• 【中国男男性行为人群中增加安全套使用和HIV检测的干预措施: 一项荟萃分析。】 复制标题 收藏 收藏
    DOI:10.1089/AID.2012.0151 复制DOI
    作者列表:Huang Z,Wang M,Fu L,Fang Y,Hao J,Tao F,Tu C
    BACKGROUND & AIMS: :Behavioral interventions have been shown to both promote and change many health-related behaviors and issues. This meta-analysis was performed to assess whether behavioral interventions have the potential to increase condom use and HIV testing uptake among men who have sex with men (MSM) in China. PubMed, Elsevier Science Direct, Chinese Biomedical Literature Database (CBM), China National Knowledge Infrastructure (CNKI), and Wanfang (Chinese) were searched to June 2011 to identify relevant articles. Data of eligible citations were extracted by two reviewers. Sixteen studies were identified. Aggregated findings indicated that interventions were associated with a significant increase in condom use between MSM and male sex partners in the last anal sex act (RR=1.17, 95% CI=1.05-1.29) and consistent condom use between MSM and male sex partners in the past 6 months (RR=1.36, 95% CI=1.15-1.60) and HIV testing (RR=2.22, 95% CI=1.72-2.88). However, no significant increase was detected in condom use over the course of the intervention among MSM engaging in sex with women. In the subgroup analyses, the positive effects were not detected in some subgroups such as anal sex with casual partners and intervention interval less than or equal to 6 months. The sensitivity analysis showed that these estimates were unchanged after removal of the study that had the biggest sample or the studies that had the most rigorous study design. This meta-analysis can inform future intervention design and implementation in terms of sample size, target populations, settings, goals for process measures, and intervention interval.
    背景与目标: : 行为干预已被证明可以促进和改变许多与健康相关的行为和问题。进行了这项荟萃分析,以评估行为干预是否有可能增加中国男男性行为者 (MSM) 中安全套的使用和HIV检测的摄入量。搜索PubMed,Elsevier Science Direct,中国生物医学文献数据库 (CBM),中国国家知识基础设施 (CNKI) 和万方 (中文) 进行了2011年6月,以识别相关文章。合格引用的数据由两名审阅者提取。确定了16项研究。汇总结果表明,干预措施与上一次肛交行为中MSM和男性性伴侣之间安全套使用的显着增加有关 (RR = 1.17,95% CI = 1.05-1.29),以及MSM和男性性伴侣之间持续使用安全套在过去6个月 (RR = 1.36,95% CI = 1.15-1.60) 和HIV检测 (RR = 2.22,95% CI = 1.72-2.88)。但是,在与女性发生性行为的MSM中,在干预过程中,安全套的使用没有显着增加。在亚组分析中,在某些亚组中未检测到积极影响,例如与休闲伴侣进行肛交以及干预间隔小于或等于6个月。敏感性分析表明,在删除样本最大的研究或研究设计最严格的研究后,这些估计值没有变化。该荟萃分析可以在样本量,目标人群,设置,过程措施的目标和干预间隔方面为未来的干预设计和实施提供信息。
  • 【斯威士兰女性性工作者使用避孕套和使用其他避孕方法之间的关联: 避孕套和避孕使用的关系水平分析。】 复制标题 收藏 收藏
    DOI:10.1097/OLQ.0b013e318283c16d 复制DOI
    作者列表:Yam EA,Mnisi Z,Sithole B,Kennedy C,Kerrigan DL,Tsui AO,Baral S
    BACKGROUND & AIMS: OBJECTIVES:Nonbarrier modern contraceptive users often are less likely to use condoms, particularly with more intimate sex partners. We examine whether female sex workers (FSWs) in Swaziland who use nonbarrier contraception use condoms less consistently and whether this inverse association varies by relationship type. METHODS:In 2011, we conducted a survey among 325 Swazi FSWs using respondent-driven sampling. Each woman reported on condom use during sexual activity in the past month with up to 3 partner types (new clients, regular clients, noncommercial partners). We used a generalized estimating equation model to conduct a relationship-level multivariate logistic regression analysis of correlates of consistent condom use in the past month. We tested whether relationship type modified the effect of nonbarrier modern contraception on condom use. RESULTS:Each participant reported up to 3 observations, for a total of 892 measures of condom use in the past month. Compared with sexual activity with new clients, sex with regular clients and noncommercial partners was less likely to be protected by consistent condom use (adjusted odds ratio, 0.30 [95% confidence interval, 0.19-0.47] for regular clients; adjusted odds ratio, 0.15 [95% confidence interval, 0.09-0.24] for noncommercial partners). There was no significant association between condom use and nonbarrier modern contraceptive use. CONCLUSIONS:These data highlight the need to provide condoms and condom-compatible lubricants and targeted education programs for FSWs and their male sex partners to encourage the consistent use of these commodities with all sex partners, irrespective of the use of other contraceptive methods.
    背景与目标:
  • 【中国安徽北部农村地区艾滋病毒高流行地区患者的艾滋病意识和安全套使用。】 复制标题 收藏 收藏
    DOI:10.231/JIM.0b013e3181e80188 复制DOI
    作者列表:Mao NL,Pan HF,Lu MM,Dai SY,Chen GM,Tian M,Huang ZJ,Ye DQ
    BACKGROUND & AIMS: :The objective was to assess AIDS awareness and condom use in a rural northern Anhui area with a high HIV prevalence. One hundred two AIDS patients underwent a structured interview using a standard questionnaire. There were 51 female and 51 male patients, whose mean age was 46.27 +/- 7.27 years and who had good knowledge of AIDS-related issues. More sexually active patients than those nonactive ones knew it more properly that AIDS was a blood-borne disease (100% vs 94.4%; P = 0.03). Significantly more female patients than male (62.7% vs 47.1%; P = 0.047) knew AIDS is incurable. Self-perceived risk was low, and only 84 respondents regarded the condom use as a common problem in their area. Two independent factors associated with a higher rate of condom use were the AIDS patients' income level and their knowledge about condom use. There was statistically significance between the patients who regularly obtained free condoms and those who did not. The patients who bought condoms on their own initiative had a higher chance of using condoms than those who did not. In conclusion, despite a high level of awareness of HIV/AIDS issues, self-perceived risk was low, condom use was infrequent, and especially men continued to have multiple sexual partners.
    背景与目标: : 目的是评估安徽北部一个艾滋病毒高流行的农村地区的艾滋病意识和避孕套使用情况。使用标准问卷对120名艾滋病患者进行了结构化访谈。有51名女性患者和51名男性患者,平均年龄为46.27 +/- 7.27岁,并且对艾滋病相关问题有很好的了解。性活跃的患者比那些不活跃的患者更清楚地知道艾滋病是一种血液传播的疾病 (100% vs 94.4%; P = 0.03)。女性患者明显多于男性 (62.7% vs 47.1%; P = 0.047) 知道艾滋病是无法治愈的。自我感知的风险很低,只有84名受访者认为使用避孕套是他们所在地区的常见问题。与安全套使用率较高的两个独立因素是艾滋病患者的收入水平及其对安全套使用的了解。定期获得免费避孕套的患者与未获得免费避孕套的患者之间具有统计学意义。主动购买避孕套的患者比不购买避孕套的患者使用避孕套的机会更高。总之,尽管人们对艾滋病毒/艾滋病问题的认识很高,但自我感知的风险很低,避孕套的使用很少,特别是男性继续有多个性伴侣。
  • 【使用避孕套可促进宫颈上皮内瘤变女性男性性伴侣与人乳头瘤病毒相关的阴茎病变的消退。】 复制标题 收藏 收藏
    DOI:10.1002/ijc.11473 复制DOI
    作者列表:Bleeker MC,Hogewoning CJ,Voorhorst FJ,van den Brule AJ,Snijders PJ,Starink TM,Berkhof J,Meijer CJ
    BACKGROUND & AIMS: :Penile HPV-associated lesions are frequently seen in male sexual partners of women with CIN. The natural course and clinical significance of these lesions are unclear. Women with CIN and their male sexual partners were randomized for condom use (condom group n = 68, noncondom group n = 68). Males were screened for the presence of penile lesions, i.e., flat lesions, papular lesions and condylomata acuminata, and of HPV in their penile swabs by PCR testing. Median follow-up time was 13.1 months (range 2.9-57.4). The outcome of our study was clinical regression of penile lesions defined as disappearance of lesions at penoscopy. Potentially prognostic factors, i.e., HPV status, lesion type and age, were studied as well. Outcomes were assessed in 57 men of the condom group and in 43 men of the noncondom group. Condom use shortened the median time to regression of flat penile lesions (7.4 months condom group vs. 13.9 months noncondom group; HR = 2.1, 95% CI 1.2-3.7). This effect was not found for papular lesions (HR = 0.5, 95% CI 0.1-2.8). HPV-negative men showed a significantly shorter median time to regression of flat lesions (3.8 months) compared to men with either HPV-positive status (8.5 months; HR = 0.4, 95% CI 0.2-0.9) or inconsistent HPV status (13.1 months; HR = 0.2, 95% CI 0.1-0.6). Regression of flat penile lesions is HPV-dependent and accelerated by condom use. This effect is probably the result of blocking viral transmission between sexual partners.
    背景与目标: : 阴茎HPV相关病变常见于CIN女性的男性性伴侣。这些病变的自然病程和临床意义尚不清楚。CIN妇女及其男性性伴侣被随机分配使用避孕套 (避孕套组n = 68,非避孕套组n = 68)。通过PCR测试,筛选了男性是否存在阴茎病变,即扁平病变,丘疹病变和尖锐湿疣,以及阴茎拭子中的HPV。中位随访时间为13.1个月 (范围2.9-57.4)。我们研究的结果是阴茎病变的临床消退,阴茎病变被定义为阴茎镜下病变的消失。还研究了潜在的预后因素,即HPV状态,病变类型和年龄。在避孕套组的57名男性和非避孕套组的43名男性中评估了结果。使用避孕套缩短了扁平阴茎病变消退的中位时间 (7.4个月避孕套组与13.9个月非避孕套组; HR = 2.1,95% CI 1.2-3.7)。对于丘疹性病变未发现这种效果 (HR = 0.5,95% CI 0.1-2.8)。与HPV阳性状态 (8.5个月; HR = 0.4,95% CI 0.2-0.9) 或HPV状态不一致 (13.1个月; HR = 0.2) 的男性相比,HPV阴性的男性显示平坦病变消退的中位时间 (3.8个月) 明显缩短。95% CI 0.1-0.6)。扁平阴茎病变的消退是HPV依赖性的,并通过使用避孕套而加速。这种效应很可能是阻止性伴侣之间的病毒传播的结果。
  • 【通过来自美国五个城市的年轻成年男性注射吸毒者之间的伙伴关系,与主要伴侣一致使用安全套的相关性。】 复制标题 收藏 收藏
    DOI:10.1016/j.drugalcdep.2007.01.004 复制DOI
    作者列表:Kapadia F,Latka MH,Hudson SM,Golub ET,Campbell JV,Bailey S,Frye V,Garfein RS,DUIT Study Team.
    BACKGROUND & AIMS: :This paper examined correlates of consistent condom use with a main partner among heterosexual male injection drug users (IDUs). Using data from a multi-site sample of young IDUs, we identified 1770 sexually active men of whom 24% (429/1770) reported an exclusive main female sex partner and 49% (862/1770) reported both main and casual female sex partners. Consistent condom use with a main partner was low among men with an exclusive main partner and those with multiple partners (12% and 17%, respectively). In multivariate analysis, consistent condom use with a main partner across partnership patterns was directly associated with anticipating a positive response to requests for condom use and by partner support of condom use; consistent condom use was inversely associated with a main partner's pregnancy desires. Among men with an exclusive main partner, consistent condom use was also inversely associated with needle sharing with a main partner. Among men with multiple partners, consistent condom use with a main partner was inversely associated with injecting with a used needle and intimate partner violence. The low prevalence of consistent condom use with main female partners among heterosexually active male IDUs indicates an increased risk for HIV transmission between men and their primary sex partners. Interventions for heterosexual males that are geared toward increasing condom use in primary relationships are warranted.
    背景与目标: : 本文研究了异性男性注射吸毒者 (IDUs) 中与主要伴侣一致使用避孕套的相关性。使用来自年轻注射吸毒者的多站点样本的数据,我们确定了1770位性活跃男性,其中24% (429/1770) 报告了唯一的主要女性性伴侣,49% (862/1770) 报告了主要和休闲女性性伴侣。在具有独家主要伴侣的男性和具有多个伴侣的男性中,与主要伴侣的一致安全套使用率较低 (分别为12% 和17%)。在多变量分析中,跨伙伴关系模式与主要伴侣一致使用安全套与预期对安全套使用请求的积极响应以及伴侣对安全套使用的支持直接相关; 一致使用安全套与主要伴侣的怀孕愿望成反比。在拥有独家主要伴侣的男性中,持续使用安全套也与与主要伴侣共用针头成反比。在拥有多个伴侣的男性中,与主要伴侣一致使用安全套与注射用过的针头和亲密伴侣的暴力行为成反比。在异性恋活跃的男性注射吸毒者中,与主要女性伴侣一致使用避孕套的流行率较低,这表明男性与其主要性伴侣之间传播艾滋病毒的风险增加。有必要对异性恋男性进行干预,以增加主要关系中的避孕套使用。
  • 【2002-2017年,美国青少年和年轻人在第一次阴道性交时使用避孕套。】 复制标题 收藏 收藏
    DOI:10.1016/j.jadohealth.2020.03.034 复制DOI
    作者列表:Holway GV,Brewster KL,Tillman KH
    BACKGROUND & AIMS: PURPOSE:The purpose of this study was to describe trends in vaginal intercourse (VI) and condom use during first VI from 2002 to 2017 among never-married 15- to 24-year-olds in the United States. METHODS:Data come from the National Survey of Family Growth. We used logistic regression and Stata's margins package to estimate the percentage reporting VI and condom use at first VI and to conduct statistical comparisons across time. RESULTS:VI was stable for 20- to 24-year-old men, but their condom use increased after 2002. For 15- to 19-year-old men, VI declined after 2011-2015 but condom use increased (83%). Among women, the overall percentage reporting VI and partner's condom use was stable, despite a significant increase in condom use among 15- to 19-year-olds between 2006-2010 and 2011-2015 (69%-75%). CONCLUSIONS:Condom use at first intercourse increased among young men, but a similar pattern was not observed for young women. Understanding why is crucial to the formulation of strategies to increase condom uptake.
    背景与目标:
  • 【青少年女性的事件级大麻使用、酒精使用和避孕套使用。】 复制标题 收藏 收藏
    DOI:10.1097/OLQ.0b013e3181f422ce 复制DOI
    作者列表:Hensel DJ,Stupiansky NW,Orr DP,Fortenberry JD
    BACKGROUND & AIMS: BACKGROUND:It is widely believed that marijuana use and alcohol use directly intercede on successful condom use. However, measurement differences and inconsistent findings in past research remain unclear whether marijuana and alcohol work directly to influence condom behavior, or spuriously function through other factors that actually reflect an increased likelihood of vaginal sex. The current study prospectively disentangles the association of marijuana and alcohol use on condom behavior among adolescent women. METHODS:Young women (N=387; 14-17 years) provided daily sexual diaries as part of a longitudinal cohort study (1999-2009) of sexual behavior and sexual relationships. To separate the effects of marijuana and alcohol use on vaginal sex from condom use (when vaginal sex occurs), we estimated a 3-category outcome variable (no vaginal sex, vaginal sex with a condom, vaginal sex without a condom), alternating no sex (Model 1) and sex without a condom (Model 2) as the referent categories. Generalized estimating equation multinomial logistic regression adjusted odds ratios for multiple sexual events from the same young woman over time. RESULTS:Subjects contributed 14,538 coital events; 30% of these events were condom-protected. Neither marijuana nor alcohol use was directly associated with lower condom use; the strongest effect of condom use (adjusted odds ratio) and nonuse was performance of these behaviors in the past week. CONCLUSIONS:This study finds no evidence of a relationship between marijuana or alcohol use and condom nonuse. Both condom use and nonuse were identified as consistent behavioral patterns, regardless of the effect of marijuana and alcohol use.
    背景与目标:
  • 【谁的意图预测?异性恋二元组使用避孕套的权力。】 复制标题 收藏 收藏
    DOI:10.1037/a0030021 复制DOI
    作者列表:VanderDrift LE,Agnew CR,Harvey SM,Warren JT
    BACKGROUND & AIMS: UNLABELLED:According to major theories of behavioral prediction, the most proximal psychological predictor of an individual's behavior is that individual's intention. With respect to interdependent behaviors such as condom use, however, relationship dynamics influence individuals' power to make decisions and to act. OBJECTIVE:The current study examines how relationship dynamics impact 3 condom use relevant outcomes: (a) the individual forming his or her own intention to use condoms, (b) the couple forming their joint intention to use condoms, and (c) actual condom use behavior. METHOD:We conducted a 2-wave longitudinal study of young heterosexual adult couples at high risk for HIV infection involving the collection of both individual- and couple-derived data. RESULTS:Results demonstrate the importance of both person (e.g., biological sex and dispositional dominance) and relational (e.g., relational power and amount of interest in the relationship, operationalized as commitment and perceived alternatives to the relationship) factors in predicting condom use intentions and behavior. Individuals who are lower in dispositional dominance are likely to incorporate their partner's intentions into their own individual intentions; the intentions of individuals who have less interest in the relationship are more highly predictive of the couple's joint intention; and the intentions of men and individuals higher in relationship power are more likely to exert a direct influence on condom use. CONCLUSIONS:These findings have implications for improving the health of high-risk individuals, including suggesting situations in which individuals are highly influenced by their partners' intentions.
    背景与目标:
  • 【男性囚犯样本中避孕套使用的预测因素: 社会认知视角。】 复制标题 收藏 收藏
    DOI: 复制DOI
    作者列表:Stephens TT,Braithwaite R,Conerly R,Brantley K
    BACKGROUND & AIMS: :The primary purpose of this study was to determine factors that predict condom self-efficacy among a sample of soon-to-be-released adult male inmates with respect to self-reported HIV/AIDS risk behaviors. Approximately 230 inmates had agreed to enroll in the study. This analysis is based on completed baseline surveys from 187 inmates. Data were collected at baseline (prior to implementing the intervention) on self-reported condom self-efficacy HIV/AIDS risk behaviors. Findings support that, requesting that your partner uses condoms every time they had sex was the strongest indicator of self-reported condom self-efficacy by inmates in the sample (p<0.01). Findings also suggest that engaging in sexual activity after smoking marijuana, limiting the number of sex partners and asking partners' HIV status were significant predictors for the dependent variable of condom self-efficacy (p<.05); engaging in sexual activity after drinking was not (p<0.11). Findings suggest that it may be wise to take a best-practice approach using former inmates as peer educators if health-based interventions are to be delivered to soon-to-be-released adult male inmates.
    背景与目标: : 这项研究的主要目的是确定预测即将释放的成年男性囚犯中有关自我报告的HIV/AIDS危险行为的避孕套自我效能的因素。大约230名囚犯同意参加这项研究。该分析基于187名囚犯完成的基线调查。在基线 (实施干预之前) 收集自我报告的避孕套自我效能HIV/AIDS风险行为的数据。调查结果支持,要求您的伴侣每次发生性行为时都使用避孕套是样本中囚犯自我报告避孕套自我效能的最强指标 (p<0.01)。研究结果还表明,吸食大麻后从事性活动,限制性伴侣的数量和询问伴侣的HIV状况是安全套自我效能因变量的重要预测因素 (p<.05); 饮酒后从事性活动不是 (p<0.11)。研究结果表明,如果要向即将释放的成年男性囚犯提供基于健康的干预措施,那么采取最佳实践方法可能是明智的,将前囚犯作为同伴教育者。
  • 【在避孕套功能的临床研究中评估和比较正确使用的失败概率。】 复制标题 收藏 收藏
    DOI:10.1081/BIP-120022774 复制DOI
    作者列表:Weaver MA,Taylor DJ,Dominik RC
    BACKGROUND & AIMS: :In a clinical study comparing the failure probabilities of two condom types, the sample of all reported acts of intercourse in which a study condom was used by a randomized participant is typically defined to be the primary analysis sample. However, it may also be desirable to make comparisons among only those acts in which the participants correctly followed all condom use instructions before, during, and after the act of intercourse (i.e., the "correct-use" subset). The timing associated with the definition of correct use creates a dilemma in that an act cannot be classified as a "correct-use act" until after the completion of both intercourse and withdrawal; if a condom fails (e.g., breaks or slips completely off of the penis) during intercourse then the couple has no chance at correct use during withdrawal. As a result of the implicitly conditional nature of this problem, it is not a simple matter to specify a correct-use subset of the primary analysis sample. With this in mind, we develop estimators for the correct-use failure probabilities, the corresponding standard errors, and test statistics for comparing the correct-use failure probabilities between condom groups. We demonstrate the utility of the proposed methods by applying them to data from a clinical study of condom contraceptive effectiveness, and we use simulated data to investigate the finite sample properties of the proposed methods. The simulation results indicate that one of our proposed estimators is at least approximately unbiased, even in small samples. Furthermore, one-sided noninferiority tests performed using this estimator tend to have sizes that are only marginally larger than the nominal test size in moderate to large samples.
    背景与目标: : 在一项比较两种避孕套失败概率的临床研究中,随机参与者使用研究避孕套的所有报告的性交行为的样本通常被定义为主要分析样本。然而,也可能希望仅在参与者在性交行为之前、期间和之后正确遵循所有避孕套使用说明的那些行为 (即,“正确使用” 子集) 之间进行比较。与正确使用的定义相关的时机造成了一个两难境地,即在性交和戒断完成之前,一项行为不能被归类为 “正确使用行为”; 如果避孕套失效 (例如,在性交过程中,这对夫妇在退出过程中没有机会正确使用阴茎。由于此问题的隐含条件性质,指定主要分析样本的正确使用子集并不是一件简单的事情。考虑到这一点,我们开发了正确使用的故障概率,相应的标准误差的估计器,以及用于比较安全套组之间正确使用的故障概率的测试统计数据。我们通过将所提出的方法应用于避孕套避孕有效性的临床研究数据来证明它们的实用性,并且我们使用模拟数据来研究所提出方法的有限样本属性。仿真结果表明,即使在小样本中,我们提出的估计量之一也至少近似无偏。此外,使用该估计器进行的单侧非劣效性检验的大小往往仅略大于中等至较大样本中的标称检验大小。
  • 【在同性恋和双性恋男性的互联网样本中,变化和使用避孕套的阶段。】 复制标题 收藏 收藏
    DOI:10.1177/1055329003261968 复制DOI
    作者列表:Gullette DL,Turner JG
    BACKGROUND & AIMS: :The purpose of this descriptive correlational study using the transtheoretical model was to determine the relationship between stages of change and condom use among gay and bisexual men with primary (steady) and casual (occasional) partners. A convenience sample of 241 gay and bisexual men was recruited from the Internet. The majority of men (n = 198, 82%) never used condoms during anal, vaginal, or oral intercourse with primary partners, indicating they were in the first of five stages of change (precontemplation). Thirty percent (n = 71) of men reported using condoms every time during anal intercourse with casual partners and were in the last stage of change (maintenance). Multiple regression analysis revealed that older bisexual men who informed partners of their HIV status and who were confident and perceived more advantages in using condoms were in higher stages of change. By placing participants into various stages of change, stage specific interventions can be designed.
    背景与目标: : 使用跨理论模型进行的描述性相关研究的目的是确定具有主要 (稳定) 和休闲 (偶尔) 伴侣的同性恋和双性恋男性的变化阶段与避孕套使用之间的关系。从互联网上招募了241名同性恋和双性恋男性的便利样本。大多数男性 (n = 198,82%) 在与主要伴侣的肛门,阴道或口交期间从未使用过避孕套,这表明他们处于变化的五个阶段 (预想) 中的第一个阶段。30% (n = 71) 的男性报告说,每次与休闲伴侣进行肛门性交时都会使用避孕套,并且处于改变 (维持) 的最后阶段。多元回归分析显示,向伴侣告知其艾滋病毒状况并有信心并认为使用安全套有更多优势的老年双性恋男性处于较高的变化阶段。通过将参与者置于变化的各个阶段,可以设计针对特定阶段的干预措施。
  • 【中国女性性工作者的避孕套使用、干预服务利用和艾滋病毒知识: 山东省艾滋病毒感染率历史较低的连续三次横断面调查结果。】 复制标题 收藏 收藏
    DOI:10.1258/ijsa.2009.009449 复制DOI
    作者列表:Liao M,Bi Z,Liu X,Kang D,Fu J,Song Q,Freeman J,Jiang B,Jia Y
    BACKGROUND & AIMS: :Heterosexual transmission of HIV through contact with female sex workers (FSWs) is a growing concern for the HIV/AIDS epidemic in China. Using consecutive cross-sectional surveys, we examined the prevalence of HIV and sexually transmitted infections (STIs), risk behaviours, HIV knowledge and the utilization of intervention services among FSWs in Shandong Province. Of 3460 participants, half reported ever having STI-related symptoms, 57.8% had ≥7 clients in the last week, half reported inconsistent use of condoms with clients and 11.2% reported ever using illicit drugs. Consistent use of condoms with clients was associated with higher education, being 20-24 years of age, being recruited from hotels, having ever received free condoms and was inversely associated with STI-related symptoms. HIV-related knowledge was associated with higher education, ever testing for HIV and inversely associated with self-reported STI-related symptoms. The low rates of condom use, high number and frequent turnover of clients, high prevalence of self-reported STIs and drug use highlight the urgency for more effective intervention in these FSWs.
    背景与目标: : 通过与女性性工作者 (fsw) 接触而传播艾滋病毒的异性是中国艾滋病毒/艾滋病流行的日益关注的问题。通过连续的横断面调查,我们检查了山东省fsw中HIV和性传播感染 (STIs) 的患病率,风险行为,HIV知识以及干预服务的利用情况。在3460名参与者中,一半报告曾患有性传播感染相关症状,57.8% 名在上周有 ≥ 7名客户,一半报告与客户使用避孕套不一致,11.2% 名报告曾使用非法药物。与客户一致使用避孕套与高等教育有关,年龄在20-24岁之间,是从酒店招募的,曾经接受过免费避孕套,并且与性传播感染相关症状呈负相关。与HIV相关的知识与高等教育,HIV检测有关,与自我报告的STI相关症状成反比。安全套使用率低,客户数量多且频繁流动,自我报告的性传播感染和药物使用率高,突显了对这些fsw进行更有效干预的紧迫性。
  • 【使用避孕套进行阴茎-阴道性交与不成熟的心理防御机制有关。】 复制标题 收藏 收藏
    DOI:10.1111/j.1743-6109.2008.00987.x 复制DOI
    作者列表:Costa RM,Brody S
    BACKGROUND & AIMS: INTRODUCTION:Freud opined that condom use during penile-vaginal intercourse (PVI), like sexual activities other than PVI, led to a detrimental effect on orgasm that fueled the neuroses. Although this hypothesis had not been empirically tested, Freud's hypothesis that inability to have a (PVI) vaginal orgasm is a sign of psychological immaturity has recently received empirical support. AIMS:The objective is to examine the hypotheses that use of immature psychological defense mechanisms correlates directly with frequency of condom use during PVI, but inversely with frequency of PVI without condoms. An additional aim is to examine the independent contributions of frequency of PVI with and without condoms, and different triggers of orgasm, in predicting the use of immature defense mechanisms. METHODS:Two hundred ten Portuguese participants (99 women) reported their frequency of PVI with and without condoms, and frequency of orgasms from different sexual activities during the preceding month, and also completed the Defense Style Questionnaire (DSQ-40). MAIN OUTCOME MEASURE:The association of DSQ-40 immature defenses (correlated with indices of psychopathology) with past month frequency of PVI with and without condoms, and orgasms from different sexual behaviors. RESULTS:Frequency of PVI with condoms correlated directly with use of immature defenses. Frequency of PVI without condoms correlated inversely with use of immature and neurotic defenses. Results were not confounded by relationship status, age, cohabitation, or social desirability responding. Regression analyses revealed that immature defenses were independently predicted by condom use for PVI and by masturbation orgasms (for both sexes). For women additional predictors were lack of vaginal orgasm, and orgasm from clitoral masturbation during PVI. CONCLUSIONS:The results are consistent with condom use during PVI being associated with psychological immaturity and predisposition to poorer mental health.
    背景与目标:
  • 【撒哈拉以南非洲四个国家的青少年正确使用安全套和使用一致性的知识。】 复制标题 收藏 收藏
    DOI: 复制DOI
    作者列表:Bankole A,Ahmed FH,Neema S,Ouedraogo C,Konyani S
    BACKGROUND & AIMS: :Using data from the 2004 National Adolescent Surveys, this paper undertook a detail analysis of knowledge of correct condom use and consistency of use, as well as their covariates, among adolescents in Burkina Faso, Ghana, Malawi and Uganda. The strongest predictor of knowledge of correct condom use among both male and female adolescents is exposure to a condom use demonstration. In Burkina Faso, Ghana and Uganda, adolescents who have seen a condom demonstration are 2 to 5 times as likely as those who have not to have good knowledge of correct condom use. Age, ever received sex education in school, ever attended school and exposure to the radio are also significant predictors of knowledge of correct use, particularly among men. As indicated by behavior among young men, the extent to which adolescents use the condom consistently varies across countries. Yet, it is nowhere near the required 100% level. The proportion reporting consistent use of the method in the 3 months preceding the survey is 38% in Burkina Faso, 47% in Ghana, 20% in Malawi and 36% in Uganda. Age difference between partners is a major determinant of consistent use of condoms: young men whose partner is 0-4 years younger are about two and a half times more likely to use condoms consistently than those who whose partner is 5-9 years younger. Other important predictors of consistent condom use are residence, education, living arrangement and exposure to mass media, specifically the radio and newspaper. Findings from this study point to areas that policy and program can address to provide adolescents access to the kinds of information and service they need to achieve healthy sexual and reproductive lives.
    背景与目标: : 本文利用2004次全国青少年调查的数据,对布基纳法索、加纳、马拉维和乌干达青少年正确使用避孕套和使用一致性的知识及其协变量进行了详细分析。在男性和女性青少年中,正确使用安全套知识的最强预测指标是暴露于安全套使用演示中。在布基纳法索,加纳和乌干达,看过避孕套示范的青少年是那些不了解正确使用避孕套的青少年的2至5倍。年龄,曾经在学校接受过性教育,曾经上学和接触广播也是正确使用知识的重要预测因素,尤其是在男性中。正如年轻人的行为所表明的那样,青少年使用避孕套的程度在不同国家之间一直存在差异。然而,它远没有达到所需的100% 水平。在调查前3个月报告一致使用该方法的比例38% 在布基纳法索,47% 在加纳,20% 在马拉维,36% 在乌干达。伴侣之间的年龄差异是持续使用安全套的主要决定因素: 伴侣年龄在0-4岁之间的年轻男性比伴侣年龄在5-9岁之间的年轻男性持续使用安全套的可能性高约2.5倍。持续使用安全套的其他重要预测因素是居住,教育,生活安排和接触大众媒体,特别是广播和报纸。这项研究的结果指出了政策和计划可以解决的领域,以使青少年获得实现健康的性生活和生殖生活所需的各种信息和服务。
  • 【对避孕套使用进行建模: 计划行为理论是否可以解释低风险社区样本中的避孕套使用?】 复制标题 收藏 收藏
    DOI:10.1080/13548506.2013.824592 复制DOI
    作者列表:Thomas J,Shiels C,Gabbay MB
    BACKGROUND & AIMS: :To date, most condom research has focused on young or high-risk groups, with little evidence about influences on condom use amongst lower-risk community samples. These groups are not risk free and may still wish to negotiate safer sex; yet the considerations involved could be different from those in higher-risk groups. Our research addresses this gap: We report a cross-sectional questionnaire study enquiring about recent condom use and future use intentions in community settings. Our sample (n = 311) purposively included couples in established relationships, known to be condom users. Items included demographics, sexual history and social-cognitive variables taken from the theory of planned behaviour. The strongest association with condom use/use intentions amongst our respondents was sexual partner's perceived willingness to use them. This applied across both univariate and multivariate analyses. Whilst most social-cognitive variables (attitudes; self-efficacy and peer social norms) were significant in univariate analyses, this was not supported in multivariate regression. Of the social-cognitive variables, only "condom-related attitudes" were retained in the model explaining recent condom use, whilst none of them entered the model explaining future use intentions. Further analysis showed that attitudes concerning pleasure, identity stigma and condom effectiveness were most salient for this cohort. Our results suggest that, in community samples, the decision to use a condom involves different considerations from those highlighted in previous research. Explanatory models for established couples should embrace interpersonal perspectives, emphasising couple-factors rather than individual beliefs. Messages to this cohort could usefully focus on negotiation skills, condom advantages (other than disease prevention) and reducing the stigma associated with use.
    背景与目标: : 迄今为止,大多数避孕套研究都集中在年轻或高危人群上,几乎没有证据表明在低风险社区样本中影响避孕套使用。这些群体并非没有风险,可能仍希望谈判更安全的性行为; 然而,所涉及的考虑可能与高风险群体的考虑不同。我们的研究解决了这一差距: 我们报告了一项横断面问卷研究,询问社区环境中最近使用避孕套和未来使用意图。我们的样本 (n   =   311) 有目的地包括已建立关系的夫妇,已知是避孕套使用者。项目包括人口统计学,性史和来自计划行为理论的社会认知变量。在我们的受访者中,与避孕套的使用/使用意图最强烈的关联是性伴侣的使用意愿。这适用于单变量和多变量分析。尽管大多数社会认知变量 (态度,自我效能感和同伴社会规范) 在单变量分析中很重要,但多元回归不支持。在社会认知变量中,解释最近使用避孕套的模型中仅保留了 “与避孕套相关的态度”,而没有一个进入模型解释未来的使用意图。进一步的分析表明,有关愉悦,身份污名和避孕套有效性的态度对于该人群最为突出。我们的结果表明,在社区样本中,使用避孕套的决定涉及与先前研究中强调的不同的考虑因素。既定夫妻的解释模型应包含人际关系的观点,强调夫妻因素而不是个人信念。向该队列发送的消息可以有效地集中于谈判技巧,避孕套的优势 (疾病预防除外) 以及减少与使用相关的污名。

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