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1.
Pediatr Clin North Am ; 70(1): 67-82, 2023 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-36402472

RESUMO

Injuries and deaths due to firearms in children and young adults is a public health crisis in the United States. Pediatric clinicians are powerful advocates to reduce harm due to firearms. By forming coalitions with legislators on a bipartisan basis, working with government relations teams in the hospitals, and partnering with community allies and stakeholders, pediatric clinicians can work to enact legislation and influence policies at the individual, state, and national levels. This can include advocacy for strengthening Child Access Prevention Laws and firearm safer storage campaigns.


Assuntos
Armas de Fogo , Ferimentos por Arma de Fogo , Adulto Jovem , Criança , Humanos , Estados Unidos , Ferimentos por Arma de Fogo/prevenção & controle , Saúde Pública , Família , Parceiros Sexuais
2.
Addict Behav ; 136: 107488, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-36088786

RESUMO

The short-term consequences of drinking events may be positive or negative. Most studies have considered only one outcome, but people may experience different alcohol outcomes on different occasions, depending on the circumstances. The present study sought to identify predictors of drinking events that resulted in couple intimacy, conflict, or neither outcome using existing data from a 30-day ecological momentary assessment (EMA) study. Participants were a community sample of partnered, moderately drinking adults with a recent history of verbal or physical partner aggression (N = 249 couples). They provided reports of drinking events, intimacy and conflict events, and ratings of relationship harmony and discord in three randomly signaled reports each day. Mixed-effects multinomial analyses were used to compare predictors of drinking events that, within three hours, resulted in intimacy, conflict, or neither outcome. Consistent with previous research, characteristics of the drinker (individual tendencies to experience intimacy or conflict) and characteristics of the drinking event (alcohol quantity, drinking companions) both predicted drinking outcomes. Moreover, the pre-drinking relationship context predicted post-drinking relationship outcomes, consistent with the idea that alcohol focuses attention on salient contextual cues. Specifically, greater pre-drinking relationship harmony predicted greater likelihood of experiencing intimacy after drinking, whereas greater pre-drinking relationship discord predicted greater likelihood of experiencing conflict after drinking. In summary, characteristics of the drinker, the drinking event, and the pre-drinking relationship context contribute to the likelihood that a given drinking event will have short-term positive or negative relationship outcomes.


Assuntos
Amor , Peçonhas , Adulto , Consumo de Bebidas Alcoólicas/epidemiologia , Humanos , Comportamento Sexual , Parceiros Sexuais , Violência
3.
Front Public Health ; 10: 1004869, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36324439

RESUMO

Background: Sexual behavior is one of the main routes of HIV/AIDS spread. HIV disclosure to sexual partners has been confirmed to be an important strategy for HIV/AIDS prevention and control. We conducted a systematic review and meta-analysis to pool proportions and characteristics of HIV disclosure to sexual partners among people diagnosed with HIV in China. Methods: We searched eight databases and extracted the data on HIV disclosure to partners. Heterogeneity of the data was tested with I 2. Published bias subjectively and objectively analyzed through the funnel plot and Egger's regression test. Subgroup analyses were performed to explore the variation in the proportion by sexual partnership types (unclassified, regular, casual sexual partners), whether being men who have sex with men (MSM), and when to diagnose. The sources of heterogeneity were analyzed. Sensitivity analysis was carried out to evaluate the stability of the results. Results: Out of 3,698 studies, 44 were included in the review; 11 targeted on MSM. The pooled proportion of HIV disclosure to sexual partners was 65% (95% CI: 56%-75%; 34 studies). Sub-group analyses indicated the proportions of HIV disclosure to regular, casual and unclassified sexual partners were 63% (95% CI: 45%-81%; 31 studies), 20% (95% CI: 8%-33%; nine studies), and 66% (95% CI: 59%-73%; 14 studies), respectively. Fifty-seven percent (95% CI: 45%-69%; three studies) disclosed on the day of diagnosis, 62% (95% CI: 42%-82%; four studies) disclosed within 1 month, and 39% (95% CI: 2%-77%; four studies) disclosed 1 month later. Among MSM, the disclosure to regular male partners, regular female sexual partners, spouses, and casual partner were 47% (95% CI: 29%-65%; six studies), 49% (95% CI: 33%-65%; three studies), 48% (95% CI: 18%-78%; seven studies), and 34% (95% CI: 19%-49%; four studies), respectively. Conclusions: The disclosure prevalence of people diagnosed with HIV to sexual partners still need improving in China, and it varies among partner types, key populations, and time being diagnosed. HIV disclosure strategies and procedures need to be developed more detailed and tailored based on the pain points of disclosure status, so as to ultimately prevent HIV transmission through sexual contact. Systematic review registration: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022291631, identifier: CRD42022291631.


Assuntos
Infecções por HIV , Minorias Sexuais e de Gênero , Masculino , Feminino , Humanos , Parceiros Sexuais , Homossexualidade Masculina , Revelação , Infecções por HIV/diagnóstico , Infecções por HIV/epidemiologia , Infecções por HIV/prevenção & controle
4.
Proc Natl Acad Sci U S A ; 119(45): e2206925119, 2022 11 08.
Artigo em Inglês | MEDLINE | ID: mdl-36322750

RESUMO

Romantic first impressions seem to linger, but why? Few studies have investigated how romantic desire during initial interactions predicts later relational outcomes (e.g., later romantic interest, contact attempts) using a design that can tease apart different possible mechanisms (e.g., mate value, selectivity, compatibility). Across three speed-dating studies (n = 559) with longitudinal follow-ups (including college and community samples, and a sample of men who date men), we investigated whether different components of initial romantic impressions predicted later romantic outcomes and relationship initiation. Using the social relations model, we partitioned initial desire at speed dating (determined from 6,600+ total dates) into partner effects (a date's consensual desirability, e.g., mate value), actor effects (a participant's general desirousness, e.g., selectivity), and relationship effects (a participant's unique liking for a date over and beyond partner and actor effects, e.g., compatibility) to predict later evaluations (romantic interest, physical attraction, and desire to know better) and behaviors (direct messaging and going on dates). Meta-analyses across the three studies showed that, across 6,100+ follow-up reports, partner and relationship effects were especially strong predictors of relationship initiation variables. Consistent with evolutionary models of human pair bonding, these findings suggest that both consensually desirable traits and unique impressions of compatibility have lingering effects on relationship development, even from the moment that two potential partners meet.


Assuntos
Relações Interpessoais , Comportamento Sexual , Masculino , Humanos , Parceiros Sexuais
5.
Sci Rep ; 12(1): 19013, 2022 Nov 08.
Artigo em Inglês | MEDLINE | ID: mdl-36347930

RESUMO

Violence around pregnancy is critical in nature and major public health problem worldwide. Thus, the present study aims to determine the extent of perinatal partner violence and to identify its individual and community-level factors among postpartum women in Southern Ethiopia. A total of 1342 postpartum women nested in 38 'Kebles' (clusters) were enumerated using multistage-clustered sampling techniques for multilevel analysis. Different parameters were computed for model comparison and model fitness. The overall prevalence of intimate partner violence before, during, and/or after pregnancy was estimated to be 39.9% [95% CI 36.9-44.5]. About 18% of women reported continuous abuse over the perinatal period. Postpartum women who live in rural areas [adjusted odds ratio (AOR) = 2.46; 95% CI 1.21-5.01], or in neighborhoods with high IPV favoring norms [AOR = 1.49; 95%CI 1.01-2.20], high female literacy [AOR = 2.84; 95%CI 1.62-5.01], high female autonomy [AOR = 2.06; 95%CI 1.36-3.12], or in neighborhoods with lower wealth status [AOR = 1.74; 95%CI 1.14-2.66] were more likely to encounter PIPV. The complex patterns of interplaying factors operating at different levels could put pregnant or postpartum women at higher risk of IPV victimization. Therefore, policies that prioritize the improvement of contextual factors, particularly norms toward IPV and women's empowerment are likely to be the most effective interventions.


Assuntos
Violência por Parceiro Íntimo , Parceiros Sexuais , Gravidez , Feminino , Humanos , Análise Multinível , Etiópia/epidemiologia , Modelos Logísticos , Período Pós-Parto , Prevalência , Fatores de Risco
6.
BMC Infect Dis ; 22(1): 850, 2022 Nov 14.
Artigo em Inglês | MEDLINE | ID: mdl-36376835

RESUMO

BACKGROUND: Despite a large amount of behavioral interventions to reduce human immunodeficiency virus (HIV)-related high-risk sexual behaviors, consistent condom use remains suboptimal among men who have sex with men (MSM). However, current databases are lack of synthesized evidence to explain why MSM practiced condomless sex. OBJECTIVE: Our study aims to conduct a systematic review and meta-synthesis of 39 eligible qualitative studies to explore the barriers to condom use among MSM. METHODS: A systematic review and meta-synthesis of qualitative studies (1994-2021). On March 4, 2021, a comprehensive search was conducted in 14 electronic databases. The study was conducted based on the Joanna Briggs Institute's recommendations. RESULTS: Thematic analysis produced six synthesized themes, which were classified into three levels according to the Social-ecology Model. Individual level barriers to condom use included physical discomfort, lack of HIV/STI-related knowledge and substance use; interpersonal-level barrier was mainly the condom stigma, namely regarding using condom as symbols of distrust or HIV/sexually transmitted infections (STIs) prevention, or as violating traditional cognition of sex, or as an embarrassing topic; environmental/structural-level barriers included situational unavailability, unaffordability of condoms and power imbalance in the sexual relationship. CONCLUSION: This meta-synthesis offered in-depth understanding of condom use barriers for MSM and could guide the development of multifactorial interventions according to the identified barriers, especially targeting to reduce condom stigma, which has not been focused and intervened previously.


Assuntos
Infecções por HIV , Minorias Sexuais e de Gênero , Infecções Sexualmente Transmissíveis , Humanos , Masculino , Sexo sem Proteção , Homossexualidade Masculina , Infecções Sexualmente Transmissíveis/prevenção & controle , Infecções por HIV/prevenção & controle , Comportamento Sexual , Preservativos , Parceiros Sexuais
7.
Artigo em Inglês | MEDLINE | ID: mdl-36360705

RESUMO

Recovery is a preferred outcome for assessing intervention effectiveness in the context of intimate partner violence (IPV), but measurement tools are in nascent form. It is therefore unclear what the recovery potential of survivors may be. A national online survey explored the self-rated recovery progress of Australian women (n = 1116), using visual analog scales (VAS) for recovery, hope, and other demographic variables. Findings show that many women rated themselves as completely recovered (14% of the eligible sample and 22% of the women who had left their partner > 10 years previously). However, most women experienced recovery as an ongoing process of healing (81%) and some women made little recovery progress (5%). Nevertheless, 77% of women who had separated >10 years ago rated their recovery as significant (scores of >70/100). Surprisingly, hope and recovery scores were only moderately correlated. This requires further investigation to determine what impacts on hope in long-term recovery, and how subjective and objective measures of hope and recovery vary in the context of IPV. The VAS was an efficient unidimensional measure for an online survey and is proposed for use in clinical and service contexts requiring subjective measures.


Assuntos
Violência por Parceiro Íntimo , Feminino , Humanos , Austrália , Sobreviventes , Inquéritos e Questionários , Estudos Longitudinais , Parceiros Sexuais
8.
Artigo em Inglês | MEDLINE | ID: mdl-36360854

RESUMO

Breast cancer (BC) is the leading cause of cancer in women, and has implications for sexual function (SF). In this study, we used an evidence map to identify, describe, and organise the current available evidence regarding SF in women with BC. We searched the MEDLINE, PsycINFO, and CINAHL databases for observational studies assessing SF in women with BC published in English, Spanish, Portuguese, and French between 2000 and 2021 (sample ≥ 50 women). Of the 64 included studies (13,257 women with BC), 58 were published since 2010. Women who were married, partnered, or in relationships represented 74.1% of the entire sample. Only a single study was conducted on women representing a sexual minority. We identified 22 assessment instruments and 40 sexual dysfunction (SdF) domains. The number of publications on SF in women with BC has increased in the last 10 years, but still remains low. Some groups of women are underrepresented, and some SdF domains are underdiagnosed, with the assessment instrument used affecting which domains are studied. Women with BC need to be better screened, as their quality of life (QoL) is affected by SdF.


Assuntos
Neoplasias da Mama , Disfunções Sexuais Fisiológicas , Feminino , Humanos , Neoplasias da Mama/epidemiologia , Neoplasias da Mama/complicações , Qualidade de Vida , Disfunções Sexuais Fisiológicas/etiologia , Parceiros Sexuais , Estudos Observacionais como Assunto
9.
Artigo em Inglês | MEDLINE | ID: mdl-36361005

RESUMO

Previous research that has examined the use of sexually explicit material (SEM) in the Spanish population and its relationship with sociodemographic variables, sexual satisfaction, and satisfaction with the relationship are practically non-existent. Therefore, the main goal was to analyze the pattern of use of SEM (frequency, format, context, content, and purpose of its use) and its relationship with sociodemographic variables (sex, age, sexual orientation, educational level, religiosity, status of partner, number of sexual partners, and age of first exposure to SEM), sexual satisfaction, and relationship satisfaction. The sample consisted of 221 participants, with an average age equal to 29.88 years (SD = 9.73) and of Spanish nationality. All participants completed a sociodemographic questionnaire, as well as the Spanish adaptations of the Sexual Media Questionnaire, Global Measure of Sexual Satisfaction, and Global Measure of Relationship Satisfaction. Based on the results, it was found that men use SEM more frequently than women, that the age of first exposure is 14 years old, the most used pattern of SEM is internet websites with sexual content in which adult men and women appear, and the way to visualize it is alone as private stimulation. In addition, it was shown that a higher frequency of SEM use implies a decrease in sexual satisfaction and vice versa, while there is no association between the frequency of SEM use and satisfaction with the relationship. The importance of considering the use of SEM, both in research on sexual satisfaction and in clinical practice, is discussed.


Assuntos
Literatura Erótica , Satisfação Pessoal , Adulto , Feminino , Humanos , Masculino , Adolescente , Orgasmo , Comportamento Sexual , Parceiros Sexuais
10.
Artigo em Inglês | MEDLINE | ID: mdl-36361116

RESUMO

In Poland, there is little research on university students' risky sexual behaviours. Additionally, existing studies analyse the behaviours selectively and do not group them into clusters. Hence, effective prevention is impossible. The research aims to gather information regarding the prevalence, forms and clusters of students' risky sexual experiences. In 2019, a cross-sectional study was conducted in 12 universities in south-eastern Poland on a random sample (n = 2764). Fifteen risky sexual experiences, both condom-protected and unprotected, were analysed; they were mainly unprotected vaginal, oral, anal contacts; protected and unprotected sexual experiences while intoxicated and with unknown persons. Thanks Ward's hierarchical method, four inseparable clusters of students with similar risky experiences were distinguished. Their dominant features were: (A) (24% of interviewees)-drunk partners, (B) (4.8%)-partners intoxicated with drugs, (C) (3.1%)-partner abuse and exceeding partner sexual norms, (D) (17.8%)-the anonymity of partners and going beyond the convention. It was stated that 60.3% of the respondents do not belong to any of the identified clusters. Sex education and the promotion of student sexual health should be intensified; the development of attitudes of avoiding risky sexual behaviours and dealing with their consequences should be considered.


Assuntos
Assunção de Riscos , Comportamento Sexual , Feminino , Humanos , Universidades , Estudos Transversais , Estudantes , Parceiros Sexuais
11.
Artigo em Inglês | MEDLINE | ID: mdl-36361171

RESUMO

HIV pre-exposure prophylaxis (PrEP) is highly effective but depends on patients' care engagement, which is often mediocre and poorly measured in real-world settings. This study aimed to assess the effectiveness of a PrEP program in a sexual health center that included accompanying measures to improve engagement. A retrospective observational study was conducted. All men who have sex with men (MSM) who initiated PrEP for the first time between 1 August 2018 and 30 June 2019 in the Fernand-Widal sexual health center, Paris, France, were included. Among the 125 MSM who initiated PrEP, the median age was 33 and most had only male partners. At initiation, 58% were considered at very high risk of HIV infection, mainly due to a history of post-exposure prophylaxis. During the first year, patients attended a median of three visits (Q1-Q3, 2-4). At 12 months, 96% (95% CI, 92.6 to 99.4) had a successful PrEP course, assessed by a novel metric. These results highlight the possibility of achieving a high PrEP success ratio among MSM in a real-world setting. The accompanying measures and one-on-one counseling by a trained counselor could explain the effectiveness of this PrEP program.


Assuntos
Fármacos Anti-HIV , Infecções por HIV , Profilaxia Pré-Exposição , Saúde Sexual , Minorias Sexuais e de Gênero , Humanos , Masculino , Adulto , Profilaxia Pré-Exposição/métodos , Homossexualidade Masculina/psicologia , Infecções por HIV/psicologia , Paris , Parceiros Sexuais , Aconselhamento , Fármacos Anti-HIV/uso terapêutico
12.
Artigo em Inglês | MEDLINE | ID: mdl-36361250

RESUMO

To assess the association between women's autonomy and intimate partner violence (IPV) against women of childbearing age. Secondary analysis of the 2019 Demographic and Family Health Survey (ENDES-acronym in Spanish) was carried out. The study population was women aged 15-49 years who are currently married or living with a partner. A Poisson family generalized linear regression model was estimated to calculate adjusted prevalence ratios (aPR) for the association between women's autonomy and IPV with their respective 95% confidence intervals (CI). Data from 18,621 women were analyzed. The highest proportion of women had low autonomy (low: 42%; moderate: 39.2%; high: 18.8%). A prevalence of IPV of 40.1% was found (psychological/verbal: 38.8%; physical: 8.8%; sexual: 2.3%). The adjusted model found that women with a low level of autonomy (aPR: 1.15, 95%CI: 1.01-1.31) had a higher prevalence of IPV compared to women with high autonomy. This association was also found for the specific case of psychological/verbal violence (aPR: 1.15, 95%CI: 1.01-1.31). No association was found between women's level of autonomy and physical or sexual violence by a partner. Four out of 10 women of childbearing age have experienced IPV in the last 12 months. In general, women with lower levels of autonomy are more likely to present IPV compared to women with high autonomy.


Assuntos
Violência por Parceiro Íntimo , Humanos , Feminino , Peru/epidemiologia , Estudos Transversais , Fatores de Risco , Inquéritos Epidemiológicos , Prevalência , Parceiros Sexuais
13.
BMC Public Health ; 22(1): 2081, 2022 11 15.
Artigo em Inglês | MEDLINE | ID: mdl-36380301

RESUMO

BACKGROUND: One in three women from lower and middle-income countries are subjected to physical and/or sexual intimate partner violence (IPV) in their life span. Prior studies have highlighted a range of adverse health impacts of sexual IPV. However, less is known about the link between multiple high-risk fertility behaviours and sexual intimate partner violence. The present study examines the statistical association between multiple high-risk fertility behaviours and sexual intimate partner violence among women in India. METHODS: The present study used a nationally representative dataset, the National Family Health Survey (NFHS-4) 2015-16. A total of 23,597 women were included in the study; a subsample of married women of reproductive age who have had at least one child 5 years prior to the survey and who had valid information about sexual IPV. Logistic regression models were employed alongside descriptive statistics. RESULTS: Approximately 7% of women who are or had been married face sexual IPV. The prevalence of sexual violence was higher among women who had short birth intervals and women who had given birth more than three times (12%). Around 11% of women who had experienced any high-risk fertility behaviours also experienced sexual violence. The unadjusted association suggested that multiple high-risk fertility behaviours were 32% (UORs = 1.32, 95% CI: 1.16-1.50) higher for those women who experienced sexual violence. After adjusting for other sociodemographic variables, except for women's education and wealth quantile, the odds of multiple high-risk fertility behaviours were 16% (AOR = 1.16; 95% CI: 1.02-1.34) higher among women who faced sexual violence. The inclusion of women's educational attainment and wealth status in the model made the association between sexual IPV and high-risk fertility behaviours insignificant. CONCLUSION: Sexual intimate partner violence is statistically associated with high-risk fertility behaviours among women in India. Programs and strategies designed to improve women's reproductive health should investigate the different dimensions of sexual IPV in India.


Assuntos
Violência por Parceiro Íntimo , Criança , Feminino , Humanos , Pré-Escolar , Estudos Transversais , Índia/epidemiologia , Prevalência , Inquéritos Epidemiológicos , Fertilidade , Parceiros Sexuais , Fatores de Risco
14.
PLoS One ; 17(11): e0276981, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36327305

RESUMO

Understanding the structure of human sexual contact networks is vital in a broad range of disciplines, including sociology, biology, public health, and anthropology. However, sexual contact networks are yet to be understood because technical and privacy issues make it difficult to conduct accurate, large-scale surveys. In this study, we surveyed data openly available on one of the largest adult entertainment websites in Japan, where male clients (MCs) can write online customer reviews of female commercial sex workers (FCSWs). In particular, our investigation focused on a type of establishment called "soapland," the only type of sex industry in Japan where sexual intercourse is publicly permitted. Soaplands are scattered throughout Japan, and the study website covers approximately 66% of them. Using such a vast amount of data on a nationwide scale, we clarified the network structure of commercial sex, characterized by small-world, scale-free, and disassortative mating properties. To study geographical characteristics, we compared the resulting network with three different artificially generated networks via the random rewiring of links. Moreover, we considered a simple epidemic model on the resulting network, and investigated whether it would be more effective to provide infection control measures to FCSWs or MCs. We determined that active FCSWs constitute an important pathway of infection propagation in commercial sex networks, but MCs also play an essential role as weak ties.


Assuntos
Infecções por HIV , Trabalho Sexual , Adulto , Masculino , Feminino , Humanos , Comportamento Sexual , Coito , Japão , Infecções por HIV/epidemiologia , Parceiros Sexuais
16.
Artigo em Inglês | MEDLINE | ID: mdl-36360643

RESUMO

OBJECTIVE: To estimate the prevalence and factors associated with reproductive desire in a sample of women living with HIV/AIDS (WLHA) with serodiscordant partners. STUDY DESIGN: Between September 2015 and August 2016, a cross-sectional study was conducted among 110 WLHA from HIV/AIDS treatment services and non-governmental organizations. An interview was conducted using a structured questionnaire to collect sociodemographic data, reproductive desire, and potential predictor variables. Poisson regression was used to analyze the factors associated with reproductive desire in the sample. RESULTS: The prevalence of reproductive desire was 32.7% (95% Confidence Interval: % CI: 24.7-42.0%). In regression analysis, we observed an association between reproductive desire and the following variables: age < 30 years; relationship time < 2 years; reproductive desire for the partner; and absence of children. CONCLUSIONS: The prevalence of reproductive desire in the investigated sample was relatively high. Young age and reproductive desire for the partner were the main associated factors.


Assuntos
Síndrome de Imunodeficiência Adquirida , Infecções por HIV , Criança , Humanos , Feminino , Adulto , Estudos Transversais , Reprodução , Inquéritos e Questionários , Prevalência , Infecções por HIV/tratamento farmacológico , Infecções por HIV/epidemiologia , Parceiros Sexuais
17.
AIDS ; 36(15): 2161-2169, 2022 Dec 01.
Artigo em Inglês | MEDLINE | ID: mdl-36382435

RESUMO

OBJECTIVE: To estimate trends in the proportion of sexually active U.S. adults with HIV (PWH) reporting an HIV-discordant sexual partner taking preexposure prophylaxis (PrEP) and proportion of partners taking PrEP. DESIGN: The Medical Monitoring Project is a complex sample survey of U.S. adults with diagnosed HIV. METHODS: We used annual cross-sectional data collected during June 2015-May 2020 to estimate the annual percentage change (EAPC), overall and by selected characteristics, in reported partner PrEP use among PWH with HIV-discordant partners (N = 8707) and reported PrEP use among these partners (N = 15 844). RESULTS: The proportion of PWH reporting PrEP use by one or more HIV-discordant sex partner rose 19.5% annually (11.3 to 24.4%). The prevalence rose from 6.0 to 17.4% (EAPC, 25.8%) among Black PWH, 10.1 to 26.0% (EAPC, 19.5%) among Hispanic/Latino PWH, and 20.8 to 34.6% (EAPC, 16.3%) among White PWH. Among MSM with HIV, the prevalence increased from 9.6 to 32.6% (EAPC, 28.2%) among Black MSM, 16.6 to 36.0% (EAPC, 15.6%) among Hispanic/Latino MSM, and 24.9 to 44.1% (EAPC, 17.9%) among White MSM. Among HIV-discordant sex partners, the proportion reported to be taking PrEP increased 21.1% annually (7.8 to 18.8%). Reported PrEP use rose from 4.9 to 14.2% (EAPC, 29.9%) among Black partners, 6.5 to 16.8% (EAPC, 20.3%) among Hispanic/Latino partners, and 12.7 to 26.1% (EAPC, 17.0%) among White partners. CONCLUSIONS: One in five HIV-discordant sexual partners of PWH was reported to be taking PrEP. PrEP use rose among all examined populations, although the increases did not eliminate disparities in PrEP use.


Assuntos
Infecções por HIV , Profilaxia Pré-Exposição , Adulto , Masculino , Estados Unidos/epidemiologia , Humanos , Parceiros Sexuais , Homossexualidade Masculina , Estudos Transversais , Infecções por HIV/epidemiologia , Infecções por HIV/prevenção & controle , Infecções por HIV/tratamento farmacológico
19.
PLoS One ; 17(10): e0276404, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36288332

RESUMO

BACKGROUND: Participation in HIV vaccine trials is an essential step towards development of an effective preventive vaccine. A Phase I/II HIV vaccine trial enrolls volunteers at low risk of acquiring HIV infection, however a few may still become infected. Understanding the experiences of volunteers who acquired HIV infection while participating in such trials is essential for future research. Here, we describe experiences of HIV infected volunteers in Phase I/II HIV vaccine trials conducted in urban Tanzania. MATERIALS AND METHODS: We used a case study design. In-depth interviews were conducted with four participants who became HIV infected during long follow-up visits after completion of vaccination schedules in a Phase I/II trial. Between 3 and 8 years after HIV positive diagnosis, each participant was interviewed at three time points within a two-year interval so as to allow for accumulation of experiences and cross-checking the emerging constructs. Data was analyzed using a qualitative data analysis framework. RESULTS: Analysis revealed that participation in HIV vaccine trials involves balancing controversies and the spirit of informed decision. The participants declared that they did not acquire HIV from the experimental vaccine. Disclosure of HIV status within the family was gender specific. Men were hesitant to disclose their HIV status to their sexual partners fearing for the consequences. Women's attempt to disclose their HIV status yielded negative reactions from the sexual partners. The acquired knowledge from the HIV vaccine research enabled the participants to cope with the uncertainties and their health status. CONCLUSIONS: The knowledge acquired during the Phase I/II HIV vaccine trial appears to be an essential resource to cope with uncertainties post research. The HIV vaccine trial implementers need to understand the challenges the volunteers may confront after the trial while coping with their health status. Longitudinal studies are essential to trace the effects of uncertainties to the individual participants.


Assuntos
Vacinas contra a AIDS , Infecções por HIV , Masculino , Humanos , Feminino , Infecções por HIV/prevenção & controle , Tanzânia , Parceiros Sexuais , Voluntários
20.
BMC Public Health ; 22(1): 1923, 2022 10 15.
Artigo em Inglês | MEDLINE | ID: mdl-36243701

RESUMO

BACKGROUND: Black sexual minority men (SMM) ages 30 and older are under-represented in HIV studies in sub-Saharan Africa, despite being at increased risk of HIV infection and contributing to potential onward HIV transmission. To better understand the social and sexual lives of older Black South African SMM, we conducted in-depth interviews with SMM who were > 30 years old. METHODS: From March-September 2016, we recruited a convenience sample of 37 SMM ages 30 and older by partnering with an LGBTQ+ organization in Tshwane, Pretoria. Men were interviewed about various aspects of their lives, including their sexual orientation, social connectedness, experiences with stigma and perspectives on participating in research. RESULTS: Participants described their experiences with their sexual identities, cultural and social implications of disclosure, and their perspective on South Africa's political perspectives on the LGBTQ+ community. Men described how these experiences influence their trust in research and comfort participating in studies. CONCLUSIONS: Inferences drawn from these findings provide direction on how to improve middle-aged SMM's representation in research, such as recruiting a higher proportion of older and middle-aged SMM to serve as seed participants and building stronger community partnerships to disseminate study findings to settings where data collection is conducted.


Assuntos
Infecções por HIV , Minorias Sexuais e de Gênero , Adulto , Feminino , Homossexualidade Masculina , Humanos , Masculino , Pessoa de Meia-Idade , Comportamento Sexual , Parceiros Sexuais , África do Sul/epidemiologia
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