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1.
BMC Infect Dis ; 19(1): 925, 2019 Oct 30.
Artigo em Inglês | MEDLINE | ID: mdl-31666015

RESUMO

BACKGROUND: Ruili is a border city in southwest China along the heroin trafficking route. In recent decades, the city has witnessed increased in HIV transmission. The current study aims to explore the spatiotemporal trends in HIV prevalence identify and map the spatial variation and clustering of factors associated with HIV transmission through drug use and heterosexual contact transmissions at the village level from 1989 through 2016. METHODS: Geographic information system-based spatiotemporal analyses, including global and local spatial autocorrelation analyses and space-time scanning statistics, were applied to detect the location and extent of HIV/AIDS high-risk areas. RESULTS: Drug use and heterosexual contact were identified as the major transmission routes causing infection in Ruili. Results of global spatial analysis showed significant clustering throughout the city caused by transmission via drug use in the early phase of the epidemic and transmission via heterosexual contact in the late phase of the epidemic during the study period. Hotspots of transmission from drug use were randomly distributed throughout the city. However, the hotspots of transmission by heterosexual contact were located in the central area only around the Jiegao China-Myanmar land port. Space-time scanning showed that transmission from drug use clustered in the southwest area between 1989 and 1990, while transmission by heterosexual contact clustered in the central area between 2004 and 2014. CONCLUSIONS: Heterosexual contact has become the dominant mode of transmission. Interventions should focus on highly clustered area where is around the Jiegao land port.


Assuntos
Infecções por HIV/epidemiologia , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Síndrome de Imunodeficiência Adquirida/epidemiologia , Síndrome de Imunodeficiência Adquirida/transmissão , Adulto , China/epidemiologia , Cidades , Análise por Conglomerados , Epidemias , Feminino , Sistemas de Informação Geográfica , Infecções por HIV/transmissão , Heterossexualidade , Humanos , Masculino , Mianmar , Prevalência , Comportamento Sexual , Análise Espaço-Temporal , Transtornos Relacionados ao Uso de Substâncias/virologia
2.
Emerg Microbes Infect ; 8(1): 1546-1549, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31661379

RESUMO

The growing multidrug-resistant Neisseria gonorrhoeae is a serious global threat to gonococcal therapy. During 2017-2018, we identified a rare multidrug-resistant (ceftriaxone and azithromycin) strain (GC250) and four strains (GC185, GC195, GC196 and GC249) with both resistance to ceftriaxone and decreased susceptibility to azithromycin. All strains belonged to NG-STAR ST1143, including the mosaic penA-60.001, which is closely related to ceftriaxone resistance. The characterization of antimicrobial resistance (AMR) determinants and phylogenetic analysis showed these five strains were closely related to internationally spreading ceftriaxone-resistant N. gonorrhoeae FC428, but with higher azithromycin MIC. Findings here demonstrated that this clone not only initiated clonal expansion in China, but acquired azithromycin resistance.


Assuntos
Antibacterianos/farmacologia , Azitromicina/farmacologia , Ceftriaxona/farmacologia , Farmacorresistência Bacteriana Múltipla , Gonorreia/microbiologia , Neisseria gonorrhoeae/efeitos dos fármacos , Neisseria gonorrhoeae/isolamento & purificação , China , Feminino , Heterossexualidade , Humanos , Masculino , Testes de Sensibilidade Microbiana , Neisseria gonorrhoeae/classificação , Neisseria gonorrhoeae/genética , Filogenia
3.
BMC Infect Dis ; 19(1): 906, 2019 Oct 29.
Artigo em Inglês | MEDLINE | ID: mdl-31664925

RESUMO

BACKGROUND: Migrants often face barriers to accessing healthcare. We examined disparities in access to and use of HIV-related health services between migrant and non-migrant people recently diagnosed with HIV living in the Netherlands, taken into account sexual orientation. Also, we examined differences in experiences in living with HIV between these groups. METHODS: We used a questionnaire and clinical data collected between July 2013 and June 2015 among migrant and non-migrant participants of the European cross-sectional aMASE (Advancing Migrant Access to health Services in Europe) study in the Netherlands. Using univariable logistic regression analyses, we compared outcomes on between migrants and non-migrants, stratified by sexual orientation (with non-migrant men having sex with men [MSM] as the reference group). RESULTS: We included 77 migrant MSM, 115 non-migrant MSM, 21 migrant heterosexual men, 14 non-migrant heterosexual men and 20 migrant women. In univariable analyses, all heterosexual groups were less likely to ever have had an HIV-negative test before their diagnosis and were more likely to be diagnosed late than non-migrant MSM. All migrant groups were more likely to have experienced difficulties accessing general healthcare in the Netherlands and were less likely to have heard of post-exposure prophylaxis than non-migrant MSM. Migrants frequently reported uncertainty about their rights to healthcare and language barriers. Most (93%) participants visited a healthcare facility in the 2 years before HIV diagnosis but only in 41% an HIV test was discussed during that visit (no statistical difference between groups). Migrant heterosexuals were more likely to have missed appointments at their HIV clinic due to the travel costs than non-migrant MSM. Migrant MSM and women were more likely to have experienced HIV discrimination in the Netherlands than non-migrant MSM. CONCLUSION: Disparities in access to and use of HIV-related health services and experiences exist by migrant status but also by sexual orientation. Our data suggests heterosexual men and women may particularly benefit from improved access to HIV testing (e.g., through provider-initiated testing), while migrant MSM may benefit from improved access to HIV prevention interventions (e.g., pre-exposure prophylaxis).


Assuntos
Infecções por HIV/diagnóstico , Infecções por HIV/terapia , Acesso aos Serviços de Saúde , Disparidades em Assistência à Saúde , Comportamento Sexual , Migrantes , Adulto , Estudos Transversais , Feminino , Infecções por HIV/prevenção & controle , Heterossexualidade , Homossexualidade Masculina , Humanos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Países Baixos , Minorias Sexuais e de Gênero , Inquéritos e Questionários , Viagem/economia
4.
J Couns Psychol ; 66(5): 564-576, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31580125

RESUMO

Sexual minorities high in attachment avoidance (i.e., discomfort with closeness) and attachment anxiety (i.e., fear of abandonment) tend to report greater internalized heterosexism. Yet, the causes of this link have not been fully explored. Some propose that insecure attachment schemas may make it difficult to form the types of social connections that can help alleviate internalized stigma (and vice versa: internalized heterosexism might make one avoid the types of relationships that would foster secure attachment). This study used structural equation modeling to test whether reduced connection to the LGBTQ+ community could help explain the link between insecure attachment and internalized heterosexism. Study 1 (n = 480) explored links between attachment avoidance, attachment anxiety, community connectedness and internalized heterosexism. Higher avoidance predicted lower connection which, in turn, predicted higher internalized heterosexism. Attachment avoidance's association with internalized heterosexism was fully explained by an indirect effect through connectedness. Conversely, attachment anxiety did not predict connectedness or internalized heterosexism. Study 2 (n = 447) replicated these findings. These results suggest low connectedness might help explain the association between attachment insecurity and internalized heterosexism, though this path might be specific to attachment avoidance. (PsycINFO Database Record (c) 2019 APA, all rights reserved).


Assuntos
Aprendizagem da Esquiva , Heterossexualidade/psicologia , Relações Interpessoais , Modelos Psicológicos , Apego ao Objeto , Minorias Sexuais e de Gênero/psicologia , Adolescente , Adulto , Idoso , Ansiedade/epidemiologia , Ansiedade/psicologia , Mecanismos de Defesa , Medo/psicologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estigma Social , Adulto Jovem
5.
Cent Eur J Public Health ; 27(3): 229-234, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31580559

RESUMO

OBJECTIVE: Late presentation of the patients with human immunodeficiency virus (HIV) infection is associated with less favourable treatment responses, more accelerated clinical progression, and a higher mortality risk. Although HIV prevalence is low in Turkey, it is steadily increasing and the information about late presentation among HIV-positives is limited. We aimed to analyze the status of late presentation among HIV-positive patients in Turkey. METHODS: All newly diagnosed HIV/AIDS patients from 2003 to 2016 were enrolled in this study by five dedicated centres in Istanbul, Turkey. Demographic data, CD4+ counts, and HIV RNA were collected from medical records and were transferred to a HIV database system. Late pre- sentation was defined as presentation for care with a CD4 count < 350 cells/mm3 or presentation with an AIDS-defining event, regardless of the CD4 cell count. A medical literature search was done for the analysis of late presentation in Turkey. RESULTS: The cohort included 1,673 patients (1,440 males, median age 35 years). Among them, 847 (50.6%) had an early diagnosis, with a CD count of more than 350 cells/mm3. The remaining 826 were late presenters. Among late presenters, 427 (25.5% of all, 51.7% of late presenters) presented with advanced HIV disease. Late presenters were more elderly and less educated. The gender seemed comparable between groups. Late presentation was more likely among married patients. Early presenters were more likely among homosexuals, those diagnosed in screening studies, and in lower HIV-RNA viral load category. There has been a decreasing trend among late presenters in 2011-2016 when compared to 2003-2011 period. CONCLUSION: Current data suggest that half of HIV-infected patients present late in Turkey. In our cohort, those presented late were more elderly, less educated, married and had heterosexual intercourse. On admission, late presenters had more HIV-related diseases and were more likely in higher HIV-RNA category. In the cohort, men having sex with men were less likely late presenters. Efforts to reduce the proportion of late presentation are essential for almost every country. The countries should identify the risk factors of late presentation and should improve early diagnosis and presentation for HIV care.


Assuntos
Diagnóstico Tardio , Infecções por HIV , Adulto , Idoso , Contagem de Linfócito CD4/métodos , Infecções por HIV/diagnóstico , Infecções por HIV/epidemiologia , Heterossexualidade/estatística & dados numéricos , Humanos , Masculino , Fatores de Risco , Turquia
6.
J Youth Adolesc ; 48(10): 1883-1898, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31520237

RESUMO

Research on sexual and gender minority student achievement indicates that such students report lowered achievement relative to other students. Increased victimization and less school belonging, amongst other factors, have been identified as contributing to these inequalities. However, supportive schooling structures and caregiver support may support their achievement. A nationally representative survey of secondary school students was used to identify specific factors that support achievement for sexual minority (n = 485), gender minority (n = 298), and heterosexual cisgender (where one's sex assigned at birth "matches" a binary gender identity, i.e., a male assigned at birth identifies as a boy/man, n = 7064) students in New Zealand. While reported victimization did not affect achievement for sexual and gender minority students, school belonging, and teacher expectations of success, emerged as significant factors. Differences emerged between sexual minority and gender minority achievement factors, suggesting a range of detailed policy implications and recommendations.


Assuntos
Sucesso Acadêmico , Logro , Vítimas de Crime/psicologia , Heterossexualidade/psicologia , Grupos Minoritários/psicologia , Minorias Sexuais e de Gênero/psicologia , Adolescente , Bullying/estatística & dados numéricos , Vítimas de Crime/estatística & dados numéricos , Feminino , Heterossexualidade/estatística & dados numéricos , Humanos , Masculino , Grupos Minoritários/estatística & dados numéricos , Nova Zelândia , Comportamento Sexual/estatística & dados numéricos , Minorias Sexuais e de Gênero/estatística & dados numéricos , Estudantes/estatística & dados numéricos , Inquéritos e Questionários
7.
Artigo em Inglês | MEDLINE | ID: mdl-31470648

RESUMO

Purpose: The objective of this study was to examine the influence of sexual identity and adverse childhood experiences (ACEs) on non-suicidal self-injury (NSSI) among rural high school students in less developed areas of China. Methods: Behavior risk factors data collected from 1810 students from a high school in Jiangxi province, China. Five measures of childhood abuse and household dysfunction were summarized, and ACE was divided into 0, 1, 2, 3-5 ACEs. Logistic regression analysis was used to explore the influence of sexual identity, adverse childhood experiences, and their interaction with non-suicidal self-injury. Results: Compared with heterosexual students, high school students who identify as lesbian, gay, or bisexual (LGB) have a higher tendency of non-suicidal self-injury (AOR = 3.250, 95% CI = 1.69-6.28, p < 0.01). There was also a graded relationship between cumulative ACEs exposure and non-suicidal self-injury behaviors (AOR = 1.627, 95% CI = 1.02-2.60, p < 0.05). Odds for NSSI are higher among students with both experienced ACEs and identified as LGB (AOR = 2.821, 95% CI = 1.51-5.29, p < 0.05). Conclusions: Non-suicidal self-injury is associated with ACEs exposure and with those who identify as LGB, and the NSSI odds are greater when students identify as LGB and have experienced ACEs. More interventions to reduce non-suicidal self-injury should focus on LGB and ACEs and more attention needs to be paid to those who identify as LGB and have been exposed to ACEs.


Assuntos
Experiências Adversas da Infância/estatística & dados numéricos , Identidade de Gênero , Comportamento Autodestrutivo , Estudantes/estatística & dados numéricos , Adolescente , Bissexualidade , Criança , Maus-Tratos Infantis , China , Características da Família , Feminino , Heterossexualidade/estatística & dados numéricos , Homossexualidade Feminina , Humanos , Masculino , Fatores de Risco , População Rural , Instituições Acadêmicas , Comportamento Sexual/estatística & dados numéricos , Minorias Sexuais e de Gênero
8.
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
9.
Sex Reprod Healthc ; 21: 67-74, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31395236

RESUMO

OBJECTIVES: This study examined the associations between sexual orientation of young people and their health and risk behaviours in Thailand and Sweden, and to explore similarities and differences between the countries. STUDY DESIGN: A cross-sectional study using data from the Life and Health - Young surveys in Thailand and Sweden. Three different statistical analyses were used to examine the associations of the variables. RESULTS: In total, 3869 students aged 16-18 years old were included: 1488 Thai students and 2381 Swedish students. Significantly more Thai (20%) than Swedish (9%) students identified themselves as bisexual, homosexual or unsure (p < .001). Bivariate analysis showed that, in Thailand, self-harm was more often reported by the homosexual, unsure, and bisexual groups than by the heterosexual group (p = .005). In Sweden, early sexual debut was more often reported by the unsure, bisexual, and homosexual groups than by the heterosexual group (p = .033). Multiple logistic regression analysis showed that homosexual and unsure sexual orientations were significantly associated with self-harm (p < .05) among Thai students. Unsure sexual orientation was significantly associated with early sexual debut (p = .04) among Swedish students. Multiple correspondence analysis indicated that sexual orientation was associated with health and risk behaviours, and varied by different subcategories of students' backgrounds such as country, sexual orientation, family structure and adult support. CONCLUSIONS: Sexual minority young people reported more risk behaviours and poorer health than their heterosexual counterparts. The findings are useful for policy programmes on sexual and reproductive health and rights of young people.


Assuntos
Comportamentos de Risco à Saúde , Sexualidade/estatística & dados numéricos , Adolescente , Comportamento do Adolescente , Fatores Etários , Bissexualidade/estatística & dados numéricos , Estudos Transversais , Características da Família , Feminino , Inquéritos Epidemiológicos , Heterossexualidade/estatística & dados numéricos , Homossexualidade/estatística & dados numéricos , Humanos , Masculino , Comportamento Autodestrutivo/epidemiologia , Apoio Social , Suécia/epidemiologia , Tailândia/epidemiologia
10.
J Youth Adolesc ; 48(10): 1938-1951, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31446586

RESUMO

Sexual/gender minority (Sexual/gender minority people are also referred to as Lesbian, Gay, Bisexual, Transgender, Queer) youth are more likely than cisgender heterosexual youth to exhibit depressive symptoms and be victimized. School climate research indicates that the presence of a Gay-Straight Alliance (a Gay-Straight Alliance or Gender-Sexuality Alliance is also referred to as a GSA and is a youth group to support sexual/gender minority youth), a supportive school climate, and seeking help from teachers are associated with more positive mental health outcomes; however, they are not typically measured together. This study uses a survey that measures all four measures of school environment with a national sample of 240 sexual/gender minority high school students ages 14-18 (mean age 15.77) where 53% of participants had a Gay-Straight Alliance in their school. The sample is 53% cisgender, 100% sexual minority and 62% white. Adjusting for demographics and presence of a Gay-Straight Alliance, fewer depressive symptoms were associated with lower help-seeking intentions for suicidal thoughts. The presence of Gay-Straight Alliance was not statistically associated with past-month help-seeking intentions or behaviors. Additionally, a more supportive school climate was associated with lower anxiety and depressive symptoms. However, the presence of a Gay-Straight Alliance was not statistically associated with anxiety or depressive symptoms. These findings suggest that a supportive school climate and supportive school personnel may be important for supporting the mental health of sexual/gender minority students.


Assuntos
Vítimas de Crime/psicologia , Saúde Mental/estatística & dados numéricos , Preconceito/psicologia , Minorias Sexuais e de Gênero/psicologia , Sexualidade/psicologia , Adolescente , Saúde do Adolescente , Bissexualidade/psicologia , Bullying/estatística & dados numéricos , Feminino , Heterossexualidade/psicologia , Humanos , Masculino , Instituições Acadêmicas , Comportamento Sexual/psicologia , Estudantes/psicologia
11.
Int J Infect Dis ; 87: 128-134, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31404674

RESUMO

OBJECTIVES: HIV-1 heterosexual transmission among individuals on antiretroviral treatment (ART) with undetectable viremia is extremely rare. The aim of this study was to evaluate the risk of sexual HIV-1 transmission and other sexually transmitted infections (STIs) in HIV-1 serodifferent couples while the index partner is on ART. METHODS: HIV transmission was evaluated in 200 HIV-1 heterosexual serodifferent couples in a stable relationship (≥3 months). All HIV-positive individuals had been on ART for ≥3 months and had been followed up for a median preceding time of 4.5 years (range 0.3-16 years) at the HIV couples clinic at Hospital Nossa Senhora da Conceição in Porto Alegre, Brazil. Following written informed consent, participants responded to demographic/behavioral questionnaires. Quantitative PCR for HIV RNA, T-cell subsets, and STI testing (syphilis, herpes, human papillomavirus, gonorrhea, and bacterial vaginosis) were performed. Self-collected vaginal swabs were obtained for quantitative HIV genital viral load testing. RESULTS: Among 200 couples, 70% of index partners were female. Five seroconversions were observed; the HIV infection incidence was 2.5% (95% confidence interval 0.8% to 5.7%). Mean plasma viral load results were higher in HIV transmitters compared to non-transmitters (p=0.02). The presence of STIs was significantly greater in couples who seroconverted (60.0% vs. 13.3%; odds ratio 9.75, 95% confidence interval 1.55-61.2; p=0.023). The duration of undetectable HIV viremia and presence of STIs were associated with HIV transmission. CONCLUSIONS: Undetectable viremia was the main factor associated with non-transmissibility of HIV in this setting.


Assuntos
Infecções por HIV/transmissão , Heterossexualidade/estatística & dados numéricos , Doenças Sexualmente Transmissíveis/transmissão , Adulto , Fármacos Anti-HIV/uso terapêutico , Brasil , Feminino , Infecções por HIV/tratamento farmacológico , Infecções por HIV/psicologia , Infecções por HIV/virologia , HIV-1/efeitos dos fármacos , HIV-1/genética , HIV-1/fisiologia , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Razão de Chances , Parceiros Sexuais , Doenças Sexualmente Transmissíveis/diagnóstico , Doenças Sexualmente Transmissíveis/psicologia , Carga Viral , Adulto Jovem
12.
Eur J Oncol Nurs ; 42: 42-49, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31446263

RESUMO

PURPOSE: Treatment decisions, such as breast reconstruction is made by the dyad patient-physician, but close others can have an influence on the process. Shared decision-making models include close others but current studies generally investigate physician-patient interactions only. Moreover, little is known about couples' interactions throughout the breast cancer journey and treatment decision-making. Thus, the aim of the present study was to explore couples' experiences of mastectomy and breast reconstruction decision-making, the month following the mastectomy. METHOD: Ten unstructured individual interviews, with five couples facing mastectomy for breast cancer, were conducted. A dyadic interpretative phenomenological analysis (IPA) was carried on the data set. RESULTS: Eight super-ordinate themes emerged from the data. Couples' experiences were marked by the experience of the disease, the mastectomy and the impact they produced. The relationships with health professionals and partners were also important. Partners were not only supportive and protective, but directly (i.e., couples talk about treatments) and indirectly influenced (i.e., women make a decision taking into consideration how it will impact their couple) the women in their decision to have or not a breast reconstruction. The interpretative accounts underline how women and partners cope with the disease thinking about the aftertreatment. CONCLUSIONS: This study explains for the first time how intimate partners influence breast reconstruction decision-making and how couples cope individually with the disease immediately after mastectomy. Health professionals need to involve partners more in the treatment decision-making process as the women consider and talks to them about the choices they have to make.


Assuntos
Neoplasias da Mama/psicologia , Neoplasias da Mama/cirurgia , Tomada de Decisões , Mamoplastia , Mastectomia , Adaptação Psicológica , Adulto , Feminino , Heterossexualidade , Humanos , Relações Interpessoais , Masculino , Pessoa de Meia-Idade , Comportamento Sexual , Parceiros Sexuais
13.
Body Image ; 30: 145-149, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31323438

RESUMO

This cross-sectional study explored similarities and differences between heterosexual, bisexual, and lesbian women in levels of, and relationships between, the following constructs using a Tripartite Influence Model framework: family, peer, and media appearance pressures, thin- and muscular-ideal internalization, and eating disorder (ED) pathology. Self-identified heterosexual (n = 1,528), bisexual (n = 89), and lesbian (n = 278) undergraduate women completed the Sociocultural Attitudes Towards Appearance Questionnaire-4 and the Eating Disorder Examination-Questionnaire. Sexual orientation differences in appearance pressures, appearance-ideal internalization, and ED pathology were examined via analysis of variance tests. Relationships between these variables were examined with multi-group path analyses, controlling for age, race/ethnicity, and body mass index. Compared with lesbian women, heterosexual and bisexual women reported higher levels of peer appearance pressures. Paths from peer appearance pressures and thin-ideal internalization to shape/weight overvaluation and body dissatisfaction were strongest for bisexual women. Overall, results indicate notable similarities between heterosexual, bisexual, and lesbian women. However, preliminary evidence for potential differences highlights the importance of examining variation in ED risk between sexual minority subgroups.


Assuntos
Bissexualidade/psicologia , Imagem Corporal/psicologia , Heterossexualidade/psicologia , Homossexualidade Feminina/psicologia , Modelos Psicológicos , Minorias Sexuais e de Gênero/psicologia , Estudos Transversais , Transtornos da Alimentação e da Ingestão de Alimentos/psicologia , Feminino , Humanos , Motivação , Grupo Associado , Infuência dos Pares , Estudantes , Inquéritos e Questionários
14.
BMC Public Health ; 19(1): 996, 2019 Jul 24.
Artigo em Inglês | MEDLINE | ID: mdl-31340785

RESUMO

BACKGROUND: Heterosexual men in South Africa are a large key population to exposure to HIV, yet preferences for HIV pre-exposure prophylaxis (PrEP) among this population have not, to date, been investigated in the literature. This paper aims to explore HIV prevention preferences among heterosexual men in urban South Africa, as well as to examine the demand and characteristics of men who favour long-acting injectable (LAI) PrEP over condoms and oral PrEP. METHODS: Data were collected among 178 self-reported HIV-negative heterosexual men, who were given example products and information before being asked which they preferred. Multivariate logistic regression was used to analyse which characteristics were associated with product choice. RESULTS: 48% (n = 85) of participants preferred LAI PrEP, while 33% (n = 58) and 20% (n = 35) chose oral PrEP and condoms respectively. Having children (marginal effect = 0.22; 95% CI [0.01, 0.44]) or having higher risk attitude scores (marginal effect = 0.03; 95% CI [0.01, 0.06]) was significantly associated with a choice of LAI PrEP, while those who had unprotected anal intercourse (marginal effect = - 0.42; 95% CI [- 0.57, - 0.27]) and those who were concerned with protection against other sexually transmitted infections over HIV (marginal effect = - 0.42; 95% CI [- 0.60, - 0.24]) appeared less likely to prefer LAI PrEP. CONCLUSIONS: The results suggested a relatively high demand and theoretical acceptability for LAI PrEP among heterosexual men in urban South Africa, but there appeared to be fewer distinct predictors for the willingness to use LAI PrEP compared to studies conducted among gay and bisexual men and women. Nevertheless, the findings contribute to the mapping of the demand and determinants of heterosexual men's preferences for novel antiretroviral-based prevention in sub-Saharan Africa, and the data could aid in the differentiated design of future HIV prevention strategies using LAI PrEP in conjunction with other methods.


Assuntos
Infecções por HIV/prevenção & controle , Heterossexualidade/estatística & dados numéricos , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Profilaxia Pré-Exposição/estatística & dados numéricos , População Urbana/estatística & dados numéricos , Adulto , Antirretrovirais/uso terapêutico , Preservativos/estatística & dados numéricos , HIV , Humanos , Masculino , Profilaxia Pré-Exposição/métodos , África do Sul , Adulto Jovem
15.
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
16.
AIDS Behav ; 23(9): 2453-2466, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31321636

RESUMO

Voluntary medical male circumcision (VMMC) is an evidence-based biomedical HIV prevention but under-utilized by male sexually transmitted diseases patients (MSTDP) in China. A parallel-group, non-blinded randomized controlled trial was conducted. Participants were uncircumcised heterosexual MSTDP attending four sexually transmitted diseases (STD) clinics in three Chinese cities. A total of 244 MSTDP were randomized 1:1 into the intervention group (n = 108) and the control group (n = 136). In addition to the education booklet received by the control group, the intervention group watched a 10-min video clip and received a brief counseling delivered by clinicians in the STD clinics. The interventions were developed based on the Health Belief Model and the Theory of Planned Behavior. At Month 6, participants in the intervention group reported significantly higher uptake of VMMC (14.8% versus 2.9%; RR 5.03, 95% CI 1.73, 14.62, p = 0.001). The brief STD clinic-based intervention was effective in increasing VMMC uptake among MSTDP in China.Trial registry: This study is registered at ClinicalTrials.gov, number NCT03414710. https://clinicaltrials.gov/ct2/show/NCT03414710 .


Assuntos
Circuncisão Masculina/psicologia , Aconselhamento/métodos , Infecções por HIV/prevenção & controle , Promoção da Saúde/organização & administração , Heterossexualidade , Doenças Sexualmente Transmissíveis/prevenção & controle , Adolescente , Adulto , China , Circuncisão Masculina/etnologia , Circuncisão Masculina/estatística & dados numéricos , Humanos , Masculino , Pessoa de Meia-Idade , Adulto Jovem
17.
J Behav Addict ; 8(2): 234-241, 2019 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-31257916

RESUMO

BACKGROUND AND AIMS: Addicted individuals often demonstrate relatively automatic action tendencies in response to addiction-related stimuli, whereby they approach rather than avoid addictive stimuli. This study assessed whether an approach bias for erotic stimuli exists among heterosexual college-aged males who report using pornography. METHODS: We tested 72 male undergraduate students using an approach-avoidance task employing erotic stimuli, during which participants were instructed to push or pull a joystick in response to image orientation. To simulate approach and avoidance movements, pulling the joystick enlarged the image and pushing shrunk the image. Frequency and severity of pornography use was assessed using a Brief Pornography Screener and the Problematic Pornography Use Scale (PPUS). RESULTS: Participants demonstrated a significant approach bias for erotic stimuli as compared to neutral stimuli, and this approach bias significantly correlated with pornography-use measures. Moreover, individuals with problematic pornography use (as classified by the PPUS) showed more than double the approach bias than did non-problematic users. DISCUSSION AND CONCLUSION: The observation of cognitive biases for erotic stimuli in individuals with problematic pornography use indicate similarities between behavioral and substance addictions.


Assuntos
Comportamento Aditivo/diagnóstico , Comportamento Aditivo/psicologia , Comportamento de Escolha , Literatura Erótica/psicologia , Heterossexualidade/psicologia , Inquéritos e Questionários , Adulto , Viés , Humanos , Masculino , Estudantes/psicologia , Estudantes/estatística & dados numéricos , Universidades , Adulto Jovem
19.
BMC Infect Dis ; 19(1): 669, 2019 Jul 29.
Artigo em Inglês | MEDLINE | ID: mdl-31357947

RESUMO

BACKGROUND: As a gateway for HIV-1 in China, Yunnan has experienced dramatic changes in HIV-1 epidemics, during which HIV-1 genotypes have become complex. To track dynamic changes in HIV-1 genotypes, an HIV-1 molecular epidemiological study was implemented in the recently infected population in Yunnan. METHODS: From 6,357 HIV-1-positive samples diagnosed during the first half of 2015 in Yunnan, 586 samples were identified as recent infections with BED-capture enzyme immunoassay (CEIA) and were subjected to phylogenetic analyses. Spatial scanning analyses for the main HIV-1 genotypes were also performed. RESULTS: Among the 439 specimens successfully genotyped, more than ten genotypes were detected, including CRF08_BC (45.3%), CRF07_BC (19.4%), unique recombinant forms (URFs) (18.2%), CRF01_AE (11.4%), subtype C (2.1%), CRF85_BC (1.1%), CRF55_01B (0.9%), subtype B (0.5%), CRF64_BC (0.5%), CRF59_01B (0.2%), CRF83_cpx (0.2%) and CRF87_cpx (0.2%). Females, Chinese, heterosexual contact and intravenous drug injection were significantly associated with CRF08_BC infection; homosexual contact was significantly associated with CRF01_AE and CRF07_BC infection; males and non-Chinese had a higher risk of URF infection than females. Among all HIV-1 genotypes, the geographic coverage of CRF08_BC was the largest. For CRF08_BC, CRF07_BC, URFs and CRF01_AE, spatial clusters were detected. The two CRF08_BC clusters and one URF cluster were associated with heterosexual transmission, and two of CRF01_AE clusters were associated with homosexual transmission. Transmitted drug resistance (TDR)-associated mutations were detected in 2.4% of individuals. CONCLUSIONS: The diversity of HIV-1 genotypes increased in recent infections because of a long-term HIV-1 epidemic in Yunnan. The predominant HIV-1 strains showed distinct demographic characteristics and formed spatial clusters. These findings improved our understanding of the evolution of HIV-1 in Yunnan and provided information for further HIV-1 control and prevention.


Assuntos
Farmacorresistência Viral/genética , Epidemias , Variação Genética , Infecções por HIV/virologia , HIV-1/genética , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , China/epidemiologia , Feminino , Genótipo , Infecções por HIV/epidemiologia , HIV-1/classificação , Heterossexualidade , Homossexualidade , Humanos , Masculino , Pessoa de Meia-Idade , Mutação , Filogenia , Análise Espacial , Adulto Jovem
20.
RECIIS (Online) ; 13(2): 261-272, abr.-jun. 2019. ilus
Artigo em Português | LILACS | ID: biblio-1005595

RESUMO

Nos textos jornalísticos, chama a atenção a diferença entre as imagens de casos de violência contra a mulher cisgênero e heterossexual e as contra pessoas LGBTQ+. Tratando-se das pessoas LGBTQ+, as imagens costumam ser brutais, com exposição de sangue e de corpos feridos por armas diversas. Já a cobertura de casos de violência contra a mulher cis e heterossexual é diametralmente oposta: as imagens tendem a ser pouco contundentes, muitas vezes mostrando paisagens de lugares onde ocorreram os crimes, em alguns casos mostrando os rostos de agressores e vítimas, nunca cenas de sangue ou corpos com marcas de agressão. Neste artigo, tomamos a instabilidade textual como ponto de partida para refletirmos sobre o contraste entre os modos de tratamento jornalístico conferidos no Brasil a essas duas violências e o que impacta no entendimento acerca das relações que conformam a visualidade e a cultura visual.


In Brazilian journalistic texts, the difference between the images of cases of violence against cis and heterosexual women and those against LGBTQ+ people are astonishing. In the case of LGBTQ+ people, the images are usually brutal, with exposure of blood and bodies injured by various weapons. The coverage of cases of violence against cis and heterosexual women is the opposite: the images tend to be inconclusive, often showing landscapes of places where crimes occurred, sometimes showing the faces of perpetrators and victims and never scenes of blood or bodies with marks of aggression. In this article, we take the textual instability as a starting point to reflect on the contrast between the ways of journalistic treatment in Brazil conferred to these two violences and what impacts on the understanding about the relations that conform the visuality and the visual culture.


En los textos periodísticos, llama la atención la diferencia entre las imágenes de casos de violencia contra la mujer cis heterosexual y las contra personas LGBTQ+. Tratándose de las personas LGBTQ+, las imágenes suelen ser brutales, con exposición de sangre y de cuerpos heridos por armas diversas. La cobertura de casos de violencia contra la mujer cis heterosexual es diametralmente opuesta: las imágenes tienden a ser poco contundentes, muchas veces mostrando paisajes de lugares donde ocurrieron los crímenes, en algunos momentos mostrando los rostros de agresores y víctimas y nunca escenas de sangre o cuerpos con marcas de agresión. En este artículo tomamos la inestabilidad textual como punto de partida para reflexionar sobre el contraste entre los modos de tratamiento periodístico en Brasil conferidos a esas dos violencias y lo que impacta en el entendimiento acerca de las relaciones que conforman la visualidad y la cultura visual.


Assuntos
Humanos , Mulheres , Jornalismo , Cultura , Violência contra a Mulher , Minorias Sexuais e de Gênero , Identidade de Gênero , Violência , Brasil , Heterossexualidade , Ódio
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