Educación sexual, conocimiento de ITS y conductas protectoras/de riesgo en personas entre 18 y 30 años

Introducción: Las infecciones de transmisión sexual (ITS) se adquieren principalmente por el contacto sexual y pueden afectar a personas de cualquier edad, sin embargo los adolescentes son el grupo etario más afectado, por tanto es probable que sus conductas sean más de riesgo que protectoras. Objetivo: El objetivo de la investigación es determinar la relación entre el nivel de educación sexual y el conocimiento sobre ITS y las conductas de riesgo y protectoras en los jóvenes. Método: Investigación de diseño analítico, estudio de tipo descriptivo, transversal con datos de tipo cuantitativos, con una muestra de 130 hombres y mujeres, considerando 10 personas por edad desde los 18 a los 30 años. Resultados: No existe relación estadísticamente significativa entre la educación sexual y las conductas de riesgo y/o protectores (p > 0,05), ni tampoco entre la educación sexual y el uso del preservativo, tanto interno como externo (p > 0,05). Conclusión: A pesar de tener educación sexual, no todas las personas utilizan de forma frecuente los anticonceptivos de barrera y principalmente es sorprendente el poco uso del condón de vagina en la población en general, siendo las personas de orientación heterosexual las que lo utilizan menos.

Introduction: Sexually transmitted infections (STIs) are mainly acquired through sexual contact and can affect people of any age; however, adolescents are the most affected age group, therefore, it is likely that their behaviors are more risky than protective. Objective: The objective of the research is to determine the relationship between the level of sexual education and knowledge about STIs and risk and protective behaviors in young people. Method: Analytical design research, descriptive, cross-sectional study with quantitative data, with a sample of 130 men and women, considering 10 people by age from 18 to 30 years. Results: There is no statistically significant relationship between sexual education and risk and/or protective behaviors (p > 0.05) nor between sexual education and condom use, both internal and external (p > 0.05). Conclusion: Despite having sexual education, not all people use frequently barrier contraceptives and, mainly, the little use of the vaginal condom in the general population is surprising, with people of heterosexual orientation being those that use it less.

Psychosocial characteristics pattern correlated with HIV-related risky sexual behavior among HIV-negative men who have sex with men: a latent profile analysis

BACKGROUND@#Men who have sex with men (MSM) have become a high risk population of HIV infection due to their risky sexual behaviors. The latent pattern of psychosocial characteristics plays an important effect in HIV-related risky behaviors among HIV-negative MSM.@*METHOD@#Participants were recruited from Wuhan, Nanchang, and Changsha city from September 2017 to January 2018. Social support was assessed by the multidimensional scale of social support, Connor-Davidson Resilience scale-10 items for reliance, the assessment of Stigma towards Homosexuality for sexual minority stigma, the Likert subscale of nondisclosure for identity concealment, the ACE questionnaire-Kaiser-CDC for adverse childhood experience, the Centers for Epidemiological Studies Depression Scale for depression. Latent profile analysis (LPA) and multivariate regression were used to analyze the data.@*RESULTS@#Three psychosocial characteristic patterns were revealed by the LPA. "Social support and resilience group" (SR group), "Identity concealment group" (IC group) and "Adverse childhood experience" (ACE group) were identified, respectively. In comparison with "SR group", "IC group" have a higher likelihood of one-night male partners (AOR = 2.74, 95%CI = [1.54, 4.90]), both fixed and one-night male partners (AOR = 2.01, 95%CI = [1.34, 3.01]) and HIV-unsure male partner (AOR = 2.12, 95%CI = [1.44, 3.13]). Similarly, "ACE group" were more likely having inconsistent condom use (AOR = 2.58, 95%CI = [1.41, 4.73]), and having sex with HIV-positive male partner (AOR = 4.90, 95%CI = [1.95, 12.30]) with comparison of "SR group". In addition, we further revealed that "ACE group" had a higher ratio (90.0%) of inconsistent condom use among MSM whose male partners were HIV-positive.@*CONCLUSIONS@#Six important psychosocial factors were divided into three latent pattern classes. Compared with "SR group", "IC group" and "ACE group" were more likely to engage in HIV-related risky sexual behaviors. Further research may pay more attention to "IC group" and "ACE group" for targeted intervention.

Association of risky driving behavior with psychiatric disorders among Iranian drivers: A case-control study / 中华创伤杂志(英文版)

PURPOSE@#This study aimed to investigate the possible association between psychological disorders and risky driving behavior (RDB) in Iran.@*METHODS@#This case-control study conducted in Shiraz, Iran in 2021. The case group included drivers with psychological disorders and the control group included those without any disorders. The inclusion criteria for selecting patients were: active driving at the time of the study, being 18 - 65 years old, having a driving license, having a psychological disorder including depression, bipolar disorder, anxiety spectrum disorder, or psychotic disorder spectrum confirmed by a psychiatrist, and completing an informed consent form. The exclusion criterion was the existence of conditions that interfered with answering and understanding the questions. The inclusion criteria for selecting the healthy cases were: active driving at the time of the study, being 18 - 65 years old, having a driving license, lack of any past or present history of psychiatric problems, and completing an informed consent form. The data were gathered using a researcher-made checklist and Manchester driving behavior questionnaire. First, partition around medoids method was used to extract clusters of RDB. Then, backward logistic regression was applied to investigate the association between the independent variables and the clusters of RDB.@*RESULTS@#The sample comprised of 344 (153 with psychological disorder and 191 without confirmed psychological disorder) drivers. Backward elimination logistic regression on total data revealed that share of medical expenditure ≤ 10% of total household expenditure (OR = 3.27, 95% CI: 1.48 - 7.24), psychological disorder (OR = 3.08, 95% CI: 1.67 - 5.70), and substance abuse class (OR = 6.38, 95% CI: 3.55 - 11.48) were associated with high level of RDB.@*CONCLUSION@#Substance abuse, psychological illnesses, and share of medical costs from total household expenditure were found to be main predictors of RDB. Further investigations are necessary to explain the impact of different psychological illnesses on driving behavior.

Psychoneuroimmunologic Correlates in a Group of Men who Have Sex with Men with Risky Sexual Behaviors / Os Correlatos Psiconeuroimunológicos em um Grupo de Homens que Fazem Sexo com Homens com Comportamentos Sexuais de Risco

ABSTRACT This work aims to know what correlations can be found among psychological, neuropsychological, neurobiological, and immunological measures in a group of men who have sex with men negative for anti-HIV-1/2 antibodies which have sexual risk behaviors. Statistically significant correlations were found among certain behavioral, emotional, personality, neurobiological, and immunological variables. The circuit of interactions among depression, stress, neuroticism, and conscientiousness stands out, which could indirectly explain risky sexual behavior. In summary, there is a relationship between personality characteristics, mood disorders, risk behaviors, and an activated T cell profile.

RESUMO O objetivo deste trabalho é conhecer as correlações que podem ser encontradas entre as medidas psicológicas, neuropsicológicas, neurobiológicas e imunológicas em um grupo de homens que fazem sexo com homens com HIV-1/2 anti-corpos-negativos que se envolvem em comportamentos sexuais de risco. Foram encontradas correlações estatisticamente significativas entre certas variáveis comportamentais, emocionais, de personalidade, neurobiológicas e imunológicas. Destaca-se o circuito de interações entre depressão, estresse, neuroticismo e responsabilidade, que poderia explicar indiretamente o comportamento sexual de risco. Em resumo, há uma relação entre características de personalidade, distúrbios de humor, comportamentos de risco e um perfil de célula T ativado.

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

Consumo de riesgo para alcohol durante el tiempo de cuarentena por la pandemia del COVID-19 en Paraguay, 2020: encuesta virtual

Introducción: Para la contención de la pandemia causada por la enfermedad del coronavirus (COVID-19) se aplicaron una serie de medidas sanitarias a toda la población, como el distanciamiento social, cierre de fronteras y cuarentena en el hogar. Dichas medidas, además, pudieron haber repercutido en un deterioro de la salud en general, un aumento del consumo de bebidas alcohólicas y otras sustancias para contrarrestar o reducir la intensidad de su respuesta a estas consecuencias. Objetivo: Determinar las características demográficas del consumo de riesgo para alcohol durante el tiempo de cuarentena estricta por la pandemia de covid-19. Metodología: Estudio observacional analítico de corte transverso tipo exploratorio. Constó de 16.538 encuestas virtuales realizadas a personas mayores de edad pertenecientes a todo el territorio nacional entre junio y septiembre del 2020. Se excluyó a 219 encuestados por no cumplir criterios de inclusión o datos incorrectamente llenados. Se determinó el consumo de riesgo mediante una prueba que calificaba el consumo por puntajes. Más de 5 puntos para hombres, más de 4 para mujeres. Resultados: 12224 participantes adultos (18-65 años) con una media de 31,9 años (±9,2), formaron parte del análisis, con predominio de participación masculina 64,5% (n=10531). El 74,9% (n=12224) proveniente del Eje Metropolitano. Según géneros, el OR fue 1,15 IC95 (1,08 - 1,23), vp=0,001. Al comparar nivel educativo, secundaria completa/incompleta, el OR fue 1,56 IC95 (1,19 - 2,06), vp=0,001. Y al comparar por ejes de residencias el OR fue 0,83 IC95 (0,77 - 0,89), vp=0,001. Discusión: Se pudo observar que, durante el tiempo de cuarentena, el consumo de alcohol crecía conforme el nivel educativo de la población aumentaba. Los hombres presentaron un consumo de riesgo mayor que los hombres. Conocer este comportamiento ayudaría a plantear acciones que ayuden a prevenir el consumo de alcohol en el grupo de mayor riesgo.

Introduction: The impact of the outbreak of pandemic proportions of COVID-19 has initiated several health and social measures worldwide. Thus, there is growing concern about the consequences of preventive social confinement associated with the pandemic due to the potential increase in the consumption of alcohol and other harmful substances. Between 2010-2014, in Paraguay approximately 5% of deaths over 15 years of age are attributable to alcohol consumption and are associated with external cause injuries, cancers, liver disease, cardiovascular diseases, addictions and domestic violence. Early detection and treatment are recommended intervention strategies to prevent these consequences. Objective: To determine the demographic characteristics of alcohol risk consumption during the covid-19 pandemic quarantine period. Methods: Analytical cross-sectional, exploratory observational study. It consisted of 16,538 virtual surveys carried out on persons of legal age throughout the national territory between June and September 2020. A total of 219 respondents were excluded for not meeting the inclusion criteria or for incorrectly filled out data. Risk consumption was determined using a test that rated consumption by scores. More than 5 points for men, more than 4 for women. Results: 12224 adult participants (18-65 years old) with a mean age of 31.9 years (±9.2), were part of the analysis, with a predominance of male participation 64.5% (n=10531). The 74.9% (n=12224) came from the Metropolitan Axis. According to gender, the OR was 1.15 CI95 (1.08 - 1.23), pv=0.001. When comparing educational level, high school complete/incomplete, the OR was 1.56 CI95 (1.19 - 2.06), pv=0.001. And when comparing by axes of residence, the OR was 0.83 CI95 (0.77 - 0.89), pv=0.001. Discussion: It was observed that, during the quarantine period, alcohol consumption increased as the educational level of the population increased. Males presented a higher risk consumption than males. Knowing this behavior would help to propose actions to help prevent alcohol consumption in the most at-risk group.

Percepciones asociadas a conductas sexuales de riesgo / Perceptions associated with risky sexual behaviors

Resumen: Objetivo: Identificar en un grupo de jóvenes tabasqueños las percepciones asociadas con conductas sexuales de riesgo. Material y métodos: Se trata de un estudio mixto y transversal, realizado con un muestreo no probabilístico a conveniencia de 60 personas, quienes cumplían con los criterios de inclusión (18-25 años) pertenecientes al estado de Tabasco, 30 hombres y 30 mujeres. Se les aplicó la encuesta de salud y hábitos sexuales. Resultados: Las mujeres señalaron como sus mayores fuentes de educación sexual a los médicos (30%) y a sus madres (23%); mientras que, en el grupo de los hombres, fueron médicos, amistades, libros, etc. Para la percepción de riesgo de contraer VIH con el comportamiento sexual actual, los hombres percibieron mayor riesgo de contagio que las mujeres. Relacionado con las medidas que protegen del VIH, el uso del preservativo fue el método identificado como el más seguro, tanto en hombres (96.66%) como en mujeres (100%). En segundo lugar, se reconoció la opción "hacerse pruebas con frecuencia"; sin embargo, el 65% señaló nunca haberse realizado la prueba de VIH. Acerca del uso de los preservativos, en ambos grupos, predominaron respuestas, tales como, "son complicados de usar", "crean desconfianza en la pareja", entre otras. Sobre la percepción de los mecanismos a través de los cuales se podría adquirir el VIH, los 60 (100%) encuestados marcaron que el VIH se transmite a través de las relaciones sexuales; sin embargo, la opción "por picadura de mosquito" fue elegida por 3 (10%) hombres y una mujer (3.33%). Conclusiones: Las percepciones erróneas pueden ser determinantes para acceder a prácticas sexuales inseguras. Identificar las percepciones equivocadas, las fuentes, calidad y veracidad de la información en temas de sexualidad, así como los factores de riesgo y de protección, puede servir para diseñar intervenciones psicoeducativas eficientes, como estrategia de prevención para los adolescentes y los jóvenes.

Abstract: Objective: To identify youth perceptions associated to risky sexual behaviors in a group of teenagers from Tabasco. Material and methods: It is a mixed, cross-sectional study with a non-probabilistic sampling which was carried out at the convenience of 60 people who met the inclusion criteria (18-25 years old) belonging to the state of Tabasco, consisting of 30 women and 30 men. Health and sexual habits surveys were applied to them. Results: Women indicated doctors (30%) and their mothers (23%) as their main sources of sexual education; while, in the group of men, they referred to doctors, friends, books, etc. For the perception of risk of acquiring HIV with current sexual behavior, men perceived a higher risk of infection in comparison to women. In relation of measures that protect against HIV, the use of condoms was identified as the safest method, both in men (96.66%) and in women (100%). The second safest option they referred to was "to get tested frequently"; however, 65% reported never having an HIV test in the past. Regarding the use of condoms, in both groups, responses predominated, such as, "they are difficult to use", "they create mistrust in the partner", among others. Concerning about the perception of mechanisms through which HIV could be acquired, 60 participants (100%) indicated that HIV is transmitted through sexual intercourse; however, the option "by mosquito bite" was chosen by 3 men (10%) and one woman (3.33%). Conclusions: Wrongful perceptions can be decisive in the practice of unsafe sexual practices. Identifying misperceptions, sources, quality and veracity of information on sexuality issues, as well as risk and protective factors, can be useful to design efficient psychoeducational interventions as a prevention strategy for adolescents and the youth.

Problemas emocionales, personalidad oscura, sexting y grooming en adolescentes: el rol del género y la edad / Emotional Problems, Dark Personality, Sexting and Grooming in Adolescents: the role of Gender and Age

Resumen El presente estudio tuvo como objetivo estudiar si los problemas emocionales (depresión y ansiedad) y la Personalidad Oscura eran predictores del sexting y el grooming, y si este comportamiento varía según el género y la edad. Se constituyó una muestra de 728 adolescentes entre 11 y 18 años (38% hombres) de tres escuelas secundarias privadas ubicadas en Buenos Aires y Paraná, Argentina. Completaron un Cuestionario de sexting, el Cuestionario de Solicitación e Interacción Sexual a menores online por parte de adultos para evaluar el comportamiento de grooming, la Escala de síntomas psicosomáticos de Rosenberg, el Inventario de depresión de Kovacs para niños y el Dirty Dozen para los rasgos de Personalidad Oscura. Los resultados mostraron que 12% de los adolescentes admitió haber padecido una conducta de grooming. Las formas más frecuentes fueron el envío de mensajes escritos de carácter sexual (11%) y fotos (10%) y luego, en orden de frecuencia, el envío de videos (4%), pero no se detectaron diferencias por género. Los predictores significativos de sexting y el tamaño de su varianza explicada variaban según el género (R² = 47% para mujeres y R² = 12% para hombres, respectivamente). En el caso de las mujeres, mayor edad y puntajes de psicopatía fueron predictores significativos, y en el de los hombres, menor ansiedad fue el predictor significativo. Un modelo estructural explicó una varianza del 6% para el sexting y 21% para el grooming, indicando que no hubo invarianza, según el género. Las regresiones lineales para predecir el grooming a partir del sexting también sugirieron que el género moderaba esta relación.

Abstract The present study aimed to study if emotional problems (depression and anxiety) and Dark Personality were predictors of sexting and grooming, and if this behavior differs by gender and age. A sample of 728 adolescents between 11 and 18 years of age (38% male) from three private high schools located in Buenos Aires and Paraná, Argentina, was drawn. They completed a Sexting questionnaire, the Questionnaire for Online Sexual Solicitation and Interaction of Minors with Adults for grooming behavior, Rosenberg Scale of Psychosomatic Symptoms, the Kovacs Depression Inventory for Children and the Dirty Dozen for dark personality traits. Results showed that 12% of adolescents admitted having carried out a sexting behavior. Sending written messages of a sexual nature (11%) and photos (10%) were the most prevalent ways, followed by videos (4%), but no differences were detected according to gender. Significant predictors of sexting and the size of its explained variance ranged by gender (R² = 47% for females and R² = 12% for men, respectively). In the case of females, older age and psychopathy were the significant predictors. In the case of males, less anxiety was the significant predictors. A structural model explained a variance of 6% for sexting and 21% for grooming, indicating that there was no inavariance, according to gender. Linear regressions to predict grooming from sexting also suggested this relationship was moderated by gender.

Terapia cognitivo conductual para pacientes con riesgo clínico de psicosis / Cognitive behavior therapy for young patients at clinical risk for psychosis

INTRODUCCIÓN. Los estudios de tratamiento indican que el riesgo de transición a un trastorno psicótico puede al menos retrasarse en la población clínica de alto riesgo de psicosis (CHR), además de mejorar variables relacionadas con la calidad de vida de los pacientes, existiendo evidencia a favor de la terapia cognitivo conductual (TCC). MÉTODOS. Se realizó una síntesis narrativa, basada en la búsqueda de artículos originales, que abordasen la efectividad de la TCC en pacientes CHR, publicados en los últimos cinco años, incluidos en esta síntesis. RESULTADOS. Se incluyeron un total de 10 artículos que evalúan la TCC en CHR, siendo un tratamiento efectivo y ampliamente utilizado, lo que se asocia a una disminución en las consecuencias psicosociales que conlleva el retraso en la presentación del cuadro clínico y/o la disminución de síntomas comórbidos. CONCLUSIÓN. Actualmente, la TCC se ha convertido en el tratamiento de primera elección para CHR, existiendo una gran variedad de estrategias psicoterapéuticas específicas dentro de este grupo de intervención.

INTRODUCTION. Treatment studies indicate that the risk of transition to a psychotic disorder can at least be delayed in the clinical population at high risk for psychosis (CHR), in addition to improving variables related to the quality of life of patients, with evidence in favor of cognitive behavioral therapy (CBT). METHODS. A narrative synthesis was carried out, based on the search for original articles, which addressed the effectiveness of CBT in CHR patients, published in the last five years, included in this synthesis. RESULTS. A total of 10 articles that evaluate CBT in CHR were included, being an effective and widely used treatment, which is associated with a decrease in the psychosocial consequences that the delay in the presentation of the clinical picture and/or the decrease in symptoms entails. comorbid. CONCLUSION. Currently, CBT has become the treatment of first choice for CHR, with a wide variety of specific psychotherapeutic strategies within this intervention group.

Comportamentos sexuais de risco, orientação sexual, uso de substâncias e saúde mental: Um estudo de base populacional no Brasil / Risky sexual behaviors, sexual orientation, substance use, and mental health: A population-based study in Brazil

A presente tese trata-se de um estudo de prevalências e associações no âmbito da sexualidade e dos comportamentos sexuais. Foram utilizados os dados do novo módulo de atividade sexual incluído na Pesquisa Nacional de Saúde (PNS) em 2019 voltado para a população de 18 anos ou mais de idade (n=85.859). No primeiro artigo, foi traçado um panorama dos comportamentos sexuais de risco na população adulta relacionados ao não uso de preservativo na última relação sexual e à iniciação sexual precoce (antes dos 15 anos). Foram calculadas as prevalências, e respectivos intervalos de confiança (IC), dos desfechos segundo características socioeconômicas, demográficas e regionais da população. Observou-se que a iniciação sexual precoce é mais prevalente entre pessoas das gerações mais novas, com menores níveis de instrução e rendimento domiciliar. O não uso de preservativo foi mais prevalente entre mulheres, mais velhos e casados ou em coabitação. Foram observadas disparidades relevantes no não uso do preservativo entre os sexos no grupo dos que não coabitam com parceiro. No segundo artigo, avaliou-se a associação entre o consumo pesado de álcool e o uso inconsistente de preservativo entre pessoas de 18 a 59 anos solteiras, viúvas ou divorciadas que não coabitavam com parceiro (n=15.835). Foram estimadas razões de prevalências ajustadas (RPa) com modelos de regressão de Poisson estratificados por sexo e grupos de idade. Verificou-se que indivíduos de todas as faixas etárias e ambos os sexos com padrão de consumo pesado de álcool foram significativamente mais propensos ao uso inconsistente de preservativo que os demais. As estimativas obtidas não foram consideradas estatisticamente diferentes entre adultos jovens (RPa 1,32, IC 95%: 1,14-1,54) e de meia idade (RPa 1,31; IC 95%: 1,19-1,44 para pessoas de 25 a 39 e RPa 1,26; IC 95%: 1,13-1,40 para 40 a 59 anos). No terceiro e último artigo da presente tese, o uso de substâncias (álcool e tabaco) e a depressão foram analisados segundo a orientação sexual autoidentificada da população adulta. Foram estimadas as prevalências e razões de prevalência ajustadas por meio de modelos de regressão de Poisson estratificados por sexo para cada um dos desfechos analisados. Após controle por covariáveis, homens gays apresentaram maior prevalência de depressão, uso diário de tabaco e uso nocivo de álcool e tabaco (RPa entre 1,71 e 1,92) e homens bissexuais com maiores prevalências (quase três vezes) de depressão que homens heterossexuais. Mulheres lésbicas apresentaram maior prevalência de binge drinking, heavy drinking, uso diário de tabaco e uso nocivo de álcool e tabaco que mulheres heterossexuais (RPa entre 2,55 e 4,44). Entre as mulheres bissexuais os resultados foram significativos para todos os desfechos analisado (RPa variou entre 1,83 e 3,26). Sendo assim, essa tese fornece evidências relevantes para subsidiar ações em saúde pública que visem a redução de comportamentos sexuais de risco e das disparidades em saúde relacionadas a orientação sexual da população adulta brasileira.

This thesis is a study of prevalence and associations in the scope of sexuality and sexual behavior. Data are from the new module of sexual activity included in the National Health Survey (PNS, for its Portuguese acronym) in 2019, aimed at the population aged 18 and over (n=85,859). In the first article, a panorama of risky sexual behaviors in the adult population related to the non-use of condoms in the last sexual intercourse and early sexual initiation (before 15 years of age) was performed. Prevalence, and respective confidence intervals (CI), of the outcomes were calculated according to socioeconomic, demographic and regional characteristics of the population. It was observed that early sexual initiation is more prevalent among younger generations, with lower education levels and household income. Non-use of condoms was more prevalent among women, older people and married/cohabiting with a partner. Relevant disparities in non-use of condom between the sexes were observed in the non-cohabiting unmarried group. In the second article, the association between heavy alcohol consumption and inconsistent condom use was investigated among unmarried not cohabiting with a partner people aged 18 to 59 years (n=15,835). Adjusted prevalence ratios (APR) were estimated with Poisson regression models stratified by sex and age groups. It was observed that individuals from all age groups and both sexes who have heavy drinking pattern were significantly more likely to inconsistent condom use. The estimates were not considered statistically different between young (APR 1.32, 95% CI: 1.14-1.54) and middle-aged adults (APR 1.31; 95% CI: 1.19-1.44 for aged 25 to 39 and APR 1.26; 95% CI: 1.13-1.40 for aged 40 to 59 years). In the third and last article of this thesis, substance use (alcohol and tobacco) and depression were analyzed according to the self-identified sexual orientation of the adult population. Prevalence and adjusted prevalence ratios were estimated using Poisson regression models stratified by sex for each outcome. After controlling for covariates, gay men had a higher prevalence of depression, daily tobacco use and hazardous use of alcohol and tobacco (APR between 1.71 and 1.92) and bisexual men had a higher prevalence (almost three times) of depression than heterosexual men. Lesbian women had a higher prevalence of binge drinking, heavy drinking, daily tobacco use and hazardous use of alcohol and tobacco than heterosexual women (APR between 2.55 and 4.44). Among bisexual women, the results were significant for all outcomes analyzed (APR ranged between 1.83 and 3.26). Therefore, this thesis provides relevant evidence to support public health actions aimed at reducing risky sexual behavior and health disparities related to sexual orientation in the Brazilian adult population.

Factors associated with risky sexual behaviour among sexually experienced undergraduates in Osun state, Nigeria

Background: Risky sexual behavior (RSB) is common among youths which predispose them to sexually transmitted infections. This study sets out to identify the factors associated with RSB among undergraduates in Osun state. Methods: The study design was descriptive cross sectional and a total of 550 respondents from two universities in Osun state were sampled using a multistage sampling technique, out of which data from 266 sexually experienced respondents was further analyzed. Data collected via a semi­structured self-administered questionnaire and analyzed using univariate, bivariate and multivariate analyses. Results: The 266 respondents consisted of 54.5% males and 45.5% females and larger percentage of them were in the age group 15-24years. Seven out of ten respondents (69.9%) were sexually active while 65.8% were involved in at least one RSB. Of the 266 respondents, 28.6% ever had concurrent multiple sexual partners, 15.8% used alcohol/drugs at last sex while 48.1% did not use condom at last sex. More males (71.7%), alcohol users (76.8%), drug users (78.0%), pornography watchers (82.7%), internet users (71.2%) respondents "not in good terms with mum" (86.7%) and "those whose mum doesn't instruct them morally" (84.2%) were involved in RSB compared to their respective counterparts (p<0.05). However, there were no identifiable predictors of RSB on regression analysis. Conclusion: Risky Sexual Behavior is prevalent among undergraduates with males being more involved, among other associated factors. Concerned stakeholders should engage youths via behavioral change communication strategies so as to significantly reduce their involvement in RSB

Factors associated with risky sexual behaviour among clients undertaking HIV testing and counselling services at a secondary referral hospital Lagos, Nigeria

Background: This study determined the prevalence of risky sexual behaviour and its associated factors among clients who accessed HIV counselling and testing services at a secondary referral hospital in Lagos, Nigeria. Methods: A retrospective review of clients' records was conducted. The Client Intake Form of people who accessed HIV counselling and testing services at Mainland Hospital in Lagos, Nigeria between July 1, 2016, and December 31, 2017, were reviewed. Multivariate analysis was conducted to determine the associated factors of risky sexual behaviour. Results: A total of 4273 client's records were analyzed, 3884 (90.9%) reported having sex before HIV counselling and testing (HCT). The prevalence of risky sexual behaviour among clients was 41.5%. More males and HIV positive clients had unprotected sex with a casual partner three months before HIV counselling and testing (p < 0.05). More singles than the married had unprotected sex with casual partners (p <0.001) and multiple sexual partners (p =0.002). The prevalence of risky sexual behaviour reduced with advancing age. Being single and having an HIV infection were associated with risky sexual behaviour in this study. Conclusion: Age, marital status and HIV status were associated factors of risky sexual behaviour

Contexts, beliefs and health behaviour: Are individuals who engage in risky sexual behaviour likely to wear face-masks against COVID-19?

and availability of sanitation facilities, individual health beliefs and behaviour are critical in combating the sustained prevalence of Covid-19. Behaviour has, however, been shown to be consistent but could be context-dependent based on the individual's beliefs. To investigate whether or not individuals' protective behaviour against coronavirus is associated with their behaviour in a previous health context. Facemask usage and engagement in risky sexual behaviour (RSB) were employed as corollaries of Covid-19 protective behaviour and a previous health context respectively. Data on them and other sociodemographic correlates of health behaviour were collected on 522 Nigerians via a web-based survey. The data were analyzed using frequency, Chi Square and Binary Logistics Regression. About 31% of the population wore facemasks in public, 48.1% believed Covid existed and was severe, and 31.6% had engaged in RSB. Individuals who engaged in RSB had lower odds of wearing facemasks in public in both the general population and across the rural-urban divide. The relationship was, however, only statistically significant (OR:0.642, p<0.05) in the adjusted regression model. Other significant determinants of facemask use were gender, place of residence, employment status and beliefs about Covid. The similarity of individual beliefs and behaviours in different health contexts provides an opportunity to model behaviour change communication policies for preventing and combating the spread of coronavirus and other infectious diseases

Construção e validação da escala multifatorial de atração por eventos mórbidos / Construction and Validation of Attraction for Morbid Events Multifactor Scale

Resumo Objetivo. Este estudo buscou construir e validar a Escala Multifatorial de Atração por Eventos Mórbidos (AMAEM). Método. Do primeiro estudo participaram 252 pessoas da população geral, as quais responderam à EMAEM e a perguntas sociodemográficas. A análise de componentes principais indicou uma estrutura de cinco fatores. No segundo estudo, a amostra foi de 609 pessoas da população geral brasileira, as quais a escala de personalidade e a escala de busca de sensações. Resultado. A análise fatorial confirmatória apoaiou a adequação do modelo de cinco fatores. Adicionalmente, demonstrou ainda que os fatores da EMAEM podem contribuir com a compreensão de características da personalidade e sua associação com o engajamento em comportamentos antissociais.

Abstract Objective. This study aimed to construct and validate the Attraction for Morbid Events Multifactor Scale (EMAEM). Method. Two empiric studies were conducted. 252 people from the general population participated in the first study, in which a main component analysis was conducted to attest the factor structure of EMAEM. In this study, the five-factor model was most suitable. In the second study, the participants were 609 people from the general population that answered personality and antisocial behavior scales, besides EMAEM. Results. Confirmatory Factor Analysis shows the suitability of the five-factor model. Moreover, the EMAEM scale can provide aids to a better understanding of personality traits associated with engaging in risky behavior.

Conductas sexuales de riesgo en una muestra de estudiantes universitarios argentinos: relación con consumo de sustancias, inicio sexual temprano e impulsividad rasgo / Risky sexual behaviors in a sample of Argentinean college students: Relationship with substance use, early sexual onset and trait-like impulsivity

Resumen Introducción: Los adultos emergentes universitarios son particularmente vulnerables a presentar consumo abusivo de sustancias y conductas sexuales de riesgo (CSR), lo que incrementa el riesgo de contraer infecciones de transmisión sexual (ITS) o embarazo no deseado. Objetivo: Examinar, en universitarios, si el tipo de consumo de sustancias (alcohol versus uso concurrente de alcohol y marihuana) y el nivel de impulsividad rasgo se asocian con la frecuencia de CSR con parejas ocasionales. Método: Una muestra de 467 estudiantes completó una encuesta online que medía frecuencia de CSR, ocurrencia de consumo de alcohol y de marihuana en el último año y nivel de impulsividad. Resultados: Los consumidores de alcohol y marihuana, comparados con los consumidores de alcohol, reportaron mayor promedio de parejas sexuales al año y mayor arrepentimiento por no cuidarse contra ITS/embarazo. Los participantes con uso concurrente de sustancias, y niveles medios y altos en las facetas de impulsividad, falta de perseverancia y de premeditación, mostraron mayor frecuencia de encuentros sexuales que los consumidores de alcohol o con baja impulsividad. Conclusiones: Los hallazgos sugieren que el uso concurrente de sustancias y ciertas facetas de impulsividad se asocian a una mayor frecuencia de determinadas CSR. Esta información podría ser útil para intervenir preventivamente en CSR en universitarios argentinos.

Abstract Introduction: College students, a subpopulation of emerging adults, are particularly vulnerable to exhibit substance abuse and risky sexual behaviors. These behaviors put people at risk for sexually transmitted infections and/or unwanted pregnancy. Aim: To examine, in college students, whether the pattern of substance use (i.e., alcohol versus co-use of alcohol and marijuana) and the level of impulsivity are associated with the frequency of risky sexual behaviors with occasional partners. Method: A sample of 467 college students completed an online survey that assessed the frequency of risky sexual behaviors, past-year alcohol and marijuana use and trait-like impulsivity. Results: Alcohol/marijuana co-users, compared with alcohol users, reported a higher average of sexual partners per year and greater feelings of regret following careless sexual encounters. Co-users with medium or high levels in lack of perseverance and lack of premeditation (i.e., two facets of impulsivity) reported higher frequency of sexual encounters than alcohol users and/or students with low impulsivity. Conclusions: Findings suggest substance co-use, alongside different facets of impulsivity, are associated with greater frequency of specific risky sexual behaviors. These findings could better inform interventions aimed at prevent risky sexual behaviors in Argentinean college students.

Mediaciones parentales y uso de internet por niños, niñas y adolescentes colombianos / Parental mediations and internet use by colombian children and adolescents

Resumen Este artículo presenta los resultados de un estudio correlacional sobre los controles y las mediaciones parentales frente al uso de internet por niños, niñas y adolescentes colombianos. Se trata de la encuesta EU Kids Online que fue aplicada en el año 2010 en 25 países europeos y, posteriormente, en Brasil en 2013 y en Chile en 2016. En el presente estudio, le encuesta fue adaptada y validada para la población colombiana mediante un panel de expertos y entrevistas cognitivas a usuarios. Se conformó una muestra estratificada y no probabilística de 303 estudiantes de ambos sexos de colegios públicos y privados, con edades entre 9 y 17 años y uno de sus padres o cuidadores, habitantes de 11 ciudades del país, quienes respondieron a los tres instrumentos de KidsOnline, una encuesta autoaplicada, otra dirigida a los estudiantes, y una tercera dirigida a los padres o cuidadores. Los resultados muestran relaciones entre el control parental y un menor tiempo de conexión a internet por parte de los hijos: el control del padre está relacionado con menor presencia de conductas adictivas a internet y al celular y, por el contrario, una relación autoritaria con la madre está relacionada con mayor presencia de conductas de riesgo en los hijos y específicamente, en el uso de internet. Además, las habilidades digitales de los padres son las que mejor están asociadas con una mediación activa, que los involucra más en las actividades digitales de sus hijos.

Abstract Nowadays, parents must develop strategies to accompany their children in the use of digital technologies. The reason for this is that the internet is a social space. Online life offers possibilities for individual and social development, but it also promotes the emergence of new risks such as sexting, cyberbullying, and cyber dependence. There are two ways parents can guide their children: parental mediation and parental control. Parental mediation is the set of actions that parents take to manage the use and consumption of the media by their sons and daughters. There are three types of parental mediation: restrictive mediation, permissive mediation, and active mediation. In this context, this research aims to correlate mediation and parental control strategies with their use of the internet for children and adolescents. The EU Kids Online survey was used to achieve this goal. This questionnaire was adapted for the Colombian population through expert review and cognitive validation to children and adolescents in Medellin, Cali, and Cartagena (Colombia). The adaptation followed the procedures and standards of Kids Online Brasil and Kids Online Chile. The stratified and non-probabilistic sample consisted of 303 children and adolescents aged 9 to 17 years from ten cities in Colombia. The results indicate that the more parental control, the shorter the child connection time. Whether it's behavioral or psychological control. While the greater the psychological control of the mother, the greater the presence of addictive behaviors of children and adolescents to the internet and cell phone. Besides, the more psychological control of the mother, the more risky behaviors the children assume. Conversely, if the mother performs greater behavioral control, the presence of risky behaviors in the child is less. Also, restrictive control of internet use has a higher relationship with a lower presence of general risk behaviors and lower risks assumed by children on the internet. This was also related to high rates of restrictive mediation by parents. As conclusions, it is possible to say that any type of control that parents exercise over their children's use of the internet (restrictive, co-visioned or technical) is related to shorter connection time and less cell phone addiction. Besides, a conflicting relationship with the mother increases the addictive behaviors of the internet and the smartphone. Especially when the kind of control the mother exerts is psychological. Whereas, if the mother exerts greater behavioral control, the presence of risky behaviors in the child is less. This research could serve as the basis for the design and implementation of psychoeducational training programs for parents and caregivers aimed at developing effective parental mediation skills and strategies to guide children and adolescents in their use of digital technologies. Also, the findings of this study could lay the scientific basis for the presentation of social projects that impact public policies on the responsible and healthy use of the internet. Moreover, when Colombia has a Ministry of Information and Communication Technologies and media outreach strategies on ICT care. Finally, researches done in psychology about this topic are limited in Latin America. For this reason, the findings of this work are a significant step forward on the explanation of ITC use in the region from a disciplinary point of view. This article seeks to encourage researchers to continue to advance their knowledge of the relationships between parental mediation and the use of the internet by children and adolescents.

Consumo de riesgo de alcohol y sentido de vida en adolescentes de 18 a 20 años en Tezontepec de Aldama / Risk consumption of alcohol and its impact on the meaning of life in adolescents aged 18 to 20 in Tezontepec de Aldama

Introducción: el consumo de alcohol aumento en los últimos años en adolescentes, la Organización Mundial de la Salud (OMS) indica que América Latina se posiciona en primer lugar de consumo y México ocupa el décimo lugar, en la población adolescente 38.8 % ha consumido alcohol alguna vez en su vida. Objetivo: conocer el nivel de consumo de riesgo de alcohol y el sentido de vida en los adolescentes de 18 a 20 años de edad de la comunidad de Presas, Tezontepec de Aldama, Hidalgo. Material y métodos: de aplicabilidad básica, cuantitativo, con un nivel de alcance descriptivo; diseño metodológico no experimental (observacional), prolectivo, transversal, prospectivo. Resultados: por medio de la escala dimensional del sentido de vida, 34 participantes refieren tener una búsqueda de sentido de vida expresan, experimentar una vida sin propósito y sin sentido, aunque en ocasiones poseen momentos en los que se sienten orientados. En cuanto, al instrumento de medición AUDIT, 10 participantes refieren tener un alto consumo de alcohol. Conclusión: hoy el alcohol sigue siendo un problema en la comunidad adolescente al mismo tiempo impacta de manera negativa en su sentido de vida.

Introduction: adolescent alcohol consumption has increased in recent years. The World Health Organization (WHO) indicates that Latin America is ranked first in this consumption and Mexico's adolescent population occupies tenth place. 38.8% of them have consumed alcohol at some point in their life as much as you have consumed in the last year. Objective: to know the level of risky alcohol consumption and the meaning of life in adolescents between 18 and 20 years of age in the community of Presas, Tezontepec de Aldama. Material and methods: of basic applicability with a quantitative approach and with a descriptive scope level, with a methodological design; non-experimental (observational), prolective, transversal, prospective. Results: 34 participants report having a search for a sense of life, expressing that they are people who experience a life without purpose and meaning, although sometimes they have moments when they feel oriented. Regarding the results of the AUDIT Measurement Instrument, 10 participants report having a high consumption of alcohol, stating that they are personnel who consume alcohol more frequently. Conclusion: alcohol is still a problem in the community today. Adolescent at the same time negatively impacts their sense of life; since young people who are at risk of alcohol have a low meaning of life

Early childhood abuse: adult impulsivity and risky behavior / Abuso na infância: impulsividade no adulto e comportamentos de risco

We review the role of childhood abuse (CA) in the practice of impulsive, risk-taking behaviors during adulthood. CA deregulates the adult response to stress, which in turn disrupts the prefrontal-striatal systems that provide executive control over reward-related behavior. The result is impulsivity and risk-taking, including self-medication with drugs and alcohol and the practice of unsafe sex. These behaviors decrease quality of life and impair the attainment of long-term goals. Risky sexual behavior, in particular, increases the chance of HIV infection and perpetuates the epidemic.

Revisamos o papel do abuso na infância na prática de comportamentos impulsivos e de risco durante a vida adulta. O abuso na infância desregula a resposta do adulto ao estresse, o que, por sua vez, impede os circuitos frontoestriatais de fornecerem o adequado controle executivo sobre comportamentos associados à recompensa. O resultado é a impulsividade e escolhas de risco, incluindo automedicação com drogas e álcool e a prática de sexo inseguro, reduzindo a qualidade de vida e prejudicando o alcance de metas de longo prazo. O comportamento sexual de risco, em particular, aumenta a chance de infecção pelo Vírus de Imunodeficiência Humana e perpetua a sua epidemia.

Intervenções familiares para prevenir comportamentos de risco na adolescência: possibilidades a partir da Teoria Familiar Sistêmica / Family-based interventions to prevent risky behaviors in adolescence: possibilities from the Family Systems Theory

Esta revisão narrativa visa discutir como a Teoria Familiar Sistêmica (TFS) pode contribuir para a prevenção ao envolvimento em comportamentos de risco na adolescência. A alternativa proposta baseia-se na promoção de fatores como limites e afeto, acolhimento aos sentimentos e às necessidades dos membros da família; estabelecimento de fronteiras nítidas que permitam o desenvolvimento de autonomia e pertencimento; e presença de uma comunicação familiar efetiva e de valores familiares pró-sociais. Para tanto, diferentes técnicas podem ser usadas, tais como a reestruturação, o genograma, as técnicas narrativas, a linha do tempo, as metáforas e a escultura familiar. Este estudo apontou a viabilidade do uso da TFS como teoria que embasa o desenvolvimento de intervenções familiares preventivas e oferece ferramentas para familiares e profissionais. Estudos futuros devem examinar mecanismos de mudança em intervenções preventivas familiares e a avaliação empírica do uso das técnicas apresentadas.

This narrative review aims to discuss how Systemic Family Theory (STF) can contribute to prevent involvement in risky behavior in adolescence. The proposal presented here is based on the promotion of factors such as limits and affection, welcoming the feelings and needs of family members; the establishment of clear boundaries that allow the development of autonomy and belonging; and the presence of effective family communication and pro-social family values. For this, different techniques can be used, such as restructuring, genogram, narrative techniques, timeline, metaphors and family sculpture. This study pointed out the feasibility of using STF as a theory that underlies the development of preventive family interventions and offers tools for family members and professionals. Future studies should examine mechanisms of change in family preventive interventions and the empirical assessment of the use of the techniques presented.

Um Édipo sem fronteiras: a insistência do arcaico no sex-addict / An Oedipus without borders: the archaic's insistence on the sex addict / Un Edipo sin fronteras: la insistencia del arcaico en el sex-addict

Na adicção sexual, a realização do ato sexual se impõe ao sujeito de modo compulsivo. A sexualidade perde grande parte de seu potencial fantasístico, passando a servir como motor de uma busca desmedida e destrutiva de prazer que não comporta a possibilidade de vínculo libidinal com o outro. Este artigo, fundamentado no saber psicanalítico, tem por objetivo explorar o papel do complexo de Édipo nas determinações da situação clínica em questão, aspecto teórico de fundamental importância para a compreensão dos impasses que entravam a relação do sex-addict com seus parceiros e com sua própria sexualidade. A problemática edípica não se reduz à clássica descrição freudiana do complexo de Édipo, mas abarca uma série de condições e circunstâncias que precedem o ingresso do infante nessa etapa, sendo a construção da cena primitiva o fator decisivo que viabilizará ou não a entrada do sujeito num efetivo sistema de triangulação. Dedicaremos, portanto, particular atenção à vertente originária do Édipo, a qual tem na construção da cena primitiva o seu núcleo essencial. Esse eixo de trabalho nos conduzirá, por fim, a refletir sobre a adicção sexual em suas manifestações mais radicais e extremas, nas quais a crescente adesão a situações de risco por parte do sex-addict se torna paradigmática de uma busca sem limites e perigosa que, em seu sentido mais profundo, revela determinadas contingências de uma tumultuada história relacional.

In sexual addiction, the performance of the sexual act imposes itself on the subject compulsively. Sexuality loses much of its potential of fantasy, starting to serve as the engine of an excessive and destructive search for pleasure that does not include the possibility of libidinal bond with the other. This article, based on psychoanalytical knowledge, aims at exploring the role of the Oedipus complex in the determinations of the clinical situation in question, a theoretical aspect of fundamental importance for understanding the impasses that interfere with the sex addict relationship with his/her partners and with his/her own sexuality. The oedipal problem is not reduced to the classic Freudian description of the Oedipus complex, but it encompasses a series of conditions and circumstances that precede the infant's entry into this stage, the construction of the primal scene being the decisive factor that will enable or not the entrance of the subject into an effective triangulation system. We will therefore devote particular attention to the original aspect of the Oedipus, which has its essential nucleus in the construction of the primal scene. This axis of work will ultimately lead us to reflect on sexual addiction in its most radical and extreme manifestations, where the increasing adherence to risky situations by the sex addict becomes paradigmatic of a limitless and dangerous search that, in its deepest sense, reveals certain contingencies of a tumultuous relational history.

En la adicción sexual, la realización del acto sexual se impone al sujeto de modo compulsivo. La sexualidad pierde gran parte de su potencial fantasístico, pasando a servir como motor de una búsqueda desmedida y destructiva de placer que no comporta la posibilidad de vínculo libidinal con el otro. Este artículo, fundamentado en el saber psicoanalítico, tiene por objetivo explorar el papel del complejo de Edipo en las determinaciones de la situación clínica en cuestión, aspecto teórico de fundamental importancia para la comprensión de los impasses que entraban la relación del sex-addict con sus parejas y con su pareja propia sexualidad. La problemática edípica no se reduce a la clásica descripción freudiana del complejo de Edipo, pero abarca una serie de condiciones y circunstancias que preceden al ingreso del infante en esa etapa, siendo la construcción de la escena primitiva el factor decisivo que viabilizará o no la entrada del sujeto en un efectivo sistema de triangulación. Dedicaremos, por lo tanto, particular atención a la vertiente originaria del Edipo, la cual tiene en la construcción de la escena primitiva su núcleo esencial. Este eje de trabajo nos conducirá, por fin, a reflexionar sobre la adicción sexual en sus manifestaciones más radicales y extremas, donde la creciente adhesión a situaciones de riesgo por parte del sex-addict se vuelve paradigmática de una búsqueda sin límites y peligrosa que, en su sentido más profundo, revela ciertas contingencias de una tumultuosa historia relacional.