Sexually transmitted infections (STIs) and unplanned pregnancy are significant public health concerns. Abstinence-only until marriage (AOUM) and abstinence pledge programs have received a significant amount of government funding in an attempt to address these problems. Despite receiving over two billion dollars in funding, the programs have not been shown to be effective in achieving their stated goals. In addition, there are significant concerns about the content of AOUM curriculums, including medical inaccuracy and use of outdated gender stereotypes.

Background: Street-involved youth are known to be at a greatly increased risk of HIV and sexually transmitted infections (STIs); however, the role that environmental and structural factors play in driving disease transmission risk among this population has not been thoroughly examined. Methods: The At Risk Youth Study (ARYS) is a prospective cohort of homeless and street-involved youth between the ages of 14 and 26. From September 2005 to October 2006, participants completed a baseline questionnaire which elicited information regarding sexual activity, injection and non-injection drug use, addiction treatment experience, encounters with police and security guards, and health service utilization. Environmental and structural correlates of number of recent sex partners were identified using quasi-Poisson regression. Factors independently associated with consistent condom use were also examined using logistic regression. Results: Among 529 participants, 415 (78.4%) were sexually active during the past six months, of whom 253 (61.0%) reported multiple sex partners and 288 (69.6%) reported inconsistent condom use during this time period. In multivariate logistic regression, homelessness and self-reported structural barriers to accessing health services were inversely associated with consistent condom use. In multivariate analysis, living in a shelter, hostel, or single room occupancy hotel was positively associated with greater numbers of recent sex partners. Structural factors that were associated with number of sex partners included having a warrant or area restriction that affects access to health services, and for males, being accosted by the police. Conclusions: Unstable housing, homelessness, and structural factors related to the criminalization and displacement of street-involved youth were associated with an increased risk of HIV and STI transmission, even after extensive adjustment for sociodemographic and individual level characteristics. These findings suggest that both environmental and structural factors influence the spread of HIV and STIs, and point to the need for environmental-structural interventions to reduce the burden of these diseases among this population.

Clinical and epidemiological studies have provided a large body of evidence supporting a link between HIV and other sexually transmitted co-infections. Co-infections have been associated with promoting HIV transmission and acquisition. One of the closest studied interactions is the co-infection with N. gonorrhoeae, the etiological agent of gonorrhea, yet a clear understanding of this relationship is still elusive. Studies aimed at deciphering how N. gonorrhoeae mediates these effects have provided mixed results with some suggesting co-infection promotes HIV replication, and others suggesting the opposite. The aim of this thesis is to uncover molecular mechanisms that explain these results through in vitro co-infection studies using a combination of mixed peripheral mononuclear blood cells (PBMCs) and isolated human cell types. The results presented here demonstrate that gonococcal co-infection profoundly inhibits HIV replication in co-infected PBMCs. This inhibition is due to both the release of anti-HIV IFN via TLR9-mediated activation of plasmacytoid dendritic cells (pDCs), and the activation of  T cells. In addition, I show that responses between CD4+ T cell lines, such as the Jurkat cell line, and primary CD4+ T cells can differ, which may explain some of the contrasting results seen in published literature. The results in this thesis have implications for understanding the relationship between gonococci and HIV, providing new insight into molecular and immunological interactions that influence viral transmission, and reveal new opportunities to combat HIV.

Clinical and epidemiological studies have provided a large body of evidence supporting a link between HIV and other sexually transmitted co-infections. Co-infections have been associated with promoting HIV transmission and acquisition. One of the closest studied interactions is the co-infection with N. gonorrhoeae, the etiological agent of gonorrhea, yet a clear understanding of this relationship is still elusive. Studies aimed at deciphering how N. gonorrhoeae mediates these effects have provided mixed results with some suggesting co-infection promotes HIV replication, and others suggesting the opposite. The aim of this thesis is to uncover molecular mechanisms that explain these results through in vitro co-infection studies using a combination of mixed peripheral mononuclear blood cells (PBMCs) and isolated human cell types. The results presented here demonstrate that gonococcal co-infection profoundly inhibits HIV replication in co-infected PBMCs. This inhibition is due to both the release of anti-HIV IFN via TLR9-mediated activation of plasmacytoid dendritic cells (pDCs), and the activation of  T cells. In addition, I show that responses between CD4+ T cell lines, such as the Jurkat cell line, and primary CD4+ T cells can differ, which may explain some of the contrasting results seen in published literature. The results in this thesis have implications for understanding the relationship between gonococci and HIV, providing new insight into molecular and immunological interactions that influence viral transmission, and reveal new opportunities to combat HIV.

Sexually transmitted infections (STIs) and unplanned pregnancy are significant public health concerns. Abstinence-only until marriage (AOUM) and abstinence pledge programs have received a significant amount of government funding in an attempt to address these problems. Despite receiving over two billion dollars in funding, the programs have not been shown to be effective in achieving their stated goals. In addition, there are significant concerns about the content of AOUM curriculums, including medical inaccuracy and use of outdated gender stereotypes.

Background: Street-involved youth are known to be at a greatly increased risk of HIV and sexually transmitted infections (STIs); however, the role that environmental and structural factors play in driving disease transmission risk among this population has not been thoroughly examined. Methods: The At Risk Youth Study (ARYS) is a prospective cohort of homeless and street-involved youth between the ages of 14 and 26. From September 2005 to October 2006, participants completed a baseline questionnaire which elicited information regarding sexual activity, injection and non-injection drug use, addiction treatment experience, encounters with police and security guards, and health service utilization. Environmental and structural correlates of number of recent sex partners were identified using quasi-Poisson regression. Factors independently associated with consistent condom use were also examined using logistic regression. Results: Among 529 participants, 415 (78.4%) were sexually active during the past six months, of whom 253 (61.0%) reported multiple sex partners and 288 (69.6%) reported inconsistent condom use during this time period. In multivariate logistic regression, homelessness and self-reported structural barriers to accessing health services were inversely associated with consistent condom use. In multivariate analysis, living in a shelter, hostel, or single room occupancy hotel was positively associated with greater numbers of recent sex partners. Structural factors that were associated with number of sex partners included having a warrant or area restriction that affects access to health services, and for males, being accosted by the police. Conclusions: Unstable housing, homelessness, and structural factors related to the criminalization and displacement of street-involved youth were associated with an increased risk of HIV and STI transmission, even after extensive adjustment for sociodemographic and individual level characteristics. These findings suggest that both environmental and structural factors influence the spread of HIV and STIs, and point to the need for environmental-structural interventions to reduce the burden of these diseases among this population.

Background: Street-involved youth are known to be at a greatly increased risk of HIV and sexually transmitted infections (STIs); however, the role that environmental and structural factors play in driving disease transmission risk among this population has not been thoroughly examined. Methods: The At Risk Youth Study (ARYS) is a prospective cohort of homeless and street-involved youth between the ages of 14 and 26. From September 2005 to October 2006, participants completed a baseline questionnaire which elicited information regarding sexual activity, injection and non-injection drug use, addiction treatment experience, encounters with police and security guards, and health service utilization. Environmental and structural correlates of number of recent sex partners were identified using quasi-Poisson regression. Factors independently associated with consistent condom use were also examined using logistic regression. Results: Among 529 participants, 415 (78.4%) were sexually active during the past six months, of whom 253 (61.0%) reported multiple sex partners and 288 (69.6%) reported inconsistent condom use during this time period. In multivariate logistic regression, homelessness and self-reported structural barriers to accessing health services were inversely associated with consistent condom use. In multivariate analysis, living in a shelter, hostel, or single room occupancy hotel was positively associated with greater numbers of recent sex partners. Structural factors that were associated with number of sex partners included having a warrant or area restriction that affects access to health services, and for males, being accosted by the police. Conclusions: Unstable housing, homelessness, and structural factors related to the criminalization and displacement of street-involved youth were associated with an increased risk of HIV and STI transmission, even after extensive adjustment for sociodemographic and individual level characteristics. These findings suggest that both environmental and structural factors influence the spread of HIV and STIs, and point to the need for environmental-structural interventions to reduce the burden of these diseases among this population. / Medicine, Faculty of / Population and Public Health (SPPH), School of / Graduate

No description available.

Over the last decade, the incidence rates of many sexually transmitted infections (STI) have been on the rise, especially amongst young adults. Popular Canadian media outlets have speculated that the reason behind these increases is the use of mobile dating applications which foster romantic and sexual connections. This cross-sectional study assesses whether students who use mobile dating apps are more or less likely to have been diagnosed with an STI in the previous 12 months and engage in risky sexual behaviour, compared to students who did not use mobile dating apps in the previous 12 months. An anonymous online questionnaire was used to collect data from 965 study participants currently enrolled at an Ontario university. The survey required participants to self-report STI testing behaviour and diagnoses, as well as sexual behaviours, including number of sexual partners, relationship type, condom use, substance use and sex work. I found that Ontario university students who used dating apps in the previous 12 months were more likely to have a greater number of sexual partners in the previous year (p<0.05), have multiple concurrent sexual partners (OR=10.72, 95% CI: 6.10-18.84), frequently use alcohol (OR=3.94, 95% CI:2.17-7.14) and cannabis (OR=3.36, 95% CI:1.45-7.78) in combination with sexual activity, and were more likely to have been tested for STIs in the previous 12 months (OR=2.25, 95% CI: 1.73-2.94) compared to non-dating app users. However, mobile dating app users were not more likely to have been diagnosed with an STI in the previous 12 months compared to non-dating app users. / Thesis / Master of Public Health (MPH) / This study investigated whether students who use mobile dating apps are more or less likely to engage in risky sexual behavior, and to have been tested for and diagnosed with a sexually transmitted infection (STI) in the previous 12 months, compared to students who do not use mobile dating apps. An anonymous online survey was used to collect data on sexual behaviour and STI history from Ontario university students. I found that Ontario university students who used dating apps in the previous 12 months were more likely to have a greater number of sexual partners in the previous year, have multiple concurrent sexual partners, use alcohol and cannabis in combination with sexual activity, and get tested for STIs more frequently than non-dating app users. However, mobile dating app users were not more likely to have been diagnosed with an STI in the previous 12 months compared to non-dating app users.

This diploma thesis is focused to the analysis of sexual education on high schools in Liberec region. The most part of the diploma thesis is composed by the questionnaire survey which was perfomed on two comprehensive schools, two secondary schools and two vocational schools. The research attended the students of the third school classes only (18-19 years old). The questionnaire survey was focused to the students knowledge and attitude towards the sexual education. I have defined 9 hypothesis based on the research which were statistically analyzed after that. It appears that the students of comprehensive schools have better knowledges than the students from other secondary/vocational schools and that the knowledges are different among the boys and girls. The congizance of sexual education generally appear as good. The teachers paying attention to this topic during the lessons because they consider the theme important as well as the students. On the other hand the survey revealed that the students did not learn any news during the school lessons in this respect which they know more likely from the Internet. It shows importance to integrate the sexual lessons to the primary schools rather that. Key words: sexual education, contraception, sexually transmitted infection, questionnaire survey.