Source: Masters Abstracts International, Volume: 47-01, page: 0342. Adviser: Kristy O. Murray. Includes bibliographical references.

Thesis (M.S.)--University of Michigan, 1982.

Abstract: Background: The global estimated adult and child deaths from HIV/AIDS in 2006 were 2.9 million and those living with HIV stood at 39.5 million. Of the HIV deaths, 72% (2.1 million) occurred in Sub-Saharan Africa (SSA). Two thirds (63%) of all adults and children with HIV globally live in, with its epicenter in Southern Africa. One third (32%) of all people with HIV globally live in Southern Africa and 34% of all deaths due to AIDS in 2006 occurred there. In South Africa, a total of 5.5 million people, including 240,000 children younger than 15 years, were living with HIV in 2005. HIV data gathered in the country’s antenatal clinic surveillance system suggest that HIV prevalence has not yet reached a plateau. There is a continuing trend nationally in HIV infection levels among pregnant women attending public antenatal clinics: from 22.4% in 1999 to 30.2% in 2005 (a 35% increase). Aim: The aim of this study was to assess sexual practices, the prevalence of condom usage and sexually transmitted diseases, and their associations among 930 men and women aged 15-60 years in Orange farm South Africa. Objectives: 1. To determine condom usage among males and females aged 15–60 year old. 2. To determine the number of new partners, short-term partners and unprotected sexual acts in this particular age group of men and women. 3. To assess the prevalence of sexually transmitted diseases in this age group. 4. To assess the relationship between sexual practices and sexually transmitted diseases in this community. Methods: The project was a secondary data analysis of a population-based, cross-sectional study was conducted in Orange Farm, South Africa in 2002. The original study involved 930 men and women respondents. A two-stage random sampling technique was used to select households. A self-weighting random sample of twenty households was chosen from clusters of 15 households. All men and women aged 15 to 60 years, who slept in the selected households the night before the study team’s visit, were eligible for inclusion in the study. The main focus of this secondary study was to analyze the baseline data collected for the level and risk factors for sexually transmitted diseases in this age group. All 930 men and women were included in the analysis. Results: The risk factor under consideration viz: condom usage was not optimal, and the prevalence of sexually transmitted disease is high in this population with HIV prevalence at 21.8%. Women in the age-group 15-24 years were disproportionately more affected by HIV in this community as compared to men. Among the HIV positive respondents, 61.8% had at least single or over 2 non-spousal partners in the last year. At the time of the interviews, 34.7% had never used condoms and 84.3% did not use condoms in any of the sexual episodes of the last month. Conclusion: An important goal is to practice partner reduction and to encourage especially those who are single to use condoms consistently. Further qualitative research on sexual behaviours involving focus group discussions, in-depth interviews or participant observation should be conducted in this community to complement the quantitative methods. They produce results that directly represent how people feel and provide information on behaviour through the observation of events and activities.

MSc (Med), Epidemiology and Biostatistics, University of the Witwatersrand / Introduction This secondary data analysis of a prospective cohort study set out to describe the association between the use of hormonal contraception and sexually transmitted infection (STI) acquisition in a cohort of 752 HIV negative women who were followed up for a year. Methods Outcome variables were measured by standard laboratory tests (PCR for Chlamydia trachomatis (CT) and Neiserria gonorrhoea (NG), culture for Trichomonas vaginalis (TV) and gram stain with Nugent score for Bacterial Vaginosis (BV). Exposure variable information was collected by structured interview. Basic descriptive statistics were applied to describe the characteristics of the cohort, including a comparison of women who used contraception and those who did not. A time series analysis including incidence rates for the outcomes (CT, NG, TV and BV), Kaplan Meier curves for time to event measurement and Cox regression models (univariate and multivariate), for the estimation of risk were applied. Results The analysis found no significant difference between women who use hormonal contraception and those who did not with respect to baseline demographic characteristics. Incidence rates per 100 women years to follow up with 95% confidence intervals were: CT 13 (7 to 17), NG 2 (1 to 4), TV 6 (4 to10), BV 72 (63 to 83). Kaplan Meier curves showed no significant difference in time to event between women who used contraception and those who did not. Adjusted hazard ratios for women who used contraception was 1.12 (0.69 to1.82) for CT, 0.47 (0.17 to 1.30) for NG, 1.06 (0.48 to 2.34) for TV and 0.27 (0.05 to 1.52) for BV. Conclusion This analysis did not reveal any significant associations between the use of hormonal contraception and the acquisition of STIs, however the trends in risks follow those reported in the literature.

Thesis (M.Pharm.)--University of the Witwatersrand, Faculty of Health Sciences, 2013. / Sexually transmitted infections (STIs) are a global concern and more specifically southern Africa has seen a tremendous upsurge in infection rates. KwaZulu-Natal is the province found to have the highest Human Immunodeficiency Virus and STI infection rates. From an ethnobotanical study conducted specifically in northern Maputaland (Mabibi, Tshongwe, Mseleni and Mbazwana), it was found that the lay people most often used plants in various combinations for the treatment of STI related symptoms. The use of these plant combinations were thus antimicrobially investigated and the toxicity properties determined. The dichloromethane: methanol (organic) and aqueous extracts were prepared for each plant in situ using collected ground dried plant material. The plants (individually and in combination) were investigated for toxic potential using the 3-[4,5-dimethyl-2-thiazol-yl]-2,5-diphenyl-2H-tetrazolium bromide (MTT) cellular viability assay on the human kidney epithelial (Graham) cell line. The antimicrobial activities for each sample, as well as for each combination, were then further investigated using the minimum inhibitory concentration (MIC) assay. The six STI pathogens investigated in this study were Candida albicans (ATCC 10321), Ureaplasma urealyticum (clinical strain), Oligella ureolytica (ATCC 43534), Gardnerella vaginalis (ATCC 14018), Trichomonas vaginalis (clinical strain) and Neisseria gonnorhoeae (ATCC 19424).

sami.alcedo@gmail.com / Background Millions of travellers around the world have gathered together into online communities. The objective is to analyse the factors associated with risky sexual behaviour among travellers. Methods Cross-sectional study was conducted within an online community of travellers using an online survey; we included travellers who had engaged in sexual activity while on their last trip. Risky sexual behaviour was defined as inconsistent condom use (<100%), and the factors associated were evaluated using the prevalence ratio (PR). Results Of the 468 participants, 245 had sex during their last trip. 59.7% did not consistently use condoms, and one out of every four participants reported never using condoms. Having a travel destination of Latin America or the Caribbean was significantly associated with inconsistent condom use. This association was maintained (PR 1.37, CI 95% 1.06–1.77) after adjusting for gender, age, migration, the presence of travel partners, and the use of drugs and alcohol prior to sexual activity. Conclusion An association was observed between travel destination (specifically Latin America or the Caribbean) and risky sexual behaviour. For this reason, tourists should be educated in STI transmission and regional STI and HIV incidences both before and during their travels; public health systems ought to work together with travel agencies, international airports, etc., in order to distribute this information and ensure a responsible travel experience. / Revisión por pares

Typescript (photocopy). / Digitized by Kansas Correctional Industries

A adolescÃncia à uma fase da vida caracterizada por diversos acontecimentos, dentre os quais se destaca o inÃcio da atividade sexual. PorÃm, devido Ãs modificaÃÃes advindas do processo de adolescer, as prÃticas sexuais, em muitos casos, sÃo realizadas de forma desprotegidas, com isso tornando o adolescente vulnerÃvel Ãs DST/Aids. Diante deste panorama, surge o enfermeiro para tentar intervir junto a este grupo com o intuito de prevenir Ãs DST/Aids. Uma das formas de se alcanÃar isto à por meio da educaÃÃo em saÃde que pode fazer uso de tecnologias educativas na sua prÃtica. Dentre os diversos tipos de tecnologias educativas destaque-se o jogo educativo que devido Ãs suas caracterÃsticas dinÃmicas e lÃdicas favorecem o processo ensino-aprendizagem dos adolescentes, sendo uma ferramenta importante na prevenÃÃo das DST/Aids na adolescÃncia. Com isto, este estudo teve o intuito de validar um jogo educativo, no auxÃlio da prevenÃÃo de adolescentes Ãs DST/Aids, em escolas pÃblicas de Fortaleza-CE e comparar a aquisiÃÃo do conhecimento dos adolescentes em relaÃÃo prevenÃÃo de DST/Aids usando o jogo educativo, a palestra expositiva e aula ministrada tradicionalmente. Trata-se de um estudo quase-experimental com abordagem quantitativa que foi dividido em duas fases, sendo que a primeira foi composta de 120 adolescentes e a segunda de 198 inicialmente. A primeira fase compreendeu a construÃÃo dos instrumentos de prà e pÃs-teste que foi utilizado na fase seguinte. Na segunda etapa ocorreu a aplicaÃÃo da intervenÃÃo propriamente dita, sendo que um grupo participou do jogo educativo que abordava a prevenÃÃo das DST/Aids, o segundo grupo participou de uma palestra ilustrada tambÃm sobre a mesma temÃtica e o terceiro grupo da aula ministrada em sala de aula pelo professor responsÃvel. O trÃs grupos responderam ao prÃ-teste antes da intervenÃÃo educativa e ao pÃs-teste vinte dias depois da intervenÃÃo realizada. A anÃlise dos dados ocorreu por meio de testes estatÃsticos do Software Statistical Package for Social Sciences (SPSS), versÃo 17.0 for Windows. Considerou significantes as anÃlises estatÃsticas inferenciais quando p < 0,05. Salienta-se que a anÃlise tambÃm ocorreu baseada na literatura da referente ao tema. Esta pesquisa atendeu os aspectos Ãticos, sendo aprovada com o protocolo nÃmero 229.369. A primeira etapa da pesquisa originou o prÃ-teste e o pÃs-teste com dez questÃes de mÃltipla-escolha, menciona-se que estes instrumentos foram oriundos de um questionÃrio com trinta questÃes. No que se refere à segunda etapa, foi verificado que nÃo houve diferenÃa estatisticamente significante entre as variÃveis sexo (p valor 0,168), sÃrie (p valor 0,509), moradia (p valor 0,905) e inÃcio da atividade sexual ( p valor 0,695). No que se refere Ãs diferenÃas estatisticamente significantes entre a aplicaÃÃo do jogo educativo, palestra expositiva e aula ministrada tradicionalmente, notou-se que nÃo houve diferenÃa entre a palestra e o jogo, mÃdia dos postos foram 2,1 e 2,45 respectivamente. No entanto quando comparado o jogo ao grupo que nÃo recebeu uma intervenÃÃo especÃfica, percebeu-se que houve diferenÃa (p valor < 0,001). Por meio deste estudo concluiu-se que o jogo educativo auxilia no processo educativo do adolescente assim como a palestra expositiva, no entanto melhor que nenhuma atividade especÃfica na prevenÃÃo de DST/Aids. / Adolescence is a stage of life characterized by several events. One of the most important is the sexual activity. But due to the resulting changes at the adolescent process, sexual practices, in many cases, are made of unprotected form, as a result of it, teenagers are becoming more vulnerable to sexual diseases like STD / AIDS. In order to prevent this, the nurse comes up to try to intervene with this group in order to prevent and inform them about STD / AIDS. One way to achieve this is through health education that can make use of educational technologies in their practice. Among the various types of educational technologies highlighted, the educational game, due to its dynamic and entertaining features, favors the teaching-learning process of adolescents, being an important tool in the prevention of STD / AIDS in adolescence. This study aimed to validate an educational game built to help with the prevention of adolescent STD / AIDS in public schools of Fortaleza city, and also to compare the acquisition of knowledge of adolescents regarding STD / AIDS educational game using the expository lecture and regular class. It was a quasi-experimental study with a quantitative approach that was divided into two phases, the first of which was composed of 120 adolescents and the second of, initially, 198 adolescents. The first phase included the construction of a pre- and a post-test that were used in the next step. However, the second step was the application of the intervention itself, and one group received the educational game that addressed to the prevention of STD / AIDS, the second group also attended an illustrated lecture on the same topic and the third group class taught in the classroom by the teacher responsible for the group . The three groups responded to the pretest before the educational intervention and the posttest twentieth day following the intervention performed. Data analysis was based on statistical tests of the Software Statistical Package for Social Sciences (SPSS) version 17.0 for Windows. Considered significant inferential statistical analysis at p < 0.05 . It is noted that the analysis was also based on the literature on the topic. This research meets the ethical aspects, being approved with the number 229 369 protocol. The first stage of this research contained the pre- and post-tests, each one composed by ten multiple-choice questions, which were derived from a previous thirty question questionnaire. Regarding the second step, no statistically significant differences in the results were found among the variables âgenderâ (p value 0.168), âgradeâ (p value 0.509), âdwellingâ (p value 0.905) and âearly sexual activityâ (p value 0.695). In regard to statistically significant differences between the application of the educational game, the expository lecture and the regular class, no relevant distinction was noticed through the results of the educational game and the expository lecture, for their average score were 2.1 and 2.45 respectively. However, when compared the results of the game to those of the group that did not receive a specific intervention, a difference was noticed in the outcome (p value <0.001). Through this study it was concluded that the educational game assists in the educational process of the adolescent as well as the illustrated lecture, however rather than any specific activity in the prevention of STD / AIDS.

CoordenaÃÃo de AperfeiÃoamento de Pessoal de NÃvel Superior / A violÃncia sexual caracteriza-se como um grave problema de saÃde pÃblica que acarreta distÃrbios no desenvolvimento biopsicossocial e sexual de suas vÃtimas, principalmente quando essa agressÃo ocorre na fase da adolescÃncia, pois esses sujeitos se encontram numa etapa da vida marcada por mudanÃas e adaptaÃÃes, especialmente no Ãmbito da sexualidade. Portanto, as crenÃas e valores das vitimas de violÃncia sexual precisam ser compreendidas para promover a adoÃÃo de comportamentos sexuais saudÃveis. Objetivou-se compreender como as crenÃas e valores das adolescentes vitimas de violÃncia sexual influenciam no comportamento de prevenÃÃo das DST e da AIDS com base no Modelo de CrenÃas em SaÃde (MCS) . Trata-se de uma pesquisa qualitativa, descritiva, realizada numa InstituiÃÃo de Acolhimento no Municipal de Fortaleza, no perÃodo de maio a julho de 2011, com oito adolescentes vitimas de violÃncia sexual. Foram utilizados como instrumentos e procedimentos para a coleta de informaÃÃes: a observaÃÃo participante de todos os encontros, que foram registrados no diÃrio de campo; todo o material produzido durante os grupos focais, como cartazes, desenhos, entre outros; e a transcriÃÃo da gravaÃÃo dos diÃlogos durante as estratÃgias de grupo e do roteiro de entrevista semiestruturada. As informaÃÃes foram organizadas conforme as dimensÃes do MCS. Todos os aspectos legais e Ãticos da pesquisa envolvendo os seres humanos foram respeitados. Inicialmente, foi necessÃrio caracterizar as participantes do estudo e observou-se que as histÃrias de vida dessas adolescentes estavam condizentes com a literatura. Em relaÃÃo Ãs categorias criadas conforme o MCS: as adolescentes tem um dÃfice de conhecimento em relaÃÃo a essas doenÃas e nÃo se consideraram susceptÃveis as DST/AIDS por acreditarem que nÃo irÃo se relacionar sexualmente com homens, mesmo identificando a maior vulnerabilidade da mulher a essas patologias; em relaÃÃo à percepÃÃo da gravidade, elas classificaram essas doenÃas como graves, incurÃveis e que alteram o convÃvio social, demonstrando medo de contrair uma dessas patologias; identificaram como benefÃcios e barreiras do mÃtodo preventivo ser de fÃcil acesso e utilizaÃÃo e prevenir tanto doenÃas como gravidez, mas interferem no prazer sexual; e seu uso està relacionado com questÃes culturais e sociais, ressalta-se tambÃm, que o abuso de Ãlcool e drogas intervÃm na adoÃÃo de comportamentos saudÃveis. Conclui-se que as crenÃas e valores dessas adolescentes as tornam vulnerÃveis a DST/AIDS, sendo necessÃrio refletir sobre as consequÃncias da violÃncia sexual na vida dessas adolescentes para a elaboraÃÃo de estratÃgias e aÃÃes preventivas voltadas para esse publico-alvo no que concerne ao desenvolvimento da sexualidade de forma segura, minimizando traumas e sofrimentos advindos dessa experiÃncia na vida dessas adolescentes, tornando-as conscientes dos seus direitos sexuais e reprodutivos. / Sexual assault is characterized as a serious public health problem that leads to disorders in the bio-psychosocial and sexual development of the victims, especially when the aggression happens in adolescence, because these subjects are in a stage of life marked by changes and adaptations, especially concerning sexuality. Therefore, the values and beliefs of the victims of sexual assault must be understood to promote the adoption of a healthy sexual behavior. It was aimed to understand how beliefs and values of adolescent victims of sexual assault influence the behavior of prevention of STD/AIDS based on the Health Belief Model. It is a qualitative descriptive research carried out at a Host Institution in the City of Fortaleza from May to July 2011 with eight adolescent victims of sexual assault. Using as tools and procedures for data collection: participant observation of all meetings, which were registered in a field diary; all the material produced during the focus groups, such as posters, drawings, among others; and the transcription of the dialogue recording during the group strategies and semi-structured interviews. The information was organized according to the Health Belief Model dimensions. All legal and ethical aspects of researches involving human beings were respected. Initially, it was necessary to characterize the study participants and it was found that the life stories of these adolescents were consistent with the literature. Regarding the categories created according to the Health Belief Model: the adolescents lack knowledge about these diseases and don't considered them susceptible to STD/AIDS because they believe that they will not relate sexually with men, in spite identifying the greater vulnerability of women to such pathologies; concerning the perception of gravity, they classified these diseases as serious, incurable, and that changes social life, demonstrating fear of contracting these diseases; they identified as benefits and barriers of preventive method: it is easy to access and use, and prevents both diseases as pregnancy, but interferes with sexual pleasure; and its use is related to cultural and social issues, we also emphasize that the abuse of alcohol and drugs interferes in the adoption of healthy behaviors. We conclude that the beliefs and values of these adolescents make them vulnerable to STD/AIDS, being necessary to reflect on the consequences of sexual violence in their lives to build strategies and preventive actions aimed at this target audience in terms of a safe development of sexuality, minimizing trauma and suffering resulting from this experience in their lives, making them aware of their sexual and reproductive rights.

Bibliography: leaves 103-113. Uses GIS to map the pattern of widespread transmission, commercial sex workers, poverty prevalence, illiteracy rate, population displacement and other social indicators to show the vulnerability of the region's population; and to demonstrate that there is no single point of radiation of HIV/AIDS in the sub region. Discusses mitigation and prevention strategies and proposes the use of GIS be incorporated in the fight against HIV/AIDS in sub Saharan Africa.