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2.
Rev Colomb Obstet Ginecol ; 71(1): 9-20, 2020 Mar.
Artigo em Espanhol | MEDLINE | ID: mdl-32418372

RESUMO

OBJECTIVE: To compare sexual negotiation levels and self-efficacy in male condom use in men and women. METHODS: Comparative crosssectional study of undergraduate students carried out during the year 2018 in a private university in the city of Querétaro, Mexico. Non-probabilistic sampling was used. Measured variables included sociodemographic characteristics, risky sexual behaviors, negotiation skills and sexual self-efficacy for condom use. The Mann Whitney U test and non-parametric variance analysis (Kruskal - Wallis) were used. RESULTS: Overall, 270 students were enrolled; 89.6% of university students were sexually active; the mean age of sexual activity initiation was 15.41 years. The average reported number of sexual partners was 4.2. In each sexual relation, 27.8% had used a condom. Differences were found between men and women in terms of sexual negotiation styles in the avoidance (p=0.04) and accommodation (p<0.00) domains, with higher scores for men compared to women. Women scored higher for self-efficacy in condom use (p<0.001). CONCLUSIONS: The young university students interviewed engage in risky sexual activities. Women exhibit greater sexual self-efficacy as well as better skills at negotiating condom use. Strengthening public policies targeted to the student population for the prevention of risky sexual behavior is needed. Further studies on interventions aimed at building strong sexual negotiation and self-efficacy among adolescents are required.

4.
Zhonghua Liu Xing Bing Xue Za Zhi ; 41(5): 743-746, 2020 May 10.
Artigo em Chinês | MEDLINE | ID: mdl-32447918

RESUMO

Objective: To understand the prevalence of Neisseria gonorrhoeae (NG) infection and related factors in outpatients of sexually transmitted disease (STD) in Shenzhen and provide scientific evidence for targeted intervention. Methods: A cross-sectional study was conducted in STD outpatients who were aged 18-49 years, had had sexual intercourse, had not received antibiotics in the last 2 weeks and sought medical cares in 22 medical institutions in 6 districts of Shenzhen from 15 April, 2018 to 16 May, 2018, their basic information and urine samples were collected, and NG in urine sample was detected by nucleic acid amplification test. Logistic regression analysis was conducted to identify the related factors for NG infection. Results: The information collection and sample collection were completed for 8 324 STD outpatients, among these STD outpatients, 196 were NG positive, with a positive rate of 2.4% (196/8 324). The positive rate of NG in men (5.8%, 148/2 567) was higher than that in women (0.8%, 47/5 742) (χ(2)=189.43, P<0.05). Aged 24 years or below (OR=2.11, 95%CI: 1.44-3.09), single/divorced/widowed (OR=1.98, 95%CI:1.38-2.84), having casual sex in the last 3 months (OR=1.77, 95%CI:1.29-2.43) were the related factors for NG infection. Conclusions: We found that NG infection rate was high in STD outpatients in Shenzhen. The infection rates in men and in women differed obviously. It is necessary to conduct gonorrhea screening and intervention in STD outpatients with high-risk behaviors, such as extramarital and casual sex behaviors, and standardize the treatment to reduce the incidence and spread of gonorrhea and other STDs.


Assuntos
Gonorreia , Doenças Sexualmente Transmissíveis , Adolescente , Adulto , China , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pacientes Ambulatoriais , Comportamento Sexual , Adulto Jovem
5.
Enferm. glob ; 19(58): 109-119, abr. 2020. tab
Artigo em Espanhol | IBECS-Express | ID: ibc-ET1-5637

RESUMO

OBJETIVO: Analizar las prácticas sexuales y el comportamiento de jóvenes universitarios frente a las Infecciones Sexualmente Transmisibles. METODOLOGÍA: Se trata de un estudio descriptivo, transversal, en abordaje cuantitativo realizado en una universidad privada en Río de Janeiro. Participaron 768 estudiantes, con edades entre 18 y 29 años, regularmente matriculados. RESULTADOS: Los universitarios son solteros (58,72%), heterosexuales (85,80%) y sexualmente activos (85,16%); iniciaron actividades sexuales en el grupo de edad de 12-17 años (76,9%); el 77,83% relató tener una alianza fija y de esos 54,62% no utilizan preservativo; 50,31% informaron una multiplicidad de asociaciones sexuales, y el 62,84% no usa el preservativo en todas las relaciones sexuales. Los estudiantes informaron consumir alcohol (66,41%), siendo uso esporádico (50,39%), sin embargo, añaden que no tomaron antes de la última relación sexual (69,42%). En cuanto a los cuidados con la salud, el 57,81% buscó atención en los últimos 12 meses, siendo informada por 4,82% jóvenes la ocurrencia de infecciones sexualmente transmisibles. CONCLUSIÓN: La asunción del comportamiento de riesgo por los jóvenes los hace vulnerables a las IST. Las acciones de educación en salud y estímulo para el autocuidado del grupo son relevantes para reducir perjuicios a la salud sexual de ese contingente poblacional


OBJECTIVE: To analyze the sexual practices and the behavior of university students regarding Sexually Transmitted Infections. METHODOLOGY: This is a descriptive, cross-sectional, quantitative study conducted at a private university in Rio de Janeiro. A total of 768 students, aged 18 to 29 years, and regularly enrolled in the institution participated in the study. RESULTS: University students were mostly single (58.72%), heterosexual (85.80%), sexually active (85.16%), had initiated sexual life in the age group of 12-17 years (76.9%), reported having a steady partnership (77.83%), did not use condoms (54.62%), reported multiplicity of sexual partners (50.31%), and did not use condoms in all sexual intercourses (62.84%). The students reported using alcohol (66.41%), although sporadically (50.39%), but they had not used before the last sexual intercourse (69.42%). Regarding health care, 57.81% sought care in the last 12 months, and the occurrence of sexually transmitted infections was reported by 4.82% of them. CONCLUSION: The adoption of risky behaviors by young people makes them vulnerable to STIs. Health education actions and encouragement of self-care are relevant to reduce the sexual health problems of this population contingent


OBJETIVO: Analisar as práticas sexuais e o comportamento de universitários de uma instituição privada frente às Infecções Sexualmente Transmissíveis. METODOLOGIA: trata-se de um estudo descritivo, transversal, em abordagem quantitativa realizado em uma universidade privada no Rio de Janeiro. Participaram 768 estudantes, com idades entre 18 - 29 anos, regularmente matriculados. RESULTADOS: Os universitários são solteiros (58,72%), heterossexuais (85,80%) e sexualmente ativos (85,16%); iniciaram atividades sexuais na faixa etária de 12-17 anos (76,9%); 77,83% relatou ter parceria fixa e desses 54,62% não utilizam preservativo; 50,31% informaram multiplicidade de parcerias sexuais, e 62,84% não usa o preservativo em todas as relações sexuais. Os estudantes informaram fazer uso de álcool (66,41%), sendo uso esporádico (50,39%), contudo, acrescentam que não utilizaram antes da última relação sexual (69,42%). Quanto aos cuidados com a saúde, 57,81% buscou atendimento nos últimos 12 meses, sendo informada por 4,82% jovens a ocorrência de infecções sexualmente transmissíveis. CONCLUSÃO: A assunção do comportamento de risco pelos jovens torna-os vulneráveis às IST. Ações de educação em saúde e estímulo para o autocuidado do grupo são relevantes para reduzir agravos à saúde sexual desse contingente populacional

6.
Artigo em Espanhol | IBECS-Express | ID: ibc-ET5-1038

RESUMO

La transmisión del VIH sigue siendo un importante problema de salud pública en todo el mundo. Estrategias tradicionales de prevención como la educación sexual, el cribado y el inicio precoz de tratamiento antirretroviral, a pesar de ser efectivas, resultan insuficientes para el control de las nuevas infecciones. En este contexto, se ha propuesto la profilaxis preexposición (PrEP) como estrategia preventiva. Actualmente, se ha demostrado ampliamente que la administración de fármacos antirretrovirales en personas expuestas y no infectadas por VIH puede reducir el riesgo de transmisión sin asociarse a inconvenientes significativos. A pesar de haber demostrado su eficacia para la prevención de nuevas infecciones, la PrEP sigue siendo un tema controvertido, especialmente su coste-efectividad, y no se ha conseguido acceso unánime a los grupos de mayor riesgo de infección. Por ello, y basándonos en la evidencia actual, planteamos que el debate no debería ser si la PrEP es coste-eficaz, sino las posibles repercusiones de implementarla


HIV infection remains an important public health problem worldwide. The traditional preventive measures, such as sexual education, screening, and early antiretroviral treatment initiation, despite having shown their effectiveness, are not enough to control new infections. In this context, Pre-Exposure Prophylaxis (PrEP) has been investigated as a preventive measure. Currently, it has been extensively documented that the administration of antiretroviral treatment in an HIV exposed, but not infected population, could reduce the risk of transmission without significant drawbacks. Despite its high efficacy for HIV prevention, the use of PrEP remains a controversial measure, particularly its cost-effectiveness. For this reason, the access to PrEP is not available for all the HIV risk groups. Therefore, and based on the evidence found, the current approach must be the repercussions of not to implement PrEP, more than its cost or its effectiveness

7.
Medwave ; 20(3): e7884, 2020 Apr 17.
Artigo em Espanhol | MEDLINE | ID: mdl-32343685

RESUMO

Women who have sex with other women are a group that has been mostly invisible from public health policies. This category includes the group of lesbians, bisexual women, heterosexual behaviour, and homosexual practices, who have sexual relations with transsexual and transgender (trans) women and trans men who have sex with women. In the absence of a Spanish literature review of a study that addresses women who have sex with other women, a narrative bibliographic review was done using the PubMed/MEDLINE, Scopus, Dialnet, and Taylor and Francis databases. From a universe of 679 articles and after applying the inclusion criteria, 40 documents were analysed, from 1998 to 2019. Three meta-categories were identified (sexual education, the incidence of certain sexually transmitted infections, and aspects related to sexual practices), concerning prevention and risky behaviours. Women who have sex with other women are a particularly vulnerable group when it comes to sexually transmitted infections. These may include bacterial vaginitis, human papillomavirus and acquired immunodeficiency virus. Likewise, there is a lack of specific training and information in health and education professionals, as well as in women who have sex with other women.

9.
BMC Infect Dis ; 20(1): 299, 2020 Apr 22.
Artigo em Inglês | MEDLINE | ID: mdl-32321442

RESUMO

BACKGROUND: Sexualized drug use (SDU) refers to use of any psychoactive substance before/during sexual intercourse. Chemsex is a subset of SDU, which is defined as the use of some specific psychoactive substances (methamphetamine, mephedrone, γ-hydroxybutyrate, ketamine and cocaine) before/during sexual intercourse. SDU and chemsex are prevalent among gay, bisexual and other men who have sex with men (GBMSM). This study investigated uptake and willingness to use pre-exposure prophylaxis (PrEP) among a sample of GBMSM in Hong Kong with experience of SDU in the past year. METHODS: A total of 600 GBMSM were recruited by convenient sampling through outreaching in gay venues, online recruitment and peer referral. Participants completed a cross-sectional anonymous telephone interview. This study was based on a subsample of 580 GBMSM self-reported as HIV negative/unknown sero-status. RESULTS: Of the participants, 82 (14.1%) and 37 (6.4%) had experience of SDU and chemsex in the past year. The prevalence of PrEP uptake was 4.0% among all participants and 14.6% among those with experience of SDU in the past year. Among GBMSM with experience of SDU in the past year who were not on PrEP (n = 70), 67.1% were willing to use daily oral PrEP in the next 6 months. Multivariate logistic regression models showed that positive attitudes toward PrEP (AOR: 2.37, 95%CI: 1.47, 3.82), perceived support from significant others to use PrEP (AOR: 9.67, 95%CI: 2.95, 31.71), and perceived behavioral control of using PrEP (AOR: 19.68, 95%CI: 5.44, 71.26) were significantly associated with higher willingness to use PrEP. CONCLUSION: GBMSM with experience of recent SDU are potentially good candidates of PrEP implementation. This group of GBMSM reported high prevalence of uptake and willingness to use PrEP. Perceptions related to PrEP based on the Theory of Planned Behavior were significantly associated with willingness to use PrEP.


Assuntos
Homossexualidade Masculina/estatística & dados numéricos , Participação do Paciente/estatística & dados numéricos , Profilaxia Pré-Exposição/métodos , Psicotrópicos/uso terapêutico , Minorias Sexuais e de Gênero/estatística & dados numéricos , Doenças Sexualmente Transmissíveis/prevenção & controle , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Volição , Adolescente , Adulto , Atitude Frente a Saúde , Bissexualidade/psicologia , Bissexualidade/estatística & dados numéricos , China/epidemiologia , Estudos Transversais , Infecções por HIV/epidemiologia , Infecções por HIV/prevenção & controle , Conhecimentos, Atitudes e Prática em Saúde , Homossexualidade Masculina/psicologia , Hong Kong/epidemiologia , Humanos , Entrevistas como Assunto , Masculino , Pessoa de Meia-Idade , Profilaxia Pré-Exposição/estatística & dados numéricos , Prevalência , Comportamento Sexual/fisiologia , Comportamento Sexual/estatística & dados numéricos , Minorias Sexuais e de Gênero/psicologia , Doenças Sexualmente Transmissíveis/epidemiologia , Inquéritos e Questionários , Volição/fisiologia , Adulto Jovem
11.
Cent Eur J Public Health ; 28(1): 3-12, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-32228810

RESUMO

OBJECTIVE: This study aimed to obtain sexual and reproductive behaviour data of late adolescent women in the Czech Republic and to analyse the relationships between sexual behaviour and social, demographic, and behavioural factors. METHODS: Data were obtained using the Computer-Assisted Web Interviewing method from 25 April to 2 May 2018 from a representative group of sexually active women aged 18-24 years. Results were statistically evaluated using sign schema on adjusted residuals. RESULTS: A total of 525 women participated (median age of coitarche - 16 years, condom use with/without hormonal contraception - 65%, unprotected sex - 9.3% in the sexual debut). Anamnestic artificial abortion and sexually transmitted disease (STD) rates were 5.3% and 3.8%, respectively. Early coitarche, number of sexual partners, history of abortion, and STDs were positively correlated with current hormonal contraceptive use; the number of sexual partners and use of hormonal contraception were negatively correlated. Hormonal contraceptive users were more likely vaccinated against human papilloma virus (HPV) in comparison with women without any contraception. There was no correlation between risky sexual behaviour, contraceptive use, and socio-demographic factors. CONCLUSION: Women with early coitarche and a high cumulative number of sexual partners have more unwanted pregnancies and STDs; moreover, those with regular coital activity without contraception are less frequently vaccinated against HPV.


Assuntos
Anticoncepcionais/administração & dosagem , Assunção de Riscos , Comportamento Sexual/psicologia , Adolescente , República Tcheca/epidemiologia , Feminino , Humanos , Gravidez , Doenças Sexualmente Transmissíveis/epidemiologia , Adulto Jovem
12.
BMJ ; 369: m1043, 2020 04 02.
Artigo em Inglês | MEDLINE | ID: mdl-32241761

RESUMO

OBJECTIVES: To outline which infectious diseases in the pre-covid-19 era persist in children and adolescents in China and to describe recent trends and variations by age, sex, season, and province. DESIGN: National surveillance studies, 2008-17. SETTING: 31 provinces in mainland China. PARTICIPANTS: 4 959 790 Chinese students aged 6 to 22 years with a diagnosis of any of 44 notifiable infectious diseases. The diseases were categorised into seven groups: quarantinable; vaccine preventable; gastrointestinal and enteroviral; vectorborne; zoonotic; bacterial; and sexually transmitted and bloodborne. MAIN OUTCOME MEASURES: Diagnosis of, and deaths from, 44 notifiable infectious diseases. RESULTS: From 2008 to 2017, 44 notifiable infectious diseases were diagnosed in 4 959 790 participants (3 045 905 males, 1 913 885 females) and there were 2532 deaths (1663 males, 869 females). The leading causes of death among infectious diseases shifted from rabies and tuberculosis to HIV/AIDS, particularly in males. Mortality from infectious diseases decreased steadily from 0.21 per 100 000 population in 2008 to 0.07 per 100 000 in 2017. Quarantinable conditions with high mortality have effectively disappeared. The incidence of notifiable infectious diseases in children and adolescents decreased from 280 per 100 000 in 2008 to 162 per 100 000 in 2015, but rose again to 242 per 100 000 in 2017, largely related to mumps and seasonal influenza. Excluding mumps and influenza, the incidence of vaccine preventable diseases fell from 96 per 100 000 in 2008 to 7 per 100 000 in 2017. The incidence of gastrointestinal and enterovirus diseases remained constant, but typhoid, paratyphoid, and dysentery continued to decline. Vectorborne diseases all declined, with a particularly noticeable reduction in malaria. Zoonotic infections remained at low incidence, but there were still unpredictable outbreaks, such as pandemic A/H1N1 2009 influenza. Tuberculosis remained the most common bacterial infection, although cases of scarlet fever doubled between 2008 and 2017. Sexually transmitted diseases and bloodborne infections increased significantly, particularly from 2011 to 2017, among which HIV/AIDS increased fivefold, particularly in males. Difference was noticeable between regions, with children and adolescents in western China continuing to carry a disproportionate burden from infectious diseases. CONCLUSIONS: China's success in infectious disease control in the pre-covid-19 era was notable, with deaths due to infectious diseases in children and adolescents aged 6-22 years becoming rare. Many challenges remain around reducing regional inequalities, scaling-up of vaccination, prevention of further escalation of HIV/AIDS, renewed efforts for persisting diseases, and undertaking early and effective response to highly transmissible seasonal and unpredictable diseases such as that caused by the novel SARS-CoV-2 virus.


Assuntos
Controle de Doenças Transmissíveis , Programas de Imunização , Vacinação , Doenças Preveníveis por Vacina , Adolescente , Betacoronavirus , Criança , China/epidemiologia , Controle de Doenças Transmissíveis/métodos , Controle de Doenças Transmissíveis/normas , Infecções por Coronavirus , Surtos de Doenças , Feminino , Humanos , Incidência , Vírus da Influenza A Subtipo H1N1 , Influenza Humana/prevenção & controle , Malária/economia , Malária/prevenção & controle , Masculino , Pandemias , Pneumonia Viral , Estudos Retrospectivos , Escarlatina/epidemiologia , Escarlatina/prevenção & controle , Doenças Sexualmente Transmissíveis/epidemiologia , Doenças Sexualmente Transmissíveis/prevenção & controle , Tuberculose/epidemiologia , Tuberculose/prevenção & controle , Doenças Preveníveis por Vacina/prevenção & controle
13.
Washington, D.C.; OPS; 2020-04-07. (OPS/NMH/MH/Covid-19/20-0008).
em Espanhol | PAHO-IRIS | ID: phr-52034

RESUMO

La violencia contra la mujer sigue siendo una gran amenaza para la salud pública mundial y la salud de la mujer durante las emergencias • La violencia contra la mujer sigue siendo sumamente prevalente y la violencia de pareja es su forma más común. • Una de cada tres mujeres en todo el mundo ha sufrido alguna vez en su vida violencia física o sexual infligida por un compañero íntimo o violencia sexual infligida por cualquier otro agresor. La mayor parte de las veces se trata de violencia de pareja. • La violencia contra la mujer tiende a aumentar en cualquier tipo de emergencia, incluidas las epidemias. La probabilidad de estar expuestas a más riesgos y tener más necesidades es mayor en las mujeres mayores y las mujeres con discapacidad. Las mujeres desplazadas, las refugiadas y las que viven en zonas afectadas por conflictos son particularmente vulnerables. • Aunque hay pocos datos, los informes de China, el Reino Unido, los Estados Unidos y otros países indican que los casos de violencia doméstica han aumentado desde que comenzó el brote de COVID-19. El número de casos de violencia doméstica notificados en febrero del 2020 a una estación de policía de Jingzhou, una ciudad de la provincia de Hubei, fue tres veces mayor que en el mismo período del año anterior. • La violencia contra la mujer, en particular la violencia de pareja y la violencia doméstica, tiene efectos importantes sobre la salud de las mujeres, y de sus hijos y hijas. Puede dar lugar a traumatismos y problemas graves de salud física, mental y sexual y reproductiva, incluidas las infecciones de transmisión sexual, la infección por el VIH y los embarazos no planificados...


Assuntos
Infecções por Coronavirus , Coronavirus , Violência contra a Mulher , Gênero e Saúde
14.
Artigo em Inglês | MEDLINE | ID: mdl-32236386

RESUMO

The aim of study was to assess the prevalence of Treponema pallidum and HIV infection in Amerindian people (Mbya Guarani) over the age of 11 in Puerto Iguazu (Argentina) and to describe the contact tracking of cases. The method was a cross-sectional study in the Mbya Guarani people living in three villages of Puerto Iguazu (community A, pop. 1,146; community B, pop. 369; and community C, pop. 149). Participants were randomly invited to participate in the survey and in blood testing. Of the 551 participants, 48 were infected by T. pallidum (8.71%; 95% confidence interval [CI] 7.38-10.04). The infection prevalence decreased with age, standing at 9.66% in the 11-19 age group, 8.42% in 20-39 age group and 4.54% in people aged 40 and older. We tracked 130 contacts for the 48 T. pallidum cases; 39/40 (97.5%) sexual contacts tested positive for syphilis. Among the 90 children born to infected mothers, 76 aged 18 months or older tested negative, while 8/14 younger children were still at risk for congenital syphilis. There were four cases of HIV infection (0.72%, 95% CI 0.31-1.13). Prevalence of T. pallidum infection and HIV infection are relevant in this indigenous community of Argentina, representing a public health concern.


Assuntos
Busca de Comunicante/estatística & dados numéricos , Infecções por HIV/epidemiologia , Índios Sul-Americanos/estatística & dados numéricos , Sífilis/epidemiologia , Adolescente , Adulto , Argentina/epidemiologia , Criança , Estudos Transversais , Feminino , Seguimentos , Infecções por HIV/diagnóstico , Infecções por HIV/transmissão , Humanos , Lactente , Masculino , Prevalência , Estudos Soroepidemiológicos , Sífilis/diagnóstico , Sífilis/transmissão , Adulto Jovem
15.
Rev Saude Publica ; 54: 41, 2020.
Artigo em Inglês, Português | MEDLINE | ID: mdl-32321057

RESUMO

OBJECTIVE: To describe the sexual behavior of freshmen undergraduate students according to demographic, economic, psychosocial and behavioral characteristics, and evaluate the prevalence of risky sexual behavior and its associated factors. METHODS: A cross-sectional study of the census type with undergraduate students over 18 years old of 80 undergraduate courses of the Universidade Federal de Pelotas (UFPel), in Rio Grande do Sul (RS), who entered in the first semester of 2017 and remained enrolled in the second semester. Undergraduate students who reported having had sex were evaluated. We considered as risky sexual behavior having more than one sexual partner within the last three months and not having used condoms in the last sexual intercourse. RESULTS: The prevalence of risky sexual behavior was 9% (95%CI 7.6-10.5). Men presented more risky behavior than women, with a prevalence of 10.8% and 7.5%, respectively. Of the undergraduate students, 45% did not use condoms in the last sexual intercourse, and 24% had two partners or more within three months before the survey. Smartphone applications for sexual purposes were used by 23% of students within three months before the survey. Risky sexual behavior was associated with gender, age at first sexual intercourse, frequency of alcohol consumption, consumption of psychoactive substances before the last sexual intercourse and use of smartphone applications for sexual purposes. CONCLUSION: Although undergraduate students are expected to be an informed population, the prevalence of risky sexual behavior was important, indicating the need to expand public investment in sexual education and awareness actions.


Assuntos
Censos , Comportamentos de Risco à Saúde , Comportamento Sexual/estatística & dados numéricos , Estudantes/estatística & dados numéricos , Adolescente , Adulto , Consumo de Bebidas Alcoólicas/epidemiologia , Consumo de Bebidas Alcoólicas/psicologia , Brasil/epidemiologia , Coito/psicologia , Estudos Transversais , Feminino , Humanos , Masculino , Prevalência , Fatores Sexuais , Comportamento Sexual/psicologia , Parceiros Sexuais/psicologia , Doenças Sexualmente Transmissíveis/epidemiologia , Doenças Sexualmente Transmissíveis/psicologia , Fatores Socioeconômicos , Estudantes/psicologia , Adulto Jovem
19.
BMC Infect Dis ; 20(1): 204, 2020 Mar 06.
Artigo em Inglês | MEDLINE | ID: mdl-32143643

RESUMO

BACKGROUND: Bolivia has the highest prevalence of cervical cancer in South America and the prevalence of viral sexually transmitted infections (STIs) among people in urban cities is increasing. Little is known about the prevalence of viral STIs in rural communities, which generally have limited access to health care. In order to study the prevalence of viral STIs in rural Bolivia, we recruited women from villages and towns in the Department of La Paz in Bolivia. METHODS: Three hundred ninety-four female participants were assessed for IgG-antibodies to herpes simplex virus type 2 (HSV-2), human immunodeficiency virus (HIV) and hepatitis B virus (HBV, anti-HBc), as well as for the presence of HBV surface antigen (HBsAg) in dried blood spots. The prevalence of 12 high-risk types of human papillomavirus (HPV) was assessed by qPCR in dried cervicovaginal cell spots from 376 of these women. χ2 test was used to compare variables between the populations and binary logistic regression was used to identify risk factors associated with the positivity of the tests. RESULTS: The seroprevalence of HSV-2 was 53% and of HBV 10.3%. HBAg was detected in 15.8% of women with anti-HBV antibodies indicating chronic infection. The frequency of high-risk HPV infection was 27%, with the most prevalent high-risk HPV types being HPV 56, 39 and 31 followed by HPV 16 and 18. Finally, none of the 394 women were seropositive for HIV, and about 64% of the studied population was positive for at least one of the viral infections. CONCLUSIONS: Women in Bolivian rural communities in La Paz show a high prevalence of HBV, HPV and, in particular, HSV-2. In contrast, none of the women were HIV positive, suggesting that the HIV prevalence in this population is low. The pattern of high-risk HPV types differed from many other countries with a predominance of HPV-types not included in the Gardasil vaccine which was officially introduced in Bolivia in April 2017.


Assuntos
Herpesvirus Humano 2/genética , Infecções por Papillomavirus/diagnóstico , Doenças Virais Sexualmente Transmissíveis/diagnóstico , Adulto , Anticorpos Antivirais/sangue , Bolívia/epidemiologia , Feminino , Genótipo , Infecções por HIV/diagnóstico , Infecções por HIV/epidemiologia , Hepatite B/diagnóstico , Hepatite B/epidemiologia , Anticorpos Anti-Hepatite B/sangue , Antígenos de Superfície da Hepatite B/sangue , Herpesvirus Humano 2/isolamento & purificação , Humanos , Pessoa de Meia-Idade , Infecções por Papillomavirus/epidemiologia , Prevalência , Risco , População Rural , Doenças Virais Sexualmente Transmissíveis/epidemiologia , Adulto Jovem
20.
BMC Infect Dis ; 20(1): 195, 2020 Mar 06.
Artigo em Inglês | MEDLINE | ID: mdl-32138673

RESUMO

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


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