Factors associated with condom use inyoung people-A population-based survey

Prevalence and factors associated with risky sexual behavior among Brazilian school adolescents

This article evaluated the prevalence and factors associated with risky sexual behavior (RSB) among Brazilian school adolescents. This is a cross-sectional study with data collected from the National Survey of School Health, 2019 edition, with a representative sample of 7th grade of elementary school to 3rd year of high school Brazilian school adolescents. This work evaluated sociodemographic, behavioral, sexual and reproductive health, mental health, sociability characteristics, medical advice received at school, and body image. RSB was characterized as the non-use of a condom during sexual intercourse. The data were analyzed using hierarchical Poisson regression modeling. The prevalence of RSB was of 40.3%, with the lowest proportion appearing in the North region (37.4%). The highest prevalence of RSB was found among female adolescents, whose first sexual intercourse occurred at 13 years of age or under, who were victims of sexual violence, who practiced bullying, and who used illicit drugs, cigarettes, and alcohol. Those who used a condom during their first sexual intercourse showed the lowest prevalence of RSB. The high prevalence of RSB among Brazilian school adolescents, together with the knowledge of the associated factors, serves to define strategies to favor improvements in the sexual and reproductive health of these young people.

Prevalence and determinants of condom use among the youth in Malawi: evidence from the 2015/16 Malawi Demographic and Health Survey

BACKGROUND

Unprotected sexual intercourse among the youth is common in Malawi. This has led to high rates of sexually transmitted infections (STIs), Human Immunodeficiency Virus (HIV), and unplanned pregnancies. The study investigated the prevalence and the determinants of male and female condom use for the prevention of sexually transmitted infections and unplanned pregnancies among the youth in Malawi.

METHODS

The 2015/2016 Malawi Demographic and Health Survey (MDHS) data were used among 15 to 24-year-old male and female who had sexual intercourse four months preceding the survey. A total of 1543 male and 5143 female were selected from 3226 male and 10,367 female respectively and analyzed with SPSS version 20 using.descriptive, bivariate, and logistic regression.

RESULTS

The study found a low prevalence (27.1%) of condom use among the youth in the last sexual intercourse within four months before the survey. More male (55.8%) used condoms than female (18.5%). The significant predictors of condom use among the male and female youth were: being sexually active (OR 0.39 CI 0.33-0.47), aged 20-24 (OR 0.80 CI 0.68-0.95), ever married (OR 0.07 CI 0.06-0.08), coming from central region (OR 0.56 CI 0.40-0.77), and southern region (OR 0.59 CI 0.42-0.83), residing in the rural area (OR 0.74 CI 0.61-0.90) and ever tested of HIV (OR 1.29 CI 1.03-1.55).

CONCLUSION

Having established low prevalence of condom use among the youth in Malawi, there is a need to scale up programs and policies that target the youth to practice safe sex, which will assist in addressing the challenges of STIs, including HIV, and preventing unplanned pregnancies in Malawi.

Sexual exposure to HIV in Angolan men who have sex with men immigrants: A cross-sectional study in Portugal and Brazil

BACKGROUND

In different contexts, international migrants are vulnerable to health disparities that increase the risk of HIV/AIDS exposure and continue to bear a significant burden of new virus infections in developed and developing countries. In this study, we sought to examine sexual practices and factors linked to HIV exposure among a sample of Angolan men who have sex with men (MSM) immigrants.

METHODS

The study was conducted in two Portuguese-speaking countries, Brazil and Portugal, and involved 250 Angolan MSM immigrants between September 2020 and February 2021, using sampling methods to constitute the sample and the HIV Incidence Risk Index (HIRI) to define virus exposure risk. Odds ratio (OR) and adjusted odds ratio (aOR) were used to calculate the chances of higher HIRI index in the sample.

RESULTS

Our results showed that 76.8% of participants presented a high HIRI index, influenced by the practice of chemsex (aOR: 4.26), having a known/repeated partner (aOR: 4.59), and engaging in passive sex without a condom in the last 30 days (aOR: 1.29) or 6 months (aOR: 1.98).

CONCLUSIONS

It is crucial to focus on this vulnerable population and implement sexual health policies that integrate combined HIV prevention measures aimed at immigrant MSM.

Assessing Condom Use and Views on HIV Counselling and Testing among TVET College Students in Limpopo Province, South Africa

South Africa's population is predominantly young, presenting a powerful resource for the country. Despite this, adolescents and young people remain at the epicentre of the HIV epidemic, particularly adolescent girls and young women (AGYW). There are limited studies that investigate the views on HIV Counselling and Testing (HCT) and condom use among adolescents and young people, and college students in particular, in South Africa. This cross-sectional study assessed condom use among college students and their views and opinions on HCT. Utilising an adapted questionnaire from the Australian Secondary students and the South African Sexual Health survey, the data from 396 students were analysed using univariate and multiple logistic regression performed using Stata IC version 16. The majority of the students (n = 339, 85.8%) had a sexual partner at the time of the study. Our findings reveal a relatively high occurrence of condom use in the last sexual encounter (n = 225, 60%) and high HCT uptake (n = 50, 88.4%). Females were generally more comfortable regarding HIV services compared to their male counterparts. More than half, 54.6% vs. 36.0% were comfortable about testing, 34.0% vs. 48.3% felt very scared about testing for HIV, 3.6% vs. 10.1% reported that they were not ready to take an HIV test, 7.6% vs. 5.6% intended getting tested soon (p = 0.0002). Condom use was significantly associated with the use of a condom during the first sexual encounter (aOR = 4.71, 95% CI: 2.14, 10.37) and knowing their partner's HIV status (aOR = 2.08, 95% CI: 1.19-3.65). The HCT and condom promotion strategies implemented by Higher Health in TVET colleges is showing success and colleges in other parts of the region could emulate these best practices. Program developers should consider tailor-made combinations of prevention interventions that would appeal to both female and male college students to improve condom use and uptake of HIV testing services.

Universitários e o Uso do Preservativo como Método de Prevenção das Infecções Sexualmente Transmissíveis

Introdução: O objetivo deste estudo foi analisar o conhecimento, a atitude e a prática dos universitários da área da saúde que já tiveram relações sexuais, sobre o uso do preservativo como método de prevenção das infecções sexualmente transmissíveis (IST). Metodologia: Estudo descritivo do tipo inquérito sobre Conhecimento, Atitude e Prática, com delineamento transversal e abordagem quantitativa. Foi executada em formato on-line, cujas informações foram obtidas por meio da aplicação de um questionário durante o período de setembro a dezembro de 2021. A análise de dados foi realizada por meio dos softwares JASP 0.9.1.0 e BioEstat 5.0. Resultados: Dos 162 participantes, 64.8% possuíam conhecimento adequado; 52.5%, atitude adequada; e 98.1%, prática inadequada em relação à prevenção. O conhecimento esteve associado com a religião (p=0.015), frequência de realização de testes rápidos (p=0.016) e diagnóstico prévio de IST (p=0.029); a atitude esteve associada com a renda familiar (p=0.027), procedência (p=0.017) e sexo (p=0.000); houve associação da prática com o relacionamento (p=0.040). Discussão: O acesso apropriado a meios de prevenção e de informações favorece melhores atitudes e práticas em relação ao uso dos preservativos. Conclusão: Os universitários podem estar vulneráveis às IST, sendo importante ações educativas voltadas à adesão do preservativo.

Prevalence of Good Condom Usage and Its Association with Condom Use Self-Efficacy among Youth Attending HIV/STDs Clinics in Primary-Care Settings in Malaysia

The low prevalence of condom usage among youth with Human Immunodeficiency Virus/Sexually Transmitted Diseases (HIV/STDs) is a concern. Condom use self-efficacy has been identified as a significant predictor of condom usage. This cross-sectional study examines the prevalence of good condom usage and its association with condom use self-efficacy among Malaysian urban youth, aged between 18 to 24 years old attending HIV/STDs clinics in primary-care settings, Selangor. Utilising the Harmonised Malay version of Condom Use Self-Efficacy Scale (CUSES M-H) questionnaire, the data from 218 responders were analysed using univariate and multiple logistic regression. The prevalence of good condom usage was 61% (95% CI: 54%, 68%). The average mean score of condom use self-efficacy was 3.07. Condom use self-efficacy was divided into four subscales of mechanics, perceived barriers, assertiveness and intoxicants. The assertiveness subscale had the highest average mean score of 3.42, while the intoxicant subscale score had the lowest average mean score of 2.24. Good condom usage was significantly associated with condom use during first sexual intercourse (aOR = 5.81, 95% CI: 1.97, 17.14), duration diagnosis of HIV/STDs of more than 12 months (aOR = 6.40, 95% CI: 2.30, 17.86) and the high assertiveness subscale score (aOR = 1.19, 95% CI: 1.03, 1.36). A behavioural change campaign that targets high-risk youth in primary care settings could promote condom use self-efficacy particularly assertiveness to increase condom usage among the youth.

"I always prefer to withdraw than use a condom": contextualising condomless sex among East Asian and sub-Saharan African international students in Sydney

BACKGROUND

Incidence and prevalence of blood-borne viruses and sexually transmissible infections among young people continue to necessitate population-based studies to understand how contextualised sexual health services can be developed and implemented to promote protective behaviours such as consistent condom use. This study examined condomless sexual practice among a sample of East Asian and sub-Saharan African international university students in Sydney, Australia.

METHODS

This qualitative study was methodologically guided by interpretative phenomenological analysis. Data was provided by 20 international students sampled from five universities in Sydney, who participated in either face-to-face or telephone semi-structured in-depth interviews. The interview sessions were audio-recorded, transcribed verbatim, coded in NVivo and analysed using reflexive thematic analysis.

RESULTS

Condomless sexual practices appear to be common among the study group based on participants' self-reports of their own practices and the practices of friends and peers. Three themes contextualising condomless among the study participants were generated from the interview transcripts: (1) unanticipated sex, condom related stigma and alcohol use (2) pleasure-seeking, curiosity and intimacy (3) condomless sex as a gendered practice.

CONCLUSIONS

The result of this study has implications for public health research, practice and policy around design, implementation and evaluation of multi-layered and population-specific sexual health services that are tailored to addressing the needs of international students, who  migrate from traditional sexual cultures to Australia, where sexual norms are more liberal.

Representações sociais de adolescentes sobre a transmissão do HIV/AIDS nas relações sexuais: vulnerabilidades e riscos

RESUMO Objetivo compreender as representações sociais de adolescentes sobre vulnerabilidades e riscos para contrair o HIV/Aids nas relações sexuais. Método estudo de representações sociais, realizado a partir de entrevistas individuais com 15 adolescentes e grupo focal com oito adolescentes de uma escola pública do Recife, Pernambuco, Brasil. Os dados foram coletados no período de maio a outubro de 2016. Para tratamento dos dados, empregou-se a técnica de análise de conteúdo temática-categorial com o auxílio do Software QSR Nvivo11. Resultados as categorias: riscos de contrair HIV/Aids nas relações sexuais; e dos riscos de contrair HIV/Aids nas relações sexuais às vulnerabilidades abrigam os temas não usar preservativo, ter usado álcool e/ou drogas, ter vários parceiros, ter dificuldades de acesso aos serviços de saúde e de educação sexual nas escolas; e não ter conversas com os pais ou familiares. Conclusão e implicações para a prática compreendeu-se que as representações sociais circulam no imaginário e no ambiente escolar, interferindo na realidade dos adolescentes. Propõe-se priorizar políticas públicas focadas nas dimensões emocionais, afetivas e sociais.

Determinants of sexual exposure to HIV in Portuguese and Brazilian adolescents: a path analysis

OBJECTIVE

to analyze the direct and indirect effects of determinants of sexual exposure to the human immunodeficiency virus among male adolescents who have sex with men and the implications for nursing care.

METHOD

cross-sectional study carried out with 578 Portuguese and Brazilian adolescents aged 18 and 19. Interrelationships of conjugal status, use of dating apps, practice of chemsex, unawareness, partner credibility, challenging sexual practices and ineffective forms of protection against sexual exposure to the human immunodeficiency virus were evaluated using the Path Analysis technique.

RESULTS

significant direct effect on sexual exposure to the human immunodeficiency virus: conjugal status (β=-0.16), use of apps (β=-0.30), challenging sexual practices (β=0.48) and ineffective forms of protection (β=0.35). Indirect paths: partner credibility influenced ineffective forms of protection (β=0.77); having a steady/polyamorous relationship influenced the use of dating apps (β=-0.46); chemsex, mediated by challenging sexual practices (β=0.67), determined greater sexual exposure.

CONCLUSION

adolescent sexual behaviors and forms of amorous/sexual relationship must be considered in nursing care planning to reduce sexual exposure to the human immunodeficiency virus.

(1) Adolescents present high prevalence (81.0%) of sexual exposure to HIV. (2) Specificities of sexual practices are determinant factors of sexual exposure. (3) The higher the credibility given to a partner, the higher the sexual exposure to HIV. (4) Challenging sexual practices (such as fisting) determine sexual exposure. (5) Nursing care must focus on lowering exposure to HIV.

Condom use education, promotion and reasons for condom use: Perspectives of healthcare providers and young adults in Vhembe district, Limpopo province

BACKGROUND

Condom use is a critical component of a comprehensive and sustainable approach to the prevention of unintended pregnancies and sexually transmitted infections (STIs) (including HIV). Despite government making condoms freely available in the healthcare facilities in Vhembe district, there are reports of an increase in teenage pregnancies and STIs, including HIV, amongst young adults. The aim of the study was to gain an in-depth understanding of condom use promotion and reasons of condom use amongst young adults in Vhembe district, in Limpopo province.

METHODS

A descriptive phenomenological design was used to explore the reasons for promoting condom use amongst young adults themselves and from the perspectives of healthcare providers who are critical role players in condom education and provision. Purposive sampling was used to sample young adults and healthcare providers at three of Vhembe district's primary healthcare facilities. Individual semi-structured interviews were conducted, after which thematic data analysis was used to develop themes and subthemes.

RESULTS

Two superordinate themes emerged from data analysis, namely approaches to promote condom use and reasons for condom use. Two themes emerged in respect of approaches for promotion of condom use: information sharing in the form of education, the distribution of informative material, and the adoption of a multi-sectoral approach. Self-protection emerged as a reason for condom use, to prevent disease, pregnancy and 'u wela', and was indicative of not trusting a sexual partner.

CONCLUSION

To effectively promote condom use, a multidisciplinary team approach involving nurses, lay counsellors and peer educators need to be strengthened at local primary health facilities in order to facilitate the distribution of condoms and educate young adults on consistent condom use.

Dating Applications, Sexual Behaviors, and Attitudes of College Students in Brazil's Legal Amazon

Although dating applications (apps) have become popular among young adults, there is a dearth of information regarding the sexual health implications among Brazilian college students. This study examined risky sexual behavior and attitudes of dating app users, based on their sex in Brazil’s Legal Amazon. Three hundred and fifty-nine students reported their sociodemographic data, dating app use, and sexual behaviors and attitudes through self-administered questionnaires. Bivariate analyses and analysis of variance (ANOVA) with Bonferroni post-hoc tests were performed. Dating app use was reported by 238 (66.3%) subjects, most of whom had an encounter and sex with a casual partner. Women frequently requested condom use. Trust in one’s partner or having repeated encounters were the main reasons for engaging in risky sexual behavior. Men had a greater number of sexual partners and less protective attitudes. Sexual health awareness by apps was not reported by 97% of women, and most of them were not tested for sexually transmitted infections. A positive attitude toward sexual health was not a predictor of safe sex. Important similarities and differences regarding risky sexual behaviors and attitudes were observed between the sexes, many of which correlated with increased sexual vulnerability during the sexual encounters arranged through the dating apps. This cross-sectional study supports efforts on sexual health promotion and sexual education implementation in the face of growing usage of apps among young adults for sexual matters.