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1.
Pediatrics ; 144(6)2019 12.
Artigo em Inglês | MEDLINE | ID: mdl-31740497

RESUMO

Despite significant declines over the past 2 decades, the United States continues to experience birth rates among teenagers that are significantly higher than other high-income nations. Use of emergency contraception (EC) within 120 hours after unprotected or underprotected intercourse can reduce the risk of pregnancy. Emergency contraceptive methods include oral medications labeled and dedicated for use as EC by the US Food and Drug Administration (ulipristal and levonorgestrel), the "off-label" use of combined oral contraceptives, and insertion of a copper intrauterine device. Indications for the use of EC include intercourse without use of contraception; condom breakage or slippage; missed or late doses of contraceptives, including the oral contraceptive pill, contraceptive patch, contraceptive ring, and injectable contraception; vomiting after use of oral contraceptives; and sexual assault. Our aim in this updated policy statement is to (1) educate pediatricians and other physicians on available emergency contraceptive methods; (2) provide current data on the safety, efficacy, and use of EC in teenagers; and (3) encourage routine counseling and advance EC prescription as 1 public health strategy to reduce teenaged pregnancy.


Assuntos
Anticoncepção Pós-Coito/métodos , Papel do Médico , Relações Médico-Paciente , Sexo sem Proteção/efeitos dos fármacos , Adolescente , Feminino , Antagonistas de Hormônios/administração & dosagem , Humanos , Masculino , Pediatras/psicologia , Papel do Médico/psicologia , Comportamento Sexual/efeitos dos fármacos , Comportamento Sexual/fisiologia , Comportamento Sexual/psicologia , Sexo sem Proteção/fisiologia , Sexo sem Proteção/psicologia
2.
Afr J AIDS Res ; 18(3): 244-253, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31575340

RESUMO

Unprotected sexual activity increases the risk of pregnancy and HIV and AIDS. More than three decades into the AIDS pandemic, the condom remains the most effective strategy for protecting against the dual risks of pregnancy and HIV and AIDS, but data from national surveys suggest that condom use among young people aged 15-24 is on the decline in South Africa. This study uses qualitative data from 20 in-depth interviews and one focus group to examine the risk behaviours of university students aged 18-24 years old, with particular emphasis on understanding the decline in the use of condoms. It is well documented that South Africa has one of the highest prevalence rates of HIV and AIDS in the world, however the findings of this study suggest that even though students were well informed about the perceived risks associated with unsafe sexual behaviours, they continue to engage in risk behaviours including unprotected sexual intercourse, multiple sexual partners and the use of alcohol. Male students were more likely than female students to report risky sexual behaviours. Condom use is occurring but not consistently. The majority of students did not use condoms during their first sexual encounter because of a lack of preparedness. Negative attitudes towards condoms continue to discourage students from using them consistently, especially those provided by the government. In light of this, it is recommended that rigorous efforts are directed towards challenging inaccurate perceptions about, and attitudes towards, condom use to promote consistency.


Assuntos
Infecções por HIV/psicologia , Conhecimentos, Atitudes e Prática em Saúde , Assunção de Riscos , Comportamento Sexual/psicologia , Estudantes/estatística & dados numéricos , Sexo sem Proteção/psicologia , Adolescente , Preservativos/estatística & dados numéricos , Feminino , HIV , Humanos , Masculino , Gravidez , Parceiros Sexuais/psicologia , África do Sul , Inquéritos e Questionários , Universidades/estatística & dados numéricos , Adulto Jovem
4.
Ethiop J Health Sci ; 29(4): 461-470, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31447519

RESUMO

Background: Among the number of reasons that expose the youth to reproductive health risks, lack of adequate information on sexual and reproductive health issues is of prior concern. Given the lack of readily available information about sexual activity to teens, they turn to media for information about sexual norms and may also use the media as a sexual super-peer that encourages them to be sexually active. Therefore, this study was aimed to assess the association between exposure to sexually explicit materials and sexually risky behaviors among undergraduate students of Ambo University, Ethiopia. Methods: Institutional based cross-sectional study was conducted among 403 university students in 2018. Study participants were selected by systematic random sampling technique. Self- administered questionnaire was used to collect data. Data were analyzed using SPSS statistical software version 20. Uni-variate, bivariate and multiple logistic regression analyses were done. With 95% CI, the p-value of less than 0.05 was taken as the level of significance. Results: About 55% and 52% of the university students were exposed to sexually explicit electronic materials throughout their life and in the last 12 months prior to data collection period respectively. Searching for sex information was the top reason for why university students resorted to watching sexually explicit materials. Sexually active students, senior students and male students were more likely to engage in watching sexually explicit electronic materials compared to their counterparts. Conclusion: A high numbers of university students were being exposed to sexually explicit electronic materials for the sake of searching about sexual and related information. This exposure has a significant association with risky sexual behaviors specifically. We highly recommend that university organize awareness creation forum on the area of sexual health, HIV/AIDS and STI, and related matters.


Assuntos
Literatura Erótica/psicologia , Comportamento Sexual/psicologia , Adolescente , Adulto , Estudos Transversais , Etiópia , Feminino , Humanos , Modelos Logísticos , Masculino , Comportamento Sexual/estatística & dados numéricos , Inquéritos e Questionários , Universidades , Sexo sem Proteção/psicologia , Sexo sem Proteção/estatística & dados numéricos , Adulto Jovem
5.
Trials ; 20(1): 439, 2019 Jul 17.
Artigo em Inglês | MEDLINE | ID: mdl-31315685

RESUMO

BACKGROUND: Economic vulnerability, such as homelessness and unemployment, contributes to the HIV risk among racial minorities in the U.S., who are disproportionately infected. Yet, few economic-strengthening interventions have been adapted for HIV prevention in economically-vulnerable African-American young adults. Engaging Microenterprise for Resource Generation and Health Empowerment (EMERGE) is a feasibility randomized clinical trial of an HIV prevention microenterprise intervention with integrated text messages ("nudges") that are informed by behavioral economic principles. The trial aims to reduce sexual risk behaviors and increase employment and uptake of HIV preventive behaviors. METHODS/DESIGN: In total, 40 young adults who are African-American, aged 18-24, live in Baltimore City, have experienced at least one episode of homelessness in the last 12 months, are unemployed or underemployed (fewer than 10 h per week), are not enrolled in school, own a cell phone with text messaging, and report at least one episode of unprotected or unsafe sex in the prior 12 months will be recruited from two community-based organizations providing residential supportive services to urban youth. Participants will undergo a 3-week run-in period and thereafter be randomly assigned to one of two groups with active interventions for 20 weeks. The first group ("comparison") will receive text messages with information on job openings. The second group ("experimental") will receive text messages with information on job openings plus information on HIV prevention and business educational sessions, a mentored apprenticeship, and a start-up grant, and business and HIV prevention text messages based on principles from behavioral economics. The two primary outcomes relate to the feasibility of conducting a larger trial. Secondary outcomes relate to employment, sexual risk behaviors, and HIV preventive practices. All participants will be assessed using an in-person questionnaire at pre-intervention (prior to randomization) and at 3 weeks post-intervention. To obtain repeated, longitudinal measures, participants will be assessed weekly using text message surveys from pre-intervention up to 3 weeks post-intervention. DISCUSSION: This study will be one of the first U.S.-based feasibility randomized clinical trials of an HIV prevention microenterprise intervention for economically-vulnerable African-American young adults. The findings will inform whether and how to conduct a larger efficacy trial for HIV risk reduction in this population. TRIAL REGISTRATION: ClinicalTrials.gov, NCT03766165 . Registered on 4 December 2018.


Assuntos
Afro-Americanos , Emprego , Infecções por HIV/prevenção & controle , Serviços Preventivos de Saúde , Comportamento Sexual , Empresa de Pequeno Porte , Envio de Mensagens de Texto , Sexo sem Proteção/prevenção & controle , Populações Vulneráveis , Adolescente , Afro-Americanos/psicologia , Fatores Etários , Baltimore/epidemiologia , Emprego/psicologia , Estudos de Viabilidade , Feminino , Infecções por HIV/etnologia , Infecções por HIV/psicologia , Infecções por HIV/transmissão , Comportamentos Relacionados com a Saúde/etnologia , Conhecimentos, Atitudes e Prática em Saúde/etnologia , Humanos , Masculino , Fatores de Proteção , Ensaios Clínicos Controlados Aleatórios como Assunto , Fatores de Risco , Fatores de Tempo , Sexo sem Proteção/etnologia , Sexo sem Proteção/psicologia , Populações Vulneráveis/etnologia , Populações Vulneráveis/psicologia , Adulto Jovem
6.
J Behav Addict ; 8(2): 335-342, 2019 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-31257917

RESUMO

BACKGROUND: This study sought to examine the occurrence of the problematic use of smartphones in a university sample and associated physical and mental health correlates, including potential relationships with risky sexual practices. METHODS: A 156-item anonymous online survey was distributed via e-mail to a sample of 9,449 university students. In addition to problematic smartphone usage, current use of alcohol and drugs, psychological and physical status, and academic performance were assessed. RESULTS: A total of 31,425 participants were included in the analysis, of whom 20.1% reported problematic smartphone use. Problematic use of smartphones was associated with lower grade point averages and with alcohol use disorder symptoms. It was also significantly associated with impulsivity (Barratt scale and ADHD) and elevated occurrence of PTSD, anxiety, and depression. Finally, those with current problems with smartphone use were significantly more sexually active. CONCLUSIONS: Problematic use of smartphones is common and has public health importance due to these demonstrable associations with alcohol use, certain mental health diagnoses (especially ADHD, anxiety, depression, and PTSD), and worse scholastic performance. Clinicians should enquire about excessive smartphone use as it may be associated with a range of mental health issues. Research is needed to address longitudinal associations.


Assuntos
Desempenho Acadêmico/psicologia , Consumo de Bebidas Alcoólicas/epidemiologia , Comportamento Aditivo/epidemiologia , Comportamento Impulsivo , Transtornos Mentais/epidemiologia , Smartphone/estatística & dados numéricos , Desempenho Acadêmico/estatística & dados numéricos , Adulto , Consumo de Bebidas Alcoólicas/psicologia , Comportamento Aditivo/psicologia , Comorbidade , Feminino , Humanos , Masculino , Transtornos Mentais/psicologia , Meio-Oeste dos Estados Unidos/epidemiologia , Fatores de Risco , Assunção de Riscos , Estudantes/psicologia , Estudantes/estatística & dados numéricos , Universidades , Sexo sem Proteção/psicologia , Sexo sem Proteção/estatística & dados numéricos , Adulto Jovem
7.
J Prev Med Hyg ; 60(2): E84-E92, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31312737

RESUMO

Introduction: STIs are a serious public health problem. Worldwide, 500 million people a year acquire a STI, and young are the most affected. Methods: This study was conducted administering an anonymous questionnaire to 1228 Sicilian students of high school and university. Results: The students had variable understanding of STIs and their complications. The results demonstrate an extreme variability in the knowledge of STIs. Multiple linear regression showed that sexual health knowledge was associated with age and sexual orientation. Conclusions: Our results show that knowledge of STIs is poor and inadequate. This finding can put students at risk of STIs.


Assuntos
Conhecimentos, Atitudes e Prática em Saúde , Doenças Sexualmente Transmissíveis/psicologia , Estudantes/psicologia , Sexo sem Proteção/estatística & dados numéricos , Adolescente , Adulto , Fatores Etários , Feminino , Humanos , Itália , Masculino , Instituições Acadêmicas , Comportamento Sexual/psicologia , Comportamento Sexual/estatística & dados numéricos , Estudantes/estatística & dados numéricos , Inquéritos e Questionários , Universidades , Sexo sem Proteção/psicologia , Adulto Jovem
8.
AIDS Educ Prev ; 31(4): 380-393, 2019 08.
Artigo em Inglês | MEDLINE | ID: mdl-31361515

RESUMO

Russia has over 1.2 million HIV infections and Europe's highest HIV incidence. Although its HIV epidemic is intertwined with high alcohol consumption rates, the interaction between alcohol use and HIV care in Russia is understudied. Five hundred eighty-six HIV-positive persons were recruited using social network methods in St. Petersburg. Fifty-nine percent of males, and 45% of females, drank regularly. Thirty percent of alcohol users reported binge drinking (males: ≥ 5 drinks; females ≥ 4 drinks) in the past week. Alcohol use was associated with lower HIV care engagement and having a detectable viral load. Multivariate analyses showed that any alcohol consumption, number of alcohol drinks consumed, and having a binge drinking day in the past week were associated with male gender, use of illicit drugs, drug injection, smaller social network size, lower social supports, being unmarried, and reporting condomless intercourse with non-main partners. Interventions to improve HIV care in Russia must comprehensively address the use of alcohol and substances that interfere with care engagement.


Assuntos
Consumo de Bebidas Alcoólicas/epidemiologia , Alcoolismo/epidemiologia , Fármacos Anti-HIV/uso terapêutico , Infecções por HIV/tratamento farmacológico , Parceiros Sexuais , Rede Social , Sexo sem Proteção/estatística & dados numéricos , Adulto , Consumo de Bebidas Alcoólicas/efeitos adversos , Feminino , Infecções por HIV/epidemiologia , Infecções por HIV/prevenção & controle , Infecções por HIV/transmissão , Humanos , Masculino , Prevalência , Assunção de Riscos , Federação Russa/epidemiologia , Comportamento Sexual/psicologia , Comportamento Sexual/estatística & dados numéricos , Apoio Social , Sexo sem Proteção/psicologia , Carga Viral
9.
BMC Public Health ; 19(1): 978, 2019 Jul 22.
Artigo em Inglês | MEDLINE | ID: mdl-31331300

RESUMO

BACKGROUND: Condom use remains consistently low among Chinese men who have sex with men (MSM). This study aims to identify factors associated with condom use after online video intervention. METHODS: This is a secondary data analysis of data collected from an online non-inferiority trial comparing the effectiveness of two condom use promotion video interventions among Chinese MSM. Participants from the two groups were combined since the effectiveness of two video interventions were shown to be non-inferior. Univariable and multivariable logistic regression were used to identify factors associated with condomless sex after the intervention during the follow-up interval. RESULTS: Overall, 1173 participants were recruited at baseline and 791 (67.4%) completed the three-month follow-up survey. 57.3% (453/791) of the participants reported condomless sex after intervention in the three-month follow-up interval. MSM who have had sex under the influence of alcohol in the last 3 months (Odds Ratio(OR) = 1.90; 95% CI: 1.22, 2.97; Adjusted OR(AOR) = 1.79; 95% CI: 1.13, 2.83) and ever have had sex tourism (OR = 2.75; 95% CI: 1.34, 5.63; AOR = 2.40; 95% CI: 1.15, 5.07) at baseline were more likely to have condomless sex after intervention in the three-month follow-up period. MSM who had a higher level of community engagement in sexual health (OR = 0.54; 95% CI: 0.35, 0.82; AOR = 0.49; 95% CI: 0.32, 0.75 with substantial engagement) and who viewed additional condom promotion videos during the follow-up period by themselves (OR = 0.67; 95% CI = 0.50, 0.89; AOR = 0.67; 95% CI: 0.50, 0.91). were less likely to have condomless sex during the follow-up period. CONCLUSION: The intervention appeared to be effective among MSM who reported viewing additional condom promotion videos by themselves and more community engagement after the intervention. In MSM who reported risky sexual behaviors at baseline, the intervention appeared less effective. Tailored intervention videos that target particular subgroups, active in-person community engagement, and optimized intervention frequency should be considered in future sexual health interventions.


Assuntos
Preservativos/estatística & dados numéricos , Promoção da Saúde/métodos , Homossexualidade Masculina/psicologia , Sexo sem Proteção/psicologia , Adulto , China/epidemiologia , Educação a Distância , Infecções por HIV/epidemiologia , Homossexualidade Masculina/estatística & dados numéricos , Humanos , Masculino , Assunção de Riscos , Inquéritos e Questionários , Gravação de Videoteipe
10.
BMC Womens Health ; 19(1): 77, 2019 06 14.
Artigo em Inglês | MEDLINE | ID: mdl-31200702

RESUMO

BACKGROUND: Low-fee female sex workers (FSW) lack power to effectively negotiate male condom use with clients. Female condoms (FCs) may provide an alternative strategy. This study was conducted to assess the acceptability of FC use among low-fee FSWs, and to identify appropriate candidates for future FC promotion. METHODS: A one-month follow-up study was conducted. At entry into the study, eligible participants completed a baseline questionnaire and were given 10 FCs. At the one-month follow up encounter, the number of used FC packages were counted and each participant completed a follow-up questionnaire. Logistic regression was used to identify variables associated with more frequent use of FCs (> 2 times). RESULTS: A total of 312 low-fee FSWs were enrolled at baseline and all participants completed the follow-up evaluation. Among them, 123 (39.4%) participants had used more than two FCs. Participants who were illiterate or had completed at most primary school education (OR: 2.4, 95% CI: 1.4-7.2), charged ≤30 RMB per client (≤30 vs. 51-80 RMB, OR: 3.8, 95% CI: 1.9-7.6), or had consistently used condoms with regular clients in the past month (OR: 2.4, 95%CI: 1.4-4.2) were more likely to use FCs. CONCLUSION: Low-fee FSWs charging ≤30 RMB per client, and those who are less educated may be appropriate initial candidates for FC promotion in China. Strategies to consider include teaching FSWs tactics for negotiation of FC use that can initially be applied with regular clients, and providing education to maximize ease-of use, and minimize discomfort with FC usage.


Assuntos
Preservativos Femininos/estatística & dados numéricos , Infecções por HIV/prevenção & controle , Profissionais do Sexo/psicologia , Sexo sem Proteção/psicologia , Adulto , China , Estudos Transversais , Feminino , Seguimentos , Infecções por HIV/psicologia , Humanos , Negociação , Sexo Seguro/psicologia , Profissionais do Sexo/estatística & dados numéricos , Inquéritos e Questionários , Sexo sem Proteção/prevenção & controle , Adulto Jovem
11.
J Acquir Immune Defic Syndr ; 81(3): 300-303, 2019 07 01.
Artigo em Inglês | MEDLINE | ID: mdl-31194704

RESUMO

BACKGROUND: Results from the HPTN 065 study showed that financial incentives (FI) were associated with significantly higher viral load suppression and higher levels of engagement in care among patients at HIV care sites randomized to FI versus sites randomized to standard of care (SOC). We assessed HIV viral suppression and continuity in care after intervention withdrawal to determine the durability of FI on these outcomes. SETTING: A total of 37 HIV test and 39 HIV care sites in the Bronx, New York, and Washington, DC, participated in the study. METHODS: Laboratory data reported to the US National HIV Surveillance System were used to determine site-level viral suppression and continuity in care outcomes. Postintervention effects were assessed for the 3 quarters after discontinuation of FI. Generalized estimation equations were used to compare FI and SOC site-level outcomes after intervention withdrawal. RESULTS: After FI withdrawal, a trend remained for an increase in viral suppression by 2.7% (-0.3%, 5.6%, P = 0.076) at FI versus SOC sites, decreasing from the 3.8% increase noted during implementation of the intervention. The significant increase in continuity in care during the FI intervention was sustained after intervention with 7.5% (P = 0.007) higher continuity in care at FI versus SOC sites. CONCLUSIONS: After the withdrawal of FI, findings at the 9-months postintervention withdrawal from this large study showed evidence of durable effects of FI on continuity in care, with trend for continued higher viral suppression. These findings are promising for adoption of such interventions to enhance key HIV-related care outcomes.


Assuntos
Continuidade da Assistência ao Paciente , Infecções por HIV/prevenção & controle , Homossexualidade Masculina/estatística & dados numéricos , Carga Viral , Adolescente , Adulto , Fatores Etários , Infecções por HIV/tratamento farmacológico , Homossexualidade Masculina/psicologia , Humanos , Masculino , Pessoa de Meia-Idade , Motivação , Parceiros Sexuais , Sexo sem Proteção/psicologia , Sexo sem Proteção/estatística & dados numéricos , Adulto Jovem
12.
BMC Public Health ; 19(1): 722, 2019 Jun 10.
Artigo em Inglês | MEDLINE | ID: mdl-31182070

RESUMO

BACKGROUND: The HIV prevalence among men who have sex with men (MSM) in China has increased yearly. This study aimed to explore the association between the characteristics of social communication and condomless anal intercourse (CAI) among MSM and the implications for prevention and control of HIV among MSM in China using an egocentric network framework. METHODS: The data were collected in Guangzhou between November 2016 and May 2017 through standardized face-to-face interviews. The participants were recruited among MSM who received voluntary counselling and testing services (VCT) provided by nongovernmental organizations (NGOs) and the local Centers for Disease Control and Prevention (CDC). We used the framework of the egocentric network analysis, the odd ratios of CAI were analyzed using generalized estimating equations (GEE). RESULTS: In total, 1073 MSM who nominated 2667 sexual partners were sampled. MSM who were approximately 30 years old and chose sexual partners of different age category were more likely to engage in CAI. Participants with high level education who were in partnerships with individuals with lower education levels had a higher risk of CAI. Participants who reported having a strong relationship with their sexual partners(AOR = 1.31) were associated with a higher probability of experiencing CAI during sex; while having sexual partners who were unmarried (OR = 0.56), and participants who reported meeting sexual partners online (AOR = 0.74) or, having sex with an occasional partner (AOR = 0.44)were less likely to engage in CAI. CONCLUSION: Our study indicates that the strength of sexual dyadic relational ties and different social communication mixing patterns across ages, educational categories, and marital status were associated with CAI.


Assuntos
Preservativos/estatística & dados numéricos , Homossexualidade Masculina/estatística & dados numéricos , Comportamento Sexual/estatística & dados numéricos , Minorias Sexuais e de Gênero/estatística & dados numéricos , Sexo sem Proteção/estatística & dados numéricos , Adulto , China/epidemiologia , Infecções por HIV/epidemiologia , Infecções por HIV/prevenção & controle , Homossexualidade Masculina/psicologia , Humanos , Masculino , Estado Civil , Pessoa de Meia-Idade , Razão de Chances , Prevalência , Comportamento Sexual/psicologia , Parceiros Sexuais , Minorias Sexuais e de Gênero/psicologia , Sexo sem Proteção/psicologia
14.
Indian J Public Health ; 63(2): 114-118, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31219059

RESUMO

Background: Unsafe injecting drug use is a documented risk factor for the transmission of human immunodeficiency virus infection. Harm reduction strategy aims at reducing this deleterious consequence. Objectives: To study the prevalence and predictors of injecting as well as sexual risk behavior among male injecting drug users (IDUs). Methods: A cross-sectional study was conducted among 250 male IDUs from January 2017 to March 2018. Risk behavioral data were collected after obtaining informed consent of the study participants. This included information on sharing, reusing needles/injections, and sexual behavior. Descriptive statistics and logistic regression model was run using the Epi Info software version 7.2 for Windows. Results: In the past one month, 25.3% had shared needles/syringes by either borrowing or lending or both. Inconsistent condom use during sexual intercourse with a regular, casual, and paid sex partner was practiced by 64.7% (77/119), 65.8% (48/73), and 45.0% (18/40), respectively. The binary logistic regression analysis revealed that unsafe injecting drug behavior was higher among daily users: (OR = 3.0 [1.3-6.6]) and comparatively lower among those who preferred to avail needles/syringes from Needle Syringe Exchange Program (OR = 0.4 [0.2-0.9]); as compared to their counterparts. Conclusions: The findings suggest that IDUs in the study area are engaging in risk behaviors. Behavior change communication and harm reduction strategy should be strengthened.


Assuntos
Assunção de Riscos , Abuso de Substâncias por Via Intravenosa/psicologia , Adolescente , Adulto , Estudos Transversais , Humanos , Índia/epidemiologia , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Prevalência , Abuso de Substâncias por Via Intravenosa/epidemiologia , Sexo sem Proteção/psicologia , Sexo sem Proteção/estatística & dados numéricos , Adulto Jovem
15.
Cien Saude Colet ; 24(4): 1417-1426, 2019 Apr.
Artigo em Espanhol, Inglês | MEDLINE | ID: mdl-31066843

RESUMO

HIV infection, acquired with the conscious participation of the recipient, is a complex problem of international concern, especially among men who have sex with men. Behaviors emerge such as bareback (intentionally unprotected anal sex between men) and bugchasing (bareback sex when one participant is HIV+ and the other is not). A group of emerging risk behaviors for HIV infection was characterized. A review of the literature in the MEDLINE, Web of Science and regional SciELO databases was performed. HIV-related search terms such as unprotected sex, barebacking/bareback and bug chasing, were used. Bareback and bug chaser behaviors occur, among other factors, through social homonegativity, ART positive coverage, insufficient prevention campaigns, search for new sensations and attempts to strengthen the relationship with the HIV+ member. Unprotected sex is primarily associated with having HIV/AIDS diagnoses, physical violence due to sexual orientation, viewing homosexual sex sites, and having bought or sold sex. It is necessary to work with individual behaviors that draw individuals close to infection.


Assuntos
Infecções por HIV/epidemiologia , Assunção de Riscos , Sexo sem Proteção/estatística & dados numéricos , Infecções por HIV/psicologia , Infecções por HIV/transmissão , Homossexualidade Masculina/psicologia , Humanos , Masculino , Comportamento Sexual , Minorias Sexuais e de Gênero/psicologia , Sexo sem Proteção/psicologia
16.
Public Health Rep ; 134(1_suppl): 63S-70S, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31059417

RESUMO

OBJECTIVES: The effect of incarceration on HIV risk-related behaviors among at-risk heterosexual men is understudied. The objective of our study was to examine the association between incarceration and HIV risk-related behaviors among a sample of predominantly non-Hispanic black and Hispanic heterosexual men residing in urban areas in the United States with a high prevalence of AIDS. METHODS: We analyzed data from the 2013 National HIV Behavioral Surveillance system on 5321 at-risk heterosexual men using log-linked Poisson regression models, adjusted for demographic characteristics and clustered on city. RESULTS: Of 5321 men, 1417 (26.6%) had recently been incarcerated (in the past 12 months), 2781 (52.3%) had ever been incarcerated but not in the past 12 months, and 1123 (21.1%) had never been incarcerated. Recent incarceration was associated with multiple casual female sexual partners (adjusted prevalence ratio [aPR] = 1.23; 95% confidence interval [CI], 1.05-1.44), condomless sex with multiple female sexual partners (aPR = 1.32; 95% CI, 1.06-1.66), injection drug use (aPR = 3.75; 95% CI, 2.64-5.32), and having sexual partners who were more likely to have ever injected drugs (aPR = 1.84; 95% CI, 1.48-2.28), been incarcerated (aPR = 2.28; 95% CI, 2.01-2.59), or had a concurrent sexual partner (aPR = 1.08; 95% CI, 1.05-1.11), as compared with never-incarcerated men. CONCLUSIONS: Incarceration history was associated with HIV risk-related behaviors among heterosexual men from urban areas in the United States. Correctional rehabilitation initiatives are needed to promote strategies that mitigate HIV risk-related behaviors and promote healthy reentry into communities among heterosexual men at high risk for HIV.


Assuntos
Afro-Americanos/psicologia , Afro-Americanos/estatística & dados numéricos , Heterossexualidade/estatística & dados numéricos , Prisioneiros/psicologia , Prisioneiros/estatística & dados numéricos , Assunção de Riscos , Parceiros Sexuais/psicologia , Adolescente , Adulto , Idoso , Cidades/epidemiologia , Feminino , Infecções por HIV/epidemiologia , Infecções por HIV/psicologia , Humanos , Masculino , Pessoa de Meia-Idade , Abuso de Substâncias por Via Intravenosa/epidemiologia , Abuso de Substâncias por Via Intravenosa/psicologia , Estados Unidos/epidemiologia , Sexo sem Proteção/psicologia , Sexo sem Proteção/estatística & dados numéricos , Adulto Jovem
17.
PLoS One ; 14(5): e0216208, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31059524

RESUMO

BACKGROUND: Women of reproductive age are at the highest risk of both HIV infection and unintended pregnancy in sub-Saharan Africa. Highly effective contraceptives (HECs) such as hormonal injectable and implants are widely used in this region. HECs are effective for preventing pregnancies. However, unlike condoms, HECs offer no protection against HIV. Dual-method use, or the use of condoms with HECs, is an ideal option to reduce HIV risk but is infrequently practiced. Rather, women tend not to use condoms when they use HECs and increase their HIV risk from their sexual partners. However, it remains unknown whether HIV status affects such tendency. Given the increasing popularity of HECs in sub-Saharan Africa, this study examined the association between the use of HECs and condom use among HIV-positive and negative women. METHODS: A cross-sectional study was conducted among 833 sexually active women aged 18-49 years, recruited from six clinics in Siaya county, Kenya. From March to May 2017, female research assistants interviewed the women using a structured questionnaire. Multiple logistic regression analysis was conducted to examine the association between HEC use and consistent condom use in the past 90 days, adjusting for potential confounders. It was also examined with regular partners (husbands or live-in partners) and non-regular partners, separately. In addition, a sub-sample analysis of HIV-negative or unknown women was conducted. RESULTS: In total, 735 women were available for the analysis. Among the women, 231 (31.4%) were HIV-positive. HIV-positive women were more likely to use HECs than HIV-negative or status unknown women (70.1% vs. 61.7%, p = 0.027). HEC use was significantly associated with decreased condom use with a regular partner (adjusted odds ratio (AOR) = 0.25; 95% CI 0.15-0.43, p<0.001) and a non-regular partner (AOR = 0.25; 95% CI 0.11-0.58, p = 0.001). However, compared with HIV-negative or status unknown women, HIV-positive women were more likely to use HECs and condoms consistently with a regular partner (AOR = 6.54, 95% CI 2.15-20.00, p = 0.001). Other factors significantly associated with consistent condom use included partner's positive attitude toward contraception, partner's HIV-positive status, high HIV risk perception, and desire for children in the future. CONCLUSION: Dual-method use was limited among HIV-negative women and women who had HIV-negative partners due to inconsistent condom use. The use of HECs was significantly associated with decreased condom use, regardless of partner type and their HIV status. Due to this inverse association, HIV-negative women may increase their HIV risk from their sexual partners. Therefore, interventions should be strengthened to reduce their dual risks of HIV infection and unintended pregnancy by promoting dual-method use. Family planning services should strengthen counseling on the possible risk of HIV infection from their sexual partners and target not only women but also their partners, who may play a key role in condom use.


Assuntos
Preservativos/estatística & dados numéricos , Infecções por HIV/psicologia , População Rural/estatística & dados numéricos , Sexo Seguro/estatística & dados numéricos , Adolescente , Adulto , Comportamento Contraceptivo/estatística & dados numéricos , Estudos Transversais , Feminino , Soronegatividade para HIV , Soropositividade para HIV/epidemiologia , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Quênia/epidemiologia , Modelos Logísticos , Pessoa de Meia-Idade , Parceiros Sexuais , Inquéritos e Questionários , Sexo sem Proteção/psicologia , Sexo sem Proteção/estatística & dados numéricos , Adulto Jovem
20.
Psychol Addict Behav ; 33(4): 349-359, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30958012

RESUMO

To examine the mechanisms underlying the efficacy of a dual-target motivational intervention (MI) to reduce heavy drinking and risky sex. A priori hypotheses were that: increases in alcohol-related readiness to change (RTC) and self-efficacy would mediate the effect of MI on alcohol use; increases in sex-related RTC and self-efficacy would mediate the effect of MI on risky sex; and reductions in alcohol use would mediate reductions in risky sex. Patients in Emergency Departments who screened positive for heavy drinking and risky sex were randomly assigned to receive MI or brief advice. RTC and self-efficacy were assessed at baseline and immediately postintervention. Alcohol use and sexual behavior was assessed at baseline, 3-, 6-, and 9-month follow up. Single- and serial-mediation models were tested. Patients who received MI had higher postintervention RTC and self-efficacy, but neither mechanism mediated the effects of MI on behavioral outcomes. Reduction in heavy drinking mediated the effect of MI on frequency of sex under the influence (SUI). Further, the effect of MI on condomless sex was mediated by an indirect path in which reductions in heavy drinking at 3 months predicted less SUI at 6 months, which in turn predicted reduction in condomless sex at 9-months. Although some effect of dual-target MI on risky sex is independent of drinking, treatment-related reduction in heavy drinking does account for a significant portion of reduction in risky sex, providing support for the utility of this intervention in patient populations where heavy drinking and risky sex co-occur. (PsycINFO Database Record (c) 2019 APA, all rights reserved).


Assuntos
Consumo de Bebidas Alcoólicas/prevenção & controle , Entrevista Motivacional , Autoeficácia , Sexo sem Proteção/prevenção & controle , Adolescente , Adulto , Consumo de Bebidas Alcoólicas/psicologia , Serviço Hospitalar de Emergência , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Sexo sem Proteção/psicologia , Adulto Jovem
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