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/epidemiologíaRESUMEN
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.
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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 , AdolescenteRESUMEN
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.
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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 SaludRESUMEN
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 , AdultoRESUMEN
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.
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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 numéricosRESUMEN
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.
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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 RiesgosRESUMEN
Pre-exposure prophylaxis (PrEP) is a highly effective tool to prevent HIV, yet it is underutilized among women. The current study aims to evaluate the awareness, attitudes, and perceptions of PrEP among a large survey sample of Black and Latina women in New York City (NYC). Interviewer-administered surveys were conducted in high HIV incidence neighborhoods in NYC among Black, Latina, and Afro-Latina women who reported recent sex with a man in 2017 (n = 398) and 2018 (n = 405). About 40% of participants were aware of PrEP, whereas 30.4% indicated interest in using it. The top reason for not utilizing it was low HIV risk perception. However, most participants supported the idea that using PrEP meant asserting control over their health (94.1%). Primary care providers and obstetricians/gynecologists were participants' preferred sources for PrEP (91.6%). Across survey cycles, compared to non-Black Latina participants, Black participants had significantly higher PrEP awareness (44.4% vs. 29.1%). PrEP awareness was also significantly higher among survey participants in 2018 (45.2%) than in 2017 (34.3%). Less than half of the participants were aware of PrEP, but those who were aware expressed largely positive attitudes toward the medication. Our findings may inform future PrEP implementation strategies to optimize awareness and access to PrEP among women disproportionately affected by HIV, like focusing on personal empowerment instead of risk-based messaging and training women's sexual health care providers in PrEP provision.
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Negro o Afroamericano , Infecciones por VIH , Conocimientos, Actitudes y Práctica en Salud , Hispánicos o Latinos , Profilaxis Pre-Exposición , Adolescente , Adulto , Femenino , Humanos , Persona de Mediana Edad , Adulto Joven , Fármacos Anti-VIH/uso terapéutico , Fármacos Anti-VIH/administración & dosificación , Negro o Afroamericano/psicología , Negro o Afroamericano/estadística & datos numéricos , Encuestas Epidemiológicas , Hispánicos o Latinos/psicología , Hispánicos o Latinos/estadística & datos numéricos , Infecciones por VIH/prevención & control , Infecciones por VIH/etnología , Infecciones por VIH/psicología , Ciudad de Nueva York/epidemiología , Aceptación de la Atención de Salud/estadística & datos numéricos , Aceptación de la Atención de Salud/etnología , Aceptación de la Atención de Salud/psicología , Profilaxis Pre-Exposición/estadística & datos numéricos , Conducta Sexual/estadística & datos numéricos , Salud Sexual/etnologíaRESUMEN
Objective: This study aimed to investigate the factors associated with online dating among college students engaging in casual sexual behavior, by understanding these factors, targeted intervention measures can be formulated for relevant departments to help college students better manage their sexual health and offer useful reference for the development of sexual health education. Methods: A cross-sectional survey was conducted using a stratified cluster sampling method. Demographic and behavioral information was gathered through questionnaires for univariable and multivariable logistic regression analysis. Results: A total of 595 college students engaging in casual sexual behavior were included in the study, of whom 345 (57.98%) had found casual sexual partners through the internet. Multiple regression analysis indicated that male participants, those aged 20-21 years, those who had recently attended AIDS-themed lectures or health education classes at school, participants who were willing to engage in commercial sexual activities during online dating, participants who accepted sexual activities among men who have sex with men (MSM), those who reported having sexual intercourse with regular partners in the past year, participants who wanted to know if their online dating partners were HIV-diagnosed, those who had engaged in commercial sexual behavior in the past year and those who perceived themselves to be at risk of HIV infection were more likely to engage in online dating. Participants with general/disharmonious family relationships, those who consistently used condoms during casual sexual behavior and those who occasionally used condoms were less likely to engage in online dating. Conclusion: There were a certain extent proportion of casual partners among college students were sourced from the internet, indicating the profound influence of online dating on casual sexual behavior. Therefore, future research and intervention measures should focus on sexual health education and promotion on online dating platforms, strengthen regulations and guidance on college students' online dating behavior, and raise awareness of HIV prevention in this group.
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Conducta Sexual , Parejas Sexuales , Estudiantes , Humanos , Masculino , Estudios Transversales , China , Estudiantes/estadística & datos numéricos , Estudiantes/psicología , Conducta Sexual/estadística & datos numéricos , Conducta Sexual/psicología , Adulto Joven , Universidades , Encuestas y Cuestionarios , Femenino , Parejas Sexuales/psicología , Internet , Adolescente , AdultoRESUMEN
BACKGROUND: Adolescents' risky sexual behaviours (RSB) are detrimental to their sexual and reproductive health (SRH) well-being and present a serious public health threat, particularly in low- and middle-income countries (LMICs). AIM: This study aims to assess RSB among Grade 12 school-going adolescents after exposure to comprehensive sexuality education (CSE). SETTING: This study was conducted in Kitwe district, Zambia. METHODS: This cross-sectional study included 807 Grade 12 pupils at 13 selected secondary schools. Data were collected using a structured questionnaire. Proportionate probability sampling involving 13 schools was employed. Risky sexual behaviours binary outcome variables were based on transactional sex, sex while drunk, multiple sexual partners, age-disparate sexual relationships, and condomless sex. We conducted univariate and bivariate analyses to summarise sociodemographic factors and fitted binary and multivariable logistic regression models. RESULTS: The prevalence of RSB was 40.4%. Drinking alcohol (adjusted odds ratio [AOR] = 20.825; 95% CI [6.7-64.489]); ever had sex (AOR = 9.024; 95% CI [1.953-41.704]); school location (AOR = 6.50; 95% CI [1.61-26.24]); living with mother only (AOR = 4.820; 95% CI [1.328-17.493]); sex (male) (AOR = 2.632; 95% CI [1.469-4.713]), watching pornography (AOR = 1.745; 95% CI [1008-3.021]); religion (AOR = 0.472; 95% CI [0.250-0.891]) and attending religious functions (AOR = 0.317; 95% CI [0.118-0.848]) were significantly associated with RSB. Of the sexually active pupils, 221 (67.7%), 64 (19.6%) and 41 (12.5%) were in the low, medium and high-risk categories, respectively. CONCLUSION: Close to half of the respondents engaged in RSB. This is a significant number that needs intervention. The CSE programme needs to be linked with structural programmes that address the social drivers of RSB among adolescents.Contribution: The study provides a backdrop for evaluating current CSE strategies in LMICs.
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Conducta del Adolescente , Asunción de Riesgos , Educación Sexual , Conducta Sexual , Humanos , Zambia , Masculino , Adolescente , Estudios Transversales , Femenino , Educación Sexual/métodos , Conducta Sexual/estadística & datos numéricos , Conducta Sexual/psicología , Conducta del Adolescente/psicología , Encuestas y Cuestionarios , Instituciones Académicas/estadística & datos numéricos , Estudiantes/psicología , Estudiantes/estadística & datos numéricos , Prevalencia , Sexo Inseguro/estadística & datos numéricosAsunto(s)
Recolección de Datos , Identidad de Género , Conducta Sexual , Humanos , Recolección de Datos/normas , Recolección de Datos/métodos , Estados Unidos , Conducta Sexual/estadística & datos numéricos , Atención Dirigida al Paciente/normas , Atención Dirigida al Paciente/estadística & datos numéricos , Discriminación Social/prevención & control , Disparidades en Atención de Salud , Estigma Social , RevelaciónRESUMEN
BACKGROUND: Adequate literacy in reproductive and sexual health is essential for adolescents to obtain, comprehend, evaluate and apply information necessary for making well-informed decisions, as low literacy leads to harmful decision-making, risk-taking and poorer health and self-management. These factors increase the magnitude and severity of problems related to sexuality and reproduction, including unintended pregnancy, HIV/sexually transmitted infections, unsafe abortion and death. However, information regarding the status and affecting factors of literacy in the reproductive and sexual health of adolescents is scarce. OBJECTIVE: To assess reproductive and sexual health literacy status and associated factors among late-adolescent high school students. DESIGN: A cross-sectional, institution-based study. SETTING: The study included eight secondary schools in Arba Minch town (Gamo Zone) and three in Sawla town (Gofa Zone) in the South Ethiopia Region. METHODS: The study was done between 20 May and 20 June 2023, among late adolescent high school students. Using multistage sampling, 577 students were recruited. Reproductive health literacy was assessed using the Health Literacy Measure for Adolescents tool. Data were loaded into EpiData-V.3.1 and analysed using SPSS-V.25. Binary logistic regression analyses were used to identify associated factors. Variables with a p value <0.25 in bivariable logistic regression were candidates for multivariable logistic regression. A Hosmer-Lemeshow goodness-of-fit statistic was checked and satisfied. Statistical significance was indicated at a p value<0.05. RESULT: The proportion of students with limited reproductive and sexual health literacy was 69.6% (CI 65.3% to 72.8%). The limited literacy status was significantly associated with school type (public school AOR 0.28 (0.17 to 0.46)), mother's occupation (merchant AOR 0.42 (0.23 to 0.76)), family monthly income (income 10 000-20 000 birr AOR 0.45 (0.22 to 0.95)), having regular physical exercise >30 min (more than once per week, AOR 0.44 (0.23 to 0.84)), and knowledge about condoms (poor AOR 2.23 (1.38 to 3.64)). CONCLUSION: A notable segment of adolescents exhibited limited reproductive and sexual health literacy. The result emphasises the necessity of all relevant parties to work diligently to guarantee that school adolescents can easily obtain, comprehend, evaluate and use reproductive and sexuality-related information.
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Conocimientos, Actitudes y Práctica en Salud , Alfabetización en Salud , Salud Reproductiva , Salud Sexual , Estudiantes , Humanos , Adolescente , Etiopía , Estudios Transversales , Femenino , Masculino , Estudiantes/estadística & datos numéricos , Estudiantes/psicología , Embarazo , Encuestas y Cuestionarios , Instituciones Académicas , Conducta Sexual/estadística & datos numéricosRESUMEN
BACKGROUND: Premarital sexual intercourse has essential implications for the sexual and reproductive health and rights of young women. These include increased sexual pleasure and satisfaction as well as exposure to the risks of unintended pregnancy and sexually transmitted infections, including HIV/AIDS. This study examined the trends, patterns, and associations of premarital sexual intercourse among young women aged 15-24 in Sierra Leone. METHODS: Nationally representative cross-sectional data from the 2008, 2013, and 2019 Demographic and Health Surveys in Sierra Leone were used for the study. A weighted sample of 9,675 never-married young women was used to estimate the pooled prevalence of premarital sexual intercourse in Sierra Leone. Percentages were used to present the results of the trends and patterns of premarital sexual intercourse. We employed a multilevel binary logistic regression modelling technique to examine the associations of premarital sexual intercourse. The results were presented using adjusted odds ratio with their respective 95% confidence interval. RESULTS: The pooled prevalence of premarital sexual intercourse among the young women in Sierra Leone was 62.9%. Over the survey years, premarital sexual intercourse increased from 59.8% in 2008 to 65.1% in 2013. However, it declined by 3.5% to 61.6% in 2019. Young women aged 20-24 (aOR = 12.47, 95% CI = 10.54-14.76) had higher odds of engaging in premarital sexual intercourse than those aged 15-19. Young women with higher educational levels (aOR = 1.87, 95% CI = 1.17-2.99), those who were working (aOR = 1.60, 95% CI = 1.44-1.78), those who listened to the radio (aOR = 1.33, 95% CI = 1.29-1.60), and those who lived in the Northwestern (aOR = 2.19, 95% CI = 1.68-2.84), Eastern (aOR = 1.47, 95% CI = 1.23-1.760, Northern (aOR = 1.48, 95% CI = 1.25 -, 1.76), and Southern (aOR = 1.63, 95% CI = 1.36-1.94) regions were more likely to engage in premarital sexual intercourse compared to those with no formal education, those not working, those who did not listen to the radio, and those who lived in the Western region, respectively. Young women in the richest wealth category (aOR = 0.62, 95% CI = 0.49-0.78), and residing in rural areas (aOR = 0.84, 95% CI = 0.72-0.98) had lower odds of engaging in premarital sexual intercourse relative to those from the poorest wealth quintile and those living in urban areas. CONCLUSION: Our study found a high prevalence of premarital sexual intercourse among young women in Sierra Leone. Premarital sexual intercourse was associated with age, educational level, wealth, employment, and region. This necessitates providing them with comprehensive information regarding sexual and reproductive health behaviours, specifically emphasising the benefits and adverse consequences of engaging in sexual experimentation. Additionally, it is crucial to promote the adoption of abstinence, injections, implants, and condom usage through consistent advocacy for youth-risk communication.
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Conducta Sexual , Humanos , Femenino , Adolescente , Adulto Joven , Sierra Leona/epidemiología , Estudios Transversales , Conducta Sexual/estadística & datos numéricos , Coito , Adulto , Prevalencia , Persona Soltera/estadística & datos numéricosRESUMEN
BACKGROUND: This study aimed to examine the transmission dynamics of Neisseria gonorrhoeae (NG) in heterosexual sex work networks (HSWNs) and the impact of variation in sexual behavior and interventions on NG epidemiology. METHODS: The study employed an individual-based mathematical model to simulate NG transmission dynamics in sexual networks involving female sex workers (FSWs) and their clients, primarily focusing on the Middle East and North Africa region. A deterministic model was also used to describe NG transmission from clients to their spouses. RESULTS: NG epidemiology in HSWNs displays two distinct patterns. In the common low-partner-number HSWNs, a significant proportion of NG incidence occurs among FSWs, with NG prevalence 13 times higher among FSWs than clients, and three times higher among clients than their spouses. Interventions substantially reduce incidence. Increasing condom use from 10â¯% to 50â¯% lowers NG prevalence among FSWs, clients, and their spouses from 12.2â¯% to 6.4 %, 1.2 % to 0.5 %, and 0.4 % to 0.2 %, respectively. Increasing symptomatic treatment coverage among FSWs from 0â¯% to 100â¯% decreases prevalence from 10.6â¯% to 4.5 %, 0.8 % to 0.4 %, and 0.3 % to 0.1 %, respectively. Increasing asymptomatic treatment coverage among FSWs from 0â¯% to 50â¯% decreases prevalence from 8.2â¯% to 0.4 %, 0.6 % to 0.1 %, and 0.2 % to 0.0 %, respectively, with very low prevalence when coverage exceeds 50â¯%. In high-partner-number HSWNs, prevalence among FSWs saturates at a high level, and the vast majority of incidence occurs among clients and their spouses, with a limited impact of incremental increases in interventions. CONCLUSION: NG epidemiology in HSWNs is typically a "fragile epidemiology" that is responsive to a range of interventions even if the interventions are incremental, partially efficacious, and only applied to FSWs.
Asunto(s)
Gonorrea , Modelos Teóricos , Neisseria gonorrhoeae , Trabajadores Sexuales , Humanos , Trabajadores Sexuales/estadística & datos numéricos , Femenino , Gonorrea/epidemiología , Gonorrea/transmisión , Conducta Sexual/estadística & datos numéricos , Prevalencia , Incidencia , Parejas Sexuales , Adulto , Medio Oriente/epidemiología , Masculino , Condones/estadística & datos numéricosRESUMEN
Previous studies have shown that men who have sex with men (MSM) with different anal sexual roles, namely bottom, versatile, and top, are at different risk of HIV infection and psychological distress. However, the evidence was primarily derived from cross-sectional designs from Western countries, and it remains unclear how anal sexual roles change over a long time and their health impacts among MSM from Eastern countries. We aimed to describe the changes in anal sexual roles among a Chinese sample of MSM over 14 years and explore their effects on HIV infection, depression, anxiety, and suicidal ideation. Between 2009 and 2023, a longitudinal study was conducted on 373 MSM in Changsha, China, to assess their anal sexual roles, HIV infection, and psychological distress, including depression, anxiety, and suicidal ideation. Generalized linear models with a binomial probability was used to analyze the predictive effect of anal sexual roles on HIV infection and psychological distress. At baseline, 30.3% of MSM self-identified as bottom, 32.2% as versatile, and 37.5% as top, and these numbers changed slightly to 35.9%, 33.0%, and 31.1%, respectively, at follow-up (p = 0.131). From baseline to follow-up, 48 (12.9%) new HIV cases were identified. The prevalence of depression increased from 23.1 to 38.1% (p < 0.001), anxiety increased from 25.5% to 35.4% (p = 0.003), and suicidal ideation increased from 30.8 to 38.9% (p = 0.021). MSM with bottom and versatile roles were more likely to have HIV infection, depression, anxiety, and suicidal ideation than those with top roles. MSM's risk of HIV infection and psychological distress varies according to their anal sexual roles, suggesting that future HIV prevention and mental health improvement programs for MSM may benefit from providing targeted and individualized support based on their anal sexual roles, with a particular focus on those with bottom and versatile roles.
Asunto(s)
Depresión , Infecciones por VIH , Homosexualidad Masculina , Distrés Psicológico , Conducta Sexual , Ideación Suicida , Humanos , Masculino , Infecciones por VIH/epidemiología , Infecciones por VIH/psicología , Homosexualidad Masculina/psicología , Homosexualidad Masculina/estadística & datos numéricos , Estudios Longitudinales , China/epidemiología , Adulto , Conducta Sexual/psicología , Conducta Sexual/estadística & datos numéricos , Depresión/epidemiología , Depresión/psicología , Ansiedad/epidemiología , Ansiedad/psicología , Adulto Joven , AdolescenteRESUMEN
Substance use is a significant risk factor for HIV infection among adolescent men who have sex with men (AMSM). Substance use may reduce the use of HIV prevention measures or increase the likelihood of engaging in activities with a higher risk of HIV transmission, but there is a lack of studies dedicated to analyzing these mechanisms in adolescents and young MSM. This study aimed to explore the impact of substance use on condomless anal sex (CAS) in a large, racially diverse sample of AMSM. Additionally, we investigated how an individual's general level of substance use moderated the association between substance use before sex and CAS at the partnership level. Baseline data for an HIV prevention intervention were collected through online surveys from April 2018 to June 2020. The sample consisted of 1624 AMSM (M age, 16.69 years) who reported at least one sexual partner in the previous 3 months. Participants provided information about their three most recent sexual partners, including their relationship to the partner, PrEP use, frequency of alcohol, marijuana, and non-prescription drug use before sex, and the number of CAS acts. Participants also completed measures of their substance use frequency. Multilevel modeling in Mplus was used for data analysis, accounting for sexual partnerships nested within participants. All models controlled for PrEP use and relationship status. Results revealed a significant positive association between the frequency of non-prescription drug use before sex and CAS at the partnership level. This indicates that higher non-prescription drug use frequency before sex was associated with a greater number of CAS acts with partners. Moreover, the cross-level interaction between alcohol frequency and non-prescription drug use before sex was statistically significant. Specifically, for participants with high alcohol frequency scores, there was a significant positive association between non-prescription drug use before sex and CAS at the partnership level. AMSM with higher average alcohol consumption were more likely to engage in CAS when using non-prescription drugs prior to sex with a partner, compared to those with lower alcohol consumption. This study's use of multilevel data analysis contributes innovatively to the field by shedding light on how substance use operates within sexual relationships and different partnership dynamics. Tailored interventions targeting substance use should be developed to reduce HIV risk among AMSM.
Asunto(s)
Infecciones por VIH , Homosexualidad Masculina , Parejas Sexuales , Trastornos Relacionados con Sustancias , Sexo Inseguro , Humanos , Masculino , Adolescente , Homosexualidad Masculina/estadística & datos numéricos , Homosexualidad Masculina/psicología , Trastornos Relacionados con Sustancias/epidemiología , Parejas Sexuales/psicología , Sexo Inseguro/estadística & datos numéricos , Infecciones por VIH/prevención & control , Conducta Sexual/estadística & datos numéricos , Conducta Sexual/psicología , Adulto Joven , Factores de Riesgo , Asunción de RiesgosRESUMEN
Paid sex is associated with HIV and other sexually transmitted infections, which are highly prevalent in Sub-Saharan Africa (SSA). However, few data exist on this sexual practice among the general population in SSA, including the Democratic Republic of the Congo, where data on paid sex mainly comes from sex workers. In the DRC, most HIV Voluntary Counseling and Testing (VCT) centers do not discuss paid sex as a risk factor. Thus, we aimed to analyze the prevalence of paid sex, its associated factors and association with HIV among women and men attending HIV VCT at a reference hospital in Kinshasa. From 2016 to 2018, the Observational Kinshasa AIDS Initiative cohort analyzed the impact of HIV VCT on changes in HIV knowledge, attitudes, and sexual behaviors at follow-up. Participants aged 15-69 years were HIV tested and interviewed at baseline and at 6- and 12-month follow-ups. At baseline, participants were asked about their history of "ever" having had exchanged sex for money. At both follow-ups, the frequency of this practice was referred to as "the previous 6 months." Descriptive, bivariate, and multivariate logistic regression analyses were carried out to evaluate the prevalence of paid sex, its associated factors, and the association between paid sex and HIV. Statistical analyses were performed with Stata 15.1. Among 797 participants at baseline, 10% of those sexually experienced reported having ever had paid sex (18% men and 4% women, p < 0.001). At 6 and 12-month follow-ups, 5% and 2%, respectively. Paid sex was significantly and independently associated with being male (aOR = 2.7; 95% CI = 1.4-5.2), working or studying (aOR = 2.8; 95% CI = 1.5-5.0), daily newspaper reading (aOR = 4.4; 95% CI = 1.7-11.2); daily/weekly alcohol consumption (aOR = 3.3; 95% CI = 1.8-6.1), first sexual intercourse before age 15 years (aOR = 2.3; 95% CI = 1.1-5.0), multiple sexual partners (aOR = 4.1; 95% CI = 2.2-7.7), and extragenital sexual practices (aOR = 2.4; 95% CI = 1.3-4.4). A high religiosity (daily/weekly church attendance and praying) was inversely associated with paid sex (aOR = 0.1; 95% CI = 0.0-0.4). The high prevalence of paid sex among people attending HIV VCT in Kinshasa, associated with other sexual and consumption risk behaviors, highlights the need to include paid sex among the risk factors mentioned in HIV prevention counseling.
Asunto(s)
Consejo , Infecciones por VIH , Conducta Sexual , Humanos , Masculino , República Democrática del Congo/epidemiología , Adulto , Femenino , Infecciones por VIH/epidemiología , Persona de Mediana Edad , Prevalencia , Adolescente , Estudios Prospectivos , Consejo/estadística & datos numéricos , Adulto Joven , Conducta Sexual/estadística & datos numéricos , Trabajo Sexual/estadística & datos numéricos , Factores de Riesgo , Conocimientos, Actitudes y Práctica en Salud , Anciano , Prueba de VIH/estadística & datos numéricos , Trabajadores Sexuales/estadística & datos numéricos , Trabajadores Sexuales/psicologíaRESUMEN
Sexualized substance use or "chemsex" may contribute to the HIV epidemic among men who have sex with men (MSM) in Thailand. Specific patterns of chemsex use may be associated with different HIV/STI transmission risks. We examined typologies and correlates of sexualized substance use among a sample of high-risk MSM (n = 532) who had attended a private sex party or circuit party in the past three years using latent class analysis. Multinomial regression was used to adjust for variables associated with the 3-class latent class model. We identified a 3-class model as the best fitting model, which included: (1) "negligible sexualized substance users" (36.7%), who had never engaged in chemsex in the past six months; (2) "sexualized substance users" (13.9%), who had a high level of sexualized alcohol use and a wide range of other substances before or during sex in the past six months; and (3) "exclusive chemsex users" (49.4%), who predominantly used crystal methamphetamine, amyl nitrite, and erectile dysfunctional drugs before or during sex in the past six months. Compared to negligible sexualized substance users, exclusive chemsex users were more likely to be HIV-positive, more likely to have six or more sexual partners in the past six months, less likely to have condom use at last anal intercourse, and more likely to have provided sex work. Relative to negligible sexualized substance users, sexualized substance users reported more frequent online sex-seeking behaviors. These subgroups of Thai MSM have unique substance use patterns and HIV-related risk profiles, underscoring the importance of targeted HIV prevention strategies.
Asunto(s)
Infecciones por VIH , Homosexualidad Masculina , Análisis de Clases Latentes , Asunción de Riesgos , Trastornos Relacionados con Sustancias , Humanos , Masculino , Tailandia/epidemiología , Homosexualidad Masculina/estadística & datos numéricos , Homosexualidad Masculina/psicología , Infecciones por VIH/transmisión , Infecciones por VIH/epidemiología , Adulto , Trastornos Relacionados con Sustancias/epidemiología , Conducta Sexual/estadística & datos numéricos , Conducta Sexual/psicología , Parejas Sexuales/psicología , Sexo Inseguro/estadística & datos numéricos , Sexo Inseguro/psicología , Adulto JovenRESUMEN
BACKGROUND: Previous studies showed that comorbidity and demographic factors added to burden on health-related quality of life (HRQoL). Only one study explored the relationship between HRQoL and comorbidity in college students with mental disorders, leaving generalizability of findings uncertain. Less is known about the association of demographics on HRQoL. This study investigated HRQoL based on demographics and comorbidity among college students with mental disorders. METHODS: Participants were students (N = 5535) across 26 U.S. colleges and universities who met criteria for depression, generalized anxiety, panic, social anxiety, post-traumatic stress, or eating disorders based on self-report measures. ANOVA and linear regressions were conducted. RESULTS: Overall, female, minoritized (gender, sexual orientation, race, or ethnicity), and lower socioeconomic status students reported lower HRQoL than male, heterosexual, White, non-Hispanic, and higher socioeconomic status peers. After accounting for comorbidity, differences in physical HRQoL based on sex assigned at birth and gender were no longer significant. For mental HRQoL, only gender and sexual orientation remained significant. A greater number of comorbidities was associated with lower HRQoL regardless of demographic group. LIMITATIONS: The non-experimental design limits causal inference. The study focused on univariable associations without examining potential interactions between demographic factors. Future research should explore structural factors like discrimination. CONCLUSION: Results suggested that increased comorbidities placed an additional burden on HRQoL and that certain demographic groups were more vulnerable to HRQoL impairment among students with mental disorders. Findings suggest the need for prevention of disorders and their comorbidity and implementing tailored interventions for specific student subgroups with increased vulnerability.
Asunto(s)
Comorbilidad , Trastornos de Alimentación y de la Ingestión de Alimentos , Calidad de Vida , Estudiantes , Humanos , Femenino , Masculino , Calidad de Vida/psicología , Estudiantes/estadística & datos numéricos , Estudiantes/psicología , Adulto Joven , Universidades , Trastornos de Alimentación y de la Ingestión de Alimentos/epidemiología , Trastornos de Alimentación y de la Ingestión de Alimentos/psicología , Adulto , Identidad de Género , Adolescente , Etnicidad/estadística & datos numéricos , Etnicidad/psicología , Estrés Financiero/psicología , Estrés Financiero/epidemiología , Trastornos de Ansiedad/epidemiología , Trastornos de Ansiedad/psicología , Conducta Sexual/estadística & datos numéricos , Conducta Sexual/psicología , Estados Unidos/epidemiología , Escolaridad , Grupos Raciales/estadística & datos numéricos , Grupos Raciales/psicología , Padres/psicología , Depresión/epidemiología , Depresión/psicología , Ansiedad/epidemiología , Ansiedad/psicología , Trastornos Mentales/epidemiología , Trastornos Mentales/psicologíaRESUMEN
BACKGROUND: Disasters are increasing in frequency and intensity due to climate change. Youth are the largest and most vulnerable group exposed to disasters. More evidence is needed regarding how youth mental health and health behaviors vary based on disaster exposure, how mental health influences health behaviors, and how diverse groups of youth may be differentially affected. METHODS: Using data from the Youth Risk Behavior Survey and Federal Emergency Management Agency, we examined the impact of Hurricane Sandy (2012) on mental health (sadness, suicidality) and health behaviors (substance use, physical activity, screen time, sexual behaviors) of 240,365 youth. Difference-in-differences regression analyses evaluated pre-disaster (2005-2011) and post-disaster (2013-2019) changes. RESULTS: There were 83,442 (34.7 %) adolescents (51.2 % female, 18.1 % non-Hispanic White) located in 6 districts exposed to Hurricane Sandy and 156,923 (65.3 %) adolescents located in 13 non-exposed districts. Exposure was associated with differences in substance use, physical (in)activity, and risky sexual behaviors, but not mental health outcomes. Mental health did not moderate the association between disaster exposure and health behaviors. Hispanic adolescents and those identifying as Other races/ethnicities were most vulnerable to post-disaster negative health outcomes. LIMITATIONS: Study limitations include questionnaire design, cross-sectional data, sampling, and possible response biases. CONCLUSIONS: Findings provide critical information about youth mental health and health behaviors following disasters, as well as how youth may differ in their responses. Findings provide guidance for early identification and resource allocation for youth at higher risk for post-disaster health issues.