Safe Sex

安全性行为
  • 文章类型: Journal Article
    女性性工作者(FSW)由于无保护的性行为而容易感染艾滋病毒和其他性传播感染。了解和解决FSW之间安全性行为的差距可以帮助减少艾滋病毒的获取和传播。这项研究描述了性行为,他们在蒙巴萨县的FSW中与艾滋病毒服务的关联和使用,肯尼亚。
    在蒙巴萨县的五个酒吧和五个俱乐部中,以预定的间隔,通过时间定位聚类随机设计招募参与者进行基线调查,直到样本量达到160。使用R进行描述性统计和推断分析,并且p<0.05被认为具有统计学意义。
    几乎所有(99%)的参与者都是未婚的,11%受过高等教育。百分之九十八(98%)报告阴道性交,51%的人报告在性交前使用酒精/药物,28%的人进行无保护的性交。大约64%的人在三个月内进行了艾滋病毒检测,14%的人认为重复使用避孕套是安全的,10%的人认为从事无保护的性行为是安全的。在双变量分析中,如果FSW报告更频繁的性行为,他们更有可能进行无保护的性交,更频繁地和常客做爱,艾滋病知识贫乏,酒精/药物使用,和暴力。在多变量分析中,危险性行为与性交的频率有关,酒精/药物使用,艾滋病知识贫乏。
    女性性工作者在物质的影响下进行无保护的性行为,相信重复使用避孕套,性交频率很高。对艾滋病毒和药物使用的了解不足与无保护性行为显着相关。需要采取干预措施来解决这些可改变的因素,以减轻FSW中艾滋病毒的风险。
    UNASSIGNED: 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.
    UNASSIGNED: 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.
    UNASSIGNED: 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.
    UNASSIGNED: 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.
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  • 文章类型: Journal Article
    被监禁的人经常进入监狱,有高风险的生活方式行为史,可能导致传染病的传播。监狱提供了一个独特的环境,可以通过传播信息和教育来促进服务不足的人口的健康公平。性健康教育有可能减轻被监禁人口的负面健康后果,并改善重返社区后的性健康做法,对被监禁的个人和社区都有利。有限的实证研究检查了美国惩教设施中的性健康信息和教育。手册,给所有被监禁的人,有可能提供重要的信息和教育,以促进安全性行为和预防疾病传播。这项工作,根据美国疾病控制和预防中心的22项重要性健康教育建议,检查监狱手册中推荐的性健康信息和指导的存在(或不存在)。对美国50个州中的49个州的手册(n=74)进行了定性分析,结果揭示了有限的信息,在监禁期间或之后进行有关性健康/安全性行为的教育或指导。利用手册进行全面的性教育可能是向已经处于危险中的服务不足人口的成员迈出的关键一步。
    Incarcerated individuals frequently enter prison with a history of high-risk lifestyle behaviours likely to contribute to the transmission of infectious disease. Prisons offer a unique setting in which to advance health equity to an underserved population by disseminating information and education. Sexual health education has the potential to mitigate negative health consequences in the incarcerated population and improve sexual health practices upon community re-entry, benefiting both incarcerated individuals and communities. Limited empirical research examines sexual health information and education in US correctional facilities. Handbooks, given to all people upon incarceration, have the potential to provide vital information and education to promote safe sexual practice and prevent disease transmission. This work, guided by 22 critical sexual health education recommendations from the US Centers for Disease Control and Prevention, examines the presence (or absence) of recommended sexual health information and guidance in prison handbooks. Handbooks (n = 74) from 49 of 50 US states were qualitatively analysed with results revealing limited information, education or guidance about sexual health/safe sexual practice during incarceration or afterwards. Utilising handbooks for comprehensive sexual education could be a critical step towards reaching members of an already at-risk underserved population.
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  • 文章类型: Journal Article
    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.
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  • 文章类型: Journal Article
    博茨瓦纳是受艾滋病毒/艾滋病流行严重影响的国家之一。尽管开展了广泛的艾滋病毒预防运动,艾滋病毒的发病率,尤其是在女性中,仍然很高。避孕套在预防新的艾滋病毒感染方面发挥着重要作用,虽然男人和女人并不总是使用它们。
    该研究评估了个体,博茨瓦纳女性持续使用避孕套的关系和社区因素。
    一项横断面研究,使用从2012年基于性别的暴力指标的全国调查中得出的二级数据。
    初步调查对639名女性进行了抽样,18岁及以上,使用多阶段程序。二次分析的最终样本量包括总共480名女性,她们有性生活经验,并报告与男性伴侣一起使用避孕套。采用多变量逻辑回归分析来评估持续使用安全套与解释变量之间的关联。多元逻辑回归调整了聚类/社区随机效应。
    在过去的一年里,大约43%的女性持续使用避孕套。在过去一年中受雇的女性中,使用安全套的可能性更高(调整后的比值比=1.77;95%置信区间=1.25-2.50)。同时,与伴侣生活在一起的女性(调整后的比值比=0.46;95%置信区间=0.28-0.74),具有非基督教信仰(调整后的赔率比=0.52;95%置信区间=0.29-0.92),认为如果他们的伴侣要求使用安全套(调整后的比值比=0.19;95%置信区间=0.06-0.58)会生气,并且认为他们的社区认为女性需要丈夫的许可才能从事有偿工作(调整后的比值比=0.56;95%置信区间=0.38-0.83),那么他们坚持使用安全套的可能性较小.
    博茨瓦纳女性人口中一致使用避孕套的情况并不理想。在有工作的女性中,避孕套的持续使用较高,在和伴侣住在一起的女性中,有非基督教信仰,担心他们的伴侣在要求使用避孕套时的反应,并持有不公平的社区性别信仰。为了加强女性对避孕套的持续使用,友好的避孕套使用信息,应考虑女性经济赋权战略和方案,让宗教领袖参与进来,并在性生殖健康/艾滋病毒干预措施中促进进步和健康的男性做法。
    UNASSIGNED: Botswana is one of the countries severely impacted by the HIV/AIDS pandemic. Despite an extensive HIV prevention campaign, the incidence of HIV, particularly among women, remains high. Condoms play a significant role in preventing new HIV infections, although men and women do not consistently use them.
    UNASSIGNED: The study assessed the individual, relationship and community factors associated with consistent condom use among women in Botswana.
    UNASSIGNED: A cross-sectional study using secondary data drawn from a national survey on Gender-Based Violence Indicators in 2012.
    UNASSIGNED: The primary survey sampled 639 women, aged 18 years and older, using a multistage procedure. The final sample size for the secondary analysis included a total of 480 women who were sexually experienced and had reported using condoms with their male partners. Multivariate logistic regression analysis was employed to assess the association between consistent condom use and the explanatory variables. The multivariate logistic regression adjusted for cluster/community random effects.
    UNASSIGNED: About 43% of the women used condoms consistently in the past year. Consistent condom use was more likely among women who were employed in the past year (adjusted odds ratio = 1.77; 95% confidence interval = 1.25-2.50). While, women who lived with their partners (adjusted odds ratio = 0.46; 95% confidence interval = 0.28-0.74), had non-Christian beliefs (adjusted odds ratio = 0.52; 95% confidence interval = 0.29-0.92), perceived that their partners would be angry if they ask to use a condom (adjusted odds ratio = 0.19; 95% confidence interval = 0.06-0.58) and perceived that their community says women need their husband\'s permission to do paid work (adjusted odds ratio = 0.56; 95% confidence interval = 0.38-0.83) were less likely to use condoms consistently.
    UNASSIGNED: Consistent condom use among Botswana\'s female population is suboptimal. Consistent condom use was higher among women with employment, and lower among women who lived with their partners, had non-Christian beliefs, feared their partners\' reaction upon asking for condom use and held inequitable community gender beliefs. To enhance women\'s consistent use of condoms, friendly condom use information, female economic empowerment strategies and programmes that involve religious leaders and promote progressive and healthy masculine practices in Sexual Reproductive Health/HIV interventions should be considered.
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  • 文章类型: Journal Article
    背景:人类免疫病毒或获得性免疫缺陷综合征,是对全球数百万人健康的重大威胁。在埃塞俄比亚,有超过一百万人感染艾滋病毒/艾滋病。持续和适当使用避孕套,特别是那些有艾滋病毒阳性客户的人,对于采取全面和长期的方法来避免艾滋病毒和其他性传播感染以及意外怀孕至关重要。但经常报告不规律使用避孕套。关于埃塞俄比亚经常使用避孕套的流行率和相关性的报告不一致。本研究的目的是概述埃塞俄比亚艾滋病毒感染者使用安全套的最新研究。
    方法:PubMed的四个数据库,科学直接,Scopus,和谷歌学者被使用。最后,系统评价和荟萃分析包括10项符合资格标准的研究。数据是使用有条理的检查表进行数据提取收集的,STATA14用于分析。据报道,在研究之前的每次性接触中都使用了避孕套。通过将经常使用避孕套的患者总数除以HIV/AIDS患者总数并将结果乘以100来计算HIV/AIDS患者中一致使用避孕套的患病率。使用合并比值比(OR)描述与一致使用避孕套相关的因素,并根据纳入的主要研究的二元结果进行计算。基于相关因子确定统计显著性,因为它们的置信水平不应包括1。通过使用随机效应模型进行按地区和出版年份的亚组分析。多震级信号的STATA命令,使用随机xlab(.1,5,10)lcols(作者)by(变量)文本(120)xsize(18)ysize(14)进行亚组分析.为了评估发表偏见的存在,漏斗图,计算了5%显著水平的Egger检验和Begg检验。漏斗图的不对称性和Egger检验和Begg检验P值0>0.5表明不存在发表偏倚。CochraneQ检验统计量和I2检验用于评估异质性。
    结果:一致使用安全套的合并幅度为50.56%(95CI:38.09-63.02)。持续使用避孕套的预测因素包括城市居住(AOR=3.46;95%CI:2.24-5.35),婚姻状况(AOR=0.33;95%CI:0.18-0.61),和艾滋病毒披露状态(AOR=5.61;95CI:2.29-13.73)。
    结论:我们研究中一半的HIV/AIDS患者经常使用避孕套。根据这项研究,城市居住权,披露状态,和婚姻状况均与HIV/AIDS患者一致使用安全套相关.因此,应向已婚夫妇和农村地区的人们提供有关安全套使用的健康教育。此外,披露艾滋病毒感染状况和持续使用避孕套的必要性对于持续使用避孕套至关重要。
    BACKGROUND: The human immune virus or acquired immune deficiency syndrome, is a major threat to the health of millions of people worldwide. In Ethiopia, there were more than a million people living with HIV/AIDS. The continuous and appropriate use of condoms, particularly among those who have HIV-positive clients, is essential to a comprehensive and long-term approach to avoiding HIV and other STIs as well as unintended pregnancy. But irregular condom use is regularly reported. There is inconsistent reports of the prevalence and correlates of frequent condom use in Ethiopia. This study\'s goal is to provide an overview of the most recent research on magnitude condom use among people living with HIV in Ethiopia.
    METHODS: Four databases of PubMed, Science Direct, Scopus, and Google Scholar were used. Finally, 10 studies that satisfied the eligibility criteria were included in the systematic review and meta-analysis. The data were collected using a methodical checklist for data extraction, and STATA 14 was utilized for the analysis. The consistent condom use was reported as use of condom in every sexual encounter preceding the study. The prevalence of consistent condom usage among HIV/AIDS patients was calculated by dividing the total number of patients who regularly used condoms by the total number of HIV/AIDS patients and multiplying that result by 100. The factors associated with a consistent use of condom were described using the pooled odds ratio (OR) and calculated based on binary outcomes from the included primary studies. The statistical significance was determined based on the correlation factor as their confidence level should not include 1. Subgroup analyses by region and publication years were carried out by using a random-effects model. The STATA commands of metan magnitude semagnitude, random xlab(.1,5,10) lcols (authors) by (variables)texts(120) xsize(18) ysize (14) were used to carried out the subgroup analysis. To assess the presence of publication bias, funnel plot, Egger test and Begg\'s test at 5% significant level were computed. The asymmetry of funnel plot and the Egger test and Begg\'s test P value of 0 >0.5 showed the absence of publication bias. The Cochrane Q test statistic and I2 tests were used to assess heterogeneity.
    RESULTS: The pooled magnitude of consistent condom use was 50.56% (95%CI: 38.09-63.02). The predictors of consistent condom use includes urban residence (AOR = 3.46; 95% CI: 2.24-5.35), marital status (AOR = 0.33; 95% CI: 0.18-0.61), and HIV disclosure status (AOR = 5.61;95%CI: 2.29-13.73).
    CONCLUSIONS: Half of the HIV/AIDS patients in our study regularly used condoms. According to this study, urban residency, disclosure status, and marital status were all associated with consistent condom use among HIV/AIDS patients. Therefore, health education about condom use should be provided to married couples and people living in rural regions. In addition, disclosing HIV status and the necessity of constant condom usage would be crucial for consistent condom use.
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  • 文章类型: Journal Article
    美国的土著青年面临着与不良童年经历有关的无家可归的高风险,例如父母使用物质和低教育程度。这样的经历可能会导致不良的身心健康问题;这些年轻人也具有心理上的积极属性(希望,自我效能感,弹性,乐观)与健康结果有关。这项次要分析的目的是描述经历无家可归的土著青年(IYEH)的人口统计学特征和心理资本,他们参加了与安全性行为和生活满意度有关的纵向干预研究。共有602名土著参与者(n=111;平均年龄21.25±1.82岁)从奥斯汀的寄宿中心招募,德克萨斯州和哥伦布,俄亥俄州。干预后立即收集数据,间隔3个月和6个月。对于这个分析,仅使用在最终时间点收集的数据.克朗巴赫阿尔法的有效量表为0.75-0.92(希望,复原力,乐观,物质拒绝的自我效能感,安全性行为的自我效能感,安全的性行为,社会关系,和生活满意度)被使用。大多数IYEH报告吸烟,饮酒,和使用药物。希望的心理资本变量,谈判安全性行为的自我效能感,弹性,和乐观情绪密切相关,但不是安全性行为或使用避孕套的意图。弹性和乐观情绪与社会联系显着相关,但与其他心理资本变量无关。生活满意度与希望显著相关,弹性,和乐观。研究结果对进一步的理论和研究发展具有启示意义。
    Indigenous youth in the United States are at high-risk for experiencing homelessness related to adverse childhood experiences such as parental substance use and low educational attainment. Such experiences may lead to adverse physical and mental health issues; these youth also have positive attributes of psychological capita (hope, self-efficacy, resilience, optimism) that are related to health outcomes. The purpose of this secondary analysis was to describe demographic attributes and psychological capital in Indigenous youth experiencing homelessness (IYEH) who participated in a longitudinal intervention study related to safe sex behaviors and life satisfaction. From a total of 602, Indigenous participants (n = 111; mean age 21.25 ± 1.82 years) were recruited from drop-in centers in Austin, Texas and Columbus, Ohio. Data were collected immediately after the intervention and at 3- and 6-month intervals. For this analysis, only data collected at the final time-point were used. Valid scales with Cronbach alphas of 0.75-0.92 (Hope, Resilience, Optimism, Self-efficacy for Substance Refusal, Self-efficacy for Safer Sex, Safe Sex Behaviors, Social Connectedness, and Life Satisfaction) were used. The majority of the IYEH reported smoking, drinking, and using drugs. Psychological capital variables of hope, self-efficacy for negotiating safer sex, resilience, and optimism were significantly related to one another, but not to safe sex behaviors or intention to use condoms. Resilience and optimism were significantly related to social connectedness but not to other psychological capital variables. Life satisfaction was significantly associated with hope, resilience, and optimism. Findings have implications for further theory and research development.
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  • 文章类型: Journal Article
    背景:虽然已经承认存在各种复杂的随意性关系(CSR),研究很少描述在这些关系中使用避孕套的普遍性,或者它们是如何混合的,特别是关系特征,影响避孕套的使用。这项研究旨在描述承诺关系和各种类型的偶然性关系(CSR)中安全套的使用,在文化验证的关系类型(承诺,有好处的朋友,联播,战利品电话)。
    方法:新兴成年人(N=728,18-29岁,M=22.56;SD=3.01)完成了四个街区的调查:社会人口统计学;简短的性史;前一年的关系;和当前的关系,评估关系类型,十个关系特征(例如,承诺,情感和性的排他性,合作伙伴熟人,性参与)和避孕套使用(阴道,口服,和肛门),通过三种措施(在最后相遇时使用,likert型量表和使用百分比)。
    结果:结果显示了按关系类型划分的避孕套使用模式,并阐明了关系特征如何分为三个因素:承诺,亲密,和以性行为为媒介的避孕套的使用。避孕套在阴道中的使用频率高于肛交和口交,在承诺的关系中不那么频繁。在承诺的关系和联播之间,在阴道性行为中使用避孕套没有发现显着差异,这些关系中的避孕套明显低于战利品中的避孕套。在所有测试的对比和阴道性交中使用避孕套之间介导的亲密关系,而性行为在承诺与承诺之间调解在肛交和口交中使用CSR和避孕套。
    结论:研究结果表明,需要考虑CSR的多样性,以了解安全套的使用,并强调亲密关系作为与阴道性行为中安全套使用以及口交和肛交中性行为相关的相关机制的作用。在调整促进健康的努力时应考虑到这一点。
    BACKGROUND: While the existence of a complex variety of casual sexual relationships (CSRs) has been acknowledged, studies rarely describe the prevalence of condom use across these relationships or how their hybrid nature, specifically relationship characteristics, affect condom use. This study aims to describe condom use within committed relationships and various types of casual sexual relationships (CSRs), examining the influence of relationship characteristics on condom use among culturally validated relationship types (committed, friends with benefits, hookups, booty call).
    METHODS: Emerging adults (N = 728, 18-29 years, M = 22.56; SD = 3.01) completed a survey with four blocks: sociodemographics; brief sexual history; relationships over the previous year; and current relationship, assessing relationship type, ten relationship characteristics (e.g., commitment, emotional and sexual exclusivity, partner acquaintance, sexual involvement) and condom use (vaginal, oral, and anal), operationalized by three measures (use at last encounter, likert-type scale and percentage of use).
    RESULTS: The results showed patterns in condom use by relationship type and illuminated how relationship characteristics-grouped into three factors: commitment, intimacy, and sexuality-mediate condom use. Condom use was more frequent in vaginal than anal and oral sex, and less frequent in committed relationships. No significant differences were found in condom use in vaginal sex between committed relationships and hookups, with condom in these relationships being significantly lower than in booty call. Intimacy mediated between all contrasts tested and condom use in vaginal sex, while sexuality mediated between committed vs. CSRs and condom use in anal and oral sex.
    CONCLUSIONS: Findings point to the need of considering the diversity of CSRs for understanding condom use and highlight the role of intimacy as a relevant mechanism associated with condom use in vaginal sex and of sexuality in oral and anal sex, which should be taken into consideration in the tailoring of health promoting efforts.
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  • 文章类型: Journal Article
    目的:在移动应用程序中开发严肃的游戏,以在青少年的积极参与下学习安全性行为和避孕;并评估内容,该技术与青少年和专家的外观和可用性。
    方法:这是一个严肃游戏开发的应用研究项目,分两个阶段进行:技术本身的开发;和内容的评估,应用程序的外观和可用性。巴西圣保罗市一所公立学校的青少年参加了技术开发阶段。评估是由青少年和公共卫生和卫生技术领域的专家进行的。使用了以下标准:教育方面,环境接口和教学资源。
    结果:开发了PrinventonApp®,在虚拟城市中设置的严肃游戏,旨在解决青少年性行为。该应用程序收到90%的积极响应,内容有效性指数为0.80,这被认为是足够的。建议和说明被接受和执行。就主题而言,严肃的游戏被认为是有趣且重要的。
    结论:发现开发的技术可以帮助青少年了解安全性行为和避孕,通过以一种有趣而现实的方式解决青春期的性行为。
    OBJECTIVE: to develop a serious game in a mobile application for learning about safe sex and contraception with the active participation of adolescents; and evaluate the content, appearance and usability of the technology with adolescents and experts.
    METHODS: this is an applied research project into the development of a serious game, carried out in two stages: development of the technology itself; and evaluation of the content, appearance and usability of the application. Teenagers from a public school in the city of São Paulo-Brazil took part in the technology development stage. The evaluation was carried out by the adolescents and experts in the areas of public health and health technology. The following criteria were used: educational aspects, environment interface and didactic resources.
    RESULTS: Prinventon App ® was developed, a serious game set in a virtual city, designed to address adolescent sexuality. The app received 90% positive responses and had a Content Validity Index of 0.80, which was considered adequate. The suggestions and notes were accepted and implemented. The serious game was considered interesting and important in terms of the subject matter.
    CONCLUSIONS: it was found that the technology developed can help adolescents learn about safe sex and contraception, by addressing sexuality in adolescence in a playful and realistic way.
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  • 文章类型: Journal Article
    我们使用干预映射方法(IMA)来得出多层次的HIV预防策略,旨在在女性性工作者(FSW)中制定HIV预防干预计划。我们还旨在试点测试基于IMA的“艾滋病毒预防和意识计划(HIV-PAP)”对大不里士FSW中安全性行为及其决定因素的影响,伊朗。为了开发HIV-PAP,我们进行了IMA的六步过程。在步骤1中,在一项横断面研究中,140FSW进行了面对面的采访。在步骤2,基于用于识别优先级因子的重要性和可变性来提供程序矩阵。在步骤3和4中,选择了行为改变的方法和策略,并开发了HIV-PAP计划的组成部分和材料。在步骤5和6,评估(作为试验测试与静态组比较设计)进行了应用预实验研究,其中30个FSW被分配到干预组(n=15)和对照组(n=15).干预组参加了为期两个月的项目,一个月后,初始问卷由两组完成.受访者(M年龄:33.4岁,SD:9.7)仅在谈判使用避孕套(49.8%)时获得低分(低于50%),在感知的社会支持(61.6%)和知识(60.5%)方面得分中等(50-65%)。针对其他变量进行了调整,FSW中与安全性行为相关的因素(R2=32.0%)是诱发因素[自我效能感(β=0.331),感知规范(β=0.945),和感知障碍(β=0.258)],安全套使用协商(β=1.386),和环境因素(β=0.333)。我们基于IM的框架具有足够的拟合指数(χ2=130.8,CFI=0.78)。寻找干预后的组间比较,我们发现知识的显著平均差异(MD)(MD:2.18;95%置信区间(CI)-.38至4.74,p<0.05),使用避孕套的自我效能感(MD:6.71;95%CI-1.85至9.29,p<0.05),感知风险(MD:2.03;95%CI0.58,至3.49,p<0.05),感知社会支持(MD:4.64;95%CI-5.37至11.31,p<0.01),和安全性行为(MD:7.75;95%CI-4.19至9.71,p<0.05)。HIV-PAP在促进FSW中安全性行为及其决定因素方面显示出有效性。在法律禁止性工作的情况下,医疗保健提供者应更好地了解FSW中安全性行为的决定因素。在这样的社区,他们应该尝试开发或适应这种特定阶段的干预措施,其中促进上述因素是该计划的核心优先事项。
    We used an Intervention Mapping Approach (IMA) to derive multi-level HIV prevention strategies aiming to develop an HIV prevention intervention program among female sex workers (FSWs). We also aimed at pilot testing the effects of the IMA-based \"HIV Prevention and Awareness Program (HIV-PAP)\" on safe sex behaviors and its determinants among FSWs in Tabriz, Iran. To develop HIV-PAP, we conducted the six-step process of IMA. At Step 1, in a cross-sectional study, 140 FSWs were face-to-face interviewed. At Step 2, the program matrix was provided based on the importance and variability for identifying priority factors. At Steps 3 and 4, the methods and strategies for behavioral change were selected, and the HIV-PAP program components and materials were developed. At Steps 5 and 6, evaluation (as a pilot testing with Static-Group Comparison design) was conducted applying a pre-experimental study, in which 30 FSWs were assigned to intervention (n = 15) and control (n = 15) groups. The intervention group participated in a two-month long program, and one month later, the initial questionnaires were completed by both groups. The respondents (M age: 33.4 years, SD: 9.7) acquired low score (less than 50%) in negotiating for condom use (49.8%) only, and moderate scores (50-65%) in perceived social support (61.6%) and knowledge (60.5%). Adjusted for other variables, the factors (R2 = 32.0%) associated with safe sex behaviors among FSWs were predisposing factors [self-efficacy (β = 0.331), perceived norms (β = 0.945), and perceived barriers (β = 0.258)], condom use negotiation (β = 1.386), and environmental factors (β = 0.333). Our IM-based framework had an adequate fit index (χ2 = 130.8, CFI = 0.78). Looking for inter-group comparison after intervention, we found significant mean difference (MD) for knowledge (MD: 2.18; 95% Confidence Interval (CI) - .38 to 4.74, p < 0.05), self-efficacy to use condom (MD: 6.71; 95% CI - 1.85 to 9.29, p < 0.05), perceived risk (MD: 2.03; 95% CI 0.58, to 3.49, p < 0.05), perceived social support (MD: 4.64; 95% CI - 5.37 to 11.31, p < 0.01), and safe sexual behaviors (MD: 7.75; 95% CI - 4.19 to 9.71, p < 0.05). The HIV-PAP showed effectiveness in promoting safe sexual behaviors and their determinants among FSWs. Healthcare providers should better understand the determinants of safe sexual behaviors among FSWs in the settings with legal prohibitions for sex work. In such communities, they should try to either develop or adapt such stage-specific interventions, within which promoting the above-mentioned factors is the core priorities of the program.
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  • 文章类型: Journal Article
    欧洲女性性工作者(FSW)对暴露前预防(PrEP)的使用知之甚少。西班牙承认FSW是感染艾滋病毒的高风险人群,并在2019年首次在全国范围内使用该药物时给予他们补贴。然而,2022年,FSW仅占PrEP用户的0.2%。2022年1月至3月间,通过位于马德里的当地非政府组织的实地活动,共采访了102名HIV阴性FSW。参与者是在固定的招聘期内通过便利抽样选出的。FSW完成了一项73项调查,其中包含有关个人的问题,职业,社会,和结构决定因素。这项研究的目的是确定(1)使用口头PrEP的意图及其决定因素的普遍性,(2)避孕套使用不一致的患病率,这是在国家卫生系统中有资格获得FSW补贴PrEP的风险因素,及其决定因素。重要的是,研究样本中街道FSW的比例过高(71.6%)。四分之一(25.5%)的研究参与者不一致地使用避孕套。PrEP意识较低(9.8%),但使用PrEP的意向较高(72.5%)。使用口服PrEP的意图与通过服用PrEP而对HIV的保护和单独使用避孕套的保护不足的感觉显着相关。避孕套使用不一致与海洛因/可卡因频繁使用显著相关,有注射毒品的客户,并愿意采取PrEP,尽管它不能保护100%免受艾滋病毒感染。FSW,在这个特定的样本中,有针对性的PrEP宣传活动和实施项目可能会受益,这些活动和项目优先考虑使用毒品的人,并且更有可能从事无公寓性行为。
    There is scant knowledge regarding pre-exposure prophylaxis (PrEP) use among female sex workers (FSWs) in Europe. Spain recognized FSWs as a population at high risk of acquiring HIV and granted them subsidized access to PrEP when the medication first became nationally available in 2019. Nevertheless, FSWs represented just 0.2% of PrEP users in 2022. A total of 102 HIV-negative FSWs reached through field activities of local NGOs located in Madrid were interviewed between January and March 2022. Participants were selected through convenience sampling over a fixed recruitment period. FSWs completed a 73-item survey with questions about individual, occupational, social, and structural determinants. The objective of this study was to identify (1) the prevalence of intention to use oral PrEP and its determinants, and (2) the prevalence of inconsistent condom use, which is the risk factor that qualifies FSWs for subsidized PrEP in the national health system, and its determinants. Importantly, the study sample overrepresented street-based FSWs (71.6%). A quarter (25.5%) of the study participants used condoms inconsistently. PrEP awareness was low (9.8%), but intention to use PrEP was high (72.5%). Intention to use oral PrEP was significantly associated with feeling protected against HIV by taking PrEP and perceiving insufficient protection by condom use alone. Inconsistent condom use was significantly associated with frequent heroin/cocaine use, having clients who inject drugs, and willingness to take PrEP despite it not protecting 100% against HIV infection. FSWs, in this specific sample, are likely to benefit from targeted PrEP awareness campaigns and implementation projects that prioritize those who use drugs and are more likely to engage in condomless sex.
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