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Leung J, Lim C, Belete H, Mcclure-Thomas C, Foo S, Chan GCK. Regional and Country Prevalence Estimates of Unsafe Sex Among Adolescents in 68 Low-Income and Middle-Income Countries. Arch Sex Behav 2024:10.1007/s10508-024-02861-1. [PMID: 38637452 DOI: 10.1007/s10508-024-02861-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Revised: 03/24/2024] [Accepted: 03/25/2024] [Indexed: 04/20/2024]
Abstract
Prioritizing adolescent health is a public health priority to achieve the sustainable development goals, including reducing the risk of unsafe sex. Data on unsafe sex have remained scarce among adolescents in low-and middle-income countries (LMICs). To estimate the prevalence of unsafe sex in LMICs, we conducted secondary data analysis on the Global School-based Student Health Surveys among 244,863 students aged 13-17 years from 68 countries across five World Health Organization regions. The overall prevalence of ever had sex was 16.2%. The highest to lowest regional prevalence estimation of ever had sex was 30.5% (28.9-32.1) in the Americas, 28.6% (26.8-30.4) in Africa, 10.9% (9.2-12.6) in the Eastern Mediterranean, 9.6% (8.8-10.5) in South-East Asia, and 8.0% (6.8-9.1) in the Western Pacific. The highest prevalence of sexual intercourse before age 14 and practicing sexual intercourse without condom use were 36.5% (34.5-38.5) and 32.2% (30.1-34.3) in Africa, respectively. Findings suggest that current interventions are inadequate in promoting the uptake of safe sexual behaviors and an urgent intervention is needed.
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Affiliation(s)
- Janni Leung
- Faculty of Health and Behavioural Sciences, National Centre for Youth Substance Use Research, The University of Queensland, 31 Upland Road, St. Lucia, QLD, 4067, Australia
| | - Carmen Lim
- Faculty of Health and Behavioural Sciences, National Centre for Youth Substance Use Research, The University of Queensland, 31 Upland Road, St. Lucia, QLD, 4067, Australia
| | - Habte Belete
- Faculty of Health and Behavioural Sciences, National Centre for Youth Substance Use Research, The University of Queensland, 31 Upland Road, St. Lucia, QLD, 4067, Australia.
- Department of Psychiatry, Bahir Dar University, Bahir Dar, Ethiopia.
| | - Caitlin Mcclure-Thomas
- Faculty of Health and Behavioural Sciences, National Centre for Youth Substance Use Research, The University of Queensland, 31 Upland Road, St. Lucia, QLD, 4067, Australia
| | - Shaun Foo
- Faculty of Health and Behavioural Sciences, National Centre for Youth Substance Use Research, The University of Queensland, 31 Upland Road, St. Lucia, QLD, 4067, Australia
| | - Gary Chung Kai Chan
- Faculty of Health and Behavioural Sciences, National Centre for Youth Substance Use Research, The University of Queensland, 31 Upland Road, St. Lucia, QLD, 4067, Australia
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Velasco-Gijón IM, Polo-Oliver A, Gutiérrez-Ramírez L, Arias-Arias Á, Tejera-Muñoz A. [Survey to know the perception of sexual education in adolescents]. Rev Esp Salud Publica 2024; 98:e202402005. [PMID: 38333924] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Accepted: 11/29/2023] [Indexed: 02/10/2024] Open
Abstract
OBJECTIVE Sex education is essential for an accurate approach of sexuality in adolescents, being more effective when it is carried out at early ages. This study aimed to estimate the sexual health knowledge and the information in this regard perceived by adolescents, as well as where it came from. METHODS A cross-sectional observational study was performed in students from two public high schools in Castilla-La Mancha who were surveyed about sexual knowledge. Comparisons were made by using the Student's t test or Mann Whitney U test, the Chi-square test (or Fisher's exact test) depending on the variables. RESULTS 248 students were included (68.1% from Madridejos and 31.9% from Herencia) with a mean age of 14.67±1.1 years. The 47.2% were women. Only 4.8% of the participants affirm to talk about sexuality with their parents. The 56% declared had consumed pornographic content, with a mean first access age of 12.8±1 years. Significant statistically differences were found between the information received in schools and in the familiar surroundings, being alcohol and drug intake, sexually transmitted infections (STI), and contraceptive methods more frequently treated at the educational centers. A 25% of the surveyed students who reported having performed sexual relations stated not having used condom. Approximately, half of the participants did not perceive a high risk of getting STIs (HIV, herpes and chlamydia) in the case of having sex without condom. CONCLUSIONS There is a lack of sexual knowledge in adolescents, perceiving a noteworthy heterogeneity in the offered information depending on it is received in high school or in familiar surroundings.
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Affiliation(s)
- Isabel M Velasco-Gijón
- Centro de Salud de Madridejos; GAI Alcázar de San Juan. Alcázar de San Juan (Ciudad Real). España
| | - Ana Polo-Oliver
- Centro de Salud Alcázar I; GAI Alcázar de San Juan. Alcázar de San Juan (Ciudad Real). España
| | - Lucía Gutiérrez-Ramírez
- Unidad de Apoyo a la Investigación; Hospital Mancha Centro. Alcázar de San Juan (Ciudad Real). España
- Instituto de Investigación de Castilla-La Mancha (IDISCAM). Toledo. España
- Fundación del Hospital Nacional de Parapléjicos para la Investigación y la Integración. Toledo. España
| | - Ángel Arias-Arias
- Unidad de Apoyo a la Investigación; Hospital Mancha Centro. Alcázar de San Juan (Ciudad Real). España
- Instituto de Investigación de Castilla-La Mancha (IDISCAM). Toledo. España
| | - Antonio Tejera-Muñoz
- Unidad de Apoyo a la Investigación; Hospital Mancha Centro. Alcázar de San Juan (Ciudad Real). España
- Instituto de Investigación de Castilla-La Mancha (IDISCAM). Toledo. España
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Jahdi F, Ebadi A, Oskouie F, Kashanian M, Merghati-Khoei E. Development and psychometric evaluation of a Risky Sexual Behaviour Scale for Married Women (RSBS-MW) in Iran: a mixed-method study. HUM FERTIL 2023; 26:1286-1298. [PMID: 36644874 DOI: 10.1080/14647273.2023.2164940] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2022] [Accepted: 10/09/2022] [Indexed: 01/17/2023]
Abstract
A valid and reliable culture-based scale for the evaluation of risky sexual behaviours for married Iranian women is lacking. This study aimed to develop, and psychometrically test, a risky sexual behaviour scale for married Iranian women. A mixed-method sequential exploratory design was conducted from 2016 to 2020 in Tehran, Iran. First, a qualitative study was employed to define the concept of risky sexual behaviour using 16 semi-structured individual interviews and 10 focus group discussions (n = 100). Then, an item pool was generated, and the scale was developed. Finally, in the quantitative study, the psychometric properties of the scale were evaluated by validity and reliability tests. A maximum likelihood extraction with promax rotation was performed on 400 sexually active married women to assess the construct validity. The six components: (i) 'quality of sexual relations'; (ii) 'unusual pleasures in sexual relations'; (iii) 'sexual coercion'; (iv) 'verbal violence in sexual relations'; (v) 'self-care in sexual relations'; and (vi) 'concealment in sexual relations' could explain 57.49% of the total observed variance. The findings showed that the 27-item Risky Sexual Behaviour Scale (RSBS-MW) for married women in Iran has excellent internal consistency (α = 0.94) and stability (ICC = 0.98). Health care providers can use it to access risky sexual behaviours in married Iranian women.
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Affiliation(s)
- Fereshteh Jahdi
- Nursing and Midwifery Care Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Abbas Ebadi
- Behavioral Sciences Research Center, Life Style Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran
- School of Nursing, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Fatemeh Oskouie
- Nursing and Midwifery Care Research Center, Iran University of Medical Sciences, Tehran, Iran
- School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran
| | - Maryam Kashanian
- Department of Obstetrics and Gynecology, Iran University of Medical Sciences, Tehran, Iran
| | - Effat Merghati-Khoei
- Iranian National Center for Addiction Studies (INCAS), Institute for High-Risk Behavior Reduction, Tehran University of Medical Sciences, Tehran, Iran
- Brain and Spinal Cord Injury Research Center, Neuroscience Institution, Tehran University of Medical Sciences, Tehran, Iran
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Hayashi K, Wakabayashi C, Ikushima Y, Tarui M. Characterizing changes in drug use behaviour following supply shortages of 5-MeO-DIPT, alkyl nitrites and new psychoactive substances among men living with HIV in Japan. Int J Drug Policy 2023; 118:104080. [PMID: 37307787 DOI: 10.1016/j.drugpo.2023.104080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Revised: 04/13/2023] [Accepted: 05/26/2023] [Indexed: 06/14/2023]
Abstract
BACKGROUND Since 2005, Japan has incrementally banned a range of new psychoactive substances (NPS), including 5-MeO-DIPT (5MO; foxy) and alkyl nitrites (AN; rush, poppers) that have commonly been used among men who have sex with men (MSM). After the largest ban in 2014, these drugs were reported to have disappeared from the domestic market. Given that 5MO/AN/NPS use has been prevalent among men living with HIV in Japan, a population largely comprised of MSM, we sought to characterize changes in their drug use behavior following the supply shortages. METHODS Using data from two waves of a nationwide survey of people living with HIV in Japan in 2013 and 2019-20 (n = 1042), we employed multivariable modified Poisson regression to identify correlates of self-reported reactions to the 5MO/AN/NPS shortages and changes in drug use behavior in 2019-20 vs. 2013. RESULTS Among 391 men (96.7% MSM) surveyed in 2019-20, following the supply shortages, 234 (59.8%) stopped using 5MO/AN/NPS, 52 (13.3%) retained access to the supply, and 117 (29.9%) used substitute drugs: most commonly, methamphetamine (60.7%). Individuals who used substitutes were more likely to report unprotected sex (adjusted relative risk [ARR]=1.67; 95% confidence interval [CI]: 1.13-2.47) as well as low (ARR=2.35; 95% CI: 1.46-3.79) and lower middle (vs. upper middle to high) socioeconomic status (ARR=1.55; 95% CI: 1.00-2.41). The prevalence of past-year methamphetamine use (ARR=1.93; 95% CI: 1.11-3.35) and self-reported uncontrollable drug use (ARR=1.62; 95% CI: 1.07-2.53) were significantly higher in 2019-20 compared to 2013. CONCLUSION Following the supply shortages, approximately one-fifth of our participants used methamphetamine as a substitute for 5MO/AN/NPS. Methamphetamine use and perceived uncontrollable drug use also appeared to have increased at the population level after the supply shortages. These findings suggest a potentially harmful substance displacement effect of the aggressive ban. Harm reduction interventions are needed in this population.
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Affiliation(s)
- Kanna Hayashi
- Faculty of Health Sciences, Simon Fraser University, Blusson Hall, Room 11300, 8888 University Drive, Burnaby, BC V5A 1S6, Canada; British Columbia Centre on Substance Use, 400-1045 Howe Street, Vancouver, BC V6Z 2A9, Canada.
| | - Chihiro Wakabayashi
- Department of Health Sciences, Saitama Prefectural University, 820 Sannomiya, Koshigaya-shi, Saitama 343-8540, Japan
| | - Yuzuru Ikushima
- Positive Living and Community Empowerment Tokyo (PLACE TOKYO), 4-11-5-403 Takadanobaba, Shinjuku-ku, Tokyo 169-0075, Japan
| | - Masayoshi Tarui
- Faculty of Letters, Keio University, 2-15-45 Mita, Minato-ku, Tokyo 108-8345, Japan
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Reyes BD, Hargreaves DS, Creese H. Early-life maternal attachment and risky health behaviours in adolescence: findings from the United Kingdom Millennium Cohort Study. BMC Public Health 2021; 21:2039. [PMID: 34749702 PMCID: PMC8577004 DOI: 10.1186/s12889-021-12141-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Accepted: 10/27/2021] [Indexed: 11/29/2022] Open
Abstract
Background Early uptake of multiple risky behaviours during adolescence, such as substance use, antisocial and sexual behaviours, can lead to poor health outcomes without timely interventions. This study investigated how early-life maternal attachment, or emotional bonds between mothers and infants, influenced later risky behaviours in adolescence alongside other potential explanatory pathways using the United Kingdom Millennium Cohort Study. Methods Total maternal attachment scores measured at 9 months using the Condon (1998) Maternal Postnatal Attachment Scale compared higher and lower attachment, where mothers in the lowest 10th percentile represented lower attachment. Multiple risky behaviours, defined as two or more risky behaviours (including smoking cigarettes, vaping, alcohol consumption, illegal drug use, antisocial behaviour, criminal engagement, unsafe sex, and gambling), were scored from 0 to 8 at age 17. Five multivariate logistic regression models examined associations between maternal attachment and multiple risky behaviours among Millennium Cohort Study members (n = 7796). Mediation analysis sequentially adjusted for blocks of explanatory mechanisms, including low attachment mechanisms (multiple births, infant prematurity, sex, breastfeeding, unplanned pregnancy and maternal age at birth), maternal depression, and social inequalities (single-parent status, socioeconomic circumstance by maternal education and household income) at 9 months and poor adolescent mental health at 14 years. Results Children of mothers with lower maternal attachment at 9 months had 23% increased odds of multiple risky behaviours at 17 years (OR: 1.23, 95% CI: 1.00–1.50) in the unadjusted baseline model. All five explanatory blocks attenuated baseline odds. Low attachment mechanisms attenuated 13%, social inequalities 17%, and poor mental health 17%. Maternal depression attenuated the highest proportion (26%) after fully adjusting for all factors (30%). Conclusions Lower maternal attachment in early life predicted increased adolescent multiple risky behaviours. Almost a third of the excess risk was attributable to child, maternal and socioeconomic factors, with over a quarter explained by maternal depression. Recognising the influence of early-life risk factors on adolescent health could innovate current policies and interventions addressing multiple risky behaviour uptake affecting health inequalities across the life course. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-021-12141-5.
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Affiliation(s)
- Beatrice D Reyes
- Department of Primary Care and Public Health, School of Public Health, Imperial College London, W6 8RP, London, UK.
| | - Dougal S Hargreaves
- Department of Primary Care and Public Health, School of Public Health, Imperial College London, W6 8RP, London, UK
| | - Hanna Creese
- Department of Primary Care and Public Health, School of Public Health, Imperial College London, W6 8RP, London, UK
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Dalimi A, Payameni S. Trichomonas Vaginalis Infection in Men with High-Risk Sexual Behaviors. Iran J Parasitol 2021; 16:411-417. [PMID: 34630586 PMCID: PMC8476721 DOI: 10.18502/ijpa.v16i3.7094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/21/2020] [Accepted: 10/19/2020] [Indexed: 11/24/2022]
Abstract
Background: Trichomonas vaginalis is a protozoan pathogen of the human genitourinary tract, which is the cause of trichomoniasis. The disease is one of the most important non-viral sexually transmitted infections in the world. Many studies have been performed on the molecular identification of Trichomonas in men in different parts of the world, but in Iran, such a study has been very limited. We aimed to detect T. vaginalis in urine of men with unusual sexual behavior by wet mount microscopic observation, culturing in TYM-33 and molecular method in Tehran, Iran. Methods: Totally, 47 urine samples were collected from men with high-risk sexual behaviors referred to Health Care Centers in South of Tehran, Iran during 2017–2018. After urine centrifugation and wet mount sediment preparation, the samples were cultured in TYM-33 medium and examined microscopically. Then DNA was extracted from urine sediment samples and finally the 18srRNA gene was amplified by PCR. Results: Thirty-one (65.95%) urine samples were positive for T. vaginalis by PCR. Of these, only 6 (12.76%) were detected positive by wet mount method and 25 (53.19%) by culture and successive passages. Conclusion: The high prevalence of trichomoniasis among men with high-risk sexual behavior in Tehran indicates a potent health risk condition for families. Of course, this percentage is not the real infection rate in ordinary men in Tehran. This situation could be controlled by promoting concurrent diagnosis and treatment of T. vaginalis infection in men and women, as well as strengthening religious beliefs and health education in the individuals.
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Affiliation(s)
- Abdolhossein Dalimi
- Department of Parasitology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - Samira Payameni
- Department of Parasitology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
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Valizadeh F, Chaman R, Motaghi Z, Nazari AM. Prevalence of Sexual Transmitted Infections (STIs) and Un-Protected Sex in Temporary Marriage in Iran: A Systematic Review and Meta-Analysis. Iran J Public Health 2021; 50:1156-1166. [PMID: 34540736 PMCID: PMC8410962 DOI: 10.18502/ijph.v50i6.6414] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/05/2020] [Accepted: 11/26/2020] [Indexed: 12/25/2022]
Abstract
Background: Temporary marriage (TM) is legitimate sexual relations without social, moral approval, which can be a threat to individuals’ health, it is a risk factor for spread of Sexual Transmitted Infections (STIs). Therefore, it is necessary to identify and control STIs in TM-individuals and subsequent save of “society health”. In this meat-analysis, we examined the prevalence of STIs in TM in Iran. We further examined un-protected sex among TM-individuals. Method: Up to Feb 2020, we searched international and national electronic databases identify to published studies on the prevalence of STIs in TM. We estimated the prevalence of STIs in TM using a random-effect pooled estimate analysis approach. Results: Totally, we retrieved 1616 studies from the previously mentioned databases, of which, 18 met the eligibility criteria, published from 1995 to 2020 in different provinces. The total sample size of the included studied contained 2056 TM-individuals, of which 368 were found with STIs and 955 with unprotected sex. The pooled prevalence of STIs and unprotected sex among TM women was 39% (95%CI: 24% to 54%), 55% (95%CI: 40% to 70%) Conclusion: STI and unprotected sex are high among TM-individuals which call an urgent need for community and health care providers to provide especially designed medical and psycho-social supportive care services in a safe and unprejudiced environment for TM-individuals. Furthermore, untrained health care providers for TM-individuals, under reporting, social stigma should be taken in to account. Denying the presence of such realities, does not eradicate the facts but results in catastrophic public health problems.
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Affiliation(s)
- Farzaneh Valizadeh
- Student Research Committee, School of Nursing and Midwifery, Shahroud University of Medical Sciences, Shahroud, Iran
| | - Reza Chaman
- Center for Health Related Social and Behavioral Sciences Research, Shahroud University of Medical Sciences, Shahroud, Iran
| | - Zahra Motaghi
- Department of Reproductive Health, Shahroud University of Medical Sciences, Shahroud, Iran
| | - Ali Mohammad Nazari
- Department of Reproductive Health, Shahroud University of Medical Sciences, Shahroud, Iran
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Messersmith LJ, Adjei R, Beard J, Bazzi AR, Earlywine JJ, Darko E, Agyarko-Poku T, Asafo MK, Bempah SA, Adu-Sarkodie Y. High levels of used syringe use and unsafe sex among people who inject drugs in Kumasi, Ghana: an urgent call for a comprehensive harm reduction approach. Harm Reduct J 2021; 18:62. [PMID: 34112187 PMCID: PMC8194176 DOI: 10.1186/s12954-021-00510-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Accepted: 06/01/2021] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Drug use is a growing concern in Ghana. People who inject drugs (PWID) are highly vulnerable to HIV and other infectious diseases. Ghana's National Strategic Plan for HIV/AIDS 2016-2020 identifies PWID as a key population, but efforts to address the needs of PWID have lagged behind those targeting sex workers and men who have sex with men. Lack of information about PWID is a critical barrier to implementing effective HIV prevention and treatment. We aimed to learn more about the vulnerability of the PWID population in order to inform much-needed harm reduction interventions. METHODS From April to July 2018, we conducted a mixed methods study in Kumasi, Ghana, to identify all major drug using locations, count the numbers of PWID to obtain rough population size estimations, and administer anonymous surveys to 221 PWID regarding drug use and sexual behavior. We also tested for HIV, HCV, and HBV from syringes used by survey participants. RESULTS Key informants identified five major drug using locations and estimated the total PWID population size to be between 600 and 2000. Enumerators counted between 35 and 61 individuals present at each of the five bases. Sharing syringes and reusing discarded syringes are common practices. Over half of survey participants (59%) reported past-month syringe sharing (34% used a used syringe and 52% gave away a used syringe). Individuals with higher injection frequency (≥ 21 times weekly) and who injected with four or more people had higher odds of syringe sharing. Of the survey participants reporting sex in the last month (23%), most reported having one partner, but only 12% used condoms. Nearly all women (11/13) reported exchanging sex for drugs and 6/13 reported exchanging sex for money in the last six months. Fifteen percent of participants (all men) reported paying for sex using drugs or money. Of the used syringes, prevalence estimates were 3% (HIV), 2% (HCV), and 9% (HBV). CONCLUSIONS Our findings confirm the urgent need to implement harm reduction interventions targeting PWID and to build a strong and enabling legal and policy environment in Ghana to support these efforts.
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Affiliation(s)
- Lisa J Messersmith
- Department of Global Health, Boston University School of Public Health, 801 Massachusetts Ave., Boston, MA, 02118, USA.
| | - Rose Adjei
- Kwame Nkrumah University of Science and Technology School of Medicine, Kumasi, Ghana
| | - Jennifer Beard
- Department of Global Health, Boston University School of Public Health, 801 Massachusetts Ave., Boston, MA, 02118, USA
| | - Angela R Bazzi
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California, San Diego, La Jolla, CA, USA
| | - Joel J Earlywine
- Department of Health Services, University of Washington, Seattle, WA, 98195, USA
| | - Edwin Darko
- Kwame Nkrumah University of Science and Technology School of Medicine, Kumasi, Ghana
| | | | | | - Sherry Adoma Bempah
- Institute for Distance Learning, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Yaw Adu-Sarkodie
- Kwame Nkrumah University of Science and Technology School of Medicine, Kumasi, Ghana
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Pundhir A, Shukla A, Goel AD, Pundhir P, Gupta MK, Parashar P, Varshney AM. Exploring unsafe sexual practices among truck drivers at Meerut District, India: a cross-sectional study. Afr Health Sci 2021; 21:547-556. [PMID: 34795707 PMCID: PMC8568232 DOI: 10.4314/ahs.v21i2.9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Background Despite implementation of HIV prevention programmes for truck drivers in India, unsafe sex behavior among truck drivers has been documented. Objective The objective of this study was to assess knowledge about HIV Transmission and modes of prevention, pattern of condom use with high risk partners and explore the practice of unsafe sex and its risk factors among truck drivers. Methods This exploratory cross-sectional study design was conducted on a recruited convenient sample of 100 truck drivers above 18 years from March to May 2015. Binary logistic regression was used to compute unadjusted odds ratio [95% Confidence Interval] for establishing association of risk factors with unsafe sex. Results Overall, only 7% had complete knowledge about HIV/AIDS transmission and prevention. 54% of truck drivers have sex with a high risk partner (commercial sexual worker or men having sex with men) and thirty-eight percent reported unsafe sexual practices due to inconsistent condom use with them. The various risk factors found significantly associated with unsafe sex were mean age of first intercourse (OR= 0.92, 95% CI: 0.75 – 0.97), access to pornography (OR = 4.4, 95% CI: 1.8 – 10.7) and conuming psychoactive substance before sex (OR = 4.06, 95% CI: 1.09 – 15.02). Conclusion Socio-demographic, occupational factors, pornography access and consuming psychoactive substances seems to influence the sexual behaviour of truckers.
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Affiliation(s)
- Ashish Pundhir
- Department of Community Medicine Rama Medical College, Kanpur ,Uttar Pradesh India - 209217
| | - Arvind Shukla
- Department of Community Medicine and Family Medicine All India Institute of Medical Sciences-Raipur Raipur, Chattisgarh
| | - Akhil Dhanesh Goel
- Department of Community Medicine and Family Medicine, All India Institute of Medical Sciences Jodhpur, Rajasthan, India
| | - Pooja Pundhir
- Department of Internal Medicine Memorial Hermann Hospital Houston, Texas, USA
| | - Manoj Kumar Gupta
- Department of Community Medicine and Family Medicine, All India Institute of Medical Sciences Jodhpur, Rajasthan, India
| | - Pawan Parashar
- Department of Community Medicine Subharti Medical College Meerut, Uttar Pradesh, India
| | - Amit Mohan Varshney
- Department of Community Medicine Maharani Laxmibai Medical College Jhansi, Uttar Pradesh
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Najafi F, Shadmani FK, Ghalandari M, Darbandi M. Disability-adjusted life years and mortality rate attributed to unsafe sex and drug use for AIDS in the Middle East and North Africa countries. Arch Public Health 2020; 78:130. [PMID: 33298151 PMCID: PMC7724628 DOI: 10.1186/s13690-020-00511-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Accepted: 11/23/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND The Middle East and North Africa, is one of few regions where the number of new human immunodeficiency virus infections is increasing. The present study aimed to estimate the attributable burden of unsafe sex and drug use in Acquired immunodeficiency syndrome in the Middle East and North Africa countries. METHODS We used the Global Burden of Disease data 2017 to estimate the attributable mortality and disability-adjusted life-years to unsafe sex and drug use in Acquired immunodeficiency syndrome in the Middle East and North Africa countries (21 countries) from 1990 to 2017 by region, sex and age. The percent change was calculated at three time points by country and sex. RESULTS The rate of Disability-adjusted life years/100,000 attributed to drug use for Acquired immunodeficiency syndrome increased 1.10 (95% CI: 0.75-1.71) to 13.39 (95% CI: 9.98-18.17) in women of Middle East and North Africa countries from 1990 to 2017, and there is an increasing trend in Disability-adjusted life years attributable to drug use for Acquired immunodeficiency syndrome in men. The rate of Disability-adjusted life years/100,000 attributed to unsafe sex for Acquired immunodeficiency syndrome increased in women of Middle East and North Africa countries, 5.15 (95% CI: 3.34-8.07) to 53.44 (95% CI: 38.79-75.89); and 10.06 (95% CI: 6.61-16.18) to 46.16 (95% CI: 31.30-72.66) in men. Age-standardized mortality rate attributed to drug use and unsafe sex for Acquired immunodeficiency syndrome increased from 1990 to 2017 in both sex in Middle East and North Africa countries. CONCLUSION The rate of Disability-adjusted life years /100,000 and age-standardized mortality rate attributed to unsafe sex and drug use increased in Middle East and North Africa from 1990 to 2017. While most of such countries have traditional cultures with religious believes, such increase need to be addressed in more depth by all policy makers.
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Affiliation(s)
- Farid Najafi
- Research Center for Environmental Determinants of Health (RCEDH), Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
- Cardiovascular Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Fatemeh Khosravi Shadmani
- Research Center for Environmental Determinants of Health (RCEDH), Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Mojtaba Ghalandari
- Mahneshan Health Center, Zanjan University of Medical Sciences, Zanjan, Iran
- Department Epidemiology, Public Health College, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Mitra Darbandi
- Research Center for Environmental Determinants of Health (RCEDH), Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran.
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Sourinejad H, Noroozi M, Taleghani F, Kheirabadi GR. The process of risky sexual behaviors formation in women drug users: a protocol for a grounded theory study. Reprod Health 2020; 17:80. [PMID: 32487219 PMCID: PMC7268307 DOI: 10.1186/s12978-020-00936-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Accepted: 05/25/2020] [Indexed: 11/30/2022] Open
Abstract
Background Drug use is an important underlying factor in risky sexual behaviors. Risky sexual behaviors can lead to STIs and HIV/AIDS, especially in women. For better understanding of the relationship between drug use and risky sexual behaviors in women, it is necessary to identify the process of the formation of these behaviors that is a multidimensional process influenced by multiple socio-cultural factors. Therefore, the present study aims to explore the process of risky sexual behaviors formation in women drug users. Methods This is a grounded theory qualitative study with Corbin and Strauss approach. The participants of the study are women drug users with risky sexual behaviors who, using purposeful sampling method, will be selected from the Counseling and Harm Reduction centers for vulnerable women, the Drug Rehabilitation centers affiliated to the Isfahan University of Medical Sciences, Therapeutic Community Rehabilitation centers, Drop in Centers affiliated to the Welfare Organization, Medium-term Residential centers (women’s camps), and Women’s Empowerment centers in Isfahan, Iran. Sampling will continue using snowball method and the strategy of maximum variation in terms of the age, occupation, education, duration of the drug use, and type of the drug. During the sampling process, theoretical sampling will gradually replace purposeful sampling, so that sampling will proceed based on the emergence of the theory and for understanding of the concept and, then, the next participants will be selected. Sampling will continue until data saturation is reached. Data will be collected using individual semi-structured in-depth interviews, observation, field notes, and memo writing. Data will be coded as they are collected, and the analysis will be performed at three levels of open, axial, and selective coding and based on the constant comparative analysis. The four criteria of credibility, dependability, transferability and confirmability will be used to ensure the trustworthiness of the data. Discussion The findings of the present study are expected to provide a better understanding of the process of risky sexual behaviors formation in women drug users. The findings may also lead to the identification of the barriers and factors contributing to the formation of such behaviors and, finally, will promote the reproductive and sexual health of these women. This study can also provide the guide and the ground for designing and conducting further studies in the related areas through using various qualitative and quantitative methods.
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Affiliation(s)
- Hadis Sourinejad
- Student Research Committee, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mahnaz Noroozi
- Department of Midwifery and Reproductive Health, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran.
| | - Fariba Taleghani
- Department of Adult Health Nursing, School of Nursing & Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Gholam Reza Kheirabadi
- Behavioral Sciences Research Center, Department of Psychiatry, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
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12
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Nguyen BT, Violette C, Li HZ, Jensen JT. Expectations for Sex without Birth Control among Young Men: Risk Factors from the USA National Survey of Reproductive and Contraceptive Knowledge. World J Mens Health 2019; 38:573-581. [PMID: 31749339 PMCID: PMC7502322 DOI: 10.5534/wjmh.190098] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2019] [Revised: 09/16/2019] [Accepted: 09/30/2019] [Indexed: 11/15/2022] Open
Abstract
Purpose Male partner engagement in family planning can influence women's contraceptive behaviors and risk of unintended pregnancy. We identified factors associated with self-reported expectations for future contraceptive use among a nationally-representative sample of young men. Materials and Methods The National Survey of Reproductive and Contraceptive Knowledge asked unmarried, sexually active men (ages, 18–29 y), who were neither involved in nor trying for a pregnancy, about their likelihood of having sex without contraception in the following three months. Demographics, social factors, and contraceptive awareness and attitudes were examined for potential associations using weighted analyses. Results Of 903 men surveyed, nearly 600 were sexually active and expected to have sex in the following 3 months; nearly half (43%) reported at least some likelihood (23% slightly, 7% very, 13% extreme likely) that they would have sex without any contraception. Factors independently associated with sex without contraception included: not completing high school, not being in school full-time, not receiving sex education, limited awareness of contraceptive methods, multiple sexual partners, and friends with unintended pregnancies. Conclusions Despite not wanting a pregnancy, many young men report they will have sex without contraception. While comprehensive sex education may increase contraceptive use, interpersonal and social factors also influence men's expected use of contraception.
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Affiliation(s)
- Brian T Nguyen
- Section of Family Planning, Department of Obstetrics and Gynecology, Keck School of Medicine of the University of Southern California, Los Angeles, CA, USA.,Department of Obstetrics and Gynecology, Oregon Health & Sciences University, Portland, OR, USA.
| | | | - Hong Z Li
- Department of Obstetrics and Gynecology, Oregon Health & Sciences University, Portland, OR, USA
| | - Jeffrey T Jensen
- Department of Obstetrics and Gynecology, Oregon Health & Sciences University, Portland, OR, USA
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Esmaeili A, Shokoohi M, Danesh A, Sharifi H, Karamouzian M, Haghdoost A, Shahesmaeili A, Akbarpour S, Morris MD, Mirzazadeh A. Dual Unsafe Injection and Sexual Behaviors for HIV Infection Among People Who Inject Drugs in Iran. AIDS Behav 2019; 23:1594-1603. [PMID: 30460664 DOI: 10.1007/s10461-018-2345-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
We used two national surveys (2010: N = 1597; 2013: N = 1057) of people who inject drugs (PWID) in past-month to assess the prevalence and population size of PWID with either safe or unsafe injection and sex behaviors, overall and by HIV status. In 2013, only 27.0% (vs. 32.3% in 2010) had safe injection and sex, 24.6% (vs. 23.3% in 2010) had unsafe injection and sex, 26.4% (vs. 26.5% in 2010) had only unsafe injection, and 22.0% (vs. 18.0% in 2010) had unsafe sex only. Among HIV-positive PWID in 2013, only 22.1% (~ 2200 persons) had safe injection and sex, 14.2% (~ 1400 persons) had unsafe injection and sex, 53.1% (~ 5200 persons) had unsafe injection, and 10.6% had unsafe sex (~ 1100 persons). Among HIV-negative PWID in 2013, only 27.5% (~ 22,200 persons) had safe injection and sex, 25.9% (~ 20,900 PWID) had unsafe injection and sex, 23.2% (~ 18,700 persons) had unsafe injection, and 23.3% (~ 18,800 persons) had unsafe sex. HIV-positive and -negative PWID in Iran continue to be at risk of HIV acquisition or transmission which calls for targeted preventions services.
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Affiliation(s)
- Aryan Esmaeili
- HIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
- Department of Epidemiology and Biostatistics, University of California San Francisco, 550 16th Street, San Francisco, CA, 94158, USA
| | - Mostafa Shokoohi
- HIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
- Epidemiology and Biostatistics, Schulich School of Medicine & Dentistry, The University of Western Ontario, London, ON, Canada
| | - Ahmad Danesh
- Golestan Research Center of Psychiatry, Golestan University of Medical Sciences, Gorgan, Golestan, Iran
| | - Hamid Sharifi
- HIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Mohammad Karamouzian
- HIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
- School of Population and Public Health, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - AliAkbar Haghdoost
- HIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
- Modeling in Health Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Armita Shahesmaeili
- HIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Samaneh Akbarpour
- Center for Disease Control (CDC), Ministry of Health and Medical Education, Tehran, Iran
| | - Meghan D Morris
- Department of Epidemiology and Biostatistics, University of California San Francisco, 550 16th Street, San Francisco, CA, 94158, USA
| | - Ali Mirzazadeh
- HIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran.
- Department of Epidemiology and Biostatistics, University of California San Francisco, 550 16th Street, San Francisco, CA, 94158, USA.
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Zhang DC, Chen ZH, Ma Y, Wu ZY. [Qualitative study on unprotected sexual behaviors among male students who have sex with men in Beijing]. Zhonghua Yu Fang Yi Xue Za Zhi 2019; 52:1234-1238. [PMID: 30522222 DOI: 10.3760/cma.j.issn.0253-9624.2018.12.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To investigate the related factors of unprotected sexual behaviors among male students who have sex with men in Beijing. Methods: Male students who have sex with men were recruited from May 2018 to July 2018 at two voluntary counseling and testing (VCT) clinics in Beijing by convenient sampling method. Information being collected during in-depth personal interviews with a semi-structured outline included ways to seek sexual partners, sexual partners characteristics, attitude of condom use, incidence and causes of unprotected sexual behaviors, rush poppers and alcohol use. The text information was summarized and analyzed by Nvivo 11.0 software. Results: A total of 35 male students who have sex with men were recruited and interviewed, the median of age was 22 years old (P(25)-P(75): 21-24 years old). We found that incomprehensive knowledge of condom use, low risk perception of non-anal sexual behaviors, rush poppers and alcohol use were risk factors of unprotected sexual behaviors on individual level. Besides, sex with regular sex partners, partners who were much older or not from campus, and insertive partners are more likely to be unprotected. Furthermore, refusal of condom use by sexual partners and low self-efficacy of decision-making on condom use were the main reasons for unprotected sexual behaviors among male student who have sex with men. Conclusion: Lack of condom use knowledge, low risk perception of non-anal sexual behaviors and insufficient ability to refuse non-condom requirements for regular sex partners, partners who were much older or not from campus, and insertive partners are related factors of unprotected sexual behaviors among male students who have sex with men.
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Affiliation(s)
- D C Zhang
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei 230032, China (Present address: National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China)
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15
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Guo J, Guo W, Yang HL, Chen FF, Fu LL, Liu LL, Cui Y, Dai Y. [Analysis on influencing factors of unprotected sexual behavior among men who have sex with men based on structural equation model]. Zhonghua Yu Fang Yi Xue Za Zhi 2018; 52:1225-8. [PMID: 30522220 DOI: 10.3760/cma.j.issn.0253-9624.2018.12.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To analyze the influencing factors and mechanism for unprotected sexual behavior of men who have sex with men (MSM) in China. Methods: MSM who are more than 16 years old and have had homosexual sexual behaviors in recent years were recruited from five cities (Tianjin, Harbin, Nanjing, Chongqing and Xi'an) with active MSM population during 2013-2014 through network, site recruitment and peer recommendation using convenient sampling method. 3 519 subjects were included in this study. The sexual behavior related information of MSM in five cities was investigated using questionnaires. The confirmatory factor analysis was used to construct the measurement model by using the robust estimation method based on the weighted least square method to estimate parameters, and the final model was determined through evaluation and modification. Results: A total of 3 519 subjects were (29.9±8.76) years old, with a clear sexual orientation of 3 223 (91.6%), and 2 287 (65.0%) were aware of free HIV/AIDS treatment policies. The proportion of using condom last time was 77.2% (n=2 718), and the proportion of using condom every time was 36.9% (n=1 299) and 43.2% (n=1 521) respectively for the past six months with fixed and temporary partners. Structural equation model provided a good fit, the root mean square error of approximation, comparative fit index and non-normed fit index was 0.07, 0.97, 0.95, respectively. Knowing AIDS knowledge, educational level and sexual orientation had direct effects on unprotected sexual behavior, and the path coefficients were 0.179,-0.049 and -0.159, respectively. While the role of interventions was indirect, the path coefficient was 0.147. Conclusion: Lower education and unclear sexual orientation are disadvantages for reducing unprotected sexual behavior. Interventions mainly affect the unprotected sexual behavior by improving the level of HIV/AIDS knowledge. Increasing the comprehensive knowledge of MSM through intervention should be highly valued.
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Rocha GM, Kerr LRFS, Kendall C, Guimarães MDC. Risk behavior score: a practical approach for assessing risk among men who have sex with men in Brazil. Braz J Infect Dis 2018; 22:113-122. [PMID: 29551334 PMCID: PMC9428223 DOI: 10.1016/j.bjid.2018.02.008] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2017] [Revised: 02/20/2018] [Accepted: 02/22/2018] [Indexed: 01/01/2023] Open
Abstract
HIV/AIDS epidemic is not well controlled, and multiple sexual behavior factors help explain high rates of HIV infection among men who have sex with men (MSM). This article proposes to exam the use of a potential risk behavior score for HIV infection, based on the type and number of sexual partners, and condom use, and their associated factors in a sample of MSM in Brazil. A cross sectional RDS (Respondent Driven Sampling) study was performed among 3738 MSM aged 18+ years old from ten Brazilian cities. The risk behavior score was composed by the number of male partners and anal condom use in the last year with steady, casual, and commercial partners. Most participants were 25+ years old (58.1%), non-white (83.1%), and single (84.9%). Final weighted ordinal logistic model showed that age ≤ 25 years old (p = 0.037), homosexual or bisexual identity (p < 0.001), sexual initiation before 15-year-old (p < 0.001), having sex with men only in the last 12 months (p < 0.001), frequent alcohol and illicit drug use (p < 0.001), and use of local sites to meet sexual partners in the last month were independently associated with higher scores of risky behavior. Specific strategies should be developed aimed at the MSM population. Additionally, pre-exposed prophylaxis (Prep) should be considered for those at higher score as a strategy for reducing risk for HIV infection in this population.
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Affiliation(s)
- Gustavo Machado Rocha
- Universidade Federal de São João Del-Rei, Campus Centro Oeste Dona Lindu, Divinópolis, Minas Gerais, Brasil.
| | | | - Carl Kendall
- Department of Global Community Health and Behavioral Sciences, Tulane University School of Public Health and Tropical Medicine, New Orleans, USA
| | - Mark Drew Crosland Guimarães
- Departamento de Medicina Preventiva e Social, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brasil
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Khuzwayo N, Taylor M. Exploring the socio-ecological levels for prevention of sexual risk behaviours of the youth in uMgungundlovu District Municipality, KwaZulu-Natal. Afr J Prim Health Care Fam Med 2018; 10:e1-e8. [PMID: 29781679 PMCID: PMC5843945 DOI: 10.4102/phcfm.v10i1.1590] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2017] [Revised: 10/13/2017] [Accepted: 10/19/2017] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Prevention of youth sexual risk behaviour among the youth in uMgungundlovu District Municipality continues to be a primary challenge for public health and health promotion. Current prevention interventions are targeted at an individual level, whilst youth behaviour is influenced by many social and environmental factors. AIM The aim of the study was to explore the factors influencing sexual risk behaviours of the youth at different socio-ecological levels in uMgungundlovu District Municipality. METHODS An explorative and descriptive qualitative study design was used, using in-depth interviews and focus group discussions for data collection. A framework analysis was used to develop themes derived from the socio-ecological theory. RESULTS Four themes were identified that influence youth to engage in sexual risk behaviours: (1) individual factors, related to role modelling behaviour, gender and negative stereotypes towards females; (2) the microsystem in which youth function including the influence of family and peers; (3) the exo-system comprising the disadvantaged socio-economic status of the communities where the youth live; and (4) the macrosystem where negative social norms were reported to influence youth health outcomes. CONCLUSION Sexual risk behaviour among youth in uMgungundlovu is influenced by many factors at multiple social levels. Interventions directed at these multiple levels are needed urgently.
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Affiliation(s)
- Nelisiwe Khuzwayo
- School of Nursing and Public Health Medicine, University of KwaZulu-Natal.
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18
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Mwangi M, Waruru A, Waruiru W, Gichangi A, Toroitich-Ruto C, Kim AA. Factors associated with unsafe sex among Kenyan youth: Results from a nationally representative population-based survey. East Afr J Appl Health Monitor Eval 2018; 2:25-37. [PMID: 31149660 PMCID: PMC6537612] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
BACKGROUND Understanding sexual risk among youth can inform the design of effective HIV prevention interventions. METHODS The 2012 Kenya AIDS Indicator Survey was a nationally representative population-based survey. We administered a questionnaire and collected blood samples for HIV testing. We examined factors associated with unsafe sex among unmarried youth aged 15-19 and 20-24 years. RESULTS Of 2,090 unmarried youth aged 15-19 years, 33.3% (95% confidence interval [CI] 30.6-36.1) had ever had sex. Among those, 66.0% (95% CI 61.3-70.7) had sex in the past year (sexually active), and of these, 38.7% (95% 33.4 -44.0) reported unsafe sex. No differences were observed in unsafe sex by sex. Factors associated with increased adjusted odds of unsafe sex among youth aged 15-19 years were residence in Central province; having primary or lower education; sexual debut before age 15 years; ever receiving money, gifts or favours for sex (transactional sex); multiple sexual partners in the past year; and low self-perceived risk of HIV. Of the 1,079 unmarried youth aged 20-24 years, 77.2% (95% CI 74.2-80.2) had ever had sex. Of these, 73.1% (95% CI69.8-76.3) were sexually active, and 24.1% (95% CI 18.1-30.1) of women and 31.9% (95% CI 26.4-37.5) of men reported unsafe sex in the past year. Factors associated with increased adjusted odds of unsafe sex among youth aged 20-24 years were primary or lower education, transactional sex and multiple partners in the past year. CONCLUSION Unsafe sex is common among Kenyan youth, especially those aged 15-19 years. HIV prevention efforts need to target youth, support educational progression and economic empowerment.
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Affiliation(s)
- Mary Mwangi
- Divison of Global HIV/AIDS, US Centers for Disease Control and Prevention, Nairobi, Kenya
| | - Anthony Waruru
- Divison of Global HIV/AIDS, US Centers for Disease Control and Prevention, Nairobi, Kenya
| | - Wanjiru Waruiru
- Institute for Global Health Sciences, University of California, San Francisco, California, United States of America
| | - Anthony Gichangi
- Divison of Global HIV/AIDS, US Centers for Disease Control and Prevention, Nairobi, Kenya
| | - Cathy Toroitich-Ruto
- Divison of Global HIV/AIDS, US Centers for Disease Control and Prevention, Nairobi, Kenya
| | - Andrea A. Kim
- Divison of Global HIV/AIDS, US Centers for Disease Control and Prevention, Nairobi, Kenya
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Moure-Rodríguez L, Doallo S, Juan-Salvadores P, Corral M, Cadaveira F, Caamaño-Isorna F. [Heavy episodic drinking, cannabis use and unsafe sex among university students]. Gac Sanit 2016; 30:438-443. [PMID: 27155789 DOI: 10.1016/j.gaceta.2016.03.007] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/27/2016] [Revised: 03/11/2016] [Accepted: 03/15/2016] [Indexed: 10/21/2022]
Abstract
OBJECTIVE To determine the incidence of unsafe sex among university students and its association with heavy episodic drinking (HED) and cannabis use. METHOD A cohort study was carried out from 2005 to 2011 among university students of the Compostela Cohort (n=517). HED was measured using the third question of the Alcohol Use Disorders Identification Test (AUDIT). Unsafe sex was considered to be sex under the influence of alcohol (SUA) and sex without a condom (SWC). Logistic regression models were created. RESULTS The incidence of SUA was 40.9% for women and 53.0% for men, while the SWC incidence ranged from 13.7% for women to 25.7% for men. HED and cannabis use were associated with SUA in both women (OR=2.08, 95% CI: 1.03-4.21; OR=2.78, 95%CI: 1.57-4.92) and men (OR=4.74 (95%CI: 1.49-15.09; OR=4.37, 95%CI: 1.17- 16.36). Moreover, cannabis use in women was associated with SWC (OR=2.96, 95%CI: 1.52-5.75). The population attributable fractions of SUA for HED were 24.7% and 52.9% for women and men, respectively. CONCLUSIONS HED and cannabis use represent a public health problem due to their association with a variety of problems, including engagement in unsafe sex. Our results suggest that a significant proportion of unsafe sex could be avoided by reducing this consumption pattern of alcohol.
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Affiliation(s)
| | - Sonia Doallo
- Departamento de Psicología Clínica y Psicobiología, Universidade de Santiago de Compostela, Santiago de Compostela (A Coruña), España
| | - Pablo Juan-Salvadores
- CIBER de Epidemiología y Salud Pública (CIBERESP), España; Departamento de Medicina Preventiva, Universidade de Santiago de Compostela, Santiago de Compostela (A Coruña), España
| | - Montserrat Corral
- Departamento de Psicología Clínica y Psicobiología, Universidade de Santiago de Compostela, Santiago de Compostela (A Coruña), España
| | - Fernando Cadaveira
- Departamento de Psicología Clínica y Psicobiología, Universidade de Santiago de Compostela, Santiago de Compostela (A Coruña), España
| | - Francisco Caamaño-Isorna
- CIBER de Epidemiología y Salud Pública (CIBERESP), España; Departamento de Medicina Preventiva, Universidade de Santiago de Compostela, Santiago de Compostela (A Coruña), España
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Marengo E, Martino DJ, Igoa A, Fassi G, Scápola M, Urtueta Baamonde M, Strejilevich SA. Sexual risk behaviors among women with bipolar disorder. Psychiatry Res 2015; 230:835-8. [PMID: 26564549 DOI: 10.1016/j.psychres.2015.10.021] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2015] [Revised: 10/08/2015] [Accepted: 10/20/2015] [Indexed: 01/13/2023]
Abstract
The aim of this study was to investigate sexual health and sexual risk behaviors for sexually transmitted infections (STI) among women with bipolar disorder (BDW). Sixty-three euthymic women diagnosed with bipolar disorder type I, II or not otherwise specified were included and matched with a control group of 63 healthy women. Demographic and clinical data, structured sexual health measures and extensive assessment of sexual risk behavior were obtained and compared between groups. BDW had casual partners, were in non-monogamous sexual partnerships and had sex with partners with unknown HIV condition more frequently than healthy control women. History of two or more STI was more frequent among BDW. Inclusion of sexual behavior risk assessment among BDW in treatment is necessary to better identify those women with higher risk for STI and to take measures to improve their sexual health.
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Affiliation(s)
- Eliana Marengo
- Bipolar Disorder Program, Institute of Neurosciences, Favaloro University, Buenos Aires, Argentina; National Council of Scientific and Technical Research (CONICET), Argentina
| | - Diego J Martino
- Bipolar Disorder Program, Institute of Neurosciences, Favaloro University, Buenos Aires, Argentina; National Council of Scientific and Technical Research (CONICET), Argentina
| | - Ana Igoa
- Bipolar Disorder Program, Institute of Neurosciences, Favaloro University, Buenos Aires, Argentina
| | - Guillermo Fassi
- Bipolar Disorder Program, Institute of Neurosciences, Favaloro University, Buenos Aires, Argentina
| | - María Scápola
- Bipolar Disorder Program, Institute of Neurosciences, Favaloro University, Buenos Aires, Argentina
| | - Mariana Urtueta Baamonde
- Bipolar Disorder Program, Institute of Neurosciences, Favaloro University, Buenos Aires, Argentina
| | - Sergio A Strejilevich
- Bipolar Disorder Program, Institute of Neurosciences, Favaloro University, Buenos Aires, Argentina.
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Gasch Gallén À, Tomás Aznar C, Rubio Aranda E. [Type of partner, socio-economic factors and risk practices in men who have sex with men]. Gac Sanit 2015; 29:412-8. [PMID: 26272442 DOI: 10.1016/j.gaceta.2015.07.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/25/2015] [Revised: 06/24/2015] [Accepted: 07/10/2015] [Indexed: 11/28/2022]
Abstract
OBJECTIVE Men who have sex with men (MSM) perform risk practices that pose a challenge to prevention strategies. The aim of this study was to analyse the association between receptive and insertive unprotected anal intercourse (RUAI and IUAI) according to the type of partner and the practice of barebacking with socioeconomic factors. METHODS A descriptive study was conducted through a self-administered questionnaire distributed by a software tool in social networks and non-governmental organizations from June-2014 to January-2015. Participants consisted of 601 people living in Spain. Pearson's χ(2) test and logistic regression models were applied with odds ratios (OR) and 95% confidence intervals (95% CI). RESULTS In stable couples, the risk of RUAI increased in individuals with a medium income (OR: 1.79; 95%CI: 1.14-2.80) and in those who lived together (OR: 2.94; 95%CI: 1.74-4.98) and IUAI increased in individuals living with a partner (OR: 5.58; 95%IC: 3.24-9.59). When the partner was a friend, the risk of RUAI was higher among individuals with secondary education (OR: 2.20; 95%CI: 1.44-3.36) and those who were retired (OR: 3.6; 95%CI: 1.25-10.37), while living with a partner was a protective factor (OR: 0.56; 95%CI: 0.32-0.98). The risk of barebacking was greater in younger men (OR: 2.59; 95%CI: 1.27-5.28), in those with secondary education (OR: 1.51; 95%CI: 0.99-2.29) and in those living with a partner (OR: 3.64; 95%CI: 2.12-6.24). DISCUSSION There is a need to reduce vulnerability due to socioeconomic factors that influence engagement in risk practices and to highlight the importance of barebacking, mainly in young MSM. Partner-based interventions and harm reduction strategies should be incorporated into preventive strategies.
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Affiliation(s)
- Àngel Gasch Gallén
- Departamento de Fisiatría y Enfermería, Facultad de Ciencias de la Salud, Universidad de Zaragoza, Zaragoza, España.
| | - Concepción Tomás Aznar
- Departamento de Fisiatría y Enfermería, Facultad de Ciencias de la Salud, Universidad de Zaragoza, Zaragoza, España
| | - Encarnación Rubio Aranda
- Departamento de Microbiología, Medicina Preventiva y Salud Pública, Facultad de Medicina, Universidad de Zaragoza, Zaragoza, España
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Wray TB, Simons JS, Maisto SA. Effects of alcohol intoxication and autonomic arousal on delay discounting and risky sex in young adult heterosexual men. Addict Behav 2015; 42:9-13. [PMID: 25462647 DOI: 10.1016/j.addbeh.2014.10.037] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2014] [Revised: 09/19/2014] [Accepted: 10/24/2014] [Indexed: 10/24/2022]
Abstract
OBJECTIVES The relationship between alcohol use and risky sexual behavior is complex and depends on psychological and environmental factors. The alcohol myopia model predicts that, due to alcohol's impact on attention, the behavior of intoxicated individuals will become increasingly directed by salient cues. Autonomic arousal (AA) may have a similar effect on attention. Experiential delay discounting (DD) may be increased by both alcohol consumption and AA due to their common effects and may mediate the relationship between these conditions and risky sex. METHODS This study employed a 3 (alcohol, placebo, control)×2 (high, low arousal) experimental design to examine the effects of acute alcohol intoxication and AA on experiential delay discounting, subjective sexual arousal, and risky sex. RESULTS Path models revealed complex results that only partially supported study hypotheses. Ratings of subjective sexual arousal did not differ across either beverage or arousal conditions. DD was also unrelated to any study variable. However, subjective sexual arousal was positively related to risky sexual intentions. Alcohol intoxication was also positively associated with increased unprotected sex intentions, consistent with past studies. CONCLUSIONS These results affirm the role of subjective sexual arousal and alcohol intoxication in risky sexual decision-making, yielding effect sizes similar to comparable past studies. The lack of differences across autonomic arousal groups also suggests that effects of attentional myopia may be behavior-specific. Failure to replicate effects of alcohol intoxication on DD also suggests reservation regarding its involvement in alcohol-involved risky sex.
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Matser A, Heiligenberg M, Geskus R, Heijman T, Low N, Kretzschmar M, van der Loeff MS. The importance of partnership factors and individual factors associated with absent or inconsistent condom use in heterosexuals: a cross-sectional study. Sex Transm Infect 2014; 90:325-31. [PMID: 24550539 DOI: 10.1136/sextrans-2013-051087] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES Decisions to use condoms are made within partnerships. We examined the associations between inconsistent or no condom use and individual and partnership characteristics. We also examined the relative importance of individual versus partnership factors. METHODS Cross-sectional study of heterosexual individuals enrolled from the sexually transmitted infections (STI) outpatient clinic in Amsterdam, the Netherlands, from May to August 2010. Participants completed a questionnaire about sexual behaviour with the last four partners in the preceding year. Participant and partnership factors associated with inconsistent or no condom use in steady and casual partnerships were identified. RESULTS 2144 individuals were included, reporting 6401 partnerships; 54.7% were female, the median age was 25 (IQR 22-30) years and 79.9% were Dutch. Inconsistent or no condom use occurred in 86.1% of 2387 steady partnerships and in 66.5% of 4014 casual partnerships. There was statistical evidence of associations between inconsistent condom use in steady partnerships and ethnic concordance, longer duration, higher number of sex acts, practising anal sex, and sex-related drug use. In casual partnerships, associations were found with having an older partner, ethnic concordance, longer duration, higher number of sex acts, anal sex, sex-related drug use, ongoing partnerships and concurrency. In multivariable models, partnership factors explained 50.9% of the variance in steady partnerships and 70.1% in casual partnerships compared with 10.5% and 15.4% respectively for individual factors. CONCLUSIONS Among heterosexual STI clinic attendees in Amsterdam, partnership factors are more important factors related with inconsistent condom use than characteristics of the individual.
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Affiliation(s)
- Amy Matser
- Cluster of Infectious Diseases, Public Health Service of Amsterdam, Amsterdam, The Netherlands Julius Centre for Health Sciences & Primary Care, University Medical Centre Utrecht (UMCU), Utrecht, The Netherlands
| | - Marlies Heiligenberg
- Cluster of Infectious Diseases, Public Health Service of Amsterdam, Amsterdam, The Netherlands Center for Infection and Immunology Amsterdam (CINIMA), Academic Medical Center (AMC), Amsterdam, The Netherlands
| | - Ronald Geskus
- Cluster of Infectious Diseases, Public Health Service of Amsterdam, Amsterdam, The Netherlands Department of Clinical Epidemiology, Biostatistics and Bioinformatics, University of Amsterdam, Amsterdam, The Netherlands
| | - Titia Heijman
- Cluster of Infectious Diseases, Public Health Service of Amsterdam, Amsterdam, The Netherlands
| | - Nicola Low
- Division of Clinical Epidemiology & Biostatistics, Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
| | - Mirjam Kretzschmar
- Julius Centre for Health Sciences & Primary Care, University Medical Centre Utrecht (UMCU), Utrecht, The Netherlands Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
| | - Maarten Schim van der Loeff
- Cluster of Infectious Diseases, Public Health Service of Amsterdam, Amsterdam, The Netherlands Center for Infection and Immunology Amsterdam (CINIMA), Academic Medical Center (AMC), Amsterdam, The Netherlands
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Lavielle-Sotomayor P, Jiménez-Valdez F, Vázquez-Rodríguez A, Aguirre-García MDC, Castillo-Trejo M, Vega-Mendoza S. [The impact of family characteristics in sexual risk behaviour of teens]. Rev Med Inst Mex Seguro Soc 2014; 52:38-43. [PMID: 24625482] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
OBJECTIVE To assess risk sexual behaviour in adolescents and its relationship with family characteristics. METHODS In a representative and random sample of 909 teenagers, their sex life, structure, satisfaction and family dynamics were evaluated. It was used chi-squared test, in order to compare the frequency of family negative characteristics between the groups of adolescents with and without risky sexual behaviors. RESULTS The early onset of sexual life was more frequent in adolescents with dysfunctional expression of affection in their families, and single-parent or nuclear family structure. The lack of condom use was associated with a lack of affection, and a poor comunication within the family. Having more than three partners was related to the expression of affection and the degree of satisfaction of the teenager with his family. Unplanned pregnancies and sex transmission diseases were most frequent in adolescents belonging to extended families with a poor expression of affection. CONCLUSIONS The level of communication, the monitoring of conduct, the warmth and proximity play a very important role as protectors of sexual risk behaviour in teens.
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Affiliation(s)
- Pilar Lavielle-Sotomayor
- Unidad de Investigación en Epidemiología Clínica, Hospital de Especialidades, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social. Servicio de Salud Mental, Hospital General de México OD, Secretaría de Salud.
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