Submitted by Luciana Ferreira (lucgeral@gmail.com) on 2018-07-24T11:01:05Z No. of bitstreams: 2 Dissertação - Caroline Ferreira dos Anjos - 2018.pdf: 4783820 bytes, checksum: 4be6a8717d4a44e3f68036d54f78fc44 (MD5) license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) / Approved for entry into archive by Luciana Ferreira (lucgeral@gmail.com) on 2018-07-24T11:03:09Z (GMT) No. of bitstreams: 2 Dissertação - Caroline Ferreira dos Anjos - 2018.pdf: 4783820 bytes, checksum: 4be6a8717d4a44e3f68036d54f78fc44 (MD5) license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) / Made available in DSpace on 2018-07-24T11:03:09Z (GMT). No. of bitstreams: 2 Dissertação - Caroline Ferreira dos Anjos - 2018.pdf: 4783820 bytes, checksum: 4be6a8717d4a44e3f68036d54f78fc44 (MD5) license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) Previous issue date: 2018-07-03 / Adolescents and young people engage in risky sexual behavior, resulting in increased number of sexually transmitted infections, and maintaining high rates of pregnancy. PURPOSE. To evaluate the differences in sociodemographic and behavioral characteristics among sexually active and virgin participants; to estimate the prevalence and to identify factors associated with sexual iniciation up to age 15, and inconsistent condom use, and identify the reasons for not using condom among adolescents and young adults. METHODS. A community-based, cross-sectional study involving 1072 adolescents and young women, aged 15 to 24 years, living in three medium-sized cities in the state of Goiás, between 2007 and 2009. All of them answered a questionnaire containing sociodemographic and behavioral data. In order to evaluate the factors associated with sexual iniciation up to age 15, and inconsistent condom use, a logistic regression analysis was performed, with odds ratio (OR) and adjusted OR, with 95% confidence interval and level of statistical significance of 5% (p <0.05). All of them signed the free and informed consent form. For minors under 18 years old the exemption of the parents' signature was obtained by court order. The project was approved by the Ethics and Research Committee. RESULTS. Of 1072, 64.9% were sexually active. Sexually active women were 6.3 (95% CI: 3.98-9.96) times more probability of being older than 19 years old, and 2.04 (95% CI: 1.19-3.49) times more probability of having schooling less than eight years. The prevalence of sexual iniciation up to age 15 was 46.4% (95% CI: 42.7-50.1) and inconsistent condom use was 73.2% (95% CI: 63.9% 82.6). The factors associated with sexual iniciation up to age 15 were age less than 19 years old, had no religion and had schooling less than eight years, with a OR of 3.13 (2.22-4.40), 2.05 (1.17-3.58) and 6.21 (4.14- 9.32) respectively. The only factor associated with inconsistent condom use was marital status or stable union, with OR 4.63 (2.86-7.50). The most frequently cited reasons for non-use of condom were "partner trust" by 49.8% and "partner dislikes" by 43.7%. CONCLUSION. The prevalence of sexual initiation up to age 15, and inconsistent condom use were high. The factors associated with these behaviors were different. Age less than 19 years old were associated with sexualiniciation up to 15, indicating a likely reduction in the age of sexual iniciation in adolescence. The most frequent reasons for not using condoms were related to the sexual partner, which indicates that gender factors need to be addressed in sex education strategies. / Adolescentes e jovens se envolvem em comportamento sexual de risco, o que resulta em aumento do número de casos de infecções sexualmente transmissíveis, e manutenção de altas taxas de gravidez. OBJETIVOS. Avaliar as diferenças nas características sociodemográficas e comportamentais entre as participantes sexualmente ativas e virgens; estimar a prevalência e identificar os fatores associados ao início da atividade sexual até os 15 anos e ao uso inconsistente do preservativo e identificar os motivos do não uso do preservativo masculino entre adolescentes e adultas jovens. METODOLOGIA. Estudo de base comunitária, transversal, envolvendo 1072 adolescentes e jovens do sexo feminino, de 15 a 24 anos, residentes em três cidades de médio portedo estado de Goiás, entre 2007 e 2009. Todas responderam um questionário contendo dados sociodemográficos e comportamentais. Para avaliar os fatores associados ao início da atividade sexual até os 15 anos e ao uso inconsistente do preservativo foi realizada análise de regressão logística, com cálculo de odds ratio (OR) e OR ajustado, com intervalo de confiança de 95% e nível de significância estatística de 5% (p<0,05). Todas assinaram o termo de consentimento livre e esclarecido. Para menores de 18 anos a isenção da assinatura dos pais foi obtida por ordem judicial. O projeto foi aprovado pelo Comitê de Ética e Pesquisa. RESULTADOS. Das 1072, 64,9% eram sexualmente ativas. As sexualmente ativas apresentaram 6,3 (IC 95%: 3,98-9,96) vezes maior probabilidade de terem idade acima de 19 anos, e 2,04 (IC 95%: 1,19-3,49) vezes maior probabilidade de terem escolaridade menor que oito anos. A prevalência do início da atividade sexual até os 15 anos foi de 46,4% (IC 95%: 42,7-50,1) e do uso inconsistente do preservativo foi de 73,2% (IC 95%: 63,9-82,6). Os fatores associados ao início da atividade sexual até os 15 anos foram a idade menor do que 19 anos, não possuir religião e ter escolaridade menor do que oito anos, com OR de 3,13 (IC 95%: 2,22-4,40), 2,05 (IC 95%: 1,17-3,58) e 6,21 (IC 95%: 4,14-9,32) respectivamente. O único fator associado ao uso inconsistente do preservativo foi o estado civil casada ou em união estável, com OR 4,63 (IC 95%: 2,86-7,50). Os motivos mais frequentemente citados para o não uso do preservativo foram a “confiança no parceiro” por 49,8% e “o parceiro não gosta” por 43,7%. CONCLUSÃO. A prevalência do início da atividade sexual até os 15 anos e do uso inconsistente do preservativo foram elevadas. Os fatores associados a esses comportamentos foram diferentes. A idade menor que 19 anos esteve associada à iniciação sexual até os 15, indicando provável redução da idade de iniciação sexual na adolescência. Os motivos mais frequentes para o não uso do preservativo foram ligados ao parceiro, o que indica que fatores ligados ao gênero precisam ser abordados nas estratégias de educação sexual.

Over time, criminals have become more aware of the different types of trace evidence that are capable of being identified by forensic analysis. As a result, the frequency of actions taken to prevent the transmission of evidence, specifically biological fluids and subsequent DNA evidence, with the usage of condoms in the commission of sexual assaults, has increased. With the increased use of condoms, comes the increased awareness and probative nature of forensic analysis of the potentially unique chemical profiles residues may leave behind. This includes the identification of lubricant type and of any additives that may be present, such as spermicides, flavoring or topical anesthetics. The two predominate condom lubricants are polydimethylsiloxane (PDMS) and polyethylene glycol (PEG): PEG, a water-soluble lubricant, is soluble in polar solvents, such as methanol, while PDMS, a silicone-based lubricant, is reported to be soluble in non-polar solvents, such as hexane. A total of thirty condoms representing eight brands, each of a different type, were evaluated by Attenuated Total Reflectance - Fourier Transform Infrared Spectroscopy (ATR-FTIR). It has been reported that PDMS is the more prevalent condom lubricant compared to PEG; this trend was reflected in this small subset of products. Of the thirty condom lubricants analyzed, twenty-five were PDMS (approximately 83%), six PEG (approximately 7%), six glycerol (approximately 7%) and one “other” (approximately 3%). A direct extraction method was developed to isolate the lubricant from the condoms. Following the direct extraction of the condom lubricants from ten condoms of different brands and types containing PDMS, the extraction capabilities of three solvents: hexane, methanol and methylene chloride, in the presence of blood and saliva separately, were evaluated. Two different biological fluid/lubricant sample types were created: liquid suspensions of lubricant, biological fluid and solvent; and contrived casework samples consisting of a mixture of lubricant and biological fluid dried onto a cotton swab. Hexane was capable of isolating only the PDMS lubricant in the presence of biological fluids. In an effort to extract and identify the water-soluble lubricant PEG and any additional additives, two Trojan condoms marketed as containing the spermicide nonoxynol 9 (N9) and one Durex condom marketed as containing the topical anesthetic benzocaine were obtained. Methanol was used as the direct extraction solvent as much of the published literature has determined that additives, such as spermicides and topical anesthetics, are often found in combination with PEG, which must be extracted in a polar solvent. Although capable of extracting the lubricant PEG, PDMS, and the N9 from the condoms directly, the presence of biological fluids prevented the successful isolation of any condom lubricants or additives with the use of methanol. This extraction study established the solubility of PDMS in both methanol and hexane as well as the limited solubility of PEG in methanol. To identify a solvent capable of extracting both lubricant types as well as the spermicide additive N9 in the presence of biological fluids, the extraction capabilities of methylene chloride were assessed. In the literature, methylene chloride is often used to eliminate a two-step, or two-solvent, extraction for condom lubricants. The isolation of PDMS and N9 had mixed results when using methylene chloride as a solvent. PDMS and N9 were successfully isolated and identified in one of the Trojan brand spermicidal condoms, but not the other, most likely due to a difference in concentration of N9 in the two condoms. Only PEG could be isolated in the Durex condom marketed as containing benzocaine using methylene chloride. In the blood and saliva/lubricant contrived casework samples extracted with methylene chloride, the PDMS and PEG in the respective condoms were isolated but N9 was not. An evaluation of solvent extraction efficiency was made by comparing the ability of each solvent to isolate condom lubricant and additives in the presence of biological fluids. Methylene chloride was found to be the most effective solvent when compared to hexane and methanol for this purpose.

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Older African American (AA) women are at increased risk for HIV and STDs. The purpose of this quantitative study was to examine the influence of provider-initiated condom use education on condom use among unmarried, heterosexually active AA women aged 50 and over using the constructs of self-efficacy and attitudes of the health belief theoretical model. The relationships between provider education on condom use, condom use self-efficacy, condom use attitudes, and actual condom use were tested individually, and provider education on actual condom use was tested after controlling for condom use self-efficacy and attitudes among 95 study participants recruited primarily from Raleigh-Durham, NC. A 2-tailed sample t test or analysis of covariance was used for analysis. Provider education on condom usage failed to show a benefit with regard to condom usage, condom use self-efficacy, and attitudes toward condom usage. Additionally, women who received provider education on condom use were less likely to use condoms. Possibly these women had a low perception of risk and vulnerability to HIV and STDs, which correlated with lower condom use. The counter intuitive findings could also be related to another variable that was not tested and should spur more research. Results could be used to contribute to the design of an intervention model that specifically addresses the sexual behaviors of older AA women. Results of this study, combined with previous research, can help emphasize the need for improved patient-provider communication so that provider communication produces a more positive outcome and helps limit the spread of HIV and STDs, a limitation that would benefit individuals, whole communities, and the nation.

Background: Many factors affect whether women will insist that their sexual partners use a condom. This research project will identify some of the predictors of condom use among unmarried women in Ghana, Africa. Methods: This research project evaluated data from the 2008 DHS of women in Ghana, Africa for predictors of condom use among unmarried women. A total of 4,916 women completed the surveys. Of these, 1,966 women were unmarried. The research project employed multiple logistic regression analysis to determine condom use predictors at the time of the last sexual encounter for these 1,966 unmarried women. Results: Women with a secondary education or beyond were 3.2 (95% CI=2-5.2) times more likely to have insisted on the use of a condom than women with a primary education or less. Women ages 15-24 were 5.3 (95% CI=2.5-11.3) times more likely to have insisted on the use of a condom than women ages 35-49. Women ages 25-34 were not significantly different than the women ages 35-49. Women living in an urban area were 1.8 (95% CI=1.3-2.5) times more likely to have insisted on the use of a condom than women living in a rural area. Women with a higher level of literacy (could read a full sentence) were 3.6 (95% CI=2.5-5.1) times more likely to have insisted on the use of a condom than women with a lower level of literacy (were unable to read a full sentence). And in concert, women who read a newspaper or a magazine once a week or more were 2.4 (95% CI=1.6-3.5) times more likely to have insisted on the use of a condom than women who read a news paper or a magazine less than once a week. Similarly, women who watched television once a week or more were 2.9 (95%CI= 1.9-4.3) times more likely to have insisted on the use of a condom than women who watched less than once a week. Women who were determined to have “excellent” knowledge about HIV were 5.8 (95% CI=1.5-22.3) times more likely to have insisted on the use of a condom than women who were determined to have “fair or poor” knowledge. The results for women with a “good” knowledge were not significantly different than for those with “fair or poor” knowledge. Women who were determined, through a series of questions about wife beating, to have a low tolerance for abuse towards women (“strong” attitude about domestic violence/women’s rights) were 1.8 (95% CI=1.2-2.7) times more likely to have insisted on the use of a condom than women who were determined to have a high tolerance for abuse towards women (“poor” attitude about domestic violence/women’s rights). Results for women with a “fair” attitude were not significantly different from those with a “poor” attitude. Total life time sexual partners, frequency of listening to the radio, and interestingly, access to condoms did not significantly affect condom use. After multivariate adjustment, the significant predictors of condom use at the time of last sexual encounter were age, literacy, and amount of television watched. The results were: women age 15-24 (compared to women ages 35-49), women who could read a full sentence, and women who watched television once a week or more were 3.7 (95% CI=1.7-8.1), 2.1 (95% CI=1.4-3.3), and 1.8 (95% CI=1.2-2.8) times more likely to have insisted on the use of a condom during their last sexual encounter, respectively. Conclusion: Education, age, locality, literacy, media exposure (through reading the news paper or a magazine and watching television), knowledge about HIV, and attitude about domestic were predictors of condom use by the sexual partner of unmarried Ghanaian women at the time of last sexual encounter. After multivariate adjustment, only age, literacy, and amount of television watched were significant predictors of condom use at the time of the last sexual encounter.

The male condoms were massively expanded to Africa in 1990s as a result of growing HIV prevalence in most parts of Sub-Saharan Africa. Many transnational non-profit organizations together with national governments were engaged in this expansion of condom distribution. The biggest condom donator are the United States of America which have already provided tens of milliards of dollars to fight against AIDS by distribution of condoms. Was this financial aid used effectively and did the money have the right intended effect? Scientists agree on the statement that the effectiveness of condoms as contraceptives is around 90%. What is the efficiency of using condoms helping against the transmission of the virus HIV, if a single HIV virus cell is much smaller than a sperm cell? With the help of regression analysis using panel data we can give a definite answer to the crucial question -- do condoms help or prevent the spread of HIV virus?

Introduction South Africa is one of the countries hardest hit by HIV/AIDS. Of particular concern, new infections among young people, especially young women and girls are on the rise. Despite widespread awareness and prevention campaigns, the prevalence of HIV and deaths caused by AIDS are still on the increase, whereas condom use particularly in rural areas remains low. Consistent condom use is central to the prevention of unwanted pregnancies, HIV and other STIs, yet young men and women alike are hesitant to use condoms because of threats to their relationships, cultural roles and at times economic survival. Purpose The purpose of this study is to identify socio-cultural and behavioral factors that influence condom use among youths in Limpopo province, South Africa. This adds to a growing body of knowledge on the determinants of condom use and how they might shape effective HIV prevention programs. Objectives 1. To conduct a secondary data analysis that examines the determinants of condom use, for men and women separately in relation to the following factors: Socio-demographic characteristics- age, education, marital status, migration and iv socio-economic status Sexual behavior characteristics- partnership type (spousal, non spousal, or both), age at sexual debut, number of lifetime sexual partners, contraceptive use (females only) and HIV-status Socio-cultural characteristics - perceived risk of HIV infection, condom self efficacy (males only), partner communication on sex, condoms, HIV and other STI’s, beliefs on gender norms, attitudes towards gender violence, knowledge on HIV/AIDS and HIV/AIDS related stigma To compare the results of this analysis to other national studies on condom use among young people. To use the results of this analysis to make recommendations to improve HIV control in rural South Africa.Methods This study is a secondary analysis of data collected from a sample of 2236 sexually active young people aged between 14-35 years in Limpopo province, South Africa. The data used in this study is part of a wider public health intervention, the Intervention with Micro-finance for AIDS and Gender Equity (IMAGE) study. STATA 8.0 was used to analyze data in bivariate and multivariate analyses to assess determinants of consistent condom use and condom use at last sex for males and females separately as the patterns of associations are likely to differ between them. Results Overall condom use in this population was low: less than a quarter of respondents used condoms consistently and less than one third of men and women used condoms at last sex. This is especially true of females, married couples and those who have multiple partners. In multivariate analysis, significant predictors of consistent condom use for both sexes included good communication, older age at sexual debut, low risk perception of HIV infection, progressive attitudes towards gender violence and high HIV-related stigma. High condom self-efficacy, defined as the intention to pick up or purchase condoms with the intention of use, was the most powerful predictor of both condom use indices among males. Among females only, having fewer than three lifetime sexual partners was positively associated with using condoms consistently. Lastly, females who used condoms as their main method of contraception were up to 20 times more likely to use them consistently and at last sex. Conclusions HIV prevention programmes in this population should focus on delaying sexual debut, increasing perceived risk of HIV infection, encouraging partner communication, making condoms more easily accessible to young men and addressing gender inequalities. Furthermore, the dual protection offered by condoms against unwanted pregnancies and against HIV and other STI’s should be emphasized in this population as it plays an important role in the prevention of HIV.

In Russia today women use traditional forms of birth control at unusually high rates, whereas, conversely their use of modern contraceptives is unusually low. During the Soviet period, women's access to modern contraceptive methods may have been limited. However, one would postulate that after the collapse of the Soviet Union, the nature of the new reforms that developed would have lent itself to an increase in modern contraception usage on par with other countries. In Russia today there is not a lack of availability of modern contraceptives. Yet, women are still not using modern contraception at a rate that is congruent with an increase in availability. What then is influencing Russian women's decisions? The contraceptive acceptance of Russian women today is shaped by cultural legacies of the Soviet Union surrounding both contraceptives themselves and sex and sex education.

Human immunodeficiency virus (HIV) and acquired immunodeficiency syndrome (AIDS) are ailments that have a social and political impact in the U.S. Since their discovery more than three decades ago, there has been an intense focus on eradicating these deadly diseases. Although there has been a lot of progress in the fight against HIV and AIDS, there are communities still disproportionately affected by it. Based on data from the Center for Disease Control and Prevention (CDC), one such community is young adults age 20 to 24 (CDC, 2016a). These young adults are at the focal center of the HIV/AIDS epidemic for various reasons; yet, this group is often overlooked in HIV literature and prevention/intervention strategies. Additionally, this community is known for inconsistent condom use, although there have been countless public service announcements (PSAs) and interventions promoting the use of condoms as a means of preventing not only unwanted pregnancy but the contraction of sexual transmitted infections (STIs) including HIV/AIDS. The aim of the current study was to test a comprehensive moderated mediation model and assess factors associated with condom use among early young adults age 18 to 24 above and beyond known variables such as age, gender, and ethnicity/race. These variables included participants’ age of sexual debut, number of lifetime sexual partners, perceived threat of contracting STIs and HIV/AIDS, and exposure to cues to action as predictors of condom use. The decision to expand the study to assess condom use among early young adults (18 -24) as opposed to focusing exclusively on young adults (20 -24) was based on early young adults being less likely to be tested for HIV compared to other age groups (CDC, 2008). For the moderated mediation model, I drew on the health belief model (HBM) and tested whether 1) the relationship between sexual debut and condom use was mediated by number of lifetime sexual partnerships, and 2) the relationships between sexual debut and the mediator were moderated by perceived threat, and whether the relationships between the mediator and condom use was moderated by perceived threat and cues to action. The full model was not supported. The implication of this study is that more current research is needed to understand early young adults and their condom use, as they are a community that is most vulnerable to HIV/AIDS and a key component in the fight against this disease.