Safer sex practices among newly diagnosed HIV-positive men who have sex with men in China: results from an ethnographic study

PubMed Central

Li, Haochu; Sankar, Andrea; Holroyd, Eleanor; Jiang, Baofa

2017-01-01

ABSTRACT The study reported here sought to understand the rationales of safer sex practices adopted by newly diagnosed HIV-positive men who have sex with men (MSM). Guided by a socio-ecological framework, an ethnography was conducted among newly diagnosed HIV-positive MSM. In-depth interviews and participant observation were employed to produce an account of the social and cultural settings that was faithful to the perspectives of participants. A total of 31 participants with diverse backgrounds were recruited in a southern city of China. Participant observation was conducted in local healthcare settings, MSM venues, and NGO offices. Most participants (24/31) reported stopping unprotected anal intercourse (UAI) immediately after being diagnosed as HIV-positive. Factors associated with safer sex practices were identified at both individual and environmental levels, including self-protection, establishment of self-esteem, dignity, altruism and reciprocity, disease experience as a source of personal growth, and organizational culture and values. Newly diagnosed HIV-positive MSM navigate their sexual practices within the context of multiple competing factors. Implications for sustained behaviour change enabling safer sex practices include stimulating survival instinct, facilitating safer sex decision making, motivating and facilitating personal growth, and encouraging volunteerism to promote intentional activities for safer sex practices. PMID:29284374

Safer sex practices among newly diagnosed HIV-positive men who have sex with men in China: results from an ethnographic study.

PubMed

Li, Haochu; Sankar, Andrea; Holroyd, Eleanor; Jiang, Baofa

2017-12-01

The study reported here sought to understand the rationales of safer sex practices adopted by newly diagnosed HIV-positive men who have sex with men (MSM). Guided by a socio-ecological framework, an ethnography was conducted among newly diagnosed HIV-positive MSM. In-depth interviews and participant observation were employed to produce an account of the social and cultural settings that was faithful to the perspectives of participants. A total of 31 participants with diverse backgrounds were recruited in a southern city of China. Participant observation was conducted in local healthcare settings, MSM venues, and NGO offices. Most participants (24/31) reported stopping unprotected anal intercourse (UAI) immediately after being diagnosed as HIV-positive. Factors associated with safer sex practices were identified at both individual and environmental levels, including self-protection, establishment of self-esteem, dignity, altruism and reciprocity, disease experience as a source of personal growth, and organizational culture and values. Newly diagnosed HIV-positive MSM navigate their sexual practices within the context of multiple competing factors. Implications for sustained behaviour change enabling safer sex practices include stimulating survival instinct, facilitating safer sex decision making, motivating and facilitating personal growth, and encouraging volunteerism to promote intentional activities for safer sex practices.

Understanding barriers to safer sex practice in Zimbabwean marriages: implications for future HIV prevention interventions.

PubMed

Mugweni, Esther; Omar, Mayeh; Pearson, Stephen

2015-06-01

Against the backdrop of high human immunodeficiency virus (HIV) prevalence in stable relationships in Southern Africa, our study presents sociocultural barriers to safer sex practice in Zimbabwean marriages. We conducted 36 in-depth interviews and four focus group discussions with married men and women in Zimbabwe in 2008. Our aim was to identify barriers faced by married women when negotiating for safer sex. Participants identified individual, relational and community-level barriers. Individual level barriers made women voiceless to negotiate for safer sex. Being voiceless emanated from lack sexual decision-making power, economic dependence, low self-efficacy or fear of actual or perceived consequences of negotiating for safer sex. Relational barriers included trust and self-disclosure. At the community level, extended family members and religious leaders were said to explicitly or implicitly discourage women's safer sex negotiation. Given the complexity and multi-levelled nature of barriers affecting sexual behaviour in marriage, our findings suggest that HIV prevention interventions targeted at married women would benefit from empowering individual women, couples and also addressing the wider community. © The Author 2014. Published by Oxford University Press. All rights reserved. For permissions, please email: journals.permissions@oup.com.

HIV knowledge, risk perception, and safer sex practices among female sex workers in Port Moresby, Papua New Guinea

PubMed Central

Bruce, Eunice; Bauai, Ludwina; Sapuri, Mathias; Kaldor, John M; Fairley, Christopher K; Keogh, Louise A

2011-01-01

Sex workers are considered a high-risk group for sexually transmitted infections, including human immunodeficiency virus (HIV), and are often targeted by prevention interventions with safer sex messages. The purpose of this study was to explore the extent to which knowledge of HIV and perception of risk influence safer sex practices among female sex workers (FSWs) in Port Moresby, Papua New Guinea. FSWs (n = 174) were recruited from 19 sites to participate in the study. Qualitative data were collected using semistructured interviews with FSWs (n = 142) through focus group discussions and (n = 32) individual interviews. In addition, quantitative data were collected from all FSWs using a short structured, demographic questionnaire. Data were analyzed using recurring themes and calculations of confidence intervals. Despite some common misperceptions, overall, most FSWs were basically aware of the risks of HIV and informed about transmission and prevention modalities but used condoms inconsistently. Most reported using condoms ‘sometimes’, almost one-sixth ‘never’ used condoms, only a fraction used condoms ‘always’ with clients, and none used condoms ‘always’ with regular sexual partners (RSPs). Among these FSWs, being knowledgeable about the risks, transmission, and prevention of HIV did not translate into safe sex. The findings suggest that certain contextual barriers to safer sex practices exist. These barriers could heighten HIV vulnerability and possibly may be responsible for infection in FSWs. Specific interventions that focus on improving condom self-efficacy in FSWs and simultaneously target clients and RSPs with safer sex messages are recommended. PMID:21445375

Parent-Adolescent Sexual Communication and Adolescent Safer Sex Behavior: A Meta-Analysis.

PubMed

Widman, Laura; Choukas-Bradley, Sophia; Noar, Seth M; Nesi, Jacqueline; Garrett, Kyla

2016-01-01

Parent-adolescent sexual communication has received considerable attention as a factor that can positively affect safer sex behavior among youth; however, the evidence linking such communication to youth contraceptive and condom use has not been empirically synthesized. To examine the effect of parent-adolescent sexual communication on safer sex behavior among youth and explore potential moderators of this association. A systematic search of studies published from database inception through June 30, 2014, using the MEDLINE, PsycINFO, and Communication & Mass Media Complete databases and relevant review articles yielded 5098 studies, of which 52 studies with 25,314 adolescents met the study eligibility criteria. Analysis was conducted from July 1, 2014, to July 27, 2015. Studies were included if they sampled adolescents (mean sample age ≤18 years), included an adolescent report of sexual communication with one or both parents, measured safer sex behavior, and were published in English. Correlation coefficients (r) and 95% CIs were computed from studies and meta-analyzed using random-effects models. Safer sex behavior, including use of contraceptives or condoms. Fifty-two articles, including 71 independent effects representing more than 3 decades of research on 25,314 adolescents (weighted mean age, 15.2 years) were synthesized. Across studies, there was a significant weighted mean effect (r = 0.10; 95% CI, 0.08-0.13) linking parent-adolescent sexual communication with safer sex behavior, which was statistically heterogeneous (Q = 203.50, P < .001, I2 = 65.60). Moderation analyses revealed larger effects for communication with girls (r = 0.12) than boys (r = 0.04) and among youth who discussed sex with their mothers (r = 0.14) compared with their fathers (r = 0.03). Effects did not differ for contraceptive vs condom use or among longitudinal vs cross-sectional studies, indicating that parent sexual communication had a similar effect

Negotiation for safer sex among married women in Cambodia: the role of women's autonomy.

PubMed

Ung, Mengieng; Boateng, Godfred O; Armah, Frederick A; Amoyaw, Jonathan A; Luginaah, Isaac; Kuuire, Vincent

2014-01-01

Negotiating safer sex among married women has been identified as an important determinant of vulnerability or resilience to new HIV infections. Using the Cambodia Demographic and Health Survey data of 2010, this paper examined negotiation for safer sex among 11,218 married women in the context of Cambodia's highly touted reduction in HIV/AIDS prevalence. The results from a complementary log-log regression model indicate that wealthier and highly educated married women were more likely to report that they can refuse sexual intercourse and ask their husbands to use a condom. Interestingly, while women who were fully involved in decision-making on their own health care were 19% more likely to refuse sex, they were 14% less likely to be able to ask their husbands to use a condom, compared with their counterparts who were not involved in this decision-making. Women who were partially involved in decision-making on family visits were 17% less likely to be able to ask their husbands to use a condom compared with those who were not involved. In this context, involvement in decision-making may have translated into trust and risk compensation. Those who believed in HIV transmission myths were less likely to negotiate safer sex relative to their counterparts who did not hold such myths to be true. Women's ability to negotiate for safer sex is, therefore, a function of their autonomy in terms of their full participation in decision-making in health care, household expenditure and mobility. Policy implications of the capacity of women to negotiate for safer sex are delineated.

Community Influences on Married Women's Safer Sex Negotiation Attitudes in Bangladesh: A Multilevel Analysis.

PubMed

Jesmin, Syeda S; Cready, Cynthia M

2016-02-01

The influence of disadvantaged or deprived community on individuals' health risk-behaviors is increasingly being documented in a growing body of literature. However, little is known about the effects of community characteristics on women's sexual attitudes and behaviors. To examine community effects on married women's safer sex negotiation attitudes, we analyzed cross-sectional data from the 2011 Bangladesh Demographic and Health Surveys on a sample of 15,134 married women in 600 communities. We estimated two multilevel logistic regression models. Model 1, which included only individual-level variables, showed that women's autonomy/empowerment, age, and HIV knowledge had significant associations with their safer sex negotiation attitudes. We did not find any socioeconomic status gradient in safer sex negotiation attitudes at the individual level. Adding community-level variables in Model 2 significantly improved the fit of the model. Strikingly, we found that higher community-level poverty was associated with greater positive safer sex negotiation attitudes. Prevailing gender norms and overall women's empowerment in the community also had significant effects. While research on community influences calls for focusing on disadvantaged communities, our research highlights the importance of not underestimating the challenges that married women in economically privileged communities may face in negotiating safer sex. To have sufficient and equitable impact on married women's sexual and reproductive health, sexual and reproductive health promotion policies and programs need to be directed to women in wealthier communities as well.

Using a Narrative to Spark Safer Sex Communication

ERIC Educational Resources Information Center

Donné, Lennie; Hoeks, John; Jansen, Carel

2017-01-01

Objective: College students are a group at risk for contracting sexually transmitted infections (STIs). While they are generally well informed about STIs, they do not consistently use condoms. An important element in preventing STIs is safer sex communication, especially with a sexual partner. This may be difficult, however, because of a lack of…

Safer sexual practices among African American women: intersectional socialisation and sexual assertiveness.

PubMed

Brown, Danice L; Blackmon, Sha'Kema; Shiflett, Alexandra

2018-06-01

Scholars have posited that childhood socialisation experiences may play a key role in influencing behaviours and attitudes that contribute to the acquisition of HIV. This study examined the links between past ethnic-racial and gender socialisation, sexual assertiveness and the safe sexual practices of African American college women utilising a cluster analytic approach. After identifying separate racial-gender and ethnic-gender socialisation profiles, results indicated that ethnic-gender socialisation cluster profiles were directly associated with sexual assertiveness and safer sex behaviour. Greater levels of ethnic socialisation and low traditional gender role socialisation were found to be associated with greater sexual assertiveness and safer sex behaviour. Further analysis showed that sexual assertiveness mediated the links between the identified ethnic-gender socialisation profiles and safer sex behaviour. Implications for policy and programme development are discussed.

Predictors of safer sex on the college campus: a social cognitive theory analysis.

PubMed

O'Leary, A; Goodhart, F; Jemmott, L S; Boccher-Lattimore, D

1992-05-01

In April and May 1989, the authors surveyed a sample of students enrolled on four college campuses in New Jersey (N = 923) concerning their HIV transmission-related behavior, knowledge, and a variety of conceptual variables taken primarily from social cognitive theory that were thought to be potentially predictive of safer sexual behavior. Analyses of sexually active, unmarried students' responses indicated that men expected more negative outcomes of condom use and were more likely to have sexual intercourse while under the influence of alcohol or other drugs, whereas women reported higher perceived self-efficacy to practice safer sex. Regression analyses indicated that, among the factors assessed, stronger perceptions of self-efficacy to engage in safer behavior, expecting fewer negative outcomes of condom use, and less frequency of sex in conjunction with alcohol or other drug use significantly predicted safer sexual behavior. Enhanced self-efficacy to discuss personal history with a new partner was associated with a greater number of risky encounters. Implications of these findings for intervention efforts with students are discussed.

Identifying Psychosocial Variables That Predict Safer Sex Intentions in Adolescents and Young Adults

PubMed Central

Brüll, Phil; Ruiter, Robert A. C.; Wiers, Reinout W.; Kok, Gerjo

2016-01-01

Young people are especially vulnerable to sexually transmitted infections (STIs). The triad of deliberate and effective safer sex behavior encompasses condom use, combined with additional information about a partner’s sexual health, and the kind of sex acts usually performed. To identify psychosocial predictors of young people’s intentions to have safer sex, as related to this triad, we conducted an online study with 211 sexually active participants aged between 18 and 24 years. Predictors [i.e., perceived behavioral control (PBC), subjective norms, and intention] taken from Fishbein and Ajzen’s Reasoned Action Approach (RAA), were combined with more distal variables (e.g., behavioral inhibition, sensation seeking, parental monitoring, and knowledge about STIs). Beyond the highly predictive power of RAA variables, additional variance was explained by the number of instances of unprotected sexual intercourse (SI) during the last 12 months and reasons for using barrier protection during first SI. In particular, past condom non-use behavior moderated PBC related to intended condom use. Further, various distal variables showed significant univariate associations with intentions related to the three behaviors of interest. It may, therefore, be helpful to include measures of past behavior as well as certain additional distal variables in future safer sex programs designed to promote health-sustaining sexual behavior. PMID:27148520

Can a woman refuse sex if her husband has a sexually transmitted infection? Attitudes toward safer-sex negotiation among married women in Bangladesh.

PubMed

Jesmin, Syeda S; Cready, Cynthia M

2014-06-01

In developing countries, HIV, sexually transmitted infections (STIs) and unintended pregnancy take an enormous toll on women's reproductive health, yet preventive programmes are lacking as married women's risks are frequently underestimated. We examined predictors of married Bangladeshi women's attitudes towards safer-sex negotiation using data on 15,178 currently married women aged 15-49 from the 2011 Bangladesh Demographic Health Survey. Approximately 92% of women believed that a wife's refusal to have sex with her husband is justified if he has an STI. Multilevel logistic regression analysis revealed that the likelihood of a woman holding this belief increased with her autonomy, as measured by the ability to go to a health centre/hospital without another adult, participation in household decision making and rejection of wife beating (p < 0.001). Other significant predictors were knowledge/awareness of STIs (p < 0.05), living in Dhaka division (p < 0.001) and younger age (p < 0.01). Our findings suggest that sexual health education programmes may be more effective if they include strategies to address social norms and cultural practices that limit women's autonomy in society.

Minority Stress and Safer Sex Practices Among Sexual Minority Women in Toronto, Canada: Results from a Cross-Sectional Internet-Based Survey.

PubMed

Logie, Carmen H; Lacombe-Duncan, Ashley; MacKenzie, Rachel K; Poteat, Tonia

2016-12-01

Sexual stigma is a chronic stressor that enhances vulnerability to mental health disparities among lesbian, gay, bisexual, and queer people. Sexual stigma has also been associated with reduced uptake of safer sex practices, such as condom use, among gay and bisexual men. Scant research has examined the relationship between sexual stigma and safer sex practices among sexual minority women (SMW), including lesbian, bisexual, and queer women. We explored associations between sexual stigma and safer sex practices among SMW. We also tested the interaction between sexual stigma, social support, and resilient coping in this relationship. A cross-sectional internet-based survey was administered to SMW in Toronto, Canada. Among 388 participants with complete measurement data, simple linear regression indicated both perceived and enacted sexual stigma were positively associated with uptake of safer sex practices. In multivariable analyses, significant interactions were found between perceived sexual stigma and resilient coping, and between enacted sexual stigma and social support. At low levels of resilient coping, higher levels of perceived sexual stigma were associated with fewer safer sex practices, while at high levels of resilient coping the relationship was reversed. At low levels of social support, higher levels of enacted sexual stigma were associated with fewer safer sex practices, while at high levels of social support the relationship was reversed. These findings document complex relationships between sexual stigma dimensions, coping, social support, and safer sex practices. Understanding the role these variables play in uptake of safer sex practices can inform sexual health interventions tailored for SMW.

Safer sex negotiation and its association with condom use among clients of female sex workers in Bangladesh.

PubMed

Kamal, S M Mostafa; Hassan, Che Hashim; Salikon, Roslan Hj

2015-03-01

This study examines safer sex negotiation and its association with condom use among clients of female sex workers (FSWs) in Bangladesh. Data were collected from 484 FSWs living in Dhaka city following a convenient sampling procedure. Overall, 47% of the clients were suggested to use condom during last sexual intercourse and 21% did so. Both bivariate and multivariable binary logistic regression analyses yielded significantly increased risk of negotiation for safer sex with clients among FSWs with higher education. The power bargaining significantly (P < .001) increased the risk of condom use by 2.15 times (95% confidence interval = 1.28-3.59). The odds of condom use were significantly higher among the FSWs with higher education, unmarried, hotel-based, and among those with higher level of HIV/AIDS-related knowledge. The Bangladeshi FSWs have little control over their profession. HIV prevention programs should aim to encourage FSWs through information, education, and communication program to insist on condom use among clients. © 2013 APJPH.

Misperceptions regarding protective barrier method use for safer sex among African-American women who have sex with women.

PubMed

Muzny, Christina A; Harbison, Hanne S; Pembleton, Elizabeth S; Hook, Edward W; Austin, Erika L

2013-05-01

Barrier methods for HIV and sexually transmissible infection (STI) prevention among women who have sex with women (WSW) are available, although their effectiveness has not been systematically investigated. These methods are infrequently used by WSW. As part of a larger study on STI risk perceptions and safer sex among African-American WSW, we discovered several misperceptions regarding barrier methods that may be associated with their limited use. Participants were recruited from the Jefferson County Health Department STI Clinic and through word of mouth in Birmingham, Alabama, for focus group discussions exploring perceptions of STI risk and safer sex. Seven focus groups with 29 participants were conducted (age range: 19-43 years). Several misperceptions regarding barrier methods were identified, notably the conflation of dental dams and female condoms. Descriptions of the use of barrier methods were qualified with phrases suggesting their hypothetical, rather than actual, use. Additional evidence that barrier methods are not actually used came from beliefs that dental dams and female condoms are available in major grocery stores or department store chains. Those providing sexual health services to WSW should be cautious in assuming that WSW have accurate information regarding barrier methods for safer sex. Sexual health services provided to WSW should include an accurate description of what barrier methods are, how to distinguish them from barrier methods more commonly used during heterosexual sex (female and male condoms), and how to use them correctly. Future studies are needed to address how effectively these measures reduce transmission of STIs among WSW.

Does motivational interviewing counseling time influence HIV-positive persons' self-efficacy to practice safer sex?

PubMed

Chariyeva, Zulfiya; Golin, Carol E; Earp, Jo Anne; Suchindran, Chirayath

2012-04-01

This study examined the impact of motivational interviewing (MI) counseling time on self-efficacy to practice safer sex for people living with HIV/AIDS (PLWHA). In 4 month intervals we followed a cohort of 490 PLWHA for 12 months. We conducted hierarchical linear regression models to examine changes in safer sex self-efficacy when participants received zero, low to moderate (5-131 min) and high (132-320 min) doses of MI time. We conducted a similar analysis using number of counseling sessions as the predictor variable. Participants with low to moderate doses of MI counseling had 0.26 higher self-efficacy scores than participants with zero MI time (p=0.01). Also, they had 0.26 lower self-efficacy scores than participants with high amounts of MI time (p=0.04). Participants with high doses of MI had a 0.5 higher self-efficacy score than participants with zero amount of MI time (p<0.0001). Participants who received 3-4 counseling sessions had 0.41 greater self-efficacy scores than participants who did not receive any sessions (p<0.0001) but did not differ from participants receiving 1-2 sessions. MI time is a key to enhancing safer sex self-efficacy among PLWHA. Safer sex self-efficacy improves the more MI counseling time and sessions PLWHA receive. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

Pregnancy Intentions and Safer Pregnancy Knowledge Among Female Sex Workers in Port Elizabeth, South Africa.

PubMed

Rao, Amrita; Baral, Stefan; Phaswana-Mafuya, Nancy; Lambert, Andrew; Kose, Zamakayise; Mcingana, Mfezi; Holland, Claire; Ketende, Sosthenes; Schwartz, Sheree

2016-07-01

To assess the association between human immunodeficiency virus (HIV) and pregnancy intentions and safer conception knowledge among female sex workers in Port Elizabeth, South Africa. This cross-sectional study recruited female sex workers in Port Elizabeth using respondent-driven sampling and completed an interviewer-administered questionnaire alongside HIV testing and counseling. In this secondary analysis, robust Poisson regression was used to model prevalence ratios for positive fertility intentions in this cross-sectional study. Knowledge of safer conception methods by HIV status was compared using Fisher exact tests. Overall 391 women were represented in the analyses. More than 50% had a prior HIV diagnosis, and an additional 12% were diagnosed with HIV during the study. Approximately half (n=185) of the women reported future pregnancy intentions. In univariate analysis, a prior HIV diagnosis was negatively associated with pregnancy intentions as compared with HIV-negative women (prevalence ratio 0.68, 95% confidence interval 0.55-0.85). Only parity remained independently associated with future pregnancy intentions in multivariate regression after controlling for HIV status, age, race, relationship status, and years selling sex. Knowledge of safer conception methods such as timed sex without a condom, preexposure prophylaxis, or self-insemination was low and similar between those with and without future pregnancy plans. Pregnancy intentions did not significantly vary according to HIV status. Fertility intentions were high, however, and knowledge of safer conception methods low, suggesting a need to provide female sex workers with advice around options to conceive safely in the context of high HIV prevalence.

Cocaine-dependent adults and recreational cocaine users are more likely than controls to choose immediate unsafe sex over delayed safer sex.

PubMed

Koffarnus, Mikhail N; Johnson, Matthew W; Thompson-Lake, Daisy G Y; Wesley, Michael J; Lohrenz, Terry; Montague, P Read; Bickel, Warren K

2016-08-01

Cocaine users have a higher incidence of risky sexual behavior and HIV infection than nonusers. Our aim was to measure whether safer sex discount rates-a measure of the likelihood of having immediate unprotected sex versus waiting to have safer sex-differed between controls and cocaine users of varying severity. Of the 162 individuals included in the primary data analyses, 69 met the Diagnostic and Statistical Manual of Mental Disorders (4th ed., text rev.; DSM-IV-TR) criteria for cocaine dependence, 29 were recreational cocaine users who did not meet the dependence criteria, and 64 were controls. Participants completed the Sexual Discounting Task, which measures a person's likelihood of using a condom when one is immediately available and how that likelihood decreases as a function of delay to condom availability with regard to 4 images chosen by the participants of hypothetical sexual partners differing in perceived desirability and likelihood of having a sexually transmitted infection. When a condom was immediately available, the stated likelihood of condom use sometimes differed between cocaine users and controls, which depended on the image condition. Even after controlling for rates of condom use when one is immediately available, the cocaine-dependent and recreational users groups were more sensitive to delay to condom availability than controls. Safer sex discount rates were also related to intelligence scores. The Sexual Discounting Task identifies delay as a key variable that impacts the likelihood of using a condom among these groups and suggests that HIV prevention efforts may be differentially effective based on an individual's safer sex discount rate. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

Pathways from Resilient Coping to Safer Sex Communication Among African, Caribbean, and Black Women in Toronto, Canada: Results from a Cross-sectional Survey.

PubMed

Logie, Carmen H; Okumu, Moses; Ryan, Shannon; Yehdego, Mary

2018-05-22

African, Caribbean, and Black (ACB) women in Canada are disproportionately impacted by HIV and other sexually transmitted infections. Although there is reported suboptimal consistent condom use with ACB women, limited research has explored safer sex communication among this population. Coping frameworks highlight the role that resilient coping and condom use self-efficacy may play in facilitating safer sex communication. Structural perspectives stress the need to explore associations between HIV vulnerabilities and food insecurity. We examined pathways from resilient coping to safer sex communication through the mediator of condom use self-efficacy among ACB women in Toronto. We conducted a cross-sectional survey with a purposive sample of ACB women aged 16 and older across Toronto, Canada. We conducted path analysis to test the direct effects of resilient coping on safer sex communication, and indirect pathways through the mediator (condom use self-efficacy) while controlling for food insecurity. Participant (n = 80; mean age 27, SD 7.93) ethnicities included African (58.8%, n = 47), Caribbean (30%, n = 24), and others (11.3%, n = 9). Participants with food security reported significantly higher safer sex communication. We found no direct effect of resilient coping on safer sex communication. Findings support the hypothesized mediation process; resilient coping was associated with condom use self-efficacy, which in turn was associated with safer sex communication. Findings that condom use self-efficacy mediated the association between resilient coping and safer sex communication align with theoretical assertions of the protective role of adaptive coping strategies. Findings can inform tailored HIV and STI preventive interventions with ACB women.

Contextual influences on safer sex negotiation among female sex workers (FSWs) in Hong Kong: the role of non-governmental organizations (NGOs), FSWs' managers, and clients.

PubMed

Cheng, Shannon S Y; Mak, Winnie W S

2010-05-01

Despite social-cognitive interventions to increase safer sex awareness, condom use among female sex workers (FSWs) continued to be inconsistent. To account for the possible influences of contextual factors that may hinder or promote FSWs' safer sex negotiation and condom use, the present study examined the effects of non-governmental organizations (NGOs), FSWs' managers, and clients on FSWs' negotiation efficacy and condom-use efficacy, and the effects of efficacy on condom use. One hundred and nineteen FSWs in Hong Kong completed a questionnaire that focused on their perceived influences of NGOs, managers, and clients toward safer sex negotiation and condom use. Hierarchical regression results showed that whereas NGOs' influence and clients' support were positively related to negotiation self-efficacy, managers' pressure, and clients' pressure were negatively related to negotiation self-efficacy. Managers' pressure was negatively related to condom-use self-efficacy. Logistic regression results showed that FSWs with high condom-use self-efficacy was 24 times more likely to use condom in the previous six months than their counterparts. The present study indicated the importance of social contexts in affecting FSWs' safer sex negotiation and condom-use self-efficacy. Implications on preventive programs for FSWs, managers, and clients were discussed.

Sexual communication, safer sex self-efficacy, and condom use among young Chinese migrants in Beijing, China.

PubMed

Xiao, Zhiwen; Li, Xiaoming; Lin, Danhua; Jiang, Shulin; Liu, Yingjie; Li, Shuming

2013-12-01

Mediation effect of sexual communication on the relationship between safer sex self-efficacy and condom use was tested among 307 homosexually active migrant men, 376 heterosexually active migrant men, and 265 heterosexually active migrant women. The study found certain aspects of sexual communication mediated the effect of self-efficacy on condom use among the three samples. The findings underscored the importance of including components that promote safer sex self-efficacy and sexual communication in HIV prevention interventions for Chinese migrants.

In search of a psychology of safer-sex promotion; beyond beliefs and texts.

PubMed

Abraham, C; Sheeran, P

1993-06-01

Belief and attitudinal change are important to the promotion of safer sexual behaviour. However, the individual decision-making psychology implicit in belief-change models provides only a partial picture of the determinants of sexual behaviour. A broader psychological understanding emphasizing the complex social skills involved in regulating sexual interaction is advocated. A discourse analysis critique of the viability of characterizing individuals' psychology on the basis of verbal responses is discussed and it is noted that psychological models linking such responses to underlying beliefs and cognitions must be based on measures which accurately predict health behaviour. It is concluded that an interactive model incorporating personal, interpersonal and situational constraints on sexual behaviour could be used to design effective programmes addressing barriers to HIV protection. Such interventions would promote communication and sexual negotiating skills and could be included in school curricula. This would have radical implications for sex education, shifting its theoretical basis from biology to social psychology and its methods from information-giving to participation and practice.

Achieving Safety: Safer Sex, Communication, and Desire among Young Gay Men

ERIC Educational Resources Information Center

Eisenberg, Anna; Bauermeister, Jose A.; Pingel, Emily; Johns, Michelle Marie; Santana, Matthew Leslie

2011-01-01

Conceptualizations of safer sex practices among young gay men (YGM) are frequently structured around communication between partners and the subsequent utilization or absence of condoms in a sexual encounter. Drawing on a sample of 34 in-depth interviews with YGM, ages 18 to 24, the authors explore the ways in which conceptualizations and…

‘It is not expected for married couples’: a qualitative study on challenges to safer sex communication among polygamous and monogamous partners in southeastern Tanzania

PubMed Central

Mtenga, Sally Mmanyi; Geubbels, Eveline; Tanner, Marcel; Merten, Sonja; Pfeiffer, Constanze

2016-01-01

Background Behavioral change approaches for human immunodeficiency virus (HIV) prevention in Tanzania encourage married partners to observe safe sex practices (condom use, avoidance of, or safe sex with multiple partners). To implement this advice, partners need to communicate with each other about safer sex, which is often challenging. Although social-structural factors are crucial in understanding sexual behavior, only a few studies focus on understanding safer sex dialogue in a broader social context. Design Drawing on the WHO-Commission on the Social Determinants of Health (WHO-CSDH) framework, this study explored key social-structural constructs for studying health in the context of improving safer sex dialogue between polygamous and monogamous partners. Twenty-four in-depth interviews (IDIs) and six focus group discussions (FGDs) with 38 men and women aged 18–60 years were conducted in Ifakara town located in Kilombero district, Tanzania. The study was nested within the community health surveillance project MZIMA (Kiswahili: ‘being healthy’). Partners’ experiences of safer sex dialogue in polygamous and monogamous relations were investigated and the challenges to safer sex dialogue explored. Results The study revealed that open safer sex dialogue in marriage is limited and challenged by social norms about marriage (a view that safer sex dialogue imply that partners are ‘not really’ married); marital status (a belief that safer sex dialogue is not practical in polygamous marriages, the elder wife should be exempted from the dialogue since she is at lower risk of engaging in extramarital affairs); relationship quality (marital conflicts, extramarital affairs, trust, and sexual dissatisfaction); and gender power relations (the notion that females’ initiative to discuss condom use and HIV couple counseling and testing may lead to conflict or divorce). Conclusions Implementing safer sex practices requires interventions beyond promotion messages. HIV

Gender power control, sexual experiences, safer sex practices, and potential HIV risk behaviors among young Asian-American women.

PubMed

Hahm, Hyeouk Chris; Lee, Jieha; Rough, Kathryn; Strathdee, Steffanie A

2012-01-01

We examined the prevalence of three domains of sexual behaviors among young Asian-American women: sexual experiences, safer sex practices, and potential HIV risk behaviors. We also investigated the impact of gender power control on these domains. Among sexually experienced women, 51% reported using condoms during their most recent sex act, 63% reported inconsistent condom use, and 18% reported ever having forced sex. Multiple logistic regression analyses revealed that women's perceived lower relationship power control was not associated with vaginal sex or safer sex practices, but it was powerfully associated with forced sex and all three potential HIV risk behaviors. This study demonstrates that control within young Asian-American women's intimate relationships exerts different associations depending on the type of sexual behavior. The application of the Theory of Gender and Power should be employed with prudence when designing HIV interventions for this population.

Better learning in schools to improve attitudes toward abstinence and intentions for safer sex among adolescents in urban Nepal.

PubMed

Shrestha, Rachana Manandhar; Otsuka, Keiko; Poudel, Krishna C; Yasuoka, Junko; Lamichhane, Medin; Jimba, Masamine

2013-03-20

School-based sex education is an effective medium to convey health information and skills about preventing sexually transmitted infections (STIs) and unwanted pregnancies among adolescents. However, research on school-based sex education is limited in many developing countries, including Nepal. This study thus had two main objectives: (1) to assess students' evaluation of school-based sex education, and (2) to examine the associations between students' evaluations of school-based sex education and their (a) attitudes toward abstinence and (b) intentions for safer sex. This cross-sectional study was conducted among 634 students from six schools in the Kathmandu Valley during May-June 2010. We used a self-administered questionnaire to assess students' evaluations of school-based sex education, attitudes toward abstinence, and intentions for safer sex. The data were then analyzed using multiple linear regression models. Regarding "information on HIV and sexual health", many students perceived that they received the least amount of information on HIV counseling and testing centers (mean 2.29, SD 1.00) through their schools. In terms of "support and involvement of teachers and parents" in sex education, parents' participation ranked as the lowest (mean 1.81, SD 1.01). Audiotapes were reported as the least used among the listed "teaching aids for sexual health education" (mean 1.54, SD 0.82). In multivariate analysis, receiving more "information on HIV and sexual health" was positively associated with more positive "attitudes toward abstinence" (β = 0.11, p = <0.018) and greater "intentions for safer sex" (β = 0.17, p = <0.001) among students. Similarly, increased "support and involvement from teachers and parents" was also positively associated with more positive "attitudes toward abstinence" (β = 0.16, p = <0.001) and greater "intentions for safer sex" (β = 0.15, p = <0.002). Our results suggest that students' needs and expectations

Gender Power Control, Sexual Experiences, Safer Sex Practices, and Potential HIV Risk Behaviors Among Young Asian-American Women

PubMed Central

Lee, Jieha; Rough, Kathryn; Strathdee, Steffanie A.

2012-01-01

We examined the prevalence of three domains of sexual behaviors among young Asian-American women: sexual experiences, safer sex practices, and potential HIV risk behaviors. We also investigated the impact of gender power control on these domains. Among sexually experienced women, 51% reported using condoms during their most recent sex act, 63% reported inconsistent condom use, and 18% reported ever having forced sex. Multiple logistic regression analyses revealed that women’s perceived lower relationship power control was not associated with vaginal sex or safer sex practices, but it was powerfully associated with forced sex and all three potential HIV risk behaviors. This study demonstrates that control within young Asian-American women’s intimate relationships exerts different associations depending on the type of sexual behavior. The application of the Theory of Gender and Power should be employed with prudence when designing HIV interventions for this population. PMID:21259042

Midlife safer sex challenges for heterosexual New Zealand women re-partnering or in casual relationships.

PubMed

Morison, Trish; Cook, Catherine M

2015-06-01

The rate of sexually transmitted infections (STIs) amongst midlife and older heterosexual women in New Zealand is rising. Popular culture celebrates a heightened sexuality for this population group. However, depictions of sexually savvy 'cougars' are at odds with reality for many women. International literature highlights that these women are often ill-equipped to negotiate safer sex and condom use, instead focusing on pleasing men and attributing their silence to spontaneity. The study aimed to explore barriers to safer heterosexual sex as perceived by midlife and older New Zealand women who are re-partnering or in casual relationships. This qualitative study utilised Interpretive Phenomenology Analysis, supported by the theory of gender and power, to examine the gender-normative assumptions and behaviours in women's accounts of unprotected sex. Eight single women aged 40-69 participated in individual, in-depth interviews. This exploration included eliciting women's accounts of potential information resources, such as clinical consultations. Analysis indicated that these women held misconceptions about STI transmission but had not sought educational material, nor discussed their sexual health with health professionals. Results highlighted women's ambivalence about prioritising safer sex, preferring to comply with partners' wishes, particularly when under the influence of alcohol. Women described valuing their own pleasure and their distaste for condom use, but data emphasised that women predominantly aligned their choices with men's preferences. This study highlights that the women were both ill-informed and vulnerable with regards to sexual health. General practitioners are well placed to provide education and sexual health advice.

Better learning in schools to improve attitudes toward abstinence and intentions for safer sex among adolescents in urban Nepal

PubMed Central

2013-01-01

Background School-based sex education is an effective medium to convey health information and skills about preventing sexually transmitted infections (STIs) and unwanted pregnancies among adolescents. However, research on school-based sex education is limited in many developing countries, including Nepal. This study thus had two main objectives: (1) to assess students’ evaluation of school-based sex education, and (2) to examine the associations between students’ evaluations of school-based sex education and their (a) attitudes toward abstinence and (b) intentions for safer sex. Methods This cross-sectional study was conducted among 634 students from six schools in the Kathmandu Valley during May–June 2010. We used a self-administered questionnaire to assess students’ evaluations of school-based sex education, attitudes toward abstinence, and intentions for safer sex. The data were then analyzed using multiple linear regression models. Results Regarding “information on HIV and sexual health”, many students perceived that they received the least amount of information on HIV counseling and testing centers (mean 2.29, SD 1.00) through their schools. In terms of “support and involvement of teachers and parents” in sex education, parents’ participation ranked as the lowest (mean 1.81, SD 1.01). Audiotapes were reported as the least used among the listed “teaching aids for sexual health education” (mean 1.54, SD 0.82). In multivariate analysis, receiving more “information on HIV and sexual health” was positively associated with more positive “attitudes toward abstinence” (β = 0.11, p = <0.018) and greater “intentions for safer sex” (β = 0.17, p = <0.001) among students. Similarly, increased “support and involvement from teachers and parents” was also positively associated with more positive “attitudes toward abstinence” (β = 0.16, p = <0.001) and greater “intentions for safer sex” (β = 0.15, p�

HIV-Positive Mothers' Communication about Safer Sex and Std Prevention with Their Children

ERIC Educational Resources Information Center

Murphy, Debra A.; Roberts, Kathleen Johnston; Herbeck, Diane M.

2012-01-01

Mothers play an important role in promoting the sexual health of their adolescent children. Fifty-seven HIV-positive mothers with adolescent children participated in an in-depth, qualitative interview regarding whether they have talked to their children about safer sex and sexually transmitted disease (STD) prevention, including at what age they…

Measurement Noninvariance of Safer Sex Self-Efficacy Between Heterosexual and Sexual Minority Black Youth.

PubMed

Gerke, Donald; Budd, Elizabeth L; Plax, Kathryn

2016-01-01

Black and lesbian, gay, bisexual, or questioning (LGBQ) youth in the United States are disproportionately affected by HIV and other sexually transmitted diseases (STDs). Although self-efficacy is strongly, positively associated with safer sex behaviors, no studies have examined the validity of a safer sex self-efficacy scale used by many federally funded HIV/STD prevention programs. This study aims to test factor validity of the Sexual Self-Efficacy Scale by using confirmatory factor analysis (CFA) to determine if scale validity varies between heterosexual and LGBQ Black youth. The study uses cross-sectional data collected through baseline surveys with 226 Black youth (15 to 24 years) enrolled in community-based HIV-prevention programs. Participants use a 4-point Likert-type scale to report their confidence in performing 6 healthy sexual behaviors. CFAs are conducted on 2 factor structures of the scale. Using the best-fitting model, the scale is tested for measurement invariance between the 2 groups. A single-factor model with correlated errors of condom-specific items fits the sample well and, when tested with the heterosexual group, the model demonstrates good fit. However, when tested with the LGBQ group, the same model yields poor fit, indicating factorial noninvariance between the groups. The Sexual Self-Efficacy Scale does not perform equally well among Black heterosexual and LGBQ youth. Study findings suggest additional research is needed to inform development of measures for safer sex self-efficacy among Black LGBQ youth to ensure validity of conceptual understanding and to accurately assess effectiveness of HIV/STD prevention interventions among this population.

Can Computer-Mediated Interventions Change Theoretical Mediators of Safer Sex? A Meta-Analysis

ERIC Educational Resources Information Center

Noar, Seth M.; Pierce, Larson B.; Black, Hulda G.

2010-01-01

The purpose of this study was to conduct a meta-analysis of computer-mediated interventions (CMIs) aimed at changing theoretical mediators of safer sex. Meta-analytic aggregation of effect sizes from k = 20 studies indicated that CMIs significantly improved HIV/AIDS knowledge, d = 0.276, p less than 0.001, k = 15, N = 6,625; sexual/condom…

Seriously Mentally Ill Women's Safer Sex Behaviors and the Theory of Reasoned Action

ERIC Educational Resources Information Center

Randolph, Mary E.; Pinkerton, Steven D.; Somlai, Anton M.; Kelly, Jeffrey A.; McAuliffe, Timothy L.; Gibson, Richard H.; Hackl, Kristin

2009-01-01

Seriously mentally ill women at risk for HIV infection (n = 96) participated in structured interviews assessing sexual and substance-use behavior over a 3-month period. The majority of the women (63.5%) did not use condoms. Consistent with the theory of reasoned action, attitudes toward condom use and perceived social norms about safer sex were…

Married women's negotiation for safer sexual intercourse in Kenya: Does experience of female genital mutilation matter?

PubMed

Chai, Xiangnan; Sano, Yujiro; Kansanga, Moses; Baada, Jemima; Antabe, Roger

2017-12-01

Married women's ability to negotiate for safer sex is important for HIV prevention in sub-Saharan Africa, including Kenya. Yet, its relationship to female genital mutilation is rarely explored, although female genital mutilation has been described as a social norm and marker of womanhood that can control women's sexuality. Drawing on the social normative influence theory, this study addressed this void in the literature. We analysed data from the 2014 Kenya Demographic and Health Survey using logistic regression. Our sample included 8,602 married women. Two indicators of safer sex, namely the ability to refuse sex and the ability to ask for condom use, were explored. We found that women who had undergone genital mutilation were significantly less likely to report that they can refuse sex (OR=0.87; p<.05) and that they can ask for condom use during sexual intercourse (OR=0.62; p<.001) than their counterparts who had not undergone genital mutilation, while controlling for theoretically relevant variables. Our findings indicate that the experience of female genital mutilation may influence married women's ability to negotiate for safer sex through gendered socialization and expectations. Based on these findings, several policy implications are suggested. For instance, culturally sensitive programmes are needed that target both married women who have undergone genital mutilation and their husbands to understand the importance of safer sexual practices within marriage. Copyright © 2017. Published by Elsevier B.V.

Secrets and safety in the age of AIDS: does HIV disclosure lead to safer sex?

PubMed

Simoni, Jane M; Pantalone, David W

2004-01-01

To fuel the HIV/AIDS epidemic, HIV-seropositive individuals must interact unsafely with HIV-seronegative individuals. Research indicates that up to one third of individuals diagnosed with HIV continue to have unprotected sex, at times without informing partners, who may be of negative or unknown serostatus. Some research and public health interventions have focused on encouraging HIV-positive individuals to reveal their serostatus to their sexual partners, predicated upon the assumption that disclosure will increase the safety of subsequent sexual activity with informed partners. This review examines the empirical literature on disclosure of HIV status and subsequent sexual risk behaviors of HIV-positive individuals. Only 15 of the 23 studies reviewed provided data that allowed us to examine the association between disclosure and safer sex. Fewer still provided a methodologically sound analysis, and those that did provided conflicting results, often with significant effects limited to only 1 subgroup of participants. However, this failure to demonstrate a consistent association does not necessarily mean that disclosure is irrelevant to the practice of safer sex. We discuss limitations of the research to date and implications for policy and practice.

Using Social Cognitive Theory to Predict Safer Sex Behaviors in African American College Students

ERIC Educational Resources Information Center

Kanekar, Amar; Sharma, Manoj

2009-01-01

Safer sex is important for protection against STDs and HIV/AIDS. Most of the HIV-related research is targeted towards high-risk groups such as prostitutes, gays and substance abusers there is evidence that HIV/AIDS is increasing in college students particularly among African-American college students. The purpose of this study was to study…

Egocentric networks of Chinese men who have sex with men: network components, condom use norms, and safer sex.

PubMed

Liu, Hongjie; Feng, Tiejian; Liu, Hui; Feng, Hucang; Cai, Yumao; Rhodes, Anne G; Grusky, Oscar

2009-10-01

Research on risk behaviors among men who have sex with men (MSM) is often based on individualistic models of health behavior, but sexual behavior is inherently social in nature and often determined by constituents of social networks. The objective of this study was to examine relationships among social networks, network norms of condom use, and safer sex. A respondent-driven sampling study recruited 350 MSM in the Shenzhen region of China between November and December 2007 and collected information on network components (relations, structures, and functions) and HIV risk behavior among egos (those interviewed) and their network alters. A total of 2385 alters were nominated by the 350 egos. Egos reported an average of 4 nonsexual relation alters and 2 sexual-partner alters. Egos perceived receiving more tangible and emotional support from nonsexual relation alters than from sexual-partner alters. Two thirds (69%) of egos consistently used condoms. Sixty-seven percent of egos reported having 1 or more alters who always encouraged egos to use condoms, 84% had 1 or more alters who consistently used condoms, and 55% had 1 or more alters who insisted on condom use. Both subjective and descriptive norms were positively associated with consistent condom use. Network components were associated with the levels of the two norms. These findings suggest that social network components may activate or strengthen condom use norms within networks, which, in turn, determine consistent condom use among MSM. HIV behavioral interventions need to target the promotion of safer sex practices through enhancing peer norms of condom use within networks.

Understanding Barriers to Safer Sex Practice in Zimbabwean Marriages: Implications for Future HIV Prevention Interventions

ERIC Educational Resources Information Center

Mugweni, Esther; Omar, Mayeh; Pearson, Stephen

2015-01-01

Against the backdrop of high human immunodeficiency virus (HIV) prevalence in stable relationships in Southern Africa, our study presents sociocultural barriers to safer sex practice in Zimbabwean marriages. We conducted 36 in-depth interviews and four focus group discussions with married men and women in Zimbabwe in 2008. Our aim was to identify…

Effects of a Televised Two-City Safer Sex Mass Media Campaign Targeting High-Sensation-Seeking and Impulsive-Decision-Making Young Adults

ERIC Educational Resources Information Center

Zimmerman, Rick S.; Palmgreen, Philip M.; Noar, Seth M.; Lustria, Mia Liza A.; Lu, Hung-Yi; Horosewski, Mary Lee

2007-01-01

This study evaluates the ability of a safer sex televised public service announcement (PSA) campaign to increase safer sexual behavior among at-risk young adults. Independent, monthly random samples of 100 individuals were surveyed in each city for 21 months as part of an interrupted-time-series design with a control community. The 3-month…

The Men's Safer Sex project: intervention development and feasibility randomised controlled trial of an interactive digital intervention to increase condom use in men.

PubMed

Bailey, Julia V; Webster, Rosie; Hunter, Rachael; Griffin, Mark; Freemantle, Nicholas; Rait, Greta; Estcourt, Claudia; Michie, Susan; Anderson, Jane; Stephenson, Judith; Gerressu, Makeda; Ang, Chee Siang; Murray, Elizabeth

2016-12-01

% confidence interval (CI) 0.52 to 1.96]. New STI diagnoses were recorded for 8.8% (7/80) of the intervention group and 13.0% (9/69) of the control group (IRR 0.75, 95% CI 0.29 to 1.89). (2) Health-care resource data were more complete using patient files than questionnaires. The probability that the intervention is cost-effective is sensitive to the source of data used and whether or not data on intended pregnancies are included. (3) The pilot RCT fitted well around clinical activities but 37% of the intervention group did not see the Men's Safer Sex website and technical problems were frustrating. Men's views of the Men's Safer Sex website and research procedures were largely positive. It would be feasible to conduct a large-scale RCT using clinic STI diagnoses as a primary outcome; however, technical errors and a poor response rate limited the collection of online self-reported outcomes. The next steps are (1) to optimise software for online trials, (2) to find the best ways to integrate digital health promotion with clinical services, (3) to develop more precise methods for collecting resource use data and (4) to work out how to overcome barriers to digital intervention testing and implementation in the NHS. Current Controlled Trials ISRCTN18649610. This project was funded by the NIHR Health Technology Assessment programme and will be published in full in Health Technology Assessment ; Vol. 20, No. 91. See the NIHR Journals Library website for further project information.

Breakage is the norm: use of condoms and lubrication in anal sex among Black South African men who have sex with men.

PubMed

Lee, Matthew; Sandfort, Theo; Collier, Kate; Lane, Tim; Reddy, Vasu

2017-04-01

This paper explores condom use and lubrication practices among Black men who have sex with men in South African townships. Results are from 81 in-depth individual interviews conducted among a purposive sample from four townships surrounding Pretoria as part of a larger qualitative study. Awareness that condoms should be used to have safer anal sex was ubiquitous. Fewer men reported that lubricants should be used to facilitate anal intercourse. Partner pressure and partner distrust were the most common barriers cited for not using condoms and lubricants. Knowledge about condom-lubricant compatibility was rare. Condom problems were a norm, with widespread expectations of condom failure. Men's subjectivities - their perceptions of and preferences for specific brands, types and flavours of condoms and lubricants - influenced engagement with such safer-sex technologies. However, what was available in these settings was often neither what men needed nor preferred. Findings show the need to enhance access to appropriate and comprehensive: safer-sex supplies, health services and health education, and underline the importance of efforts to develop targeted programmes relevant to experiences of men who have sex with men in the South African context.

A Peer-Led, Social Media-Delivered, Safer Sex Intervention for Chinese College Students: Randomized Controlled Trial

PubMed Central

Sun, Wai Han; Wong, Carlos King Ho

2017-01-01

Background The peer-led, social media-delivered intervention is an emerging method in sexual health promotion. However, no research has yet investigated its effectiveness as compared with other online channels or in an Asian population. Objective The objective of this study is to compare a peer-led, social media-delivered, safer sex intervention with a sexual health website. Both conditions target Chinese college students in Hong Kong. Methods A randomized controlled trial was conducted with a peer-led, safer sex Facebook group as the intervention and an existing online sexual health website as the control. The intervention materials were developed with peer input and followed the information-motivation-behavioral skills model; the intervention was moderated by peer educators. The participants filled out the online questionnaires before and after the 6-week intervention period. Outcome evaluations included safer sex attitudes, behavioral skills, and behaviors, while process evaluation focused on online experience, online-visiting frequency, and online engagement. The effect of online-visiting frequency and online engagement on outcome variables was investigated. Results Of 196 eligible participants—100 in the control group and 96 in the intervention group—who joined the study, 2 (1.0%) control participants joined the Facebook group and 24 of the remaining 194 participants (12.4%) were lost to follow-up. For the process evaluation, participants in the intervention group reported more satisfying online experiences (P<.001) and a higher level of online-visiting frequency (P<.001). They also had more positive comments when compared with the control group. For outcome evaluation, within-group analysis showed significant improvement in condom use attitude (P=.02) and behavioral skills (P<.001) in the intervention group, but not in the control group. No significant between-group difference was found. After adjusting for demographic data, increased online

Do Safer Sex Self-Efficacy, Attitudes toward Condoms, and HIV Transmission Risk Beliefs Differ among Men who have Sex with Men, Heterosexual Men, and Women Living with HIV?

PubMed Central

Widman, Laura; Golin, Carol E.; Grodensky, Catherine A.; Suchindran, Chirayath

2013-01-01

To understand sexual decision-making processes among people living with HIV, we compared safer sex self-efficacy, condom attitudes, sexual beliefs, and rates of unprotected anal or vaginal intercourse with at-risk partners (UAVI-AR) in the past 3 months among 476 people living with HIV: 185 men who have sex with men (MSM), 130 heterosexual men, and 161 heterosexual women. Participants were enrolled in SafeTalk, a randomized, controlled trial of a safer sex intervention. We found 15% of MSM, 9% of heterosexual men, and 12% of heterosexual women engaged in UAVI-AR. Groups did not differ in self-efficacy or sexual attitudes/beliefs. However, the associations between these variables and UAVI-AR varied within groups: greater self-efficacy predicted less UAVI-AR for MSM and women, whereas more positive condom attitudes – but not self-efficacy – predicted less UAVI-AR for heterosexual men. These results suggest HIV prevention programs should tailor materials to different subgroups. PMID:22252475

Women's household decision-making autonomy and safer sex negotiation in Nigeria: An analysis of the Nigeria Demographic and Health Survey.

PubMed

Sano, Yujiro; Sedziafa, Alice P; Vercillo, Siera; Antabe, Roger; Luginaah, Isaac

2018-02-01

Although married women's safer sex negotiation with their husbands is critical in reducing new HIV infections in Nigeria, its linkage to women's household decision-making autonomy is less explored in Nigeria. Drawing data from the 2013 Nigeria Demographic and Health Survey and using the logistic regression technique, we examined the associations between women's household decision-making autonomy and two indicators of the ability to engage in safer sex including whether married women 1) can refuse sex and 2) ask for condom use during sexual intercourse with husbands. Findings indicate that 64% and 41% of married women can refuse sex and ask for condom use, respectively. While the impact of women's household decision-making autonomy on the ability to refuse sex remained statistically significant after controlling for theoretically relevant variables (OR = 1.15; p < 0.001), its impact on the ability to ask for condom use became weakly significant once socioeconomic variables were controlled (OR = 1.03; p < 0.1). Based on these results, we have two suggestions. First, it may be important that marital-based policies and counselling promote environments in which married women can establish equal power relations with their husbands. Second, it is also important to eliminate structural barriers that hinder married women's economic opportunities in Nigeria.

A Randomised Controlled Trial Using Mobile Advertising to Promote Safer Sex and Sun Safety to Young People

ERIC Educational Resources Information Center

Gold, J.; Aitken, C. K.; Dixon, H. G.; Lim, M. S. C.; Gouillou, M.; Spelman, T.; Wakefield, M.; Hellard, M. E.

2011-01-01

Mobile phone text messages (SMS) are a promising method of health promotion, but a simple and low cost way to obtain phone numbers is required to reach a wide population. We conducted a randomised controlled trial with simultaneous brief interventions to (i) evaluate effectiveness of messages related to safer sex and sun safety and (ii) pilot the…

A Peer-Led, Social Media-Delivered, Safer Sex Intervention for Chinese College Students: Randomized Controlled Trial.

PubMed

Sun, Wai Han; Wong, Carlos King Ho; Wong, William Chi Wai

2017-08-09

The peer-led, social media-delivered intervention is an emerging method in sexual health promotion. However, no research has yet investigated its effectiveness as compared with other online channels or in an Asian population. The objective of this study is to compare a peer-led, social media-delivered, safer sex intervention with a sexual health website. Both conditions target Chinese college students in Hong Kong. A randomized controlled trial was conducted with a peer-led, safer sex Facebook group as the intervention and an existing online sexual health website as the control. The intervention materials were developed with peer input and followed the information-motivation-behavioral skills model; the intervention was moderated by peer educators. The participants filled out the online questionnaires before and after the 6-week intervention period. Outcome evaluations included safer sex attitudes, behavioral skills, and behaviors, while process evaluation focused on online experience, online-visiting frequency, and online engagement. The effect of online-visiting frequency and online engagement on outcome variables was investigated. Of 196 eligible participants-100 in the control group and 96 in the intervention group-who joined the study, 2 (1.0%) control participants joined the Facebook group and 24 of the remaining 194 participants (12.4%) were lost to follow-up. For the process evaluation, participants in the intervention group reported more satisfying online experiences (P<.001) and a higher level of online-visiting frequency (P<.001). They also had more positive comments when compared with the control group. For outcome evaluation, within-group analysis showed significant improvement in condom use attitude (P=.02) and behavioral skills (P<.001) in the intervention group, but not in the control group. No significant between-group difference was found. After adjusting for demographic data, increased online-visiting frequency was associated with better

Substance Use and Sexual Risk Behavior Among Black South African Men Who Have Sex With Men: The Moderating Effects of Reasons for Drinking and Safer Sex Intentions.

PubMed

Knox, Justin; Reddy, Vasu; Lane, Tim; Hasin, Deborah; Sandfort, Theo

2017-07-01

Research studies suggest an association between substance use and sexual risk behavior, but are not completely consistent. The moderating effects of other psychosocial factors might help explain these inconsistencies. The current study therefore assessed whether substance use is associated with sexual risk behavior, and whether this relationship is modified by expectancies about the effects of alcohol, reasons for consuming alcohol, or intentions to engage in safe sex. A cross-sectional survey was conducted among 480 black South African men who have sex with men recruited using respondent-driven sampling. In multivariable analyses, the effect of alcohol use on unprotected receptive anal intercourse (URAI) was modified by drinking to enhance social interaction (R 2 change = 0.03, p < 0.01). The effect of drug use on URAI was modified by safe sex intentions (R 2 change = 0.03, p < 0.001). Alcohol use was positively associated with URAI only among those who drink to enhance social interaction (β = 0.08, p < 0.05). Drug use was positively associated with URAI only among those with high safe sex intentions (β = 0.30, p < 0.001). Our findings suggest that efforts to minimize the impact of substance use on HIV risk behavior should target men who drink to enhance social interaction and men who intend to engage in safer sex. Efforts made to increase safer sex intentions as a way to reduce HIV risk behavior should additionally consider the effects of substance use.

Young People's Views and Experiences of a Mobile Phone Texting Intervention to Promote Safer Sex Behavior.

PubMed

French, Rebecca Sophia; McCarthy, Ona; Baraitser, Paula; Wellings, Kaye; Bailey, Julia V; Free, Caroline

2016-04-15

The risk of poor sexual health, including unplanned pregnancy and sexually transmitted infections (STIs), is greatest amongst young people. Innovative and acceptable interventions to improve sexual health are required. Mobile phone text messaging (short message service, SMS) interventions have the potential to reach large numbers of people at relatively low cost, but greater understanding is needed on how these interventions should be developed and how they work. The aim of this paper is to explore young people's views of and experiences with a mobile phone text messaging intervention to promote safer sex behavior. We undertook qualitative interviews with young people aged 16 to 24 years as part of a pilot trial of a sexual health intervention delivered by text message in the United Kingdom. Study participants received sexual health promotion text messages based on behavior-change techniques. The message content, tailored by gender and STI status, included support for correct STI treatment and promotion of safer sex behaviors. Young people were eligible if they had received a positive chlamydia test or had more than one partner and at least one episode of unprotected sex in the last year. Telephone interviews were conducted 2 to 3 weeks after initiation of the intervention. A semi-structured topic guide was followed to explore participant experiences and a thematic analysis was conducted. We conducted 16 telephone interviews with participants who had received the text intervention and an additional four interviews with those in the control group (13 women and 7 men). Intervention participants found text messages easy to understand and appearing to come from a friendly and trustworthy source. They considered the frequency and timing of messages to be appropriate, and delivery via mobile phones convenient. Receipt of support by text message allowed recipients to assimilate information at their own pace, and prompted reflection on and sharing of messages with friends

Negotiating safety and sexual risk reduction with clients in unsanctioned safer indoor sex work environments: a qualitative study.

PubMed

Krüsi, Andrea; Chettiar, Jill; Ridgway, Amelia; Abbott, Janice; Strathdee, Steffanie A; Shannon, Kate

2012-06-01

We examined how unique, low-barrier, supportive housing programs for women who are functioning as unsanctioned indoor sex work environments in a Canadian urban setting influence risk negotiation with clients in sex work transactions. We conducted 39 semistructured qualitative interviews and 6 focus groups with women who live in low-barrier, supportive housing for marginalized sex workers with substance use issues. All interviews were transcribed verbatim and thematically analyzed. Women's accounts indicated that unsanctioned indoor sex work environments promoted increased control over negotiating sex work transactions, including the capacity to refuse unwanted services, negotiate condom use, and avoid violent perpetrators. Despite the lack of formal legal and policy support for indoor sex work venues in Canada, the environmental-structural supports afforded by these unsanctioned indoor sex work environments, including surveillance cameras and support from staff or police in removing violent clients, were linked to improved police relationships and facilitated the institution of informal peer-safety mechanisms. This study has drawn attention to the potential role of safer indoor sex work environments as venues for public health and violence prevention interventions and has indicated the critical importance of removing the sociolegal barriers preventing the formal implementation of such programs.

Young People’s Views and Experiences of a Mobile Phone Texting Intervention to Promote Safer Sex Behavior

PubMed Central

McCarthy, Ona; Baraitser, Paula; Wellings, Kaye; Bailey, Julia V; Free, Caroline

2016-01-01

Background The risk of poor sexual health, including unplanned pregnancy and sexually transmitted infections (STIs), is greatest amongst young people. Innovative and acceptable interventions to improve sexual health are required. Mobile phone text messaging (short message service, SMS) interventions have the potential to reach large numbers of people at relatively low cost, but greater understanding is needed on how these interventions should be developed and how they work. Objectives The aim of this paper is to explore young people’s views of and experiences with a mobile phone text messaging intervention to promote safer sex behavior. Methods We undertook qualitative interviews with young people aged 16 to 24 years as part of a pilot trial of a sexual health intervention delivered by text message in the United Kingdom. Study participants received sexual health promotion text messages based on behavior-change techniques. The message content, tailored by gender and STI status, included support for correct STI treatment and promotion of safer sex behaviors. Young people were eligible if they had received a positive chlamydia test or had more than one partner and at least one episode of unprotected sex in the last year. Telephone interviews were conducted 2 to 3 weeks after initiation of the intervention. A semi-structured topic guide was followed to explore participant experiences and a thematic analysis was conducted. Results We conducted 16 telephone interviews with participants who had received the text intervention and an additional four interviews with those in the control group (13 women and 7 men). Intervention participants found text messages easy to understand and appearing to come from a friendly and trustworthy source. They considered the frequency and timing of messages to be appropriate, and delivery via mobile phones convenient. Receipt of support by text message allowed recipients to assimilate information at their own pace, and prompted reflection

A randomised controlled trial using mobile advertising to promote safer sex and sun safety to young people.

PubMed

Gold, J; Aitken, C K; Dixon, H G; Lim, M S C; Gouillou, M; Spelman, T; Wakefield, M; Hellard, M E

2011-10-01

Mobile phone text messages (SMS) are a promising method of health promotion, but a simple and low cost way to obtain phone numbers is required to reach a wide population. We conducted a randomised controlled trial with simultaneous brief interventions to (i) evaluate effectiveness of messages related to safer sex and sun safety and (ii) pilot the use of mobile advertising for health promotion. Mobile advertising subscribers aged 16-29 years residing in Victoria, Australia (n = 7606) were randomised to the 'sex' or 'sun' group and received eight messages during the 2008-2009 summer period. Changes in sex- and sun-related knowledge and behaviour were measured by questionnaires completed on mobile phones. At follow-up, the sex group had significantly higher sexual health knowledge and fewer sexual partners than the sun group. The sun group had no change in hat-wearing frequency compared with a significant decline in hat-wearing frequency in the sex group. This is the first study of mobile advertising for health promotion, which can successfully reach most young people. Challenges experienced with project implementation and evaluation should be considered as new technological approaches to health promotion continue to be expanded.

Effects of a Televised Two-City Safer Sex Mass Media Campaign Targeting High-Sensation-Seeking and Impulsive-Decision-Making Young Adults

PubMed Central

Zimmerman, Rick S.; Palmgreen, Philip M.; Noar, Seth M.; Lustria, Mia Liza A.; Lu, Hung-Yi; Horosewski, Mary Lee

2015-01-01

This study evaluates the ability of a safer sex televised public service announcement (PSA) campaign to increase safer sexual behavior among at-risk young adults. Independent, monthly random samples of 100 individuals were surveyed in each city for 21 months as part of an interrupted-time-series design with a control community. The 3-month high-audience-saturation campaign took place in Lexington, KY, with Knoxville, TN, as a comparison city. Messages were especially designed and selected for the target audience (those above the median on a composite sensation-seeking/impulsive-decision-making scale). Data indicate high campaign exposure among the target audience, with 85%–96% reporting viewing one or more PSAs. Analyses indicate significant 5-month increases in condom use, condom-use self-efficacy, and behavioral intentions among the target group in the campaign city with no changes in the comparison city. The results suggest that a carefully targeted, intensive mass media campaign using televised PSAs can change safer sexual behaviors. PMID:17602097

Negotiating Safety and Sexual Risk Reduction With Clients in Unsanctioned Safer Indoor Sex Work Environments: A Qualitative Study

PubMed Central

Krüsi, Andrea; Chettiar, Jill; Ridgway, Amelia; Abbott, Janice; Strathdee, Steffanie A.

2012-01-01

Objectives. We examined how unique, low-barrier, supportive housing programs for women who are functioning as unsanctioned indoor sex work environments in a Canadian urban setting influence risk negotiation with clients in sex work transactions. Methods. We conducted 39 semistructured qualitative interviews and 6 focus groups with women who live in low-barrier, supportive housing for marginalized sex workers with substance use issues. All interviews were transcribed verbatim and thematically analyzed. Results. Women’s accounts indicated that unsanctioned indoor sex work environments promoted increased control over negotiating sex work transactions, including the capacity to refuse unwanted services, negotiate condom use, and avoid violent perpetrators. Despite the lack of formal legal and policy support for indoor sex work venues in Canada, the environmental-structural supports afforded by these unsanctioned indoor sex work environments, including surveillance cameras and support from staff or police in removing violent clients, were linked to improved police relationships and facilitated the institution of informal peer-safety mechanisms. Conclusions. This study has drawn attention to the potential role of safer indoor sex work environments as venues for public health and violence prevention interventions and has indicated the critical importance of removing the sociolegal barriers preventing the formal implementation of such programs. PMID:22571708

Are HIV-positive young black MSM having safer sex than those who are HIV-negative?

PubMed

Crosby, Richard A; Mena, Leandro; Geter, Angelica

2017-04-01

In the United States, young Black men who have sex with men (YBMSM) bear the single largest burden of the HIV/AIDS epidemic. Whether HIV-positive men in this population practice relatively safer sex than their HIV negative counterparts has not been recently investigated. The purpose of this study was to compare selected sexual risk behaviors between YBMSM who are HIV-positive to their HIV-negative counterparts of the same geographic location in the southern US. A convenience sample of 600 YBMSM completed a computer-assisted self-interview in a private area of a clinic dedicated to sexual health. Frequency/prevalence of 16 sexual risk behaviors was compared between men who were HIV-positive and those who were HIV-negative at the time. Bivariate associations were tested in regression models adjusted for age and having a main male sex partner. One-quarter of the sample (25.5%) was HIV-positive at study enrollment. Remarkably few differences in sexual risk behaviors were observed. HIV-positive men were less likely to report recent sex with a woman ( P = .003), and they were more likely to report recent sex with persons known to be HIV-positive ( P < .001). Of 16 assessed outcome measures, these two significant findings represented the only significant differences in the adjusted analyses. YBMSM residing in the southern US may experience high levels of HIV exposure risk or risk of exposing others to HIV. A particularly urgent need exists to improve post-diagnostic HIV prevention efforts for HIV-positive YBMSM.

Pragati: an empowerment programme for female sex workers in Bangalore, India.

PubMed

Euser, Sjoerd M; Souverein, Dennis; Rama Narayana Gowda, Pushpalatha; Shekhar Gowda, Chandra; Grootendorst, Diana; Ramaiah, Rajendra; Barot, Snehal; Kumar, Sunil; Jenniskens, Françoise; Kumar, Shiv; Den Boer, Jeroen W

2012-11-27

To describe the effects of a broad empowerment programme among female sex workers (FSWs) in Bangalore, India, which seeks to develop the capacities of these women to address the issues that threaten their lives and livelihoods. This study is based on a comprehensive, on-going HIV-prevention and empowering programme, known as Pragati, which reaches out to approximately 10,000-12,000 FSWs in Bangalore each year. The programme has been designed in collaboration with the sex worker community and provides a personalised set of services, which include STI prevention and treatment services, crisis-response facilities, de-addiction services, and microfinance support all of which have been tailored to adequately fulfil each woman's needs. During the period examined by this study, the programme reached out to 20,330 individual FSWs [median (IQR) age 28 (24-35) years]. The programme's personal records of the participating FSWs were used for this descriptive study. Between 2005 and 2010, the number of participating FSWs increased from 2,307 to 13,392. These women intensified their contact with the programme over time: the number of programme contacts increased from 10,351 in 2005 to 167,709 in 2010. Furthermore, data on the effects of crisis-response facilities, de-addiction and microfinance services, condom distribution schemes, and STI diagnosis and treatment showed an accumulating involvement of the participating FSWs in these programme services. This programme, which focuses on social and economic empowerment among FSWs, is successful in reaching and involving the target population.

Effect of Sex Education Programme on at-risk sexual behaviour of school-going adolescents in Ilorin, Nigeria.

PubMed

Esere, Mary Ogechi

2008-06-01

Adolescents display sexual behaviours and developmental characteristics that place them at risk for Sexually Transmitted Diseases (STDs). Because young people experiment sexually and because of the consequences of indiscriminate sexual activities on the youth, there is the need to mount sex education programmes that are geared towards enlightenment and appropriate education about sex and sexuality. To determine whether Sex Education Intervention Programme would reduce at-risk sexual behaviours of school-going adolescents. Pre-test, post-test control group quasi-experimental design. A randomly selected co-educational school in Ilorin Metropolis, Nigeria. 24 school-going adolescents aged 13-19 years. Sex Education Programme (treatment group) versus Control programme (placebo). Self-reported exposure to sexually transmitted diseases, multiple sex partners, anal sex, oral sex, non use of condom. When the treatment (intervention) group was compared with the control group in an intention to treat analysis, there were significant differences in at-risk sexual behaviours of the two groups. Those in the intervention group reported less at-risk sexual behaviours than their counterparts in the control group. The treatment group evaluated the intervention programme positively and their knowledge of sexual health improved. Lack of behavioural effect on the control group could be linked to differential quality of delivery of intervention. Compared with the control group, this specially designed intervention sex education programme reduced at-risk sexual behaviour in adolescents. Based on this finding, it was recommended that sex education be introduced into the curriculum of secondary school education in Nigeria.

Effects of the culturally-sensitive comprehensive sex education programme among Thai secondary school students.

PubMed

Thato, R; Jenkins, R A; Dusitsin, N

2008-05-01

This paper reports on a study to evaluate the effectiveness of a culturally-sensitive comprehensive sex education programme among Thai secondary school students. Increasing number of adolescents in Thailand have been engaging in premarital sex. No theory-based, abstinence-oriented models of sex education have been evaluated in this population. A quasi-experimental study was conducted in 2006-2007. Outcome measures included sexual behaviour, condom use, intention to refuse sex, intention to use condoms, and knowledge regarding sexually transmitted infections/human immunodeficiency virus/acquired immunodeficiency syndrome and pregnancy. Students in the experimental group had lower levels of reported sexual intercourse at 3- and 6-month follow-ups, compared with those in control group (P < 0.01). Students participating in the programme had significantly greater intention to refuse sex in the future across time than controls (P < 0.05). Sexually active adolescents participating in the programme reported significantly lower frequencies of sexual intercourse across time than controls (P < 0.01). However, the programme did not influence consistent condom use (P > 0.05), although the intervention was associated with increased intention to use condoms (P < 0.01). Knowledge about sexually transmitted infections/human immunodeficiency virus/acquired immunodeficiency syndrome and pregnancy among students in the intervention group was significantly greater than that of the controls (P < 0.05). School nurses can play a major role by applying this kind of sex education programme. For nurse researchers, it would be useful to extend this research by considering alternative ways to foster condom use in the non-commercial partnerships that have become common among adolescents.

Pragati: an empowerment programme for female sex workers in Bangalore, India

PubMed Central

Euser, Sjoerd M.; Souverein, Dennis; Rama Narayana Gowda, Pushpalatha; Shekhar Gowda, Chandra; Grootendorst, Diana; Ramaiah, Rajendra; Barot, Snehal; Kumar, Sunil; Jenniskens, Françoise; Kumar, Shiv; Den Boer, Jeroen W.

2012-01-01

Objectives To describe the effects of a broad empowerment programme among female sex workers (FSWs) in Bangalore, India, which seeks to develop the capacities of these women to address the issues that threaten their lives and livelihoods. Design This study is based on a comprehensive, on-going HIV-prevention and empowering programme, known as Pragati, which reaches out to approximately 10,000–12,000 FSWs in Bangalore each year. The programme has been designed in collaboration with the sex worker community and provides a personalised set of services, which include STI prevention and treatment services, crisis-response facilities, de-addiction services, and microfinance support all of which have been tailored to adequately fulfil each woman's needs. During the period examined by this study, the programme reached out to 20,330 individual FSWs [median (IQR) age 28 (24–35) years]. The programme's personal records of the participating FSWs were used for this descriptive study. Results Between 2005 and 2010, the number of participating FSWs increased from 2,307 to 13,392. These women intensified their contact with the programme over time: the number of programme contacts increased from 10,351 in 2005 to 167,709 in 2010. Furthermore, data on the effects of crisis-response facilities, de-addiction and microfinance services, condom distribution schemes, and STI diagnosis and treatment showed an accumulating involvement of the participating FSWs in these programme services. Conclusion This programme, which focuses on social and economic empowerment among FSWs, is successful in reaching and involving the target population. PMID:23195516

Key Programme Science lessons from an HIV prevention 'Learning Site' for sex workers in Mombasa, Kenya.

PubMed

McClarty, Leigh M; Bhattacharjee, Parinita; Isac, Shajy; Emmanuel, Faran; Kioko, Japheth; Njiraini, Margaret; Gichangi, Peter; Okoth, Clifford Duncan; Musimbi-Mbole, Janet; Blanchard, James F; Moses, Stephen; Muysyoki, Helgar; Becker, Marissa L

2017-12-14

In 2013, Kenya's National AIDS and STI Control Programme established a Learning Site (LS) in Mombasa County to support and strengthen capacity for HIV prevention programming within organisations working with sex workers. A defining feature of LS was the use of a Programme Science approach throughout its development and implementation. We provide an overview of the key components of LS, present findings from 23 months of programme monitoring data, and highlight key Programme Science lessons from its implementation and monitoring. Routine monitoring data collected from September 2013 through July 2015 are presented. Individual-level service utilisation data were collected monthly and indicators of interest were analysed over time to illustrate trends in enrolment, programme coverage and service utilisation among sex workers in Mombasa County. Over the monitoring period, outreach programme enrolment occurred rapidly; condom distribution targets were met consistently; rates of STI screening remained high and diagnoses declined; and reporting of and response to violent incidents increased. At the same time, enrolment in LS clinics was relatively low among female sex workers, and HIV testing at LS was low among both female and male sex workers. Lessons learnt from operationalising the Programme Science framework through the Mombasa LS can inform the development and implementation of similar LS in different geographical and epidemiological contexts. Importantly, meaningful involvement of sex workers in the design, implementation and monitoring processes ensures that overall programme performance is optimised in the context of local, 'on-the-ground' realities. Additionally, learnings from LS highlight the importance of introducing enhanced monitoring and evaluations systems into complex programmes to better understand and explain programme dynamics over time. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights

Assessment and treatment of sex offenders: the Prince of Wales Programme.

PubMed

McConaghy, N

1990-06-01

The treatment programme for sex offenders at the Prince of Wales Hospital, Sydney, is described. Penile circumference assessment is not used as there is no evidence it provides a valid measure of individuals' paedophile or rapist tendencies. Sex offenders' self-reports remain the major source of information in their assessment. The development of the two major techniques used--imaginal desensitization and short-term medroxyprogesterone--is outlined. About 80% of subjects can be expected to show a good response to one or other of these therapies. Of those who do not, most respond to the alternative or aversive therapy. Adolescent offenders appear to require more intensive treatment. Results appear comparable with those of more intensive programmes in use overseas.

Development of a theory-guided pan-European computer-assisted safer sex intervention.

PubMed

Nöstlinger, Christiana; Borms, Ruth; Dec-Pietrowska, Joanna; Dias, Sonia; Rojas, Daniela; Platteau, Tom; Vanden Berghe, Wim; Kok, Gerjo

2016-12-01

HIV is a growing public health problem in Europe, with men-having-sex-with-men and migrants from endemic regions as the most affected key populations. More evidence on effective behavioral interventions to reduce sexual risk is needed. This article describes the systematic development of a theory-guided computer-assisted safer sex intervention, aiming at supporting people living with HIV in sexual risk reduction. We applied the Intervention Mapping (IM) protocol to develop this counseling intervention in the framework of a European multicenter study. We conducted a needs assessment guided by the information-motivation-behavioral (IMB) skills model, formulated change objectives and selected theory-based methods and practical strategies, i.e. interactive computer-assisted modules as supporting tools for provider-delivered counseling. Theoretical foundations were the IMB skills model, social cognitive theory and the transtheoretical model, complemented by dual process models of affective decision making to account for the specifics of sexual behavior. The counseling approach for delivering three individual sessions was tailored to participants' needs and contexts, adopting elements of motivational interviewing and cognitive-behavioral therapy. We implemented and evaluated the intervention using a randomized controlled trial combined with a process evaluation. IM provided a useful framework for developing a coherent intervention for heterogeneous target groups, which was feasible and effective across the culturally diverse settings. This article responds to the need for transparent descriptions of the development and content of evidence-based behavior change interventions as potential pillars of effective combination prevention strategies. © The Author 2015. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Female gratification, sexual power and safer sex: female sexuality as an empowering resource among women in Rwanda.

PubMed

Skafte, Ina; Silberschmidt, Margrethe

2014-01-01

The gender-based response to HIV in sub-Saharan Africa has tended to reinforce normative stereotypes of women as subordinated, passive and powerless victims, in particular in sexual relations. However, based on qualitative data from Rwanda, this paper argues that such conceptualisations fail to recognise that while women do comply with prevalent social norms, they also challenge these norms and sex becomes a domain in which they can exert power. Female sexuality and sexual gratification - acknowledged and valued by women as well as men - play a pivotal role in the Rwandese mode of sexual intercourse. This provides women a central position in sexual relations, which affords them sexual power. Recognising their sexuality as a resource and drawing upon this 'sexual capital', women are active social agents who have the capacity to manipulate and challenge male dominance in a deliberate strategy both to practice safer sex and to access decision-making power and material resources. This suggests that inherent in sexual relations is a potential for the empowerment of women and the transformation of gender relations.

Vulnerability re-assessed: the changing face of sex work in Guntur district, Andhra Pradesh.

PubMed

Beattie, Tara S H; Bradley, Janet E; Vanta, Uma Devi; Lowndes, Catherine M; Alary, Michel

2013-01-01

We conducted a qualitative study to examine the impact of an HIV prevention programme on female sex workers' lives in Guntur district, Andhra Pradesh. The study found evidence that, in addition to the HIV prevention programme, structural and environmental factors had recently changed the way sex work was being practiced. Recent closure of the brothels and implementation of a late-night street curfew by the police meant sex work had become more hidden, with clients often solicited using mobile phones from home or their work place (e.g., in the fields or factories). Sex work had become safer, with violence by non-regular partners rarely reported. Women understood the risks of unprotected vaginal sex and reported using condoms with their clients. However, clients were more frequently requesting anal sex, possibly due to recent exposure to pornography following increased accessibility to modern technologies such as mobile phones and the Internet. Anal sex with clients was common but women were often unaware of the associated risks and reported unprotected anal sex. HIV positive and/or older women faced severe financial hardship and difficulty soliciting sufficient clients, and reported unprotected vaginal and anal sex to earn enough to survive. Taken together, the findings from this study suggest changing vulnerability to HIV in this setting. It will be important for HIV prevention programmes to be flexible and creative in their approaches if they are to continue to reach this target community effectively.

What do young people want from sex education? The results of a needs assessment from a peer-led sex education programme.

PubMed

Forrest, Simon; Strange, Vicki; Oakley, Ann; The Ripple Study Team

2004-07-01

This paper presents data on the need for sexual health information and advice of 4353 students aged 13/14 years in 13 English secondary schools. Data were collected by peer educators as part of a sex education programme, and through a questionnaire survey administered by researchers. Data illustrate young people's need for concrete information and advice on issues related to physical development and puberty; transmission of sexually transmitted diseases; accessing and using condoms and other contraception; using sexual health services; managing relationships and dealing with jealousy, love and sexual attraction; how people have sex; sexual pleasure; masturbation; and homosexuality. Differences between the concerns and interests raised by young people and current UK guidance on sex and relationships education are examined, and the implications of these findings for designing future policy and effective school based sex education programmes are discussed. The paper highlights some of the wider social norms around sex and sexuality that influence young people's understanding and sexual behaviour, and the importance of addressing these within sex education is noted. Factors influencing the processes of expressing and assessing needs are explored.

Sex and secrecy: How HIV-status disclosure affects safe sex among HIV-positive adolescents.

PubMed

Toska, Elona; Cluver, Lucie D; Hodes, Rebecca; Kidia, Khameer K

2015-01-01

HIV-positive adolescents who engage in unsafe sex are at heightened risk for transmitting or re-acquiring HIV. Disclosure of HIV-status to sexual partners may impact on condom use, but no study has explored the effects of (i) adolescent knowledge of one's HIV-status, (ii) knowledge of partner status and (iii) disclosure to partners, on safer sex behaviour. This study aimed to identify whether knowledge of HIV-status by HIV-positive adolescents and partners was associated with safer sex. Eight fifty eight HIV-positive adolescents (10-19 years old, 52% female, 68.1% vertically infected) who had ever initiated antiretroviral treatment in 41 health facilities in the Eastern Cape, South Africa, were interviewed using standardised questionnaires. Quantitative analyses used multivariate logistic regressions, controlling for confounders. Qualitative research included interviews, focus group discussions and observations with 43 HIV-positive teenagers and their healthcare workers. N = 128 (14.9%) of the total sample had ever had sex, while N = 109 (85.1%) of sexually active adolescents had boy/girlfriend. In total, 68.1% of the sample knew their status, 41.5% of those who were sexually active and in relationships knew their partner's status, and 35.5% had disclosed to their partners. For adolescents, knowing one's status was associated with safer sex (OR = 4.355, CI 1.085-17.474, p = .038). Neither knowing their partner's status, nor disclosing one's HIV-status to a partner, were associated with safer sex. HIV-positive adolescents feared rejection, stigma and public exposure if disclosing to sexual and romantic partners. Counselling by healthcare workers for HIV-positive adolescents focused on benefits of disclosure, but did not address the fears and risks associated with disclosure. These findings challenge assumptions that disclosure is automatically protective in sexual and romantic relationships for HIV-positive adolescents, who may be ill-equipped to

Exploring the development of existing sex education programmes for people with intellectual disabilities: an intervention mapping approach.

PubMed

Schaafsma, Dilana; Stoffelen, Joke M T; Kok, Gerjo; Curfs, Leopold M G

2013-03-01

People with intellectual disabilities face barriers that affect their sexual health. Sex education programmes have been developed by professionals working in the field of intellectual disabilities with the aim to overcome these barriers. The aim of this study was to explore the development of these programmes. Sex education programmes geared to people with intellectual disabilities were examined in the context of the Intervention Mapping protocol. Data were obtained via interviews with the programme developers. All programmes lack specific programme outcomes, do not have a theoretical basis, did not involve members of relevant groups in the development process and lack systematic evaluation. Based on our findings and the literature, we conclude that these programmes are unlikely to be effective. Future programmes should be developed using a more systematic and theory- and evidence-based approach. © 2012 Blackwell Publishing Ltd.

Exploring the Development of Existing Sex Education Programmes for People with Intellectual Disabilities: An Intervention Mapping Approach

ERIC Educational Resources Information Center

Schaafsma, Dilana; Stoffelen, Joke M. T.; Kok, Gerjo; Curfs, Leopold M. G.

2013-01-01

Background: People with intellectual disabilities face barriers that affect their sexual health. Sex education programmes have been developed by professionals working in the field of intellectual disabilities with the aim to overcome these barriers. The aim of this study was to explore the development of these programmes. Methods: Sex education…

THE RELATIONSHIP BETWEEN SOCIAL, POLICY AND PHYSICAL VENUE FEATURES AND SOCIAL COHESION ON CONDOM USE FOR PREGNANCY PREVENTION AMONG SEX WORKERS: A SAFER INDOOR WORK ENVIRONMENT SCALE

PubMed Central

Duff, Putu; Shoveller, Jean; Dobrer, Sabina; Ogilvie, Gina; Montaner, Julio; Chettiar, Jill; Shannon, Kate

2015-01-01

Background This study aims to: report on a newly developed ‘Safer Indoor Work Environmental Scale’ that characterizes the social, policy and physical features of indoor venues and social cohesion; and using this scale, longitudinally evaluate the association between these features on sex workers’ (SWs’) condom use for pregnancy prevention. Methods Drawing on a prospective open cohort of female SWs working in indoor venues, a newly-developed ‘Safer Indoor Work Environment Scale’ was used to build six multivariable models with generalized estimating equations (GEE), to determine the independent effects of social, policy and venue-based features and social cohesion on condom use. Results Of 588 indoor SWs, 63.6% used condoms for pregnancy prevention in the last month. In multivariable GEE analysis, the following venue-based features were significantly correlated with barrier contraceptive use for pregnancy prevention: managerial practices and venue safety policies (Adjusted Odds Ratio (AOR)=1.09; 95% Confidence Interval (95%CI) 1.01–1.17) access to sexual and reproductive health services/supplies (AOR=1.10; 95%CI 1.00–1.20) access to drug harm reduction (AOR=1.13; 95%CI 1.01–1.28), and social cohesion among workers (AOR=1.05; 95%CI 1.03–1.07). Access to security features was marginally associated with condom use (AOR=1.13; 95%CI 0.99–1.29). Conclusion The findings of the current study highlight how work environment and social cohesion among SWs are related to improved condom use. Given global calls for the decriminalization of sex work, and potential legislative reforms in Canada, this study points to the critical need for new institutional arrangements (e.g., legal and regulatory frameworks; labour standards) to support safer sex workplaces. PMID:25678713

The relationship between social, policy and physical venue features and social cohesion on condom use for pregnancy prevention among sex workers: a safer indoor work environment scale.

PubMed

Duff, Putu; Shoveller, Jean; Dobrer, Sabina; Ogilvie, Gina; Montaner, Julio; Chettiar, Jill; Shannon, Kate

2015-07-01

This study aims to report on a newly developed Safer Indoor Work Environmental Scale that characterises the social, policy and physical features of indoor venues and social cohesion; and using this scale, longitudinally evaluate the association between these features on sex workers' (SWs') condom use for pregnancy prevention. Drawing on a prospective open cohort of female SWs working in indoor venues, a newly developed Safer Indoor Work Environment Scale was used to build six multivariable models with generalised estimating equations (GEE), to determine the independent effects of social, policy and physical venue-based features and social cohesion on condom use. Of 588 indoor SWs, 63.6% used condoms for pregnancy prevention in the last month. In multivariable GEE analysis, the following venue-based features were significantly correlated with barrier contraceptive use for pregnancy prevention: managerial practices and venue safety policies (adjusted OR (AOR)=1.09; 95% CI 1.01 to 1.17), access to sexual and reproductive health services/supplies (AOR=1.10; 95% CI 1.00 to 1.20), access to drug harm reduction (AOR=1.13; 95% CI 1.01 to 1.28) and social cohesion among workers (AOR=1.05; 95% CI 1.03 to 1.07). Access to security features was marginally associated with condom use (AOR=1.13; 95% CI 0.99 to 1.29). The findings of the current study highlight how work environment and social cohesion among SWs are related to improved condom use. Given global calls for the decriminalisation of sex work, and potential legislative reforms in Canada, this study points to the critical need for new institutional arrangements (eg, legal and regulatory frameworks; labour standards) to support safer sex workplaces. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Men who have sex with men in Southeastern Europe: Underground and at increased risk for HIV/STIs.

PubMed

Longfield, Kim; Astatke, Hibist; Smith, Reid; McPeak, Georgia; Ayers, Jim

2007-01-01

This paper reports on research that aimed to identify risk factors and preventive behaviours for HIV/STIs among men who have sex with men in Bulgaria, Kosovo, Macedonia and Romania. Twelve peer researchers conducted interviews on sexual behaviour, condom use and HIV/STI awareness. Data analysis revealed common themes across countries. Sexual activity takes place both in public spaces and private homes. Many men believe that careful partner selection and closing sexual networks to outsiders mitigate risk. Risk behaviours include unprotected sex within multiple partnerships, inconsistent condom use and the use of oil-based lubricants that compromise the integrity of condoms. Perceived susceptibility for infection is low and misconceptions exist about modes of transmission. Stigma and discrimination force men into clandestine settings and relationships where safer sexual behaviour is difficult. HIV prevention programmes should convey messages through the internet and peer networks, improve access to condoms and water-based lubricant, raise awareness about STIs, link men who have sex with men to appropriate services and reduce stigma to enable safer behaviour.

AIDS prevention in the sex industry.

PubMed

Morgan-thomas, R; Overs, C

1992-01-01

Most sex work research examines the impact of HIV on prostitutes and on society and involves testing prostitutes for HIV antibodies, but it does not examine the role of others in the sex industry. Sex industry workers include female prostitutes, transvestites, transsexuals, and male prostitutes, bar and brothel owners, taxi drivers, sex workers' partners, and sex business managers. Since sex workers provide sexual services to clients, they are in a perfect position to teach them about sexual health. Society must recognize that we cannot wish the sex industry away and that we need an effective health promotion strategy now. Some successful relevant AIDS education campaigns provide us some guidelines on how to develop campaigns. Any campaign targeting the sex industry should also target the public. Sex workers should participate in developing health messages and educational activities. They should also participate in the project. Any campaign must deal with major obstacles to safer sexual practices of which sex workers are aware and be consulted. Common obstacles are client demand for unprotected sex and irregular and inadequate supply of inexpensive condoms. A health promotion strategy cannot be effective, however, if sex workers do not have access to social support and health care services. Health promotion workers should also encourage local authorities to end discrimination of sex workers so they can freely obtain needed services. In some countries, sex workers operate fantasy workshops providing peers with ideas to sell sex services which reduce the risk of HIV transmission. Other campaigns distribute safer sex messages on small cards, cigarette lighters, key rings, condom packages, and T shirts. Training of sex workers other than prostitutes to reinforce safer sex messages to clients is also effective, e.g., taxi drivers can say they will take a client to a woman who uses condoms rather than to a clean girl. Street theater and puppets have also successfully

Homelessness among a cohort of women in street-based sex work: the need for safer environment interventions.

PubMed

Duff, Putu; Deering, Kathleen; Gibson, Kate; Tyndall, Mark; Shannon, Kate

2011-08-12

Drawing on data from a community-based prospective cohort study in Vancouver, Canada, we examined the prevalence and individual, interpersonal and work environment correlates of homelessness among 252 women in street-based sex work. Bivariate and multivariate logistic regression using generalized estimating equations (GEE) was used to examine the individual, interpersonal and work environment factors that were associated with homelessness among street-based sex workers. Among 252 women, 43.3% reported homelessness over an 18-month follow-up period. In the multivariable GEE logistic regression analysis, younger age (adjusted odds ratio [aOR] = 0.93; 95%confidence interval [95%CI] 0.93-0.98), sexual violence by non-commercial partners (aOR = 2.14; 95%CI 1.06-4.34), servicing a higher number of clients (10+ per week vs < 10) (aOR = 1.68; 95%CI 1.05-2.69), intensive, daily crack use (aOR = 1.65; 95%CI 1.11-2.45), and servicing clients in public spaces (aOR = 1.52; CI 1.00-2.31) were independently associated with sleeping on the street. These findings indicate a critical need for safer environment interventions that mitigate the social and physical risks faced by homeless FSWs and increase access to safe, secure housing for women.

Albania's students teach their peers about sexuality and safer sex.

PubMed

Iliriani, E; Asllani, P

1995-01-01

Under the previous pronatalist regime, Albania was the country with the youngest population and the highest birth rate in Europe. Nevertheless, sexuality used to be repressed, and the penalty for homosexuality was 10 years in prison. The repercussions of this period when information, education, and services in the field of sexual health were withheld are still felt. There are still thousands of young people and teenagers who lack the knowledge about sexuality and reproduction. Every day in Albania, at least one student has an abortion. The Organization for the Propagation of Sexual Education (SOPSE) was officially launched in November 1993, and it was initially based among students of the University of Tirana. After attending workshops concerned with health education, they became the first peer educators for sex, contraception and AIDS information. SOPSE has carried out about 700 sessions of counseling in student residences at the branch created at the University of Korca and has also distributed about 2000 condoms. SOPSE also organized a masked ball for students at the University of Tirana. 25 SOPSE members each invited 4 other students, and everyone received a free condom. The ball was also attended by representatives from Action Plus, an Albanian nongovernmental organization concerned with AIDS prevention, which distributed condoms and information at the ball. In addition, there were participants from the UN Development Programme, the World Health Organization, the Ministry of Health, the International Planned Parenthood Federation, and the Albanian Family Planning Association, as well as a number of journalists and medical professors. Part of the evening was devoted to telling the students about SOPSE, putting across safe sex messages, introducing contraceptive methods, and discussing sexuality and the risks of sexually transmitted diseases and HIV infection.

Declining HIV Prevalence in Parallel With Safer Sex Behaviors in Burkina Faso: Evidence From Surveillance and Population-Based Surveys.

PubMed

Kirakoya-Samadoulougou, Fati; Nagot, Nicolas; Samadoulougou, Sekou; Sokey, Mamadou; Guiré, Abdoulaye; Sombié, Issiaka; Meda, Nicolas

2016-06-20

To investigate trends in HIV prevalence and changes in reported sexual behaviors between 1998 and 2014 in Burkina Faso. We obtained data on HIV prevalence from antenatal care (ANC) surveillance sites (N = 9) that were consistently included in surveillance between 1998 and 2014. We also analyzed data on HIV prevalence and reported sex behaviors from 3 population-based surveys from the Demographic and Health Surveys (DHS), conducted in 1998-99, 2003, and 2010. Sex behavior indicators comprised never-married youth who have never had sex; sex with more than 1 partner; sex with a nonmarital, non-cohabiting partner; condom use at last sex with a nonmarital, non-cohabiting partner; and sex before age 15. We calculated survey-specific HIV prevalence with 95% confidence intervals (CIs) and used the chi-square test or chi-square test for trend to compare HIV prevalence across survey years and to analyze trends in reported sex behaviors. HIV prevalence among pregnant women ages 15-49 decreased by 72% in urban areas, from 7.1% in 1998 to 2.0% in 2014, and by 75% in rural areas, from 2.0% in 2003 to 0.5% in 2014. HIV declined most in younger age groups, which is a good reflection of recent incidence, with declines of 55% among 15-19-year-olds, 72% among 20-24-year-olds, 40% among 25-29-year-olds, and 7% among those ≥30 years old (considering urban and rural data combined). Data reported in the DHS corroborated these declines in HIV prevalence: between 2003 and 2010, HIV prevalence dropped significantly-by 89% among girls ages 15-19, from 0.9% (95% CI, 0.2 to 1.6) to 0.1% (95% CI, 0.0 to 0.4), and by 78% among young women ages 20-24, from 1.8% (95% CI, 1.6 to 3.0) to 0.4% (95% CI, 0.0 to 0.7). During the same time period, people reported safer sex behaviors. For example, significantly higher percentages of never-married youth reported they had never had sex, lower percentages of sexually active youth reported multiple sex partners, and lower percentages of youth reported

Spring Fever: Process Evaluation of a Sex and Relationships Education Programme for Primary School Pupils

ERIC Educational Resources Information Center

Newby, Katie V.; Mathieu-Chartier, Sara

2018-01-01

In primary schools in England, programmes of Sex and Relationships Education (SRE) are rare. Provision has been judged as requiring improvement in over one-third of these schools at a time when statutory provision has been mandated by the government. The aim of this study was to examine the early implementation of Spring Fever, a programme of…

Heavy Sexual Content Versus Safer Sex Content: A Content Analysis of the Entertainment Education Drama Shuga.

PubMed

Booker, Nancy Achieng'; Miller, Ann Neville; Ngure, Peter

2016-12-01

Extremely popular with Kenyan youth, the entertainment-education drama Shuga was designed with specific goals of promoting condom use, single versus multiple sexual partners, and destigmatization of HIV. Almost as soon as it aired, however, it generated controversy due to its extensive sexual themes and relatively explicit portrayal of sexual issues. To determine how safer sex, antistigma messages, and overall sexual content were integrated into Shuga, we conducted a content analysis. Results indicated that condom use and HIV destigmatization messages were frequently and clearly communicated. Negative consequences for risky sexual behavior were communicated over the course of the entire series. Messages about multiple concurrent partnerships were not evident. In addition, in terms of scenes per hour of programming, Shuga had 10.3 times the amount of sexual content overall, 8.2 times the amount of sexual talk, 17.8 times the amount of sexual behavior, and 9.4 times the amount of sexual intercourse as found in previous analysis of U.S. entertainment programming. Research is needed to determine how these factors may interact to influence adolescent viewers of entertainment education dramas.

In-Depth Investigation of Interpersonal Discussions in Response to a Safer Sex Mass Media Campaign

PubMed Central

Helme, Donald W.; Noar, Seth M.; Allard, Suzanne; Zimmerman, Rick S.; Palmgreen, Philip; McClanahan, Karen J.

2015-01-01

We know from theory and limited research that people talk about campaign messages—and that these conversations may play an important role in campaign reach and possibly even efficacy. We know very little, however, about what individuals talk about and with whom they talk. The current study seeks to fill this gap by reporting qualitative and descriptive quantitative data from interviews conducted with 139 young adults about conversations that took place in the context of a large, televised safer sex mass media campaign. Results indicated that public service announcements (PSAs) were often viewed in the company of friends and significant others, and that it was not uncommon for conversations about the PSAs to take place. Three broad categories of conversations that took place involved discussions about PSA realism, the seriousness of the message, and humor. While in some cases conversations seemed to advance the goal of the campaign (e.g., participants discussed sexually transmitted disease [STD] risk and condom use), in other cases they did not (e.g., participants discussed the lack of realism in a particular PSA). Implications for campaign theory, design, and implementation are discussed. PMID:21409674

A Pilot Intervention to Promote Safer Sex in Heterosexual Puerto Rican Couples

PubMed Central

Pérez-Jiménez, David; Seal, David Wyatt; Ronis, David L.

2014-01-01

Although the sexual transmission of HIV occurs in the context of an intimate relationship, preventive interventions with couples are scarce, particularly those designed for Hispanics. In this article, we present the effect of a pilot intervention directed to prevent HIV/AIDS in heterosexual couples in Puerto Rico. The intervention was theory-based and consisted of five three-hour group sessions. Primary goals included increasing male condom use and the practice of mutual masturbation as a safer sex method, and promoting favorable attitudes toward these behaviors. Twenty-six couples participated in this study. Fifteen were randomly assigned to the intervention group and eleven to a control group. Retention rates at post-intervention and follow-up were 82% for the whole sample. Results showed that there was a significant increase in the use of male condoms with main partners in the intervention group when compared with the control group. Couples in the intervention group also had better scores on secondary outcomes, such as attitudes toward condom use and mutual masturbation, HIV information, sexual decision-making, and social support. We found that these effects persisted over the three month follow up. A significant effect was also observed for the practice of mutual masturbation, but not for sexual negotiation. These results showed that promoting male condom use in dyadic interventions among heterosexual couples in Puerto Rico is feasible. Our findings suggest that because vaginal penetration has been constructed as the sexual script endpoint among many Hispanic couples, promoting other non-penetrative practices, such as mutual masturbation, may be difficult. PMID:25512880

A Pilot Intervention to Promote Safer Sex in Heterosexual Puerto Rican Couples.

PubMed

Pérez-Jiménez, David; Seal, David Wyatt; Ronis, David L

2014-09-01

Although the sexual transmission of HIV occurs in the context of an intimate relationship, preventive interventions with couples are scarce, particularly those designed for Hispanics. In this article, we present the effect of a pilot intervention directed to prevent HIV/AIDS in heterosexual couples in Puerto Rico. The intervention was theory-based and consisted of five three-hour group sessions. Primary goals included increasing male condom use and the practice of mutual masturbation as a safer sex method, and promoting favorable attitudes toward these behaviors. Twenty-six couples participated in this study. Fifteen were randomly assigned to the intervention group and eleven to a control group. Retention rates at post-intervention and follow-up were 82% for the whole sample. Results showed that there was a significant increase in the use of male condoms with main partners in the intervention group when compared with the control group. Couples in the intervention group also had better scores on secondary outcomes, such as attitudes toward condom use and mutual masturbation, HIV information, sexual decision-making, and social support. We found that these effects persisted over the three month follow up. A significant effect was also observed for the practice of mutual masturbation, but not for sexual negotiation. These results showed that promoting male condom use in dyadic interventions among heterosexual couples in Puerto Rico is feasible. Our findings suggest that because vaginal penetration has been constructed as the sexual script endpoint among many Hispanic couples, promoting other non-penetrative practices, such as mutual masturbation, may be difficult.

Promoting male partner HIV testing and safer sexual decision making through secondary distribution of self-tests by HIV-negative female sex workers and women receiving antenatal and post-partum care in Kenya: a cohort study.

PubMed

Thirumurthy, Harsha; Masters, Samuel H; Mavedzenge, Sue Napierala; Maman, Suzanne; Omanga, Eunice; Agot, Kawango

2016-06-01

tests from participants in antenatal care, two (2%) of 91 in post-partum care, and 41 (14%) of 298 from female sex workers had positive results. Participants reported sexual intercourse with 235 (62%) of 380 sexual partners who tested HIV-negative, compared with eight (18%) of 45 who tested HIV-positive (p<0·0001); condoms were used in all eight intercourse events after positive results compared with 104 (44%) after of negative results (p<0·0018). Four participants reported intimate partner violence as a result of self-test distribution: two in the post-partum care group and two female sex workers. No other adverse events were reported. Provision of multiple HIV self-tests to women at high risk of HIV infection was successful in promoting HIV testing among their sexual partners and in facilitating safer sexual decisions. This novel strategy warrants further consideration as countries develop self-testing policies and programmes. Bill & Melinda Gates Foundation. Copyright © 2016 Elsevier Ltd. All rights reserved.

Development of a Sex Education Programme for 12-Year-Old to 14-Year-Old Turkish Adolescents

ERIC Educational Resources Information Center

Cok, Figen; Gray, Lizbeth Ann

2007-01-01

Previous research has documented a need for the development of a sex education programme in Turkish schools in terms of adolescence readiness and the presence of misconceptions regarding critical aspects of sexual issues. Currently no school-based sex education is available for Turkish adolescents. This paper presents the development of a…

STS-64 SAFER Assembly

NASA Image and Video Library

1993-12-10

S93-50137 (December 1993) --- This small mobility-aiding back harness, complemented in extravehicular activity (EVA) with a hand controller unit and called the Simplified Aid for EVA Rescue (SAFER) system, will get extensive in-space evaluation and testing during the STS-64 mission. In this view the SAFER is open to reveal the gas supply and thrusters. SAFER is to fly on STS-76 as well.

STI prevention and the male sex industry in London: evaluating a pilot peer education programme

PubMed Central

Ziersch, A; Gaffney, J; Tomlinson, D

2000-01-01

Objective: To evaluate the effectiveness of a pilot peer education STI prevention programme with male sex workers. Design: A process and outcome evaluation of the pilot programme undertaken in three London male escort agencies, using a quasi-experimental design. Subjects: Workers in three London escort agencies, including 88 who completed a questionnaire, five peer educators, and a further 16 men (including management) working in two of these agencies. Methods: A peer education STI prevention programme run by the Working Men Project (WMP), a specialist sexual health service for male sex workers, was piloted in two London escort agencies. Five male sex workers participated in a 2 day peer education training programme. They then returned to their respective agencies to disseminate information and condoms, in an attempt to influence norms of behaviour. An outcome evaluation aimed to assess changes in STI related knowledge, high risk sexual behaviour, and attendance at a sexual health service. A pre-intervention questionnaire assessing variables such as STI related knowledge, sexual behaviour, and demographic information was administered in both agency A and agency B and a third agency, C, which acted as a control. Ten weeks after the peer educators returned to their agencies, the same questionnaire was administered in the same agencies. Peer educator referrals to the WMP were also recorded over this time period. The process evaluation involved interviews and focus groups with peer educators, and the completion of diaries about their experiences in the role. A further 16 men working in the agencies (including managers and an owner) were interviewed about their experience of the programme. Participant observation was also undertaken through regular outreach work to the agencies. Results: 57 men completed the questionnaire at time 1 and 44 at time 2. Unfortunately, only 13 of these were matched, precluding any meaningful analysis of change in STI related knowledge and

Using computer technology for HIV prevention among African-Americans: development of a tailored information program for safer sex (TIPSS)

PubMed Central

Noar, Seth M.; Webb, Elizabeth M.; Van Stee, Stephanie K.; Redding, Colleen A.; Feist-Price, Sonja; Crosby, Richard; Troutman, Adewale

2011-01-01

New prevention options are urgently needed for African-Americans in the United States given the disproportionate impact of HIV/AIDS on this group. This combined with recent evidence supporting the efficacy of computer technology-based interventions in HIV prevention led our research group to pursue the development of a computer-delivered individually tailored intervention for heterosexually active African-Americans—the tailored information program for safer sex (TIPSS). In the current article, we discuss the development of the TIPSS program, including (i) the targeted population and behavior, (ii) theoretical basis for the intervention, (iii) design of the intervention, (iv) formative research, (v) technical development and testing and (vi) intervention delivery and ongoing randomized controlled trial. Given the many advantages of computer-based interventions, including low-cost delivery once developed, they offer much promise for the future of HIV prevention among African-Americans and other at-risk groups. PMID:21257676

Sex and Prevention Concerns for Positive People

MedlinePlus

... with any comments or concerns. February 17, 2011 Sex and prevention concerns for positive people Facebook Twitter ... partner, and vice versa. The reality of safer sex You put yourself at risk for infections through ...

SaferProducts.gov

MedlinePlus

... Register & Respond Search Recalls & Reports About Questions Welcome Consumers Report your unsafe product on SaferProducts.gov. Tell CPSC. ... Unsafe Product Business Sign In Search Recalls/Repairs & Reports Advanced Search Most ... does not guarantee the accuracy, completeness, or adequacy of the contents of the Publicly Available Consumer Product Safety Information Database on SaferProducts.gov, particularly ...

STI prevention and the male sex industry in London: evaluating a pilot peer education programme.

PubMed

Ziersch, A; Gaffney, J; Tomlinson, D R

2000-12-01

To evaluate the effectiveness of a pilot peer education STI prevention programme with male sex workers. A process and outcome evaluation of the pilot programme undertaken in three London male escort agencies, using a quasi-experimental design. Workers in three London escort agencies, including 88 who completed a questionnaire, five peer educators, and a further 16 men (including management) working in two of these agencies. A peer education STI prevention programme run by the Working Men Project (WMP), a specialist sexual health service for male sex workers, was piloted in two London escort agencies. Five male sex workers participated in a 2 day peer education training programme. They then returned to their respective agencies to disseminate information and condoms, in an attempt to influence norms of behaviour. An outcome evaluation aimed to assess changes in STI related knowledge, high risk sexual behaviour, and attendance at a sexual health service. A pre-intervention questionnaire assessing variables such as STI related knowledge, sexual behaviour, and demographic information was administered in both agency A and agency B and a third agency, C, which acted as a control. Ten weeks after the peer educators returned to their agencies, the same questionnaire was administered in the same agencies. Peer educator referrals to the WMP were also recorded over this time period. The process evaluation involved interviews and focus groups with peer educators, and the completion of diaries about their experiences in the role. A further 16 men working in the agencies (including managers and an owner) were interviewed about their experience of the programme. Participant observation was also undertaken through regular outreach work to the agencies. 57 men completed the questionnaire at time 1 and 44 at time 2. Unfortunately, only 13 of these were matched, precluding any meaningful analysis of change in STI related knowledge and sexual behaviour. The questionnaire provided a

Pedestrian Safer Journey

Science.gov Websites

Pedestrian Safer Journey Skills for Safe Walking for Ages 5 to 18 Use in the classroom or one-on -one. To start, click on an age group below: Ages 5-9 Ages 10-14 Ages 15-18 What is Pedestrian Safer get the conversation started with children and youth. Three videos - one for each of three age groups

Need for a Comprehensive Sex and Relationship Education Programme for Adults with Learning Disability.

PubMed

Enow, Humphrey; Nagalingam, Priya; Singh, Ranbir; Thalitaya, Madhusudan Deepak

2015-09-01

Most people with learning disabilities (PWLD) have little understanding of the concept of sex and relationship. PWLD are vulnerable and more likely to be victims of sexual offending. Currently, the only formal access to sex and relationship education that PWLD have is in special need schools. The right to express their sexuality is frequently restricted or denied by restricted policies, negative attitudes and lack of awareness of their needs. To provide a Comprehensive Sex and Relationship Education programme for PWLD. These group/individual sessions will led by a sexuality support worker with experience in working with PWLD. They will be supported by members of the multidisciplinary team including, psychiatrist, psychologist, occupational therapists etc. Providing sex and relationship education PWLD would help them achieve a fulfilling and rewarding sexual experience and make them less vulnerable to sexual abuse. There should be greater emphasis to be placed on sex and relationship education in PWLD; preferably by qualified professionals.

Consensus statement: Supporting Safer Conception and Pregnancy For Men And Women Living with and Affected by HIV.

PubMed

Matthews, Lynn T; Beyeza-Kashesya, Jolly; Cooke, Ian; Davies, Natasha; Heffron, Renee; Kaida, Angela; Kinuthia, John; Mmeje, Okeoma; Semprini, Augusto E; Weber, Shannon

2018-06-01

Safer conception interventions reduce HIV incidence while supporting the reproductive goals of people living with or affected by HIV. We developed a consensus statement to address demand, summarize science, identify information gaps, outline research and policy priorities, and advocate for safer conception services. This statement emerged from a process incorporating consultation from meetings, literature, and key stakeholders. Three co-authors developed an outline which was discussed and modified with co-authors, working group members, and additional clinical, policy, and community experts in safer conception, HIV, and fertility. Co-authors and working group members developed and approved the final manuscript. Consensus across themes of demand, safer conception strategies, and implementation were identified. There is demand for safer conception services. Access is limited by stigma towards PLWH having children and limits to provider knowledge. Efficacy, effectiveness, safety, and acceptability data support a range of safer conception strategies including ART, PrEP, limiting condomless sex to peak fertility, home insemination, male circumcision, STI treatment, couples-based HIV testing, semen processing, and fertility care. Lack of guidelines and training limit implementation. Key outstanding questions within each theme are identified. Consumer demand, scientific data, and global goals to reduce HIV incidence support safer conception service implementation. We recommend that providers offer services to HIV-affected men and women, and program administrators integrate safer conception care into HIV and reproductive health programs. Answers to outstanding questions will refine services but should not hinder steps to empower people to adopt safer conception strategies to meet reproductive goals.

The women's heart health programme: a pilot trial of sex-specific cardiovascular management.

PubMed

Low, Ting Ting; Chan, Siew Pang; Wai, Shin Hnin; Ang, Zhou; Kyu, Kyu; Lee, Kim Yee; Ching, Anne; Comer, Sarah; Tan, Naomi Qiu Pin; Thong, Elizabeth Grace Hui En; Nang, Tracy; Dutta, Mohan; Lam, Carolyn S P

2018-04-16

There is increasing knowledge of sex-specific differences in cardiovascular disease and recognition of sex disparities in management. In our study, we investigated whether a cardiovascular programme tailored to the specific needs of women could lead to improved outcomes. We randomised 100 female patients to receive cardiology follow-up with the conventional sex-neutral cardiac programme (control), or the sex-tailored Women's Heart Health Programme (intervention). The intervention group was managed by an all-women multidisciplinary team and received culture-centred health intervention workshops, designed through in-depth interviews with the participants. The primary outcome was cardiovascular risk factor improvement at 1 year. Secondary outcomes include cardiovascular event rates, quality of life scores, and self-reported improvement in knowledge, attitudes, intentions and practices. Generalised structural equation model analysis was used to determine if the intervention group had better outcomes at alpha level 0.1. The mean age was 67.3 ± 12.7 years, with an ethnic distribution of 70% Chinese, 18% Malays, and 12% Indians. The majority of these patients had no formal or primary level of education (63%), and were mostly unemployed (78%). Patients in intervention group had better control of diabetes mellitus (lower HbA1c of 0.63% [CI 0.21-1.04], p = 0.015) and lower body-mass-index (0.74 kg/m 2 [CI 0.02-1.46], p = 0.092) at 1 year, but there was no significant difference in blood pressure or lipid control. Overall, there was a trend towards better risk factor control, 31.6% of intervention group versus 26.5% of control group achieved improvement in at least 1 CV risk factor control to target range. There was no significant difference in incidence of cardiovascular events, quality of life, or domains in knowledge, attitudes, intention and practices. This pilot study is the first of its kind evaluating a new model of care for women with heart disease

A Sex Education Programme for Mothers in Iran: Does Preschool Children's Sex Education Influence Mothers' Knowledge and Attitudes?

ERIC Educational Resources Information Center

Martin, Jeno; Riazi, Hedyeh; Firoozi, Armin; Nasiri, Maliheh

2018-01-01

Mothers have an important role to play in teaching their children about sexual issues and shaping children's sexual knowledge, attitudes and behaviours. In many cases, however, mothers themselves need help and support. This study was conducted to examine the effects of a sex education programme on the knowledge and attitudes of the mothers of…

Sex workers talk about sex work: six contradictory characteristics of legalised sex work in Melbourne, Australia.

PubMed

Begum, Sufia; Hocking, Jane S; Groves, Jan; Fairley, Christopher K; Keogh, Louise A

2013-01-01

Despite research suggesting that legal sex work is safe and that emotional risks and social stigma are of greater concern than health risks, much research on sex work has focused on health risks. Given the legalisation of sex work in Victoria, Australia, it is timely to look beyond health. Three focus groups were conducted with a total of 14 female sex workers on their experience of legal sex work, both positive and negative, and the social acceptability of their profession. Thematic analysis was used to identify the key ways that sex workers described sex work. Women saw legal sex work as safer than illegal sex work, but still not socially acceptable. However, they also described six contradictory elements of sex work, which was seen as: financially rewarding and entrapping; empowering and demeaning; increasing some opportunities while reducing others; flexible and demanding; offering both intimacy and competition; and leading to a 'double life'. While legalisation has improved the safety of sex work, stigma and discrimination persist.

Implementation of The World Starts With Me, a comprehensive rights-based sex education programme in Uganda.

PubMed

Rijsdijk, Liesbeth E; Bos, Arjan E R; Lie, Rico; Leerlooijer, Joanne N; Eiling, Ellen; Atema, Vera; Gebhardt, Winifred A; Ruiter, Robert A C

2014-04-01

This article presents a process evaluation of the implementation of the sex education programme the World Starts With Me (WSWM) for secondary school students in Uganda. The purpose of this mixed-methods study was to examine factors associated with dose delivered (number of lessons implemented) and fidelity of implementation (implementation according to the manual), as well as to identify the main barriers and facilitators of implementation. Teachers' confidence in teaching WSWM was negatively associated with dose delivered. Confidence in educating and discussing sexuality issues in class was positively associated with fidelity of implementation, whereas the importance teachers attached to open sex education showed a negative association with fidelity. Main barriers for implementing WSWM were lack of time, unavailability of computers, lack of student manuals and lack of financial support and rewards. Other barriers for successful implementation were related to high turnover of staff and insufficient training and guidance of teachers. Teachers' beliefs/attitudes towards sexuality of adolescents, condom use and sex education were found to be important socio-cognitive factors intervening with full fidelity of implementation. These findings can be used to improve the intervention implementation and to better plan for large-scale dissemination of school-based sex education programmes in sub-Saharan Africa.

Evaluation of a School-Based Sex Education Programme Delivered to Grade Nine Students in Canada

ERIC Educational Resources Information Center

Smylie, Lisa; Maticka-Tyndale, Eleanor; Boyd, Dana

2008-01-01

The effectiveness of a multidimensional Canadian sex education programme was evaluated using 240 Grade Nine students. The intervention was offered by representatives from various community groups and involved instructional classes on anatomy/physiology of the reproductive system and sexually transmitted infections, a video and group discussion on…

"It's Intense, to an Extent": A Qualitative Study of the Emotional Challenges Faced by Staff Working on a Treatment Programme for Intellectually Disabled Sex Offenders

ERIC Educational Resources Information Center

Sandhu, Daljit K.; Rose, John; Rostill-Brookes, Helen J.; Thrift, Su

2012-01-01

Background: This study explores the emotional challenges faced by staff working on a sex offender treatment programme for people with an intellectual disability. Methods: Semi-structured interviews were carried out with eight participants working on a treatment programme for sex offenders with an intellectual disability. Interviews were analysed…

Promoting safer sexual practices among young adults: a survey of health workers in Moshi Rural District, Tanzania.

PubMed

Ngomuo, E T; Klepp, K I; Rise, J; Mnyika, K S

1995-01-01

As part of the national effort to prevent further spread of HIV/AIDS, rural health workers in Tanzania are asked to promote safer sex practices among the sexually active population. We conducted a survey among health workers in Moshi Rural District, Kilimanjaro, designed to assess their attitudes, perceived norms and self-efficacy with respect to the promotion of safer sexual practices among young adults 15-35 years old. Health workers at all private and governmental health facilities were included (n = 342; participation rate of 68.4%). We observed relatively strong associations between the frequency and quality of reported counselling behaviour and perceived norms, attitudes and self-efficacy (standardized regression coefficients (beta) of 0.329, 0.252 and 0.159 respectively). In addition, exposure to behaviour change strategies during formal training and marital status of the health workers were associated with counselling behaviour (beta of 0.133 and 0.118 respectively). Overall, these factors accounted for 40.8% of the observed variance in reported counselling behaviour. It is recommended that continued education for health workers focus on providing normative support for promoting safer sex, provide information which may help foster positive attitudes and teach practical counselling skills to further increase the self-efficacy regarding counselling young people.

Sex Education Knowledge Differences between Freshmen and Senior College Undergraduates

ERIC Educational Resources Information Center

Franklin, Ruth M.; Dotger, Sharon

2011-01-01

Abstinence sexuality education (sex ed) is the only federally funded sex ed in the United States. The strict curriculum of this education does not educate American adolescents about safer sex practices and leaves a knowledge gap in these adolescents that follows them into college. The Problem: This project aimed to identify sex knowledge…

Evaluation of a safer male circumcision training programme for traditional surgeons and nurses in the Eastern Cape, South Africa.

PubMed

Peltzer, Karl; Nqeketo, Ayanda; Petros, George; Kanta, Xola

2008-06-18

Training designed to improve circumcision knowledge, attitude and practice was delivered over 5 days to 34 traditional surgeons and 49 traditional nurses in the Eastern Cape, South Africa. Training included the following topics: initiation rites; statutory regulation of traditional male circumcision and initiation into Manhood (TCIM); structure and function of the male sex organs; procedure of safe circumcision, infection control; sexually transmitted infections (STIs); HIV/AIDS; infection control measures; aftercare of the initiate including after care of the circumcision wound and initiate as a whole; detection and early management of common complications of circumcision; nutrition and fluid management; code of conduct and ethics; and sexual health education. The evaluation of the training consisted of a prospective assessment of knowledge and attitude immediately prior to and after training. Significant improvement in knowledge and/or attitudes was observed in legal aspects, STI, HIV and environmental aspects, attitudes in terms of improved collaboration with biomedical health care providers, normal and abnormal anatomy and physiology, sexually transmitted infections and including HIV, circumcision practice and aftercare of initiates. We concluded that safer circumcision training can be successfully delivered to traditional surgeons and nurses.

Goneis.gr: Training Greek Parents on ICT and Safer Internet

NASA Astrophysics Data System (ADS)

Manouselis, Nikos; Riviou, Katerina; Palavitsinis, Nikos; Giannikopoulou, Vasiliki; Tsanakas, Panayotis

Children's use of the Internet has significantly risen in the last decade. Nevertheless, children spend a lot of time online which makes them susceptible to various threats (such as inappropriate material, offensive language, etc). Parents are the last frontier to this menace but they also need to be educated and trained in order to protect their children. Goneis.gr is an initiative launched by the Greek government that aims to educate parents on safer Internet and the use of parental control software. Parents are also entitled to distance learning courses covering basic computer skills. This paper presents the results of two separate surveys that took place in the last few months (December 2008-January 2009). The first survey targeted the parents that have completed the programme and the second one the educational providers that participate in the programme and offer the training to the beneficiaries.

Safer Chemicals Research Fact Sheets

EPA Pesticide Factsheets

Chemical safety is a major priority of the U.S. EPA. Moving toward a healthier, more sustainable environment requires making safer, “greener” chemicals and producing new and existing chemicals in ways that are safer for humans and wildlife.

Importance of Women's Relative Socioeconomic Status within Sexual Relationships in Communication about Safer Sex and HIV/STI Prevention.

PubMed

Muchomba, Felix M; Chan, Christine; El-Bassel, Nabila

2015-06-01

The socioeconomic status (SES) of women is increasingly considered an important factor for HIV/STI risk. The HIV/STI literature has largely focused on women's absolute levels of SES, and therefore, the importance of their SES relative to their male sexual partners remains understudied. This paper examines the association between women's relative SES and frequency of safer sex communication among heterosexual couples. A convenience sample of 342 couples (N = 684) recruited in New York City was asked about frequency of discussions with their partner about the need to use male condoms, about HIV prevention, and about STI prevention in the previous 90 days. Differences between partners in education, income, employment, housing, and incarceration history were combined using principal component analysis to form an index of women's relative SES. Negative binomial regression models assessed associations between woman's relative SES and communication frequency controlling for age, sex, race, ethnicity, education, and relationship type using a generalized estimating equation framework. On average, participants had 2.5, 4.2, and 4.8 discussions regarding the need to use male condoms, about HIV prevention, and about STI prevention, respectively. A one standard deviation increase in a woman's relative SES score was associated with increased frequency of discussions about male condom use (adjusted rate ratio [aRR], 1.15; 95% confidence interval [CI], 1.03-1.29), about HIV prevention (aRR, 1.25; CI, 1.14-1.37), and about STI prevention (aRR, 1.29; CI, 1.18-1.41). Women's relative SES may be an important factor for sexual communication, and further research on its role in HIV/STI risk may uncover avenues for intervention.

Safer Choice

EPA Pesticide Factsheets

Safer Choice is a voluntary program that works to advance the mission of EPA to protect human health and the environment by helping product manufacturers choose the safest chemical ingredients possible.

Improved HIV Awareness and Perceived Empowerment to Negotiate Safe Sex among Married Women in Ethiopia between 2005 and 2011

PubMed Central

De Coninck, Zaake; Feyissa, Ibrahim A.; Ekström, Anna Mia; Marrone, Gaetano

2014-01-01

Introduction The HIV prevalence rate in Ethiopia for married (or cohabiting) women is 3 times that found amongst women who have never been married. While marriage used to be seen as a protective factor against HIV, evidence suggests that this is no longer necessarily the case. This study analyses the trend and socio-demographic determinants of HIV awareness and safe sex negotiation among married women in Ethiopia between 2005 and 2011. Methods Data from Ethiopian Demographic and Health Surveys conducted in 2005 and in 2011 were analysed. Socio-demographic variables as well as ‘survey year’ were selected to assess their interaction with selected HIV awareness and safe sex negotiation indicators. Multivariable regression analyses were performed. Odds ratios and confidence intervals were computed. Results A significant increase in knowledge of HIV and ability to negotiate safer sex occurred between 2005 and 2011 reflecting a positive trend in gender empowerment amongst married Ethiopian women. Some of these advancements were striking, for instance respondents were 3.6 times more likely to have “Heard of AIDS” in 2011 than in 2005. HIV awareness and safer sex negotiation were significantly associated with higher education, higher socioeconomic status, those who had heard of HIV, those of the Orthodox Christian faith, and (to some extent) those living in rural areas. Conclusion HIV awareness has increased significantly in Ethiopia over the last decade but married women are still disproportionately susceptible to HIV. Community programmes, already effective in Ethiopia, also need to target this vulnerable sub-group of women. PMID:25506823

Cost-Effectiveness of Combined Sexual and Injection Risk Reduction Interventions among Female Sex Workers Who Inject Drugs in Two Very Distinct Mexican Border Cities.

PubMed Central

Burgos, Jose L.; Patterson, Thomas L.; Graff-Zivin, Joshua S.; Kahn, James G.; Rangel, M. Gudelia; Lozada, M. Remedios; Staines, Hugo; Strathdee, Steffanie A.

2016-01-01

Background We evaluated the cost-effectiveness of combined single session brief behavioral intervention, either didactic or interactive (Mujer Mas Segura, MMS) to promote safer-sex and safer-injection practices among female sex workers who inject drugs (FSW-IDUs) in Tijuana (TJ) and Ciudad-Juarez (CJ) Mexico. Data for this analysis was obtained from a factorial RCT in 2008–2010 coinciding with expansion of needle exchange programs (NEP) in TJ, but not in CJ. Methods A Markov model was developed to estimate the incremental cost per quality adjusted life year gained (QALY) over a lifetime time frame among a hypothetical cohort of 1,000 FSW-IDUs comparing a less intensive didactic vs. a more intensive interactive format of the MMS, separately for safer sex and safer injection combined behavioral interventions. The costs for antiretroviral therapy was not included in the model. We applied a societal perspective, a discount rate of 3% per year and currency adjusted to US$2014. A multivariate sensitivity analysis was performed. The combined and individual components of the MMS interactive behavioral intervention were compared with the didactic formats by calculating the incremental cost-effectiveness ratios (ICER), defined as incremental unit of cost per additional health benefit (e.g., HIV/STI cases averted, QALYs) compared to the next least costly strategy. Following guidelines from the World Health Organization, a combined strategy was considered highly cost-effective if the incremental cost per QALY gained fell below the gross domestic product per capita (GDP) in Mexico (equivalent to US$10,300). Findings For CJ, the mixed intervention approach of interactive safer sex/didactic safer injection had an incremental cost-effectiveness ratio (ICER) of US$4,360 ($310–$7,200) per QALY gained compared with a dually didactic strategy. Using the dually interactive strategy had an ICER of US$5,874 ($310–$7,200) compared with the mixed approach. For TJ, the combination of

Cost-Effectiveness of Combined Sexual and Injection Risk Reduction Interventions among Female Sex Workers Who Inject Drugs in Two Very Distinct Mexican Border Cities.

PubMed

Burgos, Jose L; Patterson, Thomas L; Graff-Zivin, Joshua S; Kahn, James G; Rangel, M Gudelia; Lozada, M Remedios; Staines, Hugo; Strathdee, Steffanie A

2016-01-01

We evaluated the cost-effectiveness of combined single session brief behavioral intervention, either didactic or interactive (Mujer Mas Segura, MMS) to promote safer-sex and safer-injection practices among female sex workers who inject drugs (FSW-IDUs) in Tijuana (TJ) and Ciudad-Juarez (CJ) Mexico. Data for this analysis was obtained from a factorial RCT in 2008-2010 coinciding with expansion of needle exchange programs (NEP) in TJ, but not in CJ. A Markov model was developed to estimate the incremental cost per quality adjusted life year gained (QALY) over a lifetime time frame among a hypothetical cohort of 1,000 FSW-IDUs comparing a less intensive didactic vs. a more intensive interactive format of the MMS, separately for safer sex and safer injection combined behavioral interventions. The costs for antiretroviral therapy was not included in the model. We applied a societal perspective, a discount rate of 3% per year and currency adjusted to US$2014. A multivariate sensitivity analysis was performed. The combined and individual components of the MMS interactive behavioral intervention were compared with the didactic formats by calculating the incremental cost-effectiveness ratios (ICER), defined as incremental unit of cost per additional health benefit (e.g., HIV/STI cases averted, QALYs) compared to the next least costly strategy. Following guidelines from the World Health Organization, a combined strategy was considered highly cost-effective if the incremental cost per QALY gained fell below the gross domestic product per capita (GDP) in Mexico (equivalent to US$10,300). For CJ, the mixed intervention approach of interactive safer sex/didactic safer injection had an incremental cost-effectiveness ratio (ICER) of US$4,360 ($310-$7,200) per QALY gained compared with a dually didactic strategy. Using the dually interactive strategy had an ICER of US$5,874 ($310-$7,200) compared with the mixed approach. For TJ, the combination of interactive safer sex

Safer sex maintenance among gay men: are we making any progress?

PubMed

Ekstrand, M L

1992-08-01

Although early acquired immunodeficiency syndrome (AIDS) prevention programs produced dramatic reductions in unsafe sexual practices on the part of homosexual men, there is evidence that new behaviors have not been maintained consistently. Various cohort studies have related risky sex relapse to low self-efficacy, emotional depression, and relationship issues. Unprotected sex is widely perceived as more pleasurable than condom use and is likely to be practiced by gay men concerned with their partner's presumed preferences. This finding suggests a need to identify ways of increasing the pleasure associated with safe sex by eroticizing condom use. Approaches that include erotic descriptions of safe sex (e.g., pamphlets with explicit photographs, mass media campaigns that use sexually explicit language, and attractively packaged condoms) have been found to increase behavioral risk reduction practices. All interventions aimed at preventing risky sex relapse should be empirically based and delivered in a fashion acceptable to the homosexual community.

Strategies for reducing police arrest in the context of an HIV prevention programme for female sex workers: evidence from structural interventions in Karnataka, South India.

PubMed

Bhattacharjee, Parinita; Isac, Shajy; McClarty, Leigh M; Mohan, Haranahalli L; Maddur, Srinath; Jagannath, Sunitha B; Venkataramaiah, Balasubramanya K; Moses, Stephen; Blanchard, James F; Gurnani, Vandana

2016-01-01

Female sex workers (FSWs) frequently experience violence in their work environments, violating their basic rights and increasing their vulnerability to HIV infection. Structural interventions addressing such violence are critical components of comprehensive HIV prevention programmes. We describe structural interventions developed to address violence against FSWs in the form of police arrest, in the context of the Bill and Melinda Gates Foundation's India AIDS Initiative (Avahan) in Karnataka, South India. We examine changes in FSW arrest between two consecutive time points during the intervention and identify characteristics that may increase FSW vulnerability to arrest in Karnataka. Structural interventions with police involved advocacy work with senior police officials, sensitization workshops, and integration of HIV and human rights topics in pre-service curricula. Programmes for FSWs aimed to enhance collectivization, empowerment and awareness about human rights and to introduce crisis response mechanisms. Three rounds of integrated behavioural and biological assessment surveys were conducted among FSWs from 2004 to 2011. We conducted bivariate and multivariate analyses using data from the second (R2) and third (R3) survey rounds to examine changes in arrests among FSWs over time and to assess associations between police arrest, and the sociodemographic and sex work-related characteristics of FSWs. Among 4110 FSWs surveyed, rates of ever being arrested by the police significantly decreased over time, from 9.9% in R2 to 6.1% in R3 (adjusted odds ratio (AOR) [95% CI]=0.63 [0.48 to 0.83]). Arrests in the preceding year significantly decreased, from 5.5% in R2 to 2.8% in R3 (AOR [95% CI]=0.59 [0.41 to 0.86]). FSWs arrested as part of arbitrary police raids also decreased from 49.6 to 19.5% (AOR [95% CI]=0.21 [0.11 to 0.42]). Certain characteristics, including financial dependency on sex work, street- or brothel-based solicitation and high client volumes, were found

Strategies for reducing police arrest in the context of an HIV prevention programme for female sex workers: evidence from structural interventions in Karnataka, South India

PubMed Central

Bhattacharjee, Parinita; Isac, Shajy; McClarty, Leigh M; Mohan, Haranahalli L; Maddur, Srinath; Jagannath, Sunitha B; Venkataramaiah, Balasubramanya K; Moses, Stephen; Blanchard, James F; Gurnani, Vandana

2016-01-01

Introduction Female sex workers (FSWs) frequently experience violence in their work environments, violating their basic rights and increasing their vulnerability to HIV infection. Structural interventions addressing such violence are critical components of comprehensive HIV prevention programmes. We describe structural interventions developed to address violence against FSWs in the form of police arrest, in the context of the Bill and Melinda Gates Foundation's India AIDS Initiative (Avahan) in Karnataka, South India. We examine changes in FSW arrest between two consecutive time points during the intervention and identify characteristics that may increase FSW vulnerability to arrest in Karnataka. Methods Structural interventions with police involved advocacy work with senior police officials, sensitization workshops, and integration of HIV and human rights topics in pre-service curricula. Programmes for FSWs aimed to enhance collectivization, empowerment and awareness about human rights and to introduce crisis response mechanisms. Three rounds of integrated behavioural and biological assessment surveys were conducted among FSWs from 2004 to 2011. We conducted bivariate and multivariate analyses using data from the second (R2) and third (R3) survey rounds to examine changes in arrests among FSWs over time and to assess associations between police arrest, and the sociodemographic and sex work-related characteristics of FSWs. Results Among 4110 FSWs surveyed, rates of ever being arrested by the police significantly decreased over time, from 9.9% in R2 to 6.1% in R3 (adjusted odds ratio (AOR) [95% CI]=0.63 [0.48 to 0.83]). Arrests in the preceding year significantly decreased, from 5.5% in R2 to 2.8% in R3 (AOR [95% CI]=0.59 [0.41 to 0.86]). FSWs arrested as part of arbitrary police raids also decreased from 49.6 to 19.5% (AOR [95% CI]=0.21 [0.11 to 0.42]). Certain characteristics, including financial dependency on sex work, street- or brothel-based solicitation and

Implementation of the World Starts with Me, a Comprehensive Rights-Based Sex Education Programme in Uganda

ERIC Educational Resources Information Center

Rijsdijk, Liesbeth E.; Bos, Arjan E. R.; Lie, Rico; Leerlooijer, Joanne N.; Eiling, Ellen; Atema, Vera; Gebhardt, Winifred A.; Ruiter, Robert A. C.

2014-01-01

This article presents a process evaluation of the implementation of the sex education programme the World Starts With Me (WSWM) for secondary school students in Uganda. The purpose of this mixed-methods study was to examine factors associated with dose delivered (number of lessons implemented) and fidelity of implementation (implementation…

Communication and Information About "Safer Sex:" Intervention Issues Within Communities of African Migrants Living in Poorer Neighbourhoods in Portugal.

PubMed

de Matos, Margarida Gaspar; Gaspar, Tania; Simons-Morton, Bruce; Reis, Marta; Ramiro, Lúcia

2008-01-01

The aims of this study are to determine the influence of migrant status on sexual behavior and communication about "safer sex" and to identify ethnic-specific prevention issues. Data were obtained from a special administration of the Health Behavior in School-Aged Children Survey in a special sample of Portuguese schools located in low-income Lisbon neighborhoods with large proportions of African migrants.Survey participants included 919 6th, 8th and 10th graders (52.3% female), of whom 19.2% were migrant foreigners from African Portuguese-speaking countries, including Cape Verde (60.8%), Mozambique (1.6%), Angola (16.8%), S. Tomé (8%), and Guinea-Bissau (14.8%). Subsequently, four focus groups were held with adolescent who had participated in the survey (n = 45), three focus group with health and education professionals (n = 25), and one focus group with parents (n = 6).Compared with Portuguese adolescents, African migrant teens reported initial sexual intercourse at earlier ages, less frequent condom use, and less frequent and less comfortable communications with parents about sexual issues.Implications for selective prevention of STD are discussed and recommendations are made.

Acceptability and preferences for safer conception HIV prevention strategies: a qualitative study.

PubMed

Schwartz, Sheree R; West, Nora; Phofa, Rebecca; Yende, Nompumelelo; Sanne, Ian; Bassett, Jean; Van Rie, Annelies

2016-10-01

Safer conception strategies to reduce the HIV transmission risk include antiretroviral therapy for HIV-positive partners, pre-exposure prophylaxis for HIV-negative partners, condomless sex limited to fertile periods, and home-based self-insemination. Resistance to taking treatment or cultural concerns may limit uptake of strategies and intervention success. Understanding the acceptability and preferences between different approaches is important to optimise service delivery. Between February and July 2013, 42 adults (21 HIV-positive and 21 HIV-negative) receiving primary care at Witkoppen Health and Welfare Centre in Johannesburg, South Africa, participated in focus group discussions or in-depth interviews. Themes were analysed using a grounded theory approach. Acceptability of antiretroviral-based strategies varied. Concerns over side effects, antiretroviral treatment duration and beliefs that treatment is only for the sick were common barriers; however, desperation for a child was noted as a facilitator for uptake. HIV-negative men and HIV-positive women had favourable attitudes towards self-insemination, though paternity and safety concerns were raised. Self-insemination was generally preferred over pre-exposure prophylaxis by HIV-negative men, and antiretroviral-based strategies were preferred by couples with HIV-negative female partners, despite concerns raised about condomless sex while virally suppressed. Knowledge about the fertile window was low. A strong counselling component will be required for effective uptake and adherence to safer conception services. © The Author(s) 2016.

Acceptability and preferences for safer conception HIV prevention strategies: A qualitative study

PubMed Central

Schwartz, Sheree; West, Nora; Phofa, Rebecca; Yende, Nompumelelo; Sanne, Ian; Bassett, Jean; Van Rie, Annelies

2016-01-01

Safer conception strategies to reduce HIV transmission risk include antiretroviral therapy (ART) for HIV-positive partners, pre-exposure prophylaxis (PrEP) for HIV-negative partners, condomless sex limited to fertile periods, and home-based self-insemination. Resistance to taking treatment or cultural concerns may limit uptake of strategies and intervention success. Understanding the acceptability and preferences between different approaches is important to optimize service delivery. Between February-July 2013, 42 adults (21 HIV-positive and 21 HIV-negative) receiving primary care at Witkoppen Health and Welfare Centre in Johannesburg, South Africa, participated in focus group discussions or in-depth interviews. Themes were analyzed using a grounded theory approach. Acceptability of antiretroviral-based (ARV) strategies varied. Concerns over side effects, ARV treatment duration, and beliefs that treatment is only for the sick were common barriers, however desperation for a child was noted as a facilitator for uptake. HIV-negative men and HIV-positive women had favorable attitudes towards self-insemination, though paternity and safety concerns were raised. Self-insemination was generally preferred over PrEP by HIV-negative men, and ARV-based strategies were preferred by couples with HIV-negative female partners, despite concerns raised about condomless sex while virally suppressed. Knowledge about the fertile window was low. A strong counselling component will be required for effective uptake and adherence to safer conception services. PMID:26384950

Safer Environment

EPA Pesticide Factsheets

The U.S. Environmental Protection Agency (EPA) has proposed Mercury and Air Toxics Standards (MATS) for power plants to limit mercury, acid gases and other toxic pollution from power plants. This page describes how new rules mean a safer environment.

Perceived susceptibility to pregnancy and its association with safer sex, contraceptive adherence and subsequent pregnancy among adolescent and young adult women.

PubMed

Rahman, Mahbubur; Berenson, Abbey B; Herrera, Sandra R

2013-04-01

The study was conducted to examine the hypotheses that adolescent and young adult women who perceived they are susceptible to pregnancy when birth control is not used are less likely to practice unsafe sex, discontinue oral contraception (OC) and become pregnant during a 12-month follow-up period. We conducted secondary analyses using data collected for a randomized controlled trial on OC adherence among 1155 low-income women 16-24 years of age. Demographics, lifestyle variables, perceived susceptibility to pregnancy assessed at baseline, and data on OC and condom use and pregnancy status collected during 12 months of follow-up were used for the analyses. Overall, 62.3% of women accurately understood the risks of pregnancy without using any birth control method. However, perceived susceptibility was not associated with OC continuation [odds ratio (OR) 0.94, 95% confidence interval (CI) 0.79-1.11], condom use at last sexual intercourse (OR 1.02, 95% CI 0.84-1.24), dual method use (OR 1.17, 95% CI 0.92-1.48) and subsequent pregnancy (hazards ratio 1.08, 95% CI 0.77-1.49) during the 12-month follow-up period. Perceived susceptibility to pregnancy, an important component of the health belief model, does not seem to have any impact on use of birth control methods, safer sex or rate of subsequent pregnancy among low-income adolescent and young adult women. Copyright © 2013 Elsevier Inc. All rights reserved.

Sex and the Public Schools.

ERIC Educational Resources Information Center

Black, Susan

1995-01-01

Recent statistics concerning teen pregnancies and sexually transmitted diseases are compelling reasons for reaching kids before they become sexually active. Comprehensive K-12 programs are essential, despite conflicts over abstinence, abstinence-but, and safer-sex approaches. Adverse program criticism can be diffused if administrators examine…

Transactional sex and the challenges to safer sexual behaviors: a study among male sex workers in Chennai, India

PubMed Central

Biello, Katie B.; Thomas, Beena E.; Johnson, Blake E.; Closson, Elizabeth F.; Navakodi, Pandiaraja; Dhanalakshmi, A.; Menon, Sunil; Mayer, Kenneth H.; Safren, Steven A.; Mimiaga, Matthew J.

2017-01-01

Male sex workers (MSW) are a significant but invisible population in India who are at risk for HIV/STI. Few studies from India have documented HIV risk factors and motivations for sex work in this population. Between 2013 and 2014, a community-based convenience sample of 100 MSW in Chennai (south India) completed a baseline risk assessment as part of a behavioral intervention. Participants were ≥18 years, and reported current sex work. We report medians and proportions, and Wilcoxon-Mann-Whitney and chi-square tests are used to examine differences between sex work and sexual behavior measures by income source. Participants were engaged in sex work for 5.0 years (IQR=2.3-10.0), and earned 3,000 (IQR=2000-8000) Rupees (<50 USD) per month from sex work. Sixty-four percent reported ever testing for HIV and 20.2% for any STI. The most common reasons for starting sex work were money (83.0) and pleasure (56.0%). Participants reported 8.0 (IQR=3.0-15.0) male clients and 7 (IQR=4.0-15.0) condomless anal sex acts with male clients in the past month. Compared to participants with an additional source of income, those whose only source of income was sex work reported more male clients in the past month (10.0 vs. 6.0, p=0.017), as well as more condomless anal sex acts with male clients (8.0 vs. 5.0, p=0.008). Nearly 70.0% were offered more money not to use a condom during sex with a client, and 74.2% reported accepting more money not to use a condom. Three-quarters reported having experienced difficulty using condoms with clients. MSW in India engage in high levels of sexual risk for HIV/STIs. Money appears to be a driving factor for engaging in sex work and condomless sex with clients. HIV prevention interventions with MSW should focus on facilitating skills that will support their ability to negotiate sexual safety in the context of monetary disincentives. PMID:27397549

Condoms used but sex not well protected.

PubMed

Lau, J T F; Zhou, H; Su, X Y; Feng, T J; Hong, F C; Tsui, H Y; Ma, Y L; Wang, Z; Walden, D

2014-10-01

Condom use is often equated to safer sex. The prevalence of condom use during sex work among female sex workers (FSW) in China is high. Condom use, however, co-exists with condom failure and improper use and hence risk of HIV transmission. In a cross-sectional study, we interviewed 195 FSW in Shenzhen, China. The prevalence of condom use in the last episode of sex work was 97.4 %, However, respectively 53.8 and 86.2 % had experienced at least one condition of condom failure that may lead to genital contact (wearing condoms after penetration, condom breakage/slippage, condoms removed by clients) and at least one condition of improper condom use (not removing air from the tip of the condom, not pulling it down to the root of penis and not choosing good quality condoms). Factors of individual level (e.g. never choosing high quality condoms for sex work), inter-personal level (e.g. agreement to have unprotected sex if fond of clients or paid more) and environmental/structural level (e.g. non-availability of condoms) were associated with various types of condom failure and improper use. Although HIV prevention interventions have increased prevalence of condom use among FSW, the risk of HIV transmission may still be high as "unsafe" sex due to condom failure and improper use is prevalent. Interventions promoting safer sex need to address such issues and take socio-ecological factors into account. Condom use during sex work is not equivalent to well protected sex as the protective effects could be compromised by frequent condom failure and improper use.

Sex and Relationships Education in Schools--Evaluation of a Pilot Programme for the Certification of Community Nurses

ERIC Educational Resources Information Center

Chalmers, Helen; Tyrer, Paul; Aggleton, Peter

2006-01-01

Objective: In support of the UK Government's teenage pregnancy and sexual health strategies, a certificated programme of professional development for school nurses and other community nurses was developed to provide support for personal, social and health education (PSHE) work, including sex and relationships education (SRE), for young people.…

Sexually active older Australian's knowledge of sexually transmitted infections and safer sexual practices.

PubMed

Lyons, Anthony; Heywood, Wendy; Fileborn, Bianca; Minichiello, Victor; Barrett, Catherine; Brown, Graham; Hinchliff, Sharron; Malta, Sue; Crameri, Pauline

2017-06-01

Rates of sexually transmitted infections (STIs) are rising among older Australians. We conducted a large survey of older people's knowledge of STIs and safer sexual practices. A total of 2,137 Australians aged 60 years and older completed the survey, which included 15 questions assessing knowledge of STIs and safer sexual practices. We examined both levels of knowledge and factors associated with an overall knowledge score. In total, 1,652 respondents reported having sex in the past five years and answered all knowledge questions. This group had good general knowledge but poorer knowledge in areas such as the protection offered by condoms and potential transmission modes for specific STIs. Women had better knowledge than men. Men in their 60s, men with higher education levels, and men who thought they were at risk of STIs reported better knowledge than other men. Knowledge was also better among men and women who had been tested for STIs or reported 'other' sources of knowledge on STIs. Many older Australians lack knowledge of STIs and safer sexual practices. Implications for public health: To reverse current trends toward increasing STI diagnoses in this population, policies and education campaigns aimed at improving knowledge levels may need to be considered. © 2017 The Authors.

Transactional sex and the challenges to safer sexual behaviors: a study among male sex workers in Chennai, India.

PubMed

Biello, Katie B; Thomas, Beena E; Johnson, Blake E; Closson, Elizabeth F; Navakodi, Pandiaraja; Dhanalakshmi, A; Menon, Sunil; Mayer, Kenneth H; Safren, Steven A; Mimiaga, Matthew J

2017-02-01

Male sex workers (MSW) are a significant but invisible population in India who are at risk for HIV/sexually transmitted infections (STIs). Few studies from India have documented HIV risk factors and motivations for sex work in this population. Between 2013 and 2014, a community-based convenience sample of 100 MSW in Chennai (south India) completed a baseline risk assessment as part of a behavioral intervention. Participants were ≥18 years, and reported current sex work. We report medians and proportions, and Wilcoxon-Mann-Whitney and chi-square tests are used to examine differences between sex work and sexual behavior measures by income source. Participants were engaged in sex work for 5.0 years (IQR = 2.3-10.0), and earned 3000 (IQR = 2000-8000) Rupees (<50 USD) per month from sex work. Sixty-four percent reported ever testing for HIV and 20.2% for any STI. The most common reasons for starting sex work were money (83.0%) and pleasure (56.0%). Compared to participants with an additional source of income, those whose only source of income was sex work reported more male clients in the past month (10.0 vs. 6.0, p = .017), as well as more condomless anal sex acts with male clients (8.0 vs. 5.0, p = .008). Nearly 70.0% were offered more money not to use a condom during sex with a client, and 74.2% reported accepting more money not to use a condom. Three-quarters reported having experienced difficulty using condoms with clients. MSW in India engage in high levels of sexual risk for HIV/STIs. Money appears to be a driving factor for engaging in sex work and condomless sex with clients. HIV prevention interventions with MSW should focus on facilitating skills that will support their ability to negotiate sexual safety in the context of monetary disincentives.

Sexual Partner Typologies among Single Young Men who Have Sex with Men

PubMed Central

Bauermeister, José A.

2014-01-01

Using data from a sample of single YMSM (N=1,359; ages 18-24; 65% White; 93% gay), we examined whether the number of unprotected anal intercourse (UAI) partners with differed across relationship typologies (e.g., friends with benefits, hookups, romantic interests). We then examined how safer sex self-efficacy, decisional balance to forego condoms, ideal relationship attributes (i.e., intimacy, passion and commitment), and limerence were associated with UAI. Different partner types were associated with greater UAI partners; single partner types were associated with fewer UAI partners, irrespective of how they were categorized. UAI partners was associated with decisional balance (OR=1.89; p<.001), passion ideation (OR=1.38; p<.001), and difficulty negotiating safer sex with romantic partners (OR=1.16; p<.001). Odds of UAI partners decreased with higher scores of commitment ideation (OR=.91; p<.05) and difficulty negotiating safer sex with casual partners (OR=.96; p<.05). We discuss the importance of acknowledging how different sexual partnerships, alongside its motivational correlates, influence UAI risk in order to inform HIV-prevention interventions. PMID:25358726

Safer Systems: A NextGen Aviation Safety Strategic Goal

NASA Technical Reports Server (NTRS)

Darr, Stephen T.; Ricks, Wendell R.; Lemos, Katherine A.

2008-01-01

The Joint Planning and Development Office (JPDO), is charged by Congress with developing the concepts and plans for the Next Generation Air Transportation System (NextGen). The National Aviation Safety Strategic Plan (NASSP), developed by the Safety Working Group of the JPDO, focuses on establishing the goals, objectives, and strategies needed to realize the safety objectives of the NextGen Integrated Plan. The three goal areas of the NASSP are Safer Practices, Safer Systems, and Safer Worldwide. Safer Practices emphasizes an integrated, systematic approach to safety risk management through implementation of formalized Safety Management Systems (SMS) that incorporate safety data analysis processes, and the enhancement of methods for ensuring safety is an inherent characteristic of NextGen. Safer Systems emphasizes implementation of safety-enhancing technologies, which will improve safety for human-centered interfaces and enhance the safety of airborne and ground-based systems. Safer Worldwide encourages coordinating the adoption of the safer practices and safer systems technologies, policies and procedures worldwide, such that the maximum level of safety is achieved across air transportation system boundaries. This paper introduces the NASSP and its development, and focuses on the Safer Systems elements of the NASSP, which incorporates three objectives for NextGen systems: 1) provide risk reducing system interfaces, 2) provide safety enhancements for airborne systems, and 3) provide safety enhancements for ground-based systems. The goal of this paper is to expose avionics and air traffic management system developers to NASSP objectives and Safer Systems strategies.

Beyond HIV-serodiscordance: Partnership communication dynamics that affect engagement in safer conception care

PubMed Central

Burns, Bridget F.; Bajunirwe, Francis; Kabakyenga, Jerome; Bwana, Mwebesa; Ng, Courtney; Kastner, Jasmine; Kembabazi, Annet; Sanyu, Naomi; Kusasira, Adrine; Haberer, Jessica E.; Bangsberg, David R.; Kaida, Angela

2017-01-01

Introduction We explored acceptability and feasibility of safer conception methods among HIV-affected couples in Uganda. Methods We recruited HIV-positive men and women on antiretroviral therapy (ART) (‘index’) from the Uganda Antiretroviral Rural Treatment Outcomes cohort who reported an HIV-negative or unknown-serostatus partner (‘partner’), HIV-serostatus disclosure to partner, and personal or partner desire for a child within two years. We conducted in-depth interviews with 40 individuals from 20 couples, using a narrative approach with tailored images to assess acceptability of five safer conception strategies: ART for the infected partner, pre-exposure prophylaxis (PrEP) for the uninfected partner, condomless sex timed to peak fertility, manual insemination, and male circumcision. Translated and transcribed data were analyzed using thematic analysis. Results 11/20 index participants were women, median age of 32.5 years, median of 2 living children, and 80% had HIV-RNA <400 copies/mL. Awareness of HIV prevention strategies beyond condoms and abstinence was limited and precluded opportunity to explore or validly assess acceptability or feasibility of safer conception methods. Four key partnership communication challenges emerged as primary barriers to engagement in safer conception care, including: (1) HIV-serostatus disclosure: Although disclosure was an inclusion criterion, partners commonly reported not knowing the index partner’s HIV status. Similarly, the partner’s HIV-serostatus, as reported by the index, was frequently inaccurate. (2) Childbearing intention: Many couples had divergent childbearing intentions and made incorrect assumptions about their partner’s desires. (3) HIV risk perception: Participants had disparate understandings of HIV transmission and disagreed on the acceptable level of HIV risk to meet reproductive goals. (4) Partnership commitment: Participants revealed significant discord in perceptions of partnership commitment

Young People's Concerns about Sex: Unsolicited Questions to a Teenage Radio Talkback Programme over Three Years

ERIC Educational Resources Information Center

Kang, Melissa; Quine, Susan

2007-01-01

This paper describes a novel qualitative study that identified the concerns of young people about sex through a talk-back segment from 2002 to 2004 on an Australian national radio popular music programme targeting 15-24 year olds. Two hundred and thirty-one unsolicited callers (150 female and 81 male) went to air over the study period, and 212…

Selling sex in unsafe spaces: sex work risk environments in Phnom Penh, Cambodia

PubMed Central

2011-01-01

Background The risk environment framework provides a valuable but under-utilised heuristic for understanding environmental vulnerability to HIV and other sexually transmitted infections among female sex workers. Brothels have been shown to be safer than street-based sex work, with higher rates of consistent condom use and lower HIV prevalence. While entertainment venues are also assumed to be safer than street-based sex work, few studies have examined environmental influences on vulnerability to HIV in this context. Methods As part of the Young Women's Health Study, a prospective observational study of young women (15-29 years) engaged in sex work in Phnom Penh, we conducted in-depth interviews (n = 33) to explore vulnerability to HIV/STI and related harms. Interviews were conducted in Khmer by trained interviewers, transcribed and translated into English and analysed for thematic content. Results The intensification of anti-prostitution and anti-trafficking efforts in Cambodia has increased the number of women working in entertainment venues and on the street. Our results confirm that street-based sex work places women at risk of HIV/STI infection and identify significant environmental risks related to entertainment-based sex work, including limited access to condoms and alcohol-related intoxication. Our data also indicate that exposure to violence and interactions with the police are mediated by the settings in which sex is sold. In particular, transacting sex in environments such as guest houses where there is little or no oversight in the form of peer or managerial support or protection, may increase vulnerability to HIV/STI. Conclusions Entertainment venues may also provide a high risk environment for sex work. Our results indicate that strategies designed to address HIV prevention among brothel-based FSWs in Cambodia have not translated well to street and entertainment-based sex work venues in which increasing numbers of women are working. There is an urgent

Chemical Safety Alert: Safer Technology and Alternatives

EPA Pesticide Factsheets

This alert is intended to introduce safer technology concepts and general approaches, explains the concepts and principles, and gives brief examples of the integration of safer technologies into facility risk management activities.

Disclosure and Self-Efficacy Among HIV-Positive Men Who Have Sex with Men: A Comparison Between Older and Younger Adults.

PubMed

Brown, Monique J; Serovich, Julianne M; Kimberly, Judy A; Umasabor-Bubu, Ogie

2015-11-01

Men who have sex with men (MSM) continue to be disproportionately affected by HIV in the US. HIV among older adults also continues to be an important public health problem. Age is associated with disclosure of HIV serostatus and self-efficacy for condom use. However, studies examining self-efficacy and disclosure among older MSM (age 50 and older) living with HIV are lacking. The aim of this study was to assess the associations between being 50 and older, and disclosure behaviors, intentions and attitudes, and self-efficacy for condom use, disclosure, and negotiation for safer sex practices among HIV-positive MSM. Data were gathered from 340 participants at the baseline assessment of a longitudinal disclosure intervention study. Linear regression was used to determine the association between being older (age 50 and older) and disclosure behaviors, intentions and attitudes, and self-efficacy for condom use, disclosure, and negotiation for safer sex practices. After adjusting for time since diagnosis and number of sexual partners, MSM aged 50 and older scored lower in disclosure behavior (β = -7.49; 95% CI: -14.8, -0.18) and in self-efficacy for negotiation of safer sex practices (β = -0.80; 95% CI: -1.57, -0.04) compared to MSM 18-34 years. Intervention and prevention programs should endeavor to improve disclosure and self-efficacy for negotiating safer sex practices among older HIV-positive MSM. More health care providers should initiate sexual health discussions, especially among older HIV-positive MSM populations, which may help to improve their disclosure behavior and self-efficacy for negotiating safer sex practices.

Disclosure and Self-Efficacy Among HIV-Positive Men Who Have Sex with Men: A Comparison Between Older and Younger Adults

PubMed Central

Serovich, Julianne M.; Kimberly, Judy A.; Umasabor-Bubu, Ogie

2015-01-01

Abstract Men who have sex with men (MSM) continue to be disproportionately affected by HIV in the US. HIV among older adults also continues to be an important public health problem. Age is associated with disclosure of HIV serostatus and self-efficacy for condom use. However, studies examining self-efficacy and disclosure among older MSM (age 50 and older) living with HIV are lacking. The aim of this study was to assess the associations between being 50 and older, and disclosure behaviors, intentions and attitudes, and self-efficacy for condom use, disclosure, and negotiation for safer sex practices among HIV-positive MSM. Data were gathered from 340 participants at the baseline assessment of a longitudinal disclosure intervention study. Linear regression was used to determine the association between being older (age 50 and older) and disclosure behaviors, intentions and attitudes, and self-efficacy for condom use, disclosure, and negotiation for safer sex practices. After adjusting for time since diagnosis and number of sexual partners, MSM aged 50 and older scored lower in disclosure behavior (β = −7.49; 95% CI: −14.8, −0.18) and in self-efficacy for negotiation of safer sex practices (β = −0.80; 95% CI: −1.57, −0.04) compared to MSM 18–34 years. Intervention and prevention programs should endeavor to improve disclosure and self-efficacy for negotiating safer sex practices among older HIV-positive MSM. More health care providers should initiate sexual health discussions, especially among older HIV-positive MSM populations, which may help to improve their disclosure behavior and self-efficacy for negotiating safer sex practices. PMID:26348705

Considering risk contexts in explaining the paradoxical HIV increase among female sex workers in Mumbai and Thane, India.

PubMed

Bandewar, Sunita V S; Bharat, Shalini; Kongelf, Anine; Pisal, Hemlata; Collumbien, Martine

2016-01-28

The period 2006-2009 saw intensive scale-up of HIV prevention efforts and an increase in reported safer sex among brothel and street-based sex workers in Mumbai and Thane (Maharashtra, India). Yet during the same period, the prevalence of HIV increased in these groups. A better understanding of sex workers' risk environment is needed to explain this paradox. In this qualitative study we conducted 36 individual interviews, 9 joint interviews, and 10 focus group discussions with people associated with HIV interventions between March and May 2012. Dramatic changes in Mumbai's urban landscape dominated participants' accounts, with dwindling sex worker numbers in traditional brothel areas attributed to urban restructuring. Gentrification and anti-trafficking efforts explained an escalation in police raids. This contributed to dispersal of sex work with the sex-trade management adapting by becoming more hidden and mobile, leading to increased vulnerability. Affordable mobile phone technology enabled independent sex workers to trade in more hidden ways and there was an increased dependence on lovers for support. The risk context has become ever more challenging, with animosity against sex work amplified since the scale up of targeted interventions. Focus on condom use with sex workers inadvertently contributed to the diversification of the sex trade as clients seek out women who are less visible. Sex workers and other marginalised women who sell sex all strictly prioritise anonymity. Power structures in the sex trade continue to pose insurmountable barriers to reaching young and new sex workers. Economic vulnerability shaped women's decisions to compromise on condom use. Surveys monitoring HIV prevalence among 'visible' street and brothel-bases sex workers are increasingly un-representative of all women selling sex and self-reported condom use is no longer a valid measure of risk reduction. Targeted harm reduction programmes with sex workers fail when implemented in

Population-based colorectal cancer screening programmes using a faecal immunochemical test: should faecal haemoglobin cut-offs differ by age and sex?

PubMed

Arana-Arri, Eunate; Idigoras, Isabel; Uranga, Begoña; Pérez, Raquel; Irurzun, Ana; Gutiérrez-Ibarluzea, Iñaki; Fraser, Callum G; Portillo, Isabel

2017-08-29

The Basque Colorectal Cancer Screening Programme has both high participation rate and high compliance rate of colonoscopy after a positive faecal occult blood test (FIT). Although, colorectal cancer (CRC) screening with biannual (FIT) has shown to reduce CRC mortality, the ultimate effectiveness of the screening programmes depends on the accuracy of FIT and post-FIT colonoscopy, and thus, harms related to false results might not be underestimated. Current CRC screening programmes use a single faecal haemoglobin concentration (f-Hb) cut-off for colonoscopy referral for both sexes and all ages. We aimed to determine optimum f-Hb cut-offs by sex and age without compromising neoplasia detection and interval cancer proportion. Prospective cohort study using a single-sample faecal immunochemical test (FIT) on 444,582 invited average-risk subjects aged 50-69 years. A result was considered positive at ≥20 μg Hb/g faeces. Outcome measures were analysed by sex and age for a wide range of f-Hb cut-offs. We analysed 17,387 positive participants in the programme who underwent colonoscopy. Participation rate was 66.5%. Men had a positivity rate for f-Hb of 8.3% and women 4.8% (p < 0.0001). The detection rate for advanced neoplasia (cancer plus advanced adenoma) was 44.0‰ for men and 15.9‰ for women (p < 0.0001). The number of colonoscopies required decreased in both sexes and all age groups through increasing the f-Hb cut-off. However, the loss in CRC detection increased by up to 28.1% in men and 22.9% in women. CRC missed were generally at early stages (Stage I-II: from 70.2% in men to 66.3% in women). This study provides detailed outcomes in men and women of different ages at a range of f-Hb cut-offs. We found differences in positivity rates, neoplasia detection rate, number needed to screen, and interval cancers in men and women and in younger and older groups. However, there are factors other than sex and age to consider when consideration is given to setting

Experiences Using Pre-Exposure Prophylaxis for Safer Conception Among HIV Serodiscordant Heterosexual Couples in the United States.

PubMed

Bazzi, Angela R; Leech, Ashley A; Biancarelli, Dea L; Sullivan, Meg; Drainoni, Mari-Lynn

2017-08-01

Antiretroviral pre-exposure prophylaxis (PrEP) is a promising HIV prevention strategy for HIV serodiscordant couples (HIV-infected male, uninfected female) seeking safer conception. However, most research on PrEP for safer conception has focused on couples in sub-Saharan Africa; little is known about the perspectives or experiences of heterosexual couples in the United States. We conducted qualitative interviews with six couples (six women and five of their male partners) receiving PrEP for conception services at an urban safety net hospital in the US Northeast. In-depth interview guides explored couple relationships and contextual factors and attitudes, perceptions, and decision-making processes surrounding PrEP for safer conception. Thematic analyses focused on identifying the following emergent themes. We found that couple relationships were situated within broader social and cultural contexts of immigration, family, and community that shaped their experiences with HIV and serodiscordant relationship status. Despite strong partner support within relationships, HIV stigma and disapproval of serodiscordant relationships contributed to couples' feelings of social isolation and subsequent aspirations to have "normal" families. By enabling "natural" conception through condomless sex, PrEP for safer conception provided a sense of enhanced relationship intimacy. Couples called for increasing public awareness of PrEP through positive messaging as a way to combat HIV stigma. Findings suggest that relationship dynamics and broader social contexts appear to shape HIV serodiscordant couples' fertility desires and motivations to use PrEP. However, increased public awareness of PrEP for safer conception may be needed to combat HIV stigma at the community level.

Exploring stakeholder perceptions of acceptability and feasibility of needle exchange programmes, syringe vending machines and safer injection facilities in Tijuana, Mexico

PubMed Central

Philbin, Morgan M.; Mantsios, Andrea; Lozada, Remedios; Case, Patricia; Pollini, Robin A.; Alvelais, Jorge; Latkin, Carl A.; Magis-Rodriguez, Carlos; Strathdee, Steffanie A.

2009-01-01

Background Injection drug use is a growing public health crisis along the U.S.–Mexican border and rising rates of blood-borne infections highlight the pressing need for harm reduction interventions. We explored the acceptability and feasibility of such interventions in Tijuana, a city adjacent to San Diego, California. Methods Using in-depth qualitative interviews conducted from August 2006–March 2007 with 40 key stakeholders – pharmacists, legal professionals, health officials, religious officials, drug treatment providers, and law enforcement personnel – we explored the acceptability and feasibility of interventions to reduce drug-related harm in Tijuana, Mexico. Interviews were taped with consent, transcribed verbatim, and translated. Content analysis was conducted to identify themes which included barriers, structural limitations, and suggestions for implementation. Results Topics included acceptance and feasibility of needle exchange programmes (NEPs), syringe vending machines, and safer injection facilities (SIFs), structural barriers and suggestions for implementation. Of these interventions, NEPs were deemed the most acceptable (75%); however, only half believed these could be feasibly implemented, citing barriers involving religion, police, and lack of political will, public awareness, and funding. Conclusions Increasing HIV infection rates among injection drug users in Tijuana have prompted interest in public health responses. Our results may assist policy strategists in implementing social-structural interventions that will help create enabling environments that facilitate the scale-up and implementation of harm reduction in Tijuana. PMID:18963906

Exploring stakeholder perceptions of acceptability and feasibility of needle exchange programmes, syringe vending machines and safer injection facilities in Tijuana, Mexico.

PubMed

Philbin, Morgan M; Mantsios, Andrea; Lozada, Remedios; Case, Patricia; Pollini, Robin A; Alvelais, Jorge; Latkin, Carl A; Magis-Rodriguez, Carlos; Strathdee, Steffanie A

2009-07-01

Injection drug use is a growing public health crisis along the U.S.-Mexican border and rising rates of blood-borne infections highlight the pressing need for harm reduction interventions. We explored the acceptability and feasibility of such interventions in Tijuana, a city adjacent to San Diego, California. Using in-depth qualitative interviews conducted from August 2006-March 2007 with 40 key stakeholders - pharmacists, legal professionals, health officials, religious officials, drug treatment providers, and law enforcement personnel - we explored the acceptability and feasibility of interventions to reduce drug-related harm in Tijuana, Mexico. Interviews were taped with consent, transcribed verbatim, and translated. Content analysis was conducted to identify themes which included barriers, structural limitations, and suggestions for implementation. Topics included acceptance and feasibility of needle exchange programmes (NEPs), syringe vending machines, and safer injection facilities (SIFs), structural barriers and suggestions for implementation. Of these interventions, NEPs were deemed the most acceptable (75%); however, only half believed these could be feasibly implemented, citing barriers involving religion, police, and lack of political will, public awareness, and funding. Increasing HIV infection rates among injection drug users in Tijuana have prompted interest in public health responses. Our results may assist policy strategists in implementing social-structural interventions that will help create enabling environments that facilitate the scale-up and implementation of harm reduction in Tijuana.

Cancer screening in Portugal: sex differences in prevalence, awareness of organized programmes and perception of benefits and adverse effects.

PubMed

Costa, Ana Rute; Silva, Susana; Moura-Ferreira, Pedro; Villaverde-Cabral, Manuel; Santos, Osvaldo; Carmo, Isabel do; Barros, Henrique; Lunet, Nuno

2017-04-01

Cancer screening has contributed to downward trends in cancer mortality, but is also associated with adverse effects, which highlights the importance of promoting the participation based on informed decisions. We aimed to describe the use of cancer screening (either in organized programmes or as opportunistic screening), awareness of organized programmes and perception of its potential benefits and adverse effects, depicting possible sex differences. We evaluated 1624 Portuguese-speaking dwellers, aged between 16 and 79 years, through face-to-face interviews. To quantify sex differences, adjusted prevalence ratios and respective 95% confidence intervals were computed using Poisson regression. Among eligible age groups, the lifetime prevalence of screening for breast and cervical cancers was 89.8 and 71.9%, respectively. The prevalence was 23.7% for colorectal cancer and no significant sex differences were observed. Prostate cancer screening was reported by 63.8% of men. Over half of the participants referred that cancers such as prostate, skin, lung and stomach should be screened for, in addition to those for which organized programmes are recommended. Reassurance by negative results was identified as the main potential benefit of screening by nearly one-third of men and women. Anxiety while waiting for results was the most mentioned potential adverse effect (60.4%); men refer less often this and financial costs, although statistical significance of these results was borderline. This study provides a benchmark to plan and monitor the effects of awareness-raising interventions, as well as for international comparisons across countries with different cancer prevention and control structures. © 2016 The Authors. Health Expectations Published by John Wiley & Sons Ltd.

Bringing the fundamentals of gender studies into safer-sex education.

PubMed

Lever, J

1995-01-01

The effectiveness of mass media advertisements promoting condom use is being compromised by a failure to acknowledge the impact of gender power relations on sexual negotiation. Most such advertisements are directed toward women; implicit is an assumption that females are responsible for safe sex and in a position to overcome male resistance to condom use. However, men in all-male, peer-led focus groups (where they are presumably more honest and open) express the belief that they should control all aspects of sexual encounters and a resentment of women who suggest condom use. Similarly, participants in all-female groups acknowledge their discomfort with raising the issue of condom use and being assertive about their own protection. A shift toward targeting men in condom advertisements would be more consistent with current gender relations and sexual practices. Even better would be messages that promote shared responsibility for safe sex.

'Something for something': the importance of talking about transactional sex with youth in South Africa using a resilience-based approach.

PubMed

van der Heijden, Ingrid; Swartz, Sharlene

2014-01-01

Transactional sex is a common feature of sexual relationships in South Africa but has severe health implications for those who engage in it. This paper presents perspectives on transactional sex based on interviews and focus group discussions with young people in Gauteng and Limpopo, South Africa. The discussions were part of an evaluation of a peer education programme promoting HIV prevention called Vhutshilo, aimed at 14-16 year olds. The session on transactional sex entitled 'Something for Something' evoked strong responses from youth. Youth recognised transactional sex as a common phenomenon in their communities and associated it with many risks. However, when comparing young people's qualitative responses to the impact of the session as measured by the quantitative impact survey, no significant differences were discernible between youth in the programme and those in a control group who were not exposed to the session. Further analysis showed that the content of the session was limited to the negative consequences and health risks of transactional sex and focused mostly on the adverse contexts in South Africa that force youth into such relationships. The session did little to situate transactional relationships within the everyday realities of sexual decision making and youth values of peer status and consumerism. We argue that the session's findings reveal a narrow understanding of the dynamic contexts under which transactional sex occurs and fails to take into account the resilience of youth to make choices of whether or not to engage in such relationships, and how they can engage in these types of relationships safely. We conclude that HIV prevention curriculums need to leverage youth resilience and protective skills within the confines of difficult economic and social circumstances to allow them to successfully navigate safer sexual relationships.

A new public health context to understand male sex work.

PubMed

Minichiello, Victor; Scott, John; Callander, Denton

2015-03-24

Researching male sex work offers insight into the sexual lives of men and women while developing a more realistic appreciation for the changing issues associated with male sex work. This type of research is important because it not only reflects a growing and diversifying consumer demand for male sex work, but also because it enables the construction of knowledge that is up-to-date with changing ideas around sex and sexualities. This paper discusses a range of issues emerging in the male sex industry. Notably, globalisation and technology have contributed to the normalisation of male sex work and reshaped the landscape in which the male sex industry operates. As part of this discussion, we review STI and HIV rates among male sex workers at a global level, which are widely disparate and geographically contextual, with rates of HIV among male sex workers ranging from 0% in some areas to 50% in others. The Internet has reshaped the way that male sex workers and clients connect and has been identified as a useful space for safer sex messages and research that seeks out hidden or commonly excluded populations. We argue for a public health context that recognises the emerging and changing nature of male sex work, which means programs and policies that are appropriate for this population group. Online communities relating to male sex work are important avenues for safer sexual messages and unique opportunities to reach often excluded sub-populations of both clients and male sex workers. The changing structure and organisation of male sex work alongside rapidly changing cultural, academic and medical discourses provide new insight but also new challenges to how we conceive the sexualities of men and male sex workers. Public health initiatives must reflect upon and incorporate this knowledge.

Sexual Decision-Making in HIV-Positive Men Who Have Sex with Men: How Moral Concerns and Sexual Motives Guide Intended Condom Use with Steady and Casual Sex Partners

PubMed Central

Hospers, Harm J.; van Empelen, Pepijn; Breukelen, Gerard van; Kok, Gerjo

2007-01-01

Determinants of intended condom use with steady and casual sex partners were examined among Dutch HIV-positive men who have sex with men (MSM) (N = 296). Given the proposition that safer sex behavior among HIV-positive people is a form of prosocial behavior, the present study extended the general framework of the Theory of Planned Behavior with Schwartz’s norm-activation theory and tested the assumption that personal norms would mediate the effects of other psychosocial factors on intended condom use for anal sex. In addition, it was hypothesized that, depending on the context in which sex occurs, specific motives for unprotected anal sex may have a negative influence on intended condom use and, as such, undermine a prosocial tendency to practice safer sex. Therefore, we also investigated the influence of sexual motives for unprotected anal sex on intended condom use with steady and casual sex partners. Results indicated that the Theory of Planned Behavior adequately predicted condom use intentions (for casual sex partners and steady sex partners, the explained variance was 52% and 53%, respectively). However, our proposed model of sexual decision-making significantly improved the prediction of behavioral intentions. For steady and casual sex partners, the assumption of the mediating role of personal norms on condom use intention was confirmed empirically. Additionally, sexual motives for unprotected anal sex exerted, as expected, a direct, negative effect on condom use intention with casual sex partners. The implications of the findings for future research and the development of HIV-prevention programs for HIV-positive MSM are discussed. PMID:17333328

Sex on premises venue (SOPV) health promotion project in response to sustained increases in HIV notifications.

PubMed

Mullens, Amy B; Staunton, Shaun; Debattista, Joseph; Hamernik, Elisabeth; Gill, Darren

2009-03-01

Due to increases in HIV notifications in Queensland, a health promotion outreach project was developed with sex on premises venues (SOPV) in Brisbane. A health promotion officer (HPO) promoted safer sex behaviours among SOPV patrons over 14 months, including providing information, counselling and skills to enhance safer sexual behaviours and providing referrals. Surveys were introduced to facilitate discussions regarding HIV/sexually transmissible infections, testing and safer sex practices. The project demonstrated feasibility within this highly sexualised environment, and was enhanced by careful monitoring and revising the procedure to improve patron/staff responses to the project. The introduction of a survey instrument was a significant contributor to the project's effectiveness, providing opportunities for patrons to discuss a variety of key sexual health issues. This initiative reflected effective partnering between the Health Department, a community HIV/lesbian, gay, bisexual and transgender organisation and private industry. Despite initial difficulties, the presence of a health worker within an SOPV was acceptable to patrons and allowed for brief interventions to be conducted. This project was deemed effective for a limited time period and within certain constraints.

The Impact of Parental Reaction to Sexual Orientation on Depressive Symptoms and Sexual Risk Behavior Among Hispanic Men Who Have Sex with Men.

PubMed

Mitrani, Victoria B; De Santis, Joseph P; McCabe, Brian E; Deleon, Diego A; Gattamorta, Karina A; Leblanc, Natalie M

2017-08-01

This study examined the relationship of parent reaction to sexual orientation with depressive symptoms and safer sex among Hispanic adult men who have sex with men (MSM). We also examined men's acculturation to the U.S. (Americanism) in relation with these variables. Cross-sectional data collected from July 2011 to December 2012, from 125 MSM with a mean age of 43.02years. Instruments included the Perceived Parent Reaction Scale, the Centers for Epidemiological Studies Depression Scale, the Safer Sex Behavior Questionnaire and the Bidimensional Acculturation Scale. Data was analyzed using Hierarchical generalized linear models (GZLM). Among men whose parents knew of their sexual orientation, rejection of son's sexual orientation from mother (p=0.032) and from father (p=0.004) was related to higher number of depressive symptoms. Parent reactions were not directly related to safer sex behaviors. Americanism was associated with lower depressive symptoms (p=0.001) but was not related to safer sex behaviors. Current parent attitudes about their sons' sexual orientation had an effect on the sons' emotional wellbeing and acculturation may play a protective role. Mental health and primary care clinicians working with Hispanic MSM should assess for level of family support and provide resources to assist with disclosure and family acceptance of sexual orientation as indicated, particularly among recently immigrated men who may be at higher risk. Copyright © 2017 Elsevier Inc. All rights reserved.

Strange bedfellows: bridging the worlds of academia, public health and the sex industry to improve sexual health outcomes

PubMed Central

2011-01-01

The public health response to sexually transmitted infections, particularly HIV, has been and continues to be overwhelmingly focused on risk, disease and negative outcomes of sex, while avoiding discussion of positive motivations for sex (e.g. pleasure, desire, love). Recent advocacy efforts have challenged this approach and organisations have promoted the eroticisation of safer sex, especially in the context of HIV prevention. This paper is a case study of one of these organizations – The Pleasure Project. It gives a brief background on the public-health approach to sex and sexual health, and recommends an alternative approach which incorporates constructs of pleasure and desire into sexual health interventions. The Pleasure Project’s aims and unorthodox communications strategies are described, as are the response to and impact of its work, lessons learned and ongoing challenges to its approach. The Pleasure Project combines evidence (rigorous and experimental as well as qualitative and anecdotal) with experiential knowledge from the sex industry and safer-sex promotion to communicate messages about eroticising safer sex to influence researchers, public health practitioners and policymakers, mainstream media and the porn world. There are significant barriers to this work, because it challenges common and entrenched norms and values related to sex and pleasure and their role in the public health sphere. Other barriers include: the limited range of existing rigorous intervention trials which incorporate pleasure constructs; the lack of effective indicators to measure pleasure constructs; limited funding and resources; discomfort among public health practitioners, researchers and donors with concepts of pleasure and sex; and rejection of erotic media as a potential tool for prevention. Despite the backdrop of sex-negative public health practice, there is anecdotal evidence that safer sex, including condom use, can be eroticised and made pleasurable, based on

Sexual and reproductive health outcomes among female sex workers in Johannesburg and Pretoria, South Africa: Recommendations for public health programmes.

PubMed

Slabbert, Mariette; Venter, Francois; Gay, Cynthia; Roelofsen, Corine; Lalla-Edward, Samanta; Rees, Helen

2017-07-04

The sexual and reproductive health (SRH) status of female sex workers is influenced by a wide range of demographic, behavioural and structural factors. These factors vary considerably across and even within settings. Adopting an overly standardised approach to sex worker programmes may compromise its impact on some sub-groups in local areas. Records of female sex workers attending clinic-, community-, or hotel-based health services in Johannesburg (n = 1422 women) and Pretoria (n = 408 women), South Africa were analysed. We describe the population's characteristics and identified factors associated with sexual and reproductive health outcomes, namely HIV status; previous symptomatic sexually transmitted infection (STI); modern contraceptive use and number of child dependents. The women in Johannesburg were less likely than those in Pretoria to have HIV (42.2% vs 52.9%), or previous symptomatic STIs (44.3% vs. 8.3%), and were 1.4 fold less likely to have child dependents (20.1% vs. 15.3%). About 43% of women in Johannesburg were Zimbabwean and 40% in Pretoria. Of concern, only about 15% of women in both sites were using modern contraceptives. Johannesburg women were also more likely to access health services at a hotel (85.0% vs. 80.6%) or clinic (5.7% vs. 0.5%), to have completed secondary education (57.1% vs. 36.0%), and moved house more than twice during the past year (19.6 vs. 2.0%). In both cities, risk of HIV rose rapidly with age (23.8%-58.2% vs. 22.0%-64.8%). Of interest, HIV prevalence was considerably higher in those with consistent condom use with one's main partner than inconsistent users. Sex worker populations are heterogeneous. Local health programmes must prioritise services that reflect the variety and complexity of sex worker needs and behaviours, and should be designed in consultation with sex workers. Segmenting sex worker populations according to age, country of origin and place of service delivery, and training healthcare providers

An integrated theoretical approach to substance use and risky sexual behavior among men who have sex with men.

PubMed

Wells, Brooke E; Golub, Sarit A; Parsons, Jeffrey T

2011-04-01

Research demonstrates a consistent association between substance use and sexual risk, particularly among men who have sex with men (MSM). The present study builds upon two existing theories (Cognitive Escape Theory and Expectancy Theory) to examine the synergistic role of sexual conflict (surrounding unsafe sex) and expectancies in sexual behavior among 135 MSM. Two conflicts were examined: (1) The conflict between motivation to practice safer sex and temptation for unprotected sex; and (2) The conflict between motivation to practice safer sex and perceived benefits of unprotected sex. Factorial ANOVAs (2 × 2; high versus low expectancies and conflict versus no conflict) revealed a significant interaction between conflict and expectancies-individuals who reported high levels of conflict were more sensitive to the effect of expectancies than were those experiencing low levels of sexual conflict. Results demonstrate the synergistic effects of conflict and expectancies and highlight the importance of integrating existing theories to more fully consider the intrapsychic operation and experience of sexual conflicts.

Correlates of Self-efficacy for Condom Use among Male Clients of Female Sex Workers in Tijuana, Mexico

PubMed Central

Volkmann, Tyson; Wagner, Karla D.; Strathdee, Steffanie A.; Semple, Shirley J.; Ompad, Danielle C.; Chavarin, Claudia V.; Patterson, Thomas L.

2013-01-01

Male clients of female sex workers (FSWs) in Tijuana, Mexico engage in high levels of unprotected sex. While behavioral change theories posit that self-efficacy predicts condom use, correlates of self-efficacy for condom use remain largely unstudied. We examined these correlates among male clients of FSWs in Tijuana. Eligible male clients were at least 18 years of age, HIV-negative, lived in Tijuana or San Diego, reported unprotected sex with a Tijuana FSW at least once in the past four months, and agreed to be treated for sexually transmitted infections (STIs). Participants completed an interviewer-administered questionnaire including demographics, substance use, psychosocial and psychosexual characteristics (e.g., outcome expectancies for negotiation of safer sex, social support, and sexual sensation seeking), and sexual behaviors. Participants also underwent HIV/STI testing. A stepwise hierarchical multiple regression analysis identified correlates of self-efficacy for condom use. Of 393 male clients, median age was 37 years. Participants were mostly Spanish-speaking and employed. Factors independently associated with higher self-efficacy for condom use were higher positive outcome expectancies for negotiation of safer sex, lower sexual sensation seeking scores, and higher social support scores. Both psychosocial and psychosexual factors may influence self-efficacy for condom use among male clients of FSWs. These factors represent central constructs in sociocognitive models that explain behavioral change and could be intervention targets for improving self-efficacy for condom use and, ultimately, safer sex behavior. PMID:23842786

Correlates of self-efficacy for condom use among male clients of female sex workers in Tijuana, Mexico.

PubMed

Volkmann, Tyson; Wagner, Karla D; Strathdee, Steffanie A; Semple, Shirley J; Ompad, Danielle C; Chavarin, Claudia V; Patterson, Thomas L

2014-05-01

Male clients of female sex workers (FSWs) in Tijuana, Mexico engage in high levels of unprotected sex. While behavioral change theories posit that self-efficacy predicts condom use, correlates of self-efficacy for condom use remain largely unstudied. We examined these correlates among male clients of FSWs in Tijuana. Eligible male clients were at least 18 years of age, HIV-negative, lived in Tijuana or San Diego, reported unprotected sex with a Tijuana FSW at least once in the past 4 months, and agreed to be treated for sexually transmitted infections (STIs). Participants completed an interviewer-administered questionnaire including demographics, substance use, psychosocial and psychosexual characteristics (e.g., outcome expectancies for negotiation of safer sex, social support, and sexual sensation seeking), and sexual behaviors. Participants also underwent HIV/STI testing. A stepwise hierarchical multiple regression analysis identified correlates of self-efficacy for condom use. Of 393 male clients, median age was 37 years. Participants were mostly Spanish-speaking and employed. Factors independently associated with higher self-efficacy for condom use were higher positive outcome expectancies for negotiation of safer sex, lower sexual sensation seeking scores, and higher social support scores. Both psychosocial and psychosexual factors may influence self-efficacy for condom use among male clients of FSWs. These factors represent central constructs in sociocognitive models that explain behavioral change and could be intervention targets for improving self-efficacy for condom use and, ultimately, safer sex behavior.

Indicators of HIV-risk resilience among men who have sex with men: a content analysis of online profiles.

PubMed

White Hughto, Jaclyn M; Hidalgo, Anna P; Bazzi, Angela R; Reisner, Sari L; Mimiaga, Matthew J

2016-06-02

Background: HIV-risk resilience, or positive adaptation in the face of risk, is increasingly being recognised as an important characteristic among men who have sex with men (MSM). However, resilience in the context of online partner seeking remains underexplored among MSM. Methods: Using content analysis methodology, this study operationalised indicators of HIV-risk resilience in the profiles of 933 MSM using a sexual networking website. HIV-risk resilience included endorsing foreplay only (non-penetrative sex) or a versatile sexual position; being "out" (e.g. disclosed sexual orientation), having a profile photo, seeking friendship, seeking a relationship, serosorting, not endorsing alcohol or drug use, safer sexual adventurism (e.g. role playing, bondage), and safer sex. Results: The majority of men were between 18 and 35 years old (76.0%) and 73.3% were racial/ethnic minorities. The mean number of resilience components endorsed was 5.2 (s.d. = 1.5; range 0-9). Nearly half (48.0%) reported being "out" and 68.7% had a profile photo. The majority of men were seeking relationships (66.5%) and/or friendships (69.7%), were sexually versatile (53.3%), and preferred safer sex only (76.3%). The majority did not endorse drug use (82.0%) and 25.4% did not endorse alcohol use. Nearly one-quarter (21.4%) endorsed sexual adventurism and 2.5% were serosorting by partner's HIV negative status. Conclusion: HIV-risk resilience may be common among MSM using sexual networking websites and may manifest in safer sex intentions. Rather than exclusively focusing on sexual risk reduction, health promotion efforts targeting MSM online should acknowledge, measure, and leverage existent HIV-risk resilience strategies in this group.

Safer Choice Partner of the Year Awards Application Form

EPA Pesticide Factsheets

EPA's Design for the Environment program developed the Safer Product Labeling Program Partner of the Year Award program to recognize DfE stakeholders that have furthered the safer chemistry goals of the program

The price of sex: condom use and the determinants of the price of sex among female sex workers in eastern Zimbabwe.

PubMed

Elmes, Jocelyn; Nhongo, Kundai; Ward, Helen; Hallett, Timothy; Nyamukapa, Constance; White, Peter J; Gregson, Simon

2014-12-01

Higher prices for unprotected sex threaten the high levels of condom use that contributed to the decline in Zimbabwe's human immunodeficiency virus (HIV) epidemic. To improve understanding of financial pressures competing against safer sex, we explore factors associated with the price of commercial sex in rural eastern Zimbabwe. We collected and analyzed cross-sectional data on 311 women, recruited during October-December 2010, who reported that they received payment for their most-recent or second-most-recent sex acts in the past year. Zero-inflated negative binomial models with robust standard errors clustered on female sex worker (FSW) were used to explore social and behavioral determinants of price. The median price of sex was $10 (interquartile range [IQR], $5-$20) per night and $10 (IQR, $5-$15) per act. Amounts paid in cash and commodities did not differ significantly. At the most-recent sex act, more-educated FSWs received 30%-74% higher payments. Client requests for condom use significantly predicted protected sex (P < .01), but clients paid on average 42.9% more for unprotected sex. Within a work environment where clients' preferences determine condom use, FSWs effectively use their individual capital to negotiate the terms of condom use. Strengthening FSWs' preferences for protected sex could help maintain high levels of condom use. © The Author 2014. Published by Oxford University Press on behalf of the Infectious Diseases Society of America.

The Price of Sex: Condom Use and the Determinants of the Price of Sex Among Female Sex Workers in Eastern Zimbabwe

PubMed Central

Elmes, Jocelyn; Nhongo, Kundai; Ward, Helen; Hallett, Timothy; Nyamukapa, Constance; White, Peter J.; Gregson, Simon

2014-01-01

Background. Higher prices for unprotected sex threaten the high levels of condom use that contributed to the decline in Zimbabwe's human immunodeficiency virus (HIV) epidemic. To improve understanding of financial pressures competing against safer sex, we explore factors associated with the price of commercial sex in rural eastern Zimbabwe. Methods. We collected and analyzed cross-sectional data on 311 women, recruited during October–December 2010, who reported that they received payment for their most-recent or second-most-recent sex acts in the past year. Zero-inflated negative binomial models with robust standard errors clustered on female sex worker (FSW) were used to explore social and behavioral determinants of price. Results. The median price of sex was $10 (interquartile range [IQR], $5–$20) per night and $10 (IQR, $5–$15) per act. Amounts paid in cash and commodities did not differ significantly. At the most-recent sex act, more-educated FSWs received 30%–74% higher payments. Client requests for condom use significantly predicted protected sex (P < .01), but clients paid on average 42.9% more for unprotected sex. Conclusions. Within a work environment where clients' preferences determine condom use, FSWs effectively use their individual capital to negotiate the terms of condom use. Strengthening FSWs' preferences for protected sex could help maintain high levels of condom use. PMID:25381377

An appraisal of female sex work in Nigeria--implications for designing and scaling up HIV prevention programmes.

PubMed

Ikpeazu, Akudo; Momah-Haruna, Amaka; Madu Mari, Baba; Thompson, Laura H; Ogungbemi, Kayode; Daniel, Uduak; Aboki, Hafsatu; Isac, Shajy; Gorgens, Marelize; Mziray, Elizabeth; Njie, Ndella; Akala, Francisca Ayodeji; Emmanuel, Faran; Odek, Willis Omondi; Blanchard, James F

2014-01-01

The HIV epidemic in Nigeria is complex with diverse factors driving the epidemic. Accordingly, Nigeria's National Agency for the Control of AIDS is coordinating a large-scale initiative to conduct HIV epidemic appraisals across all states. These appraisals will help to better characterize the drivers of the epidemic and ensure that the HIV prevention programmes match the local epidemic context, with resources allocated to interventions that have the greatest impact locally. Currently, the mapping and size estimation of Female Sex Workers (FSWs)--a major component of the appraisal has been completed in seven states. These states are using the data generated to plan, prioritize and scale-up sub-national HIV prevention programmes. It involved a two-level process of identifying and validating locations where FSWs solicit and/or meet clients ("hotspots"). In the first level, secondary key informants were interviewed to collect information about the geographic location and description of the hotspots. For the second level, FSWs were interviewed at each hotspot and information on population size estimates, typologies and operational dynamics of the FSWs were collected. Across the seven states, a total of 17,266 secondary key informants and 5,732 FSWs were interviewed. 10,233 hotspots were identified with an estimated 126,489 FSWs ranging from 5,920 in Anambra to 46,691 in Lagos. The most common hotspots were bars/nightclubs (30%), hotels/lodges (29.6%), streets (16.6%), and brothels (14.6%). Furthermore, the population density of FSWs (per thousand adult men) across the states ranged from 2 in Anambra to 17 in the Federal Capital Territory. FSW populations in Nigeria are large and diverse, with substantial differences between and within states. Improved understanding of the location, population size, density, organizational typologies and clients of sex work has informed and is central to Nigeria's planning process for scaling up focused HIV prevention programmes.

Safer disclosure of HIV serostatus for women living with HIV who experience or fear violence: a systematic review.

PubMed

Kennedy, Caitlin E; Haberlen, Sabina; Amin, Avni; Baggaley, Rachel; Narasimhan, Manjulaa

2015-01-01

Supporting individuals as they disclose their HIV serostatus may lead to a variety of individual and public health benefits. However, many women living with HIV are hesitant to disclose their HIV status due to fear of negative outcomes such as violence, abandonment, relationship dissolution and stigma. We conducted a systematic review of studies evaluating interventions to facilitate safer disclosure of HIV status for women living with HIV who experience or fear violence. Articles, conference abstracts and programme reports were included if they reported post-intervention evaluation results and were published before 1 April 2015. Searching was conducted through electronic databases for peer-reviewed articles and conference abstracts, reviewing websites of relevant organizations for grey literature, hand searching reference lists of included studies and contacting experts. Systematic methods were used for screening and data abstraction, which was conducted in duplicate. Study quality (rigor) was assessed with the Cochrane risk of bias tool. Two interventions met the inclusion criteria: the Safe Homes and Respect for Everyone cluster-randomized trial of combination HIV and intimate partner violence (IPV) services in Rakai, Uganda, and the South Africa HIV/AIDS Antenatal Post-Test Support study individual randomized trial of an enhanced counselling intervention for pregnant women undergoing HIV testing and counselling. Both programmes integrated screening for IPV into HIV testing services and trained counsellors to facilitate discussions about disclosure based on a woman's risk of violence. However, both were implemented as part of multiple-component interventions, making it impossible to isolate the impact of the safer disclosure components. The existing evidence base for interventions to facilitate safe HIV serostatus disclosure for women who experience or fear violence is limited. Development and implementation of new approaches and rigorous evaluation of safe

Seropositive sex workers and HIV / AIDS prevention: a need for realistic policy development.

PubMed

Overs, C

1992-01-01

In a major change of official responses to prostitution many programs strive to reduce the incidence of infection by the human immunodeficiency virus (HIV) and by sexually transmitted diseases (STDs) among sex workers and clients by encouraging safer sex, albeit still trying to ensure that only HIV-negative people engage in sex work. Legal sanctions have been used to limit the activities of seropositive sex workers under the assumption that sex workers with HIV will transmit the virus because of a high prevalence of unprotected sex practices in some places. Where safer sex is the norm for commercial sex transactions, the concern is that sex workers may neglect safe practices and customers may become infected. The fact is that often the clients demand unprotected sex, even when sex workers prefer to use condoms. The risk of accidental infection when protected sex is practiced may even be lower in commercial transactions in which at least one partner is very experienced in condom use and other safe practices. It is usually assumed that HIV-positive sex workers will not inform clients of their status, however, and clients will not inform sex workers of their serostatus either. Where sex workers practice safe sex, intervention programs should provide education on condom use and ensure the availability of inexpensive condoms. In addition to gynecological, antenatal and STD services, health and social services, including child care and legal support, have to be easily accessible. Religious and cultural impediments to realistic HIV/STD prevention should be studied in order to modify or eliminate them. Sex workers who are seropositive probably behave similarly to other people in a community with regard to exposing others to risk, and they are careful about not infecting others, especially if it is guaranteed that their environment supports them.

The impact of peer outreach on HIV knowledge and prevention behaviours of male sex workers in Mombasa, Kenya.

PubMed

Geibel, Scott; King'ola, Nzioki; Temmerman, Marleen; Luchters, Stanley

2012-08-01

Targeting most at-risk populations is an essential component of HIV prevention strategies. Peer education programmes have been found to increase HIV knowledge, condom use and safer sex behaviours among female sex workers in Africa and men who have sex with men elsewhere. The authors aimed to evaluate the impact of a peer-driven intervention on male sex workers who sell sex to men in Mombasa, Kenya. Using time-venue sampling, a baseline survey of 425 male sex workers was conducted in late 2006, after which, 40 peer educators were trained in HIV prevention, basic counselling skills and distribution of condoms and lubricants. A follow-up time-venue survey of 442 male sex workers was conducted in early 2008, and pre- and post-intervention changes were examined. The impact of peer educator exposure on HIV knowledge and condom use was analysed. Positive changes in HIV prevention behaviours were observed, including increases in consistent use of condoms with both male clients (35.9%-50.2%, p<0.001) and non-paying male partners (27.4%-39.5%, p=0.008). Exposure to peer educators (AOR=1.97, 95% CI 1.29 to 3.02) and ever having been counselled or tested for HIV (AOR=1.71, 95% CI 1.10 to 2.66) were associated with consistent condom use in multivariate analysis. Peer educator contact was also associated with improved HIV knowledge and use of water-based lubricants. Peer outreach programming reached highly stigmatised male sex workers in Mombasa, resulting in significant, but limited, improvements in HIV knowledge and prevention behaviours. Improved peer coverage and additional prevention initiatives are needed to sufficiently mitigate HIV transmission.

The Effect of a Health Belief Intervention on Safer Sex Practices.

ERIC Educational Resources Information Center

Rehnberg, Timothy; Barabasz, Marianne

Increases in HIV infection among young heterosexual women has prompted a call for the development of new safe sex interventions for this population. This study tested the effectiveness of an intervention conceptualized on the basis of the Health Belief Model and combined with Bandura's self-efficacy theory. Subjects (N=82) were sexually active…

Psychological Symptoms are Associated with Both Abstinence and Risky Sex among Men with HIV

PubMed Central

Miller, Carol T.; Solomon, Sondra E.; Bunn, Janice Y.; Varni, Susan E.; Hodge, James J.

2015-01-01

Sexual abstinence is often deemed the “safest behavior” in HIV prevention, but is sometimes associated with psychological symptoms (e.g., depression) just as sexually risky behavior is. This study explored whether sexual abstinence and risky sexual behavior among men with HIV are associated with similar constellations of psychological symptoms. Prior research has not addressed this issue because abstinent people often are not included in the sample, or when data are analyzed, researchers combine abstinent people with sexually active people who practice safer sex. Past research also neglects the co-morbidity of psychological symptoms. A latent class analysis of the psychological symptoms (assessed with the Symptom Check List 90-R; Derogatis, 1994) of 140 men with HIV, mostly from rural New England, revealed three latent classes; men who were asymptomatic on all symptom domains (28.8%), men who were symptomatic on all domains (34.1%), and men who were symptomatic on internalizing domains (37.1%), but were asymptomatic on the externalizing symptoms of hostility and paranoid ideation. Logistic regression showed that sexual behavior during the past 90 days of men in the all symptom class and the internalizing symptoms class was similar, with abstinence and risky sex predominating, and safer sex being relatively uncommon for both classes. The sexual behavior of men in the asymptomatic class differed, with safer sex being relatively more likely to occur compared to the symptomatic classes. These findings suggest that the psychological symptom profile of sexually abstinent people places them at risk for inconsistent condom use should they engage in sexual behavior. PMID:25614050

The business case for transitioning to safer chemicals.

PubMed

McFadden, Roger D

2011-01-01

Emerging domestic and international chemical regulations and a heightened consumer awareness of chemicals of concern in products is challenging American businesses to reevaluate and reconsider their approaches to supply chain management and product design. Some of these companies recognize business opportunities and are responding proactively with innovative strategies and tactics. This article describes steps that Staples Inc., the world's largest office products provider, is taking to meet demand for products that are safer and more sustainable. In trying to meet the demand for safer products, Staples faces significant barriers, including the complexity of supply chains, data gaps, and confidential business information. New collaborations between companies, government, and advocates, and improved tools and criteria for defining safer products enhance the ability of businesses, like Staples, to meet new consumer demands.

The Impact of PTSD Symptoms on Women's Safer-Sex Negotiation: Influence of Ethnicity

PubMed Central

Horsey, Katie J.; Palmieri, Patrick A.; Hobfoll, Stevan E.

2010-01-01

PTSD has been shown to predict later self reported sexual risk behavior, yet behavioral research is lacking in this area. The present study investigated the impact of PTSD severity on negotiation and interpersonal skills effectiveness in simulated high-risk sexual situations among 368 inner-city women. Participants engaged in role-play scenarios involving 1) refusing sex without a condom, 2) abstaining from drinking prior to sex, and 3) refusing sex until both partners were tested for HIV. Interviews were audio taped and rated along dimensions of negotiation effectiveness by blind raters. Hierarchical linear regression analyses were conducted to investigate the impact of PTSD and ethnicity on 4 theoretically derived skill sets 1) assertiveness, 2) using health and preparedness skills 3) social joining skills and 4) higher order negotiation skills. Generally, results indicated that PTSD severity predicted poorer rated negotiation effectiveness among European Americans, but not African Americans. African Americans' expectations that may prepare them for facing more hardship may help explain ethnic differences. PMID:22267974

Safer stops for vulnerable customers

DOT National Transportation Integrated Search

2003-03-01

This synthesis report presents a brief synopsis of the current literature and technologies being used in the development of safer and more secure bus stops. While the focus is more specifically with regard to vulnerable populations - women, children,...

The many faces of sex work

PubMed Central

Harcourt, C; Donovan, B

2005-01-01

Objective: To compile a global typography of commercial sex work. Methods: A Medline search and review of 681 "prostitution" articles was conducted. In addition, the investigators pooled their 20 years of collected papers and monographs, and their observations in more than 15 countries. Arbitrary categories were developed to compile a workable typology of sex work. Results: At least 25 types of sex work were identified according to worksite, principal mode of soliciting clients, or sexual practices. These types of work are often grouped under the headings of "direct" and "indirect" prostitution, with the latter group less likely to be perceived or to perceive themselves as sex workers. In general, policing sex work can change its typology and location but its prevalence is rarely affected. The public health implications of sex work vary widely. Conclusion: Developing comprehensive sexual health promotion programmes requires a complete understanding of the types of sex work in a particular area. This study provides a checklist for developing appropriate and targeted programmes. PMID:15923285

The many faces of sex work.

PubMed

Harcourt, C; Donovan, B

2005-06-01

To compile a global typography of commercial sex work. A Medline search and review of 681 "prostitution" articles was conducted. In addition, the investigators pooled their 20 years of collected papers and monographs, and their observations in more than 15 countries. Arbitrary categories were developed to compile a workable typology of sex work. At least 25 types of sex work were identified according to worksite, principal mode of soliciting clients, or sexual practices. These types of work are often grouped under the headings of "direct" and "indirect" prostitution, with the latter group less likely to be perceived or to perceive themselves as sex workers. In general, policing sex work can change its typology and location but its prevalence is rarely affected. The public health implications of sex work vary widely. Developing comprehensive sexual health promotion programmes requires a complete understanding of the types of sex work in a particular area. This study provides a checklist for developing appropriate and targeted programmes.

Sex worker activism, feminist discourse and HIV in Bangladesh.

PubMed

Sultana, Habiba

2015-01-01

This paper explores the relationship between sex worker activism and HIV-related discourse in Bangladesh, relating recent developments in activism to the influence of feminist thought. Following their eviction in 1991 from brothels from red light areas, Bangladeshi sex workers started a social movement, at just about the same time that programmes started to work with sex workers to reduce the transmission of HIV. This paper argues that both sex worker activism and HIV-prevention initiatives find impetus in feminist pro-sex-work perspectives, which place emphasis on individual and collective agency. However, by participating in these programmes, sex workers failed to contest the imagery of themselves as 'vectors' of HIV. In this way, they were unwittingly complicit in reproducing their identity as 'polluting others'. Moreover, by focusing on individual behaviour and the agency of sex workers, HIV programmes ignored the fact that the 'choices' made by sex workers are influenced by a wide range of structural and discursive factors, including gender norms and notions of bodily purity, which in turn have implications for the construction of HIV-related risk.

Antiretrovirals and safer conception for HIV-serodiscordant couples

PubMed Central

Matthews, Lynn T.; Smit, Jennifer A.; Cu-Uvin, Susan; Cohan, Deborah

2013-01-01

Purpose of review Many men and women living with HIV and their uninfected partners attempt to conceive children. HIV-prevention science can be applied to reduce sexual transmission risk while respecting couples’ reproductive goals. Here we discuss antiretrovirals as prevention in the context of safer conception for HIV-serodiscordant couples. Recent findings Antiretroviral therapy (ART) for the infected partner and pre-exposure prophylaxis (PrEP) for the uninfected partner reduce the risk of heterosexual HIV transmission. Several demonstration projects suggest the feasibility and acceptability of antiretroviral (ARV)s as periconception HIV-prevention for HIV-serodiscordant couples. The application of ARVs to periconception risk reduction may be limited by adherence. Summary For male-infected (M+F−) couples who cannot access sperm processing and female-infected (F+M−) couples unwilling to carry out insemination without intercourse, ART for the infected partner, PrEP for the uninfected partner, combined with treatment for sexually transmitted infections, sex limited to peak fertility, and medical male circumcision (for F+M couples) provide excellent, well tolerated options for reducing the risk of periconception HIV sexual transmission. PMID:23032734

Safer choices: reducing teen pregnancy, HIV, and STDs.

PubMed Central

Coyle, K.; Basen-Engquist, K.; Kirby, D.; Parcel, G.; Banspach, S.; Collins, J.; Baumler, E.; Carvajal, S.; Harrist, R.

2001-01-01

OBJECTIVES: This study evaluated the long-term effectiveness of Safer Choices, a theory-based, multi-component educational program designed to reduce sexual risk behaviors and increase protective behaviors in preventing HIV, other STDs, and pregnancy among high school students. METHODS: The study used a randomized controlled trial involving 20 high schools in California and Texas. A cohort of 3869 ninth-grade students was tracked for 31 months from fall semester 1993 (baseline) to spring semester 1996 (31-month follow-up). Data were collected using self-report surveys administered by trained data collectors. Response rate at 31-month follow-up was 79%. RESULTS: Safer Choices had its greatest effect on measures involving condom use. The program reduced the frequency of intercourse without a condom during the three months prior to the survey, reduced the number of sexual partners with whom students had intercourse without a condom, and increased use of condoms and other protection against pregnancy at last intercourse. Safer Choices also improved 7 of 13 psychosocial variables, many related to condom use, but did not have a significant effect upon rates of sexual initiation. CONCLUSIONS: The Safer Choices program was effective in reducing important risk behaviors for HIV, other STDs, and pregnancy and in enhancing most psychosocial determinants of such behavior. PMID:11889277

An Appraisal of Female Sex Work in Nigeria - Implications for Designing and Scaling Up HIV Prevention Programmes

PubMed Central

Ikpeazu, Akudo; Momah-Haruna, Amaka; Madu Mari, Baba; Thompson, Laura H.; Ogungbemi, Kayode; Daniel, Uduak; Aboki, Hafsatu; Isac, Shajy; Gorgens, Marelize; Mziray, Elizabeth; Njie, Ndella; Akala, Francisca Ayodeji; Emmanuel, Faran; Odek, Willis Omondi; Blanchard, James F.

2014-01-01

Background The HIV epidemic in Nigeria is complex with diverse factors driving the epidemic. Accordingly, Nigeria's National Agency for the Control of AIDS is coordinating a large-scale initiative to conduct HIV epidemic appraisals across all states. These appraisals will help to better characterize the drivers of the epidemic and ensure that the HIV prevention programmes match the local epidemic context, with resources allocated to interventions that have the greatest impact locally. Currently, the mapping and size estimation of Female Sex Workers (FSWs) - a major component of the appraisal has been completed in seven states. These states are using the data generated to plan, prioritize and scale-up sub-national HIV prevention programmes. Methodology It involved a two-level process of identifying and validating locations where FSWs solicit and/or meet clients (“hotspots”). In the first level, secondary key informants were interviewed to collect information about the geographic location and description of the hotspots. For the second level, FSWs were interviewed at each hotspot and information on population size estimates, typologies and operational dynamics of the FSWs were collected. Results Across the seven states, a total of 17,266 secondary key informants and 5,732 FSWs were interviewed. 10,233 hotspots were identified with an estimated 126,489 FSWs ranging from 5,920 in Anambra to 46,691 in Lagos. The most common hotspots were bars/nightclubs (30%), hotels/lodges (29.6%), streets (16.6%), and brothels (14.6%). Furthermore, the population density of FSWs (per thousand adult men) across the states ranged from 2 in Anambra to 17 in the Federal Capital Territory. Conclusion FSW populations in Nigeria are large and diverse, with substantial differences between and within states. Improved understanding of the location, population size, density, organizational typologies and clients of sex work has informed and is central to Nigeria's planning process for

Shopping for a safer car

DOT National Transportation Integrated Search

2010-01-01

This brochure provides some helpful tips on what to look for when shopping for a safer car. Automakers are increasingly advertising the safety features of their cars. The problem is sorting out their claims and zeroing in on the safety features that ...

Sex work among men who have sex with men and transgender women in Bogotá.

PubMed

Bianchi, Fernanda T; Reisen, Carol A; Zea, Maria Cecilia; Vidal-Ortiz, Salvador; Gonzales, Felisa A; Betancourt, Fabián; Aguilar, Marcela; Poppen, Paul J

2014-11-01

This qualitative study examined sex work among internally displaced male and transgender female sex workers in Bogotá, Colombia. Internal displacement has occurred in Colombia as a result of decades of conflict among armed groups and has created large-scale migration from rural to urban areas. Informed by the polymorphous model of sex work, which posits that contextual conditions shape the experience of sex work, we examined three main research questions. The first dealt with how internal displacement was related to the initiation of sex work; the second concerned the effect of agency on sex worker satisfaction; and the third examined how sex work in this context was related to HIV and other risks. Life history interviews were conducted with 26 displaced individuals who had done sex work: 14 were men who have sex with men and 12 were transgender women (natal males). Findings revealed that many participants began doing sex work in the period immediately after displacement, because of a lack of money, housing, and social support. HIV risk was greater during this time due to limited knowledge of HIV and inexperience negotiating safer sex with clients. Other findings indicated that sex workers who exerted more control and choice in the circumstances of their work reported greater satisfaction. In addition, we found that although many sex workers insisted on condom use with clients, several noted that they would sometimes have unprotected sex for additional money. Specific characteristics affecting the experience of sex work among the transgender women were also discussed.

Sex Work among Men Who Have Sex with Men and Transgender Women in Bogotá

PubMed Central

Bianchi, Fernanda T.; Reisen, Carol A.; Zea, Maria Cecilia; Vidal-Ortiz, Salvador; Gonzales, Felisa A.; Betancourt, Fabián; Aguilar, Marcela; Poppen, Paul J.

2014-01-01

This qualitative study examined sex work among internally displaced male and transgender female sex workers in Bogotá, Colombia. Internal displacement has occurred in Colombia as a result of decades of conflict among armed groups and has created large-scale migration from rural to urban areas. Informed by the polymorphous model of sex work, which posits that contextual conditions shape the experience of sex work, we examined three main research questions. The first dealt with how internal displacement was related to the initiation of sex work; the second concerned the effect of agency on sex worker satisfaction; and the third examined how sex work in this context was related to HIV and other risks. Life history interviews were conducted with a 26 displaced individuals who had done sex work: 14 were men who have sex with men (MSM) and 12 were transgender women (natal males). Findings revealed that many participants began doing sex work in the period immediately after displacement, because of a lack of money, housing, and social support. HIV risk was greater during this time due to limited knowledge of HIV and inexperience negotiating safer sex with clients. Other findings indicated that sex workers who exerted more control and choice in the circumstances of their work reported greater satisfaction. In addition, we found that although many sex workers insisted on condom use with clients, several noted that they would sometimes have unprotected sex for additional money. Specific characteristics affecting the experience of sex work among the transgender women were also discussed. PMID:24464550

Safer-drinking Strategies Used by Chronically Homeless Individuals with Alcohol Dependence

PubMed Central

Grazioli, Véronique S.; Hicks, Jennifer; Kaese, Greta; Lenert, James; Collins, Susan E.

2015-01-01

Chronically homeless individuals with alcohol dependence experience severe alcohol-related consequences. It is therefore important to identify factors that might be associated with reduced alcohol-related harm, such as the use of safer-drinking strategies. Whereas effectiveness of safer-drinking strategies has been well-documented among young adults, no studies have explored this topic among more severely affected populations, such as chronically homeless individuals with alcohol dependence. The aims of this study were thus to qualitatively and quantitatively document safer-drinking strategies used in this population. Participants (N=31) were currently or formerly chronically homeless individuals with alcohol dependence participating in a pilot study of extended-release naltrexone and harm-reduction counseling. At weeks 0 and 8, research staff provided a list of safer-drinking strategies for participants to endorse. Implementation of endorsed safer-drinking strategies was recorded at the next appointment. At both time points, strategies to buffer the effects of alcohol on the body (e.g., eating prior to and during drinking) were most highly endorsed, followed by changing the manner in which one drinks (e.g., spacing drinks), and reducing alcohol consumption. Quantitative analyses indicated that all participants endorsed safer-drinking strategies, and nearly all strategies were implemented (80–90% at weeks 0 and 8, respectively). These preliminary findings indicate that chronically homeless people with alcohol dependence use strategies to reduce harm associated with their drinking. Larger randomized controlled trials are needed to test whether interventions that teach safer-drinking strategies may reduce overall alcohol-related harm in this population. PMID:25690515

Non-monosexual Partnerships: Information, Motivation and Self-Efficacy among Methamphetamine-Using Men Who Have Sex with Men Who Also Have Sex with Women or Transgender Persons

PubMed Central

Noor, Syed WB.; Wilkerson, J. Michael; Schick, Vanessa; Iantaffi, Alex

2016-01-01

Objectives Sex with more than one gender is associated with higher substance use, and sexual HIV risk. Methods We examined knowledge, motivation, and self-efficacy to engage in safer substance use and sexual behavior among methamphetamine-using U.S. men who have sex with more than one gender (N=343). Results Almost half(46.2%) of the men reported having sex with a man and a woman or transgender partner in the last 30 days. Compared to monosexual MSM, non-monosexual MSM reported greater condom use self-efficacy however, they reported more sexual partners who inject drugs. Conclusion We observed distinct differences between men who do or do not have sex with more than one gender. PMID:28255423

Integrating MBSE into Ongoing Projects: Requirements Validation and Test Planning for the ISS SAFER

NASA Technical Reports Server (NTRS)

Anderson, Herbert A.; Williams, Antony; Pierce, Gregory

2016-01-01

The International Space Station (ISS) Simplified Aid for Extra Vehicular Activity (EVA) Rescue (SAFER) is the spacewalking astronaut's final safety measure against separating from the ISS and being unable to return safely. Since the late 1990s, the SAFER has been a standard element of the spacewalking astronaut's equipment. The ISS SAFER project was chartered to develop a new block of SAFER units using a highly similar design to the legacy SAFER (known as the USA SAFER). An on-orbit test module was also included in the project to enable periodic maintenance/propulsion system checkout on the ISS SAFER. On the ISS SAFER project, model-based systems engineering (MBSE) was not the initial systems engineering (SE) approach, given the volume of heritage systems engineering and integration (SE&I) products. The initial emphasis was ensuring traceability to ISS program standards as well as to legacy USA SAFER requirements. The requirements management capabilities of the Cradle systems engineering tool were to be utilized to that end. During development, however, MBSE approaches were applied selectively to address specific challenges in requirements validation and test and verification (T&V) planning, which provided measurable efficiencies to the project. From an MBSE perspective, ISS SAFER development presented a challenge and an opportunity. Addressing the challenge first, the project was tasked to use the original USA SAFER operational and design requirements baseline, with a number of additional ISS program requirements to address evolving certification expectations for systems operating on the ISS. Additionally, a need to redesign the ISS SAFER avionics architecture resulted in a set of changes to the design requirements baseline. Finally, the project added an entirely new functionality for on-orbit maintenance. After initial requirements integration, the system requirements count was approaching 1000, which represented a growth of 4x over the original USA SAFER system

Traditional gender roles, forced sex and HIV in Zimbabwean marriages.

PubMed

Mugweni, Esther; Pearson, Stephen; Omar, Mayeh

2012-01-01

Little is known on how forced sex contributes to the sexual transmission of HIV in marriage. This paper describes traditional gender norms surrounding forced sex in Zimbabwean marriage. Data were collected from 4 focus group discussions and 36 in-depth interviews with married women and men in Harare. Results indicate that hegemonic masculinity characterised by a perceived entitlement to sex, male dominance and being a provider contributed to forced sex in marriage. A femininity characterised by a tolerance of marital rape, the desire to please the husband and submission contributed to women experiencing forced sex. An alternative femininity characterised by sexual pleasure-seeking contributed to women forcing their spouses to have sex. Future HIV interventions must go beyond narrowly advocating for safer sex within marriage and instead address practices that increase risk as well as promote positive marital relationship needs such as mutual respect, love and friendship.

Sex worker activism, feminist discourse and HIV in Bangladesh

PubMed Central

Sultana, Habiba

2015-01-01

This paper explores the relationship between sex worker activism and HIV-related discourse in Bangladesh, relating recent developments in activism to the influence of feminist thought. Following their eviction in 1991 from brothels from red light areas, Bangladeshi sex workers started a social movement, at just about the same time that programmes started to work with sex workers to reduce the transmission of HIV. This paper argues that both sex worker activism and HIV-prevention initiatives find impetus in feminist pro-sex-work perspectives, which place emphasis on individual and collective agency. However, by participating in these programmes, sex workers failed to contest the imagery of themselves as ‘vectors’ of HIV. In this way, they were unwittingly complicit in reproducing their identity as ‘polluting others’. Moreover, by focusing on individual behaviour and the agency of sex workers, HIV programmes ignored the fact that the ‘choices’ made by sex workers are influenced by a wide range of structural and discursive factors, including gender norms and notions of bodily purity, which in turn have implications for the construction of HIV-related risk. PMID:25588539

From psycho-social theory to sustainable classroom practice: developing a research-based teacher-delivered sex education programme.

PubMed

Wight, D; Abraham, C

2000-02-01

This paper describes the development of a theoretically based sex education programme currently undergoing a randomized controlled trial in the UK. It considers some of the practical difficulties involved in translating research-based conclusions into acceptable, replicable and potentially effective classroom lessons. The discussion acknowledges that the implications of social psychological research and the requirements of rigorous evaluation may conflict with accepted principles inherent in current sex education practice. It also emphasizes that theoretical ideas must be carefully embedded in lessons which are informed by an awareness of classroom culture, and the needs and skills of teachers. For example, the use of same-sex student groups to reflect on the gendered construction of sexuality may be problematic. Materials must be tailored to recipients' circumstances, which may require substituting for limited experience with the use of detailed scripts and scenarios. Furthermore, role-play techniques for sexual negotiation that work elsewhere may not be effective in the UK. The use of trigger video sessions and other techniques are recommended. Finally, the problems involved in promoting condom-related skills are discussed. The paper concludes that, if an intervention is to be sustainable beyond the research stage, it must be designed to overcome such problems while remaining theoretically informed.

Combating human trafficking in the sex trade: can sex workers do it better?

PubMed

Jana, Smarajit; Dey, Bharati; Reza-Paul, Sushena; Steen, Richard

2014-12-01

The dominant anti-trafficking paradigm conflates trafficking and sex work, denying evidence that most sex workers choose their profession and justifying police actions that disrupt communities, drive sex workers underground and increase vulnerability. We review an alternative response to combating human trafficking and child prostitution in the sex trade, the self-regulatory board (SRB) developed by Durbar Mahila Samanwaya Committee (DMSC, Sonagachi). DMSC-led interventions to remove minors and unwilling women from sex work account for over 80% of successful 'rescues' reported in West Bengal. From 2009 through 2011, 2195 women and girls were screened by SRBs: 170 (7.7%) minors and 45 (2.1%) unwilling adult women were assisted and followed up. The remaining 90.2% received counselling, health care and the option to join savings schemes and other community programmes designed to reduce sex worker vulnerability. Between 1992 and 2011 the proportion of minors in sex work in Sonagachi declined from 25 to 2%. With its universal surveillance of sex workers entering the profession, attention to rapid and confidential intervention and case management, and primary prevention of trafficking-including microcredit and educational programmes for children of sex workers-the SRB approach stands as a new model of success in anti-trafficking work. © The Author 2013. Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Impact and economic evaluations of a combination prevention programme for men who have sex with men in Mexico.

PubMed

Colchero, M Arantxa; Bautista-Arredondo, Sergio; Cortés-Ortiz, María A; Romero-Martinez, Martín; Salas, Jessica; Sosa-Rubí, Sandra G; Uribe, Patricia

2016-01-01

Despite the high-profile support for combination prevention programmes (CPPs) since 2008, there is little rigorous evidence on their impact and cost-effectiveness. In 2010, Mexico received funds from the Global Fund to implement a series of behavioural, biomedical, and structural interventions over 3 years targeted to men who have sex with men. The aims of the study were to estimate the impact of the programme across a range of outcomes and cost-effectiveness. A quasi-experiment was designed before the implementation of the CPP, in which 24 cities were randomly selected for impact evaluation and 12 pairs of cities were matched. In practice, though, implementation of the programme was staggered over 1 year. Therefore, we used two different approaches to estimate impact: a difference-in-difference estimation comparing both groups and a dose-response approach using time exposure to the programme at the city level. Results from the difference-in-difference estimation showed modest impact on condom use. However, the dose-response findings revealed a 7.5% increase in HIV testing per additional year exposed to the programme, relative to baseline coverage; an increase in awareness of HIV status among HIV-positive individuals of 6.6%; a 6.4% increase in HIV-positive individuals on treatment; and an 8% reduction in the perception of stigma/discrimination from healthcare personnel. The cost per person not exposed to an untreated HIV-positive individual was gauged to be US$400. The study provides evidence of the effectiveness and cost of a CPP along the HIV treatment cascade: access to HIV tests, awareness of HIV status, and antiretroviral therapy initiation.

From marginal to marginalised: The inclusion of men who have sex with men in global and national AIDS programmes and policy.

PubMed

McKay, Tara

2016-01-01

In the last decade, gay men and other men who have sex with men (msm) have come to the fore of global policy debates about AIDS prevention. In stark contrast to programmes and policy during the first two decades of the epidemic, which largely excluded msm outside of the Western countries, the Joint United Nations Programme on HIV/AIDS now identifies gay men and other msm as 'marginalized but not marginal' to the global response. Drawing on archival data and five waves of United Nations Country Progress Reports on HIV/AIDS (2001-2012), this paper examines the productive power of international organisations in the development and diffusion of the msm category, and considers how international organisations have shaped the interpretation of msm in national policies and programmes. These data show that the increasing separation of sexual identity and sexual behaviour at the global level helped to construct notions of risk and disease that were sufficiently broad to accommodate the diverse interests of global policy-makers, activists, and governments. However, as various international and national actors have attempted to develop prevention programmes for msm, the failure of the msm category to map onto lived experience is increasingly apparent.

The safer clinical systems project in renal care.

PubMed

Weale, Andy R

2013-09-01

Current systems in place in healthcare are designed to detect harm after it has happened (e.g critical incident reports) and make recommendations based on an assessment of that event. Safer Clinical Systems, a Health Foundation funded project, is designed to proactively search for risk within systems, rather than being reactive to harm. The aim of the Safer Clinical Systems project in Renal Care was to reduce the risks associated with shared care for patients who are undergoing surgery but are looked after peri-operatively by nephrology teams on nephrology wards. This report details our findings of the diagnostic phase of Safer Clinical Systems: the proactive search for risk. We have evaluated the current system of care using a set of risk evaluation and process mapping tools (Failure Modes and Effects Analysis (FMEA) and Hierarchical Task Analysis HTA). We have engaged staff with the process mapping and risk assessment tools. We now understand our system and understand where the highest risk tasks are undertaken during a renal in-patient stay during which a patient has an operation. These key tasks occur across the perioperaive period and are not confined to one aspect of care. A measurement strategy and intervention plan have been designed around these tasks. Safer Clinical Systems has identified high risk, low reliability tasks in our system. We look forward to fully reporting these data in 2014. © 2013 European Dialysis and Transplant Nurses Association/European Renal Care Association.

Outcome Expectancy and Sexual Compulsivity among Men who have Sex with Men Living with HIV

PubMed Central

Brown, Monique J.; Serovich, Julianne M.; Kimberly, Judy A.

2016-01-01

Sexual compulsivity is operationalized by engaging in repetitive sexual acts, having multiple sexual partners and/or the excessive use of pornography. Outcome expectancy refers to the beliefs about the consequences of engaging in a given behavior. Research examining the relationship between outcome expectancy and sexual compulsivity is limited. The aim of this study was to assess the association between outcome expectancy and sexual compulsivity among men who have sex with men (MSM) living with HIV. Data were obtained from 338 MSM. Simple and multiple linear regression models were used to assess the association between outcome expectancy and sexual compulsivity. After adjusting for age, race/ethnicity, income, education, and employment status, for every one point increase in outcome expectancies for condom use, HIV disclosure and negotiation of safer sex practices, there was, on average, an approximate one point decrease in sexual compulsivity score. Prevention and intervention programs geared towards reducing sexual compulsivity among MSM should focus on increasing outcome expectancies for condom use, HIV disclosure and negotiation of safer sex practices. PMID:26979416

Safer childbirth: a rights-based approach.

PubMed

Boama, Vincent; Arulkumaran, Sabaratnam

2009-08-01

The Millennium Development Goals (MDGs) set very high targets for women's reproductive health through reductions in maternal and infant mortality, among other things. Reductions in maternal mortality and morbidity can be achieved through various different approaches, such as the confidential review of maternal deaths, use of evidence-based treatments and interventions, using a health systems approach, use of information technology, global and regional partnerships, and making pregnancy safer through initiatives that increase the focus on human rights. A combination of these and other approaches can have a synergistic impact on reductions in maternal mortality. This paper highlights some of the current global efforts on safer pregnancy with a focus on reproductive rights. We encourage readers to do more in every corner of the world to advocate for women's reproductive rights and, in this way, we may achieve the MDGs by 2015.

SAFER CVIEW interface re-certification : description of re-certification process for CVISN stakeholders : version 1.0

DOT National Transportation Integrated Search

2008-04-23

In order to improve data quality in the SAFER system, two major software changes have been made in the recent SAFER releases. SAFER version 4.9, released in October 2005, has implemented data rules (SAFER CR 131) to support the requirements for manda...

National infection prevention and control programmes: Endorsing quality of care.

PubMed

Stempliuk, Valeska; Ramon-Pardo, Pilar; Holder, Reynaldo

2014-01-01

Core components Health care-associated infections (HAIs) are a major cause of morbidity and mortality. In addition to pain and suffering, HAIs increase the cost of health care and generates indirect costs from loss of productivity for patients and society as a whole. Since 2005, the Pan American Health Organization has provided support to countries for the assessment of their capacities in infection prevention and control (IPC). More than 130 hospitals in 18 countries were found to have poor IPC programmes. However, in the midst of many competing health priorities, IPC programmes are not high on the agenda of ministries of health, and the sustainability of national programmes is not viewed as a key point in making health care systems more consistent and trustworthy. Comprehensive IPC programmes will enable countries to reduce the mobility, mortality and cost of HAIs and improve quality of care. This paper addresses the relevance of national infection prevention and control (NIPC) programmes in promoting, supporting and reinforcing IPC interventions at the level of hospitals. A strong commitment from national health authorities in support of national IPC programmes is crucial to obtaining a steady decrease of HAIs, lowering health costs due to HAIs and ensuring safer care.

Safety and fitness electronic records system (SAFER) : draft master test plan

DOT National Transportation Integrated Search

1995-12-31

The purpose of this plan is to establish a formal set of guidelines and activities to be : adhered to and performed by JHU/APL and the developer to ensure that the SAFER System has been tested successfully and is fully compliant with the SAFER System...

People with Intellectual Disabilities Talk About Sexuality: Implications for the Development of Sex Education.

PubMed

Schaafsma, D; Kok, G; Stoffelen, J M T; Curfs, L M G

2017-01-01

Existing sex education programmes have failed in involving people with intellectual disabilities in the development of these programmes. Not involving the target population decreases the likelihood that the sex education programme will be effective. This study was conducted to assess the perspectives of people with intellectual disabilities on several sexuality-related topics. Semi-structured interviews were held with 20 people with intellectual disabilities covering topics such as: sex education, relationships, sex, social media, parenthood and support. The reported frequency of sex education the participants receive is low. Their knowledge regarding sex education is mainly limited to topics such as safe sex, contraception and STI's and tends to be superficial. Additionally, knowledge on safe sex does not always translate to safe sex behaviour. Finally, relationships are important for most participants; mainly because they don't want to be alone. Findings from both this study and literature shows that there seems to be a need for high quality sex education. Topics to consider to include are: online relationships, social media and parenthood. It would also be beneficial to focus on sexuality-related skills. Finally, to increase the effectiveness of a sex education programme, it is advisable that a theory-and evidence-based framework, such as Intervention Mapping, is used for its development.

Client retention and health among sex workers in Nairobi, Kenya.

PubMed

Izugbara, Chimaraoke O

2012-12-01

It is still a small body of research that directly addresses female sex workers' relationships with their regular commercial male partners. I used ethnographic data from Nairobi, Kenya to interrogate motivations and strategies for recruiting and retaining regular male clients among female sex workers (FSWs). Regular commercial male partners, popularly called customer care, wera or wesh by Nairobi's FSWs, played diverse roles in their lives. Client retention enabled sex workers to manage the risk of reduced marriage prospects, guaranteed them steady work, livelihoods, and incomes, and prevented their victimization and harassment. To retain clients, sex workers obliged them a great deal, pretended they had quit prostitution, and sometimes resorted to magical practices. However, these strategies were also accompanied by risks that reinforced the vulnerability of sex workers. Lack of critical attention to sex workers' practices for managing perceived risks in their particular type of work may hamper current programmatic efforts to make their job safer.

Australian men's sexual practices in saunas, sex clubs and other male sex on premises venues.

PubMed

Lyons, Anthony; Smith, Anthony M A; Grierson, Jeffrey W; von Doussa, Henry

2010-06-01

Sex on premises venues (SOPVs) where men have sex with men have been implicated in the spread of sexually transmissible infections, but few studies have described men's sexual encounters in SOPVs, particularly the degree to which men from different backgrounds engage in risky sexual practices. Interviewer administered surveys were conducted with 186 Australian men who have sex with men (MSM) within 48 h of visiting an SOPV. They reported their sexual practices, the characteristics of their partners and other circumstances surrounding their sexual encounters. All analyses were based on the number of sexual encounters (n = 430). Oral sex was the most common practice, occurring in 74.9% of encounters, followed by massage, frottage or kissing (53.7%), solo or mutual masturbation (36.3%), and anal sex (32.1%). Multivariate analyses revealed age as a significant factor for having protected anal sex (P = 0.001), insertive anal sex (P = 0.004) and receptive anal sex (P < 0.001). These practices were more frequent in encounters among younger men, while masturbation (P = 0.03) was more frequent among older men. When men's sexual partners were affected by alcohol, encounters were less likely to involve unprotected anal intercourse (P = 0.006) and more likely to involve massage, frottage or kissing (P = 0.009). Men disclosed their HIV status in only 7.7% of encounters. With the likelihood of risky sexual practices varying according to background, results from this study should be used to guide interventions aiming to promote safer sex in SOPVs.

Entertainment Venue Visiting and Commercial Sex in China.

PubMed

Lin, Chunqing; Li, Li; Wu, Zunyou; Guan, Jihui; Xu, Yu; Wu, Di; Lieber, Eli; Rotheram-Borus, Mary Jane

2010-01-01

Entertainment venues in China play an important role in the sexually transmitted disease (STD)/HIV epidemic. Most previous studies have focused on sex workers working in entertainment venues, but little is known about their clients. This study investigated the perceptions and behavior of the patrons visiting entertainment venues. Qualitative in-depth interviews were conducted with 30 male market vendors who visited entertainment venues at least once in the past 3 months in an eastern city in China. Information about their risky behavior, attitude toward commercial sex, and STD/HIV prevention approaches was collected. Saunas, karaoke bars, and massage centers are the most frequently visited entertainment venues. Seventy-three percent of study participants reported purchasing commercial sex at these entertainment venues. Participants expressed a very liberal attitude toward commercial sex. Seeking commercial sex was perceived as a characteristic of a male's nature. The perceived risks of STD/HIV infection do not deter participants from engaging in commercial sex. Commercial sex clients reported irregular condom use and a number of other misperceptions and improper practices toward preventing STD/HIV infection. Venue-based intervention is urgently needed to target the population. The sex workers themselves could potentially serve as "health educators" to communicate prevention information to their clients and encourage safer sex behavior.

Entertainment Venue Visiting and Commercial Sex in China

PubMed Central

Lin, Chunqing; Li, Li; Wu, Zunyou; Guan, Jihui; Xu, Yu; Wu, Di; Lieber, Eli; Rotheram-Borus, Mary Jane

2014-01-01

Entertainment venues in China play an important role in the sexually transmitted disease (STD)/HIV epidemic. Most previous studies have focused on sex workers working in entertainment venues, but little is known about their clients. This study investigated the perceptions and behavior of the patrons visiting entertainment venues. Qualitative in-depth interviews were conducted with 30 male market vendors who visited entertainment venues at least once in the past 3 months in an eastern city in China. Information about their risky behavior, attitude toward commercial sex, and STD/HIV prevention approaches was collected. Saunas, karaoke bars, and massage centers are the most frequently visited entertainment venues. Seventy-three percent of study participants reported purchasing commercial sex at these entertainment venues. Participants expressed a very liberal attitude toward commercial sex. Seeking commercial sex was perceived as a characteristic of a male’s nature. The perceived risks of STD/HIV infection do not deter participants from engaging in commercial sex. Commercial sex clients reported irregular condom use and a number of other misperceptions and improper practices toward preventing STD/HIV infection. Venue-based intervention is urgently needed to target the population. The sex workers themselves could potentially serve as “health educators” to communicate prevention information to their clients and encourage safer sex behavior. PMID:25132901

Breaking the bond between stimulant use and risky sex: a qualitative study.

PubMed

Lyons, Thomas; Chandra, Gopika; Goldstein, Jerome; Ostrow, David G

2010-10-01

Stimulant-using men who have sex with men (MSM) are at increased risk for human immunodeficiency virus (HIV) transmission, and are more likely to practice unprotected anal sex than MSM who do not use methamphetamine and/or crack cocaine. In this paper the authors report on interviews with stimulant-using men who have sex with men who have participated in Crystal Meth Anonymous and other 12-step groups, focusing on those who did not have unprotected anal intercourse during a 6-month follow-up period and their reasons for doing so. The authors find 4 common themes cited: a diminished sexual drive; exclusive sex with a primary partner; greater sense of responsibility/commitment to safer sex; and most commonly of the four, an overall healthier sex life. Participants' use of terms such as "healthy," "enjoyable," and "fulfilling" to describe sex not on stimulants, and avoidance of these terms for sex on stimulants, suggests a distinct dimension of sexual experience.

A randomized study comparing blood glucose control and risk of severe hypoglycemia achieved by non-programmable versus programmable external insulin pumps.

PubMed

Catargi, B; Breilh, D; Gin, H; Rigalleau, V; Saux, M C; Roger, P; Tabarin, A

2001-06-01

To compare a non-programmable and a programmable insulin external pump using regular insulin on glycemic stability, the risk of severe hypoglycemia and metabolic control in type 1 diabetic patients. Ten type 1 diabetic patients were involved in a randomized, crossover study comparing two periods of 3 months with continuous subcutaneous insulin infusion (CSII) either with a non-programmable insulin pump or a programmable insulin pump. Comparisons were made among mean blood glucose values before and after meals, at bedtime and at 2: 00 a.m.; the risk of severe hypoglycemia assessed by the low blood glucose index (LBGI); and HbA1c. Mean average blood glucose (BG) measurements were significantly lower with the programmable in comparison with the non-programmable insulin pump (respectively 157+/-78 vs. 165+/-79, p=0.034). While postprandial values for BG were not different between the two pumps, the use of the programmable pump resulted in a significant decrease in mean preprandial BG levels (140+/-68 vs. 150+/-73 mg/dl p=0.039). Conversely mean BG level was lower at 2 a.m. with the non-prgrammable pump (125+/-81 vs. 134 +/-93 mg/dl, p=0.02) but with a higher incidence of hypoglycemia. Mean LBGI was comparable with the two pumps (3.1+/-8.6 vs. 2.8+/-6.9, p=0.1). There was a 0.2% decrease in HbA1c during the programmable pump period that did not reach statistical significance (p=0.37). The present study suggests that programmable external insulin pumps, although more complex and more expensive than non-programmable insulin pumps, significantly reduce fasting glycemia during the day without increasing the risk of severe hypoglycemia and are safer during the night.

Violence prevention and municipal licensing of indoor sex work venues in the Greater Vancouver Area: narratives of migrant sex workers, managers and business owners.

PubMed

Anderson, Solanna; Jia, Jessica Xi; Liu, Vivian; Chattier, Jill; Krüsi, Andrea; Allan, Sarah; Maher, Lisa; Shannon, Kate

2015-01-01

Using a socio-ecological, structural determinants framework, this study assesses the impact of municipal licensing policies and related policing practices across the Greater Vancouver Area (Canada) on the risk of violence within indoor sex work venues. Qualitative interviews were conducted with 46 migrant/immigrant sex workers, managers and owners of licensed indoor sex work establishments and micro-brothels. Findings indicate that policing practices and licensing requirements increase sex workers' risk of violence and conflict with clients and result in heightened stress, an inability to rely on police support, lost income and the displacement of sex workers to more hidden informal work venues. Prohibitive licensing and policing practices prevent sex workers, managers and owners from adopting safer workplace measures and exacerbate health and safety risks for sex workers. This study provides critical evidence of the negative public health implications of prohibitive municipal licensing in the context of a criminalised and enforcement-based approach to sex work. Workplace safety recommendations include the decriminalisation of sex work and the elimination of disproportionately high fees for licences, criminal record restrictions, door lock restrictions, employee registration requirements and the use of police as licensing inspectors.

Violence prevention and municipal licensing of indoor sex work venues in the Greater Vancouver Area: narratives of migrant sex workers, managers and business owners

PubMed Central

Anderson, Solanna; Jia, Jessica Xi; Liu, Vivian; Chattier, Jill; Krüsi, Andrea; Allan, Sarah; Maher, Lisa; Shannon, Kate

2015-01-01

Using a socio-ecological, structural determinants framework, this study assesses the impact of municipal licensing policies and related policing practices across the Greater Vancouver Area (Canada) on the risk of violence within indoor sex work venues. Qualitative interviews were conducted with 46 migrant/immigrant sex workers, managers and owners of licensed indoor sex work establishments and micro-brothels. Findings indicate that policing practices and licensing requirements increase sex workers’ risk of violence and conflict with clients, and result in heightened stress, an inability to rely on police support, lost income and the displacement of sex workers to more hidden informal work venues. Prohibitive licensing and policing practices prevent sex workers, managers and owners from adopting safer workplace measures and exacerbate health and safety risks for sex workers. This study provides critical evidence of the negative public health implications of prohibitive municipal licensing in the context of a criminalised and enforcement-based approach to sex work. Workplace safety recommendations include the decriminalisation of sex work and the elimination of disproportionately high fees for licenses, criminal record restrictions, door lock restrictions, employee registration requirements and the use of police as licensing inspectors. PMID:25686777

Temporal trends in clinical characteristics and management according to sex in patients with cardiogenic shock after acute myocardial infarction: The FAST-MI programme.

PubMed

Isorni, Marc-Antoine; Aissaoui, Nadia; Angoulvant, Denis; Bonello, Laurent; Lemesle, Gilles; Delmas, Clément; Henry, Patrick; Schiele, François; Ferrières, Jean; Simon, Tabassome; Danchin, Nicolas; Puymirat, Étienne

2018-02-22

Cardiogenic shock (CS) complicating acute myocardial infarction (AMI) occurs more frequently in women, but little is known about its potential specificities according to sex. To analyse the incidence, management and 1-year mortality of CS according to sex using the FAST-MI programme. The FAST-MI programme consists of four nationwide French surveys carried out 5 years apart from 1995 to 2010, including consecutive patients with AMI over a 1-month period, and with a 1-year follow-up. Among the 10,610 patients included in the surveys, the incidence of CS was 4.8% in men and 8.2% in women (P<0.001). Absolute incidence of CS decreased from 1995 to 2010 in both sexes. Mean age in patients with CS tended to decrease in men (from 72±12 to 69±13 years) and to increase in women (from 78±10 to 80±9 years). One-year mortality decreased significantly in men (from 70% in 1995 to 48% in 2010) and in women (from 81% to 54%). Using Cox multivariable analysis, female sex was not an independent correlate of 1-year mortality [hazard ratio (HR): 0.98, 95% confidence interval (CI): 0.78-1.22]. Early use of percutaneous coronary intervention was, however, an independent predictor of 1-year survival in women (HR: 0.55, 95% CI: 0.37-0.81), but showed only a non-significant trend in men (HR: 0.85, 95% CI: 0.61-1.19). The incidence of CS-AMI has decreased in both men and women, but remains higher in women. One-year mortality has significantly decreased for both men and women, and the role of early percutaneous coronary intervention as a potential mediator of decreased mortality seems greater in women than in men. Copyright © 2018 Elsevier Masson SAS. All rights reserved.

The impact of age, sex and socioeconomic deprivation on outcomes in a colorectal cancer screening programme.

PubMed

Mansouri, David; McMillan, Donald C; Grant, Yasmin; Crighton, Emilia M; Horgan, Paul G

2013-01-01

Population-based colorectal cancer screening has been shown to reduce cancer specific mortality and is used across the UK. Despite evidence that older age, male sex and deprivation are associated with an increased incidence of colorectal cancer, uptake of bowel cancer screening varies across demographic groups. The aim of this study was to assess the impact of age, sex and deprivation on outcomes throughout the screening process. A prospectively maintained database, encompassing the first screening round of a faecal occult blood test screening programme in a single geographical area, was analysed. Overall, 395,096 individuals were invited to screening, 204,139 (52%) participated and 6079 (3%) tested positive. Of the positive tests, 4625 (76%) attended for colonoscopy and cancer was detected in 396 individuals (9%). Lower uptake of screening was associated with younger age, male sex and deprivation (all p<0.001). Only deprivation was associated with failure to proceed to colonoscopy following a positive test (p<0.001). Despite higher positivity rates in those that were more deprived (p<0.001), the likelihood of detecting cancer in those attending for colonoscopy was lower (8% most deprived vs 10% least deprived, p = 0.003). Individuals who are deprived are less likely to participate in screening, less likely to undergo colonoscopy and less likely to have cancer identified as a result of a positive test. Therefore, this study suggests that strategies aimed at improving participation of deprived individuals in colorectal cancer screening should be directed at all stages of the screening process and not just uptake of the test.

70 Years of Making the World Safer

DOE Office of Scientific and Technical Information (OSTI.GOV)

None

This video shows our roles in making the world safer — working to end World War II, providing stable isotopes for research, providing unique precision manufacturing capabilities, and meeting nonproliferation and global security missions.

Using Technology to Create Safer Schools.

ERIC Educational Resources Information Center

Townley, Arthur J.; Martinez, Kenneth

1995-01-01

Although classes to create student self-esteem and antigang programs are gaining in popularity, most school districts have not used available technology to help create safer campuses. Increased availability of telephones and two-way radios would enhance school security, along with incorporation of newer technologies such as computers, digitized…

Scaling up prevention programmes to reduce the sexual transmission of HIV in China.

PubMed

Rou, Keming; Sullivan, Sheena G; Liu, Peng; Wu, Zunyou

2010-12-01

Since 2007, sex has been the major mode of HIV transmission in China, accounting for 75% of new infections in 2009. Reducing sexual transmission is a major challenge for China in controling the HIV epidemic. This article discusses the pilot programmes that have guided the expansion of sex education and behavioural interventions to reduce the sexual transmission of HIV in China. Commercial sex became prevalent across China in the early 1980s, prompting some health officials to become concerned that this would fuel an HIV epidemic. Initial pilot intervention projects to increase condom use among sex workers were launched in 1996 on a small scale and, having demonstrated their effectiveness, were expanded nationwide during the 2000s. Since then, supportive policies to expand sex education to other groups and throughout the country have been introduced and the range of targets for education programmes and behavioural interventions has broadened considerably to also include school children, college students, married couples, migrant workers and men who have sex with men. Prevention programmes for reducing sexual transmission of HIV have reasonable coverage, but can still improve. The quality of intervention needs to be improved in order to have a meaningful impact on changing behaviour to reducing HIV sexual transmission. Systematic evaluation of the policies, guidelines and intervention programmes needs to be conducted to understand their impact and to maintain adherence.

Ageing and healthy sexuality among women living with HIV.

PubMed

Narasimhan, Manjulaa; Payne, Caitlin; Caldas, Stephanie; Beard, John R; Kennedy, Caitlin E

2016-11-01

Populations around the world are rapidly ageing and effective treatment for HIV means women living with HIV (WLHIV) can live longer, healthier lives. HIV testing and screening programmes and safer sex initiatives often exclude older sexually active WLHIV. Systematically reviewing the literature to inform World Health Organization guidelines on the sexual and reproductive health and rights (SRHR) of WLHIV, identified four studies examining healthy sexuality among older WLHIV. In Uganda, WLHIV reported lower rates of sexual activity and rated sex as less important than men. In the United States, HIV stigma, disclosure, and body image concerns, among other issues, were described as inhibiting relationship formation and safer sexual practices. Sexual activity declined similarly over time for all women, including for WLHIV who reported more protected sex, while a significant minority of WLHIV reported unprotected sex. A single intervention, the "ROADMAP" intervention, demonstrated significant increases in HIV knowledge and decreases in HIV stigma and high risk sexual behaviour. WLHIV face ageist discrimination and other barriers to remaining sexually active and maintaining healthy sexual relationships, including challenges procuring condoms and seeking advice on safe sex practices, reduced ability to negotiate safer sex, physical and social changes associated with menopause, and sexual health challenges due to disability and comorbidities. Normative guidance does not adequately address the SRHR of older WLHIV, and while this systematic review highlights the paucity of data, it also calls for additional research and attention to this important area. Copyright © 2016 Elsevier Inc. All rights reserved.

The SAFER Latinos Project: Addressing a Community Ecology Underlying Latino Youth Violence

ERIC Educational Resources Information Center

Edberg, Mark; Cleary, Sean D.; Collins, Elizabeth; Klevens, Joanne; Leiva, Rodrigo; Bazurto, Martha; Rivera, Ivonne; del Cid, Alex Taylor; Montero, Luisa; Calderon, Melba

2010-01-01

This paper describes the intervention model, early implementation experience, and challenges for the "Seguridad, Apoyo, Familia, Educacion, y Recursos" (SAFER) Latinos project. The SAFER Latinos project is an attempt to build the evidence for a multilevel participatory youth violence prevention model tailored to the specific circumstances of…

Piloting a Savings-Led Microfinance Intervention with Women Engaging in Sex Work in Mongolia: Further Innovation for HIV Risk Reduction

PubMed Central

Tsai, Laura Cordisco; Witte, Susan S.; Aira, Toivgoo; Altantsetseg, Batsukh; Riedel, Marion

2014-01-01

This paper describes a pilot study testing the feasibility of an innovative savings-led microfinance intervention in increasing the economic empowerment and reducing the sexual risk behavior of women engaging in sex work in Mongolia. Women’s economic vulnerability may increase their risk for HIV by compromising their ability to negotiate safer sex with partners and heightening the likelihood they will exchange sex for survival. Microfinance has been considered a potentially powerful structural HIV prevention strategy with women conducting sex work, as diversification of income sources may increase women’s capacity to negotiate safer transactional sex. With 50% of all reported female HIV cases in Mongolia detected among women engaging in sex work, direct prevention intervention with women conducting sex work represents an opportunity to prevent a potentially rapid increase in HIV infection in urban Mongolia. The piloted intervention consisted of a matched savings program in which matched savings could be used for business development or vocational education, combined with financial literacy and business development training for women engaging in sex work. Results of the pilot demonstrate participants’ increased confidence in their ability to manage finances, greater hope for pursuing vocational goals, moderate knowledge gains regarding financial literacy, and an initial transition from sex work to alternative income generation for five out of nine participants. The pilot findings highlight the potential for such an intervention and the need for a clinical trial testing the efficacy of savings-led microfinance programs in reducing HIV risk for women engaging in sex work in Mongolia. PMID:24900163

Piloting a Savings-Led Microfinance Intervention with Women Engaging in Sex Work in Mongolia: Further Innovation for HIV Risk Reduction.

PubMed

Tsai, Laura Cordisco; Witte, Susan S; Aira, Toivgoo; Altantsetseg, Batsukh; Riedel, Marion

2011-12-30

This paper describes a pilot study testing the feasibility of an innovative savings-led microfinance intervention in increasing the economic empowerment and reducing the sexual risk behavior of women engaging in sex work in Mongolia. Women's economic vulnerability may increase their risk for HIV by compromising their ability to negotiate safer sex with partners and heightening the likelihood they will exchange sex for survival. Microfinance has been considered a potentially powerful structural HIV prevention strategy with women conducting sex work, as diversification of income sources may increase women's capacity to negotiate safer transactional sex. With 50% of all reported female HIV cases in Mongolia detected among women engaging in sex work, direct prevention intervention with women conducting sex work represents an opportunity to prevent a potentially rapid increase in HIV infection in urban Mongolia. The piloted intervention consisted of a matched savings program in which matched savings could be used for business development or vocational education, combined with financial literacy and business development training for women engaging in sex work. Results of the pilot demonstrate participants' increased confidence in their ability to manage finances, greater hope for pursuing vocational goals, moderate knowledge gains regarding financial literacy, and an initial transition from sex work to alternative income generation for five out of nine participants. The pilot findings highlight the potential for such an intervention and the need for a clinical trial testing the efficacy of savings-led microfinance programs in reducing HIV risk for women engaging in sex work in Mongolia.

Bareback sex and gay men: an HIV prevention failure.

PubMed

Goodroad, B K; Kirksey, K M; Butensky, E

2000-01-01

Bareback sex, or actively seeking unprotected anal intercourse is occurring in the gay male community. This represents a new phenomenon, different from previously identified "relapse" unsafe sexual behavior and poses an important HIV prevention problem. This article reviews the extant literature regarding bareback sex. The lay press and scientific literature are reviewed. Although discussion of issues surrounding bareback sex is abundant in the gay press, scientific literature regarding this phenomenon is nonexistent. The evidence-based literature addresses relapse to unsafe sexual behavior. Although this literature provides further understanding of safer sexual behaviors in gay men, barebacking is a unique issue that requires additional exploration. In this article, factors underlying bareback sexual behavior are explored, including previous HIV prevention efforts and their relationship to this phenomenon. Finally, bareback sex in the gay male community and its implications for nursing practice, research, and education are explored. The harm reduction model is offered as a useful guide for nursing assessment and intervention.

Precautionary policies in local government: green chemistry and safer alternatives.

PubMed

Raphael, Debbie O; Geiger, Chris A

2011-01-01

Local governments like the City and County of San Francisco have shouldered the burden of toxic chemicals released into the environment through the substantial costs of health care, environmental cleanup, and infrastructure to purify drinking water, manage wastewater, and manage solid waste. Cities can no longer afford to wait for federal regulation to prevent toxic chemicals from appearing in products used locally. San Francisco's Precautionary Principle Policy calls on the City to act on early warning signs of harm and to use the best available science to identify safer alternatives. Under its umbrella, a wide array of policy tools have been utilized including financial incentives through procurement contracts, certification and promotion of safer business practices, requirements for information disclosure, and bans and restrictions on the sale of products when safer alternatives are readily available. These policies can often become the models for regional, state, and national change.

Feasibility, acceptability, and initial efficacy of an online sexual health promotion program for LGBT youth: the Queer Sex Ed intervention.

PubMed

Mustanski, Brian; Greene, George J; Ryan, Daniel; Whitton, Sarah W

2015-01-01

Lesbian, gay, bisexual, and transgender (LGBT) youth experience multiple sexual health inequities driven, in part, by deficits in parental and peer support, school-based sex education programs, and community services. Research suggests that the Internet may be an important resource in the development of sexual health among LGBT youth. We examined the feasibility of recruiting youth in same-sex relationships into an online sexual health intervention, evaluated intervention acceptability, and obtained initial estimates of intervention efficacy. LGBT youth (16 to 20 years old) completed Queer Sex Ed (QSE), an online, multimedia sexual health intervention consisting of five modules. The final sample (N = 202) completed the pretest, intervention, and posttest assessments. The primary study outcomes were sexual orientation identity and self-acceptance (e.g., coming-out self-efficacy), sexual health knowledge (e.g., sexual functioning), relationship variables (e.g., communication skills), and safer sex (e.g., sexual assertiveness). Analyses indicated that 15 of the 17 outcomes were found to be significant (p < .05). Effect sizes ranged from small for sexual orientation (e.g., internalized homophobia) and relationship variables (e.g., communication skills) to moderate for safer sex (e.g., contraceptive knowledge) outcomes. This study demonstrated the feasibility, acceptability, and initial efficacy of QSE, an innovative online comprehensive sexual health program for LGBT youth.

The Men's Safer Sex (MenSS) trial: protocol for a pilot randomised controlled trial of an interactive digital intervention to increase condom use in men.

PubMed

Bailey, Julia V; Webster, Rosie; Hunter, Rachael; Freemantle, Nick; Rait, Greta; Michie, Susan; Estcourt, Claudia; Anderson, Jane; Gerressu, Makeda; Stephenson, Judith; Ang, Chee Siang; Hart, Graham; Dhanjal, Sacha; Murray, Elizabeth

2015-02-16

Sexually transmitted infections (STI) are a major public health problem. Condoms provide effective protection but there are many barriers to use. Face-to-face health promotion interventions are resource-intensive and show mixed results. Interactive digital interventions may provide a suitable alternative, allowing private access to personally tailored behaviour change support. We have developed an interactive digital intervention (the Men's Safer Sex (MenSS) website) which aims to increase condom use in men. We describe the protocol for a pilot trial to assess the feasibility of a full-scale randomised controlled trial of the MenSS website in addition to usual sexual health clinical care. Men aged 16 or over who report female sexual partners and recent unprotected sex or suspected acute STI. PARTICIPANTS (N=166) will be enrolled using a tablet computer in clinic waiting rooms. All trial procedures will be online, that is, eligibility checks; study consent; trial registration; automated random allocation; and data submission. At baseline and at 3, 6 and 12 months, an online questionnaire will assess condom use, self-reported STI diagnoses, and mediators of condom use (eg, knowledge, intention). Reminders will be by email and mobile phone. The primary outcome is condom use, measured at 3 months. STI rates will be recorded from sexual health clinic medical records at 12 months. The feasibility of a cost-effectiveness analysis will be assessed, to calculate incremental cost per STI prevented (Chlamydia or Gonorrhoea), from the NHS perspective. Ethical approval: City and East NHS Research Ethics Committee (reference number 13 LO 1801). Findings will be made available through publication in peer-reviewed journals, and to participants and members of the public via Twitter and from the University College London eHealth Unit website. Raw data will be made available on request. Current Controlled Trials. ISRCTN18649610. Registered 15 October 2013 http

The Men's Safer Sex (MenSS) trial: protocol for a pilot randomised controlled trial of an interactive digital intervention to increase condom use in men

PubMed Central

Bailey, Julia V; Webster, Rosie; Hunter, Rachael; Freemantle, Nick; Rait, Greta; Michie, Susan; Estcourt, Claudia; Anderson, Jane; Gerressu, Makeda; Stephenson, Judith; Ang, Chee Siang; Hart, Graham; Dhanjal, Sacha; Murray, Elizabeth

2015-01-01

Introduction Sexually transmitted infections (STI) are a major public health problem. Condoms provide effective protection but there are many barriers to use. Face-to-face health promotion interventions are resource-intensive and show mixed results. Interactive digital interventions may provide a suitable alternative, allowing private access to personally tailored behaviour change support. We have developed an interactive digital intervention (the Men's Safer Sex (MenSS) website) which aims to increase condom use in men. We describe the protocol for a pilot trial to assess the feasibility of a full-scale randomised controlled trial of the MenSS website in addition to usual sexual health clinical care. Methods and analysis Participants: Men aged 16 or over who report female sexual partners and recent unprotected sex or suspected acute STI. Participants (N=166) will be enrolled using a tablet computer in clinic waiting rooms. All trial procedures will be online, that is, eligibility checks; study consent; trial registration; automated random allocation; and data submission. At baseline and at 3, 6 and 12 months, an online questionnaire will assess condom use, self-reported STI diagnoses, and mediators of condom use (eg, knowledge, intention). Reminders will be by email and mobile phone. The primary outcome is condom use, measured at 3 months. STI rates will be recorded from sexual health clinic medical records at 12 months. The feasibility of a cost-effectiveness analysis will be assessed, to calculate incremental cost per STI prevented (Chlamydia or Gonorrhoea), from the NHS perspective. Ethics and dissemination Ethical approval: City and East NHS Research Ethics Committee (reference number 13 LO 1801). Findings will be made available through publication in peer-reviewed journals, and to participants and members of the public via Twitter and from the University College London eHealth Unit website. Raw data will be made available on request. Trial registration

"We need somewhere to smoke crack": An ethnographic study of an unsanctioned safer smoking room in Vancouver, Canada.

PubMed

McNeil, Ryan; Kerr, Thomas; Lampkin, Hugh; Small, Will

2015-07-01

Many cities around the globe have experienced substantial increases in crack cocaine use. Public health programmes have begun to address crack smoking, primarily through the distribution of safer crack use equipment, but their impacts have been limited. More comprehensive safer environmental interventions, specifically safer smoking rooms (SSR), have been implemented only in select European cities. However, none have been subjected to rigorous evaluation. This ethnographic study was undertaken at an 'unsanctioned' SSR operated by a drug user-led organization in Vancouver, Canada, to explore how this intervention shaped crack smoking practices, public crack smoking, and related harms. Ethnographic fieldwork was undertaken at this SSR from September to December 2011, and included approximately 50 hours of ethnographic observation and 23 in-depth interviews with people who smoke crack. Data were analyzed by drawing on the 'Risk Environment' framework and concepts of 'symbolic', 'everyday', and 'structural' violence. Our findings illustrate how a high demand for SSRs was driven by the need to minimize exposure to policing (structural violence), drug scene violence (everyday violence), and stigma (symbolic violence) that characterized unregulated drug use settings (e.g., public spaces). Although resource scarcity and social norms operating within the local drug scene (e.g., gendered power relations) perpetuated crack pipe-sharing within unregulated drug use settings, the SSR fostered harm reduction practices by reshaping the social-structural context of crack smoking and reduced the potential for health harms. Given the significant potential of SSRs in reducing health and social harms, there is an urgent need to scale up these interventions. Integrating SSRs into public health systems, and supplementing these interventions with health and social supports, has potential to improve the health and safety of crack-smoking populations. Copyright © 2015 Elsevier B.V. All

"Now that you are circumcised, you cannot have first sex with your wife": post circumcision sexual behaviours and beliefs among men in Wakiso district, Uganda.

PubMed

Kibira, Simon Peter Sebina; Atuyambe, Lynn Muhimbuura; Sandøy, Ingvild Fossgard; Makumbi, Fredrick Edward; Daniel, Marguerite

2017-06-05

Safe male circumcision is an important biomedical intervention in the comprehensive HIV prevention programmes implemented in 14 sub-Saharan African countries with high HIV prevalence. To sustain its partial protective benefit, it is important that perceived reduced HIV risk does not lead to behavioural risk compensation among circumcised men and their sexual partners. This study explored beliefs that may influence post circumcision sexual behaviours among circumcised men in a programme setting. Forty-eight in-depth interviews were conducted with newly circumcised men in Wakiso district, central Uganda. Twenty-five men seeking circumcision services at public health facilities in the district were recruited from May to June 2015 and, interviewed at baseline and after 6 months. Participants' beliefs and sexual behaviours were compared just after circumcision and at follow up to explore changes. Data were managed using atlas.ti7 and analysed following a thematic network analysis framework. Four themes following safe male circumcision emerged from this study. Beliefs related to: (1) sexual cleansing, (2) healing, (3) post SMC sexual capabilities and (4) continued HIV transmission risk. Most men maintained or adopted safer sexual behaviour; being faithful to their partner after circumcision or using condoms with extramarital partners following the knowledge that there was continued HIV risk post circumcision. The most prevalent risky belief was regarding sexual cleansing post circumcision, and as a result of this belief, some men had one off condom-less sexual intercourse with a casual partner. Some resumed sex before the recommended period due to misunderstanding of what comprised healing. Although most men maintained or adopted safer sexual behaviour, there were instances of risky sexual behaviour resulting from beliefs regarding the first sexual intercourse after circumcision or misunderstandings of what comprised wound healing. If not addressed, these may attenuate

Graphene Based Ultra-Capacitors for Safer, More Efficient Energy Storage

NASA Technical Reports Server (NTRS)

Roberson, Luke B.; Mackey, Paul J.; Zide, Carson J.

2016-01-01

Current power storage methods must be continuously improved in order to keep up with the increasingly competitive electronics industry. This technological advancement is also essential for the continuation of deep space exploration. Today's energy storage industry relies heavily on the use of dangerous and corrosive chemicals such as lithium and phosphoric acid. These chemicals can prove hazardous to the user if the device is ruptured. Similarly they can damage the environment if they are disposed of improperly. A safer, more efficient alternative is needed across a wide range of NASA missions. One solution would a solid-state carbon based energy storage device. Carbon is a safer, less environmentally hazardous alternative to current energy storage materials. Using the amorphous carbon nanostructure, graphene, this idea of a safer portable energy is possible. Graphene was electrochemically produced in the lab and several coin cell devices were built this summer to create a working prototype of a solid-state graphene battery.

Enhanced recovery clinical education programme improves quality of post-operative care

PubMed Central

McDonald, Ruth

2015-01-01

Quality is the driving principle of Enhanced Recovery (ER). It improves the patient experience by getting patients better sooner and changes clinical practice to make care safer and more efficient. As a consequence of ER patients spend less time in hospital. A successful ER programme began to fail after organisational restructuring and staff changes. Patients did not meet their ER goals and length of stay (LOS) increased. An ER nurse was appointed to get the programme back on track. This involved a multidisciplinary approach to an ER clinical education programme. The programme aimed to develop knowledge of the physiology of post-operative recovery and the evidence underpinning the interventions required. This was considered crucial to secure longer term staff engagement while avoiding unthinking protocol driven compliance. Success of the education programme was measured by improved outcomes in patient LOS and readmission statistics. During the four months of the clinical education programme there were no significant changes in monthly LOS. At six months post implementation of the programme there was a reduction in LOS of 0.6 days compared to the previous six months. At 12 months there was a reduction in 1.1 days compared with previous 12 months. There was a mean reduction of 28 day readmissions for all elective gynaecology surgery of 1.1 patients per month in the 12 months post programme implementation compared to the 12 months before. Delivering a multidisciplinary participatory education programme improved overall understanding of ER, and achieved sustained improvement in ER for patient benefit. PMID:26734343

Enhanced recovery clinical education programme improves quality of post-operative care.

PubMed

McDonald, Ruth

2015-01-01

Quality is the driving principle of Enhanced Recovery (ER). It improves the patient experience by getting patients better sooner and changes clinical practice to make care safer and more efficient. As a consequence of ER patients spend less time in hospital. A successful ER programme began to fail after organisational restructuring and staff changes. Patients did not meet their ER goals and length of stay (LOS) increased. An ER nurse was appointed to get the programme back on track. This involved a multidisciplinary approach to an ER clinical education programme. The programme aimed to develop knowledge of the physiology of post-operative recovery and the evidence underpinning the interventions required. This was considered crucial to secure longer term staff engagement while avoiding unthinking protocol driven compliance. Success of the education programme was measured by improved outcomes in patient LOS and readmission statistics. During the four months of the clinical education programme there were no significant changes in monthly LOS. At six months post implementation of the programme there was a reduction in LOS of 0.6 days compared to the previous six months. At 12 months there was a reduction in 1.1 days compared with previous 12 months. There was a mean reduction of 28 day readmissions for all elective gynaecology surgery of 1.1 patients per month in the 12 months post programme implementation compared to the 12 months before. Delivering a multidisciplinary participatory education programme improved overall understanding of ER, and achieved sustained improvement in ER for patient benefit.

Client demands for unsafe sex: the socioeconomic risk environment for HIV among street and off-street sex workers.

PubMed

Deering, Kathleen N; Lyons, Tara; Feng, Cindy X; Nosyk, Bohdan; Strathdee, Steffanie A; Montaner, Julio S G; Shannon, Kate

2013-08-01

Among sex workers (SWs) in Vancouver, Canada, this study identified social, drug use, sex work, environmental-structural, and client-related factors associated with being offered and accepting more money after clients' demand for sex without a condom. Cross-sectional study using baseline (February 2010 to October 2011) data from a longitudinal cohort of 510 SWs. A 2-part multivariable regression model was used to identify factors associated with 2 separate outcomes: (1) being offered more money for sex without a condom in the last 6 months; and (2) accepting more money, among those who had been offered more money. The sample included 490 SWs. In multivariable analysis, being offered more money for sex without a condom was more likely for SWs who used speedballs, had higher average numbers of clients per week, had difficulty accessing condoms, and had clients who visited other SWs. Accepting more money for sex without a condom was more likely for SWs self-reporting as a sexual minority and who had experienced client violence and used crystal methamphetamine less than daily (versus none) and less likely for SWs who solicited mainly indoors for clients (versus outdoor/public places). These results highlight the high demand for sex without a condom by clients of SWs. HIV prevention efforts should shift responsibility toward clients to reduce offers of more money for unsafe sex. Programs that mitigate the social and economic risk environments of SWs alongside the removal of criminal sanctions on sex work to enable condom use within safer indoor workspaces are urgently required.

The role of collectives in STI and HIV/AIDS prevention among female sex workers in Karnataka, India.

PubMed

Halli, S S; Ramesh, B M; O'Neil, J; Moses, S; Blanchard, J F

2006-10-01

This paper evaluates the role of female sex worker (FSW) collectives in the state of Karnataka, India, regarding their facilitating effect in increasing knowledge and promoting change towards safer sexual behaviour. In 2002 a state-wide survey of FSWs was administered to a stratified sample of 1,512 women. Following the survey, a collectivization index was developed to measure the degree of involvement of FSWs in collective-related activities. The results indicate that a higher degree of collectivization was associated with increased knowledge and higher reported condom use. Reported condom use was higher with commercial clients than with regular partners or husbands among all women and a gradient was observed in most outcome variables between women with low, medium and high collectivization index scores. Collectivization seems to have a positive impact in increasing knowledge and in empowering FSWs in Karnataka to adopt safer sex practices, particularly with commercial clients. While these results are encouraging, they may be confounded by social desirability, selection and other biases. More longitudinal and qualitative studies are required to better understand the nature of sex worker collectives and the benefits that they can provide.

Process assessment of a peer education programme for HIV prevention among sex workers in Dhaka, Bangladesh : a social support framework.

PubMed

Sarafian, Isabelle

2012-08-01

This study evaluated the process of a peer education program for hotel-based sex workers in Dhaka, Bangladesh, with social support proposed as an organizing framework. Programme outcomes were examined through baseline and follow-up assessments. Sex workers naïve to peer education were assessed on socio-cognitive and behavioural variables; a subsample was reassessed at follow-up 23 weeks later on average. Process was assessed in terms of the content of peer education sessions. These sessions were recorded and coded into percentages of social support types provided by the peer educator to her audience: informational, instrumental, appraisal, emotional, companionship, non-support. Peer educators were classified into three "social support profiles" based on average proportions of emotional and informational support they provided. Seeing more peer educators with a high informational support profile was related to higher sex worker self-efficacy, self-reported STI symptoms, and self-reported condom use at follow-up; the same was true for the high emotional support profile and treatment seeking. Social support constituted a useful framework, but needs further exploration. This study provided a direct, in-depth examination of the process of peer education based on a comprehensive theoretical framework. Copyright © 2011 Elsevier Ltd. All rights reserved.

Application of the WHO keys of safer food to improve food handling practices of food vendors in a poor resource community in Ghana.

PubMed

Donkor, Eric S; Kayang, Boniface B; Quaye, Jonathan; Akyeh, Moses L

2009-11-01

Data was collected from food vendors in a poor resource community in Ghana, which showed that the vendors constituted an important source of oro-faecal transmission. Following this, the WHO five keys of safer food were utilized in an evidence based training programme for the vendors to improve their food handling practices. Impact assessment of the food safety training showed that 67.6% of the vendors had acquired some knowledge from the workshop and were putting it into practice. Lack of food safety equipment was a major hinderance to behavioral change among the vendors as far food handling practices are concerned.

Sex worker incarceration in the People's Republic of China.

PubMed

Tucker, J D; Ren, X

2008-02-01

Tens of thousands of commercial sex workers in China are administratively detained each year in female re-education through labor (RTL) centres for moral education and vocational training. Recent increases in syphilis and heterosexual HIV make tailored HIV prevention efforts for sex workers increasingly important in many regions of China. However, RTL centres focused on detaining commercial sex workers have not traditionally been linked to sexually transmitted infections (STI)/HIV programmes. The stigma of being incarcerated and selling sex complicates STI/HIV prevention for these women. Incarcerated sex workers represent a particularly marginalized HIV risk group that has been excluded from domestic and international HIV programmes to date. Although several laws and administrative decrees provide a legal mandate for sex worker STI/HIV testing, treatment and rights, there is still substantial variation in how laws are implemented. Creating devoted medical services and legal aid for incarcerated sex workers is important in curbing the spread of heterosexual HIV and other STIs in China. Recent legal and social developments suggest that China's RTL system will be transformed in the near future, gaining momentum for reform that could improve the sexual and human rights of incarcerated sex workers.

Underage and underserved: reaching young women who sell sex in Zimbabwe.

PubMed

Busza, Joanna; Mtetwa, Sibongile; Mapfumo, Rumbidzo; Hanisch, Dagmar; Wong-Gruenwald, Ramona; Cowan, Frances

2016-03-01

Young women who sell sex (YWSS) in Southern Africa are highly vulnerable to HIV, as the risks of being young and female in a high prevalence setting coalesce with those of commercial sex. YWSS are less able to negotiate safe sex, more likely to have higher risk partners, and less likely to use available health services compared to older sex workers. In Zimbabwe's national HIV programme for sex workers, fewer than 1% of clients were 15-29. We developed monthly interactive workshops for YWSS based on an Activity Pack consisting of 21 sessions organised into six modules. The aim was to encourage YWSS' interaction with each other, build their trust, confidence and skills, and encourage uptake of clinical services. We conducted a process evaluation to assess programme strengths, identify challenges, and recommend changes. This paper presents findings synthesising programme records with qualitative data and discusses feasibility, acceptability, and outputs during the pilot phase. In total, 143 YWSS attended meetings and most were from the target 15-19-year-old age group. Participants enjoyed the sessions and reported improved cooperation, willingness to negotiate with clients, and self-reflection about their futures. Staff found facilitating sessions easy and activities clear and appropriate. Challenges included identifying appropriate referrals, initial recruitment of women in some sites, and managing participants' requests for financial compensation. The number of clients aged 15-19 increased at sex worker clinics in all sites. This programme is the first to target YWSS in Zimbabwe to address their disproportionately low service use. It proved feasible to staff and acceptable to participants over a one-year period. Given enhanced vulnerability of YWSS, this programme provides one workable model for reaching this underserved group.

NREL Blows Up Batteries to Make the World Safer (Text Version) | NREL

Science.gov Websites

World Safer (Text Version) Making lithium-ion batteries safer for earthlings and astronauts is something very large explosions] Not like that. Matt blows up lithium-ion batteries to test them for safety. Matt technology used by NASA in outer space. Matt and his team study battery failure using innovative technologies

Application of an ecological framework to examine barriers to the adoption of safer conception strategies by HIV-affected couples.

PubMed

Saleem, Haneefa T; Surkan, Pamela J; Kerrigan, Deanna; Kennedy, Caitlin E

2016-01-01

Safer conception interventions can significantly reduce the risk of horizontal HIV transmission between HIV-serodiscordant partners. However, prior to implementing safer conception interventions, it is essential to understand potential barriers to their adoption so that strategies can be developed to overcome these barriers. This paper examines potential barriers to the adoption of safer conception strategies by HIV-affected couples in Iringa, Tanzania using an ecological framework. We interviewed 30 HIV-positive women, 30 HIV-positive men and 30 health providers engaged in delivering HIV-related services. We also conducted direct observations at five health facilities. Findings suggest that there are multiple barriers to safer conception that operate at the individual, relational, environmental, structural, and super-structural levels. The barriers to safer conception identified are complex and interact across these levels. Barriers at the individual level included antiretroviral adherence, knowledge of HIV status, knowledge and acceptability of safer conception strategies, and poor nutrition. At the relational level, unplanned pregnancies, non-disclosure of status, gendered power dynamics within relationships, and patient-provider interactions posed a threat to safer conception. HIV stigma and distance to health facilities were environmental barriers to safer conception. At the structural level there were multiple barriers to safer conception, including limited safer conception policy guidelines for people living with HIV (PLHIV), lack of health provider training in safer conception strategies and preconception counseling for PLHIV, limited resources, and lack of integration of HIV and sexual and reproductive health services. Poverty and gender norms were super-structural factors that influenced and reinforced barriers to safer conception, which influenced and operated across different levels of the framework. Multi-level interventions are needed to ensure

Client demands for unsafe sex: the socio-economic risk environment for HIV among street and off-street sex workers

PubMed Central

DEERING, Kathleen N; LYONS, Tara; FENG, Cindy X; NOSYK, Bohdan; STRATHDEE, Steffanie A; MONTANER, Julio SG; SHANNON, Kate

2013-01-01

Objective Among sex workers (SWs) in Vancouver, Canada, this study identified social, drug use, sex work, environmental-structural and client-related factors associated with being offered and accepting more money after clients' demand for sex without a condom. Design Cross-sectional study using baseline (February/10-October/11) data from a longitudinal cohort of 510 SWs. Methods A two-part multivariable regression model was used to identify factors associated with two separate outcomes: (1) being offered and (2) accepting more money for sex without a condom in the last six months, among those who had been offered more money. Results The sample included 490 SWs. In multivariable analysis, being offered more money for sex without a condom was more likely for SWs who used speedballs, had higher average numbers of clients per week, had difficulty accessing condoms and had clients who visited other SWs. Accepting more money for sex without a condom was more likely for SWs self-reporting as a sexual minority and who had experienced client violence and used crystal methamphetamine use less than daily (vs. none), and less likely for SWs who solicited for clients mainly indoors (vs. outdoor/public places). Conclusions These results highlight the high demand for sex without a condom by clients of SWs. HIV prevention efforts should shift responsibility toward clients to reduce offers of more money for unsafe sex. Programs that mitigate the social and economic risk environments of SWs alongside the removal of criminal sanctions on sex work to enable condom use within safer indoor work spaces are urgently required. PMID:23614990

An action agenda for HIV and sex workers.

PubMed

Beyrer, Chris; Crago, Anna-Louise; Bekker, Linda-Gail; Butler, Jenny; Shannon, Kate; Kerrigan, Deanna; Decker, Michele R; Baral, Stefan D; Poteat, Tonia; Wirtz, Andrea L; Weir, Brian W; Barré-Sinoussi, Françoise; Kazatchkine, Michel; Sidibé, Michel; Dehne, Karl-Lorenz; Boily, Marie-Claude; Strathdee, Steffanie A

2015-01-17

The women, men, and transgender people who sell sex globally have disproportionate risks and burdens of HIV in countries of low, middle, and high income, and in concentrated and generalised epidemic contexts. The greatest HIV burdens continue to be in African female sex workers. Worldwide, sex workers still face reduced access to needed HIV prevention, treatment, and care services. Legal environments, policies, police practices, absence of funding for research and HIV programmes, human rights violations, and stigma and discrimination continue to challenge sex workers' abilities to protect themselves, their families, and their sexual partners from HIV. These realities must change to realise the benefits of advances in HIV prevention and treatment and to achieve global control of the HIV pandemic. Effective combination prevention and treatment approaches are feasible, can be tailored for cultural competence, can be cost-saving, and can help to address the unmet needs of sex workers and their communities in ways that uphold their human rights. To address HIV in sex workers will need sustained community engagement and empowerment, continued research, political will, structural and policy reform, and innovative programmes. But such actions can and must be achieved for sex worker communities everywhere. Copyright © 2015 Elsevier Ltd. All rights reserved.

70 Years of Making the World Safer: Extended

DOE Office of Scientific and Technical Information (OSTI.GOV)

None

Extended version with narration. This video shows our roles in making the world safer — working to end World War II, providing stable isotopes for research, providing unique precision manufacturing capabilities, and meeting nonproliferation and global security missions.

Love grows with sex: teenagers negotiating sex and gender in the context of HIV and the implications for sex education.

PubMed

Bhana, Deevia

2017-03-01

How do teenagers located in the KwaZulu-Natal province of South Africa, the epicentre of the HIV pandemic, give meaning to sexuality? This paper examines teenage black Africans investments in sex and sexuality and the gendered dynamics through which sexuality is articulated. Whilst unequal gender relations of power continue to feature prominently within relationship dynamics fuelling the gendering of HIV, attention to the micro-processes through which relationships are forged remain significant in illustrating the complex connections between love, sex and gender. Drawing on empirical findings with teenagers between the ages of 16 and 17 years old, the paper shows how relationships are conceptualised based on discourses of love. Love is inextricably bound up with sex and when teenagers talk about love and sex they also talk about condom use, multiple sexual partners and gender inequalities. What teenagers were interested in for their sexual relationships was not raised in sex education programmes at school. Implications for addressing teenage constructions of sexuality are discussed in the conclusion.

How sex work becomes an option: Experiences of female sex workers in Kerman, Iran.

PubMed

Karamouzian, Mohammad; Foroozanfar, Zohre; Ahmadi, Azal; Haghdoost, Ali Akbar; Vogel, Joanna; Zolala, Farzaneh

2016-01-01

Sex work is rarely an occupation of choice for Iranian women and is often described as a last resort. While several factors play a role in creating an environment where individuals become involved in sex work, female sex workers' experiences regarding entry into sex work in Iran are poorly understood. In this qualitative study, a convenience sample of 24 participants was recruited from a drop-in centre for vulnerable women in Kerman, Iran. Through in-depth interviews, participants were asked about their personal lived experiences of initiating sex work. Grounded theory was used to analyse findings from this research. We learned that major factors impacting on women's initiation into sex work circulated around their vulnerability and chronic poverty. Participants continued to sell sex due to their limited opportunities, drug dependence and financial needs. Improving sex workers' economic status could be a vital intervention in providing vulnerable women with options other than sex work. Female sex workers should be provided with government support and educational programmes delivered through special centres. Despite the illegal status of their work, sex workers' needs should be recognised across all aspects of policy and legislation.

Substance Use and HIV Among Female Sex Workers and Female Prisoners: Risk Environments and Implications for Prevention, Treatment, and Policies

PubMed Central

Strathdee, Steffanie A.; West, Brooke S.; Reed, Elizabeth; Moazan, Babak; Azim, Tasnim; Dolan, Kate

2015-01-01

Female sex workers (FSWs) and female prisoners experience elevated HIV prevalence relative to the general population because of unprotected sex and unsafe drug use practices, but the antecedents of these behaviors are often structural in nature. We review the literature on HIV risk environments for FSWs and female prisoners, highlighting similarities and differences in the physical, social, economic, and policy/legal environments that need to be understood to optimize HIV prevention, treatment, and policy responses. Sex work venues, mobility, gender norms, stigma, debt, and the laws and policies governing sex work are important influences in the HIV risk environment among FSWs, affecting their exposure to violence and ability to practice safer sex and safer drug use behaviors. Female prisoners are much more likely to have a drug problem than do male prisoners and have higher HIV prevalence, yet are much less likely to have access to HIV prevention and treatment and access to drug treatment in prison. Women who trade sex or are imprisoned and engage in substance use should not be considered in separate silos because sex workers have high rates of incarceration and many female prisoners have a history of sex work. Repeated cycles of arrest, incarceration, and release can be socially and economically destabilizing for women, exacerbating their HIV risk. This dynamic interplay requires a multisectoral approach to HIV prevention and treatment that appreciates and respects that not all women are willing, able, or want to stop sex work or drug use. Women who engage in sex work, use drugs, or are imprisoned come from all communities and deserve sustained access to HIV prevention and treatment for substance use and HIV, helping them and their families to lead healthy and satisfying lives. PMID:25978477

Substance Use and HIV Among Female Sex Workers and Female Prisoners: Risk Environments and Implications for Prevention, Treatment, and Policies.

PubMed

Strathdee, Steffanie A; West, Brooke S; Reed, Elizabeth; Moazen, Babak; Moazan, Babak; Azim, Tasnim; Dolan, Kate

2015-06-01

Female sex workers (FSWs) and female prisoners experience elevated HIV prevalence relative to the general population because of unprotected sex and unsafe drug use practices, but the antecedents of these behaviors are often structural in nature. We review the literature on HIV risk environments for FSWs and female prisoners, highlighting similarities and differences in the physical, social, economic, and policy/legal environments that need to be understood to optimize HIV prevention, treatment, and policy responses. Sex work venues, mobility, gender norms, stigma, debt, and the laws and policies governing sex work are important influences in the HIV risk environment among FSWs, affecting their exposure to violence and ability to practice safer sex and safer drug use behaviors. Female prisoners are much more likely to have a drug problem than do male prisoners and have higher HIV prevalence, yet are much less likely to have access to HIV prevention and treatment and access to drug treatment in prison. Women who trade sex or are imprisoned and engage in substance use should not be considered in separate silos because sex workers have high rates of incarceration and many female prisoners have a history of sex work. Repeated cycles of arrest, incarceration, and release can be socially and economically destabilizing for women, exacerbating their HIV risk. This dynamic interplay requires a multisectoral approach to HIV prevention and treatment that appreciates and respects that not all women are willing, able, or want to stop sex work or drug use. Women who engage in sex work, use drugs, or are imprisoned come from all communities and deserve sustained access to HIV prevention and treatment for substance use and HIV, helping them and their families to lead healthy and satisfying lives.

SAFER Inspection of Space Shuttle Thermal Protection System

NASA Technical Reports Server (NTRS)

Scoville, Zebulon C.; Rajula, Sudhakar

2005-01-01

In the aftermath of the space shuttle Columbia accident, it quickly became clear that new methods would need to be developed that would provide the capability to inspect and repair the shuttle's thermal protection system (TPS). A boom extension to the Remote Manipulator System (RMS) with a laser topography sensor package was identified as the primary means for measuring the damage depth in acreage tile as well as scanning Reinforced Carbon- Carbon (RCC) surfaces. However, concern over the system's fault tolerance made it prudent to investigate alternate means of acquiring close range photographs and contour depth measurements in the event of a failure. One method that was identified early was to use the Simplified Aid For EVA Rescue (SAFER) propulsion system to allow EVA access to damaged areas of concern. Several issues were identified as potential hazards to SAFER use for this operation. First, the ability of an astronaut to maintain controlled flight depends upon efficient technique and hardware reliability. If either of these is insufficient during flight operations, a safety tether must be used to rescue the crewmember. This operation can jeopardize the integrity of the Extra-vehicular Mobility Unit (EMU) or delicate TPS materials. Controls were developed to prevent the likelihood of requiring a tether rescue, and procedures were written to maximize the chances for success if it cannot be avoided. Crewmember ability to manage tether cable tension during nominal flight also had to be evaluated to ensure it would not negatively affect propellant consumption. Second, although propellant consumption, flight control, orbital dynamics, and flight complexity can all be accurately evaluated in Virtual Reality (VR) Laboratory at Johnson Space Center, there are some shortcomings. As a crewmember's hand is extended to simulate measurement of tile damage, it will pass through the vehicle without resistance. In reality, this force will push the crewmember away from the

Adolescents, sex and injecting drug use: risks for HIV infection.

PubMed

Barnard, M; McKeganey, N

1990-01-01

In this paper we present data on the HIV-related risks for adolescents growing up in an area where injecting drug use is prevalent and HIV infection has been identified among local injecting drug users. We report on young peoples' knowledge, attitudes and perceptions of drug use and injectors; HIV and AIDS; sex, safer sex and condom use. These adolescents had an extensive and practically oriented knowledge of illicit drugs and drug injectors. The majority of adolescents contacted had an unsophisticated but approximate understanding of HIV transmission dynamics and how to guard against infection. Our data suggest that many adolescents find issues relating to sex awkward, embarrassing and difficult subjects for discussion. In a final section we consider some of the policy implications of our work focussing in particular on the prevention of injecting, the promotion of condom use, and the necessity of avoiding a focus upon risk groups.

Enhanced gene disruption by programmable nucleases delivered by a minicircle vector.

PubMed

Dad, A-B K; Ramakrishna, S; Song, M; Kim, H

2014-11-01

Targeted genetic modification using programmable nucleases such as zinc finger nucleases (ZFNs) and transcription activator-like effector nucleases (TALENs) is of great value in biomedical research, medicine and biotechnology. Minicircle vectors, which lack extraneous bacterial sequences, have several advantages over conventional plasmids for transgene delivery. Here, for the first time, we delivered programmable nucleases into human cells using transient transfection of a minicircle vector and compared the results with those obtained using a conventional plasmid. Surrogate reporter assays and T7 endonuclease analyses revealed that cells in the minicircle vector group displayed significantly higher mutation frequencies at the target sites than those in the conventional plasmid group. Quantitative PCR and reverse transcription-PCR showed higher vector copy number and programmable nuclease transcript levels, respectively, in 293T cells after minicircle versus conventional plasmid vector transfection. In addition, tryphan blue staining and flow cytometry after annexin V and propidium iodide staining showed that cell viability was also significantly higher in the minicircle group than in the conventional plasmid group. Taken together, our results show that gene disruption using minicircle vector-mediated delivery of ZFNs and TALENs is a more efficient, safer and less toxic method than using a conventional plasmid, and indicate that the minicircle vector could serve as an advanced delivery method for programmable nucleases.

The condom imperative in anal sex - one size may not fit all: a qualitative descriptive study of men who have sex with men.

PubMed

Neville, Stephen; Adams, Jeffery; Moorley, Calvin; Jackson, Debra

2016-12-01

To explore men who have sex with men's views about condom use when having anal intercourse. Internationally, health promotion campaigns use behavioural change strategies to support men who have sex with men to always use condoms when having anal sex with other men. The health promotion message given to this group is consistent and explicitly stated that 'use a condom every time for anal sex regardless of relationship status'. Qualitative analysis of data from a cohort of New Zealand men who have sex with men. A total of 960 useable questionnaires were completed: 571 online and 389 in hard copy. Qualitative data were analysed using a thematic data analytic process. Three themes relating to condom use in men who have sex with men were identified. These are as follows: 'Safer sex is good sex', 'Condom use is good but …' and 'I use condoms sometimes'. The range of responses towards condom use for anal sex in men who have sex with men in our sample reveal this as a complex public health issue, with not all men who have sex with men willing to consistently use condoms. It is important that nurses do not assume that all men who have sex with men are willing to use condoms for anal sex, and should create opportunities for men who have sex with men to raise any concerns about the use of condoms. In this way, nurses can assist in providing information that may help men who have sex with men to make decisions that will minimise risk of contracting infections associated with sexual activity. © 2016 John Wiley & Sons Ltd.

Pharmacology, physiology and performance: occupational drug use and HIV risk among female entertainment and sex workers in Cambodia.

PubMed

Dixon, Thomas Crewe; Ngak, Song; Stein, Ellen; Carrico, Adam; Page, Kimberly; Maher, Lisa

2015-10-16

In Cambodia, HIV prevalence among female entertainment and sex workers (FESW) is up to twenty times higher than in the general population. Use of amphetamine-type stimulants (ATS) has been associated with increased risk of HIV and other sexually transmitted infections in key populations, including FESW. While one in four Cambodian FESW report recent ATS use, little attention has been paid to how the occupational contexts of sex work shape patterns of use. Currently, no HIV prevention interventions target ATS use in this population. We conducted in-depth interviews with FESW (n = 30) with the goal of exploring experiences and motivations for ATS use and informing the development of a conditional cash transfer (CCT) intervention designed to reduce ATS use and HIV risk. Interviews were conducted and transcribed in Khmer and translated into English. Interview narratives were read and re-read and emerging themes reviewed and refined to develop an initial coding scheme. Data were formally coded using both open and axial coding to clarify and consolidate initial themes. The most common driver of ATS use among FESW was increased functionality. ATS was seen as a performance enhancer, acting as an appetite suppressant and enabling women to meet the physiological demands of sex work, including long working hours, multiple clients and extended sexual transactions. While our results are consistent with studies linking ATS use to heightened sexual risk, via unprotected and/or prolonged sex, for women in the current study, the negative consequences of ATS use were outweighed by perceived functional benefits. FESW in Cambodia harness the pharmacological properties of ATS to meet the physiological demands of sex work in a context of limited economic opportunities. There is an urgent need to both provide Cambodian women with options for income generation that do not risk their health and to better regulate the conditions of sex work to provide safer working environments

Correlates of unprotected anal intercourse: the influence of anal sex position among men who have sex with men in Beijing, china.

PubMed

Zhang, Heng; Lu, Hongyan; Pan, Stephen W; Xia, Dongyan; Zhao, Yuejuan; Xiao, Yan; He, Xiong; Yue, Hai; Sun, Zheya; Xu, Yunan; Ruan, Yuhua; Shao, Yiming

2015-02-01

Understanding barriers to consistent condom use among men who have sex with men (MSM) requires consideration of the context in which risk behaviors occur. Anal sex position is one such context. This pooled cross-sectional study used survey data from 1,230 MSM and their 2,618 reported male sexual partnerships. Overall, nearly half of the participants engaged in unprotected anal intercourse (UAI) with at least one of upto three partners in the past 6 months. "Insertive" men engaged in less UAI (39 %) than "receptive" (53 %) or "versatile" (51 %) men. Regardless of sexual position, UAI was associated with cohabiting with a male or female partner and perceiving great or moderate risk of HIV from male contact at the individual level, and steady (vs. casual) partnership at the dyad level. However, early MSM anal sex debut, high number of male partners, alcohol use, receiving and buying condoms, HIV testing, and MSM sex-seeking venues were found to be only statistically significantly correlated with UAI among some but not all sexual positions, implying that interventions to increase condom use should take into account how anal sex position may influence willingness and ability to engage in safer sex. Dyad level data appear to provide additional insight into the influence of sexual positions, and should be used to complement individual data for future intervention designs.

Evaluation of a tobacco prevention programme among teenagers in Sweden.

PubMed

Hedman, Linnéa; Andersson, Martin; Stridsman, Caroline; Rönmark, Eva

2015-05-14

To study the prevalence of tobacco use among teenagers, to evaluate a tobacco prevention programme and to study factors related to participation in the prevention programme. Population-based prospective cohort study. Within the Obstructive Lung disease in Northern Sweden (OLIN) studies, a cohort study about asthma in schoolchildren started in 2006. All children aged 7-8 years in three municipalities were invited to a questionnaire survey and 2585 (96%) participated. The cohort was followed up at age 11-12 years (n=2612, 95% of invited) and 14-15 years (n=2345, 88% of invited). In 2010, some of the children in the OLIN cohort (n=447) were invited to a local tobacco prevention programme and 224 (50%) chose to participate. At the age of 14-15 years, the prevalence of daily smoking was 3.5%. Factors related to smoking were female sex, having a smoking mother, participation in sports and lower parental socioeconomic status (SES). The prevalence of using snus was 3.3% and risk factors were male sex, having a smoking mother, having a snus-using father and non-participation in the prevention programme. In the prevention programme, the prevalence of tobacco use was significantly lower among the participants compared with the controls in the cohort. Factors related to non-participation were male sex, having a smoking mother, lower parental SES and participation in sports. The prevalence of tobacco use was lower among the participants in the tobacco prevention programme compared with the non-participants as well as with the controls in the cohort. However, the observed benefit of the intervention may be overestimated as participation was biased by selection. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Male sex workers in Córdoba, Argentina: sociodemographic characteristics and sex work experiences.

PubMed

Mariño, Rodrigo; Minichiello, Victor; Disogra, Carlos

2003-05-01

To report on the sociodemographic characteristics and work experiences of 31 male sex workers (MSWs) in the city of Córdoba, Argentina. Information on each of the MSWs was collected using a questionnaire that covered his personal characteristics and his work background, self-assessed general health status, and use of health and social services. Scales were included in order to assess attitudes towards condom use, knowledge about safe sex, perceptions about the risk of getting HIV, individual self-efficacy, and locus of control. The questionnaire also asked each respondent to rank his level of agreement with interactive strategies for gaining client compliance with safe sex practices. In terms of their self-identity, out of the 30 MSWs who answered the question, 10 of them (33.3%) self-identified as heterosexual and 9 (30%) as bisexual. Alcohol and drug consumption and unsafe sexual practices were relatively low among the MSWs. Of the 31 MSWs responding, 21 of them (67.7%) reported that they had been tested for HIV, but only 13 of them (41.9%) said they had been vaccinated for either hepatitis A or hepatitis B. A variety of differences were found between the study's 17 street sex workers (sex workers who offer their services in public places such as streets and parks) and the 14 independent sex workers (sex workers who are self-employed, advertise and manage their own business, and have an exclusive location for their commercial sex work). The street MSWs were younger and had less formal education. Independent MSWs were economically more settled, had been working longer in the sex industry, and were more comfortable about having sex with men. Independent MSWs were also more likely to report a gay sexual orientation and less likely to report using alcohol, marijuana, or other substances. The differences between street MSWs and independent MSWs are important since they could influence the negotiating of safer sex practices with clients. Programs aimed at preventing

UNDERSTANDING THE CONTEXT OF HIV RISK BEHAVIOR AMONG HIV-POSITIVE AND HIV-NEGATIVE FEMALE SEX WORKERS AND MALE BAR CLIENTS FOLLOWING ANTIRETROVIRAL THERAPY ROLLOUT IN MOMBASA, KENYA

PubMed Central

McClelland, Lauren; Wanje, George; Kashonga, Frances; Kibe, Lydiah; McClelland, R. Scott; Kiarie, James; Mandaliya, Kishorchandra; Peshu, Norbert; Kurth, Ann

2011-01-01

This study explored perceptions of HIV following local introduction of antiretroviral therapy (ART), among 30 HIV-positive and -negative female sex workers (FSWs) and 10 male bar patrons in Mombasa, Kenya. Semi-structured interviews were analyzed qualitatively to identify determinants of sexual risk behaviors. ART was not perceived as a barrier to safer sex and in some cases led to decreased high-risk behaviors. Barriers to safer sex included economic pressure and sexual partnership types. Many women reported that negotiating condom use is more difficult in long-term partnerships. These women favored short-term partnerships to minimize risk through consistent condom use. For women living with HIV, concern about maintaining health and avoiding HIV superinfection was a strong motivator of protective behaviors. For HIV-negative women, a negative HIV test was a powerful motivator. Incorporation of context- and serostatus-specific factors (e.g., self-protection for HIV-positive women) into tailored prevention counseling may support high-risk women to reduce risk behaviors. PMID:21861605

First flight test results of the Simplified Aid For EVA Rescue (SAFER) propulsion unit

NASA Technical Reports Server (NTRS)

Meade, Carl J.

1995-01-01

The Simplified Aid for EVA Rescue (SAFER) is a small, self-contained, propulsive-backpack system that provides free-flying mobility for an astronaut engaged in a space walk, also known as extravehicular activity (EVA.) SAFER contains no redundant systems and is intended for contingency use only. In essence, it is a small, simplified version of the Manned Maneuvering Unit (MMU) last flown aboard the Space Shuttle in 1985. The operational SAFER unit will only be used to return an adrift EVA astronaut to the spacecraft. Currently, if an EVA crew member inadvertently becomes separated from the Space Shuttle, the Orbiter will maneuver to within the crew member's reach envelope, allowing the astronaut to regain contact with the Orbiter. However, with the advent of operations aboard the Russian MIR Space Station and the International Space Station, the Space Shuttle will not be available to effect a timely rescue. Under these conditions, a SAFER unit would be worn by each EVA crew member. Flight test of the pre-production model of SAFER occurred in September 1994. The crew of Space Shuttle Mission STS-64 flew a 6.9 hour test flight which included performance, flying qualities, systems, and operational utility evaluations. We found that the unit offers adequate propellant and control authority to stabilize and enable the return of a tumbling/separating crew member. With certain modifications, production model of SAFER can provide self-rescue capability to a separated crew member. This paper will present the program background, explain the flight test results and provide some insight into the complex operations of flight test in space.

Alcohol risk management in college settings: the safer California universities randomized trial.

PubMed

Saltz, Robert F; Paschall, Mallie J; McGaffigan, Richard P; Nygaard, Peter M O

2010-12-01

Potentially effective environmental strategies have been recommended to reduce heavy alcohol use among college students. However, studies to date on environmental prevention strategies are few in number and have been limited by their nonexperimental designs, inadequate sample sizes, and lack of attention to settings where the majority of heavy drinking events occur. To determine whether environmental prevention strategies targeting off-campus settings would reduce the likelihood and incidence of student intoxication at those settings. The Safer California Universities study involved 14 large public universities, half of which were assigned randomly to the Safer intervention condition after baseline data collection in 2003. Environmental interventions took place in 2005 and 2006 after 1 year of planning with seven Safer intervention universities. Random cross-sectional samples of undergraduates completed online surveys in four consecutive fall semesters (2003-2006). Campuses and communities surrounding eight campuses of the University of California and six in the California State University system were utilized. The study used random samples of undergraduates (∼500-1000 per campus per year) attending the 14 public California universities. Safer environmental interventions included nuisance party enforcement operations, minor decoy operations, driving-under-the-influence checkpoints, social host ordinances, and use of campus and local media to increase the visibility of environmental strategies. Proportion of drinking occasions in which students drank to intoxication at six different settings during the fall semester (residence hall party, campus event, fraternity or sorority party, party at off-campus apartment or house, bar/restaurant, outdoor setting), any intoxication at each setting during the semester, and whether students drank to intoxication the last time they went to each setting. Significant reductions in the incidence and likelihood of intoxication at

Connecting Toxicology and Chemistry to Ensure Safer Chemical Design

EPA Science Inventory

Designing safer, healthier and sustainable products and processes requires the engagement of toxicologists and the incorporation of twenty-first century toxicology principles and practices. Hazard reduction through molecular design benefits from trans-disciplinary collaboration, ...

Two cross-sectional studies in south India assessing the effect of an HIV prevention programme for female sex workers on reducing syphilis among their clients.

PubMed

Rajaram, Subramanian Potty; Banandur, Pradeep; Thammattoor, Usha K; Thomas, Tinku; Mainkar, Mandar K; Paranjape, Ramesh; Adhikary, Rajatashurva; Duchesne, Thierry; Ramesh, Banadakoppa M; Isac, Shajy; Moses, Stephen; Alary, Michel

2014-11-01

To assess the impact of the Avahan HIV prevention programme for female sex workers (FSWs) in south India on reducing syphilis prevalence among their clients, by comparing rates of syphilis over time as reported in two large-scale surveys of FSWs' clients. A random-effect multilevel logistic regression analysis was performed using syphilis as the dependent variable, with individual independent variables (from the two survey rounds) at level 1 and the district-level programme (from the Avahan computerised monitoring and information system) and contextual variables (from Indian government datasets) at level 2. Programme variables included their 2006 value and their difference in value between 2008 and 2006, as well as the interaction between the latter and the study round. The analysis also controlled for baseline syphilis prevalence and its interaction with the study round. Syphilis decreased significantly among FSWs' clients, from 4.8% (round 1) to 2.6% (round 2), p<0.001. The OR of the interaction term between the difference in programme coverage of FSWs and the round was 0.98 (p=0.023), suggesting that increased coverage was associated with a reduced incidence of syphilis. This study suggests that the Avahan intervention programme among FSWs reduced syphilis rates among their clients. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Combination HIV prevention for female sex workers: what is the evidence?

PubMed

Bekker, Linda-Gail; Johnson, Leigh; Cowan, Frances; Overs, Cheryl; Besada, Donela; Hillier, Sharon; Cates, Willard

2015-01-03

Sex work occurs in many forms and sex workers of all genders have been affected by HIV epidemics worldwide. The determinants of HIV risk associated with sex work occur at several levels, including individual biological and behavioural, dyadic and network, and community and social environmental levels. Evidence indicates that effective HIV prevention packages for sex workers should include combinations of biomedical, behavioural, and structural interventions tailored to local contexts, and be led and implemented by sex worker communities. A model simulation based on the South African heterosexual epidemic suggests that condom promotion and distribution programmes in South Africa have already reduced HIV incidence in sex workers and their clients by more than 70%. Under optimistic model assumptions, oral pre-exposure prophylaxis together with test and treat programmes could further reduce HIV incidence in South African sex workers and their clients by up to 40% over a 10-year period. Combining these biomedical approaches with a prevention package, including behavioural and structural components as part of a community-driven approach, will help to reduce HIV infection in sex workers in different settings worldwide. Copyright © 2015 Elsevier Ltd. All rights reserved.

Socio-demographics, sexual behaviours, and use of HIV prevention services among men who have sex with men and women in Western China.

PubMed

Dai, Zhenzhen; Zhong, Xiaoni; Peng, Bin; Zhang, Yan; Liang, Hao; Peng, HongBin; Zhong, Xiao Hua; Liu, Xiyao; Huang, Ailong

2016-02-01

This paper looks into the differences of sexual risk behaviours and prevention services among men who have sex with men and women and men who have sex with men only. The data from a cross-sectional survey of 159 men who have sex with men and women and 1186 men who have sex with men only in western China is analysed. It is found that men who have sex with men and women, with multiple anal sex partners, have higher rates of selling and buying sex than men who have sex with men only, but obtain less HIV-related knowledge from partners or HIV consulting and testing services. More efforts should be made to promote safer sexual behaviours and reduce the barriers for access to health services. © The Author(s) 2015.

Involving the Hard to Reach: Developing and Evaluating a Sexual Health Programme for Early School Leavers in Hong Kong

ERIC Educational Resources Information Center

Wong, William C. W.; Holroyd, Eleanor A.; Lee, Albert; Wong, Jonathan C. P.; Leung, Phil W. S.

2011-01-01

Early school leavers cannot access school-based sex education programmes, increasing their vulnerability to sexual health issues. This study evaluated a culturally-sensitive and target-orientated sex education programme involving this group. Early school leavers were recruited from two branches of the Chinese Young Men's Christian Association in…

Under construction: building a safer industry.

PubMed Central

Tibbetts, John

2002-01-01

A revolution in the building industry over the past decade has spawned a new generation of safer materials and practices, decreasing some health risks for construction workers. Concerned consumers, builders, materials manufacturers, and government regulatory agencies have all contributed to a turn toward "green" building materials and practices, meaning that homeowners and office workers now are better able to live and work in healthier environments, and many construction workers are handling and installing less-toxic materials. PMID:11882489

Safer handling practice: influence of staff education on older people.

PubMed

Wilson, Christine Brown

The purpose of this small-scale survey was to explore the level of moving and handling training undertaken by nurses within private sector continuing care environments and the potential this training had to influence the care of older people. This study uses a definition of safer handling practice derived from existing literature to examine how nurses report the application of this training and whether they observe changes to the mobility of older people within their care. The limitations of this study indicate that generalizations must be made cautiously. However, this study tentatively suggests that potential exists to influence positively the use of safer handling practice as defined within this study. Recommendations for further study are made.

Pregnancy termination in Matlab, Bangladesh: trends and correlates of use of safer and less-safe methods.

PubMed

DaVanzo, Julie; Rahman, Mizanur

2014-09-01

Menstrual regulation (MR), a relatively safe form of pregnancy termination, is legal in Bangladesh during the early stages of pregnancy. However, little is known about the factors associated with whether women who terminate pregnancies choose this method or a less-safe one. Data from the Matlab Demographic Surveillance System on 122,691 pregnancies-5,221 (4.3%) of which were terminated-were used to examine trends between 1989 and 2008 in termination and in use of safer methods (MR or dilation and curettage) and less-safe (all other) methods of pregnancy termination. Logistic and multinomial logistic regressions were used to assess factors associated with whether women terminate pregnancies and whether they use safer methods. Sixty-seven percent of pregnancy terminations were by safer methods and 33% by less-safe means. The proportion of pregnancies that were terminated increased between 1989 and 2008; this increase was entirely due to increased use of safer methods. Women younger than 18 and those 25 or older were more likely than women aged 20-24 to terminate their pregnancies (odds ratios ranged from 1.5 among women aged 16-17 or 25-29 to 26.1 among those aged 45 or older). Among women who terminated their pregnancies, those aged 25-44 were more likely than those aged 20-24 to use a safer method. Compared with women who had no formal education, those with some education were more likely to terminate their pregnancies and to do so using safer methods. A growing proportion of pregnancies in Matlab are terminated, and these terminations are increasingly done using safer methods.

Problematics of empowerment: sex worker HIV prevention in the Pacific.

PubMed

McMillan, Karen E; Worth, Heather

2016-12-01

A recent overview of HIV/STI prevention programmes for sex workers in the Pacific region indicates that, despite a regional policy shift from universal to targeted interventions, Pacific Island countries currently lack core HIV/STI prevention services for sex workers. Across the region, condom distribution, peer outreach and support services for sex workers have ceased even in countries where such programmes had previously existed. This article cautions that the endorsement of empowerment projects does not negate the important role of condom access in HIV and STI prevention efforts for Pacific sex workers. While community empowerment underpins, and is essential to the sustainability of, effective interventions, it does not constitute an adequate form of HIV and STI prevention in and of itself. We contend that in the context of the Pacific Islands, timely and effective HIV prevention measures must specifically attend to the implementation of, and sustained support for, behavioural interventions such as sex-worker-specific peer education, condom and lubricant distribution, and access to appropriate sexual health services. Further, the responsibility for delivery of these should not be borne solely by fledgling sex worker organizations and communities. The evolution of targeted interventions in the Pacific and the current lack of funded condom distribution programmes highlight a more generalizable imperative within HIV prevention to ensure that behaviour change efforts are not considered to be extraneous to, or rendered redundant by, empowerment-based interventions. © The Author 2015. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Sexual and physical violence against female sex workers in Kenya: a qualitative enquiry.

PubMed

Okal, Jerry; Chersich, Matthew F; Tsui, Sharon; Sutherland, Elizabeth; Temmerman, Marleen; Luchters, Stanley

2011-05-01

Few studies in Africa provide detailed descriptions of the vulnerabilities of female sex workers (FSW) to sexual and physical violence, and how this impacts on their HIV risk. This qualitative study documents FSW's experiences of violence in Mombasa and Naivasha, Kenya. Eighty-one FSW who obtained clients from the streets, transportation depots, taverns, discos and residential areas were recruited through local sex workers trained as peer counsellors to participate in eight focus-group discussions. Analysis showed the pervasiveness of sexual and physical violence among FSW, commonly triggered by negotiation around condoms and payment. Pressing financial needs of FSW, gender-power differentials, illegality of trading in sex and cultural subscriptions to men's entitlement for sex sans money underscore much of this violence. Sex workers with more experience had developed skills to avoid threats of violence by identifying potentially violent clients, finding safer working areas and minimising conflict with the police. Addressing violence and concomitant HIV risks and vulnerabilities faced by FSW should be included in Kenya's national HIV/AIDS strategic plan. This study indicates the need for multilevel interventions, including legal reforms so that laws governing sex work promote the health and human rights of sex workers in Kenya.

Empathy among students in engineering programmes

NASA Astrophysics Data System (ADS)

Rasoal, Chato; Danielsson, Henrik; Jungert, Tomas

2012-10-01

Engineers face challenges when they are to manage project groups and be leaders for organisations because such positions demand skills in social competence and empathy. Previous studies have shown that engineers have low degrees of social competence skills. In this study, the level of empathy as measured by the four subscales of the Interpersonal Reactivity Index, perspective taking, fantasy, empathic distress and empathic concern, among engineering students was compared to students in health care profession programmes. Participants were undergraduate students at Linköping University, 365 students from four different health care profession programmes and 115 students from two different engineering programmes. When the empathy measures were corrected for effects of sex, engineering students from one of the programmes had lower empathy than psychology and social worker students on the fantasy and perspective-taking subscales. These results raise questions regarding opportunities for engineering students to develop their empathic abilities. It is important that engineering students acquire both theoretical and practical knowledge and skills regarding empathy.

Sex work in Tallinn, Estonia: the sociospatial penetration of sex work into society.

PubMed

Aral, S O; St Lawrence, J S; Uusküla, A

2006-10-01

It is important to describe and understand the underlying patterns and dynamics that govern sex work in societies undergoing rapid political and social changes, its heterogeneity across populations, and its evolution through time in order to inform future research, sound policy formation, and programme delivery. To describe the socioeconomic and cultural determinants, organisational structure, distinct categories, and spatial patterning of sex work in Tallinn, Estonia, and identify recent temporal changes in sex work patterns. In-depth interviews with key informants; naturalistic observations of sex work and drug use venues, geo-mapping of sex work sites, review of media, public policy, and commissioned reports, and analyses of existing data. Sex work takes place in a hierarchy of locations in Tallinn ranging from elite brothels and "love flats" to truck stops. These sites vary in terms of their public health importance and social organisation. There are full time, part time, and intermittent male and female sex workers. Among others, the taxi driver, madam and the bartender are central roles in the organisation of sex work in Tallinn. Cell phone and internet technology enable sex work to be highly dispersed and spatially mobile. Future research and programmatic service delivery or outreach efforts should respond to the changing profile of sex work in Tallinn and its implications for STD/HIV epidemiology.

Sex work in Tallinn, Estonia: the sociospatial penetration of sex work into society

PubMed Central

Aral, S O; Lawrence, J S St; Uusküla, A

2006-01-01

Background It is important to describe and understand the underlying patterns and dynamics that govern sex work in societies undergoing rapid political and social changes, its heterogeneity across populations, and its evolution through time in order to inform future research, sound policy formation, and programme delivery. Objectives To describe the socioeconomic and cultural determinants, organisational structure, distinct categories, and spatial patterning of sex work in Tallinn, Estonia, and identify recent temporal changes in sex work patterns. Methods In‐depth interviews with key informants; naturalistic observations of sex work and drug use venues, geo‐mapping of sex work sites, review of media, public policy, and commissioned reports, and analyses of existing data. Results Sex work takes place in a hierarchy of locations in Tallinn ranging from elite brothels and “love flats” to truck stops. These sites vary in terms of their public health importance and social organisation. There are full time, part time, and intermittent male and female sex workers. Among others, the taxi driver, madam and the bartender are central roles in the organisation of sex work in Tallinn. Cell phone and internet technology enable sex work to be highly dispersed and spatially mobile. Conclusion Future research and programmatic service delivery or outreach efforts should respond to the changing profile of sex work in Tallinn and its implications for STD/HIV epidemiology. PMID:16807288

Contributions of an intensive HIV prevention programme in increasing HIV testing among men who have sex with men in Andhra Pradesh, India.

PubMed

Ramesh, Sowmya; Mehrotra, Purnima; Saggurti, Niranjan

2015-01-01

The objective of this study was to identify the factors associated with uptake of HIV testing and to assess their relative contributions in increasing HIV testing. Data are drawn from two rounds of cross-sectional Integrated Behavioural and Biological Assessment (IBBA) surveys of self-identified men who have sex with men (MSM) from Andhra Pradesh, India, recruited through probability-based sampling in 2005-2006 and 2009-2010 (IBBA1, n = 1621; IBBA2, n = 1608, respectively). Logistic regression model was used to assess the relationship between socio-demographic characteristics, sexual behaviours, programme exposure and HIV testing. Significant factors were further parsed using decomposition analysis to examine the contribution of different components of that factor towards the change in HIV testing. There was a significant increase in the proportion of MSM reporting HIV testing from IBBA1 to IBBA2. Higher literacy levels, being 25-34 years old, being a kothi (predominantly receptive), engaging in both commercial and non-commercial sexual relationships and intervention programme exposure contributed the most to the increase in HIV testing.

Increases in knowledge following a course of sex education for people with intellectual disabilities.

PubMed

Lindsay, W R; Bellshaw, E; Culross, G; Staines, C; Michie, A

1992-12-01

Although sex education programmes are thought to be useful in teaching people with intellectual disabilities, there is very little evidence that the material taught is retained by clients. This paper reports data which has been collected routinely on a sex education programme. Forty-six subjects were assessed on their level of sexual knowledge in seven areas: parts of the body, masturbation, male puberty, female puberty, intercourse, pregnancy and childbirth, and birth control and venereal disease. They were retested after a 9-month sex education programme and tested again at a 3-month follow-up. A control group of 14 subjects were tested on two occasions, 4 months apart. There were significant and substantial increases in sexual knowledge on all areas for the experimental group. The control group showed no corresponding increases in knowledge.

Sex determination using the Probabilistic Sex Diagnosis (DSP: Diagnose Sexuelle Probabiliste) tool in a virtual environment.

PubMed

Chapman, Tara; Lefevre, Philippe; Semal, Patrick; Moiseev, Fedor; Sholukha, Victor; Louryan, Stéphane; Rooze, Marcel; Van Sint Jan, Serge

2014-01-01

The hip bone is one of the most reliable indicators of sex in the human body due to the fact it is the most dimorphic bone. Probabilistic Sex Diagnosis (DSP: Diagnose Sexuelle Probabiliste) developed by Murail et al., in 2005, is a sex determination method based on a worldwide hip bone metrical database. Sex is determined by comparing specific measurements taken from each specimen using sliding callipers and computing the probability of specimens being female or male. In forensic science it is sometimes not possible to sex a body due to corpse decay or injury. Skeletalization and dissection of a body is a laborious process and desecrates the body. There were two aims to this study. The first aim was to examine the accuracy of the DSP method in comparison with a current visual sexing method on sex determination. A further aim was to see if it was possible to virtually utilise the DSP method on both the hip bone and the pelvic girdle in order to utilise this method for forensic sciences. For the first part of the study, forty-nine dry hip bones of unknown sex were obtained from the Body Donation Programme of the Université Libre de Bruxelles (ULB). A comparison was made between DSP analysis and visual sexing on dry bone by two researchers. CT scans of bones were then analysed to obtain three-dimensional (3D) virtual models and the method of DSP was analysed virtually by importing the models into a customised software programme called lhpFusionBox which was developed at ULB. The software enables DSP distances to be measured via virtually-palpated bony landmarks. There was found to be 100% agreement of sex between the manual and virtual DSP method. The second part of the study aimed to further validate the method by analysing thirty-nine supplementary pelvic girdles of known sex blind. There was found to be a 100% accuracy rate further demonstrating that the virtual DSP method is robust. Statistically significant differences were found in the identification of sex

Exploring dynamics of anal sex among female sex workers in Andhra Pradesh.

PubMed

Tucker, Saroj; Krishna, Rama; Prabhakar, Parimi; Panyam, Swarup; Anand, Pankaj

2012-01-01

The anal sex among heterosexual couples is on the rise as reported in many scientific studies. Considering that unprotected anal sex has higher risk of human immunodeficiency virus (HIV) transmission than the vaginal sex, we undertook a study to understand the anal sex practices among Female Sex Workers (FSW). The study was conducted among FSW attending 11 randomly selected sexually transmitted infection (STI) clinics in Bill and Melinda Gates supported targeted interventions in Andhra Pradesh. A structured questionnaire was administered to the 555 FSW attending these clinics by project clinic counselors. Informed consent was obtained from all the study participants. Engaging in anal sex was self reported by 22% of sex workers, though demand from clients was reported to be much higher (40%). The reasons for anal sex practices included more money (61%), clout/influence of the client (45%), risk of losing client (27%), and forced sex (1.2%). Factors associated with anal sex were higher number of clients, higher duration of sex work, higher income, and older age group. Associated risks perceived by FSW were bleeding and injury to anal canal (98%) while only 28% associated it with higher HIV transmission risk. Reported Condom and lubricant use was about 88% and 39% respectively. The study shows that there is frequent anal sex, inconsistent condom and infrequent lubricant usage, economic and physical coercion, and low awareness of STI/HIV transmission risk among FSW, which have serious implications for HIV prevention programmes. There is a need to focus on anal sex education and use of lubricants along with condoms during anal sex in FSW-targeted interventions in AP.

NREL, NASA, and UCL Team Up to Make Lithium-Ion Batteries Safer on Earth

Science.gov Websites

and in Space | News | NREL NREL, NASA, and UCL Team Up to Make Lithium-Ion Batteries Safer on Earth and in Space NREL, NASA, and UCL Team Up to Make Lithium-Ion Batteries Safer on Earth and in Space . NREL joined forces with NASA in finding new, more precise ways to trigger internal short circuits

Young women's perceptions of transactional sex and sexual agency: a qualitative study in the context of rural South Africa.

PubMed

Ranganathan, Meghna; MacPhail, Catherine; Pettifor, Audrey; Kahn, Kathleen; Khoza, Nomhle; Twine, Rhian; Watts, Charlotte; Heise, Lori

2017-08-22

educational programmes could be coupled with income generation trainings, in order to leverage youth resilience and protective skills within the confines of difficult economic and social circumstances. This would provide young women with the knowledge and means to more successfully navigate safer sexual relationships.

A NOVEL SAFER CONCEPTION COUNSELING TOOLKIT FOR THE PREVENTION OF HIV: A MIXED-METHODS EVALUATION IN KISUMU, KENYA

PubMed Central

Brown, Joelle; Njoroge, Betty; Akama, Eliud; Breitnauer, Brooke; Leddy, Anna; Darbes, Lynae; Omondi, Richard; Mmeje, Okeoma

2017-01-01

Safer conception strategies can prevent HIV transmission between HIV-discordant partners while allowing them to conceive. However, HIV care providers in sub-Saharan Africa report they are not trained in safer conception, and patients are not routinely offered safer conception services. This mixed-methods pilot study evaluated the impact, acceptability, and feasibility of a novel Safer Conception Counseling Toolkit among providers and patients in Kenya. We enrolled 20 HIV-positive women, 10 HIV-discordant couples, and 10 providers from HIV care and treatment clinics. Providers completed questionnaires before/after training, and then counseled HIV-affected patients. Change in patient knowledge was assessed before/after counseling. Qualitative interviews were conducted among providers and patients. The Toolkit was associated with large, significant increases in patient knowledge, and provider confidence, knowledge, and favorable attitudes toward safer conception counseling; 20% felt confident before versus 100% after training (p < 0.01). PMID:27925487

SAFER vehicle inspection: a multimodal robotic sensing platform

NASA Astrophysics Data System (ADS)

Page, David L.; Fougerolle, Yohan; Koschan, Andreas F.; Gribok, Andrei; Abidi, Mongi A.; Gorsich, David J.; Gerhart, Grant R.

2004-09-01

The current threats to U.S. security both military and civilian have led to an increased interest in the development of technologies to safeguard national facilities such as military bases, federal buildings, nuclear power plants, and national laboratories. As a result, the Imaging, Robotics, and Intelligent Systems (IRIS) Laboratory at The University of Tennessee (UT) has established a research consortium, known as SAFER (Security Automation and Future Electromotive Robotics), to develop, test, and deploy sensing and imaging systems for unmanned ground vehicles (UGV). The targeted missions for these UGV systems include -- but are not limited to --under vehicle threat assessment, stand-off check-point inspections, scout surveillance, intruder detection, obstacle-breach situations, and render-safe scenarios. This paper presents a general overview of the SAFER project. Beyond this general overview, we further focus on a specific problem where we collect 3D range scans of under vehicle carriages. These scans require appropriate segmentation and representation algorithms to facilitate the vehicle inspection process. We discuss the theory for these algorithms and present results from applying them to actual vehicle scans.

Feasibility and initial efficacy of a culturally sensitive women-centered substance use intervention in Georgia: Sex risk outcomes.

PubMed

Jones, Hendrée E; Kirtadze, Irma; Otiashvili, David; Murphy, Keryn; O'Grady, Kevin E; Zule, William; Krupitsky, Evgeny; Wechsberg, Wendee M

2015-12-08

This paper reports on the feasibility and initial efficacy of a culturally sensitive, comprehensive women-centered substance use intervention for women who inject drugs in Georgia in terms of the primary and secondary sex risk outcomes. The hypothesis under examination was that, relative to case management participants, participants in a culturally sensitive, comprehensive women-specific and -centered intervention would, on average, show significant decreases in past-30-day frequency of unprotected sex, unprotected sex at the last sexual encounter, and increases in condom use and safer sex actions. The study was a two-arm randomized trial, in which 173 potentially eligible women were screened, and those 128 women determined to be eligible were assigned at random to either Reinforcement-based Treatment plus Women's Co-Op (RBT + WC) or case management (CM). RBT + WC participants received 12 sessions of a structured intervention with the goal of reducing risky sex and substance use and improving physical and mental health. CM participants received 12 sessions of case management and informational brochures that focused on the same issues on which RBT + WC focused. Participants were assessed at baseline, post-treatment, and 3 months following treatment enrollment. Analyses revealed case management having significantly overall higher Safer Sex action scores than RBT + WC, and a significant decrease over time for past 30-day number of unprotected sex acts. Unprotected sex at the last encounter and Condom Use action scores were nonsignificant. Women who inject drugs in Georgia are engaging in risky sexual practices, and are in need of an intervention that addresses these risky behaviors. Reasons for the failure to find differences between a culturally sensitive, comprehensive women-centered intervention and case management tailored to the needs of women who inject drugs in Georgia may have been the result of inadequate power to detect an effect in a sample

Sex Squad: Engaging Humour to Reinvigorate Sexual Health Education

ERIC Educational Resources Information Center

Gordon, Robert; Gere, David

2016-01-01

The Sex Squad is a collective of US-based college students, who create and perform monologues, scenes and musical parodies for ninth graders (ranging in age from 13 to 15). The Sex Squad is the central element in the "AMP!" programme for adolescent sexual health, developed at the University of California-Los Angeles in collaboration with…

Safer Schools in the UK--A Case Study

ERIC Educational Resources Information Center

Hayden, Carol; Holt, Amanda; Martin, Denise; Nee, Claire

2011-01-01

This article reports a research that is based on a European Safer Schools Partnership that included ten countries and specifically the UK case study which was located in London. The initiators of this partnership had been involved in early SSPs in the UK and the educationalists were very much focussed on work that would address problematic…

Buffering Syndemic Effects in a Sexual Risk-Reduction Intervention for Male Clients of Female Sex Workers: Results From a Randomized Controlled Trial.

PubMed

Pitpitan, Eileen V; Strathdee, Steffanie A; Semple, Shirley J; Chavarin, Claudia V; Magis-Rodriguez, Carlos; Patterson, Thomas L

2015-09-01

We sought to test the efficacy of a sexual risk intervention for male clients of female sex workers (FSWs) and examine whether efficacy was moderated by syndemic risk. From 2010 to 2014, we conducted a 2-arm randomized controlled trial (60-minute, theory-based, safer sex intervention versus a didactic time-equivalent attention control) that included 400 male clients of FSWs on the US-Mexico border with follow-up at 4, 8, and 12 months. We measured 5 syndemic risk factors, including substance use and depression. Primary outcomes were sexually transmitted infections incidence and total unprotected sex with FSWs. Although participants in both groups became safer, there was no significant difference in behavior change between groups. However, baseline syndemic risk moderated intervention efficacy. At baseline, there was a positive association between syndemic risk and unprotected sex. Then at 12 months, longitudinal analyses showed the association depended on intervention participation (B = -0.71; 95% confidence interval [CI] = -1.22, -0.20; P = .007). Among control participants there still existed this modest association (B = 0.36; 95% CI = -0.49, 1.22; P = .09); among intervention participants there was a significant negative association (B = -0.35; 95% CI = -0.63, -0.06; P = .02). A brief intervention might attenuate syndemic risks among clients of FSWs. Other populations experiencing syndemic problems may also benefit from such programs.

Determinants of condom use in female sex workers in Surabaya, Indonesia.

PubMed

Joesoef, M R; Kio, D; Linnan, M; Kamboji, A; Barakbah, Y; Idajadi, A

2000-04-01

In the developing world condom use among sex workers and their clients plays a dominant role in the transmission of HIV/STD. In Surabaya, Indonesia, data from the 1993 STD prevalence survey in female sex workers (brothels, street, massage parlours, barber shops, call-girl houses, and nightclubs) reveal that only 5% (33/692) of the brothel workers and 14% (25/177) of the street walkers had condoms in their possession at the time of the interview. During the last paid sexual intercourse, sex workers from the brothels, streets, and nightclubs used condoms infrequently (14%, 20%, and 25%, respectively). Sex workers from massage parlours, barber shops, and call girls were about 5 to 3 times more likely to use condoms than sex workers from nightclubs (adjusted odds ratio of 3.5, 4.9, and 4.2, respectively); thus condom promotion programmes should be targeted at sex workers at brothels, streets, and nightclubs. Programmes should include: (1) free distribution of condoms to sex establishments at the initial stage, and condom social marketing at later stages; (2) penalties, including legal sanctions, against any sex establishments that do not consistently use condoms; (3) participation of brothel owners and madams in encouraging sex workers to consistently have clients use condoms during sexual intercourse; and (4) establishment of sentinel surveillance to monitor STD/HIV and condom-use compliance.

Safer Sex Media Messages and Adolescent Sexual Behavior: 3-Year Follow-Up Results From Project iMPPACS

PubMed Central

Romer, Daniel; Valois, Robert F.; Vanable, Peter; Carey, Michael P.; Stanton, Bonita; Brown, Larry; DiClemente, Ralph; Salazar, Laura F.

2013-01-01

Objectives. We estimated the long-term (36-month) effects of Project iMPPACS, a multisite randomized controlled trial of mass media and small-group intervention for African American adolescents. Methods. We collected 6 waves of longitudinal data on program participants aged 14 to 17 years (n = 1139) in Providence, Rhode Island; Syracuse, New York; Columbia, South Carolina; and Macon, Georgia, 36 months (December 2009–December 2010) after the intervention began (August 2006–January 2008). Seemingly unrelated regressions at each wave estimated the effects of 3 types of mass media messages (the thematic mediators: selection, pleasure, and negotiation) on condom use intention and self-reported unprotected vaginal sex events. Results. All 3 mediators of behavior change that were introduced during the media intervention were sustained at the follow-up assessments at least 18 months after the intervention ended, with intention having the largest correlation. Unprotected vaginal sex increased with each wave of the study, although cities receiving media exposure had smaller increases. Conclusions. Project iMPPACS demonstrates that mass media influence delivered over an extended period, when adolescents were beginning to learn patterns of behavior associated with sex, persisted after the media program ended. PMID:23153149

Safer sex media messages and adolescent sexual behavior: 3-year follow-up results from project iMPPACS.

PubMed

Hennessy, Michael; Romer, Daniel; Valois, Robert F; Vanable, Peter; Carey, Michael P; Stanton, Bonita; Brown, Larry; DiClemente, Ralph; Salazar, Laura F

2013-01-01

We estimated the long-term (36-month) effects of Project iMPPACS, a multisite randomized controlled trial of mass media and small-group intervention for African American adolescents. We collected 6 waves of longitudinal data on program participants aged 14 to 17 years (n = 1139) in Providence, Rhode Island; Syracuse, New York; Columbia, South Carolina; and Macon, Georgia, 36 months (December 2009-December 2010) after the intervention began (August 2006-January 2008). Seemingly unrelated regressions at each wave estimated the effects of 3 types of mass media messages (the thematic mediators: selection, pleasure, and negotiation) on condom use intention and self-reported unprotected vaginal sex events. All 3 mediators of behavior change that were introduced during the media intervention were sustained at the follow-up assessments at least 18 months after the intervention ended, with intention having the largest correlation. Unprotected vaginal sex increased with each wave of the study, although cities receiving media exposure had smaller increases. Project iMPPACS demonstrates that mass media influence delivered over an extended period, when adolescents were beginning to learn patterns of behavior associated with sex, persisted after the media program ended.

Negotiating the Edge: The Rationalization of Sexual Risk Taking Among Western Male Sex Tourists to Thailand.

PubMed

Bishop, Simon; Limmer, Mark

2017-09-08

Every year thousands of Western men travel to Thailand as sex tourists to participate in paid-for sex. Although many of these men will use condoms to protect themselves against sexually transmitted infections (STIs), others will not, despite the risks. By applying Steven Lyng's (1990) concept of edgework to data collected from 14 face-to-face interviews with male sex tourists in Pattaya, Thailand, and 1,237 online discussion board posts, this article explores the ways in which these men understood and sought to rationalize the sexual risks they took. We argue that notions of likelihood of infection and significance of consequence underpin these behaviors, and we identify the existence of understandings of sexual risk that reject mainstream safer-sex messages and frame condomless sex as a broadly safe activity for heterosexual men. The article concludes by summarizing the difficulties inherent in driving behavior change among this group of men, for whom sexual risks appear to be easily rationalized away as either inconsequential or irrelevant.

Back to Basics: How Young Mothers Learn about Sex and Sexuality

ERIC Educational Resources Information Center

Dudley, James; Crowder, Amanda; Montgomery, Tchernavia R.

2014-01-01

Adolescent pregnancy continues to be a major concern for policy-makers, programme developers, helping professionals and society generally in the USA, especially in light of the US federal government's legislative emphasis on abstinence-only sex education until recently. Studies have found that abstinence-only programmes do not succeed in…

Police violence and sexual risk among female and transvestite sex workers in Serbia: qualitative study

PubMed Central

Simić, Milena; Baroš, Sladjana; Platt, Lucy; Žikić, Bojan

2008-01-01

Objective To explore female and transvestite sex workers’ perceptions of risk in the sex work environment in Serbia. Design Qualitative interview study. Setting Street based locations for sex work in Belgrade and Pancevo, Serbia. Participants 31 female and transvestite sex workers. Results Violence, including police violence, was reported as a primary concern in relation to risk. Violence was linked to unprotected sex and the reduced capacity for avoiding sexual risk. Participants reported that coerced sex was routinely provided to the police in exchange for freedom from detainment, arrest, or fine, and was enforced by the perceived threat of violence, sometimes realised. Accounts contained multiple instances of physical and sexual assault, presented as abuses of police authority, and described policing as a form of moral punishment. This was largely through non-physical means but was also enforced through physical violence, especially towards transvestite and Roma sex workers, whose experience of police violence was reported as relentless and brutal and connected with broader social forces of discrimination in this setting, especially towards Roma. Conclusion Preventing violence towards sex workers, which can link with vulnerability to sexually transmitted infections, is a priority in Serbia. This requires monitoring perpetrators of violence, providing legal support to sex workers, and creating safer environments for sex work. PMID:18667468

Police violence and sexual risk among female and transvestite sex workers in Serbia: qualitative study.

PubMed

Rhodes, Tim; Simic, Milena; Baros, Sladjana; Platt, Lucy; Zikic, Bojan

2008-07-30

To explore female and transvestite sex workers' perceptions of risk in the sex work environment in Serbia. Qualitative interview study. Street based locations for sex work in Belgrade and Pancevo, Serbia. 31 female and transvestite sex workers. Violence, including police violence, was reported as a primary concern in relation to risk. Violence was linked to unprotected sex and the reduced capacity for avoiding sexual risk. Participants reported that coerced sex was routinely provided to the police in exchange for freedom from detainment, arrest, or fine, and was enforced by the perceived threat of violence, sometimes realised. Accounts contained multiple instances of physical and sexual assault, presented as abuses of police authority, and described policing as a form of moral punishment. This was largely through non-physical means but was also enforced through physical violence, especially towards transvestite and Roma sex workers, whose experience of police violence was reported as relentless and brutal and connected with broader social forces of discrimination in this setting, especially towards Roma. Preventing violence towards sex workers, which can link with vulnerability to sexually transmitted infections, is a priority in Serbia. This requires monitoring perpetrators of violence, providing legal support to sex workers, and creating safer environments for sex work.

The Condom Works in All Situations? Paradoxical Messages in Mainstream Sex Education in Sweden

ERIC Educational Resources Information Center

Bolander, Eva

2015-01-01

The condom plays a vital part in safe sex, the ideal outcome of mainstream Swedish sex education. As researchers have pointed out, however, the condom is not a neutral object; rather, it plays a part in shaping, in different ways, both sexual practices and the idea of what sex is. This paper focuses on sex education television programmes produced…

Pushed to the Margins--Sex and Relationships in Greek Primary Textbooks

ERIC Educational Resources Information Center

Gerouki, Margarita

2008-01-01

In 2001, the Greek Government introduced sex and gender relationships education as a thematic unit for interdisciplinary Health Education activities. However, the diffusion of such programmes remains extremely limited. The present paper discusses how sex and relationships issues are presented in contemporary Greek primary school textbooks since…

A Pilot Study of a Group-Based HIV and STI Prevention Intervention for Lesbian, Bisexual, Queer, and Other Women Who Have Sex with Women in Canada.

PubMed

Logie, Carmen H; Lacombe-Duncan, Ashley; Weaver, James; Navia, Daniela; Este, David

2015-06-01

Limited research has evaluated interventions to reduce HIV and sexually transmitted infection (STI) vulnerability among lesbian, bisexual, and queer (LBQ) women, and other women who have sex with women. The Queer Women Conversations (QWC) study examined the effectiveness of a group-based psycho-educational HIV/STI intervention with LBQ women in Toronto and Calgary, Canada. We conducted a nonrandomized cohort pilot study. Participants completed a pre-test, post-test, and 6-week follow-up. The primary outcome was sexual risk practices, while secondary objectives included intrapersonal (self-esteem, STI knowledge, resilient coping, depression), interpersonal (safer sex self-efficacy), community (community connectedness, social support), and structural (sexual stigma, access to healthcare) factors. The study was registered at http://clinicaltrials.gov. Forty-four women (mean age 28.7 years) participated in a weekend retreat consisting of six consecutive sessions tailored for LBQ women. Sessions covered a range of topics addressing behavioral and social-structural determinants of HIV/STI risk, including STI information, safer sex negotiation skills, and addressing sexual stigma. Adjusted for socio-demographic characteristics, sexual risk practices (β2=-2.96, 95% CI -4.43, -1.50), barrier use self-efficacy (β2=1.52, 95% CI 0.51, 2.53), STI knowledge (β2=4.41, 95% CI 3.52, 5.30), and sexual stigma (β2=-2.62, 95% CI -3.48, -1.75) scores showed statistically significant changes 6 weeks post-intervention. Initial increases in safer sex self-efficacy, social support, and community connectedness were not sustained at 6-week follow up, highlighting the need for booster sessions or alternative approaches to address social factors. Study results may inform HIV/STI prevention interventions, sexual health care provision, and support services tailored for LBQ women.

Assessing reported condom use among female sex workers in southern India through examination of condom availability.

PubMed

Bradley, Janet; Moses, Stephen; Blanchard, James F; Rajaram, S; Ramesh, B M; Verma, Supriya; Alary, Michel

2010-02-01

A key indicator of success of HIV prevention programmes is the number of female sex worker (FSW) sex acts protected by condoms. This measure usually relies on FSW reports, which may be biased. We examined condom availability data in five Karnataka districts to estimate the proportion of FSW sex acts potentially protected by condoms. Financial, programme, population, condom and contraceptive data were obtained from governmental and non-governmental sources, surveys and HIV prevention programmes. Sexual behaviour data were obtained from general population and FSW surveys. We examined four scenarios in a sensitivity analysis, each one assuming different proportions of available condoms that might have been used by sex workers. Possible condom use rates for all FSW sex acts ranged from 3%-36% in 2004 to 56%-96% in 2008. The two most realistic scenarios that discounted the number of private sector condoms that might have been bought for sex acts other than with FSWs showed that 16-24% of FSW sex acts could have been protected by condoms in 2004 rising to 77-85% in 2008. These data suggest that condom availability in these Karnataka districts in 2004 was low in relation to the number of FSW sex acts, but rose substantially over the ensuing 4 years. Condom availability data can be useful for triangulation with other available data, such as self-reported condom use, to provide a range of possibilities regarding the number of FSW sex acts protected by condoms.

Performance, power and condom use: reconceptualised masculinities amongst Western male sex tourists to Thailand.

PubMed

Bishop, Simon; Limmer, Mark

2018-03-01

Each year large numbers of Western men travel to Thailand for sex tourism. Although many will use condoms during their sexual encounters, others will not, potentially exposing themselves to the risk of acquiring sexually transmitted infections, including HIV. Although sex tourism in Thailand has been well documented, the social drivers underpinning voluntary sexual risk-taking through the avoidance of condoms remain poorly understood. Engaging with R.W. Connell's concept of hegemonic masculinity and drawing on data collected from 1237 online discussion board posts and 14 face-to-face interviews, this study considers the ways in which understandings and performances of masculinities may inform the sexual risk-taking behaviours of Western male sex tourists. It argues that for some of these men, unprotected sex is viewed not as a reckless behaviour but, instead, as a safe and appropriate masculine practice, supported by relationships that are often framed as romantic and within a setting where HIV is still largely considered a homosexual disease. With sex workers often disempowered to request safer sexual practices, and some men's attitudes towards unprotected sex resistant to external health promotion advice, the paper concludes by considering what this might mean for policy and practice.

McArthur conducts SAFER onboard training during Expedition 12

NASA Image and Video Library

2005-10-21

ISS012-E-06035 (21 October 2005) --- Astronaut William S. McArthur Jr., Expedition 12 commander and NASA science officer, holds a Hand Control Module (HCM) while looking at laptop computer graphics during a Simplified Aid for EVA Rescue (SAFER) training session in the Unity node of the international space station.

McArthur conducts SAFER onboard training during Expedition 12

NASA Image and Video Library

2005-10-21

ISS012-E-06030 (21 October 2005) --- Astronaut William S. McArthur Jr., Expedition 12 commander and NASA science officer, holds a Hand Control Module (HCM) while looking at laptop computer graphics during a Simplified Aid for EVA Rescue (SAFER) training session in the Unity node of the international space station.

Immobilizer-assisted management of metal-contaminated agricultural soils for safer food production.

PubMed

Kim, Kwon-Rae; Kim, Jeong-Gyu; Park, Jeong-Sik; Kim, Min-Suk; Owens, Gary; Youn, Gyu-Hoon; Lee, Jin-Su

2012-07-15

Production of food crops on metal contaminated agricultural soils is of concern because consumers are potentially exposed to hazardous metals via dietary intake of such crops or crop derived products. Therefore, the current study was conducted to develop management protocols for crop cultivation to allow safer food production. Metal uptake, as influenced by pH change-induced immobilizing agents (dolomite, steel slag, and agricultural lime) and sorption agents (zeolite and compost), was monitored in three common plants representative of leafy (Chinese cabbage), root (spring onion) and fruit (red pepper) vegetables, in a field experiment. The efficiency of the immobilizing agents was assessed by their ability to decrease the phytoavailability of metals (Cd, Pb, and Zn). The fruit vegetable (red pepper) showed the least accumulation of Cd (0.16-0.29 mgkg(-1) DW) and Pb (0.2-0.9 mgkg(-1) DW) in edible parts regardless of treatment, indicating selection of low metal accumulating crops was a reasonable strategy for safer food production. However, safer food production was more likely to be achievable by combining crop selection with immobilizing agent amendment of soils. Among the immobilizing agents, pH change-induced immobilizers were more effective than sorption agents, showing decreases in Cd and Pb concentrations in each plant well below standard limits. The efficiency of pH change-induced immobilizers was also comparable to reductions obtained by 'clean soil cover' where the total metal concentrations of the plow layer was reduced via capping the surface with uncontaminated soil, implying that pH change-induced immobilizers can be practically applied to metal contaminated agricultural soils for safer food production. Copyright © 2012 Elsevier Ltd. All rights reserved.

Factors associated with condom use negotiation by female sex workers in Bangladesh.

PubMed

Alam, Nazmul; Chowdhury, Mahbub Elahi; Mridha, Malay K; Ahmed, Anisuddin; Reichenbach, Laura J; Streatfield, Peter Kim; Azim, Tasnim

2013-10-01

Negotiation for condom use by female sex workers with their male clients can enhance condom use. A cross-sectional study was conducted among 1395 female sex workers; 439 from two brothels, 442 from 30 hotels, and 514 from streets of two cities in Bangladesh to determine the predictors of condom use negotiation. Consistent condom use rates in the 7 days prior to interview were reported to be 16.2%, 21.7%, and 4.5% among the brothel, hotel, and street-based female sex workers, respectively. Overall, 28.1% of female sex workers negotiated for condom use with their clients. Participation in behaviour change communication (BCC) programmes (AOR, 1.5; 95% CI, 1.2-2.0) and self-perceived risk of human immunodeficiency virus infection (AOR, 1.8 95% CI, 1.6-2.1) were positive predictors for condom negotiation. Compared to the hotel-based female sex workers, street (AOR, 0.6; 95% CI, 0.4-0.9) and brothel-based female sex workers (AOR, 0.7; 95% CI, 0.5-0.9) were less likely to negotiate for condom use. Female sex workers in Bangladesh are at high risk for sexually transmitted infection / human immunodeficiency virus infection because of low overall negotiation for condom use. Participation in BCC programmes had positive effect on condom negotiation by female sex workers, and should be strengthened in commercial sex venues.

Typology of older female sex workers and sexual risks for HIV infection in China: a qualitative study

PubMed Central

Hao, Chun; Sherman, Susan G.; Jiang, Baofa; Li, Xiaojing; Xu, Yongfang; Jiang, Zhenxia; Zang, Chunpeng

2013-01-01

The HIV epidemic continues to develop among older adults in China, including older female sex workers. Yet, few studies have been conducted among this relatively hidden population. The objectives of this study were to investigate the reasons for women's entry into sex work during their thirties and to develop typology of older women sex workers. Semi-structured in-depth interviews with sixty-three older women sex workers and six focus groups interviews with stakeholders were conducted in three cities in China in 2012. Data were analysed inductively using constant comparative method. The mean age of participants was 43 years old and the mean age of entry into sex work was 39 years old. The primary reasons for entry into sex work include heavy economic burdens, limited employment opportunities, and the appealing nature of sex work. Street-based and venue-based older sex workers were identified based on where they solicited clients. Street-based older sex workers were more likely to engage in unsafe commercial sex due to financial incentives, whereas those in entertainment venues were unlikely to use condoms with regular clients. The development of effective HIV interventions needs to consider older women sex workers unique characteristics and target factors that impede safer sex practices. PMID:23998493

Remembering the message: the use of a reminder cue to increase condom use following a safer sex intervention.

PubMed

Dal Cin, Sonya; MacDonald, Tara K; Fong, Geoffrey T; Zanna, Mark P; Elton-Marshall, Tara E

2006-05-01

Condom use interventions may be more powerful if they provide cues to recall safe-sex messages when sexual activity occurs. The authors tested this notion by assigning sexually active introductory psychology students (N = 196) to a standard safe-sex intervention, a safe-sex with reminder intervention, or a control (drinking and driving) intervention. Participants assigned to the reminder intervention were given a "friendship bracelet" to wear and were instructed to have the bracelet remind them of the intervention. In a follow-up session (5-7 weeks later), they were asked questions pertaining to condom use. Of the 125 participants who had engaged in sexual intercourse, condom use at last intercourse was higher in the bracelet condition (55%) than in the standard (27%) or control (36%) conditions. The authors also found that the bracelet remained effective, even when participants were under the influence of alcohol. These findings therefore imply that health intervention programs may be more efficacious if they include strategies such as reminder cues to increase the salience of health information in the appropriate contexts. 2006 APA, all rights reserved

Building Stakeholder Partnerships for an On-Site HIV Testing Programme

PubMed Central

Woods, William J.; Erwin, Kathleen; Lazarus, Margery; Serice, Heather; Grinstead, Olga; Binson, Diane

2009-01-01

Because of the large number of individuals at risk for HIV infection who visit gay saunas and sex clubs, these venues are useful settings in which to offer HIV outreach programmes for voluntary counselling and testing (VCT). Nevertheless, establishing a successful VCT programme in such a setting can be a daunting challenge, in large part because there are many barriers to managing the various components likely to be involved. Using qualitative data from a process evaluation of a new VCT programme at a gay sauna in California, USA, we describe how the various stakeholders overcame barriers of disparate interests and responsibilities to work together to successfully facilitate a regular and frequent on-site VCT programme that was fully utilized by patrons. PMID:18432424

Social-ecological factors associated with selling sex among men who have sex with men in Jamaica: results from a cross-sectional tablet-based survey.

PubMed

Logie, Carmen H; Lacombe-Duncan, Ashley; Kenny, Kathleen S; Levermore, Kandasi; Jones, Nicolette; Baral, Stefan D; Wang, Ying; Marshall, Annecka; Newman, Peter A

2018-01-01

Globally, men who have sex with men (MSM) experience social marginalization and criminalization that increase HIV vulnerability by constraining access to HIV prevention and care. People who sell sex also experience criminalization, rights violations, and violence, which elevate HIV exposure. MSM who sell sex may experience intersectional stigma and intensified social marginalization, yet have largely been overlooked in epidemiological and social HIV research. In Jamaica, where same sex practices and sex work are criminalized, scant research has investigated sex selling among MSM, including associations with HIV vulnerability. We aimed to examine social ecological factors associated with selling sex among MSM in Jamaica, including exchanging sex for money, shelter, food, transportation, or drugs/alcohol (past 12 months). We conducted a cross-sectional survey with a peer-driven sample of MSM in Kingston, Ocho Rios, and Montego Bay. Multivariable logistic regression analyses were conducted to estimate intrapersonal/individual, interpersonal/social, and structural factors associated with selling sex. Among 556 MSM, one-third (n = 182; 32.7%) reported selling sex. In the final multivariable model, correlates of selling sex included: individual/intrapersonal (lower safer sex self-efficacy [AOR: 0.85, 95% CI: 0.77, 0.94]), interpersonal/social (concurrent partnerships [AOR: 5.52, 95% CI: 1.56, 19.53], a higher need for social support [AOR: 1.08, 95% CI: 1.03, 1.12], lifetime forced sex [AOR: 2.74, 95% 1.65, 4.55]) and structural-level factors (sexual stigma [AOR: 1.09, 95% CI: 1.04, 1.15], food insecurity [AOR: 2.38, 95% CI: 1.41, 4.02], housing insecurity [AOR: 1.94, 95% CI: 1.16, 3.26], no regular healthcare provider [AOR: 2.72, 95% CI: 1.60, 4.64]). This study highlights social ecological correlates of selling sex among MSM in Jamaica, in particular elevated stigma and economic insecurity. Findings suggest that MSM in Jamaica who sell sex experience intensified

Social-ecological factors associated with selling sex among men who have sex with men in Jamaica: results from a cross-sectional tablet-based survey

PubMed Central

Logie, Carmen H.; Lacombe-Duncan, Ashley; Kenny, Kathleen S.; Levermore, Kandasi; Jones, Nicolette; Baral, Stefan D.; Wang, Ying; Marshall, Annecka; Newman, Peter A.

2018-01-01

ABSTRACT Background: Globally, men who have sex with men (MSM) experience social marginalization and criminalization that increase HIV vulnerability by constraining access to HIV prevention and care. People who sell sex also experience criminalization, rights violations, and violence, which elevate HIV exposure. MSM who sell sex may experience intersectional stigma and intensified social marginalization, yet have largely been overlooked in epidemiological and social HIV research. In Jamaica, where same sex practices and sex work are criminalized, scant research has investigated sex selling among MSM, including associations with HIV vulnerability. Objective: We aimed to examine social ecological factors associated with selling sex among MSM in Jamaica, including exchanging sex for money, shelter, food, transportation, or drugs/alcohol (past 12 months). Methods: We conducted a cross-sectional survey with a peer-driven sample of MSM in Kingston, Ocho Rios, and Montego Bay. Multivariable logistic regression analyses were conducted to estimate intrapersonal/individual, interpersonal/social, and structural factors associated with selling sex. Results: Among 556 MSM, one-third (n = 182; 32.7%) reported selling sex. In the final multivariable model, correlates of selling sex included: individual/intrapersonal (lower safer sex self-efficacy [AOR: 0.85, 95% CI: 0.77, 0.94]), interpersonal/social (concurrent partnerships [AOR: 5.52, 95% CI: 1.56, 19.53], a higher need for social support [AOR: 1.08, 95% CI: 1.03, 1.12], lifetime forced sex [AOR: 2.74, 95% 1.65, 4.55]) and structural-level factors (sexual stigma [AOR: 1.09, 95% CI: 1.04, 1.15], food insecurity [AOR: 2.38, 95% CI: 1.41, 4.02], housing insecurity [AOR: 1.94, 95% CI: 1.16, 3.26], no regular healthcare provider [AOR: 2.72, 95% CI: 1.60, 4.64]). Conclusions: This study highlights social ecological correlates of selling sex among MSM in Jamaica, in particular elevated stigma and economic insecurity. Findings

Pre-marital sex and its predicting factors among Malaysian youths.

PubMed

Manaf, Mohd Rizal Abdul; Tahir, Mastura Mohd; Sidi, Hatta; Midin, Marhani; Nik Jaafar, Nik Ruzyanei; Das, Srijit; Malek, Abdul Muizz Abd

2014-01-01

This study aimed to examine the prevalence of pre-marital sex and its predicting factors among youth trainees undergoing a national skill training programme in the state of Malaysia. Participants filled up health screening surveys at the beginning of their training period. A total of 1328 out of 1377 trainees were included in the study. Logistic regression was done to determine the potential predicting factors of pre-marital sex among the trainees. Most trainees were 18 years old (97.1%) and 56% were female and 44% were male. The prevalence of pre-marital sex among trainees of these youths was 4.6%. A total of 6.2% of the female trainees as compared to 2.6% of their male counterpart had had pre-marital sex. Analysis using multiple logistic regression revealed only six significant predictor variables which were religion, race, lover, reading or watching porn, masturbation and bullying. The prevalence of pre-marital sex amongst Malaysian youths is low as compared to those in developed countries. However, as pre-marital sex and pregnancy outside wedlock are largely socially unacceptable in Malaysia and may be kept hidden from others, the complications and social problems that may follow from this behaviour should be taken into consideration. Measures such as sex education and awareness programmes are needed among youth to curb this phenomenon from becoming a social as well as a public health concern. Crown Copyright © 2014. Published by Elsevier Inc. All rights reserved.

Buffering Syndemic Effects in a Sexual Risk-Reduction Intervention for Male Clients of Female Sex Workers: Results From a Randomized Controlled Trial

PubMed Central

Strathdee, Steffanie A.; Semple, Shirley J.; Chavarin, Claudia V.; Magis-Rodriguez, Carlos; Patterson, Thomas L.

2015-01-01

Objectives. We sought to test the efficacy of a sexual risk intervention for male clients of female sex workers (FSWs) and examine whether efficacy was moderated by syndemic risk. Methods. From 2010 to 2014, we conducted a 2-arm randomized controlled trial (60-minute, theory-based, safer sex intervention versus a didactic time-equivalent attention control) that included 400 male clients of FSWs on the US–Mexico border with follow-up at 4, 8, and 12 months. We measured 5 syndemic risk factors, including substance use and depression. Primary outcomes were sexually transmitted infections incidence and total unprotected sex with FSWs. Results. Although participants in both groups became safer, there was no significant difference in behavior change between groups. However, baseline syndemic risk moderated intervention efficacy. At baseline, there was a positive association between syndemic risk and unprotected sex. Then at 12 months, longitudinal analyses showed the association depended on intervention participation (B = −0.71; 95% confidence interval [CI] = –1.22, –0.20; P = .007). Among control participants there still existed this modest association (B = 0.36; 95% CI = –0.49, 1.22; P = .09); among intervention participants there was a significant negative association (B = −0.35; 95% CI = –0.63, –0.06; P = .02). Conclusion. A brief intervention might attenuate syndemic risks among clients of FSWs. Other populations experiencing syndemic problems may also benefit from such programs. PMID:25713953

Teaching Modules to Build HIV/AIDS Knowledge and Safer Sex Skills among African-American College Students

ERIC Educational Resources Information Center

Kanekar, Amar; Sharma, Manoj

2011-01-01

The HIV/AIDS epidemic has taken a tremendous toll on the population of the United States. College students, including African-Americans aged 13-24 years, across the nation are susceptible to contracting sexually transmitted diseases including HIV/AIDS as they participate in unsafe sex practices. The purpose of this article is to provide teaching…

Self-rescue strategies for EVA crewmembers equipped with the SAFER backpack

NASA Technical Reports Server (NTRS)

Williams, Trevor; Baughman, David

1994-01-01

An extravehicular astronaut who becomes separated from a space station has three options available: grappling the station immediately by means of a 'shepherd's crook' device; rescue by either a second crewmember flying an MMU or a robotic-controlled MMU; or self-rescue by means of a propulsive system. The first option requires very fast response by a tumbling astronaut; the second requires constant availability of an MMU, as well as a rendezvous procedure thousands of feet from the station. This paper will consider the third option, propulsive self-rescue. In particular, the capability of the new Simplified Aid for EVA Rescue (SAFER) propulsive backpack, which is to be tested on STS-64 in Sep. 1994, will be studied. This system possesses an attitude hold function that can automatically detumble an astronaut after separation. On-orbit tests of candidate self-rescue systems have demonstrated the need for such a feature. SAFER has a total delta(v) capability of about 10 fps, to cover both rotations and translations, compared with a possible separation rate of 2.5 fps. But the delta(v) required for self-rescue is critically dependent on the delay before return can be initiated, as a consequence of orbital effects. A very important practical question is then whether the total delta(v) of SAFER is adequate to perform self-rescue for worst case values of separation speed, time to detumble, and time for the astronaut to visually acquire the station. This paper shows that SAFER does indeed have sufficient propellant to carry out self-rescue in all realistic separation cases, as well as in cases which are considerably more severe than anything likely to be encountered in practice. The return trajectories and total delta(v)'s discussed are obtained by means of an 'inertial line-of-sight targeting' scheme, derived in the paper, which allows orbital effects to be corrected by making use of the visual information available to the pilot, namely the line-of-sight direction to the

‘Safer Environment Interventions’: A qualitative synthesis of the experiences and perceptions of people who inject drugs

PubMed Central

McNeil, Ryan; Small, Will

2014-01-01

There is growing acknowledgment that social, structural, and environmental forces produce vulnerability to health harms among people who inject drugs (PWID), and safer environment interventions (SEI) have been identified as critical to mitigating the impacts of these contextual forces on drug-related harm. To date, however, SEIs have been under-theorized in the literature, and how they minimize drug-related risks across intervention types and settings has not been adequately examined. This article presents findings from a systematic review and meta-synthesis of qualitative studies reporting PWID’s experiences with three types of SEIs (syringe exchange programmes, supervised injection facilities and peer-based harm reduction interventions) published between 1997 and 2012. This meta-synthesis seeks to develop a comprehensive understanding of SEIs informed by the experiences of PWID. Twenty-nine papers representing twenty-one unique studies that included an aggregate of more than 800 PWID were included in this meta-synthesis. This meta- synthesis found that SEIs fostered social and physical environments that mitigated drug-related harms and increased access to social and material resources. Specifically, SEIs: (1) provided refuge from street-based drug scenes; (2) enabled safer injecting by reshaping the social and environmental contexts of injection drug use; (3) mediated access to resources and health care services; and, (4) were constrained by drug prohibition and law enforcement activities. These findings indicate that it is critical to situate SEIs in relation to the lived experiences of PWID, and in particular provide broader environmental support to PWID. Given that existing drug laws limit the effectiveness of interventions, drug policy reforms are needed to enable public health, and specifically SEIs, to occupy a more prominent role in the response to injection drug use. PMID:24561777

Asymmetric spermatocyte division as a mechanism for controlling sex ratios.

PubMed

Shakes, Diane C; Neva, Bryan J; Huynh, Henry; Chaudhuri, Jyotiska; Pires-Dasilva, Andre

2011-01-18

Although Mendel's first law predicts that crosses between XY (or XO) males and XX females should yield equal numbers of males and females, individuals in a wide variety of metazoans transmit their sex chromosomes unequally and produce broods with highly skewed sex ratios. Here, we report two modifications to the cellular programme of spermatogenesis, which, in combination, help to explain why males of the free-living nematode species Rhabditis sp. SB347 sire <5% male progeny. First, the spermatogenesis programme involves a modified meiosis in which chromatids of the unpaired X chromosome separate prematurely, in meiosis I. Second, during anaphase II, cellular components essential for sperm motility are partitioned almost exclusively to the X-bearing sperm. Our studies reveal a novel cellular mechanism for the differential transmission of X-bearing sperm and suggest Rhabditis sp. SB347 as a useful model for studying sex chromosome drive and the evolution of new mating systems.

Effects of government registration on unprotected sex amongst female sex workers in Tijuana; Mexico.

PubMed

Sirotin, Nicole; Strathdee, Steffanie A; Lozada, Remedios; Abramovitz, Daniela; Semple, Shirley J; Bucardo, Jesús; Patterson, Thomas L

2010-11-01

Sex work is partially regulated in Tijuana, but little is known of its health effects. A recent behavioural intervention amongst female sex workers (FSWs) decreased incidence of HIV/STIs by 40%. We evaluated effects of sex worker regulation on condom use amongst FSWs randomized to this intervention. FSWs aged ≥18 years who reported unprotected sex with ≥1 client in the last 2 months and whether they were registered with Tijuana's Municipal Health Department underwent a brief, theory-based behavioural intervention to increase condom use. At baseline and 6 months, women underwent interviews and testing for HIV, syphilis, Chlamydia trachomatis and Neisseria gonorrhoeae. Negative binomial regression was used to determine the effect of registration on numbers of unprotected sex acts and cumulative HIV/STI incidence. Of 187 women, 83 (44%) were registered. Lack of registration was associated with higher rates of unprotected sex (rate ratio: 1.7, 95% CI: 1.2-2.3), compared to FSWs who were registered, after controlling for potential confounders. Registration predicted increased condom use amongst FSWs enrolled in a behavioural intervention. Public health programmes designed to improve condom use amongst FSWs may benefit from understanding the impact of existing regulation systems on HIV risk behaviours. Copyright © 2010 Elsevier B.V. All rights reserved.

Identifying Subtypes of Spousal Assaulters Using the B-SAFER

ERIC Educational Resources Information Center

Thijssen, Jill; de Ruiter, Corine

2011-01-01

In the present study, a structured risk assessment instrument for intimate partner violence, the Brief Spousal Assault Form for the Evaluation of Risk (B-SAFER), was coded for 146 files of spousal assault cases from the Dutch probation service, dating from 2004 and 2005. The aim of the study was twofold: (a) to validate Holtzworth-Munroe and…

CDC Vital Signs: Making Health Care Safer -- Think Sepsis. Time Matters.

MedlinePlus

... Press Kit Read the MMWR Science Clips Making Health Care Safer Think sepsis. Time matters. Language: English (US) ... the antibiotic type, dose, and duration are correct. Health care facility CEOs/administrators can Make infection control a ...

Streets, drugs, and the economy of sex in the age of AIDS.

PubMed

Weeks, M R; Grier, M; Romero-Daza, N; Puglisi-Vasquez, M J; Singer, M

1998-01-01

Drug addicted women whose economic and social base is urban streets face limited options for income generation and multiple dangers of predation, assault, arrest, and illness. Exchanging sex for money or drugs offers one important source of income in this context. Yet the legal, social, and safety risks associated with these exchanges reduce the likelihood of regular safer sex practices during these encounters, thereby increasing the risk of HIV infection. Such conditions lead women engaged in sexual exchanges for money to varied and complex responses influenced by multiple and often contradictory pressures, both personal and contextual. Street-recruited women drug users in an AIDS prevention program in Hart-ford, Connecticut reported a range of condom use when engaging in sex for money exchanges. This paper explores their differences by ethnicity, economic resources, and drug use, and analyzes these and other factors that impact on street risks through sexual income generation. Surveys and in-depth interviews with drug-addicted women sex workers describe their various approaches to addressing multiple risks on the streets and suggest significant effort by women in these contexts to avoid the many risks, including HIV infection.

Women with intellectual disabilities talk about their perceptions of sex.

PubMed

Bernert, D J; Ogletree, R J

2013-03-01

Sexuality is learned through sexual socialisation that women with intellectual disabilities (IDs) understand and express. Rules of sexual engagement for these women can include barriers for their socialisation, intimate partner selection, and sexual expression. These rules can become more limiting when coupled with rules of femininity that encourage sexual restraint for women. This ethnography explored how women with IDs perceived their sexuality and how sexuality functioned in their lives. Sources of data included 48 multiple and in-depth interviews and observations with 14 women. This article specifically describes how the women constructed 'sex' and how they described experiencing sex as two of their multiple expressions of sexuality in this study. Most of the women had very limited and exclusively heterosexual sexual experiences, and the majority of women reported practicing abstinence. Criteria they identified for sex included having protected sex, marital and monogamous sex for the purpose of procreation or parenting, and having feelings for a sexual partner. Most held negative perceptions of sex they attributed to fear of the first act, fear of experiencing negative consequences, physiological concerns about the act, and perceived or actual lack of pleasure.   Although the women displayed some sense of self-determinism in their sexual behaviour, negative perceptions of sex resulted in self-imposed abstinence predicated by fear of intercourse, intimacy, or outcome. Central to their sexuality education then is increasing self-efficacy perceptions and performance of safer sex practices to prevent negative sexual consequence. Sexuality education from a positive perspective that enhances their sexual self-determinism and encourages sexual health is recommended. © 2012 The Author. Journal of Intellectual Disability Research © 2012 Blackwell Publishing Ltd.

Near elimination of ventricular pacing in SafeR mode compared to DDD modes: a randomized study of 422 patients.

PubMed

Davy, Jean-Marc; Hoffmann, Ellen; Frey, Axel; Jocham, Kurt; Rossi, Stefano; Dupuis, Jean-Marc; Frabetti, Lorenzo; Ducloux, Pascale; Prades, Emmanuel; Jauvert, Gaël

2012-04-01

SafeR performance versus DDD/automatic mode conversion (DDD/AMC) and DDD with a 250-ms atrioventricular (AV) delay (DDD/LD) modes was assessed toward ventricular pacing (Vp) reduction. After a 1-month run-in phase, recipients of dual-chamber pacemakers without persistent AV block and persistent atrial fibrillation (AF) were randomly assigned to SafeR, DDD/AMC, or DDD/LD in a 1:1:1 design. The main endpoint was the percentage of Vp (%Vp) at 2 months and 1 year after randomization, ascertained from device memories. Secondary endpoints include %Vp at 1 year according to pacing indication and 1-year AF incidence based on automatic mode switch device stored episodes. Among 422 randomized patients (73.2±10.6 years, 50% men, sinus node dysfunction 47.4%, paroxysmal AV block 30.3%, bradycardia-tachycardia syndrome 21.8%), 141 were assigned to SafeR versus 146 to DDD/AMC and 135 to DDD/LD modes. Mean %Vp at 2 months was 3.4±12.6% in SafeR versus 33.6±34.7% and 14.0±26.0% in DDD/AMC and DDD/LD modes, respectively (P<0.0001 for both). At 1 year, mean %Vp in SafeR was 4.5±15.3% versus 37.9±34.4% and 16.7±28.0% in DDD/AMC and DDD/LD modes, respectively (P<0.0001 for both). The proportion of patients in whom Vp was completely eliminated was significantly higher in SafeR (69%) versus DDD/AMC (15%) and DDD/LD (45%) modes (P<0.0001 for both), regardless of pacing indication. The absolute risk of developing permanent AF or of remaining in AF for >30% of the time was 5.4% lower in SafeR than in the DDD pacing group (ns). In this selected patient population, SafeR markedly suppressed unnecessary Vp compared with DDD modes. ©2012, The Authors. Journal compilation ©2012 Wiley Periodicals, Inc.

Anal sex and associated HIV-related sexual risk factors among female sex workers in Andhra Pradesh, India.

PubMed

Patra, Rajesh Kumar; Mahapatra, Bidhubhusan; Kovvali, Dolly; Proddutoor, Laxminarayana; Saggurti, Niranjan

2012-11-01

This study aims to understand the correlates of anal sex practices among female sex workers (FSWs) and examine the association of anal sex with HIV-related sexual risk factors in Andhra Pradesh, India. A cross-sectional behavioural survey was conducted in 2011 among 795 FSWs aged 18 years or older. Probability-based cluster sampling was used to select respondents from sex work hotspots. One-quarter (23%) of FSWs had practiced anal sex in the last year. The odds of practicing anal sex were higher among FSWs aged 35 years or more than in those aged less than 25 years (adjusted odds ratio (AOR): 2.05, P<0.05), in those formerly married compared to those currently married (AOR: 1.88, P<0.01), in those having an income only from sex work compared to those having additional sources of income (AOR: 1.54, P<0.05), those reporting heavy alcohol consumption compared to those who did not (AOR: 2.80, P<0.01) and those who experienced violence compared to those who had not (AOR: 2.80, P<0.01). FSWs practicing anal sex were more likely to experience sexually transmissible infection (STI) related symptoms than those practicing only vaginal sex. There was no association between anal sex practice and condom use. Anal sex is associated with STI symptoms, a factor for HIV risk. HIV intervention programmes need to educate FSWs about the risks associated with anal sex.

Inconsistent condom use by male clients during anal intercourse with occasional and regular female sex workers (FSWs): survey findings from southern states of India

PubMed Central

Ramanathan, Shreena; Nagarajan, Karikalan; Ramakrishnan, Lakshmi; Mainkar, Mandar K; Goswami, Prabuddhagopal; Yadav, Diwakar; Sen, Shrabanti; George, Bitra; Rachakulla, Harikumar; Subramanian, Thilakavathi; Paranjape, Ramesh S

2014-01-01

Objectives Self-reported anal intercourse by female sex workers (FSWs) documented in recent studies from India range between 11.9% and 22%. However, comparable data on anal intercourse and condom use from male clients of FSWs is lacking. Using data from a bio-behavioural survey (2009–2010), we examined prevalence of anal intercourse, male clients’ self-reported inconsistent condom use during anal intercourse with FSWs, and correlates of this behaviour in India's high HIV prevalence southern states (Andhra Pradesh, Maharashtra and Tamil Nadu combined). Methods Using two-stage time location cluster sampling, we recruited 4803 clients of FSWs, ages 18–60 years, who had purchased sex from an FSW in the past month. After obtaining informed consent, respondents were interviewed and tested for HIV and sexually transmitted infections (syphilis, gonorrhoea and chlamydia). Logistic regression analysis was used to identify the factors associated with inconsistent condom use during anal intercourse (in the past 6 months) with FSWs. Results Overall, 12.3% clients reported anal intercourse in the past 6 months, of whom 48.4% used condoms inconsistently. Clients of FSWs who were ages 26 years or older (AOR 2.68, p=0.032); employed as manual labourers (AOR 2.43, p=0.013); consumed alcohol (AOR 2.63, p=0.001); reported five or more sex acts with FSWs in the past month (AOR 2.53, p=0.031); and perceived themselves to be at higher risk for HIV (AOR 4.82, p=0.001) were more likely to inconsistently use condoms during anal intercourse. Conclusions The results suggest that sex workers and their clients commonly practice anal intercourse, but a relatively high proportion of clients do not consistently use condoms, leading to a greater risk of acquiring HIV and its further transmission to other male and female sexual partners. Given the multidirectional risk, safer sex communication on heterosexual anal intercourse must be incorporated into HIV prevention programmes. PMID

Organisational readiness: exploring the preconditions for success in organisation-wide patient safety improvement programmes.

PubMed

Burnett, Susan; Benn, Jonathan; Pinto, Anna; Parand, Anam; Iskander, Sandra; Vincent, Charles

2010-08-01

Patient safety has been high on the agenda for more than a decade. Despite many national initiatives aimed at improving patient safety, the challenge remains to find coherent and sustainable organisation-wide safety-improvement programmes. In the UK, the Safer Patients' Initiative (SPI) was established to address this challenge. Important in the success of such an endeavour is understanding 'readiness' at the organisational level, identifying the preconditions for success in this type of programme. This article reports on a case study of the four NHS organisations participating in the first phase of SPI, examining the perceptions of organisational readiness and the relationship of these factors with impact by those actively involved in the initiative. A mixed-methods design was used, involving a survey and semistructured interviews with senior executive leads, the principal SPI programme coordinator and the four operational leads in each of the SPI clinical work areas in all four organisations taking part in the first phase of SPI. This preliminary work would suggest that prior to the start of organisation-wide quality- and safety-improvement programmes, organisations would benefit from an assessment of readiness with time spent in the preparation of the organisational infrastructure, processes and culture. Furthermore, a better understanding of the preconditions that mark an organisation as ready for improvement work would allow policymakers to set realistic expectations about the outcomes of safety campaigns.

Correlates of unprotected sex in a sample of young club drug users

PubMed Central

Remy, Lysa; Narvaez, Joana; Sordi, Anne; Guimarães, Luciano S. P.; Von Diemen, Lisia; Surratt, Hilary; Kurtz, Steven; Pechansky, Flavio

2013-01-01

OBJECTIVES: To assess the demographic characteristics, psychiatric symptoms, substance use patterns, and sexual risk behaviors in a sample of club drug users to identify factors associated with unprotected sex during the 12 months prior to the interview. METHODS: This cross-sectional study employed the targeted sampling and ethnographic mapping approaches via face-to-face interviews conducted at bars and electronic music festivals using an adapted, semi-structured version of the Global Appraisal of Individual Needs questionnaire. The sample comprised 240 male and female young adults who had used ecstasy and/or LSD in the 90 days prior to the interview and who were not receiving treatment for alcohol or drug abuse. RESULTS: Of the 240 subjects selected (mean age: 22.9±4.5 years), 57.9% were men; of the male subjects, 52.5% reported having had unprotected sex in the previous 12 months. Of the total sample, 63.33% reported having had unprotected sex. Multivariate regression analysis showed that anal sex (PR = 1.26; 95% confidence interval (CI): 1.044–1.543; p = 0.017) and the use of alcohol/drugs to make sex last longer (PR = 1.430; 95% CI: 1.181–1.732; p<0.001) are associated with unprotected sex. CONCLUSIONS: The implementation of intervention strategies aimed at reducing sexually risky behaviors should take into consideration the specific characteristics of drug users and should include the development of safer sex negotiation skills. PMID:24270948

Social networks and social support among ball-attending African American men who have sex with men and transgender women are associated with HIV-related outcomes.

PubMed

Arnold, Emily A; Sterrett-Hong, Emma; Jonas, Adam; Pollack, Lance M

2018-02-01

The House Ball Community (HBC) is an understudied network of African American men who have sex with men and transgender women, who join family-like houses that compete in elaborate balls in cities across the United States. From 2011 to 2012, we surveyed 274 recent attendees of balls in the San Francisco Bay Area, focusing on social networks, social support, and HIV-related behaviours. Participants with a high percentage of alters who were supportive of HIV testing were significantly more likely to have tested in the past six months (p = .02), and less likely to have engaged in unprotected anal intercourse (UAI) in the past three months (p = .003). Multivariate regression analyses of social network characteristics, and social support, revealed that testing in the past six months was significantly associated with social support for safer sex, instrumental social support, and age. Similarly, UAI in the past three months was significantly associated with social support for safer sex, homophily based on sexual identity and HIV status. HIV-related social support provided through the HBC networks was correlated with recent HIV testing and reduced UAI. Approaches utilising networks within alternative kinship systems, may increase HIV-related social support and improve HIV-related outcomes.

Sex in advertising research: a review of content, effects, and functions of sexual information in consumer advertising.

PubMed

Reichert, Tom

2002-01-01

This article is a review of academic research on the content and effects of sexual information in advertising (i.e., sex in advertising). In addition to covering common types of sexual content analyzed in research, inquiry on processing and emotional response effects is reviewed. Several areas for continued research are identified, especially with regard to advertisers' use of sexual outcomes as reasons for using brands and the ability of sexual information to influence brand perceptions. This review has applicability to advertising and marketing research and practice, as well as to any area that employs sexual information for persuasive purposes (e.g., safer-sex social marketing campaigns). In addition, it is hoped that sex researchers will recognize and elaborate on the role of sexual response identified in this research to further inform advertising theory and effects research.

HIV infection among foreign transsexual sex workers in Rome: prevalence, behavior patterns, and seroconversion rates.

PubMed

Spizzichino, L; Zaccarelli, M; Rezza, G; Ippolito, G; Antinori, A; Gattari, P

2001-07-01

The Azienda Sanitaria Locale Roma E (ASL-RME) outpatient clinic is the main reference center in Rome for HIV testing of foreign people. To define the prevalence and incidence of HIV infection among foreign transsexual sex workers attending the center. A cross-sectional, follow-up study was conducted. Between 1993 and 1999, 353 transsexuals attended the ASL-RME. They were from Colombia (n = 208), Brazil (n = 122), and other countries (n = 23). Most of these transsexuals reported having 5 to 10 partners per day. The overall HIV prevalence was 38.2%, which multivariate analysis found to be associated with origin from Brazil and a higher number of sex partners. The observed HIV seroconversion rate was 4.1 per 100 person-years, and non-regular condom use was the only factor related to seroconversion. The data from this study suggest that promotion of safer sex practices and regular condom use still is the main priority among marginalized population subgroups, such as foreign prostitutes, involved in sex activities that put them at risk for HIV infection.

Safer sex and condom use: findings from the Second Australian Study of Health and Relationships.

PubMed

de Visser, Richard O; Badcock, Paul B; Rissel, Chris; Richters, Juliet; Smith, Anthony M A; Grulich, Andrew E; Simpson, Judy M

2014-11-01

Background It is important to have current and reliable estimates of the frequency and correlates of condom use among Australian adults. A representative sample of 20094 men and women aged 16-69 years, from all states and territories, completed computer-assisted telephone interviews. The overall participation rate among eligible people was 66.2%. Although most respondents had used a condom at some time in their lives, fewer than half of those who were sexually active in the year before being interviewed had used a condom in that year. Condom use in the last year was associated with youth, speaking a language other than English at home, bisexual identity, greater education, residence in major cities, lower income and having multiple sexual partners in the last year. One-quarter of respondents used a condom the last time they had vaginal intercourse and one-sixth of these were put on after genital contact. Condom use during most recent vaginal sex was associated with youth, lower income, having sex with a non-regular partner and not using another form of contraception. Condom use appears to have increased between 2001-02 and 2012-13. Consistent with other research, this study showed that condom use was strongly associated with partner type and use of other contraception. There may be a need to highlight among people with multiple sexual partners the fact that non-barrier methods of contraception do not offer protection against sexually transmissible infections. The finding that many condoms were applied after genital contact suggests a need to promote both use and correct use of condoms.

Speaking of sex workers: How suppression of research has distorted the United States' domestic HIV response.

PubMed

Forbes, Anna

2015-05-01

Sex workers remain a vulnerable population at risk for HIV acquisition and transmission. Research suggests that interventions at the individual level, such as condom distribution, are less effective in preventing HIV among sex workers than structural changes such as allowing safer work settings and reducing the harassment and abuse of sex workers by clients and police. In the US, HIV incidence has not declined in the last decade. This may be due in part to its policy of wilful ignorance about sex work, but the data to resolve the question simply do not exist. Political actions such as PEPFAR's prostitution pledge and a congressional campaign against "waste, fraud and abuse" in research are products of an ideological environment that suppresses research on HIV prevention and treatment needs of sex workers. Even basic prevalence data are missing because there is no "sex worker" category in the US National HIV Behavior Surveillance System. However, international efforts are taking a public health approach and are calling for decriminalization of sex work, as the most effective public health strategy for reducing HIV incidence among sex workers. Although such an approach is not yet politically feasible in the US, some urgent practical policy changes can be implemented to improve data collection and generation of evidence to support HIV prevention and treatment programs targeting sex workers. Copyright © 2015. Published by Elsevier Ltd.

Safety and fitness electronic records (SAFER) system : logical architecture document : working draft

DOT National Transportation Integrated Search

1997-01-31

This Logical Architecture Document includes the products developed during the functional analysis of the Safety and Fitness Electronic Records (SAFER) System. This document, along with the companion Operational Concept and Physical Architecture Docum...

A Safer Formulation Concept for Flame-Generated Engineered Nanomaterials

PubMed Central

Gass, Samuel; Cohen, Joel M.; Pyrgiotakis, Georgios; Sotiriou, Georgios A.; Pratsinis, Sotiris E.; Demokritou, Philip

2013-01-01

The likely success or failure of the nanotechnology industry depends on the environmental health and safety of engineered nanomaterials (ENMs). While efforts toward engineering safer ENMs are sparse, such efforts are considered crucial to the sustainability of the nanotech industry. A promising approach in this regard is to coat potentially toxic nanomaterials with a biologically inert layer of amorphous SiO2. Core-shell particles exhibit the surface properties of their amorphous SiO2 shell while maintaining specific functional properties of their core material. A major challenge in the development of functional core-shell particles is the design of scalable high-yield processes that can meet large-scale industrial demand. Here, we present a safer formulation concept for flame-generated ENMs based on a one-step, in flight SiO2 encapsulation process, which was recently introduced by the authors as a means for a scalable manufacturing of SiO2 coated ENMs. Firstly, the versatility of the SiO2-coating process is demonstrated by applying it to four ENMs (CeO2, ZnO, Fe2O3, Ag) marked by their prevalence in consumer products as well as their range in toxicity. The ENM-dependent coating fundamentals are assessed and process parameters are optimized for each ENM investigated. The effects of the SiO2-coating on core material structure, composition and morphology, as well as the coating efficiency on each nanostructured material, are evaluated using state-of-the-art analytical methods (XRD, N2 adsorption, TEM, XPS, isopropanol chemisorption). Finally, the biological interactions of SiO2-coated vs. uncoated ENMs are evaluated using cellular bioassays, providing valuable evidence for reduced toxicity for the SiO2-coated ENMs. Results indicate that the proposed ‘safer by design’ concept bears great promise for scaled-up application in industry in order to reduce the toxicological profile of ENMs for certain applications. PMID:23961338

Development of Methods to Evaluate Safer Flight Characteristics

NASA Technical Reports Server (NTRS)

Basciano, Thomas E., Jr.; Erickson, Jon D.

1997-01-01

The goal of the proposed research is to begin development of a simulation that models the flight characteristics of the Simplified Aid For EVA Rescue (SAFER) pack. Development of such a simulation was initiated to ultimately study the effect an Orbital Replacement Unit (ORU) has on SAFER dynamics. A major function of this program will be to calculate fuel consumption for many ORUs with different masses and locations. This will ultimately determine the maximum ORU mass an astronaut can carry and still perform a self-rescue without jettisoning the unit. A second primary goal is to eventually simulate relative motion (vibration) between the ORU and astronaut. After relative motion is accurately modeled it will be possible to evaluate the robustness of the control system and optimize performance as needed. The first stage in developing the simulation is the ability to model a standardized, total, self-rescue scenario, making it possible to accurately compare different program runs. In orbit an astronaut has only limited data and will not be able to follow the most fuel efficient trajectory; therefore, it is important to correctly model the procedures an astronaut would use in orbit so that good fuel consumption data can be obtained. Once this part of the program is well tested and verified, the vibration (relative motion) of the ORU with respect to the astronaut can be studied.

Intimate relationships of Devadasi sex workers in South India: An exploration of risks of HIV/STI transmission.

PubMed

Ramanaik, Satyanarayana; Thompson, Laura H; du Plessis, Elsabé; Pelto, Pertti; Annigeri, Vinod; Doddamane, Mahesh; Bhattacharjee, Parinita; Shaw, Souradet Y; Deering, Kathleen; Khan, Shamshad; Halli, Shiva S; Lorway, Robert

2014-01-01

Global literature on female sex workers suggests that being in an intimate relationship is associated with barriers to practising safe sex behaviours. Condom use within intimate relationships is often seen as a sign of infidelity and fosters mistrust which could affect longevity, trust and intimacy within partnerships. Using qualitative data from Devadasi sex workers and their intimate male partners in Bagalkot District, Karnataka, India, we examined both partners' perspectives to understand the quality and dynamics of these relationships and the factors that influence condom use in intimate relationships. Our thematic analysis of individual interviews conducted in May 2011 with 20 couples suggests that many Devadasi sex workers and their intimate partners define their relationships as 'like marriage' which reduced their motivation to use condoms. Evidence from this study suggests that active participation in sex workers' collectives (sanghas) can increase condom use, education and family planning services, among other things, and could be helpful for both Devadasis and their intimate partners to better understand and accept safer sexual practices. Our work has direct implications for designing couple-based health interventions for traditional Devadasi sex workers and their intimate partners in India.

The Treatment Advocacy Program: A Randomized Controlled Trial of a Peer-Led Safer Sex Intervention for HIV-Infected Men Who Have Sex with Men

ERIC Educational Resources Information Center

McKirnan, David J.; Tolou-Shams, Marina; Courtenay-Quirk, Cari

2010-01-01

Objective: Primary care may be an effective venue for delivering behavioral interventions for sexual safety among HIV-positive men who have sex with men (MSM); however, few studies show efficacy for such an approach. We tested the efficacy of the Treatment Advocacy Program (TAP), a 4-session, primary-care-based, individual counseling intervention…

Safer staining method for acid fast bacilli.

PubMed Central

Ellis, R C; Zabrowarny, L A

1993-01-01

To develop a method for staining acid fast bacilli which excluded highly toxic phenol from the staining solution. A lipophilic agent, a liquid organic detergent, LOC High Studs, distributed by Amway, was substituted. The acid fast bacilli stained red; nuclei, cytoplasm, and cytoplasmic elements stained blue on a clear background. These results compare very favourably with acid fast bacilli stained by the traditional method. Detergents are efficient lipophilic agents and safer to handle than phenol. The method described here stains acid fast bacilli as efficiently as traditional carbol fuchsin methods. LOC High Suds is considerably cheaper than phenol. Images PMID:7687254

Safer staining method for acid fast bacilli.

PubMed

Ellis, R C; Zabrowarny, L A

1993-06-01

To develop a method for staining acid fast bacilli which excluded highly toxic phenol from the staining solution. A lipophilic agent, a liquid organic detergent, LOC High Studs, distributed by Amway, was substituted. The acid fast bacilli stained red; nuclei, cytoplasm, and cytoplasmic elements stained blue on a clear background. These results compare very favourably with acid fast bacilli stained by the traditional method. Detergents are efficient lipophilic agents and safer to handle than phenol. The method described here stains acid fast bacilli as efficiently as traditional carbol fuchsin methods. LOC High Suds is considerably cheaper than phenol.

The nexus of nursing leadership and a culture of safer patient care.

PubMed

Murray, Melanie; Sundin, Deborah; Cope, Vicki

2018-03-01

To explore the connection between +6 nursing leadership and enhanced patient safety. Critical reports from the Institute of Medicine in 1999 and Francis QC report of 2013 indicate that healthcare organisations, inclusive of nursing leadership, were remiss or inconsistent in fostering a culture of safety. The factors required to foster organisational safety culture include supportive leadership, effective communication, an orientation programme and ongoing training, appropriate staffing, open communication regarding errors, compliance to policy and procedure, and environmental safety and security. As nurses have the highest patient interaction, and leadership is discernible at all levels of nursing, nurse leaders are the nexus to influencing organisational culture towards safer practices. The position of this article was to explore the need to form a nexus between safety culture and leadership for the provision of safe care. Safety is crucial in health care for patient safety and patient outcomes. A culture of safety has been exposed as a major influence on patient safety practices, heavily influenced by leadership behaviours. The relationship between leadership and safety plays a pivotal role in creating positive safety outcomes for patient care. A safe culture is one nurtured by effective leadership. Patient safety is the responsibility of all healthcare workers, from the highest executive to the bedside nurse, thus effective leadership throughout all levels is essential in engaging staff to provide high quality care for the best possible patient outcomes. © 2017 John Wiley & Sons Ltd.

Sexual practices, identities and health among women who have sex with women in Lesotho - a mixed-methods study.

PubMed

Poteat, Tonia; Logie, Carmen; Adams, Darrin; Lebona, Judith; Letsie, Puleng; Beyrer, Chris; Baral, Stefan

2014-01-01

Despite the high prevalence of HIV and STIs among women in Africa and the growing literature on HIV and STIs among women who have sex with women, research on the sexual health of women who have sex with women in Africa is scant. This study used mixed methods to describe sexual identity, practices and health among women who have sex with women in Lesotho. Most respondents (48%) described themselves as lesbian, 29% as bisexual and 23% as heterosexual. Almost half (45%) had disclosed their same-sex attraction to family, but only 25% had done so with healthcare workers. A total of 8% reported having HIV. Self-reported HIV was associated with having three or more male partners, having male and female partners at the same time and having a history of STIs. Gender norms, the criminalisation of homosexuality, varied knowledge of, and access to, safer-sex strategies, and mixed experiences of HIV/STI testing and sexual healthcare provided social and structural contexts for HIV- and STI-related vulnerability.

The role of a regular sex partner in sexually transmitted infections and reinfections: results from the study of female entertainment establishment workers in the Philippines.

PubMed

Chiao, Chi; Morisky, Donald E

2007-08-01

The main objective of this study is to understand the association between living with a regular sex partner, risk-taking behaviors, and one's history of sexually transmitted infections (STIs). Data on sexual behavior and STI histories were obtained from 876 Filipina entertainment establishment workers (FEEWs) through a large-scale participatory research survey. About one-third of FEEWs live with a regular sex partner. Single FEEWs are significantly more likely than partnered FEEWs to engage in commercial sex. Being single, engaging in commercial sex, and using condoms inconsistently, in turn, are significantly associated with a positive STI history. These results suggest that living with a regular sex partner is an independent and protective factor against having an initial STI and subsequent reinfection. Programmatic strategies aimed at reducing STIs among entertainment establishment workers through promoting safer sex behaviors could potentially benefit by including a component that addresses sexual networks.

Notions of Sex, Sexuality and Relationships among Adolescent Boys in Rural Southeastern Nigeria

ERIC Educational Resources Information Center

Izugbara, C. Otutubikey

2004-01-01

Although young people in Nigeria become sexually active at a very early age, little is known about how they view sex, sexuality, and relationships with the opposite sex. Yet knowledge of their notions and expectations regarding these issues has the potential to improve care and inform the development of sexuality education programmes. This paper…

Building social capital in healthcare organizations: thinking ecologically for safer care.

PubMed

Hofmeyer, Anne; Marck, Patricia B

2008-01-01

Research on patient safety and health human resources, 2 critical issues for 21st century healthcare, converges on similar findings. Specifically, it is apparent that along with the patients, families, and communities we serve, nurses and other healthcare professionals navigate a volatile health care system where persistent restructuring, market pressures, and workforce instability present ongoing threats to the delivery of safer care. Drawing from the fields of nursing, healthcare ethics, health systems management, and ecological restoration, we outline the role of social capital for organizational integrity, healthy workplace cultures, sustainable resource management, improved nurse retention, effective knowledge translation, and safer patient care. Nursing leaders can use ecological thinking to build the vital resource of social capital by taking concrete steps to commit the necessary human and material resources to: (1) forge relations to foster bonding, bridging and linking social capital; (2) build solidarity and trust; (3) foster collective action and cooperation; (4) strengthen communication and knowledge exchange; and (5) create capacity for social cohesion and inclusion.

HIV Prevention Among Women Who Use Substances And Report Sex Work: Risk Groups Identified Among South African Women.

PubMed

Wechsberg, Wendee M; Peasant, Courtney; Kline, Tracy; Zule, William A; Ndirangu, Jacqueline; Browne, Felicia A; Gabel, Colby; van der Horst, Charles

2017-11-01

This cross-sectional study presents baseline data from women (n = 641) in a community-based randomized trial in Pretoria, South Africa. Women were eligible if they reported recent alcohol or other drug (AOD) use and condomless sex. Latent class analyses were conducted separately for those who reported sex work and those who did not. Among those who reported sex work, a Risky Sex class (n = 72, 28%) and Low Sexual Risk class (n = 190, 73%) emerged. Those in the Risky Sex class were more likely to report that their last episode of sexual intercourse was with their boyfriend (vs. a client/other partner) compared with the Low Sexual Risk class (p < 0.001). Among participants who did not report sex work, a Drug-Using, Violence-Exposed, and Impaired Sex class (n = 53; 14%) and Risky Sex and Moderate Drinking class (n = 326; 86%) emerged. The findings suggest that interventions for women who engage in sex work should promote safer sexual behavior and empowerment with main partners. Women who use AODs, experience physical or sexual violence, and have impaired sex may be a key population at risk for HIV and should be considered for tailored behavioral interventions in conjunction with South Africa's plan to disseminate HIV prevention methods to vulnerable women. ClinicalTrials.gov registration NCT01497405.

Estimation of the size of the female sex worker population in Rwanda using three different methods

PubMed Central

Kayitesi, Catherine; Gwiza, Aimé; Ruton, Hinda; Koleros, Andrew; Gupta, Neil; Balisanga, Helene; Riedel, David J; Nsanzimana, Sabin

2014-01-01

HIV prevalence is disproportionately high among female sex workers compared to the general population. Many African countries lack useful data on the size of female sex worker populations to inform national HIV programmes. A female sex worker size estimation exercise using three different venue-based methodologies was conducted among female sex workers in all provinces of Rwanda in August 2010. The female sex worker national population size was estimated using capture–recapture and enumeration methods, and the multiplier method was used to estimate the size of the female sex worker population in Kigali. A structured questionnaire was also used to supplement the data. The estimated number of female sex workers by the capture–recapture method was 3205 (95% confidence interval: 2998–3412). The female sex worker size was estimated at 3348 using the enumeration method. In Kigali, the female sex worker size was estimated at 2253 (95% confidence interval: 1916–2524) using the multiplier method. Nearly 80% of all female sex workers in Rwanda were found to be based in the capital, Kigali. This study provided a first-time estimate of the female sex worker population size in Rwanda using capture–recapture, enumeration, and multiplier methods. The capture–recapture and enumeration methods provided similar estimates of female sex worker in Rwanda. Combination of such size estimation methods is feasible and productive in low-resource settings and should be considered vital to inform national HIV programmes. PMID:25336306

Estimation of the size of the female sex worker population in Rwanda using three different methods.

PubMed

Mutagoma, Mwumvaneza; Kayitesi, Catherine; Gwiza, Aimé; Ruton, Hinda; Koleros, Andrew; Gupta, Neil; Balisanga, Helene; Riedel, David J; Nsanzimana, Sabin

2015-10-01

HIV prevalence is disproportionately high among female sex workers compared to the general population. Many African countries lack useful data on the size of female sex worker populations to inform national HIV programmes. A female sex worker size estimation exercise using three different venue-based methodologies was conducted among female sex workers in all provinces of Rwanda in August 2010. The female sex worker national population size was estimated using capture-recapture and enumeration methods, and the multiplier method was used to estimate the size of the female sex worker population in Kigali. A structured questionnaire was also used to supplement the data. The estimated number of female sex workers by the capture-recapture method was 3205 (95% confidence interval: 2998-3412). The female sex worker size was estimated at 3348 using the enumeration method. In Kigali, the female sex worker size was estimated at 2253 (95% confidence interval: 1916-2524) using the multiplier method. Nearly 80% of all female sex workers in Rwanda were found to be based in the capital, Kigali. This study provided a first-time estimate of the female sex worker population size in Rwanda using capture-recapture, enumeration, and multiplier methods. The capture-recapture and enumeration methods provided similar estimates of female sex worker in Rwanda. Combination of such size estimation methods is feasible and productive in low-resource settings and should be considered vital to inform national HIV programmes. © The Author(s) 2015.

Monitoring HIV Prevention Programme Outcomes among Key Populations in Kenya: Findings from a National Survey

PubMed Central

Musyoki, Helgar; Anthony, John; Kioko, Japheth; Kaosa, Shem; Ogwang, Bernard E.; Githuka, George; Sirengo, Martin; Birir, Sarah; Blanchard, James F.; Muraguri, Nicholas; Isac, Shajy; Moses, Stephen

2015-01-01

In preparation for the implementation of the Kenya AIDS Strategic Framework 2014/15-2018/19, the Kenya National AIDS and STI Control Programme facilitated a national polling booth survey as part of a baseline assessment of HIV-related risk behaviours among FSWs, MSM, and PWID, and their utilization of existing preventive interventions, as well as structural factors that may influence KPs’ vulnerability to HIV. The survey was conducted among “key populations” (female sex workers, men who have sex with men, and people who inject drugs) to understand current HIV risk and prevention behaviours, utilization of existing programmes and services, and experiences of violence. In total, 3,448 female sex workers, 1,308 men who have sex with men, and 690 people who inject drugs were randomly selected to participate in polling booth survey sessions from seven priority sites. Survey responses were aggregated and descriptive statistics derived. In general, reported condom use among all key populations was quite high with paying clients, and lower with regular, non-paying partners. Many participants reported unavailability of condoms or clean injecting equipment within the past month. Exposure to, and utilization of, existing HIV prevention services varied significantly among the groups, and was reported least commonly by female sex workers. Encouragingly, approximately three-quarters of all key population members reported receiving an HIV test in the past three months. All key population groups reported experiencing high levels of physical and sexual violence from partners/clients, and/or arrest and violence by law enforcement officials. Although some of the findings are encouraging, there is room for improvement in HIV prevention programmes and services for key populations across Kenya. PMID:26313642

An Evaluation of Mpowerment on Individual-Level HIV Risk Behavior, Testing, and Psychosocial Factors Among Young MSM of Color: The Monitoring and Evaluation of MP (MEM) Project.

PubMed

Shelley, Gene; Williams, Weston; Uhl, Gary; Hoyte, Tamoka; Eke, Adanze; Wright, Carolyn; Rebchook, Gregory; Pollack, Lance; Bell, Kelly; Wang, Yan; Cheng, Qi; Kegeles, Susan M

2017-02-01

Young men who have sex with men (MSM) of color are at increased risk for HIV infection. Mpowerment (MP) is an intervention designed to reduce risky sexual behavior and increase HIV testing among young MSM ages 18-29. From 2009 to 2012, three community-based organizations with support from the U.S. Centers for Disease Control and Prevention evaluated MP among N = 298 participants. Following a repeated measures design, data from 3- and 6-month follow-ups were compared to baseline. HIV testing and self-efficacy for safer sex increased at both follow-up time points; self-acceptance as an MSM was higher at follow-up 2. Condomless anal/vaginal sex was lower at follow-up 1 only. Frequency of exchange of safer sex messages among gay/bisexual/transgender friends was lower at follow-up 1, but similar to baseline at follow-up 2. Exposure to MP was associated with improved perceived positive social norms about safer sex and safer sex messages among gay/bisexual/transgender friends.

Entertainment-education in the context of humor: effects on safer sex intentions and risk perceptions.

PubMed

Moyer-Gusé, Emily; Mahood, Chad; Brookes, Sarah

2011-12-01

Past research has examined the effects of entertainment narratives on story-related behaviors, but most has focused primarily on dramatic genres rather than comedy. The present study examines how the presence or absence of pregnancy-related humor influences viewers' counterarguing, perceived severity, and intentions to engage in unprotected sexual behavior. Results were consistent with expectations in that related humor reduced counterarguing while also trivializing the severity of the consequences of sexual behavior. When the pregnancy storyline was presented in its original humorous context, viewers reported greater intentions to engage in unprotected sex than when pregnancy was presented in a more serious tone. Model testing clarified this finding by revealing the underlying mechanisms. Practical and theoretical implications are discussed.

Television and sex-role acquisition. 1: Content.

PubMed

Durkin, K

1985-06-01

Television has earned considerable public and academic criticism in recent years for the alleged bias in its sex-role content. A fundamental concern of many critics is with the representation of male and female roles that confronts children. This paper reviews the evidence accumulating from numerous content analyses of both adult and children's television. Overall, the evidence confirms that there are marked differences in the ways the medium presents the sexes. These differences are both quantitative and qualitative but the general pattern at either level is to present males as dominant and females as nurturant and complementary. Some qualifications, exceptions and gaps in the literature are discussed. The paper is the first of a three-part review series of television and sex-role acquisition: the subsequent papers will review respectively the effects of sex-stereotyped TV content upon children and the prospects for counter-stereotyped programmes aiming to modify young viewers' beliefs and attitudes.

Expanding Rational Molecular Design beyond Pharma: Metrics to Guide Safer Chemical Design

EPA Science Inventory

The demand for safer, healthier and sustainable products, materials and processes has been increasing over the past several years. Differentiating which chemicals are relatively less hazardous than others, often referred to as “greener” or “sustainable, demands a comprehensive, h...

Expanding Rational Molecular Design beyond Pharma: Metrics toGuide Safer Chemical Design

EPA Science Inventory

The demand for safer, healthier and sustainable products, materials and processes has been increasing over the past several years. Differentiating which chemicals are relatively less hazardous than others, often referred to as “greener” or “sustainable, demands a comprehensive, h...

Promoting Sex Education Among Teenagers Through an Interactive Game: Reasons for Success and Implications.

PubMed

Chu, Samuel Kai Wah; Kwan, Alvin C M; Reynolds, Rebecca; Mellecker, Robin R; Tam, Frankie; Lee, Grace; Hong, Athena; Leung, Ching Yin

2015-06-01

A game application, "Making Smart Choices", was developed to fill the gap of limited easy-to-access resources available on sex education in Hong Kong and to disseminate correct knowledge and positive attitudes toward sex to teenagers using popular platforms such as tablets, Facebook, and the Web. Three versions of the game (iPAD, Facebook, and Web-based) were developed using HTML5. A theoretical framework that involved game-based learning and participatory design approach was used to design, develop, modify, and optimize the game for use with secondary school students (n=1176) 12-16 years of age. Pre- and post-test scores of students' safer sex knowledge were compared to test the effectiveness of the game. Students' survey and interviews were analyzed to assess participant feelings and attitudes toward the game. The Wilcoxon Signed-Rank test indicated that students' sex knowledge (n=788) improved with a medium effect size (0.477) after playing the game. Increases in positive attitudes toward sex and relationship and in awareness of making smart sexual choices were reported from student surveys and interviews. Students described the game as "interesting," "interactive," "informative," and "real-to-life." We advocate that the participatory design approach, which supports collaborative efforts of different stakeholders, is an effective framework for developing game-based learning tools for sex education. Our work provides preliminary findings that suggest game-based learning, preferably delivered through popular interactive platforms, can be effective in promoting sex education to teenagers.

Women's experiences with anal sex: motivations and implications for STD prevention.

PubMed

Maynard, Emily; Carballo-Diéguez, Alex; Ventuneac, Ana; Exner, Theresa; Mayer, Kenneth

2009-09-01

Heterosexual anal intercourse is a highly efficient mode of HIV transmission, yet little is known about the contexts in which women engage in it, or when and with whom they use condoms. Similarly, sexuality and reproductive health research has paid little attention to female desire and pleasure-seeking. In-depth interviews were conducted in Boston in 2006 with 28 women who reported having had unprotected anal intercourse in the last year with a man who was HIV-positive or whose serostatus was unknown. Sexual scripting theory guided analyses of their experiences with and motivations to practice anal intercourse. Participants engaged in anal intercourse for a wide variety of reasons: to experience physical pleasure, enhance emotional intimacy, please their male partners or avoid violence. Male partners usually initiated anal sex. Anal intercourse often occurred in the context of vaginal and oral sex. Among reasons women cited for not using condoms were familiarity with their partner and feeling that condoms made anal sex less pleasurable. Knowledge of HIV and STD risks did not appear to encourage condom use. Women who perceive condom use during anal sex as limiting their pleasure or intimacy may be at increased risk for acquiring HIV. Consequently, interventions to promote safer anal intercourse must find a way to increase the use of barrier methods without decreasing pleasure or perceived intimacy between sexual partners.

The Role of a Regular Sex Partner in Sexually Transmitted Infections and Reinfections: Results From the Study of Female Entertainment Establishment Workers in the Philippines

PubMed Central

CHIAO, CHI; MORISKY, DONALD E.

2011-01-01

Objective The main objective of this study is to understand the association between living with a regular sex partner, risk-taking behaviors, and one’s history of sexually transmitted infections (STIs). Methods Data on sexual behavior and STI histories were obtained from 876 Filipina entertainment establishment workers (FEEWs) through a large-scale participatory research survey. Results About one-third of FEEWs live with a regular sex partner. Single FEEWs are significantly more likely than partnered FEEWs to engage in commercial sex. Being single, engaging in commercial sex, and using condoms inconsistently, in turn, are significantly associated with a positive STI history. Conclusion These results suggest that living with a regular sex partner is an independent and protective factor against having an initial STI and subsequent reinfection. Programmatic strategies aimed at reducing STIs among entertainment establishment workers through promoting safer sex behaviors could potentially benefit by including a component that addresses sexual networks. PMID:17710751

Emtricitabine and Tenofovir

MedlinePlus

... Truvada) is also used along with practicing safer sex to help prevent high-risk people from getting ... cancer. Taking these medications along with practicing safer sex and making other lifestyle changes may decrease the ...

Sputum, sex and scanty smears: new case definition may reduce sex disparities in smear-positive tuberculosis.

PubMed

Ramsay, A; Bonnet, M; Gagnidze, L; Githui, W; Varaine, F; Guérin, P J

2009-05-01

Urban clinic, Nairobi. To evaluate the impact of specimen quality and different smear-positive tuberculosis (TB) case (SPC) definitions on SPC detection by sex. Prospective study among TB suspects. A total of 695 patients were recruited: 644 produced > or =1 specimen for microscopy. The male/female sex ratio was 0.8. There were no significant differences in numbers of men and women submitting three specimens (274/314 vs. 339/380, P = 0.43). Significantly more men than women produced a set of three 'good' quality specimens (175/274 vs. 182/339, P = 0.01). Lowering thresholds for definitions to include scanty smears resulted in increases in SPC detection in both sexes; the increase was significantly higher for women. The revised World Health Organization (WHO) case definition was associated with the highest detection rates in women. When analysis was restricted only to patients submitting 'good' quality specimen sets, the difference in detection between sexes was on the threshold for significance (P = 0.05). Higher SPC notification rates in men are commonly reported by TB control programmes. The revised WHO SPC definition may reduce sex disparities in notification. This should be considered when evaluating other interventions aimed at reducing these. Further study is required on the effects of the human immuno-deficiency virus and instructed specimen collection on sex-specific impact of new SPC definition.

Reducing Risk: Counseling Men Infected with HIV Who Have Sex with Men on Safer Sex Practices with Seroconcordant Partners.

PubMed

Blackwell, Christopher W

2018-01-01

The incidence of new HIV infections in the United States continues to be greatest among men who have sex with men (MSM). MSM infected with HIV often seek seroconcordant sexual partners based on intent to limit psychosocial, legal, and health risks they perceive as higher with serodiscordant sexual partners. However, the rationales for limiting sexual relationships exclusively with other MSM infected with HIV may be rooted in misinformation or misperception. Thus, these clients may have a unique sexual health knowledge deficit that nurses, social workers, and other clinicians need to address to help them reduce risk. This article focuses on sexually related health risks that are distinct to MSM infected with HIV seroconcordant partners. Data on the most recent HIV-infection incidence rates in MSM in the United States is provided. Discussion concentrates on the risk these individuals may have in communicating and acquiring sexually transmitted diseases other than HIV, the risk of HIV superinfection, and how sexually transmitted diseases affect persons who are immunocompromised differently than those who are immunocompetent. Finally, recommendations for healthcare professionals who counsel MSM infected with HIV in sexual decision making is provided.

WISDOM GPR investigations in a Mars-analog environment during the SAFER rover operation simulation

NASA Astrophysics Data System (ADS)

Dorizon, S.; Ciarletti, V.; Plettemeier, D.; Vieau, A.-J.; Benedix, W.-S.; Mütze, M.; Hassen-Kodja, R.; Humeau, O.

2014-04-01

The WISDOM (Water Ice Subsurface Deposits Observations on Mars) Ground Penetrating Radar has been selected to be onboard the ExoMars 2018 rover mission [1]. This instrument will investigate the Martian shallow subsurface and provide the geological context of the mission, by characterizing the subsurface in terms of structure, stratigraphy and potential buried objects. It will also quantify the geoelectrical properties of the medium, which are directly related to its nature, its water or salts content and its hardness [2]. WISDOM data will provide important clues to guide the drilling operations to location of potential exobiological interest. A prototype available in LATMOS, France, is currently tested in a wide range of natural environments. In this context, the WISDOM team participated in the SAFER (Sample Acquisition Field Experiment with a Rover) field trial that occurred from 7th to 13th October 2013 in the Atacama Desert, Chile. Designed to gather together scientists and engineers in a context of a real Martian mission with a rover, the SAFER trial was the opportunity to use three onboard ExoMars instruments, namely CLUPI (Close- UP Imager), PANCAM (Panoramic Camera) and WISDOM, to investigate the chosen area. We present the results derived from WISDOM data acquired over the SAFER trial site to characterize the shallow subsurface of the area.

Beliefs about cybersex and Internet-mediated sex of Latino men who have Internet sex with men: relationships with sexual practices in cybersex and in real life.

PubMed

Ross, M W; Rosser, B R S; Stanton, J

2004-11-01

Cybersex (engaging in sexual self-stimulation while online with another person) and meeting partners for sex are commonly reported among men who have Internet sex with men (MISM). We studied 1,026 Latino MISM in the US and constructed a scale to measure beliefs about cybersex. Respondents were recruited to an online Internet study and compensated for their effort. Factor analysis indicated that there were three dimensions: (1) liking cybersex: perceived anonymity and safety of cybersex; (2) potential for greater IRL interaction in seeking partners on the Internet; and (3) a dimension of negative beliefs about Internet contacts which was not psychometrically stable. Safety referred to physical and HIV-related safety. We formed two scales to describe the first two dimensions. Respondents who were high on the 'liking cybersex: perceived anonymity and safety' scale were more likely than low scorers to use chat-rooms and webcams. They were also more likely than low scorers to have had cybersex and phone sex before meeting. Those who were high on the 'IRL interaction' scale were more likely than low scorers to use e-mail, bulletin boards and paid websites. However, there was significantly less disclosure about HIV status and discussion about safer sex by those higher on the 'IRL interaction scale', and when sex in real life did occur, those higher on the 'IRL interaction' scale were more likely to have receptive oral or anal sex, whereas those high on the 'liking cybersex: perceived anonymity/safety' scale were less likely to have insertive sex or be drunk/high. MISM scoring high on the 'IRL interaction' scale were significantly more likely than low scorers to prefer to meet partners on the Internet. We discuss the implications of the Internet for MSM and for sexual IRL interactions in the Internet age.

Correlates of Seroadaptation Strategies Among Black Men Who have Sex with Men (MSM) in 4 US Cities

PubMed Central

Koblin, Beryl; Nandi, Vijay; Xu, Guozhen; Latkin, Carl; Seal, David; Flores, Stephen A.; Spikes, Pilgrim

2015-01-01

We assessed associations of demographic, psychosocial, and substance use factors with seroadaptation strategies among 835 BMSM in four US cities. Seroadaptation strategies were practiced by 59.8 % of men, with 10.5 % practicing 100 % condom use, 26.5 % serosorting, 7.2 % condom serosorting, and 15.6 % seropositioning. In multivariable analyses, compared to men who used no seroadaptation strategies, serosorters were older, were less likely to be HIV infected, had fewer male sex partners, and had higher levels of social support and sexual self-efficacy. Condom serosorters had less psychological distress, were more likely to use methamphetamine, and had higher levels of sexual self-efficacy. Seropositioners were older, were less likely to be HIV infected, to have a main partner, and report alcohol/drug use with sex, while having higher levels of sexual self-efficacy. Seroadaptation practices among BMSM need to be considered to address perceived safer sex strategies and strengthen access to a broader reach of culturally-relevant prevention efforts. PMID:26363789

Opportunities for HIV Prevention Communication During Sexual Encounters with Black Men Who Have Sex with Men.

PubMed

Aholou, Tiffiany M; Nanin, Jose; Drumhiller, Kathryn; Sutton, Madeline Y

2017-01-01

Conversations about HIV prevention before engaging in sex may result in safer sex practices and decreased HIV transmission. However, partner communication for HIV prevention has been understudied among black/African American men who have sex with men (BMSM), a group that is disproportionately affected by HIV. We explored and described encounters and perceptions about HIV prevention conversations among BMSM and their sex partner(s) in New York City. We conducted an inductive thematic analysis of semi-structured interviews with BMSM who reported sex with a man in the previous 3 months. Interviews were professionally transcribed; Nvivo was used for data analysis. Twenty-two BMSM were included in this analysis; median age = 29.1 years; 71.4% self-identified as MSM; 85.7% were ever HIV tested; and 52.6% reported no disclosure or discussion about HIV status with their previous sex partner. The main themes were: (1) missed opportunities for HIV prevention conversations (e.g., no HIV prevention conversations or HIV prevention conversations after sex had occurred); (2) barriers to HIV prevention conversations (e.g., being in the moment; not wanting to pause); (3) emotional thoughts after sex (e.g., feeling worried about possible HIV exposure); and (4) rethinking relationships and sexual health (e.g., changed sex practices by asking partners' HIV status before sex; started using condoms). These findings offer insight into HIV prevention conversations by BMSM around the time of or during sexual encounters and may inform and strengthen partner-level HIV prevention communication interventions for BMSM.

A safer alternative: Cannabis substitution as harm reduction.

PubMed

Lau, Nicholas; Sales, Paloma; Averill, Sheigla; Murphy, Fiona; Sato, Sye-Ok; Murphy, Sheigla

2015-11-01

Substitution is operationalised as a conscious choice made by users to use one drug instead of, or in conjunction with another based on: perceived safety, level of addiction potential, effectiveness in relieving symptoms, access and level of acceptance. Harm reduction is a set of strategies that aim to minimise problems associated with drug use while recognising that for some users, abstinence may be neither a realistic nor a desirable goal. In this paper, we aim for deeper understandings of older adult cannabis users' beliefs and substitution practices as part of the harm reduction framework. We present selected findings from our qualitative study of Baby Boomer (born 1946-1964) marijuana users in the San Francisco Bay Area. Although the sample consisted of primary cannabis users, many had personal experience with other drugs throughout their lifetimes. Data collection consisted of an audio-recorded, semi-structured in-depth life history interview followed by a questionnaire and health survey. Qualitative interviews were analysed to discover users' harm reduction beliefs and cannabis substitution practices. Study participants described using cannabis as a safer alternative for alcohol, illicit drugs and pharmaceuticals based on their perceptions of less adverse side effects, low-risk for addiction and greater effectiveness at relieving symptoms, such as chronic pain. Cannabis substitution can be an effective harm reduction method for those who are unable or unwilling to stop using drugs completely. More research is needed on cannabis as a safer alternative. © 2015 Australasian Professional Society on Alcohol and other Drugs.

[Determining the efficacy of a high-school life-skills' programme in Huancavelica, Peru].

PubMed

Choque-Larrauri, Raúl; Chirinos-Cáceres, Jesús Lorenzo

2009-01-01

Determining the efficacy of a life-skills' programme within the context of a school health promotion programme using teenagers from a high-school in the district of Huancavelica, Peru during school year 2006. This was non-equivalent experimental research with pre-test and post-test. The subjects consisted of 284 high school students. The variables analyzed were communication, self esteem, assertiveness, decision making, sex and age. There was a significant increase in the experimental group's communication and assertiveness skills' development. There were no significant differences in decision-making and self-esteem skills. The life-skills' programme was effective during one school year, especially in terms of learning and developing communication and assertiveness skills. However, self-esteem and decision-making skills did not present a statistically significance difference. Programme implementation must thus be redirected and the life-skills' programme should be implemented throughout all high-school years.

75 FR 71123 - Agency Information Collection Activities; Proposed Collection; Comment Request; Safer Detergent...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-11-22

...-HQ-OPPT-2010-0874. The DCO is open from 8 a.m. to 4 p.m., Monday through Friday, excluding legal..., cleaners, airplane deicers, and fire-fighting foams. Safer surfactants are those that break down quickly to...

Men Selling Sex to Men in Sweden: Balancing Safety and Risk.

PubMed

Kuosmanen, Jari; de Cabo, Annelie

2018-04-01

The purpose of this study is to examine how men who sell sex to men perceive the risks in this activity and what experiences they have of actual denigration, threats, and violence in their relations with customers. We also discuss the self-defense strategies they have used to protect themselves. The study is based on an Internet survey on Swedish websites. Statistical analyses have been carried out, and in interpreting the results, Finkelhor and Asdigian's revised routine activities theory has been used. The results show that the vulnerability of sellers of sex is greatest during the time when the sexual act is being performed, and that this is primarily linked to the customer's antagonism and seeking gratification by overstepping agreed boundaries, particularly with regard to sexual services including BDSM. Their vulnerability was also connected to the seller's diminished capacity for self-protection due to personal and external pressures. A smaller proportion of the men described risk prevention activities. These involved refusing a customer after an initial contact, protecting themselves from infection, being on their guard during the whole process, selecting the place, and deciding not to carry out certain sexual acts. An important implication concerns the occupational health and safety that men who sell sex to men can develop for themselves, while remaining within the law. International studies have demonstrated that selling sex in collective, indoor forms provides the greatest security. For decades, Swedish prostitution policy has had the ambition of reducing prostitution through targeting those who purchase sex, and those who promote prostitution in criminal legislation. This effectively prevents more systematic and collective attempts to create safer conditions for selling sex. In conclusion, it can be stated that while it is legal to sell sex in Sweden, this is done at the seller's own risk.

NREL Blows Up Batteries to Make the World Safer | News | NREL

Science.gov Websites

lithium-ion batteries safer for earthlings and astronauts is something NREL excels at. In this video . Matt and his team study battery failure using innovative technologies, such as the award-winning Battery Internal Short Circuit (ISC) Device that can precisely identify weak spots in battery cells. This

Sexual behaviour, structural vulnerabilities and HIV prevalence among female sex workers in Pakistan

PubMed Central

Mishra, Sharmistha; Thompson, Laura H; Sonia, Altaf; Khalid, Nosheen; Emmanuel, Faran; Blanchard, James F

2013-01-01

Background We sought to describe differences in individual and structural vulnerabilities faced by female sex workers (FSWs) in Pakistan between 2006 and 2011, and to characterise risk factors for inconsistent condom use and HIV prevalence in this population. Methods To describe differences in vulnerabilities, we analysed behavioural data from serial cross-sectional surveys conducted across nine cities in 2006 and 2011. Using data from 12 cities in 2011, we used logistic regression to characterise risk factors for (a) inconsistent condom use in the past month (N=6987), and (b) HIV (N=4301). Results Compared to FSWs in 2006, FSWs in 2011 were significantly more likely to solicit clients via cell phones, and to report a larger client volume and anal sex with clients, but also consistent condom use with clients (30.0% vs 23.6% in 2006). In 2011, independent risk factors for inconsistent condom use with clients included: recent sexual violence, recent sex with a person who injects drugs, and absence of programme exposure. HIV prevalence was 0.63% (95% CI 0.43% to 0.92%) in 2011, and was associated with a recent history of injection drug use and absence of programme exposure. Conclusions While condom use with clients was higher in 2011, protective behaviours remained low and vulnerabilities related to sex work may have risen. HIV is emerging in this population and an adaptive HIV prevention programme that addresses different vulnerabilities and the intersection of sexual networks with injection drug use is needed. PMID:23413402

Governing sex workers in Timor Leste.

PubMed

Harrington, Carol

2011-01-01

This paper argues that international security forces in Timor Leste depend upon civilian partners in HIV/AIDs "knowledge networks" to monitor prostitutes' disease status. These networks produce mobile expertise, techniques of government and forms of personhood that facilitate international government of distant populations without overt coercion. HIV/AIDs experts promote techniques of peer education, empowerment and community mobilisation to construct women who sell sex as health conscious sex workers. Such techniques make impoverished women responsible for their disease status, obscuring the political and economic contexts that produced that status. In the militarised context of Timor Leste, knowledge of the sexual conduct of sub-populations labelled high risk circulates among global HIV/AIDs knowledge networks, confirming their expert status while obscuring the sexual harm produced by military intervention. HIV/AIDs knowledge networks have recently begun to build Timorese sex worker organisations by contracting an Australian sex worker NGO to train a Timorese NGO tasked with building sex worker identity and community. Such efforts fail to address the needs and priorities of the women supposedly empowered. The paper engages theories of global knowledge networks, mobile technologies of government, and governmentality to analyse policy documents, reports, programmes, official statements, speeches, and journalistic accounts regarding prostitution in Timor Leste.

An integrated structural intervention to reduce vulnerability to HIV and sexually transmitted infections among female sex workers in Karnataka state, south India.

PubMed

Gurnani, Vandana; Beattie, Tara S; Bhattacharjee, Parinita; Mohan, H L; Maddur, Srinath; Washington, Reynold; Isac, Shajy; Ramesh, B M; Moses, Stephen; Blanchard, James F

2011-10-02

Structural factors are known to affect individual risk and vulnerability to HIV. In the context of an HIV prevention programme for over 60,000 female sex workers (FSWs) in south India, we developed structural interventions involving policy makers, secondary stakeholders (police, government officials, lawyers, media) and primary stakeholders (FSWs themselves). The purpose of the interventions was to address context-specific factors (social inequity, violence and harassment, and stigma and discrimination) contributing to HIV vulnerability. We advocated with government authorities for HIV/AIDS as an economic, social and developmental issue, and solicited political leadership to embed HIV/AIDS issues throughout governmental programmes. We mobilised FSWs and appraised them of their legal rights, and worked with FSWs and people with HIV/AIDS to implement sensitization and awareness training for more than 175 government officials, 13,500 police and 950 journalists. Standardised, routine programme monitoring indicators on service provision, service uptake, and community activities were collected monthly from 18 districts in Karnataka between 2007 and 2009. Daily tracking of news articles concerning HIV/AIDS and FSWs was undertaken manually in selected districts between 2005 and 2008. The HIV prevention programme is now operating at scale, with over 60,000 FSWs regularly contacted by peer educators, and over 17,000 FSWs accessing project services for sexually transmitted infections monthly. FSW membership in community-based organisations has increased from 8,000 to 37,000, and over 46,000 FSWs have now been referred for government-sponsored social entitlements. FSWs were supported to redress > 90% of the 4,600 reported incidents of violence and harassment reported between 2007-2009, and monitoring of news stories has shown a 50% increase in the number of positive media reports on HIV/AIDS and FSWs. Stigma, discrimination, violence, harassment and social equity issues are

Having the rug pulled from under your feet: one project's experience of the US policy reversal on sex work.

PubMed

Busza, Joanna

2006-07-01

After the election of President George W Bush in 2000, US government policy toward sexual and reproductive health changed dramatically. In May 2003, the Global AIDS Act was passed and prohibits allocation of US government funds to organizations that 'promote or advocate' legalization and practice of prostitution and sex trafficking. There are few documented examples of early impacts of this policy reversal on USAID-funded programmes already working with sex worker communities. This paper offers an anecdotal account of one programme in Cambodia that found itself caught in the ideological cross-fire of US politics, and describes consequent negative effects on the project's ability to offer appropriate and effective HIV prevention services to vulnerable migrant sex workers.

Examining the Role of Serostatus Disclosure on Unprotected Sex Among People Living with HIV

PubMed Central

Golin, Carol; Widman, Laura; Grodensky, Catherine; Earp, Jo Anne; Suchindran, Chirayath

2014-01-01

Abstract Given the increasing prevalence of HIV, it is important to identify factors associated with safer sex behaviors between people living with HIV and their partners. Utilizing a diverse sample of 242 HIV-infected adults [n=69 men who have sex with men (MSM); n=68 men who have sex with women (MSW); n=105 women who have sex with men (WSM)], we examined the association between serostatus disclosure and unprotected anal or vaginal intercourse (UAVI) and the moderating effect of sexual behavior group on this association. Overall, 88.7% disclosed to their current partner. Approximately 18.8% of MSM, 17.7% of MSW, and 29.5% of WSM reported UAVI. Controlling for age, time since diagnosis, and partner serostatus, we found main effects on UAVI for disclosure and sexual behavior group; specifically, disclosure was inversely related to unprotected sex [AOR=0.09, 95% CI (0.02, 0.43), p<0.001], and MSM were less likely to engage in UAVI relative to WSM [AOR=0.11, 95% CI (0.17, 0.82), p<0.05]. However, the relationship between disclosure and UAVI was not moderated by sexual behavior group. Future strategies that aim to increase disclosure to partners may consider focusing on its value as a means by which to reduce sexual risk behavior. PMID:25397358

Inconsistent condom use by male clients during anal intercourse with occasional and regular female sex workers (FSWs): survey findings from southern states of India.

PubMed

Ramanathan, Shreena; Nagarajan, Karikalan; Ramakrishnan, Lakshmi; Mainkar, Mandar K; Goswami, Prabuddhagopal; Yadav, Diwakar; Sen, Shrabanti; George, Bitra; Rachakulla, Harikumar; Subramanian, Thilakavathi; Paranjape, Ramesh S

2014-11-19

Self-reported anal intercourse by female sex workers (FSWs) documented in recent studies from India range between 11.9% and 22%. However, comparable data on anal intercourse and condom use from male clients of FSWs is lacking. Using data from a bio-behavioural survey (2009-2010), we examined prevalence of anal intercourse, male clients' self-reported inconsistent condom use during anal intercourse with FSWs, and correlates of this behaviour in India's high HIV prevalence southern states (Andhra Pradesh, Maharashtra and Tamil Nadu combined). Using two-stage time location cluster sampling, we recruited 4803 clients of FSWs, ages 18-60 years, who had purchased sex from an FSW in the past month. After obtaining informed consent, respondents were interviewed and tested for HIV and sexually transmitted infections (syphilis, gonorrhoea and chlamydia). Logistic regression analysis was used to identify the factors associated with inconsistent condom use during anal intercourse (in the past 6 months) with FSWs. Overall, 12.3% clients reported anal intercourse in the past 6 months, of whom 48.4% used condoms inconsistently. Clients of FSWs who were ages 26 years or older (AOR 2.68, p=0.032); employed as manual labourers (AOR 2.43, p=0.013); consumed alcohol (AOR 2.63, p=0.001); reported five or more sex acts with FSWs in the past month (AOR 2.53, p=0.031); and perceived themselves to be at higher risk for HIV (AOR 4.82, p=0.001) were more likely to inconsistently use condoms during anal intercourse. The results suggest that sex workers and their clients commonly practice anal intercourse, but a relatively high proportion of clients do not consistently use condoms, leading to a greater risk of acquiring HIV and its further transmission to other male and female sexual partners. Given the multidirectional risk, safer sex communication on heterosexual anal intercourse must be incorporated into HIV prevention programmes. Published by the BMJ Publishing Group Limited. For

Conjectures concerning cross-sex hormone treatment of aging transsexual persons.

PubMed

Gooren, Louis; Lips, Paul

2014-08-01

Guidelines for cross-sex hormone treatment of transsexual people are now in place. However, little attention has been paid to the issue of treatment suitability for older people. Does existing treatment need to be adapted as subjects age, and does it make a difference if treatment is only started when the subject is already older? To assess the necessity of adapting cross-sex hormone administration for elderly transsexual people. Risks/benefits of continued use of cross-sex hormones with regard to bone health, cardiovascular risks, and malignancies. Due to lack of data on the subject population, sex hormone treatment of other conditions in older non-transsexual people has been taken as the best available analogy to determine the extent to which these might be applicable to comparable transsexual persons. Findings in transsexual people receiving cross-sex hormone treatment sometimes modified the above approach of applying guidelines for the elderly to the aging transsexual population. Testosterone administration to female-to-male transsexual persons (FtoM) carries little risk with regard to cardiovascular disease and cancer. For those with high hematocrit or cardiac insufficiency the dose can be reduced. Administration of estrogens to male-to-female transsexual persons (MtoF), particularly when combined with progestins, does significantly increase the risk of developing cardiovascular disease (almost a twofold incidence compared with the general population). This may require dose adjustment or changing from oral to safer transdermal estrogens. Tumors of the breasts, prostate and pituitary may occur. In FtoM, breast cancer can occur even after breast ablation. Older subjects can commence cross-sex hormone treatment without disproportionate risks. Cross-sex hormones may be continued into old age but monitoring for cardiovascular disease and malignancies, both of the old and new sex, is recommended. MtoF will have more health complications in old age than Fto

Sex determination in horses - current status and future perspectives.

PubMed

Aurich, Christine; Schneider, Jana

2014-04-01

In the equine species, sex determination of the conceptus is of growing interest for the breeding industry. In horses, the sex ratio of the offspring depends on changes in body condition of the mother at conception and under natural conditions may thus markedly deviate from an expected 1:1 ratio. Insemination with sex-sorted spermatozoa allows a pronounced shift of the sex ratio but at present pregnancy rates are low and vary considerably under field conditions. In equine embryo transfer programmes, sex determination in embryos before transfer via genetic methods is a promising approach with high reliability. In ongoing pregnancies, fetal sex can be determined in utero by transrectal or transabdominal ultrasound between days 57 and 220 after ovulation, but experience is required to achieve satisfying accuracy. Recently, genetic sexing via identification of circulating cell-free fetal DNA in the maternal circulation has been successfully performed in the last three months of pregnancy. Development of this technique may also allow fetal sex determination at earlier stages of pregnancy. Further research is required to allow for techniques that enable sex determination in equine embryos as well as in ongoing pregnancies under field conditions. Copyright © 2014 Elsevier B.V. All rights reserved.

Incorporating Risk Assessment and Inherently Safer Design Practices into Chemical Engineering Education

ERIC Educational Resources Information Center

Seay, Jeffrey R.; Eden, Mario R.

2008-01-01

This paper introduces, via case study example, the benefit of including risk assessment methodology and inherently safer design practices into the curriculum for chemical engineering students. This work illustrates how these tools can be applied during the earliest stages of conceptual process design. The impacts of decisions made during…

The decriminalization of prostitution is associated with better coverage of health promotion programs for sex workers.

PubMed

Harcourt, Christine; O'Connor, Jody; Egger, Sandra; Fairley, Christopher K; Wand, Handan; Chen, Marcus Y; Marshall, Lewis; Kaldor, John M; Donovan, Basil

2010-10-01

In order to assess whether the law has an impact on the delivery of health promotion services to sex workers, we compared health promotion programs in three Australian cities with different prostitution laws. The cities were Melbourne (brothels legalized if licensed, unlicensed brothels criminalized), Perth (criminalization of all forms of sex work) and Sydney (sex work largely decriminalized, without licensing). We interviewed key informants and gave questionnaires to representative samples of female sex workers in urban brothels. Despite the different laws, each city had a thriving and diverse sex industry and a government-funded sex worker health promotion program with shopfront, phone, online and outreach facilities. The Sydney program was the only one run by a community-based organisation and the only program employing multi-lingual staff with evening outreach to all brothels. The Melbourne program did not service the unlicensed sector, while the Perth program accessed the minority of brothels by invitation only. More Sydney workers reported a sexual health centre as a source of safer sex training and information (Sydney 52% v Melbourne 33% and Perth 35%; p<0.001). Sex workers in Melbourne's licensed brothels were the most likely to have access to free condoms (Melbourne 88%, Sydney 39%, Perth 12%; p<0.001). The legal context appeared to affect the conduct of health promotion programs targeting the sex industry. Brothel licensing and police-controlled illegal brothels can result in the unlicensed sector being isolated from peer-education and support. © 2010 The Authors. Journal Compilation © 2010 Public Health Association of Australia.

Unsafe sex: decision-making biases and heuristics.

PubMed

Kaplan, B J; Shayne, V T

1993-01-01

This paper suggests that continued high-risk behavior is the result of the heuristics used to make judgments under uncertainty, and that the same heuristics may be mobilized to increase the use of safer-sex practices. In order to explain why it is that individuals fail to make effective use of the information they may have concerning rates of infection, consequences of infection and their own at-risk status, theory and research in several areas will be considered. Developments in the breadth of areas to which basic research on decision-making has been applied continue to provide new approaches toward understanding and overcoming the processes by which we reason (Kahnemann, 1991). It is worth reminding ourselves that public health campaigns in other areas have led to changes in behavior. Reasoning, even with its biases, is still the route by which we make decisions, most of them effective and self-protective.

The Effects of Gay Sexually Explicit Media on the HIV Risk Behavior of Men who have Sex with Men

PubMed Central

Simon Rosser, B. R.; Smolenski, Derek J.; Erickson, Darin; Iantaffi, Alex; Brady, Sonya S.; Galos, Dylan L.; Grey, Jeremy A.; Hald, Gert Martin; Horvath, Keith J.; Kilian, Gunna; Træen, Bente; Wilkerson, J. Michael

2013-01-01

This study sought to study consumption patterns of gay-oriented sexually explicit media (SEM) by men who have sex with men (MSM); and to investigate a hypothesized relationship between gay SEM consumption and HIV risk behavior. Participants were 1391 MSM living in the US, recruited online to complete a SEM consumption and sexual risk survey. Almost all (98.5%) reported some gay SEM exposure over the last 90 days. While 41% reported a preference to watch actors perform anal sex without condoms (termed “bareback SEM”), 17% preferred to actors perform anal sex with condoms (termed “safer sex SEM”) and 42% reported no preference. Overall SEM consumption was not associated with HIV risk; however participants who watched more bareback SEM reported significantly greater odds of engaging in risk behavior. The results suggest that a preference for bareback SEM is associated with engaging in risk behavior. More research to understand how MSM develop and maintain preferences in viewing SEM, and to identify new ways to use SEM in HIV prevention, is recommended. PMID:23564010

Male sex determination: insights into molecular mechanisms

PubMed Central

McClelland, Kathryn; Bowles, Josephine; Koopman, Peter

2012-01-01

Disorders of sex development often arise from anomalies in the molecular or cellular networks that guide the differentiation of the embryonic gonad into either a testis or an ovary, two functionally distinct organs. The activation of the Y-linked gene Sry (sex-determining region Y) and its downstream target Sox9 (Sry box-containing gene 9) triggers testis differentiation by stimulating the differentiation of Sertoli cells, which then direct testis morphogenesis. Once engaged, a genetic pathway promotes the testis development while actively suppressing genes involved in ovarian development. This review focuses on the events of testis determination and the struggle to maintain male fate in the face of antagonistic pressure from the underlying female programme. PMID:22179516

A cross-sectional evaluation of the prevalence and associations of HIV among female sex workers in the Gambia.

PubMed

Peitzmeier, Sarah; Mason, Krystal; Ceesay, Nuha; Diouf, Daouda; Drame, Fatou; Loum, Jaegan; Baral, Stefan

2014-03-01

To determine HIV prevalence among female sex workers in the Gambia and HIV risk factors, we accrued participants (n = 251) through peer-referral and venue-based recruitment. Blood samples were screened for HIV and participants were administered a questionnaire. Bivariate and multivariate logistic regression identified factors associated with HIV status. Forty respondents (15.9%) were HIV-positive: 20 (8.0%) were infected with HIV-1 only, 10 (4.0%) with HIV-2 only, and 10 (4.0%) with both HIV-1 and HIV-2; 12.5% (n = 5/40) knew their status. Condom usage at last sex was 97.1% (n = 170/175) with new clients and 44.2% (n = 53/120) with non-paying partners. Having a non-paying partner, living with relatives or friends, having felt scared to walk in public, selling sex in multiple locations, and recent depressive symptoms were positively associated with HIV under multivariate regression. Female sex workers have a higher prevalence of HIV compared to the general Gambian population. Interventions should be rights-based, promote safer sex practices and regular testing for female sex workers and linkage to HIV treatment and care with adherence support for those living with HIV. In addition, service providers should consider non-paying partners of female sex workers, improve knowledge and availability of condoms and lubricant, and address safety and mental health needs.

"Money talks, bullshit walks" interrogating notions of consumption and survival sex among young women engaging in transactional sex in post-apartheid South Africa: a qualitative enquiry.

PubMed

Zembe, Yanga Z; Townsend, Loraine; Thorson, Anna; Ekström, Anna Mia

2013-07-18

Transactional sex is believed to be a significant driver of the HIV epidemic among young women in South Africa. This sexual risk behaviour is commonly associated with age mixing, concurrency and unsafe sex. It is often described as a survival- or consumption-driven behaviour. South Africa's history of political oppression as well as the globalization-related economic policies adopted post-apartheid, are suggested as the underlying contexts within which high risk behaviours occur among Black populations. What remains unclear is how these factors combine to affect the particular ways in which transactional sex is used to negotiate life among young Black women in the country.In this paper we explore the drivers of transactional sex among young women aged 16-24, who reside in a peri-urban community in South Africa. We also interrogate prevailing constructions of the risk behaviour in the context of modernity, widespread availability of commodities, and wealth inequalities in the country. Data were collected through 5 focus group discussions and 6 individual interviews amongst young women, men, and community members of various age groups in a township in the Western Cape, South Africa. Young women engaged in transactional sex to meet various needs: some related to survival and others to consumption. In this poverty-stricken community, factors that created a high demand for transactional sex among young women included the pursuit of fashionable images, popular culture, the increased availability of commodities, widespread use of global technologies, poverty and wealth inequalities. Transactional sex encounters were characterized by sexual risk, a casual attitude towards HIV, and male dominance. However, the risk behaviour also allowed women opportunities to adopt new social roles as benefactors in sexual relationships with younger men. Transactional sex allows poor, young women to access what young people in many parts of the world also prioritize: fashionable clothing

History of Abuse and Psychological Distress Symptoms among Female Sex Workers in Two Mexico-U.S. Border Cities

PubMed Central

Ulibarri, Monica; Semple, Shirley J.; Rao, Swati; Strathdee, Steffanie A.; Fraga-Vallejo, Miguel A.; Bucardo, Jesus; De la Torre, Adela; Salazar-Reyna, Juan; Orozovich, Prisci; Staines-Orozco, Hugo S.; Amaro, Hortensia; Magis-Rodriguez, Carlos; Patterson, Thomas L.

2009-01-01

This study examined histories of past emotional, physical, and sexual abuse as correlates of current psychological distress using data from 916 female sex workers (FSWs) who were enrolled in a safer-sex behavioral intervention in Tijuana and Ciudad (Cd.) Juarez, Mexico. We hypothesized that histories of abuse would be associated with higher symptom levels of depression and somatization, and that social support would moderate the relationship. Nonparametric correlations and a series of hierarchical regression analyses revealed that all forms of past abuse predicted higher levels of depressive symptoms, and physical and sexual abuse were significantly associated with higher levels of somatic symptoms. Social support was also significantly associated with fewer symptoms of distress; however, it was not shown to moderate the relationship between abuse history and distress. PMID:19634364

Audit of patients' knowledge of their oral contraceptive pill.

PubMed

Schroeder, K; Dwyer, D; Barton, S E

1994-01-01

Government and media education has promoted the use of condoms in an attempt to reduce the spread of the human immunodeficiency virus (HIV). Condoms have been identified, in vitro, as an effective barrier to HIV and a large heterosexual study has shown there was no transmission of infection in those couples systematically using condoms. Safer sex knowledge and practice and HIV knowledge were assessed in 584 individuals, 16-74 years old, attending a London genitourinary medicine (GUM) clinic via a self-administered, anonymous questionnaire. Over 80% were heterosexual, 64% had attended a GUM clinic before, 60% had a history of sexually transmitted infection. Over 80% were aware of the protective effect of condoms and the risks of intravenous drug use; 66% of geographical risk factors; 49% of the risks of anal sex; and 53% perceived masturbation as safer. Only 10.4% always used condoms; over 50% gave no reason for non-use. Use was not increased in higher risk respondents nor in those with good safer sex/HIV knowledge, nor was there any sex difference. Although knowledge of some aspects of safer sex was good, anal sex risks, geographical sex risks, and alternative safer sexual practices were less well known. In addition, condom use was disappointingly low, even in the presence of good safer sex knowledge, awareness of high risk behavior and despite intense media health education. As a result of this survey educational input was increased, allowing an interaction which is lacking in media campaigns, and a variety of condoms were introduced in an attempt to increase use. Re-audit will be important in assessing the effects of such changes. Pre-adolescent targeting before sexual patterns are learned may be useful. Further research into this difficult area is essential.

The Talking Sex Project: descriptions of the study population and correlates of sexual practices at baseline.

PubMed

Myers, T; Tudiver, F G; Kurtz, R G; Jackson, E A; Orr, K W; Rowe, C J; Bullock, S L

1992-01-01

The Talking Sex Project is an HIV risk reduction education project for gay and bisexual men. It was developed to evaluate two types of small discussion groups using a randomized control study design. This paper reports on the baseline measures of knowledge, attitudes and sexual practices. The 612 subjects had a mean age of 32 years, were all English speaking and were relatively highly educated. Bivariate analyses found that younger men, those in a relationship, those reporting bisexual activity and those with higher levels of substance use were significantly more likely to have unprotected anal intercourse. While overall knowledge was not associated with sexual behaviour, a significant relationship was found with knowledge of risk of anal sex. Attitudes, in particular, the belief in the efficacy of condoms and the enjoyment of safer sex were found to have the strongest associations with protected anal intercourse. The paper provides an understanding of some of the factors which may be important to behaviour change and clues for the targeting of programs.

Seismographs, sensors, and satellites: Better technology for safer communities

USGS Publications Warehouse

Groat, C.G.

2004-01-01

In the past 25 years, our ability to measure, monitor, and model the processes that lead to natural disasters has increased dramatically. Equally important has been the improvement in our technological capability to communicate information about hazards to those whose lives may be affected. These innovations in tracking and communicating the changes-floods, earthquakes, wildfires, volcanic eruptions-in our dynamic planet, supported by a deeper understanding of earth processes, enable us to expand our predictive capabilities and point the way to a safer future. ?? 2004 Elsevier Ltd. All rights reserved.

The Stamp-in-Safety programme, an intervention to promote better supervision of children on childcare centre playgrounds: an evaluation in an urban setting.

PubMed

Chelvakumar, Gayathri; Sheehan, Karen; Hill, Amy L; Lowe, Danita; Mandich, Nicole; Schwebel, David C

2010-10-01

Using a non-equivalent control group design, this report evaluated a previously studied behavioural intervention, the Stamp-in-Safety programme, which is designed to reduce the injury risk for young children on playgrounds at childcare centres by increasing the quality of adult supervision and rewarding children for safe play. In an urban, commercial childcare centre, 71 children aged 3-5 years and 15 teachers participated. Primary outcome measures were teacher verbalisations (warnings, explanations, redirects), teacher location (core, outskirt, or fringe of playground), child risk-taking behaviours (using equipment appropriately) and the number of injuries on the playground. Analyses revealed that the intervention had a modest positive effect in promoting safer teacher and child playground behaviours. This study reaffirms previous results that the Stamp-in-Safety programme is an effective method to decrease the risk of playground injuries at childcare centres.

Why sex and gender matter in implementation research.

PubMed

Tannenbaum, Cara; Greaves, Lorraine; Graham, Ian D

2016-10-27

There has been a recent swell in activity by health research funding organizations and science journal editors to increase uptake of sex and gender considerations in study design, conduct and reporting in order to ensure that research results apply to everyone. However, examination of the implementation research literature reveals that attention to sex and gender has not yet infiltrated research methods in this field. The rationale for routinely considering sex and gender in implementation research is multifold. Sex and gender are important in decision-making, communication, stakeholder engagement and preferences for the uptake of interventions. Gender roles, gender identity, gender relations, and institutionalized gender influence the way in which an implementation strategy works, for whom, under what circumstances and why. There is emerging evidence that programme theories may operate differently within and across sexes, genders and other intersectional characteristics under various circumstances. Furthermore, without proper study, implementation strategies may inadvertently exploit or ignore, rather than transform thinking about sex and gender-related factors. Techniques are described for measuring and analyzing sex and gender in implementation research using both quantitative and qualitative methods. The present paper describes the application of methods for integrating sex and gender in implementation research. Consistently asking critical questions about sex and gender will likely lead to the discovery of positive outcomes, as well as unintended consequences. The result has potential to strengthen both the practice and science of implementation, improve health outcomes and reduce gender inequities.

Genetic variants influencing effectiveness of exercise training programmes in obesity - an overview of human studies.

PubMed

Leońska-Duniec, A; Ahmetov, I I; Zmijewski, P

2016-09-01

Frequent and regular physical activity has significant benefits for health, including improvement of body composition and help in weight control. Consequently, promoting training programmes, particularly in those who are genetically predisposed, is a significant step towards controlling the presently increasing epidemic of obesity. Although the physiological responses of the human body to exercise are quite well described, the genetic background of these reactions still remains mostly unknown. This review not only summarizes the current evidence, through a literature review and the results of our studies on the influence of gene variants on the characteristics and range of the body's adaptive response to training, but also explores research organization problems, future trends, and possibilities. We describe the most reliable candidate genetic markers that are involved in energy balance pathways and body composition changes in response to training programmes, such as FTO, MC4R, ACE, PPARG, LEP, LEPR, ADRB2, and ADRB3. This knowledge can have an enormous impact not only on individualization of exercise programmes to make them more efficient and safer, but also on improved recovery, traumatology, medical care, diet, supplementation and many other areas. Nevertheless, the current studies still represent only the first steps towards a better understanding of the genetic factors that influence obesity-related traits, as well as gene variant x physical activity interactions, so further research is necessary.

HIV, syphilis infection, and sexual practices among transgenders, male sex workers, and other men who have sex with men in Jakarta, Indonesia

PubMed Central

Pisani, E; Girault, P; Gultom, M; Sukartini, N; Kumalawati, J; Jazan, S; Donegan, E

2004-01-01

Objectives: To establish the prevalence of HIV, syphilis, and sexual risk behaviour among three groups of men who have sex with men in Jakarta, Indonesia, and to investigate sexual links between these men and broader heterosexual populations. Methods: Anonymous, cross sectional surveys among community recruited transgender and male sex workers and self recognised men who have sex with men (MSM) were undertaken in mid-2002 in Jakarta, Indonesia. Places where transgender and male sex workers sell sex and where men go to meet non-commercial male sex partners were mapped. Probability samples were selected for the sex worker populations, while a mixed probability and convenience sample was drawn for self recognised MSM. Blood was drawn for HIV and syphilis serology and community interviewers administered a standardised questionnaire. Results: HIV prevalence was 22% among transgender sex workers, 3.6% among male sex workers, and 2.5% among self recognised MSM, and syphilis prevalence was 19.3%, 2.0% and 1.1% respectively. 59.3% of transgender sex workers and 64.8% of male sex workers reported recent unprotected anal intercourse with clients, and 53.1% of other MSM reported unprotected anal sex with male partners. Some 54.4% of male sex workers and 18.3% of other MSM reported female partners in the preceding year. Conclusion: HIV has reached substantial levels among transgender sex workers, and is not negligible in other MSM groups. Risk behaviour is high in all subpopulations, and bisexual behaviour is common, meaning the threat of a wider epidemic is substantial. Prevention programmes targeting male-male sex are needed to reduce this threat. PMID:15572631

Associations Between Sex Education and Contraceptive Use Among Heterosexually Active, Adolescent Males in the United States.

PubMed

Jaramillo, Nicole; Buhi, Eric R; Elder, John P; Corliss, Heather L

2017-05-01

This study examined associations between reports of receiving education on topics commonly included in sex education (e.g., abstinence only, comprehensive) prior to age 18 years and contraceptive use at the last sex among heterosexually active, 15- to 20-year-old males in the United States. Cross-sectional data from 539 males participating in the 2011-2013 National Survey of Family Growth were analyzed. Bivariate and multinomial logistic regression analyses adjusting for confounding estimated associations between receipt of seven sex education topics (e.g., information on HIV/AIDS, how to say no to sex) and contraceptive use at the last sex (i.e., dual barrier and female-controlled effective methods, female-controlled effective method only, barrier method only, and no method). Nearly, all participants (99%) reported receiving sex education on at least one topic. Education on sexually transmitted diseases (94.7%) and HIV/AIDS (92.0%) were the most commonly reported topics received; education on where to get birth control was the least common (41.6%). Instruction about birth control methods (adjusted odds ratio [AOR] = 3.01; 95% confidence interval [CI] = 1.32-6.87) and how to say no to sex (AOR = 3.39; CI = 1.33-8.64) were positively associated with dual contraception compared to no use. For each additional sex education topic respondents were exposed to, their odds of using dual methods compared to no method was 47% greater (AOR = 1.47; CI = 1.16-1.86). Exposure to a larger number of sex education topics is associated with young men's report of dual contraception use at the last sex. Comprehensive sex education, focusing on a range of topics, may be most effective at promoting safer sex among adolescent males. Copyright © 2016 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

Who attends a UK diabetes screening programme? Findings from the ADDITION-Cambridge study.

PubMed

Sargeant, L A; Simmons, R K; Barling, R S; Butler, R; Williams, K M; Prevost, A T; Kinmonth, A L; Wareham, N J; Griffin, S J

2010-09-01

One of the factors influencing the cost-effectiveness of population screening for Type 2 diabetes may be uptake. We examined attendance and practice- and individual-level factors influencing uptake at each stage of a diabetes screening programme in general practice. A stepwise screening programme was undertaken among 135, 825 people aged 40-69 years without known diabetes in 49 general practices in East England. The programme included a score based on routinely available data (age, sex, body mass index and prescribed medication) to identify those at high risk, who were offered random capillary blood glucose (RBG) and glycosylated haemoglobin tests. Those screening positive were offered fasting capillary blood glucose (FBG) and confirmatory oral glucose tolerance tests (OGTT). There were 33 539 high-risk individuals invited for a RBG screening test; 24 654 (74%) attended. Ninety-four per cent attended the follow-up FBG test and 82% the diagnostic OGTT. Seventy per cent of individuals completed the screening programme. Practices with higher general practitioner staff complements and those located in more deprived areas had lower uptake for RBG and FBG tests. Male sex and a higher body mass index were associated with lower attendance for RBG testing. Older age, prescription of antihypertensive medication and a higher risk score were associated with higher attendance for FBG and RBG tests. High attendance rates can be achieved by targeted stepwise screening of individuals assessed as high risk by data routinely available in general practice. Different strategies may be required to increase initial attendance, ensure completion of the screening programme, and reduce the risk that screening increases health inequalities.

SAFER, an Analysis Method of Quantitative Proteomic Data, Reveals New Interactors of the C. elegans Autophagic Protein LGG-1.

PubMed

Yi, Zhou; Manil-Ségalen, Marion; Sago, Laila; Glatigny, Annie; Redeker, Virginie; Legouis, Renaud; Mucchielli-Giorgi, Marie-Hélène

2016-05-06

Affinity purifications followed by mass spectrometric analysis are used to identify protein-protein interactions. Because quantitative proteomic data are noisy, it is necessary to develop statistical methods to eliminate false-positives and identify true partners. We present here a novel approach for filtering false interactors, named "SAFER" for mass Spectrometry data Analysis by Filtering of Experimental Replicates, which is based on the reproducibility of the replicates and the fold-change of the protein intensities between bait and control. To identify regulators or targets of autophagy, we characterized the interactors of LGG1, a ubiquitin-like protein involved in autophagosome formation in C. elegans. LGG-1 partners were purified by affinity, analyzed by nanoLC-MS/MS mass spectrometry, and quantified by a label-free proteomic approach based on the mass spectrometric signal intensity of peptide precursor ions. Because the selection of confident interactions depends on the method used for statistical analysis, we compared SAFER with several statistical tests and different scoring algorithms on this set of data. We show that SAFER recovers high-confidence interactors that have been ignored by the other methods and identified new candidates involved in the autophagy process. We further validated our method on a public data set and conclude that SAFER notably improves the identification of protein interactors.

Social participation and drug use in a cohort of Brazilian sex workers.

PubMed

Leslie, Hannah Hogan; Ahern, Jennifer; Chinaglia, Magda; Kerrigan, Deanna; Lippman, Sheri A

2013-06-01

Structural interventions focused on community mobilisation to engender an enabling social context have reduced sexual risk behaviours among sex workers. Interventions to date have increased social participation and shown an association between participation and safer sex. Social participation could modify risk for other health behaviours, particularly drug use. We assessed social participation and drug use before and after implementation of a clinical, social and structural intervention with sex workers intended to prevent sexually transmitted infections/HIV infection. We followed 420 sex workers participating in the Encontros intervention in Corumbá, Brazil, between 2003 and 2005. We estimated the association of participation in external social groups with drug use at baseline and follow-up using logistic regression and marginal modelling. Follow-up analyses of preintervention/postintervention change in drug use employed inverse probability weighting to account for censoring and were stratified by exposure to the intervention. Social participation showed a protective association with drug use at baseline (1 SD higher level of social participation associated with 3.8% lower prevalence of drug use, 95% CI -0.1 to 8.3). Among individuals exposed to Encontros, higher social participation was associated with an 8.6% lower level of drug use (95% CI 0.1 to 23.3). No significant association was found among the unexposed. A structural intervention that modified sex workers' social environment, specifically participation in external social groups, was associated with reduced drug use. These findings suggest that sexual risk prevention initiatives that enhance social integration among marginalised populations can produce broad health impacts, including reductions in drug use.

Community-level intimate partner violence and the circumstances of first sex among young women from five African countries.

PubMed

Gómez, Anu Manchikanti; Speizer, Ilene S

2010-06-19

Gender-based violence is an important risk factor for adverse reproductive health (RH). Community-level violence may inhibit young women's ability to engage in safer sexual behaviors due to a lack of control over sexual encounters. Few studies examine violence as a contextual risk factor. Using nationally representative data from five African countries, the association between community-level physical or sexual intimate partner violence (IPV) and the circumstances of first sex (premarital or marital) among young women (ages 20-29) was examined. In Mali, and Kenya bivariate analyses showed that young women who had premarital first sex were from communities where a significantly higher percentage of women reported IPV experience compared to young women who had marital first sex. Multivariate analyses confirmed the findings for these two countries; young women from communities with higher IPV were significantly more likely to have had premarital first sex compared to first sex in union. In Liberia, community-level IPV was associated with a lower risk of premarital sex as compared to first sex in union at a marginal significance level. There was no significant relationship between community-level IPV and the circumstances of first sex in the Democratic Republic of Congo or Zimbabwe. These findings indicate that context matters for RH. Individualized efforts to improve RH may be limited in their effectiveness if they do not acknowledge the context of young women's lives. Programs should target prevention of violence to improve RH outcomes of youth.

Support for safer behaviour.

PubMed

Pujari, S

1994-01-01

Counseling persons about human immunodeficiency virus (HIV) testing and safe sex practices is performed in India at acquired immunodeficiency syndrome (AIDS) counseling centers, such as the one in Pune. The center provides counseling to clients, primarily men, before and after HIV testing. Support groups are offered for HIV-positive persons. Clients are referred by doctors, sexually transmitted disease (STD) clinics, and health care institutions. Advertising is by word of mouth. Previously, when blood banks were sending HIV-positive persons for counseling, confirmatory testing had not been performed, and 30% were actually HIV negative. Now the center, in cooperation with the blood banks, contacts all HIV-positive patients. After counseling, a confirmatory test is performed, if the patient agrees. HIV-positive persons are encouraged, but not pressured, to contact partners. Breaking confidentially is avoided. The center also counsels patients at the local government STD clinic. Again, these are mainly men. All patients have a follow up session after diagnosis to discuss sexual practices, risk reduction practices, disease prevention, and condom use. In India, culture constrains open discussion about sex. However, if counselors begin with neutral topics, such as work or children, men are more willing to speak about sexual practices and lifestyles. Counselors discuss the possible reasons for unsafe behavior and offer practical solutions. Counseling men in STD clinics also indirectly reaches their partners, the wives and sex workers who are in less of a position to protect themselves.

Advanced and safer lithium-ion battery based on sustainable electrodes

NASA Astrophysics Data System (ADS)

Ding, Xiang; Huang, Xiaobing; Jin, Junling; Ming, Hai; Wang, Limin; Ming, Jun

2018-03-01

Seeking advanced and safer lithium-ion battery with sustainable characteristic is significant for the development of electronic devices and electric vehicles. Herein, a new porous TiO2 nanobundles (PTNBs) is synthesized though a scalable and green hydrothermal strategy from the TiO2 powders without using any high-cost and harmful organic titanium-based compounds. The PTNBs exhibits an extremely high lithium storage capacity of 296 mAh g-1 at 100 mA g-1, where the capacity can maintain over 146 mAh g-1 even after 500 cycles at 1000 mA g-1. To pursue more reliable Li-ion batteries, full batteries of PTNBs/LiNixMn1-xO4 (x = 0, 0.5) using spinel structured cathode are constructed. The batteries have the features of sustainability and deliver high capacities of 112 mAh gcathode-1 and 102 mAh gcathode-1 with stable capacity retentions of 99% and 90% over 140 cycles. Note that the energy densities can achieve as high as 267 and 270 Wh kgcathode-1 (535 and 540 Wh kganode-1) respectively, which is feasible to satisfy diverse requirements for energy storage products. We believe that the universal synthetic strategy, appealing structure and intriguing properties of PTNBs is applicable for wider applications, while the concept of sustainable strategy seeking reliable and safer Li-ion battery can attract broad interest.

Drug assertiveness and sexual risk-taking behavior in a sample of HIV-positive, methamphetamine-using men who have sex with men

PubMed Central

Semple, Shirley J.; Strathdee, Steffanie A.; Zians, Jim; McQuaid, John R.; Patterson, Thomas L.

2011-01-01

Drug assertiveness skills have been demonstrated effective in reducing substance use behaviors among patients with alcohol- or heroin-use disorders. This study examined the association between drug assertiveness and methamphetamine use, psychological factors, and sexual risk behaviors in a sample of 250 HIV-positive men who have sex with men (MSM) enrolled in a safer sex intervention in San Diego, CA. Less assertiveness in turning down drugs was associated with greater frequency and larger amounts of methamphetamine use, lower self-esteem, higher scores on a measure of sexual sensation-seeking, and greater attendance at risky sexual venues. These data suggest that drug assertiveness training should be incorporated into drug abuse treatment programs and other risk reduction interventions for methamphetamine users. PMID:21550758

Factors associated with the content of sex education in U.S. public secondary schools.

PubMed

Landry, David J; Darroch, Jacqueline E; Singh, Susheela; Higgins, Jenny

2003-01-01

While sex education is almost universal in U.S. schools, its content varies considerably. Topics such as abstinence, and basic information on HIV and other sexually transmitted diseases (STDs), are commonly taught; birth control and how to access STD and contraceptive services are taught less often. Factors potentially associated with these variations need to be examined. Data on 1,657 respondents to a 1999 national survey of teachers providing sex education in grades 7-12 were assessed for variation in topics covered. Logistic regression was used to ascertain factors associated with instruction on selected topics. The content of sex education varied by region and by instructors' approach to teaching about abstinence and contraception. For example, teaching abstinence as the only means of pregnancy and STD prevention was more common in the South than in the Northeast (30% vs. 17%). Emphasizing the ineffectiveness of contraceptives was less common in the Northeast (17%) than in other regions (27-32%). Instructors teaching that methods are ineffective and presenting abstinence as teenagers' only option had significantly reduced odds of teaching various skills and topics (odds ratios, 0.1-0.5). Instructors' approach to teaching about methods is a very powerful indicator of the content of sex education. Given the well-documented relationship between what teenagers learn about safer sexual behavior and their use of methods when they initiate sexual activity, sex education in all U.S. high schools should include accurate information about condoms and other contraceptives.

'Nice girls don't': women and the condom conundrum.

PubMed

Cook, Catherine

2012-02-01

This study aims to highlight the tensions between the 'risks' of condom negotiation to feminine identity and safer sex health education messages of individual choice and responsibility. Effective education incorporates nurses' recognition that deterrents to women practising safer sex may increase subsequent to a diagnosis of a viral sexually transmitted infection. Health educational messages and clinicians' teaching emphasise rational decision-making with regard to condom use with a focus on the acquisition of technical information and ready access to condoms. These messages do not take into account the social complexities for women in negotiating condom use with men that deter condom use. A qualitative, feminist post-structuralist research design was used. In-depth email interviews were conducted with 12 clinicians with expertise in the sexual health field and 26 women with a diagnosis of either herpes simplex virus or human papilloma virus. A thematic analysis approach was used to analyse the semi-structured and interactive interviews. Few women in the study had received any direct safer sex education from clinicians and wanted them to initiate this discussion. Most women found the topic of safer sex became more difficult once diagnosed with a viral sexually transmitted infection. Women's dilemmas were whether to disclose the diagnosis as part of insisting on condom use, whether condom use mitigated the obligation to disclose or whether any talk or condom use was avoided as too 'risky' to feminine identity. Paradoxically, it may be harder for women to negotiate safer sex and ask for condoms to be used, once diagnosed with a viral sexually transmitted infection. Women want clinicians to give advice about the dissonance between 'rational' safer sex messages and social expectations of appropriate femininity. Relevance to clinical practice.  Nurses have a key role in engaging with women in considering safer sex practices. Nurses need to be able to demonstrate to

Demographic, migration status, and work-related changes in Asian female sex workers surveyed in Sydney, 1993 and 2003.

PubMed

Pell, C; Dabbhadatta, J; Harcourt, C; Tribe, K; O'Connor, C

2006-04-01

To compare demography, sexual health awareness, migration and workplace conditions of Asian female sex workers in Sydney in 1993 and 2003. A Chinese interpreter and a Thai-speaking health education officer (HEO) were used to administer a questionnaire survey to Thai- and Chinese-speaking sex workers attending sexual health clinics in 1993. A follow-up survey, which included some women contacted at work as well as clinic attenders, was administered by Thai- and Chinese-speaking HEOs in 2003. Ninety-one female sex workers were surveyed in 1993 and 165 in 2003. Median age increased (26 years vs. 33 years, p=0.000), as did numbers of Chinese- versus Thai-speakers (1993, 25.3% Chinese vs. 2003, 58.2% Chinese, p=0.000). In 2003, the women reported more years of schooling and better English skills. Fewer reported previous sex work (48.4% vs. 17.6%, p=0.000). Numbers currently or ever on a contract decreased sharply (27.5% vs. 9.1%, p=0.000) and the majority were apparently working legally. Condom use at work for vaginal (51.6% vs. 84.8%) and oral sex (39.6% vs. 66.1%) increased significantly (p=0.001). Chinese-speaking sex workers were less informed about HIV transmission and safer sex practices than were Thai sex workers. Drug and alcohol use was low. Positive changes have occurred in the conditions of Asian female sex workers surveyed over 10 years in Sydney. Maintaining current levels of health service delivery will ensure continued improvements in health and workplace conditions and address inequalities between language groups.

Engineering safer-by-design, transparent, silica-coated ZnO nanorods with reduced DNA damage potential

PubMed Central

Sotiriou, Georgios A.; Watson, Christa; Murdaugh, Kimberly M.; Darrah, Thomas H.; Pyrgiotakis, Georgios; Elder, Alison; Brain, Joseph D.; Demokritou, Philip

2014-01-01

Zinc oxide (ZnO) nanoparticles absorb UV light efficiently while remaining transparent in the visible light spectrum rendering them attractive in cosmetics and polymer films. Their broad use, however, raises concerns regarding potential environmental health risks and it has been shown that ZnO nanoparticles can induce significant DNA damage and cytotoxicity. Even though research on ZnO nanoparticle synthesis has made great progress, efforts on developing safer ZnO nanoparticles that maintain their inherent optoelectronic properties while exhibiting minimal toxicity are limited. Here, a safer-by-design concept was pursued by hermetically encapsulating ZnO nanorods in a biologically inert, nanothin amorphous SiO2 coating during their gas-phase synthesis. It is demonstrated that the SiO2 nanothin layer hermetically encapsulates the core ZnO nanorods without altering their optoelectronic properties. Furthermore, the effect of SiO2 on the toxicological profile of the core ZnO nanorods was assessed using the Nano-Cometchip assay by monitoring DNA damage at a cellular level using human lymphoblastoid cells (TK6). Results indicate significantly lower DNA damage (>3 times) for the SiO2-coated ZnO nanorods compared to uncoated ones. Such an industry-relevant, scalable, safer-by-design formulation of nanostructured materials can liberate their employment in nano-enabled products and minimize risks to the environment and human health. PMID:24955241

Genetic variants influencing effectiveness of exercise training programmes in obesity – an overview of human studies

PubMed Central

Ahmetov, II; Zmijewski, P

2016-01-01

Frequent and regular physical activity has significant benefits for health, including improvement of body composition and help in weight control. Consequently, promoting training programmes, particularly in those who are genetically predisposed, is a significant step towards controlling the presently increasing epidemic of obesity. Although the physiological responses of the human body to exercise are quite well described, the genetic background of these reactions still remains mostly unknown. This review not only summarizes the current evidence, through a literature review and the results of our studies on the influence of gene variants on the characteristics and range of the body's adaptive response to training, but also explores research organization problems, future trends, and possibilities. We describe the most reliable candidate genetic markers that are involved in energy balance pathways and body composition changes in response to training programmes, such as FTO, MC4R, ACE, PPARG, LEP, LEPR, ADRB2, and ADRB3. This knowledge can have an enormous impact not only on individualization of exercise programmes to make them more efficient and safer, but also on improved recovery, traumatology, medical care, diet, supplementation and many other areas. Nevertheless, the current studies still represent only the first steps towards a better understanding of the genetic factors that influence obesity-related traits, as well as gene variant x physical activity interactions, so further research is necessary. PMID:27601774

Designing Safer Analgesics via μ-Opioid Receptor Pathways.

PubMed

Chan, H C Stephen; McCarthy, Dillon; Li, Jianing; Palczewski, Krzysztof; Yuan, Shuguang

2017-11-01

Pain is both a major clinical and economic problem, affecting more people than diabetes, heart disease, and cancer combined. While a variety of prescribed or over-the-counter (OTC) medications are available for pain management, opioid medications, especially those acting on the μ-opioid receptor (μOR) and related pathways, have proven to be the most effective, despite some serious side effects including respiration depression, pruritus, dependence, and constipation. It is therefore imperative that both academia and industry develop novel μOR analgesics which retain their opioid analgesic properties but with fewer or no adverse effects. In this review we outline recent progress towards the discovery of safer opioid analgesics. Copyright © 2017 Elsevier Ltd. All rights reserved.

Designing Safer Analgesics via μ-Opioid Receptor Pathways

PubMed Central

Chan, H.C. Stephen; McCarthy, Dillon; Li, Jianing; Palczewski, Krzysztof; Yuan, Shuguang

2017-01-01

Pain is both a major clinical and economic problem, affecting more people than diabetes, heart disease, and cancer combined. While a variety of prescribed or over-the-counter (OTC) medications are available for pain management, opioid medications, especially those acting on the μ-opioid receptor (μOR) and related pathways, have proven to be the most effective, despite some serious side effects including respiration depression, pruritus, dependence, and constipation. It is therefore imperative that both academia and industry develop novel μOR analgesics which retain their opioid analgesic properties but with fewer or no adverse effects. In this review we outline recent progress towards the discovery of safer opioid analgesics. PMID:28935293

Risky health environments: women sex workers' struggles to find safe, secure and non-exploitative housing in Canada's poorest postal code.

PubMed

Lazarus, L; Chettiar, J; Deering, K; Nabess, R; Shannon, K

2011-12-01

This study explored low-income and transitional housing environments of women sex workers and their role in shaping agency and power in negotiating safety and sexual risk reduction in Vancouver, Canada. A series of 12 focus group discussions were conducted with 73 women currently involved in street-based sex work. These women were purposively sampled for a range of experiences living in low-income housing environments, including homeless shelters, transitional housing, and co-ed and women-only single-room occupancy (SRO) hotels. Drawing on the risk environment framework and theoretical constructs of gender, agency and power, analyses demonstrate that women continue to be vulnerable to violence and sexual and economic exploitation and have reduced ability to negotiate risk reduction resulting from the physical, structural and social environments of current dominant male-centred housing models. Within the physical environment, women described inhabitable housing conditions in SROs with infestations of bedbugs and rats, leading women to even more transitional housing options such as shelters and couch-surfing. In many cases, this resulted in their economic exploitation and increased sexual risk. Within the structural environment, enforcement of curfews and guest policies forced women to accept risky clients to meet curfew, or work outdoors where their ability to negotiate safety and condom use were limited. Certain policies promoted women's agency and mitigated their ability to reduce risks when selling sex. These included flexible curfews and being able to bring clients home. The social environments of co-ed single-room occupancy hotels resulted in repeated violence by male residents and discrimination by male building staff. Women-only shelters and SROs facilitated 'enabling environments' where women developed support systems with other working women that resulted in safer work practices. The narratives expressed in this study reveal the critical need for public

Doug Kirby's Contribution to the Field of Sex Education

ERIC Educational Resources Information Center

Kantor, Leslie M.; Rolleri, Lori; Kolios, Katherine

2014-01-01

Doug Kirby transformed the field of sex education by conducting rigorous research that led to new, critical insights about ways to strengthen programmes, evaluation and policies related to sexual health throughout the world. Throughout his career, Kirby was meticulous in compiling evidence and translating findings into actionable recommendations…

Sexual hazards, life experiences and social circumstances among male sex workers in Nigeria.

PubMed

Okanlawon, Kehinde; Adebowale, Ayo Stephen; Titilayo, Ayotunde

2013-01-01

The sexual health and rights needs of male sex workers in Nigeria remain poorly understood and served. Men who sell sex are at high risk of discrimination and violation because of laws criminalising same-sex activity and sex work. This paper examines the experiences, social circumstances, vulnerabilities and sexual hazards experienced by male sex workers in Nigeria. In-depth interviews were used to explore the experiences of six male sex workers who were selected by means of convenience sampling from among those who came for counselling. Findings reveal that economic disadvantage drives some men to engage in sex work and risky sexual behaviour. Subsequently, sex work may put their lives and health at risk as a result of violation by the police and clients, including ritual murder. Men's extreme vulnerability points to the need for appropriate interventions to improve well-being. Sexual health and rights programmes must identify ways of making male sex workers less vulnerable to abuse, and devise strategies for protecting their health and human rights, while empowering them economically to reduce their dependency on often risky sexual behaviour for livelihoods.

Efficacy of a Clinic-Based Safer Sex Program for Human Immunodeficiency Virus-Uninfected and Human Immunodeficiency Virus-Infected Young Black Men Who Have Sex With Men: A Randomized Controlled Trial.

PubMed

Crosby, Richard A; Mena, Leandro; Salazar, Laura F; Hardin, James W; Brown, Tim; Vickers Smith, Rachel

2018-03-01

To test the efficacy of a single-session, clinic-based intervention designed to promote condom use among young black men who have sex with men (YBMSM). Six hundred YBMSM were enrolled in a randomized controlled trial, using a 12-month observation period. An intent-to-treat analysis was performed, with multiple imputation for missing data. Compared with the reference group, human immunodeficiency virus (HIV)-infected men in the intervention group had 64% greater odds of reporting consistent condom use for anal receptive sex over 12 months (estimated odds ratio, 1.64; 95% confidence interval, 1.23-2.17, P = 0.001). Also, compared with the reference group, HIV-uninfected men in the intervention group had more than twice the odds of reporting consistent condom use for anal receptive sex over 12 months (estimated odds ratio, 2.14; 95% confidence interval, 1.74-2.63, P < 0.001). Significant intervention effects relative to incident sexually transmitted diseases were not observed. A single-session, clinic-based, intervention may help protect HIV-uninfected YBMSM against HIV acquisition and HIV-infected YBMSM from transmitting the virus to insertive partners.

Are Schools Making the Grade? School Districts Nationwide Adopt Safer Pest Management Policies.

ERIC Educational Resources Information Center

Piper, Cortney; Owens, Kagan

2002-01-01

This report documents school districts that have adopted safer pest management policies, such as integrated pest management (IPM), in response to state requirements or as a voluntary measure that exceeds state law. It also documents the state of local school pest management policies and illustrates the opportunities that exist for better…

The Female Sex Work Industry in a District of India in the Context of HIV Prevention

PubMed Central

Buzdugan, Raluca; Halli, Shiva S.; Hiremath, Jyoti M.; Jayanna, Krishnamurthy; Raghavendra, T.; Moses, Stephen; Blanchard, James; Scambler, Graham; Cowan, Frances

2012-01-01

HIV prevalence in India remains high among female sex workers. This paper presents the main findings of a qualitative study of the modes of operation of female sex work in Belgaum district, Karnataka, India, incorporating fifty interviews with sex workers. Thirteen sex work settings (distinguished by sex workers' main places of solicitation and sex) are identified. In addition to previously documented brothel, lodge, street, dhaba (highway restaurant), and highway-based sex workers, under-researched or newly emerging sex worker categories are identified, including phone-based sex workers, parlour girls, and agricultural workers. Women working in brothels, lodges, dhabas, and on highways describe factors that put them at high HIV risk. Of these, dhaba and highway-based sex workers are poorly covered by existing interventions. The paper examines the HIV-related vulnerability factors specific to each sex work setting. The modes of operation and HIV-vulnerabilities of sex work settings identified in this paper have important implications for the local programme. PMID:23346389

The Female Sex Work Industry in a District of India in the Context of HIV Prevention.

PubMed

Buzdugan, Raluca; Halli, Shiva S; Hiremath, Jyoti M; Jayanna, Krishnamurthy; Raghavendra, T; Moses, Stephen; Blanchard, James; Scambler, Graham; Cowan, Frances

2012-01-01

HIV prevalence in India remains high among female sex workers. This paper presents the main findings of a qualitative study of the modes of operation of female sex work in Belgaum district, Karnataka, India, incorporating fifty interviews with sex workers. Thirteen sex work settings (distinguished by sex workers' main places of solicitation and sex) are identified. In addition to previously documented brothel, lodge, street, dhaba (highway restaurant), and highway-based sex workers, under-researched or newly emerging sex worker categories are identified, including phone-based sex workers, parlour girls, and agricultural workers. Women working in brothels, lodges, dhabas, and on highways describe factors that put them at high HIV risk. Of these, dhaba and highway-based sex workers are poorly covered by existing interventions. The paper examines the HIV-related vulnerability factors specific to each sex work setting. The modes of operation and HIV-vulnerabilities of sex work settings identified in this paper have important implications for the local programme.

Condom Negotiations among Female Sex Workers in the Philippines: Environmental Influences

PubMed Central

Urada, Lianne A.; Morisky, Donald E.; Pimentel-Simbulan, Nymia; Silverman, Jay G.; Strathdee, Steffanie A.

2012-01-01

Background Social and structural influences of condom negotiation among female sex workers (FSWs) remain understudied. This study assesses environmental and individual factors associated with condom negotiation among FSWs at high risk for acquiring HIV in a large urban setting of Metro Manila, Philippines. Methods Female bar/spa workers (N = 498), aged 18 and over, underwent interview-led surveys examining their sexual health practices in the context of their risk environments. Data were collected from April 2009-January 2010 from 54 venues. Multiple logistic regressions were conducted to assess socio-behavioral factors (e.g., age, education, length of time employed as an entertainer, and alcohol/drug use) and socio-structural factors (e.g., venue-level peer/manager support, condom rule/availability, and sex trafficking) associated with condom negotiation, adjusting for individuals nested within venues. Results Of 142 FSWs who traded sex in the previous 6 months (included in the analysis), 24% did not typically negotiate condom use with venue patrons. Factors in the physical environment - trafficked/coerced into work (AOR = 12.92, 95% CI = 3.34–49.90), economic environment - sex without a condom to make more money (AOR = 1.52, 95% CI 1.01–2.30), policy environment - sex without a condom because none was available (AOR = 2.58, 95% CI = 1.49–4.48), and individual risk - substance use (AOR = 2.36, 95% CI = 1.28–4.35) were independently associated with FSWs' lack of condom negotiation with venue patrons. Conclusions Factors in the physical, economic, and policy environments, over individual (excepting substance use) and social level factors, were significantly associated with these FSWs' condom negotiations in the Philippines. Drawing upon Rhodes' risk environment framework, these results highlight the need for policies that support safer sex negotiations among sex workers in the context of their risk environments. Interventions

Outcomes of a community-based HIV-prevention pilot programme for township men who have sex with men in Cape Town, South Africa.

PubMed

Batist, Elizabeth; Brown, Benjamin; Scheibe, Andrew; Baral, Stefan D; Bekker, Linda-Gail

2013-12-02

Men who have sex with men (MSM) in Cape Town's townships remain in need of targeted HIV-prevention services. In 2012, a pilot community-based HIV-prevention programme was implemented that aimed to reach MSM in five Cape Town townships, disseminate HIV-prevention information and supplies, and promote the use of condoms and HIV services. Convenience sampling was used to recruit self-identified MSM who were 18 years old or older in five Cape Town townships. The six-month pilot programme trained five community leaders who, along with staff, provided HIV-prevention information and supplies to MSM through small-group meetings, community-based social activities and inter-community events. After the completion of the pilot programme, in-depth interviews and focus group discussions (FGDs) were conducted with a subset of conveniently sampled participants and with each of the community leaders. Qualitative data were then analyzed thematically. Overall, 98 mostly gay-identified black MSM consented to participate, 57 community-based activities were facilitated and 9 inter-community events were conducted. Following their enrollment, 60% (59/98) of participants attended at least one pilot activity. Of those participants, 47% (28/59) attended at least half of the scheduled activities. A total of 36 participants took part in FGDs, and five in-depth interviews were completed with community leaders. Participants reported gaining access to MSM-specific HIV-prevention information, condoms and water-based lubricant through the small-group meetings. Some participants described how their feelings of loneliness, social isolation, self-esteem and self-efficacy were improved after taking part. The social activities and group meetings were viable strategies for disseminating HIV-prevention information, condoms and water-based lubricant to MSM in this setting. Many MSM were also able to receive social support, reduce social isolation and improve their self-esteem. Further research is needed to

Self-silencing and age as risk factors for sexually acquired HIV in midlife and older women.

PubMed

Jacobs, Robin J; Thomlison, Barbara

2009-02-01

Objectives. This study explores the contribution of psychosocial factors on sex behaviors of midlife and older women. Methods. A community-based sample of ethnically diverse women (N = 572) between the ages of 50 and 93 completed standardized measures of self-silencing, self-esteem, sensation seeking behavior, HIV-related stigma behavior, sexual assertiveness, and safer sex behaviors. Results. Results from the regression analysis indicated the model significantly predicted safer sex behaviors (p < .001), with self silencing(â = -.115, p < .05) and age (â = .173, p < .001) as significant predictors.Bivariate correlation analysis indicated an inverse correlation between HIV stigma (p < .05) and safer sex behaviors. Discussion. Implications for further study and practice are discussed to include considerations for development of age- and gender-appropriate prevention interventions assisting women with interpersonal processes combined with skills for active involvement in addressing high-risk sex behaviors.

78 FR 9923 - Proposed Data Collections Submitted for Public Comment and Recommendations

Federal Register 2010, 2011, 2012, 2013, 2014

2013-02-12

... antiretroviral therapy (ART), (3) attend clinic regularly for primary care, and (4) practice safer sex. These are... screener completed by patients; (2) a computer-based intervention (CBI) in which patients see short videos... attendance, adherence to ART, and safer sex; and (3) one-on-one counseling from a prevention specialist if...

Joining and leaving sex work: experiences of women in Kigali, Rwanda.

PubMed

Ingabire, Marie Chantal; Mitchell, Kirstin; Veldhuijzen, Nienke; Umulisa, Marie Michelle; Nyinawabega, Jeanine; Kestelyn, Evelyne; Van Steijn, Minouk; Van De Wijgert, Janneke; Pool, Robert

2012-10-01

Although sex work can bring significant economic benefit there are serious downsides, not least vulnerability to adverse sexual health outcomes. Focus-groups discussions and in-depth interviews were conducted with 70 female sex workers to explore the context in which they started sex work, their motivations to leave, and their experiences of trying to leave. The pathway to becoming a sex worker was underscored by poverty, with disruptive events leading to increasing vulnerability and increasingly difficult life choices. A sizeable minority of women became sex workers while working as house-girls, a position associated with financial, physical and sexual vulnerability. The majority of participants were still working as sex workers, citing financial reasons for not leaving. Motivations to leave sex work included experiencing a frightening incident, peer pressure and concerns about dependent children. Those who left often described a change in their financial circumstances that enabled them to leave. Some had left but had returned to sex work following a financial crisis or because they found their new life too hard. House-girls are particularly vulnerable and therefore an appropriate focus for prevention. Programmes assisting women to leave need to include financial safety nets so that a time of financial difficulty does not necessitate a return to sex work.

Circumstances, experiences and processes surrounding women's entry into sex work in India.

PubMed

McClarty, Leigh M; Bhattacharjee, Parinita; Blanchard, James F; Lorway, Robert R; Ramanaik, Satyanarayana; Mishra, Sharmistha; Isac, Shajy; Ramesh, B M; Washington, Reynold; Moses, Stephen; Becker, Marissa L

2014-01-01

Evidence suggests that in India, the early stages of a woman's career as a sex worker may be an important period to target for HIV and sexually transmitted infection prevention. Before such an intervention is designed and implemented, it is necessary to first understand the life circumstances of women at the start of their sex work careers. We performed a review to bring together available literature pertaining to entry into sex work in India and to highlight knowledge gaps. We found that historical traditions of dedication into sex work, financial insecurity, family discord, violence and coercion, and desire for financial independence are commonly reported reasons for entering into sex work. We also found that families and the broader sex worker community play an important role in the early stages of a woman's sex work career. We suggest that HIV-prevention programmes in India would substantially benefit from a deeper understanding of the life circumstances of new and young women sex workers. Further research should be conducted focusing on family and community involvement in women's entry into sex work, and on the important period of time after a woman's first commercial sex encounter, but before self-identification as a sex worker.

HIV prevention while the bulldozers roll: exploring the effect of the demolition of Goa's red-light area.

PubMed

Shahmanesh, Maryam; Wayal, Sonali; Andrew, Gracy; Patel, Vikram; Cowan, Frances M; Hart, Graham

2009-08-01

Interventions targeting sex-workers are pivotal to HIV prevention in India. Community mobilisation is considered by the National AIDS Control Programme to be an integral component of this strategy. Nevertheless societal factors, and specifically policy and legislation around sex-work, are potential barriers to widespread collectivisation and empowerment of sex-workers. Between November 2003 and December 2005 we conducted participatory observation and rapid ethnographic mapping with several hundred brief informant interviews, in addition to 34 semi-structured interviews with key-informants, 16 in-depth interviews with female sex-workers, and 3 focus-group-discussions with clients and mediators. This provides a detailed examination of the demolition of Baina, one of India's large red-light areas, in 2004, and one of the first accounts of the effect of dismantling the red-light area on the organisation of sex-work and sex-workers' sexual risk. The results suggest that the concentrated and homogeneous brothel-based sex-work environment rapidly evolved into heterogeneous, clandestine and dispersed modes of operation. The social context of sex-work that emerged from the dust of the demolition was higher risk and less conducive to HIV prevention. The demolition acted as a negative structural intervention; a catastrophic event that fragmented sex-workers' collective identity and agency and rendered them voiceless and marginalised. The findings suggest that an abolitionist approach to sex-work and legislation or policy that either criminalises this large group of women, or renders them as invisible victims, will increase the stigma and exclusion they experience. For the targeted HIV prevention approaches advocated by the National AIDS Control Programme to be effective, there is a need for legislation and policy that supports sex-workers' agency and self-organisation and enables them to create a safer working environment for themselves.

Focus on sex differences in grant applications submitted to the Netherlands Organization for Health Research and Development.

PubMed

Keuken, Debby G; Haafkens, Joke A; Klazinga, Niek S

2007-10-24

Several measures have been implemented at international level to ensure that there is a greater focus on sex differences in health research. This study evaluates the effect of various formal incentives that were introduced by a Dutch financer of health research to encourage applicants to include sex differences in research proposals. We sampled 213 health research proposals submitted in 2003 to the programmes Prevention (N = 104) and Innovation (N = 109) by the Netherlands Organization for Health Research and Development (ZonMw). These proposals were analysed and categorized with regard to the expressed intention to take sex differences into consideration. Furthermore, those proposals in which such intention was absent were appraised by researchers to determine whether an intention of this kind would have been relevant. We found that 23 % of proposals submitted to Prevention (incentive: programme specific instructions) and 10% of those submitted to Innovation (general set of guidelines) took account of sex differences (difference 13%; 95% CI: 3.1-22.9). Conversely, 66% of the research proposals in Prevention, and 20% in Innovation, failed to take sex differences into consideration, even though this might well have been relevant. There is still insufficient incentive for those submitting research proposals to ZonMw to systematically incorporate sex differences when drafting such documents. The provisions in ZonMw's policy need to be amended and better monitored. For this, we formulated some recommendations.

RISKY HEALTH ENVIRONMENTS:WOMEN SEX WORKERS’ STRUGGLES TO FIND SAFE, SECURE AND NON-EXPLOITATIVE HOUSING IN CANADA’S POOREST POSTAL CODE

PubMed Central

Lazarus, L; Chettiar, J; Deering, K; Nabess, R; Shannon, K

2011-01-01

This study explored low-income and transitional housing environments of women sex workers and their role in shaping agency and power in negotiating safety and sexual risk reduction in Vancouver, Canada. A series of 12 focus group discussions were conducted with 73 women currently involved in street-based sex work. These women were purposively sampled for a range of experiences living in low-income housing environments, including homeless shelters, transitional housing, and co-ed and women-only single room occupancy (SRO) hotels. Drawing on the risk environment framework and theoretical constructs of gender, agency and power, analyses demonstrate that women continue to be vulnerable to violence and sexual and economic exploitation and have reduced ability to negotiate risk reduction resulting from the physical, structural and social environments of current dominant male-centred housing models. Within the physical environment, women described inhabitable housing conditions in SROs with infestations of bedbugs and rats, leading women to even more transitional housing options such as shelters and couch-surfing. In many cases, this resulted in their economic exploitation and increased sexual risk. Within the structural environment, enforcement of curfews and guest policies forced women to accept risky clients to meet curfew, or work outdoors where their ability to negotiate safety and condom use were limited. Certain policies promoted women’s agency and mitigated their ability to reduce risks when selling sex. These included flexible curfews and being able to bring clients home. The social environments of co-ed single-room occupancy hotels resulted in repeated violence by male residents and discrimination by male building staff. Women-only shelters and SROs facilitated ‘enabling environments’ where women developed support systems with other working women that resulted in safer work practices. The narratives expressed in this study reveal the critical need for

Parental Influence, Gay Youths, and Safer Sex

ERIC Educational Resources Information Center

LaSala, Michael C.

2007-01-01

To begin to understand the role that family relationships and interactions play in young gay men's decisions to avoid unsafe sexual practices, parents and sons (ages 16 to 25) in 30 families were qualitatively interviewed about issues and concerns related to HIV risk. Most of the youths reported feeling obliged to their parents to stay healthy,…

Safer Sex Workshops for Enhancing Self-Esteem.

ERIC Educational Resources Information Center

Biddington, Carol M.

Although the mechanisms of transmission of the Human Immunodeficiency Virus (HIV) are well known, the elimination of HIV infections remains a major social problem. While traditional education techniques have been effective in increasing knowledge levels, they have not been adequate in changing sexual behavior. Since students' self-esteem plays a…

Guidance Notes on Safer School Construction: Global Facility for Disaster Reduction and Recovery

ERIC Educational Resources Information Center

World Bank Publications, 2009

2009-01-01

This document provides a framework of guiding principles and general steps addressing the construction of safer and more disaster resilient education facilities. It is aimed to be adapted to the local context and used to develop a context-specific plan to address a critical gap to reaching the Education for All (EFA) and Millennium Development…

Limiting options: Sex ratios, incarceration rates and sexual risk behavior among people on probation and parole

PubMed Central

Green, Traci C.; Pouget, Enrique R.; Harrington, Magdalena; Taxman, Faye S.; Rhodes, Anne G.; O’Connell, Daniel; Martin, Steven S.; Prendergast, Michael; Friedmann, Peter D.

2012-01-01

Background To investigate how incarceration may affect risk of acquiring HIV and other sexually transmitted infections, we tested associations of ex-offenders’ sexual risk behavior with the male-female sex ratio and the male incarceration rate. Methods Longitudinal data from 1287 drug-involved persons on probation and parole as part of the Criminal Justice Drug Abuse Treatment Studies were matched by county of residence with population factors, and stratified by race/ethnicity and gender. Generalized estimating equations assessed associations of having unprotected sex with a partner who had HIV risk factors, and having more than 1 sex partner in the past month. Results Among non-Hispanic Black men and women, low sex ratios were associated with greater risk of having unprotected sex with a risky partner (Adjusted relative risk (ARR) = 1.76, 95% confidence interval (CI) = 1.29, 2.42; ARR = 2.48, 95% CI = 1.31, 4.73, respectively). Among non-Hispanic Black and non-Hispanic White women, low sex ratios were associated with having more than 1 sex partner (ARR = 2.00, 95% CI = 1.02, 3.94; ARR = 1.71, 95% CI = 1.06, 2.75, respectively). High incarceration rates were associated with greater risk of having a risky partner for all men (non-Hispanic Black: ARR= 2.14, 95% CI=1.39, 3.30; non-Hispanic White: ARR= 1.39, 95% CI: 1.05, 1.85; Hispanic: ARR = 3.99, 95% CI =1.55, 10.26) and having more than one partner among non-Hispanic White men (ARR= 1.92, 95% CI = 1.40, 2.64). Conclusions Low sex ratios and high incarceration rates may influence the number and risk characteristics of sex partners of ex-offenders. HIV-prevention policies and programs for ex-offenders could be improved by addressing structural barriers to safer sexual behavior. PMID:22592827