Factors associated with condom use behaviour among young university students / Fatores associados ao uso de camisinha entre jovens universitários / Factores asociados con el uso del condom entre jóvenes universitarios

As the rates of sexually transmitted infections among Brazilian youth rise, college students present with low rates of condom use. Understanding which factors affect preventive behaviours may assist in promoting them. This study aimed to test the Theory of Planned Behaviour (TPB) as a model of condom use behaviour among young university students. Data on sexual behaviour, TPB, and personality variables were collected online with 343 sexually active students aged between 18 and 29. Seventy participants also provided follow-up data after 30 days. Structural equation models and ordinal regressions were used to analyse the effects of TPB variables on condom use behaviour. Attitude was the main predictor of behavioural intention in the cross-sectional and longitudinal models. Being in a relationship and lower age at sexual debut were also associated with less frequent condom use behaviour in the cross-sectional analysis. Behavioural intention and perceived control were associated with condom use behaviour. (AU)

Enquanto a incidência de infecções sexualmente transmissíveis cresce entre jovens brasileiros, universitários apresentam pouco uso de preservativos. Compreender quais fatores afetam a adoção de comportamentos preventivos pode auxiliar na sua promoção. Esse estudo testou a Teoria do Comportamento Planejado (TCP) como modelo de uso de camisinha entre jovens universitários. Foram coletados dados sobre comportamento sexual, TCP, e personalidade em questionário online com 343 estudantes sexualmente ativos entre 18 e 29 anos de idade. Setenta participantes também responderam ao follow-up após 30 dias. Modelos de equações estruturais e regressões ordinais foram usados para analisar os efeitos das variáveis da TCP no uso de preservativo. Atitude foi o principal preditor da intenção comportamental nos modelos transversal e longitudinal. Estar em um relacionamento e menor idade na primeira relação sexual também foram associados a uso menos frequente de preservativo na análise transversal. Intenção comportamental e controle percebido foram associados com uso de preservativo. (AU)

Mientras la incidencia de infecciones de transmisión sexual aumenta entre los jóvenes brasileños, los estudiantes universitarios reportan poco uso de preservativos. Comprender qué factores inciden en la adopción de conductas preventivas puede ayudar en su promoción. Este estudio probó la Teoría del Comportamiento Planeado (TCP) como modelo de uso de preservativos entre jóvenes universitarios. Los datos sobre comportamiento sexual, TCP y personalidad fueron recopilados en un cuestionario en línea con 343 estudiantes sexualmente activos entre 18 y 29 años. Setenta participantes también respondieron al seguimiento después de 30 días. Se utilizaron modelos de ecuaciones estructurales y regresiones ordinales para analizar los efectos de las variables de TCP sobre la utilización del condón. La actitud fue el principal predictor de la intención en los modelos transversal y longitudinal. Estar en una relación y una edad más temprana en la primera relación sexual se asociaron con el uso menos frecuente de preservativo en el análisis transversal. La intención conductual y el control percibido se asociaron con el uso de condones. (AU)

Percepção de risco e comportamentos de saúde em relação ao sexo casual em universitárias / Risk perception and health behaviors in relation to casual sex in college women / Percepción de riesgo y conductas de salud en relación al sexo casual en estudiantes universitárias

Este estudo buscou explorar e comparar a percepção dos riscos à saúde física e os comportamentos de saúde do sexo casual entre universitárias com (CEX) e sem experiência (SEX) de sexo casual. Participaram 1.133 universitárias brasileiras (média de idade igual a 21,05 anos, DP = 2,05), a maioria nascidas e residentes na região Sul do país, que responderam a um questionário on-line com questões sobre a percepção dos riscos físicos, comportamentos de saúde, comportamento e histórico sexual. Foi encontrada diferença significativa nos comportamentos de saúde e nas percepções de risco entre os grupos. O grupo CEX apresentou mais comportamentos de saúde e cuidados que o grupo SEX. Embora o sexo casual esteja relacionado aos comportamentos de risco, neste estudo, as mulheres CEX apresentaram mais medidas de proteção à saúde que as mulheres SEX. (AU)

This study aimed to explore and compare the perceptions of physical health risks and healthy sex behaviors among female university students with (CEX) and without (SEX) experience in casual sex. With a comparative cross-sectional design, the study included 1,133 Brazilian female university students (mean age 21.05 years, SD=2.05), mostly born and resident in the southern region of the country, who completed an online questionnaire about their perception of physical risks, their health behaviors, and their sexual behavior and history. There was a significant difference in health behaviors and risk perceptions between the two groups, where the CEX group showed higher levels of healthy behaviors and care than the SEX group. Although casual sex is related to risk behaviors, in this study, women in the CEX group reported taking more health protection measures than those in the SEX group. (AU)

La investigación tuvo como objetivo explorar y comparar la percepción de riesgo con la salud física y las conductas de salud relacionadas al sexo casual entre estudiantes universitarias con (CEX) y sin experiencia (SEX) de sexo casual. Participaron 1.133 estudiantes universitarias brasileñas (edad media de 21,05 años, DS=2,054), mayoritariamente nacidas y residentes de la región sur del país, que contestaron a un cuestionario online con preguntas sobre percepción de riesgos físicos, sus conductas de salud e historial sexual. Se pudo observar una diferencia significativa en los comportamientos de salud y en las percepciones de riesgo entre los grupos. El grupo CEX presentó más conductas saludables y de cuidados que el grupo SEX. Aunque el sexo casual esté relacionado con conductas de riesgo, en este estudio las mujeres CEX presentaron más medidas de protección a la salud que las mujeres del grupo SEX. (AU)

Trabajadores sexuales masculinos: entre el sexo seguro y el riesgo. Etnografía en una sauna gay de Barcelona, España / Male sex workers: between safe sex and risk. Ethnography in a gay sauna in Barcelona, Spain

Resumen Esta etnografía se realizó en Barcelona, ciudad que ofrece diferentes recursos de ocio homosexual, como las saunas gay. El objetivo fue analizar desde los estudios sobre género y masculinidades, cómo se articula la sexualidad, la percepción sobre la infección por VIH y otras infecciones de transmisión sexual (ITS), y las medidas preventivas en trabajadores sexuales masculinos (TSM) usuarios de saunas gay. Se realizaron 10 entrevistas en profundidad y observación entre 2012 y 2016. Las prácticas de sexo seguro son más frecuentes con clientes, mientras que las de riesgo se realizan más con parejas no comerciales. La orientación sexual juega un rol relevante, los homosexuales asumen más prácticas de riesgo en el trabajo sexual que los heterosexuales. Consumo de drogas o la escasez de redes de apoyo se relacionaron con mayor vulnerabilidad social y conductas de riesgo. Contraer el VIH aún genera miedo, mientras que tener otras ITS se percibe como parte de la vida sexual de un hombre. El TSM afianza una masculinidad con múltiples parejas sexuales, breadwinner y por otra parte, cuestiona un modelo heteronormativo. Las intervenciones para la prevención del VIH e ITS en este colectivo, deberían considerar los determinantes sociales como las precarias alternativas laborales y el ofrecer mayor soporte social.

Abstract This ethnography was conducted in Barcelona, a city that provides different gay leisure resources, such as gay saunas. We aimed to analyze from studies on gender and masculinities, how sexuality, perception of HIV infection and other sexually transmitted infections (STIs), and preventive measures are articulated in gay sauna male sex workers (MSW). Ten in-depth interviews and observation were conducted between 2012 and 2016. Safe sex practices are more frequent with clients, while risk practices are carried out more with non-commercial partners. Sexual orientation plays an important role. Homosexuals assume riskier practices in sex work than heterosexuals. Drug use or lack of support networks were associated with higher social vulnerability and risk behaviors. Contracting HIV still creates fear, while having other STIs is perceived as part of a man's sexual life. The MSW affirms masculinity with concurrent sexual partners, breadwinner, and on the other hand, questions a heteronormative model. Interventions for the prevention of HIV and STIs in this group should consider social determinants such as inferior work alternatives and the provision of more significant social support.

Conductas de riesgo hacia la infección por VIH. Una revisión de tendencias emergentes / Risk behaviors for HIV infection. A review of emerging trends

Resumen La infección por VIH, adquirida con participación consciente del receptor, es un problema complejo de alcance mundial, particular entre hombres que tienen sexo con otros hombres. Emergen comportamientos como el Bareback (sexo anal sin protección de modo intencional entre hombres) y, Bugchasing (sexo bareback cuando uno de los participantes es VIH+ y el otro no). Se caracterizó un grupo de conductas emergentes de riesgo hacia la infección por VIH. Se realizó una revisión bibliográfica en las bases de datos Medline, Web of Sciences, y Scielo regional. Se utilizaron términos de búsqueda como, sexo sin protección, Barebacking/Bareback, y Bug chasing, todos relacionados al VIH. Las conductas Barecack, y Bug Chaser se producen entre otros factores por el Homonegativiso social, la cobertura positiva de la Terapia Antirretroviral, campañas de prevención insuficientes, búsqueda de nuevas sensaciones, y el intento de fortalecer la relación con un miembro de la pareja VIH+. El sexo sin protección por su parte se asocia principalmente a tener diagnóstico de VIH/sida, violencia física debido a la orientación sexual, asistir a sitios de sexo Gay y haber comprado o vendido sexo. Se debe trabajar con los comportamientos individuales que acercan al sujeto a la infección.

Abstract HIV infection, acquired with the conscious participation of the recipient, is a complex problem of international concern, especially among men who have sex with men. Behaviors emerge such as bareback (intentionally unprotected anal sex between men) and bugchasing (bareback sex when one participant is HIV+ and the other is not). A group of emerging risk behaviors for HIV infection was characterized. A review of the literature in the MEDLINE, Web of Science and regional SciELO databases was performed. HIV-related search terms such as unprotected sex, barebacking/bareback and bug chasing, were used. Bareback and bug chaser behaviors occur, among other factors, through social homonegativity, ART positive coverage, insufficient prevention campaigns, search for new sensations and attempts to strengthen the relationship with the HIV+ member. Unprotected sex is primarily associated with having HIV/AIDS diagnoses, physical violence due to sexual orientation, viewing homosexual sex sites, and having bought or sold sex. It is necessary to work with individual behaviors that draw individuals close to infection.

Sexual compulsivity, anxiety, depression, and sexual risk behavior among treatment-seeking men in São Paulo, Brazil

Objective: There is a lack of studies on negative mood states and sexual risk behavior in men of all sexual orientations who seek treatment for excessive sexual behavior (ESB). We aim to examine sexual compulsivity (SC), anxiety, depression, and sexual risk behavior in a treatment-seeking sample of men and controls. Methods: We enrolled 88 (37 [42%] gay or bisexual and 51 [58%] heterosexual) ESB outpatients and 64 controls. Assessments included the Sexual Compulsivity Scale (SCS), the Beck Anxiety Inventory (BAI), the Beck Depression Inventory (BDI), and sexual risk behaviors. Results: Compared to controls, ESB outpatients showed increased SC, anxiety, and depression, which were correlated. Regarding sex with casual partners, ESB outpatients reported more sexual intercourse, a greater number of partners, more anal intercourse, and unprotected anal intercourse. Anxiety, depression, and SC were associated with protected vaginal intercourse with a main partner, whereas they were associated with unprotected anal intercourse with a casual partner. Depression was associated with unprotected vaginal intercourse with a casual partner. Condomless anal intercourse was predicted by SC and was also reported by the heterosexual ESB outpatients (36%). Conclusion: The data contribute to the field by providing information on men of all sexual orientations who are searching for mental healthcare. The connections among these psychopathological factors and sexual risk behavior have implications for public health, clinicians, and research.

Comportamentos sexuais, Resiliência e Conhecimento sobre HIV/AIDS: Uma análise psicossocial / Sexual Behaviors, Resilience and Knowledge about HIV/AIDS: A Psychosocial Analysis / Conductas Sexuales, Resiliencia y Conocimiento sobre el VIH/SIDA: Un análisis psicosocial

Apesar dos avanços observados no tratamento do HIV/AIDS nas últimas décadas, denota-se o aumento das condutas sexuais de risco, que contribuem no aumento de novos casos de HIV+. Este artigo teve como objetivo principal analisar se os constructos psicossociais, resiliência e conhecimento sobre HIV/AIDS, protetores contra a vulnerabilidade à infecção pelo vírus HIV, estão associados às características sociodemográficas. Contou-se com 600 pessoas adultas da população em geral (M= 27,31 anos; DP=9,37), sendo 59,2% mulheres e 40,8% homens. Utilizaram-se os seguintes instrumentos: questionário de dados sociodemográficos e comportamentos sexuais, escala de conhecimento sobre HIV/AIDS e a escala de resiliência CD-RISC-BR. Empregou-se o software SPSS versão 22 para a análise dos dados. Observou-se que os níveis de resiliência variaram significativamente em função das variáveis sociodemográficas: sexo, escolaridade, situação laboral, iniciação sexual e realização do teste de HIV. No que se refere ao conhecimento sobre HIV, encontrou-se diferenças estatisticamente significativas em função das características: orientação sexual, iniciação sexual e realização do teste de HIV. Por fim, espera-se que este estudo possa contribuir na formulação de intervenções preventivas em saúde aos comportamentos sexuais de risco ao HIV.(AU)

Despite the advances observed in HIV/AIDS treatment of in recent decades, sexual risk behavior and the number of new HIV cases have increased. The main objective of this study was to analyze whether the psychosocial constructs, resilience and knowledge about HIV/AIDS, which are protectors against vulnerability to HIV infection, are associated with socio-demographic characteristics of individuals. The sample consisted of 600 adults from the general population. The mean age was 27.31 years (SD = 9.37), 59.2% were female and 40.8% were male. The following instruments were used: questionnaire on socio-demographic data and sexual behavior, scale of knowledge about HIV/AIDS and the CD-RISC-BR resilience scale. SPSS software (v. 22) was used for data analysis. The levels of resilience varied significantly according to socio-demographic variables: gender, schooling, work situation, sexual initiation and HIV test. Regarding knowledge about HIV, we found statistically significant differences according to the characteristics: sexual orientation, sexual initiation and HIV test. Finally, it is expected that this study may contribute to the formulation of preventive health interventions regarding sexual risk behaviors and HIV.(AU)

A pesar de los avances observados en el tratamiento del VIH/SIDA en las últimas décadas, se denota el aumento de las conductas sexuales de riesgo, que contribuyen en el aumento de nuevos casos de VIH+. Este artículo tuvo como objetivo principal analizar si los constructos psicosociales, resiliencia y conocimiento sobre VIH/SIDA, protectores contra la vulnerabilidad a la infección por el VIH, están asociados a las características sociodemográficas. Se contó con 600 personas adultas de la población en general (M = 27,31 años, DP = 9,37), siendo 59,2% mujeres y 40,8% varones. Se utilizaron los siguientes instrumentos: cuestionario de datos sociodemográficos y comportamientos sexuales, escala de conocimiento sobre VIH/SIDA y la escala de resiliencia CD-RISC-BR. Se empleó el software SPSS versión 22 para el análisis de los datos. Se observó que los niveles de resiliencia variaron significativamente en función de las variables sociodemográficas: sexo, escolaridad, situación laboral, iniciación sexual y realización de la prueba de VIH. En lo que se refiere al conocimiento sobre el VIH, se encontraron diferencias estadísticamente significativas en función de las características: orientación sexual, iniciación sexual y realización del test de VIH. Finalmente, se espera que este estudio pueda contribuir en la formulación de intervenciones preventivas en salud a los comportamientos sexuales de riesgo al VIH.(AU)

Vulnerabilidade ao HIV de homens que fazem sexo com homens usuários de aplicativos geossociais para encontros / HIV vulnerability of men who have sex with men users of geossocial dating applications

Homens que fazem sexo com homens (HSH) são uma população desproporcionalmente mais afligidos pela infecção do HIV. A alta prevalência da infecção entre essa população, evidencia a necessidade de acompanhar novos comportamentos, no qual se destaca o uso das redes sociais móveis para agilizar o ato sexual ocasional. Assim, nosso estudo teve como objetivo analisar as vulnerabilidades de homens que fazem sexo com homens, usuários de aplicativos geossociais de encontro, à infecção por HIV. Para isso foram realizadas duas etapas sequenciais: 1ª- Revisão integrativa da literatura e 2ª - Estudo descritivo e exploratório. A pesquisa obedeceu as diretrizes éticas sobre pesquisas com seres humanos, reguladas pela resolução 466/12 e aprovado pelo Comitê de Ética e Pesquisa da Escola de Enfermagem de Ribeirão Preto /USP (1.921.265/2017). A revisão foi guiada pela questão: o uso de aplicativos de geossociais de encontro para encontrar parceiros sexuais aumenta o comportamento de risco para a infecção pelo HIV por HSH? Pesquisamos as bases de dados PubMed, Web of Science, CINAHL e LILACS, considerando estudos primários publicados até dezembro de 2015, sem restrições de tempo. O conhecimento sintetizado guiou a estruturação e interpretação da próxima etapa. O estudo exploratório objetivou avaliar o conhecimento de homens que fazem sexo com homens usuários de aplicativo de encontro baseado em geolocalização, sobre o HIV/aids e implicações no estabelecimento de parcerias. Realizou-se entrevistas com 30 usuários do Hornet® recrutados no aplicativo pela técnica Time-Location Sampling (TLS). Os depoimentos gerados tiveram tratamento estatístico no software IRaMuTeQ, posteriormente analisados pela Classificação Hierárquica Descendente. A coleta de dados foi propiciada pela TLS modificada a realidade virtual. Na coleta de dados utilizouse a técnica Computer-Assisted Interview (CASI). A coleta foi realizada por dois pesquisadores devidamente treinados, que se registraram no aplicativo para ter acesso aos usuários e criaram um perfil público. Foram abordados os primeiros usuários online, que registraram em seu perfil o status sorológico atual para o HIV/aids. Usuários de aplicativos possuem conhecimento insuficiente sobre medidas de prevenção do HIV/aids, principalmente quando se descarta o preservativo masculino. O sexo com os parceiros encontrados por meio de aplicativos foi caracterizado como ocasional, imediato, desprotegido, associado ao uso de drogas e sem informações sobre o status de HIV dos parceiros. As relações estabelecidas pelos aplicativos revelam novos padrões de comportamento e relacionamento, colocando HSH frente a situações com alto risco de infecção pelo HIV e diferentes formas de proteção, que podem ocorrer simultaneamente

Men who have sex with men (MSM) are a population disproportionately more afflicted by HIV infection. The high prevalence of infection among this population evidences the need to follow new behaviors, in which the use of mobile social networks is emphasized to accelerate the occasional sexual act. Thus, our study aimed to analyze the vulnerabilities of men who have sex with men, users of geossocial applications against HIV infection. For this, two sequential steps were performed: 1st - Integrative literature review and 2nd - Descriptive and exploratory study. The research obeyed the ethical guidelines on research with human beings, regulated by resolution 466/12 and approved by the Committee of Ethics and Research of the School of Nursing of Ribeirão Preto/USP (1.921.265/2017). The review was guided by the question: does using geossocial dating applications to find sexual partners increase the risk behavior for HIV infection by MSM? We searched the databases PubMed, Web of Science, CINAHL and LILACS, considering primary studies published until December 2015, without time restrictions. The synthesized knowledge guided the structuring and interpretation of the next step. The exploratory study aimed to evaluate the knowledge of men who have sex with men using geolocation-based dating software, about HIV/aids and implications for establishing partnerships. Interviews were conducted with 30 Hornet® users recruited in the application using the Time-Location Sampling (TLS) technique. The statements generated had statistical treatment in the IRaMuTeQ software, later analyzed by the Descending Hierarchical Classification. The data collection was provided by the modified TLS virtual reality. The Computer-Assisted Interview (CASI) technique was used for data collection. The collection was performed by two properly trained researchers, who registered in the application to have access to the users and created a public profile. The first online users, who recorded the current HIV/aids serological status in their profile, were discussed. Application users have insufficient knowledge about HIV/aids prevention measures, especially when discarding the male condom. Sex with partners found through applications was characterized as casual, immediate, unprotected, associated with drug use, and without information about partners' HIV status. The relationships established by the applications reveal new patterns of behavior and relationships, placing MSM in situations of high risk of HIV infection and different forms of protection, which may occur simultaneously

El uso inconsistente del condón en mujeres mexicanas que viven con VIH: un reto para los servicios de salud / Inconsistent condom use among Mexican women living with HIV: a challenge for health services

Objetivo. Describir prácticas de uso del condón en mujeres mexicanas con VIH y analizar factores que lo facilitan u obstaculizan. Material y métodos. Análisis cualitativo de 55 entrevistas con mujeres que viven con VIH en edad reproductiva. Resultados. El uso inconsistente y el no uso del condón en la última relación sexual fueron comunes y no mostraron una relación clara con el estatus serológico de la pareja. Factores favorables al uso del condón fueron las percepciones de su beneficio para la salud, significados simbólicos del condón en relaciones de pareja y transformación o persistencia de normas de género. Conclusiones. Las normas de género y las actitudes de la pareja masculina intervienen en el uso del condón entre mujeres con VIH. Para incrementar su uso consistente, el sistema de salud debe ofrecer consejería y servicios con perspectiva de género e implementar acciones innovadoras que involucren a las parejas masculinas.

Objective. To describe condom use among Mexican women living with HIV and analyze factors that facilitate or impede its utilization. Materials and methods. Qualitative analysis of 55 interviews with women of reproductive age living with HIV. Results. Inconsistent condom use and non-use at last sexual intercourse was common, and not clearly related to the male partners' HIV-status. Factors that influenced condom use included perceptions of health benefits, symbolic meaning assigned to the condom within the relationship, and the transformation or persistence of inequitable gender norms. Conclusions. Gender norms and male partners' attitudes strongly influence condom use among women living with HIV. To increase consistent condom use the health system must implement counseling and service delivery with a gender perspective and innovative actions to involve male partners.

"Dame una pastilla": los significados del VIH/sida en la práctica del bareback en la ciudad de México e implicaciones para la prevención / "Give me a pill": the meanings of AIDS in bareback practice in Mexico City and its implications for HIV prevention

Objetivo. Analizar los significados que, sobre el sexo bareback, tienen hombres gay en la ciudad de México. Material y métodos. Investigación cualitativa basada en la teoría fundamentada que utilizó entrevistas semiestructuradas a barebackeros reclutados a través de páginas web. También se realizó un análisis documental sobre el tema. Resultados. Los entrevistados reportaron tener sexo desprotegido. La argumentación al respecto indicó que el acceso al tratamiento antirretroviral modifica la percepción del riesgo de infección. La confianza en torno a los beneficios de este tratamiento y la disminución de las campañas de prevención se identificaron como nociones que guían esta práctica. Conclusiones. Los hombres gay de la ciudad de México con ingresos económicos medios y altos y acceso a antirretrovirales han variado su percepción respecto al VIH. Esto hace necesaria una revisión de los programas de prevención, reducción de riesgos, diagnósticos tempranos y un análisis de nuevas formas de estigmatización y discriminación que podrían causar las campañas que desconozcan estos nuevos significados.

Objective. To analyze and understand the meanings that gay men in Mexico City associate to unprotected sex such as bareback practices. Materials and methods. Exploratory qualitative study that uses grounded theory analysis of semistructured interviews with gay men that practice bareback sex recruited through the internet. Also a documentary analysis was performed. Results. Gay men engage in bareback sexual practices because they have access to antiretroviral therapy. Access to treatment changes the meanings around AIDS and the perceived risk of infection. The confidence on treatment and the dropback of the Mexican government on preventive strategies explain these perceptions. Conclusions. Urban and middle class gay men in Mexico City have changed their perception with respect to HIV infection. It is necessary to understand the meanings related to bareback sexual practices and the use of condoms as a preventive strategy. We have to retake the discussion on preventive strategies, damage mitigation, stigma, discrimination, early diagnosis and the impact of antiretroviral therapy.

Factors associated with unprotected sexual practice among men and women with mental illnesses in Brazil / Fatores associados com a prática do sexo desprotegido entre homens e mulheres com transtornos mentais no Brasil / Los factores asociados con la práctica del sexo sin protección entre hombres y mujeres con trastornos mentales en Brasil

This study estimated the rate and correlates of recent unprotected sex among sexually active psychiatric patients in Brazil, stratified by gender. The prevalence of unprotected sex among women and men were 89% and 77%, respectively. Significant correlates with unprotected sex were: being married/in union, living with children/partner, and cigarette smoking in both genders; lower income, depression and anxiety diagnoses among men only; older age, no previous HIV testing, sex under the influence of alcohol/drugs, and verbal violence among women only. Interventions to reduce risk behavior among psychiatric patients in Brazil are urgent and should take into account gender differences.

Este estudo estimou a prevalência e os fatores associados com o sexo desprotegido recente entre pacientes psiquiátricos sexualmente ativos no Brasil, estratificados por sexo. A prevalência de sexo desprotegido entre mulheres e homens foi 89% e 77%, respectivamente. Os fatores associados significativamente com o sexo desprotegido foram: estar casado/em união, viver com filhos/parceiros, e tabagismo em ambos os sexos; baixa renda e diagnósticos de depressão e ansiedade apenas entre homens; idade maior que 40 anos, nenhum teste prévio para o HIV, sexo sob a influência de álcool/drogas e violência verbal apenas entre as mulheres. Intervenções para reduzir comportamentos de risco entre pacientes psiquiátricos no Brasil são urgentes e devem considerar as diferenças de gênero.

Este estudio estima la prevalencia y los factores asociados con el sexo no protegido reciente entre los pacientes psiquiátricos sexualmente activos en Brasil, estratificado por sexo. La prevalencia de relaciones sexuales sin protección entre hombres y mujeres fue de 89% y 77%, respectivamente. Los factores asociados significativamente con el sexo sin protección fueron: estar casado/en unión, vivir con los niños/pareja, y el tabaquismo en ambos sexos; bajos ingresos y diagnóstico de depresión y ansiedad entre los hombres solamente; edad mayor de 40 años, ninguna prueba anterior para VIH, sexo bajo la influencia de alcohol/drogas y la violencia verbal sólo entre las mujeres. Las intervenciones para reducir los comportamientos de riesgo entre los pacientes psiquiátricos en Brasil son urgentes y deben considerar las diferencias de género.

Comportamento sexual de risco em jovens: aspectos cognitivos e emocionais / Sexual risk behavior in youngsters: cognitive and emotional aspects / Conducta sexual de riesgo en jóvenes: aspectos cognitivos y emocionales

O estudo avalia a contribuição dos construtos da Teoria do Comportamento Planejado e variáveis emocionais sobre a intenção de repetir o comportamento de manter relações sexuais sem preservativo entre jovens. Participaram 1.245 estudantes com idades entre 15 e 24 anos, de Canoas/RS. A prevalência do comportamento foi de 40% (500 jovens), os quais constituíram a amostra. Os instrumentos usados foram: questionário baseado na Teoria do Comportamento Planejado aplicada ao comportamento e sobre a intensidade de emoções básicas antes, durante e depois da realização. Os dados foram analisados através de regressão linear múltipla. No modelo final, o construto atitude se apresentou como o maior preditor da intenção (80%). As emoções de medo depois, alegria antes e culpa depois explicaram, conjuntamente, 12,5%. Os resultados indicam a influência dos aspectos emocionais na realização do comportamento e revelam a prioridade do componente atitudinal na predição da intenção de realizar relações sexuais sem preservativo entre jovens...

The study assesses the contribution of the Theory of Planned Behavior's constructs and emotional variables on the intention to repeat the behavior of maintain sexual intercourse without using condom among youngsters. Participated 1,245 students aged between 15 and 24 years, from Canoas/RS. The prevalence of the behavior was 40% (500 youngsters), which constituted the sample. The instruments were: questionnaire on the Theory of Planned Behavior applied to behavior and on the intensity of basic emotions before, during and after implementation. Data were analyzed using multiple linear regression. In the final model, the attitude presented itself as the greatest predictor of intention (80%). The emotions of fear after, joy before and guilt after, jointly, explained 12,5%. Results indicate the importance of emotional aspects in the behavior realization, but reveal the priority of the attitudinal component in the prediction of the intention to have sex without condom among youngsters...

El estudio evalúa la contribución de los constructos de la Teoría del Comportamiento Planificado y variables emocionales sobre la intención de repetir la conducta de mantener relaciones sexuales sin preservativo entre jóvenes. Participaron 1245 estudiantes con edad entre 15 y 24 años, de Canoas/RS. La prevalencia de la conducta fue de 40% (500 jóvenes), los cuales constituyeron la muestra. Los instrumentos fueron: cuestionario sobre la Teoría del Comportamiento Planificado aplicada a la conducta y sobre la intensidad de emociones básicas antes, durante y después de la realización. Los datos fueron analizados a través de regresión lineal múltiple. En el modelo final la actitud presentóse como el mayor predictor de la intención (80%). Las emociones de miedo después, alegría antes y culpa después explicaron conjuntamente el 12,5%. Los resultados indican la importancia de los aspectos emocionales en la realización de la conducta, pero revelan la prioridad del componente actitudinal en la predicción de la intención de mantener relaciones sexuales sin preservativo entre jóvenes...

Sexarca, informação e uso de métodos contraceptivos: comparação entre adolescentes / First sexual intercourse, information and contraceptive use: a comparison between adolescents / Sexarca, información y uso de métodos anticonceptivos: comparación entre adolescentes

Este trabalho teve por objetivo comparar a idade da primeira relação sexual, a informação sobre métodos contraceptivos, além de seu uso com a ocorrência da gestação na adolescência em dois grupos (50 grávidas e 50 não grávidas). Foi utilizado um questionário desenvolvido para o estudo que investigou essas variáveis. Verificou-se que não há diferença significativa nos grupos entre idade da sexarca, uso de contracepção na sexarca e tipo de contraceptivo utilizado. Contudo, os grupos diferem em relação ao uso de métodos contraceptivos nas relações sexuais subsequentes. Os dados revelam a multiplicidade de fatores envolvidos no comportamento contraceptivo demonstrando a necessidade de absorção desses fatores por parte das políticas públicas voltadas para o público adolescentes...

This study aimed to compare the age at first sexual intercourse, information about contraceptive methods, besides its use with the occurrence of adolescent pregnancy in two groups (50 pregnant and 50 nonpregnant). The questionnaire developed for the study investigated these variables. It was found that there is no significant difference between groups in age at first sexual intercourse, use of contraception at first sexual intercourse and type of contraceptive used. However, the groups differ with respect to the use of contraceptives in the subsequent sexual intercourses. The data reveals the multiplicity of factors involved in contraceptive behavior demonstrating the need for absorption of these factors on the part of public politics directed to adolescents...

Este estudio tuvo como objetivo comparar la edad de la primera relación sexual, la información sobre los métodos anticonceptivos, además de su uso con la ocurrencia del embarazo en la adolescencia en dos grupos (50 embarazadas y 50 no embarazadas). El cuestionario elaborado para el estudio investigó esas variables. Se encontró que no hay diferencia significativa en los grupos entre edad de la sexarca, el uso de anticonceptivos en la sexarca y el tipo de anticonceptivo utilizado. Sin embargo, los grupos difieren con respecto a la utilización de anticonceptivos en las relaciones sexuales posteriores. Los datos revelan la multiplicidad de factores implicados en el comportamiento anticonceptivo que demuestran la necesidad de absorción de estos factores en las políticas públicas vueltas a los adolescentes...

Correlates of unprotected sex in a sample of young club drug users

OBJECTIVES: To assess the demographic characteristics, psychiatric symptoms, substance use patterns, and sexual risk behaviors in a sample of club drug users to identify factors associated with unprotected sex during the 12 months prior to the interview. METHODS: This cross-sectional study employed the targeted sampling and ethnographic mapping approaches via face-to-face interviews conducted at bars and electronic music festivals using an adapted, semi-structured version of the Global Appraisal of Individual Needs questionnaire. The sample comprised 240 male and female young adults who had used ecstasy and/or LSD in the 90 days prior to the interview and who were not receiving treatment for alcohol or drug abuse. RESULTS: Of the 240 subjects selected (mean age: 22.9±4.5 years), 57.9% were men; of the male subjects, 52.5% reported having had unprotected sex in the previous 12 months. Of the total sample, 63.33% reported having had unprotected sex. Multivariate regression analysis showed that anal sex (PR = 1.26; 95% confidence interval (CI): 1.044-1.543; p = 0.017) and the use of alcohol/drugs to make sex last longer (PR = 1.430; 95% CI: 1.181-1.732; p<0.001) are associated with unprotected sex. CONCLUSIONS: The implementation of intervention strategies aimed at reducing sexually risky behaviors should take into consideration the specific characteristics of drug users and should include the development of safer sex negotiation skills. .

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.

Validation of the Jamaican maternal sexual role modelling questionnaire / Validación del cuestionario sobre la modelación del rol sexual materno en Jamaica

OBJECTIVE: Urban Jamaican adolescent girls face significant risk for sexually transmitted infections including HIV. Studies from the United States of America have found that parents influence adolescents' sexual risk attitudes and behaviours through parent-child sexual communication and monitoring/ supervision. Data from an ongoing mother-daughter HIV risk reduction intervention study in Kingston, Jamaica identified an additional influence of adolescent girls' sexual risk - maternal sexual role modelling (MSRM). As no reliable and valid questionnaires existed to measure MSRM, one was developed. The objective of the current study was to evaluate the psychometric properties of the Jamaican Maternal Sexual Role Modelling questionnaire. METHOD: Data were collected from 209 Jamaican female adolescents recruited from Kingston, St Andrew and St Catherine parishes. RESULTS: The final 19-item Jamaican MSRM questionnaire was found to have excellent internal reliability (Cronbach's alpha = 0.89). Content validity expert ratings and modified kappa statistics were all 1.0. Principal component analysis identified a three-factor structure that accounted for 53.7% of the variance. Greater MSRM scale scores, indicating more positive and protective maternal sexual role modelling, were associated with less sexual experience, lower intentions to have sex, greater intentions to use condoms if having sex and greater condom use self-efficacy among adolescent girls. CONCLUSION: The MSRM scale was found to be a reliable and valid measure of Jamaican adolescent females' perceptions of their mothers' sexual role modelling. Further research is needed to assess the reliability and validity of the instrument with other populations.

OBJETIVO: Las jóvenes adolescentes urbanas de Jamaica, enfrentan un riesgo significativo de infecciones de trasmisión sexual, incluyendo el VIH. Estudios de los Estados Unidos de América han encontrado que los padres influyen en las conductas y actitudes de riesgo sexual de los adolescentes a través de la comunicación entre padres e hijos sobre asuntos de sexo, acompañada de supervisión y monitoreo. Datos obtenidos a partir de un estudio de intervención que se desarrolla actualmente en Kingston, Jamaica, para reducir el riesgo de VIH madre-hija, identificaron una influencia adicional de riesgo sexual entre las adolescentes: la modelación del rol sexual materno (MRSM). Como que no existían cuestionarios válidos y fiables para medir la MRSM, se desarrolló uno a propósito de este trabajo. El objetivo del presente estudio fue evaluar las propiedades psicométricas del cuestionario de la modelación del rol sexual materno jamaicano. MÉTODO: Se recopilaron datos de 209 adolescentes jamaicanas reclutadas en los distritos de Kingston, St Andrew y St Catherine. RESULTADOS: Se halló que el cuestionario final MRSM jamaicano de 19 ítems poseía excelente fiabilidad interna (alfa de Cronbach = 0.89). Las valoraciones (ratings) de los expertos con respecto a la validez del contenido, así como las estadísticas Kappa modificadas, fueron todas 1.0. El análisis del componente principal identificó una estructura de tres factores que daba cuenta del 53.7% de la varianza. Mayores puntuaciones de la escala MRSM, que indicaban una modelación del rol sexual materno más positiva y protectora, estuvieron asociadas con menor experiencia sexual, menos intenciones de tener sexo, más intenciones de usar condón a la hora de mantener relaciones sexuales, y mayor auto-eficacia en el uso de condón entre las adolescentes. CONCLUSIÓN: Se halló que la escala MRSM es fiable y constituye una medida válida de las percepciones que las adolescentes jamaicanas tienen en relación con la modelación del rol sexual de sus madres. Se necesita continuar las investigaciones a fin de evaluar la fiabilidad y validez del instrumento con otras poblaciones.

Factores que predisponen, facilitan y refuerzan el uso del preservativo en jóvenes universitarios de Cali, Colombia / Factors predisposing, facilitating and strengthening condom use amongst university students in Cali, Colombia

Objetivos Identificar la frecuencia del uso habitual del condón y los factores que predicen, facilitan y refuerzan su uso en jóvenes universitarios. Métodos Estudio analítico de corte transversal con análisis multivariado. La muestra fue de 397 estudiantes seleccionados aleatoriamente mediante un muestreo estratificado por Facultades a quienes se les aplicó una encuesta asistida por computador denominada "Reconociendo mi salud sexual". Resultados El uso habitual de condón se da para el 33 % de la población. Los factores predisponentes para su uso habitual fueron, el tener la intención y alta autoeficacia en su uso con la pareja ocasional. Entre los factores facilitadores, el uso con la pareja habitual aumenta en 19 veces la oportunidad de utilizarlo habitualmente. El ser hombre se asoció con su uso tanto en los factores predisponentes como facilitadores. Entre los reforzantes, considerar que el condón intensifica el placer al sentirse protegidos y que entre los amigos el condón sea aceptado, se asoció a su uso habitual. En contraste, desplazar el uso del condón por otros métodos anticonceptivos disminuyó la probabilidad de usarlo habitualmente en un 60 %. Conclusión El no uso habitual del condón en las relaciones pene-ano y su desplazamiento por el uso de otro método anticonceptivo, son claras evidencias de la mayor preocupación que representa para la juventud el embarazo en comparación con las ITS. Se recomienda, la formulación y ejecución de programas que apunten simultáneamente y con igual énfasis a la prevención de embarazos, del VIH y otras ITS.

Objective Identifying condom use frequency and factors predisposing, facilitating and reinforcing its consistent use in college students. Methods This was a cross-sectional analytical study involving multivariate analysis. The sample consisted of 397 students who were randomly selected using stratified sampling by faculty who had applied a computer-assisted survey entitled, "Recognizing my sexual health." Results 33 % of the sample population reported routine condo muse. The predisposing factors for regular condo muse were the intention to use one and high self-efficacy regarding use with casual partners. Facilitating factors revealed that condom use with a habitual partner increased the opportunity to use it 19-fold. Being male was associated with its use regarding both predisposing and facilitating factors. It is worth stressing that, amongst there in forcing factors, considering that a condom intensifies pleasure by feeling protected was associated with its regular use as was the condom being accepted by friends. By contrast, abandoning condom use for other contraceptive methods reduced the probability of it being used usually by 60 %. Conclusions Non-regular condom use in penile-anal intercourse and its displacement by other contraceptive methods provided clear evidence of young people's major concern concerning becoming pregnant rather than avoiding contracting an STI. Formulating and implementing programs simultaneously aimed at and placing equal emphasis on avoiding pregnancy and preventing HIV and other STI is recommended.

Vulnerability to AIDS among the elderly in an urban center in central Brazil

OBJECTIVE: As the world population ages with an improved quality of life and sexual longevity, the prevalence of AIDS is rising among the elderly. The purpose of this study was to estimate the vulnerability to AIDS among individuals attending senior community centers in Campo Grande, Mato Grosso do Sul, Brazil. METHOD: This descriptive, exploratory investigation included 329 subjects selected in a probabilistic manner. Individuals with scores on the Mini-Mental State Examination indicating cognitive impairment were excluded from the analyses. Barthel's and Lawton's functional assessment scales were applied. Interviews were conducted to evaluate the presence of cognitive and behavioral factors associated with HIV transmission. RESULTS: Most subjects were non-dependent, fell within the 60- to 69-year age bracket and were female. A majority of individuals reported having knowledge about AIDS and were aware that the elderly are vulnerable to the disease. More than a quarter (26.9 percent) of the sample reported previous HIV testing. No participants reported drug use, homosexual orientation, or alcohol abuse. A minority of participants reported using medication for erectile dysfunction. Casual and multiple partners accounted for 12 percent and 34 percent of reported intercourse experiences, respectively. Condom use was reported by 14 percent of respondents. CONCLUSION: Unprotected sex was the primary factor accounting for vulnerability to AIDS among the elderly.

Fatores associados à idade da primeira relação sexual em jovens: estudo de base populacional / Factors associated with age at first intercourse: a population-based study

A primeira relação sexual é considerada um evento importante na vida dos jovens e tem iniciado cada vez mais cedo. O objetivo do presente estudo foi descrever os fatores relacionados à idade precoce da primeira relação sexual, de jovens de 18 a 24 anos na cidade de Pelotas, Rio Grande do Sul, Brasil. Este é um estudo transversal de base populacional, em uma amostra representativa de 1.621 jovens que ocorreu entre agosto de 2007 e dezembro de 2008. Foram aplicados questionários sobre comportamentos de saúde que continham itens relativos à sexualidade. A regressão de Cox foi utilizada para aferir a associação com a idade precoce de início da vida sexual. Após a análise multivariada, as variáveis diretamente relacionadas com a iniciação sexual precoce foram: sexo masculino, baixo nível socioeconômico, baixa escolaridade, ter pais separados, morar com companheiro(a), não praticar uma religião, uso de tabaco e drogas, e o não uso da camisinha na última relação. Considerando o contexto social atual, evidencia-se a necessidade de uma adequada orientação sexual com aspecto preventivo.

First sexual intercourse is considered an important event in young people's lives and has occurred at an increasingly early age. The aim of this study was to identify factors associated with early age at first intercourse in individuals 18 to 24 years of age in Pelotas, Rio Grande do Sul State, Brazil. This was a population-based cross-sectional study in a representative sample of 1,621 young people from August 2007 to December 2008. Subjects answered a questionnaire on health behaviors, including items related to their sexual lives. Cox regression was used to assess the association between early age at sexual initiation. After multivariate analysis, variables that are directly related to early sexual initiation were: male gender, low socioeconomic status, low schooling, divorced parents, living with a partner, not practicing a religion, smoking, drug use in the previous three months, and non-use of condoms during last intercourse. Considering the current social context, the study highlights the need for adequate sexual orientation with a preventive approach.