Text in English / The Department of Education nationwide introduced HIV and AIDS care and support for learning and teaching programmes as intervention strategies for supporting vulnerable learners. Despite these interventions, teenagers continue to fall pregnant and this increases their vulnerability to HIV infection. HIV and STIs are rife among teenagers owing to ignorance and peer pressure, among other factors. The aim of this exploratory qualitative study was to explore factors that influence condom use among high school teenagers aged between 16 and 18 in Dutywa District. Focus group discussions and in-depth face-to-face interviews with 12 high school teenagers from one high school (High School X) were used to collect data. Thematic analysis was used to analyse data. The findings of this study revealed that high school teenagers are not using condoms to any significant degree. In their opinion, condoms limit sexual pleasure; they indicate a lack of trust and unfaithfulness between partners and are associated with sexually transmitted diseases. The findings of this study are significant for the policy implementation of schools. / Sociology / M.A. (Social Behaviour Studies in HIV and AIDS)

Given the lack of effective vaccine or medicine, changing an individual's risk behaviours has been crucial in preventing the spread of HIV. Consistent and correct condom use has been considered as the most effective form of HIV prevention among female sex workers. Despite coordinated national level interventions over the last decade, a consistent decline in condom use among female sex workers has been evidenced in the Ethiopian context, particularly with non-paying partners. Thus far, no study has been produced that has illustrated major determinants of consistent condom use among female sex workers which would help in developing effective intervention strategies for the prevention of HIV spread in the country. In other countries, the Information, Motivation and Behaviour (IMB) model has been used to identify individual level determents of condom use. However, the researcher postulated that behaviour emanating from the personality structure of individuals could be the fundamental individual level determents of adherence to condom use and chose to investigate this using the Enneagram theory of personality, which was acknowledged for its heuristic value in explaining and enhancing self-development of at-risk individuals. This cross-sectional study was conducted in Addis Ababa. With the Without Finite Population Correction of the Sample Size Estimation Formula, the sample size of 350 was set and participants were recruited using Respondent-Driven Sampling (RDS). Using trained female sex workers, the Essential Enneagram Test (EET) and an Information-Motivation-Behaviour (IMB) questionnaire were administered to collect data. General Linear Modeling (GLM) Multivariate analysis was carried out to assess the correlation between personality style and consistent condom use among participants in the last seven days before the interview. The finding of this study revealed that personality type, measured by the Essential Enneagram Test (EET), is able to predict adherence to condom use among female sex workers and provided a new dimension for policy makers and practitioners in behavioural intervention programmes, such as Information-Education-Communication, peer-to-peer approaches, as well as health and rehabilitation services by using the Enneagram principles and universal growth process. / Psychology / D. Litt. et Phil. (Psychology)

Given the lack of effective vaccine or medicine, changing an individual's risk behaviours has been crucial in preventing the spread of HIV. Consistent and correct condom use has been considered as the most effective form of HIV prevention among female sex workers. Despite coordinated national level interventions over the last decade, a consistent decline in condom use among female sex workers has been evidenced in the Ethiopian context, particularly with non-paying partners. Thus far, no study has been produced that has illustrated major determinants of consistent condom use among female sex workers which would help in developing effective intervention strategies for the prevention of HIV spread in the country. In other countries, the Information, Motivation and Behaviour (IMB) model has been used to identify individual level determents of condom use. However, the researcher postulated that behaviour emanating from the personality structure of individuals could be the fundamental individual level determents of adherence to condom use and chose to investigate this using the Enneagram theory of personality, which was acknowledged for its heuristic value in explaining and enhancing self-development of at-risk individuals. This cross-sectional study was conducted in Addis Ababa. With the Without Finite Population Correction of the Sample Size Estimation Formula, the sample size of 350 was set and participants were recruited using Respondent-Driven Sampling (RDS). Using trained female sex workers, the Essential Enneagram Test (EET) and an Information-Motivation-Behaviour (IMB) questionnaire were administered to collect data. General Linear Modeling (GLM) Multivariate analysis was carried out to assess the correlation between personality style and consistent condom use among participants in the last seven days before the interview. The finding of this study revealed that personality type, measured by the Essential Enneagram Test (EET), is able to predict adherence to condom use among female sex workers and provided a new dimension for policy makers and practitioners in behavioural intervention programmes, such as Information-Education-Communication, peer-to-peer approaches, as well as health and rehabilitation services by using the Enneagram principles and universal growth process. / Psychology / D. Litt. et Phil. (Psychology)

Conclusions. The "bridging effect" for HIV transmission is evident. Variables predicting condom use during commercial sex are multidimensional. Integrative programs are hence required. Methadone clinics may offer a platform for offering such services to IDU-FSWs. The performance of the TPB could be enhanced by addition of external variables; its applicability varies according to the wellbeing status of the IDU-FSWs. Future randomized control studies are warranted to design effective evidence-based programs targeting IDU-FSWs. / Introduction. Injecting drug users (IDUs) drive the HIV epidemic in China. Female injecting drug users who are sex workers (IDU-FSWs) is a strategic "bridge population" for HIV transmission from the IDU to non-IDU populations. Background characteristics, health behavioral theories (e.g. the Theory of Planned Behavior, TPB), drug dependence, economic pressure, psychological problems, social support and gender power are potential predictors of condom use during commercial sex among IDU-FSWs. Most of these associations have not been investigated in China or elsewhere, and the TPB has not been applied to HIV-vulnerable populations in China. A knowledge gap exists. / Objectives. This study validated two instruments measuring severity of drug dependence. The prevalence of inconsistent condom use among IDU-FSWs and its associations with the aforementioned variables were investigated. The hypotheses that different blocks of variables would have independent effects on condom use during commercial sex, and the effects of TPB-related variables on condom use would be moderated by some external variables (e.g. severity of drug dependence) were tested. / Results. The Opiate Addiction Severity Inventory-Revised (OASI-R) was fully validated in the Study I. Around 6.8% of IDU-FSWs were HIV positive and respectively 48% and 64% of them practiced needle sharing and unprotected commercial sex (last six months). After adjusting for significant background variables, the five TPB-related variables (AOR=0.43 to 1.92, p<0.001), severity of drug dependence (AOR=1.05, p<0.01), economic pressure (AOR=1.07, p<0.05) and all studied psychosocial variables (e.g. depression, social support and gender power; AOR=0.70 to 1.67, p<0.05) were significantly associated with condom use during commercial sex. / Subjects and methods. Two cross-sectional studies were conducted. In Study I, 178 non-institutionalized drug users were interviewed in Dazhou, Sichuan. In Study II, 281 non-institutionalized IDU-FSWs were interviewed in Dazhou, Sichuan and Hengyang, Hunan, using snowballing method and face-to-face interviews. Statistical methods such as hierarchical and interaction modeling, stratification analysis, ROC method were used in this study. / The final hierarchical model predicting condom use during commercial sex included variables coming from four blocks of independent variables, with ROC area = 94% and sensitivity/specificity = 0.84/0.91. A "Wellbeing Status Index" moderated the associations between some of the TPB-related variables and condom use during commercial sex. / Gu, Jing. / Adviser: Joseph T. F. Lau. / Source: Dissertation Abstracts International, Volume: 70-06, Section: B, page: 3462. / Thesis (Ph.D.)--Chinese University of Hong Kong, 2008. / Includes bibliographical references (leaves 228-246). / Electronic reproduction. Hong Kong : Chinese University of Hong Kong, [2012] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Electronic reproduction. [Ann Arbor, MI] : ProQuest Information and Learning, [200-] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Abstracts in English and Chinese. / School code: 1307.

Antiretroviral drugs were introduced into Uganda during the past decade and have revolutionised the treatment of AIDS. However, in as much as success was recorded, new challenges emerged. One such challenge was the continued use of condoms. This study investigated existing knowledge, attitudes and practices of condom use in a time of highly active antiretroviral therapy in a rural area. A quantitative, cross sectional design, with probability sampling form the general population was utilised. A self-designed questionnaire was used to collect data which was then analysed at the descriptive statistics level. The results indicated that: knowledge of HIV, its transmission, condoms and antiretroviral drugs were high among the respondents; condom acceptance and use were low; and respondents would not intentionally engage in unprotected sexual intercourse because of availability of ARVs. However it was acknowledged that some people taking ARVs have engaged in risky sexual behaviours that would expose others to infection. / Health Studies / M.A. (Public Health)

Text in English / The Department of Education nationwide introduced HIV and AIDS care and support for learning and teaching programmes as intervention strategies for supporting vulnerable learners. Despite these interventions, teenagers continue to fall pregnant and this increases their vulnerability to HIV infection. HIV and STIs are rife among teenagers owing to ignorance and peer pressure, among other factors. The aim of this exploratory qualitative study was to explore factors that influence condom use among high school teenagers aged between 16 and 18 in Dutywa District. Focus group discussions and in-depth face-to-face interviews with 12 high school teenagers from one high school (High School X) were used to collect data. Thematic analysis was used to analyse data. The findings of this study revealed that high school teenagers are not using condoms to any significant degree. In their opinion, condoms limit sexual pleasure; they indicate a lack of trust and unfaithfulness between partners and are associated with sexually transmitted diseases. The findings of this study are significant for the policy implementation of schools. / Sociology / M.A. (Social Behaviour Studies in HIV and AIDS)

<p>The overall aim of this thesis was to inestigate Swedish adolescents' perceptions and behaviours regarding sexual risk taking. Specific objectives were to explore teenagers' perceptions of contraceptive use, unintended pregnancy, and abortion; teenage girls' experiences of decision making process and support connected to abortion; and male adolescents' perceptions of sexual risk taking and barriers to practicing safe sex. Another objective was to evaluate the effect of advance provision of emergency contraceptive pills to teenage girls. The methodologies included focus group discussions, in-depth interviews, and a randomized controlled trial. </p><p>Among the adolescents in our studies, teenage parenthood was generally viewed as a "catastrophe", and the majority expressed supportive attitudes towards abortion (studies I-IV). Occasions of failure to use contraceptives were common, especially when sex was unplanned (studies I-V). Pregnancy prevention was perceived as the woman's responsibility. However, many girls were reluctant about using homonal contraceptives due to worries about negative side effects (I, III). Initiating condom use was difficult for girls, as well as for boys, for a number of reasons (I-IV): fear of ruining an intimate situation, associations with disease, distrust, pleasure reduction, and (for the boys) the fear of loosing one's erection. Males generally perceived personal and partner-related risks connected to unprotected intercourse as low. Few males were worried that an unintended pregnancy would be carried to term, and the majority would urge the girl towards abortion if she seemed ambivalent (II, IV). Girls viewed the abortion decision as a natural, yet difficult choice, strongly influenced by attitudes of partners, parents, peers and societal norms (III). Teenage girls provided with emergency contraceptive pills in advance used it more frequently and sooner after unprotected intercourse compared with controls, without jeopardising regular contraceptive use (V).</p>

Objetivo: Descrever a iniciação sexual e o uso de métodos anticoncepcionais e estimar fatores associados a estas condutas, em adolescentes de 13 a 17 anos de idade, de escolas da rede pública de ensino secundário da Ilha de Santiago, Cabo Verde. Métodos: Estudo transversal realizado com amostra probabilística e representativa de 768 adolescentes com idade entre 13 e 17 anos, de escolas secundárias públicas da Ilha de Santiago em 2007. A associação foi testada pelo teste de proporção, qui-quadrado de Pearson ou Fisher e regressão logística. Para estimar os fatores associados ao uso de métodos anticoncepcionais e preservativo, foi analisada a sub-amostra de 368 adolescentes sexualmente ativos. O início da vida sexual, o uso de métodos anticoncepcionais e o uso de preservativo foram analisados como desfechos. Foram consideradas variáveis independentes: características sociodemográficas, afetivo-sexuais e comportamentais. Foi utilizada regressão logística para análise simultânea dos fatores, considerando-se nível de significância de 5%. Resultados: Entre os adolescentes do sexo masculino, os fatores associados ao início da vida sexual foram: idade maior que 14 anos, ser católico e consumir bebidas alcoólicas. Entre as adolescentes do sexo feminino, possuir mais de nove anos de estudo e parceria afetivosexual foram associados ao início da vida sexual. Entre os 368 adolescentes, 69,3% referiram ter usado métodos anticoncepcionais na sua última relação sexual, sendo mais freqüentes o preservativo (94,9%) e a pílula (26,4%). Fatores significativos e positivamente associados ao uso de métodos anticoncepcionais na última relação foram: morar em município da capital (OR=2,02; IC95%: 1,23;3,32), ter namorado anteriormente à época da entrevista (OR=2,82; IC95%: 1,51;5,26) e ter mais de oito anos de estudo (OR=2,03; IC95%: 1,23;3,33). A prevalência de uso de preservativo na última relação sexual foi de 94,9%. Fatores associados ao uso de preservativo na última relação foram: religião não católica (OR=0,68, IC 95%: 0,52;0,88) e parceria afetivo-sexual no período anterior à pesquisa (OR = 5,15, IC 95%: 1,79; 14,80). Conclusões: Ao contrário de outros contextos da África Subsaariana, foram constadas taxas elevadas de uso de preservativo por adolescentes no início da vida sexual. Os adolescentes podem iniciar a vida sexual de maneira mais segura se tiverem informação, educação sexual e acesso a métodos de prevenção à gravidez e IST. O elevado uso de preservativo e a associação entre escolaridade e utilização de métodos anticoncepcionais entre adolescentes na última relação sexual podem expressar resultados positivos das políticas de saúde sexual e reprodutiva atuais, contribuindo para diminuição da infecção por HIV. Todavia, a influência da religião e da parceria afetivo-sexual no uso de preservativo revela a necessidade de ações de prevenção voltadas para segmentos religiosos não católicos e que não possuem parceria afetivo-sexual. Este estudo oferece elementos para a reflexão sobre o delineamento de políticas de redução da vulnerabilidade dos jovens às IST/Aids e sobre os limites e desafios da promoção do uso do preservativo e educação sexual focando as relações desiguais de gênero. / Objective: To describe the onset of sexual life and the use of contraceptive methods and to estimate factors associated among adolescents aged 13-17 years from public high schools in Santiago Island, Cape Verde. Methods: A cross-sectional study with a probabilistic and representative sample of 768 adolescents aged 13-17 years from public high schools was carried out in Santiago Island, Cape Verde, in 2007. The association was verified by means of test of proportions, Pearsons chi-square, Fishers exact and logistic regression. The subsample of 368 sexually active adolescents was analyzed to estimate the factors associated with contraceptive methods and condom use. The first sexual intercourse and contraceptive methods and condom use were analyzed as outcomes. Sociodemographic, sexual-affective and behavioral characteristics were the independent variables. Logistic regression was used for simultaneous analysis of factors at a 5% significance level. Results: Among male adolescents, the factors associated with the first sexual intercourse were: age over 14 years, being catholic and alcohol consumption. For female adolescents, having more than nine years of schooling and sexual-affective partnership were associated with the first sexual intercourse. Among the 368 adolescents, 69.3% reported use of contraceptive methods in the last sexual intercourse; the most frequent methods were condom (94.9%) and pill (26.4%). Significant and positive factors associated with the use of contraceptive methods in the last sexual intercourse were: living in the capital (OR=2.02; 95%CI: 1.23;3.32), having dated previously the study (OR=2.82; 95%CI: 1.51;5.26) and having more than eight years of schooling (OR=2.03; 95%CI: 1.23;3.33). The prevalence of condom use in the last sexual intercourse was 94.9%. Factors associated with condom use in the last sexual intercourse were: being non-catholic (OR=0.68, 95%CI: 0.52;0.88) and having affective-sexual partnership previously the study (OR=5.15, 95%CI: 1.79;14.80). Conclusions: Contrary to other Sub-Saharan Africa contexts, high rates of condom use in adolescents first sexual intercourse were observed. Adolescents are able to begin sexual life more safely as long as they are provide with information, sexual education and access to contraceptive and STI prevention methods. The high condom use and the association between schooling and contraceptive methods utilization in the last sexual intercourse may express positive outcomes from the current sexual and reproductive health policies, accounting for the decrease in HIV infection. However, the influence of religion and sexual-affective partnership on condom use indicates the need for preventive measures targeted at noncatholic groups and those without affective-sexual partnership. This study contributes for the reflection upon the design of policies aimed at reducing the vulnerability of young people to STI/AIDS and the limits and challenges to promote condom use and sexual education focusing on gender inequalities.

Objetivo: Descrever a iniciação sexual e o uso de métodos anticoncepcionais e estimar fatores associados a estas condutas, em adolescentes de 13 a 17 anos de idade, de escolas da rede pública de ensino secundário da Ilha de Santiago, Cabo Verde. Métodos: Estudo transversal realizado com amostra probabilística e representativa de 768 adolescentes com idade entre 13 e 17 anos, de escolas secundárias públicas da Ilha de Santiago em 2007. A associação foi testada pelo teste de proporção, qui-quadrado de Pearson ou Fisher e regressão logística. Para estimar os fatores associados ao uso de métodos anticoncepcionais e preservativo, foi analisada a sub-amostra de 368 adolescentes sexualmente ativos. O início da vida sexual, o uso de métodos anticoncepcionais e o uso de preservativo foram analisados como desfechos. Foram consideradas variáveis independentes: características sociodemográficas, afetivo-sexuais e comportamentais. Foi utilizada regressão logística para análise simultânea dos fatores, considerando-se nível de significância de 5%. Resultados: Entre os adolescentes do sexo masculino, os fatores associados ao início da vida sexual foram: idade maior que 14 anos, ser católico e consumir bebidas alcoólicas. Entre as adolescentes do sexo feminino, possuir mais de nove anos de estudo e parceria afetivosexual foram associados ao início da vida sexual. Entre os 368 adolescentes, 69,3% referiram ter usado métodos anticoncepcionais na sua última relação sexual, sendo mais freqüentes o preservativo (94,9%) e a pílula (26,4%). Fatores significativos e positivamente associados ao uso de métodos anticoncepcionais na última relação foram: morar em município da capital (OR=2,02; IC95%: 1,23;3,32), ter namorado anteriormente à época da entrevista (OR=2,82; IC95%: 1,51;5,26) e ter mais de oito anos de estudo (OR=2,03; IC95%: 1,23;3,33). A prevalência de uso de preservativo na última relação sexual foi de 94,9%. Fatores associados ao uso de preservativo na última relação foram: religião não católica (OR=0,68, IC 95%: 0,52;0,88) e parceria afetivo-sexual no período anterior à pesquisa (OR = 5,15, IC 95%: 1,79; 14,80). Conclusões: Ao contrário de outros contextos da África Subsaariana, foram constadas taxas elevadas de uso de preservativo por adolescentes no início da vida sexual. Os adolescentes podem iniciar a vida sexual de maneira mais segura se tiverem informação, educação sexual e acesso a métodos de prevenção à gravidez e IST. O elevado uso de preservativo e a associação entre escolaridade e utilização de métodos anticoncepcionais entre adolescentes na última relação sexual podem expressar resultados positivos das políticas de saúde sexual e reprodutiva atuais, contribuindo para diminuição da infecção por HIV. Todavia, a influência da religião e da parceria afetivo-sexual no uso de preservativo revela a necessidade de ações de prevenção voltadas para segmentos religiosos não católicos e que não possuem parceria afetivo-sexual. Este estudo oferece elementos para a reflexão sobre o delineamento de políticas de redução da vulnerabilidade dos jovens às IST/Aids e sobre os limites e desafios da promoção do uso do preservativo e educação sexual focando as relações desiguais de gênero. / Objective: To describe the onset of sexual life and the use of contraceptive methods and to estimate factors associated among adolescents aged 13-17 years from public high schools in Santiago Island, Cape Verde. Methods: A cross-sectional study with a probabilistic and representative sample of 768 adolescents aged 13-17 years from public high schools was carried out in Santiago Island, Cape Verde, in 2007. The association was verified by means of test of proportions, Pearsons chi-square, Fishers exact and logistic regression. The subsample of 368 sexually active adolescents was analyzed to estimate the factors associated with contraceptive methods and condom use. The first sexual intercourse and contraceptive methods and condom use were analyzed as outcomes. Sociodemographic, sexual-affective and behavioral characteristics were the independent variables. Logistic regression was used for simultaneous analysis of factors at a 5% significance level. Results: Among male adolescents, the factors associated with the first sexual intercourse were: age over 14 years, being catholic and alcohol consumption. For female adolescents, having more than nine years of schooling and sexual-affective partnership were associated with the first sexual intercourse. Among the 368 adolescents, 69.3% reported use of contraceptive methods in the last sexual intercourse; the most frequent methods were condom (94.9%) and pill (26.4%). Significant and positive factors associated with the use of contraceptive methods in the last sexual intercourse were: living in the capital (OR=2.02; 95%CI: 1.23;3.32), having dated previously the study (OR=2.82; 95%CI: 1.51;5.26) and having more than eight years of schooling (OR=2.03; 95%CI: 1.23;3.33). The prevalence of condom use in the last sexual intercourse was 94.9%. Factors associated with condom use in the last sexual intercourse were: being non-catholic (OR=0.68, 95%CI: 0.52;0.88) and having affective-sexual partnership previously the study (OR=5.15, 95%CI: 1.79;14.80). Conclusions: Contrary to other Sub-Saharan Africa contexts, high rates of condom use in adolescents first sexual intercourse were observed. Adolescents are able to begin sexual life more safely as long as they are provide with information, sexual education and access to contraceptive and STI prevention methods. The high condom use and the association between schooling and contraceptive methods utilization in the last sexual intercourse may express positive outcomes from the current sexual and reproductive health policies, accounting for the decrease in HIV infection. However, the influence of religion and sexual-affective partnership on condom use indicates the need for preventive measures targeted at noncatholic groups and those without affective-sexual partnership. This study contributes for the reflection upon the design of policies aimed at reducing the vulnerability of young people to STI/AIDS and the limits and challenges to promote condom use and sexual education focusing on gender inequalities.

<p>Kondomanvändning vid sexuella kontakter har en betydande roll för att hindra utbredningen av sexuellt överförbara sjukdomar. I föreliggande studie har fokus legat på att undersöka högskolestudenters attityder till kondomanvändning. För att finna svar på frågeställningarna genomfördes en enkätundersökning på den utvalda högskolan. Totalt deltog 287 studenter som besvarat enkäten vilken bestod av frågor kring kondomanvändning vid sexuellt umgänge med sin partner samt vid tillfälliga sexuella relationer. Resultatet från enkätundersökningen har sammanställts och analyserats statistiskt. Undersökningen visade att studenter hade överlag en positiv attityd till att använda kondom samt ansåg att en diskussion bör föras tillsammans med sin partner om kondomanvändning. Studenterna ansåg att den främsta anledningen till att kondom inte användes var att den var avtändande i den sexuella situationen och resultatet visade även att studenterna använde kondom huvudsakligen för att förhindra sexuellt överförbara sjukdomar. Studenters attityder till kondomanvändning var positiv men för att minska spridning av sexuellt överförbara sjukdomar krävs en beteendeförändring som kan ske genom en förändring av normer och värderingar.</p> / <p>Condom use during sexual contacts has a significant role in preventing expansion of sexual transmitted diseases. The focus in this study has been to examine collegestudents attitudes towards condom use. A survey was performed on 287 students at the chosen college. The survey contained questions regarding condom use during sexual relations with a partner and during casual sexual relations. The results from the survey were statisticly analyzed and showed that students had a positive attitude towards condom use. They also thought it was important to have a discussion between the two partners regarding condom use. The students thought that the main reason that condoms were not used during sexual relations was because it led to a sexual turn off. The study also showed that if a condom was used it was primarily to prevent sexual transmitted diseases. Students attitudes towards condom use were positive, but to reduce sexual transmitted diseases from spreading there has to be a change in behavior and this can only be change through a change in norm and values.</p>