Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 6.658
Filtrar
1.
AIDS Educ Prev ; 33(3): 169-186, 2021 06.
Artigo em Inglês | MEDLINE | ID: mdl-34014113

RESUMO

The objective of this study was to evaluate the efficacy of two psychosocial interventions (Didactic and ACCENT) on socio-cognitive risk factors, in vulnerable Mozambican women at risk for HIV/AIDS infection. The study design was a randomized controlled trial on Mozambican women at HIV/AIDS risk (n = 150). The participants were randomized into three groups: Didactic Intervention (experimental group), ACCENT intervention (experimental group), and control group. We used an adapted version of the Women's Health Questionnaire, which includes a series of scales and questionnaires assessing psychosocial relevant dimensions to female protection towards HIV/AIDS: HIV/AIDS knowledge, condom use negotiation self-efficacy, and perceived barriers against safer sex. Both interventions were equally effective in increasing HIV/AIDS knowledge. The ACCENT intervention was especially effective in promoting condom use negotiation self-efficacy and in decreasing perceived barriers against safer sex, essential variables for sexual protection. These results support the adaptation of Western interventions to the African context.


Assuntos
Síndrome de Imunodeficiência Adquirida/prevenção & controle , Preservativos/estatística & dados numéricos , Infecções por HIV/prevenção & controle , Conhecimentos, Atitudes e Prática em Saúde , Negociação , Intervenção Psicossocial , Autoeficácia , Adolescente , Adulto , Cognição , Feminino , Promoção da Saúde , Humanos , Fatores de Risco , Sexo Seguro , Comportamento Sexual/psicologia , Saúde Sexual , Inquéritos e Questionários , Saúde da Mulher
2.
Exp Clin Psychopharmacol ; 29(2): 178-190, 2021 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-33793290

RESUMO

Alcohol use is a key risk factor for HIV infection among men who have sex with men (MSM), primarily because it interferes with condom use. However, little is known about the cognitive-emotional mechanisms through which alcohol influences decisions to use condoms with high-risk partners among MSM. In this study, we tested whether alcohol-related deficits in inhibitory control and attention bias toward sexual cues (vs. condoms and neutral cues) accounted for increases in condomless anal sex (CAS) intentions after drinking among MSM. Heavy-drinking, high-risk MSM (N = 83) were randomly assigned to receive (a) alcohol, (b) placebo, or (c) control beverages before behavioral tasks assessing inhibitory control and attention bias, and a video-based sexual risk scenario that assessed several aspects of sexual decision making. Results showed that inhibitory control and attention bias to sexual cues did not mediate associations between intoxication and CAS intentions. Inhibitory control deficits also did not moderate the indirect effects of intoxication on CAS intentions through attention bias. Three-way interactions between alcohol/placebo condition, inhibitory control, and attention bias were also not significant. Together, these findings provide little evidence that these two processes play a significant role in alcohol-involved HIV risk, at least as assessed by the specific tasks used in this study. (PsycInfo Database Record (c) 2021 APA, all rights reserved).


Assuntos
Intoxicação Alcoólica/psicologia , Infecções por HIV/psicologia , Homossexualidade Masculina/psicologia , Comportamento Sexual/psicologia , Adulto , Consumo de Bebidas Alcoólicas/psicologia , Cognição , Preservativos/estatística & dados numéricos , Emoções , Humanos , Intenção , Masculino , Pessoa de Meia-Idade , Fatores de Risco , Assunção de Riscos , Parceiros Sexuais/psicologia , Minorias Sexuais e de Gênero/psicologia , Sexo sem Proteção/estatística & dados numéricos , Adulto Jovem
3.
Public Health ; 194: 116-120, 2021 May.
Artigo em Inglês | MEDLINE | ID: mdl-33887599

RESUMO

OBJECTIVES: Sexual behaviors of homeless youth in Iran have not been well studied. This study aimed to measure the frequency and associated factors of sex out of marriage and condom use among homeless youth in Kerman, Iran. STUDY DESIGN: In this cross-sectional study, we recruited 202 homeless youth (age: 15-29 years who experienced 30 or more days of homelessness in the last 12 months) from 11 street locations between September to December 2017. METHODS: Of 202 participants, 169 (83.7%) reported sex in the last 12 months and were include in this analysis. We assessed the prevalence of sex out of marriage in the last 12 months, condom use in last sex, and then evaluated their covariates in multivariable logistic regression analysis. RESULTS: The prevalence of sex out of marriage was 19.6% (95% confidence intervals [CIs]: 13.8%, 26.3%) and the prevalence of condom use was 43.8% (95% CI: 36.2%, 51.6%). Sex out of marriage was significantly correlated with male gender (adjusted odds ratio [AOR]: 24.38; 95% CI: 3.1-192.1) and being unmarried (AOR: 5.94; 95% CI: 2.3-15.5). Condom use was significantly correlated with male gender (AOR: 2.16; 95% CI: 1.1-4.2) and higher educational status (AOR: 4.30; 95% CI: 2.1-8.8). CONCLUSION: Our findings indicate that one in five homeless youth had sex out of marriage, and less than half did no use condom. These should be addressed by adapting education and harm reduction programs targeting this specific population in Iran.


Assuntos
Preservativos/estatística & dados numéricos , Jovens em Situação de Rua/psicologia , Casamento/estatística & dados numéricos , Comportamento Sexual/estatística & dados numéricos , Adolescente , Adulto , Estudos Transversais , Feminino , Jovens em Situação de Rua/estatística & dados numéricos , Humanos , Irã (Geográfico) , Masculino , Adulto Jovem
4.
Afr J AIDS Res ; 20(1): 6-14, 2021 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-33685378

RESUMO

The male condom is the most cost-effective method for prevention of HIV and other sexually transmitted infections (STIs), yet in high-burden countries, promotion of its use remains difficult to achieve, especially among high-risk individuals. This review reports on women's perspectives of male condom use and identifies outcome measures that will assist in understanding barriers to male condom use in a South African setting. The Boolean search method was used to retrieve literature, from which 18 studies met the inclusion criteria. The use of the male condom was generally low and inconsistent. Use was higher among women who engaged in transactional sex. Most women had difficulty in negotiating condom use with their partners, particularly if they were in male-dominated relationships or were financially dependent on their partner. Women with higher education levels were able to negotiate use more easily. Interventions for assertive negotiation skills were useful. However, the stigma of infidelity and HIV infection are barriers to condom use. Incorrect use further reduces protection. This review emphasises that women are a vulnerable group who are not always able to control their own protection. Further implementation of the health policies promoting interventions for condom use are required to assist women in taking control of their own protection. Intervention measures should be adapted to include the male population so that they understand and accept condom use. Education to address unequal gender dynamics within relationships is also essential. Much work is required to make women feel less vulnerable in their relationships.


Assuntos
Preservativos , Infecções por HIV/prevenção & controle , Doenças Sexualmente Transmissíveis/prevenção & controle , Adulto , Preservativos/estatística & dados numéricos , Feminino , Humanos , Masculino , Negociação , Avaliação de Resultados em Cuidados de Saúde , Comportamento Sexual , África do Sul
5.
PLoS One ; 16(2): e0245925, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33539363

RESUMO

OBJECTIVE: Since the recent introduction of preexposure prophylaxis (PrEP), several studies have reported a decrease in the use of condoms and a rise in STIs among users. This rise in risk behavior associated with the advent of PrEP is known as "risk compensation." The aim of this study is to measure clinical and behavioral changes associated with the introduction of PrEP by analyzing condom use for anal intercourse, number of sexual partners, sexualized drug use and STI incidence. METHODS: We performed a retrospective descriptive study of PrEP users followed every 3months over a 2-year period spanning 2017-2019 in a referral clinic specializing in STI/HIV in Madrid, Spain. One hundred ten men who have sex with men and transgender women underwent regular screening for STIs and hepatitis C virus (HCV) infection. Sociodemographic, clinical, and behavioral data were gathered for all subjects studied. RESULTS: The risk compensation observed in this study consisted primarily of a lower rate of condom use, while the number of sexual partners and recreational drug consumption remained stable. We observed a very high incidence of STIs in this sample, particularly rectal gonorrhea and chlamydia. The factors shown to be independently associated with the presence of an STI on multivariate analysis were age below 30 years and over 10 sexual partners/month. CONCLUSION: The incidence of STI acquisition was higher than expected, indicating a need for strategies to minimize this impact, particularly among younger individuals with a higher number of sexual partners.


Assuntos
Preservativos/estatística & dados numéricos , Homossexualidade Masculina/estatística & dados numéricos , Profilaxia Pré-Exposição/estatística & dados numéricos , Doenças Sexualmente Transmissíveis/epidemiologia , Doenças Sexualmente Transmissíveis/prevenção & controle , Adulto , Homossexualidade Masculina/psicologia , Humanos , Incidência , Masculino , Assunção de Riscos , Adulto Jovem
6.
Lancet HIV ; 8(4): e206-e215, 2021 04.
Artigo em Inglês | MEDLINE | ID: mdl-33617783

RESUMO

BACKGROUND: During the COVID-19 pandemic, men who have sex with men (MSM) in the USA have reported similar or fewer sexual partners and reduced HIV testing and care access compared with before the pandemic. Pre-exposure prophylaxis (PrEP) use has also declined. We aimed to quantify the potential effect of COVID-19 on HIV incidence and HIV-related mortality among US MSM. METHODS: We used a calibrated, deterministic, compartmental HIV transmission model for MSM in Baltimore (MD, USA) and available data on COVID-19-related disruptions to HIV services to predict effects of reductions in sexual partners (0%, 25%, 50%), condom use (5%), HIV testing (20%), viral suppression (10%), PrEP initiations (72%), PrEP adherence (9%), and antiretroviral therapy (ART) initiations (50%). In our main analysis, we modelled disruptions due to COVID-19 starting Jan 1, 2020, and lasting 6 months. We estimated the median change in cumulative new HIV infections and HIV-related deaths among MSM over 1 and 5 years, compared with a base case scenario without COVID-19-related disruptions. FINDINGS: A 25% reduction in sexual partners for 6 months among MSM in Baltimore, without HIV service changes, could reduce new HIV infections by median 12·2% (95% credible interval 11·7 to 12·8) over 1 year and median 3·0% (2·6 to 3·4) over 5 years. In the absence of changes in sexual behaviour, the 6-month estimated reductions in condom use, HIV testing, viral suppression, PrEP initiations, PrEP adherence, and ART initiations combined are predicted to increase new HIV infections by median 10·5% (5·8 to 16·5) over 1 year, and by median 3·5% (2·1 to 5·4) over 5 years. Disruptions to ART initiations and viral suppression are estimated to substantially increase HIV-related deaths (ART initiations by median 1·7% [0·8 to 3·2], viral suppression by median 9·5% [5·2 to 15·9]) over 1 year, with smaller proportional increases over 5 years. The other individual disruptions (to HIV testing, PrEP and condom use, PrEP initiation, and partner numbers) were estimated to have little effect on HIV-related deaths (<1% change over 1 or 5 years). A 25% reduction in sexual partnerships is estimated to offset the effect of the combined service disruptions on new HIV infections (change over 1 year: median -3·9% [-7·4 to 1·0]; over 5 years: median 0·0% [-0·9 to 1·4]), but not on HIV deaths (change over 1 year: 11·0% [6·2 to 17·7]; over 5 years: 2·6% [1·5 to 4·3]). INTERPRETATION: Maintaining access to ART and adherence support is of the utmost importance to maintain viral suppression and minimise excess HIV-related mortality due to COVID-19 restrictions in the USA, even if disruptions to services are accompanied by reductions in sexual partnerships. FUNDING: National Institutes of Health.


Assuntos
Fármacos Anti-HIV/uso terapêutico , COVID-19/epidemiologia , Preservativos/estatística & dados numéricos , Infecções por HIV/epidemiologia , Modelos Estatísticos , Profilaxia Pré-Exposição/estatística & dados numéricos , Adolescente , Adulto , Afro-Americanos , Terapia Antirretroviral de Alta Atividade , Baltimore/epidemiologia , Grupo com Ancestrais do Continente Europeu , Infecções por HIV/etnologia , Infecções por HIV/mortalidade , Infecções por HIV/transmissão , Acesso aos Serviços de Saúde/estatística & dados numéricos , Homossexualidade Masculina , Humanos , Incidência , Masculino , Prognóstico , Assunção de Riscos , Parceiros Sexuais , Análise de Sobrevida
7.
J Acquir Immune Defic Syndr ; 87(1): 652-662, 2021 05 01.
Artigo em Inglês | MEDLINE | ID: mdl-33507013

RESUMO

INTRODUCTION: Young women who sell sex (YWSS) are at disproportionate risk of HIV. Reducing YWSS' vulnerability requires engaging their male sexual partners. To achieve this, we need to understand the characteristics and dynamics of their sexual partnerships to inform effective interventions. METHODS: We conducted a mixed-methods study to compare YWSS' qualitative descriptions of male partners with categories reported in a behavioral survey. Data were drawn from enrollment into an evaluation of the DREAMS initiative in Zimbabwe in 2017. As part of a respondent-driven sampling survey, we recruited 40 seed participants from 2 intervention and 4 comparison sites. We conducted semistructured interviews with 19 "seeds," followed by a behavioral survey with 2387 YWSS. We interpreted quantitative and qualitative data together to understand how YWSS perceived male sexual partners, assess how well survey variables related to narrative descriptions, and describe patterns of risk behavior within partnerships. RESULTS: Qualitative data suggest survey categories "husband" and "client" reflect YWSS' perceptions but "regular partner/boyfriend" and "casual partner" do not. In interviews, use of the term "boyfriend" was common, describing diverse relationships with mixed emotional and financial benefits. More than 85% of male partners provided money to YWSS, but women were less likely to report condomless sex with clients than regular partners (11% vs 37%) and more likely to report condomless sex with partners who ever forced them to have sex (37% vs 21%). CONCLUSIONS: Reducing HIV risk among YWSS requires prevention messages and tools that recognize diverse and changing vulnerability within and between sexual relationships with different male partners.


Assuntos
Infecções por HIV/epidemiologia , Profissionais do Sexo/psicologia , Profissionais do Sexo/estatística & dados numéricos , Comportamento Sexual/psicologia , Comportamento Sexual/estatística & dados numéricos , Adolescente , Adulto , Preservativos/estatística & dados numéricos , Feminino , Infecções por HIV/prevenção & controle , Humanos , Masculino , Assunção de Riscos , Profissionais do Sexo/educação , Parceiros Sexuais/psicologia , Sexo sem Proteção , Adulto Jovem , Zimbábue
8.
Reprod Health ; 18(1): 7, 2021 Jan 06.
Artigo em Inglês | MEDLINE | ID: mdl-33407642

RESUMO

BACKGROUND: Misconceptions about the usefulness of condoms and other contraceptives still expose many unmarried adolescents to the risk of unwanted teenage pregnancies and sexually-transmitted infections (STIs). This study explored beliefs and misconceptions about condoms and other contraceptives among adolescents in Ebonyi state, south-east Nigeria. METHOD: A qualitative study was undertaken in six local government areas in Ebonyi state, southeast Nigeria. Data were collected within a period of one month from in and out-of-school adolescents aged 13-18 years using twelve focus group discussions (FGD). The data were analyzed using the thematic framework approach. RESULT: Majority of the adolescents were knowledgeable about methods of contraception, how they are used and their modes of action. They were also knowledgeable about the dual effects of condoms in prevention of pregnancy and STIs. However, some misconceptions that were expressed by some adolescents were that pregnancy could be prevented by the use of (i) hard drugs, (ii) laxatives, (iii) white chlorine, and (iv) boiled alcoholic beverages. Condoms were described by some adolescent boys as reusable. Condoms were also perceived by some adolescents to reduce sexual pleasure, and this opinion was mostly held by boys. Coitus interruptus (withdrawal method) was therefore considered more preferable than condoms for prevention of pregnancy. CONCLUSION: Although majority adolescents have knowledge about contraception and condom use, some misconceptions still persist. These misconceptions put many adolescents at increased risk for pregnancy and STIs which are detrimental to their health and wellbeing. Concerted efforts should be made through educational and behaviour change interventions in schools and within communities to debunk persisting misconceptions about contraception including the use of condom, and properly educate adolescents on safe sex practices. Adolescents engage in unprotected sexual intercourse and other risky sexual behaviours because of some mistaken beliefs and wrong impressions about how to prevent unwanted pregnancy. These risky sexual behaviours predispose adolescents to sexually transmitted infections, unsafe abortion and other reproductive health problems. In this qualitative study, we explored some of these mistaken beliefs about condoms and other methods of preventing pregnancy. During focus group discussions, adolescents identified modern contraceptive methods, and described their modes of action and how they are used. They also discussed their contraceptive preferences and perceived effects of condoms on sexual pleasure. Although some of these adolescents were able to correctly mention various types of contraceptives and their modes of action, there were numerous wrong impressions. Hard drugs, laxatives, white chlorine and boiled alcoholic beverage were listed as emergency contraceptive methods. Emergency pills were perceived to work by flushing away spermatozoa from a girl's system after sexual intercourse. Male condoms were perceived to be potentially dangerous because they could break and enter into the body of the female sexual partner. Some adolescent boys had the notion that particular brands of male condoms could be washed and reused. Notions about condom use and sexual pleasure varied for girls and boys. Some adolescent girls perceived that condom use during sex increases sexual pleasure because of the assurance of being protected from STIs and pregnancy. Adolescent boys were of the opinion that condoms interfere with the pleasure of direct 'flesh to flesh' contact during sex. There was a general belief that contraceptive use in early age reduces fertility prospects for boys and girls. Mistaken beliefs about methods of preventing pregnancy persist among adolescents, and this raises concerns about the quality of information they receive. Concerted efforts should be made to debunk these wrong beliefs and properly educate adolescents on safe sex practices.


Assuntos
Preservativos/estatística & dados numéricos , Anticoncepção/psicologia , Conhecimentos, Atitudes e Prática em Saúde , Gravidez na Adolescência/prevenção & controle , Sexo Seguro/estatística & dados numéricos , Doenças Sexualmente Transmissíveis/prevenção & controle , Adolescente , Anticoncepção/métodos , Feminino , Humanos , Masculino , Nigéria , Gravidez , Comportamento Sexual
9.
AIDS Behav ; 25(3): 748-757, 2021 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-32940826

RESUMO

In Brazil, pre-exposure prophylaxis (PrEP) is currently available for gay, bisexual, and other men who have sex with men. As PrEP use depends on an individual's perceived risk, we explored pathways by which potentially modifiable behaviors lead to high perceived HIV risk. Using online surveys (N = 16,667), we conducted a path analysis on the basis of ordered sequences of multivariate logistic regressions. High perceived HIV risk was low (26.3%) compared to condomless receptive anal sex (41.4%). While younger age increased the odds of binge drinking and of condomless receptive anal sex, it was associated with decreased odds of high perceived HIV risk. In contrast, use of stimulants increased the odds of condomless receptive anal sex and of high perceived HIV risk. Our results suggest that binge drinking and use of stimulants are key points in different pathways to high-risk sexual behavior and may lead to different perceptions of HIV risk.


Assuntos
Consumo Excessivo de Bebidas Alcoólicas/epidemiologia , Preservativos/estatística & dados numéricos , Infecções por HIV/prevenção & controle , Homossexualidade Masculina/estatística & dados numéricos , Transtornos Relacionados ao Uso de Substâncias/psicologia , Adolescente , Adulto , Consumo Excessivo de Bebidas Alcoólicas/complicações , Brasil/epidemiologia , Estudos Transversais , Infecções por HIV/epidemiologia , Homossexualidade Masculina/psicologia , Humanos , Masculino , Profilaxia Pré-Exposição , Comportamento Sexual , Parceiros Sexuais , Transtornos Relacionados ao Uso de Substâncias/epidemiologia
10.
Sex Transm Infect ; 97(2): 85-87, 2021 03.
Artigo em Inglês | MEDLINE | ID: mdl-32967930

RESUMO

OBJECTIVES: To describe the early impact of COVID-19 and associated control measures on the sexual behaviour of pre-exposure prophylaxis (PrEP) users in Wales. METHODS: Data were obtained from an ecological momentary assessment study of PrEP use and sexual behaviour. Participants were individuals accessing PrEP through the National Health Service (NHS) sexual health clinics across four health boards in Wales. Weekly data documenting condomless sex in the preceding week were analysed between 03/02/2020 and 10/05/2020. The introduction of social distancing measures and changes to sexual health clinics in Wales occurred on the week starting 16/03/2020. Two-level logistic regression models were fitted to condomless sex (yes/no) over time, included an indicator for the week starting 16/03/2020, and were extended to explore differential associations by relationship status and sexual health clinic. RESULTS: Data were available from 56 participants and included 697 person-weeks (89% of the maximum number that could have been obtained). On average, 42% of participants reported condomless sex in the period prior to the introduction of social distancing measures and 20% reported condomless sex after (OR=0.16, 95% CI 0.07 to 0.37, p<0.001). There was some evidence to suggest that this association was moderated by relationship status (OR for single participants=0.09, 95% CI 0.06 to 0.23; OR for not single participants=0.46, 95% CI 0.16 to 1.25). CONCLUSIONS: The introduction of social distancing measures and changes to PrEP services across Wales was associated with a marked reduction in reported instances of condomless sexual intercourse among respondents, with a larger reduction in those who were single compared with those who were not. The long-term impact of COVID-19 and associated control measures on this population's physical and mental health and well-being requires close examination.


Assuntos
COVID-19 , Infecções por HIV/prevenção & controle , Distanciamento Físico , Profilaxia Pré-Exposição , Sexo sem Proteção/estatística & dados numéricos , Adulto , Controle de Doenças Transmissíveis , Preservativos/estatística & dados numéricos , Avaliação Momentânea Ecológica , Humanos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , SARS-CoV-2 , Comportamento Sexual/estatística & dados numéricos , País de Gales
11.
AIDS Behav ; 25(3): 973-982, 2021 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-33025391

RESUMO

To reduce HIV incidence in countries such as Eswatini (Swaziland), UNAIDS has recommended male circumcision as one possible effective strategy. We analyzed the 2016s Swaziland HIV Incidence Measurement Survey to explore the association between early circumcision and HIV history among 2964 sexually active adult males aged 15 to 64 years old. Early circumcision was defined as circumcision practiced at an age of 15 years old or younger. Results from logistic regression and OLS regression found that male adults with early circumcision are more likely to have multiple sexual partners and to use condoms. Multiple partners and condom use at last sex encounter remained associated with a higher odds of being HIV positive after controlling for all factors. Nevertheless, early circumcision is significantly associated with a lower odds of being HIV positive (AOR 0.53, p < 0.01). These findings suggest that HIV prevention may benefit when early male circumcision is carried out.


Assuntos
Circuncisão Masculina/efeitos adversos , Preservativos/estatística & dados numéricos , Infecções por HIV/prevenção & controle , Comportamento Sexual/estatística & dados numéricos , Adolescente , Adulto , Distribuição por Idade , Essuatíni/epidemiologia , Infecções por HIV/epidemiologia , Humanos , Masculino , Pessoa de Meia-Idade , Comportamento Sexual/psicologia , Parceiros Sexuais , Fatores de Tempo , Adulto Jovem
12.
AIDS Behav ; 25(3): 679-688, 2021 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-32910352

RESUMO

Sexual empowerment is a key strategy in HIV prevention intervention design, yet its measurement has been conceptualized as homogeneous. To date, no studies have examined whether young Black men who have sex with men (YBMSM) exhibit heterogeneity across sexual empowerment. Using baseline data from a randomized controlled trial (N = 275, HIV-negative YBMSM), we classified YBMSM into sexual empowerment profiles based on five indicators using a latent profile analysis and assessed the associations between the sexual empowerment profiles and stigma-related experiences using multinomial logistic regression. Three profiles were identified: psychologically empowered with safer sex intentions (profile 1); psychologically disempowered with safer sex intentions (profile 2); and psychologically disempowered without safer sex intentions (profile 3). YBMSM reporting fewer stigma-related experiences were more likely to be profile 1 than profile 2 and profile 3. To empower YBMSM, interventions based on sexual empowerment profile targeting the psychological/behavioral aspects of empowerment and addressing stigma are needed.


Assuntos
Afro-Americanos/estatística & dados numéricos , Preservativos/estatística & dados numéricos , Discriminação Psicológica , Empoderamento , Infecções por HIV/prevenção & controle , Homossexualidade Masculina/psicologia , Estigma Social , Adulto , Homossexualidade Masculina/etnologia , Humanos , Análise de Classes Latentes , Masculino , Ensaios Clínicos Controlados Aleatórios como Assunto , Sexo Seguro , Autoeficácia , Comportamento Sexual , Parceiros Sexuais
13.
AIDS Care ; 33(2): 206-213, 2021 02.
Artigo em Inglês | MEDLINE | ID: mdl-32372660

RESUMO

Transportation cost is a barrier to HIV treatment, yet no studies have examined its association with contraceptive use among women living with HIV. We analyzed cross-sectional data from women attending three public healthcare facilities in Shinyanga, Tanzania where they initiated antiretroviral therapy for HIV infection in the previous 90 days; all facilities offered free contraception. Women self-reported current contraceptive use and the round-trip cost of transportation to the facility. Among 421 women aged 18-49, 86 (20.4%) were using any modern contraceptive method, of which half were using modern methods other than condoms. Women who paid more than 2,000 Tanzanian shillings for transportation had a significantly lower prevalence of any modern method use than women who paid nothing (9.1% vs. 21.3%; adjusted difference: -12.9; 95% confidence interval: -21.3, -4.4). A similar difference was observed for non-condom modern method use. We conclude that high transportation cost may impede contraceptive use even among women accessing HIV treatment.


Assuntos
Antirretrovirais/uso terapêutico , Comportamento Contraceptivo/estatística & dados numéricos , Anticoncepcionais Femininos/administração & dosagem , Infecções por HIV/tratamento farmacológico , Acesso aos Serviços de Saúde/estatística & dados numéricos , Transportes/economia , Adolescente , Adulto , Terapia Antirretroviral de Alta Atividade , Preservativos/estatística & dados numéricos , Anticoncepção , Estudos Transversais , Feminino , Insegurança Alimentar , Necessidades e Demandas de Serviços de Saúde , Humanos , Pessoa de Meia-Idade , Tanzânia , Adulto Jovem
14.
Arch Sex Behav ; 50(2): 479-493, 2021 02.
Artigo em Inglês | MEDLINE | ID: mdl-32239362

RESUMO

Methamphetamine use has increased among gender and sexually diverse people in several countries, including Bangladesh. This study aimed to explore the effects of methamphetamine on the sexual lives of these people in Dhaka, Bangladesh. An exploratory qualitative study was conducted, comprising 30 in-depth interviews with gender and sexually diverse people including males having sex with males, male sex workers, and transgender women (hijra) under HIV intervention coverage. Ten key informant interviews were also conducted with individuals who have expertise in relevant disciplines such as drug use, harm reduction, and HIV and AIDS. Digitally recorded data were manually analyzed under the thematic analysis framework. Findings indicated that many participants reported that methamphetamine brought changes in their sexual lives such as increased sexual drive, engagement in group sex, the increased ability to perform serial sex, transactional sex, impulsive and coercive sex, initiation and switching of male-to-male sexual practices, and limited condom use. Key informants noted that there is a dearth of methamphetamine-related services in Bangladesh. Methamphetamine use was found to lead to diverse effects on the sexual lives of gender and sexually diverse people, thus making it a driving force for shaping sexual practices and, hence, sexual risks. Therefore, it is essential for policy-level stakeholders and program managers to consider the risks of methamphetamine use due to their negative ramifications on sexual health, including HIV risks.


Assuntos
Drogas Ilícitas/efeitos adversos , Metanfetamina/efeitos adversos , Profissionais do Sexo/estatística & dados numéricos , Transexualidade/epidemiologia , Sexo sem Proteção/estatística & dados numéricos , Adulto , Bangladesh , Preservativos/estatística & dados numéricos , Feminino , Infecções por HIV/epidemiologia , Humanos , Masculino , Pesquisa Qualitativa , Comportamento Sexual/estatística & dados numéricos , Fatores Socioeconômicos
15.
AIDS Care ; 33(1): 92-100, 2021 01.
Artigo em Inglês | MEDLINE | ID: mdl-32207327

RESUMO

Communication around condom use in the context of PrEP services presents a potential conundrum for patients and providers. Within the Partners Scale-Up Project, which supports integration of PrEP delivery in HIV care clinics, we interviewed 41 providers and 61 PrEP users and identified themes relating to condom messaging and use. Most providers counselled PrEP initiators to always use both PrEP and condoms, except when trying to conceive. However, others reported contexts and rationales for not emphasizing condom use. Providers reported that PrEP users were sometimes confused, even frustrated, with their insistence on using condoms in addition to PrEP. PrEP users generally regarded PrEP as a more feasible and desirable HIV prevention method than condoms, enabling increased sexual pleasure and conception, and reducing the conflict and stigma associated with condom use. Innovative approaches to condom counselling in PrEP programs are needed.


Assuntos
Preservativos/estatística & dados numéricos , Infecções por HIV/prevenção & controle , Pessoal de Saúde/psicologia , Profilaxia Pré-Exposição/estatística & dados numéricos , Adulto , Idoso , Feminino , Infecções por HIV/transmissão , Humanos , Entrevistas como Assunto , Quênia , Masculino , Pessoa de Meia-Idade , Profilaxia Pré-Exposição/métodos , Pesquisa Qualitativa , Parceiros Sexuais
16.
Arch Sex Behav ; 50(1): 219-227, 2021 01.
Artigo em Inglês | MEDLINE | ID: mdl-32720186

RESUMO

Adolescent girls and young women (AGYW) are at high risk of HIV and other sexually transmitted infections (STIs), including at first sexual intercourse. The literature is scarce on factors influencing use of protective strategies at this critical time. We conducted 20 in-depth interviews and five focus group discussions with purposively sampled AGYW aged 16-20 years who reported first sex while enrolled in a larger cohort study and willing to participate. All AGYW were counseled on HIV prevention and had access to reproductive health information and services. Data collected were transcribed, translated and analyzed thematically. We identified two approaches to first sex. In one approach, the AGYW facilitated protection use, and those AGYW reported intention and preparation to initiate sexual activity and ability to request condom use, as well as their male partner's willingness to use and provide condoms. In another approach, AGYW experienced first sexual intercourse without agency (the feeling of control over actions and their consequences [Moore, 2016]) and described lack of prior intentions and planning, discomfort with discussions about sex and condom use, and desire to experience sexual pleasure as reported by peers. No AGYW mentioned parents/adults as playing any role as facilitators of protection use at first sex, highlighting the need for further research on the missing gap. The AGYW were trusting of verbal reports by male partners describing themselves as having never engaged in sex, HIV negative, and free of STIs. We found that some AGYW were empowered to plan, discuss, and request protection at first sex, and others did not take agency. First sex is a time of vulnerability where innovative strategies are needed to strengthen AGYW's agency and promote condom use and other HIV/STI prevention methods.


Assuntos
Coito/psicologia , Preservativos/estatística & dados numéricos , Sexo Seguro/psicologia , Adolescente , Adulto , Estudos de Coortes , Feminino , Humanos , Quênia , Masculino , Estudos Prospectivos , Adulto Jovem
17.
AIDS Behav ; 25(1): 40-48, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-32876905

RESUMO

This paper presents data from a recent cross-sectional survey of gay, bisexual and other men who have sex with men (GBMSM) in the US, to understand changes in sexual behavior and access to HIV prevention options (i.e. condoms and pre-exposure prophylaxis (PrEP)) during the COVID-19 lockdown period. The Love and Sex in the Time of COVID-19 survey was conducted online from April to May, 2020. GBMSM were recruited through advertisements featured on social networking platforms, recruiting a sample size of 518 GBMSM. Analysis considers changes three in self-reported measures of sexual behavior: number of sex partners, number of anal sex partners and number of anal sex partners not protected by pre-exposure prophylaxis (PrEP) or condoms. Approximately two-thirds of the sample reported that they believed it was possible to contract COVID-19 through sex, with anal sex reported as the least risky sex act. Men did not generally feel it was important to reduce their number of sex partners during COVID-19, but reported a moderate willingness to have sex during COVID-19. For the period between February and April-May 20,202, participants reported a mean increase of 2.3 sex partners during COVID-19, a mean increase of 2.1 anal sex partners (range - 40 to 70), but a very small increase in the number of unprotected anal sex partners. Increases in sexual behavior during COVID-19 were associated with increases in substance use during the same period. High levels of sexual activity continue to be reported during the COVID-19 lockdown period and these high levels of sexual activity are often paralleled by increases in substance use and binge drinking. There is a clear need to continue to provide comprehensive HIV prevention and care services during COVID-19, and telehealth and other eHealth platforms provide a safe, flexible mechanism for providing services.


Assuntos
Bissexualidade/psicologia , COVID-19/prevenção & controle , Infecções por HIV/tratamento farmacológico , Infecções por HIV/prevenção & controle , Homossexualidade Masculina/psicologia , Profilaxia Pré-Exposição , Comportamento Sexual/psicologia , Adolescente , Adulto , COVID-19/psicologia , Preservativos/estatística & dados numéricos , Estudos Transversais , Infecções por HIV/epidemiologia , Acesso aos Serviços de Saúde , Humanos , Masculino , Pessoa de Meia-Idade , SARS-CoV-2 , Comportamento Sexual/estatística & dados numéricos , Parceiros Sexuais , Minorias Sexuais e de Gênero , Sexo sem Proteção/psicologia , Sexo sem Proteção/estatística & dados numéricos , Adulto Jovem
18.
Biomed Res Int ; 2020: 8855276, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33299885

RESUMO

Background: Early age at first sexual practice is a public health issue and now common around the world especially in the developing countries. The development of effective strategies to reduce the adverse consequences of early sexual initiation becomes real when sufficient data is available. Therefore, this study is aimed at assessing the prevalence and factors associated to early sexual initiation among college students in southwest Ethiopia. Methods: A cross-sectional study was conducted among 453 college students in southwest Ethiopia from April to May 2018. A two-stage stratified sampling technique was used to select the study participants. The data were collected using structured pretested self-administered questionnaire. The collected data were entered using Epi-Data version 4.2.0.0 and analyzed using SPSS version 20. Logistic regression models were fitted to assess the effect of independent variables on the outcome variable. Significance was declared at p < 0.05 in the multivariable logistic regression analysis. Results: The proportion of early sexual initiation among college students was 17.9%, 95% CI (14.4%-24.4%). The mean age of sexual intercourse was 17.6 (±2 SD) years. Nearly three-fourths (73.4%) of the respondent's reason for early sexual intercourse was falling in love. More than half (62.2%) of the respondents used a condom for their first sexual intercourse. The factors associated with early sexual initiation were being female (AOR = 2.09and 95% CI [1.17-2.35]), chewing khat (AOR = 7.05 and 95% CI [3.81-13.1]), exposed to pornographic materials at age < 18 years (AOR = 3.57 and 95% CI [1.94-6.89]), and poor knowledge of sexually transmitted diseases (AOR = 8.69 and 95% CI [3.52-21.5]). Conclusion: The prevalence of early sexual initiation among college students was alarmingly high. This may be associated with a huge burden of poor sexual and reproductive health. Therefore, creating awareness of the factors and related negative sexual and reproductive health effect of early sexual initiation for young peoples through the use of mass media (television and radio), school teachers, and parents plays a paramount importance.


Assuntos
Conhecimentos, Atitudes e Prática em Saúde , Saúde Reprodutiva/educação , Comportamento Sexual/estatística & dados numéricos , Estudantes/estatística & dados numéricos , Adolescente , Comportamento do Adolescente , Adulto , Preservativos/estatística & dados numéricos , Estudos Transversais , Etiópia/epidemiologia , Feminino , Humanos , Masculino , Prevalência , Análise de Regressão , Saúde Sexual , Inquéritos e Questionários , Universidades , Adulto Jovem
19.
Rev. enferm. UERJ ; 28: e45752, jan.-dez. 2020.
Artigo em Inglês, Português | LILACS, BDENF - Enfermagem | ID: biblio-1117683

RESUMO

Objetivo: estimar a prevalência do uso do preservativo e os fatores associados em trabalhadores da construção civil. Método: estudo transversal, analítico, com 370 trabalhadores da grande João Pessoa, Paraíba. Considerou como variável de desfecho o uso do preservativo na última relação sexual. Utilizou-se questionário estruturado. Análise de regressão logística bivariada e múltipla foi utilizada para identificar associação entre as variáveis sociodemográficas e o uso do preservativo. Resultados: a maioria dos participantes é do sexo masculino, adultos jovens, casados e com baixa escolaridade. A prevalência estimada de uso do preservativo foi de 23,5% (IC 95%: 19,2% - 27,8%). Indivíduos com menos de 39 anos possuem 1,82 vezes mais chances de usar o preservativo e ser casado diminui (RC=0,26) as chances de uso. Conclusão: há baixa prevalência de uso do preservativo em trabalhadores da construção civil. A prevenção combinada é uma alternativa para controle das infecções transmissíveis, sendo o preservativo o principal coadjuvante.


Objective: to estimate the prevalence of condom use and the associated factors in construction workers. Method: in this crosssectional, analytical study with 370 workers from greater João Pessoa, Paraíba, Brazil, the outcome variable was condom use at last sexual intercourse. A structured questionnaire was used. Bivariate and multiple logistic regression analysis was used to identify associations between sociodemographic variables and condom use. Results: most participants were young, male adults, married and with little education. Estimated prevalence of condom use was 23.5% (95% CI; 19.2% - 27.8%). Individuals under 39 years old were found to be 1.82 times more likely to use condoms than individuals aged 40 years or older (OR = 1.82; 95% CI), while being married reduced the likelihood (OR = 0.26). Conclusion: prevalence of condom use is low among construction workers. Combined prevention is one option for controlling communicable diseases, with condoms as the main support.


Objetivo: estimar la prevalencia del uso de condón y los factores asociados en trabajadores de la construcción. Método: en este estudio transversal y analítico con 370 trabajadores del área metropolitana de João Pessoa, Paraíba, Brazil, la variable de resultado fue el uso de condón en la última relación sexual. Se utilizó un cuestionario estructurado y análisis de regresión logística bivariada y múltiple para identificar asociaciones entre las variables sociodemográficas y el uso del condón. Resultados: la mayoría de los participantes fueron jóvenes, varones adultos, casados y con poca educación. La prevalencia estimada del uso de condones fue del 23,5% (IC del 95%; 19,2% - 27,8%). Se encontró que las personas menores de 39 años tenían 1,82 veces más probabilidades de usar condones que las personas de 40 años o más (OR = 1,82; IC del 95%), mientras que estar casado redujo la probabilidad (OR = 0,26). Conclusión: la prevalencia del uso de condones es baja entre los trabajadores de la construcción. La prevención combinada es una opción para controlar las enfermedades transmisibles, con el condón como principal apoyo.


Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto , Pessoa de Meia-Idade , Adulto Jovem , Comportamento Sexual/estatística & dados numéricos , Saúde do Trabalhador , Preservativos/estatística & dados numéricos , Sexo sem Proteção/estatística & dados numéricos , Brasil , Indústria da Construção , Estudos Transversais , Prevenção de Doenças , Correlação de Dados , Enfermagem do Trabalho
20.
Afr Health Sci ; 20(2): 658-665, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-33163028

RESUMO

Background: Despite significant gains in the HIV epidemic in South Africa, with reduction in mortality and elimination of vertical transmission, national HIV prevalence remains high, with women rather than men continuing to bear higher burden of the disease. Population subgroups, through ignorance, disbelief or recklessness, continue to engage in risky sexual behaviour. A substantial proportion of minibus taxi drivers engage in risky sex, seldom seeing themselves at risk for STIs or HIV/AIDS. These taxi drivers have been linked with so-called taxi queens, with whom they engage in transactional and intergenerational relationships. Objectives: The study explored condom use and condom negotiation strategies among taxi drivers and taxi queens in Kwa- Zulu-Natal, South Africa. Methods: Applying explorative qualitative design, we conducted focus group discussion and individual interviews among participants who were purposively recruited in KwaZulu-Natal. Result: Qualitative data analysis revealed that condom use and negotiation are sources of conflict for the participants. In addition, the strategies employed by participants to ensure condom usage are not always sustainable and are likely to be problematic due to a variety of complex factors. Conclusion: Our study concludes by recommending a nested public health response that takes cognizance of factors that promote sustainable condom use strategies among this population subgroup.


Assuntos
Condução de Veículo , Preservativos/estatística & dados numéricos , Infecções por HIV/prevenção & controle , Infecções por HIV/transmissão , Conhecimentos, Atitudes e Prática em Saúde , Ocupações , Sexo Seguro/estatística & dados numéricos , Parceiros Sexuais/psicologia , Adulto , Condução de Veículo/estatística & dados numéricos , Feminino , Grupos Focais , Infecções por HIV/epidemiologia , Infecções por HIV/psicologia , Humanos , Masculino , Pessoa de Meia-Idade , Veículos Automotores , Pesquisa Qualitativa , Assunção de Riscos , Comportamento Sexual , África do Sul/epidemiologia , Inquéritos e Questionários , Transportes
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA
...