The Role of Education and Demographic Factors in Condom Use among Male Drug Users in Malaysia

@#Introduction: The rising prevalence of human immunodeficiency virus (HIV) among people who inject drugs is a major public health issue. This study intends to explore education and demographic correlates of use of condoms among male drug users in Malaysia. Methods: Data were extracted from the Integrated Biological and Behavioral Surveillance Survey 2017. Pearson’s chi-square tests and a logistic regression were used to examine the associations between condom use and education, and demographic factors. Results: Only a small proportion of drug users used condoms (25.7%). Educational backgrounds, age, ethnicity and marital status were associated with condom use. The likelihood of using condoms was lower among less educated drug users (aOR: 0.308–0.339). There was an interaction effect of education and age on condom use (aOR: 0.116–0.308). Chinese (aOR: 3.117) and those of other ethnicities (aOR: 2.934) were more likely to use condoms when compared with Malays. Being married (aOR: 0.291) or divorced/widowed (aOR: 0.346) was associated with reduced odds of using condoms. Conclusion: Education and demographic factors play an important role in influencing the decisions of Malaysian drug users to use condoms. Therefore, HIV-preventive measures targeting drug users could benefit by paying special attention to these factors.

Challenges on sexual health communication with secondary school learners, Limpopo province

A conversation about sexuality is most likely to encourage healthy and positive sexual practices while reducing risky sexual behaviour among adolescents. Traditionally, sexuality is discussed in hushed tones in proverbs and is reserved for adults. On the other hand, adolescents must be well informed about their sexuality to assist them to make informed decisions about their sexual behaviour.Objectives: The study determined parents' views regarding challenges of sexual health communication among secondary school learners in the Limpopo province.Method: A qualitative, exploratory-descriptive and contextual approach was employed for the study. Fifty-six parents were purposively selected, resulting in five focus group discussions that had 8­12 members. One central question was asked, and based on the participants' responses, probing questions followed. Data were analysed using thematic analysis. Trustworthiness and ethical considerations were ensured.Results: Three themes, namely communication concerns, role shifting in imparting sexuality education and poor parent­child relationships, and eight subthemes emerged from the data.Conclusion: This study identified that communication concerns influence parent­child dialogue on sexuality education. Therefore, there is a need to address factors hindering communication such as cultural barriers, role shifting in imparting sexuality education and poor parent­child relationships. This study suggests that parents should be empowered in dealing with children's sexuality.Contribution: Parents should be equipped with reproductive knowledge to enable them to talk freely about sexuality with their children. This should be complemented with broader programmes aimed at promoting sexual health education within the traditional family institution

Sexual Behaviours of Secondary School Students in Port Harcourt.

Background: Sexual behaviours of adolescents are currently receiving global attention because a high proportion of new HIV and other sexually transmitted infections’ diagnosis are among young people. This study aimed to assess the sexual behaviours of secondary school students in Port Harcourt. Methods: This is a school-based cross sectional descriptive study, carried out in six public secondary schools in Port Harcourt Metropolis in Rivers State, Nigeria in February 2014. A structured pre-tested, self-administered questionnaire was distributed to 1047 senior secondary 1 to 3 students selected through multistage sampling technique. Information sought included sociodemographics, if they have had sexual intercourse, age at first sex, involvement in sexual intercourse in the last 3 months before the survey, condom use and number of sex partners. Statistical analysis was performed using SPSS version 20.0 statistical software. Univariate and multiple logistic regression analysis were done to describe socio-demographics and sexual behaviours of study participants and to identify independently associated factors. Results: One thousand and forty seven students participated in the study; mean age 16.19±1.64 SD. Five hundred and thirty seven (51.3%) females and 510 (48.7%) males, male: female ratio was 0.9: 1. Four hundred and forty nine (42.9%) students reported having had sex at least once in their life time. Mean age at first sexual intercourse was 13.37±3.66SD. More females reported having sex compared to the males (χ2=7.357, P=.007). The commonest reason for having sex was because their friends had also had sex. Two hundred and seventy eight (61.9%) students reportedly had sex in the past 3 months before the survey, out of which 14.0% had sex with 4 or more sexual partners and 18% had sex more than once a week. Nineteen point eight percent of the currently sexually active students used condom during their last sexual intercourse. One hundred and forty six (27.2%) females had been pregnant at least once, out of which 75.3% had induced abortion. Students who watched pornographic movies (OR=2.189, CI=1.624-2.951) and those who dated the opposite sex (OR=2.839, CI=2.092-3.851) were 2 times more likely to have engaged in sexual intercourse than those who didn’t. Students who were sexually harassed were 5 times more likely to be sexually experienced than those who were not sexually harassed (OR=5.927, CI=4.408-7.971). Conclusion: There was a high rate of risky sexual behaviours amongst the secondary school students in Port Harcourt. Intervention program aimed at sexuality education and behavioural change should be inculcated into secondary school education curriculum in Port Harcourt.

Health behaviours & problems among young people in India: Cause for concern & call for action.

the young people in the age group of 10-24 yr in India constitutes one of the precious resources of India characterized by growth and development and is a phase of vulnerability often influenced by several intrinsic and extrinsic factors that affect their health and safety. Nearly 10-30 per cent of young people suffer from health impacting behaviours and conditions that need urgent attention of policy makers and public health professionals. Nutritional disorders (both malnutrition and over-nutrition), tobacco use, harmful alcohol use, other substance use, high risk sexual behaviours, stress, common mental disorders, and injuries (road traffic injuries, suicides, violence of different types) specifically affect this population and have long lasting impact. Multiple behaviours and conditions often coexist in the same individual adding a cumulative risk for their poor health. Many of these being precursors and determinants of non communicable diseases (NCDs) including mental and neurological disorders and injuries place a heavy burden on Indian society in terms of mortality, morbidity, disability and socio-economic losses. Many health policies and programmes have focused on prioritized individual health problems and integrated (both vertical and horizontal) coordinated approaches are found lacking. Healthy life-style and health promotion policies and programmes that are central for health of youth, driven by robust population-based studies are required in India which will also address the growing tide of NCDs and injuries.

Risky sexual behaviours and associated factors among people with disabilities in dessie city.

Background: Despite the assumptions that people with disabilities are considered sexually inactive, this group of people is likely to engage in sexual risk behaviours. People with disabilities are the neglected group of population; investigating their sexual behaviour helps to design interventions by the local government and concerned bodies. Therefore, the aim of this study was to study the prevalence and factors associated with risky sexual behaviours among people with disabilities. Methods: Institutional based Cross-sectional study was conducted in 2013. All disabled individuals who were enrolled as a member of the disability associations in the city were included in the study. Data were collected by pre-tested structured interview questionnaires by trained data collectors. The data were coded, entered, cleaned and analyzed using univariate, bivariate and multivariate analysis with SPSS version 16 soft ware package. Results: About 301(73.1%) of the respondents were sexually debuted, of which 153(50.8%) were sexually debuted before the age of 18 years and 166(55.1%) reported that they have had more than one sexual partner in the last twelve months. Besides, 32.5% of the study participants reported to have risky sexual behaviours. The age of respondents was a statistically significant predictors of sexual behavior with [(AOR=1.5, 95%CI:0.88-2.57), (AOR=1.54, 95%CI:0.68-3.52) and (AOR=3.1, 95%CI:1.64-5.87)]. Drinking alcohol was another predictors of sexual behaviour where [(AOR=1.72, 95%CI:1.10-2.70)]. Besides educational status and family size were other significant predictors of risky sexual behaviour on multivariable logistic regression with [(AOR= 3.14, 95%CI:1.02- 9.74), AOR=6.31, 95%CI:1.78-22.31), AOR=3.30, 95%CI:1.13- 9.68), and AOR=3.28, 95%CI:1.07-10.10)] and [AOR=1.73, 95%CI:1.10-2.70)] respectively. Conclusion: People with disabilities were engaged in sexual risk behaviour. Age, alcohol use, educational status, and family size were significant predictors of risky sexual behaviours among people with disabilities on which interventions need to be done by concerned bodies on this vulnerable group of people, especially by labor and social affairs of Ethiopia.

Interpersonal competence and sex risk behaviours among Jamaican adolescents / Competencia interpersonal y comportamientos de riesgo sexual entre los adolescentes Jamaicanos

OBJECTIVE: Of particular public health concern to the Jamaican authorities is the consistently high numbers of new HIV infections among adolescents and young adults. The thrust in HIV/AIDS prevention campaigns has largely been toward an increase in knowledge and attitudes as opposed to personality variables. However, it is widely believed that persons with high interpersonal skills may be less likely to engage in sex risk behaviours. This study investigated interpersonal competence as a personality characteristic associated with sexual risk-taking among Jamaican adolescents. METHODS: A cross-sectional survey of 500 adolescents, ages 13−18 years (250 males and 250 females) from nine randomly selected secondary government schools within Kingston and St Andrew was used. The sample ensured maximum variation in age groups. The BarOn EQ-i:YV(S) was utilized to provide a measure of interpersonal competence and the Sex Risk Scale from the Adolescent Risk Inventory acted as a measure of sex risk behaviours. The Spearman's rho correlational statistic was used to investigate the hypothesis. RESULTS: Of the students surveyed, 58.6% reported that they were sexually active; 31.8% reported having multiple sexual partners and 28.2% reporting inconsistent condom use. A significant, inverse relationship was observed between interpersonal competence and sex risk behaviours (p < 0.05). CONCLUSION: This research provided evidence that adolescents with high interpersonal skills are less likely to participate in risky sexual behaviours. Therefore, interventions aimed at reducing risky adolescent sexual practices might benefit from the inclusion of strategies to build interpersonal skills.

OBJETIVO: De interés particular para las autoridades jamaicanas de la salud pública es el número consistentemente alto de nuevas infecciones de VIH entre adolescentes y adultos jóvenes. El desempeño principal de las campañas de prevención del VIH/SIDA ha estado dirigido en gran parte hacia el aumento de conocimientos y actitudes, en vez de a variables de la personalidad. Sin embargo, existe la creencia ampliamente extendida de que las personas con buen desarrollo de sus habilidades interpersonales, serán menos propensas a involucrarse en conductas de riesgo sexual. Este estudio investigó la competencia interpersonal como una característica de personalidad asociada con riesgos sexuales entre adolescentes jamaicanos. MÉTODOS: Se llevó a cabo un estudio transversal de 500 adolescentes, con edades entre 13−18 años (250 varones, y 250 hembras) de nueve escuelas secundarias del gobierno, seleccionadas al azar en las áreas de Kingston y Saint Andrew. La muestra garantizó una máxima variación en los grupos de edad. Se usó el test BarOn EQ-i:YV (S) para obtener una medida de la competencia interpersonal, en tanto que la Escala de Riesgo Sexual del Inventario de Riesgo Adolescente actuó como una medida de los comportamientos de riesgo sexual. Las estadísticas correlaciónales de Spearman fueron utilizadas para investigar la hipótesis. RESULTADOS: De los estudiantes encuestados, 58.6% informó estar sexualmente activos; 31.8% informó tener múltiples parejas sexuales, y el 28.2%, reportó un uso sistemático del condón. Se observó una relación inversa significativa entre la competencia interpersonal y las conductas de riesgo sexual (p < 0.05). CONCLUSIÓN: Esta investigación proporcionó evidencia de que los adolescentes con alto desarrollo de habilidades interpersonales son menos propensos a participar en conductas sexuales riesgosas. Por lo tanto, las intervenciones destinadas a reducir las prácticas sexuales adolescentes riesgosas, podrían beneficiarse con la inclusión de las estrategias para desarrollar las habilidades interpersonales.

Las infecciones de transmisión sexual desde el hacer y el saber de estudiantes de deportes / Sexually transmitted diseases from the know-how of adolescent athletes

Introducción: las infecciones de transmisión sexual tienen altas tasas de prevalencia e incidencia en las personas menores de 24 años y son muy frecuentes en los adolescentes sexualmente activos. Objetivos: determinar los comportamientos sexuales y el nivel de información sobre signos y síntomas de la infecciones de transmisión sexual en atletas adolescentes de ambos sexos. Métodos: se realizó un estudio descriptivo en el que la recolección de datos se hizo mediante la aplicación de una encuesta probabilística a 177 atletas. Los datos recogidos en el cuestionario se analizaron con la ayuda del software SPSS 11.5, el uso de estadígrafos descriptivos, y la prueba de ji-cuadrada para determinar el nivel de asociación entre variables. Resultados: el 91,3 % tenía relaciones coitales con una edad promedio al inicio de 14,5 ± 1,3 años. Los varones fueron -estadísticamente- más proclives a tener varias parejas sexuales. El porcentaje de uso del condón se hizo mayor en la medida que transcurrió el tiempo entre la iniciación sexual y las últimas relaciones sexuales coitales practicadas. Fue muy bajo el reconocimiento sindrómico de las infecciones de transmisión sexual por los participantes. Conclusiones: a pesar de que los atletas refieren que hoy se protegen más que ayer, el bajo nivel de información mostrado en torno a los signos y síntomas que denotan la presencia de una infección de transmisión sexual y sus consecuencias, los hace vulnerables ante el contagio de estas enfermedades, sobre todo a los varones.

Introduction: sexually transmitted diseases present high rates of prevalence and incidence in people younger than 24 years and are very frequent in sexually active adolescents. Objectives: to determine the sexual behaviors and the level of information on signs and symptoms of sexually transmitted infections in adolescent athletes of both sexes. Methods: a descriptive study was conducted including a probabilistic survey to 177 adolescent athletes of both sexes to collect data. The questionnaire responses were analyzed with the help of SPSS software 11.5, and descriptive statistics in addition to the ji-square test to determine the level of association among variables. Results: in the study group, 91.3 % had had sexual intercourses at a mean age at onset of 14.5 ± 1.3 years. The males were - statistically - more likely to have several sexual couples. The percentage of use of condom was higher as more time elapsed from sexual initiation to the most recent sexual intercourses. Recognition of the signs and symptoms of sexually transmitted diseases was very low. Conclusions: despite the fact that the adolescent athletes refer to protect themselves more at present, their low level of information about the signs and symptoms of sexually transmitted diseases and their adverse effects make them vulnerable to the contagion with these diseases, mainly the male athletes.

Behavioural risk factors of men associated with transmission of sexually transmitted infections (STIs) in Sri Lanka

Background: Unprotected sex is a major risk factor for transmission of sexually transmitted infections (STIs). We explored the behavioural risk factors for STIs among men who presented with STI-related symptoms. Methods: A systematic sample of 112 males presenting with STI symptoms at district sexually transmitted disease (STD) clinic located in Kandy, Sri Lanka were enrolled during 2009. They were interviewed using a semi-structured questionnaire. Selected sexual behaviours were discussed with them in greater detail. The chi-square and difference-in-two-proportion tests were used for testing the statistical significance for quantitative data, and qualitative methods were used for the analysis of responses to open-ended questions and in-depth discussion. Results: The median age of the respondents was 28 years. The majority of them (56%) had never been married. The median age at the first sexual intercourse was 22 years. The majority(87%) of respondents had their first intercourse before marriage; mostly with older females. Most (103, 92%) men reported having sexual intercourse during the past six months; of them, 40.8% had sex with multiple partners. Only 18.5% used condoms at the first premarital intercourse. The consistent use of condoms with non-marital partners during the past six months was only 13.7%. Common reasons for non-use of condoms were: belief that partner was faithful; poor knowledge about risk of unprotected sex; view that condoms reduce pleasure and negatively affect intimacy; and inhibition in accessing condoms in public. Conclusions: Sexual behaviours were found to be risky among men attending STD clinics in Sri Lanka. Strategies of sexual health promotion among vulnarable groups should be evaluated for planning proper interventions.