Safer Sex Programs Research Articles

Os antecedentes da cocriação de valor em programas de incentivo ao sexo seguro: contribuições da Lógica Dominada por Serviço ao Marketing Social

Neste trabalho aborda-se a utilidade da Lógica Dominada por Serviço (LUSCH; VARGO, 2014), para o entendimento de fenômenos do Marketing Social, com ênfase na cocriação de valor pelo beneficiário de programas sociais voltados para a adoção do sexo seguro. Após pesquisa bibliográfica sobre o tema, elaborou-se modelo hierárquico contendo os constructos que envolvem a cocriação de valor e seus potenciais antecedentes. A partir do modelo foi criado o questionário, que foi aplicado a estudantes universitários na cidade de Teófilo Otoni-MG. Os resultados, obtidos por meio de Modelagem de Equações Estruturais, mostram que o constructo nível de atividades tem como antecedente o traço elementar abertura a experiências, enquanto que o constructo número de interações é explicado pelos traços elementares abertura a experiência, neuroticismo e necessidade de recursos materiais (negativamente).

Messages about sexuality: an ecological perspective

The goal of this two-part study was to identify the perceived influence of sexuality messages from parents, peers, school and the media – four microsystems within the Ecological Model – on emerging adult US college women's sexual attitudes. Findings suggest that parents were the most likely source of the message to ‘remain abstinent until marriage’, and participants reported this message as being more influential when coming from school than from the media. The school and the media were the most likely sources of the messages to ‘be safe and use protection’ and to ‘use birth control so you don't get pregnant’. College women reported that the message to ‘use protection’ influenced their sexual behaviour more, however, when it came from their parents than from school, and more when it came from school than from the media. These results have implications for future prevention programming. Specifically, with respect to these messages, and without generalising beyond these data, parents and school appear to be more influential than peers and the media, and thus should be leveraged in development of new sex education and safer sex programmes.

Some Case Studies of AIDS/HIV Patients in India

The present study deals with the mental health of AIDS patients. Therefore it is essential that we should have some clear ideas about the scientific nature of AIDS and mental health. Human Immunodeficiency Virus Infection / Acquired Immunodeficiency Syndrome (HIV/AIDS) is a disease of the human immune system caused by infection with human immunodeficiency virus (HIV). During the initial infection, a person may experience a brief period of influenza-like illness. This is typically followed by a prolonged period without symptoms. As the illness progresses, it interferes more and more with the immune system, making the person much more likely to get infections, including opportunistic infections and tumors that do not usually affect people who have working immune systems. HIV is transmitted primarily via unprotected sexual intercourse (including anal and even oral sex), contaminated blood transfusions, hypodermic needles, and from mother to child during pregnancy, delivery, or breastfeeding. Some bodily fluids, such as saliva and tears, do not transmit HIV. Prevention of HIV infection, primarily through safe sex and needle-exchange programs, is a key strategy to control the spread of the disease. There is no cure or vaccine; however, antiretroviral treatment can slow the course of the disease and may lead to a near-normal life expectancy. While antiretroviral treatment reduces the risk of death and complications from the disease, these medications are expensive and may be associated with side effects.

The redlining of harm reduction programs

First came an assault on Vancouver, British Columbia’s safe injection site. That was followed by the axing of safe tattooing programs in prisons ([www.cmaj.ca/lookup/doi/10.1503/cmaj.070017][1]), as well as opposition to needle exchange and safe sex programs. Meanwhile, federal funding for drug

Transvestites’ narratives about their experience with HIV/Aids

Objective. To describe reflections of a group of transvestites, who work or have worked as prostitutes, about their experience as people who live with HIV/Aids, and their necessities of nursing support. 
 Methodology. Qualitative study. 10 transvestites with HIV/Aids from 23 to 40 years of age, linked to prostitution, who attend a third level hospital of Bogota, were interviewed in depth. For data analysis the AtlasTi vr. 6 was used. 
 Results. For these people money’s priority over health, alcohol consumption, and psychoactive substances take them not to use protection with the clients; preservative use failure with the sex couple precedes the infection. Depression is frequent. Attending the HIV program is essential for coping with the disease. 
 Conclusion. There is a high HIV/Aids vulnerability in this group of people. It is necessary to create safe sex programs and strengthen life sense.

Shattering the Myth of Invulnerability: Exploring the Prevention Needs of Sexual Minority Women Living with HIV/AIDS

Developing effective safer-sex programs for women living with HIV/AIDS (WLH/A) is a national HIV prevention priority. Existing programs focus predominantly on heterosexual women's experiences and ignore the needs of sexual minority women (SMW). Thus, we conducted semi-structured interviews with 16 sexual minority WLH/A to better understand their sexual risk behaviors and corresponding HIV prevention needs. Most of the interviewees were African American (75%) and poor (75%). We used strategies of Grounded Theory to code the interviews for key themes, which included the following: differences between relationships, risk, and protective behaviors in male and female relationships; links between substance abuse and unsafe sex; need for safer-sex or prevention programs to address SMW-specific skills and topics; and the importance of addressing women's resiliency and the social context of women's risk in prevention programs. Conclusions include concrete suggestions to make safer-sex programs more responsive to the needs of SMW.

Determinants of Condom Use: Results of the Canadian Community Health Survey 3.1

Objectives: To examine the independent effects of mood disorder, age, race/ethnicity, personal income, being a current student, having a regular medical doctor and substance use in relationship to condom use at last intercourse in a Canadian population stratified by sex. Methods: We used Cycle 3.1 of the 2006 Canadian Community Health Survey (CCHS 3.1), a population-based, voluntary, cross-sectional survey of subjects ages 12–85 years. Data collection took place between January and December 2005. From the survey, a study sample of 20,975 people was drawn, consisting of individuals providing valid responses (yes/no) to mood disorder and last-time condom use. The question of sexual behaviours was asked only of those ages 15–49 years. Logistic regression was used to examine individual variables as potential determinants of last-time condom use stratified by sex. Results: The relationship between mood disorder and condom use was non-significant in both males (AOR= 0.85, 95% CI=0.70−1.04) and females (AOR=0.90, 95% CI=0.78−1.03). Increasing age was found to be inversely associated with last-time condom use in both males and females. Male factors significantly associated with last-time condom use were being of white ethnicity (AOR=0.71, 95% CI=0.64−0.79) and being a current student (AOR=1.28, 95% CI=1.16−1.42). Female factors associated with last-time condom use were being of white ethnicity (AOR=0.71, 95% CI = 0.63−0.79) and being a former drinker (AOR=2.25, 95% CI=1.63−3.11). Conclusion: Our results identify important determinants of last-time condom use in both males and females in the CCHS 3.1. These findings may have important implications for the devising and implementation of safe sex programs in a Canadian population ages 15–49 years.

Determinants of condom use: Results of the Canadian Community Health Survey 3.1

To examine the independent effects of mood disorder, age, race/ethnicity, personal income, being a current student, having a regular medical doctor and substance use in relationship to condom use at last intercourse in a Canadian population stratified by sex. We used Cycle 3.1 of the 2006 Canadian Community Health Survey (CCHS 3.1), a population-based, voluntary, cross-sectional survey of subjects ages 12-85 years. Data collection took place between January and December 2005. From the survey, a study sample of 20,975 people was drawn, consisting of individuals providing valid responses (yes/no) to mood disorder and last-time condom use. The question of sexual behaviours was asked only of those ages 15-49 years. Logistic regression was used to examine individual variables as potential determinants of last-time condom use stratified by sex. The relationship between mood disorder and condom use was non-significant in both males (AOR = 0.85, 95% CI = 0.70-1.04) and females (AOR = 0.90, 95% CI = 0.78-1.03). Increasing age was found to be inversely associated with last-time condom use in both males and females. Male factors significantly associated with last-time condom use were being of white ethnicity (AOR = 0.71, 95% CI = 0.64-0.79) and being a current student (AOR = 1.28, 95% CI =1.16-1.42). Female factors associated with last-time condom use were being of white ethnicity (AOR = 0.71, 95% CI = 0.63-0.79) and being a former drinker (AOR = 2.25, 95% CI = 1.63-3.11). Our results identify important determinants of last-time condom use in both males and females in the CCHS 3.1. These findings may have important implications for the devising and implementation of safe sex programs in a Canadian population ages 15-49 years.

Randomized controlled trial to investigate impact of site‐based safer sex programmes in Kingston, Jamaica: trial design, methods and baseline findings

To describe the design, methods and baseline findings of a multi-level prevention intervention to increase consistent condom use among persons at public social sites in Kingston, Jamaica, who have new or concurrent sexual partnerships. A two-arm randomized controlled trial (RCT) of 147 sites where persons meet new sex partners. Sites were identified by community informants as places where people meet new sexual partners, which include bars, street locations, bus stops, malls and others. Sites were sorted into 50 clusters based on geographic proximity and type of site and randomized to receive a multi-level site-based intervention or not. Intervention components include on-site HIV testing, condom promotion and peer education. Effectiveness of the intervention will be measured by comparing the proportion of persons with new or multiple partners in the past year who report recent inconsistent condom use at intervention vs. control sites. Baseline surveys were conducted at 66 intervention (711 men, 845 women) and 65 control sites (654 men, 738 women). Characteristics of intervention and control sites as well as the characteristics of patrons at these sites were similar. The outcome variable was balanced with approximately 30% of men and 25% of women at intervention and control sites reporting a new partner or more than one partner in the past year and recent inconsistent condom use. The baseline findings confirm that the population is an appropriate target group for HIV prevention and that randomization will provide the means to estimate programme effectiveness.

Adolescents’ Sexually Transmitted Disease Protective Attitudes Predict Sexually Transmitted Disease Acquisition in Early Adulthood

Estimates suggest that about 48% of nearly 19 million cases of sexually transmitted diseases (STDs) occurring annually in the United States are acquired by persons aged 15-24 years. The purpose of this study was to test the hypothesis that adolescents' attitudes about protecting themselves from STDs predict their laboratory-confirmed prevalence of STDs in early adulthood. Wave 3 of the National Longitudinal Study of Adolescent Health assessed Chlamydia trachomatis, Neisseria gonorrhoeae, and Trichomonas vaginalis. This wave 3 data were regressed on data collected in wave 1 (when those followed were teens). A single-item measure (with a 5-point response option) assessed adolescents' attitude: "It would be a big hassle to do the things necessary to completely protect yourself from getting an STD." Valid urine specimens were provided by 8297 adolescents who also completed the self-reported measures needed for this study. Overall, 6.4% of the weighted sample tested positive for at least 1 of the 3 STDs. Controlling for age, gender, minority status, and age of sexual debut (all of which are well-established predictors of STD prevalence), attitude toward STD protection achieved significance (P<.001). Each additional point on the 5-point scale increased adolescents' odds of testing positive for an STD in early adulthood by about 13%. Of interest, the attitudinal measure did not interact with any of the other variables. Findings provide evidence suggesting that safer sex programs may benefit adolescents by fostering positive attitudes toward practices that avert STD acquisition.

Understanding Failure of Condom Use Intention Among Adolescents

Although interventions based on cognitive theories can reduce rates of unsafe sexual behavior in adolescents, effect sizes remain small. This study was a qualitative investigation of inner-city adolescents' intentions to use condoms following participation in an intensive safer sex program. In-depth interviews with 26 adolescents were analyzed using standard qualitative methods. Although participants reported strong intentions to use condoms, they described many exceptions to their intention. Condom use intentions were also trumped by the presence of alternative, often conflicting intentions. Typical barriers to condom use played a minor role compared to exceptions and competing intentions. Boys and girls differed in the ways exception to intention and alternate intentions interfered with condom use; these reflected gender roles and norms, which are often neglected in HIV/STD prevention programs. The authors conclude that the barrier model to explain non-condom use is incomplete and that the concept of intention itself may need more conceptual work.

Policy and prevention as competing imperatives in US Navy life and medicine

On the face of it, US Navy sexual health initiatives face a challenge similar to those on college and university campuses: how to prepare individuals coming into adulthood for both the positive and less positive health consequences of sexual intimacy. However, rules unique to military settings that forbid relationships between certain categories of personnel and that delimit the appropriate context and content of sexual expression have special implications for Navy safer sex programmes. Guided by in‐depth interviews with 58 Navy officers and enlisted members, this paper examines how official policies regulating sexual behaviour sometimes hinder the effective prevention and medical management of sexually transmitted infections and unplanned pregnancies. Two findings in particular are worthy of note: first, perceptions of sexual risk are often displaced from concerns about health to concerns about ‘getting caught’ for violating Navy rules; and second, official prevention efforts do not adequately reflect the realities of sexual life (especially on deployments). Current US Navy rules governing sex may therefore have the inadvertent effects of contributing to sexual health risk and of preventing the occurrence not of sex, but of safer sex. Résumé A première vue, les initiatives prises par la marine américaine en matière de santé sexuelle sont confrontées à un défi similaire à celui rencontré sur les campus universitaires : comment préparer les individus atteignant l'âge adulte aux conséquences positives ou moins positives de l'intimité sexuelle sur leur santé. Cependant, les règles spécifiques au cadre militaire, qui interdisent les relations entre certaines catégories de personnel et délimitent le contexte approprié et le contenu de l'expression sexuelle, créent des ramifications distinctes pour les programmes de sexe sans risque de la marine. Guidé par 58 entretiens en profondeur avec des officiers de la marine et de simples recrues, cet article examine comment les politiques officielles qui régulent les comportements sexuels peuvent quelquefois faire obstacle à l'efficacité de la prévention et de la prise en charge médicale des infections sexuellement transmissibles et des grossesses non désirées. Deux résultats méritent une attention particulière : premièrement, les perceptions du risque sexuel se déplacent souvent des préoccupations sur la santé vers celles de « se faire prendre » pour avoir enfreint les règlements de la marine ; deuxièmement, les efforts officiels en prévention ne reflètent pas de manière adéquate les réalités de la vie sexuelle (en particulier lors de déploiements de troupes). Les règles actuelles concernant les rapports sexuels dans la marine américaine peuvent par conséquent avoir pour effets indésirables de contribuer à l'accroissement des risques en santé sexuelle et à empêcher la prévention, non pas des rapports sexuels, mais des rapports sexuels non protégés. Resumen Las iniciativas de la marina de los EE. UU. con respecto a la salud sexual se enfrentan a los mismos desafíos que en escuelas y campus universitarios: cómo preparar a los estudiantes que se hacen adultos sobre las consecuencias positivas y menos positivas de la salud con respecto a la intimidad sexual. No obstante, las normas exclusivas en ambientes militares, que prohíben relaciones entre ciertas categorías del personal y que delimitan el contexto y el contenido apropiado de expresión sexual, crean distintas ramificaciones para los programas de salud sexual en la marina. A partir de entrevistas exhaustivas con 58 oficiales de la marina y miembros alistados, en este ensayo se analiza cómo las políticas oficiales que regulan las conductas sexuales representan a veces un obstáculo para la prevención eficaz y el control médico de las infecciones de transmisión sexual y los embarazos no deseados. Hacemos especial hincapié en dos factores dignos de mención: en primer lugar, con frecuencia se da más importancia a preocupaciones tipo “me van a pillar” quebrantando las normas de la marina que a las percepciones del riesgo sexual; y en segundo lugar, los esfuerzos de prevención oficial no reflejan adecuadamente las realidades de la vida sexual (especialmente en los despliegues militares). Las normas actuales en la marina de los EE. UU. que rigen las conductas sexuales podrían por consiguiente tener el efecto involuntario de contribuir a propagarse una conducta de riesgo sexual. En vez de evitar las relaciones sexuales, las normas impiden las relaciones sexuales seguras.

Making condoms available in schools. The evidence is not conclusive.

This article deals with three main controversial approaches in reducing rates of sexually transmitted diseases and unintended pregnancy among North American teenagers: abstinence-only programs safer sex education and making condoms available in schools. The American Medical Association (AMA) Council on Scientific Affairs concluded recently that there are no published studies that measure behavioral effects of the abstinence-only curricula that evaluations of safer-sex sexuality education show inconsistent but promising results and that programs to make condoms available in school “usually demonstrate increased condom use.” The author of this article however disputes the AMA’s findings. He contends that there is a strong indication that some abstinence-only program may delay sex and that some safer sex programs do reduce unprotected sex. He also notes that the evidence showing condom availability leads to greater condom use is not consistent. He attributes the different conclusions to differences in the research methods in communities schools and student needs or other factors.

Safer-Sex Programs Increase Condom Use Among Black Adolescents

659 students were recruited from 3 middle schools in Philadelphia to participate in a sexual risk reduction program designed for low-income Black adolescents. The adolescents were of mean age 11.8 years and 53% were female. When they entered the program 25% had ever had sexual intercourse and 15% had had intercourse within the 3 preceding months. Participants were randomly assigned to attend either a program encouraging young people to abstain from sexual intercourse a program encouraging sexually active teens to use condoms against HIV and other STDs or a program explaining how to reduce participants risk of other major diseases affecting Blacks. 1 year after the intervention the proportion of participants reporting sexual intercourse was similar in all 3 groups. However the adolescents who completed the safer sex education program reported more frequent condom use than their peers who received abstinence-only or general health education. In addition those who began having sex before entering the safer sex program have intercourse less often and have unprotected sex less often than do students in abstinence and general health programs. In contrast 1 year after attending the abstinence education program Black teenagers differed from those in general health programs only in their greater frequency of condom use.