Master's thesis. / Format: PDF. Bibl.

Background HIV/AIDS has always been a concern since it first came up in 1981 in the field of medicine and public health. The trend of overall HIV epidemic has slow down through over 30 years fighting against the disease. Yet, being the largest population nowadays, young people still face high risk of HIV/AID. Sexual transmitted diseases, similar with HIV infection, are also a serious concern in young people. Peer education is widely used in the sexual education in young people. No review focused on the school-based peer education while most young people received their sexual education in schools. This systematic review aims to evaluate the effectiveness of school-based peer education on HIV/STD prevention and evaluate the factors that are likely to influence the effect of school-based peer education. Method Searching through PubMed and Cochrane Library, a literature review was carried out on the relevant articles about the evaluation of school-based peer education in developing and developed countries around the world from 2000-01-01 to 2014-05-31. Findings 10 experimental studies were chosen in this review, including 3 randomized controlled trials. Among 10 studies, 8 found significant improved about the general knowledge of HIV/STD and all studies showed positive change in attitude and risk perception in the peer-led education. However, no studies found significant effect of peer education on the behavioral change regarding condom use, postponing sexual intercourses and the reduction of sexual partners, etc. The interaction of peer education and the quality of peer-educators plus other demographical factors such as socioeconomic status and religions may influence the effect of school-based peer-led education. Conclusion School-based peer education was demonstrated to be effective on the prevention of HIV/STD in knowledge and attitude improvement, similar with other kinds of peer education. Peer educators and interactions between educators and educatees play important roles in the peer education. Yet, the effect of school-based education still requires long-term assessment. / published_or_final_version / Public Health / Master / Master of Public Health

published_or_final_version / Medical Sciences / Master / Master of Medical Sciences

published_or_final_version / Medical Sciences / Master / Master of Medical Sciences

Background: Adolescents and young adults aged 15 to 24 acquire nearly half of all new STDs in the United States, yet they represent only 25% of the sexually active population. Young men and women in this age group have the highest rates of chlamydia, gonorrhea, and syphilis, especially in the African American population. Adolescent risk factors include having a history of pregnancy or STDs, being arrested or incarcerated, substance abuse, early sexual debut and having 4 or more lifetime sexual partners. Protective behaviors such as parental involvement, school enrollment, and consistent condom use have been associated with decreased incidence of STDs. The purpose of this study is to observe changes in adolescent behaviors and experiences that are known risk factors for acquiring sexually transmitted diseases. The aim is to identify the time at which STD prevention interventions may be administered most effectively. In addition, the study aims to identify relevant themes and content that may be useful in creating interventions targeted to different age groups and genders. Methods: This study utilizes primary data collected between 1999 and 2003 by Dr. Rothenberg and colleagues for a community-based network study of low-income African American adolescents living in a working class neighborhood in Southwest Atlanta. Two descriptive analyses were conducted: a period analysis in which all participants ages 15 to 18 who completed any or all of three interviews were included; and a cohort analysis, which included only participants who completed three interviews and who were 15, 16, 17 or 18 years of age at the time of the first interview. Univariate analysis was used to describe each variable and the resulting frequencies and percentages were reported. Results: In both period and cohort analyses, higher proportions of older adolescents (ages 17 and 18) reported engaging in risky behaviors including drinking alcohol, using marijuana, having sex and having multiple sexual partners, compared to younger adolescents (ages 15 and 16). Males reported higher proportions of engaging in risky behaviors than females, but also higher proportions of condom use. The proportion of participants diagnosed with one or more STDs decreased at each interview. In the cohort analysis, the proportion of participants who perceived their STD risk as “medium” or “high” increased over time. Conclusions: The findings suggest that as adolescents mature they engage in a greater variety of risky behaviors known to have a positive association to STD diagnosis. Period analyses, which have usually been done to study the sexual behaviors of adolescents, may give aberrant results that are clearer when the population is studied as a cohort. Future studies are needed to more precisely identify the period during which adolescents experience rapid changes in their risk behaviors.

It is an important step in clinical practice to discriminate real diseased patients from healthy persons. It would be great to get such discrimination from some common information like personal information, life style, and the contact with diseased patient. In this study, a score is calculated for each patient based on a survey through generalized linear model, and then the diseased status is decided according to previous sexually transmitted diseases (STDs) records. This study will facilitate clinics in grouping patients into real diseased or healthy, which in turn will affect the method clinics take to screen patients: complete screening for possible diseased patient and some common screening for potentially healthy persons.

The high levels of HIV prevalence amongst young people in sub-Saharan African countries, have led to the clarion call for researchers to investigate the determinants to young people's sexual risk-taking behaviour while others are exploring the usage of entertainment education (EE) so that effective prevention and interventions may be developed. One critical aspect is that research efforts so far have been hampered by the adoption of models and perspectives that are narrow and do not adequately capture the complexity associated with young people's sexual experiences. The distinctiveness of this study is therefore grounded in the focus on the risky sexual practices students engage in and their underlying risk and protective multisystemic factors and their response to the EE interventions, in particular the Scrutinise Campus Campaign. Thus, using the Problem Behaviour Theory, Reception Theory and the Social Cognitive Learning Theory, this study investigates the phenomena of students' sexual risk behaviour and their response to the Scrutinise Campus campaign. The study is situated within the interpretative paradigm. It used a hermeneutic phenomenological methodology underpinned by in-depth interviews, focus group discussions, participant observation and field notes to draw data for this study. The study sample included students and the Scrutinise Campus Campaign officers. Findings of this study sustain the conclusion that students' sexual risk behaviour is influenced by interrelated, interactional and transactional factors from the multisysternic factors: biological, environmental/social, behavioural and personality domains that either instigate or buffer against students' sexual risk behaviour. However, Scrutinise Campus campaign's messages do not fully address students' sexual risk practices and their underlying factors as experienced by students. It is critical to employ a comprehensive and continuum of EE interventions that are broad in scope arid target factors from multiple systems of influence including the multisystemic factors. Most significantly, sources of protective influence should not be ignored when designing and implementing EE prevention programmes and, to the extent possible, both risk arid protective factors should be addressed in the interventions. This may help to effectively address students' sexual-risk taking behaviour in universities. / Thesis (Ph.D.)-University of KwaZulu-Natal, Durban, 2012.

Since the 1994 International Conference on Population and Development there has been a shift away from meeting demographic targets towards meeting the reproductive goals of individual men and women. Partially as a response to the increase in the level of HIV infection, and the associated high levels of STIs, there has been an increasing focus on integrating HIV/STI services within mainstream Maternal Child Health and Family Planning programmes. Thus clients attending clinics that provide integrated services have the opportunity to receive multiple services during a single visit to a facility. The aim of this research was to evaluate the process of integrating FPIMCH and STI/HIV services in urban and rural areas within KwaZulu-Natal, using data gathered form semi structured interviews with clients leaving the health facilities. The research also examined the overall quality of care received within the integrated clinics. The results show that clients rarely receive a range of services on a single visit, despite the integration of services. In most cases, clients do receive the services for which they attended the health facility. However the study found that providers are missing important opportunities to inform, educate and counsel clients on a variety of reproductive health matters. This is important if we are to avoid the negative consequences of an unwanted pregnancy and STIs (including HIV/AIDS). It was also found that the overall quality of care within integrated clinics was low amongst all clients attending the facility. / Thesis (M.Dev.Studies)-University of Natal, Durban, 2003.

Background: Contracting asexually transmitted disease is strongly associated with stigmaand shame. Stigma associated with these diseases has a significant impact on self-image andpropensityto seek care. Despitehigh incidencethere is a generallack of awareness about therisks and theeffectsthatthese diseases have on both mental and physical health. Health carepersonnel are experiencing difficulties to meet and care for these patients. Aim: The aim ofthis studyisto describe patients'experiences of health care after they were diagnosed with asexually transmitted disease. Method: The study was conducted as a systematic literaturereviewbased on tenoriginal articles. Ameta-synthesiswas used for the analysisandthe resultwasdiscussedwithHalldórsdóttir's (1996) theory;"Caring and Uncaring Encounters inNursing and Health Care–From the Patients Perspective". Result: Five themes emerged;The importance of emotional support;Beingjudged by the health personnel; The importanceof information;To (not) talk about sexandThe environmentalimpact on the confidentiality.Conclusion:Patients with sexually transmitted diseasesare experiencingencounters withhealth care bothnegativelyand positively, although there were mostlynegative experiencesofthe encounters. Several factors affect patients' experiences.Encounter with health care affectspatients' well-being and health. Clinical significance: The knowledge fromthis studymightenable a patientcentredapproach. Based on this knowledge,healthcouldbe developed so thatthe encounter itselfpromotesempowerment and an increased sense of well-being and health. / Bakgrund: Att få en sexuellt överförbar sjukdom är tydligt förknippatmed stigma och skam. Stigma har en betydande påverkan på individens självbild och benägenhet att testa sig. Trots hög incidensidentifieras en generellt bristande medvetenhet om de risker och effekter dessa sjukdomar har påbåde psykisk och fysisk hälsa. Vårdpersonal upplever svårigheter att bemötapatienter med sexuellt överförbara sjukdomar. Syfte: Studiens syfte är att beskriva patientersupplevelser av mötet med vården efter att de diagnostiserats meden sexuellt överförbarsjukdom. Metod: Studien genomfördes som en systematisk litteraturöversikt där tio originalartiklar sammanställdes med en metasyntes och diskuterades utifrån Halldórsdóttirs (1996) teori;"Vårdande och icke-vårdande möteni omvårdnad och hälso-och sjukvård–utifrån ett patientperspektiv". Resultat: Fem teman framkom som återkommande upplevelser; Betydelsen av emotionellt stöd; Att bli dömd av vårdpersonalen, Betydelsen avinformation; Att (inte) tala om sex och Den fysiska miljöns påverkan på konfidentialiteten. Slutsats: Patientermed sexuellt överförbara sjukdomar upplever mötet med vården ivarierande grad negativt och positivt. Dock framkom det övervägande negativa upplevelser av mötet. Flertalet faktorer påverkar patienternas upplevelse. Mötet med vården påverkar patienternas välbefinnande och hälsa. Kliniskbetydelse: Kunskapen från resultatet i denna studie kan möjliggöra en patientcentrerad vård. Utifrån resultatet kan vården utvecklas så att mötet upplevs som vårdande, och där mötet i sig samt kontakten med vården skapar egenmakt och en ökad känsla av välbefinnande och hälsa.

<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>