Philosophiae Doctor - PhD / HIV/AIDS has made a huge impact on human development and sexual reproductive habits in this century in the world and especially in sub-Saharan Africa. It has only recently been acknowledged that HIV/AIDS has an equal if not greater effect on or threat to people with disabilities. Survivors of traumatic spinal cord injury (TSCI) with resultant disability are incorrectly believed to be sexually inactive, unlikely to use drugs or alcohol and at less risk of violence or rape than their non-disabled peers. This group can thus be described as economically, educationally and socially disadvantaged, which in itself, suggest that they are a high-risk group for HIV infection. The overall aim of this study is to examine the factors that could contribute to the risk and vulnerability to HIV/AIDS among individuals with spinal cord injuries in South Africa. The specific objectives of the study are to assess the behavioral and protective factors that could contribute to risk and vulnerability to HIV infection among individuals and spinal cord injuries; and to explore the socio-cultural issues that might increase individuals with spinal cord injuries’ vulnerability to HIV/AIDS. The design of this study was a mixed methods design, particularly the sequential explanatory strategy was used will used in this study. The study was conducted in four (4) conveniently selected provinces (highest prevalence of SCI). The Quad-Para Association of South Africa’s (QASA) provincial databases was used to invite individuals with SCI to participate in the study. Data for quantitative part of the study was collected by means of self-administered questionnaires. The questionnaire consisted of various sections requesting for information on: Demographics; HIV-Knowledge (HIV- KQ-18); Sexual behaviours; Sexual communication and negotiation skills; Self-efficacy to refuse sex. Separate binary logistics analysis was done to assess which of the selected factors are associated with risky sexual behaviour. The forced entry method approach was used to determine which of these factors have the greatest productive power to predict sexual risk behaviour. No “a priori” sample size was developed for the qualitative part, but participants were recruited until saturation has been reached of all the categories. Consenting participants were visited by the researcher for data collection in the environment indicated by the participant. Permission to conduct the study was obtained from the Research Ethics Committee at the University of the Western Cape (UWC). The study was conducted according to ethical practices pertaining to the study of human subjects as specified by the UWC and Faculty of Community and Health Sciences Research Ethics Committee of the UWC.

Approximately 2.2 million children and adolescents are arrested each year, and these youthful offenders often display serious psychosocial dysfunction across a wide spectrum of areas: family dysfunction, mental health distress, problems with drug use, risky sexual behaviors, and a history of traumatic experiences. Of particular interest, the rate of female adolescent arrest and incarceration has been on the rise over the past several decades, yet female juvenile offenders are understudied compared with their male peers. It is important to identify risk factors that predispose certain female adolescents to criminal behavior to inform future interventions. Given the associations of mental health problems, substance use, trauma, and family dysfunction with crime in adolescent girls, further study is warranted to more clearly understand the links between these psychosocial factors and criminality in adolescents, especially girls. The impacts of mental health disorders, family functioning, risky sexual behavior, trauma, and substance use on juvenile justice involved youths are of great public health and social importance because of the potential to intervene and to prevent criminal behavior in at-risk teens. However, the relationships between these risk factors and the severity of juvenile offending in girls have not been studied adequately. By analyzing data from interviews and follow-up criminal records for almost 500 arrested and detained adolescent girls, we first investigated the associations between concurrent substance use and psychosocial dysfunction in this population. Secondly, we examined which psychosocial domains (i.e., mental health disorders, substance use/abuse, trauma, sexual behavior, and family functioning) were most predictive of recidivism and violent recidivism during adolescence for this group of offending girls. Finally, we studied which psychosocial variables best predicted time to next arrest, thereby determining if psychosocial functioning can also predict the amount of time before a given adolescent reoffends. Our findings indicated that substance use and sexual risk behaviors are the most important psychosocial predictors of poor outcomes in adolescent female juvenile offenders.

Background: Teen pregnancy is associated with an array of negative social and health related outcomes for the mother as well as the baby. The risk of becoming a parent before the age of 20 is clearly elevated for former child welfare clients. Aim: The aim of this study is therefore to investigate the elevated birth rates among female adolescent child welfare clients by examining the relationship between contraceptive behaviour and pregnancies. Method: The study was based on a set of compiled register data. The study population were all females between the ages 14 and 19 during the years 2006-2008 (n. 487 115). The study group of main interest were child welfare clients who were compared to peers in the majority population as well as international and national adoptees. Analysis was conducted with multivariate logistic regression and the observed association was controlled for maternal, socio-demographic and behavioural factors. Results: The two sub-populations of child welfare clients both had much higher rates of retrieved hormonal contraceptives compared to the majority population, the international and the national adoptees up to age 17. In the ages 18 and 19 the rates were instead lower than the majority population. The child welfare clients had a stronger association to births than all groups of comparison, which was consistent with earlier research. All findings persisted after controlling for socio-demographic, maternal and behavioural factors. Conclusion: The child welfare clients showed a specific pattern of contraceptive behaviour over the age groups which was not consistent with the groups of comparison or with the expected relationship to birth rates. This suggests that teenage births cannot unanimously be predicted by the rates of retrieved hormonal contraceptives. The results imply that other factors than those investigated in this study are more influential regarding the contraceptive behaviour of this adolescent population.

The purpose of the current study was to explore the relation between a culture specific theory of resiliency (TRIOS: Time, Rhythm, Improvisation, Oratory & Spirituality) and sexual health outcomes (Sexual Risk History, HIV Testing & Attitudes and Beliefs, Partner Information & Condom Self-Efficacy) among Black women. Participants were 124 Black women recruited from a larger sexual health intervention study. TRIOS was hypothesized to be correlated with outcomes and predict unique variance in outcomes beyond measures of Self-Esteem & Racial Identity. Time, Improvisation and Spirituality were hypothesized to uniquely predict limited sexual risk history, healthy HIV testing attitudes and beliefs, fewer risk indicators among sex partners, & higher condom self efficacy. The psychometric structure of TRIOS within the sample was examined. Tests included a Correlation Matrix, two sets of four Hierarchical Regressions and an Exploratory Factor Analysis. Correlations were found between TRIOS components and Sexual Risk History and Condom Self-Efficacy. Time and Improvisation uniquely predicted declines in Risky Sexual History. Rhythm uniquely predicted declines in Condom Self-Efficacy. Effects of Oratory were mixed. Methodological limitations and implications for interventions and future research were discussed.

Tidigare forskning kring sexuellt riskbeteende i Sverige har hitintills främst fokuserat på attityder till kondom och kondomanvändning. I dagsläget saknas forskning kring sambandet mellan sexuellt riskbeteende och personlighet i Sverige. I denna studie genomfördes en enkätundersökning bland 59 unga vuxna för att undersöka samband mellan sexuellt riskbeteende och personlighet. Några signifikanta samband hittades; bland annat mellan social förmåga och impulsiva sexuella beteenden. När enbart sexuellt riskbeteende studerades så fanns signifikanta medelvärdesskillnader mellan könen. Det hittades även att självförtroende är en viktig komponent för generellt sexuellt riskbeteende bland män och kvinnor. / Earlier research on sexual risk-taking in Sweden has primarily concerned attitudes towards condom and condom use. In the current situation, research on the relationship between sexual risk-taking and personality in Sweden is still missing. A survey was conducted among 59 young adults to investigate relationship between sexual risk-taking and personality. Some significant relationships were found; for instance between social ability and impulsive sexual behaviors. When only sexual risk-taking was considered, there were significant mean differences between the genders. Also, self-confidence was found to be an important component for general sexual risk-taking among men and women.

The overall aim was to explore the experiences of sexual risk taking among Chlamydia Trachomatis positive (CT+), HIV positive (HIV+), and HIV tested young women and men. The specific aims were to explore, from a gender perspective, the course of events, the norms, considerations and emotions involved in sexual risk taking in CT+, explore the perception of sexual risk taking in HIV+ youth, and their understanding of why they caught HIV and look at how the Law of Communicable Diseases Act impacts their sexuality. Moreover, to investigate why young adults test for HIV, how they construct the HIV risk, and what implications testing has for them. 42 informants between 17-24 years of age were recruited from a youth clinic in Umeå and from three infection clinics for HIV patients in Sweden. In depth interviews and focus group interviews were tape-recorded, transcribed verbatim and analyzed according to a Grounded Theory approach. The finding revealed that behind sexual risk taking, there was a drive to go steady, where lust and trust guided if sex would take place. In one-night stands women were expected to be less forward compared with men. We found an uneven responsibility concerning condom use where men expected women to be "condom promoters". By catching CT, women experienced guilt, while men felt content through knowing "the source of contamination". Among the HIV+ youth, socio-cultural factors such as; lack of adult supervision, naivité, love, alcohol, drugs, the macho ideal and cultures of silence blinded the informants to the risks and made them vulnerable. By grouping narratives according to degree of consensus in sexual encounters, this demonstrated that sexual risks happened in a context of gendered power relations where the informants had varied agency. The Law of Communicable Diseases Act implied both support and burden for these HIV+ youth. A lot of responsibility was put on them and to be able to handle the infromation duty they tried to switch off lust, switch off the disease, or balance lust and obedience. Among the HIV tested youth, HIV was seen a distant threat. Many had event-driven reasons for testing for HIV; multiple partners being one. Risk zones, like bars were perceived to be a milieu that often was expected to include one-night stands. Responsibility for testing was a gendered issue; "natural" for women, while men rather escaped from responsibility and had a testing resistance. Receiving a "green card" confirmed healthiness and provided relief, and made the informants felt "clean". They could restart with new ambitious, including reconsidering risk. The findings can be used in public health and in health care sectors that work with young people. We present suggestions on how to decrease the spread of STIs: To implement how men could play an equal part in sexual and reproductive health. Promote general CT screening for men. Liberal HIV testing among both young women and men. Promote safer sex behaviour from the uninfected youth, especially focusing on men??. Consider the role of gender and social background in the context of risky behaviours. Give lots of positive rewards concerning HIV disclosure to diminish the risk for HIV transmission.

Sammanfattning Introduktion: Sexuelt överförbara sjukdomar är ett av de stötsta hoten mot en normal reproduktion och sexuela hälsan, där den mest kända är HIV och AIDS. Empidemilogin i Thailand över de senaste decenierna visar en ökade prevalens av sexuellt överförbara sjukdomar. Den största orsaken till sjukdomar är ett resultat av sexuellt risk beteende och inkonsekvent kondomanvändande. Syfte: Syftet med studien var att undersöka sexuelt risk beteende och attityder till kondomanvändande hos thailänska universitetsstuderande i Bangkok. Metod: En deskriptiv tvärnittsstudie med kvantitativ metod användes i studien. Ett frågeformulär med 5 delar delades ut till 300 universitetsstudenter på två olika universitetet i Bangkok, Thailand. 269 deltagare fyllde i enkäten korrekt och 132 av dessa uppfyllde inklusionskriterierna. Resultat: 132 deltagare uppgav att de hade haft samlag. 15 (11.4%) av dessa hade ett lågt riskbeteende, 97 (73.5%) hade ett normalt riskbeteende och 20 (15.2%) hade ett högt riskbeteende. De fanns ingen signifikant skillnad mellan manliga (n=97) och kvinnliga (n=35) deltagare gällande deras sexuella risk beteende (p=0.68) och deras attityd till kondomanvändande (p=0.990). Ett samband mellan variablerna högt sexuellt riskbeteende och negativ attityd till kondomanvändande kunde ses, r=0.326, n= 132, p= 0.00. Slutsats: Majoriteten av universitets studenterna i denna studie hade ett normalt riskbeteende. Attityden till kondomanvändande var till största delen positiv med undantag gällande enstaka frågor. Vidare studier gällande thailänska universitetsstudenter och deras sexuella hälsa är av största vikt för att vidare minska riskbeteendet och sexuellt överförbara sjukdomar i populationen. / Abstract Introduction: One of the largest threats towards normal reproduction and sexual health is sexual transmitted diseases, were the most known is HIV and AIDS. The epidemiology of Thailand shows that over the last two decades several surveys reports an increase in the young adults' STD prevalence. The infections are mostly gained as a result of sexual risk behaviors and inconsistent condom use. AIM: The aim was to investigate sexual risk behavior and attitudes to condom use among Thailand university students in Bangkok. Method: The design used in this study was a descriptive cross-sectional quantitative method. A single five part questionnaire was handed out to 300 students within two different universities in Bangkok, Thailand. 269 participants completed the questionnaire and 132 of them met the inclusion criteria. Result: 132 participants reported having had sexual intercourse. 15 (11.4%) had a low risk behavior, 97 (73.5%) had an average risk behavior and 20 (15.2%) had a high risk behavior. There were no significant difference between male (n=97) and female (n=35) participants regarding sexual risk behavior (p= 0,68) and their attitudes towards condom-use (p= 0.990). A correlation between the two variables high sexual risk behavior and negative attitudes towards condom-use could be seen, r=0.326, n= 132, p= 0.00. Conclusions: The majority of the university students in our study showed an average risk behavior. The attitudes towards condoms were mostly positive with the exceptions of some specific questions. Further studies about Thai university students regarding sexual health is of importance to further decrease the sexual risks and STDs in the population.

Made available in DSpace on 2014-06-11T19:35:13Z (GMT). No. of bitstreams: 0 Previous issue date: 2011-08-19Bitstream added on 2014-06-13T20:26:21Z : No. of bitstreams: 1 romero_lr_dr_botfm.pdf: 456798 bytes, checksum: 12d198981db3d29e3da98567e20b8729 (MD5) / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) / Fundação para o Desenvolvimento da UNESP (FUNDUNESP) / A adolescência caracteriza-se por mudanças intensas no aspecto físico, emocional e social. Soma-se o fato de que a influência do grupo de amigos neste momento da vida parece ganhar força e interferir ou determinar o comportamento, sobretudo, relacionado à saúde. O uso de substâncias psicoativas e do comportamento sexual de risco, nessa fase da vida, situa-se como preocupação crescente na literatura. Embora importante para diminuição de práticas sexuais de risco, entre os adolescentes, o conhecimento sobre a prevenção das doenças sexualmente transmissíveis e Aids (DST/Aids), tem dividido atenções com outras variáveis do modo de viver do adolescente. Dessa forma, o presente trabalho teve como objetivo estudar a associação de conhecimentos sobre a prevenção das DST/Aids, a prevalência de práticas sexuais de risco, uso de drogas, desempenho escolar, o nível de atividade física habitual e a quantidade e formas de utilização do tempo livre e lazer entre estudantes do ensino fundamental e médio de escolas públicas e privadas de um município do interior paulista. Teve como população alvo os alunos de 7a e 8a séries do ensino fundamental, assim como estudantes do 1o, 2o e 3o ano do ensino médio. Foi conduzido um estudo do tipo transversal com aplicação de questionário estruturado, previamente testado, individual, anônimo e de autopreenchimento. O teste Qui-quadrado foi aplicado para avaliar as diferenças entre as freqüências e o teste de Regressão Logística passo-a-passo para trás para identificar os possíveis fatores preditores de conhecimento sobre prevenção das DST/Aids e prática sexual sem o uso de preservativo. Todos os testes tiveram nível de significância de 5%. Dentre os resultados, cerca de 50% pertence ao sexo masculino, faixa etária de 12 a 19 anos, com idade média... / Adolescence is characterized by deep changes in the physical, emotional and social. Added to the fact that the influence of the group of friends at this time of life seems to gain strength and interfere or determine the behavior, especially related to health. The use of psychoactive substances and sexual risk behavior in this phase of life, stands as growing concern in the literature. While important to decrease risky sexual practices among adolescents, knowledge about the prevention of sexually transmitted diseases and AIDS (STD / AIDS), has shared stage with other variables in the way of life of adolescents. Thus, this work aimed to study the association of knowledge about STD / AIDS, the prevalence of risky sexual practices, drug use, school performance, level of physical activity and the amount and ways of using free time and leisure among students in elementary and secondary education in public and private schools from a city in São Paulo. Target population had students 7th and 8th-graders, as well as students first, second and third years of high school. We conducted a cross-sectional study with a structured questionnaire, previously tested, individual anonymous self-completion. The chi-square test was applied to assess differences between frequencies and logistic regression test step by step back to identify possible predictors of knowledge about STD / AIDS and sexual intercourse without condom use. All tests had a significance level of 5%. Among the results, about 50% are male, aged 12 to 19 years, mean age 15 years (± 1.5 years), and just over 50% enrolled in primary education. Individuals with less knowledge about the prevention of STD / AIDS more frequently reported not having free time during the week, driving for pleasure and go to church or religious service, and sex without... (Complete abstract click electronic access below)

Orientador: Ivete Dalben / Banca: Ana Tereza de Abreu Ramos Cerqueira / Banca: Margareth Aparecida Santini de Almeida / Banca: Luciene Ferreira da Silva / Banca: Naila Janilde Seabra Santos / Resumo: A adolescência caracteriza-se por mudanças intensas no aspecto físico, emocional e social. Soma-se o fato de que a influência do grupo de amigos neste momento da vida parece ganhar força e interferir ou determinar o comportamento, sobretudo, relacionado à saúde. O uso de substâncias psicoativas e do comportamento sexual de risco, nessa fase da vida, situa-se como preocupação crescente na literatura. Embora importante para diminuição de práticas sexuais de risco, entre os adolescentes, o conhecimento sobre a prevenção das doenças sexualmente transmissíveis e Aids (DST/Aids), tem dividido atenções com outras variáveis do modo de viver do adolescente. Dessa forma, o presente trabalho teve como objetivo estudar a associação de conhecimentos sobre a prevenção das DST/Aids, a prevalência de práticas sexuais de risco, uso de drogas, desempenho escolar, o nível de atividade física habitual e a quantidade e formas de utilização do tempo livre e lazer entre estudantes do ensino fundamental e médio de escolas públicas e privadas de um município do interior paulista. Teve como população alvo os alunos de 7a e 8a séries do ensino fundamental, assim como estudantes do 1o, 2o e 3o ano do ensino médio. Foi conduzido um estudo do tipo transversal com aplicação de questionário estruturado, previamente testado, individual, anônimo e de autopreenchimento. O teste Qui-quadrado foi aplicado para avaliar as diferenças entre as freqüências e o teste de Regressão Logística passo-a-passo para trás para identificar os possíveis fatores preditores de conhecimento sobre prevenção das DST/Aids e prática sexual sem o uso de preservativo. Todos os testes tiveram nível de significância de 5%. Dentre os resultados, cerca de 50% pertence ao sexo masculino, faixa etária de 12 a 19 anos, com idade média... (Resumo completo, clicar acesso eletrônico abaixo) / Abstract: Adolescence is characterized by deep changes in the physical, emotional and social. Added to the fact that the influence of the group of friends at this time of life seems to gain strength and interfere or determine the behavior, especially related to health. The use of psychoactive substances and sexual risk behavior in this phase of life, stands as growing concern in the literature. While important to decrease risky sexual practices among adolescents, knowledge about the prevention of sexually transmitted diseases and AIDS (STD / AIDS), has shared stage with other variables in the way of life of adolescents. Thus, this work aimed to study the association of knowledge about STD / AIDS, the prevalence of risky sexual practices, drug use, school performance, level of physical activity and the amount and ways of using free time and leisure among students in elementary and secondary education in public and private schools from a city in São Paulo. Target population had students 7th and 8th-graders, as well as students first, second and third years of high school. We conducted a cross-sectional study with a structured questionnaire, previously tested, individual anonymous self-completion. The chi-square test was applied to assess differences between frequencies and logistic regression test step by step back to identify possible predictors of knowledge about STD / AIDS and sexual intercourse without condom use. All tests had a significance level of 5%. Among the results, about 50% are male, aged 12 to 19 years, mean age 15 years (± 1.5 years), and just over 50% enrolled in primary education. Individuals with less knowledge about the prevention of STD / AIDS more frequently reported not having free time during the week, driving for pleasure and go to church or religious service, and sex without... (Complete abstract click electronic access below) / Doutor

abstract: Sexual risk taking is prevalent in adolescence, particularly among Latino teens, and can have serious consequences in the form of contraction of STIs, HIV, and increased risk of unintended pregnancy. Family contexts characterized by conflict and lack of support are antecedents of adolescent sexual risk taking, but evidence elucidating the mechanisms underlying this association is lacking. The current study sought to test two potential pathways to sexual risk taking within the framework of social developmental theory, among a sample of 189 Mexican origin adolescents and their caregivers interviewed in the 7th, 8th, and 12th grades. Structural equation modeling was utilized to examine pathways from 7th grade family risk to age of sexual initiation, number of lifetime sexual partners, and condom nonuse reported in the 12th grade. Deviant peer affiliations and academic engagement at 8th grade were tested as mediators of this relationship for boys and girls. Results confirm the importance of the family context, with family risk exerting direct effects on the number of lifetime sexual partners for both genders, and on age of sexual initiation for females only. Deviant peer affiliations serve as a mediator of family risk for males, but not females. When included in a model alongside deviant peers, academic engagement does not play the hypothesized mediating role between family risk and any of the sexual risk outcomes. Future research ought to consider additional mediators that better account for the relation between family risk and sexual risk taking among females. / Dissertation/Thesis / M.A. Psychology 2012