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1.
Pan Afr Med J ; 47: 209, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-39247770

RESUMEN

Introduction: female sex workers (FSWs) are vulnerable to acquiring HIV and other sexually transmitted infections due to unprotected sex. Understanding and addressing the gaps in safer sex among FSWs can help to reduce HIV acquisition and transmission. This study described sexual practices, their correlates and use of HIV services among FSWs in Mombasa County, Kenya. Methods: participants were recruited for a baseline survey by a time-location cluster randomized design at predetermined intervals from five bars and five clubs in Mombasa County until a sample size of 160 was reached. Descriptive statistics and inferential analysis using R were conducted, and p<0.05 was regarded as statistically significant. Results: nearly all (99%) of the participants were unmarried, and 11% had tertiary education. Ninety-eight percent (98%) reported vaginal intercourse, 51% reported using alcohol/drugs before sex, and 28% practiced unprotected intercourse. About 64% had tested for HIV within three months, 14% believed that it is safe to reuse condoms, and 10% that it is safe to engage in unprotected sex. In bi-variate analysis, FSWs were more likely to engage in unprotected intercourse if they reported more frequent sex, more frequent sex with regular clients, poor HIV knowledge, alcohol/drug use, and violence. In multivariate analysis, risky sexual practices were associated with frequency of sexual intercourse, alcohol/drug use, and poor HIV knowledge. Conclusion: female sex workers engage in unprotected sex while under the influence of substances, belief in re-using condoms and have high frequency of sexual intercourse. Inadequate knowledge of HIV and substance use significantly correlated with unprotected sex. Interventions to address these modifiable factors are needed to mitigate the risk of HIV among FSWs.


Asunto(s)
Condones , Infecciones por VIH , Trabajadores Sexuales , Conducta Sexual , Sexo Inseguro , Humanos , Kenia , Trabajadores Sexuales/estadística & datos numéricos , Femenino , Infecciones por VIH/prevención & control , Infecciones por VIH/epidemiología , Adulto , Adulto Joven , Sexo Inseguro/estadística & datos numéricos , Conducta Sexual/estadística & datos numéricos , Condones/estadística & datos numéricos , Adolescente , Conocimientos, Actitudes y Práctica en Salud , Asunción de Riesgos , Trabajo Sexual/estadística & datos numéricos , Encuestas y Cuestionarios , Sexo Seguro/estadística & datos numéricos , Prueba de VIH/estadística & datos numéricos , Trastornos Relacionados con Sustancias/epidemiología
2.
J Med Internet Res ; 26: e49362, 2024 Sep 09.
Artículo en Inglés | MEDLINE | ID: mdl-39250213

RESUMEN

BACKGROUND: Male factory workers in China are vulnerable to HIV transmission. Commercial and nonmarital noncommercial contacts are the driving forces of heterosexual HIV transmission among male factory workers in China. There is a lack of effective HIV interventions for male factory workers in China. OBJECTIVE: The primary objective of this randomized controlled trial was to compare the efficacy of an enhanced versus the standard version of a WeChat mini program in reducing sexual intercourse with nonregular female sex partners and female sex workers among male factory workers in Shenzhen, China. METHODS: A nonblinded 2-arm parallel randomized controlled trial was conducted between December 2021 and April 2023. Participants were adult male factory workers in Shenzhen who had access to a smartphone and WeChat. Those who had oral or anal sex with a man or self-reported as HIV positive were excluded. A total of 247 participants were randomly assigned to the intervention group (n=125, 50.6%) or the control group (n=122, 49.4%); 221 (89.5%) and 220 (89.1%) completed follow-up surveys at T1 (6 months after completion of the interventions) and T2 (6 months after T1). Participants in the control group had access to the standard WeChat mini program that provided basic HIV-related knowledge and information about local free HIV testing services. Participants in the intervention group had access to the enhanced WeChat mini program. The enhanced mini program covered all the information in the standard mini program. In addition, the enhanced mini program assessed users' behaviors and invited users to watch different web-based videos on reducing nonmarital sexual contacts and promoting HIV testing based on their behavioral characteristics at months 0 and 1. The videos were developed based on in-depth interviews with male factory workers. Intention-to-treat analysis was used for outcome analyses. Multiple imputation was used to replace missing outcome values at T1 and T2. RESULTS: At T1, fewer participants in the intervention group reported sexual intercourse with a nonregular female sex partner in the past 6 months compared with the control group (1/125, 0.8% vs 8/122, 6.6%; relative risk=0.12, 95% CI 0.02-0.96; P=.02). However, there were no between-group differences in sexual intercourse with a nonregular female sex partner at T2 (10/125, 8% vs 14/122, 11.5%; P=.36) or sexual intercourse with a female sex worker at T1 (2/125, 1.6% vs 2/122, 1.6%; P=.98) or T2 (8/125, 6.4% vs 8/122, 6.6%; P=.96). CONCLUSIONS: The enhanced WeChat mini program was more effective than the standard WeChat mini program in reducing sexual intercourse with nonregular female sex partners among male factory workers in the short term but not in the longer term. Improvements should be made to the WeChat mini program before implementation. TRIAL REGISTRATION: ClinicalTrials.gov NCT05811611; https://clinicaltrials.gov/study/NCT05811611.


Asunto(s)
Infecciones por VIH , Heterosexualidad , Humanos , Masculino , Adulto , Infecciones por VIH/prevención & control , Heterosexualidad/estadística & datos numéricos , China , Femenino , Trabajadores Sexuales/estadística & datos numéricos , Conducta Sexual , Parejas Sexuales , Adulto Joven
3.
JMIR Public Health Surveill ; 10: e56958, 2024 Sep 10.
Artículo en Inglés | MEDLINE | ID: mdl-39254571

RESUMEN

Background: Drug users are a high-risk group for HIV infection and are prominent HIV carriers. Given the emergence of new drugs, we explored current drug-using behaviors, HIV infections, and the correlation between drug-using behaviors and HIV infection risk among drug users from 2014 to 2021. Objective: We aimed to identify the prevalence of HIV infection risk among drug users and explore drug use behaviors based on the updated data, which could provide evidence for the precision of HIV prevention strategies among drug users. Methods: Data were collected from sentinel surveillance of drug users in rehabilitation centers and communities in Hangzhou (2014-2021), including sociodemographic characteristics, HIV awareness, drug use, risky sexual behaviors, and HIV infection status. Multivariate logistic regression was used to identify the factors influencing HIV infection and risky sexual behaviors among drug users. Results: In total, 5623 drug users (male: n=4734, 84.19%; age: mean 38.38, SD 9.94 years) were included. New drugs dominated among the participants (n=3674, 65.34%). The main mode of drug use was noninjection (n=4756, 84.58%). Overall, for 27.45% (n=1544) of injected drugs in the last month before the investigation, the average daily injection frequency was 3.10 (SD 8.24). Meanwhile, 3.43% of participants shared needles. The incidence of sexual behaviors after drug use was 33.13% (n=1863), with 35.75% (n=666) of them using a condom in the last time. Overall, 116 participants tested positive for HIV antibodies (infection rate=2.06%). New drug users exhibited more postuse sexual behaviors than traditional drug users (odds ratio [OR] 7.771, 95% CI 6.126-9.856; P<.001). HIV-aware drug users were more likely to engage in risky sexual behaviors (OR 1.624, 95% CI 1.152-2.291; P=.006). New-type drug users were more likely to engage in unprotected sexual behavior (OR 1.457, 95% CI 1.055-2.011; P=.02). Paradoxically, drug users with greater HIV awareness were more prone to engaging in unprotected sexual behavior (OR 5.820, 95% CI 4.650-7.284; P<.001). Women engaged less in unprotected sex than men (OR 0.356, 95% CI 0.190-0.665; P=.001). HIV rates were higher among injecting drug users (OR 2.692, 95% CI 0.995-7.287; P=.04) and lower among drug users who used condoms during recent sex than those who did not (OR 0.202, 95% CI 0.076-0.537; P=.001). Higher education levels were associated with higher HIV infection rates. However, there was no significant correlation between HIV cognition level and HIV infection. Conclusions: New drug types and noninjection were the main patterns in last 7 years. Using new types of drugs, rather than traditional drugs, was associated with an increased risk of HIV infection. Injection drug use was a risk factor for HIV infection. HIV awareness among drug users was high, but the incidence of risky sexual behaviors remained high. Therefore, it is important to promote the behavioral transformation of high-risk populations from cognition to attitude, and then to taking protective measures.


Asunto(s)
Consumidores de Drogas , Infecciones por VIH , Asunción de Riesgos , Trastornos Relacionados con Sustancias , Humanos , Masculino , China/epidemiología , Infecciones por VIH/epidemiología , Estudios Transversales , Femenino , Adulto , Consumidores de Drogas/estadística & datos numéricos , Consumidores de Drogas/psicología , Persona de Mediana Edad , Trastornos Relacionados con Sustancias/epidemiología , Prevalencia , Factores de Riesgo , Conducta Sexual/estadística & datos numéricos , Adulto Joven , Vigilancia de Guardia , Adolescente
4.
BMC Public Health ; 24(1): 2416, 2024 Sep 05.
Artículo en Inglés | MEDLINE | ID: mdl-39237891

RESUMEN

BACKGROUND: HIV/AIDS has emerged as a nationwide epidemic and has taken the forefront position as the primary infectious killer of adults in China. The control and prevention of the disease have been hampered by a weak link in the form of heterosexual transmission. However, conventional intervention measures have demonstrated suboptimal efficacy in reducing the incidence of new HIV infections. In light of the current epidemiological characteristics, we have developed and executed an innovative intervention model known as the Joint Prevention and Control Mechanism of the 'CDC-Public Security Bureau-NGO'. The purpose of this research is to assess the impact of this model on the AIDS awareness, HIV infection rates, sexual behavior, and associated factors among female sex workers and elderly clients. Through the provision of robust evidence of the efficacy of this innovative model, we seek to advocate for its implementation in future interventions. METHODS: The research design of this study incorporates both a serial cross-sectional study and time-series analysis from 2014 to 2021, including a 4-year traditional intervention (2014-2017) and the 4-year 'CDC-Public Security Bureau-NGO' innovative intervention (2018-2021), was conducted to evaluate the effects of the new intervention. The GM(1, 1) model was performed to predict the proportion of HIV infection without implementing the innovative intervention in 2018-2021; P and C values were used to evaluate the performance of the model. Mann-Kendall test and descriptive methods were used to analyzed the trend of traditional and innovative interventions models on HIV positive detection rate in FSWs and elderly clients. RESULTS: The condom usage rates during the last commercial sexual encounter for FSWs and elderly clients improved from 74.9% and 9.1%, respectively, to 96.9% and 28.1%. (P < 0.05), newly reported cases of HIV have decreased by 15.56% yearly and the HIV positive detection rate among middle-aged and elderly people has dropped by 14.47%. The innovative intervention model has significantly reduced the HIV infection rates. CONCLUSIONS: The 'CDC-Public Security Bureau-NGO' innovative intervention has achieved beneficial effects on HIV/AIDS prevention and control and provides a good reference for Guangxi, China.


Asunto(s)
Infecciones por VIH , Humanos , China/epidemiología , Femenino , Adulto , Estudios Transversales , Estados Unidos/epidemiología , Infecciones por VIH/prevención & control , Infecciones por VIH/epidemiología , Persona de Mediana Edad , Centers for Disease Control and Prevention, U.S. , Síndrome de Inmunodeficiencia Adquirida/prevención & control , Síndrome de Inmunodeficiencia Adquirida/epidemiología , Trabajadores Sexuales/estadística & datos numéricos , Anciano , Adulto Joven , Conducta Sexual/estadística & datos numéricos , Masculino , Conocimientos, Actitudes y Práctica en Salud
6.
Afr J Reprod Health ; 28(8): 48-56, 2024 Aug 31.
Artículo en Inglés | MEDLINE | ID: mdl-39225359

RESUMEN

Artisanal and small-scale mining (ASM) is a significant source of income for tens of millions of people worldwide. Consistent condom use is pivotal in the prevention of HIV/AIDS and other STIs. This study assessed sexual behaviors and factors associated with consistent condom use among young male artisanal miners in Kassanda District, Uganda. A cross-sectional survey was conducted with 304 miners aged 15-24 years. Data -analysis included frequency distributions, chi-squared tests, and binary logistic regression. 89% had sexual intercourse in the past year, 55% had multiple partners, 11% engaged in transactional sex, and only 42% used condoms consistently. Married/cohabiting young men (OR=0.41; CI=0.19-0.87), those with a neutral attitude towards condom use (OR=0.30; CI=0.11-0.85), and those with only their mothers as parents (OR=0.37; CI=0.19-0.73) were less likely to use condoms consistently. The study highlights the need for targeted interventions promoting condom use among married young men and those raised by single mothers to reduce the risk of STI transmission.


L'exploitation minière artisanale et à petite échelle (ASM) constitue une source de revenus importante pour des dizaines de millions de personnes dans le monde. L'utilisation systématique du préservatif est essentielle à la prévention du VIH/SIDA et d'autres IST. Cette étude a évalué les comportements sexuels et les facteurs associés à l'utilisation systématique du préservatif chez les jeunes mineurs artisanaux du district de Kassanda, en Ouganda. Une enquête transversale a été menée auprès de 304 mineurs âgés de 15 à 24 ans. L'analyse des données comprenait des distributions de fréquences, des tests du chi carré et une régression logistique binaire. 89 % ont eu des rapports sexuels au cours de l'année écoulée, 55 % ont eu plusieurs partenaires, 11 % se sont livrés à des relations sexuelles transactionnelles et seulement 42 % ont utilisé des préservatifs de manière constante. Jeunes hommes mariés/cohabitants (OR=0,41 ; IC=0,19-0,87), ceux ayant une attitude neutre à l'égard de l'utilisation du préservatif (OR=0,30 ; IC=0,11-0,85) et ceux dont la mère est seule comme parent (OR=0,37 ; IC=0,19-0,73) étaient moins susceptibles d'utiliser régulièrement des préservatifs. L'étude souligne la nécessité d'interventions ciblées promouvant l'utilisation du préservatif parmi les jeunes hommes mariés et ceux élevés par des mères célibataires afin de réduire le risque de transmission des IST.


Asunto(s)
Condones , Conocimientos, Actitudes y Práctica en Salud , Conducta Sexual , Humanos , Masculino , Condones/estadística & datos numéricos , Uganda , Estudios Transversales , Adolescente , Adulto Joven , Conducta Sexual/estadística & datos numéricos , Mineros/estadística & datos numéricos , Minería , Enfermedades de Transmisión Sexual/prevención & control , Parejas Sexuales , Infecciones por VIH/prevención & control , Infecciones por VIH/epidemiología , Sexo Seguro/estadística & datos numéricos , Adulto
7.
Afr J Reprod Health ; 28(8s): 107-114, 2024 Aug 31.
Artículo en Inglés | MEDLINE | ID: mdl-39283318

RESUMEN

In Senegal, the needs for care related to sexual and reproductive health and rights (SRHR) among adolescents are significant. This study evaluates the accessibility and use of gender-related SRHR services by adolescents in the municipalities of Kaolack and Gossas. It is based on quantitative and qualitative data from 2,263 adolescents in the 2 sites, 84 in-depth individual interviews, 12 focus groups with adolescents and sexual reproductive Health actors, and 4 interviews with key informants. Quantitative analysis consisted of the interpretation of univariate statistics and bivariate analyses, while qualitative analysis relied on the coding and thematic analysis of verbatim statements. The results show low use of health structures (3% and 0.4% in Gossas and Kaolack respectively). This was attributed to the perceptions that services are not suitable to the needs of adolescents, and also because of socio-cultural constraints in the two sites. Additionally, the distribution of access to reproductive health services by sex shows gaps between boys and girls. We conclude that efforts should be made to tailor the sexual and reproductive health services offered to adolescents to their needs and social circumstances.


Au Sénégal, les besoins en soins de Santé Sexuelle et Reproductive des Adolescent(e)s (SSRA) sont importants. Cette étude évalue l'accessibilité et l'utilisation des services de SSRA, en rapport avec le genre dans les communes de Kaolack et de Gossas. Elle est basée sur les données quantitatives et qualitatives provenant de 2263 adolescents, de 84 entretiens individuels approfondis, de 12 focus groupes avec des adolescents/tes et des acteurs de la SSRA et de 4 entretiens avec les informateurs clés. L'analyse quantitative concerne les statistiques univariées et bivariées, alors que l'analyse qualitative s'appuie sur le codage et l'extraction des verbatim. L'étude révèle une faible utilisation des structures de santé, liée à leur inadaptation aux besoins des adolescent(e)s et aux contraintes socio-culturelles. Le recours des adolescent(e)s aux services de SSRA (3% et 0,4% à Gossas et Kaolack respectivement) est très faible et on note des écarts entre les garçons et les filles.


Asunto(s)
Grupos Focales , Accesibilidad a los Servicios de Salud , Servicios de Salud Reproductiva , Humanos , Adolescente , Femenino , Masculino , Senegal , Salud Sexual , Investigación Cualitativa , Salud Reproductiva , Conducta Sexual , Entrevistas como Asunto
8.
Afr J Reprod Health ; 28(8s): 115-121, 2024 Aug 31.
Artículo en Inglés | MEDLINE | ID: mdl-39283478

RESUMEN

Togo, like other sub-Saharan African countries, is not spared from the phenomenon of teenage pregnancies. Each year, on average, about ten cases of teenage student pregnancies are recorded in schools. Despite multiple efforts by the Togolese government and non-governmental organizations to stem this phenomenon, it still persists and is growing. This paper aims to analyse the influence of the Vodou workshop practice on the occurrence of adolescent pregnancies. The paper relied on analysis of 105 Key Informant Interviews in four villages in the maritime region. The results reveal that the Vodou rites and initiations practices constitute a major preventable factor in the causation of early pregnancies among teenagers in rural Togo.


Le Togo, à l'instar d'autres pays de l'Afrique sub-Saharienne, n'est pas épargné du phénomène des grossesses précoces. Chaque année, en moyenne, une dizaine de cas de grossesses des élèves d'adolescentes est enregistrée dans les établissements scolaires. Malgré de multiples efforts déployés par le gouvernement togolais et les organisations non gouvernementales pour endiguer ce phénomène, il persiste toujours, et prend de l'ampleur. L'objectif de cet article est d'analyser l'influence de la pratique du culte Vodou sur la survenue des grossesses des adolescentes initiées. La recherche est basée sur l'analyse de 105 interviews individuels conduites dans quatre localités dans la région maritime. Les résultats révèlent que les rites et initiations pratiqués dans les couvents Vodou constituent un facteur de prévention des grossesses précoces chez les adolescentes initiées.


Asunto(s)
Embarazo en Adolescencia , Población Rural , Humanos , Femenino , Togo/epidemiología , Embarazo , Adolescente , Embarazo en Adolescencia/estadística & datos numéricos , Embarazo en Adolescencia/prevención & control , Incidencia , Conducta Sexual , Conocimientos, Actitudes y Práctica en Salud , Adulto Joven , Conducta Anticonceptiva/estadística & datos numéricos
9.
Afr J Reprod Health ; 28(8s): 122-129, 2024 Aug 31.
Artículo en Inglés | MEDLINE | ID: mdl-39283587

RESUMEN

This article shows how certain traditional socio-cultural practices that influence the root causes of teenage pregnancy violate the rights of adolescents. The data came from the action-research entitled "Multisectoral and transformative approaches to rites and initiations for adolescent sexual and reproductive health rights", conducted by the Togolese Association for Family Welfare (ATBEF) in May 2022. The option is made for a qualitative approach. The information collected was recorded on dictaphones and then transcribed from the local languages of collection into French. Content analysis was used to write the research report. The results reveal that these practices, which are still prevalent in the localities of the study, and which exert pressure on adolescent girls, are also products of violations of many girls' rights.


Cet article montre en quoi certaines pratiques socio-culturelles traditionnelles qui influencent les causes profondes de la survenue des grossesses chez les adolescentes, constituent une violation des droits de ces dernières. Les données proviennent de la recherche action titrée « Approches multisectorielles et transformatrices des rites et initiations pour les droits en santé sexuelle et de la reproduction des adolescentes ¼, menée par l'Association Togolaise pour le Bien-Etre Familial (ATBEF) en mai 2022. L'option est faite pour une approche qualitative. Les informations collectées ont été enregistrées sur dictaphones puis transcrites des langues locales de collecte vers le français. L'analyse de contenu a été utilisée pour la rédaction du rapport de recherche. Les résultats révèlent que ces pratiques encore prégnantes dans les localités de l'étude et qui exercent des pressions sur les adolescentes, sont aussi des produits des violations de nombreux droits des filles.


Asunto(s)
Embarazo en Adolescencia , Normas Sociales , Humanos , Femenino , Adolescente , Embarazo , Normas Sociales/etnología , Togo , Conducta Sexual , Conducta del Adolescente/psicología , Investigación Cualitativa , Derechos Sexuales y Reproductivos , Cultura
10.
Afr J Reprod Health ; 28(8s): 176-184, 2024 Aug 31.
Artículo en Inglés | MEDLINE | ID: mdl-39284206

RESUMEN

This article problematizes gender-based violence (GBV) as a social practice and explains its role as a social mechanism for controlling bodies. Based on a mixed methodological approach (combining questionnaires, qualitative interviews, focus groups, and participant observation) targeting both adolescent girls and community actors, this study reveals forms of GBV that are little explored among the adolescent population. Social practices, such as "nëpp nëppël" or the culture of silence, frequently conceal GBV within families, hindering reporting and thus limiting adolescents' access to sexual and reproductive health and rights (SRHR) services and influencing their limited knowledge of SRHR. Shelter centres, such as Kullimaaroo, are crucially important in this context by providing holistic support to victims of GBV, but such structures are rare in Senegal. We conclude that it is necessary to adopt a holistic approach taking into account social practices to address the complex relationship between GBV and SRHR among adolescents in Senegal.


Cet article problématise les violences basées sur le genre (VBG) comme des pratiques sociales et explicite leur rôle de mécanisme social de contrôle des corps. Basé sur une approche méthodologique mixte (associant des questionnaires, des entretiens qualitatifs, des focus-group, de l'observation participante, etc.) ciblant à la fois les adolescentes et les acteurs communautaires, cette enquête révèle des formes de VBG peu explorées chez la population adolescente. Les pratiques sociales, comme le "nëpp nëppël" ou la culture du silence, dissimulent fréquemment ces VBG au sein des familles, entravant la dénonciation et limitant ainsi leur accès aux services de santé sexuelle et reproductive (SSR) et influençant leurs connaissances limitées en SSR. Les centres d'hébergement, tels que Kullimaaroo, revêtent une importance cruciale dans ce contexte en fournissant un soutien holistique aux victimes de VBG, mais ces structures restent rares au Sénégal. Il est nécessaire d'adopter une approche holistique prenant en compte les pratiques sociales pour traiter les enjeux complexes de l'articulation entre les VBG et la SSR chez les adolescentes, un domaine actuellement insuffisamment documenté.


Asunto(s)
Violencia de Género , Salud Reproductiva , Salud Sexual , Humanos , Femenino , Adolescente , Senegal , Investigación Cualitativa , Grupos Focales , Conducta Sexual/psicología , Derechos Sexuales y Reproductivos , Encuestas y Cuestionarios
11.
Afr J Reprod Health ; 28(8s): 185-191, 2024 Aug 31.
Artículo en Inglés | MEDLINE | ID: mdl-39284224

RESUMEN

Teenage pregnancy and marriage are major concerns in many schools in Togo, due to the large number of cases recorded each year by the Ministry of Primary, Secondary, Technical Education, and Handicrafts. The aim of this article is to describe the rites associated with early pregnancy and the perceptions held by the populations of Gando in the Savannah region. The study was based on documentary research and interviews with several actors, including initiating priests, canton chiefs, and young initiates. The results show that the rites: Okpenkpen, Tkonte, Ignogues have a link with early pregnancy, and the populations perceive them relatively well.


Les grossesses et mariages chez les adolescentes constituent une vive préoccupation dans beaucoup d'établissements scolaires au Togo en raison du nombre important de cas recensés chaque année par le Ministère des enseignements primaire, secondaire, technique et de l'artisanat. L'objectif de cet article est de décrire les rites ayant un lien avec les grossesses précoces et les perceptions qu'ont les populations de Gando dans la région des Savanes. Pour y parvenir, la méthodologie utilisée est basée sur la recherche documentaire et les entretiens avec plusieurs acteurs, entre autres, les prêtres initiateurs, les chefs de cantons et les jeunes initiés. Les résultats montrent que les rites : Okpenkpen, Tkonte, Ignogues ont un lien avec les grossesses précoces et les populations les perçoivent relativement bien.


Asunto(s)
Embarazo en Adolescencia , Conducta Sexual , Humanos , Femenino , Embarazo en Adolescencia/psicología , Togo , Adolescente , Embarazo , Conducta Sexual/psicología , Conducta del Adolescente/psicología , Catolicismo , Matrimonio/psicología
12.
PLoS One ; 19(9): e0310266, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-39259759

RESUMEN

INTRODUCTION: Nepal is characterized by low empowerment of women which may have negative effects on their health status as well as sexual and reproductive rights. We seek to identify key determinants of women empowerment in Nepal using a rich set of socio-demographic and socio-economic characteristics as well as behavioral factors and regional indicators. METHODS: This study utilizes 4,211 women aged between 15 and 49 years from the 2022 Demographic and Health Survey (DHS) for Nepal. Following the previous study for Mozambique, we use Principal Component Analysis (PCA) to identify components of women's empowerment along three domains: beliefs about violence, decision-making and control over sexuality and safe sex. We use logistic regressions to identify significant predictors of empowerment in each domain and provide crude and adjusted odds ratios along with their 95% confidence intervals. RESULTS: We found that older age is generally associated with higher empowerment across all these domains. Interestingly, while partner controlling behavior tended to decrease empowerment in beliefs about violence and control over sexuality, it was linked to increased decision-making empowerment. Notable regional differences emerged, with higher levels of empowerment observed in the Madhesh and Sudurpashchim regions. Further, education level and wealth were correlated with increased empowerment in control over sexuality and safe sex, though not in the other two domains. Access to media showed mixed effects, reducing empowerment in decision-making but enhancing it in control over sexuality and safe sex. CONCLUSION: Our results have many similarities but also notable differences with previous literature which emphasizes the importance of regular and region-specific studies of women's empowerment, acknowledging the potential for its change over time and also the prevailing differences across regions.


Asunto(s)
Empoderamiento , Humanos , Femenino , Adulto , Nepal , Adolescente , Persona de Mediana Edad , Adulto Joven , Toma de Decisiones , Factores Socioeconómicos , Poder Psicológico , Conducta Sexual/psicología , Sexo Seguro/psicología
13.
BMC Public Health ; 24(1): 2474, 2024 Sep 11.
Artículo en Inglés | MEDLINE | ID: mdl-39261836

RESUMEN

BACKGROUND: Sexual behaviors, particularly risky sexual behavior, has become a serious public health concern among adolescents worldwide, presenting a substantial obstacle to the prevention of sexually transmitted infections, including human immunodeficiency virus (HIV). However, there is limited research using consistent and standardized methodology to examine associations between tobacco and alcohol use frequency and both total and risky sexual behaviors among adolescents. We aimed to examine the association between tobacco and/or alcohol use with both total and risky sexual behaviors among adolescents worldwide. METHODS: Data were collected from the Global School-based Student Health Survey, which comprised 211,847 adolescents aged 12-17 years from 59 countries. The frequency of tobacco or alcohol use during the past 30 days was categorized as 0, 1-2, 3-5, 6-9, or ≥ 10 days. Tobacco and alcohol use were also categorized as non-use, tobacco use alone, alcohol use alone, and combined use. Multi-variable logistic regression analysis was used to examine both the independent and combined associations of tobacco and alcohol use with total and risky sexual behaviors. RESULTS: Compared with no tobacco use, the odds ratio of engaging in sexual intercourse increased with the frequency of tobacco use from 1 to 2 days to ≥ 10 days (total: 2.03 [95% confidence interval 1.47-2.81] to 3.98[2.63-6.03]; risky: 2.43[1.75-3.38] to 4.21[3.26-5.42]), as well as with the frequency of alcohol use. Overall, combined users had greater likelihood of both total and risky sexual behaviors than tobacco users alone, alcohol users alone, and non-users. Similarly, the association between risky sexual behaviors and tobacco use alone was more pronounced among adolescent girls (vs. adolescent boys), as were those of risky sexual behaviors with alcohol use alone among younger adolescents aged 12-14 years (vs. aged 15-17 years) and with tobacco and/or alcohol use among adolescents in the Western Pacific region (vs. Regions of Africa and Americas). CONCLUSIONS: Our findings suggest independent and combined associations between tobacco and/or alcohol use with sexual behaviors among adolescents, with variations across age, sex, and WHO region.


Asunto(s)
Consumo de Bebidas Alcohólicas , Asunción de Riesgos , Conducta Sexual , Uso de Tabaco , Humanos , Adolescente , Masculino , Femenino , Conducta Sexual/estadística & datos numéricos , Conducta Sexual/psicología , Niño , Consumo de Bebidas Alcohólicas/epidemiología , Consumo de Bebidas Alcohólicas/psicología , Uso de Tabaco/epidemiología , Conducta del Adolescente/psicología , Encuestas Epidemiológicas , Salud Global/estadística & datos numéricos
14.
Commun Biol ; 7(1): 1145, 2024 Sep 14.
Artículo en Inglés | MEDLINE | ID: mdl-39277660

RESUMEN

Pathogenic changes in gut microbial composition precede the onset of HIV-1 infection in men who have sex with men (MSM). This process is associated with increased levels of systemic inflammatory biomarkers and risk for AIDS development. Using mediation analysis framework, in this report we link the effects of unprotected receptive intercourse among MSM prior to primary HIV-1 infection to higher levels of proinflammatory cytokines sCD14 and sCD163 in plasma and a significant decrease in the abundance of A. muciniphila, B. caccae, B. fragilis, B. uniformis, Bacteroides spp., Butyricimonas spp., and Odoribacter spp., and a potential increase in the abundance of Dehalobacterium spp. and Methanobrevibacter spp. in stools of MSM with the highest number of sexual partners. These differences in microbiota, together with a reduction in the pairwise correlations among commensal and short-chain fatty acid-producing bacteria with a number of sexual partners, support an increase in gut dysbiosis with the number of sexual partners. These results demonstrate the interconnectedness of sexual behavior, immune response, and microbiota composition, notably among MSM participating in high-risk sexual behaviors.


Asunto(s)
Microbioma Gastrointestinal , Infecciones por VIH , VIH-1 , Homosexualidad Masculina , Inflamación , Conducta Sexual , Masculino , Humanos , Infecciones por VIH/microbiología , Infecciones por VIH/inmunología , Infecciones por VIH/virología , Adulto , Inflamación/microbiología , VIH-1/fisiología , Disbiosis/microbiología , Persona de Mediana Edad
15.
PLoS One ; 19(9): e0307755, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-39236062

RESUMEN

BACKGROUND: Addressing the global challenge of sexually transmitted infections (STIs) is crucial and demands immediate attention. Raising awareness, improving healthcare facilities, and implementing preventive measures are necessary to reduce the spread and mitigate their adverse effects. The treatment seeking behavior of individuals in relation to STIs is an important factor in STI prevention and control. Thus, this study aimed to identify factors associated with STI-related care-seeking behavior among sexually active men in East Africa. METHODS: A weighted sample of 3,302 sexually active men from recent Demographic and Health Surveys (DHSs) in East African countries were included for analysis. To accommodate the inherent clustering in DHS data and the binary nature of the dependent variable, we applied a multi-level mixed-effect logistic regression model. The deviance value was used to select the best-fitted model. The strength of the association was estimated using an adjusted odds ratio, along with a 95% confidence interval, and statistical significance was determined at a p-value < 0.05. RESULT: The pooled prevalence of STI-related care-seeking behavior among sexually active men in East Africa was 71% (95%CI: 69.76, 72.75). In the multivariable multilevel model, individuals in the age groups of 25-34 (AOR = 1.58, 95%CI: 1.22, 2.04) and 44 years and above (AOR = 1.44, 95%CI: 1.01, 2.02), those who were married (AOR = 1.62, 95%CI: 1.25, 2.11), had 1 (AOR = 1.88, 95%CI: 1.50, 2.35) and ≥2 (AOR = 2.53, 95%CI: 1.89, 3.39) sexual partners excluding their spouse, had ever been tested for HIV (AOR = 1.86, 95%CI: 1.52, 2.28), and had media exposure (AOR = 1.30, 95%CI: 1.04, 1.62) had a positive association with care-seeking behavior for STIs. CONCLUSION: Based on our findings, seven out of ten sexually active men in East Africa exhibit care-seeking behavior for STIs. It is crucial to implement policies and strategies aimed at improving the health-seeking habits of young, unmarried men. Utilizing diverse media platforms to disseminate accurate information and success stories about STI symptoms is pivotal in achieving this goal.


Asunto(s)
Aceptación de la Atención de Salud , Conducta Sexual , Enfermedades de Transmisión Sexual , Humanos , Masculino , Adulto , Enfermedades de Transmisión Sexual/epidemiología , Enfermedades de Transmisión Sexual/prevención & control , África Oriental/epidemiología , Aceptación de la Atención de Salud/estadística & datos numéricos , Adulto Joven , Adolescente , Persona de Mediana Edad , Análisis Multinivel , Prevalencia
16.
Br J Community Nurs ; 29(9): 422, 2024 Sep 02.
Artículo en Inglés | MEDLINE | ID: mdl-39240807
17.
Sci Rep ; 14(1): 20378, 2024 09 02.
Artículo en Inglés | MEDLINE | ID: mdl-39223218

RESUMEN

Non-condom use is known as one of the risky sexual behaviors among youth and a contributing factor to the high prevalence of HIV in Nigeria. Therefore this study aimed to assess the spatial pattern and determinants of non-condom use among sexually active young people in Nigeria. The study employed a cross-sectional analysis of population-based data involving 288 males and 780 females aged 15-24 years, giving 1068 sexually active young people drawn from the 2018 NDHS. The study adopted a multi-level and spatial analysis to identify factors associated with non-condom use in Nigeria. The prevalence of non-condom use was 57.7% in this study. The spatial analysis showed that the Northeastern and South-South regions of Nigeria had a high proportion of non-condom use among young people, while the Northwest, North-Central, and Southwestern parts had low proportions of non-condom use. On multilevel analysis, the individual and community level factors associated with non-condom use included exposure to media (AOR 0.59; 95% CI 0.39-0.91) and younger age (AOR 0.72; 95% CI 0.53-0.98). Areas with a high proportion of non-condom use should receive the most attention through the promotion of condom use and education, alongside a focus on important associated factors.


Asunto(s)
Conducta Sexual , Humanos , Adolescente , Nigeria/epidemiología , Masculino , Femenino , Estudios Transversales , Adulto Joven , Conducta Sexual/estadística & datos numéricos , Condones/estadística & datos numéricos , Prevalencia , Adulto , Infecciones por VIH/epidemiología , Análisis Espacial , Asunción de Riesgos
18.
Afr J Reprod Health ; 28(8): 57-66, 2024 08 31.
Artículo en Inglés | MEDLINE | ID: mdl-39225614

RESUMEN

Reproductive health and reproductive health technologies are one of the challenging health studies in the developing world. The study focuses on the knowledge and attitude of adolescent students towards reproductive health technologies. It is the need and responsibility of all individuals especially adolescents (the future procreators) to know about Assisted Reproductive Technologies (ART) and the sexual health related to it. The objectives are to evaluate the level of knowledge among late adolescents (18-21 years) regarding sexual and reproductive health. To understand the attitudes of late adolescents towards sexual health and reproductive health technologies. To identify gaps in knowledge and misconceptions about sexual and reproductive health among late adolescents. To determine the awareness and perceptions of late adolescents regarding various reproductive health technologies. The study was a mixed method, 46 respondents of age groups between 18-21 years (late adolescents) were selected, using simple random sampling. A self-administered questionnaire was circulated through Google Forms. Data was collected and analysed using SPSS Statistics Data Editor version 22. The level of knowledge the late adolescents have towards sexual health and reproductive technologies is very low and the study should explore all, to know the merits and demerits of Assisted Reproductive Technologies (ART) and the alternative methods for childbirth. The dissemination of information and availability of educational resources on sexual and reproductive health may be resulting in comparable levels of knowledge among individuals of various age cohorts.


La santé reproductive et les technologies de santé reproductive constituent l'une des études de santé les plus difficiles dans les pays en développement. L'étude se concentre sur les connaissances et l'attitude des étudiants adolescents à l'égard des technologies de santé reproductive. Il est de la nécessité et de la responsabilité de tous les individus, en particulier des adolescents (les futurs procréateurs), de connaître les technologies de procréation assistée (TAR) et la santé sexuelle qui y est associée. Les objectifs sont d'évaluer le niveau de connaissances des adolescents tardifs (18-21 ans) en matière de santé sexuelle et reproductive. Comprendre les attitudes des adolescents tardifs à l'égard des technologies de santé sexuelle et de santé reproductive. Identifier les lacunes dans les connaissances et les idées fausses sur la santé sexuelle et reproductive chez les adolescents tardifs. Déterminer la sensibilisation et les perceptions des adolescents tardifs concernant diverses technologies de santé reproductive. L'étude était une méthode mixte, 46 répondants de tranches d'âge comprises entre 18 et 21 ans (adolescents tardifs) ont été sélectionnés, par échantillonnage aléatoire simple. Un questionnaire auto-administré a été diffusé via Google Forms. Les données ont été collectées et analysées à l'aide de SPSS Statistics Data Editor version 22. Le niveau de connaissances des adolescents tardifs en matière de santé sexuelle et de technologies de reproduction est très faible et l'étude devrait tout explorer pour connaître les avantages et les inconvénients des technologies de procréation assistée (ART). et les méthodes alternatives d'accouchement. La diffusion d'informations et la disponibilité de ressources éducatives sur la santé sexuelle et reproductive peuvent aboutir à des niveaux de connaissances comparables entre les individus de différentes cohortes d'âge.


Asunto(s)
Conocimientos, Actitudes y Práctica en Salud , Salud Reproductiva , Salud Sexual , Humanos , Adolescente , Femenino , Adulto Joven , Masculino , Encuestas y Cuestionarios , Conducta Sexual/psicología , Técnicas Reproductivas Asistidas/psicología , Estudiantes/psicología , Conducta del Adolescente/psicología
19.
Rev Assoc Med Bras (1992) ; 70(8): e20240416, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-39230145

RESUMEN

AIM: The research aimed to determine the attitudes of students studying in health-related departments toward sexual myths and the factors affecting them. METHODS: The study is descriptive research involving 287 students enrolled in health-related departments. The data were collected using a "Descriptive Information Form" and the "Sexual Myths Scale (SMS)" and analyzed using the SPSS 22.0 software package. The SPSS 22.0 package program was used to evaluate the data. In statistical analysis, Spearman correlation analysis was employed to determine the relationship between continuous variables and the SMS score, and the statistical significance level was accepted as p<0.05. RESULTS: The total score was found to be 53.57±17.54 (min: 28.00 to max: 140.00), reflecting a moderate level. There was a statistically significant difference between the total score of SMS according to gender, family type, maternal employment status, and paternal education level (p<0.05). It was also determined that male students, students whose mothers were unemployed, who lived in extended families, and whose fathers had low education had lower SMS scores. CONCLUSION: Despite students studying in health-related departments and receiving relevant courses, their level of sexual myths remains at a moderate level, indicating the presence of knowledge gaps and misconceptions in the subject matter. Therefore, it is crucial to implement comprehensive education and counseling services on reproductive and sexual health for all university students.


Asunto(s)
Conocimientos, Actitudes y Práctica en Salud , Conducta Sexual , Humanos , Masculino , Femenino , Universidades , Adulto Joven , Encuestas y Cuestionarios , Adulto , Estudiantes/psicología , Estudiantes/estadística & datos numéricos , Adolescente , Estudios Transversales , Brasil , Factores Sexuales , Factores Socioeconómicos , Estudiantes del Área de la Salud/estadística & datos numéricos , Estudiantes del Área de la Salud/psicología , Estadísticas no Paramétricas
20.
Medicine (Baltimore) ; 103(22): e38151, 2024 May 31.
Artículo en Inglés | MEDLINE | ID: mdl-39259084

RESUMEN

Sexual dysfunction, particularly in females, is a complex issue influenced by various factors, including depression and inflammation. The Systemic immune-inflammation index (SII), an inflammatory biomarker, has shown associations with different health conditions, but its relationship with female sexual dysfunction (FSD) remains unclear. This study aimed to investigate the association between SII and FSD in the context of depression, utilizing low sexual frequency as an assessment indicator. Data from the National Health and Nutrition Examination Survey (NHANES) 2005 to 2016, involving 1042 depressed female participants, were analyzed. FSD, indicated by low sexual frequency, and SII, derived from complete blood count results, were assessed. Logistic regression and subgroup analyses were conducted, considering demographic and health-related factors. A total of 1042 individuals were included in our analysis; 11.5163% of participants were categorized as having FSD, which decreased with the higher SII tertiles (tertile 1, 13.8329%; tertile 2, 13.5447%; tertile 3, 7.1839%; p for trend < 0.0001). Multivariate linear regression analysis showed a significant negative association between SII and FSD [0.9993 (0.9987, 0.9999)]. This negative association in a subgroup analysis is distinctly and significantly present in the Mexican American subgroup [0.9959 (0.9923, 0.9996)], while it does not reach statistical significance in other racial categories. Furthermore, the association between SII and FSD was nonlinear; using a 2-segment linear regression model, we found a U-shaped relationship between SII and FSD with an inflection point of 2100 (1000 cells/µL). In summary, in depressed individuals, a higher SII is independently associated with a decreased likelihood of FSD, emphasizing the potential role of inflammation in female sexual health.


Asunto(s)
Inflamación , Encuestas Nutricionales , Disfunciones Sexuales Fisiológicas , Humanos , Femenino , Adulto , Inflamación/sangre , Inflamación/inmunología , Disfunciones Sexuales Fisiológicas/epidemiología , Disfunciones Sexuales Fisiológicas/sangre , Persona de Mediana Edad , Depresión/epidemiología , Disfunciones Sexuales Psicológicas/epidemiología , Disfunciones Sexuales Psicológicas/sangre , Estudios Transversales , Adulto Joven , Conducta Sexual
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