A adolescÃncia à uma fase da vida caracterizada por diversos acontecimentos, dentre os quais se destaca o inÃcio da atividade sexual. PorÃm, devido Ãs modificaÃÃes advindas do processo de adolescer, as prÃticas sexuais, em muitos casos, sÃo realizadas de forma desprotegidas, com isso tornando o adolescente vulnerÃvel Ãs DST/Aids. Diante deste panorama, surge o enfermeiro para tentar intervir junto a este grupo com o intuito de prevenir Ãs DST/Aids. Uma das formas de se alcanÃar isto à por meio da educaÃÃo em saÃde que pode fazer uso de tecnologias educativas na sua prÃtica. Dentre os diversos tipos de tecnologias educativas destaque-se o jogo educativo que devido Ãs suas caracterÃsticas dinÃmicas e lÃdicas favorecem o processo ensino-aprendizagem dos adolescentes, sendo uma ferramenta importante na prevenÃÃo das DST/Aids na adolescÃncia. Com isto, este estudo teve o intuito de validar um jogo educativo, no auxÃlio da prevenÃÃo de adolescentes Ãs DST/Aids, em escolas pÃblicas de Fortaleza-CE e comparar a aquisiÃÃo do conhecimento dos adolescentes em relaÃÃo prevenÃÃo de DST/Aids usando o jogo educativo, a palestra expositiva e aula ministrada tradicionalmente. Trata-se de um estudo quase-experimental com abordagem quantitativa que foi dividido em duas fases, sendo que a primeira foi composta de 120 adolescentes e a segunda de 198 inicialmente. A primeira fase compreendeu a construÃÃo dos instrumentos de prà e pÃs-teste que foi utilizado na fase seguinte. Na segunda etapa ocorreu a aplicaÃÃo da intervenÃÃo propriamente dita, sendo que um grupo participou do jogo educativo que abordava a prevenÃÃo das DST/Aids, o segundo grupo participou de uma palestra ilustrada tambÃm sobre a mesma temÃtica e o terceiro grupo da aula ministrada em sala de aula pelo professor responsÃvel. O trÃs grupos responderam ao prÃ-teste antes da intervenÃÃo educativa e ao pÃs-teste vinte dias depois da intervenÃÃo realizada. A anÃlise dos dados ocorreu por meio de testes estatÃsticos do Software Statistical Package for Social Sciences (SPSS), versÃo 17.0 for Windows. Considerou significantes as anÃlises estatÃsticas inferenciais quando p < 0,05. Salienta-se que a anÃlise tambÃm ocorreu baseada na literatura da referente ao tema. Esta pesquisa atendeu os aspectos Ãticos, sendo aprovada com o protocolo nÃmero 229.369. A primeira etapa da pesquisa originou o prÃ-teste e o pÃs-teste com dez questÃes de mÃltipla-escolha, menciona-se que estes instrumentos foram oriundos de um questionÃrio com trinta questÃes. No que se refere à segunda etapa, foi verificado que nÃo houve diferenÃa estatisticamente significante entre as variÃveis sexo (p valor 0,168), sÃrie (p valor 0,509), moradia (p valor 0,905) e inÃcio da atividade sexual ( p valor 0,695). No que se refere Ãs diferenÃas estatisticamente significantes entre a aplicaÃÃo do jogo educativo, palestra expositiva e aula ministrada tradicionalmente, notou-se que nÃo houve diferenÃa entre a palestra e o jogo, mÃdia dos postos foram 2,1 e 2,45 respectivamente. No entanto quando comparado o jogo ao grupo que nÃo recebeu uma intervenÃÃo especÃfica, percebeu-se que houve diferenÃa (p valor < 0,001). Por meio deste estudo concluiu-se que o jogo educativo auxilia no processo educativo do adolescente assim como a palestra expositiva, no entanto melhor que nenhuma atividade especÃfica na prevenÃÃo de DST/Aids. / Adolescence is a stage of life characterized by several events. One of the most important is the sexual activity. But due to the resulting changes at the adolescent process, sexual practices, in many cases, are made of unprotected form, as a result of it, teenagers are becoming more vulnerable to sexual diseases like STD / AIDS. In order to prevent this, the nurse comes up to try to intervene with this group in order to prevent and inform them about STD / AIDS. One way to achieve this is through health education that can make use of educational technologies in their practice. Among the various types of educational technologies highlighted, the educational game, due to its dynamic and entertaining features, favors the teaching-learning process of adolescents, being an important tool in the prevention of STD / AIDS in adolescence. This study aimed to validate an educational game built to help with the prevention of adolescent STD / AIDS in public schools of Fortaleza city, and also to compare the acquisition of knowledge of adolescents regarding STD / AIDS educational game using the expository lecture and regular class. It was a quasi-experimental study with a quantitative approach that was divided into two phases, the first of which was composed of 120 adolescents and the second of, initially, 198 adolescents. The first phase included the construction of a pre- and a post-test that were used in the next step. However, the second step was the application of the intervention itself, and one group received the educational game that addressed to the prevention of STD / AIDS, the second group also attended an illustrated lecture on the same topic and the third group class taught in the classroom by the teacher responsible for the group . The three groups responded to the pretest before the educational intervention and the posttest twentieth day following the intervention performed. Data analysis was based on statistical tests of the Software Statistical Package for Social Sciences (SPSS) version 17.0 for Windows. Considered significant inferential statistical analysis at p < 0.05 . It is noted that the analysis was also based on the literature on the topic. This research meets the ethical aspects, being approved with the number 229 369 protocol. The first stage of this research contained the pre- and post-tests, each one composed by ten multiple-choice questions, which were derived from a previous thirty question questionnaire. Regarding the second step, no statistically significant differences in the results were found among the variables âgenderâ (p value 0.168), âgradeâ (p value 0.509), âdwellingâ (p value 0.905) and âearly sexual activityâ (p value 0.695). In regard to statistically significant differences between the application of the educational game, the expository lecture and the regular class, no relevant distinction was noticed through the results of the educational game and the expository lecture, for their average score were 2.1 and 2.45 respectively. However, when compared the results of the game to those of the group that did not receive a specific intervention, a difference was noticed in the outcome (p value <0.001). Through this study it was concluded that the educational game assists in the educational process of the adolescent as well as the illustrated lecture, however rather than any specific activity in the prevention of STD / AIDS.

CoordenaÃÃo de AperfeiÃoamento de Pessoal de NÃvel Superior / A violÃncia sexual caracteriza-se como um grave problema de saÃde pÃblica que acarreta distÃrbios no desenvolvimento biopsicossocial e sexual de suas vÃtimas, principalmente quando essa agressÃo ocorre na fase da adolescÃncia, pois esses sujeitos se encontram numa etapa da vida marcada por mudanÃas e adaptaÃÃes, especialmente no Ãmbito da sexualidade. Portanto, as crenÃas e valores das vitimas de violÃncia sexual precisam ser compreendidas para promover a adoÃÃo de comportamentos sexuais saudÃveis. Objetivou-se compreender como as crenÃas e valores das adolescentes vitimas de violÃncia sexual influenciam no comportamento de prevenÃÃo das DST e da AIDS com base no Modelo de CrenÃas em SaÃde (MCS) . Trata-se de uma pesquisa qualitativa, descritiva, realizada numa InstituiÃÃo de Acolhimento no Municipal de Fortaleza, no perÃodo de maio a julho de 2011, com oito adolescentes vitimas de violÃncia sexual. Foram utilizados como instrumentos e procedimentos para a coleta de informaÃÃes: a observaÃÃo participante de todos os encontros, que foram registrados no diÃrio de campo; todo o material produzido durante os grupos focais, como cartazes, desenhos, entre outros; e a transcriÃÃo da gravaÃÃo dos diÃlogos durante as estratÃgias de grupo e do roteiro de entrevista semiestruturada. As informaÃÃes foram organizadas conforme as dimensÃes do MCS. Todos os aspectos legais e Ãticos da pesquisa envolvendo os seres humanos foram respeitados. Inicialmente, foi necessÃrio caracterizar as participantes do estudo e observou-se que as histÃrias de vida dessas adolescentes estavam condizentes com a literatura. Em relaÃÃo Ãs categorias criadas conforme o MCS: as adolescentes tem um dÃfice de conhecimento em relaÃÃo a essas doenÃas e nÃo se consideraram susceptÃveis as DST/AIDS por acreditarem que nÃo irÃo se relacionar sexualmente com homens, mesmo identificando a maior vulnerabilidade da mulher a essas patologias; em relaÃÃo à percepÃÃo da gravidade, elas classificaram essas doenÃas como graves, incurÃveis e que alteram o convÃvio social, demonstrando medo de contrair uma dessas patologias; identificaram como benefÃcios e barreiras do mÃtodo preventivo ser de fÃcil acesso e utilizaÃÃo e prevenir tanto doenÃas como gravidez, mas interferem no prazer sexual; e seu uso està relacionado com questÃes culturais e sociais, ressalta-se tambÃm, que o abuso de Ãlcool e drogas intervÃm na adoÃÃo de comportamentos saudÃveis. Conclui-se que as crenÃas e valores dessas adolescentes as tornam vulnerÃveis a DST/AIDS, sendo necessÃrio refletir sobre as consequÃncias da violÃncia sexual na vida dessas adolescentes para a elaboraÃÃo de estratÃgias e aÃÃes preventivas voltadas para esse publico-alvo no que concerne ao desenvolvimento da sexualidade de forma segura, minimizando traumas e sofrimentos advindos dessa experiÃncia na vida dessas adolescentes, tornando-as conscientes dos seus direitos sexuais e reprodutivos. / Sexual assault is characterized as a serious public health problem that leads to disorders in the bio-psychosocial and sexual development of the victims, especially when the aggression happens in adolescence, because these subjects are in a stage of life marked by changes and adaptations, especially concerning sexuality. Therefore, the values and beliefs of the victims of sexual assault must be understood to promote the adoption of a healthy sexual behavior. It was aimed to understand how beliefs and values of adolescent victims of sexual assault influence the behavior of prevention of STD/AIDS based on the Health Belief Model. It is a qualitative descriptive research carried out at a Host Institution in the City of Fortaleza from May to July 2011 with eight adolescent victims of sexual assault. Using as tools and procedures for data collection: participant observation of all meetings, which were registered in a field diary; all the material produced during the focus groups, such as posters, drawings, among others; and the transcription of the dialogue recording during the group strategies and semi-structured interviews. The information was organized according to the Health Belief Model dimensions. All legal and ethical aspects of researches involving human beings were respected. Initially, it was necessary to characterize the study participants and it was found that the life stories of these adolescents were consistent with the literature. Regarding the categories created according to the Health Belief Model: the adolescents lack knowledge about these diseases and don't considered them susceptible to STD/AIDS because they believe that they will not relate sexually with men, in spite identifying the greater vulnerability of women to such pathologies; concerning the perception of gravity, they classified these diseases as serious, incurable, and that changes social life, demonstrating fear of contracting these diseases; they identified as benefits and barriers of preventive method: it is easy to access and use, and prevents both diseases as pregnancy, but interferes with sexual pleasure; and its use is related to cultural and social issues, we also emphasize that the abuse of alcohol and drugs interferes in the adoption of healthy behaviors. We conclude that the beliefs and values of these adolescents make them vulnerable to STD/AIDS, being necessary to reflect on the consequences of sexual violence in their lives to build strategies and preventive actions aimed at this target audience in terms of a safe development of sexuality, minimizing trauma and suffering resulting from this experience in their lives, making them aware of their sexual and reproductive rights.

Magister Psychologiae - MPsych / An epidemiological study was conducted with the main goal of describing the occurrences of the various STIs in the Eastern Cape province as well as biographical factors such as age, gender, and geographical location influencing them. Ten primary health care (PHC) centres located throughout the province served as sentinel sites for surveillance data collection for a period of 3 months using Daily and Monthly Report Forms. The surveillance data was analysed using relative frequencies to determine STIs prevalence. The main findings from the present study suggest that the most frequently encountered female syndromes were vaginal discharge and lower abdominal pains and most frequent male syndrome was Urethral discharge. Other syndromes accounted for less than 10% of the STI cases observed at the PHC centres during the study. The study also indicate that more STI patients were seen at urban PHC centres compared to rural ones and that most of the STI patients seen at PHC centres were women. These findings are helpful for the Health Department in the Eastern Cape Province to effectively plan for the control and prevention of all STIs including HIV I AIDS.

Bibliography: leaves 103-113. Uses GIS to map the pattern of widespread transmission, commercial sex workers, poverty prevalence, illiteracy rate, population displacement and other social indicators to show the vulnerability of the region's population; and to demonstrate that there is no single point of radiation of HIV/AIDS in the sub region. Discusses mitigation and prevention strategies and proposes the use of GIS be incorporated in the fight against HIV/AIDS in sub Saharan Africa.

Sexually transmissible infections (STIs), one of the major preventable health problems affecting the Australian population, are often asymptomatic and, if undetected, can cause sub-fertility, infertility and chronic morbidity. In addition to these significant and costly consequences, STIs increase the risk of transmission of HIV. Given that 80% of Australian patients attend their General Practitioner (GP) each year, GPs are well placed to have a significant impact on STI transmission by diagnosing and treating both asymptomatic and symptomatic disease. Good professional practice would suggest that all GPs will undertake certain actions when they are consulted by a patient who either has symptoms of an STI or who appears to be at risk of acquiring an STI. This expectation is based on the premise that all GPs share the same detailed knowledge of STI risk factors and symptoms. It assumes that they will have no difficulty in eliciting such information from the patient, that the patient will comply with STI testing and treatment and that the patient will return for follow-up, to ensure that they and their sexual partners have been adequately treated. Given the constraints of the real world in which general practice exists, the sensitive nature of sexual health, and the stigma associated with STIs, there are many barriers to achieving such an outcome. My own previous research has highlighted some of the difficulties experienced by GPs in the area of STI control. This study has used data from four different sources (policy and stakeholder documents, literature, key informant interviews and my own past research) to examine ideal practice and actual practice in the prevention and treatment of STIs. A number of discrepancies were identified, and from these arose a series of recommendations for ways of making STI control in general practice less complex. To ensure that the results of the study were firmly embedded in the reality of general practice, comments on the recommendations were sought from GPs employed in a variety of practice settings, including those with low STI caseloads. These comments were used to modify the recommendations to ensure they would offer a practical and effective contribution to STI control in Victoria.

Thesis (Ph. D.)--University of Texas at Austin, 2007. / Vita. Includes bibliographical references.

Sexually transmitted infections (STIs) and unplanned pregnancy are significant public health concerns. Abstinence-only until marriage (AOUM) and abstinence pledge programs have received a significant amount of government funding in an attempt to address these problems. Despite receiving over two billion dollars in funding, the programs have not been shown to be effective in achieving their stated goals. In addition, there are significant concerns about the content of AOUM curriculums, including medical inaccuracy and use of outdated gender stereotypes.

The genus Chlamydiae encompasses a unique class of obligate intracellular bacteria that can cause disease in a wide range of animals. In humans, Chlamydia trachomatis infections are common and are frequently observed in diseases of the eye, genital and respiratory tracts. Prevalent worldwide, Chlamydia infections can progress to chronic inflammatory sequellae and are the leading cause of curable sexually transmitted disease and preventable blindness. After falling in the face of intensified control efforts, case notifications of sexually transmitted Chlamydia in many countries are rising. In many jurisdictions, this unprecedented rise of Chlamydia case notifications has occurred after the introduction of wide spread control programs, and has been discussed to be a result of either increased testing volume, improvements to testing technologies, changes in sexual behaviour, or increased reinfection rates brought about by deleterious effects of treatment on acquired immunity. This thesis seeks to answer the question of why observed Chlamydia case notifications have rebounded? I have attempted to answer this question using simple dynamical models of Chlamydia transmission framed from immunological and epidemiological perspectives. Model structures are drawn from frameworks previously used for studying sexually transmitted infections, and represent a combination of theoretical and data-oriented formulations, as well as different (hierarchical) ecological scales. The results of this thesis highlight that increased testing volumes, rather than changes in the sensitivity and specificity of testing technologies, sexual behaviour, or truncated immunological responses brought about by treatment can explain the increase in observed chlamydia case notifications, and that simple explanations for these observed rates appear to have been dismissed in favor of an increase to the underlying prevalence. In addition to providing insights into current epidemiological trends, this thesis has also been able to produce significant insights into the natural history of chlamydial infection. In particular, the phenotype of an individual's immunobiology that results from multiple chlamydial infections suggests that longer periods between initial and repeat infection may increase an individual's chlamydial load, their duration of infection, as well as non-intuitively the formation of protective immunity, persistent infection, and the potential for immunopathogenesis. Additional population-scale analyses in this thesis also suggest the existence of a period of immunity that is, on average, much longer lasting than currently discussed in contemporary literature. The results of this research outline a potential way forward through filling several gaps in the immunological and epidemiological understanding of Chlamydia infections that involves both reviewing existing data as well as continued research using "systems science" approaches.

This thesis comprises a detailed analysis of sexual risk behavior among female sex workers participating in a prospective cohort study in Mombasa, Kenya between 1993 and 2007. To determine whether high-risk behavior has decreased over time, I examined trends in and associations with condom use and partner numbers at enrolment and over follow-up using multinomial logistic regression. While condom use increased among women enrolling into the cohort, women reduced partner numbers, rather than increasing condom use, over cohort visits. Workplace, charge for sex, duration of sex work, alcohol use, pregnancy and illness were all predictors of condom use. To evaluate the extent to which HIV risk estimates were affected by loss to follow-up, I investigated associations between sexual risk behavior, loss to follow-up, and HIV acquisition, using competing risks regression. Women reporting unprotected sex with multiple partners had the highest risk for HIV infection, and were also most likely to remain in the cohort. Finally, I used Andersen-Gill modeling to assess the impact of sexual risk behaviors on acquisition of sexually transmitted infections (STI) including gonorrhea, non-specific cervicitis, and trichomoniasis. While incident gonorrhea was closely associated with recent sexual risk behavior, incident trichomoniasis was not. Both conditions had high hazards for recurring in a 90-day window after a prior diagnosis. Non-specific cervicitis was demonstrated to be a chronic, relapsing condition associated with protected sex with multiple partners (possibly due to more frequent condom use) and with known biologic risk factors (i.e., pregnancy, hormonal contraceptive use, cervical ectopy, and genital ulcer disease). Overall, these analyses have led to a better understanding of how different sexual behavior patterns are associated with adverse outcomes, including HIV and STI acquisition, and identified specific factors associated with high-risk sexual behavior that may be amenable to intervention.

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.