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1.
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
2.
S Afr Med J ; 110(7): 661-666, 2020 Jul 07.
Artigo em Inglês | MEDLINE | ID: mdl-32880344

RESUMO

BACKGROUND: South African guidelines recommend a syndromic approach for the management of sexually transmitted infections (STIs), based on the presence of genital symptoms. However, the guidelines do not prescribe specific indications for microbiology testing for patients presenting with or without repeat genital symptoms. OBJECTIVES: To describe the prevalence of and factors associated with repeat genital symptoms among STI service attendees at primary care facilities. METHODS: This was a cross-sectional study at 7 STI primary care facilities participating in the aetiological surveillance of STIs between January 2015 and December 2016. Demographic and clinical information and appropriate genital specimens were collected from participants presenting with vaginal discharge syndrome (VDS), male urethral syndrome (MUS) and/or genital ulcer syndrome (GUS). Repeat genital symptoms were defined as self-reported history of the same STI-related genital symptoms in the preceding 12 months. Multivariable logistic regression identified factors associated with repeat genital symptoms. RESULTS: Of 1 822 eligible participants, 480 (30%) had repeat genital symptoms (25% and 75% in the preceding 3 months and 12 months, respectively). Of those with repeat genital symptoms, the median age was 28 (interquartile range (IQR) 24 - 32) years, and 54% were females. The most common aetiological agents among participants with VDS, MUS and GUS were bacterial vaginosis (n=132; 55%), Neisseria gonorrhoeae (n=172; 81%) and ulcers (n=67; 63%), respectively. One hundred and seven (20%) participants had no detectable common STI aetiology. In the multivariable analysis, repeat genital symptoms were associated with HIV co-infection (adjusted odds ratio (aOR) 1.43; 95% confidence interval (CI) 1.14 - 1.78), VDS diagnosis (aOR 1.39; 95% CI 1.10 - 1.76), self-reported condom use (aOR 1.56; 95% CI 1.20 - 2.03) and age 25 - 34 years (aOR 1.33; 95% CI 1.03 - 1.71). CONCLUSIONS: Our study found a high prevalence of repeat genital symptoms ‒ a significant proportion without STI aetiology. Identified factors of repeat genital symptoms highlight the need for improved integration of HIV and STI prevention and management. Further research is needed to determine the aetiology of repeat genital symptoms and the contribution of non-STI causes.


Assuntos
Doenças dos Genitais Femininos/epidemiologia , Doenças dos Genitais Masculinos/epidemiologia , Úlcera/epidemiologia , Descarga Vaginal/epidemiologia , Adulto , Coinfecção/epidemiologia , Preservativos/estatística & dados numéricos , Estudos Transversais , Feminino , Infecções por HIV/epidemiologia , Humanos , Masculino , Vigilância da População , Prevalência , Atenção Primária à Saúde , África do Sul/epidemiologia
4.
BMC Infect Dis ; 20(1): 563, 2020 Aug 01.
Artigo em Inglês | MEDLINE | ID: mdl-32738895

RESUMO

BACKGROUND: Despite several intervention programmes in South Africa, risky sexual behaviours among women of reproductive age remain a public health concern, making them vulnerable to unintended pregnancies and/or sexually transmitted infections (STIs), including human immunodeficiency virus (HIV) infection. The aim of this study was to investigate the predictors of risky sexual behaviours among women of reproductive age in a high HIV-burden township in KwaZulu-Natal, South Africa. METHODS: In a cross-sectional study, 471 women of reproductive age (18-49 years, mean: 25.83) in 10 public health clinics in Umlazi Township, responded to a structured questionnaire. Data were coded, entered into Epi Data Manager and exported to Stata for analysis. A Pearson Chi-square tests and logistic regression models (bivariate and multivariate) were employed to assess the level of the association between the predictor and outcome variables and the p-value < 0.05 was considered statistically significant. RESULTS: More than half (51.80%) of the women were aged 18-24 years and only a handful (18.26%) had a tertiary qualification. The majority were single (88.96%) and the unemployed accounted for 53.50%. This study found that women who had talked about condoms with their partner in the past 12 months were more likely (p = < 0.0001) to have used condoms during their last sexual intercourse. Older women (p = 0.035) were more likely to have used a condom at last sex, compared to younger women. However, women who were exposed to physical partner violence (hitting and/or slapping), those who had been diagnosed with HIV and those whose sexual partners were diagnosed with HIV, did not show a significant association with condom use at last sex. CONCLUSION: Exposure to physical partner violence and poor partner discussions about condoms are key deterrents to condom usage. Holistic interventions are required in order to address the risky behaviours, and consequently reduce sexually transmitted infections and/or unintended pregnancies.


Assuntos
Infecções por HIV/patologia , Comportamento Sexual , Adolescente , Adulto , Fatores Etários , Preservativos/estatística & dados numéricos , Estudos Transversais , Feminino , Infecções por HIV/epidemiologia , Humanos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Razão de Chances , Delitos Sexuais , África do Sul/epidemiologia , Inquéritos e Questionários , Adulto Jovem
5.
PLoS One ; 15(8): e0236552, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32776965

RESUMO

BACKGROUND: Paying for sex has often been associated with risky sexual behavior among heterosexual men, and men who pay for sex are considered as a bridging population for sexually transmitted infections. Consistent condom use during paid sex is essential for reducing sexually transmitted infections, including HIV/AIDS. In this study, we assessed the prevalence and predictors of consistent condom use among men who pay for sex in sub-Saharan Africa. MATERIALS AND METHODS: We pooled data from 29 sub-Saharan African countries' Demographic and Health Surveys. A total of 3,353 men in sub-Saharan Africa who had paid for sex in the last 12 months preceding the surveys and had complete information on all the variables of interest were used in this study. The outcome variable for the study was consistent condom use for every paid sex in the last 12 months. Both bivariate and multivariable logistic regression analyses were carried out. Results were presented as adjusted odds ratios with their corresponding 95% confidence intervals. Statistical significance was declared at p< 0.05. RESULTS: Overall, the prevalence of consistent condom use during paid sex in sub-Saharan Africa was 83.96% (CI = 80.35-87.56), ranging from 48.70% in Benin to 98% in Burkina Faso. Men aged 35-44 [AOR, 1.39 CI = 1.04-1.49], men in the richest wealth quintile [AOR, 1.96 CI = 1.30-3.00], men with secondary level of education [AOR, 1.69 CI = 1.17-2.44], and men in Burkina Faso [AOR = 67.59, CI = 8.72-523.9] had higher odds of consistent condom use during paid sex, compared to men aged 15-19, those in the poorest wealth quintile, those with no formal education, and men in Benin respectively. Conversely, Muslim men had lower odds [AOR = 0.71, CI = 0.53-0.95] of using condom consistently during paid sex, compared to Christian men. CONCLUSION: Empirical evidence from this study suggests that consistent condom use during paid sex encompasses complex social and demographic characteristics. The study also revealed that demographic characteristics such as age, wealth quintile, education, and religion were independently related to consistent condom use for paid sex among men. With sub-Saharan Africa having the highest sexual and reproductive health burden in the world, continuous application of evidence-based interventions (e.g., educational and entrepreneurial training) that account for behavioural and social vulnerabilities are required.


Assuntos
Preservativos/estatística & dados numéricos , Sexo Seguro/estatística & dados numéricos , Trabalho Sexual , Comportamento Sexual/estatística & dados numéricos , Doenças Sexualmente Transmissíveis/prevenção & controle , Adolescente , Adulto , África ao Sul do Saara , Inquéritos Epidemiológicos , Heterossexualidade , Humanos , Masculino , Pessoa de Meia-Idade , Assunção de Riscos , Adulto Jovem
6.
PLoS One ; 15(8): e0236984, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32790677

RESUMO

BACKGROUND: Understanding of the facilitators and challenges to female condom (FC) uptake has been limited due to lack of evaluation of national FC programmes. SETTING: The FC has been an integral component of South Africa's (SA) HIV prevention programme for 20 years and is the largest government-funded FC programme worldwide. METHODS: The national FC evaluation used a mixed-methods approach and consisted of key informant interviews and a telephone survey in a national sample of public and non-public sites. A sub-sample of sites participated in client and provider interviews, and a self-administered client survey. A review of distribution statistics from South Africa's District Health Information System was also conducted. RESULTS: All 256 public-sector and 28 non-public-sector facilities reported having ever distributed FCs. Less than 5% of these facilities reported stock-outs and less than 3% reported they had a supply of expired female condoms. Systems for male condom (MC) and FC distribution were complementary, with similar ordering, delivery and reporting processes. FC promotion by providers (n = 278) varied with regard to FC training, whether attitudes about FCs influenced providers offer of FCs, and how they counselled clients about FCs. Of the 4442 self-administered client surveys in 133 facilities, similar proportions of women (15.4%) and men (15.2%) had ever used FCs. Although FCs were available at almost all sites surveyed, only two-thirds of clients were aware of their availability. CONCLUSION: Data highlight the role of providers as gatekeepers to FC access in public and non-public sectors and provide support for further FC programme expansion in SA and globally.


Assuntos
Preservativos Femininos , Adolescente , Adulto , Preservativos/estatística & dados numéricos , Preservativos/provisão & distribução , Preservativos Femininos/estatística & dados numéricos , Preservativos Femininos/provisão & distribução , Feminino , Infecções por HIV/prevenção & controle , Conhecimentos, Atitudes e Prática em Saúde , Política de Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Programas Nacionais de Saúde , Setor Privado , Setor Público , África do Sul , Inquéritos e Questionários , Adulto Jovem
7.
Sex Transm Infect ; 96(6): 422-427, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32605930

RESUMO

OBJECTIVES: Transgender men who have sex with men (TMSM) represent an understudied population in relation to screening for HIV and sexually transmitted infections (STIs). We examined HIV and STI testing prevalence among TMSM along with the factors associated with testing in a diverse US nationwide sample of TMSM. METHODS: Data from a cross-sectional online convenience sample of 192 TMSM were analysed using multivariable binary logistic regression models to examine the association between sociodemographic and behavioural factors and lifetime testing for HIV, bacterial STIs and viral STIs, as well as past year testing for HIV. RESULTS: More than two-thirds of TMSM reported lifetime testing for HIV (71.4%), bacterial STIs (66.7%), and viral STIs (70.8%), and 60.9% had received HIV testing in the past year. Engaging in condomless anal sex with a casual partner whose HIV status is different or unknown and having fewer than two casual partners in the past 6 months were related to lower odds of lifetime HIV, bacterial STI, viral STI and past year HIV testing. Being younger in age was related to lower probability of testing for HIV, bacterial STIs and viral STIs. Furthermore, TMSM residing in the South were less likely to be tested for HIV and viral STIs in their lifetime, and for HIV in the past year. Finally, lower odds of lifetime testing for viral STIs was found among TMSM who reported no drug use in the past 6 months. CONCLUSIONS: These findings indicate that a notable percentage of TMSM had never tested for HIV and bacterial and viral STIs, though at rates only somewhat lower than among cisgender MSM despite similar patterns of risk behaviour. Efforts to increase HIV/STI testing among TMSM, especially among those who engage in condomless anal sex, are needed.


Assuntos
Infecções por HIV/diagnóstico , Programas de Rastreamento/estatística & dados numéricos , Comportamento Sexual/estatística & dados numéricos , Doenças Bacterianas Sexualmente Transmissíveis/diagnóstico , Doenças Virais Sexualmente Transmissíveis/diagnóstico , Pessoas Transgênero , Adolescente , Adulto , Bissexualidade , Preservativos/estatística & dados numéricos , Estudos Transversais , Feminino , Homossexualidade Masculina , Humanos , Masculino , Pessoa de Meia-Idade , Minorias Sexuais e de Gênero , Doenças Sexualmente Transmissíveis/diagnóstico , Estados Unidos , Sexo sem Proteção/estatística & dados numéricos , Adulto Jovem
8.
Pediatrics ; 146(2)2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32690805

RESUMO

Rates of sexual activity, pregnancies, and births among adolescents have continued to decline during the past decade to historic lows. Despite these positive trends, many adolescents remain at risk for unintended pregnancy and sexually transmitted infections (STIs). This technical report discusses the new data and trends in adolescent sexual behavior and barrier protection use. Since 2017, STI rates have increased and use of barrier methods, specifically external condom use, has declined among adolescents and young adults. Interventions that increase availability of or accessibility to barrier methods are most efficacious when combined with additional individual, small-group, or community-level activities that include messages about safer sex. Continued research informs public health interventions for adolescents that increase the consistent and correct use of barrier methods and promote dual protection of barrier methods for STI prevention together with other effective methods of contraception.


Assuntos
Preservativos Femininos , Preservativos , Comportamento Sexual , Adolescente , Fatores Etários , Preservativos/estatística & dados numéricos , Preservativos Femininos/estatística & dados numéricos , Comportamento Contraceptivo/estatística & dados numéricos , Pessoas com Deficiência/estatística & dados numéricos , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Relações Interpessoais , Profilaxia Pré-Exposição , Gravidez , Gravidez na Adolescência/estatística & dados numéricos , Gravidez não Planejada , Fatores Raciais , Sexo Seguro , Autoimagem , Educação Sexual , Minorias Sexuais e de Gênero/estatística & dados numéricos , Doenças Sexualmente Transmissíveis/epidemiologia , Doenças Sexualmente Transmissíveis/prevenção & controle , Apoio Social
9.
Artigo em Inglês | MEDLINE | ID: mdl-32664646

RESUMO

Dual-method use is the most reliable form of protection against unintended pregnancies and human immunodeficiency virus/sexually transmitted infections (HIV/STIs). Although dual-method use remains uncommon among women in stable relationships, some women do practice it. In this study, we explored the barriers that make dual-method use rare and the behaviors of women who practice dual-method use using a positive deviance framework in Uganda. We screened 150 women using highly effective contraceptives at five health facilities. We identified nine women who practiced dual-method use and 141 women who did not. In a qualitative study, we conducted in-depth interviews with all nine women practicing dual-method use and 10 women randomly selected out of the 141 who did not. We performed a thematic analysis using the positive deviance framework. Regardless of practicing dual-method use or not, women faced perceived barriers against dual-method use, such as partner's objection, distrust, shyness about introducing condoms into marital relationships, and limited access to condoms. However, women practicing dual-method use had higher levels of risk perception about unintended pregnancies and HIV/STIs. They also engaged in unique behaviors, such as influencing their partners' condom use by initiating discussions, educating their partners on sexual risks and condom use, and obtaining condoms by themselves. These findings will be useful in developing effective community-led and peer-based interventions promoting dual-method use to reduce the dual burden of unintended pregnancies and HIV/STIs among women in Uganda.


Assuntos
Preservativos/estatística & dados numéricos , Comportamento Contraceptivo/etnologia , Infecções por HIV/prevenção & controle , Sexo Seguro/estatística & dados numéricos , Doenças Sexualmente Transmissíveis/prevenção & controle , Criança , Feminino , Infecções por HIV/etnologia , Infecções por HIV/transmissão , Humanos , Entrevistas como Assunto , Gravidez , Pesquisa Qualitativa , Comportamento Sexual , Uganda/epidemiologia
10.
PLoS One ; 15(7): e0236557, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32706840

RESUMO

BACKGROUND: A systematic assessment was done to examine the effect of HIV interventions among MSM in Dhaka, Bangladesh. MSM were defined as males having sex with males but did not sell sex in the last year. MSM are hidden, marginalized and stigmatized population groups not only in Bangladesh but also globally. In 2010, HIV interventions for MSM were expanded in 40 districts of Bangladesh through 65 drop-in-centres (DICs) and peer outreach workers. METHODS: Data from two surveys on MSM in Dhaka in 2010 (baseline) and 2013 (midline) were used to analyse the effect of ongoing HIV prevention services. Both surveys used time location sampling to randomly select MSM for risk behaviour interviews. Two outcome variables were considered; condom use in the last anal sex act and consistent condom use during anal sex in the last month. Univariate and multivariate logistic regression methods were used to determine factors associated with condom use. RESULTS: Condom use significantly increased at the midline than baseline (p<0.001 for both). Multivariate analysis showed that having comprehensive knowledge of HIV and participation in HIV prevention programme were positively associated with both last time and consistent condom use. MSM who had comprehensive knowledge of HIV were 1.9 times (95% CI: 1.3-2.8, p = 0.002) and 2.1 times (95% CI: 1.4-3.2, p<0.001) more likely to use condoms than those who did not have comprehensive knowledge of HIV. The likelihood of using condoms among MSM was more than double at the midline than the baseline (p<0.01 for both). However, odds of condom use was significantly lower among those who perceived themselves to be at risk or were not able to assess their own risk of HIV. CONCLUSION: To sustain positive changes in HIV risk behaviours, HIV prevention programmes for MSM need to be continued and strengthened.


Assuntos
Preservativos/estatística & dados numéricos , Infecções por HIV/prevenção & controle , Homossexualidade Masculina/psicologia , Avaliação de Programas e Projetos de Saúde , Adolescente , Adulto , Bangladesh , Humanos , Entrevistas como Assunto , Conhecimento , Masculino , Razão de Chances , Assunção de Riscos , Inquéritos e Questionários , Adulto Jovem
11.
PLoS One ; 15(7): e0235094, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32609731

RESUMO

INTRODUCTION: Between 2014 and 2017, a program aimed at reducing HIV risk and promoting safe sex through consistent use of condoms sought to work through addressing social and economic vulnerabilities and strengthening community-led organizations (COs) of female sex workers (FSWs). This study examines if the program was effective by studying relationship between strengthening of COs, vulnerability reduction, and sustaining of consistent condom use behavior among FSWs. METHODS: We used a longitudinal study design to assess the change in outcomes. A three-stage sampling design was used to select FSWs for the study. Panel data of 2085 FSWs selected from 38 COs across five states of India was used to examine the change in various outcomes from 2015 (Survey Round 1) to 2017 (Survey Round 2). The CO level program pillar measuring institutional development assessed performance of COs in six domains critical for any organization's functionality and sustainability: governance, project management, financial management, program monitoring, advocacy and networking, and resource mobilization. Overall, 32 indicators from all these domains were used to compute the CO strength score. A score was computed by taking mean of average dimension scores. The overall score was divided into two groups based on the median cutoff; COs which scored below the median were considered to have low CO strength, while COs which scored above or equal to median were considered to have high CO strength. Multivariable regression modeling techniques were used to examine the effect of program pillars on outcome measures. RESULTS: Analyses showed a significant improvement in the strength of the COs over time; percentage of COs having high strength improved from 50% in 2015 to 87% in Round 2. The improvement in CO's strength increased financial security (Adjusted Odds Ratio [AOR]: 2.18, p<0.01), social welfare security (AOR: 1.71, p<0.01), and socio-legal security (AOR: 2.20, p<0.01) among FSWs. Further, improvement in financial security led to significant increase in consistent condom use with client among FSWs (AOR: 1.69, p<0.01) who were members of COs having high strength. Sustained consistent condom use was positively associated with young age (<30 years), ability to negotiate with clients for condom use, membership in self-help groups, high self-efficacy, self-confidence, and client solicitation in streets and brothels. CONCLUSIONS: Improving financial security and strengthening FSW led CO can improve sustained and consistent condom use. In addition, the program should focus on enhancing ability of FSWs to negotiate with clients for condom use, promote membership in self-help groups and target FSWs who are 30 years or older, and soliciting from homes to sustain consistent condom use across all FSWs.


Assuntos
Sexo Seguro , Trabalho Sexual , Profissionais do Sexo , Adulto , Preservativos/estatística & dados numéricos , Feminino , Humanos , Índia , Sexo Seguro/estatística & dados numéricos , Grupos de Autoajuda/estatística & dados numéricos , Trabalho Sexual/estatística & dados numéricos , Profissionais do Sexo/estatística & dados numéricos , Populações Vulneráveis/estatística & dados numéricos
12.
PLoS One ; 15(6): e0233922, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32479519

RESUMO

PURPOSE: To understand the characteristics of a minority of Australian gay and bisexual men (GBM) who, despite an increase in the number and availability of HIV risk reduction strategies, do not consistently use a strategy to protect themselves from HIV. METHODS: This analysis is based on data from 2,920 participants in a national, online, prospective observational cohort study. GBM who never or rarely used HIV risk reduction strategies (NRR) were compared with two groups using multivariate logistic regression: i) GBM using pre-exposure prophylaxis (PrEP) and ii) GBM frequently using risk reduction strategies (FRR) other than PrEP. RESULTS: Compared to PrEP users, NRR men were younger (p<0.0001), less socially engaged with gay men (p<0.0001) and less likely to have completed a postgraduate (p<0.05) or undergraduate degree (p<0.05). They were also less likely to have recently used amyl nitrite (p<0.05), erectile dysfunction medication (p<0.05) and cocaine (p<0.05) in the previous 6 months. Compared with FRR men, NRR men were less likely to have completed a postgraduate (p<0.0001) or undergraduate degree (p<0.05), scored higher on the sexual sensation-seeking scale (p<0.0001) and were more likely to identify as versatile (p<0.05), a bottom (p<0.05) or very much a bottom (p<0.05) during anal sex. CONCLUSIONS: NRR men were largely similar to other Australian GBM. However, our analysis suggests it may be appropriate to focus HIV prevention interventions on younger, less socially engaged and less educated GBM, as well as men who prefer receptive anal intercourse to promote the use of effective HIV risk reduction strategies.


Assuntos
Infecções por HIV/prevenção & controle , Profilaxia Pré-Exposição/estatística & dados numéricos , Comportamento de Redução do Risco , Sexo Seguro/estatística & dados numéricos , Minorias Sexuais e de Gênero/estatística & dados numéricos , Adulto , Fatores Etários , Austrália , Preservativos/estatística & dados numéricos , Escolaridade , Infecções por HIV/transmissão , Humanos , Internet , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Sexo Seguro/psicologia , Minorias Sexuais e de Gênero/psicologia , Adulto Jovem
13.
Einstein (Sao Paulo) ; 18: eAO4978, 2020.
Artigo em Português, Inglês | MEDLINE | ID: mdl-32428062

RESUMO

Objective To determine the prevalence of syphilis and the associated risk factors in a female prison unit. Methods This was a cross-sectional study including 113 women whom data were collected in two stages: first, blood test to check for syphilis seropositivity; and then collection of information through a form to assess risk situations for sexually transmitted infections. Results Overall, syphilis prevalence was found to be 22.1% among the female prison population (n=25) and 28.6% among pregnant women. A statistically significant relationship was found between syphilis infection and previous history of sexually transmitted infections (p=0.04). However, most participants diagnosed with the disease were unaware of a history of sexually transmitted infection in the last 12 months (n=20/80.0%). The use of condom with fixed partners was considered to be a protective factor (odds ratio of 0.76; 95% of confidence interval 0.68-0.85). Conclusion The prevalence of syphilis among the female prison population was high, particularly among pregnant women. Preventive and therapeutic measures as well as appropriate prenatal care can minimize the impact of syphilis in prison systems and, consequently, improve such health outcomes nationwide.


Assuntos
Sífilis/epidemiologia , Adolescente , Adulto , Brasil/epidemiologia , Preservativos/estatística & dados numéricos , Estudos Transversais , Feminino , Humanos , Pessoa de Meia-Idade , Prevalência , Fatores de Risco , Sífilis/prevenção & controle , Adulto Jovem
14.
AIDS Patient Care STDS ; 34(5): 228-236, 2020 05.
Artigo em Inglês | MEDLINE | ID: mdl-32396478

RESUMO

Consistent condom use is an inexpensive and efficacious HIV prevention strategy. Understanding factors associated with condom use and barriers to use can inform strategies to increase condom uptake. The ongoing African Cohort Study prospectively enrolls adults at 12 clinical sites in Uganda, Kenya, Tanzania, and Nigeria. At enrollment, participants are asked about condom use at last sex with a regular partner. Robust Poisson regression models were used to evaluate predictors of self-reported condom use. Participants who reported not using condoms were asked to provide reasons. From January 2013 to September 2019, 2482 participants reported having at least one regular sexual partner in the preceding 6 months. Of those, 1577 (63.5%) reported using a condom at last sex. Condom use was more common among older participants, males, HIV-infected participants, and those with an HIV-infected partner. Married participants, those with a partner of unknown HIV status, and those reporting alcohol use were less likely to report condom use at last sex. Condom use at last sex also varied significantly by clinical site. Partner disapproval or refusal to use a condom was a consistent driver of disparities in condom use among participants who were HIV infected, female, and aged 18-24 years. Effective HIV prevention programs should integrate condom education with the tools necessary to negotiate condom use with regular partners.


Assuntos
Preservativos/estatística & dados numéricos , Infecções por HIV/prevenção & controle , Parceiros Sexuais , Adolescente , Adulto , África , Estudos de Coortes , Feminino , Humanos , Masculino , Estudos Prospectivos , Comportamento Sexual , Adulto Jovem
15.
AIDS Behav ; 24(7): 2024-2032, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32350773

RESUMO

The COVID-19 pandemic is reinforcing health inequities among vulnerable populations, including men who have sex with men (MSM). We conducted a rapid online survey (April 2 to April 13, 2020) of COVID-19 related impacts on the sexual health of 1051 US MSM. Many participants had adverse impacts to general wellbeing, social interactions, money, food, drug use and alcohol consumption. Half had fewer sex partners and most had no change in condom access or use. Some reported challenges in accessing HIV testing, prevention and treatment services. Compared to older MSM, those 15-24 years were more likely to report economic and service impacts. While additional studies of COVID-19 epidemiology among MSM are needed, there is already evidence of emerging interruptions to HIV-related services. Scalable remote solutions such as telehealth and mailed testing and prevention supplies may be urgently needed to avert increased HIV incidence among MSM during the COVID-19 pandemic era.


Assuntos
Preservativos/estatística & dados numéricos , Infecções por Coronavirus , Coronavirus , Acesso aos Serviços de Saúde/estatística & dados numéricos , Homossexualidade Masculina/estatística & dados numéricos , Programas de Rastreamento/estatística & dados numéricos , Pandemias , Pneumonia Viral , Parceiros Sexuais , Adulto , Betacoronavirus , Infecções por Coronavirus/epidemiologia , Infecções por HIV/prevenção & controle , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Pneumonia Viral/epidemiologia , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Inquéritos e Questionários , Estados Unidos , Adulto Jovem
16.
Zhonghua Liu Xing Bing Xue Za Zhi ; 41(4): 504-507, 2020 Apr 10.
Artigo em Chinês | MEDLINE | ID: mdl-32344472

RESUMO

Objective: This study intended to explore the current sexual and childbearing stigma, experienced by chronic hepatitis B patients in China, and to develop related preventive strategies. Methods: We used a self-made questionnaire to investigate the sexual and childbearing stigma suffered by chronic hepatitis B patients in four provinces of China. Analysis of variance and chi-square test were used to compare the differences on sexual and childbearing stigma indexes between different demographic variables. Results: We surveyed 797 chronic hepatitis B patients in four provinces. Among them, 4.15% (28/675) of the patients were persuaded not to give birth to children, and 4.67% (10/210) of patients were told to stop pregnancy, by their medical care takers or by members from the family planning institutions. 3.62% (25/690) and 3.48% (24/690) of the patients were not able to enjoy the family planning or reproductive health services as they were stigmatized,suffered, as having HBV infection. Among the male chronic hepatitis B patients, the under 30 years group suffered less sexual and childbearing stigma than those who were aged 31- (P=0.011) or 51 and above year-olds (P=0.009). Among female chronic hepatitis B patients, the 31- year-olds group suffered less sexual and childbearing stigma than those under 30 years group but higher than those aged 41- (P=0.001) or 51 and above ones (P<0.001). Patients with knowledge on route of sexual transmission for HBV, were more likely to practice less related sexual behaviors than those without such knowledge (P=0.022). Patients who were aware or not that condoms could reduce the risk of HBV infection did not show statistically significant difference on sex behaviors (P=0.612). Conclusions: Chronic hepatitis B patients did suffer from sexual and childbearing related stigma, with women aged 31-40 years old the most. It is necessary to advocate on the advantage of condom use for prevention of HBV transmission among pregnant women, both horizontally and vertically. Strategies on protection the rights of patients with hepatitis B should be developed and strengthened.


Assuntos
Preservativos/estatística & dados numéricos , Conhecimentos, Atitudes e Prática em Saúde , Hepatite B Crônica/psicologia , Qualidade de Vida , Comportamento Sexual/psicologia , Estigma Social , Adolescente , Adulto , Distribuição por Idade , China , Feminino , Hepatite B Crônica/epidemiologia , Humanos , Masculino , Gravidez
17.
AIDS Patient Care STDS ; 34(4): 184-192, 2020 04.
Artigo em Inglês | MEDLINE | ID: mdl-32324483

RESUMO

Knowledge of HIV status is a necessary pre-condition for most HIV interventions, including treatment as well as biomedical and behavioral prevention interventions. We used data from a female sex worker (FSW) cohort in three Zambian transit towns to understand the effect that knowledge of HIV status has on FSWs' HIV risk-related sexual behaviors with clients. The cohort was formed from an HIV self-testing trial that followed participants for 4 months. Participants completed three rounds of data collection at baseline, 1 month, and 4 months where they reported their perceived knowledge of HIV status, number of clients on an average working night, and consistent condom use with clients. We measured the effect of knowledge of HIV status on participants' sexual behaviors by using linear regression models with individual fixed effects. The majority of the 965 participants tested for HIV at least once during the observation period (96%) and changed their knowledge of HIV status (79%). Knowledge of HIV status did not affect participants' number of clients, but it did affect their consistency of condom use. Compared with unknown HIV status, knowledge of HIV-negative status significantly increased participants' consistent condom use by 8.1% points [95% confidence interval (CI): 2.7-13.4, p = 0.003] and knowledge of HIV-positive status increased participants' consistent condom use by 6.1% points (95% CI: -0.1 to 12.9, p = 0.08); however, this latter effect was not statistically significant. FSWs in Zambia engaged in safer sex with clients when they learned their HIV status. The expansion of HIV testing programs may serve as a behavioral HIV prevention measure among FSWs.


Assuntos
Preservativos/estatística & dados numéricos , Infecções por HIV/prevenção & controle , Soronegatividade para HIV , Conhecimentos, Atitudes e Prática em Saúde , Profissionais do Sexo/psicologia , Comportamento Sexual/psicologia , Adulto , Cidades , Estudos de Coortes , Feminino , Humanos , Programas de Rastreamento , Sexo Seguro/estatística & dados numéricos , Profissionais do Sexo/estatística & dados numéricos , Populações Vulneráveis , Zâmbia
18.
AIDS Care ; 32(sup2): 47-56, 2020 05.
Artigo em Inglês | MEDLINE | ID: mdl-32189518

RESUMO

Pre-exposure prophylaxis (PrEP) is fully reimbursed by the French health insurance system since 2016. However, uptake of PrEP is slower than expected and little is known about men who have sex with men (MSM) who are eligible for PrEP according to French guidelines, but not using it. This study aims to (1) assess and describe MSM that are eligible to PrEP but not using it, and (2) identify potential individual and structural barriers of PrEP uptake among eligible MSM who are aware and intend to take PrEP. Data from EMIS-2017, a cross-sectional internet survey among gay, bisexual, and other MSM, were used. Among 7965 respondents without diagnosed HIV, 9.2% were PrEP users. Among 7231 non-PrEP users, 35.2% were eligible to PrEP and 15.2% were eligible, aware and intended to take PrEP. Eligible MSM who are not using PrEP are mostly younger, students, less "out", living in small cities, using condoms more frequently but still with low self-efficacy regarding safe sex and more distant from preventive health care and information than PrEP users. Despite free PrEP availability in France, results suggest that PrEP is not fully accessible and that there is a need to increase PrEP demand and decentralize PrEP delivery.


Assuntos
Fármacos Anti-HIV/administração & dosagem , Infecções por HIV/prevenção & controle , Conhecimentos, Atitudes e Prática em Saúde , Homossexualidade Masculina/estatística & dados numéricos , Profilaxia Pré-Exposição/estatística & dados numéricos , Adulto , Fármacos Anti-HIV/uso terapêutico , Preservativos/estatística & dados numéricos , Estudos Transversais , França , Infecções por HIV/tratamento farmacológico , Acesso aos Serviços de Saúde , Humanos , Masculino , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Profilaxia Pré-Exposição/métodos , Comportamento Sexual/estatística & dados numéricos , Inquéritos e Questionários
19.
Clin Ter ; 171(2): e130-e136, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32141484

RESUMO

AIMS: Evaluation of the knowledge and behavioral risks related to sexually transmitted infections (STIs) among the student population of the degree course in nursing at the University of Palermo. MATERIAL AND METHODS: An anonymous online a survey was provided to students that investigate to socio-demographic information, sexual habits and the level of knowledge of the STIs. Multivariable logistic regression was performed, considering it as a dependent variable "Do you permanently have unprotected sex (without a condom)? Yes", in order to evaluate the role of the variables of the questionnaire. Results are expressed as adjusted Odds Ratio (aOR). RESULTS: The sample size consists of 405. The average age of the sample is 21.65 years (standard deviation±3.24). The analysis shows that the risk of having permanently unprotected sex (without condom) is significantly associated with the following variables: "Are you engaged or single? Engaged" (aOR 3.24, 95% CI 1.66 - 6.33); "Sexual orientation. Homosexual or Bisexual (aOR 4.45, 95% CI 1.30 - 15.29); "Have you occasionally had unprotected sex (without a condom)? Yes" (aOR 5.09, 95% CI 2.69 - 9.62); "How would you define your knowledge of sexually transmitted diseases? Good" (aOR 2.07, 95% CI 1.05 - 4.08); "How would you define your knowledge about contraceptive methods? Good" (aOR 2.51, 95% CI 1.23 - 5.15); "Have you or have you ever had a sexually transmitted disease? Yes (aOR 4.43, 95% CI 1.71 - 11.53); "Do you know that men can also undergo HPV vaccination? Yes" (aOR 2.57, 95% CI 1.03 - 6.40); "Age. As the unit increase" (aOR 1.14, 95% CI 1.02 - 1.26). CONCLUSIONS: These results highlight the importance of involving university students in programs aimed at improving the knowledge in terms of STIs and increase of Sexual and reproductive health. Further, because STIs prevention is based mainly on human behavior, tailored intervention is needed especially because behavior change remains a complex challenge.


Assuntos
Preservativos , Estudantes de Enfermagem/psicologia , Sexo sem Proteção/estatística & dados numéricos , Preservativos/estatística & dados numéricos , Estudos Transversais , Feminino , Humanos , Masculino , Comportamento Sexual , Doenças Sexualmente Transmissíveis/prevenção & controle , Inquéritos e Questionários , Sexo sem Proteção/psicologia , Adulto Jovem
20.
BMC Infect Dis ; 20(1): 195, 2020 Mar 06.
Artigo em Inglês | MEDLINE | ID: mdl-32138673

RESUMO

BACKGROUND: Antiretroviral therapy (ART) demonstrates high efficacy in reducing the risk of HIV transmission to sexual partners. However, it is not clear if the use of pre-exposure prophylaxis (PrEP) in HIV-1-serodiscordant couples is necessary during natural conception when the HIV-positive partner exhibits a suppressed viral load. The purpose of this study was to assess the role of PrEP during natural conception in this population. METHODS: A retrospective, multicenter study was conducted in a cohort of HIV-1-serodiscordant couples (positive man, negative woman) with childbearing desires. HIV-positive male partners were treated with ART and achieved viral suppression for more than half a year. The HIV-negative female partners were either treated with PrEP or not treated with PrEP, and outcomes were compared between the two treatment groups. RESULTS: Of 246 HIV-1-serodiscordant couples in whom the HIV-positive partner achieved viral suppression, 104 seronegative women were treated with PrEP during natural conception and 142 seronegative women were not treated with PrEP. There were 410 condom-less sexual acts in couples treated with PrEP and 615 condom-less sexual acts in couples not treated with PrEP. We observed no instances of HIV transmission in HIV-1-serodiscordant couples with or without the use of PrEP during the process of natural conception. CONCLUSIONS: Our results show that PrEP had minimal influence in reducing the risk of HIV transmission during natural conception in HIV-1-serodiscordant couples with a stably suppressed viral load. Thus, it may be an acceptable option for HIV-negative partners to not use PrEP during the process of natural conception if the HIV-positive partner has achieved viral suppression for more than half a year.


Assuntos
Fármacos Anti-HIV/uso terapêutico , Fertilização/fisiologia , Infecções por HIV/transmissão , Profilaxia Pré-Exposição , Carga Viral/efeitos dos fármacos , Adulto , Preservativos/estatística & dados numéricos , Feminino , Infecções por HIV/tratamento farmacológico , Infecções por HIV/prevenção & controle , Soropositividade para HIV/tratamento farmacológico , Soropositividade para HIV/transmissão , HIV-1 , Humanos , Masculino , Estudos Retrospectivos , Parceiros Sexuais
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