Thesis (Ph. D.)--University of Washington, 2005. / Vita. Includes bibliographical references (leaves 72-106).

Orientador: Kester Carrara / Banca: Sandra Regina Gimeniz-Paschoal / Banca: Sandra Leal Calais / Resumo: Estudos sobre prevenção de doenças sexualmente transmissíveis e gravidez precoce em populações jovens demonstram que esse público apresenta, cada vez mais, melhor nível de conhecimento sobre as doenças e sobre o uso do preservativo. Entretanto, ainda é relativamente alto o número de jovens que não usam o preservativo durante as relações sexuais. Apesar de a Análise do Comportamento possuir um considerável potencial para auxiliar na compreensão dos processos culturais, ainda são escassos os trabalhos em Análisedo Comportamento possuir um considerável potencial para auxiliar na compreensão dos processos culturais, ainda são escassos os trabalhos em Análise do Comportamento com enfoque sobre a cultura. O presente estudo objetivou identificar e descrever características do uso de preservativos e possíveis variáveis controladoras desse comportamento em estudantes com idades entre 13 e 18 anos. Para tanto foram analisadas regras que agiam como estímulos discriminatvos antecedentes aos comportamentos de usar ou não preservativo, bem como consequências de punição ou reforçamento disponibilizadas pelos pais ou responsáveis e por serviços de saúde. Participaram da pesquisa 191 adolescentes, de ambos os sexos, estudantes de uma escola da rede pública da cidade de Bauru. Os dados foram coletados por meio de um questionário estruturado, elaborado e aplicado pela própria pesquisadora. Do total den estudantes, 83% se encontravam na faixa de 14 a 16 anos, sendo 92 do sexo masculino e 99 do sexo feminino. Em relação às famílias, 75% dos participantes residiam com cerca de 3 a 5 pessoas, sendo 43% familias nucleares.Quanto à experiência sexual, 65 participantes declararam já ter tido relações sexuais. Destes, 51 afirmaram terem usado preservativo durante a primeira relação sexual. Apenas 27 adolescentes declararam uso em todas as relações e somente... (Resumo completo, clicar acesso eletrônico abaixo) / Abstract: Studies on prevention of sexually transmitted diseases and premature pregnancy in young populations demonostrate that this public has increasingly improved knowledge about diseases and the use of condoms. However, it is still relatively high the number of young people who do not use condoms during sex. Althrough behavior analysis has a considerable potential to assist in the understanding of cultural processes there are still very few studies in behavior analysis with a focus on culture. This study aimed to identify and describe characteristics of condom use and possible behavior controlling variables in students aged between 13 and 18 years old. Therefore, some rules have been analyzed, and they acted as discriminative stimuli prior to the behavior of using condoms or not, as well as consequential punishment and reinforcement provided by parents or guardians and health services. 191 teenagers, of both sexes, from a public school in the city of Bauru, took part in the survey. Data were collected using a structure questionnaire, which was prepared and applied by the researcher herself. Of all students 83% were aged from 14 to 16 years, 92 male and 99 female. Concerning the families, 75% of the participants live with 3 to 5 people, 43% of those are nuclear families. As for the sexual experience, 65 participants said they had had sex. Of these, 51 report having used a condom using the first intercourse. Only 27 teens reported using condoms in all relationships and only 23 reported talking to their parther about condom use. Faced with situations where it is necessary to use condoms, only 18 students market all alternatives. "When it is using other methods", "when it is healthy" and "when there is love" were not market by, respectively, 77%, 58% and 66% of the sample. Receiving information from their parents about... (Complete abstract click electronic access below) / Mestre

Made available in DSpace on 2014-06-11T19:29:00Z (GMT). No. of bitstreams: 0 Previous issue date: 2011-12-06Bitstream added on 2014-06-13T19:58:30Z : No. of bitstreams: 1 brum_mm_me_bauru.pdf: 392826 bytes, checksum: d1726c4f4032e4d2766bc6820d6f5b0e (MD5) / Estudos sobre prevenção de doenças sexualmente transmissíveis e gravidez precoce em populações jovens demonstram que esse público apresenta, cada vez mais, melhor nível de conhecimento sobre as doenças e sobre o uso do preservativo. Entretanto, ainda é relativamente alto o número de jovens que não usam o preservativo durante as relações sexuais. Apesar de a Análise do Comportamento possuir um considerável potencial para auxiliar na compreensão dos processos culturais, ainda são escassos os trabalhos em Análisedo Comportamento possuir um considerável potencial para auxiliar na compreensão dos processos culturais, ainda são escassos os trabalhos em Análise do Comportamento com enfoque sobre a cultura. O presente estudo objetivou identificar e descrever características do uso de preservativos e possíveis variáveis controladoras desse comportamento em estudantes com idades entre 13 e 18 anos. Para tanto foram analisadas regras que agiam como estímulos discriminatvos antecedentes aos comportamentos de usar ou não preservativo, bem como consequências de punição ou reforçamento disponibilizadas pelos pais ou responsáveis e por serviços de saúde. Participaram da pesquisa 191 adolescentes, de ambos os sexos, estudantes de uma escola da rede pública da cidade de Bauru. Os dados foram coletados por meio de um questionário estruturado, elaborado e aplicado pela própria pesquisadora. Do total den estudantes, 83% se encontravam na faixa de 14 a 16 anos, sendo 92 do sexo masculino e 99 do sexo feminino. Em relação às famílias, 75% dos participantes residiam com cerca de 3 a 5 pessoas, sendo 43% familias nucleares.Quanto à experiência sexual, 65 participantes declararam já ter tido relações sexuais. Destes, 51 afirmaram terem usado preservativo durante a primeira relação sexual. Apenas 27 adolescentes declararam uso em todas as relações e somente... / Studies on prevention of sexually transmitted diseases and premature pregnancy in young populations demonostrate that this public has increasingly improved knowledge about diseases and the use of condoms. However, it is still relatively high the number of young people who do not use condoms during sex. Althrough behavior analysis has a considerable potential to assist in the understanding of cultural processes there are still very few studies in behavior analysis with a focus on culture. This study aimed to identify and describe characteristics of condom use and possible behavior controlling variables in students aged between 13 and 18 years old. Therefore, some rules have been analyzed, and they acted as discriminative stimuli prior to the behavior of using condoms or not, as well as consequential punishment and reinforcement provided by parents or guardians and health services. 191 teenagers, of both sexes, from a public school in the city of Bauru, took part in the survey. Data were collected using a structure questionnaire, which was prepared and applied by the researcher herself. Of all students 83% were aged from 14 to 16 years, 92 male and 99 female. Concerning the families, 75% of the participants live with 3 to 5 people, 43% of those are nuclear families. As for the sexual experience, 65 participants said they had had sex. Of these, 51 report having used a condom using the first intercourse. Only 27 teens reported using condoms in all relationships and only 23 reported talking to their parther about condom use. Faced with situations where it is necessary to use condoms, only 18 students market all alternatives. When it is using other methods, when it is healthy and when there is love were not market by, respectively, 77%, 58% and 66% of the sample. Receiving information from their parents about... (Complete abstract click electronic access below)

CoordenaÃÃo de AperfeiÃoamento de Pessoal de NÃvel Superior / Diante da maior vulnerabilidade à aquisiÃÃo de DoenÃas Sexualmente TransmissÃveis (DST)/HIV por mulheres presidiÃrias decidiu-se desenvolver este estudo. Trata-se de uma pesquisa avaliativa do tipo Conhecimento, Atitude e PrÃtica (CAP) de mulheres internas na penitenciÃria feminina do Estado do CearÃ, com os seguintes objetivos: avaliar o conhecimento, a atitude e a prÃtica de presidiÃrias quanto ao uso do preservativo masculino e feminino como medida preventiva Ãs DST/HIV; verificar o perfil sociodemogrÃfico, sexual, reprodutivo e de hÃbitos de vida de presidiÃrias; investigar fatores de vulnerabilidade de presidiÃrias Ãs DST/HIV; associar as variÃveis preditoras com o conhecimento, a atitude e a prÃtica do uso do preservativo masculino e feminino por presidiÃrias; comparar o conhecimento e a atitude com a prÃtica do uso do preservativo masculino e feminino por presidiÃrias. Pesquisa transversal, de abordagem quantitativa, envolveu uma amostra de 155 presidiÃrias. A coleta de dados foi realizada de janeiro a marÃo de 2010. O instrumento de coleta contemplou dados de caracterizaÃÃo sociodemogrÃfica, sexual, reprodutiva e de hÃbitos de vida. Em seguida, foi aplicado o InquÃrito CAP em relaÃÃo a preservativos, adaptado da investigaÃÃo de Brenna et al.(2001). Os dados foram compilados, armazenados e associados ao programa Statistical Package for the Social Sciences (SPSS) versÃo 17.0. O teste Qui-quadrado de Pearson foi aplicado. Os resultados indicaram uma maioria de jovens brasileiras, solteiras, com baixa escolaridade e renda familiar mensal, reclusas por trÃfico de drogas. Pela histÃria sexual evidenciou-se coitarca precoce, estabilidade e pouca variedade de parceiros sexuais. Usar drogas, ser presidiÃrio ou presidiÃria e possuir tatuagens/piercings representaram as principais caracterÃsticas das parcerias. A homo/bissexualidade e a prostituiÃÃo estiveram presentes em aproximadamente 35% das mulheres pesquisadas. As DST que se manifestaram antes ou apÃs a prisÃo apresentaram baixas porcentagens: 13,5% e 5,8%, respectivamente. A 15% foi concedido o direito à visita Ãntima. HÃbitos tabagistas, etilistas e uso de drogas ilÃcitas se apresentaram em mais de 60% das mulheres. O conhecimento sobre os preservativos mostrou-se superficial. Embora tivessem ouvido falar e/ou soubessem corretamente as finalidades do uso, 120 (77,4%) nÃo souberam citar trÃs cuidados necessÃrios para a utilizaÃÃo adequada do preservativo masculino, e 143 (92,3%), do feminino. Foram diagnosticadas atitudes menos favorÃveis quanto ao uso do preservativo feminino durante o sexo oral. A prÃtica adequada dos preservativos apresentou pouca representatividade, em especial do feminino. A homossexualidade, as questÃes de gÃnero, a falta de conhecimento e as dificuldades de acesso representaram obstÃculos. A atitude apresentou associaÃÃo significativa com as variÃveis idade e idade da coitarca. O uso adequado dos preservativos e a histÃria de prostituiÃÃo se associaram estatisticamente. Os componentes do CAP nÃo resguardaram associaÃÃes estatÃsticas entre si. Portanto, conhecimentos e atitudes adequadas nÃo foram suficientes para assegurar prÃticas adequadas. PossÃveis elucidaÃÃes se encontram na conjuntura de dificuldades na negociaÃÃo do uso entre os parceiros, na restriÃÃo ao acesso e na âilegalidadeâ em que ocorrem as relaÃÃes homossexuais. O fortalecimento da autonomia dos sujeitos como essÃncia do processo educativo, alÃm de considerar os saberes e opiniÃes, deve congregar os contextos das vulnerabilidades ambientais, sociais, culturais e emocionais. / Given the greater vulnerability to acquisition of Sexually Transmitted Diseases (STD)/HIV by women prisoners, decided to develop the study. It is an evaluative study of type Knowledge, Attitude and Practice (KAP) held in a female prison in the state of CearÃ, with the following objectives: Assess the knowledge, attitude and practice regarding the use of prisoners male and female condoms as a measure prevention of STD/HIV; Verify the sociodemographic, sexual, reproductive and lifestyle habits of prisoners; Investigate vulnerability factors in prisoners; Associate predictor variables with the knowledge, attitude and practice of male and female condoms by prisoners; Compare the knowledge and attitude to the practice of male and female condoms by prisoners. Search with quantitative approach, involving a sample of 155 prisoners. Data collection was conducted from January to March 2010. The instrument included data on sociodemographics, sexual, reproductive and lifestyle habits. Then we applied the KAP survey about condoms, adapted from research Brenna et al. (2001). The data were compiled, stored and associated in the Statistical Package for Social Sciences (SPSS) version 17.0. The chi-square test was used as statistical tool. The sociodemographic profile pointed to a majority of young Brazilian, single, low education level and family income, trapped for drug trafficking. The history of sexual precocity revealed the occurrence of first sexual intercourse, stability and little variety of sexual partners. However, drug use, be male or female prisoner, and has tattoos/ piercings were the principal characteristics of the partnerships. The homo/ bisexuality and prostitution was attended by about 35%. STDs acquired before or after the arrest showed low percentages, 13.5% and 5.8% respectively. Only 15% were granted the right to conjugal visits. Smoking habits, alcoholism, and illicit drug use were presented in more than 60% of women. Knowledge about condoms proved to be superficial. Although they had heard of and/ or correctly knew the reasons for use, 120 (77.4%) couldnât report three necessary cares for the proper use of male condoms and 143 (92.3%) females. Were diagnosed less favorable attitudes about the use of female and during oral sex. The practice proper condom had little representation, particularly females. Homosexuality, gender issues, lack of knowledge and access difficulties represented obstacles. The attitude was significantly associated with the variables age and age of first sexual intercourse. The proper use of condoms and the history of prostitution were statistically associated. The components of the KAP didnât showed statistical associations between them. Therefore, knowledge and attitudes werenâot adequate enough to ensure appropriate practices. Possible clarifications are in the context of difficulties in negotiating the use of the partners, restricting access and the "illegality" that occur in homosexual relations. Strengthening the autonomy of individuals, as the essence of the educational process, and consider the knowledge and opinions, should bring together the contexts of environmental vulnerability, social, cultural and emotional.

Condomless sex between gay men, also known as bareback sex, has been a popular object of research since the beginning of the AIDS epidemic. One of the most common perspectives on studying bareback sex has been through a medicalization approach, as it may be observed notably with public health and psychology. In other instances, the abandonment of condom use is framed as an intentional act of resistance to public health. Through the methodological approach of ethnography, I studied how young gay men in their twenties from Toronto understand bareback sex in relations to popular discourses of the sexual practice. While my informants initially had a certain way of talking of bareback sex, their narratives on the sexual practice changed with time and challenged the common representations of bareback sex as either a site of resistance or medicalization, which I argue was possible because of the methodological approach of ethnography. During fieldwork, other themes also emerged in regards to shaping understandings of bareback sex and HIV as it relates to young gay men, such as the traumatic memories of an older generation who witnessed the earlier days of the AIDS epidemic. From this anthropological research, I seek to invite the opportunity to rethink the relationship between sex, biomedical science, and HIV.

Despite the global figures on male HIV infection rates, and the vulnerability of men to HIV as a result of social constructions of masculinity, not enough attention has been paid to the seriousness of the problem of HIV in heterosexual men. Most research has concentrated on either homosexual or bisexual men, neglecting the experiences of heterosexual men diagnosed as HIV positive, and the implications thereof. This study aims to explore the lived experiences (emotional, cognitive and social) of black heterosexual males who are living with HIV. The focus of this study was thus on the subjective experiences and circumstances of these men, to enhance understanding of how they managed to adapt to the stress of being HIV positive. Health professionals, such as nurses, psychologists and doctors at Tshwane District Hospital, can use the results of the study to assist men when they are diagnosed, and to help them cope effectively with their subsequent challenges. The study used the phenomenological theoretical framework. It explored the lived experiences of being HIV positive through in-depth, semi-structured interviews, which were audio-recorded and transcribed . Non-probability sampling was used to identify the 5 participants in this study. Data was analysed in terms of thematic analysis and 15 themes were derived from the analysis and described using quotations from the raw data. These themes were then contextualised and explored with relevant literature. The research found that these men initially struggled to adapt to their HIV-positive status and exhibited denial, fear and loss, complicated by the sense that their masculinity was compromised. While there was some evidence of limited internal and external stigma, the men were able to find support from partners, family and friends, and were able to rise to the challenge of 'living positively'. / Dissertation (MA)--University of Pretoria, 2009. / Psychology / unrestricted

Notre étude faisait partie de l’évaluation du programme de prévention du VIH, Avahan, réalisé auprès de travailleuses du sexe (TS) en Inde. Le programme comprenait une stratégie de traitement des infections transmises sexuellement (ITS). Notre étude visait à déterminer si l’utilisation de ce traitement aurait pu avoir une influence sur le port du condom. Cette étude transversale a été réalisée auprès de 1378 TS, entre 2006 et 2007, provenant de cinq districts de l’Inde. Nous avons observé une diminution significative du port du condom chez les TS ayant reçu plus de 3 traitements dans les trois à douze derniers mois avec les clients occasionnels [Rapport de prévalence ajusté (RPa) : 0,70, intervalle de confiance 95% (IC95%): 0,57-0,84], et avec le plus récent client régulier (RPa : 0,63, IC95% : 0,51-0,78). Plus d’études sont nécessaires pour déterminer le lien causal entre ces deux variables. / Our study was part of the evaluation of the Avahan HIV prevention program targeted at female sex workers (FSW) in India. Treatment of sexually transmitted infections (STIs) was part of the strategies used in this program. We assessed whether having received a treatment was associated with consistent condom use (CCU). This cross-sectional study was conducted in 2006-2007 among 1378 FSWs in five Indian districts. Reported CCU was lowest among FSWs who had received ≥3 treatments in the last three to 12 months with their new or occasional clients [Adjusted prevalence ratio (APR): 0.70, 95% Confidence interval (95%CI): 0.57-0.84] and for the most recent repeat client (APR 0.63, 95%CI: 0.51-0.78). Further research on the causal link between those two variables is warranted.

Nous avons mesuré la fréquence de la violence physique, sexuelle et psychologique à l’encontre des femmes travailleuses du sexe et évalué l’association entre la violence, le bris du préservatif et l’infection à VIH. L’analyse multivariée de régression log-binomiale a été utilisée pour estimer les rapports de prévalence ajustés (RPa) du VIH. La prévalence du VIH était de 20,4%. Au total, 17,2%, 13,5% et 33,5% des participantes ont respectivement été exposées à la violence physique, sexuelle et psychologique; 15,9% ont rapporté avoir eu au moins un bris du préservatif au cours des rapports sexuels de la semaine précédant notre enquête. Les RPa du VIH étaient respectivement de 1,45 (intervalle de confiance [IC]95% : 1,05 – 2,00), 1,42 (IC95%1,02 – 1,98), et 1,41 (IC95%1,08 – 1,41) chez les femmes exposées à la violence physique, sexuelle et psychologique. Nos résultats montrent que les femmes exposées à la violence avaient une prévalence plus élevée du VIH. / Objective: To examine the relationship between violence, condom breakage and HIV prevalence among female sex workers (FSWs). Design: Data were obtained from the 2012 cross-sectional integrated biological and behavioural survey conducted in Benin. Methods: Multivariable log-binomial regression was used to estimate the adjusted prevalence ratios (APRs) of HIV infection and condom breakage in relation to violence towards FSWs. A score was created to examine the relationship between the number of violence types reported and HIV infection. Results: Among the 981 women who provided a blood sample, HIV prevalence was 20.4%. During the last month, 17.2%, 13.5% and 33.5% of them had experienced physical, sexual and psychological violence, respectively. In addition, 15.9% reported at least one condom breakage during the previous week. There was a significant association between all types of violence and HIV prevalence. The APRs of HIV were 1.45 (95% confidence interval [95%CI]: 1.05 - 2.00), 1.42 (95%CI: 1.02 - 1.98), and 1.41 (95%CI: 1.08 - 1.41) among those who had ever experienced physical, sexual and psychological violence, respectively. HIV prevalence increased with the violence score (p=0.002, test for trend), and physical and sexual violence were independently associated with condom breakage (p values 0.010 and 0.003, respectively). Conclusion: The results show that violence is associated with a higher HIV prevalence among FSWs and that condom breakage is a potential mediator for this association. Longitudinal studies designed to analyse this relationship and specific interventions integrated to current HIV prevention strategies are needed to reduce the burden of violence among FSWs. Key words: Violence, condom failure, HIV, female sex workers, sub-Saharan Africa.

Department of Advanced Nursing Science / MCur

A quantitative, descriptive and comparative study was conducted to determine the attitudes of young people aged 15-25 years towards the “ABC” strategy in the prevention of HIV/AIDS in Francistown, Botswana. Differences between two age groups and gender were determined. Structured questionnaire was used and 241 young people participated in the study. Data were analysed with SPSS version 13.0, guided by the Health Belief Model. The findings revealed that young people did not perceive the seriousness and severity of the HIV/AIDS when it came to the practice of “ABC” strategy. Young people’s cue to action was very high but their confidence to adopt and practice the “ABC” strategy were low. They had adequate knowledge of the benefits of abstinence and condoms but they perceived barriers towards the use of condom. The differences between the two age groups, 15-19 and 20-25 years and between the males and females were not statistically significant. / Public Health / M.A. (Public Health)