ABSTRACT Introduction: Sexually transmitted diseases (STDs) are serious problems for adolescents and young people. To protect adolescents from these diseases, there is a need to educate them on STD prevention by providing them with relevant information and equipping them with the life skills that will enable them to put knowledge into practice. It is recommended that STD-prevention programmes should take into account sex differences. However, limited data are available on how adolescent boys and girls differ in knowledge, attitudes, and practices regarding STD prevention in the same study setting. Aim: To examine sex differences in knowledge, attitudes, and practices regarding STD prevention among junior secondary school pupils in the Kassena-Nankana district, Ghana. Design: This research report is based on secondary data analysis of a cross-sectional knowledge,attitude, and practice survey of sexual and reproductive health conducted among junior secondary school pupils in the Kassena-Nankana district in 2005. The original survey had been carried out before the subject ‘Adolescent sexual and reproductive health’ was initiated in junior secondary schools in this district as an intervention study. Responses from 6,225 school pupils aged 10-19 years (3,011 schoolboys and 3,214 schoolgirls) were analysed using StataTM version 9.0 software. Results: The study found that school pupils had unsatisfactory knowledge about STDs; boys tended to be more knowledgeable than girls (p < 0.05). In terms of attitude towards condom use, a significantly higher percentage of boys (70%) compared with girls (61%) felt confident about insisting on condom use whenever they had sex. However, boys were more likely to be involved in sexual risk behaviours than girls. Eighteen percent of boys and 8% of girls reported being sexually experienced (p < 0.05). Boys started having sex earlier than girls (at 14.5 compared with 15.1 years, p < 0.05). Sixty-two percent of boys had sex with multiple partners compared with 32% of girls (p < 0.05). The mean number of lifetime sexual partners of boys and girls was 4.2 and 2.5, respectively (p < 0.05). The percentage of people reporting non-use of condoms during last sexual encounter was significantly higher among boys (37%) than girls (29%). Differences were observed in association of knowledge and attitudes regarding STD prevention with sexual activities among both boys and girls.

This study uses non-random and snowball sampling methodologies in order to get a truer insight into the life, activities and health care problems of 100 drug using prostitutes, and 50 non using prostitutes in Manchester, contacted directly in the streets or saunas / massage parlours. A subsidiary study of 120 male clients of female prostitutes was also conducted by means of self-completed questionnaires and telephone interviews. Among the sample in the main study of female prostitutes, drug users, 71% of whom were injecting users, were shown to have had a much more disrupted childhood than non users. They were also more likely to take risks in relation to condom use, to the type of sexual and drug taking activities they were engaged in, and to their general health care. A majority had been for an HIV test, with 2 reporting a positive result. Most of them (78%) had had at least one pregnancy, 10% of these making their first contact with health services whilst in labour. Access to methadone scripts tended to reduce criminal activity and rates of injecting, but only 13% had regular contact with community drug services which were not regarded as very useful. 4 The client study revealed that 62% of the sample were either married or living with a regular partner, and 86% in full time employment. One fifth had had a venereal disease check, and one fifth an HIV test (none reported positive). A majority used condoms (mostly supplied by the prostitute), although 23% reported not using one in their last contact. Clear implications arise from the study for the health, social services and criminal justice systems to ensure greater efforts are made to respond to the needs of female drug users.

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Approaches to projects and development have undergone considerable change in the last decade with significant policy shifts on governance, gender, poverty eradication, and environmental issues. Most recently this has led to the adoption and promotion of the sustainable livelihood (SL) approach. The adoption of the SL approach presents challenges to development interventions including: the future of projects and programmes, and sector wide approaches (SWAPs) and direct budgetary support.This paper `A livelihoods-grounded audit of the AIDS/STD programme in Uganda¿ the thirteenth in the series of project working papers. / Department for International Development

Drawing on the theoretical perspectives of Michel Foucault and Cindy Patton, this thesis takes a detailed and analytical look at HIV/AIDS prevention programs and literature published by U.S. public health organizations within the last decade. Of central interest is the distribution of sexual responsibility discourses advocating, implicitly or explicitly, individual self-control in the form of "safe(r) sex," with the interest to protect and sustain the "public health." The programs examined in this thesis advocate sexual responsibility and organize individuals into taxonomies defined by their risk. Individuals are classified as either "not risky" or "risky" and "responsible" or "irresponsible" through a complex relational system whereby their presumed behaviors are connected to specific identities; and specific identities are presumed to be indicative of presumed behaviors. This system, moreover, is stricly divided along exuality, racial/ethnic, and class lines. Thus, heterosexual, white, and middle- to upper-class persons are considered to be "not at risk" whereas any configuration of teh social markers of bi-/homosexual, African-American and Hispanic, and lower-class is considered to be "at risk." I term the specific type of responsibility proposed in these programs practical sexual responsibility. A direct consequence of the HIV/AIDS prevention programs is the classification of individuals into two distinct identity categories that correlate with their assumed level of risk. Practical sexual responsibility is a limited version of responsibility demanded of those assumed to be "risky."

This review of sexual education in the United States broadly defines the two most common approaches in sexual education seen in this country today. I cover the status of certain sexual behaviors and risks amongst the teenage population in the U.S. and specifically cover reported sexual activity in high school students and overall data on teen pregnancies and sexually transmitted infections (STIs). This work specifically looks at Maine, California, Texas, Maryland, North Carolina, and New Mexico to highlight the variety of state policies concerning sexual education and the differences in teenage sexual behaviors that exist within each of those six states. A description of how cultural influences can affect a young person’s sexual behavior is also given. In the final discussion section of this paper I have emphasized the need for more comprehensive sexual education programs in the United States and the importance of providing culturally sensitive programs in order to continue the fight against teenage pregnancy and STI rates in adolescents.

Increased awareness of protection against infections such as Hepatitis Band Human Immune-deficiency Virus (HIV)/ Acquired Immune Deficiency Syndrome (AIDS) and other sexually transmitted diseases has led to an increase in the demand for latex gloves and condoms leading to an increase in latex allergy. Besides latex, condoms also contain several undisclosed chemicals including antioxidants, accelerators, emulsifiers, stabilizers, lubricants, and in some cases flavourings and colourants. Though extensive testing is done to evaluate the physical quality of condoms, little information is available regarding the biological safety of condoms. In this study a modification of the direct cell culture testing method that is specified by the American Test Method F813-83 of 1998 was used to determine the cytotoxicity of the surface material of latex condoms prepared at time intervals that represents normal physiological exposure times T2, T4 and T8. The L929 cells were exposed to medium containing increasing amounts of condom washings (0-66%) for 20 hours. After exposure cell number and viability was determined using the Crystal violet (CV) and 3-(4,5-dimethyl-2-thiazolyl)-2,5-diphenyl-3H-tetrazolium bromide (MTI) assays respectively. Data was evaluated using a split-plot design with the appropriate Analysis of Variance (ANOVA). The effect of the condom washings on cell morphology and CV staining, MTI metabolism and Neutral red (NR) uptake at a fixed condom washing (16%) and exposure time T8 was evaluated microscopically. Cell membrane integrity was evaluated by Propidium iodide (PI) uptake and with PI staining after fixation and Hoechst 33324 (H33342) staining nuclear structure was evaluated with fluorescence microscopy. Apoptosis induced DNA fragmentation was evaluated by agarose gel electrophoresis. The effects of condom washings at 16% condom washing and exposure times T2, T4 and T8 was further evaluated in the HeLa cell line, a cell line in origin and type closer to that of the cervical lining. Cytotoxicity was evaluated using the CV, MTT and NR assays. In the L929 cell line, condom types Non-lubricated condoms (NLC), Lubricated condoms (LC) and Lubricated and flavoured condoms (LFC) behaved differently over time of exposure and the concentrations of condom washings. LFC were found to induce a decrease in cell number compared to other condom types, followed by LC and NLC revealed increases in cell number. Split-plot analysis, revealed that condom type x time (CT x Time) is significantly different due to the effect observed at T2 for LC. The MTT usually considered being more sensitive than the CV assay showed only toxicity for LFC and not for NLC and LC as with the CV assay. Exposure to LFC revealed significant decrease of 70 % decrease in cell viability at T8. Condom washings, LC, LFC and LFCC had no effect on cell morphology following CV staining. MTT metabolism and NR uptake was reduced and altered cell morphology was observed for L929 cells exposed to LFC and LFCC. Little PI uptake was observed for all cells exposed to condom washings. Condensed nuclei were observed for L929 cells exposed to LFC and LFCC while Hoechst staining revealed peripheral arrangement of DNA with Hoechst 33342 staining. Cell death in L929 cells were found to be mediated by apoptosis with L929 exposed to LFC showing the most damage. All effects of LFC is greater than that observed for LFCC indicating that other factors rather than the number of components present in each type of condom may account for toxicity. Toxicity of condom washings were compared to that found in the L929 cell line using the CV and MTT assays and an additional bioassay the NR assay was included. Condom types, LC, LFC and LFCC had a significant effect on cell viability and lysosomal membrane integrity. Differences observed between the L929 and HeLa cells were due to the increased viability observed for LC and the decrease in membrane integrity for LFC on HeLa cells. With LC and LFC no decrease in cell number and viability was observed as previously reported for the L929 cell line. Although no decreased in cell viability is observed for LFC a decrease of 75% in lysosomal membrane integrity is observed. The increase in cell viability found for HeLa exposed to LC (although statistically not significant) cannot be explained. Changes in cell viability and membrane integrity was only observed for HeLa cells, indicating that the HeLa cell line is more sensitive to the cytotoxic effects of condom washings. Furthermore the NR assay is a more sensitive assay than the MTT assay in detecting the cytotoxic effects of LFC condom washings at low concentrations. These are assays address only the effects of short-term exposure and not possible genotoxic effects that may occur following repeated and long-term exposure as reported in other latex products. / Dissertation (MSc (Anatomy))--University of Pretoria, 2006. / Anatomy / unrestricted

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Life-history strategies are adaptations in behavior, physiology, and anatomy that influence survival and reproductive success. Variation in life-history strategies is often determined by adaptations to environmental conditions and trade-offs with sexually-selected signals. One of the aspects controlling life-history trade-offs is the endocrine system. Testosterone is a hormone that mediates several key aspects of male reproduction, yet little is known about the causes and consequences of variation in testosterone. Using rufous-collared sparrows (Zonotrichia capensis), a Neotropical songbird with a wide distribution, I explored geographical patterns of variation in testosterone levels and infection by haemosporidians, a type of blood parasite. I found that testosterone did not vary with elevation, nor predict haemosporidian infection, but males in breeding condition were more likely to be infected (Chapter I). High levels of testosterone have been associated with an increased number of sexual contacts and can suppress the immune response, thus it may increase the risk of sexually transmitted infections. By studying the communities of bacteria that reside in the cloaca of birds, I found that they were different depending on testosterone levels, and that high-testosterone males had higher relative abundance of Chlamydiae, a class of intracellular pathogens (Chapter II). During the breeding season there is an increase in physical contacts among individuals, testosterone levels increase in males, and there are additional energetic demands, all of which can increase exposure to bacteria or facilitate infection. I compared the cloacal microbiome of the same individuals between breeding and non-breeding seasons, and found that in males, but not in females, bacterial richness and phylogenetic diversity increased when birds were in reproductive condition. This suggested that the cloacal microbiome in birds is dynamic and responsive to breeding condition and sex of the host (Chapter III). Lastly, I synthesized the most relevant findings and suggested directions for future work (Chapter IV). I conclude that variation in testosterone is not always associated with immune suppression, and that the links among reproductive physiology, behavior, and the microbiome can provide insight into the evolution of life-history strategies. / Ph. D.

We create a dynamic network model to replicate more closely the population network structures of interest. Network, Norms and HIV/STI Risk Among Youth (NNAHRAY) is a community relationship survey data set, which provides a rare sample of a human risky-behavior contact network. Combining disease compartmental models with our dynamic network model, we simulate the spread of Human Immunodeficiency Virus (HIV) and Herpes Simplex Type 2 Virus (HSV2) with consideration of HSV2's synergistic impact on HIV's transmission. Our model reproduces HIV prevalence, HSV-2 prevalence, and the contact network close to those observed in NNAHRAY, with HIV annual prevalence closer to the estimated values from the literature than those of any disease spread model based on static networks. The success of fitting our model to the target data shows the importance of considering the data sampling process, contact dynamics, and contact network structures. Our model, under certain conditions, has prevalence prediction results that are insensitive to changes in network size. The analysis of various prevention/intervention strategies targeting different risky groups gives important insights into strategy prioritization and illustrates how our model can be used to assist in making public health policy decisions in practice, both for individual diseases and in the more-recent area of study that considers synergy between two diseases.