A Chlamydia trachomatis é um patógeno causador de doenças sexualmente transmissíveis (DST). Esse agente afeta significativamente a saúde sexual e reprodutiva de mulheres, estando relacionado à esterilidade em número bastante significativo,sendo também responsável por desfechos em gestantes acometidaspor DSTs no Brasil e no mundo. Apesar da sua alta prevalência, muito pouco se sabe sobre a distribuição de genótipos de Chlamydiatrachomatis. Este estudo teve como objetivo estimar a prevalência e os fatores associados à infecção causada por esse patógeno em gestantes admitidas na Maternidade da Fundação Santa Casa de Misericórdia do Pará. O estudo constou de uma amostra mínima de 363 gestantes atendidas por demanda espontânea, sendo incluídas na amostra o excedente de 32 gestantes totalizando 395 gestantes,em um período da coleta de 3 meses. Foram aplicados testes Qui-quadrado para verificação de associações entre as variáveis selecionadas para ump<0,05 como estatisticamente significativo. A prevalência de infecção porChlamydiafoi de 9,11%. A infecção porChlamydianão se associou à idade(p = 0,826),à realização de consulta pré-natal (p = 0,451),à presença de HIV (p = 0,379)ao exame VDRL(p = 0,344) ou à prematuridade (p = 0,229). O estudo mostra alta prevalência de infecção por Chlamydiatrachomatis em gestantes. A infecção urogenital por Chlamydia trachomatis representa uma importante causa de morbidade perinatal, que pode ser adequadamente tratada por antibioticoterapia durante a gestação. A prevalência da infecção mostrou-se também superior às obtidas em outras populações de gestantes, sendo o Estado do Pará considerado de alta prevalência para a infecção. Fatores de risco para DSTs, como baixa idade, ausência de parceiro fixo e concomitância com outras DSTs apresentam-se importantes também dentro do quadro da infecção por Chlamydia trachomatis. / Chlamydia trachomatis is a pathogen that causes sexually transmitted infections (STIs). This agent significantly affects the sexual and reproductive health of women, and is related to sterility in a rather significant number of cases. It is also responsible for outcomes in pregnant women who have STIs in Brazil and worldwide. Despite its high prevalence, very little is known about the distribution of Chlamydia trachomatis genotypes. The objective of this study was to estimate the prevalence and factors associated with infection caused by this pathogen in pregnant women admitted to the Maternity Department at Fundação Santa Casa de Misericórdia do Pará, in the state of Pará. Sample of 363 pregnant women seen due to spontaneous demand, and the sample included the surplus of 32 pregnant women, to a total of 395 pregnant women in a 3-month collection period. Chi-Square tests were applied to verify the associations between the variables selected for a p < 0.05 as statistically significant. The prevalence of Chlamydia infection was 9.11%. The result of Chlamydiawas not associated with age (p = 0.826), antenatal visit (p = 0.451), presence of HIV (p = 0.379) VDRL test (p = 0.344) and with prematurity (p = 0.229). The study shows a high prevalence of infection due to Chlamydiatrachomatis in pregnant women. Urogenital infection due to Chlamydia trachomatis is a major cause of perinatal morbidity, which can be treated by antibiotics during pregnancy. The prevalence of infection also proved superior to those obtained in other populations of pregnant women, and the state of Pará is considered a place with a high prevalence of the infection. Risk factors for STIs, such as young age, absence of a fixed partner and concomitance with other STIs are also important in the picture of infection by Chlamydia trachomatis.

Background: Social networks, norms, and discussions about sexual health may inform sexual practices, influencing risk of human immunodeficiency virus (HIV) or sexually transmitted infection (STI) acquisition. To better understand social networks of Peruvian men who have sex with men (MSM) and transgender women (trans women), we examined key social network members (SNMs), participant perceptions of these network members’ opinions toward sexual health behaviors, and associations between network member characteristics and condomless anal intercourse (CAI). Methods: In a 2017 cross-sectional study, a convenience sample of 565 MSM and trans women with HIV-negative or unknown serostatus was asked to identify three close SNMs; describe discussions about HIV and STI prevention with each; and report perceived opinions of condom use, HIV/STI testing, and partner notification of STIs. Generalized estimating equations evaluated relationships between SNM characteristics, opinions, and discussions and participant-reported CAI. Results: Among participants who identified as MSM, 42.3% of key SNMs were perceived to identify as gay. MSM “never” discussed HIV and STI prevention concerns with 42.4% of heterosexual SNMs, but discussed them “at least once weekly” with 16.9 and 16.6% of gay- and bisexual- identifying SNMs, respectively. Among participants who identified as trans women, 28.2% of key SNMs were perceived as heterosexual; 25.9%, as bisexual; 24.7%, as transgender; and 21.2%, as gay. Trans women discussed HIV/STI prevention least with cis-gender heterosexual network members (40.2% “never”) and most with transgender network members (27.1% “at least once weekly”). Participants perceived most of their close social network to be completely in favor of condom use (71.2% MSM SNMs, 61.5% trans women SNMs) and HIV/STI testing (73.1% MSM SNMs, 75.6% trans women SNMs), but described less support for partner STI notification (33.4% MSM SNMs, 37.4% trans women SNMs). Most participants reported CAI with at least one of their past three sexual partners (77.5% MSM, 62.8% trans women). SNM characteristics were not significantly associated with participant-reported frequency of CAI. Conclusions: Findings compare social support, perceived social norms, and discussion patterns of Peruvian MSM and trans women, offering insight into social contexts and sexual behaviors. Trial registration: The parent study from which this analysis was derived was registered at ClinicalTrials.gov (Identifier: NCT03010020) on January 4, 2017. / National Institutes of Health / Revisión por pares

This Diploma thesis explores the issue of queer femmes' access to sexual healthcare, and specifically focuses on the current situation of accessibility of sexual healthcare centers in Berlin. Written in constructivist paradigm, it is built on intersectional feminist theory, as well as post-colonial and disability studies. By employing autoethnographic research, the author aims to review local sexual healthcare facilities by describing her own experience, supplemented by questionnaires and interviews. Sharing intimate details of her own visits during which the author was tested or treated for sexually transmitted infections, she attempts to "queer" academic practice and present an approachable and highly personal body of work that embraces the researcher's subjectivity and entangled position. Apart from presenting findings of the research, this thesis also aims to offer possible solutions on how to make sexual healthcare more accessible to queer femmes, and includes the author's plans as a sex educator. Keywords: sexual healthcare, STIs, queer femmes, sexual health, autoethnography

Sexual anxiety is a prevalent issue among men who have sex with men (MSM) that negatively affects sexual satisfaction and wellbeing. However, research investigating sexual anxiety among MSM has been scarce. This descriptive phenomenological study was conducted to address knowledge gaps and identify the predominant underlying causes of sexual anxiety among non-monogamous MSM. Using purposive sampling, eleven sexually active, non-monogamous MSM were recruited for this study (N=11). Data were collected using audio-recorded, semi-structured interviews, and analyzed using Moustakas’ (1994) structured approach to data analysis in phenomenological research. Participant descriptions of their lived experiences of sexual anxiety identified six prevalent causes among MSM individuals. These included performance anxiety, fear of HIV, fear of bacterial STIs, internalized homophobia, body image dissatisfaction, and history of sexual abuse. Not surprisingly, fear of HIV was the dominant cause of sexual anxiety among most participants. Recommendations to prevent and reduce sexual anxiety among MSM are provided.

To improve understanding of factors associated with intimate partner violence (IPV) and explore its role in sexually transmitted infection (STI) acquisition, we analyzed partnership-level correlates of IPV among men who have sex with men (MSM) and transgender women (TW) in Peru. In a 2017 cross-sectional study of rectal STI screening and HIV prevention, MSM/TW completed a sociobehavioral survey addressing demographic characteristics, sexual risk behaviors, and substance use, and were tested for rectal gonorrhea and chlamydia, syphilis, and HIV. Generalized estimating equations estimated individual- and partner-level correlates of IPV. Of 576 participants (median age, 27 years), 7.9% (36/456) of MSM and 15.0% (18/120) of TW reported IPV with ≥ 1 of their last three partners. MSM/TW reporting IPV were more likely to meet criteria for an alcohol use disorder (74.1%) than participants reporting no IPV (56.7%; p <.01). Physical violence (4.5% MSM; 9.2% TW) was associated with stable partnerships (aPR 3.79, 95% CI 1.79–8.04), partner concurrency (4.42, 1.19–16.40), and participant alcohol (4.71, 1.82–12.17) or drug use (5.38, 2.22–13.02) prior to sex. Psychological violence (4.5% MSM; 5.0% TW) was associated with stable partnerships (2.84, 1.01–7.99). Sexual IPV was reported by 1.1% of MSM and 5.0% of TW. Physical, psychological, and sexual IPV were reported in sexual partnerships of Peruvian MSM and TW, particularly with stable partners and in conjunction with substance use. / Revisión por pares

Thèse numérisée par la Direction des bibliothèques de l'Université de Montréal.

The incidence of gonorrhea had declined since the HIV epidemic in the late 1980s, but is now increasing globally due to the emergence of antibiotic-resistant forms of this disease. In South Africa, the incidence of gonorrhea is highest among Black women due to their high co-infection rates with HIV and other sexually transmitted infections (STIs). This study examined the psychosocial determinants of gonorrhea among Black women aged 18 - 35 in the Langa township in Cape Town, South Africa. All participants had reported at least one sexual experience and at least one positive test for gonorrhea in the past two years. Participant recruitment involved flyer distribution at LoveLife, the community partner to the research study. After an initial screening call, 12 women were considered eligible and participated in the study. Interview data were gathered, transcribed, then hand-coded for emergent themes, guided by the tenets of the information-motivation-behavioral (IMB) skills conceptual framework. The findings of the study identified that the women did not have extensive knowledge of gonorrhea but believed that factors such as a sense of vulnerability, stress in relationships, and social/environmental factors increased their risk of contracting gonorrhea disease. These findings have global implications, as they lay the foundation for follow-up quantitative studies and outline policy recommendations for addressing gonorrhea.

Background: The Division of Global HIV/AIDS at the Centers for Disease Control and Prevention (CDC) is working on a public health evaluation (PHE) in the eastern districts of Botswana. This PHE aims to evaluate the effectiveness of Project AIM, a group-level intervention designed to reduce HIV risk behaviors in youth ages 11 to 14, when combined with the regular Botswana Skills for Life Curriculum, a standard HIV prevention education curriculum in Botswana schools. In order to evaluate Project AIM, a self-report survey and a biological testing for herpes simplex virus type 2 (HSV-2) will be conducted. Methodology: Based on studies done on the psychosocial impact of HSV-2 diagnosis on asymptomatic individuals in the USA, the literature recommends providing pre and post counseling and education to individuals testing for genital herpes to help cope and diminish the psychosocial impact of the diagnosis. In order to prepare Botswana’s clinics and schools participating in the PHE to provide the support for newly diagnosed adolescents with HSV-2, guidance materials were developed for health care practitioners and school guidance teachers. Materials were created using Information Mapping technique to analyze, organize, and present the information, and the Microsoft Office Flesch Kinkade Grade Level (FK) tool to assess the readability levels of the materials. Results: Guidance materials were prepared using the 7±2 theoretical limit of human short-term memory information mapping rule, and the FK grade levels of 6.0 to 8.0 recommended readability scores. Guidance materials included information regarding HSV-2 symptoms, treatment, and prevention. They also included information on the PHE study, youth friendly health services, counseling and education, clinic referrals and contact information. Conclusions: The development of guidance materials for schools and clinic participants of the CDC PHE in Botswana will provide health practitioners and school guidance teachers with accurate HSV-2 information to counsel and educate student participants in this research study. The guidance materials should help students cope with potential psychosocial disorders associated with pre and post diagnosis of HSV-2.

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.

Far-ultraviolet (FUV) spectral images of Jupiter's moon Europa were obtained by the Space Telescope Imaging Spectrograph (STIS) on the Hubble Space Telescope (HST) on 20 occasions between the years 1999 and 2015. In this thesis these data are analyzed to look for Lyman-alpha emissions from a hydrogen corona. This hydrogen corona was recently discovered in absorption, also from HST Lyman-alpha images but with Europa in transit of Jupiter, and the aim of this study is to confirm the existence of the corona also in emission. Europa's thin atmosphere is dominated by molecular oxygen, mainly produced by radiolysis and sputtering of the icy surface. Atomic hydrogen, the main target for this study, is produced by sputtering from the surface and the dissociation of H2 and H2O. It quickly escapes the gravity of Europa. To study the hydrogen corona in the spectral STIS images the data need to be processed to remove the other Lyman-alpha contributions to the image. These other contributions include emissions from the geocorona, emissions from the interplanetary medium (IPM), dark current in the detector and sunlight reflected from the surface of Europa. To estimate the contribution to the image from the hydrogen corona, a basic model of the expected emissions from the corona is developed. By fitting this model to the processed STIS data values of the hydrogen density and the surface Lyman-alpha albedo of the moon are obtained. The results confirm the presence of a hydrogen corona, with varying densities between the different observations but generally about twice as large as the results from the previous study. The uncertainty for the results is however large and there is a clear correlation between hydrogen density and background level in the image, for which the reason is poorly understood. No hemispheric variability or connections to the true anomaly of the moon are found, but the hydrogen density seems to be increasing during the time of the observations. The results for the albedo is consistent with previous results, indicating a lower albedo on the leading than on the trailing hemisphere.