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1.
Rev Saude Publica ; 54: 97, 2020.
Artigo em Inglês, Português | MEDLINE | ID: mdl-33146302

RESUMO

OBJECTIVE: To identify the prevalence of violence during pregnancy and the association with the socioeconomic, behavioral and clinical characteristics of pregnant women. METHODS: Cross-sectional study in a low-risk maternity hospital in the municipality of Cariacica, Espírito Santo. A total of 330 puerperal women were interviewed from August to October 2017. Information on socioeconomic, behavioral, reproductive and clinical characteristics, as well as life experiences, was collected through a questionnaire. To identify the types of violence, the proper World Health Organization instrument was used. Gross bivariate and multivariate analysis was performed and adjusted for Poisson regression with robust variance. RESULTS: Prevalence was 16.1% (95%CI 2.5-20.4) for psychological violence, 7.6% (95%CI 5.1-11.0) for physical violence and 2.7% (95%CI 1.4-5.2) for sexual violence. Psychological violence remained associated with age, family income, beginning of sexual life, disease in pregnancy, desire to interrupt pregnancy and number of partners. Physical violence was associated with schooling, beginning of sexual life and disease in pregnancy. Sexual violence remained associated with marital status and desire to interrupt pregnancy (p < 0.05). CONCLUSIONS: Psychological violence by an intimate partner was the most prevalent among pregnant women. Women that were younger, had lower income and less schooling, who started their sexual life before the age of 14 and who wished to interrupt pregnancy, experienced violence more frequently during pregnancy.


Assuntos
Violência por Parceiro Íntimo/estatística & dados numéricos , Saúde Mental/estatística & dados numéricos , Abuso Físico/estatística & dados numéricos , Delitos Sexuais/estatística & dados numéricos , Parceiros Sexuais/psicologia , Maus-Tratos Conjugais/estatística & dados numéricos , Adulto , Brasil/epidemiologia , Estudos Transversais , Depressão/epidemiologia , Feminino , Humanos , Violência por Parceiro Íntimo/psicologia , Abuso Físico/psicologia , Gravidez , Prevalência , Fatores de Risco , Delitos Sexuais/psicologia , Fatores Socioeconômicos , Maus-Tratos Conjugais/psicologia
2.
PLoS One ; 15(10): e0229316, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33006966

RESUMO

The prevalence of criticism in everyday social situations, and its empirically demonstrated association with psychopathology, highlight the importance of understanding neural mechanisms underlying the perception and response of individuals to criticism. However, neuroimaging studies to date have been limited largely to maternal criticism. The present study aims to investigate neural responses to observing criticism occurring in the context of three different relationship types: romantic partners, friends, and parents-from a third-party perspective. 49 participants were recruited and asked to rate the perceived criticism for these relationships. Functional near-infrared spectroscopy was used to measure changes in oxygenated haemoglobin levels in the prefrontal cortex when participants read vignettes describing three different scenarios of criticism. Participants were randomly assigned to 3 groups where the given description of the relationship of the protagonist to the source of criticism for each vignette was randomised. A significant interaction between relationship type and perceived criticism ratings for mothers was found in the dorsolateral prefrontal cortex. Compared to low perceived criticism, high perceived criticism individuals showed increased activation reading vignettes describing criticism from romantic partners and parents but decreased activation for those from friends. Findings contribute to understanding neural responses to criticism as observed from a third-party perspective. Future studies can look into differentiating neural responses of personalised experiences of criticism and third-party observations.


Assuntos
Emoções/fisiologia , Amigos/psicologia , Pais/psicologia , Córtex Pré-Frontal/fisiologia , Parceiros Sexuais/psicologia , Adolescente , Adulto , Feminino , Hemoglobinas/metabolismo , Humanos , Relações Interpessoais , Masculino , Neuroimagem , Distribuição Aleatória , Adulto Jovem
3.
Afr J AIDS Res ; 19(3): 249-262, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-33119459

RESUMO

Reducing multiple and concurrent partnerships has been identified as a priority in generalised HIV epidemics, yet developing successful interventions to bring about such behaviour change has proven challenging. We offered a three-session intervention aimed to improve couple relationship quality and address HIV risk factors, particularly concurrent sexual partnerships (CSP), in a peri-urban community of Kampala, Uganda. Before launching the intervention, a different group of community members participated in eight single-gender focus group discussions (FGDs) which explored issues of couple relationship quality and satisfaction. Findings from the FGDs guided the intervention. All 162 couples invited to the intervention completed a survey pre- and post-intervention. In FGDs, women and men discussed challenges faced in their relationships, including pervasive dissatisfaction, financial constraints, deception and lack of trust, poor communication, lack of sexual satisfaction, and concurrent sexual partnerships. A difference-in-difference analysis showed no measurable impact of the intervention on relationship quality or sexual risk behaviours over a six-month follow-up among 183 individuals who participated in the intervention, although many stated in response to open-ended questions that they had experienced positive relationship changes. Qualitative findings suggest high demand for couple-focused interventions but also reveal many individual-, couple-, community- and structural-level factors which contribute to women and men seeking concurrent sexual partnerships. More intensive interventions may be needed to overcome these barriers to behaviour change and reduce HIV risk. These findings also raise questions about how to interpret divergent qualitative and quantitative data, a topic which has received little attention in the literature.


Assuntos
Infecções por HIV/prevenção & controle , Infecções por HIV/psicologia , Relações Interpessoais , Parceiros Sexuais , Adulto , Feminino , Grupos Focais , Infecções por HIV/epidemiologia , Humanos , Masculino , Fatores de Risco , Comportamento Sexual/fisiologia , Parceiros Sexuais/psicologia , População Suburbana , Uganda/epidemiologia
4.
J Womens Health (Larchmt) ; 29(10): 1239-1242, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-33006492

RESUMO

Intimate partner violence (IPV)-defined as physical, psychological, sexual, and/or economic violence typically experienced by women at home and perpetrated by their partners or expartners-is a pervasive form of violence that destroys women's feelings of love, trust, and self-esteem, with important negative consequences on physical and psychological health. Many reports from several countries have underlined a remarkable increase in the cases of IPV during the COVID-19 emergency. In this opinion article, we discussed the hypothesis that such an increase may be related to the restrictive measures enacted to contain the pandemic, including women's forced cohabitation with the abusive partner, as well as the exacerbation of partners' pre-existing psychological disorders during the lockdown. In addition, we retrospectively analyzed some data derived from our practice in a public Italian referral center for sexual and domestic violence (Service for Sexual and Domestic Violence [SVSeD]). These data interestingly revealed an opposite trend, that is, a decrease in the number of women who sought assistance since the beginning of the COVID-19 outbreak. Such a reduction should be interpreted as a negative consequence of the pandemic-related restrictive measures. Although necessary, these measures reduced women's possibilities of seeking help from antiviolence centers and/or emergency services. Owing to the COVID-19 outbreak, there is an urgent need for developing and implementing alternative treatment options for IPV victims (such as online and phone counseling and telemedicine), as well as training programs for health care professionals, especially those employed in emergency departments, to facilitate early detection of IPV.


Assuntos
Infecções por Coronavirus/prevenção & controle , Violência por Parceiro Íntimo/estatística & dados numéricos , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Quarentena/psicologia , Parceiros Sexuais/psicologia , Maus-Tratos Conjugais/estatística & dados numéricos , Betacoronavirus , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/psicologia , Feminino , Humanos , Violência por Parceiro Íntimo/psicologia , Violência por Parceiro Íntimo/tendências , Itália/epidemiologia , Masculino , Pessoa de Meia-Idade , Pneumonia Viral/epidemiologia , Pneumonia Viral/psicologia , Estudos Retrospectivos , Autoimagem , Delitos Sexuais/psicologia , Delitos Sexuais/tendências , Distância Social , Maus-Tratos Conjugais/psicologia , Maus-Tratos Conjugais/tendências
5.
Reprod Health ; 17(1): 152, 2020 Oct 07.
Artigo em Inglês | MEDLINE | ID: mdl-33028424

RESUMO

BACKGROUND: As the global pandemic of corona virus (COVID-19) spreads across continents and communities, people are forced to respond with strict preventive measures such as staying at home and keeping social distance. In relation with these measures, particularly with the staying at home, increasing rates of domestic violence are beginning to surface. Hence, this study was aimed at determining the prevalence of intimate partner violence against reproductive age women in northern Ethiopia during the COVID-19 pandemic. METHODS: A community-based cross-sectional study design was employed. The data were collected during the period of April to May, 2020 using interviews and a self-administered standard questionnaire. The data were entered into the Epi-data manager version 4.2 and exported to SPSS 22 for analysis. The descriptive analysis such as frequency distribution, percentage, and measures of central tendency were used. This was followed by binary and multiple logistic regression analysis to infer the association between the outcome and independent variables. RESULTS: A total of 682 participants were included in the study. The prevalence of intimate partner violence against women was found to stood at 24.6% with psychological violence being the most prevalent (13.3%), followed by physical (8.3%) and sexual violence (5.3%). Women were more likely to suffer from violence if they were housewives (AOR, 95% CI (18.062 (10.088, 32.342))), age less than 30 (AOR, 95% CI (23.045 (5.627, 94.377))), women with arrange marriage (AOR, 95% CI (2.535 (1.572, 4.087))) and women with husband's age being "between" 31-40 (AOR, CI 95% (2.212 (1.024, 4.777))). CONCLUSIONS: This study showed the presence of a relatively high prevalence of intimate partner violence against women. Thus, public reporting of any cases or concerns of abuse is critical and vital to mitigate the problem.


Assuntos
Betacoronavirus/isolamento & purificação , Pesquisa Participativa Baseada na Comunidade , Infecções por Coronavirus/epidemiologia , Violência Doméstica/estatística & dados numéricos , Violência por Parceiro Íntimo/estatística & dados numéricos , Pneumonia Viral/epidemiologia , Delitos Sexuais/estatística & dados numéricos , Parceiros Sexuais/psicologia , Adulto , Infecções por Coronavirus/virologia , Estudos Transversais , Etiópia/epidemiologia , Feminino , Humanos , Masculino , Pandemias , Pneumonia Viral/virologia , Prevalência , Reprodução , Fatores de Risco , Adulto Jovem
6.
PLoS One ; 15(10): e0239323, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33021998

RESUMO

BACKGROUND: Multiple sexual partnerships increase the risk of transmission of HIV and can be exacerbated by substance abuse. However, the association between psychoactive substance use and multiple sexual partnerships among young people in informal settlements of low-income countries is not well known. This study established the prevalence of multiple sexual partnerships and associated factors among young psychoactive-substance-users in informal settlements in Kampala, Uganda. METHODS: This was a cross-sectional study involving 744 young (aged 18-24 years), sexually active, psychoactive substance-users selected from 12 of the 57 informal settlements of Kampala City. The prevalence of multiple sexual partnerships and their differential distribution by socio-demographic strata was established. Modified Poisson regression models were run in Stata 14 software to generate prevalence rate ratios for the factors associated with multiple sexual partnerships. RESULTS: About 40.6% (37.9% of males and 50.0% of females) had engaged in multiple sexual partnerships in the last 30 days. Engaging in multiple sexual partnerships in the last 30 days was positively associated with being female (PR 1.29, 95% CI: 1.03-1.63); staying in the informal settlement for 6-10 years (PR 1.34, 95% CI: 1.02-1.75) and chewing khat in the last 30 days (PR 1.93, 95% CI: 1.10-3.40). CONCLUSION: Multiple sexual partnerships are highly prevalent among young psychoactive-substance-users, irrespective of the socio-demographic strata. Being female, having lived in the informal settlement for 6-10 years, and chewing khat were significantly associated with having multiple sexual partners in the last 30 days. In tackling this high-risk sexual behaviour, it is recommended that risk-reduction interventions are considered for the different socio-demographic strata identified in this study, i.e. females, those who have lived in the informal settlement for about 6-10 years, and those who chew khat.


Assuntos
Comportamento Sexual/estatística & dados numéricos , Transtornos Relacionados ao Uso de Substâncias/psicologia , Adolescente , Criança , Estudos Transversais , Feminino , Humanos , Masculino , Comportamento Sexual/psicologia , Parceiros Sexuais/psicologia , Transtornos Relacionados ao Uso de Substâncias/patologia , Fatores de Tempo , Uganda , Adulto Jovem
7.
Artigo em Inglês | MEDLINE | ID: mdl-32872679

RESUMO

Public helping reactions are essential to reduce a victim's secondary victimization in intimate partner violence against women (IPVAW) cases. Because gender-related characteristics have been linked widely to IPVAW prevalence, the study aimed to examine individual attitudes and perceptions toward different forms of violence against women, as well as gender-related macrosocial ideological and structural factors, in explaining helping reactions to IPVAW across 28 European countries. We performed multilevel logistic regression analysis, taking measures from the Eurobarometer 2016 (N = 7115) and the European Institute for Gender Equality datasets. Our study revealed a greater individual perceived IPVAW prevalence, positive perception about the appropriateness of a legal response to psychological and sexual violence against women partners, and less VAW-supportive attitudes predicted helping reactions (i.e., formal, informal), but not negative reactions to IPVAW. Moreover, individuals from European countries with a greater perceived IPVAW prevalence and gender equality preferred formal reactions to IPVAW. Otherwise, in the European countries with lesser perceived IPVAW prevalence and negative perceptions about the appropriate legal response to psychological and sexual violence, people were more likely to provide informal reactions to IPVAW. Our results showed the role of gender-related characteristics influenced real reactions toward known victim of IPVAW.


Assuntos
Comportamento de Ajuda , Violência por Parceiro Íntimo , Apoio Social , Atitude Frente a Saúde , Europa (Continente)/epidemiologia , Feminino , Humanos , Relações Interpessoais , Violência por Parceiro Íntimo/legislação & jurisprudência , Violência por Parceiro Íntimo/prevenção & controle , Violência por Parceiro Íntimo/psicologia , Violência por Parceiro Íntimo/estatística & dados numéricos , Masculino , Fatores de Risco , Fatores Sexuais , Parceiros Sexuais/psicologia , Fatores Socioeconômicos
8.
J Sex Marital Ther ; 46(8): 747-762, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32878584

RESUMO

In early 2020, the novel coronavirus 2019 (COVID-19) spread across the United States and mitigation measures drastically affected the daily lives of Americans. In this study, we assessed the association between COVID-related relationship conflict and changes in intimate and sexual behaviors and experiences. Using data from an online nationally representative probability survey of 1,010 American adults in April 2020, we estimated the impact of coronavirus-related relationship conflict on changes in intimate and sexual behaviors among those in any type of romantic or sexual relationship (Nweighted=742). Further, we assessed the association between conflict and experience of orgasm and feeling emotionally close to partner. Among individuals in relationships, 34% reported some degree of conflict with their romantic partners due to the spread of COVID-19 and its related restrictions. Those experiencing frequent coronavirus-related conflict with their partner were significantly more likely to report decreased frequency of several solo and partnered intimate and sexual behaviors compared to those not experiencing any such conflict, exhibiting a dose-response trend among partnered sexual behaviors. Since the spread of coronavirus and associated social distancing measures in the United States, Americans have experienced escalations in conflict in their romantic partnerships, which was associated with changes to their intimate and sexual lives.


Assuntos
Infecções por Coronavirus/psicologia , Satisfação Pessoal , Pneumonia Viral/psicologia , Comportamento Sexual/psicologia , Parceiros Sexuais/psicologia , Adulto , Feminino , Humanos , Relações Interpessoais , Masculino , Apego ao Objeto , Pandemias , Comportamento Sexual/estatística & dados numéricos , Inquéritos e Questionários , Estados Unidos
9.
PLoS One ; 15(9): e0238501, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32915838

RESUMO

Digital technologies are increasingly intertwined into people's sexual lives, with growing scholarly interest in the intersection of sex and technology (sex-tech). However, much of the literature is limited by its over emphasis on negative outcomes and the predominance of work by and about North Americans, creating the impression that sex-tech is largely a Western phenomenon. Based on responses from 130,885 women in 191 countries, we assessed how women around the world interact with mobile technology for sex-related purposes, and whether in areas of greater gender inequality, technological accessibility may be empowering women with knowledge about sexuality. We investigated women's use of technology to find sexual partners, learn about sex and improve their sexual relationships, and track their own sexual health. About one-fifth reported using mobile apps to find sexual partners. This use varied by region: about one-third in Oceania, one-fourth in Europe and the Americas, and one-fifth in Asia and Africa. Staying connected when apart was the most commonly selected reason for app use with a sexual partner. About one-third had used an app to track their own sexual activity. Very few reported that the app they used to improve their sexual relationships was detrimental (0.2%) or not useful (0.6%). Women in countries with greater gender inequality were less likely to have used mobile apps to find a sexual partner, but nearly four times more likely to have engaged in sending and receiving sexts. To our knowledge, this study provides the most comprehensive global data on sex-tech use thus far, demonstrates significant regional variations in sex-tech use, and is the first to examine women's engagement in sex-related mobile technology in locations with greater gender disparities. These findings may inform large-scale targeted studies, interventions, and sex education to improve the lives of women around the world.


Assuntos
Direitos Humanos/tendências , Aplicativos Móveis/tendências , Comportamento Sexual/psicologia , Adulto , África , América , Ásia , Atitude , Europa (Continente) , Feminino , Humanos , Pessoa de Meia-Idade , Educação Sexual/tendências , Parceiros Sexuais/psicologia , Sexualidade/psicologia , Tecnologia/tendências
10.
J Sex Med ; 17(10): 1827-1834, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32883631

RESUMO

BACKGROUND: Social distancing in the wake of the coronavirus disease 2019 (COVID-19) pandemic may affect the sexual behavior of men who have sex with men (MSM). In early March 2020, Israel imposed travel restrictions and limited social contacts to household members only. The effects of these restrictions on the sexual behavior and mental health of MSM are unknown. AIM: To assess sexual behaviors and mental health of Israeli MSM during social distancing and to compare sexual behaviors before and during social distancing, due to the COVID-19 pandemic. METHODS: Data were collected through anonymous web-based questionnaires in a popular geospatial application used by MSM between March and April 2020 during the social-distancing period. OUTCOMES: The dependent variable was casual sex, in violation of social-distancing regulations. Independent variables were demographic characteristics, sexual behaviors before and during social-distancing restrictions, and mental health. RESULTS: Of the 2,562 participants, 1,012 (39.5%) continued to meet new casual sex partners during this period. Being of a younger age, single, and with higher levels of mental distress predicted engagement in casual sex during the social-distancing period. MSM reduced their sexual risk and limited sexual repertoire-in particular, kissing with their sexual partners. Participants also spent more time in dating applications than in the pre-social-distancing period and increased their use of sex phone, webcams, and porn consumption. They perceived the threat of severe acute respiratory syndrome coronavirus to be greater than that of HIV: only 3.2% could imagine themselves having sex with a partner who is infected with SARS-CoV-2 compared with 30.1% in case of HIV, P < .01. CLINICAL IMPLICATIONS: MSM reduced their risk behaviors during social distancing because of the threat of COVID-19. Casual sex during social distancing was associated with negative feelings of mental distress. Future public health response in the future waves of COVID-19 morbidity should strike a balance between containment measures and the need for social distancing with its possible mental and social burdens. STRENGTHS AND LIMITATIONS: This is the first study in Israel and one of the few in the world to examine sexual behaviors among MSM during the COVID-19 social distancing period. It involved a relatively large sample, through convenience sampling, which limits causality. Findings should be interpreted cautiously, specifically because COVID-19-related behaviors and circumstances may change rapidly. CONCLUSION: The negative feelings of distress due to social distancing should be considered as a potential barrier to adherence among vulnerable populations, such as MSM. Future public health response should strike a balance between containment measures and its possible mental, social, and financial burdens. Shilo G, Mor Z. COVID-19 and the Changes in the Sexual Behavior of Men Who Have Sex With Men: Results of an Online Survey. J Sex Med 2020;17:1827-1834.


Assuntos
Infecções por Coronavirus/epidemiologia , Homossexualidade Masculina/psicologia , Pneumonia Viral/epidemiologia , Comportamento Sexual/psicologia , Minorias Sexuais e de Gênero/psicologia , Adulto , Estudos Transversais , Infecções por HIV/epidemiologia , Humanos , Israel , Masculino , Pessoa de Meia-Idade , Pandemias , Assunção de Riscos , Parceiros Sexuais/psicologia , Inquéritos e Questionários
11.
PLoS One ; 15(9): e0238240, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32886666

RESUMO

The aim of the study is to compare sociodemographic characteristics, psychosocial factors, HIV knowledge and risk behaviors of people living with HIV (PLH) and their social network members (NMs) to inform HIV prevention programs that engage PLH as prevention educators in their communities. We compared baseline characteristics of PLH enrolled in an intervention to become HIV prevention Change Agents (CAs) (n = 458) and 602 NMs they recruited. CAs and NMs responded to questionnaires through a computer-driven interface with Audio Computer-Assisted Self Interview (ACASI) software. Although NMs scored higher on socio-economic status, self-esteem and general self-efficacy, they had lower HIV knowledge (AOR 1.5; 95% CI: 1.1-2.1), greater inconsistent condom use (AOR 3.2; 95% CI: 2.4-4.9), and recent experience as perpetrators of physical (AOR 2.5; 95% CI: 1.2-5.1) or sexual (AOR 4.1; 95% CI: 1.4-12.7) intimate partner violence; and as victims of physical (AOR 1.5; 95% CI: 1.0-2.3) or sexual (AOR 2.2; 95% CI: 1.3-3.8) forms of violence than CAs. Higher HIV knowledge and lower sexual risk behaviors among CAs suggest PLH's potential as communicators of HIV prevention information to NMs. CAs' training should also focus on improving self-esteem, general self-efficacy and social support to increase their potential effectiveness as HIV prevention educators and enhance their own overall health and well-being.


Assuntos
Transmissão de Doença Infecciosa/prevenção & controle , Infecções por HIV/psicologia , Infecções por HIV/transmissão , HIV/isolamento & purificação , Assunção de Riscos , Parceiros Sexuais/psicologia , Rede Social , Adolescente , Adulto , Antirretrovirais/uso terapêutico , Estudos Transversais , Feminino , Infecções por HIV/epidemiologia , Infecções por HIV/virologia , Humanos , Masculino , Fatores de Risco , Comportamento Sexual/psicologia , Apoio Social , Tanzânia/epidemiologia , Adulto Jovem
12.
PLoS One ; 15(9): e0238314, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32886693

RESUMO

BACKGROUND: Globally, the prevalence of HIV among transgender women remains much higher than that of the general population, and a large proportion of them are unaware of their HIV status. Transgender women are exposed to gender-based violence and social stigma and discrimination in different settings that may create significant barriers to receiving HIV prevention and care services. This study aimed to identify factors associated with recent HIV testing among transgender women in Cambodia. METHODS: We conducted a cross-sectional survey in 2016 among 1375 transgender women recruited from 13 provinces using a peer-based social network recruitment method. We used a structured questionnaire for face-to-face interviews and performed rapid HIV/syphilis testing onsite. We used a multiple logistic regression analysis to identify factors associated with recent HIV testing. RESULTS: Of the total, 49.2% of the participants reported having an HIV test in the past six months. After controlling for other covariates, the odds of having an HIV test in the past six months was significantly lower among students (AOR 0.36, 95% CI 0.20-0.65), participants who perceived that they were unlikely to be HIV infected (AOR 0.50, 95% CI 0.32-0.78), and participants who reported always using condoms with male non-commercial partners in the past three months (AOR 0.65, 95% CI 0.49-0.85) relative to their respective reference group. The odds of having an HIV test in the past six months was significantly higher among participants who had been reached by community-based HIV services (AOR 5.01, 95% CI 3.29-7.65) and received HIV education (AOR 1.65, 95% CI 1.06-2.58) in the past six months relative to their respective reference group. CONCLUSIONS: Despite the widely available free HIV testing services, more than half of transgender women in this study had not received an HIV test in the past six months. Our findings suggest that a tailored and comprehensive combination prevention program, in which HIV testing is linked to care continuum and beyond, maybe an essential next step. Social media may have the potential to be promoted and utilized among transgender women populations in order to improve HIV testing and other prevention measures.


Assuntos
Infecções por HIV/diagnóstico , HIV/isolamento & purificação , Programas de Rastreamento/estatística & dados numéricos , Comportamento Sexual , Parceiros Sexuais/psicologia , Inquéritos e Questionários , Pessoas Transgênero/psicologia , Adolescente , Adulto , Camboja/epidemiologia , Estudos Transversais , Feminino , Infecções por HIV/epidemiologia , Infecções por HIV/virologia , Acesso aos Serviços de Saúde , Humanos , Masculino , Prevalência , Fatores de Risco , Estigma Social , Pessoas Transgênero/estatística & dados numéricos , Adulto Jovem
13.
PLoS One ; 15(8): e0237315, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32866153

RESUMO

The decision to allocate time and energy to find multiple sexual partners or raise children is a fundamental reproductive trade-off. The Strategic Pluralism Hypothesis argues that human reproductive strategies are facultatively calibrated towards either investing in mating or parenting (or a mixture), according to the expression of features dependent on the individual's condition. This study seeks to test predictions derived from this hypothesis in a sample of 242 young men (M ± SD = 22.12 ± 3.08) from Chile's 5th Region (33Ö¯ south latitude). Specifically, two predictions were considered that raise questions about the relationship between traits related to physical and psychological attractiveness (fluctuating facial asymmetry and self-perception of attractiveness) and competitive skills (baseline testosterone and self-perception of fighting ability) with short-term reproductive strategies. Our results indicate that psychological features related to the self-perception of physical attractiveness are related to short-term reproductive strategies. However, no evidence was found that fluctuating facial asymmetry, basal levels of testosterone and self-perception of fighting ability were related to short-term reproductive strategies. These results support the existing evidence of the importance of physical attractiveness in calibrating men's reproductive strategies but cast doubts about the role of fluctuating facial asymmetry. They also suggest that traits related to physical attractiveness, in comparison to competitive capabilities, play a more important role in calibrating men's short-term reproductive strategies.


Assuntos
Beleza , Comportamento de Escolha , Reprodução/fisiologia , Autoimagem , Comportamento Sexual/psicologia , Adolescente , Adulto , Chile , Comportamento Competitivo/fisiologia , Humanos , Parceiros Sexuais/psicologia , Inquéritos e Questionários/estatística & dados numéricos , Testosterona/sangue , Testosterona/fisiologia , Adulto Jovem
14.
Z Psychosom Med Psychother ; 66(3): 287-301, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32876551

RESUMO

Objectives: The study examines body image of male cancer patients and their female partners as well as factors influencing body image. Methods: N = 73 heterosexual couples in which the male partner was diagnosed with prostate (PC; n = 52) or laryngeal cancer (LC; n = 21) completed questionnaires on body image acceptance (Self Image Scale), relationship satisfaction (Quality of Marriage Questionnaire), and cancer-related distress (Questionnaire on Stress in Cancer Patients). The body image was assessed from two perspectives: self-acceptance (which measures a person's satisfaction or acceptance of the body) and partner-acceptance (which assesses a person's perception of the partners' appraisals of the body). Results: No differences occurred in body image acceptance between men with PC or LC. Patients with PC rated the perceived partner-acceptance lower than did their female partners. In couples with LC, women rated the self-acceptance of their partners higher than did the patients themselves. Multiple regression analysis revealed that for survivors of PC, cancer-related distress, relationship satisfaction and partner-acceptance emerged as significant predictors of self-acceptance. The only significant predictor of partner-acceptance was men's self-acceptance. Conclusions: The dissatisfaction with physical appearance is found in PK and LK patients and seems to persist for a long time. Impairment of patients' body image should be identified and addressed to prevent the negative effects on psychosocial stress for patients and relationship satisfaction.


Assuntos
Imagem Corporal , Neoplasias Laríngeas/psicologia , Neoplasias da Próstata/psicologia , Parceiros Sexuais/psicologia , Feminino , Humanos , Masculino , Satisfação Pessoal
15.
Matern Child Health J ; 24(9): 1170-1178, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32754861

RESUMO

INTRODUCTION: Drug use during pregnancy can have negative effects on maternal and child health. However, there is a dearth of data regarding drug use among pregnant women in Kenya, where illicit drug use is on the rise. In this paper, we report factors influencing women's decisions to use drugs during pregnancy. METHODS: In 2015, we conducted in-depth interviews and focus group discussions with 45 women who inject drugs and five key stakeholders involved in provision of services to people who use drugs in coastal Kenya. Inductive thematic analysis was conducted to draw out themes related to key determinants of drug use during pregnancy. RESULTS: Four key themes emerged outlining determinants of drug use during pregnancy: (i) the use of drugs to cope with the stress of unexpected pregnancy, (ii) the continued drug use during pregnancy to manage withdrawal, (iii) the dual effect of pregnancy on drug use either as a facilitator or as a moderator of drug use, and (iv) the role of male intimate partner in influencing women's drug use during pregnancy. CONCLUSION: Our paper reports women's drug use during pregnancy and the factors influencing this phenomenon. To safeguard the health and well-being of pregnant women and their unborn children, there is a need for education and awareness raising, implementing couple-based harm reduction approaches to leverage on positive male influences, improving availability of drug treatment, and provision of family planning interventions for women who use drugs.


Assuntos
Gestantes/psicologia , Parceiros Sexuais/psicologia , Transtornos Relacionados ao Uso de Substâncias/complicações , Adolescente , Adulto , Feminino , Grupos Focais , Redução do Dano , Humanos , Relações Interpessoais , Entrevistas como Assunto , Quênia , Pessoa de Meia-Idade , Gravidez , Gestantes/etnologia , Pesquisa Qualitativa , Fatores Socioeconômicos , Transtornos Relacionados ao Uso de Substâncias/psicologia , Adulto Jovem
16.
PLoS Med ; 17(8): e1003274, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32810146

RESUMO

BACKGROUND: Intimate partner violence (IPV) is associated with increased HIV risk and other adverse health and psychosocial outcomes. We assessed the impact of Unite for a Better Life (UBL), a gender-transformative, participatory intervention delivered to men, women, and couples in Ethiopia in the context of the coffee ceremony, a traditional community-based discussion forum. METHODS AND FINDINGS: Villages (n = 64) in 4 Ethiopian districts were randomly allocated to control, men's UBL, women's UBL, or couples' UBL, and approximately 106 households per village were randomly selected for inclusion in the trial. The intervention included 14 sessions delivered twice weekly by trained facilitators; control arm households were offered a short IPV educational session. Primary outcomes were women's experience of past-year physical or sexual IPV 24 months postintervention. Secondary outcomes included male perpetration of past-year physical or sexual IPV, comprehensive HIV knowledge, and condom use at last intercourse. Additional prespecified outcomes included experience and perpetration of past-year physical and/or sexual IPV and emotional IPV, HIV/AIDs knowledge and behaviors, decision-making, and gender norms. An intention-to-treat (ITT) analysis was conducted, evaluating 6,770 households surveyed at baseline in 2014-2015 (1,680 households, 16 clusters in control; 1,692 households, 16 clusters in couples' UBL; 1,707 households, 16 clusters in women's UBL; 1,691 households, 16 clusters in men's UBL). Follow-up data were available from 88% of baseline respondents and 87% of baseline spouses surveyed in 2017-2018. Results from both unadjusted and adjusted specifications are reported, the latter adjusting for age, education level, marriage length, polygamy, socioeconomic status, and months between intervention and endline. For primary outcomes, there was no effect of any UBL intervention compared to control on women's past-year experience of physical (couples' UBL arm adjusted odds ratio [AOR] = 1.00, 95% confidence interval [CI]: 0.77-1.30, p = 0.973; women's UBL arm AOR = 1.11, 95% CI 0.87-1.42, p = 0.414; men's UBL arm AOR = 1.02, 95% CI: 0.81-1.28, p = 0.865) or sexual IPV (couples' UBL arm AOR = 0.86, 95% CI: 0.62-1.20, p = 0.378; women's UBL arm AOR = 1.15, 95% CI: 0.89-1.50; p = 0.291; men's UBL arm AOR = 0.80, 95% CI: 0.63-1.01, p = 0.062). For the secondary outcomes, only the men's UBL intervention significantly reduced male perpetration of past-year sexual IPV (AOR: 0.73; 95% CI: 0.56-0.94, p = 0.014), and no intervention reduced perpetration of past-year physical IPV. Among women, the couples' UBL intervention significantly improved comprehensive HIV knowledge, and both couples' and women's UBL significantly increased reported condom use at last intercourse. Among additional outcomes of interest, the men's UBL intervention was associated with a significant reduction in women's experience of past-year physical and/or sexual IPV (AOR = 0.81, 95% CI: 0.66-0.99, p = 0.036) and men's perpetration of physical and/or sexual IPV (AOR = 0.78; 95% CI: 0.62-0.98, p = 0.037). UBL delivered to men and couples was associated with a significant reduction in HIV risk behaviors and more equitable intrahousehold decision-making and household task-sharing. The primary limitation is reliance on self-reported data. CONCLUSIONS: A gender-transformative intervention delivered to men was effective in reducing self-reported perpetration of sexual IPV but did not reduce IPV when delivered to couples or women. We found evidence of decreased sexual IPV with men's UBL across men's and women's reports and of increased HIV knowledge and condom use at last intercourse among women. The men's UBL intervention could help accelerate progress towards gender equality and combating HIV/AIDS. TRIAL REGISTRATION: The trial was prospectively registered at clinicaltrials.gov (NCT02311699) and in the American Economic Association registry (AEARCTR-0000211).


Assuntos
Características Culturais , Infecções por HIV/etnologia , Infecções por HIV/terapia , Violência por Parceiro Íntimo/etnologia , População Rural , Parceiros Sexuais , Adolescente , Adulto , Análise por Conglomerados , Serviços de Saúde Comunitária/métodos , Etiópia/etnologia , Feminino , Infecções por HIV/psicologia , Humanos , Violência por Parceiro Íntimo/psicologia , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Parceiros Sexuais/psicologia , Resultado do Tratamento , Adulto Jovem
17.
PLoS Med ; 17(8): e1003131, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32810147

RESUMO

BACKGROUND: Intimate partner violence (IPV) is linked to substance use by male perpetrators and is associated with an increased risk of depression for women who experience violence. Unite for a Better Life (UBL) is a gender-transformative intervention delivered to men, women, and couples in Ethiopia; previous evidence demonstrated the intervention significantly reduced experience of and perpetration of IPV when delivered to men and led to more equitable household task-sharing when delivered to men and couples. The aim of this analysis is to assess engagement in the UBL intervention and to examine the relationship between random assignment to the intervention and men's past-year substance use and women's reported depressive symptoms as measured at the individual level. METHODS AND FINDINGS: A sample of 64 villages in Gurague zone, Ethiopia, was randomly allocated to 4 arms (men's UBL, women's UBL, couples' UBL, or control). In each village, 106 households were randomly sampled, and households in the intervention arms were invited to participate in UBL, consisting of 14 sessions delivered by trained facilitators. Households in the control arm were offered a short educational session on IPV. Descriptive data on participant engagement in the intervention are reported, and outcomes assessed in an intention-to-treat (ITT) analysis include male use of substances (alcohol and khat) and women's depressive symptoms as measured by the Patient Health Questionnaire (PHQ-9). Results from both adjusted and unadjusted specifications are reported, the latter adjusting for baseline covariates including age, education level, marriage length, polygamy, socioeconomic status, months between intervention and endline, and the baseline level of the outcome variable. The baseline sample includes 6,770 respondents surveyed in 2014-2015, and follow-up data were available from 88% of baseline respondents surveyed in 2017-2018; the majority of respondents report no education, and 61% are Muslim. Respondents reported high attendance rates and engagement in the intervention. In addition, there was evidence of a significant reduction in frequent past-year alcohol intoxication self-reported by men (adjusted odds ratio [AOR] = 0.56, 95% CI 0.36-0.85, p = 0.007), and a significant increase in the probability of frequent khat use self-reported by men (AOR = 3.09, 95% CI 1.37-6.96, p = 0.007), both observed in the couples' UBL arm at 24 months' follow-up relative to the control arm. There was a significant increase in symptoms of moderate depression among women in the women's UBL arm only (AOR = 1.65, 95% CI 1.13-2.41, p = 0.010), again relative to the control arm. There was no evidence of shifts in symptoms of mild or severe depression. The primary limitation of this study is the reliance on self-reported data around sensitive behaviors. CONCLUSIONS: The findings suggest that the UBL intervention was associated with a reduction in men's use of alcohol when delivered to couples, but there was no evidence of a decrease in reported symptoms of depression among women in any experimental arm, and some evidence of an increase in symptoms of moderate depression in the women's UBL arm. Further research should explore how to optimize IPV prevention interventions to target related risks of mental health and substance use. TRIAL REGISTRATION: Clinicaltrials.gov NCT02311699; Socialscienceregistry.org AEARCTR-0000211.


Assuntos
Depressão/psicologia , Depressão/terapia , Violência por Parceiro Íntimo/prevenção & controle , Violência por Parceiro Íntimo/psicologia , Transtornos Relacionados ao Uso de Substâncias/psicologia , Transtornos Relacionados ao Uso de Substâncias/terapia , Adulto , Análise por Conglomerados , Depressão/epidemiologia , Etiópia/epidemiologia , Feminino , Seguimentos , Humanos , Masculino , Autorrelato , Parceiros Sexuais/psicologia , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Inquéritos e Questionários , Adulto Jovem
18.
PLoS One ; 15(8): e0238097, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32853263

RESUMO

BACKGROUND: Efforts to promote male partner involvement in the prevention of mother-to-child transmission (PMTCT) may inadvertently exploit gender power differentials to achieve programme targets. METHODS: We explored women's relative power and perceptions of male partner involvement through interviews with postpartum Zambian women living with HIV (n = 32) using a critical discourse analysis. RESULTS: Women living with HIV reported far-reaching gender power imbalances, including low participation in household decision-making, economic reliance on husbands, and oppressive gendered sexual norms, which hindered their autonomy and prevented optimal mental and physical health during and after their pregnancy. When the husband was HIV-negative, sero-discordance exacerbated women's low power in these heterosexual couples. Male involvement in HIV care was both helpful and hurtful, and often walked a fine line between support for the woman and controlling behaviours over her. Inequities in the sexual divisions of power and labour and gender norms, combined with HIV stigma created challenging circumstances for women navigating the PMTCT cascade. CONCLUSIONS: Future programmes should consider the benefits and risks of male partner involvement within specific relationships and according to women's needs, rather than advocating for universal male involvement in PMTCT. This work highlights the persistent need for gender transformative approaches alongside PMTCT efforts.


Assuntos
Infecções por HIV/psicologia , Entrevistas como Assunto , Poder Psicológico , Complicações Infecciosas na Gravidez/psicologia , Parceiros Sexuais/psicologia , Apoio Social , Adulto , Feminino , Humanos , Lactente , Masculino , Gravidez , Estigma Social , Adulto Jovem , Zâmbia
19.
PLoS One ; 15(6): e0234697, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32603363

RESUMO

Assisted HIV partner notification services provide a safe and effective way for people living with HIV (PLHIV) to inform their partners about the possibility of exposure and to offer them testing, treatment, and support. This study examined whether or not PLHIV in prison might be willing to participate in assisted HIV partner notification services and their reasons for and against disclosing their HIV-positive status to their partners. PLHIV (n = 150) recruited from Jakarta's two largest all-male prisons completed an interviewer-administered questionnaire collecting demographic and risk behavior data, and attitudes toward HIV disclosure and partner services. Among those who were sexually active and/or injecting drugs before incarceration, two-thirds (66.4%, 91/137) endorsed provider referral as an acceptable way to notify their sex partners, and nearly three quarters (72.4%, 89/123) endorsed provider referral to notify their drug-injecting partners. Only a quarter (25.1%) of participants reported that their main sex partner had ever received an HIV test. Participants with anticipated stigma were less likely to endorse provider referral for sex partners (adjusted odds ratio [aOR] = 0.58, 95% CI: 0.35, 0.96) and drug-injecting partners (aOR = 0.54, 95% CI: 0.29, 1.00). Relationship closeness was associated with higher odds of endorsing provider referral for drug-injecting partners (aOR = 2.08, 95% CI: 1.25, 3.45). Protecting partners from infection and a moral duty to inform were main reasons to disclose, while stigma and privacy concerns were main reasons not to disclose. Most incarcerated PLHIV have at-risk partners in the community who they would be willing to notify if provided with assistance. Assisted partner notification for prison populations offers a promising public health approach to accelerate diagnosis, treatment, and prevention of HIV infection in the community, particularly among women.


Assuntos
Infecções por HIV/epidemiologia , Aceitação pelo Paciente de Cuidados de Saúde , Prisioneiros , Prisões , Parceiros Sexuais , Inquéritos e Questionários , Adulto , Objetivos , Infecções por HIV/psicologia , Humanos , Indonésia , Masculino , Prisioneiros/psicologia , Encaminhamento e Consulta , Assunção de Riscos , Parceiros Sexuais/psicologia
20.
J Med Internet Res ; 22(8): e20961, 2020 08 06.
Artigo em Inglês | MEDLINE | ID: mdl-32716895

RESUMO

BACKGROUND: In the past few months, the coronavirus disease (COVID-19) pandemic has caused extensive economic and social damage. OBJECTIVE: The purpose of this study was to assess the impact of COVID-19-related measures on partner relationships and sexual and reproductive health in China. METHODS: From May 1 to 5, 2020, 3500 young Chinese individuals were recruited through WeChat or Weibo to participate in a survey to obtain information on sexual and reproductive health (eg, sexual desire, frequency of sexual intercourse, sexual satisfaction, etc). The questionnaire also collected demographic data (eg, age, race, education, current financial status, sexual orientation, relationship status, etc). RESULTS: In total, 967 participants were included in the sexual health analysis. Due to the COVID-19 pandemic and related containment measures, 22% of participants (n=212) reported a decrease in sexual desire; 41% (n=396) experienced a decrease in the sexual intercourse frequency; 30% (n=291) reported an increase in the frequency of masturbation; 20% (n=192) reported a decrease in alcohol consumption before or during sexual activities, and 31% (n=298) reported a deterioration in partner relationships during the pandemic. The logistic regression analysis indicated that the following influenced partner relationships: accommodations during the pandemic (P=.046; odds ratio [OR] 0.59; 95% CI 0.30-0.86); exclusive relationship status (yes or no) (P<.001; OR 0.44; 95 % CI 0.27-0.73); sexual desire (P=.02; OR 2.01; 95% CI 1.38-2.97); and sexual satisfaction (P<.001; OR 1.92; 95% CI 1.54-2.50). COVID-19 also caused disruptions in reproductive health services such as prenatal and postnatal care, childbirth and abortion services, contraception availability, and the management of sexually transmitted infections. CONCLUSIONS: Our results show that many young people have wide-ranging issues affecting their sexual and reproductive health due to the COVID-19 pandemic and related containment measures. Strategies and guidelines are needed to safeguard the sexual and reproductive health of young people during this pandemic.


Assuntos
Infecções por Coronavirus/epidemiologia , Inquéritos Epidemiológicos , Pandemias , Pneumonia Viral/epidemiologia , Saúde Reprodutiva/estatística & dados numéricos , Comportamento Sexual/estatística & dados numéricos , Saúde Sexual/estatística & dados numéricos , Aborto Induzido/estatística & dados numéricos , Adolescente , Adulto , China/epidemiologia , Estudos Transversais , Feminino , Humanos , Masculino , Razão de Chances , Assistência Perinatal/estatística & dados numéricos , Gravidez , Parceiros Sexuais/psicologia , Doenças Sexualmente Transmissíveis/terapia , Isolamento Social , Adulto Jovem
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