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1.
J Homosex ; 67(2): 189-205, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-30372375

RESUMO

Previous research has indicated that the sexual orientation of a sexual assault victim influences perceptions of blame. Although researchers have studied perceptions of blame toward straight and lesbian sexual assault victims, none have yet assessed perceptions of blame toward bisexual victims. The purpose of the current study is to examine perceptions of blame toward a female sexual assault victim and to determine whether the victim's sexual orientation impacts the level of attributed blame. Despite no previous research examining the impact of bisexuality on victim blaming, misconceptions that bisexual females are highly sexual, promiscuous, and untrustworthy make it likely that this population would be subject to greater levels of blame than either straight or lesbian victims. After random assignment to a vignette description of a sexual assault and completion of a victim-blaming questionnaire, results failed to support our hypotheses; participants did not blame the bisexual victim of sexual assault more than either the straight or lesbian victims. Further contrary to expected findings, males did not hold more blaming attitudes than females across conditions. Nonetheless, this study is important given the finding that attributions of blame influence whether sexual assault victims choose to disclose their assault, the failure of which can lead to negative mental health outcomes. Ultimately, the current study was a first step in understanding whether bisexual assault victims are evaluated differently than their straight and lesbian counterparts.


Assuntos
Vítimas de Crime/psicologia , Delitos Sexuais/psicologia , Comportamento Sexual/psicologia , Adulto , Atitude , Bissexualidade/psicologia , Revelação , Feminino , Homossexualidade Feminina/psicologia , Humanos , Percepção Social , Responsabilidade Social , Inquéritos e Questionários
2.
J Homosex ; 67(2): 159-173, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-30403564

RESUMO

Studies of adults who experienced sexual orientation change efforts (SOCE) have documented a range of health risks. To date, there is little research on SOCE among adolescents and no known studies of parents' role related to SOCE with adolescents. In a cross-sectional study of 245 LGBT White and Latino young adults (ages 21-25), we measured parent-initiated SOCE during adolescence and its relationship to mental health and adjustment in young adulthood. Measures include being sent to therapists and religious leaders for conversion interventions as well as parental/caregiver efforts to change their child's sexual orientation during adolescence. Attempts by parents/caregivers and being sent to therapists and religious leaders for conversion interventions were associated with depression, suicidal thoughts, suicidal attempts, less educational attainment, and less weekly income. Associations between SOCE, health, and adjustment were much stronger and more frequent for those reporting both attempts by parents and being sent to therapists and religious leaders, underscoring the need for parental education and guidance.


Assuntos
Homossexualidade/psicologia , Pais , Comportamento Sexual/psicologia , Adulto , Estudos Transversais , Depressão/psicologia , Relações Familiares , Feminino , Humanos , Masculino , Saúde Mental , Pais/psicologia , Minorias Sexuais e de Gênero , Ideação Suicida , Tentativa de Suicídio , Adulto Jovem
3.
J Clin Nurs ; 29(1-2): 94-106, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31509294

RESUMO

AIMS AND OBJECTIVES: To describe the experiences and wishes of lesbian and bisexual women concerning health care in Finland. BACKGROUND: Sexual orientation is a personal aspect of identity and also an important aspect of holistic health care. Lesbian and bisexual women have unmet health needs. The way that healthcare personnel encounter lesbian and bisexual women affects whether they disclose their sexual orientation. DESIGN: Qualitative inductive survey. METHODS: The research data for this study were collected in spring 2018 using an electronic survey (n = 22). The data were analysed using inductive content analysis. The research report has been checked using COREQ checklist, see Appendix S1. RESULTS: The research data were divided into two main domains: experiences and wishes. Women described health care as being heteronormative. They had both good and bad experiences, and their own poor experiences and those of others had a negative impact on their utilisation of healthcare services. Women had apprehensions about encountering stereotyping in health care and did not always disclose their orientation, even though recognising it would be integral to the provision of holistic health care. Lesbian and bisexual women wished that health care would refrain from heteronormativity, acknowledge issues that were important to them and engage with them without any prejudgement. They also wished healthcare environments would be improved to reflect an open acceptance of sexual minorities and also co-operate with sexual minority organisations. CONCLUSIONS: Women had conflicting experiences. Heteronormativity was seen as an obstacle for holistic health care. Women hoped health care would collaborate with the third sector. RELEVANCE TO CLINICAL PRACTICE: Sexual diversity should be acknowledged and better communicated to patients. Women hoped personnel would have the understanding to treat them in the same professional way as any other patients, but with expertise specific to their needs, for example in sexual health guidance.


Assuntos
Revelação , Satisfação do Paciente , Relações Profissional-Paciente , Minorias Sexuais e de Gênero/psicologia , Adulto , Atitude do Pessoal de Saúde , Feminino , Finlândia , Humanos , Masculino , Pessoa de Meia-Idade , Pesquisa Qualitativa , Qualidade da Assistência à Saúde , Comportamento Sexual/psicologia , Cônjuges , Inquéritos e Questionários
4.
Estud. pesqui. psicol. (Impr.) ; 19(3): 665-685, dez. 2019. tab
Artigo em Português | LILACS, Index Psicologia - Periódicos técnico-científicos | ID: biblio-1045992

RESUMO

Pesquisas sobre sexting vêm abordando quantitativamente aspectos da individualidade dos adolescentes, desconsiderando suas percepções. Portanto, o objetivo dessa pesquisa qualitativa e descritiva foi conhecer a percepção de adolescentes sobre o sexting e sobre o papel das relações familiares no fenômeno. Foram realizadas entrevistas semiestruturadas com seis adolescentes entre 14 e 17 anos de uma escola da região metropolitana de Porto Alegre, com ou sem envolvimento em sexting. A partir da análise de conteúdo, os resultados mostraram que o fenômeno foi descrito como comum e não negativo. Entretanto, os participantes o descreveram como problemático caso ocorra o compartilhamento não autorizado. O exemplo dos pais e o diálogo na família foram percebidos como influenciadores de sexting ativo. Sugere-se que educadores, pais e terapeutas não o qualifiquem pejorativamente. Também que ampliem a comunicação sobre sexualidade para além do caráter informativo, bem como a discussão dos riscos de exposição que o compartilhamento não autorizado do sexting acarreta.(AU)


Sexting research has quantitatively addressed aspects of adolescent individuality, disregarding their perceptions. Therefore, the purpose of this qualitative and descriptive research was to know the adolescents' perception about sexting and the role of family relationships in the phenomenon. Semi-structured interviews were conducted with six adolescents between 14 and 17 years of age from a school in the metropolitan region of Porto Alegre city, with or without involvement in sexting. From the content analysis, the results showed that the phenomenon was described as common and non-negative. However, participants described it as problematic if unauthorized sharing occurs. Parents' example and the dialogue in the family were perceived as influencers of active sexting. It is suggested that educators, parents and therapists do not qualify the phenomenon pejoratively. Also, they should extend communication about sexuality beyond the informational aspect, as well as the discussion of the exposure risks that the unauthorized sharing of sexting entails.(AU)


Las encuestas sobre sexting vienen abordando cuantitativamente aspectos de la individualidad de los adolescentes, desconsiderando sus percepciones. Por lo tanto, el objetivo de esta investigación cualitativa y descriptiva fue conocer la percepción de adolescentes sobre el sexting y del papel de las relaciones familiares en el fenómeno. Se realizaron entrevistas semiestructuradas con seis adolescentes entre 14 y 17 años de una escuela de la región metropolitana de Porto Alegre, con o sin participación en sexting. A partir del análisis de contenido, los resultados mostraron que el fenómeno fue descrito como común y no negativo. Sin embargo, los participantes lo describieron como problemático si se produce un intercambio no autorizado. El ejemplo de los padres y el diálogo en la familia fueron percibidos como influyentes de sexting activo. Se sugiere que los educadores, padres y terapeutas no lo califiquen peyorativamente. También que amplíen la comunicación sobre sexualidad más allá del carácter informativo, así como la discusión de los riesgos de exposición que el compartir no autorizado del sexting acarreta.(AU)


Assuntos
Humanos , Masculino , Feminino , Adolescente , Comportamento Sexual/psicologia , Internet , Adolescente
6.
Afr J Reprod Health ; 23(3): 19-29, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31782628

RESUMO

Globally, few programs consider the needs of first-time young parents (FTYPs), who face disproportionate negative health consequences during pregnancy and childbirth. Scant evidence exists on FTYPs' broader health needs. Formative research in two regions of Madagascar used a socio-ecological lens to explore, via 44 interviews and 32 focus group discussions, the influences on FTYPs at the individual, couple, family, community, and system levels. We spoke with FTYPs who had, and who had not, used sexual and reproductive health (SRH) services, their parents/kin and influential adults, and community health workers and facility health providers. Data analysis, guided by a codebook, used Atlas.ti. Age, social position, and implicit power dynamics operating within and across socio-ecological levels affected FTYPs' service-seeking behaviors. The nature and extent of influence varied by health service type. Cross-cutting social factors affecting service use/non-use included gender dynamics, pressures from mothers, in-laws, and family tradition, and adolescent stigmatization for too-early pregnancy. Structural and economic factors included limited awareness of and lack of trust in available services, unfriendliness of services, and FTYPs' limited financial resources. A socio-ecological program perspective can inform tailoring of activities to address broader SRH issues, including how relationships, gender, power, and intergenerational dynamics influence service use.


Assuntos
Conhecimentos, Atitudes e Prática em Saúde , Acesso aos Serviços de Saúde , Pais/psicologia , Serviços de Saúde Reprodutiva/estatística & dados numéricos , Adolescente , Estudos Transversais , Família , Feminino , Grupos Focais , Humanos , Madagáscar , Masculino , Gravidez , Pesquisa Qualitativa , Saúde Reprodutiva/etnologia , Comportamento Sexual/etnologia , Comportamento Sexual/psicologia , Adulto Jovem
7.
BMC Public Health ; 19(1): 1529, 2019 Nov 15.
Artigo em Inglês | MEDLINE | ID: mdl-31729969

RESUMO

BACKGROUND: Human papillomavirus (HPV) has been associated with certain types of oropharyngeal cancers and yet, the level of knowledge that dental professionals and the lay public have in terms of HPV transmission, oral sexual activities, and oral cancer development needs exploration. The aim of this study was to assess the knowledge held by practicing dental professionals as well as the lay public regarding Human Papillomavirus (HPV) transmission through oral sex and subsequent oropharyngeal cancer development. METHODS: Textual data were collected from a public forum with dental professionals in. Vancouver, who discussed the HPV-oral sex-oral cancer triad, and from survey data gathered from 212 lay public participants (also in Vancouver) who answered a 13-item questionnaire on the perceived risks of oral sex in terms of HPV infection and oropharyngeal cancer development. The data were analyzed statistically by age group, gender, and sexual orientation using descriptive statistics, while an ANOVA test was used to compare variation in the responses to the survey (p-value = 0.05). RESULTS: The forum engaged 46 health care professionals, many of whom were aware of the potential risks for head and neck cancer development due to HPV infection, while also questioning "how to effectively talk about HPV with patients." The survey revealed that 34.5% of the participants believed that oral sex is an activity with no or low risk for the transmission of HPV, while 84% of participants believed the same sexual practices were of low or no-risk for HIV (Human Immunodeficiency Virus) transmission. Most participants (82%) never discussed oral sexual activities with their physicians or dentists/dental hygienists. CONCLUSIONS: The general public remains mostly unaware of the potential links between HPV infection and oropharyngeal cancer. Physicians and dental providers should discuss oral sexual practice with their patients to raise awareness.


Assuntos
Conhecimentos, Atitudes e Prática em Saúde , Neoplasias Bucais/psicologia , Neoplasias Orofaríngeas/psicologia , Infecções por Papillomavirus/psicologia , Comportamento Sexual/psicologia , Adulto , Recursos Humanos em Odontologia/psicologia , Feminino , Infecções por HIV/psicologia , Infecções por HIV/transmissão , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias Bucais/virologia , Neoplasias Orofaríngeas/virologia , Papillomaviridae , Infecções por Papillomavirus/transmissão , Infecções por Papillomavirus/virologia , Inquéritos e Questionários
8.
BMC Public Health ; 19(1): 1360, 2019 Oct 24.
Artigo em Inglês | MEDLINE | ID: mdl-31651293

RESUMO

BACKGROUND: HIV-infected men who have sex with men (MSM) who use recreational drugs (RD) or excessive alcohol (EA) may be involved in risky sexual behaviours, including unprotected anal intercourse (UAI). This study describes the prevalence RD/EA-use among HIV-infected MSM, and compares those who used RD/EA with those who did not. METHODS: This cross-sectional study included HIV-infected MSM who were recruited in a convenient sample from two AIDS-treatment centres and events for HIV-infected MSM in Israel in 2016. Participants completed anonymous questionnaires including RD/EA-use and their sexual behaviours. RD/EA-use was defined as consumption of any psychoactive stimulants or dissociative anaesthetics, or an uptake of alcohol until drunkenness before or during sex. RESULTS: Of all 276 HIV-infected MSM, 202 (73.2%) used RD/EA. Those who used RD/EA were younger, reported earlier sexual debut, had more sexual partners, were more likely to perform UAI with casual partners, more commonly involved in paid sex, used psychiatric medications and more likely to be unsatisfied with their health-status compared to those who did not use RD/EA. HIV-infected MSM who used RD/EA reported a lower CD4-count and higher viral-load than those who did not. In a multivariate analysis, being younger, reported earlier sexual debut and been prescribed psychiatric drugs were associated with RD/EA-use among HIV-infected MSM. CONCLUSIONS: A large proportion of HIV-infected MSM used RD/EA and also engaged in risky sexual behaviours. A subset of HIV-infected MSM can benefit from mental support during their routine treatment at the AIDS treatment centres and should also receive harm reduction intervention by their providers in order to minimize potential risks pertaining to RD/EA-use.


Assuntos
Alcoolismo/epidemiologia , Infecções por HIV/epidemiologia , Homossexualidade Masculina/psicologia , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Adulto , Estudos Transversais , Homossexualidade Masculina/estatística & dados numéricos , Humanos , Israel/epidemiologia , Masculino , Pessoa de Meia-Idade , Assunção de Riscos , Comportamento Sexual/psicologia , Comportamento Sexual/estatística & dados numéricos , Inquéritos e Questionários
9.
BMC Health Serv Res ; 19(1): 746, 2019 Oct 24.
Artigo em Inglês | MEDLINE | ID: mdl-31651300

RESUMO

BACKGROUND: Globally, female sex workers (FSWs) are considered a key population group due to the high HIV prevalence. Studies show that there are various factors in some contexts that render FSWs marginalised, which limits their access to sexual reproductive health (SRH) services. Access to SRH services are particularly challenging in countries where sex work is criminalised such as is the case in South Africa. Evidently, there are alternative ways in which FSWs in this context receive non-stigmatising SRH care through non-governmental organisations. The aim of this study was to understand the functioning of these non-governmental health care services as well as to document the experiences of FSWs utilising these services. METHODS: Eleven focus group discussions were held with 91 FSWs. In addition, 21 in-depth individual interviews with researchers, stakeholders and FSWs were conducted. Interview guides were utilised for data collection. Informed consent was obtained from all participants. Data were analysed thematically. RESULTS: The FSWs expressed challenges related to SRH care access at public health facilities. The majority felt that they could not consult for SRH-related services because of stigma. The non-governmental health and advocacy organisations providing SRH services to FSWs through their mobile facilities utilising the peer approach, have done so in a way that promotes trust between FSWs and mobile health care providers. FSWs have access to tailored services, prevention materials as well as health information. This has resulted in the normalising of HIV testing as well as SRH seeking behaviours. CONCLUSION: This study has established that health and advocacy organisations have attempted to fill the gap in responding to SRH care needs of FSWs amidst intersecting vulnerabilities. FSWs' engagement with these organisations has encouraged their willingness to test for HIV. However, it is important to note that these organisations operate in urban areas, thus FSWs operating outside these areas are most likely exposed to compounding health risks and lack access to tailored services.


Assuntos
Acesso aos Serviços de Saúde , Serviços de Saúde Reprodutiva/estatística & dados numéricos , Profissionais do Sexo/estatística & dados numéricos , Adulto , Atitude Frente a Saúde , Utilização de Instalações e Serviços , Feminino , Grupos Focais , Infecções por HIV/prevenção & controle , Pessoal de Saúde , Disparidades em Assistência à Saúde/estatística & dados numéricos , Humanos , Programas de Rastreamento , Pessoa de Meia-Idade , Organizações/estatística & dados numéricos , Defesa do Paciente , Papel Profissional , Profissionais do Sexo/psicologia , Comportamento Sexual/psicologia , Estigma Social , África do Sul , Adulto Jovem
10.
Afr Health Sci ; 19(2): 1888-1896, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31656472

RESUMO

Background: Adolescents experience high rates of depression, initiation of sexual activity, and substance use. Objectives: To better understand the demographics of adolescents presenting to an adolescent clinic in Uganda, and to elucidate which factors are associated with depressive symptoms, sexual initiation, and substance use. Methods: A retrospective review was performed on intake forms obtained during interviews with adolescents presenting to the Makerere/Mulago Columbia Adolescent Health Clinic (MMCAH) in Kampala, Uganda. Results: Depressive symptoms in adolescents were correlated with having a chronic illness (p=.026), and reported poor quality of home life (p<.001). Initiation of sexual activity was also correlated with chronic illness (p=.008) and poor quality of home life (p=.006). Substance use was correlated with maternal death (p=.041), chronic illness (p=.038), and substance use among family members (p<.001) and friends (p<.001). Conclusions: Knowing the aforementioned risk factors can help us better understand the needs of adolescents presenting to MMCAH, and allows us to develop targeted interventions aimed at decreasing health risks in Kampala's adolescent population.


Assuntos
Depressão/epidemiologia , Comportamento Sexual/psicologia , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Adolescente , Serviços de Saúde do Adolescente , Criança , Depressão/diagnóstico , Depressão/psicologia , Feminino , Humanos , Masculino , Qualidade de Vida , Estudos Retrospectivos , Fatores de Risco , Uganda/epidemiologia , Adulto Jovem
11.
BMC Public Health ; 19(1): 1394, 2019 Oct 28.
Artigo em Inglês | MEDLINE | ID: mdl-31660935

RESUMO

BACKGROUND: Alcohol misuse is an important contributor to sexual acquisition and transmission of HIV in military communities. This cross-sectional study quantified the prevalence of probable problematic alcohol use among male service members in the Armed Forces of the Democratic Republic of the Congo (FARDC), identified associated factors, and investigated associations of alcohol misuse with risky sexual behaviors. METHODS: Participants included 2549 active duty male soldiers ≥ 18 years old. Data were collected via computer-assisted personal-interview from October 2013-April 2014. The Alcohol Use Disorders Identification Test (AUDIT) was used to identify probable problematic alcohol use (AUDIT score ≥ 8) compared to no/low-risk alcohol use (AUDIT score ≤ 7). Bivariate logistic regressions were used to identify factors associated with probable problematic alcohol use. Several multivariable logistic regressions (adjusted for age, marital status, education level) were used to examine associations of probable problematic alcohol use with risky sexual behaviors. Tests were two sided; statistical significance was defined as p < 0.05. RESULTS: Fifteen percent of men screened positive for probable problematic alcohol use. The odds of probable problematic alcohol use were elevated among men who were single and living with a partner (OR = 1.66; 95% CI = 1.24-2.21), ranked as a non-commissioned officer [NCO] (OR = 1.40; 95% CI = 1.10-1.77), and in the 30-39 and 40-49 age groups (OR 30-39 age group = 2.17; 95% CI = 1.56-3.02; OR 40-49 age group = 1.79; 95% CI = 1.26-2.55). Probable problematic alcohol use was associated with increased odds of having sex with a sex worker (SW), having multiple sexual partners, and participating in transactional sex (aOR sex with a SW = 2.36; 95% CI = 1.78-3.13; aOR multiple sexual partners = 2.08; 95% CI = 1.66-2.60; aOR transactional sex = 1.99; 95% CI = 1.59-2.50). CONCLUSIONS: Results emphasize the need to address alcohol use in the FARDC and integrate alcohol abuse education into HIV prevention programs among male service members. Alcohol abuse prevention efforts should target men who are 30-49 years of age, unmarried, and ranked as a NCO. Messages and interventions to reduce alcohol misuse in relation to risky sexual behaviors are needed.


Assuntos
Consumo de Bebidas Alcoólicas/epidemiologia , Militares/psicologia , Assunção de Riscos , Comportamento Sexual/psicologia , Adolescente , Adulto , Estudos Transversais , República Democrática do Congo/epidemiologia , Humanos , Masculino , Pessoa de Meia-Idade , Militares/estatística & dados numéricos , Prevalência , Adulto Jovem
12.
BMC Public Health ; 19(1): 1410, 2019 Oct 29.
Artigo em Inglês | MEDLINE | ID: mdl-31664963

RESUMO

BACKGROUND: The Woman's Condom, a newly designed condom for women, has obtained market approval in China, but it remains relatively unfamiliar to the migrant population. The aim of this study is to evaluate the short-term acceptability of the Woman's Condom and influencing factors among internal migrants. METHODS: A longitudinal study was conducted among 1800 migrants in Beijing, Chongqing, and Shanghai in China between August 2013 and August 2014.Three-level model was implemented with the Statistical Analysis System software (v.9.4 SAS Institute) to analyze within-individual changes, between-individuals effects, and between-group effects. RESULTS: Three-level model analysis revealed statistically higher short-term acceptability of the Woman's Condom among subjects who lived in Shanghai (ß = 6.50, t = 2.76, p < 0.01), unmarried and not in a cohabiting relationship (ß = 3.05, t = 2.76, p < 0.01) than those who lived in Beijing, married and in a cohabiting relationship. Female (ß = - 1.69, t = - 7.55, p < 0.01) and lower educational attainment (ß = - 2.30, t = - 1.94, p = 0.05) were negatively related, while occupations of education, health, and civil staff (ß = 1.50, t = 2.92, p < 0.01) were positively related to acceptability. It was predicted that migrants' acceptability of the Woman's Condom would significantly increase over time (ß = 1.09, t = 5.54, p < 0.01). CONCLUSIONS: The findings indicate that the Woman's Condom enjoyed relatively high short-term acceptability among migrants in China. In order to popularize the Women's Condoms in migrants, more publicity, consultation and training in open and prosperous areas should be strengthened.


Assuntos
Preservativos Femininos/estatística & dados numéricos , Comportamento Sexual/psicologia , Migrantes/psicologia , Adulto , Pequim , China , Feminino , Humanos , Relações Interpessoais , Estudos Longitudinais , Estado Civil/estatística & dados numéricos , Pessoa de Meia-Idade , Características de Residência/estatística & dados numéricos , Migrantes/estatística & dados numéricos , Adulto Jovem
13.
Afr J AIDS Res ; 18(3): 244-253, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31575340

RESUMO

Unprotected sexual activity increases the risk of pregnancy and HIV and AIDS. More than three decades into the AIDS pandemic, the condom remains the most effective strategy for protecting against the dual risks of pregnancy and HIV and AIDS, but data from national surveys suggest that condom use among young people aged 15-24 is on the decline in South Africa. This study uses qualitative data from 20 in-depth interviews and one focus group to examine the risk behaviours of university students aged 18-24 years old, with particular emphasis on understanding the decline in the use of condoms. It is well documented that South Africa has one of the highest prevalence rates of HIV and AIDS in the world, however the findings of this study suggest that even though students were well informed about the perceived risks associated with unsafe sexual behaviours, they continue to engage in risk behaviours including unprotected sexual intercourse, multiple sexual partners and the use of alcohol. Male students were more likely than female students to report risky sexual behaviours. Condom use is occurring but not consistently. The majority of students did not use condoms during their first sexual encounter because of a lack of preparedness. Negative attitudes towards condoms continue to discourage students from using them consistently, especially those provided by the government. In light of this, it is recommended that rigorous efforts are directed towards challenging inaccurate perceptions about, and attitudes towards, condom use to promote consistency.


Assuntos
Infecções por HIV/psicologia , Conhecimentos, Atitudes e Prática em Saúde , Assunção de Riscos , Comportamento Sexual/psicologia , Estudantes/estatística & dados numéricos , Sexo sem Proteção/psicologia , Adolescente , Preservativos/estatística & dados numéricos , Feminino , HIV , Humanos , Masculino , Gravidez , Parceiros Sexuais/psicologia , África do Sul , Inquéritos e Questionários , Universidades/estatística & dados numéricos , Adulto Jovem
14.
BMC Public Health ; 19(1): 1314, 2019 Oct 21.
Artigo em Inglês | MEDLINE | ID: mdl-31638943

RESUMO

BACKGROUND: Chongqing reportedly has a large MSM population and a high STI prevalence in previous studies. However, most studies are attributed to independent cross-sectional studies, few studies have investigated trends in the prevalence of syphilis and HIV, as well as behavioural characteristics among MSM using serial surveillance surveys. METHODS: Data were collected in Chongqing through face-to-face questionnaire interview and laboratory testing in Chongqing. The respondents were recruited among MSM by snowball sampling from May 2013 to December 2017. The self-report questionnaire primarily included socio-demographics, HIV knowledge, and HIV-related behaviour characteristics over the year. Blood specimens were tested to diagnose HIV and syphilis infection by Chongqing CDC. Cochran-Armitage trend test and multivariate logistic regression were conducted to compare the changes in STI prevalence and independent behavioural factors among MSM. RESULTS: There were 6568 eligible participants (98.4%). The overall HIV prevalence was 20.5% among MSM in Chongqing, with a decrease from 23.0% in 2013 to 19.2% in 2017. The overall syphilis prevalence was 5.8%, with an increase from 3.2% in 2013 to 6.7% in 2017. The proportion of consistent condom use (CCU) during anal intercourse (46.3 to 57.7%, P<0.001),CCU with regular male partners(47.7 to 59.7%, P<0.001), CCU with casual male partners (51.5 to 62.3%, P<0.001) and drug use during anal intercourse (0.3 to 1.4%, P<0.05) were increasing. By contrast, a significant decrease was reported in the percentage of MSM with more than two regular male partners (66.0 to 21.4%, P<0.001) and more than two casual male partners (38.3 to 20.7%, P<0.001). A significant difference was observed in syphilis infection, testing for HIV antibodies and drug use during anal intercourse in the past years between the HIV-positive and HIV-negative respondents. CONCLUSION: A decreasing trend of HIV prevalence was showed during among MSM from 2013 to 2017 in Chongqing. While gradual reduction of high-risk behaviors along with HIV prevalence supported development of STI counselling and testing, increasing syphilis infection and drug use during anal intercourse warrants further understanding.


Assuntos
Infecções por HIV/epidemiologia , Homossexualidade Masculina/psicologia , Homossexualidade Masculina/estatística & dados numéricos , Sífilis/epidemiologia , Adolescente , Adulto , Idoso , China/epidemiologia , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Comportamento de Redução do Risco , Comportamento Sexual/psicologia , Comportamento Sexual/estatística & dados numéricos , Inquéritos e Questionários , Adulto Jovem
15.
BMC Public Health ; 19(1): 1254, 2019 Sep 11.
Artigo em Inglês | MEDLINE | ID: mdl-31510974

RESUMO

BACKGROUND: The World Health Organisation (WHO) advocates early initiation of HIV treatment as a prevention strategy among people living with HIV. There is strong evidence for the effectiveness of antiretroviral therapy (ART) as a preventive tool for HIV transmission. We aimed to determine the sexual behaviour of HIV outpatients and assess if it reflects the current preventive strategy for HIV transmission. METHODS: We conducted a cross-sectional study among adult (aged at least 18 years) patients with confirmed HIV diagnosis, and aware of their diagnosis, attending HIV outpatient care in Kenya. Data were gathered through self-report (using validated questionnaires) and file extraction. Multivariate logistic regression assessed the association between sexual risk taking behaviour controlling for gender, HIV clinical stage, HIV treatment status, Tuberculosis (TB) treatment status, and CD4 count. RESULTS: We recruited n = 400 participants (n = 280[70%] female gender). The mean age was 39.4 (SD = 9.9) years. The mean CD4 count was 393.7 (SD = 238.2) and ranged from 2 to 1470 cells/mm3. N = 61 (15.64%) were on TB treatment. The majority (n = 366, 91.5%) were on ART. Just over half (n = 202, 50.5%) reported having a sexual partner. Of these n = 33 (16.1%) reported having unprotected sexual intercourse with a person of unknown HIV status in the previous 3 months. Multivariate analysis showed that participants not on ART (HIV treatment) were more likely to report unprotected sexual intercourse compared to those who were on ART (odds ratio .25, 95% CI .09 to .69; P = 0.007). Participants at early stage of HIV infection (stages 1/2) were more likely to report unprotected sexual intercourse compared to participants at advanced HIV infection (stages 3/4) (odds ratio .34, 95% CI .13 to .92; P = 0.035). Males participants were more likely to be involved in sexual risk taking behaviours compared to female participants (odds ratio .36, 95% CI .16 to .82; P = 0.015). TB treatment status, and CD4 count were not significantly associated with sexual risk taking. CONCLUSION: Participants not on ART have more unprotected sexual intercourse than those who are on ART. This calls for the need to scale up coverage and early ART initiation in order to reduce transmission of HIV.


Assuntos
Fármacos Anti-HIV/uso terapêutico , Infecções por HIV/tratamento farmacológico , Infecções por HIV/psicologia , Comportamento Sexual/psicologia , Adulto , Estudos Transversais , Feminino , Humanos , Quênia , Masculino , Razão de Chances , Autorrelato , Comportamento Sexual/estatística & dados numéricos , Parceiros Sexuais/psicologia , Inquéritos e Questionários , Sexo sem Proteção , Adulto Jovem
16.
Int J Gynaecol Obstet ; 147(2): 258-267, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31472075

RESUMO

OBJECTIVE: To understand how knowledge and perceptions of condoms and partner communication influence use of condoms in a high HIV prevalence setting and gender-specific differences. METHODS: A cross-sectional study was conducted in Zambia from 2015 to 2016. The survey included questions on demographics, sexual behavior, contraceptive perceptions, and behaviors. We constructed multivariate regression models using the Theory of Planned Behavior to determine associations between knowledge, perceptions, and perceived control with intended, communicated, and reported use of condoms by gender. RESULTS: The participants were 2388 sexually active urban residents aged 18-24 years. In the sample, 1646 (69%) were female, 841 (35%) married, and 1894 (61%) unemployed. Partner communication was the predictor most associated with use of condoms. Among women, partner communication was associated with over three times higher odds of condom use (odds ratio [OR] 3.51, 95% confidence interval [CI] 2.65-4.65) but being married reduced the odds of condom use by 76% (OR 0.24, 95% CI 0.17-0.33). For men, a network of friends that was supportive of the use of contraception was associated with increased odds of 55% for use of condoms (OR 1.55, 95% CI 1.10-2.18). CONCLUSION: Public health programs aimed at increasing safer sexual behavior and use of condoms must consider improving gender equity and partner communication, as knowledge of contraceptives and positive perceptions are not enough to ensure their use.


Assuntos
Preservativos/estatística & dados numéricos , Anticoncepção/psicologia , Relações Interpessoais , Parceiros Sexuais/psicologia , Adolescente , Adulto , Estudos Transversais , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Masculino , Razão de Chances , Grupo Associado , Fatores Sexuais , Comportamento Sexual/psicologia , Inquéritos e Questionários , Adulto Jovem , Zâmbia
17.
Pediatrics ; 144(4)2019 10.
Artigo em Inglês | MEDLINE | ID: mdl-31501237

RESUMO

The following is the winning submission from the third annual Section on Pediatric Trainees essay competition. This year's competition was informed by the 2018-2019 Section on Pediatric Trainees Advocacy Campaign: Advocacy Adventure, which empowered trainees to find their areas of passion, acquire and polish new skills, and organize advocacy efforts collaboratively. We asked writers to share experiences as physician advocates and were impressed with the broad variety of important topics submitted by trainees from around the country. This essay by Drs Panda and Garg highlights a critical issue facing children, human trafficking, and shares their innovative and sustainable survivor-informed training for pediatric trainees. Along with the runner-up submission by Dr Ju, which also appears in this issue, this piece is a wonderfully inspiring reminder that we are all well positioned to advocate for children in our roles as trainees and pediatricians.


Assuntos
Abuso Sexual na Infância/diagnóstico , Assistência à Saúde , Escravização/prevenção & controle , Tráfico de Pessoas/prevenção & controle , Pediatras/educação , Adolescente , Criança , Defesa da Criança e do Adolescente/educação , Escravização/psicologia , Feminino , Tráfico de Pessoas/psicologia , Humanos , Internet , Papel do Médico , Desenvolvimento de Programas , Comportamento Sexual/psicologia , Ideação Suicida , Gravação em Vídeo
18.
BMC Public Health ; 19(1): 1210, 2019 Sep 02.
Artigo em Inglês | MEDLINE | ID: mdl-31477063

RESUMO

BACKGROUND: There is little evidence on the need for differentiated HIV prevention services for men who have sex with men (MSM), female sex workers (FSW) and people who inject drugs (PWID in Nigeria. The aim of the study was to determine and compare the HIV sexual risk profiles of FSW, MSM and PWID resident in Nigeria; and identify factors associated with condom use among the groups. This will help identify if differentiated HIV prevention services are needed for MSM, FSW and PWID in Nigeria. METHODS: This is a cross-sectional study. Data on sexual practices (anal, vaginal and oral sex), history of alcohol and psychoactive substance use, and high risk sexual behaviors for HIV infection (inconsistent use of condom) was collected from study FSW, MSM and PWID resident in Enugu, Nassarawa, Benue, and Akwa-Ibom States of Nigeria between April and June, 2015. Association between sexual practices, alcohol and psychoactive substance use, and HIV sexual risk behaviors; and differences in sexual risk behaviors of MSM, FSW and PWID were determined using Pearson chi-square for categorical variables, and t-test for continuous variables. Determinants of condom use in the last 30 days were identified using logistic regression analysis. RESULTS: The study population consisted of 188 (38.5%) FSW, 145 (29.7%) MSM and 155 (31.8%) PWID. MSM (AOR: 0.17; 95%CI: 0.05-0.67; p = 0.01) and PWID (AOR: 0.07; 95%CI: 0.02-0.21; p < 0.001) were significantly less likely than FSW to have used condom in the last 30 days. A lower proportion of FSW and PWID used condom during anal sex in the last 12 months when compared with MSM (p < 0.001 respectively). The proportion of MSM (23.5%) and FSW (23.4%) who had ever used psychoactive drugs was high. Of those who had ever used psychoactive drugs, 25.0% of FSW and 29.4% of MSM had injected drugs in the last 30 days of the survey. Also, 39.3% of PWID shared needles and syringes. The use of psychoactive substances (AOR: 5.01; 95%CI: 2.59-9.68; p < 0.001) and the ability to negotiate condom use (AOR: 2.04; 95%CI: 1.06-3.93; p = 0.03) were factors associated with condom use in the last 30 days of the survey. CONCLUSION: HIV prevention programs designed for MSM, FSW and PWID need to address inconsistent condom use during sex by addressing condom negotation skills. This sexual risk behavior is common to the three groups.


Assuntos
Usuários de Drogas/psicologia , Infecções por HIV/epidemiologia , Homossexualidade Masculina/psicologia , Assunção de Riscos , Profissionais do Sexo/psicologia , Comportamento Sexual/psicologia , Adolescente , Adulto , Estudos Transversais , Usuários de Drogas/estatística & dados numéricos , Feminino , Infecções por HIV/prevenção & controle , Homossexualidade Masculina/estatística & dados numéricos , Humanos , Masculino , Nigéria/epidemiologia , Profissionais do Sexo/estatística & dados numéricos , Inquéritos e Questionários , Adulto Jovem
19.
BMC Public Health ; 19(1): 1207, 2019 Sep 02.
Artigo em Inglês | MEDLINE | ID: mdl-31477068

RESUMO

BACKGROUND: Consistent condom use is central to the prevention of transmission of human immunodeficiency virus (HIV) and other sexually transmitted diseases (STDs), especially among young adults. This study drew from a cross-sectional survey of two Nigerian universities to determine the level of consistent condom use, explored the determinants of condom use consistency and reasons for inconsistent condom use. METHODS: We adopted a descriptive cross-sectional design, which involves the recruitment of 800 male and female students using stratified random sampling. Adjusted and unadjusted logistic regression models were used to examine the factors associated with consistent condom use among a final sample of 498 students who engaged in sex in the last year preceding the study. RESULTS: Only 38.6% of sexually active participants (n = 498) used condoms consistently in the previous year. High condom self-efficacy score (AOR: 2.40; 95% CI: 1.58-3.64), discussion of HIV/STIs with sexual partner (AOR: 1.91; 95%CI: 1.29-2.83), knowing partner's HIV status (AOR: 1.48; 95% CI: 1.02-2.16), being students of university located in a high HIV prevalence area (AOR: 2.86; 95% CI: 1.92-4.28) and engaging in sex with only steady partner (AOR: 1.74; 95% CI: 1.17-2.60) were associated with a higher odds of consistent condom use. Trust, unavailability of condoms, dislike of condoms and a perception that condoms reduced sexual pleasure were the main reasons for inconsistent use of condoms. CONCLUSION: The study found a low level of consistent condom use among study participants. Counselling young adults in Nigeria on condom self-efficacy, providing condoms on campuses and encouraging the discussion of sexually transmitted infections with sexual partners are central to improving the level of consistent condom use among Nigerian university students.


Assuntos
Preservativos/estatística & dados numéricos , Comportamento Sexual/psicologia , Estudantes/psicologia , Adolescente , Adulto , Estudos Transversais , Feminino , Humanos , Masculino , Nigéria , Fatores de Risco , Estudantes/estatística & dados numéricos , Universidades , Adulto Jovem
20.
J Youth Adolesc ; 48(10): 1869-1882, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31478119

RESUMO

To understand the etiology and consequences of child sexual abuse it is important to study the victims' subjective reactions to such incidents. Because researchers have not been able to survey children about sexual abuse, not much is known about how subjective reactions are related to gender, age, age difference, and the social relationship between the offender and victim. The present study fills this gap using data gathered from a large, nationally representative sample of Finnish children ages 11 to 17 (N = 32,145). Analyses of abuse are based on a sample of 1520 children (78% girls), while analyses of peer sexual experiences are based on a sample of 3551 children (55% girls). Multivariate analyses adjusted for the use of coercion, the intimacy of the sexual experience, and other incident characteristics. It was hypothesized that, as a result of sex differences in sexuality and attitudes toward deviant behavior, girls are more sensitive than boys to age and age difference. Three findings supported the hypothesis: (1) girls were more likely than boys to have a negative reaction to sexual encounters regardless of the age difference; (2) for girls, age was negatively associated with the likelihood of a negative reaction, but age had no effect for boys; and (3) girls reacted negatively to age difference while boys did not. However, girls did not react more negatively unless the offender was at least eight years older. The results highlight the susceptibility of adolescent boys to encounters with older women. They further suggest that ignoring the role of the victim limits understanding of the vulnerability of young people to sexual abuse.


Assuntos
Abuso Sexual na Infância/psicologia , Coerção , Criminosos/psicologia , Grupo Associado , Comportamento Sexual/psicologia , Adolescente , Criança , Vítimas de Crime , Feminino , Humanos , Masculino , Fatores Sexuais , Inquéritos e Questionários
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