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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.
AIDS Educ Prev ; 32(3): 260-270, 2020 06.
Artigo em Inglês | MEDLINE | ID: mdl-32749877

RESUMO

We implemented HPTN 062, an acceptability and feasibility study of a motivational-interviewing (MI) intervention to reduce HIV transmission among individuals with acute HIV infection (AHI) in Lilongwe, Malawi. Participants were randomly assigned to receive either brief education or the MI intervention over 24 weeks; all participants received the same messages about AHI. We used mixed methods to assess participants' understanding of the association between AHI and viral load, and its connection to sexual behavior at 8 weeks. While most participants understood key aspects of AHI, MI-intervention participants gave substantially more detailed descriptions of their understanding. Nearly all participants, regardless of study arm, understood that they were highly infectious and would be very likely to transmit HIV after unprotected sex during AHI. Our findings suggest that messages about AHI delivered during the period of AHI are likely beneficial for ensuring that those with AHI understand their level of infectiousness and its association with forward transmission.


Assuntos
Fármacos Anti-HIV/uso terapêutico , Transmissão de Doença Infecciosa/prevenção & controle , Infecções por HIV/tratamento farmacológico , Infecções por HIV/psicologia , Entrevista Motivacional , Educação de Pacientes como Assunto/métodos , Comportamento Sexual , Doença Aguda , Adulto , Estudos de Viabilidade , Feminino , Infecções por HIV/prevenção & controle , Infecções por HIV/transmissão , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Malaui , Masculino , Pessoa de Meia-Idade , Avaliação de Resultados em Cuidados de Saúde , Comportamento Sexual/psicologia , Comportamento Sexual/estatística & dados numéricos , Sexo sem Proteção , Carga Viral , Adulto Jovem
3.
J Int AIDS Soc ; 23(7): e25583, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-32697423

RESUMO

INTRODUCTION: In light of the COVID-19 pandemic, considerable effort is going into identifying and protecting those at risk. Criminalization, stigmatization and the psychological, physical, behavioural and economic consequences of substance use make people who inject drugs (PWID) extremely vulnerable to many infectious diseases. While relationships between drug use and blood-borne and sexually transmitted infections are well studied, less attention has been paid to other infectious disease outbreaks among PWID. DISCUSSION: COVID-19 is likely to disproportionally affect PWID due to a high prevalence of comorbidities that make the disease more severe, unsanitary and overcrowded living conditions, stigmatization, common incarceration, homelessness and difficulties in adhering to quarantine, social distancing or self-isolation mandates. The COVID-19 pandemic also jeopardizes essential for PWID services, such as needle exchange or substitution therapy programmes, which can be affected both in a short- and a long-term perspective. Importantly, there is substantial evidence of other infectious disease outbreaks in PWID that were associated with factors that enable COVID-19 transmission, such as poor hygiene, overcrowded living conditions and communal ways of using drugs. CONCLUSIONS: The COVID-19 crisis might increase risks of homelessnes, overdoses and unsafe injecting and sexual practices for PWID. In order to address existing inequalities, consultations with PWID advocacy groups are vital when designing inclusive health response to the COVID-19 pandemic.


Assuntos
Betacoronavirus , Infecções por Coronavirus/complicações , Pneumonia Viral/complicações , Abuso de Substâncias por Via Intravenosa/complicações , Adulto , Surtos de Doenças , Overdose de Drogas/epidemiologia , Infecções por HIV/complicações , Infecções por HIV/epidemiologia , Pessoas em Situação de Rua/estatística & dados numéricos , Humanos , Injeções/efeitos adversos , Masculino , Pandemias , Fatores de Risco , Sexo sem Proteção/estatística & dados numéricos
4.
PLoS One ; 15(7): e0235237, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32667919

RESUMO

The epidemic of hepatitis C virus (HCV) infection among HIV-infected men who have sex with men (MSM) is in its second decade, but the routes of transmission remain poorly understood. We hypothesized that by pairing single genome sequencing (SGS), to enumerate infecting HCV genomes (viruses), with detailed sexual and drug histories, we could gain insight into the routes of transmission among MSM. We used SGS to analyze blood specimens from eight HIV-infected MSM who had 10 episodes of acute (seronegative) or early HCV infections. Seven of eight men reported condomless receptive anal intercourse (CRAI), six with rectal exposure to semen, and all eight denied rectal trauma or bleeding. Of the 10 HCV infections, eight resulted from transmission of a single virus; one infection resulted from transmission of either one or a few (three or four) closely-related viruses; and one infection resulted from transmission of >10 distinct viruses. The participant infected by >10 viruses reported sharing injection equipment for methamphetamine during sex. Two other participants also injected methamphetamine during sex but they did not share injection equipment and were infected by a single virus. Conclusions: Most HCV infections of HIV-infected MSM without a history of either rectal trauma or bleeding or shared injection equipment were caused by a single virus. Intra-rectal exposure to semen during CRAI is therefore likely sufficient for HCV transmission among MSM. Conversely, rectal trauma or bleeding or shared injection equipment are not necessary for HCV transmission among MSM. These results help clarify routes of HCV transmission among MSM and can therefore help guide the design of much-needed behavioral and other interventions to prevent HCV transmission among MSM.


Assuntos
Coinfecção/epidemiologia , Infecções por HIV/epidemiologia , Hepacivirus/genética , Hepatite C/transmissão , Adulto , Coinfecção/virologia , Genoma Viral/genética , Infecções por HIV/virologia , Hepacivirus/isolamento & purificação , Hepatite C/epidemiologia , Hepatite C/virologia , Humanos , Masculino , Metanfetamina/administração & dosagem , Pessoa de Meia-Idade , Uso Comum de Agulhas e Seringas/efeitos adversos , Uso Comum de Agulhas e Seringas/estatística & dados numéricos , Cidade de Nova Iorque/epidemiologia , Filogenia , RNA Viral/genética , RNA Viral/isolamento & purificação , Fatores de Risco , Análise de Sequência de RNA , Minorias Sexuais e de Gênero/estatística & dados numéricos , Abuso de Substâncias por Via Intravenosa/epidemiologia , Sexo sem Proteção/estatística & dados numéricos
5.
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
6.
PLoS One ; 15(7): e0236501, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32706823

RESUMO

OBJECTIVES: The main objectives of the study are to estimate HIV prevalence, active syphilis prevalence, and correlates of co-infection with HIV in Zambia, among recently sexually active individuals aged 15 to 59 years old. METHODS: We used data from the 2016 Zambia Population-based HIV Impact Assessment (ZAMPHIA), a national household survey that included biomarker testing for HIV and syphilis. Chembio DPP® Syphilis Screen and Confirm Assay was used to distinguish between active and older syphilis infections. This is the first time Chembio DPP® has been used in a national survey. Log-binominal modelling was utilized to understand the risk of acquiring HIV/active syphilis co-infection using select socio-demographic and sexual behavior variables. Multivariable analysis compared those with co-infection and those with no infection. All reported results account for the complex survey design and are weighted. RESULTS: A total of 19,114 individuals aged 15-59 years responded to the individual interview and had a valid syphilis and/or HIV test. The prevalence for those sexually active in the 12 months preceding ZAMPHIA 2016 was 3.5% and 13% for active syphilis and HIV, respectively. The prevalence of HIV/active syphilis co-infection was 1.5%. Factors associated with higher prevalence of co-infection versus no infection among females included, but were not limited to, those living in urban areas (adjusted prevalence ratio (aPR) = 3.0, 95% CI = 1.8, 4.8), those had sexual intercourse before age 15 years (aPR = 1.8, 95% CI = 1.1, 2.9), and those who had two or more sexual partners in the 12 months preceding the survey (aPR = 2.7, 95% CI = 1.6, 4.7). CONCLUSION: These findings show high prevalence for both mono-infection with HIV and syphilis, as well as co-infection with HIV/active syphilis in Zambia. There is a need for better screening and partner services, particularly among those engaging in high-risk sexual behaviors (e.g., engaging in transactional sex).


Assuntos
Coinfecção/epidemiologia , Infecções por HIV/epidemiologia , Sífilis/epidemiologia , Adolescente , Adulto , Estudos Transversais , Feminino , HIV-1 , Comportamentos de Risco à Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Fatores de Risco , Inquéritos e Questionários , Sexo sem Proteção , Adulto Jovem , Zâmbia/epidemiologia
7.
BMC Infect Dis ; 20(1): 338, 2020 May 12.
Artigo em Inglês | MEDLINE | ID: mdl-32398032

RESUMO

BACKGROUND: Peer education has become a strategy for health promotion among high-risk groups for HIV infection worldwide. However, the extent to which peer education could have an impact on HIV prevention or the long-term effect of this impact is still unknown. This study thus quantifies the impact of peer education over time among high-risk HIV groups globally. METHOD: Following the PRISMA guidelines, a systematic review and meta-analysis was used to assess the effects and duration of peer education. A thorough literature search of PubMed, Web of Science, Embase and Cochrane Library was performed, and studies about peer education on high-risk HIV groups were reviewed. Pooled effects were calculated and the sources of heterogeneity were explored using meta-regression and subgroup analysis. RESULTS: A total of 60 articles with 96,484 subjects were identified, and peer education was associated with 36% decreased rates of HIV infection among overall high risk groups (OR: 0.64; 95%CI: 0.47-0.87). Peer education can promote HIV testing (OR = 3.19; 95%CI:2.13,4.79) and condom use (OR = 2.66, 95% CI: 2.11-3.36) while reduce equipment sharing (OR = 0.50; 95%CI:0.33,0.75) and unprotected sex (OR = 0.82; 95%CI: 0.72-0.94). Time trend analysis revealed that peer education had a consistent effect on behavior change for over 24 months and the different follow-up times were a source of heterogeneity. CONCLUSION: Our study shows that peer education is an effective tool with long-term impact for behavior change among high-risk HIV groups worldwide. Low and middle-income countries are encouraged to conduct large-scale peer education.


Assuntos
Síndrome de Imunodeficiência Adquirida/prevenção & controle , Síndrome de Imunodeficiência Adquirida/psicologia , Promoção da Saúde/métodos , Grupo Associado , Adolescente , Adulto , Preservativos , Feminino , Humanos , Masculino , Programas de Rastreamento/tendências , Assunção de Riscos , Sexo sem Proteção/prevenção & controle , Adulto Jovem
8.
PLoS One ; 15(5): e0232889, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32437352

RESUMO

Due to the complex role of sexual excitation in risky sexual behaviors, this study aimed to disentangle this phenomenon by jointly analyzing the combined role of three forms of sexual excitation: genital and subjective, and individual´s propensity. Therefore, we examined the relationship between the components of the Dual Control Model, that is, propensity for sexual excitation/inhibition, in addition to genital and subjective arousal, and sexual assertiveness and intention to engage in casual sexual encounters in which sexual risk was implicitly or explicitly present. The sample consisted of 99 heterosexual young adults (55 men and 45 women) with ages ranging from 18 to 32 years. Participants performed an experiment in the laboratory, which involved them watching a sexual clip and then being presented with two erotic excerpts (stories) depicting casual sexual encounters in which there was an existence of implicit and explicit sexual risks. In men, the propensity for sexual inhibition was the most determining variable in preventing them from sexual risk-taking. In women, intention to engage in risky sexual behaviors was better determined by their propensity for sexual excitation and sexual assertiveness in negotiating the use of contraceptive methods. This research highlights the relevance of excitation and inhibition as a trait, in addition to subjective arousal and sexual assertiveness in intention to engage in risky sexual behaviors.


Assuntos
Assertividade , Comportamentos de Risco à Saúde , Intenção , Assunção de Riscos , Sexo sem Proteção/psicologia , Adolescente , Adulto , Nível de Alerta/fisiologia , Comportamento Contraceptivo/psicologia , Tomada de Decisões , Feminino , Comportamentos de Risco à Saúde/fisiologia , Heterossexualidade/fisiologia , Heterossexualidade/psicologia , Humanos , Inibição Psicológica , Masculino , Sexo sem Proteção/fisiologia , Adulto Jovem
9.
AIDS Patient Care STDS ; 34(5): 193-204, 2020 05.
Artigo em Inglês | MEDLINE | ID: mdl-32396477

RESUMO

HIV nonoccupational postexposure prophylaxis (nPEP) has been prescribed to men who have sex with men (MSM) for decades, but the global situation of nPEP implementation among this population remains unclear. To understand nPEP awareness, uptake, and factors associated with uptake among MSM, we searched PubMed, Scopus, Embase, the Cochrane Library, and Web of Science for studies reporting nPEP implementation among MSM published before May 19, 2019. We estimated pooled rates and their 95% confidence intervals (CIs) of awareness, uptake using a random-effects model. We identified 74 studies: 3 studies (4.1%) from upper-middle-income regions and 71 (95.9%) from high-income regions. The pooled rate of nPEP awareness and uptake was 51.6% (95% CI 40.6-62.5%) and 6.0% (5.0-7.1%), respectively. Pooled uptake rate was higher in upper-middle-income regions [8.9% (7.8-10.0%)] than in high-income regions [5.8% (4.8-6.9%)]. Unprotected anal sex was the most common exposure (range: 55.0-98.6%, median: 62.9%). Pooled completion of nPEP was 86.9% (79.5-92.8%). Of 19,546 MSM prescribed nPEP, 500 HIV seroconversions (2.6%) were observed. Having risky sexual behaviors and history of sexually transmitted infections were associated with higher nPEP uptake, whereas insufficient knowledge, underestimated risk of exposure to HIV, lack of accessibility, and social stigma might hinder nPEP uptake. Awareness and uptake of nPEP among MSM worldwide are low. Further efforts are needed to combat barriers to access nPEP, including improving accessibility and reducing stigma. Seroconversions post-nPEP uptake suggest that joint prevention precautions aside from nPEP are needed for high-risk MSM. More evidence from low-income and middle-income regions is needed.


Assuntos
Infecções por HIV/prevenção & controle , Homossexualidade Masculina/estatística & dados numéricos , Profilaxia Pós-Exposição/métodos , Sexo sem Proteção/estatística & dados numéricos , Adulto , Humanos , Masculino , Pessoa de Meia-Idade , Assunção de Riscos , Comportamento Sexual , Doenças Sexualmente Transmissíveis/prevenção & controle , Adulto Jovem
10.
West J Emerg Med ; 21(3): 640-646, 2020 Apr 21.
Artigo em Inglês | MEDLINE | ID: mdl-32421513

RESUMO

INTRODUCTION: Adolescents who seek care in the emergency department (ED) are a cohort at increased risk of unintended pregnancy. Although adolescents are interested in learning about pregnancy prevention in the ED, there is a lack of effective educational interventions in this setting. Long-acting reversible contraceptives (LARC) are highly effective and safe in teens, yet are underutilized. This study assessed contraception use among adolescents in the ED and evaluated the impact of an educational video on their interest in and uptake of LARCs. METHODS: We conducted a two-arm randomized controlled trial on a convenience sample of sexually active females 14 to 21 years old in an urban pediatric ED. Participants were randomized to an educational video or standard care. All participants completed a survey and were given an informational card about affiliated teen clinics with the option to schedule an appointment. We assessed pre-post mean differences between control and intervention participants and pre-post differences among intervention participants. Participants were followed three months after their ED visit to examine use of contraception. RESULTS: A total of 79 females were enrolled (42 control and 37 intervention). The mean age was 17 years, and most were youth of color. The proportion of participants with a prior pregnancy was 18%. Almost all participants reported wanting to avoid pregnancy, yet 18% reported not using contraception at last intercourse. At baseline, 17.7% of participants were somewhat or very interested in the intrauterine device (IUD) or implant. After watching the video, 42.3% were somewhat or very interested in the IUD and 35.7% in the implant. Among those who watched the video, there were significant increases in interest in using an IUD or implant (p<.001). Compared to controls, adolescents who watched the video were also significantly more likely to report wanting an IUD (p<0.001) or implant (p=0.002). A total of 46% were reached for follow-up. Of these, 16% had initiated a LARC method after their ED visit (p=NS). CONCLUSION: Most adolescent females in the ED want to avoid pregnancy, but are using ineffective methods of contraception. A brief educational video on LARCs was acceptable to adolescents and feasible to implement in a busy urban ED setting. Adolescents who watched the video had significantly greater interest in using LARCs, but no demonstrated change in actual adoption of contraception.


Assuntos
Serviço Hospitalar de Emergência , Contracepção Reversível de Longo Prazo/psicologia , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Educação de Pacientes como Assunto/métodos , Gravidez na Adolescência/prevenção & controle , Sexo sem Proteção/prevenção & controle , Adolescente , Comportamento do Adolescente/psicologia , Feminino , Seguimentos , Comportamentos Relacionados com a Saúde , Humanos , Dispositivos Intrauterinos/estatística & dados numéricos , Contracepção Reversível de Longo Prazo/estatística & dados numéricos , Aceitação pelo Paciente de Cuidados de Saúde/psicologia , Gravidez , Gravidez na Adolescência/psicologia , Gravidez não Planejada , Gravidez não Desejada , Estudos Prospectivos , Sexo sem Proteção/psicologia , Gravação em Vídeo , Adulto Jovem
11.
RECIIS (Online) ; 14(1): 212-224, jan.-mar. 2020.
Artigo em Português | LILACS | ID: biblio-1087309

RESUMO

A pegação masculina em espaços públicos da cidade é um fenômeno plural, rico em experiências instauradoras de práticas e modos de ocupar o mundo dissidentes da heteronorma. Não por acaso, foi submetido a muitos registros de infâmia. Dos antigos crimes jurídico-religiosos de sodomia forjados na Europa, que colonizaram, inclusive, os prazeres nas Américas, até sua inscrição patológico-criminal apoiada pela ciência do século XIX, a pegação tornou-se um atentado ao pudor, uma afronta à moral pública. Contudo, as figuras anônimas homoeróticas que circulam oscilantes pela urbe, instauradoras de territórios de prazer em meio ao espaço público, nos ajudam a entender, através de seus rastros, muitas vezes captados pelos aparelhos de poder, justamente suas histórias de repressão.


The cruising gay men in public spaces of the city is a plural phenomenon, rich in experiences instituting dissident practices and lifestyle of the heteronormativity. It is not by chance that this phenomenon was subjected to many registers of infamy. From the ancient juridical religious sodomy crimes established in Europe that even colonized the pleasures in the Americas to their pathological criminal inscription supported by nineteenth-century science, the cruising gay men became an indecent assault, an affront to the public moral principles. However, the anonymous homoerotic figures that circulate around the city, establishing pleasure territories in the midst of public space, help us to understand through their traces often captured by the power apparatus, precisely their stories of repression.


La práctica del cruising en los espacios públicos de la ciudad es un fenómeno plural, rico en experiencias que establecen prácticas y formas de ocupar el mundo disidentes de la heteronorma. No por casualidad, el fenómeno fue sometido a muchos registros de infamia. Desde los antiguos crimenes jurídico-religiosos de sodomía, establecidos en Europa y que incluso colonizaron los placeres en las Américas, hasta la inscripción criminal patológica apoyada por la ciencia del siglo XIX, la práctica del cruising se convirtió en un atentado contra el pudor, una afrenta a la moral pública. Sin embargo, las figuras anónimas homoeróticas que circulan alrededor de la ciudad, estableciendo territorios de placer en el espacio público, nos ayudan a comprender, a través de sus rastros, a menudo capturadas por los aparatos del poder, precisamente sus historias de represión.


Assuntos
Humanos , Comportamento Sexual , Parceiros Sexuais , Homossexualidade/história , Sexualidade , Sexo sem Proteção , Sociedades , Cidades , Prazer
12.
Zhonghua Liu Xing Bing Xue Za Zhi ; 41(4): 532-536, 2020 Apr 10.
Artigo em Chinês | MEDLINE | ID: mdl-32344477

RESUMO

Objective: To analyze the epidemiological characteristics of newly reported HIV/AIDS cases in Henan province during 2010-2018, and to provide theoretical evidence for strategies on prevention and control. Methods: Information about newly reported HIV/AIDS cases in Henan between January 1, 2010 and December 31, 2018 were collected from the National Comprehensive HIV/AIDS Information System. Excel 2010 and software SPSS 23.0 were used for data cleaning and statistical analysis. Results: During 2010-2018, a total of 41 223 HIV/AIDS cases were newly reported in Henan, and the number of newly reported HIV/AIDS cases increased from 3 087 in 2010 to 5 910 in 2018. Sexual contact was the predominant transmission route in newly reported HIV/AIDS cases, and the proportion of sexual transmission increased from 50.6% (1 564/3 087) in 2010 to 98.8% (5 839/5 910) in 2018. The proportion of heterosexual transmission firstly increased from 44.9% (1 387/3 087) in 2010 and then declined to 65.7% (3 885/5 910) in 2018, and the proportion of MSM behavior related transmission increased from 5.7% (177/3 087) in 2010 to 33.1% (1 954/5 910) in 2018. Among the newly reported heterosexual transmitted cases, the proportion of cases with non-marital heterosexual behaviors increased from 69.4% (962/1 387) in 2010 to 91.7% (3 562/3 885) in 2018 (χ(2)=657.802, P<0.001). The number of newly reported HIV/AIDS cases in young people aged 15-24 years and old people aged ≥60 years increased year by year. The youth cases were mainly infected by MSM behavior transmission (52.7%, 2 561/4 856), and heterosexual transmission was the main infection route of the elder cases (86.4%, 5 907/6 833). Among the elder cases infected by heterosexual transmission, cases with non-marital heterosexual behaviors were mainly males, the number of male cases increased from 122 in 2010 to 738 in 2018, and sex composition ratio was between 82.2% and 91.0%, while the sex composition ratio of female cases was increased from 9.0% (12/134) in 2010 to 17.8% (160/898) in 2018. Conclusions: From 2010 to 2018, the number of newly reported HIV/AIDS cases in Henan increased. Sexual transmission had become the main transmission route. AIDS prevention and control should focus on the control of non-marital heterosexual transmission and MSM behavior transmission, and to pay more attention to young people and people aged 60 years and above.


Assuntos
Infecções por HIV/diagnóstico , Infecções por HIV/transmissão , Heterossexualidade/estatística & dados numéricos , Homossexualidade Masculina/estatística & dados numéricos , Comportamento Sexual , Adolescente , Adulto , Distribuição por Idade , Idoso , Feminino , Infecções por HIV/epidemiologia , Humanos , Masculino , Pessoa de Meia-Idade , Minorias Sexuais e de Gênero , Sexo sem Proteção , Adulto Jovem
13.
PLoS One ; 15(4): e0230242, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32275669

RESUMO

BACKGROUND: Sexually explicit media exposure during early adolescence has been found to be associated with risky sexual behavior. However, previous study suffered from methodological issue, such as selection bias. Furthermore, little is known about the effect of multi-modality sexually explicit media exposure on risky sexual behavior, and how this relationship can be applied to non-western societies. OBJECTIVES: This study aimed to improve upon previous studies by using instrumental variable estimation. In addition, this study also included multi-modality of sexually explicit media and three risky sexual behavior measure from a sample of Taiwanese adolescents. METHODS: Participants were recruited from a prospective longitudinal study (Taiwan Youth Project). All were in 7th grade (mean age = 13.3) when the study was initiated in 2000. Sexually explicit media exposure, including ever-exposure and number of modalities exposed to, was measured in wave 2 (8th grade). Risky sexual behavior was measured in waves 8 (mean age = 20.3) and 10 (mean age = 24.3). A two-stage least squares regression was employed, with pubertal timing as the instrumental variable. RESULTS: About 50% of participants had been exposed to sexual media content by 8th grade, from an average of one modality. Sexually explicit media exposure predicted early sexual debut, unsafe sex, and multiple sexual partners (all: p < .05). Furthermore, exposure to more media modalities increased the likelihood of risky sexual behaviors. However, only the effect on early sexual debut was gender invariant. CONCLUSIONS: Exposure to sexually explicit media in early adolescence had a substantive relationship with risky sexual behavior in the emerging adulthood. Knowledge of this causal like effect provides a basis for building better preventive programs in early adolescence. One prominent way is early education on media literacy, and physicians themselves may need to be familiar with such content to initiate it.


Assuntos
Meios de Comunicação , Literatura Erótica , Comportamentos de Risco à Saúde , Sexo sem Proteção/psicologia , Adolescente , Adulto , Feminino , Humanos , Estudos Longitudinais , Masculino , Estudos Prospectivos , Taiwan
14.
PLoS One ; 15(4): e0231766, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32298383

RESUMO

INTRODUCTION: Risk reduction towards safer behaviour is promoted after enrolment in HIV prevention trials. We evaluated sexual behaviour, changes in sexual behaviour and factors associated with risky behaviour after one-year of follow-up among women enrolled in HIV prevention trials in Northern Tanzania. METHODS: Self-reported information from 1378 HIV-negative women aged 18-44 enrolled in microbicide and vaccine feasibility studies between 2008-2010,was used to assess changes in behaviour during a 12-month follow-up period. Logistic regression with random intercepts was used to estimate odds ratios for trends in each behaviour over time. A behavioural risk score was derived from coefficients of three behavioural variables in a Poisson regression model for HIV incidence and thereafter, dichotomized to risky vs less-risky behaviour. Logistic regression was then used to identify factors associated with risky behaviour at 12 months. RESULTS: At baseline, 22% reported multiple partners, 28% were involved in transactional sex and only 22% consistently used condoms with non-regular partners. The proportion of women reporting multiple partners, transactional sex and high-risk sex practices reduced at each 3-monthly visit (33%, 43% and 47% reduction in odds per visit respectively, p for linear trend <0.001 for all), however, there was no evidence of a change in the proportion of women consistently using condoms with non-regular partners (p = 0.22). Having riskier behaviours at baseline, being younger than 16 years at sexual debut, having multiple partners, selling sex and excessive alcohol intake at baseline were strongly associated with increased odds of risky sexual behaviour after 12 months (p<0.005 for all). CONCLUSION: An overall reduction in risky behaviours over time was observed in HIV prevention cohorts. Risk reduction counselling was associated with decreased risk behaviour but was insufficient to change behaviours of all those at highest risk. Biological HIV prevention interventions such as PrEP for individuals at highest risk, should complement risk reduction counselling so as to minimize HIV acquisition risk.


Assuntos
Infecções por HIV/epidemiologia , Comportamento Sexual/estatística & dados numéricos , Sexo sem Proteção/prevenção & controle , Adolescente , Adulto , Alcoolismo , Estudos de Coortes , Preservativos , Aconselhamento , Demografia , Estudos de Viabilidade , Feminino , Seguimentos , Infecções por HIV/prevenção & controle , Humanos , Modelos Logísticos , Razão de Chances , Fatores de Risco , Comportamento de Redução do Risco , Assunção de Riscos , Parceiros Sexuais , Fatores Sociológicos , Tanzânia/epidemiologia , Sexo sem Proteção/estatística & dados numéricos , Adulto Jovem
16.
AIDS Behav ; 24(11): 3024-3032, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-32236739

RESUMO

Although cash transfers (CT) are hypothesized to reduce AGYW's HIV risk, little is known about the mechanisms through which CT empower AGYW. We explored the impact of a CT intervention on AGYW's sexual decision-making in order to describe the pathways through which the cash may influence risk behavior. The study employed qualitative methods involving: 20 longitudinal in-depth interviews (IDIs), 40 cross-sectional IDIs, 20 narrative IDIs, and two focus group discussions with AGYW ages 15-23 participating in a CT intervention. AGYW's conceptualized empowerment as: "independence", "hope and aspiration". Potential pathways through which CT empowered AGYW were: economic, hope and aspiration for a better future, and access to knowledge. As a result of this empowerment, AGYW reported reductions in transactional sex, experiences of intimate partner violence, and risky-sexual behaviour. A sense of responsibility developed through economic empowerment, enhanced participants' self-esteem and confidence in decision-making leading to changes in AGYW's sexual risk behaviors.


Assuntos
Empoderamento , Infecções por HIV/prevenção & controle , Assistência Pública , Sexo sem Proteção/prevenção & controle , Adolescente , Adulto , Estudos Transversais , Feminino , Financiamento Governamental , Grupos Focais , Infecções por HIV/epidemiologia , Infecções por HIV/psicologia , Humanos , Pesquisa Qualitativa , Saúde Reprodutiva , Assunção de Riscos , Comportamento Sexual , Parceiros Sexuais , Tanzânia/epidemiologia , Adulto Jovem
17.
AIDS Care ; 32(sup2): 57-64, 2020 05.
Artigo em Inglês | MEDLINE | ID: mdl-32160759

RESUMO

Little is known about how interacting psychosocial problems may influence sexual behaviour among men having sex with men taking Pre-exposure prophylaxis (PrEP). This study assessed (1) the prevalence of depression, recreational drug-use and sexual risk behaviour; (2) changes in these psychosocial conditions over time; and (3) the interaction of drug use and depression with sexual risk behaviour. We analysed data of the Belgian Be-PrEP-ared cohort study (N = 200). We assessed depression using the PHQ-9, recreational drug use and receptive condomless anal intercourse (rCAI) with anonymous partners. Frequencies of psychosocial problems were compared at baseline, 9 and 18 months follow-up (FU). Bivariate associations between depression and drug-use behaviour, and their interaction with rCAI with anonymous sexual partners using was examined using linear regression. Receptive CAI increased from 41% at baseline to 53% at M18 (p = 0.038). At baseline, we found an interaction effect of poly-drug use and depression, potentiating rCAI with anonymous partners. Participants reporting poly-drug use associated with depression were significant more likely to report this type of sexual risk behaviour than those who did not report this association (p = 0.030). The high level of intertwined psychosocial problems call for multi-level interventions for those PrEP users experiencing a syndemic burden.


Assuntos
Depressão/epidemiologia , Profilaxia Pré-Exposição , Assunção de Riscos , Comportamento Sexual/psicologia , Parceiros Sexuais , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Sexo sem Proteção/estatística & dados numéricos , Adulto , Bélgica/epidemiologia , Estudos de Coortes , Depressão/psicologia , Infecções por HIV/epidemiologia , Homossexualidade Masculina/psicologia , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Parceiros Sexuais/psicologia , Transtornos Relacionados ao Uso de Substâncias/psicologia , Sindemia , Adulto Jovem
18.
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
19.
Rev Med Suisse ; 16(686): 543-545, 2020 Mar 18.
Artigo em Francês | MEDLINE | ID: mdl-32186800

RESUMO

Although there is a substantial literature concerning the sexuality of people suffering from a psychiatric disorder, such as depression, anxiety disorder, schizophrenia, eating disorders or personality disorders, few studies have investigated the sexuality of attention deficit/hyperactivity disorder (ADHD) patients. The purpose of this article is therefore to show current knowledge about sexuality in people suffering from ADHD. The latter seem to have less sexual satisfaction, more sexual desire, more sexual dysfunction and more risky sexual behavior than the general population.


Assuntos
Transtorno do Deficit de Atenção com Hiperatividade/psicologia , Comportamento Sexual , Sexualidade , Transtorno do Deficit de Atenção com Hiperatividade/epidemiologia , Humanos , Sexo sem Proteção/estatística & dados numéricos
20.
BMC Public Health ; 20(1): 398, 2020 Mar 27.
Artigo em Inglês | MEDLINE | ID: mdl-32216783

RESUMO

BACKGROUND: We analyse unprotected anal intercourses (UAI) self-reported by a sample of men who have sex with men (MSM), by their future testing intentions and past testing history to identify undertested subpopulations that could be contributing to onward transmission. METHODS: We recruited MSM through gay dating websites in Spain from September 2012 to April 2013. For MSM at risk of acquiring or unknowingly transmitting HIV (at risk hereafter) we calculate time at risk, number of UAI in the last 12 months and last 5 years by testing intention (low intention (LI), Medium intention (MI), high intention (HI)) and past testing history. For never testers we analyse the reasons for not having been tested. RESULTS: Of 3272 MSM at risk, 19.8% reported LI of testing. MSM with LI reported the longest period at risk (8.49 years (p < 0.001)) and reported 3.20 UAI/person in the last 12 months (vs. 3.23 and 2.56 in MSM with HI and MI (p < 0.001)) and 12.90 UAI/person in the last 5 years (vs. 8.07 and 9.82 in MSM with HI and MI (p < 0.001)). Those with LI accounted for 21 and 27% of all the UA acts occurring in the last 12 months and the last 5 years. Among never testers (40.6%), those with LI reported lower risk perception (p = 0.006). CONCLUSION: We identified a group of high risk and undertested MSM that could be behind a substantial proportion of the UAIs with potential of transmission/acquisition of HIV. Given their low willingness to seek an HIV test and low risk perception, they constitute a population that will probably require approaches other than client initiated strategies.


Assuntos
Infecções por HIV/diagnóstico , Homossexualidade Masculina/psicologia , Intenção , Programas de Rastreamento/psicologia , Aceitação pelo Paciente de Cuidados de Saúde/psicologia , Adolescente , Adulto , Estudos Transversais , Homossexualidade Masculina/estatística & dados numéricos , Humanos , Masculino , Pessoa de Meia-Idade , Medição de Risco , Autorrelato , Espanha , Sexo sem Proteção , Adulto Jovem
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