Objetivo: Caracterizar o conhecimento e uso de métodos anticoncepcionais entre adolescentes de escolas públicas. Métodos: Estudo transversal, realizado com amostra probabilística e representativa de 363 adolescentes, de ambos os sexos, que não viviam conjugalmente, com idades entre 13 e 17 anos, matriculados no período diurno, de escolas públicas, da zona urbana do município de Cruzeiro do Sul, Estado do Acre, em 2008. A pesquisa contemplou as exigências éticas. A caracterização de conhecimento e uso de métodos anticoncepcionais foi feita, a partir da aplicação de um questionário estruturado, contendo perguntas fechadas e abertas sobre sexualidade e métodos contraceptivos. Dados coletados foram digitados, revisados e processados. O banco de dados foi constituído e analisado, estatisticamente, com a utilização do software Epi Info (version 3.5.8; 2008). Os dados foram descritos, utilizando a estatística descritiva: distribuição de freqüência, medidas de tendência central e medida de dispersão. Para identificação de diferenças entre grupos de adolescentes foi utilizado o teste Quiquadrado de Pearson ou Exato de Fisher. Resultados: Dos 363 adolescentes, 55,4por cento eram do sexo feminino e 44,6por cento, do masculino, com média de idade de 14,7 (dp=1,3) anos; 32,0por cento afirmaram que haviam iniciado a vida sexual, as moças, com média de idade de 15,0 (dp=1,3) anos e os rapazes, com 13,3 (dp=1,3) anos; 98,9por cento referiram conhecer algum tipo de MAC, especialmente, o preservativo (95,3por cento) e a pílula (80,1por cento). Mais do que metade das moças e rapazes, respectivamente, 58,3por cento e 59,6por cento, referiram conhecer entre 1 e 4 tipos de MAC. Dentre os que iniciaram, ou não, a vida sexual, 78,4por cento e 65,6por cento, respectivamente, já tinham ouvido falar sobre dupla proteção. Dentre aqueles com vida sexual ativa, 79,3por cento das moças e 81,0por cento dos rapazes referiram terem feito uso de preservativo na primeira e na última relação sexual. Igualmente, 87,5por cento das garotas e 72,1por cento dos garotos, referiram fazer uso de camisinha em todas as relações sexuais. Conclusão: O alto nível de conhecimento de MAC e o elevado uso de preservativo sexual masculino entre esses adolescentes podem expressar resultados positivos das políticas públicas de saúde sexual e reprodutiva atuais, contribuindo para diminuição de gravidez não planejada e de infecções por doenças transmitidas por via sexual / To characterize the knowledge and use of contraceptive methods among public school students. Methods: Transversal study, accomplished with probabilistic and representative sample of 363 adolescents, man and woman, who didnt live conjugally, between 13 and 17 years old, matriculated in diurnal period, in public schools, in the urban area of Cruzeiro do Sul District, Acre State, in 2008. The research observed the ethic requirements. The characterization of the knowledge and use of contraceptive methods was done with the application of a structured questionary, containing open and closed questions about sexuality and contraceptive methods. The gathered data were digitated, revised and processed. The data bank was constituded and analyzed, statistically, using the software Epi Info (version 3.5:8; 2008). The data were described, using the descriptive statistic: frequency distribution, central trend measures and dispersion measure. For the identification of the differences among the adolescent groups it was used the Qui-square test of Pearson or Exact of Fisher. Results: From the 363 adolescents, 55,4per cent were female and 44,6per cent male, with average age of 14,7 (dp=1,3) years old; 32,0per cent told that they had begun sexual life, the girls with average age of 15,0 (dp=1,3) years old and the boys, with 13,3 (dp=1,3) years old; 98,9per cent affirmed to know some kind of MAC, especially the preservative (95,3per cent) and the contraceptive pills (80,1per cent). More than half of the girls and boys, respectively, 58,3per cent and 59,6per cent affirmed to know between 1 and 4 kinds of MAC. Among the ones who had begun, or not, sexual life, 78,4per cent and 65,6per cent, respectively, had already heard about double protection. Among the ones with active sexual life, 79,3per cent of the girls and 81,0per cent of the boys affirmed that they had already made use of preservative during the first and the last intercourse. Identically, 87,5per cent of the girls and 72,1per cent of the boys affirmed that they use condom in every intercourse. Conclusions: The high level of knowledge of MAC and the high use of male sexual preservative among those adolescents can express positive results of the current public sexual and reproductive health policies, contributing with the decrease of the non-planned pregnancy and infections by sexually transmitted diseases

Made available in DSpace on 2014-08-20T13:57:57Z (GMT). No. of bitstreams: 1 Dissertacao_Marilia_Arndt_Mesenburg.pdf: 360703 bytes, checksum: 042255bc103f9394c21e42d2f6a19b06 (MD5) Previous issue date: 2012-12-17 / Background: sexually transmitted diseases are an important public health problem worldwide, and the sexual behavior is a key factor for the susceptibility of these diseases. An evaluation of the sexual behavior of women in reproductive age was conducted in 1999. A replication of this study aims to evaluate the current situation and identify changes in the sexual behavior, after 13 years. Methods: it is a population-based cross-sectional study with a multistage sampling, conducted in a city in southern Brazil. Through a confidential self-applied questionnaire , we investigated the sexual behavior of 1071 women. Results: compared to the 1999 study it was observed in 2012 an increase of 14 percentage points in early sexual debut and a decrease of 8 percentage points in the non-use of condoms. The proportion of women who reported anal sex has doubled between the periods. There were no significant differences in the proportion of women reporting alcohol and drug use both by themselves and by their partners and multiple sexual partners, and there was no change in the perception of vulnerability. Conclusions: there was no trend of increase or decrease in the prevalence of the set of behaviors being observed distinct patterns for each of them. The decrease in the prevalence of non-use of condom use may be an indicator of the effectiveness of campaigns to promote safe sex. However, the increased prevalence of early sexual debut and anal sex indicates the need for campaigns to continue and to expand their focus, especially among high-risk groups. / Introdução: as doenças sexualmente transmissíveis são um grave problema de saúde mundial, sendo o comportamento sexual determinante da vulnerabilidade a essas doenças. Uma avaliação do comportamento sexual de mulheres em idade reprodutiva foi conduzida em 1999. A replicação dessa pesquisa tem como objetivo avaliar a atual situação e identificar mudanças no comportamento sexual, transcorridos 13 anos. Métodos: trata-se de estudo transversal de base populacional, com amostragem em múltiplos estágios, realizado em uma cidade no extremo sul do Brasil. Através de questionário confidencial auto aplicado, foi investigado o comportamento sexual de 1071 mulheres. Resultados: comparado ao estudo de 1999, observou-se, em 2012, um aumento de 14 pontos percentuais na iniciação sexual precoce e uma queda de 8 pontos percentuais na não utilização de preservativo. A proporção de mulheres que referiu a prática de sexo anal duplicou entre os períodos. Não foram verificadas diferenças significativas na proporção de mulheres que referiu uso de álcool ou droga próprio e pelo parceiro e múltiplos parceiros sexuais, assim como não houve alteração na percepção de vulnerabilidade. Conclusões: não foi observada tendência de aumento/diminuição na prevalência do conjunto de comportamentos, sendo verificados padrões distintos para cada um deles. A diminuição na prevalência de não utilização de preservativo pode refletir a efetividade das campanhas de promoção ao sexo seguro. No entanto, o aumento na prevalência de iniciação sexual precoce e prática de sexo anal indica, a necessidade de ampliação do foco destas campanhas e sua continuidade, especialmente entre os grupos de maior risco.

M.Cur. / An exploratory descriptive study was undertaken, focusing on sexually transmitted diseases among teenagers. The aim of the study was to explore and describe the possible reasons for the high rate of sexually transmitted diseases in teenagers. The knowledge, attitudes and opinions of teenagers and community nurses involved in the teenage clinic in a specific predominantly black area were assessed. Twenty teenagers and five community nurses in a specific predominantly black area, were participants in the study. Focus group interviews are used. The study is conducted in two phases: teenagers representing phase one (1) and community nurses as phase two (2). It can be concluded that the attitudes of community nurses may have an influence on the high rate of sexually transmitted diseases, and the knowledge of the teenagers about sexually transmitted diseases is based on myths and misconceptions. The recommendations made are that the training standards for all community nurses should be reviewed and adapted to meet the needs of teenagers attending the teenage services. The policy on in-service training must be reviewed and monitored. Community nurses' intensive training on teenage service delivery and sexually transmitted diseases services should be in correlation with the principles of Primary Health Care. Community nurses need to attend intensive courses on interpersonal skills specifically related to teenagers. Selection procedures for recruiting community nurses to attend specifically to teenagers should be researched. The attitude of community nurses and teenagers should be the core of the service delivery. Teenagers should be involved in planning programmes and the teenage clinic should be evaluated frequently to improve the standards. The availability of teenage services should result in a decrease in sexually transmitted diseases among teenagers.

Chlamydia trachomatis infections are associated with a spectrum of clinical diseases including urethritis, prostatitis and epididymitis among men and cervicitis and pelvic inflammatory disease (PID), with an increased risk of infertility and ectopic pregnancy (EP), among women. In the search for other pathogens causing urethritis, Mycoplasma genitalium was isolated from urethral specimens from two men with acute urethritis (1980). Mycoplasma bacteria are extremely difficult to isolate by culture, and clinical studies have been possible only after the advent of the first PCR-based detection method. M. genitalium has been found to be associated with lower genital tract infections in both men and women. Finding evidence for a connection between M. genitalium and upper genital tract infections in women is still of major importance. The aim in papers I and II was to develop a PCR method for genetic characterization of clinical C. trachomatis isolates by sequence analysis of the omp1 gene, and to study the distribution of genotypes within sexual networks and determine if genotyping would improve partner notification. The method was used to determine the genotypes of C. trachomatis in 237 positive urogenital and/or urine specimens from men and women attending the STDClinic in Örebro during one year. Sequence analysis of the omp1 gene revealed that the most prevalent genotypes corresponded to C. trachomatis serovar E (47%), followed by F (17%), and K (9%). There were 161 networks found and specimens were sequenced from at least two patients in 47 networks. In seven of these 47 networks there were discrepant genotypes. In the largest network comprising 26 individuals two different C. trachomatis genotypes were found, and one partner had urethritis due to a Mycoplasma genitalium infection but was C. trachomatis negative. The need for a new method for M. genitalium DNA detection was one reason for study III. An existing conventional PCR protocol for detection of M. genitalium DNA was further developed into a real-time PCR (RT-PCR) with hybridisation probes. In order to evaluate the RT-PCR assay with clinical material, specimens from 398 men and 301 women attending the STD Clinic in Örebro were analysed, using the RT-PCR assay, and also by the well established conventional PCR in Copenhagen. Using the conventional PCR method as “gold standard”, the sensitivity for the RT-PCR assay was 72.2% and 68.2% and the specificity was 99.7% and 98.6%, respectively, in urogenital specimens from men and women. The aim in paper IV was to adapt a Triton X-114 extracted Lipid-Associated Membrane Protein (LAMP) Enzyme Immuno Assays (EIA) method to detect antibodies against M. genitalium and to evaluate the association between M. genitalium and PID and EP, using sera sampled in Örebro during the 1980s, and also to compare the number of sera having M. genitalium antibodies against those having C. trachomatis antibodies, using a commercial anti- Chlamydia trachomatis EIA assay. No statistical significant association could be demonstrated between M. genitalium antibodies and PID or EP in our serum material. However, a slight trend toward association was found when focusing on younger individuals. Antibodies against C. trachomatis were found to be significantly associated with PID and EP.

M.A. / The purpose of this study was to determine if the PPASA Lifeskills HIV/AIDS programme is an effective sexuality programme for adolescents. The ANOVA was used to measure the effectiveness of the programme. The PPASA Lifeskill HIV/AIDS manual was used to present acceptable sexual knowledge, sexual behaviour and sexual values as well as attitudes. Some of the sources that were reviewed with regard to those variables are Greathead et al., Madima C., Taitz L., Kaplan P., Louw D. and Olivier M. The field experiment before and after control group (pretest-postest) design was used for the research. The Mathtech sexuality questionnaire is the instrument that was employed to measure the effectiveness of the PPASA Lifeskills HIV/AIDS programme with regard to sexual behaviour, knowledge, attitudes and values. The Anova was then used to compare means between different groups and to determine if the scores are statistically significant. Unanticipated results were produced, the experimental groups sexual behaviour got worse instead of improving. The experiential group’s data indicated that the group was not significantly better off on their sexual knowledge, behaviour and attitudes. The results do not necessarily mean that the PPASA Lifeskills HIV/AIDS programme is useless, the programme can be used effectively as long as issues like language of instruction, time frame for the presentation of the programme, information grading and the role of parents with regard to the sexuality of their children can be resolved. Future research should try to work on some of the above mentioned obstacles. Research should be well resourced, both in regard to time as well as the material. It is also important to look into that which makes sexuality education programmes fail and succeed. The school should be the main agent of presenting sexuality education. It should work towards breaking the African culture of regarding sexuality topics as taboo. Parents should also be encouraged to take part in educating their children and being there for their children all the time.

Previous studies have indicated an association between childhood sexual abuse (CSA) and an increased risk of engaging in unsafe behaviours during adulthood, including risky sexual practices. This study examined the relationship between CSA and adult HIV sexual risk behaviour among a sample of South African men who have sex with men (MSM). Potential pathological long-term mental health outcomes of CSA, including dissociation, sex-related substance abuse, depression, sexual compulsivity, impaired interpersonal communication, and over-reliance on submissive sexual scripts, were treated as variables mediating the relationship between CSA and sexual risk behaviour. Men frequenting a gay internet dating site were randomly selected to complete an electronic version of the anonymous survey. Results indicate that one-fourth of participants reported a history of CSA. Men with a history of unwanted sexual activity during childhood were more likely to report recreational substance abuse, sex-related substance abuse, sexual compulsivity, and adult revictimisation experiences. Men who were abused were also more likely to engage in unprotected anal intercourse compared to those who were not abused. Mediation analyses revealed that MSM who are survivors of CSA are particularly susceptible to drug abuse, sex-related drug abuse, and sexual compulsivity, and these sequelae in turn predict higher reported numbers of male sexual partners. The current data suggest that CSA is widespread among men at high risk for HIV infection, and that it may have a devastating influence on the quality of life and health risk behaviour of these men. These results also highlight the importance of mental health services and new approaches in HIV prevention for MSM who have been sexually abused as children. Further research is needed into the contextual factors of the childhood abuse experience which account for the variability in longterm negative mental health outcomes of CSA survivors.

This study sought to establish gender perceptual differences and their effects on the implementation of Policy in the prevention of HIV/AIDS in Makoni District, Zimbabwe. The role of women as caregivers to HIV/AIDS sufferers is also highlighted and how this has deprived them towards social, political and economic development. The source of the data used was the World Health Organisation (WHO) project on Family Planning and AIDS. The sample of the study comprised of 100 men and women from Makoni District, Zimbabwe. In addition to the survey question, focus group discussions (FGDs) were conducted. The FGD data complimented the survey results with qualitative information. The objectives of the study looked at people’s attitudes, cultural practices and sexual practices. These were analysed to determine how the gender issues within them affected the HIV/AIDS prevention strategies. The five major prevention strategies focused on in this study are: · promotion of condom use; · reduction of the number of sexual partners; · sticking to one sexual partner; · control and Treatment of Sexually Transmitted Diseases (STDs); and · Voluntary Counseling and Testing (VCT) for HIV to prevent vertical transmission of the disease. Although, the majority of the women indicated that it was acceptable for a married woman to ask her husband to use condoms, this was disputed by the findings from the FGDs. Issues of trust and fidelity were raised,but many men and women reported that they were not prepared to confront one another. The FGD results revealed that the men assert that it is normal for every man to have extra marital relationships, therefore they do not see anything wrong with it. It also came out that there are women who both have no income or partner to support them financially and are living in absolute poverty. These women, if anything, are more likely to increase the number of their sexual partners than reduce them so that they increase their economic base inorder to support their families. It has been established that for effective treatment and control of STDs, there is need for both partners to cooperate and seek treatment at the same time. However, the findings from this study revealed that lack of communication between sexual partners hampered the treatment of these diseases. On the other hand, the men indicated that talking to their wives about STDs would compel them to say where they got it. On the other hand the women reported that their men would accuse them of infidelity if they told them of an STD. FGD results however revealed that men and women were prepared to have HIV testing so that they would know of their status before planning a family. The gender perceptual differences on HIV/AIDS prevention have been identified as follows: · the need for male compliance to use condoms effectively; · the fear of losing trust by suggesting condom use; and · acceptance of male promiscuity by society that perpetuates that risky behaviour and exposure to HIV/AIDS infection and lack of communication between sexual partners, are a hindrance for effective control and treatment of STDs.

All six plants studied (Senna petersiana, Terminalia sericea, Cassine transvaalensis, Elephantorrhiza burkei, Rauvolfia caffra and Anredera cordifolia) proved to have considerable antibacterial activity. The water extracts of five of the six plants tested, showed activity against Bacillus pumilis, B. subtilis and Staphylococcus aureus respectively. Water extracts from S. petersiana showed a significant antibacterial activity by inhibiting all Gram-positive and two Gram-negative bacteria. A cytotoxicity assay of three plants (S. petersiana, T. sericea and A. cordifolia) on primary vervet monkey kidney ceelsl showed that A. cordifolia was the least cytotoxic extract with an ID50 value of 1.560 mg/ml. Both S. petersian and T. sericea showed an ID50 value of 0.024 mg/ml. Cytotoxicity as determined in this study does not necessarily mean that the active compound which can be isolated from these plants will also be toxic. Antiviral activity of S. petersiana, T. sericea and A. cordifoli crude extracts were investigated against herpes simplex virus type I at the non-toxic concentrations. Both T. sericea and A. cordifoli extracts showed to be non-active against HSV -I, but S. petersiana showed a 20 % reduction in replication of the virus after the sixth day of the experiment. Because of the sensitivity and instability of compounds in the root extract of S. petersiana, it was very difficult to isolate any pure compound. Bioassay-guided fractionation of the seeds of S. petersiana resulted in the isolation luteolin. Its structure was identified and confirmed through spectroscopic methods including IH, BC, UV, HMBC and HMBQ. An antibacterial assay of luteolin isolated from the seeds of S. petersiana showed activity against Baccilus cereus, B. pumilis, Streptococcus aureus and Staphylococcus areus at the concentration of I mg/ml. In the assay to assess the possible antiviral activity of luteolin against herpes simplex type I virus, 50% of the virus was inactivated at the concentration of 250 μg/ml. The results of this study have shown that it is possibl4e that the extracts studied, can provide humankind with valuable agents of potential use in the treatment of herpes and some bacterial species. / Dissertation (MSc ( Plant Physiology))--University of Pretoria, 2006. / Plant Science / unrestricted

Orientador: Paulo Eduardo Neves Ferreira Velho / Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas / Made available in DSpace on 2018-08-24T04:23:44Z (GMT). No. of bitstreams: 1 Castro_EneidaLazzarinide_M.pdf: 1114056 bytes, checksum: a5208169cfed868777391385bab148e2 (MD5) Previous issue date: 2013 / Resumo: Introdução: O ensino superior deve educar socialmente o cidadão, independente da sua área de conhecimento. As doenças sexualmente transmitidas (DST) são a principal causa global de doença aguda e morte e representam elevado custo socioeconômico. Os universitários são altamente expostos e ter outras infecções aumenta enormemente o risco de contrair o HIV. Objetivos: Avaliar o conhecimento de universitários sobre as DST, desenvolvendo um instrumento didático de autopercepção deste (des)conhecimento sobre o tema. Material e métodos: Um questionário foi enviado aos graduandos da Universidade Estadual de Campinas no final de 2011 e, em 2012, aos alunos recém-ingressos. Resultados e conclusões: Responderam o questionário 1.448 veteranos e 371 calouros. Metade era de cada sexo e houve representatividade de todas as áreas. Não tinham tido atividade sexual 20,0 e 38,0% dos veteranos e calouros, respectivamente. Dos alunos que já haviam tido, 26,9% não tinham parceria fixa e 28,2% mais que 2 parcerias/ano. A bissexualidade foi informada por 9,0% dos alunos, enquanto 5,8% dos homens e 1,1% das mulheres a homossexualidade. O preservativo foi usado por 99% dos alunos, mas menos de 20% deles fazia uso adequado do mesmo. Entre os alunos, 43% entenderam errado um slogan da campanha do governo. Cerca de 80% não sabiam que o preservativo não protege fora da área de barreira; não souberam identificar lesões de herpes simples e que não há cura para este vírus; quando apontadas lesões discretas da infecção pelo HPV, afirmaram que elas poderiam ser confundidas com "pintas"; pretendiam ler mais sobre DST e aprenderam algo sobre o assunto. Quase a metade dos alunos julgou que uma disciplina deveria ser oferecida a todos os graduandos. Vacinação pré-exposição poderia ter sido oferecida a mais de 43% dos calouros. Os dados encontrados serão úteis para definir estratégias de prevenção e o instrumento didático poderá ser utilizado em outros ambientes de ensino / Abstract: Higher education should educate students socially, regardless of their area of expertise. STDs are a global major cause of acute illness and death and represent high socioeconomic cost. Undergraduate students are highly exposed to them. Having other infection greatly increases the risk of contracting HIV. Our goals were to develop a teaching tool to generate perception of (un) knowledge about STDs and quantify that knowledge and the interest of the students in a course about this subject. A questionnaire was sent to students from State University of Campinas in late 2011 and, in 2012, to beginner students. The questionnaire was answered by 1,448 seniors and 371 freshmen. They were half of each gender and were representative of all areas. Twenty percent of seniors and 38,0% of freshmen had no sexual activity. Among the students that already had sexual activity, 26.9% had no regular partner and 28.2% had more than 2 partnerships a year. Bisexuality was reported by 9.0% of students, while 5.8% of men and 1.1% of female referred homosexuality. The condom was used by 99% of students, but less than 20% of them made proper use of it. Among the students, 43% misunderstood a slogan of the government campaign. About 80% of them did not know that condoms do not protect the outside barrier area; were not able to identify herpes simplex lesions and there is no cure for this virus; considered that discrete HPV lesions could be confused with nevus; wanted to read more about STDs; and learned something about the subject. Nearly half of the students felt that a course should be offered to all undergraduates. Pre-exposure vaccination could have been offered to more than 43% of freshmen. Our findings will be useful to help define strategies for prevention and the teaching tool might be used in other learning environments / Mestrado / Ensino em Saúde / Mestra em Clínica Médica

This study is an assessment of the quality of sexually transmitted disease (STD) management and control in a rural district of South Africa. A semi-structured questionnaire was administered to 5 nurses from public sector primary health care clinics, 5 doctors from the public district hospital, 5 private general practitioners, 6 traditional healers and 7 STD patients. A patient simulation exercise involving 6 nurses and 6 general practitioners was also conducted. Using routine data collection forms, the spectrum of STD syndromes and the contact tracing rate were assessed. The private sector treated nearly a third of the STDs even though they charge about ten times the price of the public sector services. In general, the clinical skills of all providers were poor. While hypothetical patient histories produced reasonable responses on STD management during the interviews, the patient simulation results showed that health service providers provided STD management that was much poorer than the questionnaires indicated. The private general practitioners did not practice syndromic STD management and often did not use laboratory tests appropriately resulting in incorrect diagnosis and inappropriate treatment for STDs. All health service providers did not counsel, promote condoms or encourage contact notification adequately. All health service providers were keen to participate in continuing medical education that better equip them to manage STDs. Any attempts at improving the quality of care in the district must therefore include private general practitioners as an important and central component of STD policy and planning. Interviews with traditional healers and patients showed the importance of using non-biomedical constructs of health and illness in developing health promotion strategies. There is an urgent need to improve STD management at district level in an attempt to meet the first milestone of ensuring that a patient presenting with an STD to a health service is correctly managed. This can be done through the design of simple quality assurance methods as demonstrated in this paper.