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Zhang X, Zhang X, Chen Y, Ou T, Wang X, Zhou H, Li X, Guo Y, Chen Z, Ruan W. Epidemiological trends and burden analysis of cervical cancer attributable to unsafe sex: A population-based study from 1990 to 2019. Public Health Nurs 2024; 41:1027-1038. [PMID: 39054588 DOI: 10.1111/phn.13382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2024] [Revised: 06/12/2024] [Accepted: 07/11/2024] [Indexed: 07/27/2024]
Abstract
BACKGROUND Unsafe sex is recognized as an important risk factor for cervical cancer (CC). Understanding the global disease burden of CC attributable to unsafe sex can assist policymakers in allocating healthcare resources. METHODS Data were obtained from the 2019 global burden of disease database (GBD). We examined global, regional, and national levels of CC mortality, disability-adjusted life years (DALYs), and age-standardized rates (ASRs) caused by unsafe sex. ASRs were evaluated using estimated annual percentage changes (EAPCs). RESULTS Attributable to unsafe sex, there were 280,479 CC-related deaths in 2019 and 8,955,013 CC-related DALYs. In the period 1990-2019, the global ASRs of CC due to unsafe sex decreased around the world; for age-standardized mortality rate (ASMR) and age-standardized DALY rate (ASDR), the EAPCs were -0.93 and -0.95. The highest ASMRs and ASDRs were found in central sub-Saharan Africa and the lowest in Australasia. CONCLUSION In the past few decades, the ASMR and ASDR of CC caused by unsafe sexual practices have decreased over time, with significant variations observed among different countries and regions. Increased focus is needed on spreading awareness about sexual health and promoting CC prevention and screening, particularly in low- and middle-income nations.
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Affiliation(s)
- Xinru Zhang
- Huiqiao Medical Center, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong Province, China
- School of Nursing, Southern Medical University, Guangzhou, Guangdong Province, China
| | - Xingxing Zhang
- Department of General Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong Province, China
| | - Yiteng Chen
- Huiqiao Medical Center, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong Province, China
- School of Nursing, Southern Medical University, Guangzhou, Guangdong Province, China
| | - Tongyin Ou
- Department of Thoracic Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong Province, China
| | - Xindi Wang
- Huiqiao Medical Center, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong Province, China
- School of Nursing, Southern Medical University, Guangzhou, Guangdong Province, China
| | - Hu Zhou
- Department of Thoracic Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong Province, China
| | - Xi Li
- Huiqiao Medical Center, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong Province, China
- School of Nursing, Southern Medical University, Guangzhou, Guangdong Province, China
| | - Yu Guo
- Huiqiao Medical Center, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong Province, China
| | - Zhiming Chen
- Department of Thoracic Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong Province, China
| | - Weiqing Ruan
- Huiqiao Medical Center, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong Province, China
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Oppong Asante K, Ampaw S, Gyan SE. Consistent condom use among sexually active young adults in Ghana: an analysis of prevalence and associated factors. Glob Health Promot 2024; 31:75-84. [PMID: 37933812 DOI: 10.1177/17579759231205850] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2023]
Abstract
Consistent and proper condom use offers a safer, economically cheap and practically effective means of preventing HIV infection. Using the 2014 Ghana Demographic and Health Survey with a sample of 2779 sexually active youth (males = 682 and females = 2,097) in the age range 15-24, this study explored the prevalence of, and factors associated with consistent condom use among sexually active young adults in Ghana. Multivariate logistic regression was used to analyse the data. Our results showed that approximately 11% of the respondents reported consistent condom use in their previous sexual activity. Females were more likely than males to have used a condom consistently. The logistic regression results showed that females who had tested for HIV were less likely to use a condom consistently. However, those who have obtained family planning information from print media and those from the northern part of Ghana were more likely to practise consistent condom use. Furthermore, males who professed the Traditional African religion were less likely to use a condom consistently. In contrast, males in the rich wealth category were more likely to use a condom consistently. These findings underscore the need for behavioural change campaigns targeting young adults, particularly those who are sexually active, to encourage consistent condom use. These interventions should target young adults with less family planning knowledge, those who know their HIV status and those who profess the Traditional African religion.
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Affiliation(s)
- Kwaku Oppong Asante
- Department of Psychology, University of Ghana, Ghana
- Department of Psychology, University of the Free State, South Africa
| | - Samuel Ampaw
- School of Economics, University of Nottingham Ningbo China, People's Republic of China
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Qiu P, He H, Zhao Y, Yang Z, Li S, Ni P, Guo Y, Ji C, Zhang C, Zhang H, Zhou C, Wang B. Global disease burden attributed to unsafe sex in 204 countries and territories from 1990 to 2019: results from the Global Burden of Disease Study 2019. Sci Rep 2023; 13:12900. [PMID: 37558737 PMCID: PMC10412620 DOI: 10.1038/s41598-023-40001-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Accepted: 08/03/2023] [Indexed: 08/11/2023] Open
Abstract
Unsafe sex has become a public safety problem that endangers society, and research on deaths and disability-adjusted life years (DALYs) related to unsafe sex is valuable for global policy-making. We aimed to estimate the deaths and DALYs attributable to unsafe sex by country, gender, age group, and sociodemographic status from 1990 to 2019. We extracted data on disease burden from the Global Disease Burden 2019 (GBD 2019) database for unsafe sex, including deaths, DALYs and age-standardized rates (ASRs). Comparative analyses were performed on data about deaths, DALYs and the responding ASRs attributable to unsafe sex in different countries and regions using the Social Demographic Index (SDI). The global age-standardized mortality rate (ASMR) and age-standardized DALY rate (ASDR) attributable to unsafe sex were 11.98 (95% uncertainty intervals (UI): 10.97-13.52) per 100,000 people and 570.78 (95% UI: 510.24-658.10) per 100,000 people, respectively. Both the ASMRs and ASDRs were the highest in southern sub-Saharan Africa and lowest in Australasia and decreased with increasing SDI levels. About unsafe-sex-related disease, HIV/AIDS has the highest ASMR [8.48 (95% UI: 7.62-9.95)/100,000 people] and ASDR [447.44 (95% UI: 394.82-533.10)/100,000 people], followed by Cervical cancer [ASMR: 3.40 (95% UI: 2.90-3.81)/100,000 people and ASDR: 107.2 (95% UI: 90.52-119.43)/100,000 people] and sexually transmitted infections excluding HIV [ASMR: 0.10 (95% UI: 0.08-0.11)/100,000 people and ASDR: 16.14 (95% UI: 10.51-25.83)/100,000 people]. The death and DALY burden caused by these three diseases were more serious in the over 75 years old age group. The 40-44 age group for men and the 35-39 age group for women had the highest population of unsafe sex-related deaths and DALYs, respectively. In addition, the burden of unsafe sex in women was more serious than those in men. Unsafe sex is an important risk factor for global disease burden and a leading cause of substantial health loss. We found that the risk of ASMRs and ASDRs attributable to unsafe sex had negative correlation with SDI levels. These results demonstrate that the need for revised policies that focus on efforts to reduce overall unsafe sex worldwide.
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Affiliation(s)
- Pei Qiu
- Department of Breast Surgery, The First Affiliated Hospital of Xi'an Jiaotong University, 277 Yanta Western Rd., Xi'an, 710061, Shaan'xi, China
- School of Medicine, Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Hairong He
- Clinical Research Center, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Yuting Zhao
- Department of Breast Surgery, The First Affiliated Hospital of Xi'an Jiaotong University, 277 Yanta Western Rd., Xi'an, 710061, Shaan'xi, China
- School of Medicine, Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Zejian Yang
- Department of Breast Surgery, The First Affiliated Hospital of Xi'an Jiaotong University, 277 Yanta Western Rd., Xi'an, 710061, Shaan'xi, China
- School of Medicine, Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Shouyu Li
- Department of Breast Surgery, The First Affiliated Hospital of Xi'an Jiaotong University, 277 Yanta Western Rd., Xi'an, 710061, Shaan'xi, China
- School of Medicine, Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Peng Ni
- Department of Breast Surgery, The First Affiliated Hospital of Xi'an Jiaotong University, 277 Yanta Western Rd., Xi'an, 710061, Shaan'xi, China
- School of Medicine, Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Yujie Guo
- School of Medicine, Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Chao Ji
- School of Medicine, Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Chenchen Zhang
- Department of Clinical Laboratory, The 940th Hospital of Joint Logistics Support Force of Chinese People's Liberation Army, Lanzhou, China
| | - Huimin Zhang
- Department of Breast Surgery, The First Affiliated Hospital of Xi'an Jiaotong University, 277 Yanta Western Rd., Xi'an, 710061, Shaan'xi, China
| | - Can Zhou
- Department of Breast Surgery, The First Affiliated Hospital of Xi'an Jiaotong University, 277 Yanta Western Rd., Xi'an, 710061, Shaan'xi, China.
| | - Bo Wang
- Center for Translational Medicine, The First Affiliated Hospital of Xi'an Jiaotong University, 277 Yanta Western Rd., Xi'an, 710061, Shaan'xi, China.
- Key Laboratory for Tumor Precision Medicine of Shaanxi Province, Xi'an, China.
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Williams DM. A meta-theoretical framework for organizing and integrating theory and research on motivation for health-related behavior. Front Psychol 2023; 14:1130813. [PMID: 36910809 PMCID: PMC9995609 DOI: 10.3389/fpsyg.2023.1130813] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Accepted: 02/03/2023] [Indexed: 02/25/2023] Open
Abstract
The concept of motivation is broad and multi-faceted. In health psychology, motivation has been conceptualized as cravings, urges, or desires for unhealthy behaviors, such as consumption of alcohol, cigarettes, or calorie-dense foods; or as behavioral intentions or proximal goals for healthy behaviors, such as smoking cessation, physical activity, or condom use. Because of the differences in terminology and associated theoretical underpinnings, it is difficult to characterize the state of the science or integrate research findings on motivation for health-related behavior. The present paper introduces a meta-theoretical Automatic-Reflective Motivation Framework (ARM-F) with the goals of organizing and integrating theory and research on motivation for health-related behaviors. At the first and broadest level, the ARM-F defines general motivation as a wanting or desire to do something. At the second level, it distinguishes between automatic and reflective motivation types, consistent with emerging perspectives in health psychology, historical and contemporary philosophical views on desire, and dual-processing perspectives in psychology. At the third level, the ARM-F preserves the nuanced terminologies and conceptualizations within the automatic (e.g., craving, urge, desire) and reflective (e.g., behavioral intention) motivation categories. The ARM-F has potential utility for organizing and integrating theory and research on motivation for health-related behavior, with implications for future research.
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Affiliation(s)
- David M Williams
- Department of Behavioral and Social Sciences, Center for Health Promotion and Health Equity, Brown University School of Public Health, Providence, RI, United States
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Chen F, Tang H, Han J, Li D, Li P, Wang N, Han M, Wang L, Wang L. Association of HCV Prior Infection and Unprotected Sex on Subsequent HIV Acquisition Risk in the Era of Treatment as Prevention. Front Med (Lausanne) 2022; 9:902271. [PMID: 35685415 PMCID: PMC9171012 DOI: 10.3389/fmed.2022.902271] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Accepted: 04/26/2022] [Indexed: 11/13/2022] Open
Abstract
Backgrounds Little was known about the impact of HCV prior infection on HIV transmission and acquisition. We aimed to explore whether HCV prior infection and its interactions with unprotected sex affected HIV acquisition. Methods This study was conducted among HIV heterosexual serodiscordant couples whose index cases were receiving treatment during 2008–2014 in Zhumadian. At baseline, we collected information on demographics and medical history of ART use, CD4 count, and HIV viral load for index partners, and also HIV and HCV status for non-index partners. For each year's visit, we followed up on sexual behaviors among couples in the recent year and HIV seroconversion of non-index partners. Analyses of the Cox model and synergistic interaction were performed. Results We identified 81 HIV seroconversions over 18,370.39 person-years, with the overall HIV seroconversion rate of 0.44 per 100 person-years. Couples, whose index cases were aged 50 years and above, had a baseline viral load >400 copies per ml and no AIDS-defining illness, and newly-initiated ART in the study period had a higher risk of HIV seroconversion. Unprotected sex and HCV prior infection showed a synergistic association with HIV acquisition risk (RERI = 3.65, SI = 0.48, AP = 2.24). Conclusion Unprotected sex and HCV infection were independent risk factors associated with HIV acquisition. The coexistence of them might have a synergistic effect on the risk which needs further research.
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Affiliation(s)
- Fangfang Chen
- National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Houlin Tang
- National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Juan Han
- Department of AIDS/STD Control and Prevention, Zhumadian Center for Disease Control and Prevention, Zhumadian, Henan, China
| | - Dongmin Li
- National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Peilong Li
- National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Ning Wang
- National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Mengjie Han
- National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Lan Wang
- Editorial Department of Chinese Journal of Epidemiology, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Lu Wang
- National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
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