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Thesis (M.A. (Clinical Psychology)) -- University of Limpopo, 2022 / Sexually transmitted infections (STIs) remain a serious global health challenge, which if left untreated, may threaten an individual’s health. The challenge regarding the prevention of STI transmission is the asymptomatic nature of STIs during their early stages. Hence, STI testing is vital in tackling the devastating impact of STIs. The Health Belief Model (HBM) provided a lens through which to understand the study as it provides a basis upon which to predict health behaviours. The study employed a qualitative research method. The study aimed to explore University of Limpopo students’ perceptions towards STI testing. The objectives of the study were (1) to establish the perceptions of second-year Psychology students at the University of Limpopo towards STI testing, and (2) to determine the importance of testing for STIs among second-year Psychology students at the University of Limpopo. The study purposively sampled 15 second-year Psychology students at the University of Limpopo. It was found that the participants were knowledgeable about STI testing. The study revealed psychological effects associated with STI testing ranging from anxiety-related attacks, stress, depression, and insomnia, among others. It further revealed important aspects learned about STI testing, i.e. that some STIs are curable, early detection facilitate early treatment, and STIs are not a myth. The importance of STI testing was also determined. It was also noted that it is important to know one’s health status to prevent mother-to-child transmission and health consequences. The study further established the experiences of STI testing, such as anxiety, stress, feeling embarrassed, ashamed, and overwhelmed. In addition, it was found that students are reluctant to test for STIs because of low-risk perception of contracting STIs, the fear of receiving positive test results, lack of knowledge, stigma, and the judgemental attitude of health professionals. The findings also revealed that students consider testing to be a good health behaviour, although the majority of them rarely consult for STI testing. Constructive counselling is highly recommended for those who consult for STI testing. It is further recommended that future research should be conducted in other universities with broader sample size.

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.

<p>Curricula should be strengthened by teaching the curability of STIs and the importance of STI treatment to prevent HIV transmission. This study focused on the control of sexually transmitted infections as a key HIV prevention strategy. Sexually transmitted infections act as a strong cofactor in the sexual transmission of HIV. Effective STI management can limit the spread of HIV.</p>

The aim of this study was to examine sexual behavior, contraceptive use, self-rated health, lifestyle factors and the prevalence of HPV vaccination among last year high school students. The study was a quantitative cross-sectional study which was a substudy of the longitudinal study " Pornography, Youth and Health". Results showed that the majority of students had had sexual intercourse (75 %, n=524) and both performed (67 %, n=479) and received oralsex (70 %, n=498). Forty percent (n=282) of the students had had one night stand, a quarter (n=159) anal sex and 29 (n=202) percent sex with a friend. The contraceptive use increased from the first to the last intercourse while the use of condoms decreased. Five percent (n=38) of the students reported a sexually transmitted disease, more women than men. Significant difference in sexual experience was shown between students in vocational versus theoretical study programs, between students with low and high self-rated health as well as between students with low versus high risk behavior regarding lifestyle factors. Two thirds of the female students were vaccinated against HPV. No significant difference regarding condom use was shown between the female students who were vaccinated against HPV compared with non-vaccinated. The knowledge of existing differences between gender, between students at different high school programs and attention to risk factors can improve sex education and contraceptive counseling in which the midwife has an important role. / Syftet med föreliggande studie var att undersöka sexualvanor, preventivmedelsanvändning, egen upplevd hälsa, livsstilsfaktorer och förekomsten av HPV-vaccination bland elever som gick sista året på gymnasiet. Studien var en kvantitativ tvärsnittsstudie som var en del av den longitudinella studien "Pornografi, ungdomar och hälsa". Resultat visade att majoriteten av eleverna hade haft samlag (75 %, n=524) samt både givit (67 %, n=479) och fått oralsex (70 %, n=498). Fyrtio procent (n=282) av eleverna hade haft one night stand, en fjärdedel (n=159) analsex och 29 procent (n=202) sex med en kompis. Preventivmedelsanvändningen ökade från första samlaget till det senaste medan kondomanvändningen minskade. Fem procent (n=38) av eleverna hade haft en könssjukdom, fler kvinnor än män. Signifikanta skillnader avseende sexuella erfarenheter fanns mellan elever på yrkesförberedande- respektive studieförberedande gymnasieprogram, mellan elever med låg- och hög självskattad hälsa samt mellan elever med lågt- och högt riskbeteende beträffande livsstilsfaktorer. Två tredjedelar av de kvinnliga eleverna var vaccinerade mot HPV. Ingen signifikant skillnad med avseende på kondomanvändning fanns mellan de kvinnliga eleverna som var vaccinerade respektive ej vaccinerade mot HPV. Kunskap om dessa skillnader mellan kön och mellan elever på olika studieprogram samt att riskfaktorer uppmärksammas kan förbättra sexualundervisning och preventivmedelsrådgivning i vilka barnmorskan har en viktig roll.

A total of 425 questionnaire-based interviews and 15 in-depth interviews with FSWs in Nepal including non-participant observation in the field were conducted in 2006. The age range of the FSWs participated was 15-46 years.  FSWs (30.8%) reported having had STI symptoms in presences 12 month.  The quantitative findings suggested that many reported having used condoms during their last sexual intercourse, but in-depth interviews suggested the opposite.  One fifth (21%) had never visited health facilities.  Of those who visited, 149 (50.3%) turned to a private clinic and pharmacy; 181 (61.1%) used Non-Governmental Organisation (NGO) clinics, 79 (26.6%) resorted to care in hospital and 30 (10.1%) treated themselves.  The remainder 85 (28.7%) were found to seek help from primary health care centre, health posts, family planning clinic or other health institutions for treatment.  The behaviour theories and models used in this study (i.e. health belief model, theory of reasoned action and planned behaviour) partly explain the decisions of FSW on use and non-use of available health services.  The study identified that lack of confidentiality and privacy created distrust among FSWs and stopped them from accessing health services.  Embarrassment, disregard by health care providers and poor communication with them, long waiting time and fear of exposure as a sex worker were major barriers to seeking health services. It is therefore necessary to provide specific training to service providers in all types of health care institutions in order to promote confidential and quality health services.

Degree of Masters in Public Health by coursework and research report Maternal and Child Johannesburg, March 2012 / Adolescent sexual behaviour related to low condom-use and early sexual debut has been a concern in the transmission of sexually transmitted infections (STIs) and HIV. Treatment-seeking behaviour is a problem in adolescents due to embarrassment and unfriendly health care services. The Birth to Twenty study group (Bt20) is a cohort of singletons born in 1990 with approximately 10% having tested positive for STIs at an early age. Their sexually activity and unprotected sex practices have increased their risk for HIV infection. The objectives of this study were to explore the perceptions, sexual behaviour and treatment-seeking behaviour of a sample of girls who had a previous STI, through their narratives. One-on-one narrative interviews were done on 19 girls with the aid of an interview schedule. A life history of their sexual encounters was documented. The interviews were taped and transcribed. Thematic analysis was performed. The majority of the girls had no knowledge of STIs before they were counselled by the Bt20 nurses yet 50% of the girls used condoms in their first sexual experiences. Once counselled, almost all the girls went on to seek treatment for their STI. A third of the girls reported poor service at the clinic and would prefer to be treated either privately or at Bt20 if possible. Information regarding the role of STIs in the transmission of HIV seems to be unclear. Improving the life orientation programme at schools with a focus on STIs and pregnancy would positively impact on HIV transmission. One-on-one counselling is effective but may not be feasible in under-resourced communities and the continued education of nurses in clinics, whilst increasing the number of adolescent friendly clinics, must be prioritised.

This dissertation discusses anti-HIV-1 microbicide research. In particular, it concentrates on microbicide formulation and delivery. Microbicides are anti-HIV-1 agents that when applied in the human vagina or rectum may prevent sexual HIV-1 transmission. Although most of the anti-HIV-1 agents being developed as microbicides are active in vitro, they have proved to be ineffective in vivo. A review of microbicide development over the last decade expounds the view that unsatisfactory microbicide failures may be a result of inefficient delivery systems employed. Thus, necessitating a thorough scientific qualitative and quantitative investigation of important aspects involved in HIV-1 transmission as a prerequisite for microbicide development. In this dissertation it is postulated that intravaginal targeting of HIV-1 increases the chances of microbicide success, wherein vaginal micro-environmental factors including pH would be maintained at HIV-1 prohibitive acidic levels to ward off other sexually transmitted diseases which compromise vaginal epithelial barrier properties. Furthermore, targeting early stages of the HIV-1 infection accompanied by computation and delivery of appropriate microbicide quantities could result in an effective microbicide formulation. In an effort to address microbicide formulation challenges, an intravaginal delivery system able to deliver anti-HIV-1 agents (zidovudine and BP36) over 28 days was formulated. This delivery system is a caplet-shaped composite system comprising zidovudine (AZT) and BP36-loaded pectin-mucin-polyethylene glycol submicrospheres embedded within a poly(D,L-lactide), magnesium stearate, polyvinyl acetate/polyvinylpyrolidone (Kollidon® SR) and poly(acrylic acid) based polymeric caplet matrix. The delivery system was tested in vitro and in vivo in the pig model. X-ray imaging illustrated the delivery system swelling and its matrix contrast fading over time as vaginal fluid permeated the matrix’s core. Plasma, vaginal fluid and tissue drug was detected and quantified using ultra performance liquid chromatography-tandem photodiode array detector. AZT plasma and vaginal fluid concentrations measured on days; 3, 7, 14, 21 and 28 decreased gradually with time. Vaginal tissue AZT concentrations (after 28 days) were higher than plasma AZT concentrations and were in the same range as vaginal fluid AZT concentrations. The herbal extract, BP36, was detected in plasma, vaginal fluid and tissue but was only qualitatively analysed due to its lack of standardization. Histopathological analysis of excised vaginal tissue revealed different scores of abnormalities comprising mild to moderate epithelial proliferation and exocytosis, subepithelial leukocyte influx, perivascular cell cuffing and isolated epithelial erosion, stromal fibrosis and isolated tissue necrosis.

Background This report examined the association and relationship between Migration, Gender and STIs among young adults in Lesotho. To achieve this, the first objective was to understand the historical trans-boundary relationship between Lesotho and South Africa and how it contributed to STIs among young adults in Lesotho. The report then described the relationship between migration and having had any STIs among young adults in Lesotho. After multivariate analysis the association, between gender and having had any STIs among young adults in Lesotho was explored for understanding. Methodology For data analysis, secondary data from the 2009 Lesotho Demographic Health Survey (LDHS) were used. The LDHS is a cross-sectional study, designed to provide estimates of health and demographic indicators at the national level, for urban-rural areas and for each of the ten districts in Lesotho. The sample size used for this report was N=6,270. The statistical methods employed for data analysis were descriptive analysis, to establish the distribution of young adult migrant groups, according to STIs, demographic, socioeconomic and sexual practices. A Chi-square test was done to test for association. And a multivariate analysis was done using the forward selection process, to examine the relationships between STIs, migration, gender and significant variables. Results Migration status was found to have an insignificant (p=0.237) association with STIs. On the other hand, after considering migration status and gender at multivariate level, migration status, specifically urban-non migrants, were found to have a significant (p<0.05) relationship with having had any STIs. Gender was found to have an insignificant (p=0.587) association with having had any STIs and an insignificant (p=0.365) relationship with having had any STIs. However at multivariate level being female was found to be 16% protective against having had any STIs. Conclusion The report found that the relationships between migration status and having had any STIs were closely linked to factors related to gender and social and cultural norms pertaining to sexual behaviour. These influences were reflected in the literature and empirical evidence of this research report.

Orientador: Lenice do Rosário de Souza / Coorientador: Hélio Amante Miot / Banca: Marli Terezinha Cassamassimo Duarte / Banca: Walter Belda Junior / Resumo: A infecção pelo HPV é a DST mais comum no mundo. Dos 630 milhões de casos novos anuais, trinta milhões são relacionados a verrugas anogenitais. Embora a forma subclínica seja mais comum, o aparecimento de condilomas também está associado à diminuição da imunidade causada pelo HIV. Tendo em vista as altas taxas de prevalência da coinfecção HPV/HIV, principalmente entre homens que fazem sexo com homens, os objetivos deste trabalho foram analisar a prevalência de verrugas anogenitais em homens portadores de HIV/aids e identificar fatores associados. Estudo transversal, descritivo e analítico com 159 homens atendidos em serviço de referência de Botucatu (SP). Dados sociodemográficos, comportamentais e clínicos foram relacionados ou não à presença de verrugas anogenitais. Após análise hierárquica dos dados, as variáveis com valor de p menor do que 0,2 foram incluídas no modelo logístico multivariado não condicional. Foram diagnosticados 49 (31,0%) pacientes HIV+ com verrugas anogenitais, cuja média de idade foi de 44,6 ± 9,6 anos. Os principais fatores associados às verrugas foram: escolaridade menor que ou igual a oito anos; maior tempo de diagnóstico do HIV; tratamento antirretroviral irregular; baixas contagens de linfócitos T CD4+. Verrugas anogenitais são prevalentes e relacionadas à imunossupressão da infecção pelo HIV. Ações como o cuidado integral do paciente e educação e prevenção em saúde colaboram para diagnóstico precoce e diminuição da vulnerabilidade a DSTs / Abstract: HPV infection is the most usual STD in the world responsible for 630 million new cases annually, of which 30 million are related with anogenital warts. Although subclinical form is the most common, warts are also associated with reduction of HV-related immunity. There are high rates involving prevalence of the association HIV/HPV around the world. Following this point of view the aim of this study was analyze the prevalence of wart in HIV-infected men and describe the associated factors. cared by a reference service in the Botucatu city - São Paulo/Brazil. Sociodemographic, behavioral and clinical data were collected by an individual interview and medical records. There were 49 (31,0%) HIV-infected men with anogenital warts with mean age of 44,6 ± 9,6 years. The main associated factors were: have up to 8 years of study; longer duration of HIV-infection; irregular treatment to HIV-infection; lower counts of lymphocytes T CD4+. Genital warts are prevalent and are associated with HIV- infection magnitude. Actions such as the complete care over the patients, increasing the education and prevention in health system could help to do a previously, diagnosis and decreasing the vulnerability to STD / Mestre