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Ballester-Arnal R, Giménez-García C, Ruiz-Palomino E, Castro-Calvo J, Gil-Llario MD. A Trend Analysis of Condom use in Spanish Young People over the Two Past Decades, 1999-2020. AIDS Behav 2022; 26:2299-2313. [PMID: 35038068 PMCID: PMC8762636 DOI: 10.1007/s10461-021-03573-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/28/2021] [Indexed: 11/18/2022]
Abstract
HIV exposure is one of the greatest sexual risks in young people, and condom use is the best protective measure. Despite the preventive efforts, trend in condom use is still unclear. This study examines the trend of condom use by gender in Spanish young people, in different sexual practices (vaginal, oral and anal), relationships (regular and casual) and having sex after drugs consumption during the two past decades (from 1999 to 2020). For this, 14,472 people who ranged from 17 to 40 years old (63.5% women) filled the AIDS Prevention Questionnaire in each year. In general, low condom use remains stable and even gets worse regardless of the type of sexual practice, relationship and the substance consumption. Regarding gender, this trend is worse in women who have been less likely to report condom use than men have. Moreover, older people have reported a minor frequency of condom use than the youngest people have done, except for anal sex. Therefore, it is necessary to analyze why, despite preventive efforts, condom use seems to decrease over time.
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de Wit JBF, Adam PCG, den Daas C, Jonas K. Sexually transmitted infection prevention behaviours: health impact, prevalence, correlates, and interventions. Psychol Health 2022; 38:675-700. [PMID: 35748408 DOI: 10.1080/08870446.2022.2090560] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
Sexually transmitted infections (STIs) remain a major public health threat, disproportionately affecting young people, and men who have sex with men. In this narrative review of the current state of behavioural science research on STI prevention, we consider the definition, health impacts, correlates and determinants, and interventions to promote STI prevention behaviour. Research on STI prevention behaviour has extended from a focus on abstinence, partner reduction and condom use, to also include novel preventive behaviours, notably treatment-as-prevention, pre-exposure prophylaxis (i.e., the preventive use of medicines by uninfected people), and vaccination for some STIs. Social-cognitive factors specified by, for instance the theory of planned behaviour, are critical proximal determinants of STI prevention behaviours, and related interventions can effectively promote STI prevention behaviours. Social-ecological perspectives highlight that individual-level determinants are embedded in more distal environmental influences, with social stigma especially affecting STI prevention behaviours and requiring effective intervention. Further to providing a major domain of application, STI prevention also poses critical challenges and opportunities for health psychology theory and research. We identify a need for health behaviour theory that addresses the processes linking multiple levels of influence on behaviour and provides practical guidance for multi-level behaviour change interventions adapted to specific contexts.
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Affiliation(s)
- John B. F. de Wit
- Department of Interdisciplinary Social Science, Utrecht University, Utrecht, The Netherlands
- Centre for Social Research in Health, UNSW Sydney, Kensington, Australia
| | - Philippe C. G. Adam
- Centre for Social Research in Health, UNSW Sydney, Kensington, Australia
- Institute for Prevention and Social Research, Bangkok, Thailand
| | - Chantal den Daas
- Department of Interdisciplinary Social Science, Utrecht University, Utrecht, The Netherlands
- School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen, Scotland
| | - Kai Jonas
- Department of Work and Social Psychology, Maastricht University, Maastricht, The Netherlands
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Brunelli L, Bravo G, Romanese F, Righini M, Lesa L, De Odorico A, Bastiani E, Pascut S, Miceli S, Brusaferro S. Sexual and reproductive health-related knowledge, attitudes and support network of Italian adolescents. PUBLIC HEALTH IN PRACTICE 2022; 3:100253. [PMID: 36101775 PMCID: PMC9461229 DOI: 10.1016/j.puhip.2022.100253] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Revised: 03/28/2022] [Accepted: 03/30/2022] [Indexed: 11/24/2022] Open
Abstract
Objectives What is the state of sexual and reproductive health (SRH) knowledge among teens? What about adolescents' attitudes toward SRH and the available supporting network? Study design A cross-sectional study conducted between April and May 2018. Methods An anonymous 36-item questionnaire on SRH knowledge, behaviors, and networks was developed, revised and validated by a multidisciplinary health professional team, then distributed to high school students in Udine (Italy). Results 747 questionnaires were collected in five high schools; respondents were predominantly male, mean age 14.8 years; 48% of students have sufficient SRH knowledge (considered as above the mean value). Factors associated with higher knowledge levels were female sex, age, SES according to father's profession, first SRH information at age 11-13, Italy as country of origin, and attendance at a technical school. Conclusions Students' knowledge on SHR resulted relatively poor. Sex, school type and previous experience of sexuality education were the most important factor associated with SRH knowledge.
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Affiliation(s)
- Laura Brunelli
- Dipartimento di Area Medica, Università degli Studi di Udine, Via Colugna 50, 33100, Udine, Italy
- SOC Accreditamento, Gestione del Rischio Clinico e Valutazione delle Performance Sanitarie, Azienda Sanitaria Universitaria Friuli Centrale, via Colugna 50, 33100, Udine, Italy
| | - Giulia Bravo
- Dipartimento di Area Medica, Università degli Studi di Udine, Via Colugna 50, 33100, Udine, Italy
| | - Federico Romanese
- Dipartimento di Prevenzione, Azienda Sanitaria Universitaria Giuliano Isontina, via Paolo de Ralli 3, 34128, Trieste, Italy
| | - Marco Righini
- Dipartimento di Area Medica, Università degli Studi di Udine, Via Colugna 50, 33100, Udine, Italy
| | - Lucia Lesa
- Direzione Medica, Azienda Sanitaria Universitaria Friuli Centrale, P.le S. Maria della Misericordia 1, 33100, Udine, Italy
| | - Anna De Odorico
- Dipartimento di Area Medica, Università degli Studi di Udine, Via Colugna 50, 33100, Udine, Italy
| | - Elisa Bastiani
- Clinica di Malattie Infettive, Azienda Sanitaria Universitaria Friuli Centrale, P.le S. Maria della Misericordia 1, 33100, Udine, Italy
| | - Stefania Pascut
- Health and Well-being Department, Municipality of Udine, via Lionello 1, 33100, Udine, Italy
| | - Stefano Miceli
- Dipartimento di Prevenzione, Azienda Sanitaria Universitaria Friuli Centrale, via Chiusaforte 2, 33100, Udine, Italy
| | - Silvio Brusaferro
- Dipartimento di Area Medica, Università degli Studi di Udine, Via Colugna 50, 33100, Udine, Italy
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How old are young people when they start having sex? Unravelling the applicability of Cox proportional hazards regression. J Public Health (Oxf) 2021. [DOI: 10.1007/s10389-021-01619-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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Molnar A, Iancu M, Radu R, Borzan CM. A Joinpoint Regression Analysis of Syphilis and Gonorrhea Incidence in 15-19-Year Old Adolescents between 2005 and 2017: A Regional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17155385. [PMID: 32726916 PMCID: PMC7432243 DOI: 10.3390/ijerph17155385] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Revised: 07/22/2020] [Accepted: 07/23/2020] [Indexed: 11/16/2022]
Abstract
Background and Objectives: Surveillance of syphilis and gonorrhea in Romania is case-based and makes use of European case definitions. Adolescence is a period characterized by vulnerabilities and opportunities, a period when health decisions, including those related to sexually transmitted infections, may have a lifetime impact. The present study investigates the trends recorded in the incidence of syphilis and gonorrhea in 15-19 year-old adolescents in the central and northwestern regions of Romania. Materials and Methods: An observational study was conducted and this included surveillance data for syphilis and gonorrhea in the period 2005-2017 (n = 939). The distribution of demographic and epidemiological variables in adolescents with syphilis and gonorrhea was evaluated, as well as the tendency of the incidence of syphilis and gonorrhea in the studied population. Joinpoint regression analysis was used to characterize the incidence trend for syphilis and gonorrhea. Results: Between 2005 and 2017, 773 cases of syphilis and 166 cases of gonorrhea were reported. The incidence of syphilis and gonorrhea decreased. Most cases of syphilis have been found out by active detection. Most cases of gonorrhea have been found out by passive detection. The age distribution in the group diagnosed with syphilis was similar to that in the group diagnosed with gonorrhea. There was a higher frequency of syphilis in females and gonorrhea was more common in males. Syphilis was more common in rural areas. Gonorrhea was more common in urban areas. Conclusions: There was a decreasing tendency in the incidence of syphilis and gonorrhea in adolescents aged 15-19 during the studied period.
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Affiliation(s)
- Anamaria Molnar
- National Institute of Public Health, Regional Center of Public Health Cluj, Louis Pasteur Str., no. 6, 400349 Cluj-Napoca, Romania; (A.M.); (R.R.)
- Department of Public Health, Iuliu Haţieganu University of Medicine and Pharmacy Cluj-Napoca, Avram Iancu Str., no. 31, 400083 Cluj-Napoca, Romania;
| | - Mihaela Iancu
- Department of Medical Informatics and Biostatistics, Iuliu Haţieganu University of Medicine and Pharmacy Cluj-Napoca, Louis Pasteur Str., no. 6, 400349 Cluj-Napoca, Romania
- Correspondence:
| | - Rodica Radu
- National Institute of Public Health, Regional Center of Public Health Cluj, Louis Pasteur Str., no. 6, 400349 Cluj-Napoca, Romania; (A.M.); (R.R.)
| | - Cristina Maria Borzan
- Department of Public Health, Iuliu Haţieganu University of Medicine and Pharmacy Cluj-Napoca, Avram Iancu Str., no. 31, 400083 Cluj-Napoca, Romania;
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Abstract
We conducted a critical appraisal of published Phase 2 and 3 efficacy trials in relation to the prevention of cervical cancer in women. Our analysis shows the trials themselves generated significant uncertainties undermining claims of efficacy in these data. There were 12 randomised control trials (RCTs) of Cervarix and Gardasil. The trial populations did not reflect vaccination target groups due to differences in age and restrictive trial inclusion criteria. The use of composite and distant surrogate outcomes makes it impossible to determine effects on clinically significant outcomes. It is still uncertain whether human papillomavirus (HPV) vaccination prevents cervical cancer as trials were not designed to detect this outcome, which takes decades to develop. Although there is evidence that vaccination prevents cervical intraepithelial neoplasia grade 1 (CIN1) this is not a clinically important outcome (no treatment is given). Trials used composite surrogate outcomes which included CIN1. High efficacy against CIN1+ (CIN1, 2, 3 and adenocarcinoma in situ (AIS)) does not necessarily mean high efficacy against CIN3+ (CIN3 and AIS), which occurs much less frequently. There are too few data to clearly conclude that HPV vaccine prevents CIN3+. CIN in general is likely to have been overdiagnosed in the trials because cervical cytology was conducted at intervals of 6-12 months rather than at the normal screening interval of 36 months. This means that the trials may have overestimated the efficacy of the vaccine as some of the lesions would have regressed spontaneously. Many trials diagnosed persistent infection on the basis of frequent testing at short intervals, i.e. less than six months. There is uncertainty as to whether detected infections would clear or persist and lead to cervical changes.
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Affiliation(s)
- Claire P Rees
- Centre for Global Public Health,
Institute of Population Health Sciences, Barts and The London School of Medicine and
Dentistry, Queen Mary University, London E1 2AB, UK
| | - Petra Brhlikova
- Institute of Health and Society,
Newcastle
University, Newcastle NE2 4AX, UK
| | - Allyson M Pollock
- Institute of Health and Society,
Newcastle
University, Newcastle NE2 4AX, UK,Allyson M Pollock.
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de Looze M, Madkour AS, Huijts T, Moreau N, Currie C. Country-Level Gender Equality and Adolescents' Contraceptive Use in Europe, Canada and Israel: Findings from 33 Countries. PERSPECTIVES ON SEXUAL AND REPRODUCTIVE HEALTH 2019; 51:43-53. [PMID: 30817858 PMCID: PMC6996477 DOI: 10.1363/psrh.12090] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/13/2018] [Revised: 11/21/2018] [Accepted: 11/26/2018] [Indexed: 05/30/2023]
Abstract
CONTEXT Although an association between gender equality and contraceptive use has been confirmed among adult samples, few studies have explored this relationship among adolescents. An examination of whether adolescents' contraceptive use is more prevalent in countries with higher levels of gender equality is needed to fill this gap. METHODS Nationally representative data from 33 countries that participated in the 2013-2014 Health Behaviour in School-Aged Children study and country-level measures of gender equality-using the 2014 Global Gender Gap Index-were analyzed. Multilevel multinomial logistic regression analyses were employed to assess associations between gender equality and contraceptive use (condom only, pill only and dual methods) at last intercourse as reported by 4,071 females and 4,110 males aged 14-16. RESULTS Increasing gender equality was positively associated with contraceptive use among both males and females. For every 0.1-point increase on the equality scale, the likelihood of condom use at last intercourse rose (odds ratio, 2.1 for females), as did the likelihood of pill use (6.5 and 9.6, respectively, for males and females) and dual method use (2.1 and 5.6, respectively). Associations with pill use and dual use remained significant after national wealth and income inequality were controlled for. Overall, associations were stronger for females than for males. CONCLUSIONS More research is needed to identify potential causal pathways and mechanisms through which gender equality and adolescents' contraceptive use may influence one another.
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Affiliation(s)
- Margaretha de Looze
- Assistant professor, Department of Inter disciplinary Social Science, Faculty of Social and Behavioural SciencesUtrecht UniversityUtrechtthe Netherlands
| | - Aubrey S. Madkour
- Associate professor, Department of Global Community Health and Behavioral SciencesTulane University School of Public Health and Tropical MedicineNew Orleans
| | - Tim Huijts
- Researcher, Research Centre for Education and the Labour Market, School of Business and EconomicsMaastricht UniversityMaastrichtthe Netherlands
| | - Nathalie Moreau
- Researcher, Service d'Information Promotion Education Santé, School of Public HealthUniversité Libre de BruxellesBrusselsBelgium
| | - Candace Currie
- Professor, Child and Adolescent Health Research Unit, WHO Collaborating Centre for International Child and Adolescent Health Policy, School of MedicineUniversity of St. AndrewsSt. AndrewsScotland
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