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1.
Rev. salud pública Parag ; 9(2): [P29-P34], Dic 2019.
Artigo em Espanhol | LILACS, BDNPAR | ID: biblio-1047052

RESUMO

Introducción: En Paraguay, la epidemia del VIH se encuentra concentrada en población clave. La ruta principal de transmisión de las infecciones de transmisión del VIH y la Sífilis es la sexual. Las mujeres trabajadoras sexuales (MTS) presentan riesgo incrementado debido a su trabajo sexual y sus comportamientos de riesgo. Objetivo: Determinar la prevalencia de VIH/Sífilis y el comportamiento de riesgo de la población de mujeres trabajadoras sexuales en seis regiones sanitarias del país durante el año 2017. Material y Métodos: El diseño del estudio fue observacional, corte transversal. La metodología utilizada para la selección de la muestra fue la de TLS (muestreo tiempo-ubicación). Se utilizaron pruebas rápidas como tamizaje inicial en todas las mujeres que ingresaron al estudio y a la vez se aplicó un instrumento para los comportamientos de riesgo. Resultados: Ingresaron 643 MTS, la edad media fue de 27 años, donde el 50% tenían entre 22 y 34 años. El 88.11% (585) realizaba el trabajo sexual en locales (prostíbulos, saunas, salón de masajes y departamentos) y el 11.89% (58) en paradas en las calles. La prevalencia del VIH fue de 1.34% (CI95% 0.513.48) y de Sífilis 8.59% (CI95% 5.78-12.59). El uso de condón en la última relación con el cliente fue de 96.02% y del 25.78% con la pareja estable en la última relación sexual. El consumo de drogas en los últimos 6 meses por más de 25 días fue de 10.78% (44/643) para la cocaína. El 54.17% de las MTS encuestadas se consideraron en igual riesgo de adquirir el VIH en comparación con el resto de las personas. Conclusión: La prevalencia de VIH fue baja y de Sífilis elevada en MTS. Se observó bajo porcentaje de uso de condón con la pareja estable, alto consumo de drogas y baja percepción de riesgo. Es importante considerar estos aspectos en el momento de planificar las intervenciones en MTS: parejas, drogas y percepción de riesgo para que se pueda lograr la eficiencia de las mismas. Palabras clave: Seroprevalencia de VIH; Serodiagnóstico de la Sífilis; Grupos de Riesgo; Paraguay


Introduction: The HIV epidemic in Paraguay is concentrated in key population. The main route of HIV and Syphilis infections transmission is sexual. Female sex workers (FSW) have increased risk due to their sex work and risk behaviors. Objective: To determine the HIV/Syphilis prevalence and risk behavior in the population of female sex workers in six health regions from the country during 2017. Material and Methods: This is a cross-sectional study. The methodology used for the selection of the sample was the TLS (time-location sampling). Rapid tests were used as initial screening of all women who entered the study and at the same time an instrument for risk behaviors was applied. Results: Of 643 FSW enrolled, the average age was 27 years, where 50% were between 22 and 34 years old. 88.11% (585) performed sex work in premises (brothels, saunas, massage parlors and departments) and 11.89% (58) at street. The HIV prevalence was 1.34% (95% CI 0.513.48) and 8.59% Syphilis (95% CI 5.78-12.59). Condom use in the last relationship with the client was 96.02% and 25.78% with the stable partner in the last sexual relationship. 54.17% of the FSW surveyed were considered at equal risk of acquiring HIV compared to the rest of the people. Conclusion: The prevalence of HIV was low and Syphilis was high in MTS. A low percentage of condom use was observed with the stable partner, high drug use and low risk perception. It is important to consider these aspects when planning interventions in MTS: couples, drugs and low risk perception so that their efficiency can be achieved. Keywords: HIV seroprevalence; Serodiagnostic of Syphilis; Risk Groups; Paraguay


Assuntos
Humanos , Feminino , Adulto , Trabalho Sexual , Mulheres Trabalhadoras , Sorodiagnóstico da Sífilis , Prevalência , HIV/imunologia , Técnicas de Laboratório Clínico , Comportamentos de Risco à Saúde
2.
Zhonghua Liu Xing Bing Xue Za Zhi ; 40(10): 1206-1211, 2019 Oct 10.
Artigo em Chinês | MEDLINE | ID: mdl-31658518

RESUMO

Objective: To analyze the characteristics of the "Interner Plus-based AIDS Comprehensive Prevention Service System" among MSM who frequently using the Internet in Guangzhou. Methods: An online survey was conducted among MSM who were recruited through gay-website portals between August and September, 2018 in Guangzhou, to collect information regarding the use of and attitudes on the "Interner Plus-based AIDS Comprehensive Prevention Service System" . Logistic regression was used to explore the association between the use of Internet intervention tools and related behavioral characteristics. Information on the awareness of AIDS, HIV testing, and condomless anal sex behavior were compared between the core or non-core services users. Results: A total of 777 Internet-based MSM were recruited as participants including 638 men (82.1%) as core service users. MSM were satisfied in using the the "Interner Plus-based AIDS Comprehensive Prevention Service System" while more than 80.0% of the users felt that the tools were helpful in: increasing the HIV awareness, promoting test uptake, and reducing those related risk behavior. Comparing with those who did not use the tools, the users showed higher rates in practising condomless anal intercourse (1.50-1.86 times), commercial sex with men (11.60-21.21 times), and unprotected vaginal intercourse (13.62-20.67 times), in the last 6 months. Proportions of core service users appeared as: [96.6% vs. 74.8%, aOR (95%CI): 8.80 (4.85-15.97)] on HIV testing, [56.4% vs. 22.3%, aOR (95%CI): 4.54 (2.94-7.02)] on regular HIV testing and [86.2% vs. 80.6%, aOR (95%CI): 1.75 (1.06-2.89)] on awareness of HIV knowledge respectively, which were all significantly higher than the non-core service users. Conclusions: The frequent Internet using MSM in Guangzhou claimed to have had high acceptance and satisfaction on the local Internet HIV intervention service tools. The "Internet Plus-based AIDS Comprehensive Prevention Service System" had effectively reached the high-risk subgroups of MSM, increasing the awareness on related risk and promoting testing on HIV.


Assuntos
Síndrome de Imunodeficiência Adquirida/prevenção & controle , Infecções por HIV/prevenção & controle , Internet , Minorias Sexuais e de Gênero , China , Feminino , Homossexualidade Masculina , Humanos , Masculino , Assunção de Riscos , Trabalho Sexual , Comportamento Sexual
3.
Zhonghua Liu Xing Bing Xue Za Zhi ; 40(10): 1212-1216, 2019 Oct 10.
Artigo em Chinês | MEDLINE | ID: mdl-31658519

RESUMO

Objective: This article was to evaluate the applicability and feasibility of "Lingnanzhun" -an "Internet Plus-based HIV Self-testing Tool" targeting MSM in Guangzhou. Hopefully, the results could be used to improve the existing HIV testing services and to support the implementation and scale-up of HIV self-testing programs. Methods: Data were collected from a survey on HIV testing preferences among the Internet-using MSM in April to June, 2015. Univariate and multivariate logistic regression analysis were applied to identify factors associated with the use of HIV self-testing service provided by Lingnanzhun. Information related to the users of Lingnanzhun during September 2014 and December 2018 was also collected. Results: 769 MSM were recruited as participants. Of them, age distribution was 16-77(28.6±6.8) years old, 88.3%(679/769) were unmarried, 42.2%(325/769) were registered residents of Guangzhou, 82.1%(631/769) had university or college education. Among them, 195 (25.4%) used the HIV self- testing program of Lingnanzhun while 574 (74.6%) using the clinic service. Compared with the clinic service users, the Lingnanzhun users showed the following characteristics: longer experience in the MSM community ≥10 years (32.8% vs. 20.9%, 64/195 vs. 120/574); having male casual sexual partners ≥2 (42.1% vs. 29.6%, 82/195 vs. 170/574); having group sex (6.2% vs. 2.6%, 12/195 vs. 15/574) and having commercial sex with men (13.8% vs. 3.0%, 27/195 vs. 17/574). Data from the Lingnanzhun users showed that a total of 3 000 users had practised 5 038 times of self HIV-testings. 11.4% (343/3 000) of the Lingnanzhun users had never been tested. Conclusions: It was applicable and feasible to provide Internet-based HIV self-testing service to MSM as a significant complement to the traditional facility-based HIV testing services. It was also useful in accessing those who were having higher risk or had never received HIV testing so as to increase the testing uptake and the frequency.


Assuntos
Infecções por HIV/diagnóstico , Internet , Minorias Sexuais e de Gênero , Adolescente , Adulto , Idoso , China , Estudos de Viabilidade , Homossexualidade Masculina , Humanos , Masculino , Pessoa de Meia-Idade , Trabalho Sexual , Comportamento Sexual , Adulto Jovem
4.
Medicine (Baltimore) ; 98(39): e17071, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31574806

RESUMO

Access to antiretroviral-based HIV prevention has been marked by sex asymmetries, and its effectiveness has been compromised by low clinical follow-up rates. We investigated risk profiles of women who received nonoccupational post-exposure prophylaxis (nPEP), as well as the rates and predictive factors of loss to follow-up after nPEP initiation.Retrospective study evaluating 501 women who received nPEP between 2014 and 2015 at 5 HIV centers (testing centers-VCT, outpatient clinics, and infectious diseases hospital). Risk profiles were drawn based on the characteristics of the women and their sexual partners, and then stratified by sociodemographic indicators and previous use of HIV prevention services. Loss to follow-up (LTFU) was defined as not presenting for follow-up visits or for HIV testing after nPEP initiation. Predictors of LTFU were analyzed by calculating adjusted prevalence ratios (aPRs).Approximately 90% of women had sexual encounters that met the criteria established in the Brazilian guidelines for nPEP. Those who declared to be sex workers (26.5%) or drug users (19.2%) had the highest social vulnerability indicators. In contrast, women who had intercourse with casual partners of unknown HIV risk (42.7%) had higher education and less experience with previous HIV testing (89.3%) or nPEP use (98.6%). Of the women who received nPEP after sexual intercourse with stable partners, 75.8% had HIV-infected partners. LTFU rate was 72.8% and predictors included being Black (aPR = 1.15, 95% confidence interval [CI]: 1.03-1.30), using drugs/alcohol (aPR = 1.15, 95% CI: 1.01-1.32) and having received nPEP at an HIV outpatient clinic (aPR = 1.35, 95% CI: 1.20-1.51) or at an infectious diseases hospital (aPR = 1.37, 95% CI: 1.11-1.69) compared with a VCT. The risk of LTFU declined as age increased (aPR 41-59 years = 0.80, 95% CI: 0.68-0.96).Most women who used nPEP had higher socioeconomic status and were not part of populations most affected by HIV. In contrast, factors that contribute to loss to follow-up were: having increased social vulnerability; increased vulnerability to HIV infection; and seeking nPEP at HIV treatment services as opposed to at a VCT.


Assuntos
Antirretrovirais/uso terapêutico , Infecções por HIV/prevenção & controle , Profilaxia Pós-Exposição , Sexo sem Proteção , Adolescente , Adulto , Brasil , Coito , Feminino , Seguimentos , Humanos , Adesão à Medicação , Pessoa de Meia-Idade , Estudos Retrospectivos , Assunção de Riscos , Trabalho Sexual , Classe Social , Transtornos Relacionados ao Uso de Substâncias/complicações , Adulto Jovem
5.
Afr J AIDS Res ; 18(3): 215-223, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31575341

RESUMO

Female sex workers (FSW) in mining sites are considered to be at very high risk of HIV infection. We aimed to characterize FSW at the Kôkôyô artisanal gold mining site in Mali, and identify factors associated with sex work using data from ANRS-12339 Sanu Gundo, a cross-sectional survey conducted in 2015 at the mine by ARCAD-SIDA, a Malian non-governmental organisation. People attending HIV-prevention activities were invited to participate in the quantitative and qualitative parts of the survey. A probit logistic regression was used for data analysis. Of 101 women who participated in the survey, 26.7% reported sex work as their main activity. Multivariate analysis showed that the probability of sex work as a main activity decreased by 1% per 1-year age increase (p = 0.020). Sex work was significantly more likely to be reported by single, divorced and widowed women (25.4% probability; p = 0.007). FSW were significantly more likely to be non-Malian (36.3% probability; p = 0.003), more likely to have a secondary activity (77% probability; p = 0.002), to work fewer than 56h/week (40.2% probability; p = 0.001) and to be in good health (12.1% probability; p = 0.016). In addition, being aware of the existence of sexually transmitted infection, using psychoactive substances, and having unprotected receptive anal sex during the previous six months were significantly associated with sex work (50.2%; p = 0.006; 45.6%, p = 0.003; and 7.4%, p = 0.016 probability, respectively). Qualitative findings confirm that poverty and boyfriends' refusal to use condoms remain key barriers to systematic condom use among FSW.


Assuntos
Infecções por HIV/prevenção & controle , Sexo Seguro/estatística & dados numéricos , Trabalho Sexual/estatística & dados numéricos , Profissionais do Sexo/estatística & dados numéricos , Sexo sem Proteção/estatística & dados numéricos , Adolescente , Adulto , Preservativos/estatística & dados numéricos , Estudos Transversais , Feminino , Humanos , Modelos Logísticos , Mali , Pobreza , Prevalência , Parceiros Sexuais , Inquéritos e Questionários , Adulto Jovem
6.
Pan Afr Med J ; 32: 185, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31497185

RESUMO

Introduction: In 2015, in Dire Dawa administration city, adult HIV prevalence was 3.26 with 9,523 HIV positive population, & 251 annual AIDS deaths. Female sex workers are one of the high-risk groups for contracting HIV. Therefore, this study has assessed the level of HIV/AIDS knowledge, risk perception and condom utilization pattern among female sex workers' in Diredawa city. Methods: A cross-sectional study was conducted from April 15-June 25, 2016, in Dire Dawa among 156 female sex workers using convenient sampling method. Respondents were interviewed face-to-face using a pretested questionnaire. Training was provided to the data collectors and supervisors. Close supervision was done and double data entry was performed. Then the data were checked for completeness, consistency and entered into Epi Info v3.1 and analyzed using SPSS v20. The descriptive statistical analysis was used to compute frequency, mean, mode and proportion of the findings of this study. The results were presented using tables, charts, graphs, and texts. Results: Among the 156 female sex workers (FSWs), 99 (63.5%) had been working on commercial sex for more than one year, 92 (59%) were usually street-based, and 80 (51.3%) had partners between 2-3 per night. Only, 17 (10.9%) respondents mentioned three and above ways of HIV/AIDS transmission and prevention methods. Less than two-thirds (64.1%) of FSWs used a condom with all partners. One hundred thirty-eight (88.5%) of participants were engaged in unsafe sexual practice at least once since their engagement in sex work. Majority of FSWs (85.3%)) believed that their occupation is hazardous and 145 (92.9%) reported that they were unhappy being a commercial sex worker. Regarding risk perception, 79 (50.64%) and 37 (23.7%) of respondents perceived their chances of contracting HIV/STIs to be high and moderate respectively. Conclusion: Knowledge about HIV/STIs and magnitude of condom utilization were good. However, a high number of unsafe sex and unsatisfactory risk perception attitudes were observed. Thus, a collaborative effort is needed to create awareness regarding risk perception attitude and increase the level of their practice towards the prevention of unsafe sex.


Assuntos
Preservativos/estatística & dados numéricos , Conhecimentos, Atitudes e Prática em Saúde , Profissionais do Sexo/estatística & dados numéricos , Comportamento Sexual/estatística & dados numéricos , Adolescente , Adulto , Estudos Transversais , Etiópia/epidemiologia , Feminino , Infecções por HIV/epidemiologia , Infecções por HIV/prevenção & controle , Humanos , Prevalência , Trabalho Sexual/estatística & dados numéricos , Parceiros Sexuais , Doenças Sexualmente Transmissíveis/epidemiologia , Doenças Sexualmente Transmissíveis/prevenção & controle , Inquéritos e Questionários , Sexo sem Proteção/estatística & dados numéricos , Adulto Jovem
7.
Zhonghua Liu Xing Bing Xue Za Zhi ; 40(8): 941-946, 2019 Aug 10.
Artigo em Chinês | MEDLINE | ID: mdl-31484258

RESUMO

Objective: This study aimed to examine the demographic characteristics, HIV related knowledge and behavior, correlates of bisexual behavior and status of HIV infection among men who have sex with men only (MSMO) and men who have sex with both men and women (MSMW) in Shandong province. Methods: According to the requirements from "National HIV/AIDS sentinel surveillance program" , a cross-sectional survey was conducted to collect information on demographics, sexual and drug use behaviors, and HIV-related services among MSM in nine sentinel surveillance sites from April to July in 2018. Blood samples were drawn for serological tests on both HIV and syphilis antibodies. Results: A total of 3 474 participants were included in this study. Related information on these participants would include: average age as (31.66±9.01) years; 35.06% (1 218) married or cohabiting with a woman, 50.52% (1 755) had college or higher education, 80.11% (2 783) self-identified as gays and 14.22% (494) self-identified as bisexual men,16.87% (586) ever having sex with woman in the past 6 months, 10.51% (365) ever using drugs. HIV and syphilis prevalence rates were 2.99% (104/3 474) and 2.76%(96/3 474). Through multivariable logistic models, MSMW were more likely to be ≥35 years of age, local residents, self-identified as heterosexual/bisexual/uncertain, ever having commercial sex with man but less likely to consistently use condoms in the past 6 months, less using internet/dating software to find male sex partners and less using drugs. There was no significant differences noticed in the following areas: number of sexual partners in the last week, condom use in the last six months with commercial sex partners, with HIV or syphilis infection and self-reported history of STD in the past year between MSMO and MSMW (P>0.05). HIV-infected MSM were more likely to have the following features, ≥45 years of age, non-local residents, finding male sex partners from the bothhouses, park/toilets or from the internet/dating software, also less likely to consistently use condoms in the past 6 months, using drugs or with syphilis infection. Conclusions: High prevalence of bisexual behavior as well as higher risk of HIV infection were noticed among MSM in Shandong province. It is important to strengthen related surveillance and effective intervention programs for MSM with different characteristics in Shandong province.


Assuntos
Infecções por HIV/epidemiologia , Conhecimentos, Atitudes e Prática em Saúde , Homossexualidade Masculina/estatística & dados numéricos , Trabalho Sexual/psicologia , Minorias Sexuais e de Gênero/estatística & dados numéricos , Adulto , China/epidemiologia , Preservativos , Estudos Transversais , Feminino , Infecções por HIV/diagnóstico , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Fatores de Risco , Comportamento Sexual , Parceiros Sexuais , Sífilis/epidemiologia , Adulto Jovem
8.
BMC Womens Health ; 19(1): 111, 2019 08 17.
Artigo em Inglês | MEDLINE | ID: mdl-31419968

RESUMO

BACKGROUND: Sub-Saharan Africa (SSA) has the highest number of people living with HIV/AIDS, with Nigeria, South Africa, and Uganda accounting for 48% of new infections. A systematic review of the HIV burden among women engaged in sex work (WESW) in 50 low- and middle-income countries found that they had increased odds of HIV infection relative to the general female population. Social structural factors, such as the sex work environment, violence, stigma, cultural issues, and criminalization of sex work are critical in shaping sexually transmitted infection (STI)/HIV risks among WESW and their clients in Uganda. Poverty is the most commonly cited reason for involvement in sex work in SSA. Against this backdrop, this study protocol describes a randomized controlled trial (RCT) that tests the impact of adding economic empowerment to traditional HIV risk reduction (HIVRR) to reduce new incidence of STIs and HIV among WESW in Rakai and the greater Masaka regions in Uganda. METHODS: This three-arm RCT will evaluate the efficacy of adding savings, financial literacy and vocational training/mentorship to traditional HIVRR on reducing new incidence of STI infections among 990 WESW across 33 hotspots. The three arms (n = 330 each) are: 1) Control group: only HIVRR versus 2) Treatment group 1: HIVRR plus Savings plus Financial Literacy (HIVRR + S + FL); and 3) Treatment group 2: HIVRR plus S plus FL plus Vocational Skills Training and Mentorship (V) (HIVRR + S + FL + V). Data will be collected at baseline (pre-test), 6, 12, 18 and 24-months post-intervention initiation. This study will use an embedded experimental mixed methods design where qualitative data will be collected post-intervention across all conditions to explore participant experiences. DISCUSSION: When WESW have access to more capital and/or alternative forms of employment and start earning formal income outside of sex work, they may be better able to improve their skills and employability for professional advancement, thereby reducing their STI/HIV risk. The study findings may advance our understanding of how best to implement gender-specific HIV prevention globally, engaging women across the HIV treatment cascade. Further, results will provide evidence for the intervention's efficacy to reduce STIs and inform implementation sustainability, including costs and cost-effectiveness. TRIAL REGISTRATION: ClinicalTrials.gov , ID: NCT03583541 .


Assuntos
Infecções por HIV/prevenção & controle , Assunção de Riscos , Trabalho Sexual , Comportamento Sexual , Adulto , Feminino , Humanos , Renda , Alfabetização , Pobreza , Ensaios Clínicos Controlados Aleatórios como Assunto , Projetos de Pesquisa , Comportamento de Redução do Risco , Uganda , Populações Vulneráveis
9.
BMC Infect Dis ; 19(1): 686, 2019 Aug 05.
Artigo em Inglês | MEDLINE | ID: mdl-31382923

RESUMO

BACKGROUND: In Europe, the highest proportion of HIV diagnoses are in gay men and other men who have sex with men (MSM). Globally, HIV prevalence is particularly high among males who report selling sex, but rates among men who buy sex from other men are less clear. This study analyzed the association of transactional sex (TS) and HIV diagnosis, sexually transmitted infection (STI) diagnoses, and various drug use; and examined the variations in TS by payment direction. METHODS: We conducted a cross-sectional, non-randomized, observational study. This European MSM Internet Survey recruited MSM from 38 European countries. For descriptive purposes we stratified according to TS behavior (frequently selling sex, frequently buying sex, neither frequently selling nor buying sex in the previous 12 months), and we constructed separate multivariable logistic regression models to investigate whether engaging in TS accounted for some of the HIV- and STI diagnoses and drug use in this population. RESULTS: Of almost 161,000 sexually active MSM, 12.2% engaged in TS. The multivariable logistic regression results showed that relative to not frequently engaging in TS, frequently selling sex was independently associated with a higher odds of reporting diagnosed HIV (ever, adjusted odds ratio [aOR] 1.60, confidence interval [CI] 95% 1.39 to 1.85), bacterial STIs (past 12 months, aOR 1.75 CI 95% 1.54 to 2.00), using heroin or crack cocaine or injecting drugs (aOR 3.17, CI 95% 2.70 to 3.73), and using benzodiazepines (aOR 2.13, CI 95% 1.88 to 2.41). Compared to men not engaging in frequent TS, frequently buying sex was associated with a higher odds of using benzodiazepines (aOR 2.13, CI 95% 1.88 to 2.41). CONCLUSIONS: MSM who frequently sell sex suffer greater sexual- and substance use risks than other MSM, but both men who frequently sell and those who buy sex are more likely to use benzodiazepines. MSM who sell sex to other men constitute an important at-risk population who must be offered targeted health services.


Assuntos
Infecções por HIV/transmissão , Homossexualidade Masculina/estatística & dados numéricos , Trabalho Sexual/estatística & dados numéricos , Adulto , Cocaína Crack , Estudos Transversais , Europa (Continente)/epidemiologia , Infecções por HIV/epidemiologia , Heroína , Humanos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Razão de Chances , Fatores de Risco , Comportamento Sexual , Minorias Sexuais e de Gênero/estatística & dados numéricos , Doenças Sexualmente Transmissíveis/epidemiologia , Doenças Sexualmente Transmissíveis/transmissão , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Adulto Jovem
10.
Artigo em Inglês | MEDLINE | ID: mdl-31269774

RESUMO

Hepatitis C remains a significant public health threat. However, the main routes of transmission have changed since the early 1990s. Currently, drug use is the main source of hepatitis C virus (HCV) infection, and some measures have been successively implemented and additional studies have been published. However, the factors correlating with HCV infection failed to clearly define. Our study pooled the odds ratios (ORs) with 95% confidence intervals (CIs) and analyzed sensitivity by searching data in the PubMed, Elsevier, Springer, Wiley, and EBSCO databases. Publication bias was determined by Egger's test. In our meta-analysis, HCV-infected and non-HCV-infected patients from 49 studies were analyzed. The pooled ORs with 95% CIs for study factors were as follows: Injecting drug use 10.11 (8.54, 11.97); sharing needles and syringes 2.24 (1.78, 2.83); duration of drug use >5 years 2.39 (1.54, 3.71); unemployment 1.50 (1.22, 1.85); commercial sexual behavior 1.00 (0.73, 1.38); married or cohabiting with a regular partner 0.88 (0.79, 0.98), and sexual behavior without a condom 1.72 (1.07, 2.78). This study found that drug users with histories of injecting drug use, sharing needles and syringes, drug use duration of >5 years, and unemployment, were at increased risk of HCV infection. Our findings indicate that sterile needles and syringes should be made available to ensure safe injection. In view of that, methadone maintenance treatment can reduce or put an end to risky drug-use behaviors, and should be scaled up further, thereby reducing HCV infection.


Assuntos
Usuários de Drogas/estatística & dados numéricos , Hepatite C/epidemiologia , Abuso de Substâncias por Via Intravenosa/epidemiologia , Hepatite C/transmissão , Humanos , Uso Comum de Agulhas e Seringas/estatística & dados numéricos , Fatores de Risco , Assunção de Riscos , Trabalho Sexual/estatística & dados numéricos , Fatores Socioeconômicos , Fatores de Tempo , Sexo sem Proteção/estatística & dados numéricos
11.
AIDS Behav ; 23(11): 2946-2955, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31332597

RESUMO

Transactional sex is associated with socioeconomic disadvantage and HIV risk but few studies in the United States (US) have examined both individual and area-level predictors of transactional sex or distinguished transactional sex from sex work. We combined data from HIV Prevention Trials Network 064 study and the US Census to estimate prevalence ratios (PR) for the relationship between census-level and individual measures of economic deprivation and housing instability on transactional sex in 417 women in North Carolina. Increased transactional sex was associated with food insecurity (PR 1.86; 95%; CI 1.57, 2.19), housing instability (PR 1.33; 95% CI 1.11, 1.59), substance abuse (PR 1.90; 95% CI 1.64, 2.19) and partner incarceration (PR 1.32; 95% CI 1.09, 1.61). Census-level indicators were not associated with transactional sex, adjusted for individual-level covariates. Interventions should support housing stability and financial opportunities among southern African American women to reduce HIV risk, particularly among women with incarcerated partners.


Assuntos
Afro-Americanos/psicologia , Infecções por HIV/prevenção & controle , Habitação , Pobreza , Trabalho Sexual , Adolescente , Adulto , Afro-Americanos/estatística & dados numéricos , Feminino , Infecções por HIV/etnologia , Infecções por HIV/psicologia , Humanos , Masculino , Análise Multinível , North Carolina/epidemiologia , Prevalência , Trabalho Sexual/estatística & dados numéricos , Parceiros Sexuais , Rede Social , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Estados Unidos
12.
Afr J AIDS Res ; 18(3): 254-257, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31333060

RESUMO

Parental obligations influence sexual behaviour among female sex workers (FSW) and may serve as a risk or protective factor for HIV acquisition. How these obligations affect behaviours beyond HIV prevention, including HIV care, is understudied. We analysed 25 interviews conducted with 11 mothers who sell sex and are living with HIV, and 4 key informants as part of a larger study examining the positive health, dignity, and prevention needs of FSW in eSwatini. Despite awareness of HIV reinfection, FSW initiated sex work and engaged in condomless sex due to financial pressures of providing for children. While women attributed having condomless sex to their obligations as a provider, motherhood also served as motivation to engage in HIV care. Further, FSW described children as a source of support in HIV care. Children reminded mothers to take their medications, prepared food to take with medications, and assisted with travel to the clinic.


Assuntos
Preservativos/estatística & dados numéricos , Infecções por HIV/prevenção & controle , Mães/estatística & dados numéricos , Sexo Seguro/estatística & dados numéricos , Profissionais do Sexo/estatística & dados numéricos , Sexo sem Proteção/estatística & dados numéricos , Adulto , Criança , Feminino , HIV , Humanos , Mães/psicologia , Poder Familiar , Trabalho Sexual/psicologia
14.
Public Health Rep ; 134(4): 432-440, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31170033

RESUMO

OBJECTIVE: The objective of this study was to determine the number, risk factors, and demographic characteristics of potential human trafficking victims from tips reported to a social services agency in a major Midwest metropolitan area from 2008 through 2017. METHODS: The agency, comprising 90 employees serving more than 10 000 persons annually, received federal funding to raise awareness about trafficking and to identify and support persons who are at risk for trafficking through training, coalition building, direct outreach and service, and case management. We, the authors, counted the numbers of tips and potential victims reported to the agency by year, type of trafficking, economic sector, sex, region of origin, and age and looked for new risk factors for trafficking. RESULTS: Data were available for 213 tips received from September 1, 2008, through June 30, 2017, and for 82 potential victims identified from July 1, 2011, through June 30, 2017. Labor trafficking (126 tips, 57 potential victims) was more common than sex trafficking (59 tips, 17 potential victims). The number of tips varied during the study period. Tips and potential victims were diverse and included male and female children and adults. Most victims were from Mexico (n = 68), the United States (n = 47), Asia (n = 31), and Central and South America (n = 23). Potential victims were exploited in several industries including agriculture, construction, commercial sex, and landscaping. New risk factors for trafficking were exploitation within marriage and work in the sales industry. CONCLUSIONS: Domestic and foreign-born men, women, and children are all at risk for labor and sex trafficking. Direct outreach to foreign-born victims should be a priority. The new risk factors should be explored.


Assuntos
Abuso Sexual na Infância/estatística & dados numéricos , Trabalho Infantil/estatística & dados numéricos , Tráfico de Pessoas/estatística & dados numéricos , Trabalho Sexual/estatística & dados numéricos , Adolescente , Adulto , Fatores Etários , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Meio-Oeste dos Estados Unidos , Fatores Sexuais , Fatores Socioeconômicos , Adulto Jovem
15.
AIDS Behav ; 23(Suppl 2): 142-152, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31197700

RESUMO

We conducted an implementation science study of a community-based ART distribution program for HIV-positive female sex workers (FSW) whereby clients received ART services through community-based mobile and home-based platforms. We compared 6-month treatment-related outcomes in the community-based ART arm (N = 256) to the standard facility-based ART delivery arm (N = 253). Those in the intervention arm were more likely to have initiated ART (100.0% vs. 71.5%; p = 0.04), be currently taking ART at the 6-month visit (100.0% vs. 95.0%; p < 0.01), and less likely to have stopped taking ART for more than 30 days continuously (0.9% vs. 5.7%; p = 0.008) or feel high levels of internalized stigma (26.6% vs. 39.9%; p = 0.001). In the adjusted regression model, internalized stigma (adjusted OR [aOR]: 0.5; 95% CI 0.28-0.83) and receiving community-based ART (aOR: 208.6; 95% CI 12.5-3479.0) were significantly associated with ART initiation. Community-based ART distribution model can improve linkage to and adherence to ART over standard facility-based ART programs for FSWs.


Assuntos
Terapia Antirretroviral de Alta Atividade/psicologia , Serviços de Saúde Comunitária/organização & administração , Assistência à Saúde/métodos , Infecções por HIV/tratamento farmacológico , Infecções por HIV/virologia , Adesão à Medicação , Profissionais do Sexo/estatística & dados numéricos , Adolescente , Adulto , Terapia Antirretroviral de Alta Atividade/estatística & dados numéricos , Feminino , Seguimentos , Infecções por HIV/diagnóstico , Infecções por HIV/epidemiologia , Humanos , Aceitação pelo Paciente de Cuidados de Saúde , Estudos Prospectivos , Trabalho Sexual , Profissionais do Sexo/psicologia , Estigma Social , Tanzânia/epidemiologia , Resultado do Tratamento , Adulto Jovem
17.
Sex Reprod Healthc ; 20: 46-53, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31084818

RESUMO

BACKGROUND: Chinese female adolescents engaged in sex trade and substance use are often criminalized and stigmatized. As a result of these cultural, legal and political constraints, ethical concerns can discourage investigators from engaging these adolescents in research. This paper aims to address the ethical tensions between protection and inclusion in conducting sexual and reproductive health (SRH) research with adolescents engaged in high-risk behaviours. Processes of moral reasoning, and examples and practical mechanisms in managing such ethical challenges were presented in the hope of advancing the research ethics policies and practice with adolescents. METHODS: We extracted ethical issues from three previously conducted SRH studies involving 517 Chinese female adolescents. Utilizing the principles of justice, beneficence, and respect for persons as articulated in the Belmont Report as a framework, we thematically summarised the key ethical considerations regarding inclusion and protection, then examine the ethical tensions and solutions within the local context. RESULTS: Findings suggest that the balance between protection and inclusion can be achieved by both considering the evolving decision-making capacity of adolescents as well as the level of risk. A community-based participatory approach shows promise in advancing adolescent engagement and empowerment. Ethically robust approaches contribute to the greater relevance and validity of the findings. CONCLUSIONS: Our studies suggest that it is crucial to achieve adolescents' meaningful involvement in all levels of research and interventions, researchers need to shift their perspectives of the target population from subjects to key stakeholders in design and implementation of research.


Assuntos
Pesquisa Biomédica/ética , Saúde Reprodutiva , Trabalho Sexual , Saúde Sexual , Transtornos Relacionados ao Uso de Substâncias , Adolescente , Beneficência , China , Pesquisa Participativa Baseada na Comunidade/ética , Feminino , Humanos , Motivação , Respeito , Justiça Social , Transtornos Relacionados ao Uso de Substâncias/complicações , Adulto Jovem
18.
J Forensic Nurs ; 15(2): 93-102, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31116177

RESUMO

Commercial sexual exploitation of children (CSEC) is the sexual abuse of children through buying, selling, or trading their sexual services. This may involve engaging a child under the age of 18 years in prostitution, pornography, stripping, exotic dancing, escort services, or other sexual services. CSEC is a problem of epidemic proportions throughout the world including the United States; however, the actual number of CSEC victims in the United States is unknown. Studies indicate that most child victims are seen by a healthcare provider while being trafficked and that many victims receive care at a pediatric hospital within 1 year of their identification as a victim. CSEC is a significant pediatric healthcare problem. It is vital that forensic nurses possess a thorough understanding of the problem and be poised to better identify, intervene, and prevent CSEC. In this article, we focus on risk factors commonly experienced by victims, recruitment strategies used by traffickers, indicators to identify child victims, and intervention and educational strategies of relevance to forensic nurses.


Assuntos
Abuso Sexual na Infância/diagnóstico , Abuso Sexual na Infância/prevenção & controle , Enfermagem Forense , Adolescente , Criança , Literatura Erótica , Pessoal de Saúde/educação , Necessidades e Demandas de Serviços de Saúde , Tráfico de Pessoas/prevenção & controle , Humanos , Anamnese , Papel do Profissional de Enfermagem , Avaliação em Enfermagem , Pais/educação , Exame Físico , Serviços Preventivos de Saúde , Fatores de Risco , Trabalho Sexual
20.
20 Century Br Hist ; 30(2): 231-263, 2019 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-31032861

RESUMO

In the 1980s, prostitution resurfaced as the object of feminist politics as second-wave activists grappled with Thatcherism, prostitute rights, tenant activism, anti-violence movements, and changes in the street sex trade and in policing. These conflicting imperatives converged on King's Cross, London. Events in King's Cross highlight some general trends, especially shifts in policing and in the geographic dispersal of the street sex trade. King's Cross also possessed singular features. It was the epicentre of street prostitution in London and the destination for hundreds of northern women migrating to the metropolis to sell sex. Intensified policing of the street trade provoked a heated neighbourhood dispute between council tenants and a media-savvy prostitute rights group. The year 1982 also marked a new configuration in local politics: the control of Camden Council by Labour Left and the formation of the Camden Women's Committee. In this challenging environment, newly elected municipal feminists in Camden set out to devise a feminist practice around prostitution. They found themselves embroiled in local disputes over public space, gender justice, policing, municipal progressivism, and resident action.


Assuntos
Feminismo , Política , Trabalho Sexual/história , História do Século XX , Londres
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