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1.
Pan Afr Med J ; 33: 302, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31692863

RESUMO

Introduction: People with disabilities have been identified as a key risk population for HIV. The aim of this study was to investigate HIV status, knowledge, attitudes, behaviours and its correlates in persons with and without disabilities in South Africa. Methods: Cross-sectional data of 26404 participants 15 years and older from the "2012 South African national HIV prevalence, incidence and behaviour survey" were analysed. Results: 1348(5.3%) had a disability. Persons with a disability were older (median age 52 years, IQR=24; versus 36 years, IQR=29), more often men, had a lower education and lower income and more likely living in a rural area than persons without disability. The prevalence of HIV infection was 16.7% in persons with disability, 23.0% in persons with visual/hearing or speech disability, 31.6% in persons with hearing disability and 16.2% in persons without disability. Antiretroviral (ARV) exposure in the HIV positive population was 41.3% among persons with disability and 30% in persons without disability. In multivariable logistic regression analysis, persons with disability had a lower odds to know an HIV testing site (Odds Ratio=OR: 0.46, Confidence Interval=CI: 0.22, 0.98) and a higher odds to have had two or more sexual partners in the past 12 months (OR 2.74, CI: 1.44, 5.21), had casual or transactional sex (OR: 6.25, CI: 2.57, 15.21) and psychological distress (OR: 2.10, CI: 1.50, 2.95) than persons without disability. In multivariable logistic regression analysis in both groups (with and without disability), psychological distress (OR: 2.90, CI: 1.53, 5.47, and OR: 1.90, CI: 1.20, 3.01, respectively) and high HIV stigma (OR: 0.31, CI: 0.25, 0.67, and OR: 0.57, CI: 0.34, 0.96, respectively) were associated with increased prevalence of HIV infection. Conclusion: The study found a high prevalence of HIV infection in persons with disabilities, in particular in those with hearing impairment. In some areas, persons with disability showed lower knowledge and higher risk behaviours than persons without disabilities. There is a need to strengthen HIV information and communication strategies geared towards targeting people with all types of disabilities.


Assuntos
Pessoas com Deficiência/estatística & dados numéricos , Infecções por HIV/epidemiologia , Conhecimentos, Atitudes e Prática em Saúde , Assunção de Riscos , Adolescente , Adulto , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Comportamento Sexual/estatística & dados numéricos , Parceiros Sexuais , África do Sul/epidemiologia , Inquéritos e Questionários , Adulto Jovem
2.
Rev Bras Epidemiol ; 22Suppl 1(Suppl 1): e190009, 2019.
Artigo em Inglês, Português | MEDLINE | ID: mdl-31576985

RESUMO

INTRODUCTION: Knowledge about risky sexual behavior among young people has been widely acknowledged as a key tool to controlling the spread of HIV. This article aimed at presenting the risk behavior of Brazilian Army conscripts toward HIV infection according to the country's geographic regions. . METHOD: We collected data from 37,282 conscripts, aged 17 to 22, during enlistment in the Brazilian Army in 2016. The prevalence of HIV infection, both self-reported and measured through laboratory results, and risk behavior factors were estimated by region. RESULTS: 75% of the sample of conscripts reported to have already started sexual activity, and the average age of their sexual initiation was 15. Condom use varied according to the type of sexual relationship, being lower among steady partners and greater among less stable relationships. HIV prevalence assessed by laboratory tests was 0.12% across the country and the highest prevalence was observed in the North region (0.24%). Alcohol and illicit drug usage was higher in the South region. DISCUSSION: The study allowed the observation of risk behavior monitoring for HIV infection among young Brazilians. Lower condom usage among steady partners may be contributing to an increase in the number of HIV-infected individuals. CONCLUSION: Results suggest the need to intensify prevention campaigns to disseminate safe sex practices among young people, in addition to the expansion of testing offer to this population.


Assuntos
Infecções por HIV/etiologia , Comportamentos de Risco à Saúde , Militares/estatística & dados numéricos , Adolescente , Adulto , Consumo de Bebidas Alcoólicas/efeitos adversos , Consumo de Bebidas Alcoólicas/epidemiologia , Brasil/epidemiologia , Preservativos/estatística & dados numéricos , Estudos Transversais , Geografia , Infecções por HIV/epidemiologia , Humanos , Masculino , Prevalência , Medição de Risco , Fatores de Risco , Comportamento Sexual/estatística & dados numéricos , Transtornos Relacionados ao Uso de Substâncias/complicações , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Adulto Jovem
3.
Pan Afr Med J ; 33: 168, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31565129

RESUMO

Introduction: Female condom awareness and use have been poorly documented in sub-Saharan region especially among street youths. This study assessed its awareness and use among street youths. Methods: A cross-sectional study was conducted among 964 youths between ages 15 to 24 years old using questionnaires to elicit information. Univariate and multivariate analysis were conducted at 5% level of significance. Results: More than half (69.9%) were males and between 20-25 years of age (61.2%). More than three-quarter (81.0%) had initiated sexual activity. Almost half (47.9%) of the respondents have heard about female condoms however only 16.8% have ever seen while 4.3% have actually ever used a female condom. Age, education, current sexual activity and experience of rape attempt were predictors of female condom awareness. Conclusion: Awareness of female condom was a significant predictor of utilization of female condoms. There is therefore a need for proper awareness and education on the effectiveness of female condoms.


Assuntos
Preservativos Femininos/estatística & dados numéricos , Conhecimentos, Atitudes e Prática em Saúde , Jovens em Situação de Rua/estatística & dados numéricos , Comportamento Sexual/estatística & dados numéricos , Adolescente , Fatores Etários , Estudos Transversais , Escolaridade , Feminino , Humanos , Masculino , Análise Multivariada , Nigéria , Inquéritos e Questionários , Adulto Jovem
4.
Cent Eur J Public Health ; 27(3): 223-228, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31580558

RESUMO

OBJECTIVE: Treponema pallidum and HIV are transmitted frequently through sexual contact, these agents with epidemiological similarities co-infect the same host. The current number of HIV-infected cases in Turkey is increasing. For this reason, we aimed to reveal the characteristics of syphilis in HIV/AIDS cases. METHODS: A retrospective longitudinal cohort study was performed, patients were followed up at 24 clinics in 16 cities from all seven regions of Turkey between January 2010 to April 2018. We examined the socio-demographic characteristics, laboratory parameters and neurosyphilis association in HIV/AIDS-syphilis co-infected cases. RESULTS: Among 3,641 patients with HIV-1 infection, 291 (8%) patients were diagnosed with syphilis co-infection. Most patients were older than 25 years (92%), 96% were males, 74% were working, 23% unemployed, and 3% were students. The three highest prevalence of syphilis were in Black Sea (10.3%), Mediterranean (8.4%) and Marmara Regions (7.4%). As for sexual orientation, 46% were heterosexuals, 42% men who have sex with men (MSM), and no data available for 12%. Patients with the number of CD4+ ≤ 350 mm3 reached 46%, 17% of the patients received antiretroviral therapy and neurosyphilis association reached 9%. CONCLUSION: Although HIV/AIDS-syphilis co-infection status appeared high in heterosexuals, MSM had a moderate level increase in cases. Our results suggested syphilis co-infection in HIV/AIDS cases should be integral part of monitoring in a national sexual transmitted diseases surveillance system. However, our data may provide base for HIV/syphilis prevention and treatment efforts in the future.


Assuntos
Coinfecção , Infecções por HIV , Minorias Sexuais e de Gênero , Sífilis , HIV , Infecções por HIV/epidemiologia , Homossexualidade Masculina/estatística & dados numéricos , Humanos , Estudos Longitudinais , Masculino , Prevalência , Estudos Retrospectivos , Comportamento Sexual/estatística & dados numéricos , Sífilis/epidemiologia , Turquia
5.
Zhonghua Yu Fang Yi Xue Za Zhi ; 53(9): 925-928, 2019 Sep 06.
Artigo em Chinês | MEDLINE | ID: mdl-31474075

RESUMO

Objective: To identify the status and risky factors of anal sexual intention in casual sex behavior in Zhejiang province. Methods: Stratified cluster sampling was conducted among college students in 13 colleges in 11 cities between October to November, 2018. 482 students were enrolled who self-reported "heterosexuality "and" ever had casual sex behavior". A self-designed network questionnaire was complimented containing basic information, knowledge of HIV, sexual behavior. Chi-square test was used to compared the difference of anal sex intention between different characteristic. The multivariate logistic regression methods was used to analyze the influence factors. Results: Among 482 students, the age was (20±1.442) years old. And 87.3% (421) were male and 29.0% (140) were from other province. The rate of anal sex intention were 19.4% (94/482) in total, with the rates of 38.1% (24/63) and 14.4% (53/367) in students with sexual number more than 5 and less than 5 (P<0.001), separately. Compared with students searching casual sexual partner with non-internet access (17.0%, 16/201), students searching sexual partner with internet access had higher risk of anal sex practice (27.8%, 78/281) (P<0.001). The rate of anal sex practice among students reporting "ever had casual sex after drinking "and" never had casual sex after drinking" were 30.5% (64/210) and 9.4% (25/266) (P<0.001). The multivariate logistic regression results revealed that compared with students searching casual sexual partner with non-internet access and reporting "never had casual sex after drinking", subjects searching sexual partner with internet access(OR (95%CI)=2.65 (1.34-5.23)) and "ever had casual sex after drinking" OR (95%CI)=3.02 (1.65-5.33) were more likely had higher risk of anal sex practice. Conclusion: Heterosexual college students in Zhejiang Province tend to have anal intercourse with causal sexual partners. Searching for causal sexual partners on internet or mobile phone dating software and having temporary sexual behavior after drinking were correlated factors.


Assuntos
Comportamentos de Risco à Saúde , Heterossexualidade , Comportamento Sexual , Adolescente , Adulto , China , Feminino , Humanos , Intenção , Masculino , Comportamento Sexual/estatística & dados numéricos , Parceiros Sexuais , Estudantes/estatística & dados numéricos , Inquéritos e Questionários , Adulto Jovem
6.
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
7.
Pan Afr Med J ; 32: 185, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31497185

RESUMO

Introduction: In 2015, in Dire Dawa administration city, adult HIV prevalence was 3.26 with 9,523 HIV positive population, & 251 annual AIDS deaths. Female sex workers are one of the high-risk groups for contracting HIV. Therefore, this study has assessed the level of HIV/AIDS knowledge, risk perception and condom utilization pattern among female sex workers' in Diredawa city. Methods: A cross-sectional study was conducted from April 15-June 25, 2016, in Dire Dawa among 156 female sex workers using convenient sampling method. Respondents were interviewed face-to-face using a pretested questionnaire. Training was provided to the data collectors and supervisors. Close supervision was done and double data entry was performed. Then the data were checked for completeness, consistency and entered into Epi Info v3.1 and analyzed using SPSS v20. The descriptive statistical analysis was used to compute frequency, mean, mode and proportion of the findings of this study. The results were presented using tables, charts, graphs, and texts. Results: Among the 156 female sex workers (FSWs), 99 (63.5%) had been working on commercial sex for more than one year, 92 (59%) were usually street-based, and 80 (51.3%) had partners between 2-3 per night. Only, 17 (10.9%) respondents mentioned three and above ways of HIV/AIDS transmission and prevention methods. Less than two-thirds (64.1%) of FSWs used a condom with all partners. One hundred thirty-eight (88.5%) of participants were engaged in unsafe sexual practice at least once since their engagement in sex work. Majority of FSWs (85.3%)) believed that their occupation is hazardous and 145 (92.9%) reported that they were unhappy being a commercial sex worker. Regarding risk perception, 79 (50.64%) and 37 (23.7%) of respondents perceived their chances of contracting HIV/STIs to be high and moderate respectively. Conclusion: Knowledge about HIV/STIs and magnitude of condom utilization were good. However, a high number of unsafe sex and unsatisfactory risk perception attitudes were observed. Thus, a collaborative effort is needed to create awareness regarding risk perception attitude and increase the level of their practice towards the prevention of unsafe sex.


Assuntos
Preservativos/estatística & dados numéricos , Conhecimentos, Atitudes e Prática em Saúde , Profissionais do Sexo/estatística & dados numéricos , Comportamento Sexual/estatística & dados numéricos , Adolescente , Adulto , Estudos Transversais , Etiópia/epidemiologia , Feminino , Infecções por HIV/epidemiologia , Infecções por HIV/prevenção & controle , Humanos , Prevalência , Trabalho Sexual/estatística & dados numéricos , Parceiros Sexuais , Doenças Sexualmente Transmissíveis/epidemiologia , Doenças Sexualmente Transmissíveis/prevenção & controle , Inquéritos e Questionários , Sexo sem Proteção/estatística & dados numéricos , Adulto Jovem
8.
BMC Public Health ; 19(1): 1103, 2019 Aug 14.
Artigo em Inglês | MEDLINE | ID: mdl-31412812

RESUMO

BACKGROUND: The family is one of the key factors that can contribute to reducing the negative consequences of high-risk sexual behavior. This study examines the influence of parents' communication with children on issues of sexuality on sexual behavior. METHODS: The study is based on a mixed research design. In 2013-2014, 1,359 people aged 18-30 years were randomly selected from urban areas covering the main university centers of Romania, and they completed a questionnaire with 60 items regarding sociodemographic data, family, sexual behavior and health risks. Out of the initial sample, 60 participants agreed to participate in face-to-face interviews, using a thematic interview guide. The quantitative data were analyzed using descriptive inferential statistics, including binary logistic regression. The qualitative data were investigated using thematic analysis. RESULTS: Exploring the issues of sexual and reproductive health (SRH) discussed with parents according to gender revealed that there was a greater concern in families to address issues of sexuality with girls. The manifestation of any form of sex education in the family was positively associated with a healthy sexual debut, both for women and men (χ2 = 7.759, χ2 = 7.866, p = 0.005). The results of the regression reinforced the idea that a lack of sex education in the family decreased the likelihood of a healthy sexual debut, both in women (OR: 0.668, p = 0.018) and in men (OR: 0.605, p = 0.013). In men, receiving information about sex at a younger age (OR: 0.335, p = 0.001) reduced the chance of a healthy sexual debut. Younger women and men were more likely than older women and men to experience a healthy sexual debut [odds ratio (OR): 1.861, p < 0.001 and OR: 1.644, p = 0.015, respectively]. Qualitative results revealed that SRH talks were generally initiated by young people, usually involved a parent of the same gender and often occurred after events in the sexual lives of young people (after first menstruation/after sexual debut). CONCLUSIONS: In designing health programs for adolescents and youth, the family should be involved in sex education. Modeling family sex education by gender can produce differentiated effects on the sexual debut of men and women.


Assuntos
Comunicação , Relações Pais-Filho , Pais/psicologia , Saúde Reprodutiva/educação , Educação Sexual/estatística & dados numéricos , Adolescente , Adulto , Feminino , Humanos , Masculino , Pesquisa Qualitativa , Romênia , Fatores Sexuais , Comportamento Sexual/estatística & dados numéricos , Inquéritos e Questionários , Adulto Jovem
9.
BMC Public Health ; 19(1): 1101, 2019 Aug 14.
Artigo em Inglês | MEDLINE | ID: mdl-31412838

RESUMO

BACKGROUND: Sexual behaviors reflect the degree of exposure to human immunodeficiency virus (HIV), hepatitis B virus (HBV), and hepatitis C virus (HCV), especially in people in sexually active stages, such as youths. Hill tribe people have their own cultures, beliefs and lifestyles related to their behaviors, including sexual behaviors, which may lead to HIV, HBV, and HCV infections, especially among youths. The study aimed to examine sexual behaviors and assess the seroprevalence of HIV, HBV, and HCV among hill tribe youths. METHODS: A cross-sectional study was conducted. The participants were recruited from 60 randomly selected hill tribe villages in Chiang Rai Province, Thailand. A validated questionnaire and 5 mL blood specimens were used to collect data. Data were collected by a self-reporting method. Rapid immunochromatographic tests were used to detect hepatitis B surface antibody (anti-HBs), hepatitis B surface antigen (HBsAg), hepatitis C antibody (anti-HCV), and human immunodeficiency virus antibody-I and- II (anti-HIV-1 and -2). Chi-square and Fisher's exact test were used to detect the associations between variables. RESULTS: A total of 1325 participants were recruited for the analysis. The majority were females (60.5%) and aged 15-17 years (58.9%). A total of 14.5% smoked, 22.4% drank alcohol, 14.2% were tattooed, and 61.4% had their ears pierced. Among the 30.3% who had sexual experience, 42.0% experienced one-night stands, 26.9% had sexual contact with a prostitute within 1 year prior to the study, 18.9% used alcohol prior to having sexual intercourse, and 15.7% had been tested for HIV/AIDS previously. Among males, 11.5% were males who had sex with males (MSM), and 4.6% were bisexual. Among females, 83.0% were females who had sex with males, and 5.0% were females who had sex with females. Different sexes and tribes were found to have significantly different risk behaviors and sexual behaviors, such as overall males having a greater proportion of sexual experience than females, and Lahu, Akha and Hmong had a higher proportion of sexual experience, having sexual experience with one-night stands, and having sexual experience with a prostitute 1 year prior to the study than others. Among the 836 obtained blood samples, none were positive for anti-HIV-I and -II, 6.4% were positive for anti-HBs, 1.9% were positive for HBsAg, and 0.2% were positive for anti-HCV. CONCLUSION: Hill tribe youths in Thailand are at risk of STIs such as HBV and HCV infections according to their risk behaviors and sexual behaviors, which differ between sexes and tribes. Effective behavioral interventions should be promoted among hill tribe youths to minimize the risk for these diseases in the future.


Assuntos
Infecções por HIV/epidemiologia , Hepatite B/epidemiologia , Hepatite C/epidemiologia , Grupos Populacionais/psicologia , Grupos Populacionais/estatística & dados numéricos , Comportamento Sexual/estatística & dados numéricos , Adolescente , Estudos Transversais , Feminino , Anticorpos Anti-HIV/sangue , HIV-1/imunologia , HIV-2/imunologia , Comportamentos de Risco à Saúde , Anticorpos Anti-Hepatite B/sangue , Antígenos de Superfície da Hepatite B/sangue , Anticorpos Anti-Hepatite C/sangue , Humanos , Masculino , Estudos Soroepidemiológicos , Inquéritos e Questionários , Tailândia/epidemiologia , Adulto Jovem
10.
BMC Public Health ; 19(1): 1142, 2019 Aug 20.
Artigo em Inglês | MEDLINE | ID: mdl-31429733

RESUMO

BACKGROUND: Adolescent pregnancy poses risks to the life of a young mother and her baby, and can affect their health, educational and future employment outcomes. In many low- and middle-income countries like the Philippines, the Demographic and Health Surveys (DHS) Program is among the most reliable and easily accessible sources of demographic and health data for researchers, development workers, and policymakers. Data on adolescent sexual and reproductive health (SRH) are often limited, but in the absence of other sources, there is room to make the most of the adolescent health data gathered by the DHS. The aim of this study is to explore what more can be learned about adolescent sexual initiation and pregnancy through the further analysis of demographic and health data, using DHS data from the Philippines as an example. METHODS: This study conducted trend analysis of DHS data over three survey rounds (2003, 2008 and 2013) to explore the context of adolescent sexual initiation and pregnancy over time. Bivariate and multivariate logistic regression were then used to study associations between adolescent pregnancy experience and selected demographic, socioeconomic and SRH variables using data from the 2013 DHS. RESULTS: This study found that between 2003 and 2013, proportions of Filipino young women experiencing adolescent sexual initiation and adolescent pregnancy have increased. Multivariate logistic regression affirmed the protective effect of education and belonging to higher wealth quintiles on the risk of adolescent pregnancy. Ever use of contraception was positively associated with adolescent pregnancy but is likely indicative of use after a prior pregnancy, and/or other factors relating to improper/inconsistent contraceptive use. CONCLUSIONS: In the absence of reliable, easily accessible data on adolescent SRH, the DHS data can provide important insights about adolescent reproductive transitions such as sexual initiation and first pregnancy. However, there are limited variables in the datasets that could proxy for other important social determinants which prior studies have linked to adolescent SRH outcomes. There remains a need for timely and targeted collection of quantitative and qualitative data on adolescent SRH that can guide programming and policy intended to foster positive health outcomes during this crucial transition period to adulthood.


Assuntos
Demografia/tendências , Gravidez na Adolescência/estatística & dados numéricos , Saúde Reprodutiva/tendências , Comportamento Sexual/estatística & dados numéricos , Saúde Sexual/tendências , Adolescente , Comportamento Contraceptivo/estatística & dados numéricos , Feminino , Humanos , Renda , Modelos Logísticos , Masculino , Filipinas/epidemiologia , Gravidez
11.
Pan Afr Med J ; 32: 182, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31404268

RESUMO

Introduction: Unintended pregnancies and adolescent childbearing are on the increase in Sub-Saharan Africa. In Ghana, 14% of adolescents aged 15-19 are already mothers or pregnant with their first child. Most of these pregnancies are associated with poor outcomes such as miscarriages, stillbirths, unsafe abortions and other complications that might result in infant or mortality. In addition, sexually-active adolescents (16-19 years) are at higher risk of contracting STIs. Evidence suggest that contraceptive use help reduce fertility rate and adolescent reproductive health. This study therefore sought to understand the magnitude and associated factors that influence female adolescents' use of contraceptive in the Atwima Kwanwoma District, Ghana. Methods: A descriptive and analytic cross-sectional study design was used for this study. Using a structured questionnaire, data were collected from randomly sampled 200 sexually active female adolescents; aged 16-19 for a three month period; June to September 2017. The questionnaire elicited data on the socio-demographic characteristics of respondents, their knowledge and perception, use of contraceptives and factors influencing their contraceptive use. Data were analyzed using STATA version 12.1 software. Results: Ninety-five percent of the respondents exhibited some knowledge about contraceptives, but this high knowledge did not translate into its use as the prevalence rate was 18%. Condom was the most widely used contraceptive (33%) and perceived side effects of contraceptives was found to be the main reason for not using the contraceptives (53.66%). Marital status and the participants who were staying with both parents were found to be associated with contraceptive use with their p-values of 0.023 and 0.002 respectively. Conclusion: Considering the fact that contraceptive knowledge does not necessarily translate into use, further studies (qualitative), are needed to understand why high knowledge levels are not associated with high usage patterns.


Assuntos
Preservativos/estatística & dados numéricos , Comportamento Contraceptivo/estatística & dados numéricos , Anticoncepção/estatística & dados numéricos , Conhecimentos, Atitudes e Prática em Saúde , Adolescente , Anticoncepcionais/administração & dosagem , Estudos Transversais , Feminino , Gana , Humanos , Estado Civil/estatística & dados numéricos , Comportamento Sexual/estatística & dados numéricos , Inquéritos e Questionários , Adulto Jovem
12.
BMC Infect Dis ; 19(1): 721, 2019 Aug 15.
Artigo em Inglês | MEDLINE | ID: mdl-31416439

RESUMO

BACKGROUND: Pre-exposure prophylaxis (PrEP) is a promising and effective tool to prevent human immunodeficiency virus (HIV) transmission; however, context-specific data to guide optimal implementation are currently lacking in China. This study aims to systematically collect comprehensive, empirical data to determine effective ways to implement PrEP among at-risk men who have sex with men (MSM) in China. METHODS: The CROPrEP project, a real-world study of PrEP use, will recruit 1000 high-risk HIV-negative MSM participants from four cities in China, who will be able to choose between daily or event-driven dosing regimens, according to their preference. Participants will be followed up at months 1, 3, 6, 9, and 12 for PrEP provision, clinical evaluation, laboratory testing (e.g., emtricitabine/tenofovir disoproxil fumarate (FTC/TDF) concentrations, and HIV/sexually transmitted infections), alongside detailed, self-administered online questionnaires regarding sexual behaviors, adherence, and attitudes. Online weekly notes will be used to record pill use and sexual practice. Various measurements will be triangulated to assess adherence, including: self-reported adherence, pill count, and drug concentration. A propensity score matching model will be fitted to examine the effectiveness of PrEP use in HIV seroconversion compared with non-PrEP users selected from a local expanding cohort study of HIV-1-negative MSM at participating research centers. Analyses using a generalized estimating equation model will focus on elucidation of the cascade of PrEP implementation, effectiveness, safety, and possible effects of PrEP use on sexual behaviors. This study will provide a comprehensive assessment of real-world PrEP use among Chinese MSM, to develop guidelines and strategies for PrEP implementation in China. DISCUSSION: The CROPrEP project is the first study of the TDF/FTC combination as PrEP in China, which will provide primary data on PrEP implementation, including: the cascade of PrEP use, "real-world" effectiveness, adherence, and safety. The findings from this study have potential to be vital for promoting the integration of PrEP within the portfolio of HIV prevention interventions and developing guidance on PrEP implementation in China. TRIAL REGISTRATION: ChiCTR-IIN-17013762 (Chinese Clinical Trial Registry). Date of registration: 8 December 2017.


Assuntos
Fármacos Anti-HIV/uso terapêutico , Infecções por HIV/prevenção & controle , Homossexualidade Masculina , Profilaxia Pré-Exposição/métodos , Adulto , China , Estudos de Coortes , Emtricitabina/uso terapêutico , Infecções por HIV/tratamento farmacológico , Humanos , Masculino , Estudos Multicêntricos como Assunto , Sexo Seguro , Autorrelato , Comportamento Sexual/estatística & dados numéricos , Minorias Sexuais e de Gênero , Inquéritos e Questionários , Tenofovir/uso terapêutico
14.
Int J Equity Health ; 18(1): 109, 2019 07 17.
Artigo em Inglês | MEDLINE | ID: mdl-31315627

RESUMO

BACKGROUND: Socio-economic and sexual orientation inequalities in cigarette smoking are well-documented; however, there is a lack of research examining the social processes driving these complex inequalities. Using an intersectional framework, the current study examines key processes contributing to inequalities in smoking between four intersectional groups by education and sexual orientation. METHODS: The sample (28,362 adults) was obtained from Wave 2 (2014-2015) of the Population Assessment of Tobacco and Health (PATH) Study. Four intersectional positions were created by education (high- and low-education) and sexual orientation (heterosexual or lesbian, gay, bisexual, or queer/questioning (LGBQ). The joint inequality, the referent socio-economic inequality, and the referent sexual orientation inequality in smoking were decomposed by demographic, material, tobacco marketing-related, and psychosocial factors using non-linear Oaxaca decomposition. RESULTS: Material conditions made the largest contribution to the joint inequality (9.8 percentage points (p.p.), 140.9%), referent socio-economic inequality (10.01 p.p., 128.4%), and referent sexual orientation inequality (4.91 p.p., 59.8%), driven by annual household income. Psychosocial factors made the second largest contributions to the joint inequality (2.12 p.p., 30.3%), referent socio-economic inequality (2.23 p.p., 28.9%), and referent sexual orientation inequality (1.68 p.p., 20.5%). Referent sexual orientation inequality was also explained by marital status (20.3%) and targeted tobacco marketing (11.3%). CONCLUSION: The study highlights the pervasive role of material conditions in inequalities in cigarette smoking across multiple dimensions of advantage and disadvantage. This points to the importance of addressing material disadvantage to reduce combined socioeconomic and sexual orientation inequalities in cigarette smoking.


Assuntos
Fumar Cigarros/epidemiologia , Comportamento Sexual/estatística & dados numéricos , Fatores Socioeconômicos , Adulto , Bissexualidade/estatística & dados numéricos , Feminino , Heterossexualidade/estatística & dados numéricos , Humanos , Masculino , Pessoa de Meia-Idade , Minorias Sexuais e de Gênero/estatística & dados numéricos
15.
Einstein (Sao Paulo) ; 17(3): eAO4782, 2019 Jun 27.
Artigo em Inglês, Português | MEDLINE | ID: mdl-31271610

RESUMO

OBJECTIVE: To determine the prevalence of risky sexual behavior and its association with overweight and obesity among adolescent students. METHODS: This is a cross-sectional study, conducted in public schools with adolescents aged 12 to 17 years. We used the questionnaire Youth Risk Behavior Survey. The body mass index percentiles were calculated by means of table from the Center for Control and Prevention of Diseases. Possible associations were assessed using the χ2 test and binary logistic regression model. The odds ratio and 95%CI were calculated. RESULTS: We evaluated 1,169 students, and 33.9% reported having had sexual intercourse. Of those, 33% did not use a condom during their last intercourse, and 32.7% had had four or more sexual partners thus far. Regarding nutritional status, 15.3% were overweight or obese. In relation to the non-use of condoms, we observed only an association with the number of lifetime sexual partners (OR: 0.50; 95%CI: 0.28-0.88). The number of lifetime sexual partners was associated with males (OR: 9.17; 95%CI: 4.16-20.22), sexual debut age at 13 years or less (OR: 2.51; 95%CI: 1.23-5.13) and drinking alcohol or using drugs before the last intercourse (OR: 6.16; 95%CI: 2.14-17.73). CONCLUSION: Risky sexual behavior rates were high and no association was found between risky sexual behaviors and overweight and obesity.


Assuntos
Comportamento do Adolescente/psicologia , Obesidade/psicologia , Sobrepeso/psicologia , Comportamento Sexual/psicologia , Comportamento Sexual/estatística & dados numéricos , Adolescente , Índice de Massa Corporal , Criança , Estudos Transversais , Humanos , Obesidade/complicações , Sobrepeso/complicações , Assunção de Riscos , Fatores Sexuais , Parceiros Sexuais
16.
Afr J AIDS Res ; 18(2): 130-137, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31282303

RESUMO

The incidence of HIV infection is increasing among adolescents in Zimbabwe. This rise in incidence is partly due to risky sexual behaviours yet there are no published research studies on sexual behaviours of HIV-positive adolescents in Zimbabwe. Hence, this study, which examined the sexual behaviours of HIV-positive adolescents. This study utilised a cross-sectional design with a conveniently selected sample of 341 HIV-positive adolescents. Data were collected through a questionnaire. Data were analysed using descriptive and analytical statistics. The study revealed that approximately 37 (11%) of the adolescents had engaged in sexual intercourse, and approximately 14 (60%) of these did not use condoms. Approximately 11 (30%) of the sexually active adolescents had multiple sexual partners, and only 9 (24.3%) of them had disclosed their HIV serostatus to their partners before sexual intercourse. A bivariate analysis revealed factors that were associated with being sexually activity. Examples of these include age (OR = 1.56, p < 0.001) and being treated by a psychiatrist (OR = 47.9, p < 0.001). A multivariate logistic regression analysis was carried out, revealing factors that were independently associated with being sexually active. Examples of these include age (AOR = 1.91, p < 0.01) and exposure to erotic television programmes (AOR = 3.9, p < 0.04). The results of the study indicate that the sexual risk behaviours of HIV-positive adolescents contributes to the increase in incidence and prevalence of HIV/AIDS in Zimbabwe. The development and rolling out of a health education programme will help health care workers to address this concern.


Assuntos
Comportamento do Adolescente/psicologia , Infecções por HIV/psicologia , Comportamento Sexual/psicologia , Adolescente , Saúde do Adolescente , Preservativos/estatística & dados numéricos , Estudos Transversais , Feminino , HIV/fisiologia , Infecções por HIV/epidemiologia , Infecções por HIV/virologia , Promoção da Saúde , Humanos , Masculino , Comportamento Sexual/estatística & dados numéricos , Parceiros Sexuais/psicologia , Zimbábue/epidemiologia
17.
Pan Afr Med J ; 32: 1, 2019.
Artigo em Francês | MEDLINE | ID: mdl-31182986

RESUMO

Introduction: In Africa, sex life after menopause remains an under-explored topic due to the fact that it is a taboo. This study aims to evaluate the quality of couple's sex life during menopause. Methods: We conducted a cross-sectional survey of a representative sample of 320 postmenopausal women. The inclusion criteria were natural menopause. Patients who had experienced early or iatrogenic menopause were excluded. Investigation form was divided into 4 sections: social and cultural characteristics, clinical data, psycho-sexual data and therapeutic data. Comparison of proportions and chi-squared test with a significance threshold of less than 0.05 were used. Results: The average age of women was 60 years; the average age of onset of menopause was 48 years and the age of the menopause was 11.3 years. All woman suffered from climacteric syndrome. Hot flushes occured in 85.9% of women, vaginal dryness in 62.8% and urinary disorders in 52.5%. Only married women reported having sex with their partner (62.1%). Women had sex occasionally in 68.9% of cases, while 18.1% of women reported no sexual activity. Decreased sexual activity was due to partner's erectile dysfunction (62% of couples) and the lack of sexual desire (83.5% of women). Lack of sexual appetite and orgasm were also reported in 92% and 100% of cases. However, 93.5% of married women thought their life was bearable. Conclusion: Marital status, dyspareunia, vaginal dryness and partner's erectile dysfunction have a significant impact on sexuality of menopausal women in Senegal.


Assuntos
Pós-Menopausa , Comportamento Sexual/estatística & dados numéricos , Disfunções Sexuais Fisiológicas/epidemiologia , Sexualidade/estatística & dados numéricos , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos Transversais , Dispareunia/epidemiologia , Disfunção Erétil/epidemiologia , Feminino , Humanos , Masculino , Menopausa/fisiologia , Pessoa de Meia-Idade , Senegal , Parceiros Sexuais , Inquéritos e Questionários , Doenças Vaginais/epidemiologia
18.
BMC Public Health ; 19(1): 821, 2019 Jun 25.
Artigo em Inglês | MEDLINE | ID: mdl-31238911

RESUMO

BACKGROUND: The human papillomavirus (HPV) is the most common sexually transmitted infection and is linked to several types of cancer. HPV vaccination uptake in the U.S. is relatively low, despite the vaccine's high efficacy. Some parents of adolescents have concerns that vaccination will encourage sexual behavior and therefore choose not to vaccinate. Previous studies investigating vaccination and sexual behavior have included only young women and girls. METHODS: The objective of this study is to assess associations between HPV-vaccination and sexual behavior in a college-age cohort of both men and women. We analyzed questionnaire data collected from the Michigan HPV and Oropharyngeal Cancer Study, a cohort study designed to investigate HPV infection and its association with sexual behavior (data collected 2015-17, Ann Arbor, MI). Here, we consider vaccination status, sexual behavior, and substance use among 241 college-aged men and women. Logistic, Poisson, and Cox regression were used to determine the relationship between probability of sexual debut, number of sexual partners, and HPV vaccination status at baseline as well as between age at sexual debut and vaccination status at debut. RESULTS: HPV vaccination status was not significantly associated with an increased likelihood of sexual debut (odds ratio: 0.80 (95% CI: 0.41-1.58), decreased age of sexual debut (hazard ratio: 0.81 (95% CI: 0.65-1.00), nor an increased number of sexual partners (per year sexually active; incidence rate ratio: 1.27 (95% CI: 0.86-1.87)) in this cohort, after controlling for age, race, sex, and substance use. Instead, race or alcohol use were independent predictors of sexual behavior. CONCLUSIONS: Concerns about the influence of the HPV vaccine on sexual behavior are likely unfounded for both men and women. These results can aid in increasing vaccine acceptability, inform and strengthen physician recommendations, and ultimately reduce the burden of HPV and HPV-related cancers in the U.S.


Assuntos
Vacinas contra Papillomavirus/administração & dosagem , Comportamento Sexual/psicologia , Comportamento Sexual/estatística & dados numéricos , Adolescente , Estudos de Coortes , Feminino , Humanos , Masculino , Michigan , Universidades , Adulto Jovem
19.
BMC Public Health ; 19(1): 722, 2019 Jun 10.
Artigo em Inglês | MEDLINE | ID: mdl-31182070

RESUMO

BACKGROUND: The HIV prevalence among men who have sex with men (MSM) in China has increased yearly. This study aimed to explore the association between the characteristics of social communication and condomless anal intercourse (CAI) among MSM and the implications for prevention and control of HIV among MSM in China using an egocentric network framework. METHODS: The data were collected in Guangzhou between November 2016 and May 2017 through standardized face-to-face interviews. The participants were recruited among MSM who received voluntary counselling and testing services (VCT) provided by nongovernmental organizations (NGOs) and the local Centers for Disease Control and Prevention (CDC). We used the framework of the egocentric network analysis, the odd ratios of CAI were analyzed using generalized estimating equations (GEE). RESULTS: In total, 1073 MSM who nominated 2667 sexual partners were sampled. MSM who were approximately 30 years old and chose sexual partners of different age category were more likely to engage in CAI. Participants with high level education who were in partnerships with individuals with lower education levels had a higher risk of CAI. Participants who reported having a strong relationship with their sexual partners(AOR = 1.31) were associated with a higher probability of experiencing CAI during sex; while having sexual partners who were unmarried (OR = 0.56), and participants who reported meeting sexual partners online (AOR = 0.74) or, having sex with an occasional partner (AOR = 0.44)were less likely to engage in CAI. CONCLUSION: Our study indicates that the strength of sexual dyadic relational ties and different social communication mixing patterns across ages, educational categories, and marital status were associated with CAI.


Assuntos
Preservativos/estatística & dados numéricos , Homossexualidade Masculina/estatística & dados numéricos , Comportamento Sexual/estatística & dados numéricos , Minorias Sexuais e de Gênero/estatística & dados numéricos , Sexo sem Proteção/estatística & dados numéricos , Adulto , China/epidemiologia , Infecções por HIV/epidemiologia , Infecções por HIV/prevenção & controle , Homossexualidade Masculina/psicologia , Humanos , Masculino , Estado Civil , Pessoa de Meia-Idade , Razão de Chances , Prevalência , Comportamento Sexual/psicologia , Parceiros Sexuais , Minorias Sexuais e de Gênero/psicologia , Sexo sem Proteção/psicologia
20.
Int J Behav Med ; 26(4): 449-453, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31218560

RESUMO

BACKGROUND: Syndemic approaches explore the synergistic relationships between social and health inequities. Such approaches are particularly salient for the Northwest Territories, Canada, that experiences national social (food insecurity, intimate partner violence [IPV]) and health (sexually transmitted infections [STI]) disparities. Safer sex efficacy (SSE) includes knowledge, intention, and relationship dynamics that facilitate safer sex negotiation. We examined factors associated with SSE among NWT adolescents. METHODS: We conducted a cross-sectional survey with a venue-based sample of adolescents aged 13-17 in 17 NWT communities from 2016 to 2017. Summary statistics and statistical comparisons were conducted, followed by crude and adjusted multivariable regression models to assess factors associated with SSE. RESULTS: Among participants (n = 610; mean age 14.2 years [SD 1.5]; 49.5% cisgender women, 48.9% cisgender men, 1.6% transgender persons; 73.3% Indigenous), one-quarter (n = 144; 23.6%) reported food insecurity and nearly one-fifth (n = 111; 18.2%) IPV. In adjusted analyses, among young women, food insecurity (ß - 1.89[CI - 2.98, - 0.80], p = 0.001) and IPV (ß - 1.31[CI - 2.53, - 0.09], p = 0.036) were associated with lower SSE, and currently dating was associated with increased SSE (ß 1.17[CI 0.15, 2.19], p = 0.024). Among young men, food insecurity (ß - 2.27[CI - 3.39, - 1.15], p = 0.014) was associated with reduced SSE. Among sexually active participants (n = 115), increased SSE was associated with consistent condom use among young women (ß 1.40[0.19, 2.61], p = 0.024) and men (ß 2.14[0.14, 4.14], p = 0.036). CONCLUSIONS: Food insecurity and IPV were associated with lower SSE-a protective factor associated with consistent condom use-underscoring the need to address poverty and violence to advance adolescent sexual health in the NWT.


Assuntos
Abastecimento de Alimentos/estatística & dados numéricos , Grupos Populacionais/estatística & dados numéricos , Pobreza/estatística & dados numéricos , Sexo Seguro/estatística & dados numéricos , Comportamento Sexual/estatística & dados numéricos , Adolescente , Regiões Árticas/epidemiologia , Estudos Transversais , Feminino , Disparidades nos Níveis de Saúde , Humanos , Relações Interpessoais , Masculino , Negociação , Territórios do Noroeste/epidemiologia , Análise de Regressão , Sindemia
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