. In this study 364 students were recruited from all pre-college schools in Adama town, Ethiopia. Bivariate and multivariate logistic regression analysis were used to examine the relationship between the outcome variables and independent variables. Results: The mean age at sexual debut was 16.1 years (± 2.72SD). Social media usage for sexual activity and having multiple sexual partners were observed among students. About 7% of students used social media for watching pornography. The odds of risky sexual behaviour were higher among social media users compared to the nonusers AOR = 1.23 (95% CI 1.13,3.12). Risky sexual behaviour was almost 4 times more likely among night club goers AOR = 4.294 (95% CI: 2.033, 9.073). Peer pressure and substance abuse were also a significant predictor for risky sexual behavior AOR = 6.97 (95% CI: 4.24, 9.69). Conclusion: Social media use, peer pressure, substance abuse, and night club going were found to be significantly associated with risky sexual behaviour among pre-college students. Thus, schools need to establish and strengthen reproductive health clubs to be able to equip students with required skills and knowledge about sexuality. Parents should be aware of the dynamic behavioral change of their children, listen and attend to their needs.


Assuntos
Assunção de Riscos , Comportamento Sexual/estatística & dados numéricos , Mídias Sociais/estatística & dados numéricos , Estudantes/estatística & dados numéricos , Adolescente , Estudos Transversais , Literatura Erótica/psicologia , Etiópia , Feminino , Humanos , Modelos Logísticos , Masculino , Infuência dos Pares , Instituições Acadêmicas , Parceiros Sexuais , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Adulto Jovem
9.
BMC Public Health ; 19(1): 1027, 2019 Jul 31.
Artigo em Inglês | MEDLINE | ID: mdl-31366339

RESUMO

BACKGROUND: Adolescent sexual risky behaviours continue to be significant drivers of the HIV epidemic globally. The objective of this study was to determine factors associated with prior engagement in high-risk sexual behaviours among adolescents (10-19 years) in Karamoja sub-region, a pastoralist and post-conflict community in North-eastern Uganda. METHODS: Between August and September 2016, we conducted a cross-sectional study among 1439 adolescents receiving primary healthcare services at nine public health facilities located in five of the seven districts that make up Karamoja sub-region. High-risk sexual behaviour was defined as engaging in sex with two or more (2+) sexual partners in the 6 months preceding the survey or exchanging sex for money or gifts with no or inconsistent use of condoms over the same period of time. Factors associated with prior engagement in high-risk sexual behaviours were analysed using a modified Poison regression model with log-link and Poisson-family via a generalized linear model. RESULTS: Eighty-two percent (81.8%, n = 1177) of the respondents had ever tested for HIV while 62 % (61.5%, n = 885) had ever had sex. Of those that had ever had sex, 11.4% (n = 101) reported prior engagement in high-risk sexual behaviours. Prior engagement in high-risk sexual behaviours was lower among men than women (adjusted prevalence ratio (adj. PR) = 0.46; 95% Confidence Interval (95% CI): 0.33, 0.62) and those whose sex debut was above 14 years (adj.PR = 0.63; 95% CI: 0.57, 0.69). However, prior engagement in high-risk sexual behaviours was significantly higher in adolescents who were not aware of their recent sexual partner's HIV status (adj.PR = 2.43; 95% CI: 1.68, 3.52) and those who used illicit drugs (adj.PR = 2.76; 95% CI: 1.88, 4.05). CONCLUSION: Prior engagement in high-risk sexual behaviours was significantly associated with having sex with partners of unknown HIV sero-status and use of illicit drugs. These findings suggest a need for targeted interventions to improve mutual HIV status disclosure between sexual partners while minimizing their use of illicit drugs/substances.


Assuntos
Comportamento do Adolescente/psicologia , Assunção de Riscos , Comportamento Sexual/psicologia , Adolescente , Agricultura , Conflitos Armados , Criança , Preservativos/estatística & dados numéricos , Estudos Transversais , Feminino , Infecções por HIV/epidemiologia , Humanos , Masculino , Fatores de Risco , Parceiros Sexuais/psicologia , Inquéritos e Questionários , Uganda/epidemiologia , Adulto Jovem
10.
BMC Public Health ; 19(1): 1129, 2019 Aug 16.
Artigo em Inglês | MEDLINE | ID: mdl-31420032

RESUMO

BACKGROUND: In China, clients of female sex workers (CFSWs) have a low rate of condom use and a high prevalence of human immunodeficiency virus (HIV). However, little is known about the high-risk sexual behaviors of HIV-positive CFSWs. METHODS: In 2014, 327 CFSWs diagnosed with HIV for 6 months or longer completed a face-to-face questionnaire for a quantitative survey. In addition, 32 HIV-positive CFSWs were recruited to participate in in-depth interviews (18 participated in both, 14 participated in-depth interviews only) to explore reasons for extramarital sexual behaviors and inconsistent condom use. The quantitative data on sexual risk behaviors were analyzed using chi-square tests. Interviews were coded inductively for emerging themes. RESULTS: Among the participants of the quantitative survey, 41.6% (136/327) had sex with regular sexual partners only in the past 6 months, of whom 64.0% (87/136) had consistent condom use; 27.5% (90/327) of the participants had sex with irregular sexual partners in the past 6 months, of which, 46.7% (42/90) had consistent condom use. The qualitative study suggested that HIV positive sero-status, willingness to protect their spouses or regular sexual partners, and lacking a sense of responsibility to protect their commercial and casual sexual partners, influence CFSWs' sexual behaviors. CONCLUSIONS: HIV-positive CFSWs continue to practice unsafe sexual behaviors with regular and irregular partners after HIV diagnosis, but were more willing to protect their regular partners. Future interventions targeting HIV-positive CFSWs should not only be confined to sero-discordant couples, but also need to instill a sense of responsibility to protect the commercial and casual partners and reduce the number of concurrent partners.


Assuntos
Soropositividade para HIV/epidemiologia , Assunção de Riscos , Profissionais do Sexo/psicologia , Comportamento Sexual/psicologia , Parceiros Sexuais/psicologia , Adulto , Idoso , China/epidemiologia , Preservativos/estatística & dados numéricos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pesquisa Qualitativa , Inquéritos e Questionários
11.
BMC Public Health ; 19(1): 1130, 2019 Aug 16.
Artigo em Inglês | MEDLINE | ID: mdl-31420034

RESUMO

BACKGROUND: In 2014, Vietnam was the first Southeast Asian country to commit to achieving the World Health Organization's 90-90-90 global HIV targets (90% know their HIV status, 90% on sustained treatment, and 90% virally suppressed) by 2020. This pledge represented further confirmation of Vietnam's efforts to respond to the HIV epidemic, one feature of which has been close collaboration with the U.S. President's Emergency Plan for AIDS Relief (PEPFAR). Starting in 2004, PEPFAR supported community outreach programs targeting high-risk populations (people who inject drugs, men who have sex with men, and sex workers). To provide early evidence on program impact, in 2007-2008 we conducted a nationwide evaluation of PEPFAR-supported outreach programs in Vietnam. The evaluation focused on assessing program effect on HIV knowledge, high-risk behaviors, and HIV testing among high-risk populations-results relevant to Vietnam's push to meet global HIV goals. METHODS: We used a mixed-methods cross-sectional evaluation design. Data collection encompassed a quantitative survey of 2199 individuals, supplemented by 125 in-depth interviews. Participants were members of high-risk populations who reported recent contact with an outreach worker (intervention group) or no recent contact (comparison group). We assessed differences in HIV knowledge, risky behaviors, and HIV testing between groups, and between high-risk populations. RESULTS: Intervention participants knew significantly more about transmission, prevention, and treatment than comparison participants. We found low levels of injection drug-use-related risk behaviors and little evidence of program impact on such behaviors. In contrast, a significantly smaller proportion of intervention than comparison participants reported risky sexual behaviors generally and within each high-risk population. Intervention participants were also more likely to have undergone HIV testing (76.1% vs. 47.0%, p < 0.0001) and to have received pre-test (78.0% vs. 33.7%, p < 0.0001) and post-test counseling (80.9% vs. 60.5%, p < 0.0001). Interviews supported evidence of high impact of outreach among all high-risk populations. CONCLUSIONS: Outreach programs appear to have reduced risky sexual behaviors and increased use of HIV testing services among high-risk populations in Vietnam. These programs can play a key role in reducing gaps in the HIV care cascade, achieving the global 90-90-90 goals, and creating an AIDS-free generation.


Assuntos
Relações Comunidade-Instituição , Infecções por HIV/prevenção & controle , Conhecimentos, Atitudes e Prática em Saúde , Programas de Rastreamento/estatística & dados numéricos , Comportamento de Redução do Risco , Adulto , Estudos Transversais , Feminino , Infecções por HIV/epidemiologia , Homossexualidade Masculina/psicologia , Homossexualidade Masculina/estatística & dados numéricos , Humanos , Masculino , Avaliação de Programas e Projetos de Saúde , Pesquisa Qualitativa , Medição de Risco , Assunção de Riscos , Profissionais do Sexo/psicologia , Profissionais do Sexo/estatística & dados numéricos , Comportamento Sexual/psicologia , Abuso de Substâncias por Via Intravenosa/epidemiologia , Inquéritos e Questionários , Vietnã/epidemiologia
12.
MMWR Morb Mortal Wkly Rep ; 68(30): 653-657, 2019 Aug 02.
Artigo em Inglês | MEDLINE | ID: mdl-31369525

RESUMO

During 2016, 6% of persons in the United States who received a diagnosis of human immunodeficiency virus (HIV) infection had their HIV infection attributed to injection drug use (1). Injection practices and sexual behaviors among HIV-positive persons who inject drugs, such as injection equipment sharing and condomless sex, can increase HIV transmission risk; nationally representative estimates of the prevalences of these behaviors are lacking. The Medical Monitoring Project (MMP) is an annual, cross-sectional survey that reports nationally representative estimates of clinical and behavioral characteristics among U.S. adults with diagnosed HIV (2). CDC used MMP data to assess high-risk injection practices and sexual behaviors among HIV-positive persons who injected drugs during the preceding 12 months and compared their HIV transmission risk behaviors with those of HIV-positive persons who did not inject drugs. During 2015-2017, approximately 10% (weighted percentage estimate) of HIV-positive persons who injected drugs engaged in distributive injection equipment sharing (giving used equipment to another person for use); nonsterile syringe acquisition and unsafe disposal methods were common. Overall, among HIV-positive persons who injected drugs, 80% received no treatment, and 57% self-reported needing drug or alcohol treatment. Compared with HIV-positive persons who did not inject drugs, those who injected drugs were more likely to have a detectable viral load (48% versus 35%; p = 0.008) and engage in high-risk sexual behaviors (p<0.001). Focusing on interventions that reduce high-risk injection practices and sexual behaviors and increase rates of viral suppression might decrease HIV transmission risk among HIV-positive persons who inject drugs. Successful substance use treatment could also lower risk for transmission and overdose through reduced injection.


Assuntos
Infecções por HIV/diagnóstico , Assunção de Riscos , Comportamento Sexual/psicologia , Abuso de Substâncias por Via Intravenosa/psicologia , Infecções por HIV/transmissão , Humanos , Abuso de Substâncias por Via Intravenosa/epidemiologia , Estados Unidos/epidemiologia , Carga Viral/estatística & dados numéricos
13.
BMC Public Health ; 19(1): 978, 2019 Jul 22.
Artigo em Inglês | MEDLINE | ID: mdl-31331300

RESUMO

BACKGROUND: Condom use remains consistently low among Chinese men who have sex with men (MSM). This study aims to identify factors associated with condom use after online video intervention. METHODS: This is a secondary data analysis of data collected from an online non-inferiority trial comparing the effectiveness of two condom use promotion video interventions among Chinese MSM. Participants from the two groups were combined since the effectiveness of two video interventions were shown to be non-inferior. Univariable and multivariable logistic regression were used to identify factors associated with condomless sex after the intervention during the follow-up interval. RESULTS: Overall, 1173 participants were recruited at baseline and 791 (67.4%) completed the three-month follow-up survey. 57.3% (453/791) of the participants reported condomless sex after intervention in the three-month follow-up interval. MSM who have had sex under the influence of alcohol in the last 3 months (Odds Ratio(OR) = 1.90; 95% CI: 1.22, 2.97; Adjusted OR(AOR) = 1.79; 95% CI: 1.13, 2.83) and ever have had sex tourism (OR = 2.75; 95% CI: 1.34, 5.63; AOR = 2.40; 95% CI: 1.15, 5.07) at baseline were more likely to have condomless sex after intervention in the three-month follow-up period. MSM who had a higher level of community engagement in sexual health (OR = 0.54; 95% CI: 0.35, 0.82; AOR = 0.49; 95% CI: 0.32, 0.75 with substantial engagement) and who viewed additional condom promotion videos during the follow-up period by themselves (OR = 0.67; 95% CI = 0.50, 0.89; AOR = 0.67; 95% CI: 0.50, 0.91). were less likely to have condomless sex during the follow-up period. CONCLUSION: The intervention appeared to be effective among MSM who reported viewing additional condom promotion videos by themselves and more community engagement after the intervention. In MSM who reported risky sexual behaviors at baseline, the intervention appeared less effective. Tailored intervention videos that target particular subgroups, active in-person community engagement, and optimized intervention frequency should be considered in future sexual health interventions.


Assuntos
Preservativos/estatística & dados numéricos , Promoção da Saúde/métodos , Homossexualidade Masculina/psicologia , Sexo sem Proteção/psicologia , Adulto , China/epidemiologia , Educação a Distância , Infecções por HIV/epidemiologia , Homossexualidade Masculina/estatística & dados numéricos , Humanos , Masculino , Assunção de Riscos , Inquéritos e Questionários , Gravação de Videoteipe
14.
BMC Infect Dis ; 19(1): 644, 2019 Jul 19.
Artigo em Inglês | MEDLINE | ID: mdl-31324233

RESUMO

BACKGROUND: Given the widespread use of the Internet among men who have sex with men (MSM) and high risk of Internet-facilitated sexual behaviors, Internet-based interventions to reduce sexual risk are urgently needed. METHODS: We recruited 1,100 participants from online and randomly assigned to two groups. One group received online HIV intervention services. Online HIV intervention was developed through mix-method formative research, measures included scenarios experiencing intervention and HIV information dissemination. Self-reported condomless anal sex with a male in the past three months was measured to evaluate the intervention effect. RESULT: Of the 1,100 participants, the majority were aged between 21 and 30 years old (62%), had a college degree or higher (80%), were single (88%), and self-identified as homosexual (78%). The estimated risk difference of condomless sex with a male in the past three months between groups was 9.3% (95% confidence interval (CI): 1.1, 17.5%). Using multiple imputations intention-to-treat, the estimated risk difference was 8.9% (95%CI: 1.2, 16.6%). Modification effects were found between intervention and characteristics including: educational attainment (p = 0.012), marital status (p = 0.005) and awareness of AIDS-related knowledge (p = 0.010). CONCLUSION: Internet appears to be a promising approach to disseminate HIV prevention amongst MSM. Interactive online intervention appeals to MSM and poses a great potential for reducing HIV risky behavior. TRIAL REGISTRATION: ChiCTR1800014260 (retrospectively registered 2 Jan, 2018).


Assuntos
Infecções por HIV/prevenção & controle , Homossexualidade Masculina , Internet , Sexo sem Proteção/prevenção & controle , Síndrome de Imunodeficiência Adquirida/prevenção & controle , Adulto , Humanos , Masculino , Estado Civil , Pessoa de Meia-Idade , Assunção de Riscos , Comportamento Sexual
15.
Public Health ; 173: 83-96, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31255962

RESUMO

OBJECTIVES: The objective of this study is to conduct a systematic review to summarise currently implemented interventions, investigating their effectiveness in reducing alcohol use and sexual risk taking behaviour in teenagers and young adults. STUDY DESIGN: This is a systematic review. METHODS: Studies published in English language with both alcohol and sexual risky behaviour reduction interventions were searched using five electronic database platforms. All review tasks such as study screening, selection, data extraction, quality rating and synthesis were performed in accordance with systematic review guidelines. RESULTS: The review included 18 studies. Fifteen studies were randomised control trials (RCTs), whereas three were interventional studies having pre-intervention and postintervention analysis. Overall study duration ranged from 6 months to 24 months. The retention rate decreased with an increase in study duration and ranged from 60% to 80% for majority of studies, whereas some studies particularly planned for a shorter period had a higher retention rate (≥90%). The study site showed a range of patterns (in schools/college = 5, at family level/home environment = 3, web based = 2, sexual health clinics = 2, mental health clinics = 1, community level = 1 and juvenile detention facility = 4). The study quality assessment showed that most studies were of medium to high quality. Evidence from this systematic review suggests that after interventions, young people are less likely to engage in risky sexual behaviour and choose harmful alcohol drinking. The major factors influencing individuals during adolescence and early adulthood include local cultural norms, acceptability of casual sex and binge drinking trends in the teenage and young communities. It was also observed that study setting and target population determine the type of intervention required and impacts on outcomes. CONCLUSIONS: This review suggests that interventions to reduce risky sexual behaviour and alcohol consumption work in teenagers and young adults. However, selection of appropriate intervention type/design, delivery methods and follow-up plans are key elements to ensure both uptake and success of such intervention projects.


Assuntos
Consumo de Bebidas Alcoólicas/psicologia , Redução do Dano , Assunção de Riscos , Comportamento Sexual/psicologia , Adolescente , Humanos , Avaliação de Programas e Projetos de Saúde , Ensaios Clínicos Controlados Aleatórios como Assunto , Adulto Jovem
16.
Accid Anal Prev ; 131: 171-179, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31277020

RESUMO

Many countries have adopted penalty point systems (PPS) to deter drivers from breaking traffic laws. To investigate the effectiveness of PPS on reducing illegal driving behavior, this study analyzed traffic violation data of a Chinese city in 2017. This analysis revealed that 1) risky driving behaviors (RDBs) are among the main causes of traffic violations and 2) almost half of the offenders with multiple violations committed the same traffic rule violations more than once. To further explain these phenomena, a survey in another Chinese city-Tianjin-was conducted. Considering the fact that most types of RDBs will, if detected by the authorities, result in traffic violations, the present study investigated the influence of a PPS, represented by penalty experience (PE), on traffic violation behaviors from the perspective of RDBs. Moreover, the impact of cognitive processes on driving behaviors via self-efficacy was considered. We found that drivers' PE is positively associated with their RDBs and that offenders with more PE are more inclined to commit RDBs; we further observed that self-efficacy partially mediates the relationship between PE and RDBs. However, no gender difference in the effect of PE on RDBs was discovered, thus indicating that PE has the same effect on male and female drivers. Based on these findings, some strategies are suggested (such as the Increasing Block Penalty Points Policy) to improve the effectiveness of the PPS.


Assuntos
Condução de Veículo/psicologia , Assunção de Riscos , Controle Social Formal , Acidentes de Trânsito/prevenção & controle , Acidentes de Trânsito/estatística & dados numéricos , Adolescente , Adulto , Condução de Veículo/legislação & jurisprudência , China , Cidades , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Fatores Sexuais , Inquéritos e Questionários , Adulto Jovem
17.
Accid Anal Prev ; 131: 191-199, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31306833

RESUMO

Fatal road traffic crashes are often related to speeding, non-use of a seatbelt, and alcohol/drug-impaired driving. The aim of this study was to examine associations between driving under the influence of drugs and/or alcohol and driver-related risk factors that have been reported as significantly contributing causes of fatal road traffic crashes. The data were extracted from Norwegian road traffic crash registries and forensic toxicology databases. Drug/alcohol investigated car and van drivers and motorcycle riders fatally injured in road traffic crashes in Norway during 2005-2015 were included in this study (n = 772). Drug and alcohol concentrations corresponding to 0.5 g/kg alcohol in blood were used as the lower limits for categorising drivers/riders as impaired; 0.2 g/kg was the upper limit for being categorised as sober. Associations between driver-related risk factors and impairment from specific substance groups were calculated using multivariable logistic regression, adjusted for other substance groups, age, and sex, and were reported when the confidence intervals did not contain the value 1 or lower. Substances found in concentrations above the impairment limits were mainly alcohol (20%), medicinal drugs (10%: benzodiazepines, opioids, z-hypnotics), stimulants (5%: amphetamines, methylphenidate, and cocaine), and cannabis (4%: THC). The drug/alcohol-impaired drivers had compared to the sober drivers more often been speeding (68% versus 32%), not used a seatbelt (69% versus 30%), and been driving without a valid driver license (26% versus 1%). Logistic regression analysis showed that impairment from alcohol or stimulants (mainly amphetamines) was associated with all three risk factors, medicinal drugs with all except speeding, and impairment from cannabis (THC) with not having a valid driver license. Among motorcycle riders, drug/alcohol impairment was associated with not having a valid driver license and non-use of a helmet. At least one of the risk factors speeding, non-use of a seatbelt/helmet, and driving without a valid license were present among the vast majority of the drug/alcohol-impaired fatally injured drivers and riders, and also among more than half of the fatally injured sober drivers.


Assuntos
Acidentes de Trânsito/mortalidade , Dirigir sob a Influência/estatística & dados numéricos , Adulto , Estudos de Casos e Controles , Feminino , Humanos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Motocicletas/estatística & dados numéricos , Noruega/epidemiologia , Fatores de Risco , Assunção de Riscos
18.
Aust N Z J Public Health ; 43(5): 424-428, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31287941

RESUMO

OBJECTIVES: Asian men who have sex with men (MSM) who have recently arrived in Australia are an emergent risk group for HIV; however, little is known about how they compare to Australian MSM diagnosed with HIV. This study compared the characteristics of these two groups. METHODS: A retrospective, cross-sectional study of MSM diagnosed with HIV between January 2014 and October 2017 in Melbourne and Sydney public sexual health clinics. Asian MSM were those who had arrived in Australia within 4 years of diagnosis. RESULTS: Among 111 Asian men, 75% spoke a language other than English, 88% did not have Medicare and 61% were international students. Compared with Australian men (n=209), Asian men reported fewer male sexual partners within 12 months (median 4 versus 10, p<0.001), were less likely to have tested for HIV previously (71% versus 89%, p<0.001) and had a lower median CD4 count (326 versus 520, p<0.001). Among Asian men, HIV subtype CRF01-AE was more common (55% versus 16%, p<0.001) and subtype B less common (29% versus 73%, p<0.001). CONCLUSIONS: Asian MSM diagnosed with HIV reported lower risk and had more advanced HIV. Implications for public health: HIV testing and preventative interventions supporting international students are required.


Assuntos
Grupo com Ancestrais do Continente Asiático/estatística & dados numéricos , Emigrantes e Imigrantes/estatística & dados numéricos , Infecções por HIV/diagnóstico , Homossexualidade Masculina/etnologia , Comportamento Sexual/etnologia , Doenças Sexualmente Transmissíveis/etnologia , Adolescente , Adulto , Grupo com Ancestrais do Continente Asiático/psicologia , Austrália/epidemiologia , Estudos Transversais , Infecções por HIV/etnologia , Homossexualidade Masculina/estatística & dados numéricos , Humanos , Masculino , Programas de Rastreamento , Pessoa de Meia-Idade , Estudos Retrospectivos , Assunção de Riscos , Parceiros Sexuais , Adulto Jovem
19.
Accid Anal Prev ; 131: 275-283, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31344508

RESUMO

Adolescents' risky driving behaviours contribute to their over-representation in road trauma. Higher-order driving instruction is suggested to reduce such behaviours. To sustain positive behaviours in the long-term, self-determination theory identifies self-regulation as fundamental. The current research explored associations between higher-order driving instruction, risky driving behaviours, and a self-regulated safety orientation. Learner drivers (n = 544), aged 16-19 years, responded to a 91-item survey. Self-regulated safety orientation was found to fully mediate the relationship between higher-order driving instruction and inattentive risky driving behaviours, and between anticipatory higher-order driving instruction and intentional risky driving behaviours. A partial mediation was found between self-regulatory higher-order instruction and intentional risky driving behaviours. These results support that higher-order driving instruction, delivered to develop a self-regulated safety orientation, has potential to reduce young novice drivers' risky driving behaviours. Further research is recommended to triangulate these results through direct observation and longitudinal evaluation.


Assuntos
Acidentes de Trânsito/prevenção & controle , Condução de Veículo/educação , Assunção de Riscos , Acidentes de Trânsito/estatística & dados numéricos , Adolescente , Adulto , Condução de Veículo/psicologia , Feminino , Humanos , Masculino , Inquéritos e Questionários , Adulto Jovem
20.
BJOG ; 126(12): 1491-1497, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31334907

RESUMO

OBJECTIVE: To evaluate the association between marijuana use and a composite adverse pregnancy outcome using biological sampling. DESIGN: Retrospective cohort study. SETTING: Single tertiary center. POPULATION: Young women (13-22 years old) with singleton, non-anomalous pregnancies delivered from September 2011 to May 2017. METHODS: Exposure was defined as marijuana detected on universal urine toxicology testing or by self-report. Multivariable logistic regression modelling was used to estimate the effect of any marijuana use on the primary composite outcome. The effect of marijuana exposure was also estimated for self-reported use, toxicology-detected use, and multiple use detected by toxicology. MAIN OUTCOME MEASURE: The primary composite outcome included spontaneous preterm birth, hypertensive disorders of pregnancy, stillbirth, or small for gestational age. RESULTS: Of 1206 pregnant young women, 17.5% (n = 211) used marijuana. Among the women who used marijuana, 8.5% (n = 18) were identified by self-report alone, 63% (n = 133) by urine toxicology alone, and 28.4% (n = 60) by both. Urine toxicology testing results were available for 1092 (90.5%) births. The composite outcome occurred more frequently in pregnancies exposed to marijuana (46 versus 34%, P < 0.001). This remained significant after adjusting for race/ethnicity and tobacco in the multivariable model (adjusted OR 1.50, 95% CI 1.09-2.05). When marijuana exposure was defined by self-report only, the association with adverse pregnancy outcome became non-significant (adjusted OR 1.01, 95% CI 0.62-1.64). CONCLUSION: In a population of young women with nearly universal biological sampling, marijuana exposure was associated with adverse pregnancy outcomes. The heterogeneity of findings in existing studies evaluating the impact of marijuana on mothers and neonates may result from the incomplete ascertainment of exposure. TWEETABLE ABSTRACT: Marijuana use, as detected by universal urine testing, was associated with a composite adverse pregnancy outcome among young mothers.


Assuntos
Uso da Maconha/efeitos adversos , Mães , Complicações na Gravidez/epidemiologia , Assunção de Riscos , Adolescente , Estudos de Coortes , Colorado/epidemiologia , Feminino , Humanos , Recém-Nascido , Recém-Nascido Pequeno para a Idade Gestacional , Modelos Logísticos , Gravidez , Complicações na Gravidez/etiologia , Complicações na Gravidez/urina , Resultado da Gravidez , Cuidado Pré-Natal , Estudos Retrospectivos , Adulto Jovem
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