<p>This study assessed the knowledge, attitudes and practices about MC as an HIV prevention intervention among adult males presenting for HIV Voluntary Counselling and Testing (VCT) services at Onandjokwe District Hospital in northern Namibia. A high level of knowledge of MC, particularly its potential to reduce the risk of HIV infection, STIs and enhance penile hygiene exists among VCT attendees in Onandjokwe District Hospital. MC will most likely to be accepted in this study area, especially when it is implemented to reduce the risk of HIV infection. The study recommends a comprehensive education and information program targeting males and their partners and a training for traditional and medical circumcisers to ensure a high quality of MC services.</p>

The overall aim of the present thesis is to contribute to the knowledge in young people´s experiences, thoughts and norms regarding sexually transmitted infections (STI) and sexual risk-taking. The specific aims are two-fold. The first aim is to explain and understand young Swedish men and women´s lived experience of an STI, in this case genital warts (I, II). The second is to explain and understand the values and attitudes of young men and women to sexual risk-taking (III) in relation to perceptions of gender (IV).   The theoretical perspectives are a reflective lifeworld approach, hermeneutic and gender perspectives. The thesis is based on individual interviews (I, II) and focus groups (III, IV).  The results show that a young person infected by an STI, will experience encounters at different levels. A person with an STI is forced to meet him/herself and their own prejudices. Loss of innocence is highly significant and symbolic for women, while other person´s attitudes are more important for men (I, II). Also, being a disease carrier is of great significance, which has an impact on their views of future meaningful relationships (II).      Sexual risk-taking, such as it was expressed in the focus groups with young people, revealed a pattern that is described as a ‘game’. In that game, a dialogue might feel more intimate than intercourse. These teenagers often view their one night stand partners as objects, as opposed to love relationships where they are viewed as subjects, i.e. persons to be cared for. Engaging in sexual risk-taking often starts at a club where these teenagers pretend that they are spontaneous (III). This game is further illuminated in a secondary analysis with a gender perspective. There are frequent misunderstandings between young men and women that are based on gender constructions, which derive from lack of communication. Hence, they have to take part in a balancing act while shaping their sexual identity and trying to maintain their self-esteem. For these young women, this also concerns not getting a bad reputation. In this act of balance, it is difficult to discuss sexuality and how to protect one’s sexual health (IV). The discussion emphasizes that a professional caring dialogue with young people about STI: s and sexual-risk taking must have reference in the young person´s own reality. Thus, professional health care workers who meet a young person infected with an STI appear to face a challenging task. This involves helping reduce anxiety by defusing the situation, and at the same time to make the person understand the importance of using a condom in order to prevent STI: s.

Millions of people in the world are infected by HIV/AIDS or/and other Sexually Transmitted Infections, STIs. Ethiopia is, with its population on almost 94 million people, one of the worst affected countries. One of the methods that are used in the prevention work in order to combat the spread of HIV/AIDS and STIs in Ethiopia is Social Marketing, a concept that adopts traditional marketing techniques in order to obtain social change. This inductive study explores how three various Ethiopian organizations are utilizing Social Marketing in their HIV/AIDS and STI prevention work throughout Ethiopia, how the concept can be used to achieve attitudinal- and behavioral change by people, as well as if the organization’s various Social Marketing projects strive to provide vulnerable groups of the Ethiopian society with empowerment, and if so, in what ways. The empirical material was collected through six qualitative interviews and two focus group discussions during an eight-week long stay in Ethiopia during March-May, 2012. The findings of this study have been analyzed through theories about human behavior with a focus on behavior change, as well as various definitions and concepts of empowerment. The study’s result shows that Social Marketing can be utilized in several ways in the HIV/AIDS and STI prevention work in Ethiopia to obtain attitudinal- and behavior changes, for instance by using various commercial techniques, street campaigns, information/education/behavioral change materials, as well as trainings, outreach work and peer education, which aims to educate people about HIV/AIDS, STIs, condoms and condom use. The organization’s joint Social Marketing project “Wise Up-program” includes Drop In Centers and Cooperative Activity for sex workers. The findings of this essay shows that these projects do strive to provide vulnerable groups of the Ethiopian society with empowerment, psychologically as well as economically.

Introduction. Sexually transmitted infections (STIs) continue to be highly prevalent among young women, and STIs continue to be a challenging health issue on college campuses. Studies have shown that the highest prevalence of human papillomavirus (HPV) is among young adult women, ages 20 to 24, including female college students. While the HPV vaccine has proven to be highly effective in preventing certain high-risk types of HPV, it is not effective in preventing all types of HPV or other STIs. Practicing other safer sex behaviors, in addition to condom use, also can help individuals protect themselves and their partners from acquiring HPV and other STIs. Purpose. Relationships between knowledge about HPV and the HPV vaccine, beliefs about HPV, acceptance of the HPV vaccine, and intentions to practice safer sex behaviors were assessed to determine if female college students who had a high acceptance of the HPV vaccine were also more likely to practice safer sex behaviors. Methods. A convenience sample of 2,706 undergraduate female college students, ages 18 to 24, from three U.S. public universities, completed an online survey that measured the following study variables: knowledge about HPV; knowledge about the HPV vaccine; acceptance of the HPV vaccine, specifically influential factors and barriers to vaccination; as well as attitudes, normative beliefs, control beliefs and intentions for practicing safer sex behaviors. Results. The majority of participants had a high level of knowledge of HPV (70.4%) and the HPV vaccine (73.7%). Over one-third of the participants (37.3%) received at least one dose of the HPV vaccine. Most participants thought they had a low susceptibility to HPV, as 54% thought they were unlikely to contract HPV; however, most (53.6%) thought that HPV would be a serious problem for them. The safer sex behavior that participants thought was the easiest was refusing to have sex with a partner that would not use a condom (51.8% “Strongly agree”) and the safer sex behavior that participants thought to be the most difficult was asking a partner to get tested for STIs (54.5% “Disagree”). Attitudes, normative beliefs, and control beliefs combined to strongly predict intentions (R = .730, p < .001), and attitudes was the strongest predictor for intentions to practice safer sex behaviors (β = .666), 95% CI [.649, .711]. There was a significant positive correlation between vaccine acceptance and intentions to practice safer sex behaviors (r = .087, p < .001), including likelihood of getting vaccinated against HPV (r = .098, p < .001). Conclusions. Findings from this study demonstrate the need for university student health centers to provide information about the HPV vaccine as part of broader STI prevention and social marketing campaigns, targeting female college students who are single, as well as those in monogamous relationships. Furthermore, because young men can be carriers of HPV and the HPV vaccine is now available to them, follow-up studies are needed to determine acceptance of the HPV vaccine among male college students as it relates to HPV knowledge, knowledge of the vaccine, and intentions to practice safer sex behaviors.

<p>This study assessed the knowledge, attitudes and practices about MC as an HIV prevention intervention among adult males presenting for HIV Voluntary Counselling and Testing (VCT) services at Onandjokwe District Hospital in northern Namibia. A high level of knowledge of MC, particularly its potential to reduce the risk of HIV infection, STIs and enhance penile hygiene exists among VCT attendees in Onandjokwe District Hospital. MC will most likely to be accepted in this study area, especially when it is implemented to reduce the risk of HIV infection. The study recommends a comprehensive education and information program targeting males and their partners and a training for traditional and medical circumcisers to ensure a high quality of MC services.</p>

Submitted by Alisson Mota (alisson.davidbeckam@gmail.com) on 2015-07-07T20:52:04Z No. of bitstreams: 1 Danielle Albuquerque Pires Rocha.pdf: 1640322 bytes, checksum: 517abde36a5e28961792c6d782a3d48b (MD5) / Approved for entry into archive by Divisão de Documentação/BC Biblioteca Central (ddbc@ufam.edu.br) on 2015-07-09T13:44:24Z (GMT) No. of bitstreams: 1 Danielle Albuquerque Pires Rocha.pdf: 1640322 bytes, checksum: 517abde36a5e28961792c6d782a3d48b (MD5) / Approved for entry into archive by Divisão de Documentação/BC Biblioteca Central (ddbc@ufam.edu.br) on 2015-07-09T13:49:14Z (GMT) No. of bitstreams: 1 Danielle Albuquerque Pires Rocha.pdf: 1640322 bytes, checksum: 517abde36a5e28961792c6d782a3d48b (MD5) / Made available in DSpace on 2015-07-09T13:49:14Z (GMT). No. of bitstreams: 1 Danielle Albuquerque Pires Rocha.pdf: 1640322 bytes, checksum: 517abde36a5e28961792c6d782a3d48b (MD5) Previous issue date: 2012-06-25 / FAPEAM - Fundação de Amparo à Pesquisa do Estado do Amazonas / The lack of precision and speed in the laboratory diagnosis of some sexually transmitted infections (STI) are commom problems faced by professionals working in this area. Additionally, the lack of some of them in the public health system become more difficult to elucidate the diagnosis. Because of these difficulties, the STI are underdiagnosed, being treated indiscriminately, using only clinical diagnosis. The molecular diagnostic methods have arisen in recent years as an excellent alternative to fill some of the gaps left by traditional methods. The aim of this research was to study the epidemiology of some sexually transmitted pathogens at molecular level, using molecular biology techniques in women attended in public health system in the city of Coari, Amazonas, Brazil. Samples were collected from 361 women for cervical cytology (Pap Smear) and molecular examination. We carried out molecular diagnosis using the technique of Polymerase Chain Reaction (PCR) and real-time PCR for some sexually transmitted pathogens, which were: Human Papillomavirus, Herpes Simplex Virus 2, Human Cytomegalovirus, Chlamydia trachomatis, Neisseria gonorrhoeae and Thichomonas vaginalis. The results showed that 47.8% of these women were infected by any of the pathogens. There was a high prevalence of infection with Human Papilomavirus (29.1%), followed by T. vaginalis (12.7%), Human Cytomegalovirus (8.3%), C. trachomatis (6.4%), N. gonorrhoeae (1.4%) and Herpes Simplex Vírus 2 (0.6%). The prevalence of HPV type in the infected women was HPV 16 (58.1%), followed by HPV 58 (20.0%). The satisfactory slides for cytological diagnosis (n=321) showed that 7 women (2.1%) showed abnormal cytology (ASCUS, LSIL and HSIL), 5 of them being infected by HPV. There were no statistically significant associations between sexually transmitted infections and the variables related to socio-demographics, medical history and sexual behavior. / A falta de precisão e rapidez no diagnóstico laboratorial de algumas doenças sexualmente transmissíveis (DST) são problemas enfrentados pelos profissionais que atuam nesta área. Além dessas dificuldades inerentes aos testes, a falta de alguns deles na rede pública de saúde dificultam ainda mais a elucidação de diagnósticos. Por causa dessas dificuldades, as DST são subdiagnosticadas, sendo tratadas indiscriminadamente, valendo-se apenas do diagnóstico clínico. Os métodos moleculares de diagnóstico têm surgidos nos últimos anos como uma excelente alternativa para preencher algumas dessas lacunas deixadas pelos métodos tradicionais. Esta pesquisa teve como finalidade estudar a epidemiologia de alguns patógenos sexualmente transmissíveis a nível molecular, valendo-se para isso de técnicas de biologia molecular, em mulheres atendidas na Atenção Primária à Saúde do Município de Coari, Amazonas (AM). Foram colhidas amostras cervicais de 361 mulheres para exame citológico (Papanicolaou) e exame molecular. Foi realizado o diagnóstico molecular através da técnica de Reação em Cadeia da Polimerase (PCR) e PCR em tempo real para alguns patógenos sexualmente transmissíveis, que foram: Papilomavírus Humano, Herpes Vírus Simples 2, Citomegalovírus Humano, Chlamydia trachomatis, Neisseria gonorrhoeae e Trichomonas vaginalis. Os resultados obtidos mostraram que 47,8% dessas mulheres estavam infectadas por algum dos patógenos estudados. Constatou-se alta prevalência de infecção por Papilomavírus Humano (29,1%), seguida pelo T. vaginalis (12,7%), Citomegalovírus Humano (8,3%), C. trachomatis (6,4%), N. gonorrhoeae (1,4%) e Herpes vírus Simples 2 (0,6%). O tipo prevalente de HPV nas mulheres infectadas foi o HPV 16 (58,1%), seguido pelo HPV 58 (20,0%). As lâminas citológicas satisfatórias para diagnóstico (n=321) mostraram que 7 mulheres (2,1%) exibiram alterações citológicas (ASCUS, LSIL e HSIL), estando 5 delas contaminadas pelo HPV. Não foram encontradas associações estatisticamente significativas entre as infecções por patógenos sexualmente transmissíveis e variáveis relacionadas à condições sócio-demográficas, história clínica e comportamento sexual.

Submitted by Renata Lopes (renatasil82@gmail.com) on 2017-05-17T19:23:55Z No. of bitstreams: 1 angelicaaparecidaamaranteterra.pdf: 10481912 bytes, checksum: 55737a5a2c8184e08f234869a7b2d92c (MD5) / Approved for entry into archive by Adriana Oliveira (adriana.oliveira@ufjf.edu.br) on 2017-05-18T11:38:00Z (GMT) No. of bitstreams: 1 angelicaaparecidaamaranteterra.pdf: 10481912 bytes, checksum: 55737a5a2c8184e08f234869a7b2d92c (MD5) / Approved for entry into archive by Adriana Oliveira (adriana.oliveira@ufjf.edu.br) on 2017-05-18T11:38:16Z (GMT) No. of bitstreams: 1 angelicaaparecidaamaranteterra.pdf: 10481912 bytes, checksum: 55737a5a2c8184e08f234869a7b2d92c (MD5) / Made available in DSpace on 2017-05-18T11:38:16Z (GMT). No. of bitstreams: 1 angelicaaparecidaamaranteterra.pdf: 10481912 bytes, checksum: 55737a5a2c8184e08f234869a7b2d92c (MD5) Previous issue date: 2013-07-29 / Com o avanço de estratégias que favorecem a redução da transmissibilidade das Infecções Sexualmente Transmissíveis (IST) e da aids no mundo, a saúde pública representa uma alternativa para o desenvolvimento de práticas preventivas relacionadas à essa temática. Assim, com vistas a contribuir para a problematização do discurso e para a efetivação de práticas preventivas na abordagem das IST/aids, esta pesquisa teve como objetivos: caracterizar as representações sociais dos enfermeiros da Estratégia Saúde da Família sobre as práticas preventivas na atenção básica em saúde na abordagem das IST/aids, e analisar as relações entre as representações sociais dos enfermeiros sobre as práticas preventivas das IST/aids e as estratégias desenvolvidas por esses profissionais para reduzir a vulnerabilidade à infecção pelo HIV. De abordagem qualitativa, o trabalho orientouse pelo referencial teórico-filosófico da Teoria das Representações Sociais. Foram entrevistados 32 enfermeiros que trabalham na rede de atenção básica em saúde em unidades de Estratégia Saúde da Família do município de Juiz de Fora – MG. Os discursos foram analisados à luz da análise de conteúdo temática proposta por Bardin. Da análise dos depoimentos emergiram três categorias: prática profissional do enfermeiro na atenção básica em saúde; práticas preventivas de IST/aids: as representações dos enfermeiros da atenção básica em saúde e fatores que dificultam as práticas preventivas do enfermeiro na atenção básica em saúde na abordagem das IST/aids. A partir da análise das categorias, observa-se a necessidade assegurar o desenvolvimento de atividades que favoreçam ações mais resolutivas para a redução da vulnerabilidade às IST/aids. É válido destacar os obstáculos que esses profissionais estão expostos, o que denota o impedimento de atividades relacionadas às práticas preventivas de IST/aids, como questões administrativas, profissionais e populacionais. A partir de uma postura críticoreflexiva, as representações dos enfermeiros da atenção básica em saúde sobre as práticas preventivas de IST/aids evidenciam a urgência de mobilização desses profissionais e seus gestores no sentido de integrar suas ações no direcionamento de práticas embasadas no modelo de promoção da saúde para que contribuíam na redução da vulnerabilidade dessas doenças. / -

Sexually transmitted infections (STIs) disproportionately impact non-Hispanic blacks in the United States. Racial differences in sexual networks can contribute to these disparities. Racial residential segregation, the separation of racial groups in a residential context, is a community factor known to influence sexual networks and has been associated with negative health outcomes. Our objective was to examine the association between racial residential segregation (henceforth, referred to as segregation), risky sexual behavior, concurrent partnerships, and STI diagnoses among non-Hispanic blacks. Demographic, sexual behavior, and STI diagnosis data for non-Hispanic blacks 15–44 years of age were obtained from the 2006–2010 National Survey of Family Growth. Segregation and community poverty data were obtained from the U.S. Census. Five distinct dimensions measured segregation, each with a representative index. Multilevel logistic regressions were conducted to test how each of the five indices were associated with risky sexual behavior, concurrent partnerships, and STI diagnoses. Risky sexual behavior results showed 16.1% (n=588) of participants engaged in risky sexual behavior. The association was stronger for the absolute centralization (adjusted odds ratio [aOR] 2.07; 95% confidence interval [CI] 2.05 – 2.08) and relative concentration indices (aOR 2.05; 95% CI 2.03 – 2.07). This suggests risky sexual behavior is most strongly associated with segregation in neighborhoods with a high density of non-Hispanic blacks and accumulation of non-Hispanic blacks in an urban core. STI diagnosis results showed 7.4% (n=305) of participants reported a STI diagnosis, and segregation was associated with STI diagnosis. The association was strongest measured with the dissimilarity index (aOR 2.41; 95% CI 2.38 – 2.43) and stronger for males. Concurrent partnerships results showed 15.6% (n=645) of participants reported concurrent partnerships. Multilevel analyses showed segregation to be associated with concurrent partnerships with the association strongest measured with the dissimilarity index. Segregation acted as a risk and a protective factor with risky sexual behavior, concurrent partnerships, and STI diagnosis, depending on the segregation measure. Additional work is needed to understand the mechanisms of how specific segregation dimensions influence risky sexual behaviors and sexually transmitted infections.

Magister Public Health - MPH / This study assessed the knowledge, attitudes and practices about MC as an HIV prevention intervention among adult males presenting for HIV Voluntary Counselling and Testing (VCT) services at Onandjokwe District Hospital in northern Namibia. A high level of knowledge of MC, particularly its potential to reduce the risk of HIV infection, STIs and enhance penile hygiene exists among VCT attendees in Onandjokwe District Hospital. MC will most likely to be accepted in this study area, especially when it is implemented to reduce the risk of HIV infection. The study recommends a comprehensive education and information program targeting males and their partners and a training for traditional and medical circumcisers to ensure a high quality of MC services. / South Africa

MAAS / Centre for African Studies / Zimbabwe launched the Voluntary medical male circumcision programme (VMMC) in November 2009, with the primary aim of curbing sexual transmitted infections (STI’s). In 2010, the district of Mazowe managed to adopt voluntary medical male circumcision programme to curb sexual transmitted infections. It is of concern that the voluntary medical male circumcision programme has been below expectations in Mazowe district. Hence, the aim of the study was to explore the effectiveness of the voluntary medical male circumcision programme among secondary school learners in Mazowe district. Furthermore, the primary goals of the study were firstly check the levels of understanding about the voluntary medical male circumcision programme among secondary school learners in Mazowe district. Secondly, explore the reasons behind the low rate of the voluntary medical male circumcision programme among secondary school learners. Thirdly, investigate whether cultural beliefs influence the learners’ choice. Lastly, recommend possible ways of improving the uptake of the voluntary medical male circumcision programme among secondary school learners in Mazowe district. A qualitative research method used in the study. Also, un-structured interviews and focused group discussions. The researcher conducted interviews using purposeful sampling method on three secondary schools in Mazowe district, Zimbabwe and about forty respondents participated in the study. The study adopted a planned behaviour and person/client centered approaches. The thesis’s conclusions deduced that most of the male respondents are not ready or willing to receive circumcision due to fear of being screened for HIV/AIDS, the cost of the procedure, pain, bleeding, to mention but a few. Furthermore, the researcher identified that in the Shona culture, medical male circumcision is rarely unknown. In addition, the Ministry of Health and Child Welfare must introduce new ways of circumcision to avoid bleeding, pain and must remove the screening of the HIV testing procedure before one is circumcise. Therefore, by these outcomes the Ministry of Child and Health Care Centre will try to find strategies in which they can scale the programme, since the study highlighted that most males are not going for circumcision, hence their lives are in predicament. More so, the study recommends v that researchers must obtain consent and ethical clearance from different relevant place so that data there will not be harm to respondents. Also, there is a need to look for policies in which the government will use to assess strategies to scale the programme, since it is of paramount importance to test the VMMC programme about the impact that it is giving to the community and to find out whether it is helpful or not. More so, in terms of future researchers, there is a need to reconnoiter barriers that hinders males from circumcised. Hence, fourth, this will motivate number of District schools to bring awareness towards males to take part in the programme and prevent males from being susceptible to the infections as recommended by the WHO in 2007. In addition, decentralizing the programme to the community, stakeholders would be able to work hand in hand with the District to make sure that the rate of the VMMC is up and those males take part in the programme willingly. Hence, this will create an efficacy of the programme since all stakeholders and the community will scale up the programme since the priority of all sides will be to scale the programme. Furthermore, clearing misconceptions associated with male learners (witchcraft, pain, bleeding, and religion, to mention but the few), providing them with right mentality about the good side of the programme. In addition, there is a need for the Ministry of Health and Child Welfare to amend new polices that allows free male circumcision, especially in public hospitals, hence, through these amendments, males might be willing to get the services. Lastly but not least, the Department of Education in Zimbabwe must set up tight mechanism for assessment for the programme, especially at secondary and high schools. This will in turn, develop an effective assessment system to see how effective the programme is in the districts. Finally, it is of paramount importance that the National HIV/AIDS council collaborates with the Ministry of Health and Child Welfare in decentralizing the service of the VMMC, since some respondents were concerned that the distance to the service centers were a hindrance for circumcision. / NRF