Concepciones de usuarios sobre nuevas vías de administración de profilaxis pre-exposición para el VIH / Users' expectations of the new pre-exposure prophylaxis for the HIV modalities

Resumen Este artículo tiene como objetivo discutir las concepciones de los Hombres Gay, Hombres Bisexuales y una Mujer Transgénero que usan o quieren usar profilaxis previa a la exposición por el virus de la inmunodeficiencia humana oral (PrEP) sobre nuevas vías de administración. Fueron entrevistados 17 usuarios del BCN Checkpoint. Las entrevistas fueron grabadas en audio, sometidas a análisis categorial temático teniendo en cuenta la perspectiva praxeográfica. Todos están adaptados al uso de la PrEP diaria y a demanda. En relación con las nuevas vías de administración (PrEP inyección intramuscular cada dos meses; pastilla mensual; inyección subcutánea cada seis meses) todos son muy receptivos a esas posibilidades, pero les falta información sobre las especificidades de cada una de ellas y una evaluación específica de sus necesidades. Tanto la satisfacción con el uso de PrEP oral, como las expectativas sobre las nuevas vías de administración son positivas. Sin embargo, lo más importante para los/a entrevistados/a es la garantía de que tendrán seguimiento para continuar cuidando de la salud afectivo-sexual, lo que no depende del tipo de vía de administración.

Abstract This article aims to discuss the expectations of Homosexual Men, Bisexual Men and a Transgender Woman, who use or want to use an oral pre-exposure prophylaxis (PrEP) for the human immunodeficiency virus (HIV) about PrEP modalities. Sixteen PrEP users, who are followed up in the BCN Checkpoint, were interviewed,. The interviews were audio-recorded, subjected to thematic categorical analysis within the theoretical framework from the praxiographic perspective. They are all adapted to the use of daily oral and event-based PrEP. In relation to the new PrEP modalities (monthly pill; intramuscular injection every two months; subcutaneous injection every six months), they are all very receptive to these possibilities, but they lack information on the specificities of each and specific assessment of their needs. Comments about the use of oral PrEP are positive, and expectations regarding the new PrEP modalities are visibly high. However, the most important thing for the interviewees is the guarantee that they will have follow-up appointments to continue taking care of their affective-sexual health, which is not dependent on the type of PrEP modalities.

Clinicoepidemiological profile of sexually transmitted disease (STD) patients presenting in a tertiary care center

Background: Sexually transmitted infections (STIs) constitute a major health problem in the developing countries and prevalence of STIs varies from region to region in our country. Aim: To study the pattern and prevalence of sexually transmitted infections and HIV seropositivity among patients presenting in a tertiary care center. Materials and methods: A retrospective data was collected in the department of Dermatology at Shri Guru Ram Rai Institute of Medical and Health Sciences (SGRRIHMS), Shri Mahant Indiresh Hospital (SMIH), a tertiary care center in Dehradun, Uttarakhand, India, from January 2011 to December 2018. A total of 525 patients were analyzed in this study. Results: A total of 525 patients were enrolled in our study. STIs were more common in men, with male (365): female (160) ratio of 2.2:1. Maximum numbers of patients were in the age group of 25 to 34 years. Unskilled workers (22.28%) and housewives (20.00%) constituted major proportion. Majority of the cases presented with warts (38.09%) followed by molluscum contagiosum (20.95%) and herpes genitalis (19.61%). But herpes genitalis (27.39%) was found to be the most common STD seen among males and warts (68.75%) among the females. HIV seropositivity was seen among 20 (3.80%) patients and was most commonly associated with herpes genitalis infection (60.00%). Gunjan Gupta, Jitendra Singh Bist, Rahul Sudan, Kewal Krishan, Neeti Kumari. Clinicoepidemiological profile of sexually transmitted disease (STD) patients presenting in a tertiary care center. IAIM, 2019; 6(2): 7-12. Page 8 Conclusion: Increased prevalence of viral STDs like herpes genitalis, genital warts and mollascum contagiosum was seen in our study. Widespread use of antibacterial lead to falling trend of bacterial STDs.

Association of Socioeconomic Status on STI/STD Awareness Among OPD patients attending a Tertiary Care Hospital

Background: Sexually transmitted infections (STI) are a major public health, social, and economic problem leading to morbidity, mortality and stigma. This study was conducted to determine the relationship between the STIs and demographic factors. In Indian society, discussing STDs is considered taboo; where ethics and social factors give rise to many obstacles. This study is designed to explore the conception and knowledge about protection against STDs within the patient community. In the present study we aim to study the association of various socioeconomic variables; and the knowledge and awareness level of STI/STDs. Methods: The convenience sample was taken from the adult patients attending and consenting to participate in the study during April- June 2018, using a semi-structured Performa. Collected data was analysed using SPSS soft ware. Results: Age, Education, and income were associated with the awareness about the STI/STD awareness. Conclusions: Socio-economic factors have an association with STI/STD awareness, and hence carry public health importance.

Fatores determinantes de conhecimentos, atitudes e práticas em DST/Aids e hepatites virais, entre jovens de 18 a 29 anos, no Brasil / Determinant factors of knowledge, attitudes and practices regarding STD/AIDS and viral hepatitis among youths aged 18 to 29 years in Brazil / Facteurs déterminants des connaissances, des attitudes et des pratiques en MST/SIDA et hépatites virales parmis les jeunes âgés de 18 à 29 ans au Brésil

Resumo O objetivo deste estudo foi avaliar a vulnerabilidade dos jovens brasileiros às DSTs/Hiv Aids e Hepatites Virais. Foram entrevistados 1.208 jovens (18 e 29 anos em 15 Estados e DF). A margem de erro da pesquisa ponderada regional e nacionalmente foi 2,8%. O estudo foi aprovado pelo CEP da Faculdade de Medicina da UnB e teve apoio da OPAS e do Ministério da Saúde. Escala com 35 questões (-35 a +35 pontos) de conhecimentos, atitudes e práticas em DSTs/Hiv Aids e Hepatites Virais foi utilizada como variável dependente. Modelos de regressão linear ajustados identificaram fatores demográficos e determinantes sociais que explicam a variação na escala. A escala atingiu nível satisfatório de consistência (Alfa Cronbach: 0,689). Fatores sociodemográficos associados à variação na escala foram: gênero, etnia, escolaridade e estado civil. Determinantes sociais associadas à variação na escala foram: hábito de conversar sobre sexualidade com pais e profissionais de saúde, consumo de álcool, ter lazer e ser engajado, acesso à internet, interesse em aprender e ter pai e/ou professor como referência pessoal. Os jovens brasileiros estão vulneráveis à transmissão de DSTs/Hiv Aids. São necessárias políticas públicas que promovam engajamento dos pais e professores em assuntos sobre sexualidade.

Abstract The scope of this study was to evaluate the vulnerability of Brazilian youths to STDs/HIV&AIDS and Viral Hepatitis. Interviews were conducted with 1,208 youths aged 18 to 29 in 15 states and the Federal District. The regional and national adjusted margin of error of the research was 2.8%. The study was approved by the School of Medicine of Brasilia University with support from PAHO and the Ministry of Health. A scale with 35 questions (knowledge, attitudes and practices) was the main dependent variable. Adjusted linear regression models identified the demographic and social determinant factors that explain scale variations. The scale attained a satisfactory level of consistency (Cronbach's Alpha: 0.689). Sociodemographic factors associated to scale variations include gender, race, education and civil status. Social determinants associated to scale variations include frequency of discussions about sexuality with parents and health professionals, alcohol consumption, leisure and being part of a social movement, access to the internet, interest in learning and having the father and/or teacher as a personal reference. Brazilian youths are vulnerable to the transmission of STDs/HIV&AIDS. Public policies are needed to promote the engagement of parents and teachers in issues related to sexuality.

Résumé L'objectif de cette étude a été d'évaluer la vulnérabilité des jeunes brésiliens aux MST/VIH SIDA et aux Hépatites Virales. À cet effet, 1.208 jeunes (âgés de 18 à 29 ans dans 15 États brésiliens et le DF [Distrito Federal] ont été interviewés. La marge d'erreur de la recherche pondérée régionalement et nationalement était de 2,8%. L'étude a été approuvée par le CEP [Comité d'Éthique en Recherche] de la Faculté de Médecine de l'UnB et a eu le support de l'OPAS [Organisation Panaméricaine de la Santé] et du Ministère de la Santé. Une échelle de 35 questions (-35 à +35 points) évaluant les connaissances, les attitudes et les pratiques en MST/VIH SIDA et Hépatites Virales a été utilisée comme une variable dépendante. Des modèles de régression linéaire ajustés ont identifié les facteurs démographiques et les déterminants sociaux qui expliquent la variation dans l'échelle. L'échelle a atteint un niveau satisfaisant de consistance (Alpha de Cronbach: 0,689). Des facteurs socio-démographiques associés à la variation dans échelle ont été pris en compte, à savoir: le genre, l´ethnie, la scolarité et l´ état civil. Les déterminants sociaux associés à la variation dans l'échelle: l´habitude de discuter sur la sexualité avec les parents et des professionnels de la santé, la consommation d'alcool, profiter du loisir et être engagé, avoir accès à Internet, avoir intérêt à apprendre et avoir un parent et/ou un enseignant comme référence personnelle.

Intervención educativa sobre infecciones de trasmisión sexual en adolescentes / Educative intervention about sexually transmitted infections in adolescents

Introducción: los adolescentes son muy inestables en sus relaciones sexuales, de ahí la importancia que conozcan sobre las infecciones de trasmisión sexual a través de una intervención educativa. Objetivo: evaluar una estrategia de Intervención Educativa en adolescentes sobre las infecciones de trasmisión sexual y el VIH/SIDA. Métodos: investigación de desarrollo, estudio de tipo interventivo en adolescentes del Área de Aguacate, Municipio Madruga, durante el año 2013, universo constituido por 91 adolescentes, seleccionándose como muestra por criterio de identificación 26 adolescentes de 8vo grado a los cuales se les aplicó la entrevista semiestructurada y la intervención educativa, se controló la edad de comienzo de las relaciones sexuales, el nivel de conocimiento antes y después de la intervención sobre factores de riesgo, vías de trasmisión sexual, actitud ante el contagio y sobre las infecciones de trasmisión sexual y el VIH/SIDA. Resultados: de la muestra estudiada, 17 adolescentes (65,3 por ciento) mantenían relaciones sexuales, el nivel de conocimiento fue malo antes de la intervención y bueno después en todas las variables medidas: factores de riesgo (53,8 por ciento, y 80,7 por ciento respectivamente), vías de trasmisión sexual (46,1 por ciento y 84,6 por ciento respectivamente), sobre infecciones de trasmisión sexual y el VIH/SIDA (57,6 por ciento y 76,9 por ciento respectivamente). La actitud ante el contagio no le preocupaba a 11 adolescentes (42,3 por ciento) y después de la intervención solo a 1 (3,8 por ciento). Conclusiones: se modificaron los conocimientos de los adolescentes sobre las infecciones de trasmisión sexual y el VIH/SIDA luego de la intervención educativa, evaluándose la misma de satisfactoria(AU)

Introduction: Adolescents are very instable in their sexual relationships, therefore the importance for them to know about sexually transmitted infections by means of an educative intervention. Objective: Assess an educative intervention strategy in adolescents about sexually transmitted infections and HIV/AIDS. Methods: Development research, intervention study in adolescents from the Aguacate area, Madruga Municipality, during the year 2013, universe constituted by 91 adolescents, while the sample chosen by identification criteria was made up by 26 adolescents in eighth grade who were applied the semi-structured interview and the educative intervention. We controlled the age to have started sexual intercourse, the level of knowledge before and after the interventions about risk factors, the sexual transmission ways, attitude to the contagion and about the sexually transmitted infections and HIV/AIDS. Results: 17 adolescents (65.3 percent) of the studied sample maintained sexual intercourse, the level of knowledge was mad before the interventions and good later on and regarding all the variable measured: risk factors (53.8 percent and 80.7 percent, respectively), sexual transmission ways (46.1 percent and 84.6 percent, respectively). The attitude to the contagion was not concerned by 11 adolescents (42.3 percent), and after the intervention just by one (3.8 percent). Conclusions: The adolescents' knowledge about sexually transmitted infections and HIV/IADS was modified after the educative intervention, which was assessed as satisfactory(AU)

History of syphilis in women living with AIDS and associated risk factors in São Paulo, Brazil / Antecedentes de sífilis em mulheres com Aids e fatores de risco associados, São Paulo, Brasil

Objective: to describe the epidemiological profile, risk behaviors, frequency of prior history of syphilis in women living with AIDS and to investigate associated factors. Methods: a cross-sectional study conducted with women living with HIV attending at Reference Center for AIDS in São Paulo. Demographic, behavioral, and clinical data were analyzed based on medical records. Results: a total of 598 women were included in the study and the prevalence of previous syphilis was 6.2% (95% CI 4,3-8,1). Seventy-three percent of women were less than 40 years of age when diagnosed with AIDS and 49.6% had more than eight years of formal education. 67.2% were white and 65.9% were not married or living with a partner, 53.2% reported that their first sexual intercourse aged more than 15 years, 56.5% reported having only one partner in the last year and 13% reported drug use. Regarding laboratory data, 83.8% had CD4+ <500 cells/ mm3 upon diagnosis of AIDS. Previous syphilis was associated with the use of crack cocaine [AOR = 6.8 (95% CI 1.7 - 27.5)], >1 sexual partner in the last year [AOR = 6.6 (95% CI 1.2 - 37.1)], CD4 + <500 cells/mm3 [AOR = 3.8 (women 1.1 - 13.6)], HIV diagnosis > 8 years [AOR = 2.4 (95% CI 1.0 - 5.8)]. Conclusion: a high prevalence of previous syphilis was found in the population studied, and crack use was identified among the main associated risk factors. Interventions to reduce the risk of sexual transmission of HIV and syphilis must be strengthened, with the implementation of control actions, screening strategies, early diagnosis and treatment, preventing complications, reducing morbidity and improving sexual and reproductive health. .

Objetivo: descrição de perfil epidemiológico, comportamentos de risco, frequência de antecedentes de sífilis em mulheres com Aids e investigar fatores associados. Métodos: estudo de corte transversal conduzido com mulheres com HIV/Aids atendidas em centro de referência para Aids em São Paulo. Dados demográficos, comportamentais e clínicos foram analisados a partir dos prontuários médicos. Resultados: foram incluídas 598 mulheres no estudo e a prevalência de antecedentes de sífilis foi 6,2% (IC 95%: 4,3 a 8,1). Um total de 73% das mulheres tinha menos de 40 anos de idade na época do diagnóstico da Aids e 49,6% alcançaram mais de 8 anos de escolaridade, sendo que 67,2% eram brancas e 65,9% não eram casadas nem viviam com parceiro, 53,2% alegaram primeiro coito com mais de 15 anos de idade, 56,5% referiram apenas um parceiro no último ano, 13% referiram uso de drogas e 83,8% apresentavam CD4+ < 500 cél/mm3 no diagnóstico da Aids. Foram fatores associados à infecção por sífilis: uso de crack [ORaj = 6,8 (IC 95% 1,7 - 27,5)], mais de 1 parceiro sexual no último ano [ORaj = 6,6 (IC 95% 1,2 - 37,1)], CD4+ < 500 cél/mm3 [ORaj = 3,8 (IC 95% 1,1 - 13,6)], diagnóstico do HIV > 8 anos [ORaj = 2,4 (IC 95% 1,0 - 5,8)]. Conclusão: elevada prevalência de sífilis foi encontrada na população estudada e o uso de crack foi o principal fa-tor identificado dentre os fatores associados. É necessário reforçar as intervenções para a redução do risco de transmissão sexual do HIV e da sífilis, com implementação de ações para o seu controle e estratégias de rastreamento, diagnóstico e tratamento precoces, evitando complicações e diminuindo a morbidade com melhoria da saúde sexual e reprodutiva. .

Male Circumcision in India: Some Considerations from the West.

ABSTRACT: In this work, I will analyse why Indian authorities find it so difficult to publicly acknowledge the medical benefits of Male Circumcision (MC). In doing so, the medical evidence in favour of the practice, as well as the moral duties that governing authorities have towards their citizens shall be taken to the fore. In addition to this argument, a brief explanation of the cultural dimension that refuses to evaluate the medical dimension of MC a priori shall be taken into account and, in relation to that, a parallel with the past and present Western tradition will be drawn, putting forward the conclusion that both contexts do not provide satisfactory justification for banning MC nor more relevantly for the Indian scenario can any cultural background represent a convincing argument against the public acknowledgement of the medical advantages provided by MC.

Co-infections associated with human immunodeficiency virus type 1 in pregnant women from southern Brazil: high rate of intraepithelial cervical lesions

Human immunodeficiency virus type 1 (HIV-positive) pregnant women require specific prophylactic and therapeutic approaches. The efficacy of established approaches is further challenged by co-infection with other sexually transmitted diseases (STDs). The objective of this study was to determine the prevalence of co-infections in pregnant women infected with different HIV-1 subtypes and to relate these findings, together with additional demographic and clinical parameters, to maternal and infant outcomes. Blood samples from pregnant women were collected and tested for syphilis, hepatitis B virus (HBV) and hepatitis C virus (HCV). Human papillomavirus (HPV) diagnosis was evaluated by the presence of alterations in the cervical epithelium detected through a cytopathological exam. Medical charts provided patient data for the mothers and children. Statistical analyses were conducted with STATA 9.0. We found a prevalence of 10.8 percent for HCV, 2.3 percent for chronic HBV, 3.1 percent for syphilis and 40.8 percent for HPV. Of those co-infected with HPV, 52.9 percent presented high-grade intraepithelial lesions or in situ carcinoma. Prematurity, birth weight, Apgar 1' and 5' and Capurro scores were similar between co-infected and non-co-infected women. The presence of other STDs did not impact maternal and concept outcomes. More than half of the patients presenting cervical cytology abnormalities suggestive of HPV had high-grade squamous intraepithelial lesions or cervical cancer, evidencing an alarming rate of these lesions.

Nivel de conocimeinto sobre medidas de prevención de VIH-SIDE y las ITS en estudiantes de al ECR / Knowledge level about HVI-AIDS and STDs prevention in ECR undergraduates

El desconocimiento sobre los factores asociados al contagio del VIH ­ SIDA así como de las Infecciones de transmi-sión sexual (ITS), es considerado un determinante importante que puede incrementar el riesgo de desarrollo de estos eventos. Algunos de los factores que han cobrado relevancia son a) el inicio temprano de las relaciones sexuales, b) el cambio de pareja y c) el no uso de medios de protección que evidencian despreocupación y por tanto riesgo para la adquisición de VIH o ITS. El objetivo de este estudio fue determinar el conocimiento sobre VIH ­ SIDA e ITS en un grupo de estudiantes de pregrado. Se realizó un estudio descriptivo tras-utilizando una muestra representativa de 143 estudiantes. Se encontraron diversos factores que pueden generar riesgo de contagio por VIH-SIDA e ITS en el grupo de estudiantes tales como: nivel socioeconómico, grupo etario y género. Se identificó una proporción importante de encuestados que respondió que la mejor forma de evitar el contagio de VIH es usando el condón, así mismo refieren que es menos probable el contagio teniendo una sola pareja o evitando las relaciones sexuales. Finalmente, aunque la población conoce las ITS, no mencionan ninguno síntoma al respecto. Se concluye que los estudiantes tienen conoci-miento de factores de riesgo para VIH SIDA, pero menos conocimiento sobre ITS, demandando procesos continuos de acompañamiento a la población desobre la prevención de VIH-SIDA e ITS.

The lack of knowledge about the factors associated to infection of HIV - AIDS as well as sexually transmitted Disea-ses (STDs), can be considered as a determining factor which can potentially increase the risk of this conditions. Some of the factors that have taken relevance are: a) an increasingly early age onset of sexual relations, b) the intimate partner change and c) the nonuse of protective means make evident unconcerned attitudes and therefore risky to develop HIV / STDs. Objective: Determining the knowledge level about HIV - AIDS and STDs in ECR students. Method: A des-criptive cross-sectional study was made in the second half of 2012. Was selected a representative sample of 143 students who answered a survey based on an investigation conducted by Davila, Tagliaferro, Bullones, and Daza (2008). Results: There are several risk factors that may lead to acquire of HIV-AIDS and STDs in ECR students, such as age; social, economic and cultural aspect; gender and more. Was identified a high proportion of respondents who replied that the best way to prevent the HIV spread is to use condoms, also stated that the contagion is less probable having one couple, or avoiding sex. Finally, although the population knows about STDs, any symptom is not mentioned. Conclusions: The ECR undergraduates' population is aware of factors related to HIV- AIDS, but they have less knowledge about STDs. Continuous processes are required to accompany the ECR student population on the prevention of HIV-AIDS and STDs

Perception of RTIs/STDs among women of reproductive age group in a District of Uttar Pradesh.

A cross sectional study was conducted during May-June 2010 among woman of reproductive age group (15-45 years) in the urban and the rural areas of Bareilly District to asses the level of awareness regarding RTIs/STDs. The two stage cluster sampling technique was adopted. A structured questionnaire was used to interview the study participants during the house to house surveys. Each woman of reproductive age of selected household was interviewed in private about her reproductive history, current knowledge, source of information and modes of transmission of RTIs/STDs. Statistical analysis was done with Epi Info computer software. Standard Normal Variate (SNV) Test for comparison of two groups’ proportion was done; z and p were calculated to know the significance of the proportions of two groups for comparison. Most of the women were aware of RTIs/STDs (80.32%) in urban areas whereas only 27.41% in rural areas were aware of these diseases. The television and radio was the main source of information in both rural (41.17% & 32.94%) and urban areas (TV-90.36%, Radio-48.19%).

Infertilidad masculina / Male infertility

Se estima que aproximadamente un 15 por ciento de las parejas son incapaces de concebir luego de un año de relaciones sexuales no protegidas; 30 por ciento son debidas a factor femenino y 30 por ciento a factor masculino. El 40 por ciento restante es de causa mixta. La evaluación inicial de rutina en el varón (que incluye una detallada historia clínica, examen físico y test básicos como perfil hormonal y análisis seminal) es por lo tanto esencial para la mejoría de su fertilidad. El varicocele, criptorquidia no tratada y las infecciones del tracto urogenital son las causas identificables más frecuentes de infertilidad masculina. Causas menos frecuentes son las disfunciones sexuales, trastornos endocrinos y efectos adversos de medicamentos. Los tratamientos para estas patologías han sido efectivos en la mayoría de los casos, permitiendo a un importante número de parejas concebir en forma espontánea. Si esto no es posible, las parejas pueden recurrir a técnicas de reproducción asistida de baja complejidad, tales como la Inseminación Intrauterina. Y sólo en aquellos casos con problemas más severos recurriremos a técnicas de reproducción de alta complejidad como por ejemplo el ICSI (Inyección Intracitoplasmática de Espermatozoides). Importantes progresos en el área de la Microcirugía permiten no sólo reparar la vía seminal en muchos casos, sino también recuperar espermatozoides de pacientes con atrofia testicular. En los últimos años, junto con el ICSI, han sido una importante contribución.

It is estimated that approximately 15 percent of couples are unable to conceive after one year of contraceptive-free intercourse; 30 percent of which are due to female factors and 30 percent to malefactors. The remaining 40 percent are due to both partners. A routine initial evaluation of the male partner (including detailed medical history, physical exam and basic tests such as hormonal profile and semen analysis) is therefore essential, for improvement of their fertility. Varicocele, untreated Cryptorquidism, infections (eg. epididymitis, orquitis, prostatitis and vesiculitis, most of which are related with sexually transmitted diseases) are the most frequent causes of male infertility. Other minor causes include sexual dysfunctions, drug adverse effects, exposure to radiationor contaminants, endocrine and genetic factors. Treatment for this condition has been effective in most cases, allowing a significant proportion of couples to conceive spontaneously. Whenever this is not possible, patients may resort to low complexity techniques such as artificial insemination, and only in more severe cases, to advanced assisted reproduction techniques such as In Vitro Fertilization (IVF) and in particular Intracytoplasmic Sperm injection (ICSI).Microsurgery has also progressed. Not only used to repair the seminal path when obstructed, but also to recover sperm from patients with testicular atrophy. In recent years, these techniques, together with ICSI, have made an important therapeutic contribution.

Drugs, women and violence in the Americas: U.S. quantitative results of a multi-centric pilot project (phase 2) / Drogas, mujeres y violencia en el continente americano: resultados de un proyecto piloto multicéntrico en Estados Unidos (fase 2)

Objetivo: Explorar las experiencias colectivas e individuales que mujeres latinomaericanas tienen en los Estados Unidos en cuanto al abuso de sustancias, violencia y conductas sexuales de riesgo. Métodos: El estudio se realizó en dos fases entre julio de 2006 y junio de 2007, en el sur de Florida. En la Fase 2, se dieron cuestionarios a las mujeres para comprobar si existe una relación entre: características demográficas, grado de aculturación, depresión, autoestima, uso/abuso de sustancias, exposición a la violencia y conocimiento de los riesgos del VIH y el sida. Resultados: Los participantes reportaron altos índices de abuso de alcohol y drogas. Sólo dos factores se asociaron con el uso de drogas de por vida: ingresos económicos y aculturación. Más de la mitad de los participantes informaron haber sido víctimas de al menos una forma de abuso (físico, sexual y/o psicológico) durante la infancia y la adultez. Un componente importante de los abusos reportados durante la edad adulta es que fueron perpetrados por un compañero íntimo. Conclusiones: Los resultados de este estudio sugieren que el abuso de sustancias, la violencia y el VIH deben abordarse de manera integradora y global...

Objectives: To explore the collective and individual experiences that Latin American females in the U.S. have with substance abuse, violence and risky sexual behaviors. Methods: This study was conducted in two phases from July 2006 to June 2007 in south Florida. This paper covers Phase 2. In Phase 2, questionnaires were provided to women to test whether there is a relationship between demographics, acculturation, depression, self-esteem and substance use/abuse; whether there is a relationship between demographics, acculturation, depression, self-esteem and violence exposure and victimization; whether there is a relationship between demographics, acculturation, depression, self-esteem, HIV knowledge and STD and HIV/AIDS risks among respondents; and whether there is a relationship between substance abuse, violence victimization and HIV/AIDS risks among respondents. Results: Participants reported high rates of alcohol and drug abuse among their current or most recent partners. This is a major concern because partner alcohol use and drug use was related to partner physical, sexual and psychological abuse. Only two factors were associated with lifetime drug use: income and acculturation. Over half of the participants reported being victims of at least one form of abuse during childhood and adulthood. A substantial component of abuse reported during adulthood was perpetrated by a currently or recent intimate partner. Conclusions: The results from this study suggest that substance abuse, violence and HIV should be addressed in an integrative and comprehensive manner. Recommendations for the development of policies, programs and services addressing substance abuse, violence and risk for HIV among Latinos are provided...

Abuso sexual em serviços de emergência: relato de caso / Sexual abuse in emergency centers: case report

Este artigo trata de paciente com 54 anos, atendida no Hospital Júlia Kubitschek, com relato de ter sido vítima de violência sexual. O agressor armado invadiu sua casa e a obrigou, mediante ameaça de morte, a manter com ele sexo vaginal, anal e oral, sem uso de preservativo. Apresentava-se ansiosa e chorosa. Havia lesão contusa em região escapular esquerda e leve hiperemia de grande lábio direito. O exame especular e a inspeção da região anal não apresentavam alterações. Foram realizadas avaliação laboratorial e profilaxia para doenças sexualmente transmissíveis (DSTs), incluindo administração de antirretrovirais. Foi encaminhada ao ambulatório de vítimas de violência sexual.

This article is about a 54-year-old female patient, assisted at Júlia Kubitschek Hospital, who reported having been victim of sexual violence. According to her, the armed aggressor broke into her house and forced her by threat of death to have vaginal, anal and oral sex with him without using condom. The patient was anxious and tearful. There were blunt injury in the left scapular region (shoulder blade area) and mild hyperemia of the right labium. Speculum examination and inspection of the anal region showed no alterations. The treatment included laboratory tests and prophylaxis for Sexually Transmitted Diseases (STDs), including administration of antiretroviral medication. The patient was referred to an outpatient center for victims of sexual violence.

Comportamento sexual de risco para DST e gravidez em adolescentes / Sexual behavion and risk for STD and pregnancy among teenagers

Introdução: o comportamento sexual de risco entre adolescentes pode ter consequências como gravidez indesejada e ocorrência de DST, tornando-se grave problema de saúde pública.Objetivo: verificar o comportamento sexual e fatores de risco para gravidez e DST entre adolescentes matriculados no ensino médio em escolas do Município de Tubarão (SC). Métodos: foram estudados adolescentes matriculados em quatro escolas escolhidas por sorteio. Foi utilizado questionário autoaplicável, após a anuência. Utilizou-se teste de qui-quadrado para associação entre as variáveis e teste de t de Student para comparação entre médias. Resultados: Dos 379 entrevistados, 41,7% estudavam em escolas privadas e 39,6% relataram ter tido relação sexual. A média deidade da sexarca foi de 15 ± 1,54 anos, variando entre 9 e 19 anos. Destes apenas 55,3% faziam uso consistente de preservativo, 46% usaram contracepção de emergência e 90,7% utilizavam contracepção. Houve relato de quatro gestações pregressas, e 44% afi rmaram a ocorrência de sintomas em esfera genital, havendo associação estatística com o não uso de preservativo (p = 0,004). O uso de drogas foi relatado por 42,5% adolescentes. A sexarca e a contracepção de emergência foram estatisticamente significativas em relação ao aluno estudar em escola pública. A prática sexual predominante foi a vaginal (50,7%) e94% tinham comportamento heterossexual. Conclusão: a ocorrência de gravidez, baixa adesão ao uso de preservativo em todas as relações sexuais, o uso de drogas e histórico de sintomas genitais permitem concluir que os adolescentes apresentaram comportamentos de risco que podem aumentar a incidência de DST, HIV e gravidez indesejada.

Introduction: the sexual risk behavior among adolescents may have consequences such as unwanted pregnancy and STDs, becoming a serious public health problem. Objective: to analyze sexual behavior and risk factors for unwanted pregnancy and STDs among adolescents enrolled in secondary education in schools of the municipality of Tubarão, Santa Catarina. Methods: the sample consisted of adolescents enrolled in four schools chosen through raffl e. A self-administered questionnaire was used after consent. Chi-square test was used to analyze association between variables and Student?s t test for comparison of means. Results: Out of 379 respondents, 41.7% studied in private schools and 39.6% reported having had sexual intercourse. The mean age at fi rst sexual intercourse was 15±1.54 years, ranging between 9 and 19 years. Of those, only 55.3% reported consistent use of condoms, 46% used emergency contraception and 90.7% used contraceptive methods. There were four reports of past pregnancies, and 44% said they had experienced symptoms in the genital area, which was statistically associated with the lack of condom use (p = 0.004). The use of drugs was reported by 42.5%. Age at fi rst sexual intercourse and emergency contraception were statistically signifi cant in relation to students studying in state schools. Conclusion: vaginal intercourse was the predominant sexual practice as reported by 50.7% of participants; 94% had heterosexual behavior. The occurrence of pregnancy, poor use of condoms and unprotected sex practices, drug use and history of genital symptoms show that adolescents have risk behaviors which may increase the incidence of STDs, HIV and unplanned pregnancy.

Sexual behavior and sexually transmitted diseases in street-based female sex workers in Rajshahi City, Bangladesh

We analyzed the sexual behavior and sexually transmitted diseases (STDs) of street-based female sex workers (SFSWs) of Rajshahi city and examined their socio-demographic profiles. Among the SFSWs attending three drop-in centers (DIC) named PIACT, PROVA, and Suraksha Madhumita in Rajshahi, 150 self-motivated and willing individuals were interviewed through a structured questionnaire to obtain obstetric histories and socio-demographic information. Among these SFSWs, 56.7 percent were infected with two or more pathogens of STDs, with gonorrhea, chlamydia, herpes, syphilis, and trichomoniasis observed in 23.3, 27.3, 24.0, 17.3, and 20.0 percent, respectively. We found a strong association between the prevalence of STDs among SFSWs and their socio-demographic profiles. Illiterate and comparatively older SFSWs who spent very little money for health purposes, had larger numbers of children, and used condoms inconsistently were observed to be at higher risk of STDs. These results observed with bivariate analysis were also confirmed by logistic regression analysis.

Periodontal and Oral Membrane Infection Status Analysis among Women in Reeducation Centers / 中华医院感染学杂志

OBJECTIVE To study the prevalence of sexually transmitted diseases(STDs) among high-risk women in reeducation centers in Shenzhen in 2001,and evaluate their periodontal and oral membrane infection status. METHODS Based on the WHO Oral Health Survey Basic Methods(1987) the STDs surveillance in 2001 had been conducted among them.Data were collected and analyzed. RESULTS Out of the 302 examinees in reeducation centers,60(19.8%) cases were identified as having STDs.The prevalence rate of gingivitis was 57.6%,dental calculus rate was 25.8%,early periodontitis rate was 4.96%,and the late periodontitis rate was 0.9%.Only(7 cases) suffered from oral-membrane disease,the rate was 2.3%. CONCLUSIONS The women with high risk in reeducation centers are the most potential sources of STDs infections.Their oral health status is as same as normal people,so it is important for oral medical workers to protect the health of patients and themselves with effective management,and enhance the works on hospital infection control.

Study on the knowledge of STDs on patients at the national institute of dermato-venereology (NIDV) in Vietnam

Objectives: Described on the knowledge of STDs of male and female patients at NIDV from 2002 to 2004 and described the knowledge on the STDs prevention in these groups. Methods: The cross-sectional study have implemented in NIDV from 2002 to 2004 by face to face interview, physical examination and laboratory tests of STD patients. Result and conclusions: Total 109 subjects were interviewed, male (56.9% men, 43% women). Most of STD patients had been heard on STDs (90.8%). Most of the patients think STDs are infection disease (87.2%); the main transmission ways are through sexual intercourses and injections (91.7%), but the knowledge in male were higher than female. The most popular media is TV, radio and newspapers (83.5%). The lower communication is in the school (15.6%), particularly from parent's patients (8.2%). The communication from friends has been mainly in male (56.5%). Most of STDs patients had been known the methods of STDs prevention are condom (57.8%) and monogamous (40.4%), but the knowledge in men were also higher than in women.

An Ethical Discussion on Special Population during the Standard Diagnosis and Treatment of STDs / 中国医学伦理学

To discuss the ethical factors influencing the standard diagnosis and treatment of sexual transmitted diseases(STDs) on special population including senile patients,pregnant and lying-in women and children.The senile patients with STDs had a decline of physiological function and might have foundational diseases,some of these patients had the psychological characteristics such as unclear talk,uncertain memory,stronger self-esteem,and had a decline of life quality.Therefore hte main ethical measures during the senile patients with STDs should include considering the pathophysiological and psychological characteristics,adopting individual diagnosis and treatment,making the skill of inquiring and physical examination,and attaching importance to the improvement of life quality.The main ethical measures during the pregnant and lying-in women with STDs should include attaching importance to the marriage examination and pregnant examination,finding potential STDs as soon as possible,and weighing potential medical risk.The main ethical measures during the children with STDs should include paying attention to the infection of family members or sex-aggression,making the protective medicine,doing well the propaganda and education,and making the children away from STDs.

A discussion of influential considerations and solving measures between doctors and patients relationship in the STDs diagnosis and treatment / 中国医学伦理学

This article discusses the influential considerations between doctors and patients relationship in the sexually transmitted diseases(STDs)diagnosis and treatment.The mainly include:(1)the medical attitude of doctors and patients;(2)the moral culture of doctors and patients;(3)the commercial consciousness in medical business;(4)the management of hospital.We bring forward some measures including of:(1)the medical attitude of doctors should be changed,the personality of patients shoud be respected;(2)the education of medical moral should be tstrengthened,the moral culture and skills should be improved during doctors and nurses;(3)the medical reforming should be deepened further.