Sexual Risk Behavior and STI Contraction Among Young Women With Prior Juvenile Justice Involvement.

PubMed

Leve, Leslie D; Van Ryzin, Mark J; Chamberlain, Patricia

Girls in the juvenile justice system are at increased risk for contracting HIV/AIDS. Sexual risk behavior was examined in 166 females with juvenile justice involvement who were followed from adolescence to young adulthood. Results indicated that childhood sexual abuse increased the incidence of unsafe sex during young adulthood, which was subsequently associated with contraction of a sexually transmitted infection (STI). Further, girls' comfort in talking with their partners about safer sex practices during adolescence moderated the association between childhood sexual abuse and unsafe sex, such that girls who had been sexually abused and were uncomfortable talking to their partners about safer sex during adolescence had an 8.5-fold increase in unsafe sex in young adulthood. The identification of behaviors amenable to intervention in the prevention of HIV/AIDS risk in this high-risk population is discussed.

Sexual Risk Behavior and STI Contraction Among Young Women With Prior Juvenile Justice Involvement

PubMed Central

Leve, Leslie D.; Van Ryzin, Mark J.; Chamberlain, Patricia

2014-01-01

Girls in the juvenile justice system are at increased risk for contracting HIV/AIDS. Sexual risk behavior was examined in 166 females with juvenile justice involvement who were followed from adolescence to young adulthood. Results indicated that childhood sexual abuse increased the incidence of unsafe sex during young adulthood, which was subsequently associated with contraction of a sexually transmitted infection (STI). Further, girls’ comfort in talking with their partners about safer sex practices during adolescence moderated the association between childhood sexual abuse and unsafe sex, such that girls who had been sexually abused and were uncomfortable talking to their partners about safer sex during adolescence had an 8.5-fold increase in unsafe sex in young adulthood. The identification of behaviors amenable to intervention in the prevention of HIV/AIDS risk in this high-risk population is discussed. PMID:26120287

Sexual behaviour related to psycho-social factors in a population of Danish homosexual and bisexual men.

PubMed

Schmidt, K W; Fouchard, J R; Krasnik, A; Zoffmann, H; Jacobsen, H L; Kreiner, S

1992-05-01

An anonymous self-administered questionnaire was distributed to (1) male members of the Danish Gay and Lesbian Association (2) through a gay magazine and (3) to readers of a gay pornographic magazine. For the purpose of this study sexual practices were classified into three categories taking into account the HIV-status of the respondent and his partner(s): safe sex (mutual masturbation, sex with condoms, sex without condoms between two HIV-positives), potentially safe sex (oral-genital sex without condoms irrespective of HIV-status, anal-genital sex without condoms between two HIV-negatives), unsafe sex (anal-genital sex without condoms between discordant partners or partners of unknown HIV status). Of the 2058 respondents 29.7% had had unsafe sex in the last 12 months. Multivariate analysis by recursive graphical models showed that sexual practice was directly related (that is conditionally dependent given the rest of the variables) to having a steady partner. Among men without a steady partner sexual practice was also directly related to age and number of partners showing an increase in unsafe sex with number of partners and a decrease with age. Thus of the men 16-19 years of age 43.5% had had unsafe sex irrespective of number of partners vs 5.7% of men older than 44 years and with one to two partners. Sexual practice was not directly related to any other demographic or psychosocial factor in the study. The adopted classification of sexual practice preclude that the high occurrence of unsafe sex could be explained by unsafe sex taking place among partners of concordant HIV status. The results emphasize the need for further preventive efforts to reduce transmission of HIV among homosexual men.

Sex, price and preferences: accounting for unsafe sexual practices in prostitution markets.

PubMed

Adriaenssens, Stef; Hendrickx, Jef

2012-06-01

Unsafe sexual practices are persistent in prostitution interactions: one in four contacts can be called unsafe. The determinants of this are still matter for debate. We account for the roles played by clients' preferences and the hypothetical price premium of unsafe sexual practices with the help of a large dataset of clients' self-reported commercial sexual transactions in Belgium and The Netherlands. Almost 25,000 reports were collected, representing the whole gamut of prostitution market segments. The first set of explanations consists of an analysis of the price-fixing elements of paid sex. With the help of the so-called hedonic pricing method we test for the existence of a price incentive for unsafe sex. In accordance with the results from studies in some prostitution markets in the developing world, the study replicates a significant wage penalty for condom use of an estimated 7.2 per cent, confirmed in both multilevel and fixed-effects regressions. The second part of the analysis reconstructs the demand side basis of this wage penalty: the consistent preference of clients of prostitution for unsafe sex. This study is the first to document empirically clients' preference for intercourse without a condom, with the help of a multilevel ordinal regression. © 2011 The Authors. Sociology of Health & Illness © 2011 Foundation for the Sociology of Health & Illness/Blackwell Publishing Ltd.

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.

“Bend a fish when the fish is not yet dry”: Adolescent Boys’ Perceptions of Sexual Risk in Tanzania

PubMed Central

Sommer, Marni; Likindikoki, Samuel; Kaaya, Sylvia

2015-01-01

Despite decades of effort, the spread of HIV/AIDS continues among many African young people. A key contributor is unsafe sexual behavior that is desired, persuaded or coerced. We explored the masculinity norms shaping pubescent boys’ perceptions of and engagement in (unsafe) sexual behaviors in Tanzania. Through a comparative case study in rural and urban Tanzania, qualitative and participatory methods were used with 160 adolescent boys in and out of school to better understand the social and contextual factors promoting unsafe sexual behaviors. Adolescent boys in both the rural and urban sites reported struggling with intense sexual desires, strong peer pressures to have sex, and social norms dissuading condom use. A growing “normalization” of AIDS suggests messages promoting the dangers of HIV infection may be less effective. Findings reinforce the need for interventions with very young adolescents. Research is needed to identify more effective approaches for promoting safer sexual practices among boys in sub-Saharan Africa. Harm reduction approaches and gender transformative approaches might prove more effective than current HIV prevention efforts focused on youth. PMID:25583374

A strategic assessment of unsafe abortion in Malawi.

PubMed

Jackson, Emily; Johnson, Brooke Ronald; Gebreselassie, Hailemichael; Kangaude, Godfrey D; Mhango, Chisale

2011-05-01

As part of efforts to achieve Millennium Development Goal 5--to reduce maternal mortality by 75% and achieve universal access to reproductive health by 2015--the Malawi Ministry of Health conducted a strategic assessment of unsafe abortion in Malawi. This paper describes the findings of the assessment, including a human rights-based review of Malawi's laws, policies and international agreements relating to sexual and reproductive health and data from 485 in-depth interviews about sexual and reproductive health, maternal mortality and unsafe abortion, conducted with Malawians from all parts of the country and social strata. Consensus recommendations to address the issue of unsafe abortion were developed by a broad base of local and international stakeholders during a national dissemination meeting. Malawi's restrictive abortion law, inaccessibility of safe abortion services, particularly for poor and young women, and lack of adequate family planning, youth-friendly and post-abortion care services were the most important barriers. The consensus reached was that to make abortion safe in Malawi, there were four areas for urgent action--abortion law reform; sexuality education and family planning; adolescent sexual and reproductive health services; and post-abortion care services. Copyright © 2011 Reproductive Health Matters. Published by Elsevier Ltd. All rights reserved.

Associations between crystal methamphetamine use and potentially unsafe sexual activity among gay men in Australia.

PubMed

Rawstorne, Patrick; Digiusto, Erol; Worth, Heather; Zablotska, Iryna

2007-10-01

It has been suggested that crystal methamphetamine may have disinhibiting or aphrodisiac effects, which may lead to unsafe sexual behavior and increase the risk of HIV transmission. Using data from two Australian studies, the Sydney Gay Community Periodic Survey study and the Positive Health (PH) cohort study, we examined changes over time in use of crystal, other recreational drugs, and Viagra, and in a range of sex-related behaviors. Compared to non-users, crystal users reported having more sex partners, looking for sex in more types of venues, and being more likely to engage in unprotected anal intercourse with casual partners (UAIC) and in esoteric sex. Crystal users were also more likely to be using other recreational drugs and Viagra than non-users. Crystal use remained significantly associated with UAIC after adjustment for other relevant variables in a log-binomial regression analysis (adjusted prevalence rate ratio=1.26; 95% CI: 1.19-1.34). The other variables (HIV status, number of sex partners, number of types of venue where men looked for sex, Viagra use, other drug use) were independently associated with UAIC, and did not show confounding or mediating effects on the crystal-UAIC association. Nevertheless, these data did not allow reliable attribution of higher levels of these sex-related behaviors among crystal users specifically to the effects of crystal. The prevalence of crystal use among Australian men who have sex with men (MSM) increased between 2002 and 2005 (e.g., from 26% to 39% among HIV-+ MSM). However, the prevalence of UAIC remained stable or decreased over time in various study subgroups, as did the prevalence of other sex-related behaviors, suggesting that crystal use does not necessarily drive unsafe sexual behavior. Crystal use and unsafe sexual behavior can, and should, be considered and addressed separately in health promotion and community education campaigns.

History of childhood sexual abuse and unsafe anal intercourse in a 6-city study of HIV-positive men who have sex with men.

PubMed

Welles, Seth L; Baker, A Cornelius; Miner, Michael H; Brennan, David J; Jacoby, Scott; Rosser, B R Simon

2009-06-01

We assessed rates of childhood sexual abuse and its demographic and mental health correlates among HIV-positive men who reported unsafe anal intercourse with other men in the past year. We conducted a cross-sectional analysis of baseline data from 593 HIV-positive men who have sex with men enrolled in the Positive Connections intervention. Childhood sexual abuse was reported by 47% of participants; 32% reported frequency as often or sometimes. Men reporting abuse were more likely to be Latino (odds ratio [OR] = 2.6; 95% confidence interval [CI] = 1.6, 4.2; P < .001) or African American (OR = 1.8; 95% CI = 1.2, 2.7; P = .005) than White. Among those who were abused, more frequent abuse was associated with more sexual contacts (for each, rate ratio [RR] = 1.3; P < .001) and unsafe anal intercourse (often, RR = 1.5; sometimes, RR = 2.0; P < .001) compared with men who were not abused. History of childhood sexual abuse is highly prevalent among HIV-positive men who engage in risky sexual behavior with other men and appears to be more common among men of color. Our findings suggest that abuse is associated with a significantly increased risk of sexually transmitted infections.

Opportunity to Learn: The Health Connection.

ERIC Educational Resources Information Center

Jackson, Shirley A.

1993-01-01

Reviews the following health issues related to the opportunity to learn for poor African-American and other minority children: (1) inadequate prenatal care; (2) malnutrition; (3) childhood diseases and illnesses; (4) unsafe environments and violence; (5) teenage sexual activity, pregnancy, and AIDS; (6) substance use and abuse; and (7) mental and…

Unplanned pregnancy-risks and use of emergency contraception: a survey of two Nigerian Universities.

PubMed

Ajayi, Anthony Idowu; Nwokocha, Ezebunwa Ethelbert; Adeniyi, Oladele Vincent; Ter Goon, Daniel; Akpan, Wilson

2017-06-02

The vulnerabilities of young women of low socio-economic status and those with little or no formal education tend to dominate the discourse on unplanned pregnancy, unsafe abortion and emergency contraception (EC) in sub-Saharan Africa. This article draws on a survey conducted among female undergraduate students to shed light on sexual behaviour and the dynamics of emergency contraceptive use among this cohort. The survey involved 420 female undergraduate students drawn using a multistage sampling technique, while a self-administered questionnaire was used for data collection. Univariate and bivariate analyses were applied to examine the factors associated with the use of emergency contraception. Of the 176 female students who reported being sexually active in the year preceding the survey, only 38.6% reported the use of condom during the entire year. Of those who reported unplanned pregnancy anxiety n = 94, about 30.1% used EC, 20.4% used non-EC pills as EC, while others reported having used no EC. A few respondents (n = 3) had terminated a pregnancy under unsafe conditions. Awareness of EC (p < 0.001), knowledge of timing of EC (p = 0.001), perceived risk of unplanned pregnancy (p < 0.001), and level of study (p = 0.013), were significantly correlated with the use of EC. The study revealed that educated youths engaged in high-risk sexual activities and also, sought recourse to unproven and unsafe contraceptive methods. Poor knowledge of EC methods and timing of use, as well as wrong perception about EC side effects, are barriers to the utilisation of EC for the prevention of unplanned pregnancy among the study participants.

Unsafe in the Camouflage Tower: Sexual Victimization and Perceptions of Military Academy Leadership

ERIC Educational Resources Information Center

Snyder, Jamie A.; Fisher, Bonnie S.; Scherer, Heidi L.; Daigle, Leah E.

2012-01-01

Few studies have examined sexual victimization among cadets and midshipmen at the three U.S. Military Academies. Self-report data from the 2005 Service Academy Sexual Assault Survey of Cadets and Midshipmen (n = 5,220) were used to examine the extent of unwanted sexual attention, sexual harassment, unwanted sexual contact, sexual coercion, and…

Prevalence of unsafe sex with one's steady partner either HIV-negative or of unknown HIV status and associated determinants in Cameroon (EVAL ANRS12-116 survey).

PubMed

Dia, Aïssata; Marcellin, Fabienne; Bonono, Renée-Cécile; Boyer, Sylvie; Bouhnik, Anne-Déborah; Protopopescu, Camelia; Koulla-Shiro, Sinata; Carrieri, Maria Patrizia; Abé, Claude; Spire, Bruno

2010-04-01

Our study aimed at estimating the prevalence of inconsistent condom use and at identifying its determinants in steady partnerships among people living with HIV/AIDS (PLWHA) in Cameroon. Analyses were based on data collected during the national cross-sectional multicentre survey EVAL (ANRS 12-116), which was conducted in Cameroon between September 2006 and March 2007 among 3151 adult PLWHA diagnosed HIV-positive for at least 3 months. The study population consisted of the 907 survey participants who reported sexual activity during the previous 3 months, with a steady partner either HIV-negative or of unknown HIV status. Logistic regression was used to identify factors associated with individuals' report of inconsistent condom use during the previous 3 months. Inconsistent condom use was reported by 35.3% of sexually active PLWHA. In a multivariate analysis adjusted for socio-demographic characteristics, not receiving antiretroviral therapy (OR (95% CI): 2.28 (1.64 to 3.18)) was independently associated with inconsistent condom use. The prevalence of unsafe sex remains high among sexually active PLWHA in Cameroon. Treatment with antiretroviral therapy is identified as a factor associated with safer sex, which further encourages the continuation of the national policy for increasing access to HIV treatment and care, and underlines the need to develop counselling strategies for all patients.

Judge upholds closing of theater that was site of high-risk sex.

PubMed

1995-05-05

New York City's decision to close a gay movie theater where inspectors found male patrons engaging in unsafe sexual activity with other men was upheld by Justice Marilyn G. Diamond of the Supreme Court in Manhattan. She rejected the theater owner's argument that the city's March 31, 1995 closure of the New David Cinema on West 54th Street violated the Constitution's guarantee of freedom of speech. The city based its action on a provision in the state health code which prohibits oral, anal or vaginal sex in commercial establishments. Despite several warnings from the city, the movie house did not follow the demands that it move forcefully to prevent high-risk sexual activity among patrons. The New David was one of two theaters and one sex club shut down by the Health Department in recent weeks, but the only one still closed at press time. Some gay activists contend the action was unjustified, since most of the sex that occurs in those establishments in consensual and involves solo or mutual masturbation. Others point out that a good deal of unsafe sex does occur. Because men often have several sexual liaisons during a single night at a theater or club, the risk of HIV transmission is magnified many-fold.

Child sexual abuse, harmful alcohol use and age as determinants of sexual risk behaviours among freshmen in a Nigerian university.

PubMed

Olley, B O

2008-08-01

In Nigeria, freshmen constitute a risk group of adolescents and young adults capable of engaging in unsafe sexual practices. This study documents the associated factors to sexual risk behaviours practices of University of Ibadan, Nigeria freshmen. Eight hundred and forty one (841), freshmen who attended a routine orientation program were asked to respond to a questionnaire. Results showed that 30.8% were sexually active and 47% did not use condom in their last sexual episode. Associated with sexual risk behaviours include: being a male freshman increasing age; lower tendency for violence; increase sexual compulsivity; alcohol abuse; history of rape and a history of Child Sexual Abuse (CSA). Three variables: alcohol abuse; history of CSA and increasing age remained significant in a multiple regression analysis. The paper presents the first evidence of vulnerability of freshmen to sexual risk practices in a Nigerian University.

Changes in sexual behavior following a sex education program in Brazilian public schools.

PubMed

Andrade, Heloísa Helena Siqueira Monteiro; Mello, Maeve Brito de; Sousa, Maria Helena; Makuch, Maria Yolanda; Bertoni, Neilane; Faúndes, Anibal

2009-05-01

This paper describes an evaluation of possible changes in sexual behavior in adolescents who participated in a school-based sex education program in selected public schools in four municipalities in the state of Minas Gerais, Brazil. The program is inserted within the context of reproductive rights, deals with risks involved in unsafe sexual practices and focuses on the positive aspects of sexuality. A quasi-experimental design with pre and post-tests and a non-equivalent control group was used to evaluate the intervention. A total of 4,795 questionnaires were included in this analysis. The program succeeded in more than doubling consistent condom use with casual partners and in increasing the use of modern contraceptives during last intercourse by 68%. The intervention had no effect on age at first intercourse or on adolescents' engagement in sexual activities. The sex education program was effective in generating positive changes in the sexual behavior of adolescents, while not stimulating participation in sexual activities.

Association between pornography use and sexual risk behaviors in adult consumers: a systematic review.

PubMed

Harkness, Emily L; Mullan, Barbara; Mullan, Barbara M; Blaszczynski, Alex

2015-02-01

The purpose of this review was to determine whether an association exists between sexual risk behaviors and pornography consumption. Consumption of pornography is common, yet research examining its link with sexual risk behaviors is in its infancy. Indicators of sexual risk behavior, including unsafe sex practices and a higher number of sexual partners, have been linked to poor health outcomes. A systematic literature search was performed using Medline, PsycINFO, Web of Knowledge, Pubmed, and CINAHL. Studies were included if they assessed the association between pornography use and indicators of sexual risk behaviors in an adult population. A total of 17 were included in the review, and all were assessed for research standards using the Quality Index Scale. For both Internet pornography and general pornography, links with greater unsafe sex practices and number of sexual partners were identified. Limitations of the literature, including low external validity and poor study design, restrict the generalizability of the findings. Accordingly, replication and more rigorous methods are recommended for future research.

The influence of perceived behaviour control, attitude and empowerment on reported condom use and intention to use condoms among adolescents in rural Tanzania.

PubMed

Kalolo, Albino; Kibusi, Stephen Matthew

2015-11-13

Despite the declining trends of Human immunodeficiency virus (HIV) infection in Sub-Saharan Africa (SSA), unsafe sexual behaviours among adolescents still represent a public health challenge. It is important to understand factors acting at different levels to influence sexual behaviour among adolescents. This study examined the influence of perceived behaviour control, subjective norms, attitudes and empowerment on intention to use condoms and reported use of condoms among adolescents in rural Tanzania. We used a questionnaire to collect data from 403 adolescents aged 14 through 19 years from nine randomly selected secondary schools in the Newala district located in the Southern part of Tanzania. The self-administered questionnaire collected information on sexual practices and factors such as attitudes, subjective norms, perceived behaviour control and empowerment. Binary logistic regression was performed to identify factors associated with intention to use and reported use of condoms. Sexually active adolescents constituted 40.6 % of the sample, among them 49.7 % did not use a condom at last sexual intercourse and 49.8 % had multiple sex partners. Many (85 %) of sexually active respondents had their sexual debut between the ages of 14 to 17 years. Girls became sexually active earlier than boys. Perceived behaviour control predicted intentions to use condoms (AOR = 3.059, 95 % CI 1.324-7.065), thus demonstrating its importance in the decision to use a condom. Empowerment (odds ratio = 3.694, 95 % CI 1.295-10.535) and a positive attitude (AOR = 3.484, 95 % CI 1.132-10.72) predicted reported condom use, thus turning the decision to actions. Subjective norms had only indirect effects on intention and reported use of condoms. The findings suggest that unsafe sex practices are prevalent among school adolescents in rural areas of Tanzania. Perceived behaviour control and positive attitudes predict intensions to use condoms whereas empowerment predicts reported condom use. The findings may imply that safe sex promotion interventions that simultaneously address socio-cognitive and ecological determinants of sexual behaviours may improve adolescents' safe sex behaviours.

Violence and unsafe sexual practices in adolescents under 15 years of age.

PubMed

Teixeira, Sérgio Araujo Martins; Taquette, Stella Regina

2010-01-01

To identify factors associated with unprotected sexual activity in females under the age of 15 years. Cross-sectional observational study of sexually active adolescents under the age of 15 seen at a public outpatient gynecology clinic. Data were collected by means of semi-structured interviews (personal information and data on sexuality), clinical examination, and laboratory tests for diagnosis of sexually transmitted infections. Data were analyzed by frequency testing, association of variables (with p <0.05) and multiple correspondence analysis. One hundred sexually active adolescents between the ages of 11 and 14 were interviewed and examined. Of these, 71% declared themselves black; one-third were behind in school; 80% began sexual activity before the age of 13; 58% reported having been victims of violence within the family environment, and 13% had suffered sexual abuse; 77% did not use condoms regularly; and 22% had STIs. Unprotected sexual activity was more frequent with first sexual intercourse before the age of 13, commercial sexual exploitation, multiple sexual partners, intrafamily violence and school delay, as well as black race, unexpected pregnancy, and STIs. The multiple types of violence suffered by teenagers, including structural, intrafamily, and sexual violence, increase their vulnerability to early, unprotected sexual activity and to STIs and unexpected pregnancy. The synergistic effects of poverty, low educational achievement, and low self-esteem reduces the odds that adolescents will build the tools required for self-protection and exposes them to further victimization outside the family environment.

The Relationship of Internalized Homonegativity to Unsafe Sexual Behavior in HIV Seropositive Men who have Sex with Men

PubMed Central

Ross, Michael W.; Simon Rosser, B. R.; Neumaier, Eric R.

2008-01-01

We studied internalized homonegativity (IH) in 675 HIV-positive MSM from six epicenters across the US who attended an HIV prevention workshop. Participants included 300 African American and over 150 Hispanic White and White Non-Hispanic men. Higher IH was significantly associated with African American race. Compulsive sexual behavior, openness as MSM, sexual comfort, depression, education level, and importance of religion also were associated with IH, and independently predicted a third of this outcome's variance. For those with higher IH, two significant paths led to unsafe sexual behavior. First, to serodiscordant unprotected anal intercourse (SDUAI) through being less “out” – thus disclosing serostatus to secondary partners less frequently. Second, to lower condom self-efficacy and SDUAI through lower sexual comfort. These data provide information on the demographic, sexual and mental health variables associated with IH. They offer an indication of the paths through which IH is associated with serodiscordant risk behavior in HIV-positive MSM. PMID:19072529

In the shadows of a prevention campaign: sexual risk behavior in the absence of crystal methamphetamine.

PubMed

Grov, Christian; Parsons, Jeffrey T; Bimbi, David S

2008-02-01

Because of its ability to reduce inhibitions and increase sexual drive, an emerging body of research has repeatedly identified crystal methamphetamine as a key variable in explaining new HIV transmissions among men who have sex with men (MSM). The implications of which have included the development of HIV prevention policies and public health campaigns centered on curbing methamphetamine use in urban gay centers throughout the United States. Data collected from a diverse sample of gay and bisexual men attending large-scale gay, lesbian, and bisexual community events in New York City (n=738) indicated that 10.2% of men used methamphetamine recently (i.e., <90 days) and that 29.9% of the sample had experienced a recent episode of unprotected anal intercourse. The majority, 81.1%, of those men reporting unsafe sex had not used methamphetamine recently. This analysis identified a bivariate relationship between methamphetamine use and sexual risk, but also highlights other variables that were significantly related to risky sexual behavior. Logistic regression analyses indicated that recent GHB use, temptation for unsafe sex, being younger in age, and identification as a barebacker were better indicators of risky sexual behavior than methamphetamine use. Policies focused on methamphetamine prevention may help to curb risky sexual behavior among select groups of individuals; however, these will not adequately address the sexual health of the many gay and bisexual men who, in the shadows of anti-methamphetamine policies and prevention programs, continue to engage in unsafe sex but are nonusers of methamphetamine.

Do traditional risk factors predict whether men who have sex with men engage in unprotected anal intercourse? The need for locally based research to guide interventions.

PubMed

Berg, Rigmor C; Grimes, Richard

2011-09-01

A great deal of research effort has been expended in an effort to identify the variables which most influence men who have sex with men's (MSM) unsafe sexual behaviors.While a set of predictor variables has emerged, these predict the unsafe behaviors of MSM in some locations but not in others, suggesting the need to investigate the predictive ability of these variables among MSM in previously understudied populations. Therefore, this study examined the ability of previously identified factors to predict unsafe sexual behaviors among MSM in Houston, Texas. Data were collected through a short self-report survey completed by MSM attending the Houston pride festival. The multiethnic participants (N = 109) represented a range of age, educational, and income backgrounds. Fifty-seven percent of the survey respondents had been drunk and/or high in sexual contexts, 19 percent evidenced alcohol dependency, 26 percent reported finding sex partners online and sex with serodiscordant or unknown serostatus partners was common. Compared to men who did not report unprotected anal intercourse (UAI) in the preceding two months, MSM who engaged in UAI were younger and more likely to use alcohol in sexual contexts, meet men online for offline sex, and perceive lower safer sex norms in their community. Although these results were statistically significant, the strength of the relationships was too small to have any practical value. The lack of useful explanatory power underscores the importance of accelerated HIV research that identifies the unique, local factors associated with unsafe sex in other previously understudied populations.

Affirm Gender and Sexual Diversity within the School Community

ERIC Educational Resources Information Center

Leonardi, Bethy; Staley, Sara

2015-01-01

Schools tend to be unsafe, unsupportive places for LGBTQ youth. Generally, teachers and administrators are provided little professional development (professional development) focused on gender and sexual diversity. Efforts to provide educators with gender and sexual diversity-focused professional development are slowly expanding, but still too…

Inhalants

MedlinePlus

... brain problems) brain damage (from cut-off oxygen flow to the brain) In addition, because nitrites are misused for sexual pleasure and performance, they can lead to unsafe sexual practices or other risky behavior. This increases the chance of getting or spreading ...

Generating public awareness in Africa. Advocacy for reproductive health: Africa.

PubMed

Nyong'o, D

1996-01-01

In 1995 the IPPF Africa Region undertook advocacy missions to six countries in the region to sensitize national leaders about family planning (FP). This mission was governed by the six challenges laid down in the IPPF's strategic plan, Vision 2000, and the program of action of the International Conference on Population and Development (ICPD) held in Cairo in 1994. In Ethiopia, Kenya, and Tanzania the concerns were adolescent sexuality, family life education, and services to youth. In Uganda unsafe abortion; while in the Central African Republic and Guinea sexual and reproductive health, unsafe abortion, the sexuality of youth, and the empowerment of women were the main issues. Documentation packages prepared for the mission included annual reports, periodicals, conference reports, booklets, and position papers. The target audiences were political leaders, national, regional, and international organizations, religious, educational, and media leaders, and the public. Press conferences were organized and lobbying was conducted with national family planning associations to strengthen networking and coalition building. In Ethiopia the IPPF president's visit pertained to the sexuality of young people. In Kenya the mission coincided with the controversy of introducing family life education in primary schools. A seminar in Nairobi brought together 100 influential people who came to an agreement on the necessity of such education. In Tanzania the advocacy team crusaded for reproductive health services for young people. The country's president fully supported FP activities even allowing the use of hospitals and health centers for the distribution of contraceptives. There was a visit to a teenage mothers' center providing vocational training and reproductive health counseling in Dar es Salaam. In Uganda UNFPA, USAID, and national family planning association representatives met to forge closer working relations and examine the issue of tax exemption for imported contraceptives. In the Central African Republic and Guinea the mission also underscored the concerns about reproductive health, unsafe abortion, and empowerment of women.

Unsafe sex in regular partnerships among heterosexual persons living with HIV: evidence from a large representative sample of individuals attending outpatients services in France (ANRS-EN12-VESPA Study).

PubMed

Bouhnik, Anne-Déborah; Préau, Marie; Lert, France; Peretti-Watel, Patrick; Schiltz, Marie-Ange; Obadia, Yolande; Spire, Bruno

2007-01-01

Risky sexual behaviour remains frequent among people living with HIV. We analysed factors associated with unsafe sex within serodiscordant couples among heterosexual individuals living with HIV in France. In 2003, a face-to-face survey was conducted among individuals selected in a random stratified sample of 102 French hospital departments delivering HIV care. This analysis included adults heterosexual participants in a regular partnership for at least 12 months with a seronegative/unknown serostatus partner, HIV-diagnosed for at least 12 months. Unsafe sex was defined as reporting inconsistent condom use in the prior 12 months. Among men and women, participants who reported unsafe sex were compared with those who did not. 663 heterosexual adults reported being in a serodiscordant regular partnership. Women accounted for 41% of participants and 26% of the sample were immigrants. Unsafe sex with the steady partner was reported by 26% of men and 34% of women (p=0.024). For men, factors independently associated with unsafe sex were being in a relationship for more than 10 years, being in a difficult financial situation and reporting regular consumption of alcohol to excess. Among women, having a history of drug use, not being aware of partner's serostatus, and reporting a difficult financial situation were independently associated with unsafe sex. In addition, immigrant women were associated with safer sex. A high number of serodiscordant couples continue to report risky sexual behaviour, and related factors are gender-specific. Couple-level interventions are essential in order to prevent HIV-transmission and to encourage negotiation within couples.

Minimizing Harm and Maximizing Pleasure: Considering the Harm Reduction Paradigm for Sexuality Education

ERIC Educational Resources Information Center

Naisteter, Michal A.; Sitron, Justin A.

2010-01-01

This article explores the potential for introducing harm reduction into sexuality education. When the goal of sexuality education is on prevention and focuses on risk and public health concerns, a discussion of pleasure is rendered problematic, as many pleasurable behaviors are inherently "unsafe" or "risky" when considered using a safe-sex lens.…

On the Limits of Sexual Health Literacy: Insights from Ugandan Schoolgirls

ERIC Educational Resources Information Center

Jones, Shelley; Norton, Bonny

2007-01-01

This article makes the case that current conceptions of sexual health literacy have limited relevance to the Ugandan context because they assume that knowledge of unsafe sexual practices will lead to changes in behavior and lifestyle. Drawing on a longitudinal case study with 15 Ugandan schoolgirls in rural Uganda from August 2004 to September…

Substance use and risky sexual behavior for exposure to HIV: Issues in methodology, interpretation, and prevention

PubMed Central

Leigh, Barbara C.; Stall, Ron

2008-01-01

Recent reports have suggested that the use of alcohol or drugs is related to sexual behavior that is high-risk for HIV infection. If substance use leads to unsafe sexual activity, understanding the dynamics of this relationship can contribute to research, preventive and education efforts to contain the spread of AIDS. In this paper, we review research on the relationship between substance use and high-risk sexual behavior. We then consider the inherent limitations of the research designs used to study this relationship, outline some methodological concerns including measurement and sampling issues, and comment on causal interpretations of correlational research findings. We end with a consideration of potential avenues for avenues for future research and a discussion of implications of these findings for current AIDS prevention policies. PMID:8256876

Parents, Peers, and Sexual Values Influence Sexual Behavior During the Transition to College

PubMed Central

Neal, Dan J.; Fromme, Kim

2018-01-01

Several decades of research have identified the contributions of psychosocial influences on adolescent and young adult sexual behavior; however, few studies have examined parental and peer influence and sexual values during the transition from high school to college. The current study tested the influence of sexual values and perceived awareness and caring (PAC), or beliefs about how much parents and peers know and care about students’ behavior, on sexual behavior during this transitional period. Using data from a longitudinal study, generalized estimating equations and the generalized linear model were used to examine the associations among sexual values, parental and peer PAC, and sexual behavior, both cross-sectionally and longitudinally. Participants (N = 1,847; 61% female) completed web-based surveys the summer before college matriculation and at the end of the first semester in college. Results indicated that individuals with high levels of both parental and peer PAC engaged in less frequent sexual behaviors and that PAC moderated the effect of sexual values on sexual behaviors. Furthermore, both PAC variables decreased during the transition from high school to college, and high school sexual values, parental PAC, and their interaction predicted the number of sexual partners during the first semester of college. Only sexual values and high school unsafe sexual behaviors predicted unsafe sexual behavior in college. Findings suggest that complex associations exist among perceived awareness and caring, sexual values, and sexual behaviors, and that the transition from high school to college may be an ideal time for safer-sex interventions. PMID:19291385

Ethnic Variation in Drinking, Drug Use, and Sexual Behavior among Adolescents in Hawaii.(research Papers)

ERIC Educational Resources Information Center

Ramisetty-Mikler, Suhasini; Caetano, Raul; Goebert, Deborah; Nishimura, Stephanie

2004-01-01

This study examined ethnic differences in substance use and sexual behavior and whether drinking and drug use constitute risk factors for unsafe sexual practices among Native Hawaiian (NH), Caucasian, and Asian/Pacific Islander (API) high school students in Hawaii. A secondary data analysis of the Youth Risk Behavior Survey (1997 and 1999) using a…

Sexual-orientation disparities in school: the mediational role of indicators of victimization in achievement and truancy because of feeling unsafe.

PubMed

Birkett, Michelle; Russell, Stephen T; Corliss, Heather L

2014-06-01

We examined sexual-orientation identity disparities in truancy and academic achievement, and the mediational role of victimization in a large high-school sample. We utilized pooled data, measuring sexual identity, from the 2005 and 2007 Youth Risk Behavioral Surveillance System Surveys. Multilevel logistic regression modeling estimated the odds of low grades and truancy because of feeling unsafe comparing lesbian/gay, bisexual, (LGB) and unsure students to heterosexuals. We stratified models by gender. Indicators of victimization were examined to mediate the relationship between identifying as a sexual minority and school achievement or truancy. LGB-identified youths reported significantly elevated odds of truancy and low grades (odds ratios = 1.6-3.2; all P < .05). Additionally, both genders noting uncertainty about their sexual identity showed increased odds of truancy. Victimization indicators mediated the relationship between identifying as a sexual minority and experiencing negative school outcomes, with greater victimization indicators being associated with increased truancy and lower grades, and the extent of mediation differed by gender. As early disparities in academic achievement and school engagement have indicated a lifetime of increased health and behavioral risk factors, early intervention targeting school victimization is necessary.

Safer sex in tourist resorts.

PubMed

Ford, N; Inman, M

1992-01-01

A survey in Torbay, England, indicated substantial sexual interaction of an unsafe kind between young residents and tourists. A pilot programme is described which sought to promote safer sexual behaviour: the attention of both tourists and local people who frequented nightclubs was engaged by peer groups who conveyed educational messages.

Changes in sexual activity and risk behaviors among PLWHA initiating ART in rural district hospitals in Cameroon -- data from the STRATALL ANRS 12110/ESTHER trial.

PubMed

Ndziessi, Gilbert; Cohen, Julien; Kouanfack, Charles; Boyer, Sylvie; Moatti, Jean-Paul; Marcellin, Fabienne; Laurent, Christian; Spire, Bruno; Delaporte, Eric; Carrieri, Maria Patrizia

2013-01-01

The continued scaling-up of antiretroviral therapy (ART) in Sub-Saharan Africa provides an opportunity to further study its impact on sexual behaviors among people living with HIV/AIDS (PLWHA). We explored time trend and correlates of sexual activity among PLWHA initiating ART in Cameroon and compared sexual risk behaviors between patients sexually active before and after initiating ART and those resuming sexual activity after ART initiation. Analyses were based on longitudinal data collected within the randomized trial (n=459) conducted in nine rural district hospitals in Cameroon. Sexual activity was defined as reporting at least one sexual partner during the previous 3 months. Inconsistent condom use (ICU) was defined as reporting to have "never," "sometimes," or "nearly always" used condoms at least once with a partner(s) either HIV-negative or of unknown HIV status during the same period. Mc Nemar tests were used to assess time trend, while mixed-effect logistic regressions were conducted to analyze the effect of time since ART initiation on sexual activity. The proportion of sexually active patients significantly increased over time: from 31.8% at baseline to 40.2 and 47.1% after 6 and 12 months of ART, respectively (p=0.001), to 55.9% after 24 months (p=0.02). After adjustment for behavioral and psychosocial factors, time since ART initiation was independently associated with reporting sexual activity (AOR [95% CI]=1.30 [1.17-1.46] per 6-month increase, p=0.001). ICU was more frequent among patients sexually active both before and after ART initiation than among those who resumed sexual activity after ART initiation (82 vs. 59%, p

Addressing semen loss concerns: towards culturally appropriate HIV/AIDS interventions in Gujarat, India.

PubMed

Lakhani, A; Gandhi, K; Collumbien, M

2001-11-01

A situation analysis of sexual networking and sexual health in an industrial area of Gujarat, India, identified anxiety about masturbation and other semen loss concerns as major preoccupations among young men. This paper describes how the Deepak Charitable Trust addressed these concerns in their HIV prevention programme for young men aged 15 to 30. Flowcharts were used as participatory learning tools and to obtain data on the perceived consequences of masturbation, both before and after intervention activities. Research was also done on the relation between semen-related anxieties and sexual risk behaviour by DCT and two other NGOs among young men engaging in unsafe sexual behaviour. DCT advocates addressing masturbation and other semen loss concerns in all sexual health campaigns in South Asia, based on the magnitude of these concerns, their potential to confound syndromic management of STIs and their significance as an idiom of psychosocial distress. Masturbation and associated anxieties about sexual performance are seen as health issues and discussed as such by the programme. There is immediate identification among young men, whether or not they are already sexually active, and it provides an excellent entry point for sexual health and safer sex education. The community response to these efforts has been entirely positive.

Enhancing global control of alcohol to reduce unsafe sex and HIV in sub-Saharan Africa

PubMed Central

2009-01-01

Sub-Saharan Africa carries a massive dual burden of HIV and alcohol disease, and these pandemics are inextricably linked. Physiological and behavioural research indicates that alcohol independently affects decision-making concerning sex, and skills for negotiating condoms and their correct use. More than 20 studies in Africa have reported higher occurrence of HIV among people with problem drinking; a finding strongly consistent across studies and similar among women and men. Conflation of HIV and alcohol disease in these setting is not surprising given patterns of heavy-episodic drinking and that drinking contexts are often coterminous with opportunities for sexual encounters. HIV and alcohol also share common ground with sexual violence. Both perpetrators and victims of sexual violence have a high likelihood of having drunk alcohol prior to the incident, as with most forms of violence and injury in sub-Saharan Africa. Reducing alcohol harms necessitates multi-level interventions and should be considered a key component of structural interventions to alleviate the burden of HIV and sexual violence. Brief interventions for people with problem drinking (an important component of primary health care), must incorporate specific discussion of links between alcohol and unsafe sex, and consequences thereof. Interventions to reduce alcohol harm among HIV-infected persons are also an important element in positive-prevention initiatives. Most importantly, implementation of known effective interventions could alleviate a large portion of the alcohol-attributable burden of disease, including its effects on unsafe sex, unintended pregnancy and HIV transmission. PMID:19919703

"This Is How You Hetero:" Sexual Minorities in Heteronormative Sex Education

ERIC Educational Resources Information Center

Hobaica, Steven; Kwon, Paul

2017-01-01

The efficacy of sex education has been questioned, as students participate in high rates of unsafe sex after completion. Without exploring various sexual minority (SM) identities (e.g., gay, lesbian, and bisexual) and forms of sex, sex education may be especially unhelpful for SMs by perpetuating the heteronormative (i.e., assuming heterosexuality…

Sexual-Orientation Disparities in School: The Mediational Role of Indicators of Victimization in Achievement and Truancy Because of Feeling Unsafe

PubMed Central

Russell, Stephen T.; Corliss, Heather L.

2014-01-01

Objectives. We examined sexual-orientation identity disparities in truancy and academic achievement, and the mediational role of victimization in a large high-school sample. Methods. We utilized pooled data, measuring sexual identity, from the 2005 and 2007 Youth Risk Behavioral Surveillance System Surveys. Multilevel logistic regression modeling estimated the odds of low grades and truancy because of feeling unsafe comparing lesbian/gay, bisexual, (LGB) and unsure students to heterosexuals. We stratified models by gender. Indicators of victimization were examined to mediate the relationship between identifying as a sexual minority and school achievement or truancy. Results. LGB-identified youths reported significantly elevated odds of truancy and low grades (odds ratios = 1.6–3.2; all P < .05). Additionally, both genders noting uncertainty about their sexual identity showed increased odds of truancy. Victimization indicators mediated the relationship between identifying as a sexual minority and experiencing negative school outcomes, with greater victimization indicators being associated with increased truancy and lower grades, and the extent of mediation differed by gender. Conclusions. As early disparities in academic achievement and school engagement have indicated a lifetime of increased health and behavioral risk factors, early intervention targeting school victimization is necessary. PMID:24825216

Barriers to Sexual Expression and Safe Sex Among Mexican Gay Men: A Qualitative Approach.

PubMed

Verduzco, Ignacio Lozano

2016-07-01

Same-sex sexual practices among men in Mexico City are stigmatized. This article analyzes sexual practices and experiences of gay men in Mexico City and its implications on emotional and sexual health. The concept of sexual practices is used from a public health perspective, and the concept of sexual experiences from a psychological one, intending to understand both physical and emotional discomfort and pleasure in sexual contexts. The aim of this article is to analyze sexual practices and experiences of gay men in Mexico City and its implications on health, particularly emotions that can lead to depression, anxiety, substance abuse, and unsafe sex. Fifteen in-depth interviews were carried out with gay men of three generations who live in Mexico City. The data were analyzed using techniques from grounded theory to identify categories, and critical discourse analysis as an analytical approach to understand how social discourses affect subjectivity, emotions, and practices. Sexual practices and experiences are the result of homoerotic desire, which gender and heteronormative culture encourage to be kept hidden and clandestine. This leads men into risk contexts where practices are hardly negotiated, thus exposing themselves to sexually transmitted infections and abuse. These practices also produce a series of emotions such as guilt, shame, fear, and sadness that may develop into mental health issues such as depression and anxiety. Interventions at all levels must consider homophobic discrimination as part of gay men's daily lives and should be oriented toward decreasing it, to diminish discomforting emotions and reduce the probability of unsafe sex practices. © The Author(s) 2014.

Evaluating implementation of the World Health Organization's Strategic Approach to strengthening sexual and reproductive health policies and programs to address unintended pregnancy and unsafe abortion.

PubMed

Rashid, Shusmita; Moore, Julia E; Timmings, Caitlyn; Vogel, Joshua P; Ganatra, Bela; Khan, Dina N; Sayal, Radha; Metin Gülmezoglu, A; Straus, Sharon E

2017-11-21

We conducted a process evaluation to assess how the World Health Organization's (WHO) Strategic Approach to strengthening sexual and reproductive health policies and programs ("the SA") was used in 15 countries that requested WHO's technical support in addressing unintended pregnancy and unsafe abortion. The SA is a three-stage planning, policy, and program implementation process. We used the social ecological model (SEM) to analyze the contextual factors that influenced SA implementation. We used a two-phased sequential approach to data collection and analysis. In Phase A, we conducted a document and literature review and synthesized data thematically. In Phase B, we conducted interviews with stakeholders who used the SA in the countries of interest. We used a qualitative method triangulation technique to analyze and combine data from both phases to understand how the SA was implemented in each country. Data from 145 documents and 19 interviews described the SA process and activities in each country. All 15 countries completed Stage 1 activities. The activities of Stage 1 determined activities in subsequent stages and varied across countries. Following Stage 1, some countries focused on reforming policies to improve access to sexual and reproductive health (SRH) services whereas others focused on improving provider-level capacity to enhance SRH service quality and improving community-level SRH education. We identified factors across SEM levels that affected SA implementation, including individual- and community-level perceptions of using the SA and the recommendations that emerged from its use, organizational capacity to conduct SA activities, and how well these activities aligned with the existing political climate. Stakeholders perceived SA implementation to be country-driven and systematic in bringing attention to important SRH issues in their countries. We identified key success factors for influencing the individual, organization, and system change required for implementing the SA. These include sustaining stakeholder engagement for all SA stages, monitoring and reporting on activities, and leveraging activities and outputs from each SA stage to obtain technical and financial support for subsequent stages. Results may be used to optimize ongoing implementation efforts to improve access to and the quality of SRH services.

Syphilis

MedlinePlus

... and lead to unsafe sexual practices. Screening for pregnant women People can be infected with syphilis and not ... on unborn children, health officials recommend that all pregnant women be screened for the disease. By Mayo Clinic ...

Sexual and reproductive health experience, knowledge and problems among university students in Ambo, central Ethiopia.

PubMed

Yared, Abenezer; Sahile, Zekariyas; Mekuria, Mulugeta

2017-03-14

Youths in universities are at high risk of STIs and SRH problems in Ethiopia. However, students did not perceive themselves at risk of STI/HIV infection though reports showed they were sexually active, had multiple sexual partners and reported symptoms of STIs. Having recognized the threat posed by SRH problems, this study aimed to assess the SRH experiences, knowledge, and problems among university students at Ambo University in Ethiopia. A cross-sectional study was conducted in Ambo University main campus from January to February 2015 using mixed approach of quantitative (survey) and qualitative (in-depth interview) methods. Proportionate stratified sampling technique was used to select 400 survey respondents and purposive sampling was employed to identify 10 in-depth interviewees. The quantitative data was coded, entered to SPSS and descriptively analyzed, while the qualitative data was categorically organized, repeatedly reviewed and thematically analyzed. Mean age during first sex of 17.29 ± SD 2.21 and mean number of past 12 months regular sexual partners of 1.36 ± SD 0.505 were recorded. Only 21.1% of survey respondents perceived themselves to be at risk of HIV. Almost all survey respondents ever heard of STIs (94.5%) and HIV/AIDS (98%), and 89.4% knew modern contraceptives such as pills (64.8%) and condoms (56.8%). Despite awareness of STIs including HIV/AIDS, more than one fifth (22.8%) had any of the STIs in the past one year. Although the quantitative data showed unwanted pregnancy (5%) and abortion (2.5%) existed in the campus minimally, high rates of unwanted pregnancy and unsafe abortion were reported in the qualitative data. SRH/STIs were problems among students of the university. Although students knew about STIs, the STI infection rate in the past year was quite high, and was almost as high as the percentage of students who reported sexual activity in the past year. Though reported by a minority of students, unwanted pregnancy and unsafe abortion may also be a problem. The university thus needs to launch a program directed towards STIs and SRH problems, particularly among female students.

Contraception for adolescents in low and middle income countries: needs, barriers, and access

PubMed Central

2014-01-01

Substantial numbers of adolescents experience the negative health consequences of early, unprotected sexual activity - unintended pregnancy, unsafe abortions, pregnancy-related mortality and morbidity and Sexually Transmitted Infections including Human Immunodeficiency Virus; as well as its social and economic costs. Improving access to and use of contraceptives – including condoms - needs to be a key component of an overall strategy to preventing these problems. This paper contains a review of research evidence and programmatic experiences on needs, barriers, and approaches to access and use of contraception by adolescents in low and middle income countries (LMIC). Although the sexual activity of adolescents (ages 10–19) varies markedly for boys versus girls and by region, a significant number of adolescents are sexually active; and this increases steadily from mid-to-late adolescence. Sexually active adolescents – both married and unmarried - need contraception. All adolescents in LMIC - especially unmarried ones - face a number of barriers in obtaining contraception and in using them correctly and consistently. Effective interventions to improve access and use of contraception include enacting and implementing laws and policies requiring the provision of sexuality education and contraceptive services for adolescents; building community support for the provision of contraception to adolescents, providing sexuality education within and outside school settings, and increasing the access to and use of contraception by making health services adolescent-friendly, integrating contraceptive services with other health services, and providing contraception through a variety of outlets. Emerging data suggest mobile phones and social media are promising means of increasing contraceptive use among adolescents. PMID:24383405

Preschoolers' Problem-Solving in Sexually Abusive and Non-Sexual Situations.

ERIC Educational Resources Information Center

Grober, Jacqueline S.; And Others

This study examined the relation of social situation variables and children's gender to children's social problem solving ability in potentially unsafe situations. A total of 62 preschoolers (mean age 4.4 years) were shown a series of four vignettes. In two vignettes, an adult or a child asked a second child to cross a street. In two other…

Human Papillomavirus Vaccine Increases High-Risk Sexual Behaviors: A Myth or Valid Concern

ERIC Educational Resources Information Center

Ratanasiripong, Nop T.

2014-01-01

In 2006, the first human pappilomavirus (HPV) vaccine was approved for females aged 9 to 26. However, the national HPV vaccination rate among young women has been low. Public concerns were raised in regard to the fact that HPV vaccination might encourage unsafe sex. This cross-sectional study examined the differences in sexual practices between…

The Sexual and Reproductive Health of Young People in Low and Middle Income Countries

ERIC Educational Resources Information Center

Edwards, Orain; Peterson, Nicholas

2013-01-01

Young people ages 10-24 account for 25 percent of the world's population: a total of 1.8 billion, most of whom are living in low- and middle-income countries. They face significant challenges, including HIV, sexually transmitted infections (STIs), adolescent pregnancy, unsafe abortion, and gender-based violence. Youth have the right to lead…

Correlates of Double Risk of HIV Acquisition and Transmission Among Women who Inject Drugs in St. Petersburg, Russia.

PubMed

Girchenko, Polina; King, Elizabeth J

2017-04-01

Russia continues to experience a growing HIV epidemic, and women account for an increasing proportion of new HIV diagnoses in the country. This study aims to provide up-to-date information on factors associated with unsafe sex and drug use behaviors among women who inject drugs in St. Petersburg, Russia. In this community-based sample of 500 women who inject drugs, 64% tested positive for HIV. Women reported the following: 21% reported injection risk, 22% reported sexual risk, and 18% reported double risk. Multivariable analyses using logistic multinomial regression showed that older age is associated with increased risk behaviors. Involvement in transactional sex is associated with injection risk [aOR = 1.59 (1.02, 2.48)] but protective against sexual risk [aOR = 0.11 (0.06, 0.19)]. Exposure to sexual violence is associated with increased injection risk [aOR = 1.78 (1.01, 3.14)] and double risk [aOR = 3.38 (1.50, 7.63)]. These findings indicate the need to address both the unsafe injection and sexual risks among women who inject drugs in Russia.

Let's fight for the gender perspective.

PubMed

Lindahl, K

1994-01-01

The author, a representative of the Swedish National Preparatory Committee for the Cairo International Conference on Population and Development (ICPD), urges that each question and proposed action be considered within the framework of a gender and human rights perspective. The starting point for all discussions of population policies should be the individual rather than global population targets. Social and economic empowerment of women is essential to the success of development programs. If population growth is to match available resources, life-styles, production, and consumption strategies must be modified. In terms of sexual and reproductive health, the socioeconomic and cultural factors that impact on the decision to accept contraception must be considered. Safe methods of contraception and legal abortion must be available, and the sexual health issue should be broadened to include consideration of the sexual violence faced by many women and children. In addition, the fact the adolescents are sexually active must be accepted if unwanted pregnancies, deaths through unsafe abortion, and the transmission of sexually transmitted diseases are to be reduced. Support for contraceptive use is a necessary, but insufficient, precondition for women's health; essential is a more holistic approach.

Cyber bullying and physical bullying in adolescent suicide: the role of violent behavior and substance use.

PubMed

Litwiller, Brett J; Brausch, Amy M

2013-05-01

The impact of bullying in all forms on the mental health and safety of adolescents is of particular interest, especially in the wake of new methods of bullying that victimize youths through technology. The current study examined the relationship between victimization from both physical and cyber bullying and adolescent suicidal behavior. Violent behavior, substance use, and unsafe sexual behavior were tested as mediators between two forms of bullying, cyber and physical, and suicidal behavior. Data were taken from a large risk-behavior screening study with a sample of 4,693 public high school students (mean age = 16.11, 47 % female). The study's findings showed that both physical bullying and cyber bullying associated with substance use, violent behavior, unsafe sexual behavior, and suicidal behavior. Substance use, violent behavior, and unsafe sexual behavior also all associated with suicidal behavior. Substance use and violent behavior partially mediated the relationship between both forms of bullying and suicidal behavior. The comparable amount of variance in suicidal behavior accounted for by both cyber bullying and physical bullying underscores the important of further cyber bullying research. The direct association of each risk behavior with suicidal behavior also underscores the importance of reducing risk behaviors. Moreover, the role of violence and substance use as mediating behaviors offers an explanation of how risk behaviors can increase an adolescent's likelihood of suicidal behavior through habituation to physical pain and psychological anxiety.

Risky music-listening behaviors and associated health-risk behaviors.

PubMed

Vogel, Ineke; van de Looij-Jansen, Petra M; Mieloo, Cathelijne L; Burdorf, Alex; de Waart, Frouwkje

2012-06-01

To examine, among adolescents and emerging adults attending inner-city lower education, associations between risky music-listening behaviors (from MP3 players and in discotheques and at pop concerts) and more traditional health-risk behaviors: substance use (cigarettes, alcohol, cannabis, and hard drugs) and unsafe sexual intercourse. A total of 944 students in Dutch inner-city senior-secondary vocational schools completed questionnaires about their music-listening and traditional health-risk behaviors. Multiple logistic regression analyses were used to examine associations between music-listening and traditional health-risk behaviors. Risky MP3-player listeners used cannabis more often during the past 4 weeks. Students exposed to risky sound levels during discotheque and pop concert attendance used cannabis less often during the past 4 weeks, were more often binge drinkers, and reported inconsistent condom use during sexual intercourse. The coexistence of risky music-listening behaviors with other health-risk behaviors provides evidence in support of the integration of risky music-listening behaviors within research on and programs aimed at reducing more traditional health-risk behaviors, such as substance abuse and unsafe sexual intercourse.

'Hu Hong' (bad thing): parental perceptions of teenagers' sexuality in urban Vietnam.

PubMed

Do, Lan Anh Thi; Boonmongkon, Pimpawun; Paek, Seung Chun; Guadamuz, Thomas E

2017-02-28

Teenagers under 18 years old in Vietnam are considered as minors who usually lack the autonomy to make decisions. They are also sometimes viewed as contributors to social evils including crime, violence and substance use. Moreover, most Vietnamese teenagers have unsafe sex before marriage. The objective of this study is to explore the parental perceptions relating to their teenagers' sexuality, particularly the social and cultural forces, that may hinder access to sexuality information. Guided by a Community Advisory Board (CAB), this qualitative study uses four focus group discussions (FGDs) consisting of 12 mothers and 12 fathers, as well as twelve individual in-depth interviews (IDIs) with a diverse sample of parents of teens in Ho Chi Minh City (HCMC), Vietnam. Content and discourse analysis were conducted, based on Foucauldian concepts. Four themes emerged: 1) Meanings of sexuality and sexuality education, 2) Early sexual intercourse destroys teenagers' future, 3) Teenagers are not hu hong (spoil/bad thing), are innocent and virgin, and 4) Policing and controlling of sexual intercourse among teens. Parents did not view their teenage children as sexual beings; those who are sexual are considered hu hong. Parents believed that teens need to be policed and controlled to prevent them from becoming hu hong, particularly girls. Controlling of sexuality information by parents was therefore common in HCMC, but differed by gender and educational levels of parents. For example, fathers more than mothers were not comfortable teaching their teenage children about sex and sexuality. Parents with higher education police their teenage children's usage of the Internet and social media, while parents with lower education control who can be friends with their teenage children. Vietnamese parents in general have negative views of sex and sexuality education for their teenage children. Recognizing that many Vietnamese teenagers have unsafe sex before marriage, parents need to change their perceptions and understand the importance of comprehensive sexuality education (CSE), which are included in UNESCO, UNFPA and UNICEF-developed CSE tools.

Impact of Highly Active Antiretroviral Treatment on HIV Seroincidence Among Men Who Have Sex With Men: San Francisco

PubMed Central

Katz, Mitchell H.; Schwarcz, Sandra K.; Kellogg, Timothy A.; Klausner, Jeffrey D.; Dilley, James W.; Gibson, Steven; McFarland, William

2002-01-01

Objectives. This study assessed the countervailing effects on HIV incidence of highly active antiretroviral treatment (HAART) among San Francisco men who have sex with men (MSM). Methods. Behavioral risk was determined on the basis of responses to cross-sectional community interviews. HIV incidence was assessed through application of an enzyme-linked immunoassay testing strategy. Results. Use of HAART among MSM living with AIDS increased from 4% in 1995 to 54% in 1999. The percentage of MSM who reported both unprotected anal intercourse and multiple sexual partners increased from 24% in 1994 to 45% in 1999. The annual HIV incidence rate increased from 2.1% in 1996 to 4.2% in 1999 among MSM who sought anonymous HIV testing, and the rate was high (5.3%) but stable in a blinded survey of MSM seeking sexually transmitted disease services. Conclusions. Any decrease in per contact risk of HIV transmission due to HAART use appears to have been counterbalanced or overwhelmed by increases in the number of unsafe sexual episodes. (Am J Public Health. 2002;92:388–394) PMID:11867317

Premarital sexual practices and its predictors among in-school youths of shendi town, west Gojjam zone, North Western Ethiopia

PubMed Central

2014-01-01

Background Youth who begin early pre-marital sexual activity are more likely to be engaged in unsafe sex. Early sexual debut puts them at increased risk for acquiring or transmitting sexually transmitted infections, including HIV; and makes them highly vulnerable to unwanted pregnancy and its consequences. This study was conducted to assess premarital sexual practices and its predictors among in-school youths in North West Ethiopia. Methods A cross-sectional study was carried among 826 in school youths from December; 2011 to January; 2012 in Shendi town. A multistage sampling technique was used to select the study participants. Binary and multiple logistic regression analyses were performed to examine the relationship between premarital sexual practices and selected exposure variables. Results Nearly one fifth 157 (19%) of the participants reported having had premarital sexual intercourse, of which 91 (22.7%) were males and 66 (15.5%) were females. The mean (SD) age at first sexual intercourse was 16 .48 (1.59) for males and 15.89 (1.68) for females. More than three - fourth of sexually active in-school youths engaged in premarital sexual relationship before celebrating their 18th birthday. Being greater than 20 years (AOR = 3.67; 95% CI = 1.98, 6.82), living with friends or relatives (AOR = 2.47; 95% CI = 1.46, 4.16), living alone (without parental control (AOR = 2.51; 95% CI = 1.38, 4.55) and watching pornographic movies (AOR = 1.73; 95% CI = 1.18, 2.53) were found to be significantly associated with premarital sexual practices. Conclusion A significant number of in-school youths had started premarital sexual activity that might predispose them to different sexual and reproductive health risks. Therefore, various efforts need to be initiated through school-based information, education, and behavioral change communication, interventions, such as life skills education and negotiation. PMID:24961239

Premarital sexual practices and its predictors among in-school youths of Shendi town, west Gojjam zone, North Western Ethiopia.

PubMed

Bogale, Alemayehu; Seme, Assefa

2014-06-25

Youth who begin early pre-marital sexual activity are more likely to be engaged in unsafe sex. Early sexual debut puts them at increased risk for acquiring or transmitting sexually transmitted infections, including HIV; and makes them highly vulnerable to unwanted pregnancy and its consequences. This study was conducted to assess premarital sexual practices and its predictors among in-school youths in North West Ethiopia. A cross-sectional study was carried among 826 in school youths from December; 2011 to January; 2012 in Shendi town. A multistage sampling technique was used to select the study participants. Binary and multiple logistic regression analyses were performed to examine the relationship between premarital sexual practices and selected exposure variables. Nearly one fifth 157 (19%) of the participants reported having had premarital sexual intercourse, of which 91 (22.7%) were males and 66 (15.5%) were females. The mean (SD) age at first sexual intercourse was 16 .48 (1.59) for males and 15.89 (1.68) for females. More than three - fourth of sexually active in-school youths engaged in premarital sexual relationship before celebrating their 18th birthday. Being greater than 20 years (AOR = 3.67; 95% CI = 1.98, 6.82), living with friends or relatives (AOR = 2.47; 95% CI = 1.46, 4.16), living alone (without parental control (AOR = 2.51; 95% CI = 1.38, 4.55) and watching pornographic movies (AOR = 1.73; 95% CI = 1.18, 2.53) were found to be significantly associated with premarital sexual practices. A significant number of in-school youths had started premarital sexual activity that might predispose them to different sexual and reproductive health risks. Therefore, various efforts need to be initiated through school-based information, education, and behavioral change communication, interventions, such as life skills education and negotiation.

A Randomized Controlled Trial of Familias Unidas for Hispanic Adolescents With Behavior Problems

PubMed Central

Pantin, Hilda; Prado, Guillermo; Lopez, Barbara; Huang, Shi; Tapia, Maria I.; Schwartz, Seth J.; Sabillon, Eduardo; Brown, C. Hendricks; Branchini, Jennifer

2009-01-01

Objective To evaluate the efficacy of Familias Unidas, a Hispanic-specific, parent-centered intervention, in preventing/reducing adolescent substance use, unsafe sexual behavior, and externalizing disorders. Methods A total of 213 8th grade Hispanic adolescents with behavior problems and their primary caregivers were assigned randomly to one of two conditions: Familias Unidas or Community Control. Participants were assessed at baseline and at 6, 18, and 30 months post baseline. Results Results showed that, relative to a Community Control condition, Familias Unidas was efficacious in preventing or reducing externalizing disorders, preventing and reducing substance use, and in reducing unsafe sexual behavior. The effects of Familias Unidas on these outcomes were partially mediated by improvements in family functioning. Conclusions These findings suggest that parent-centered intervention is an efficacious strategy for preventing/reducing specific health risk behaviors in Hispanic adolescents with behavior problems. PMID:19834053

Association between age at first sexual intercourse and knowledge, attitudes and practices regarding reproductive health and unplanned pregnancy: a cross-sectional study.

PubMed

Shu, C; Fu, A; Lu, J; Yin, M; Chen, Y; Qin, T; Shang, X; Wang, X; Zhang, M; Xiong, C; Yin, P

2016-06-01

Age at first sexual intercourse (AFSI) is decreasing among adolescents in developed nations. An early sexual debut has been associated, to some extent, with multiple sexual partners, infrequent use of condoms, unplanned pregnancy, unsafe abortion, and sexually transmitted disease and human immunodeficiency virus infection. Unplanned pregnancy among adolescents has both physical and social adverse effects. In total, 78,400 self-administered anonymous questionnaires were distributed to college students in seven cities in China to determine the age at which Chinese college students first engage in sexual activity, and the association between AFSI and knowledge, attitudes and practices (KAP) regarding reproductive health and unplanned pregnancy. Approximately 10,164 students reported that they were sexually active, and most reported that they had engaged in sexual intercourse for the first time during college. The average AFSI was 20.14 [standard deviation (SD) 2.98] years, and the average AFSI by gender was 19.97 (SD 2.97) years for males and 20.41 (SD 2.97) years for females. The unplanned pregnancy rate among the participants was 34.03%. Participants lacked knowledge about contraception and reproductive health, although most believed that it is necessary to have this knowledge. Participants' attitudes towards premarital sex were varied. Factors that were found to be associated with unplanned pregnancy were AFSI, contraceptive methods used for first sexual act, and whether contraceptive methods were used for every sexual act. The college period is a key time for Chinese students in terms of becoming sexually active. As such, comprehensive and informative reproductive health education should be provided before and during the college period. Furthermore, reproductive health education should include appropriate sexual morality education and comprehensive sex education. Gender traits and needs should be considered in sex education. Copyright © 2016 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

Teenage sexual behaviour: attitudes towards and declared sexual activity.

PubMed

Burack, R

1999-01-01

Although the teenage pregnancy rates in the UK are falling in the 16 to 19 year old range, they are still rising in the 13 to 15 year olds. Overall, they remain one of the highest within Western Europe. Teenagers continue to present a challenge to the health services due to the increase in their sexual risk taking behaviour, the earlier age at which they are starting sexual activity and a reluctance to utilise services available to them. In an attempt to develop current services and make them more 'user friendly', a sexual health needs assessment was carried out on teenagers, part of which looked at their attitudes towards risk taking sexual behaviour and their declared sexual behaviour. A quantitative survey, using a questionnaire in schools, was answered by 1500 pupils aged between 13 and 18 years old, and showed that the majority of teenagers had declared some form of sexual contact with a partner with a degree of sexual activity increasing with age. Twenty per cent of 13 year olds reported that they had already had either full or oral sexual intercourse with a partner. Feeling peer pressure, not knowing the facts about sexual risk taking and a declared intent that would increase the likelihood of putting themselves or others at risk sexually were significantly more likely in the younger teenage boys surveyed. This study confirms that there remain many different factors involved in teenagers' decision-making processes, about their developing attitudes towards sex and their resultant behaviour. Despite a lack of maturity, such opinions and attitudes are bringing about definite views and sexual behaviour patterns in teenagers as young as 12 or 13 years old who are becoming fully sexually active. In particular teenage boys are becoming fully sexually active at a younger age than the girls and are taking risks in doing so. They are being influenced by peer pressure, condoning promiscuity and are declaring the intent to practice unsafe sexual intercourse. Their level of maturity would appear to be inadequate for them to comprehend the implications and consequences of their actions. This study has shown a need for developing adequate education and provision of sexual health services for teenagers, particularly for teenage boys, and that this may go some way in helping to address the imbalances found.

Sexuality and sexual health among female youth with borderline personality disorder pathology.

PubMed

Thompson, Katherine N; Betts, Jennifer; Jovev, Martina; Nyathi, Yolanda; McDougall, Emma; Chanen, Andrew M

2017-10-27

Borderline personality disorder (BPD) is a severe mental disorder that is characterized by unstable relationships, impulsive behaviours and identity disturbance. BPD usually has its onset between puberty and young adulthood and presents disproportionately among females in clinical settings. Taken together, this makes young women with BPD a particularly vulnerable group with regard to healthy psychosexual development. It was hypothesized that female youth with BPD pathology would be more likely to score worse on measures of sexual health and safety, and to show greater uncertainty in sexual identity formation. Fifty 15 to 24 yr-old females with 3 or more Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-IV) BPD criteria were compared with 204 females from a nationally representative sample. Both groups were interviewed using a comprehensive interview for sexual health and relationships. The patient group completed a structured diagnostic interview. Young women with borderline personality pathology engaged in sexual relationships at a younger age, with more sexual partners in the previous year, in more casual relationships. They were more likely to practice unsafe sex for their first sexual experience, to be coerced into unwanted sexual activity, to be unclear about their sexual identity or their sexual attraction, and to report worse overall health status. BPD pathology in youth is associated with poor sexual health and safety, and uncertainty in sexual identity formation. These findings support the need for assessment of the sexuality and sexual health of youth with BPD, along with the need for routine screening in sexual health services for BPD features among high-risk youth. © 2017 John Wiley & Sons Australia, Ltd.

Sex and Drugs and Starting School: Differences in Precollege Alcohol-Related Sexual Risk Taking by Gender and Recent Blackout Activity.

PubMed

Haas, Amie L; Barthel, Jennifer M; Taylor, Stephanie

2017-01-01

Research has demonstrated a link between alcohol use and multiple forms of risky sexual behavior, particularly among college-age individuals. Studies have also linked heavy alcohol use to other problems, such as impaired consciousness resulting from an alcohol-induced blackout, which may impact sexual decision making. However, research has rarely examined sexual risk taking (SRT) in relation to blackouts, nor has it examined this construct during the precollege transition (i.e., the interval of time between high school graduation and college matriculation). This study examined the intersection between alcohol-involved SRT, blackouts, and gender in a sample of precollege individuals with prior alcohol use (N = 229; 54% male, 63% White). Results indicated that, despite drinking less per occasion, women reporting recent blackouts were at increased risk for experiencing unwanted, unsafe, and regretted sexual behaviors compared to men with recent blackouts and their peers with no recent blackouts. Women with recent blackouts also reported differences in alcohol expectancies that may increase their risk for experiencing negative consequences while drinking, including higher social expectancies and lower negative expectancies of danger. Future directions for research and implications for precollege interventions are discussed.

Sexual behavior and the influencing factors among out of school female adolescents in Mushin market, Lagos, Nigeria.

PubMed

Odeyemi, Kofoworola; Onajole, Adebayo; Ogunowo, Babatunde

2009-01-01

High rates of adolescent pregnancy, sexually transmitted infections, and unsafe abortions in Nigeria indicate the need for a greater understanding of factors that affect adolescent sexuality. The sexual health needs of adolescents remain poorly known and addressed particularly among vulnerable subpopulations like out-of-school adolescents. The objective of this study was to examine the sexual behavior of female out-of-school adolescents and to identify factors that influence their sexual behavior. This cross-sectional study was conducted among a representative sample of unmarried, out-of-school female adolescents (n = 332, mean age 17 y), selected using cluster sampling, who were working in a major market (Mushin) in Lagos, Nigeria. Data were collected using interviewer administered questionnaires. Many girls (43.7%) have had sexual intercourse. The mean age at initiation was 16 years. The main reason for initiation was curiosity. Risky sexual behavior and transactional sex was common. Nonconsensual sex was also reported. Sexual health knowledge was poor, and friends served as their main source of information on sexual health issues. Factors associated with the initiation of sexual activity were friends sexual behavior, the person adolescents reside with, parents marital status, availability of funds to meet basic needs, and watching pornography (p < .05). Out-of-school female adolescents engaging in risky sexual behavior are exposed to sexual abuse, lack skills to resist pressure, and have limited access to credible reproductive health information. Appropriate interventions including provision of sexuality education and a supportive environment must be instituted to address their needs.

HIV-risk behaviours of American spring break vacationers: a case of situational disinhibition?

PubMed

Apostolopoulos, Y; Sönmez, S; Yu, C H

2002-11-01

Young adults are at high risk for acquiring STDs/HIV due primarily to multiple sex partners, unprotected sex, and substance use combined with sexual activity. Contranormative settings--such as the annual spring break vacation--provide ideal conditions for the potentially lethal interaction between alcohol, drugs, and sexual risk-taking. As a steadily growing form of youth travel and characterized by binge drinking, illicit drug use, and unsafe sexual practices, spring break has become a North American institution involving large numbers of travellers. In this study, the theory of interpersonal behaviour was used to explain college students' health-risk behaviours in the context of spring break and pre- and post-spring break surveys were used to examine casual sex and condom use behaviours. Multivariate analyses revealed peer influences, prior experiences with casual sex, alcohol consumption prior to sex, and impulsivity to be significant predictors of casual sex, while impulsivity and condom availability were significant predictors of students' use of condoms during casual sex.

Impact of sexual harassment victimization by peers on subsequent adolescent victimization and adjustment: a longitudinal study.

PubMed

Chiodo, Debbie; Wolfe, David A; Crooks, Claire; Hughes, Ray; Jaffe, Peter

2009-09-01

To examine gender differences in prevalence and types of sexual harassment victimization experienced in grade 9 and how it contributes to relationship victimization and psychological adjustment 2.5 years later. A total of 1734 students from 23 schools completed self-report surveys at entry to grade 9 and end of grade 11. Self-report data were collected on victimization experiences (sexual harassment, physical dating violence, peer violence, and relational victimization) and adjustment (emotional distress, problem substance use, self-harm, suicidal thoughts, maladaptive dieting, feeling unsafe at school, and perpetration of violent delinquency). Separate analyses by sex were prespecified. Sexual harassment victimization was common among boys (42.4%) and girls (44.1%) in grade 9, with girls reporting more sexual jokes, comments, and unwanted touch than among boys, and with boys reporting more homosexual slurs or receiving unwanted sexual content. For girls, sexual harassment victimization in grade 9 was associated with elevated risk of self-harm, suicidal thoughts, maladaptive dieting, early dating, substance use, and feeling unsafe at school. A similar pattern of risk was found for boys, with the exception of dieting and self-harm behaviors. Adjusted odds ratios (AOR) indicated these students were significantly more likely than nonharassed students to report victimization by peers and dating partners 2.5 years later (AOR for boys and girls, respectively; all p < .01), including sexual harassment (AOR: 2.45; 2.9), physical dating violence (AOR: 2.02; 3.73), and physical peer violence (AOR: 2.75; 2.79). Gr 9 sexual harassment also contributed significantly to emotional distress (AOR: 2.09; 2.24), problem substance use (AOR: 1.79; 2.04), and violent delinquency perpetration (AOR: 2.1; 3.34) 2.5 years later (boys and girls, respectively; all p < .01). Sexual harassment at the beginning of high school is a strong predictor of future victimization by peers and dating partners for both girls and boys, and warrants greater prevention and intervention efforts.

[Comparison between methods as polling booth survey and face-to-face interview in understanding the high-risk behavior among HIV-positive clients of female sex workers].

PubMed

Wu, Peili; Zhou, Chu; Zhou, Yang; Ren, Xianlong; Chen, Xi; Zhao, Junshi; Deng, Xiaojun; Rou, Keming; Wu, Zunyou

2015-04-01

Face-to-face interview (FTFI) and polling booth survey (PBS) were applied to compare the high risk behavior among HIV-positive clients of female sex workers (CFSWs). This study was conducted in antiretroviral therapy (ART) out-patients centers in Hengyang city, where clients who had been informed on their HIV-positive status for 6 months or longer were recruited. FTFI was first used to tackle on 8 sensitive questions related to sexual behavior, followed by PBS to poke on the same questions. Results from FTFI and PBS were then compared. Compared with FIFI, results in the PBS showed higher proportion of participants who reported "having had history of sexually transmitted diseases before knowing that they were infected with HIV" (40.6% vs. 24.2%) but lower proportions on "frequency of having sex with regular sexual partner less than 4 times per month" and "using condoms consistently with regular sexual partners in past 6 months (44.4% vs. 63.0%)". There were no significant differences in the remaining 5 questions shown in the results from the two methods. HIV-positive CFSWs continued to practice unsafe sexual behaviors after knowing their HIV related status. Compared with FTFI, PBS seemed to have revealed higher proportion of unsafe sex behaviors, so as to generated more reliable data. While comparing with PBS, the traditional FTFI might have underestimated the risk behaviors among those HIV-positive CFSWs.

Religiosity and risky sexual behavior in African-American adolescent females.

PubMed

McCree, Donna Hubbard; Wingood, Gina M; DiClemente, Ralph; Davies, Susan; Harrington, Katherine F

2003-07-01

To examine the association between religiosity (defined by frequency of engaging in religious/spiritual activities) and African-American adolescent females' sexual behaviors, attitudes toward sex, and ability to negotiate safer sex. Between December 1996 and April 1999, 1130 female adolescents were screened for eligibility in a sexually transmitted disease (STD)/human immunodeficiency virus (HIV) prevention trial. Data collection was achieved through a confidential self-administered questionnaire that examined religiosity and a structured interview regarding sexual behavior. Descriptive statistics were used to characterize the sociodemographics of the sample and logistic regression was used to measure the association between religiosity and the outcome variables. In the study sample (n = 522), 64% of the adolescents had higher religiosity scores based on a 4-item scale (alpha =.68). Results indicate that adolescents who had higher religiosity scores were significantly more likely to have higher self-efficacy in communicating with new, as well as steady male partners about sex; about STDs, HIV, and pregnancy prevention; and in refusing an unsafe sexual encounter. These adolescents were also more likely to have initiated sex at a later age, used a condom in the past 6 months, and possess more positive attitudes toward condom use. Results from this study indicate a relationship between religiosity and sexual behaviors, attitudes toward sex, and ability to negotiate safer sex.

Crystal methamphetamine and ecstasy differ in relation to unsafe sex among young gay men.

PubMed

Schilder, Arn J; Lampinen, Thomas M; Miller, Mary Lou; Hogg, Robert S

2005-01-01

Poly-substance use in gay social ('club') settings is common. Recent studies suggest a link between 'club' drug use and sexual risk behaviours. In this qualitative study, we compare and contrast two 'club' drugs: crystal methamphetamine and ecstasy (MDMA). Life history interviews were conducted with 12 HIV seroconverters and 12 age-matched controls recruited from a prospective cohort study of young gay and bisexual men in Vancouver, British Columbia. Textual data concerning illicit substance use and unsafe sex were analyzed using NUDIST software. Most men related a substantial knowledge of and experience with crystal and ecstasy. Both drugs had attributes that enhanced gay socialization and were used in the same venues. Crystal was used to remain awake and increase energy. Ecstasy was used to induce euphoria and group connectedness. However, unlike ecstasy, crystal was associated with a distinct pattern of sexual arousal that frequently included unprotected (sometimes group) sex, was more likely to be used regularly by HIV-positive men, and was reportedly highly addictive and problematic. Crystal and ecstasy are used in the same social venues but differ markedly in relation to sexual risk behaviour.

Perceptions of sexual risk behavior among Palestinian youth in the West Bank: a qualitative investigation.

PubMed

Massad, Salwa G; Karam, Rita; Brown, Ryan; Glick, Peter; Shaheen, Mohammed; Linnemayr, Sebastian; Khammash, Umaiyeh

2014-11-24

Young people in the Middle East and North Africa (MENA) are profoundly affected by violence, high unemployment, and economic hardship. Experiences of community-level violence and personal trauma increase the likelihood that young people will engage in risky behaviors that include smoking, drug use, and unsafe sex. Little is known about the sexual behavior of young people in the region, particularly in the occupied Palestinian territory (oPt). Our aim in this study was to gain an insight into the perceived prevalence and patterns of sexual behavior among Palestinian youth. The study was based on ten focus groups and 17 in-depth interviews with young people aged 16-24 years as part of the formative phase of a cross-sectional representative study of risk behaviors in the West Bank, including Jerusalem, in 2012. The sample was selected using a combination of purposive and convenience sampling. Qualitative analysis was used to code detailed notes of focus groups and interviews. Based on participants' reports, different types of sexual activity outside marriage were not uncommon, even in conservative communities. The most reported sexual activity was non-penetrative sex: oral and anal intercourse, and virtual sex. Some young people had sexual intercourse with sex workers; they went to brothels in Israel and to brothels operating clandestinely in the West Bank, including East Jerusalem. Most respondents were of the opinion that young people did not usually use protection during sexual intercourse. Many reported that youth engage in different types of sexual activity outside marriage for several reasons: to challenge the culture, financial constraints and inability to marry, basic human need, personal pleasure, suppression, to kill boredom, and to prove manhood. In contrast with the conservative social context of the occupied Palestinian territory (oPt), the findings suggest that sexual activities outside marriage may be more common than is currently assumed. Sexual behavior in the oPt is a concern because of the low awareness of the potential health consequences. The results draw attention to the need to incorporate sexual reproductive health into the national agenda and ensure that it is included in the programs of national institutions.

Causal links between binge drinking patterns, unsafe sex and HIV in South Africa: its time to intervene.

PubMed

Chersich, M F; Rees, H V

2010-01-01

South Africa has a massive burden of HIV and alcohol disease, and these pandemics are inextricably linked. Much evidence indicates that alcohol independently influences decisions around sex, and undermines skills for condom negotiation and correct use. Thus, not surprisingly, people with problem drinking in Africa have twofold higher risk for HIV than non-drinkers. Also, sexual violence incidents often coincide with heavy alcohol use, both among perpetrators and victims. Reducing alcohol harms necessitates both population- and individual-level interventions, especially raised taxation, regulation of alcohol advertising and provision of Brief Interventions. Alcohol counselling interventions must include discussion of linkages between alcohol and sex, and consequences thereof. Within positive-prevention services, alcohol reduction interventions could diminish HIV transmission. A trial is needed to definitively demonstrate that reduced drinking lowers HIV incidence. However, given available evidence, implementation of effective interventions could alleviate much alcohol-attributable disease, including unsafe sex, sexual violence, unintended pregnancy and, likely, HIV transmission.

Infidelity, trust, and condom use among Latino youth in dating relationships.

PubMed

Brady, Sonya S; Tschann, Jeanne M; Ellen, Jonathan M; Flores, Elena

2009-04-01

Latino youth in the United States are at greater risk for contracting sexually transmitted infections (STIs) in comparison with non-Hispanic white youth. Sexually active heterosexual Latino youth aged 16 to 22 years (N = 647) were recruited for interviews through a large health maintenance organization or community clinics. Adjusting for gender, age, ethnic heritage, and recruitment method, woman's consistent use of hormonal contraceptives, ambivalence about avoiding pregnancy, longer length of sexual relationship, and greater overall trust in main partner were independently associated with inconsistent condom use and engagement in a greater number of sexual intercourse acts that were unprotected by condom use. Perception that one's main partner had potentially been unfaithful, but not one's own sexual concurrency, was associated with consistent condom use and fewer acts of unprotected sexual intercourse. Sexually concurrent youth who engaged in inconsistent condom use with other partners were more likely to engage in inconsistent condom use and a greater number of unprotected sexual intercourse acts with main partners. Increasing attachment between youth may be a risk factor for the transmission of STIs via normative declines in condom use. Perception that one's partner has potentially been unfaithful may result in greater condom use. However, many Latino adolescents and young adults who engage in sexual concurrency may not take adequate steps to protect their partners from contracting STIs. Some youth may be more focused on the emotional and social repercussions of potentially revealing infidelity by advocating condom use than the physical repercussions of unsafe sex.

Sexual abuse and risky sexual behaviors among young female hawkers in Burkina Faso: a mixed method study.

PubMed

Ouédraogo, Saide Yacine Y A; Sisawo, Ebrima J; Huang, Song-Lih

2017-01-04

Young street hawkers in Burkina Faso are increasingly exposed to workplace hazards such as physical and sexual abuse, and also unsafe sexual practices. The objectives of this study were to identify the socio-demographic status and work characteristics of young female hawkers, describe their sexual behavior and their experience with regards to sex-related violence at the workplace. The study used a mixed design combining qualitative and quantitative methods. It was carried out in two traffic stations in Burkina Faso namely Bittou customs station and Boromo bus station. Female hawkers aged 13 - 24 years were invited to participate in a questionnaire survey and local key informants were recruited to partake in an in-depth interview. The recruitment was based on their duties related to the hawkers. The study included 264 participants in the survey and 16 interviewees. The survey showed that three quarter of participants had primary education or lower. About half of them had been sexually harassed, with clients, public members and co-hawkers as the most common source of assault. Most (68.6%) hawkers were sexually active; among them 43.7% had received money or gifts for sex. Positive factors associated with commercial sex include working in Boromo and age above 17, while negative factors include being Muslim and having female genital mutilation. The interviews confirmed the relationship between hawking and the socio-economic situation of participant's family, and pointed out societal factors that expose hawkers to risky sexual behaviors. This study provides a better understanding of young female hawking activity in Boromo and Bittou. Implementing an empowerment program for female street vendors and their families, and an efficient surveillance system might help reduce these hazards.

[Sexual violence in Congo-Kinshasa: necessity of decriminalizing abortion].

PubMed

Kalonda, J C Omba

2012-01-01

The sexual violence's committed in the Democratic Republic of Congo (DRC) are from their scales and consequences on women, real public health, politico-legal, and socio-economical challenges. More than a million of women have been victims of sexual violence on a period of less than fifteen years. Systematic rapes of women were used as war weapon by different groups involved in the Congolese war. Sexual violence against women has impacted public health by spreading sexually transmissible diseases including HIV/AIDS, causing unwanted pregnancies, leading to the gynaecological complications of rape-related injuries, and inflicting psychological trauma on the victims. Despite high level of unwanted pregnancies observed, the Congolese law is very restrictive and interdict induced abortion. This paper presents three arguments which plead in favour of legalizing abortion in DRC: 1) a restrictive law on abortion forces women to use unsafe abortion and increase incidence of injuries and maternal mortality ; 2) DRC has ratified the universal Declaration of human rights, the African union charter, and has than to promote equality between sexes, in this is included women reproductive rights; 3) an unwanted birth is an additional financial charge for a woman, a factor increasing poverty and psychologically unacceptable in case of rape. From the politico-legal point of view, ending rape impunity and decriminalizing abortion are recommended. Decriminalizing abortion give women choice and save victims and pregnant women from risks related to the pregnancy, a childbirth, or an eventual unsafe abortion. These risks increase the maternal mortality already high in DRC (between 950 and 3000 for 100000 live births).

Familia Adelante: A Multi-Risk Prevention Intervention for Latino Families

ERIC Educational Resources Information Center

Cervantes, Richard; Goldbach, Jeremy; Santos, Susana M.

2011-01-01

A comprehensive approach for providing behavioral health services to youth is becoming increasingly emphasized. Latino youth are at increased risk for substance abuse, mental health concerns, unsafe sexual practices and HIV, and these outcomes have been empirically connected to individual, family and community-based stress. Despite this knowledge,…

Knowledge and utilization of contraceptive devices among unmarried undergraduate students of a tertiary institution in Kano State, Nigeria 2016.

PubMed

Ahmed, Zainab Datti; Sule, Ibrahim Baffa; Abolaji, Mohammed Lukman; Mohammed, Yahaya; Nguku, Patrick

2017-01-01

Students in the universities mostly live independently from their parents or guardians, some of them for the first time. This gives them freedom and opportunity for high risk behavior such as unplanned and unprotected sex. The results of such sexual experimentation may include unplanned and or unwanted pregnancies that may lead to unsafe abortions and sexually transmitted infections (STIs) including HIV/AIDS. Contraception has the potential to prevent unwanted pregnancies, abortion, and STIs. This study aimed at assessing the general knowledge on contraceptives, sexual practices, and level of utilization of contraceptives devices among unmarried students of the Bayero University Kano. We did an institutional based cross-sectional descriptive study. We administered a pretested, self-administered, structured questionnaire to randomly selected unmarried undergraduate students of the institution. We analyzed data using Microsoft Excel 2016 and Epi-info7. A total of 300 students were interviewed. The median age for respondents was 23 years with an age range of 16-25 years. Male respondents made up 61.3% (184) while the females made up the remaining 38.7% (116). Also, 158(47.33%) of respondents lived outside the school campus, while 158(52.67%) lived in the school hostels. Knowledge on contraception was 87.7% among respondents with internet (91%) and media (89.3%) as the commonest sources of knowledge. Proportion of sexually active students was 10.67%, while prevalence of contraceptive utilization among sexually active students was 15.63%. About 8(25%) had their sexual debut at < 16years of age, 22(68.75%) at ages between 16-20years, and 4(12.5%) above 20years of age. All sexually active respondents practice vaginal sex. Most sexual debuts were planned (44.75 %) and with friends (86.4%), and they occurred between the ages of 16-20years age group in 70.3% of respondents. Even though knowledge on contraceptive used was high among the respondents, utilization of contraceptives among sexually active students was low, thus creating a window for possible unintended and unwanted pregnancies among these group of students.

[Sexually transmitted coinfections. HIV coinfections].

PubMed

Marschalkó, Márta; Pónyai, Katinka; Kárpáti, Sarolta

2015-01-04

Coinfections of sexually transmitted infections are frequent due to the same transmission routes which may facilitate the transmission of other sexually transmitted infections. Sexually transmitted coinfections are associated with atypical and generally more severe clinical features, more complications, resistency to treatment, unfavourable outcome, and worse prognosis. Sexually transmitted infections may increase the likelihood of acquiring and transmission of HIV infection. The authors summarize the most important characteristics of sexually transmitted infections (such as HIV and hepatitis B virus, HIV and hepatitis C virus, HIV and syphilis, HIV and gonorrhoeae, HIV and chlamydia coinfections). These infections are more frequent in HIV infected patients than in the normal population. The shared transmission routes, impairment of the immune response, elevated cytokine levels and the associated inflammatory milieu produce local tissue damage, breaches in mucosal epithelium, which increases the risk of human immunodeficiency virus infection. Regular screening for sexually transmitted infections, use of more sensitive diagnostic methods, improved reporting and avoidance of unsafe sexual behaviour among certain subpopulations as well as education are essential in the prevention of sexually transmitted coinfections.

Women's perceptions and experiences of sexual violence in marital relationships and its effect on reproductive health.

PubMed

Hussain, Rafat; Khan, Adeel

2008-05-01

In this article we explore women's perceptions and experiences of sexual violence in marital relationships and its effects on reproductive health. We conducted a qualitative study composed of key informant interviews, focus group discussions, and in-depth interviews in two low- to middle-income areas of Karachi, Pakistan. Results show sexual coercion and nonconsensual sex were common and not limited to abusive relationships. Difficulties in negotiating safe sex resulted in unwanted pregnancies, some leading to unsafe abortions. The women reported escalation of violence during pregnancy to be common. Social norms prevented disclosure of sexual violence leading to limited support or intervention or both. The link between women's social status, marital violence, and reproductive health is discussed.

"Bitch, You Got What You Deserved!": Violation and Violence in Sex Buyer Reviews of Legal Brothels.

PubMed

Jovanovski, Natalie; Tyler, Meagan

2018-03-01

In this article, we use feminist critical discourse analysis to examine online brothel reviews (148 reviews and 2,424 reply posts) of sex buyers in the context of debates surrounding harm minimization. Our findings show that sex buyers actively construct and normalize narratives of sexual violation and violence against women in licensed brothels through their language, referencing objectification, unsafe sex practices, and, in more extreme cases, rape to create a sense of community with other punters. Through this analysis, we challenge existing assumptions about harm minimization in systems of prostitution, which are legalized or fully decriminalized.

Decreasing Risky Behavior on Social Network Sites: The Impact of Parental Involvement in Secondary Education Interventions.

PubMed

Vanderhoven, Ellen; Schellens, Tammy; Valcke, Martin

2016-06-01

Teenagers face significant risks when using increasingly popular social network sites. Prevention and intervention efforts to raise awareness about these risks and to change risky behavior (so-called "e-safety" interventions) are essential for the wellbeing of these minors. However, several studies have revealed that while school interventions often affect awareness, they have only a limited impact on pupils' unsafe behavior. Utilizing the Theory of Planned Behavior and theories about parental involvement, we hypothesized that involving parents in an e-safety intervention would positively influence pupils' intentions and behavior. In a quasi-experimental study with pre- and post-test measures involving 207 pupils in secondary education, we compared the impact of an intervention without parental involvement with one that included active parental involvement by means of a homework task. We found that whereas parental involvement was not necessary to improve the intervention's impact on risk awareness, it did change intentions to engage in certain unsafe behavior, such as posting personal and sexual information on the profile page of a social network site, and in reducing existing problematic behavior. This beneficial impact was particularly evident for boys. These findings suggest that developing prevention campaigns with active parental involvement is well worth the effort. Researchers and developers should therefore focus on other efficient strategies to involve parents.

Condom use by Dutch men with commercial heterosexual contacts: determinants and considerations.

PubMed

de Graaf, R; van Zessen, G; Vanwesenbeeck, I; Straver, C J; Visser, J H

1997-10-01

We report responses from 559 clients of female prostitutes, with a view to determining to what extent previously identified factors play a part in condom use. To increase the response rate to advertisements in daily and weekly newspapers, interviews were held by phone. This procedure had the advantage of ensuring the anonymity many clients demanded. Of those clients having vaginal or anal contact (91%), 14% had not always used condoms in the previous year. Compared with consistent condom users, these men were less highly educated, had twice as many commercial contacts, and had more contacts with "steady" prostitutes. They were either more emotionally motivated to visit prostitutes than were consistent condom users or exhibited a stronger need for sexual variation. They showed a more compulsive attitude toward visiting prostitutes, had a more negative attitude toward prostitution in general, evaluated condoms more negatively, had a higher personal efficacy to achieve unsafe contacts, and had a higher general risk assessment, commensurate with their behavior. Men with only safe contacts had either an intrinsic or an extrinsic motivation for condom use. Among extrinsically motivated men, their behavior change was more recent and had not yet taken root: They still envisioned unsafe commercial sex to be possible in the future. Education aimed at the small group of men practicing unsafe contacts will not easily and directly lead to behavior change. But these educational activities may support prostitutes to persist in (consistent) condom use, regardless of clients' pressure to do otherwise.

Methamphetamine-Enhanced Female Sexual Motivation is Dependent on Dopamine and Progesterone Signaling in the Medial Amygdala

PubMed Central

Holder, Mary K.; Veichweg, Shaun S.; Mong, Jessica A.

2014-01-01

Methamphetamine (METH) is a psychomotor stimulant strongly associated with increases in sexual drive and impulsive sexual behaviors that often lead to unsafe sexual practices. In women METH users, such practices have been associated with increases in unplanned pregnancies and sexually transmitted diseases. Despite this significant heath concern, the neural mechanisms underlying this drug-sex association are not known. We previously established a rodent model of METH-facilitated female sexual behavior in which estradiol and progesterone interact with METH to increase motivational components of female behavior and neuronal activation in the posterodorsal medial amygdala (MePD) (Holder et al., 2010; Holder and Mong, 2010). The current study more directly examines the mechanisms underlying the drug-sex interaction. Here, we hypothesize that METH-induced increases in MePD dopamine signaling bridge the METH-hormone interaction. In support of this hypothesis, we found that excitotoxic lesions targeted to the MePD attenuated the METH-induced increases in proceptive behavior. Furthermore, infusion of a D1 agonist into the MePD increased proceptive behavior, while infusion of a D1 antagonist blocked the ability of METH to increase proceptive behaviors. Additionally, we found that METH-treatment increased progesterone receptor (PR)- immunoreactivity in the MePD, suggesting an interaction between dopamine and progesterone signaling. Indeed, infusions of the PR antagonist, RU486, prevented METH-induced increases in sexual behavior. Thus, taken together, the current findings suggest dopamine in the MePD modulates enhanced sexual motivation via an amplification of progesterone signaling and contributes to a better understanding of the neurobiology of drug-enhanced sexual behaviors. PMID:25448531

Gender roles and sexual behavior among young women.

PubMed

Lucke, J C

1998-08-01

The associations between gender role orientation and high-risk sex behaviors were explored in a study of 400 sexually active women 16-24 years of age (mean, 20.4 years) recruited from two metropolitan family planning clinics in Queensland, Australia. Three dimensions of gender role orientation were examined: gender role personality traits, gender role attitudes, and gender role dating behavior. It was hypothesized that women with more nontraditional or "masculine" characteristics are more likely than those with traditional or "feminine" characteristics to engage in unsafe sexual behaviors. Only partial support was found for this hypothesis. Although a number of univariate relationships emerged, very few associations between sexual behavior and gender roles remained significant in the multivariate analysis. Logistic regression analysis indicated that women with two or more sexual partners in the year preceding the study were significantly more likely than those with 0-1 sex partners to have masculine personality traits and to be more liberal in their attitudes toward women in society. Nonuse of condoms with the most recent sexual partner was not significantly associated with the gender role variables; however, women who reported masculine dating behaviors were more likely to have used a condom with their most recent nonsteady sexual partner. Similarly, substance use before or during last sexual intercourse was associated with masculine traits when the partner was nonsteady but was not related to gender role orientation when the partner was steady. The association of "masculine" personality traits with multiple partners and substance use indicates that caution should be exercised in assuming that masculine gender role characteristics are beneficial for women in sexual situations.

Sexual sensation seeking, transactional sex, and rural African American cocaine users

PubMed Central

Gullette, Donna; Booth, Brenda M.; Wright, Patricia B.; Montgomery, Brooke E. E.; Stewart, Katharine E.

2014-01-01

The purpose of this study was to explore correlates of sexual sensation seeking (SSS) in a sample of rural African American cocaine users. Respondent-driven sampling was used to recruit 251 participants from two impoverished rural counties in eastern Arkansas. Consistent with previous investigations, SSS scores were associated with being younger, being male, having more sexual partners, and having more unprotected sexual encounters in the previous 30 days. Multiple regression revealed SSS was correlated with number of oral sex acts, transactional sex (exchanging sex for food, shelter, drugs, money, or other commodities), and Addiction Severity Index (ASI) drug composite. SSS continues to demonstrate a strong association with sexual risk behaviors in diverse populations, including vulnerable groups like this community. Interventions to reduce unsafe sexual behaviors among high-risk groups, including drug users and individuals who engage in transactional sex, should incorporate approaches that include high sensation seekers' needs for novelty and variety. PMID:24070647

Use of emergency contraception in Nigeria: An exploration of related factors among sexually active female university students.

PubMed

Abiodun, Olumide

2016-03-01

Unsafe abortions account for nearly one-third of maternal deaths among young people. Women who have an induced abortion are usually literate and less than 30 years old; usually undergraduates with unintended pregnancies. Many of these pregnancies could have been prevented by contraception. The aim of this study was to determine the correlates of uptake of emergency contraception among university students. A cross-sectional study was conducted among 1328 sexually active, never married female university students. Self-administered questionnaire was used to assess knowledge, perception and practice of emergency contraception. Multivariate logistic regression was used to identify the predictors of emergency contraception. Majority of the participants were aware of emergency contraception (72.6%), had good knowledge (56.0%), and had the perception that it is effective (74.6%) and easy to use (72.4%). The main sources of information about emergency contraception were friends (32.9%) and the media (20.0%). About 52.0% of the participants had unprotected sex in the preceding six months, while 718 (54.1%) had ever used emergency contraception. The main sources of the commodities were sexual partners (46.2%) and medicine stores (35.4%). The uptake of emergency contraception was predicted by being ≤19 years (AOR = 3.193), rural dwelling (AOR = 4.247), perceptions that it is effective (AOR = 2.229E11) and easy to use (AOR = 6.680E8). Use of contraception among sexually active female Nigerian university students is predicted by the perception about its effectiveness and ease of use. Sexual and reproductive health programmes should focus on improving knowledge and addressing misconception in order to improve perception about emergency contraception. Copyright © 2015 Elsevier B.V. All rights reserved.

Understanding Failure of Condom Use Intention among Adolescents: Completing an Intensive Preventive Intervention

ERIC Educational Resources Information Center

Bauman, Laurie J.; Karasz, Alison; Hamilton, Adaoha

2007-01-01

Although interventions based on cognitive theories can reduce rates of unsafe sexual behavior in adolescents, effect sizes remain small. This study was a qualitative investigation of inner-city adolescents' intentions to use condoms following participation in an intensive safer sex program. In-depth interviews with 26 adolescents were analyzed…

Sexual Orientation Trends and Disparities in School Bullying and Violence-Related Experiences, 1999–2013

PubMed Central

Watson, Ryan J.; Adjei, Jones; Homma, Yuko; Saewyc, Elizabeth

2017-01-01

Numerous recent studies have demonstrated that schools are often unsafe for lesbian, gay, and bisexual (LGB) adolescents, who are more likely than heterosexual peers to be bullied, harassed, or victimized in school contexts. Virtually all of these studies call for change, yet none investigate whether or not it has occurred. Using repeated waves of a population-based high school survey, we examine (1) the extent to which sexual orientation differences in school bullying and violence-related experiences are reported by lesbian/gay, bisexual, and heterosexual male and female adolescents; (2) trends in school bullying and violence-related experiences for each gender/orientation group, and (3) whether disparities have changed over time. Data were drawn from eight Massachusetts biennial Youth Risk Behavior Surveys from 1999 to 2013, grouped into 4 waves totaling 24,845 self-identified heterosexual, 270 lesbian/gay, and 857 bisexual youth. Disparities between LGB and heterosexual peers were found in all indicators. Heterosexual youth and gay males saw significant reductions in every outcome between the first and last waves. Among bisexual males, skipping school due to feeling unsafe, carrying weapons in school, and being bullied all decreased, but among lesbians and bisexual females only fighting in school declined significantly. Improvement trends in school safety were more consistent for heterosexual youth and gay males than for bisexual or lesbian females. Notably, despite these improvements, almost no reduction was seen in sexual orientation disparities. Future research should identify influences leading to reduced school victimization, especially focusing on ways of eliminating persistent sexual orientation disparities. Future research should identify influences leading to reduced school victimization, especially focusing on ways of eliminating persistent sexual orientation disparities. PMID:29322064

Magnitude and risk factors of abortion among regular female students in Wolaita Sodo University, Ethiopia

PubMed Central

2014-01-01

Background Induced abortion is one of the greatest human rights dilemmas of our time. Yet, abortion is a very common experience in every culture and society. According to the World Health Organization, Ethiopia had the fifth largest number of maternal deaths in 2005 and unsafe abortion was estimated to account for 32% of all maternal deaths in Ethiopia. Youth are disproportionately affected by the consequences of unsafe abortion. The objective of this study was, therefore, to determine the magnitude and identify factors associated with abortion among female Wolaita Sodo University students. Methods A descriptive, cross-sectional study was conducted in Wolaita Sodo University between May and June 2011. Data were collected from 493 randomly selected female students using structured and pre-tested questionnaires. Results The rate of abortion among students was found to be 65 per 1000 women, making it three fold the national rate of abortion for Ethiopia (23/1000 women aged 15–44). Virtually all of the abortions (96.9%) were induced and only half (16) were reported to be safe. Students with history of alcohol use, who are first-year and those enrolled in faculties with no post-Grade 10 Natural Science background had higher risk of abortion than their counterparts. About 23.7% reported sexual experience. Less than half of the respondents (44%) ever heard of emergency contraception and only 35.9% of those who are sexually experienced ever used condom. Conclusions High rate of abortion was detected among female Wolaita Sodo University students and half of the abortions took place/initiated under unsafe circumstances. Knowledge of students on legal and safe abortion services was found to be considerably poor. It is imperative that improved sexual health education, with focus on safe and legal abortion services is rendered and wider availability of Youth Friendly family planning services are realized in Universities and other places where young men and women congregate. PMID:24666926

Experiences of pregnancy and motherhood among teenage mothers in a suburb of Accra, Ghana: a qualitative study

PubMed Central

Gyesaw, Nana Yaa Konadu; Ankomah, Augustine

2013-01-01

Background The proportion of teenage girls who are mothers or who are currently pregnant in sub-Saharan African countries is staggering. There are many studies regarding teenage pregnancy, unsafe abortions, and family planning among teenagers, but very little is known about what happens after pregnancy, ie, the experience of teenage motherhood. Several studies in Ghana have identified the determinants of early sexual activity, contraception, and unsafe abortion, with teenage motherhood only mentioned in passing. Few studies have explored the experiences of adolescent mothers in detail with regard to their pregnancy and childbirth. This qualitative study explores the experiences of adolescent mothers during pregnancy, childbirth, and care of their newborns. Methods This qualitative study was based on data from focus group discussions and indepth interviews with teenage mothers in a suburb in Accra. Participants were recruited from health facilities as well as by snowball sampling. Results Some of the participants became pregnant as a result of transactional sex in order to meet their basic needs, while others became pregnant as a result of sexual violence and exploitation. A few others wanted to become pregnant to command respect from people in society. In nearly all cases, parents and guardians of the adolescent mothers were upset in the initial stages when they heard the news of the pregnancy. One key finding, quite different from in other societies, was how often teenage pregnancies are eventually accepted, by both the young women and their families. Also observed was a rarity of willingness to resort to induced abortion. Conclusion Special programs should be initiated by the government and the various responsible departments to address ignorance on sexual matters, and the challenges and risks associated with pregnancy and parenting by adolescents. Parenting techniques should be taught in sex education programs. PMID:24250233

Adolescent Maltreatment in the Child Welfare System and Developmental Patterns of Sexual Risk Behaviors

PubMed Central

Fowler, Patrick J.; Motley, Darnell; Zhang, Jinjin; Rolls-Reutz, Jennifer; Landsverk, John

2018-01-01

In this longitudinal study, we tested whether adolescent maltreatment and out-of-home placement as a response to maltreatment altered developmental patterns of sexual risk behaviors in a nationally representative sample of youth involved in the child welfare system. Participants included adolescents aged 13 to 17 (M=15.5, SD=1.49) at baseline (n=714), followed over 18 months. Computer-assisted interviews were used to collect self-reported sexual practices and experiences of physical and psychological abuse at both time points. Latent transition analyses were used to identify three patterns of sexual risk behaviors: abstainers, safe sex with multiple partners, and unsafe sex with multiple partners. Most adolescents transitioned to safer sexual behavior patterns over time. Adolescents exhibiting the riskiest sexual practices at baseline were most likely to report subsequent abuse and less likely to be placed into out-of-home care. Findings provide a more nuanced understanding of sexual risk among child welfare–involved adolescents and inform practices to promote positive transitions within the system. PMID:25155702

Media interventions to promote responsible sexual behavior.

PubMed

Keller, Sarah N; Brown, Jane D

2002-02-01

While the media have been used effectively to promote sexual responsibility in other countries for decades, few such opportunities have been seized in the United States. Mass media may be especially useful for teaching young people about reproductive health because elements of popular culture can be used to articulate messages in young people s terms, in language that won t embarrass them and may even make safe sex more attractive. Media can potentially change the way people think about sex, amidst cultural pressures to have sex at a young age, to have sex forcefully, or to have unsafe sex. Information can be communicated through a variety of channels--small media (e.g., pamphlets, brochures, and the Internet) and mass media--and in a variety of formats--campaigns, news coverage, and educational messages inserted into regular entertainment programming. Several international studies show that exposure to family planning messages through television, radio, and print media are strongly associated with contraceptive use. Domestically, safe sex media campaigns have been associated with increased teen condom use with casual partners, and reductions in the numbers of teenagers reporting sexual activity. Due to private ownership and First Amendment concerns, U.S. sexual health advocates have been working with the commercial media to incorporate subtle health messages into existing entertainment programming.

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,…

Scaling up of Life Skills Based Education in Pakistan: A Case Study

ERIC Educational Resources Information Center

Svanemyr, Joar; Baig, Qadeer; Chandra-Mouli, Venkatraman

2015-01-01

Young people between the ages of 10 and 19 make up 23% of Pakistan's population. In Pakistan, young people face many challenges in terms of sexual and reproductive health (SRH) issues. These include early marriage and pregnancy, low use of contraception, use of unsafe abortion, lack of relevant information and poor knowledge about bodily…

Legally and Morally, What Our Gay Students Must Be Given

ERIC Educational Resources Information Center

Weiler, Erica M.

2004-01-01

Schools have a legal, ethical, and moral obligation to provide to all students equal access to education and equal protection under the law. For many sexual minority students, however, schools are unsafe and survival, not education, is the priority. Schools typically do not have the information, interest, or comfort level to address the needs of…

Myths and Misconceptions about LGBTQ Youth: School Counselors' Role in Advocacy

ERIC Educational Resources Information Center

Abreu, Roberto L.; McEachern, Adriana G.; Kenny, Maureen C.

2017-01-01

Although schools are thought to be safe environments for all students, sexual minority and gender expansive (i.e., LGBTQ) students often feel unsafe and unwelcome as a result of misconceptions about their identity. This paper explores eight commonly held myths and misconceptions about LGBTQ youth. The role of professional school counselors (PSCs)…

The Crisis among Contemporary American Adolescents: A Call for the Integration of Research, Policies, and Programs.

ERIC Educational Resources Information Center

Lerner, Richard M.; And Others

1994-01-01

Points out the growing crisis among American adolescents, with approximately half of adolescents at moderate or greater risk for engaging in unsafe sexual behaviors, teenage pregnancy, and teenage child-bearing; drug and alcohol use and abuse; school underachievement, failure, and dropout; and delinquency and crime. Calls for increased research on…

Methamphetamine-enhanced female sexual motivation is dependent on dopamine and progesterone signaling in the medial amygdala.

PubMed

Holder, Mary K; Veichweg, Shaun S; Mong, Jessica A

2015-01-01

Methamphetamine (METH) is a psychomotor stimulant strongly associated with increases in sexual drive and impulsive sexual behaviors that often lead to unsafe sexual practices. In women METH users, such practices have been associated with increases in unplanned pregnancies and sexually transmitted diseases. Despite this significant heath concern, the neural mechanisms underlying this drug-sex association are not known. We previously established a rodent model of METH-facilitated female sexual behavior in which estradiol and progesterone interact with METH to increase motivational components of female behavior and neuronal activation in the posterodorsal medial amygdala (MePD) (Holder et al., 2010; Holder and Mong, 2010). The current study more directly examines the mechanisms underlying the drug-sex interaction. Here, we hypothesize that METH-induced increases in MePD dopamine signaling bridge the METH-hormone interaction. In support of this hypothesis, we found that excitotoxic lesions targeted to the MePD attenuated the METH-induced increases in proceptive behavior. Furthermore, infusion of a D1 agonist into the MePD increased proceptive behavior, while infusion of a D1 antagonist blocked the ability of METH to increase proceptive behaviors. Additionally, we found that METH-treatment increased progesterone receptor (PR) immunoreactivity in the MePD, suggesting an interaction between dopamine and progesterone signaling. Indeed, infusions of the PR antagonist, RU486, prevented METH-induced increases in sexual behavior. Thus, taken together, the current findings suggest that dopamine in the MePD modulates enhanced sexual motivation via an amplification of progesterone signaling and contributes to a better understanding of the neurobiology of drug-enhanced sexual behaviors. Copyright © 2014 Elsevier Inc. All rights reserved.

Knowledge about conception, sexual behavior, and procurement of abortion among female undergraduate students in a Nigerian university.

PubMed

Moronkola, O A; Amosu, A; Okonkwo, C

Of 1,200 questionnaires administered in a cross-sectional study involving University of Ibadan female students, 1000 were found useable for data analysis. Analysis found that a majority of respondents (56.4%) had little knowledge about conception and frequently engaged in sexual intercourse for many reasons, including: to have fun; to show they were mature; and to seek material reward. Also, 61.1% had procured abortion before and most of them did not procure it from government-owned hospitals/clinics, which may likely make them prone to health consequences of unsafe abortion. Part of our recommendations are the need to introduce health education (incorporating sexuality education) into the General Studies Program of the university and that home training on aspects relating to sexuality education be given to and promoted among young people.

Factors associated with delays in seeking post abortion care among women in Kenya.

PubMed

Mutua, Michael M; Maina, Beatrice W; Achia, Thomas O; Izugbara, Chimaraoke O

2015-10-07

Delays in seeking quality post abortion care services remain a major contributor to high levels of mortality and morbidity among women who experience unsafe abortion. However, little is known about the causes of and factors associated with delays in seeking care among women who suffer complications of unsafe abortion. This study looks at factors that are associated with delays in seeking post-abortion care among women in Kenya. Data for this study were from a nationally representative sample of 350 healthcare facilities that participated in the 2012 Incidence and Magnitude of Unsafe Abortion study in Kenya. Data included socio-demographic characteristics, reproductive health and clinical histories from all women treated with PAC during a one-month data collection period. Delay in seeking care was associated with women's age, education level, contraceptive history, fertility intentions and referral status. There is need to improve women's access to quality sexual and reproductive health information and services, contraception and abortion care. Improving current PAC services at lower level facilities will also minimize delays resulting from long referral processes.

Barriers to safe abortion access: uterine rupture as complication of unsafe abortion in a Ugandan girl.

PubMed

Olson, Rose McKeon; Kamurari, Solomon

2017-10-20

A 15-year-old girl at 18 weeks gestation by the last menstrual period presented to a rural Ugandan healthcare facility for termination of her pregnancy as a result of rape by her uncle. Skilled healthcare workers at the facility refused to provide the abortion due to fear of legal repercussions. The patient subsequently obtained an unsafe abortion by vaginal insertion of local herbs and sharp objects. She developed profuse vaginal bleeding and haemorrhagic shock. She was found to have uterine rupture and emergent hysterectomy was performed. Young and poor women are at high risk of unplanned pregnancy and subsequent mortality during pregnancy and childbirth. Unsafe abortion is a leading and entirely preventable cause of maternal mortality worldwide. Multiple barriers restrict access to safe abortions including social and moral stigma, gender-based power imbalances, inadequate contraceptive use and sexual education, high cost and poor availability, and restrictive abortion laws. © BMJ Publishing Group Ltd (unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

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.

Sexual Sensation Seeking: A Validated Scale for Spanish Gay, Lesbian and Bisexual People.

PubMed

Gil-Llario, María Dolores; Morell-Mengual, Vicente; Giménez-García, Cristina; Salmerón-Sánchez, Pedro; Ballester-Arnal, Rafael

2018-06-07

Sexual Sensation Seeking has been identified as a main predictor of unsafe sex that particularly affects LGB people. This study adapts and validates the Sexual Sensation Seeking Scale to Spanish LGB people. For this purpose, we tested the factor structure in 1237 people, ranged from 17 to 60 years old, 880 self-defined as homosexuals and 357 as bisexuals. The results support the appropriateness of this scale for Spanish LGB people and determine two factors, explaining the 49.91% of variance: "physical sensations attraction" and "sexual experiences". Our findings reveal optimal levels of internal consistency in the total scale (α = 0.81) and each factor (α = 0.84 and α = 0.71). Additional analyses have demonstrated convergent validity for this scale. Important implications of the validated Sexual Sensation Seeking Scale in Spanish LGB people are discussed, in order to early detection and preventive interventions for HIV and other sexual health problems.

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.

Poverty as a contextual factor affecting sexual health behavior among female sex workers in India.

PubMed

Dasgupta, Satarupa

2013-06-01

A thorough understanding of the environmental and structural factors that precipitate unsafe sexual practices is necessary for HIV/AIDS-prevention research among high-risk population groups like commercial sex workers. I examined how poverty contextualizes sexual health behavior, including condom compliance among commercial female sex workers in a red light district in Calcutta, India. For my research I did an ethnographic study and conducted in-depth interviews of 37 commercial female sex workers. I found that poverty, instead of serving as a catalyst for poor health choices among sex workers, acted as an impetus for pursuing safe sex practices and remaining healthy. The results indicate that sex work, poverty, and health do not always have a paradoxical relationship.

Tanzanian Adolescent Boys’ Transitions Through Puberty: The Importance of Context

PubMed Central

Likindikoki, Samuel; Kaaya, S.

2014-01-01

We explored the masculinity norms shaping transitions through puberty in rural and urban Tanzania and how these norms and their social-ecological context contribute to high-risk health behaviors. We conducted a qualitative case study of adolescent boys in and out of school in 2011 and 2012. Tanzania’s social and economic development is reshaping the transition into young manhood. Adolescent boys are losing traditional mechanisms of pubertal guidance, and new meanings of manhood are arising from globalization. Traditional masculinity norms, including pressures to demonstrate virility and fertility, remain strong. Adolescent boys in modernizing Tanzania receive inadequate guidance on their burgeoning sexuality. Contradictory masculinity norms from family and society are shaping their sexual expectations, with implications for their engagement in unsafe sexual behaviors. PMID:25320893

33 CFR 142.7 - Reports of unsafe working conditions.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 33 Navigation and Navigable Waters 2 2010-07-01 2010-07-01 false Reports of unsafe working... working conditions. (a) Any person may report a possible violation of any regulation in this subchapter or any other hazardous or unsafe working condition on any unit engaged in OCS activities to an Officer in...

76 FR 72237 - Agency Information Collection Activities: Requests for Comments; Clearance of Renewed Approval of...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-11-22

... correct corrective action to correct unsafe conditions in aircraft, engines, propellers, and appliances... action was adequate to correct the unsafe condition. The respondents are aircraft owners and operators... when an unsafe condition is discovered on a specific aircraft type. If the condition is serious enough...

77 FR 73114 - Agency Information Collection Activities: Requests for Comments; Clearance of Renewed Approval of...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-12-07

... correct corrective action to correct unsafe conditions in aircraft, engines, propellers, and appliances... action was adequate to correct the unsafe condition. The respondents are aircraft owners and operators... when an unsafe condition is discovered on a specific aircraft type. If the condition is serious enough...

Trauma-Informed Care for Children Exposed to Violence: "Tips for Teachers"

ERIC Educational Resources Information Center

Office of Juvenile Justice and Delinquency Prevention, 2011

2011-01-01

Children are very resilient--but they are not unbreakable. No matter what their age, children are deeply hurt when they are physically, sexually, or emotionally abused or when they see or hear violence in their homes and communities. When children see and hear too much that is frightening, their world feels unsafe and insecure. This brief report…

Homophobia in Secondary Schools: An Investigation of Teachers' Perceptions of Homophobia through a Collaborative Professional Development Program

ERIC Educational Resources Information Center

Jones, Joseph R.

2010-01-01

According to Gay Lesbian Straight Education Network, GLSEN, (2003), 84% of GLBT students experienced homophobic remarks or verbal harassment and of those, 91.5% reported hearing the word "faggot" or "dyke" on a regular basis, and over 60% felt unsafe in their schools because of their sexual orientation. More recently, several middle school…

Dimensions of Acculturation: Associations with Health Risk Behaviors among College Students from Immigrant Families

ERIC Educational Resources Information Center

Schwartz, Seth J.; Weisskirch, Robert S.; Zamboanga, Byron L.; Castillo, Linda G.; Ham, Lindsay S.; Huynh, Que-Lam; Park, Irene J. K.; Donovan, Roxanne; Kim, Su Yeong; Vernon, Michael; Davis, Matthew J.; Cano, Miguel A.

2011-01-01

In the present study, we examined a bidimensional model of acculturation (which includes both heritage and U.S. practices, values, and identifications) in relation to hazardous alcohol use, illicit drug use, unsafe sexual behavior, and impaired driving. A sample of 3,251 first- and second-generation immigrant students from 30 U.S. colleges and…

A Randomized Controlled Trial of a Parent-Centered Intervention in Preventing Substance Use and HIV Risk Behaviors in Hispanic Adolescents

ERIC Educational Resources Information Center

Prado, Guillermo; Pantin, Hilda; Briones, Ervin; Schwartz, Seth J.; Feaster, Daniel; Huang, Shi; Sullivan, Summer; Tapia, Maria I.; Sabillon, Eduardo; Lopez, Barbara; Szapocznik, Jose

2007-01-01

The present study evaluated the efficacy of Familias Unidas + Parent-Preadolescent Training for HIV Prevention (PATH), a Hispanic-specific, parent-centered intervention, in preventing adolescent substance use and unsafe sexual behavior. Two hundred sixty-six 8th-grade Hispanic adolescents and their primary caregivers were randomly assigned to 1 of…

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…

Adolescent maltreatment in the child welfare system and developmental patterns of sexual risk behaviors.

PubMed

Fowler, Patrick J; Motley, Darnell; Zhang, Jinjin; Rolls-Reutz, Jennifer; Landsverk, John

2015-02-01

In this longitudinal study, we tested whether adolescent maltreatment and out-of-home placement as a response to maltreatment altered developmental patterns of sexual risk behaviors in a nationally representative sample of youth involved in the child welfare system. Participants included adolescents aged 13 to 17 (M = 15.5, SD = 1.49) at baseline (n = 714), followed over 18 months. Computer-assisted interviews were used to collect self-reported sexual practices and experiences of physical and psychological abuse at both time points. Latent transition analyses were used to identify three patterns of sexual risk behaviors: abstainers, safe sex with multiple partners, and unsafe sex with multiple partners. Most adolescents transitioned to safer sexual behavior patterns over time. Adolescents exhibiting the riskiest sexual practices at baseline were most likely to report subsequent abuse and less likely to be placed into out-of-home care. Findings provide a more nuanced understanding of sexual risk among child welfare-involved adolescents and inform practices to promote positive transitions within the system. © The Author(s) 2014.

The special programme of research in human reproduction: forty years of activities to achieve reproductive health for all.

PubMed

Benagiano, Giuseppe; d'Arcangues, Catherine; Harris Requejo, Jennifer; Schafer, Alessandra; Say, Lale; Merialdi, Mario

2012-01-01

The Special Programme of Research in Human Reproduction (HRP), co-sponsored by the UNDP, UNFPA, WHO, and the World Bank, is celebrating 40 years of activities with an expansion of its mandate and new co-sponsors. When it began, in 1972, the main focus was on evaluating the acceptability, effectiveness, and safety of existing fertility-regulating methods, as well as developing new, improved modalities for family planning. In 1994, HRP not only made major contributions to the Plan of Action of the International Conference on Population and Development (ICPD); it also broadened its scope of work to include other aspects of health dealing with sexuality and reproduction, adding a specific perspective on gender issues and human rights. In 2002, HRP's mandate was once again broadened to include sexually transmitted infections and HIV/AIDS and in 2003 it was further expanded to research activities on preventing violence against women and its many dire health consequences. Today, the work of the Programme includes research on: the sexual and reproductive health of adolescents, women, and men; maternal and perinatal health; reproductive tract and sexually transmitted infections (including HIV/AIDS); family planning; infertility; unsafe abortion; sexual health; screening for cancer of the cervix in developing countries, and gender and reproductive rights. Additional activities by the Programme have included: fostering international cooperation in the field of human reproduction; the elaboration of WHO's first Global Reproductive Health Strategy; work leading to the inclusion of ICPD's goal 'reproductive health for all by 2015' into the Millennium Development Goal framework; the promotion of critical interagency statements on the public health, legal, and human rights implications of female genital mutilation and gender-biased sex selection. Finally, HRP has been involved in the creation of guidelines and tools, such as the 'Medical eligibility criteria for contraceptive use', the 'Global handbook for family planning providers', the 'Definition of core competencies in primary health care', and designing tools for operationalizing a human rights approach to sexual and reproductive health programmes. Copyright © 2012 S. Karger AG, Basel.

'I've had unsafe sex so many times why bother being safe now?': the role of cognitions in sexual risk among American Indian/Alaska Native men who have sex with men.

PubMed

Nelson, Kimberly M; Simoni, Jane M; Pearson, Cynthia R; Walters, Karina L

2011-12-01

American Indian/Alaska Native (AI/AN) men who have sex with men (MSM) are at high risk of human immunodeficiency virus (HIV) acquisition and transmission. This study aimed to investigate a potential area of focus for HIV prevention interventions by assessing the impact of sexual risk cognitions on sexual risk-taking among AI/AN MSM. AI/AN MSM (N = 173) from a national cross-sectional survey were analyzed. Reporting more frequent sexual risk cognitions overall (high sexual risk cognitions) was associated with multiple HIV risk factors including unprotected anal intercourse and serodiscordant unprotected anal intercourse. Participants with high sexual risk cognitions had a 2.3 (95% Confidence Interval: 1.1, 4.7) times greater odds of engaging in unprotected anal intercourse regardless of childhood sexual abuse, depression, and alcohol dependence. Most individual sexual risk cognitions were associated with unprotected anal intercourse, serodiscordant unprotected anal intercourse, or both. Results suggest that sexual risk cognitions may be a productive area for further work on HIV prevention among AI/AN MSM.

Jamaican Mothers’ Influences of Adolescent Girls’ Sexual Beliefs and Behaviors

PubMed Central

Hutchinson, M. Katherine; Kahwa, Eulalia; Waldron, Norman; Brown, Cerese Hepburn; Hamilton, Pansy I.; Hewitt, Hermi H.; Aiken, Joyette; Cederbaum, Julie; Alter, Emily; Jemmott, Loretta Sweet

2012-01-01

Purpose The purpose of this study was to identify the ways in which urban Jamaican mothers influence their adolescent daughters’ sexual beliefs and behaviors in order to incorporate them into the design of a family-based human immunodeficiency virus (HIV) risk reduction intervention program. Design Focus groups were conducted with 46 14- to 18-year-old adolescent girls and 30 mothers or female guardians of adolescent girls recruited from community-based organizations in and around Kingston and St. Andrew, Jamaica. Separate focus groups were held with mothers and daughters; each included 6 to 10 participants. Focus group sessions were scripted, led by teams that included trained Jamaican and American facilitators and note-takers, and audio-taped to ensure data accuracy. Data were analyzed using qualitative content analysis. Findings Four major maternal influences were identified: mother-daughter relationship quality, mother-daughter sexual communication, monitoring or supervision, and maternal sexual role modeling. Mothers’ and daughters’ reports were consistent; both groups identified positive and negative influences within each category. Conclusions Some maternal influences were positive and health promoting; others were negative and promoted unsafe sexual activity and risk for HIV and other sexually transmitted infections. These influences were incorporated into the design of a culture-specific family-based HIV risk reduction intervention tailored to the needs of urban Jamaican adolescent girls and their mothers. Clinical Relevance In order to be effective, family-based HIV risk reduction interventions should be theory based and tailored to the target audience. The four maternal influences identified in this formative study were incorporated into the subsequent intervention design. PMID:22339731

Reducing HIV sexual risk among African American women who use drugs: hearing their voices.

PubMed

Jemmott, Loretta Sweet; Brown, Emma J

2003-01-01

A pilot study was conducted to understand women's realities, perspectives, and perceived needs regarding the interaction between substance use, types of sexual relationships, and the challenges and barriers they pose to practicing safer sex. An additional purpose was to examine this population's willingness to participate in the program and receptiveness to the components of proposed interventions. Data were collected in this descriptive, exploratory study by the use of one focus group. Twelve African American women between 20 and 55 years of age who had previous drug detoxification experience participated in a 3-hour focus group. All participants were sexually active as well as current users of illicit substances, and all but one had traded sex for money, drugs, or alcohol. The focus group interview was guided by a semistructured questionnaire. Participants were recruited by counselors in detoxification units. Each unit counselor was asked to randomly select a third of their residents, explain and read the purpose of the focus group, and get the residents' verbal consent to participate. The women discussed their sexual behaviors and drug use that increased their risk for acquiring HIV. They provided insight about the effects of different drugs on one's sexual behavior, motivation for sex, and reasons for unsafe sex and made recommendations for HIV prevention intervention. Participants agreed that safer sex and healthy living intervention would be most beneficial if placed within the context of a detoxification program. The juxtaposition of increased sexual risk behavior and the potential to acquire and transmit HIV infection suggests the urgency of intervening with African American women who are substance abusers.

F.O.R.E.play: the utility of brief sexual health interventions among college students.

PubMed

Moore, Erin W; Smith, William E; Folsom, Ashlee R B

2012-01-01

The authors aimed to determine the most effective brief sexual health intervention for college students, while also evaluating students' preferences for learning about sexual health, in order to develop a university program. A total of 302 students enrolled in an introductory college course participated and were randomly assigned to 1 of 3 brief interventions during a regularly scheduled class and completed pre- and postsurveys assessing knowledge, motivation to use condoms, and condom self-efficacy. Findings indicated that having an actual person in charge of the learning process resulted in higher knowledge gains and highlighted a student preference for discussion-based learning, viewing pictures of sexually transmitted infections, and hearing real-life experiences about the consequences of unsafe sex. These findings will be used to tailor a future intervention targeting college students for use with freshmen students at this university.

Gender, sexual health and reproductive health promotion.

PubMed

Moeti, M R

1995-01-01

The underlying factors of poverty, migration, marginalization, lack of information and skills, disempowerment, and poor access to services which affect HIV/STD risk are also closely related to those which affect sexual and reproductive health. Reproductive health problems include unplanned and unwanted pregnancies, unsafe abortions, pregnancy-related illness and death, and STDs including HIV/AIDS. This interrelationship between factors is leading increasingly to the integration of HIV/STD education and prevention within the broader framework of sexual and reproductive health promotion. Such intervention allows the possible reinforcement of the impact of interventions upon important underlying factors and behaviors linked to individual, family, and community vulnerability to HIV/STDs as well as other reproductive health problems. Integration will also optimize the use of increasingly scarce resources and increase the likelihood of responses, interventions, and programs being sustainable. Sexual and reproductive health, placing HIV/STD prevention into context, and focus upon men are discussed.

Stand by Me: The Effects of a Police Anti-Bullying Presentation on South Korean High School Students' Attitudes about Bullying and Willingness to Intervene

ERIC Educational Resources Information Center

Loui, Kenny

2017-01-01

Upon assuming the presidency of the Republic of Korea in 2013, Park Geun-hye announced her administration's priority to address the country's "Four Social Evils"--sexual violence, domestic violence, school bullying, and unsafe food products. As part of this initiative, the ROK national government urged police officers to implement…

"Broken windows": Relationship between neighborhood conditions and behavioral health among low-income African American adolescents.

PubMed

Voisin, Dexter R; Kim, Dong Ha

2018-03-01

This study explored the association between neighborhood conditions and behavioral health among African American youth. Cross-sectional data were collected from 683 African American youth from low-income communities. Measures for demographics, neighborhood conditions (i.e. broken windows index), mental health, delinquency, substance use, and sexual risk behaviors were assessed. Major findings indicated that participants who reported poorer neighborhood conditions compared to those who lived in better living conditions were more likely to report higher rates of mental health problems, delinquency, substance use, and unsafe sexual behaviors. Environmental factors need to be considered when addressing the behavioral health of low-income African American youth.

Influence of the medication environment on the unsafe medication behavior of nurses: A path analysis.

PubMed

Yu, Xi; Li, Ce; Gao, Xueqin; Liu, Furong; Lin, Ping

2018-04-20

To explore the relationship between the medication environment and the unsafe medication behavior of nurses and to analyze its influence path. Unsafe medication behavior is the direct cause of medication error. The organizational environment is the foundation of and plays a guiding role in work behavior. Whether the medication environment correlates with the unsafe medication behavior of nurses remains unclear. This study used a correlative design with self-administered questionnaires, and the SHEL model, an acronym of its elements of software, hardware, environment, and liveware, was used as the framework for the medication environment. A survey was conducted among 1012 clinical nurses from five tertiary hospitals in China using the nurse unsafe medication behavior scale (NUMBS) and the nurses' perceptions of the medication environment scale (NPMES). Data were collected from January to February 2017. Path analyses were used to examine the hypothesized model. The medication environment correlated negatively with unsafe medication behavior (r=-0.48, p<0.001). The path analysis showed that software, liveware and nurses' personal factors directly affected unsafe medication behavior. Software, hardware and the environment indirectly influenced unsafe medication behavior, and nurses' personal factors played a mediating role in the relationships of unsafe medication behavior with software, hardware, and the environment. The unsafe medication behavior of nurses should be further improved. The medication environment was a predictor of unsafe medication behavior. Care managers should actively improve the medication environment to reduce the incidence of unsafe medication behaviors. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

75 FR 29803 - Agency Information Collection Activity Seeking OMB Approval

Federal Register 2010, 2011, 2012, 2013, 2014

2010-05-27

... action to correct unsafe conditions in aircraft, engines, propellers, and appliances. Reports of... issued to require correct corrective action to correct unsafe conditions in aircraft, engines, propellers...

Heterosexual Transmission of HIV in China

PubMed Central

YANG, HONGMEI; LI, XIAOMING; STANTON, BONITA; LIU, HONGJIE; LIU, HUI; WANG, NING; FANG, XIAOYI; LIN, DANHUA; CHEN, XINGUANG

2006-01-01

Objective: The objective of this study was to address the role of heterosexual transmission of HIV in China. Goal: The goal of this study was to explore the prevalence of unsafe sex and the likelihood of HIV spread heterosexually from core populations to others. Study: The authors conducted a review of behavioral studies. Results: Drug users were more likely to be involved in higher-risk sexual behaviors than were those who abstained from using drugs. Most female drug users (52-98%) reported having engaged in commercial sex. Most female sex workers (FSWs) and individuals with sexually transmitted diseases (STDs) had concurrent sexual partners. Many continued to have unprotected sex after noticing STD symptoms in themselves or their sexual partners. From 5% to 26% of rural-to-urban migrants had multiple sexual partners and 10% of males patronized FSWs during migration. Conclusions: Factors such as high rates of FSW patronage, low rates of condom use during commercial sex, having sex with both commercial and noncommercial sexual partners, and high rates of STD infection may promote a heterosexual epidemic in China. PMID:15849527

The association between poor antiretroviral adherence and unsafe sex: differences by gender and sexual orientation and implications for scale-up of treatment as prevention.

PubMed

Remien, Robert H; Dolezal, Curtis; Wagner, Glenn J; Goggin, Kathy; Wilson, Ira B; Gross, Robert; Rosen, Marc I; Shen, Jie; Simoni, Jane M; Golin, Carol E; Arnsten, Julia H; Bangsberg, David R; Liu, Honghu

2014-08-01

Non-adherence to safer sex and non-adherence to ART can each have adverse health consequences for HIV-infected individuals and their sex partners, but little is known about the association of these behaviors with each other. This "dual risk" has potential negative public health consequences since non-adherence can lead to the development of resistant virus that can then be transmitted to sex partners. Among participants in the Multi-site Adherence Collaboration in HIV we examined, at study baseline, the association between the frequency of unprotected sex (assessed by self-report) and ART adherence (assessed by Medication Event Monitoring System, Aardex) among the sexually active participants in the five studies (N = 459) that collected sexual risk behavior. The bivariate association between sexual risk behaviors and ART adherence was assessed by Pearson correlations; subsequently regression analyses were used to evaluate the role of demographic characteristics, depression and substance use in explaining the "dual risk" outcome (sexual risk and non-adherence). Among participants who had been sexually active, more unprotected anal/vaginal sex was weakly associated with poorer ART adherence (r = -0.12, p = 0.01 for the overall sample). Further analysis showed this association was driven by the heterosexual men in the sample (r = -0.29, p < 0.001), and was significant only for this group, and not for gay/bisexual men or for women (heterosexual and homosexual). Neither substance use nor depression accounted for the association between sexual risk and ART adherence. HIV-infected heterosexual men who are having difficulty adhering to ART are also more likely to engage in risky sexual behaviors and therefore may benefit from counseling about these risk behaviors. We must identify procedures to screen for these risk behaviors and develop interventions, appropriately tailored to specific populations and identified risk factors, that can be integrated into routine clinical care for people living with HIV. This will become increasingly important in the context of wider access to treatment globally, including new recommendations for ART initiation earlier in a patients' disease course (e.g., "Test and Treat" paradigms).

Adolescent suicide and health risk behaviors: Rhode Island's 2007 Youth Risk Behavior Survey.

PubMed

Jiang, Yongwen; Perry, Donald K; Hesser, Jana E

2010-05-01

Suicide is the third-leading cause of death among high school students in the U.S. This study examined the relationships among indicators of depressed mood, suicidal thoughts, suicide attempts, and demographics and risk behaviors in Rhode Island high school students. Data from Rhode Island's 2007 Youth Risk Behavior Survey were utilized for this study. The statewide sample contained 2210 randomly selected public high school students. Data were analyzed in 2008 to model for each of five depressed mood/suicide indicators using multivariable logistic regression. By examining depressed mood and suicide indicators through a multivariable approach, the strongest predictors were identified, for multiple as well as specific suicide indicators. These predictors included being female, having low grades, speaking a language other than English at home, being lesbian/gay/bisexual/unsure of sexual orientation, not going to school as a result of feeling unsafe, having been a victim of forced sexual intercourse, being a current cigarette smoker, and having a self-perception of being overweight. The strength of associations between three factors (immigrant status, feeling unsafe, and having forced sex) and suicide indicators adds new information about potential predictors of suicidal behavior in adolescents. 2010 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

Knowledge, attitudes and practices on HIV/AIDS and prevalence of HIV in the general population of Sucre, Bolivia.

PubMed

Terán Calderón, Carolina; Gorena Urizar, Dorian; González Blázquez, Cristina; Alejos Ferreras, Belén; Ramírez Rubio, Oriana; Bolumar Montrull, Francisco; Ortiz Rivera, Marta; del Amo Valero, Julia

2015-01-01

To analyse knowledge, attitudes and sexual practices on HIV/AIDS, and estimate HIV prevalence among residents of Sucre (Bolivia). Population-based survey of residents aged 15-49 randomly selected during 2008/2009. Blood samples were collected on Whatman-filter paper and tested with enzyme-linked immunosorbent assay. Knowledge on HIV/AIDS, sexual risk practices and discriminatory attitudes against people living with HIV/AIDS (PLWHA) were modelled with multiple logistic regression. Of 1499 subjects, 59% were women. All subjects were HIV-negative. Inadequate knowledge of HIV/AIDS transmission and prevention was observed in 67% and risk factors varied by gender (interaction p-value<0.05). Discriminatory attitudes were displayed by 85% subjects; associated factors were: rural residence, low educational level and low income. Unsafe sex was reported by 10%; risk factors varied by residence area (interaction p-value<0.05). In urban areas, risk factors were male sex, younger age and being in common-law union. Prevalence of HIV infection is very low and unsafe sex is relatively uncommon. Inadequate knowledge on HIV/AIDS and discriminatory attitudes towards PLWHA are extremely high and are associated to gender, ethnic and economic inequalities. Copyright © 2015 Elsevier Editora Ltda. All rights reserved.

Mujeres que Consumen Sustancias y su Vulnerabilidad frente al VIH en Santiago de Chile

PubMed Central

Irarrázabal, Lisette P.; Ferrer, Lilian; Villegas, Natalia; Sanhueza, Sebastián; Molina, Yerko; Cianelli, Rosina

2017-01-01

Introduction Women represent 15% of the people living with HIV in Chile. Risk behaviors for HIV are: multiple partners, unsafe sex, and exchange of sex for drugs/money. Methodology A correlational design was used. A sample of 203 women who were sexually active and consumed substances within the last 3-months were selected for this study. Results The average age of the participants was 32.4 years (SD = 9.2) and 68.1% were housewives. The substance most commonly used was alcohol (95.1%) and marijuana (49.8%); 23.7% of the women were drunk or drugged before having sex; 74.4% had multiple sexual partners and 95.6% had unprotected sex. There is a significant correlation (p < 0.05) between substance abuse and HIV risk behaviors. Conclusion It is necessary to develop more research to understand in depth the relationship between substance use and HIV risk among Chilean women. It is important to consider the use of substances to develop and implement HIV prevention programs in the Chilean community. PMID:27257222

Mujeres que Consumen Sustancias y su Vulnerabilidad frente al VIH en Santiago de Chile (Women Who Consume Substances and Their Vulnerability to HIV in Santiago of Chile).

PubMed

Irarrázabal, Lisette P; Ferrer, Lilian; Villegas, Natalia; Sanhueza, Sebastián; Molina, Yerko; Cianelli, Rosina

2016-06-01

Women represent 15% of the people living with HIV in Chile. Risk behaviors for HIV are: multiple partners, unsafe sex, and exchange of sex for drugs/money. A correlational design was used. A sample of 203 women who were sexually active and consumed substances within the last 3-months were selected for this study. The average age of the participants was 32.4 years (SD = 9.2) and 68.1% were housewives. The substance most commonly used was alcohol (95.1%) and marijuana (49.8%); 23.7% of the women were drunk or drugged before having sex; 74.4% had multiple sexual partners and 95.6% had unprotected sex. There is a significant correlation (p < 0.05) between substance abuse and HIV risk behaviors. It is necessary to develop more research to understand in depth the relationship between substance use and HIV risk among Chilean women. It is important to consider the use of substances to develop and implement HIV prevention programs in the Chilean community. © The Author(s) 2016.

Investing in very young adolescents' sexual and reproductive health

PubMed Central

Igras, Susan M.; Macieira, Marjorie; Murphy, Elaine; Lundgren, Rebecka

2014-01-01

Very young adolescents (VYAs) between the ages of 10 and 14 represent about half of the 1.2 billion adolescents aged 10–19 in the world today. In lower- and middle-income countries, where most unwanted pregnancies, unsafe abortions, maternal deaths and sexually transmitted infections occur, investment in positive youth development to promote sexual and reproductive health (SRH) is increasing. Most interventions, though, focus on older adolescents, overlooking VYAs. Since early adolescence marks a critical transition between childhood and older adolescence and adulthood, setting the stage for future SRH and gendered attitudes and behaviours, targeted investment in VYAs is imperative to lay foundations for healthy future relationships and positive SRH. This article advocates for such investments and identifies roles that policy-makers, donors, programme designers and researchers and evaluators can play to address the disparity. PMID:24824757

Attitude towards intimate partner violence against women and risky sexual choices of Jamaican males.

PubMed

Gibbison, G A

2007-01-01

For young Jamaican men, it is necessary to prove their virility to their peers and prove to their parents that they are of heterosexual orientation. These demands have produced a society in which men are sexually aggressive, even to the point of using violence to control the sexual choices of women. This paper examines whether Jamaican men who support intimate partner violence (IPV) against women are more likely to have unsafe sexual practices and social attitudes that could increase women 's risk of contracting sexually transmitted infections. Men who responded 'yes' to violence against women are more likely themselves to have multiple sexual partners and less likely to use condoms consistently. They are also more likely to have forced a partner to have sex within the last year. Multivariate regression analysis shows that men who responded 'yes' to IPV are likely to be young, less educated and living in urban areas. Clearly, women in certain regions or subpopulations face an increased risk of contracting sexually transmitted infections due to the sexual choices of their partners. Intervention programmes to reduce sexually transmitted infections need to be developed with specific aspects of the cultural context of sexual relationships in mind. It seems especially important that male sexual choices and attitudes be directly addressed. Specific suggestions are made about an approach that has a proven record of success in reducing risky practices in high risk groups.

Vulnerability of women living with HIV/aids1

PubMed Central

Duarte, Marli Teresinha Cassamassimo; Parada, Cristina Maria Garcia de Lima; de Souza, Lenice do Rosário

2014-01-01

Objective outline the profile of women living with the human immunodeficiency virus/aids in interior cities in São Paulo State, in the attempt to identify characteristics related to individual, social and programmatic vulnerability and to analyze the conditions in which they discovered their serological status. Method between October 2008 and December 2010, a cross-sectional study was undertaken with 184 women attended at a specialized service. The data were collected through an interview and gynecological test, including the collection of samples for the etiological diagnosis of sexually transmissible conditions. Results the women were predominantly white, between 30 and 49 years of age, lived with a partner, had a low education level, multiple sexual partners across the lifetime and unsafe sexual practices. The prevalence of sexually transmitted diseases corresponded to 87.0%. Conclusion the study suggests the need to offer gynecological care in specialized services and the accomplishment of multiprofessional actions to reinforce the female autonomy in protective decision making. PMID:24553705

A pressing need to respond to the needs and sexual and reproductive health problems of adolescent girls living with HIV in low- and middle-income countries.

PubMed

Chandra-Mouli, Venkatraman; Armstrong, Alice; Amin, Avni; Ferguson, Jane

2015-01-01

This commentary provides the rationale and makes a call for greater investment and effort to meet the sexual and reproductive health (SRH) problems of adolescent girls living with HIV in low- and middle-income countries (LMIC). Adolescent girls in LMIC are at a greater risk of acquiring HIV infection than their male peers. They also face a number of other serious SRH problems--early pregnancy, pregnancy- and childbirth-related complications, unsafe abortions, sexual abuse and intimate partner violence and sexually transmitted infections. While many LMIC have made notable progress in preventing HIV in children and adults and in improving the access of these population groups to HIV treatment and care, adolescents in general and adolescent girls in particular have not received the same effort and investment. Much more needs to be done to implement proven approaches to prevent new HIV infections in adolescent girls in LMIC and to meet the needs of those living with HIV.

Risk Behaviors for HIV and HCV Infection Among People Who Inject Drugs in Hai Phong, Viet Nam, 2014.

PubMed

Duong, Huong Thi; Jarlais, Don Des; Khuat, Oanh Hai Thi; Arasteh, Kamyar; Feelemyer, Jonathan; Khue, Pham Minh; Giang, Hoang Thi; Laureillard, Didier; Hai, Vinh Vu; Vallo, Roselyne; Michel, Laurent; Moles, Jean Pierre; Nagot, Nicolas

2017-06-13

We examined the potential for HIV and hepatitis C (HCV) transmission across persons who inject drugs (PWID), men-who-have-sex-with-men (MSM) and female commercial sex workers (CSW) PWID and the potential for sexual transmission of HIV from PWID to the general population in Hai Phong, Viet Nam. Using respondent driven and convenience sampling we recruited 603 participants in 2014. All participants used heroin; 24% used non-injected methamphetamine. HIV prevalence was 25%; HCV prevalence was 67%. HIV infection was associated with HCV prevalence and both infections were associated with length of injecting career. Reported injecting risk behaviors were low; unsafe sexual behavior was high among MSM-PWID and CSW-PWID. There is strong possibility of sexual transmission to primary partners facilitated by methamphetamine use. We would suggest future HIV prevention programs utilize multiple interventions including "treatment as prevention" to potential sexual transmission of HIV among MSM and CSW-PWID and from PWID to the general population.

Effects of a behavioral intervention to reduce serodiscordant unsafe sex among HIV positive men who have sex with men: the Positive Connections randomized controlled trial study.

PubMed

Rosser, B R Simon; Hatfield, Laura A; Miner, Michael H; Ghiselli, Margherita E; Lee, Brian R; Welles, Seth L

2010-04-01

Few behavioral interventions have been conducted to reduce high-risk sexual behavior among HIV-positive Men who have Sex with Men (HIV+ MSM). Hence, we lack well-proven interventions for this population. Positive Connections is a randomized controlled trial (n = 675 HIV+ MSM) comparing the effects of two sexual health seminars--for HIV+ MSM and all MSM--with a contrast prevention video arm. Baseline, 6-, 12- and 18-month follow-up surveys assessed psychosexual variables and frequency of serodiscordant unprotected anal intercourse (SDUAI). At post-test, intentions to avoid transmission were significantly higher in the sexual health arms. However, SDUAI frequency decreased equally across arms. HIV+ MSM engaging in SDUAI at baseline were more likely to leave the study. Tailoring interventions to HIV+ MSM did not increase their effectiveness in this study. A sexual health approach appeared as effective as an untailored video-based HIV prevention intervention in reducing SDUAI among HIV+ MSM.

Sexual risk behavior among people living with HIV and AIDS on antiretroviral therapy at the regional hospital of Sokodé, Togo

PubMed Central

2014-01-01

Background Several studies on the sexual risk behaviors in sub-Saharan Africa have reported that the initiation of antiretroviral therapy leads to safer sexual behaviors. There is however a persistence of risky sexual behavior which is evidenced by a high prevalence of sexually transmitted infections among people living with HIV and AIDS (PLWHA). We sought to determine the factors associated with risky sex among PLWHA on antiretroviral therapy in Togo. Methods An analytical cross-sectional survey was conducted from May to July 2013 at regional hospital of Sokodé, Togo, and targeted 291 PLWHA on antiretroviral therapy for at least three months. Results From May to July 2013, 291 PLWHA on antiretroviral treatment were surveyed. The mean age of PLWHA was 37.3 years and the sex ratio (male/female) was 0.4. Overall, 217 (74.6%) PLWHA were sexually active since initiation of antiretroviral treatment, of which, 74 (34.6%) had risky sexual relations. In multivariate analysis, the factors associated with risky sex were: the duration of antiretroviral treatment (1 to 3 years: aOR = 27.08; p = 0.003; more than 3 years: aOR = 10.87; p = 0.028), adherence of antiretroviral therapy (aOR = 2.56; p = 0.014), alcohol consumption before sex (aOR = 3.59; p = 0.013) and level of education (primary school: aOR = 0.34 p = 0.011; secondary school: aOR = 0.23 p = 0.003; high school: aOR = 0.10; p = 0.006). Conclusion There was a high prevalence of unsafe sex among PLWHA receiving ART at the hospital of Sokodé. Factors associated with sexual risk behaviors were: low education level, non-adherence to ART, alcohol consumption before sex and the duration of ART. It is important to strengthen the implementation of secondary prevention strategies among this population group. PMID:24952380

Compulsive sexual behavior and risk for unsafe sex among internet using men who have sex with men.

PubMed

Coleman, Eli; Horvath, Keith J; Miner, Michael; Ross, Michael W; Oakes, Michael; Rosser, B R Simon

2010-10-01

The present study explored the relationship between compulsive sexual behavior (CSB) and unprotected anal intercourse (UAI) for men who have sex with men (MSM) across a number of ethnic/racial groups and who used the Internet to seek sexual partners. A sample of 2,716 MSM (512 Asian, 445 Black, 683 Latino, 348 Other, 728 White) completed on online survey that collected information about their sexual behaviors with partners met online and offline. The survey also included the Compulsive Sexual Behavior Inventory (CSBI). Consistent with the notion that CSB is a stable trait, higher scores on the CSBI were associated with greater odds for engaging in UAI, regardless of the context in which sex partners were met (online or offline). Differences in median CSB scores were generally similar across racial and ethnic groups. The median CSB score was significantly higher for HIV-positive participants than for HIV-negative participants. HIV-prevention interventions are needed among MSM, but should take into account that some may be resistant to risk reduction strategies because of CSB.

76 FR 23218 - Airworthiness Directives; Airbus Model A330-200, A330-300, A340-300, A340-500, and A340-600...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-04-26

... runaway when the BCM is activated. * * * * * The unsafe condition is loss of control of the airplane. The... runaway when the BCM is activated. EASA AD 2009-0153 retained the requirements of EASA AD 2008-0131 and... consequently to a potential rudder runaway when the BCM is activated. * * * * * The unsafe condition is loss of...

Contextual Factors and Sexual Risk Behaviors Among Young, Black Men.

PubMed

Jones, Jamal; Salazar, Laura F; Crosby, Richard

2017-05-01

Young Black men (YBM), aged 13 to 24 years, face a disproportionate burden of sexually transmitted infections (STIs). STI acquisition among YBM is due to incorrect and inconsistent condom use and is exacerbated by multiple sexual partners. Sexual and reproductive health is influenced by a complex interaction of biological, psychological, and social determinants that contribute to increased risk for STI acquisition. However, there are key social determinants of sexual health that play a major role in adolescent sexual risk-taking behaviors: gender norms, environment, peers, and families as well as a desire to impregnate a woman. Associations between contextual factors (risky environmental context, desire to impregnate a woman, and peer norms supportive of unsafe sex) and sexual risk behaviors were examined among a sample of YBM attending adolescent health clinics. This study used baseline data from a randomized controlled trial ( N = 702). Parental monitoring was also examined as an effect modifier of those associations. Sexual risk behaviors were the frequency of condomless vaginal sex, number of sexual partners within the previous 2 months, and lifetime number of sexual partners. Mean age was 19.7. In the adjusted model, peer norms was the only significant predictor for all sexual risk outcomes ( p < .05). Parental monitoring was an effect modifier for the perceived peer norms and lifetime sexual partners association ( p = .053) where the effect of peer norms on lifetime sexual partners was lower for participants with higher levels of perceived parental monitoring.

Establishment of safety paradigms and trust in emerging adult relationships.

PubMed

Mullinax, Margo; Sanders, Stephanie; Higgins, Jenny; Dennis, Barbara; Reece, Michael; Fortenberry, J Dennis

2016-08-01

There is a critical need to understand the interplay between relationship trust and public health outcomes. The purpose of this study was to develop an understanding of emerging adult women's processes of establishing trust in sexual relationships. Twenty-five women aged 18-24 years participated in semi-structured interviews. Throughout the interviews, women compared and contrasted experiences in which they felt comfortable engaging in sexual intercourse with a partner versus times in which they did not feel comfortable. Analysis was based on a critical qualitative research orientation. When asked to speak to instances when they felt comfortable having sex, most women spoke about relationship trust. Many participants conceptualised trust based on past experiences with bad relationships or sexual violence. Based on their previous experiences of feeling unsafe or undervalued, emotional and physical security became prioritised in relationship development. Trust was developed through friendship, communication over time, and through shared life experiences. This research is among the first to qualitatively investigate trust formation and other impersonal dynamics related to sexual health decision-making. Insights from this study should be translated into future action by public health practitioners to promote healthy sexual relationships and communication about sexual health topics as a form of trust building.

Motivational interviewing with computer assistance as an intervention to empower women to make contraceptive choices while incarcerated: study protocol for randomized controlled trial.

PubMed

Clarke, Jennifer; Gold, Melanie A; Simon, Rachel E; Roberts, Mary B; Stein, Lar

2012-07-02

Unplanned pregnancies and sexually transmitted infections (STIs) are important and costly public health problems in the United States resulting from unprotected sexual intercourse. Risk factors for unplanned pregnancies and STIs (poverty, low educational attainment, homelessness, substance abuse, lack of health insurance, history of an abusive environment, and practice of commercial sex work) are especially high among women with a history of incarceration. Project CARE (Contraceptive Awareness and Reproductive Education) is designed to evaluate an innovative intervention, motivational interviewing with computer assistance (MICA), aimed at enhancing contraceptive initiation and maintenance among incarcerated women who do not want a pregnancy within the next year and who are anticipated to be released back to the community. This study aims to: (1) increase the initiation of highly effective contraceptives while incarcerated; (2) increase the continuation of highly effective contraceptive use at 3, 6, 9, and 12  months after release; and (3) decrease unsafe sexual activity. This randomized controlled trial will recruit 400 women from the Rhode Island Department of Corrections (RI DOC) women's jail at risk for an unplanned pregnancy (that is, sexually active with men and not planning/wanting to become pregnant in the next year). They will be randomized to two interventions: a control group who receive two educational videos (on contraception, STIs, and pre-conception counseling) or a treatment group who receive two sessions of personalized MICA. MICA is based on the principles of the Transtheoretical Model (TTM) and on Motivational Interviewing (MI), an empirically supported counseling technique designed to enhance readiness to change targeted behaviors. Women will be followed at 3, 6, 9, and 12  months post release and assessed for STIs, pregnancy, and reported condom use. Results from this study are expected to enhance our understanding of the efficacy of MICA to enhance contraceptive initiation and maintenance and reduce sexual risk-taking behaviors among incarcerated women who have re-entered the community. NCT01132950.

UNSAFE SEXUAL BEHAVIOUR ASSOCIATED WITH HAZARDOUS ALCOHOL USE AMONG STREET-INVOLVED YOUTH

PubMed Central

Fairbairn, Nadia; Wood, Evan; Dong, Huiru; Kerr, Thomas; DeBeck, Kora

2016-01-01

While risky sexual behaviours related to illicit drug use among street youth have been explored, the impacts of alcohol use have received less attention. This longitudinal study examined hazardous alcohol use among a population of street-involved youth, with particular attention to sexual and drug-related risk behaviours. Data were derived from the At-Risk Youth Study, a prospective cohort of street-involved youth in Vancouver, Canada. The outcome of interest was hazardous alcohol use defined by the US National Institute on Alcohol Abuse and Alcoholism. We used generalized estimating equations (GEEs) analyses to identify factors associated with hazardous alcohol use. Between 2005 and 2014, 1149 drug-using youth were recruited and 629 (55%) reported hazardous alcohol use in the previous 6 months during study follow-up. In multivariable GEE analyses, unprotected sex (adjusted odds ratio [AOR] = 1.28, 95% confidence interval [95% CI] = 1.12–1.46) and homelessness (AOR = 1.35, 95% CI = 1.19–1.54) were independently associated with hazardous alcohol use (all p < .001). Older age (AOR = 0.95, 95% CI = 0.92–0.99), Caucasian ethnicity (AOR = 0.74, 95% CI = 0.61–0.90), daily heroin use (AOR = 0.53, 95% CI = 0.42– 0.67), daily crack cocaine smoking (AOR = 0.73, 95% CI = 0.59–0.91), and daily crystal methamphetamine use (AOR = 0.52, 95% CI = 0.42–0.64) were negatively associated with hazardous alcohol use (all p < .05). In sub-analysis, consistent dose–response patterns were observed between levels of alcohol use and unprotected sex, homelessness, and daily heroin injection. In sum, hazardous alcohol use was positively associated with unsafe sexual behaviour and negatively associated with high-intensity drug use. Interventions to address hazardous alcohol use should be central to HIV prevention efforts for street-involved youth. PMID:27539676

Factors associated with sexual arousal, sexual sensation seeking, and sexual satisfaction among African-American adolescent females

PubMed Central

Sales, Jessica M.; Smearman, Erica; Brody, Gene H.; Milhausen, Robin; Philibert, Robert A.; DiClemente, Ralph J.

2013-01-01

Sexuality-related constructs such as sexual arousal, sexual sensation seeking (SSS) and sexual satisfaction have been related to sexual behaviors that place one at risk for adverse consequences such as sexually transmitted infections (STIs), HIV, and unintended pregnancy. The biopsychosocial model posits an array of factors, ranging from social environmental factors, biological, and psychological predispositions that may be associated with these sexuality constructs in adolescent samples. African-American females aged 14-20 were recruited from reproductive health clinics for an HIV intervention. Baseline survey and follow-up DNA data (N=304) was used to assess biological, psychological and social environmental associations with the sexuality constructs of arousal, SSS, and sexual satisfaction. In multivariable linear regressions, a higher depressive symptom rating was associated with higher arousability while short serotonin allele(s) status was associated with lower arousability. Impulsivity and perceived peer norms supportive of unsafe sexual behaviors were associated with increased SSS, and short serotonin allele(s) status was associated with lower SSS. Higher social support was also associated with higher levels of sexual satisfaction while short serotonin allele(s) status was associated with lower satisfaction. The sexuality constructs were also significantly related to number of sex partners, frequency of vaginal sex, and number of unprotected vaginal sex acts in the past six months. These findings emphasize the importance of understanding biopsychosocial factors, including the role of serotonin as an indicator of natural variations in sexual inclination and behaviors, that influence sexuality constructs, which in turn are associated with sexual behaviors, to allow further refinement of sexual health clinical services and programs and promote the development of healthy sexuality. PMID:24262218

Sociodemographic characteristics and health risk behaviours among students of a tertiary institution in south western Nigeria.

PubMed

Bamidele, J O; Asekun-Olarinmoye, E O; Odu, O O; Amusan, O A; Egbewale, B E

2007-06-01

The identification of early risk factors among undergraduate students that impact on health, both mental and physical is a primary focus of this survey. This is more so since people suffering from an illness may not be currently engaging in any health risk behaviours but might have engaged in such behaviours before they developed the illness condition. Therefore the identification of health risk behaviours among this group of people would permit a better understanding of localized patterns of health risk behaviours as well as help to target intervention activities towards this particular group of people.The study is based upon data obtained from a cross-sectional survey of students in a tertiary institution in South Western Nigeria. Participants voluntarily and anonymously completed a baseline semistructured questionnaire which elicited information on demographic information, sexual behaviours and substance use among others. Of the 368 respondents, majority 225 (60.9%) are in the age group of 20-24 years. A total of 152 (41.3%) are either currently or have previously indulged in heavy drinking of alcohol and a statistically significant association (p<0.05) was found between the use of alcohol and having multiple sexual partners and use of commercial sex workers. Ninety-four (25.5%) and 52 (14.1%) are currently smoking or have smoked cigarette and marijuana before respectively; while 56 (15.2%) are currently using or have before used narcotic drugs. The relationship between hard drug use and non use of condom was statistically significant (p<0.05). Ninety-two (25.0%) have more than one sexual partners at the same given period; the male respondents indulged more in having multiple partners than the female and the result was statistically significant (p<0.05). As many as 155 (47.8%) of the 324 (88.0% of the respondents) sexually active respondents had never used condom during sexual intercourse. Also 88 (27.1%) of this group of the respondents have had sexual relationship with commercial sex workers (CSW) at one time or the other. Condom use was low among the sexually active respondents. Only 29.3% of the respondents always use condom when having any sexual relationship. This study has shown that students in this survey indulge in health risk behaviours such as "unsafe sexual practices", alcohol, cigarette smoking and other substance use. The males are more involved in having multiplicity of sexual partners than their female counterpart. The study also revealed a significant association between the use of alcohol and in having multiple sexual partners. Comprehensive health education and intervention programs are needed to influence positive behavioural change among this group of students and this will require working in partnership with schools authorities and other local community groups.

Unsafe sexual behaviors among HIV-positive men and women in Honduras: the role of discrimination, condom access, and gender.

PubMed

Paz-Bailey, Gabriela; Isern Fernandez, Virginia; Morales Miranda, Sonia; Jacobson, Jerry O; Mendoza, Suyapa; Paredes, Mayte A; Danaval, Damien C; Mabey, David; Monterroso, Edgar

2012-01-01

We conducted a study among HIV-positive men and women in Honduras to describe demographics, HIV risk behaviors and sexually transmitted infection prevalence, and identify correlates of unsafe sex. Participants were recruited from HIV clinics and nongovernmental organizations in Tegucigalpa and San Pedro Sula, Honduras in a cross-sectional study in 2006. We used audio-assisted computer interviews on demographics; behaviors in the past 12 months, 6 months, and 30 days; and access to care. Assays performed included herpes (HSV-2 Herpes Select), syphilis (rapid plasma reagin [RPR] and Treponema pallidum particle agglutination assay [TPPA]) serology, and other sexually transmitted infections by polymerase chain reaction (PCR). Bivariate and multivariate analyses were conducted to assess variables associated with unprotected sex across all partner types in the past 12 months. Of 810 participants, 400 were from Tegucigalpa and 410 from San Pedro Sula; 367 (45%) were men. Mean age was 37 years (interquartile range: 31-43). Consistent condom use for men and women was below 60% for all partner types. In multivariate analysis, unprotected sex was more likely among women (odds ratio [OR]: 1.9, 95% confidence interval [CI]: 1.2-3.1, P = 0.007), those with HIV diagnoses within the past year (OR: 2.0, 95% CI: 1.1-3.7, P = 0.016), those reporting difficulty accessing condoms (OR: 2.6, 95% CI: 1.4-4.7, P = 0.003), and those reporting discrimination (OR: 1.8, 95% CI: 1.1-3.0, P = 0.016). Programs targeting HIV-positive patients need to address gender-based disparities, improve condom access and use, and help establish a protective legal and policy environment free of stigma and discrimination.

Healthcare students' knowledge and opinions about the Argentinean abortion law.

PubMed

Provenzano-Castro, Belén; Oizerovich, Silvia; Stray-Pedersen, Babill

2016-03-01

Abortion is legally restricted in Argentina. Although this law is almost 100 years old, most women who meet the criteria for legal abortion are not informed of or offered this possibility within the healthcare system. Healthcare students' knowledge and opinions on abortion may influence their future practice. They may deny a woman with an unwanted pregnancy a practice to which she is legally entitled, resulting in an unsafe abortion. This study assessed knowledge and personal opinions on the abortion law among first year healthcare students in order to design adequate educational strategies. In this descriptive, analytical, cross-sectional study, structured self-administered questionnaires were administered to 781 first year medical, nursing, midwifery, and other healthcare students from the Faculty of Medicine, University of Buenos Aires from 2011 to 2013. Data were recorded anonymously in SPSS 20. Student samples were adjusted for gender and fields of study using the University statistics. Of the students, 48.8% did not know the current regulations. Most of the students thought abortion was legally restricted and failed to recognize the circumstances in which it is allowed. Over 75% of the students were pro-abortion, especially those with sexual experience. Students lack sound knowledge on the abortion law that may affect their personal lives and influence their future professional practice. It is crucial that medical schools include sexual and reproductive health issues in their curricula in order to ensure better quality healthcare services in the future. In Argentina, approximately 400,000 abortions are performed every year, many under unsafe conditions, resulting in one third of the maternal deaths for the past decade. High quality sexual and reproductive healthcare services are a key strategy to improve adolescents' and women's health, thereby lowering maternal mortality. Copyright © 2015 Elsevier B.V. All rights reserved.

Effects of an Interactive School-Based Program for Preventing Adolescent Sexual Harassment: A Cluster-Randomized Controlled Evaluation Study.

PubMed

de Lijster, Gaby P A; Felten, Hanneke; Kok, Gerjo; Kocken, Paul L

2016-05-01

Many adolescents experience sexual harassment and victims of sexual harassment have higher risks regarding well-being and health behaviors such as higher risks of suicidal thoughts, suicidal ideation and feeling unsafe at school. A peer-performed play and school lessons on preventing sexual harassment behavior were presented to secondary school students. We evaluated its effectiveness, using a cluster-randomized controlled design to assign schools to an experimental condition [n = 14 schools; 431 students (51 % female)] and a control condition [n = 11 schools; 384 students (51 % female)]. To measure the effects of the intervention at first post-test and 6-month follow-up, our multilevel analyses used a two-level random intercept model. Outcome measures were sexual harassment behaviors, behavioral determinants and distal factors influencing these behaviors. At post-test, students in the experimental group reported a reduced intention to commit sexual harassment behavior and higher self-efficacy in rejecting it. At post-test and follow-up there was a significant positive effect on social norms for rejecting sexual harassment behavior. At follow-up, sexual self-esteem was higher in students in the experimental group than in the control group. Effects on these determinants will benefit adolescents' future sexual behaviors. In combination, the play and lessons, possibly together with continued sexual health education and skills programs on social-emotional learning in subsequent school years, have potential for preventing sexual harassment behavior.

HIV risk behaviors in the U.S. transgender population: prevalence and predictors in a large internet sample.

PubMed

Feldman, Jamie; Romine, Rebecca Swinburne; Bockting, Walter O

2014-01-01

To study the influence of gender on HIV risk, a sample of the U.S. transgender population (N = 1,229) was recruited via the Internet. HIV risk and prevalence were lower than reported in prior studies of localized, urban samples but higher than the overall U.S. population. Findings suggest that gender nonconformity alone does not itself result in markedly higher HIV risk. Sex with nontransgender men emerged as the strongest independent predictor of unsafe sex for both male-to-female (MtF) and female-to-male (FtM) participants. These sexual relationships constitute a process that may either affirm or problematize gender identity and sexual orientation, with different emphases for MtFs and FtMs, respectively.

Successful approaches. Sports stars and HEAPS.

PubMed

1996-01-01

In western Samoa, football stars are being used in the fight against acquired immunodeficiency syndrome (AIDS). Originally recruited by Palanitina Toelupe, chief health educator of the Health Education and Promotion Section (HEAPS), to assist with an anti-smoking campaign, the players became sensitized to issues regarding AIDS and agreed to visit high schools where they could urge young people to "Learn the Facts (about AIDS) and Pass the Word." With assistance from the SPC, HEAPS produced and broadcast radio and TV spots featuring the athletes; a poster was printed and distributed. Sports stars travel regionally and internationally; those with knowledge of AIDS and unsafe sex behavior can reinforce responsible sexual behavior among their teammates. Sports people should be targeted for AIDS and sexually transmitted disease (STD) education and prevention.

The association between social networks and self-rated risk of HIV infection among secondary school students in Moshi Municipality, Tanzania

PubMed Central

Lyimo, Elizabeth J.; Todd, Jim; Rickey, Lisa Ann; Njau, Bernard

2014-01-01

This study describes the social networks of secondary school students in Moshi Municipality, and their association with self-rated risk of human immunodeficiency virus (HIV) infection. A cross-sectional analytical study was conducted among 300 students aged 15–24 years in 5 secondary schools in Moshi, Tanzania. Bonding networks were defined as social groupings of students participating in activities within the school, while bridging networks were groups that included students participating in social groupings from outside of the school environs. A structured questionnaire was used to ask about participation in bonding and bridging social networks and self-rated HIV risk behavior. More participants participated in bonding networks (72%) than in bridging networks (29%). Participation in bridging networks was greater among females (25%) than males (12%, p < .005). Of 300 participants, 88 (29%) were sexually experienced, and of these 62 (70%) considered themselves to be at low risk of HIV infection. Factors associated with self-rated risk of HIV included: type of school (p < .003), family structure (p < .008), being sexually experienced (p < .004), having had sex in the past three months (p < .009), having an extra sexual partner (p < .054) and non-condom use in last sexual intercourse (p < .001), but not the presence or type of social capital. The study found no association between bonding and bridging social networks on self-rated risk of HIV among study participants. However, sexually experienced participants rated themselves at low risk of HIV infection despite practicing unsafe sex. Efforts to raise adolescents’ self-awareness of risk of HIV infection through life skills education and HIV/acquired immunodeficiency syndrome risk reduction strategies may be beneficial to students in this at-risk group. PMID:24641669

Risk perception and condom-use among Thai youths: findings from Kanchanaburi Demographic Surveillance System site in Thailand.

PubMed

Haque, Mohammad Raisul; Soonthorndhada, Amara

2009-12-01

Youths, aged 15-24 years, comprise a large fragment of the total population in Thailand, and unsafe sexual behaviours are increasing, nowadays, among young people. The study was conducted to explore the characteristics of youths and other conducive, facilitating and reinforcing factors associated with risk perception of sexually transmitted infections (STIs) among the study population. Data employed in this study were derived from the site of the Kanchanaburi Demographic Surveillance System of Thailand 2004 using a stratified systemic design. The study population was mainly young current condom-users aged 15-24 years, and cross-sectional analysis was done on this populace. The findings revealed that youths who fell into the single (unmarried) category having temporary partners were more likely to perceive the risks associated with STIs in relation to using condom. A greater proportion of unmarried youths was engaged in sexual activity before the age of 20 years and that condom-use was also inconsistent. Youths having temporary partners were more likely to perceive risk and reason for using a condom than when with their regular partner. Education played a significant role in risk perception of STIs. Risk perception was increasing with the increasing level of education. Other conducive and facilitating factors, such as household wealth, living in urban or semi-urban areas, and access to mass media such as television, also had a positive influence on risk perception. The odds ratio showed that condom-users who had indulgence in liquor were less likely to perceive the risk of STIs. Overall, socioeconomic status had a great influence on risk perception of STIs. Finally, youths exhibiting high-risk sexual behaviour need realistic risk assessments and positive ways of incorporating condom into their sexual lives.

Medical students' attitudes and perceptions on abortion: a cross-sectional survey among medical interns in Maharastra, India.

PubMed

Sjöström, Susanne; Essén, Birgitta; Sydén, Filip; Gemzell-Danielsson, Kristina; Klingberg-Allvin, Marie

2014-07-01

Although abortion care has been an established routine since decades in India, 8% of maternal mortality is attributed to unsafe abortion. Increased knowledge and improved attitudes among health care providers have a potential to reduce barriers to safe abortion care by reducing stigma and reluctance to provide abortion. Previous research has shown that medical students' attitudes can predict whether they will perform abortions. The objective of our study was to explore attitudes toward abortion among medical interns in Maharastra, India. A cross-sectional survey was carried out among 1996 medical interns in Maharastra, India. Descriptive and analytical statistics were used to interpret the study instrument. Almost one quarter of the respondents considered abortion to be morally wrong, one fifth did not find abortions for unmarried women acceptable and one quarter falsely believed that a woman needs her partner or spouse's approval to have an abortion. Most participants agreed that unsafe abortion is a serious health problem in India. A majority of the respondents rated their knowledge of sexual and reproductive health as good, but only 13% had any clinical practice in abortion care services. Disallowing attitudes toward abortion and misconceptions about the legal regulations were common among the surveyed medical students. Knowledge and attitudes toward abortion among future physicians could be improved by amendments to the medical education, potentially increasing the number of future providers delivering safe and legal abortion services. Abortion is legal in India since decades, but maternal mortality due to unsafe abortions remains high. This survey of attitudes toward abortion among medical interns in Maharastra indicates that disallowing views prevail. Improved knowledge and clinical training can increase numbers of potential abortion providers, thus limit unsafe abortion. Copyright © 2014 Elsevier Inc. All rights reserved.

Pattern and Outcome of Induced Abortion in Abakaliki, Southeast of Nigeria

PubMed Central

Ikeako, LC; Onoh, R; Ezegwui, HU; Ezeonu, PO

2014-01-01

Background: Unsafe abortion accounts for a greater proportion of maternal deaths, yet it is often not adequately considered in discussions around reducing maternal mortality. Aim: The aim of this study is to determine the pattern of unsafe abortion and the extent to which unsafe abortion contributes to maternal morbidity and mortality in our setting as well as assess the impact of post-abortion care. Subjects and Methods: A descriptive study of patients who were admitted for complications following induced abortions between January 1, 2001 and December 31, 2008 at the Federal Medical Center, Abakaliki South East of Nigeria with data obtained from case records. Results: Out of the 1,562 gynecogical admissions, a total of 83 patients presented with the complications arising from induced abortion. The age group 20-24 years was mostly affected and adolescents constituted 32.5% (27/83). Nearly 15.7% (13/83) of these patients died while the remaining 84.3% (70/83) had various complications, which were mainly septicemia 59.0% (49/83), anemia 47.0% (39/83), peritonitis 41.0% (34/83), hemorrhages 34.9% (29/83) and uterine perforation 30.1% (25/83). During the study, there were 38 gynecological deaths and abortion related death accounted for 34.2% (13/38) of these gynecological deaths. 84.3% (70/83) of the patients had no documented evidence of counseling on family planning and 59.0% (49/83) were not aware of the different methods of contraception. Conclusion: Unsafe abortion remains one of the most neglected sexual and reproductive health problems in developing countries today despite its significant contribution to maternal mortality and morbidity. Solutions and remedies include prevention of unplanned and unwanted pregnancies by sex education and access to safe and sustainable family planning methods. PMID:24971223

Prevalence and associated risk factors for syphilis in women with recurrent miscarriages.

PubMed

Hussain Laghari, Arshad; Sultana, Viqar; Hussain Samoo, Akhtar; Makhija, Pirbhomal; Ara, Jehan; Hira

2014-03-01

A Cross Sectional population based serological studies was conducted to determine the prevalence and associated risk factors for syphilis women with recurrent miscarriages. Patient's 5ml whole blood was collected through venepuncture technique. Data were collected by all women answered a questionnaire and by investigating blood sample VDRL test and FTA-ABS test. The study was conducted in a confidential manner and numbers were used to identify the participant. Total 256 women were included in the present study. Mean age of women was 29.4 years while range was 21 to 38 years (206/256). Out of the 256 samples, 05 (1.9%) were positive for active syphilis. Majority belonged to low socioeconomic group, uneducated and had previous congenital anomaly. Active infection with Treponema pallidum (T.P) in women belonging to low socioeconomic level were disquieting. This is probably due to illiteracy and high proportion of unsafe sexual behavior. It is also suggestive that seropositive status is often discovered in routine serological studies during pregnancy.

Clandestine induced abortion: prevalence, incidence and risk factors among women in a Latin American country.

PubMed

Bernabé-Ortiz, Antonio; White, Peter J; Carcamo, Cesar P; Hughes, James P; Gonzales, Marco A; Garcia, Patricia J; Garnett, Geoff P; Holmes, King K

2009-02-03

Clandestine induced abortions are a public health problem in many developing countries where access to abortion services is legally restricted. We estimated the prevalence and incidence of, and risk factors for, clandestine induced abortions in a Latin American country. We conducted a large population-based survey of women aged 18-29 years in 20 cities in Peru. We asked questions about their history of spontaneous and induced abortions, using techniques to encourage disclosure. Of 8242 eligible women, 7992 (97.0%) agreed to participate. The prevalence of reported induced abortions was 11.6% (95% confidence interval [CI] 10.9%-12.4%) among the 7962 women who participated in the survey. It was 13.6% (95% CI 12.8%-14.5%) among the 6559 women who reported having been sexually active. The annual incidence of induced abortion was 3.1% (95% CI 2.9%-3.3%) among the women who had ever been sexually active. In the multivariable analysis, risk factors for induced abortion were higher age at the time of the survey (odds ratio [OR] 1.11, 95% CI 1.07-1.15), lower age at first sexual intercourse (OR 0.87, 95% CI 0.84-0.91), geographic region (highlands: OR 1.56, 95% CI 1.23-1.97; jungle: OR 1.81, 95% CI 1.41-2.31 [v. coastal region]), having children (OR 0.82, 95% CI 0.68-0.98), having more than 1 sexual partner in lifetime (2 partners: OR 1.61, 95% CI 1.23-2.09; > or = 3 partners: OR 2.79, 95% CI 2.12-3.67), and having 1 or more sexual partners in the year before the survey (1 partner: OR 1.36, 95% CI 1.01-1.72; > or = 2 partners: OR 1.54, 95% CI 1.14-2.02). Overall, 49.0% (95% CI 47.6%-50.3%) of the women who reported being currently sexually active were not using contraception. The incidence of clandestine, potentially unsafe induced abortion in Peru is as high as or higher than the rates in many countries where induced abortion is legal and safe. The provision of contraception and safer-sex education to those who require it needs to be greatly improved and could potentially reduce the rate of induced abortion.

Mental health and risky sexual behaviors: evidence from DSM-IV Axis II disorders.

PubMed

Maclean, Johanna Catherine; Xu, Haiyong; French, Michael T; Ettner, Susan L

2013-12-01

Several economic studies link poor mental health and substance misuse with risky sexual behaviors. However, none have examined the relationships between DSM-IV Axis II mental health disorders (A2s) and risky sexual behaviors. A2 disorders are a poorly understood, yet prevalent and disabling class of mental health conditions. They develop early in life through an interaction of genetics and environment, and are persistent across the life course. Common features include poor impulse control, addiction, social isolation, and elevated sexual desires, although the defining features vary substantially across disorder. To investigate the association between A2 disorders and three measures of risky sexual behavior. We obtain data on adults age 20 to 50 years from Wave II of the National Epidemiological Survey of Alcohol and Related Conditions (NESARC). Our outcome measures include early initiation into sexual activity, and past year regular use of alcohol before sex and sexually transmitted disease diagnosis. NESARC administrators use the Alcohol Use Disorder and Associated Disabilities Interview Schedule to classify respondents as meeting criteria for the ten A2 disorders recognized by the American Psychiatric Association. We construct several measures of A2 disorders based on the NESARC administrators' classifications. Given their comorbidity with A2 disorders, we explore the importance of Axis I disorders in the estimated associations. We find that A2 disorders are generally associated with an increase in the probability of risky sexual behaviors among both men and women. In specifications that disaggregate disorders into clusters and specific conditions, the significant associations are not uniform, but are broadly consistent with the defining features of the cluster or disorder. Inclusion of A1 disorders attenuates estimated associations for some risky sexual behaviors among men, but not for women. We find positive associations between A2 disorders and our measures of risky sexual behaviors. Our findings are subject to several data limitations, however. The NESARC lacks information on more advanced risky sexual behaviors and our measure of early initiation into sexual activity is retrospective. Identifying the causal effects of mental health and risky sexual behaviors is complicated due to bias from reverse causality and omitted variables. We believe these sources of bias are less of a concern in our study, however. Specifically, A2 disorders develop early in life and pre-date the risky sexual behaviors, thus negating reverse causality. Because the NESARC contains a rich set of personal characteristics, we are also able to minimize potential omitted variable bias. A2 disorders are significantly associated with risky sexual behaviors, which could lead to greater utilization and cost of health care services. Health care providers should consider A2 disorders when developing health promotion recommendations as these disorders may place individuals at elevated risk for unsafe sexual behaviors. Future studies should examine the causal mechanisms between A2 disorders and risky sexual behaviors.

A pressing need to respond to the needs and sexual and reproductive health problems of adolescent girls living with HIV in low- and middle-income countries

PubMed Central

Chandra-Mouli, Venkatraman; Armstrong, Alice; Amin, Avni; Ferguson, Jane

2015-01-01

Introduction This commentary provides the rationale and makes a call for greater investment and effort to meet the sexual and reproductive health (SRH) problems of adolescent girls living with HIV in low- and middle-income countries (LMIC). Discussion Adolescent girls in LMIC are at a greater risk of acquiring HIV infection than their male peers. They also face a number of other serious SRH problems – early pregnancy, pregnancy- and childbirth-related complications, unsafe abortions, sexual abuse and intimate partner violence and sexually transmitted infections. While many LMIC have made notable progress in preventing HIV in children and adults and in improving the access of these population groups to HIV treatment and care, adolescents in general and adolescent girls in particular have not received the same effort and investment. Conclusions Much more needs to be done to implement proven approaches to prevent new HIV infections in adolescent girls in LMIC and to meet the needs of those living with HIV. PMID:26643463

The attitudes of Kenyan in-school adolescents toward sexual autonomy.

PubMed

Adaji, Sunday E; Warenius, Linnea U; Ong'any, Antony A; Faxelid, Elisabeth A

2010-03-01

This was a cross-sectional study to examine the attitudes of Kenyan in-school adolescents towards premarital sex, unwanted pregnancies/abortions and contraception. Data collection was undertaken using a structured questionnaire. Kenyan in-school adolescents have conservative attitudes toward premarital sex, disagreeing that adolescent boy and girls should be left alone to satisfy their sexual needs. The girls had the view that boys have uncontrollable sexual appetites. With regards to unwanted pregnancies, the majority of the respondents disagreed with allowing abortions for pregnant school girls while they agreed that a pregnant school girl should be allowed to return to school. However, the majority of the girls held the view that a school boy who had impregnated a school girl should be expelled from school. The attitudes of the respondents to contraception were also largely conservative. The conservative attitudes of the respondents conflicts with the findings of high levels of unsafe sex and reproductive ill-health among Kenyan adolescents. There is need to help Kenyan in-school adolescents to develop more realistic attitudes toward sexuality in order to improve their reproductive health.

Women, drug dependency and consequences: a study from a developing country.

PubMed

Khajedaluee, Mohammad; Dadgarmoghaddam, Maliheh; Erfanian, Majidreza; Alipourtabrizi, Arash; Khadem-Rezaiyan, Majid

2015-01-01

Introduction. Addiction in women can expose them to malnutrition, high blood pressure, cancer, and some other dangerous diseases like hepatitis, AIDS, or other sexual transmitted diseases. The aim of this study was to assess illegal sexual relations in three groups of women. Methods. This is a cross-sectional study that was done on 236 girls and young women aged 16-25 years in 2012 in three groups: vulnerable women who have substance dependency (crimes that had made women incarcerated were considered as vulnerability in this study), invulnerable women who have substance dependency (substance dependent women without a history of incarceration), and a control group (women with no history of substance dependency or being in prison). Results. 43.8% of vulnerable women who have substance dependency had extramarital sexual relations; this percentage was 55.8% in invulnerable women who have substance dependency and 1.4% in the control group. Crystal and methamphetamine abuse was higher in addicts who had extramarital sexual relations and alcohol abuse was correlated with unsafe sexual intercourse (r = 0.36, P = 0.001). There was a statistically significant difference in extramarital sexual relation based on marital status (P < 0.001). Conclusions. Poverty, drug dependency, divorce, and alcohol consumption make women prone to other high risk behaviors that need more attention.

Establishment of safety paradigms and trust in emerging adult relationships

PubMed Central

Mullinax, Margo; Sanders, Stephanie; Higgins, Jenny; Dennis, Barbara; Reece, Michael; Fortenberry, J. Dennis

2016-01-01

There is a critical need to understand the interplay between relationship trust and public health outcomes. The purpose of this study was to develop an understanding of emerging adult women’s processes of establishing trust in sexual relationships. Twenty-five women aged 18–24 years participated in semi-structured interviews. Throughout the interviews, women compared and contrasted experiences in which they felt comfortable engaging in sexual intercourse with a partner versus times in which they did not feel comfortable. Analysis was based on a critical qualitative research orientation. When asked to speak to instances when they felt comfortable having sex, most women spoke about relationship trust. Many participants conceptualised trust based on past experiences with bad relationships or sexual violence. Based on their previous experiences of feeling unsafe or undervalued, emotional and physical security became prioritised in relationship development. Trust was developed through friendship, communication over time, and through shared life experiences. This research is among the first to qualitatively investigate trust formation and other impersonal dynamics related to sexual health decision-making. Insights from this study should be translated into future action by public health practitioners to promote healthy sexual relationships and communication about sexual health topics as a form of trust building. PMID:26943023

Family fun or cultural free-for-all? A critique of the 2015 National Football League Super Bowl commercials.

PubMed

Basch, Corey H; Kernan, William D; Reeves, Rachel

2016-01-01

The purpose of this cross-sectional study was to enumerate and describe violent and risky behaviors as well as other general health behaviors exhibited in the advertisements during the National Football League (NFL) Super Bowl 2015. Commercials during the NFL Super Bowl 2015 were assessed for violent and risky behaviors. Additional health behaviors were indicated such as the advertisement of unhealthy food, promotion of physical activity, and sexual content. A total of 110 commercials were documented, accounting for 64 minutes of broadcast time. Commercials promoting automobiles, television shows, food, and movies were the most prevalent, representing just over half (53.7%) of all of the advertisements featured. Depictions of unsafe driving were found in 10.9% (n = 12) of the commercials. All 12 commercials contained some sort of risky or wild driving behavior, and speeding was observed in 11 of the 12 commercials. A total of 32 (29.1%) of the commercials were coded as including violent content.Physical activity behavior was present in 3 (2.7%) of the commercials. Conversely, substance use was observed in 3 (2.7%) of the commercials, none of which included health promotion messaging. Of the 110 commercials aired during the 2015 Super Bowl, 12.7% (n = 14) included sexual content. Parents should consider the possibility that their children may observe acts of violence or conflicting safety messages during commercial breaks.

The Role of Parental Monitoring and Affiliation with Deviant Peers in Adolescents’ Sexual Risk Taking: Toward an Interactional Model

PubMed Central

Ahmadi, Khodabakhsh; Khodadadi Sangdeh, Javad; Aminimanesh, Sajad; Mollazamani, Ali; Khanzade, Mostafa

2013-01-01

Background Adolescence is considered as an important phase for beginning sexual high risk behaviors that increases the possibility of negative, unpleasant and problematic consequences like unwanted pregnancy and probability of copulative disease transmission. Objectives To determine the prevalence of sexual risk taking among students in Tehran and to develop and test a model for the relationship between parental monitoring and affiliation with deviant peers as they predict youth risky sexual behaviors. Materials and Methods In this cross sectional study, 1266 adolescents were recruited from high schools in Tehran and three scales of sexual risk behavior, parental monitoring and adolescent affiliation with deviant peers were completed. Data was analyzed using independent sample t-test, Pearson correlation coefficient and structural equation modeling. Results According to the results, about one-fifth of subjects were at high risk in terms of unsafe sexual relationships. The percent of positive attitude among males was nearly 2 times more than that of females. The investigated model for the mediating role of affiliation with deviant peers in the relationship between parental monitoring and sexual risk taking was confirmed and explained 0.32 of sexual risk taking variance. Conclusions The results of this study suggested that parental monitoring and affiliation with deviant peers largely explained sexual risk taking among adolescents. Therefore, prevention efforts aimed at reducing risky sex should compose of these factors. In fact, the results suggested that earlier prevention efforts may be warranted. PMID:24971267

A cross-sectional study to explore postgraduate students' understanding of and beliefs about sexual and reproductive health in a public university, Malaysia.

PubMed

Soleymani, Shahla; Abdul Rahman, Hejar; Lekhraj, Rampal; Mohd Zulkefli, Nor Afiah; Matinnia, Nasrin

2015-08-29

The main sexual and reproductive health issues among young people are premarital sexual intercourse, unwanted pregnancies, unsafe abortions and sexually transmitted diseases including Human Immunodeficiency Virus. The aim of this study was to determine the knowledge related to sexual and reproductive health among Malaysian postgraduate students in a public university in Malaysia. A cross-sectional study was carried out among postgraduate students by systematic random sampling technique. A pre-tested self administered questionnaire was used to collect the data. Out of 434 respondents, the majority of students were female (78.6 %) and single (78.3 %). The overall mean age of respondents was 27.0 ranging from 20 to 46 years of age. The main sources of information for sexual and reproductive health awareness were the internet (78.6 %) and newspaper (61.8 %). The majority (97.9 %) of the students knew that AIDS is a sexually transmitted disease. Most of them believed that the spread of sexually transmitted diseases was through shaking hands (92.1 %). Use of condoms was perceived to be the best way to avoid sexually transmitted diseases (88.4 %). Sexual and reproductive health knowledge was significantly associated with the students' age, marital status and faculty. The socio-demographic factors and current educational status accounted for a significant 9 % of the variability in sexual and reproductive health knowledge, f (7, 426) = 11, p <0.001. The postgraduate students' level of knowledge on sexual and reproductive health was not satisfactory. Sexual and reproductive health knowledge was associated with the students' marital status and faculty. Intervention programs related to sexual and reproductive health are recommended.

Safe To Walk? Neighborhood Safety and Physical Activity Among Public Housing Residents

PubMed Central

Bennett, Gary G; McNeill, Lorna H; Wolin, Kathleen Y; Duncan, Dustin T; Puleo, Elaine; Emmons, Karen M

2007-01-01

Background Despite its health benefits, physical inactivity is pervasive, particularly among those living in lower-income urban communities. In such settings, neighborhood safety may impact willingness to be regularly physically active. We examined the association of perceived neighborhood safety with pedometer-determined physical activity and physical activity self-efficacy. Methods and Findings Participants were 1,180 predominantly racial/ethnic minority adults recruited from 12 urban low-income housing complexes in metropolitan Boston. Participants completed a 5-d pedometer data-collection protocol and self-reported their perceptions of neighborhood safety and self-efficacy (i.e., confidence in the ability to be physically active). Gender-stratified bivariate and multivariable random effects models were estimated to account for within-site clustering. Most participants reported feeling safe during the day, while just over one-third (36%) felt safe at night. We found no association between daytime safety reports and physical activity among both men and women. There was also no association between night-time safety reports and physical activity among men (p = 0.23) but women who reported feeling unsafe (versus safe) at night showed significantly fewer steps per day (4,302 versus 5,178, p = 0.01). Perceiving one's neighborhood as unsafe during the day was associated with significantly lower odds of having high physical activity self-efficacy among both men (OR 0.40, p = 0.01) and women (OR 0.68, p = 0.02). Conclusions Residing in a neighborhood that is perceived to be unsafe at night is a barrier to regular physical activity among individuals, especially women, living in urban low-income housing. Feeling unsafe may also diminish confidence in the ability to be more physically active. Both of these factors may limit the effectiveness of physical activity promotion strategies delivered in similar settings. PMID:17958465

HIV Risk Behaviors in the U.S. Transgender Population: Prevalence and Predictors in a Large Internet Sample

PubMed Central

Feldman, Jamie; Romine, Rebecca Swinburne; Bockting, Walter O.

2014-01-01

To study the influence of gender on HIV risk, a sample of the U.S. transgender population (N = 1,229) was recruited via the Internet. HIV risk and prevalence were lower than reported in prior studies of localized, urban samples, but higher than the overall U.S. population. Findings suggest that gender nonconformity alone does not itself result in markedly higher HIV risk. Sex with nontransgender men emerged as the strongest independent predictor of unsafe sex for both male-to-female (MtF) and female-to-male (FtM) participants. These sexual relationships constitute a process that may either affirm or problematize gender identity and sexual orientation, with different emphases for MtFs and FtMs, respectively. PMID:25022491

Risk factors for antimicrobial-resistant Neisseria gonorrhoeae and characteristics of patients infected with gonorrhea.

PubMed

Fuertes de Vega, Irene; Baliu-Piqué, Carola; Bosch Mestres, Jordi; Vergara Gómez, Andrea; Vallés, Xavier; Alsina Gibert, Mercè

2018-03-01

There are very few data available regarding risk factors associated with antibiotic resistant-Neisseria gonorrhoeae. A study was conducted on 110 samples from 101 patients with gonococcal infection, in order to describe their characteristics and compare them with the antimicrobial susceptibility profile of their samples. An association was observed between resistant infections and heterosexual men, older age, concurrent sexually transmitted infection, and unsafe sexual behaviors. There is a need for improved data on the risk factors associated with antibiotic resistant gonococcal infection in order to identify risk groups, and to propose public health strategies to control this infection. Copyright © 2016 Elsevier España, S.L.U. and Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

78 FR 23626 - Agency Information Collection Activities; Requests for Comments; Clearance of Renewed Approval of...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-04-19

..., page 73114. Airworthiness Directives are regulations issued to require action to correct unsafe... emergency corrective action is taken to determine if the action was adequate to correct the unsafe condition... DePaepe at (405) 954-9362, or by email at: [email protected] . SUPPLEMENTARY INFORMATION: [[Page...

Motivational interviewing by HIV care providers is associated with patient intentions to reduce unsafe sexual behavior.

PubMed

Flickinger, Tabor E; Rose, Gary; Wilson, Ira B; Wolfe, Hannah; Saha, Somnath; Korthuis, Philip Todd; Massa, Michele; Berry, Stephen; Laws, Michael Barton; Sharp, Victoria; Moore, Richard D; Beach, Mary Catherine

2013-10-01

Motivational interviewing (MI) can promote behavior change, but HIV care providers rarely have training in MI. Little is known about the use of MI-consistent behavior among untrained providers. This study examines the prevalence of such behaviors and their association with patient intentions to reduce high-risk sexual behavior. Audio-recorded visits between HIV-infected patients and their healthcare providers were searched for counseling dialog regarding sexual behavior. The association of providers' MI-consistence with patients' statements about behavior change was assessed. Of 417 total encounters, 27 met inclusion criteria. The odds of patient commitment to change were higher when providers used more reflections (p=0.017), used more MI consistent utterances (p=0.044), demonstrated more empathy (p=0.049), and spent more time discussing sexual behavior (p=0.023). Patients gave more statements in favor of change (change talk) when providers used more reflections (p<0.001) and more empathy (p<0.001), even after adjusting for length of relevant dialog. Untrained HIV providers do not consistently use MI techniques when counseling patients about sexual risk reduction. However, when they do, their patients are more likely to express intentions to reduce sexual risk behavior. MI holds promise as one strategy to reduce transmission of HIV and other sexually transmitted infections. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

Association between Pregnancy and Active Injection Drug Use and Sex Work among Women Injection Drug Users in Saint Petersburg, Russia.

PubMed

Girchenko, P; Ompad, D C; Bikmukhametov, D; Gensburg, L

2015-06-01

Widespread use of unsafe sexual practices among women injecting drugs both practicing and not practicing sex work leads to high levels of unplanned pregnancies in this population. The goal of this study was to investigate the association between pregnancy and active drug use and sex work. Data were collected using a convenience sample of 500 women in Saint Petersburg, Russia, in 2013. All women had recent experience of drug use, of which 200 were pregnant at the time of the study. The study consisted of a structured interview followed by a rapid HIV test. Pregnancy was protective against both active drug use and sex work. For HIV-positive women, these associations were stronger than for HIV-negative women: drug use prevalence ratio (PR) was 0.59 vs 0.85; for sex work, the PRs were 0.36 vs 0.64. Higher levels of education were associated with a lower prevalence ratio for active drug use and sex work in all models. Having children was not associated with active drug use or sex work. Pregnancy might be an optimal time for conducting interventions aimed at cessation of drug use and sex work among women injecting drugs.

Poor, Unsafe, and Overweight: The Role of Feeling Unsafe at School in Mediating the Association Among Poverty Exposure, Youth Screen Time, Physical Activity, and Weight Status

PubMed Central

Côté-Lussier, Carolyn; Fitzpatrick, Caroline; Séguin, Louise; Barnett, Tracie A.

2015-01-01

This study applied socioecological and cumulative risk exposure frameworks to test the hypotheses that 1) the experience of poverty is associated with feeling less safe at school, and 2) feeling less safe is associated with engaging in poorer weight-related behaviors, as well as an increased probability of being overweight or obese. Data were from the ongoing Québec Longitudinal Study of Child Development, initiated in 1998 with a population-based cohort of 2,120 Québec (Canada) infants 5 months of age and their parent or primary caregiver. Measures of youths' (age, 13 years) self-reported feelings of safety, screen time, physical activity, and objectively assessed not overweight/obese (70%), overweight (22%), and obese (8%) weight status were collected in 2011. Family poverty trajectory from birth was assessed by using latent growth modeling. As hypothesized, exposure to poverty was associated with feeling less safe at school and, in turn, with an increased probability of being overweight or obese. The association was most pronounced for youths who experienced chronic poverty. Compared with youths who experienced no poverty and felt unsafe, those who experienced chronic poverty and felt unsafe were nearly 18% more likely to be obese (9.2% vs. 11.2%). Although feeling unsafe was associated with screen time, screen time did not predict weight status. PMID:25921649

Meanings of sex, concepts of risk and sexual practices among migrant coal miners in Quang Ninh, Vietnam.

PubMed

Van Tuan, Ta

2010-08-01

The study explores the meanings of sex among migrant coal miners in Vietnam and identifies contextual factors influencing engagement in unsafe sexual practices. Findings reveal that sex carries a number of social meanings in the lives of migrant miners: sex is relaxation and reward for their risk and hard work; access to sex is an incentive for miners to continue working in the mine; sex strengthens identity and social networks; sex helps miners to affirm manhood, group membership and masculinity; and sex workers are confidants with whom they can share their problems. Facing accidents at work on a daily basis, miners are less inclined to worry about the long-term risks of HIV infection. In addition, being excluded from access to relevant information, miners feel distant from HIV infection. Findings suggest that interventions on sexual behaviour and practices should be sensitive to the concepts of risk and meanings of sex among migrant groups such as coal miners.

The Persistence of Sperm and the Development of Time Since Intercourse (TSI) Guidelines in Sexual Assault Cases at Forensic Science Ireland, Dublin, Ireland.

PubMed

Casey, David G; Domijan, Katarina; MacNeill, Sarah; Rizet, Damien; O'Connell, Declan; Ryan, Jennifer

2017-05-01

The persistence of sperm using confirmatory microscopic analysis, the persistence of sperm with tails, time since intercourse (TSI) analysis, and results from the acid phosphatase (AP) reaction from approximately 5581 swabs taken from circa 1450 sexual assault cases are presented. The observed proportions of sperm in the vagina and anus declines significantly after 48 h TSI, and sperm on oral swabs were observed up to 15 h TSI. The AP reaction as a predictor of sperm on intimate swabs is questioned. All AP reaction times gave a low true positive rate; 23% of sperm-positive swabs gave a negative AP reaction time. We show the AP reaction is an unsafe and an unreliable predictor of sperm on intimate swabs. We propose that TSI not AP informs precase assessment and the evaluative approach for sexual assault cases. To help inform an evaluative approach, TSI guidelines are presented. © 2016 American Academy of Forensic Sciences.

HIV Prevention in Gay Family and House Networks: Fostering Self-Determination and Sexual Safety.

PubMed

Levitt, Heidi M; Horne, Sharon G; Freeman-Coppadge, Darren; Roberts, Tangela

2017-10-01

Many gay, bisexual, and transgender (GBT) people of color (POC) join house and/or constructed family communities, which serve as support networks composed mostly of other non-biologically related GBT/POC. These networks can decrease or increase the risk of exposure to HIV via multiple mechanisms (e.g., providing informal sexual safety education versus stigmatizing family members with HIV, encouraging sexual safety practices versus unsafe escorting, teaching self-care versus substance use) but act to support family members in the face of social and economic hardship. Researchers interviewed ten members of these social networks in the Boston metro area of the US and produced a saturated grounded theory analysis to explore the role of gay family/house networks in HIV risk management. While network members utilized HIV prevention resources, interviewees described how their efficacy was related to the intentions of leadership and strength of kinship boundaries within their community, economic opportunities, and communication skills. Clinical and research implications are discussed.

Community embedded reproductive health interventions for adolescents in Latin America: development and evaluation of a complex multi-centre intervention

PubMed Central

2013-01-01

Background Adolescents in Latin America are at high risk for unwanted and unplanned pregnancies, which often result in unsafe abortions or poor maternal health outcomes. Both young men and women in the region face an increased risk of sexually transmitted infections due to inadequate sexual and reproductive health information, services and counselling. To date, many adolescent health programmes have targeted a single determinant of sexual and reproductive health. However, recent evidence suggests that the complexity of sexual and reproductive health issues demands an equally multi-layered and comprehensive approach. Methods This article describes the development, implementation and evaluation design of the community-embedded reproductive health care for adolescents (CERCA) study in three Latin American cities: Cochabamba (Bolivia), Cuenca (Ecuador) and Managua (Nicaragua). Project CERCA’s research methodology builds on existing methodological frameworks, namely: action research, community based participatory research and intervention-mapping. The interventions in each country address distinct target groups (adolescents, parents, local authorities and health providers) and seek improvement of the following sexual health behaviours: communication about sexuality, sexual and reproductive health information-seeking, access to sexual and reproductive health care and safe sexual relationships. In Managua, we implemented a randomised controlled study, and in Cochabamba and Cuenca we adopted a non-randomised controlled study to evaluate the effectiveness of Project CERCA interventions, in addition to a process evaluation. Discussion This research will result in a methodological framework that will contribute to the improved design and implementation of future adolescent sexual and reproductive health interventions. Trial registration ClinicalTrials.gov (NCT01722084) PMID:23311647

A system dynamics approach for modeling construction workers' safety attitudes and behaviors.

PubMed

Shin, Mingyu; Lee, Hyun-Soo; Park, Moonseo; Moon, Myunggi; Han, Sangwon

2014-07-01

Construction accidents are caused by an unsafe act (i.e., a person's behavior or activity that deviates from normal accepted safe procedure) and/or an unsafe condition (i.e., a hazard or an unsafe mechanical or physical environment). While there has been dramatic improvement in creating safer construction environments, relatively little is known regarding the elimination of construction workers' unsafe acts. To address this deficiency, this paper aims to develop a system dynamics (SD)-based model of construction workers' mental processes that can help analyze the feedback mechanisms and the resultant dynamics regarding the workers' safety attitudes and safe behaviors. The developed model is applied to examine the effectiveness of three safety improvement policies: incentives for safe behaviors, and increased levels of communication and immersion in accidents. Application of the model verifies the strong potential of the developed model to provide a better understanding of how to eliminate unsafe acts, and to function as a robust test-bed to assess the effectiveness of safety programs or training sessions before their implementation. Copyright © 2013 Elsevier Ltd. All rights reserved.

Unsafe Child Feces Disposal is Associated with Environmental Enteropathy and Impaired Growth.

PubMed

George, Christine Marie; Oldja, Lauren; Biswas, Shwapon; Perin, Jamie; Sack, R Bradley; Ahmed, Shahnawaz; Shahnaij, Mohammad; Haque, Rashidul; Parvin, Tahmina; Azmi, Ishrat J; Bhuyian, Sazzadul Islam; Talukder, Kaisar A; Faruque, Abu G

2016-09-01

To investigate the relationship between unsafe child feces disposal, environmental enteropathy, and impaired growth, we conducted a prospective cohort study of 216 young children in rural Bangladesh. Using a prospective cohort study design in rural Bangladesh, unsafe child feces disposal, using the Joint Monitoring Program definition, was assessed using 5-hour structured observation by trained study personnel as well as caregiver reports. Anthropometric measurements were collected at baseline and at a 9-month follow-up. Stool was analyzed for fecal markers of environmental enteropathy: alpha-1-antitrypsin, myeloperoxidase, neopterin (combined to form an environmental enteropathy disease activity score), and calprotectin. Among 216 households with young children, 84% had an unsafe child feces disposal event during structured observation and 75% had caregiver reported events. There was no significant difference in observed unsafe child feces disposal events for households with or without an improved sanitation option (82% vs 85%, P = .72) or by child's age (P = .96). Children in households where caregivers reported unsafe child feces disposal had significantly higher environmental enteropathy scores (0.82-point difference, 95% CI 0.11-1.53), and significantly greater odds of being wasted (weight-for-height z score <-2 SDs) (9% vs 0%, P = .024). In addition, children in households with observed unsafe feces disposal had significantly reduced change in weight-for-age z-score (-0.34 [95% CI -0.68, -0.01] and weight-for-height z score (-0.52 [95% CI -0.98, -0.06]). Unsafe child feces disposal was significantly associated with environmental enteropathy and impaired growth in a pediatric population in rural Bangladesh. Interventions are needed to reduce this high-risk behavior to protect the health of susceptible pediatric populations. Copyright © 2016 Elsevier Inc. All rights reserved.

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 negotiate safer sex. There is a pressing need for effective interventions that mitigate the risks of disclosure and provide HIV-positive adolescents with skills to engage in safe sex.

Motivational Interviewing with computer assistance as an intervention to empower women to make contraceptive choices while incarcerated: study protocol for randomized controlled trial

PubMed Central

2012-01-01

Background Unplanned pregnancies and sexually transmitted infections (STIs) are important and costly public health problems in the United States resulting from unprotected sexual intercourse. Risk factors for unplanned pregnancies and STIs (poverty, low educational attainment, homelessness, substance abuse, lack of health insurance, history of an abusive environment, and practice of commercial sex work) are especially high among women with a history of incarceration. Project CARE (Contraceptive Awareness and Reproductive Education) is designed to evaluate an innovative intervention, Motivational Interviewing with Computer Assistance (MICA), aimed at enhancing contraceptive initiation and maintenance among incarcerated women who do not want a pregnancy within the next year and who are anticipated to be released back to the community. This study aims to: (1) increase the initiation of highly effective contraceptives while incarcerated; (2) increase the continuation of highly effective contraceptive use at 3, 6, 9, and 12 months after release; and (3) decrease unsafe sexual activity. Methods/Design This randomized controlled trial will recruit 400 women from the Rhode Island Department of Corrections (RI DOC) women’s jail at risk for an unplanned pregnancy (that is, sexually active with men and not planning/wanting to become pregnant in the next year). They will be randomized to two interventions: a control group who receive two educational videos (on contraception, STIs, and pre-conception counseling) or a treatment group who receive two sessions of personalized MICA. MICA is based on the principles of the Transtheoretical Model (TTM) and on Motivational Interviewing (MI), an empirically supported counseling technique designed to enhance readiness to change targeted behaviors. Women will be followed at 3, 6, 9, and 12 months post release and assessed for STIs, pregnancy, and reported condom use. Discussion Results from this study are expected to enhance our understanding of the efficacy of MICA to enhance contraceptive initiation and maintenance and reduce sexual risk-taking behaviors among incarcerated women who have re-entered the community. Trial registration NCT01132950 PMID:22747705

Exploring the role of cognitive and structural forms of social capital in HIV/AIDS trends in the Kagera region of Tanzania - a grounded theory study.

PubMed

Frumence, Gasto; Eriksson, Malin; Nystrom, Lennarth; Killewo, Japhet; Emmelin, Maria

2011-04-01

The article presents a synthesis of data from three village case studies focusing on how structural and cognitive social capital may have influenced the progression of the HIV epidemic in the Kagera region of Tanzania. Grounded theory was used to develop a theoretical model describing the possible links between structural and cognitive social capital and the impact on sexual health behaviours. Focus group discussions and key informant interviews were carried out to represent the range of experiences of existing social capital. Both structural and cognitive social capital were active avenues for community members to come together, empower each other, and develop norms, values, trust and reciprocal relations. This empowerment created an enabling environment in which members could adopt protective behaviours against HIV infection. On the one hand, we observed that involvement in formal and informal organisations resulted in a reduction of numbers of sexual partners, led people to demand abstinence from sexual relations until marriage, caused fewer opportunities for casual sex, and gave individuals the agency to demand the use of condoms. On the other hand, strict membership rules and regulations excluded some members, particularly excessive alcohol drinkers and debtors, from becoming members of the social groups, which increased their vulnerability in terms of exposure to HIV. Social gatherings (especially those organised during the night) were also found to increase youths' risk of HIV infection through instances of unsafe sex. We conclude that even though social capital may at times have negative effects on individuals' HIV-prevention efforts, this study provides initial evidence that social capital is largely protective through empowering vulnerable groups such as women and the poor to protect against HIV infection and by promoting protective sexual behaviours.

Harms from other people's drinking: an international survey of their occurrence, impacts on feeling safe and legislation relating to their control.

PubMed

Bellis, Mark A; Quigg, Zara; Hughes, Karen; Ashton, Kathryn; Ferris, Jason; Winstock, Adam

2015-12-23

To examine factors associated with suffering harm from another person's alcohol consumption and explore how suffering such harms relate to feelings of safety in nightlife. Cross-sectional opportunistic survey (Global Drug Survey) using an online anonymous questionnaire in 11 languages promoted through newspapers, magazines and social media. Individuals (participating November 2014-January 2015) aged 18-34 years, reporting alcohol consumption in the past 12 months and resident in a country providing ≥ 250 respondents (n=21 countries; 63,725 respondents). Harms suffered due to others' drinking in the past 12 months, feelings of safety on nights out (on the way out, in bars/pubs, in nightclubs and when travelling home) and knowledge of over-serving laws and their implementation. In the past 12 months, >40% of respondents suffered at least one aggressive (physical, verbal or sexual assault) harm and 59.5% any harm caused by someone drunk. Suffering each category of harm was higher in younger respondents and those with more harmful alcohol consumption patterns. Men were more likely than women to have suffered physical assault (9.2% vs 4.7; p<0.001), with women much more likely to suffer sexual assault or harassment (15.3% vs 2.5%; p<0.001). Women were more likely to feel unsafe in all nightlife settings, with 40.8% typically feeling unsafe on the way home. In all settings, feeling unsafe increased with experiencing more categories of aggressive harm by a drunk person. Only 25.7% of respondents resident in countries with restrictions on selling alcohol to drunks knew about such laws and 75.8% believed that drunks usually get served alcohol. Harms from others' drinking are a threat to people's health and well-being. Public health bodies must ensure that such harms are reflected in measures of the societal costs of alcohol, and must advocate for the enforcement of legislation designed to reduce such harms. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

[Sex tourism and AIDS: doctors between duty and powerlessness].

PubMed

de Wert, Guido; Ploem, Corrette

2014-01-01

What can a doctor do if he knows that an HIV-positive patient who is refusing antiretroviral therapy is going on a sex tourism holiday to Thailand, for example? A doctor in a moral dilemma could break professional confidentiality in order to protect any sexual partners, but in this case these partners are not known. In practice, the only thing the doctor can do is to talk to the patient about his responsibility to prevent infection of others and to point out the risks of unsafe sex for the patient himself.

Ecological correlates of multiple sexual partnerships among adolescents and young adults in urban Cape Town: a cumulative risk factor approach.

PubMed

Muchiri, Evans; Odimegwu, Clifford; Banda, Pamela; Ntoimo, Lorreta; Adedini, Sunday

2017-07-01

Studies in South Africa have reported unsafe levels of risky sexual behvaiours among adolescents and young adults, with the country reporting the highest burden of HIV/AIDS globally, as well as a high rate of teenage pregnancy. While determinants of risky sexual behaviours have been investigated for factors occurring at the individual and household levels, not fully explored in the literature is the effect of community level factors. Furthermore, it is unclear whether risk factors occurring within the ecology of adolescents and young adults act cumulatively to influence their sexual practices. This article aims to address this knowledge gap using a case study of the Cape Area Panel Study of adolescents and young adults in urban Cape Town, South Africa. The ecological framework was adopted to guide the selection of risk factors at the individual, household, and community levels. Multivariate linear discriminant function analyses were used to select significant risk factors for multiple sexual partnerships and used to produce risk indices for the respondents. The cumulative risk approach was applied to test whether significant risk factors acted cumulatively. Findings point to the importance of ecological factors in influencing outcomes of multiple sexual partnerships among respondents and further demonstrate that ecological risk factors may act cumulatively. These findings are important for South Africa that is grappling with teenage pregnancy and disproportionate HIV epidemic among the youth.

Patterns of Violence Exposure and Sexual Risk in Low-Income, Urban African American Girls

PubMed Central

Wilson, Helen W.; Woods, Briana A.; Emerson, Erin; Donenberg, Geri R.

2013-01-01

Objective This study examined the relationship between violence exposure and sexual risk-taking among low-income, urban African American (AA) adolescent girls, considering overlap among different types and characteristics of violence. Methods AA adolescent girls were originally recruited from outpatient mental health clinics serving urban, mostly low-SES communities in Chicago, IL as part of a two-year longitudinal investigation of HIV-risk behavior. A subsequent follow-up was completed to assess lifetime history of trauma and violence exposure. The current study (N=177) included violence exposure and sexual risk behavior reported at the most recent interview (ages 14-22). Multiple regression was used to examine combined and unique contributions of different types, ages, settings, and perpetrators or victims of violence to variance in sexual risk. Results More extensive violence exposure and cumulative exposure to different kinds of violence were associated with overall unsafe sex, more partners, and inconsistent condom use. The most significant unique predictors, accounting for overlap among different forms of violence, were physical victimization, adolescent exposure, neighborhood violence, and violence involving dating partners. Conclusions These findings put sexual risk in the context of broad traumatic experiences but also suggest that the type and characteristics of violence exposure matter in terms of sexual health outcomes. Violence exposure should be addressed in efforts to reduce STIs among low-income, urban African American girls. PMID:24563808

Transgender HIV prevention: implementation and evaluation of a workshop.

PubMed

Bockting, W O; Rosser, B R; Scheltema, K

1999-04-01

Virtually no HIV prevention education has specifically targeted the transgender community. To fill this void, a transgender HIV prevention workshop was developed, implemented and evaluated. A 4 h workshop, grounded in the Health Belief Model and the Eroticizing Safer Sex approach, combined lectures, videos, a panel, discussion, roleplay and exercises. Evaluation using a pre-, post- and follow-up test design showed an increase in knowledge and an initial increase in positive attitudes that diminished over time. Due to the small sample size (N = 59) and limited frequency of risk behavior, a significant decrease in unsafe sexual or needle practices could not be demonstrated. However, findings suggested an increase in safer sexual behaviors such as (mutual) masturbation. Peer support improved significantly. Future prevention education should make special efforts to target the more difficult-to-reach, high-risk subgroups of the transgender population.

Cluster of HIV Infections Attributed to Unsafe Injection Practices--Cambodia, December 1, 2014-February 28, 2015.

PubMed

Vun, Mean Chhi; Galang, Romeo R; Fujita, Masami; Killam, William; Gokhale, Runa; Pitman, John; Selenic, Dejana; Mam, Sovatha; Mom, Chandara; Fontenille, Didier; Rouet, Francois; Vonthanak, Saphonn

2016-02-19

In December 2014, local health authorities in Battambang province in northwest Cambodia reported 30 cases of human immunodeficiency virus (HIV) infection in a rural commune (district subdivision) where only four cases had been reported during the preceding year. The majority of cases occurred in residents of Roka commune. The Cambodian National Center for HIV/AIDS (acquired immunodeficiency syndrome), Dermatology and Sexually Transmitted Diseases (NCHADS) investigated the outbreak in collaboration with the University of Health Sciences in Phnom Penh and members of the Roka Cluster Investigation Team. By February 28, 2015, NCHADS had confirmed 242 cases of HIV infection among the 8,893 commune residents, an infection rate of 2.7%. Molecular investigation of the HIV strains present in this outbreak indicated that the majority of cases were linked to a single HIV strain that spread quickly within this community. An NCHADS case-control study identified medical injections and infusions as the most likely modes of transmission. In response to this outbreak, the Government of Cambodia has taken measures to encourage safe injection practices by licensed medical professionals, ban unlicensed medical practitioners, increase local capacity for HIV testing and counseling, and expand access to HIV treatment in Battambang province. Measures to reduce the demand for unnecessary medical injections and the provision of unsafe injections are needed. Estimates of national HIV incidence and prevalence might need to be adjusted to account for unsafe injection as a risk exposure.

Brazilian adolescents’ knowledge and beliefs about abortion methods: a school-based internet inquiry

PubMed Central

2014-01-01

Background Internet surveys that draw from traditionally generated samples provide the unique conditions to engage adolescents in exploration of sensitive health topics. Methods We examined awareness of unwanted pregnancy, abortion behaviour, methods, and attitudes toward specific legal indications for abortion via a school-based internet survey among 378 adolescents aged 12–21 years in three Rio de Janeiro public schools. Results Forty-five percent knew peers who had undergone an abortion. Most students (66.0%) did not disclose abortion method knowledge. However, girls (aOR 4.2, 95% CI 2.4-7.2), those who had experienced their sexual debut (aOR1.76, 95% CI 1.1-3.0), and those attending a prestigious magnet school (aOR 2.7 95% CI 1.4-6.3) were more likely to report methods. Most abortion methods (79.3%) reported were ineffective, obsolete, and/or unsafe. Herbs (e.g. marijuana tea), over-the-counter medications, surgical procedures, foreign objects and blunt trauma were reported. Most techniques (85.2%) were perceived to be dangerous, including methods recommended by the World Health Organization. A majority (61.4%) supported Brazil’s existing law permitting abortion in the case of rape. There was no association between gender, age, sexual debut, parental education or socioeconomic status and attitudes toward legal abortion. However, students at the magnet school supported twice as many legal indications (2.7, SE.27) suggesting a likely role of peers and/or educators in shaping abortion views. Conclusions Abortion knowledge and attitudes are not driven simply by age, religion or class, but rather a complex interplay that includes both social spaces and gender. Prevention of abortion morbidity and mortality among adolescents requires comprehensive sexuality and reproductive health education that includes factual distinctions between safe and unsafe abortion methods. PMID:24521075

Female condom awareness, use and concerns among Nigerian female undergraduates.

PubMed

Okunlola, M A; Morhason-Bello, I O; Owonikoko, K M; Adekunle, A O

2006-05-01

A cross-sectional study of female condom awareness, usage and concerns among the female undergraduates of the University of Ibadan was conducted in September 2004. The results of 850 out of the 879 female students interviewed were used for analysis (96.6%). Over 80% had knowledge of the female condom as a form of modern contraception and the majority of them learnt about it through the mass media (39.9%) and health workers (34.4%). However, only 11.3% had ever used the female condom, with most (40%) using it to prevent both unwanted pregnancy and sexually transmitted infections including HIV (STI/HIV). The sexual partners' approval was appreciable, accounting for about 42.7% among those that had experience of the female condom usage. Major concerns mentioned such as difficulty of inserting it into the vagina and lack of sexual satisfaction, were not different from those in earlier studies. The result of this study looks promising judging from a high awareness level of the female condom, even though its usage is low. The female condom may be an alternative strategy to combat unsafe sexual practises and its sequelae in a country like Nigeria that is male dominated.

Sexual behavior and perceived risk of HIV/AIDS among young migrant factory workers in Nepal.

PubMed

Puri, M; Cleland, J

2006-03-01

To analyze the sexual behavior, perceived risk of contracting STIs and HIV/AIDS, and protective behaviors of migrant workers aged 14-19 years in carpet and garment factories in the Kathmandu Valley, Nepal. A common assumption in Nepal is that young migrant workers experience an increase in vulnerability. Moving away from the social controls of family and community, they become exposed to a mixed-gender environment and therefore might initiate sex earlier or have more casual encounters than might otherwise be the case. The analysis is based on a representative sample survey of 1050 factory workers. Information was also obtained from 23 in-depth case histories. Both bivarite and multivariate techniques were applied to identify the factors associated with involvement in risky sexual behavior. Despite religious and cultural restrictions, one in five boys and one in eight unmarried girls reported experience of sexual intercourse. Early sexual experimentation, multiple partners, and low and irregular use of condoms are not uncommon. Instances of sexual exploitation by factory owners or managers were documented but were rare. Most nonregular sex partners were described as friends from the same factory or community. Despite high-risk behavior, relatively few young people considered themselves to be at risk of getting STIs or HIV/AIDS. Information on the possible consequences of unsafe sex is inadequate. Programs aimed at promotion of safer sex practices and life skill training that facilitates communication and utilization of sexual health services should target vulnerable migrant young people.

Influencing factors on high-risk sexual behaviors in young people: an ecological perspective.

PubMed

Arabi-Mianrood, Hoda; Hamzehgardeshi, Zeinab; Khoori, Elham; Moosazadeh, Mahmood; Shahhosseini, Zohreh

2017-04-19

Background In recent years, high-risk sexual behaviors due to their negative consequences both for the individual and society have received more attention than other high-risk behaviors. Objective The aim of this study was to review the influencing factors of high-risk sexual behaviors among young people from an ecological point of view. Methods This review was conducted through searching databases including PubMed, Web of Science, Scopus, Google Scholar and the Cochrane Library with keywords such as sexual risk-taking behavior, high-risk sex, unprotected sex and unsafe sex. The relevant papers published between 1995 and 2016 were extracted. After reviewing the abstract and full text of the articles, 45 papers were used to write this article. Results From an ecological theory approach, factors which influence high-risk sexual behaviors are divided into three categories - the microsystem, the mesosystem and the macrosystem. The microsystem includes factors such as age, gender, race, marital status, place of residence, religion, level of education, personality traits, psychological problems, childhood experiences, body image and coincidence of high-risk behaviors; the mesosystem includes factors such as family structure, peers and sex education; in the macrosystem, the impact of culture and traditions of the society, economic status and the media are presented. Conclusion Given that high-risk sexual behaviors often have multiple causes, it seems that health policymakers must consider multi-dimensional interventions to influence high-risk sexual behaviors based on the ecological approach.

Family fun or cultural free-for-all? A critique of the 2015 National Football League Super Bowl commercials

PubMed Central

Basch, Corey H.; Kernan, William D; Reeves, Rachel

2016-01-01

Background: The purpose of this cross-sectional study was to enumerate and describe violent and risky behaviors as well as other general health behaviors exhibited in the advertisements during the National Football League (NFL) Super Bowl 2015. Methods: Commercials during the NFL Super Bowl 2015 were assessed for violent and risky behaviors. Additional health behaviors were indicated such as the advertisement of unhealthy food, promotion of physical activity, and sexual content. Results: A total of 110 commercials were documented, accounting for 64 minutes of broadcast time. Commercials promoting automobiles, television shows, food, and movies were the most prevalent, representing just over half (53.7%) of all of the advertisements featured. Depictions of unsafe driving were found in 10.9% (n = 12) of the commercials. All 12 commercials contained some sort of risky or wild driving behavior, and speeding was observed in 11 of the 12 commercials. A total of 32 (29.1%) of the commercials were coded as including violent content.Physical activity behavior was present in 3 (2.7%) of the commercials. Conversely, substance use was observed in 3 (2.7%) of the commercials, none of which included health promotion messaging. Of the 110 commercials aired during the 2015 Super Bowl, 12.7% (n = 14) included sexual content. Conclusion: Parents should consider the possibility that their children may observe acts of violence or conflicting safety messages during commercial breaks. PMID:27123435

Where there is no village: teaching about sexuality in crisis situations.

PubMed

Ecker, N

1998-01-01

The author conducted a training program on adolescent sexuality education and reproductive health for the staff of the humanitarian and relief agencies serving the refugee camps in Africa's Great Lakes region. Participants reported that, for many adolescent refugees, exploitative sex is inextricably linked to survival. Displaced youth are often sexually victimized in exchange for food, shelter, and protection. Participants identified numerous factors that adversely affect the sexual health of adolescent refugees: migration-related disruptions in the transfer of sexual health information; a state of cultural limbo, in which refugees are part of neither the country they fled nor the new culture; use of unaccompanied minors as a source of cheap labor; dangerous misinformation regarding HIV/AIDS and other sexually transmitted diseases; a high prevalence of unintended pregnancy and unsafe abortion; unequal power dynamics in the camps; stereotypical gender roles that promote sexual exploitation and violence; tacit acceptance of child marriage; and the fact that United Nations High Commission on Refugees-supported schools cover only elementary education. An important first step toward improving this situation is more awareness on the part of key change agents about the health, social, and emotional needs of adolescent refugees. Specific recommendations include the provision of contraceptives and other sexual health services to adolescent refugees, training of grass-roots educators to work with parents and peer educators to work with youth, standardization of program development and implementation guidelines, creation of advocacy groups, focus group discussions with the target population, and recreational and social programs to promote self-esteem and personal development.

Risks, benefits and survival strategies-views from female sex workers in Savannakhet, Laos

PubMed Central

2012-01-01

Background Female sex workers (FSWs) are vulnerable to sexually transmitted infections (STIs) and encounter socio-economic and health problems, including STIs/HIV, unintended pregnancy and complications from unsafe abortion, stigma, violence, and drug addiction. Reducing risks associated with sex work requires an understanding of the social and cultural context in which sex workers live and work. This study aimed to explore the working environment and perceived risks among FSWs in Savannakhet province in Laos. Methods Five focus group discussions (FGDs) and seven interviews were conducted with FSWs in Kaysone Phomvihan district in Laos. Latent content analysis was used to analyze the transcribed text. Results The results revealed that the FSWs were aware of risks but they also talked about benefits related to their work. The risks were grouped into six categories: STIs/HIV, unintended pregnancy, stigma, violence, being cheated, and social and economic insecurity. The reported benefits were financial security, fulfilling social obligations, and sexual pleasure. The FSWs reported using a number of strategies to reduce risks and increase benefits. Conclusions The desire to be self-sufficient and earn as much money as possible put the FSWs in disadvantaged and vulnerable situations. Fear of financial insecurity, obligations to support one’s family and the need to secure the future influenced FSWs’ decisions to have safe or unsafe sex. The FSWs were, however, not only victims. They also had some control over their lives and working environment, with most viewing their work as an easy and good way of earning money. PMID:23164407

Poor, Unsafe, and Overweight: The Role of Feeling Unsafe at School in Mediating the Association Among Poverty Exposure, Youth Screen Time, Physical Activity, and Weight Status.

PubMed

Côté-Lussier, Carolyn; Fitzpatrick, Caroline; Séguin, Louise; Barnett, Tracie A

2015-07-01

This study applied socioecological and cumulative risk exposure frameworks to test the hypotheses that 1) the experience of poverty is associated with feeling less safe at school, and 2) feeling less safe is associated with engaging in poorer weight-related behaviors, as well as an increased probability of being overweight or obese. Data were from the ongoing Québec Longitudinal Study of Child Development, initiated in 1998 with a population-based cohort of 2,120 Québec (Canada) infants 5 months of age and their parent or primary caregiver. Measures of youths' (age, 13 years) self-reported feelings of safety, screen time, physical activity, and objectively assessed not overweight/obese (70%), overweight (22%), and obese (8%) weight status were collected in 2011. Family poverty trajectory from birth was assessed by using latent growth modeling. As hypothesized, exposure to poverty was associated with feeling less safe at school and, in turn, with an increased probability of being overweight or obese. The association was most pronounced for youths who experienced chronic poverty. Compared with youths who experienced no poverty and felt unsafe, those who experienced chronic poverty and felt unsafe were nearly 18% more likely to be obese (9.2% vs. 11.2%). Although feeling unsafe was associated with screen time, screen time did not predict weight status. © The Author 2015. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

The relationship of discrimination related to sexual orientation and HIV-relevant risk behaviors among men who have sex with men.

PubMed

Rogers, Andrew H; Jardin, Charles; Mayorga, Nubia A; Bakhshaie, Jafar; Leonard, Amy; Lemaire, Chad; Zvolensky, Michael J

2018-05-30

Men who have sex with men (MSM) are at high risk for contraction and transmission of Human Immunodeficiency Virus (HIV). Increased risk of infection has been linked to high risk behaviors, such as alcohol and drug use, as well as engaging in unsafe sexual behaviors. Experiences of discrimination related to sexual orientation often experienced in this population predict risky behavior outcomes, but little research has examined the mechanisms implicated in this model. The current study examined the effect of anxiety and depressive symptoms in the relationship between discrimination related to sexual orientation and high-risk behaviors of alcohol use, drug use, using sex to cope with negative emotions, frequency of sex without a condom, and frequency of sex with an HIV+ or unknown status partner. Three hundred and eighty-nine MSM were recruited to participate in a survey based study. Results indicated anxiety was maintained a significant indirect effect between discrimination related to sexual orientation and coping behaviors (using sex to cope, alcohol, substance use), but showed no significant indirect associations with risky sexual behavior. Overall, the current study provides novel empirical evidence that discrimination related to sexual orientation is associated with increased anxiety, which in turn, is associated with certain HIV risk behaviors. Importantly, it is possible that alcohol use, drug use, and using sex to cope with negative emotions may be precursors to more risky sexual behavior, such as engaging in anal sex without a condom or having sex with an HIV+ or unknown status partner. Clinically, reducing symptoms of anxiety in the context of discrimination related to sexual orientation may help reduce HIV risk behavior among MSM. Copyright © 2018. Published by Elsevier B.V.

Counseling to reduce high-risk sexual behavior in HIV care: a multi-center, direct observation study.

PubMed

Flickinger, Tabor E; Berry, Stephen; Korthuis, P Todd; Saha, Somnath; Laws, M Barton; Sharp, Victoria; Moore, Richard D; Beach, Mary Catherine

2013-07-01

A key opportunity to reduce HIV transmission lies with healthcare providers counseling HIV-infected patients about safer sex. We audio-recorded and transcribed clinical encounters between 45 healthcare providers and 417 of their HIV-infected patients at four outpatient sites in the United States. We used logistic regressions to evaluate associations between patient and provider characteristics, and the occurrence of discussion (any talk about sex) and counseling (advice about safer sex). Of the 417 encounters, discussion of sex occurred in 187 (45% of encounters, 95% CI: 40-50%). Counseling occurred for 49% (95% CI: 35-63%) of patients reporting unsafe sex. Discussion of sex was more likely with younger or less-educated patients and with less cultural difference between patient and provider, while counseling was associated with greater provider mindfulness and lower provider empathy. These findings suggest targets to improve communication regarding sexual risk reduction in HIV care.

Associations of Teen Dating Violence Victimization With School Violence and Bullying Among US High School Students*

PubMed Central

Vivolo-Kantor, Alana M.; Olsen, Emily O’malley; Bacon, Sarah

2016-01-01

BACKGROUND Teen dating violence (TDV) negatively impacts health, mental and physical well-being, and school performance. METHODS Data from a nationally representative sample of high school students participating in the Centers for Disease Control and Prevention (CDC)’s 2013 Youth Risk Behavior Survey (YRBS) are used to demonstrate associations of physical and sexual TDV with school violence-related experiences and behaviors, including bullying victimization. Bivariate and adjusted sex-stratified regressions assessed relationships between TDV and school violence-related experiences and behaviors. RESULTS Compared to students not reporting TDV, those experiencing both physical and sexual TDV were more likely to report carrying a weapon at school, missing school because they felt unsafe, being threatened or injured with a weapon on school property, having a physical fight at school, and being bullied on school property. CONCLUSIONS School-based prevention efforts should target multiple forms of violence. PMID:27374352

Drug use and HIV risk in Trinidad and Tobago: qualitative study.

PubMed

Djumalieva, D; Imamshah, W; Wagner, U; Razum, O

2002-09-01

Crack use is an important risk factor for HIV infection because of its association with unsafe sexual practices. We investigated factors promoting the initiation of crack cocaine use; the sexual behaviour of crack users; and their rehabilitation care seeking behaviour in Trinidad and Tobago. We conducted 40 in-depth interviews with drug users. Respondents frequently reported a history of parental desertion, alcohol abuse, and physical abuse within the family. They perceived peer pressure and drug use in the family as important factors promoting first drug use. Exchanging sex for drugs was common, and practising oral sex was considered safe. Female drug users rarely seek rehabilitative care because of stigmatization and lack of care for their children. In Trinidad, attitudes towards drugs in society and families need to be changed. Campaigns promoting safer sex should emphasize the risk of oral sex. Rehabilitation facilities caring for female drug users should offer child care.

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.

Sexual behaviour and sexual and reproductive health education: a cross-sectional study in Romania.

PubMed

Rada, Cornelia

2014-06-23

Up-to-date, genuine sexual and reproductive health (SRH) education programmes have been possible in Romania only since communism collapsed in 1990. Since 2006, Romania has had no national strategy in this field. Under current global circumstances (high labour mobility, internationally mixed marriages), issues previously considered solely national have become worldwide concerns. In 2011-2012, 1215 respondents homogeneously distributed on background, gender, educational level and age group (18-74) were sampled. This article uses a 96-item questionnaire about family and SRH, presenting results on nine items: first intercourse (FI), virginity, knowing first sexual partner, safe sex, number of sexual partners and sexual education. The data were analysed using Pearson chi-square tests and latent class analysis. Some participants (7.2%) engaged in FI at age 15 or earlier. The average age at FI was lower for men (18.08), for individuals with a lower education level (18.07) and for those in rural areas (18.27), compared with that for women, those with more education and those in urban areas, respectively. The average age at FI was over 2.5 years lower for people aged 18-24 (16.99) than for those aged 60-74 (p < 0.001). More than 60% were not married or partnered with their FI partner, and 17.8% engaged in FI less than a month after meeting their partner. Less than one-fourth practiced safe sex at FI, with higher proportions for the urban sample, those with an average level of education and those aged 18-35 (p < 0.001). Higher average numbers of sexual partners were found among men (6.56, compared with 2.37 among women), in urban areas (5.07, compared with 3.75 in rural areas) and among those with higher levels of education (p < 0.005). On average, subjects first received information on SRH at 15.39 years of age, with only 10% listing the school, doctors or medics as a source. Unsafe sex, early initiation of sexual activity and poor SRH education from schools, experts and parents require a multidisciplinary approach within prevention programmes, especially among the populations at risk: rural residents, those with low levels of education and youth.

Sexual behaviour and sexual and reproductive health education: a cross-sectional study in Romania

PubMed Central

2014-01-01

Background Up-to-date, genuine sexual and reproductive health (SRH) education programmes have been possible in Romania only since communism collapsed in 1990. Since 2006, Romania has had no national strategy in this field. Under current global circumstances (high labour mobility, internationally mixed marriages), issues previously considered solely national have become worldwide concerns. Methods In 2011–2012, 1215 respondents homogeneously distributed on background, gender, educational level and age group (18–74) were sampled. This article uses a 96-item questionnaire about family and SRH, presenting results on nine items: first intercourse (FI), virginity, knowing first sexual partner, safe sex, number of sexual partners and sexual education. The data were analysed using Pearson chi-square tests and latent class analysis. Results Some participants (7.2%) engaged in FI at age 15 or earlier. The average age at FI was lower for men (18.08), for individuals with a lower education level (18.07) and for those in rural areas (18.27), compared with that for women, those with more education and those in urban areas, respectively. The average age at FI was over 2.5 years lower for people aged 18–24 (16.99) than for those aged 60–74 (p < 0.001). More than 60% were not married or partnered with their FI partner, and 17.8% engaged in FI less than a month after meeting their partner. Less than one-fourth practiced safe sex at FI, with higher proportions for the urban sample, those with an average level of education and those aged 18–35 (p < 0.001). Higher average numbers of sexual partners were found among men (6.56, compared with 2.37 among women), in urban areas (5.07, compared with 3.75 in rural areas) and among those with higher levels of education (p < 0.005). On average, subjects first received information on SRH at 15.39 years of age, with only 10% listing the school, doctors or medics as a source. Conclusions Unsafe sex, early initiation of sexual activity and poor SRH education from schools, experts and parents require a multidisciplinary approach within prevention programmes, especially among the populations at risk: rural residents, those with low levels of education and youth. PMID:24957900

Sexual Risk Behaviors Constructed in Iranian Women's Life with Substance Use Disorders: A New Implication of Human Ecological Theory.

PubMed

Jamshidimanesh, Mansoureh; Mousavi, Seyed Abbas; Merghati-Khoei, Effat; Emamian, Mohammad Hassan; Keramat, Afsaneh

2016-07-01

Drug abuse is one of the important variables influencing protective sexual behavior. The objective of this study was to explore how risky sexual behaviors develop in drug abusing women using human ecological theory. In this study, we used a descriptive exploratory approach. The participants were 32 drug abusing women from two of the selected drop-in centers (DICs) in south Tehran, Iran, where we could have access to a vast number of female drug users. Data was collected using semi-structured face-to-face interviews. Qualitative content analysis was used to analyze the data using Graneheim and Lundman procedure. Risky sexual behavior in drug use disorders in women was found in four themes with thirteen emerged; sexual untaught at micro-system with two subthemes "unsafe home" and "drop out of school", Perception of differences at meso-system with three subthemes "lack of link between family and school", "doing manly behavior" and "low awareness of health puberty than peers", inappropriate marriages at exo-system with three subthemes "stigma", "fear of losing love relationship" and "self-devotion", marginalization at macro-system with four subthemes "barrier access to rights", "selling sex as a tool of security", "lack of belief as a sex worker" and "mistrust and doubt partner" using implication of human ecological theory. Findings suggest that strategies supporting the discovery of risky sexual behaviors in drug use disorders in women are important in order to provide counseling and education to form their decisions toward safety sex.

Why Abortion is Illegal? Comparison of Legal and Illegal Abortion: A Critical Review.

PubMed

Huq, M E; Raihan, M J; Shirin, H; Chowdhury, S; Jahan, Y; Chowdhury, A S; Rahman, M M

2017-10-01

Abortion is the termination of pregnancy that occurs spontaneously or purposely. In the most developed world, abortion is legally allowed for women seeking safe termination of pregnancies. Particularly, when access to legal abortion is restricted, abortion is the resort to unsafe methods. The aim of this review is to necessitate safe abortion and to accentuate the consequences of illegal abortion in case of legal prohibition. We used Pubmed, MedLine and Scopus databases to review previous literatures of safe, unsafe, legal and illegal abortions. Research work and reports from organizations such as World Health Organization (WHO), World Bank (WB) and United Nations (UN) were included. Snowball sampling was used to obtain relevant journals. Abortion is conventional whether it is safe, unsafe, legal or illegal. The intention of the antiabortion policy was to reduce the number of abortions globally. However, instead of decreasing rates, evidences show significant increase in abortions. When abortion is legal, the preconditions to be ensured are availability, accessibility, affordability and acceptability for the safe abortion facilities. When abortion is illegal, risk reduction strategies are needed to decrease maternal morbidity and mortality. We can reduce abortion related morbidity and mortality, whether it is legal or illegal if we can ensure the appropriate access to health care, including abortion services, education on sexuality, access to contraceptives, post abortion care, and suitable interventions and liberalization of laws. The paper reviewed the Mexico City Policy and the US foreign aid strategies and highlighted the evidence based analysis for policy reform. The liberalized abortion law can save pregnant women from abortion related complications and death.

Discourses of masculinity, femininity and sexuality in Uganda's Stand Proud, Get Circumcised campaign.

PubMed

Rudrum, Sarah; Oliffe, John L; Benoit, Cecilia

2017-02-01

This paper analyses discourses of masculinity, femininity and sexuality in Stand Proud, Get Circumcised, a public health campaign promoting circumcision as an HIV-prevention strategy in Uganda. The campaign includes posters highlighting the positive reactions of women to circumcised men, and is intended to support the national rollout of voluntary medical male circumcision. We offer a critical discourse analysis of representations of masculinity, femininity and sexuality in relation to HIV prevention. The campaign materials have a playful feel and, in contrast to ABC (Abstain, Be faithful, Use condoms) campaigns, acknowledge the potential for pre-marital and extra-marital sex. However, these posters exploit male anxieties about appearance and performance, drawing on hegemonic masculinity to promote circumcision as an idealised body aesthetic. Positioning women as the campaign's face reasserts a message that women are the custodians of family health and simultaneously perpetuates a norm of estrangement between men and their health. The wives' slogan, 'we have less chance of getting HIV', is misleading, because circumcision only directly prevents female-to-male HIV transmission. Reaffirming hegemonic notions of appearance- and performance-based heterosexual masculinity reproduces existing unsafe norms about masculinity, femininity and sexuality. In selling male circumcision, the posters fail to promote an overall HIV-prevention message.

Male migration and risky sexual behavior in rural India: is the place of origin critical for HIV prevention programs?

PubMed

Saggurti, Niranjan; Mahapatra, Bidhubhusan; Swain, Suvakanta N; Jain, Anrudh K

2011-12-29

Recent studies of male migrants in India indicate that those who are infected with HIV are spreading the epidemic from high risk populations in high prevalence areas to populations in low prevalence areas. In this context, migrant men are believed to initiate and have risky sexual behaviors in places of destination and not in places of origin. The paucity of information on men's risky sexual behaviors in places of origin limits the decision to initiate HIV prevention interventions among populations in high out-migration areas in India. A cross-sectional behavioral survey was conducted among non-migrants, returned migrants (with a history of migration), and active (current) migrants in rural areas across two districts with high levels of male out-migration: Prakasam district in Andhra Pradesh and Azamgarh district in Uttar Pradesh. Surveys assessed participant demographics, migration status, migration history, and sexual behavior along the migration routes, place of initiation of sex. District-stratified regression models were used to understand the associations between migration and risky sexual behaviors (number of partners, condom use at last sex) and descriptive analyses of migrants' place of sexual initiation and continuation along migration routes. The average age at migration of our study sample was 19 years. Adjusted regression analyses revealed that active migrants were more likely to engage in sex with sex workers in the past 12 months (Prakasam: 15 percent vs. 8 percent; adjusted odds ratio (aOR)=2.1, 95% CI 1.2-3.4; Azamgarh: 19 percent vs.7 percent; aOR=4.0, 95% CI 2.4-6.6) as well as have multiple (3+) sex partners (Prakasam: 18 percent vs. 9 percent; aOR=2.0, 95% CI 1.3-3.2; Azamgarh: 28 percent vs. 21 percent; aOR=1.9, 95% CI 1.2-3.0) than non-migrants. Contrary to popular belief, a high proportion of active and returned migrants (almost 75 percent of those who had sex) initiated sex at the place of origin before migrating, which is equivalent to the proportion of non-migrants who engaged in sex with sex workers as well as with casual unpaid partners. Moreover, non-migrants were more likely than migrants to engage in unprotected sex. Findings of this study document that returned migrants and active migrants have higher sexual risk behaviors than the non-migrants. Most migrants initiate non-marital sex in the place of origin and many continue these behaviors in places of destination. Migrants' destination area behaviors are linked to sex with sex workers and they continue to practice such behaviors in the place of origin as well. Unprotected sex in places of destination with high HIV prevalence settings poses a risk of transmission from high risk population groups to migrants, and in turn to their married and other sexual partners in places of origin. These findings suggest the need for controlling the spread of HIV among both men and women resulting from unsafe sex in places of origin that have high vulnerability due to the frequent migratory nature of populations.

Male migration and risky sexual behavior in rural India: is the place of origin critical for HIV prevention programs?

PubMed Central

2011-01-01

Background Recent studies of male migrants in India indicate that those who are infected with HIV are spreading the epidemic from high risk populations in high prevalence areas to populations in low prevalence areas. In this context, migrant men are believed to initiate and have risky sexual behaviors in places of destination and not in places of origin. The paucity of information on men's risky sexual behaviors in places of origin limits the decision to initiate HIV prevention interventions among populations in high out-migration areas in India. Methods A cross-sectional behavioral survey was conducted among non-migrants, returned migrants (with a history of migration), and active (current) migrants in rural areas across two districts with high levels of male out-migration: Prakasam district in Andhra Pradesh and Azamgarh district in Uttar Pradesh. Surveys assessed participant demographics, migration status, migration history, and sexual behavior along the migration routes, place of initiation of sex. District-stratified regression models were used to understand the associations between migration and risky sexual behaviors (number of partners, condom use at last sex) and descriptive analyses of migrants' place of sexual initiation and continuation along migration routes. Results The average age at migration of our study sample was 19 years. Adjusted regression analyses revealed that active migrants were more likely to engage in sex with sex workers in the past 12 months (Prakasam: 15 percent vs. 8 percent; adjusted odds ratio (aOR)=2.1, 95% CI 1.2-3.4; Azamgarh: 19 percent vs.7 percent; aOR=4.0, 95% CI 2.4-6.6) as well as have multiple (3+) sex partners (Prakasam: 18 percent vs. 9 percent; aOR=2.0, 95% CI 1.3-3.2; Azamgarh: 28 percent vs. 21 percent; aOR=1.9, 95% CI 1.2-3.0) than non-migrants. Contrary to popular belief, a high proportion of active and returned migrants (almost 75 percent of those who had sex) initiated sex at the place of origin before migrating, which is equivalent to the proportion of non-migrants who engaged in sex with sex workers as well as with casual unpaid partners. Moreover, non-migrants were more likely than migrants to engage in unprotected sex. Conclusion Findings of this study document that returned migrants and active migrants have higher sexual risk behaviors than the non-migrants. Most migrants initiate non-marital sex in the place of origin and many continue these behaviors in places of destination. Migrants’ destination area behaviors are linked to sex with sex workers and they continue to practice such behaviors in the place of origin as well. Unprotected sex in places of destination with high HIV prevalence settings poses a risk of transmission from high risk population groups to migrants, and in turn to their married and other sexual partners in places of origin. These findings suggest the need for controlling the spread of HIV among both men and women resulting from unsafe sex in places of origin that have high vulnerability due to the frequent migratory nature of populations. PMID:22375813

[Unsafe abortions in countries that restrict legal abortions. Epidemiologic, clinical, and prognostic aspects at the University Hospital Center Yalgado-Ouédraogo of Ouagadougou].

PubMed

Ouattara, A; Ouédraogo, A; Ouédraogo, C M; Lankoande, J

2015-01-01

to describe the epidemiologic, clinical, and prognostic aspects of the management of the complications of women who had unsafe (illegal) abortions. this prospective, descriptive cross-sectional study took place the Yalgado Ouédraogo University Hospital Center (UHC-YO) in Ouagadougou during the 12-month period from June 2012 to May 2013. The study included all women admitted to the obstetrics-gynecology department during the study period and diagnosed after clinical examination with complications of an unsafe abortion. Data were collected with standardized case report forms. The analysis was conducted with Epi Info 3.5.1 software and Student's, Fisher's, and Pearson's Chi-square tests to compare the data. The threshold for statistical significance was set at 5%. during the study period, 111 women were admitted for complications of unsafe abortions, for a rate of 1 per 47 deliveries. The women's mean age was 23.6 years and ranged from 15 to 45 years. More than half the women (n=62, 55%) were pregnant for the first time. Hemorrhage was the primary reason for admission: 78 women, or 75%. Only 18 women (16%) admitted to having had an illegal intentional abortions. Complications included endometritis in 10 women (11%), anemia in 6 (5%), and hepatonephritis, also in 6 (5%). Six women died, for a mortality rate of 24%. the epidemiologic profile of women with complications from unsafe abortions is that of a young women pregnant for the first time, who has no income-producing activity. Morbidity is dominated by infectious or hemorrhagic complications and mortality is high. Strengthening activities for prevention, health and sex education, and dissemination of knowledge of and access to contraceptive methods will help to reduce these abortions and their consequences.

Automatic Detection and Classification of Unsafe Events During Power Wheelchair Use.

PubMed

Pineau, Joelle; Moghaddam, Athena K; Yuen, Hiu Kim; Archambault, Philippe S; Routhier, François; Michaud, François; Boissy, Patrick

2014-01-01

Using a powered wheelchair (PW) is a complex task requiring advanced perceptual and motor control skills. Unfortunately, PW incidents and accidents are not uncommon and their consequences can be serious. The objective of this paper is to develop technological tools that can be used to characterize a wheelchair user's driving behavior under various settings. In the experiments conducted, PWs are outfitted with a datalogging platform that records, in real-time, the 3-D acceleration of the PW. Data collection was conducted over 35 different activities, designed to capture a spectrum of PW driving events performed at different speeds (collisions with fixed or moving objects, rolling on incline plane, and rolling across multiple types obstacles). The data was processed using time-series analysis and data mining techniques, to automatically detect and identify the different events. We compared the classification accuracy using four different types of time-series features: 1) time-delay embeddings; 2) time-domain characterization; 3) frequency-domain features; and 4) wavelet transforms. In the analysis, we compared the classification accuracy obtained when distinguishing between safe and unsafe events during each of the 35 different activities. For the purposes of this study, unsafe events were defined as activities containing collisions against objects at different speed, and the remainder were defined as safe events. We were able to accurately detect 98% of unsafe events, with a low (12%) false positive rate, using only five examples of each activity. This proof-of-concept study shows that the proposed approach has the potential of capturing, based on limited input from embedded sensors, contextual information on PW use, and of automatically characterizing a user's PW driving behavior.

Men seeking sex on an intergenerational gay Internet website: an exploratory study.

PubMed

Sowell, Richard L; Phillips, Kenneth D

2010-01-01

This study explored the characteristics and sexual behaviors reported by men who have sex with men (MSM) seeking sex on an intergenerational website. Of special interest was to determine whether and how seeking sex on the Internet contributed to risky sex behaviors. This descriptive exploratory study extracted data from a stratified random sample of 1,020 profiles posted by men seeking sex on a gay intergenerational website. Frequencies and percentages were calculated for all categorical variables. Analysis of variance was used to test for differences in subgroup categories. The men in the sample were primarily Caucasian (92.3%) with a mean age of 50 years (range: 18-88 years). More than one-fourth of the men (28.5%) reported being married. Of the married men, 76.0% indicated they would engage in receptive anal intercourse. Only a small number of men in the total sample expressed interest in safe sex (17.5%), while 91 men (8.9%) directly stated that they wanted unsafe sex. Most men in the sample were seeking intergenerational sexual encounters, with 71.0% of younger men expressing a preference for older men. The Internet can play a significant role in seeking same-sex encounters across generational groups. Safe sex was not a stated priority for most men in this study, and the Internet provides an effective method of seeking unsafe sex. A number of MSM seeking sex on the Internet were married and Caucasian. This finding suggests the need for greater attention to married and/or publicly identified Caucasian, heterosexual men in human immunodeficiency virus prevention efforts. Effective Internet-based prevention programs need to be implemented and researched.

Knowledge, attitude and practices regarding HIV/AIDS among adult fishermen in coastal areas of Karachi

PubMed Central

2014-01-01

Background Migrant populations are at high risk of Human Immuno Deficiency Virus infection (HIV) and Acquired Immunodeficiency Syndrome (AIDS). Studies of HIV/AIDS knowledge, attitudes and practices among fishermen in developing countries have shown gaps in knowledge and fear of contagion with ambivalent attitudes towards HIV/AIDS and inconsistent universal precautions adherence. The aim of this study was to determine the knowledge, attitude and practices regarding HIV/AIDS among adult fishermen in a coastal area of Karachi, Pakistan. Methods Community based cross sectional study was conducted among fishermen in coastal area of Karachi from June to September 2012. A total of 297 adult fishermen were selected by using simple random sampling technique from different sectors of coastal village. Data were collected using a structured validated questionnaire. The frequency distribution of both dependent and independent variables were worked out. Comparisons of knowledge, attitude and practices regarding HIV/AIDS by socio-demographic characteristics were made using logistic regression. Results Out of 297 fishermen, majority had in-appropriate knowledge (93.6%), negative attitude (75.8%) and less adherent sexual practices (91.6%). In univariate analysis, lower education and higher income were significantly associated (OR 2.25, 95% CI, 1.11, 4.55), (OR = 3.04 CI 1.03-9.02, p value 0.04) with negative attitude and un-safe practices towards HIV/AIDS respectively, whereas no significant association of socio-economic characteristics with knowledge, attitude and practices were observed in multivariate analysis. Conclusions This study suggests that fishermen had very poor knowledge, negative attitudes towards HIV and AIDS and had unsafe sexual practices which suggest that they lack the basic understanding of HIV/AIDS infection. Extensive health education campaign should be provided to the vulnerable sections of the society for the control of HIV/AIDS. PMID:24886122

Students Feeling Unsafe in School: Fifth Graders’ Experiences

PubMed Central

Jacobson, Gloria; Riesch, Susan K.; Temkin, Barbara Myers; Kedrowski, Karen M.; Kluba, Nina

2011-01-01

Children of late elementary school age (fifth grade) provide evidence that many do not feel safe in their schools. The purpose of this study was to examine how children express their experiences of feeling unsafe in school. Questions guiding the study were: What percentage of children in this sample report feeling unsafe at school? What are the after-effects of feeling unsafe? How do children describe what makes them feel unsafe? Participants included 243 fifth grade students who, as part of their participation in a larger study, were asked, “Have you felt unsafe at school?” Children responding affirmatively described what made them feel unsafe. Fifty-seven (23.8%) participants indicated they sometimes or always felt unsafe at school, citing teasing, bullying, or other threats that typically occurred when adults were not present. Nearly a third reported being stressed and almost half felt at slight or great risk because of feeling unsafe. When children feel unsafe in school, there are implications for schools, neighborhoods, and larger communities. The related potential for children’s increased involvement in health risk behaviors because they feel unsafe merits immediate and thoughtfully-planned action. PMID:20956581

Work Safety Culture of Youth Farmworkers in North Carolina: A Pilot Study

PubMed Central

Kearney, Gregory D.; Rodriguez, Guadalupe; Quandt, Sara A.

2015-01-01

Objectives. We analyzed aspects of the behavioral, situational, and psychological elements of work safety culture of hired youth farmworkers in North Carolina. Methods. Data were from interviewer-administered questionnaires completed with 87 male and female hired farmworkers aged 10 to 17 years in North Carolina in 2013. We computed means, SDs, and Cronbach α values for the perceived work safety climate and safety perception summary scores. Results. Hired youth farmworkers in North Carolina described a negative work safety culture. Most engaged in unsafe general and unsafe work behaviors, few received training, and many were sexually harassed at work. They had mixed safety attitudes and knew that their employment was precarious. They reported a poor perceived work safety climate characterized by the perception that their supervisors “are only interested in doing the job fast and cheaply.” However, we could not detect statistically significant associations between work safety culture and injuries among these farmworkers. Conclusions. Increased scrutiny of agriculture as a suitable industry for workers as young as 10 years and additional regulations to protect hired youth farmworkers, if not to remove them from this environment, are warranted. Additional research is needed. PMID:25521896

Use of the Home Safety Self-Assessment Tool (HSSAT) within Community Health Education to Improve Home Safety.

PubMed

Horowitz, Beverly P; Almonte, Tiffany; Vasil, Andrea

2016-10-01

This exploratory research examined the benefits of a health education program utilizing the Home Safety Self-Assessment Tool (HSSAT) to increase perceived knowledge of home safety, recognition of unsafe activities, ability to safely perform activities, and develop home safety plans of 47 older adults. Focus groups in two senior centers explored social workers' perspectives on use of the HSSAT in community practice. Results for the health education program found significant differences between reported knowledge of home safety (p = .02), ability to recognize unsafe activities (p = .01), safely perform activities (p = .04), and develop a safety plan (p = .002). Social workers identified home safety as a major concern and the HSSAT a promising assessment tool. Research has implications for reducing environmental fall risks.

Healthcare providers balancing norms and practice: challenges and opportunities in providing contraceptive counselling to young people in Uganda - a qualitative study.

PubMed

Paul, Mandira; Näsström, Sara B; Klingberg-Allvin, Marie; Kiggundu, Charles; Larsson, Elin C

2016-01-01

Pregnancies among young women force girls to compromise education, resulting in low educational attainment with subsequent poverty and vulnerability. A pronounced focus is needed on contraceptive use, pregnancy, and unsafe abortion among young women. This study aims to explore healthcare providers' (HCPs) perceptions and practices regarding contraceptive counselling to young people. We conducted 27 in-depth interviews with doctors and midwives working in seven health facilities in central Uganda. Interviews were open-ended and allowed the participant to speak freely on certain topics. We used a topic guide to cover areas topics of interest focusing on post-abortion care (PAC) but also covering contraceptive counselling. Transcripts were transcribed verbatim and data were analysed using thematic analysis. The main theme, HCPs' ambivalence to providing contraceptive counselling to sexually active young people is based on two sub-themes describing the challenges of contraceptive counselling: A) HCPs echo the societal norms regarding sexual practice among young people, while at the same time our findings B) highlights the opportunities resulting from providers pragmatic approach to contraceptive counselling to young women. Providers expressed a self-identified lack of skill, limited resources, and inadequate support from the health system to successfully provide appropriate services to young people. They felt frustrated with the consultations, especially when meeting young women seeking PAC. Despite existing policies for young people's sexual and reproductive health in Uganda, HCPs are not sufficiently equipped to provide adequate contraceptive counselling to young people. Instead, HCPs are left in between the negative influence of social norms and their pragmatic approach to address the needs of young people, especially those seeking PAC. We argue that a clear policy supported by a clear strategy with practical guidelines should be implemented alongside in-service training including value clarification and attitude transformation to equip providers to be able to better cater to young people seeking sexual and reproductive health advice.

Condom utilization and sexual behavior of female sex workers in Northwest Ethiopia: A cross-sectional study.

PubMed

Tamene, Masresha Molla; Tessema, Gizachew Assefa; Beyera, Getahun Kebede

2015-01-01

Sexually transmitted infections are among the most important public health problems in the world. People who indulge in unsafe sex, such as female sex workers are the most at risk population groups due to multiple sexual partners and inconsistent condom use. The aim of this study was to assess condom utilization and sexual behavior of female sex workers in Gondar town, Northwest Ethiopia. A quantitative cross-sectional study triangulated with qualitative method was conducted from March 20 - April 10, 2014 in Gondar town. The quantitative data were collected through interviewing 488 female sex workers while in-depth interview was administered to collect qualitative data from 10 female sex workers. The collected data were entered into EPI-INFO version 3.5.3 and exported to SPSS version 20.0 software for analysis. Logistic regression analysis was done to determine the association between condom utilization and independent variables. This study revealed that less than half (47.7%) of the respondents utilized condom with any type of client. Secondary education or above, perceiving themselves at risk of HIV/AIDS infection, having awareness that sexually transmitted infections could increase HIV infection, being tested for HIV/AIDS in the last 12 months, and having lower number of clients in a month were positively associated with condom utilization. This finding depicted that condom utilization was low among female sex workers. Thus, developing and implementing target oriented behavioral change and communication strategies are needed to prevent the risk of acquiring HIV/AIDS and other sexually transmitted infections in female sex workers.

Social Stress and Substance Use Disparities by Sexual Orientation Among High School Students.

PubMed

Lowry, Richard; Johns, Michelle M; Robin, Leah E; Kann, Laura K

2017-10-01

Sexual minority youth often experience increased social stress due to prejudice, discrimination, harassment, and victimization. Increased stress may help explain the disproportionate use of substances like tobacco, alcohol, marijuana, and other illicit drug use by sexual minority youth. This study examined the effect of social stress on substance use disparities by sexual orientation among U.S. high school students. In 2016, data from the national 2015 Youth Risk Behavior Survey, conducted among a nationally representative sample of 15,624 U.S. high school students, were analyzed to examine the effect of school-related (threatened/injured at school, bullied at school, bullied electronically, felt unsafe at school) and non-school-related (forced sexual intercourse, early sexual debut) social stress on substance use disparities by sexual orientation, by comparing unadjusted prevalence ratios (PRs) and adjusted (for social stressors, age, sex, and race/ethnicity) prevalence ratios (APRs). Unadjusted PRs reflected significantly (p<0.05 or 95% CI did not include 1.0) greater substance use among students who identified as lesbian/gay or bisexual than students who identified as heterosexual. APRs for injection drug use decreased substantially among lesbian/gay (PR=12.02 vs APR=2.14) and bisexual (PR=2.62 vs APR=1.18) students; the APR for bisexual students became nonsignificant. In addition, APRs among both lesbian/gay and bisexual students decreased substantially and were no longer statistically significant for cocaine, methamphetamine, and heroin use. School-based substance use prevention programs might appropriately include strategies to reduce social stress, including policies and practices designed to provide a safe school environment and improved access to social and mental health services. Published by Elsevier Inc.

Dimensions of poverty and inconsistent condom use among youth in urban Kenya.

PubMed

Davidoff-Gore, Alena; Luke, Nancy; Wawire, Salome

2011-10-01

To date, research on the link between poverty and unsafe sexual behaviors has utilized limited measures of socioeconomic status and has overlooked key dimensions of poverty at the individual level. This study explored how various dimensions of socioeconomic status are associated with inconsistent condom use and how these associations vary by gender. We analyzed unique life history survey data from 261 young men and women in Kisumu, Kenya, and conducted analyses based on 959 person-months in which respondents had been sexually active in nonmarital relationships. Dependent variables were inconsistent condom use (not always using a condom) and never use of condoms. Condoms were used inconsistently in 57% of months and were never used in 31%. Corroborating existing literature, lower household wealth and lower educational attainment were associated with inconsistent condom use. Lower individual economic status (lower earned income, food insufficiency, and larger material transfers from partners) were also important determinants of inconsistent condom use. There were no significant differences in these associations by gender, with the exception of food insufficiency, which increased the risk of inconsistent condom use for young women but not for young men. None of these individual measures of socioeconomic status were associated with never use of a condom. The findings suggest that both household- and individual-level measures of socioeconomic status are important correlates of condom use and that individual economic resources play a crucial role in negotiations over the highest level of usage. The results highlight the importance of poverty in shaping sexual behavior, and, in particular, that increasing individual access to resources beyond the household, including ensuring access to food and providing educational and work opportunities, could prove to be effective strategies for decreasing the risk of HIV among youth.

Women's perceptions of safety and risk following police intervention for intimate partner violence.

PubMed

Dichter, Melissa E; Gelles, Richard J

2012-01-01

Police intervention is a primary response to intimate partner violence (IPV) but does not guarantee a victim's future safety. This study sought to identify factors associated with IPV survivors' perceptions of safety and risk of revictimization following police intervention. One hundred sixty-four women completed a questionnaire, and 11 of those women also took part in qualitative interviews. The findings revealed that feeling unsafe and perceiving oneself to be at risk of future violence is associated with experiencing particular forms of IPV, including battering, lethality threats, and sexual violence. Having support from others and distance from the partner helps women feel safe.

HIV-Risk Index: Development and Validation of a Brief Risk Index for Hispanic Young People.

PubMed

Ballester-Arnal, Rafael; Gil-Llario, María Dolores; Castro-Calvo, Jesús; Giménez-García, Cristina

2016-08-01

The prevalence of HIV risk behaviors among young people facilitates the spread of HIV, in particular regarding unsafe sex behavior, although this trend is different within this population. For this reason, identifying the riskier young population is required to prevent HIV infection. The main purpose of this study was to develop and validate a risk index to assess the different sexual HIV risk exposure among Hispanic Young people. For this purpose, 9861 Spanish young people were randomly distributed into two groups (derivation and validation group). According to the results, the factor analyses grouped the nine items of the HIV- risk index into two factors (factor 1, direct sexual risk indicators and factor 2, indirect sexual risk indicators) with an equal structure for men and women by a multi-group confirmatory factor analysis. The variance explained was 54.26 %. Moreover, the Cronbach's alpha coefficient revealed high internal reliability (α = .79) and the convergent validity supported its evidence based on different HIV risk indexes. Therefore, the HIV-risk index seem to be a rigorous and valid measure to estimate HIV risk exposure among young people.

Do unsafe tetanus toxoid injections play a significant role in the transmission of HIV/AIDS? Evidence from seven African countries.

PubMed

de Walque, D

2008-04-01

Although sexual transmission is generally considered to be the main factor driving the HIV/AIDS epidemic in Africa, recent studies have claimed that iatrogenic transmission should be considered as an important source of HIV infection. In particular, receipt of tetanus toxoid injections during pregnancy has been reported to be associated with HIV infection in Kenya. The objective of this paper is to assess the robustness of this association among women in nationally representative HIV surveys in seven African countries. The association between prophylactic tetanus toxoid injections during pregnancy and HIV infection was analysed, using individual-level data from women who gave birth in the past five years. These data are from the nationally representative Demographic and Health Surveys, which included HIV testing in seven African countries: Burkina Faso 2003 (N = 2424), Cameroon 2004 (N = 2600), Ethiopia 2005 (N = 2886), Ghana 2003 (N = 2560), Kenya 2003 (N = 1617), Lesotho 2004 (N = 1278) and Senegal 2005 (N = 2126). Once the odds ratios (OR) were adjusted for five-year age groups and for ethnic, urban and regional indicators, the association between prophylactic tetanus toxoid injections during pregnancy and HIV infection was never statistically significant in any of the seven countries. Only in Cameroon was there an association between previous tetanus toxoid injection and HIV positivity but it became weaker (OR 1.53, 95% CI 0.91 to 2.57) once urban location and ethnic group were adjusted for. Although the risk of HIV infection through unsafe injections and healthcare should not be ignored and should be reduced, it does not seem that there is, at present and in the seven countries studied, strong evidence supporting the claim that unsafe tetanus toxoid injections are a major factor driving the HIV epidemic.

School Indicators of Violence Experienced and Feeling Unsafe of Dutch LGB Versus Non-LGB Secondary Students and Staff, 2006-2010.

PubMed

Mooij, Ton

2016-12-01

Gender and sexual orientation are expressed in heterosexual, lesbian (L), gay (G), bisexual (B), transgender (T), or queer (Q) interests and behavior. Compared with heterosexual persons, LGBTQ persons seem to experience more antisocial behavior, including negative discrimination and violence. To assess differences in LGBTQ-related discrimination in schools, the question for this research is "Do the degrees of violence experienced and feeling unsafe of LGBTQ students and staff in a school differ from those of non-LGBTQ students and staff in the same school?" Secondary analysis was carried out on data from a Dutch national digital monitor survey on safety in secondary schools. In 2006, 2008, and 2010, participation amounted to 570 schools, 18,300 teaching and support staff, and 216,000 students. Four indicators were constructed at the school level: two Mokken Scale means assessing severity of violence experienced and two Alpha Scale means assessing feeling unsafe. Analysis of mean differences showed that LGB students experienced more violence and felt less safe than non-LGB students; LGB staff felt less safe in school than non-LGB staff. When LGB students experienced more violence at school than non-LGB students, LGB students also felt less safe than non-LGB students for all 3 years. No such relationships existed for LGB staff, or between LGB staff and LGB students. No significant relationships were found between the four LGB school indicators and contextual school variables. The outcomes and uniqueness of the study are discussed. Recommendations are made to improve assessment and promote prosocial behavior of students and staff in schools. © The Author(s) 2015.

Medical students are afraid to include abortion in their future practices: in-depth interviews in Maharastra, India.

PubMed

Sjöström, Susanne; Essén, Birgitta; Gemzell-Danielsson, Kristina; Klingberg-Allvin, Marie

2016-01-12

Unsafe abortions are estimated to cause eight per-cent of maternal mortality in India. Lack of providers, especially in rural areas, is one reason unsafe abortions take place despite decades of legal abortion. Education and training in reproductive health services has been shown to influence attitudes and increase chances that medical students will provide abortion care services in their future practice. To further explore previous findings about poor attitudes toward abortion among medical students in Maharastra, India, we conducted in-depth interviews with medical students in their final year of education. We used a qualitative design conducting in-depth interviews with twenty-three medical students in Maharastra applying a topic guide. Data was organized using thematic analysis with an inductive approach. The participants described a fear to provide abortion in their future practice. They lacked understanding of the law and confused the legal regulation of abortion with the law governing gender biased sex selection, and concluded that abortion is illegal in Maharastra. The interviewed medical students' attitudes were supported by their experiences and perceptions from the clinical setting as well as traditions and norms in society. Medical abortion using mifepristone and misoprostol was believed to be unsafe and prohibited in Maharastra. The students perceived that nurse-midwives were knowledgeable in Sexual and Reproductive Health and many found that they could be trained to perform abortions in the future. To increase chances that medical students in Maharastra will perform abortion care services in their future practice, it is important to strengthen their confidence and knowledge through improved medical education including value clarification and clinical training.

Prevalence of sexual coercion and its association with unwanted pregnancies among young pregnant females in Kampala, Uganda: a facility based cross-sectional study.

PubMed

Tusiime, Suzan; Musinguzi, Geofrey; Tinkitina, Benjamin; Mwebaza, Norah; Kisa, Rose; Anguzu, Ronald; Kiwanuka, Noah

2015-09-24

Sexual coercion is associated with sexually transmitted infections and unwanted pregnancies with consequential unsafe abortions and increased maternal morbidity and mortality. Current literature focuses mainly on its risk factors but less on its resultant deleterious health effects. We conducted a study to determine the prevalence of sexual coercion and its association with unwanted pregnancies among young pregnant women. In a cross-sectional study, four hundred and sixteen (416) consenting pregnant females aged 15-24 years attending antenatal clinics in Lubaga division Kampala district in Uganda were enrolled using systematic sampling. Quantitative and qualitative data on sexual coercion were collected by female interviewers. Adjusted Prevalence Proportion Ratios (Adj. PPRs) of unwanted pregnancy and associated 95 % confidence intervals were estimated by generalized linear models with log link function and Poisson family distribution using robust variance estimator. Quantitative data were analyzed using Stata version 10.0, while qualitative data were analyzed using manifest content analysis. Prevalence of sexual coercion was 24 % and was higher among those who had non consensual sexual debut (29.0 %) compared with those who had consensual sexual debut (22.6 %). The prevalence of unwanted pregnancy was 18.3 % and was higher among participants who had been sexually coerced relative to their counterparts (p < 0.001). History of sexual coercion in the past 12 months and non consensual sexual debut were associated with unwanted pregnancy [adj.PPR = 2.23, 95 % CI: (1.49-3.32)] and 1.72, 95 % CI: (1.16- 2.54)] respectively. Qualitative results indicated that different forms/contexts of sexual coercion, such as deception, transactional sex and physical force influenced unwanted pregnancies. This study highlights that a quarter of our participants in our quantitative study had experienced sexual coercion in the past twelve months and nearly a third of these, had history of non consensual sexual debut. Unwanted pregnancy was higher among the sexually coerced and those who had non consensual sexual debut. Sexual coercion among pregnant women aged 15-24 years in Kampala, Uganda is high and is significantly associated with unwanted pregnancy. Comprehensive sex education targeting young people (<25 years), along with availability and access to youth friendly centers may be useful in addressing sexual coercion and its negative outcomes.

Model of relationship between personal factors and Occupational Health and Safety (OHS) management toward unsafe actions: a case study

NASA Astrophysics Data System (ADS)

Syamtinningrum, M. D. P.; Partiwi, S. G.; Dewi, D. S.

2018-04-01

One indicator of a good company is when a safe business environment can be well maintained. In this work environment, the number of industrial accidents is minimum. Industrial accidents are the incidents that occurred in the workplace, especially in industrial area. Industrial accidents are generally caused by two main reasons, unsafe actions & unsafe conditions. Some research indicates that unsafe actions significantly affect the incidence in the workplace. Unsafe action is a failure to follow the proper procedures and requirements, which is led into accidents. From several previous studies it can be concluded that personal factors & OHS management are two most influential factors that affect unsafe actions. However, their relationship in influencing unsafe actions is not fully understood. Based on this reason the authors want to investigate the effect of personal factors and OHS management toward unsafe actions to workers. For this purpose, a company is selected as a case study. In this research, analyses were done by using univariate test, bivariate correlation and linear regression. The results of this study proves that two indicators of personal factors (i.e. knowledge of OHS & OHS training) and OHS management have significant effect on unsafe actions but in negative direction, while two indicators of personal factors (i.e. workload & fatigue) have positive direction of effect on unsafe actions. In addition, this research has developed a mathematical model that can be used to calculate and predict the value of unsafe actions performed by the worker. By using this model, the company will able to take preventive actions toward unsafe actions to reduce workers accidents.

Dating Violence Victimization Among High School Students in Minnesota: Associations With Family Violence, Unsafe Schools, and Resources for Support.

PubMed

Earnest, Alicia A; Brady, Sonya S

2016-02-01

The present study examines whether being a victim of violence by an adult in the household, witnessing intra-familial physical violence, and feeling unsafe at school are associated with physical dating violence victimization. It also examines whether extracurricular activity involvement and perceived care by parents, teachers, and friends attenuate those relationships, consistent with a stress-buffering model. Participants were 75,590 ninth-and twelfth-grade students (51% female, 77% White, 24% receiving free/reduced price lunch) who completed the 2010 Minnesota Student Survey. Overall, 8.5% of students reported being victims of dating violence. Significant differences were found by gender, grade, ethnicity, and free/reduced price lunch status. Logistic regression analyses demonstrated that being a victim of violence by an adult in the household, witnessing intra-familial physical violence, feeling unsafe at school, and low perceived care by parents were strongly associated with dating violence victimization. Associations of moderate strength were found for low perceived care by teachers and friends. Little to no extracurricular activity involvement was weakly associated with dating violence victimization. Attenuating effects of perceived care and extracurricular activity involvement on associations between risk factors (victimization by a family adult, witnessing intra-familial violence, feeling unsafe at school) and dating violence victimization were smaller in magnitude than main effects. Findings are thus more consistent with an additive model of risk and protective factors in relation to dating violence victimization than a stress-buffering model. Health promotion efforts should attempt to minimize family violence exposure, create safer school environments, and encourage parental involvement and support. © The Author(s) 2014.

‘It’s really a hard life’: Love, gender and HIV risk among male-to-female transgender persons

PubMed Central

MELENDEZ, RITA M.; PINTO, ROGÉRIO

2012-01-01

Scientific studies demonstrate high rates of HIV infection among male-to-female (MTF) transgender individuals and that stigma and discrimination place MTFs at increased risk for infection. However, there is little research examining how gender roles contribute to HIV risk. This paper reports on in-depth interviews with 20 MTFs attending a community clinic. Data reveal that stigma and discrimination create a heightened need for MTFs to feel safe and loved by a male companion and that in turn places them at a higher risk for acquiring HIV. Male-to-female transgender individuals appear to turn to men to feel loved and affirmed as women; their main HIV risk stems from their willingness to engage with sexual partners who provide a sense of love and acceptance but who also may also request unsafe sexual behaviours. A model illustrating how HIV risk is generated from stigma and discrimination is presented. PMID:17457728

Counseling to Reduce High-Risk Sexual Behavior in HIV Care: A Multi-Center, Direct Observation Study

PubMed Central

Berry, Stephen; Korthuis, P. Todd; Saha, Somnath; Laws, M. Barton; Sharp, Victoria; Moore, Richard D.; Beach, Mary Catherine

2013-01-01

Abstract A key opportunity to reduce HIV transmission lies with healthcare providers counseling HIV-infected patients about safer sex. We audio-recorded and transcribed clinical encounters between 45 healthcare providers and 417 of their HIV-infected patients at four outpatient sites in the United States. We used logistic regressions to evaluate associations between patient and provider characteristics, and the occurrence of discussion (any talk about sex) and counseling (advice about safer sex). Of the 417 encounters, discussion of sex occurred in 187 (45% of encounters, 95% CI: 40–50%). Counseling occurred for 49% (95% CI: 35–63%) of patients reporting unsafe sex. Discussion of sex was more likely with younger or less-educated patients and with less cultural difference between patient and provider, while counseling was associated with greater provider mindfulness and lower provider empathy. These findings suggest targets to improve communication regarding sexual risk reduction in HIV care. PMID:23802144

Associations of Teen Dating Violence Victimization With School Violence and Bullying Among US High School Students.

PubMed

Vivolo-Kantor, Alana M; Olsen, Emily O'Malley; Bacon, Sarah

2016-08-01

Teen dating violence (TDV) negatively impacts health, mental and physical well-being, and school performance. Data from a nationally representative sample of high school students participating in the Centers for Disease Control and Prevention (CDC)'s 2013 Youth Risk Behavior Survey (YRBS) are used to demonstrate associations of physical and sexual TDV with school violence-related experiences and behaviors, including bullying victimization. Bivariate and adjusted sex-stratified regressions assessed relationships between TDV and school violence-related experiences and behaviors. Compared to students not reporting TDV, those experiencing both physical and sexual TDV were more likely to report carrying a weapon at school, missing school because they felt unsafe, being threatened or injured with a weapon on school property, having a physical fight at school, and being bullied on school property. School-based prevention efforts should target multiple forms of violence. Published 2016. This article is a U.S. Government work and is in the public domain in the USA.

“It’s One of the Better Drugs to Use”: Perceptions of Cocaine Use Among Gay and Bisexual Asian American Men

PubMed Central

Fazio, Adam; Hunt, Geoffrey; Moloney, Molly

2010-01-01

Research on drug use among gay and bisexual men has primarily focused on examining the link between drug use – most notably, methamphetamine – sexual practices, and risk of HIV transmission. Drawing on in-depth qualitative data from 40 interviews with gay and bisexual Asian American men, we examine perceptions and meanings associated with cocaine use in the San Francisco Bay Area gay community. We found that our participants, in contrast to their negative perceptions of methamphetamine use, believed that cocaine enhanced sociability and was acceptable for use in most social situations. Furthermore, participants perceived little connection between cocaine use and risky sexual practices, emphasizing the drug’s safety relative to other illicit substances. Overall, these findings suggest that an increase in the favorability of cocaine use might be an unintended consequence of methamphetamine prevention campaigns, targeting the gay community, with their emphasis on the harmful effects of drug use, unsafe sex and HIV risk. PMID:20952603

Promoting Occupational Safety and Health for Cambodian Entertainment Sector Workers.

PubMed

Hsu, Lee-Nah; Howard, Richard; Torriente, Anna Maria; Por, Chuong

2016-08-01

Cambodia has developed booming textile, garment, tourism, and entertainment service industries since the mid-1990s. The 2007 global financial crisis pushed many garment workers, who lost their jobs, into the entertainment sector. Entertainment workers are typically engaged informally by their employers and are subjected to long working hours, sexual harassment, and violence. Many who sell beverages are forced into excessive alcohol consumption as part of their work. Many are also expected by their employers and clients to provide sexual services. To address unsafe and unhealthy working conditions for these workers, an innovative occupational safety and health regulation was adopted in 2014. This first-of-its-kind occupational safety and health regulation was developed jointly by the Cambodian Ministry of Labour and Vocational Training and employers' and workers' organizations in the entertainment sector. The implementation of this regulation can also be a viable contribution of occupational safety and health to HIV interventions for these workers. © The Author(s) 2016.

Self-Efficacy for Sexual Risk Reduction and Partner HIV Status as Correlates of Sexual Risk Behavior Among HIV-Positive Adolescent Girls and Women

PubMed Central

Boone, Melissa R.; Cherenack, Emily M.

2015-01-01

Abstract Little is known about the correlates of sexual risk behavior among HIV-positive adolescent girls and women in the United States. This study investigates two potential factors related to unprotected vaginal and anal intercourse (UVAI) that have yet to be thoroughly studied in this group: self-efficacy for sexual risk reduction and partner HIV status. Data was analyzed from 331 HIV-positive adolescent girls and women between 12 and 24 years old who reported vaginal and/or anal intercourse with a male partner in the past 3 months at fifteen sites across the United States. Results show that overall self-efficacy (B = −0.15, p=0.01), self-efficacy to discuss safe sex with one's partner (B = −0.14, p=0.01), and self-efficacy to refuse unsafe sex (B = −0.21, p=0.01) are related to UVAI episodes. Participants with only HIV-positive partners or with both HIV-positive and HIV-negative partners showed a trend towards higher percentages of UVAI episodes compared to participants with only HIV-negative partners (F(2, 319)=2.80, p=0.06). These findings point to the importance of including self-efficacy and partner HIV status in risk-reduction research and interventions developed for HIV-positive adolescent girls and young women. PMID:25856632

Self-Efficacy for Sexual Risk Reduction and Partner HIV Status as Correlates of Sexual Risk Behavior Among HIV-Positive Adolescent Girls and Women.

PubMed

Boone, Melissa R; Cherenack, Emily M; Wilson, Patrick A

2015-06-01

Little is known about the correlates of sexual risk behavior among HIV-positive adolescent girls and women in the United States. This study investigates two potential factors related to unprotected vaginal and anal intercourse (UVAI) that have yet to be thoroughly studied in this group: self-efficacy for sexual risk reduction and partner HIV status. Data was analyzed from 331 HIV-positive adolescent girls and women between 12 and 24 years old who reported vaginal and/or anal intercourse with a male partner in the past 3 months at fifteen sites across the United States. Results show that overall self-efficacy (B=-0.15, p=0.01), self-efficacy to discuss safe sex with one's partner (B=-0.14, p=0.01), and self-efficacy to refuse unsafe sex (B=-0.21, p=0.01) are related to UVAI episodes. Participants with only HIV-positive partners or with both HIV-positive and HIV-negative partners showed a trend towards higher percentages of UVAI episodes compared to participants with only HIV-negative partners (F(2, 319)=2.80, p=0.06). These findings point to the importance of including self-efficacy and partner HIV status in risk-reduction research and interventions developed for HIV-positive adolescent girls and young women.

Knowledge, Perceptions and Acceptability to Strengthening Adolescents’ Sexual and Reproductive Health Education amongst Secondary Schools in Gulu District

PubMed Central

Herman, Lule; Ovuga, E.; Mshilla, M.; Ojara, S.; Kimbugwe, G.; Adrawa, A. P.; Mahuro, N.

2014-01-01

Adolescents in Northern Uganda are at risk of teenage pregnancies, unsafe abortions and sexually transmitted infections (STIs). There is silence on sex both at home and school. This cross sectional descriptive analytical study interviews a random sample of 827 students and 13 teachers on knowledge, perception and acceptability to a comprehensive adolescent sexual and reproductive health education in “O” and “A” level secondary schools in Gulu District. Quantitative data was analysed using SPSS 16.0. Directed content analysis of themes of transcribed qualitative data was conducted manually for common codes, sub-categories and categories. Of the 827 students; 54.3% (449) reported being in a sexual relationship especially those aged 15–17 years. Majority 96.1% (807) supported the teaching of a comprehensive ASRHE, citing no negative impact 71.5% (601). Majority 81.6% (686) agreed that such education could help prevention of STIs, abortions and teenage pregnancies, and that it should be taught by health workers 69.0% (580). Majority 76.6% (203) reported that ASRHE was not currently being taught in their schools. Students had low knowledge levels and misconceptions about ASRHE. ASRHE was highly acceptable though not being emphasized; its success in school settings requires multidisciplinary culturally sensitive approaches amongst which health workers should be frontiers. PMID:24748950

Individual and Contextual Factors Associated with Immigrant Youth Feeling Unsafe in School: A Social-Ecological Analysis.

PubMed

Hong, Jun Sung; Merrin, Gabriel J; Crosby, Shantel; Jozefowicz, Debra M Hernandez; Lee, Jeoung Min; Allen-Meares, Paula

2016-10-01

Despite the increasing proportion of immigrant youth in U.S. school districts, no studies have investigated their perceptions of their school. This study examines factors associated with perceptions of school safety among immigrant youth within individual, family, peer, and school contexts. Data were drawn from Wave II of the Children of Immigrants Longitudinal Study (n = 4288) and hierarchical logistic regression analyses were conducted. African-Americans, females, and youth with limited English proficiency were more likely to perceive their school as unsafe. Youth who reported that family cohesion was important and those who had close friends perceived their school as safe. Also, those who experienced illegal activities in school reported feeling unsafe. Assessment and intervention in schools needs to consider individual and contextual factors associated with perceptions of school safety. Additional research is needed to examine individual and contextual factors related to immigrant youths' perceptions of school.

Factors associated with partner notification of STIs in men who have sex with men on PrEP in France: a cross-sectional substudy of the ANRS-IPERGAY trial.

PubMed

Suzan-Monti, Marie; Cotte, Laurent; Fressard, Lisa; Cua, Eric; Capitant, Catherine; Meyer, Laurence; Pialoux, Gilles; Molina, Jean-Michel; Spire, Bruno

2018-01-29

Partner notification (PN) is a useful public health approach to enhance targeted testing of people at high risk of HIV and other STIs, and subsequent linkage to care for those diagnosed. In France, no specific PN guidelines exist and information about current practices is scarce. We used the ANRS-IPERGAY PrEP trial to investigate PN in HIV-negative men who have sex with men (MSM) reporting a bacterial STI. This substudy included 275 participants who completed a specific online PN questionnaire during the open-label extension study of the ANRS-Intervention Préventive de l'Exposition aux Risques avec et pour les Gays (IPERGAY) trial. Variables used as proxies of at-risk practices were defined using data collected at the previous follow-up visit about participants' most recent sexual encounter and preventive behaviours. χ 2 or Fisher's exact test helped select variables eligible for multiple logistic models. Of the 275 participants, 250 reported at least one previous STI. Among the latter, 172 (68.8%) had informed their partner(s) of their most recent STI. Of these, 138 (80.2%) and 83 (48.3%) had notified their casual and main partners, respectively. Participants were less likely to notify their main partner when their most recent sexual encounter involved unsafe anal sex with a casual partner (adjusted OR (aOR) (95% CI) 0.18 (0.06 to 0.54), P=0.02). Older participants were less likely to inform casual partners (aOR (95% CI) 0.44 (0.21 to 0.94), P=0.03), while those practising chemsex during their most recent sexual encounter were more likely to inform their casual partners (aOR (95% CI) 2.56 (1.07 to 6.09), P=0.03). Unsafe sexual encounters with people other than main partners and street drugs use were two sociobehavioural factors identified, respectively, as a barrier to main PN and a motivator for casual PN, in a sample of high-risk MSM. These results provide an insight into current PN practices regarding STI in France and might inform future decisions about how to define feasible and acceptable PN programmes. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Confronting the 'sugar daddy' stereotype: age and economic asymmetries and risky sexual behavior in urban Kenya.

PubMed

Luke, Nancy

2005-03-01

"Sugar daddy" relationships, which are characterized by large age and economic asymmetries between partners, are believed to be a major factor in the spread of HIV in Sub-Saharan Africa. Information is needed about sugar daddy partnerships-and about age and economic asymmetries more generally-to determine how common they are and whether they are related to unsafe sexual behavior. The sample comprised 1,052 men aged 21-45 who were surveyed in Kisumu, Kenya, in 2001. Data on these men and their 1,614 recent non-marital partnerships were analyzed to calculate the prevalence of sugar daddies and sugar daddy relationships, as well as a range of age and economic disparities within non-marital partnerships. Logistic regression models were constructed to assess relationships between condom use at last sexual intercourse and various measures of age and economic asymmetry. The mean age difference between non-marital sexual partners was 5.5 years, and 47% of men's female partners were adolescents. Fourteen percent of partnerships involved an age difference of at least 10 years, and 23% involved more than the mean amount of male-to-female material assistance. Men who reported at least one partnership with both these characteristics were defined as sugar daddies and made up 5% of the sample; sugar daddy relationships accounted for 4% of partnerships. Sugar daddy partnerships and the largest age and economic asymmetries we constructed were associated with decreased odds of condom use. Although sugar daddy relationships are not as pervasive as generally assumed, age and economic asymmetries in non-marital partnerships are relatively common. All these types of asymmetries are associated with nonuse of condoms. Increasing women's power within asymmetric sexual relationships could improve their ability to negotiate safer sexual behaviors, such as condom use.

Factors associated with the use of irreversible contraception and continuous use of reversible contraception in a cohort of HIV-positive women.

PubMed

Kancheva Landolt, Nadia; Ramautarsing, Reshmie Ashmanie; Phanuphak, Nittaya; Teeratakulpisarn, Nipat; Pinyakorn, Suteeraporn; Rodbamrung, Piyanee; Chaithongwongwatthana, Surasith; Ananworanich, Jintanat

2013-07-01

Effective contraception can be lifesaving by reducing maternal mortality linked to childbirth and unsafe abortion and by reducing vertical and horizontal transmission of HIV, in the case of an HIV-positive woman. This study is a secondary analysis of a prospective cohort study. We assessed factors associated with the use of irreversible contraception and the continuous use of reversible contraception in HIV-positive Thai women. We used descriptive statistics to present baseline characteristics and logistic regression to assess the association between contraceptive use and factors in the study. Of 196 women included in the analysis, 87% self-reported always using male condoms and 56% continuously using another effective contraceptive method during the period of the study (12-18 months). The choice of effective contraceptive methods was suboptimal--42% were sterilized, 14% used hormonal contraception and no participant reported the use of an intrauterine device. Sexual activity and past contraceptive use were factors associated positively with current continuous contraceptive use. Live births and lower levels of education were additional factors associated positively with sterilization. Despite high contraceptive use, there are still uncovered contraceptive needs among HIV-positive women in Thailand. HIV-positive women need established specialized family planning services, offering an optimal variety of contraceptive choices and tailored to their individual needs. As sterilization is an irreversible choice, it cannot be a viable alternative for every woman. Due to the positive trend between current and past contraceptive use, we consider that it may be possible to improve family planning programs if they start as early as possible in a woman's life and are continued throughout her sexually active and reproductive years. Copyright © 2013 Elsevier Inc. All rights reserved.

76 FR 38062 - Airworthiness Directives; Gulfstream Aerospace LP Model Galaxy and Gulfstream 200 Airplanes

Federal Register 2010, 2011, 2012, 2013, 2014

2011-06-29

... with certified mechanical properties of this fastener can potentially lead to an unsafe condition. The... certified mechanical properties of this fastener can potentially lead to an unsafe condition. The unsafe...-conformity with certified mechanical properties of this fastener can potentially lead to an unsafe condition...

Association of Urogenital Symptoms with History of Water Contact in Young Women in Areas Endemic for S. haematobium. A Cross-Sectional Study in Rural South Africa.

PubMed

Galappaththi-Arachchige, Hashini Nilushika; Amlie Hegertun, Ingrid Elise; Holmen, Sigve; Qvigstad, Erik; Kleppa, Elisabeth; Sebitloane, Motshedisi; Ndhlovu, Patricia Doris; Vennervald, Birgitte Jyding; Gundersen, Svein Gunnar; Taylor, Myra; Kjetland, Eyrun Floerecke

2016-11-14

Female genital schistosomiasis is a neglected tropical disease caused by Schistosoma haematobium . Infected females may suffer from symptoms mimicking sexually transmitted infections. We explored if self-reported history of unsafe water contact could be used as a simple predictor of genital schistosomiasis. In a cross-sectional study in rural South Africa, 883 sexually active women aged 16-22 years were included. Questions were asked about urogenital symptoms and water contact history. Urine samples were tested for S. haematobium ova. A score based on self-reported water contact was calculated and the association with symptoms was explored while adjusting for other genital infections using multivariable logistic regression analyses. S. haematobium ova were detected in the urine of 30.5% of subjects. Having ova in the urine was associated with the water contact score ( p < 0.001). Symptoms that were associated with water contact included burning sensation in the genitals ( p = 0.005), spot bleeding ( p = 0.012), abnormal discharge smell ( p = 0.018), bloody discharge ( p = 0.020), genital ulcer ( p = 0.038), red urine ( p < 0.001), stress incontinence ( p = 0.001) and lower abdominal pain ( p = 0.028). In S. haematobium endemic areas, self-reported water contact was strongly associated with urogenital symptoms. In low-resource settings, a simple history including risk of water contact behaviour can serve as an indicator of urogenital schistosomiasis.

Unsafe abortion: a tragic saga of maternal suffering.

PubMed

Regmi, M C; Rijal, P; Subedi, S S; Uprety, D; Budathoki, B; Agrawal, A

2010-01-01

Unsafe abortion is a significant cause of maternal morbidity and mortality in developing countries despite provision of adequate care and legalization of abortion. The aim of this study was to find out the contribution of unsafe abortion in maternal mortality and its other consequences. A retrospective study was carried out in the Department of Obstetrics and Gynecology in BPKIHS between 2005 April to 2008 September analyzing all the unsafe abortion related admissions. There were 70 unsafe abortion patients. Majority of them (52.8%) were of high grade. Most of them recovered but there were total 8 maternal deaths. Unsafe abortion is still a significant medical and social problem even in post legalization era of this country.

Sexual behavior, stages of condom use, and self-efficacy among college students in Taiwan.

PubMed

Tung, Wei-Chen; Cook, Daniel M; Lu, Minggen

2011-01-01

The purposes of this study were: (1) to assess sexual behaviors and condom use behaviors; (2) to compare sexual behaviors and condom use behaviors between gender groups; and (3) to explore differences in specific items of self-efficacy to practicing condom use by the transtheoretical model stages of readiness to change among college students in Taiwan. A survey of students at two universities yielded 996 valid responses. The survey questions collected reports of demographic information, sexual history, condom use in general, and likely condom use in specific situations in relation to self-efficacy. Only 27.8% (n=277) reported ever having had sex, of these only 31.4% used condoms every time (those in action and maintenance). Condom use among women was lower than among men with men 5.1 times more likely to use condoms to prevent sexually transmitted infections (OR=5.1, 95% CI: 2.14-12.16, p=0.0002). The stages of change model with reported attitudes (self-efficacy) toward condom use in specific situations. The Tukey-Kramer multiple comparisons showed that participants in the maintenance stage reported significantly higher scores than those in the pre-contemplation, contemplation, and preparation stages for all 10 self-efficacy items (p<0.0001). Circumstances that are the most challenging for condom adherence across the stages are: partner preference to forego use, situations involving alcohol and drug use, and perceived low-risk scenarios. College students in Taiwan would benefit from targeted interventions that link risky sex to alcohol, and that address the interpersonal pressure within relationships that compel women students to practice unsafe sex.

29 CFR 1960.28 - Employee reports of unsafe or unhealthful working conditions.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 29 Labor 9 2010-07-01 2010-07-01 false Employee reports of unsafe or unhealthful working... of unsafe or unhealthful working conditions. (a) The purpose of employee reports is to inform agencies of the existence of, or potential for, unsafe or unhealthful working conditions. A report under...

Impact of an active video game on healthy children's physical activity

USDA-ARS?s Scientific Manuscript database

This naturalistic study tests whether children receiving a new (to them) active video game spontaneously engage in more physical activity than those receiving an inactive video game, and whether the effect would be greater among children in unsafe neighborhoods,who might not be allowed to play outsi...

Temporal trends and spatial distribution of unsafe abortion in Brazil, 1996-2012

PubMed Central

Martins-Melo, Francisco Rogerlândio; Lima, Mauricélia da Silveira; Alencar, Carlos Henrique; Ramos, Alberto Novaes; Carvalho, Francisco Herlânio Costa; Machado, Márcia Maria Tavares; Heukelbach, Jorg

2014-01-01

OBJECTIVE To analyze temporal trends and distribution patterns of unsafe abortion in Brazil. METHODS Ecological study based on records of hospital admissions of women due to abortion in Brazil between 1996 and 2012, obtained from the Hospital Information System of the Ministry of Health. We estimated the number of unsafe abortions stratified by place of residence, using indirect estimate techniques. The following indicators were calculated: ratio of unsafe abortions/100 live births and rate of unsafe abortion/1,000 women of childbearing age. We analyzed temporal trends through polynomial regression and spatial distribution using municipalities as the unit of analysis. RESULTS In the study period, a total of 4,007,327 hospital admissions due to abortions were recorded in Brazil. We estimated a total of 16,905,911 unsafe abortions in the country, with an annual mean of 994,465 abortions (mean unsafe abortion rate: 17.0 abortions/1,000 women of childbearing age; ratio of unsafe abortions: 33.2/100 live births). Unsafe abortion presented a declining trend at national level (R2: 94.0%, p < 0.001), with unequal patterns between regions. There was a significant reduction of unsafe abortion in the Northeast (R2: 93.0%, p < 0.001), Southeast (R2: 92.0%, p < 0.001) and Central-West regions (R2: 64.0%, p < 0.001), whereas the North (R2: 39.0%, p = 0.030) presented an increase, and the South (R2: 22.0%, p = 0.340) remained stable. Spatial analysis identified the presence of clusters of municipalities with high values for unsafe abortion, located mainly in states of the North, Northeast and Southeast Regions. CONCLUSIONS Unsafe abortion remains a public health problem in Brazil, with marked regional differences, mainly concentrated in the socioeconomically disadvantaged regions of the country. Qualification of attention to women’s health, especially to reproductive aspects and attention to pre- and post-abortion processes, are necessary and urgent strategies to be implemented in the country. PMID:25119946

A Synthesis of 20 Years of Research on Sexual Risk Taking Among Asian/Pacific Islander Men Who Have Sex With Men in Western Countries.

PubMed

Shi Shiu, Chen; Voisin, Dexter R; Chen, Wet-Ti; Lo, Yi-An; Hardestry, Melissa; Nguyen, Huong

2016-05-01

Over the past two decades, there has emerged a body of literature documenting a number of risk factors associated with Asian/Pacific Islander men who have sex with men's unsafe sexual behaviors. This study aims to systematically review existing empirical studies and synthesize research results into a social-ecological framework using a mixed research synthesis. Empirical research articles published in peer-reviewed journals between January 1990 and June 2013 were identified in six databases, including PubMed, Ovid MEDLINE, PsycINFO, Social Work Abstract, CINAL, and Web of Knowledge. Both quantitative and qualitative studies were included. Two analysts independently reviewed the articles, and findings were organized on a social-ecological framework. Twenty-two articles were included in the analysis; among these 13 were quantitative, 8 were qualitative, and 1 was mixed-methods research. Results indicated that demographic characteristics, psychological resources, behavioral patterns, relationships with family and friends, dynamics with romantic or sexual partners, community involvement, culture, discrimination, and institutional factors were related to unprotected anal intercourse. This article presents a critique of this literature and discusses implications for future research with this population. It concludes with prevention/intervention initiatives based on review findings. © The Author(s) 2015.

A Synthesis of 20 Years of Research on Sexual Risk Taking Among Asian/Pacific Islander Men Who Have Sex With Men in Western Countries

PubMed Central

Shiu, Chen Shi; Voisin, Dexter R.; Chen, Wet-Ti; Lo, Yi-An; Hardestry, Melissa; Nguyen, Huong

2017-01-01

Over the past two decades, there has emerged a body of literature documenting a number of risk factors associated with Asian/Pacific Islander men who have sex with men’s unsafe sexual behaviors. This study aims to systematically review existing empirical studies and synthesize research results into a social–ecological framework using a mixed research synthesis. Empirical research articles published in peer-reviewed journals between January 1990 and June 2013 were identified in six databases, including PubMed, Ovid MEDLINE, PsycINFO, Social Work Abstract, CINAL, and Web of Knowledge. Both quantitative and qualitative studies were included. Two analysts independently reviewed the articles, and findings were organized on a social–ecological framework. Twenty-two articles were included in the analysis; among these 13 were quantitative, 8 were qualitative, and 1 was mixed-methods research. Results indicated that demographic characteristics, psychological resources, behavioral patterns, relationships with family and friends, dynamics with romantic or sexual partners, community involvement, culture, discrimination, and institutional factors were related to unprotected anal intercourse. This article presents a critique of this literature and discusses implications for future research with this population. It concludes with prevention/intervention initiatives based on review findings. PMID:25563383

Factors influencing unsafe behaviors and accidents on construction sites: a review.

PubMed

Khosravi, Yahya; Asilian-Mahabadi, Hassan; Hajizadeh, Ebrahim; Hassanzadeh-Rangi, Narmin; Bastani, Hamid; Behzadan, Amir H

2014-01-01

Construction is a hazardous occupation due to the unique nature of activities involved and the repetitiveness of several field behaviors. The aim of this methodological and theoretical review is to explore the empirical factors influencing unsafe behaviors and accidents on construction sites. In this work, results and findings from 56 related previous studies were investigated. These studies were categorized based on their design, type, methods of data collection, analytical methods, variables, and key findings. A qualitative content analysis procedure was used to extract variables, themes, and factors. In addition, all studies were reviewed to determine the quality rating and to evaluate the strength of provided evidence. The content analysis identified 8 main categories: (a) society, (b) organization, (c) project management, (d) supervision, (e) contractor, (f) site condition, (g) work group, and (h) individual characteristics. The review highlighted the importance of more distal factors, e.g., society and organization, and project management, that may contribute to reducing the likelihood of unsafe behaviors and accidents through the promotion of site condition and individual features (as proximal factors). Further research is necessary to provide a better understanding of the links between unsafe behavior theories and empirical findings, challenge theoretical assumptions, develop new applied theories, and make stronger recommendations.

Shifting Boundaries: an experimental evaluation of a dating violence prevention program in middle schools.

PubMed

Taylor, Bruce G; Stein, Nan D; Mumford, Elizabeth A; Woods, Daniel

2013-02-01

We randomly assigned the Shifting Boundaries interventions to 30 public middle schools in New York City, enrolling 117 sixth and seventh grade classes (over 2,500 students) to receive a classroom, a building, a combined, or neither intervention. The classroom intervention included a six-session curriculum emphasizing the laws and consequences for perpetrators of dating violence and sexual harassment (DV/H), the social construction of gender roles, and healthy relationships. The building-based intervention included the use of building-based restraining orders, higher levels of faculty/security presence in safe/unsafe "hot spots" mapped by students, and posters to increase DV/H awareness and reporting. Student surveys were implemented at baseline, immediately after the intervention, and 6-months post-intervention. As hypothesized, behaviors improved as a result of the interventions. The building-only and the combined interventions were effective in reducing sexual violence victimization involving either peers or dating partners at 6-months post-intervention. This was mirrored by reductions in sexual violence perpetration by peers in the building-only intervention. While the preponderance of results indicates that the interventions were effective, an anomalous result (increase in sexual harassment victimization reports that was contradicted by lower frequency estimates) did emerge. However, after analysis these anomalous results were deemed to be most likely spurious. The success of the building-only intervention alone is important because it can be implemented with very few extra costs to schools.

Violence -- subtle and not so subtle -- understanding women's reproductive and sexual rights in Africa.

PubMed

Toubia, N

1995-01-01

This article discusses violence in relation to women's reproductive and sexual rights in Africa. Two types of violent behaviors are defined. One type is defined as a straightforward, aggressive act of brutality inflicted on one person by another, which may range from battery to rape, and which may occur domestically or be inflicted by a stranger. The other type of violent behavior is the violation of rights or denial of rights, which often operates not only on personal, but also on societal or cultural levels. These definitions allow us to address the record of violence against women in a broad social and political context in which not only men but women and society as a whole act to perpetuate systems resulting in various forms of abuse. In Africa, the strong patriarchal tradition with the economic mode of more formal and systematic, less centralized commerce makes it virtually impossible for a woman to move, act, or think freely. The most damaging type of sexual violence against women centers on the lack of control that women are allowed over their fertility. Denial of reproductive rights, services and information acts as pervasive form of violence, with significant consequences. Women face both the threats of direct bodily violence from strangers and within their own homes; and the exposure to the risk of HIV infection and other sexually transmitted diseases, of unwanted and unplanned pregnancy, and of unsafe abortion due to the violation of women's basic human rights.

Alcohol consumption and high risk sexual behaviour among female sex workers in Uganda.

PubMed

Mbonye, Martin; Rutakumwa, Rwamahe; Weiss, Helen; Seeley, Janet

2014-01-01

Alcohol consumption has been associated with high risk sexual behaviour among key populations such as female sex workers. We explored the drivers of alcohol consumption and its relationship to high risk sexual behaviour. Participants were drawn from a cohort of 1027 women selected from 'hot spots' in the suburbs of Kampala city. We conducted 3 in-depth interviews with 40 female sex workers between 2010 and 2011. Data were analysed thematically, focusing on alcohol use within the context of sex work. Alcohol consumption was very high with only seven women reporting that they did not drink. Alcohol consumption was driven by the emotional and economic needs of the participants, but also promoted by clients who encouraged consumption. Many sex workers only started drinking alcohol when they joined sex work on the advice of more experienced peers, as a way to cope with the job. Alcohol was blamed for unsafe sex, acts of violence and poor decision making which increased sexual and physical violence. Alcohol was reported to affect medication adherence for HIV-positive women who forgot to take medicine. The findings suggest that the drivers of alcohol consumption are multifaceted in this group and require both individual and structural interventions. Alcohol reduction counselling can be supportive at the individual level and should be an integral part of HIV prevention programmes for female sex workers and others such as patrons in bars. The counselling should be addressed in a sensitive manner to bar owners and managers.

The association between symptoms of mental disorders and health risk behaviours in Vietnamese HIV positive outpatients: a cross-sectional study.

PubMed

Thai, Truc T; Jones, Mairwen K; Harris, Lynne M; Heard, Robert C

2017-03-14

A high prevalence of symptoms of mental disorders (SOMD) has been found among people living with HIV/AIDS (PLHIV). Additionally, SOMD may impact on the prevalence of high-risk health behaviours (HRB). This study investigates the relationship between SOMD and HRB in a large sample of Vietnamese HIV positive outpatients. A cross-sectional study was conducted with 400 outpatients at two HIV/AIDS clinics in Ho Chi Minh City, Vietnam, selected using a systematic sampling technique. Validated scales were used to measure SOMD, specifically symptoms of depression, anxiety, alcohol use disorder (AUD), substance use disorder (SUD) and HIV associated dementia (HAD). Participants completed a self-report questionnaire assessing HRB during the preceding 12 months including unsafe sexual practices and illicit drug use. Multivariable logistic regression models were used to evaluate associations between SOMD and HRB. The majority of participants (63.5%) were male and the median age was 34.0 years. Unsafe sexual practices and illicit drug use were reported by 13.8 and 5.5% of participants. The prevalences of HAD, depression, AUD, anxiety and SUD symptoms were 39.8, 36.5, 13.3 10.5, 3.3% respectively. There was no association between SOMD and HRB either with or without adjusting for correlates of HRB, except between symptoms of SUD and illicit drug use. PLHIV who had symptoms of SUD were more likely to use illicit drugs (adjusted Odds Ratio 81.14, 95% CI 12.55-524.47). While the prevalence of SOMD among HIV positive outpatients was high, most SOMD were not associated with increased HRB. Only illicit drug use was predicted by symptoms of SUD. Screening PLHIV for symptoms of SUD may be useful for detecting people likely to be engaging in illicit drug use to reduce the risk of secondary disease transmission.

Unsafe injections in the developing world and transmission of bloodborne pathogens: a review.

PubMed Central

Simonsen, L.; Kane, A.; Lloyd, J.; Zaffran, M.; Kane, M.

1999-01-01

Unsafe injections are suspected to occur routinely in developing countries. We carried out a literature review to quantify the prevalence of unsafe injections and to assess the disease burden of bloodborne infections attributable to this practice. Quantitative information on injection use and unsafe injections (defined as the reuse of syringe or needle between patients without sterilization) was obtained by reviewing the published literature and unpublished WHO reports. The transmissibility of hepatitis B and C viruses and human immunodeficiency virus (HIV) was estimated using data from studies of needle-stick injuries. Finally, all epidemiological studies that linked unsafe injections and bloodborne infections were evaluated to assess the attributable burden of bloodborne infections. It was estimated that each person in the developing world receives 1.5 injections per year on average. However, institutionalized children, and children and adults who are ill or hospitalized, including those infected with HIV, are often exposed to 10-100 times as many injections. An average of 95% of all injections are therapeutic, the majority of which were judged to be unnecessary. At least 50% of injections were unsafe in 14 of 19 countries (representing five developing world regions) for which data were available. Eighteen studies reported a convincing link between unsafe injections and the transmission of hepatitis B and C, HIV, Ebola and Lassa virus infections and malaria. Five studies attributed 20-80% of all new hepatitis B infections to unsafe injections, while three implicated unsafe injections as a major mode of transmission of hepatitis C. In conclusion, unsafe injections occur routinely in most developing world regions, implying a significant potential for the transmission of any bloodborne pathogen. Unsafe injections currently account for a significant proportion of all new hepatitis B and C infections. This situation needs to be addressed immediately, as a political and policy issue, with responsibilities clearly defined at the global, country and community levels. PMID:10593026

Disposal of children's stools and its association with childhood diarrhea in India.

PubMed

Bawankule, Rahul; Singh, Abhishek; Kumar, Kaushalendra; Pedgaonkar, Sarang

2017-01-05

Children's stool disposal is often overlooked in sanitation programs of any country. Unsafe disposal of children's stool makes children susceptible to many diseases that transmit through faecal-oral route. Therefore, the study aims to examine the magnitude of unsafe disposal of children's stools in India, the factors associated with it and finally its association with childhood diarrhea. Data from the third round of the National Family Health Survey (NFHS-3) conducted in 2005-06 is used to carry out the analysis. The binary logistic regression model is used to examine the factors associated with unsafe disposal of children's stool. Binary logistic regression is also used to examine the association between unsafe disposal of children's stool and childhood diarrhea. Overall, stools of 79% of children in India were disposed of unsafely. The urban-rural gap in the unsafe disposal of children's stool was wide. Mother's illiteracy and lack of exposure to media, the age of the child, religion and caste/tribe of the household head, wealth index, access to toilet facility and urban-rural residence were statistically associated with unsafe disposal of stool. The odds of diarrhea in children whose stools were disposed of unsafely was estimated to be 11% higher (95% CI: 1.01-1.21) than that of children whose stools were disposed of safely. An increase in the unsafe disposal of children's stool in the community also increased the risk of diarrhea in children. We found significant statistical association between children's stool disposal and diarrhea. Therefore, gains in reduction of childhood diarrhea can be achieved in India through the complete elimination of unsafe disposal of children's stools. The sanitation programmes currently being run in India must also focus on safe disposal of children's stool.

Cognitive function and unsafe driving acts during an on-road test among community-dwelling older adults with cognitive impairments.

PubMed

Hotta, Ryo; Makizako, Hyuma; Doi, Takehiko; Tsutsumimoto, Kota; Nakakubo, Sho; Makino, Keitaro; Shimada, Hiroyuki

2018-02-19

To examine the relationship between cognitive function and unsafe driving acts among community-dwelling older adults with cognitive impairments. Participants (n = 160) were older residents of Obu, Japan, aged ≥65 years with cognitive impairments. They regularly drove and were assessed for the number of unsafe driving acts without adequate verification during an on-road test. We also evaluated cognitive function (attention, executive function and processing speed). Other examined variables included demographics, driving characteristics and visual condition. Participants were classified into two groups according to the number of unsafe driving acts as follows: high group (≥4 unsafe driving acts) and low group (≤3 unsafe driving acts). The high group participants were older in age (P < 0.001) and obtained a lower score on the symbol digit substitution task (P = 0.002) than the low group. The number of unsafe driving acts showed modest significant positive correlations with age (r = 0.396, P < 0.001). The symbol digit substitution task score was significantly associated with the number of unsafe driving acts (β = -0.196, P < 0.05) after adjusting for age group. Processing speed was associated with unsafe driving acts that became worse with increasing age. Future study will be required to longitudinally examine the influence of processing speed on traffic accidents for those with cognitive impairments. Geriatr Gerontol Int 2018; ••: ••-••. © 2018 Japan Geriatrics Society.

Drivers' social-work relationships as antecedents of unsafe driving: A social network perspective.

PubMed

Arizon Peretz, Renana; Luria, Gil

2017-09-01

In order to reduce road accidents rates, studies around the globe have attempted to shed light on the antecedents for unsafe road behaviors. The aim of the current research is to contribute to this literature by offering a new organizational antecedent of driver's unsafe behavior: The driver's relationships with his or her peers, as reflected in three types of social networks: negative relationships network, friendship networks and advice networks (safety consulting). We hypothesized that a driver's position in negative relationship networks, friendship networks, and advice networks will predict unsafe driving. Additionally, we hypothesized the existence of mutual influences among the driver's positions in these various networks, and suggested that the driver's positions interact to predict unsafe driving behaviors. The research included 83 professional drivers from four different organizations. Driving behavior data were gathered via the IVDR (In-Vehicle Data Recorder) system, installed in every truck to measure and record the driver's behavior. The findings indicated that the drivers' position in the team networks predicts safe driving behavior: Centrality in negative relationship networks is positively related to unsafe driving, and centrality in friendship networks is negatively related to unsafe driving, while centrality in advice networks is not related to unsafe driving. Furthermore, we found an interaction effect between negative network centrality and centrality in friendship networks. The relation between negative networks and unsafe behavior is weaker when high levels of friendship network centrality exist. The implications will be presented in the Discussion section. Copyright © 2017 Elsevier Ltd. All rights reserved.

Effects of human and organizational deficiencies on workers'safety behavior in a mining site in Iran.

PubMed

Mirzaei Aliabadi, Mostafa; Aghaei, Hamed; Kalatpour, Omid; Soltanian, Ali Reza; SeyedTabib, Maryam

2018-05-18

Mines are a dangerous workplace worldwide with a high accident rate. According to the Statistical Center of Iran, the number of occupational accidents in Iranian mines has increased in recent years. This study determined and explained human and organizational deficiencies influencing Iranian mining accidents. In this study, the data associated with 305 mining accidents were investigated. The data were analyzed based on a systems analysis approach to identify critical deficiencies in organizational influences, unsafe supervision, preconditions for unsafe acts, and workers' unsafe acts. Partial Least Square Structural Equation Modeling [PLS-SEM] was utilized for modeling the interactions between these deficiencies. It was demonstrated that organizational deficiencies had a direct positive effect on workers' violations (path coefficient=0.16) and workers' errors (path coefficient=0.23). The effect of unsafe supervision on workers' violations and workers' errors was also significant with the path coefficients of 0.14 and 0.20. Likewise, preconditions for unsafe acts also had a significant effect on both workers' violations (path coefficient=0.16) and workers' errors (path coefficient=0.21). Moreover, organizational deficiencies had an indirect positive effect on workers' unsafe acts mediated by unsafe supervision and preconditions for unsafe acts. Among the variables examined in the current study, organizational influences had the strongest impacts on workers' unsafe acts. Organizational deficiencies are the main causes of accidents in mining sectors that affects all other aspects of system safety. For preventing occupational accidents, organizational deficiencies should be modified first.

Beyond "getting drugs into bodies": social science perspectives on pre-exposure prophylaxis for HIV.

PubMed

Auerbach, Judith D; Hoppe, Trevor A

2015-01-01

Social scientists have much to contribute to the analysis of the real and potential contribution of pre-exposure prophylaxis (PrEP) to HIV prevention around the world. Beyond just a matter of clinical efficacy and getting pills into people's mouths, PrEP raises a number of important social-psychological questions that must be attended to in order to translate biomedical and clinical findings into uptake of PrEP among enough people at risk of HIV infection to produce population-level effectiveness. PrEP is a dynamic phenomenon with "dialectical" attributes that invite both optimism and cynicism as a desirable and effective HIV prevention strategy. PrEP disrupts traditional notions of "safe" and "unsafe" sex; it confers on its users a level of agency and control not generally achieved with condoms; and it affects sexual practices and sexual cultures in meaningful ways. As these dynamics play out in different contexts, and as new modes of PrEP administration emerge, it will be important for social scientists to be engaged in assessing their impact on PrEP implementation and effectiveness.

Estimating the number of secondary Ebola cases resulting from an unsafe burial and risk factors for transmission during the West Africa Ebola epidemic

PubMed Central

Dalziel, Benjamin D.; Kagume Njenge, Hilary; Johnson, Ginger; Nugba Ballah, Roselyn; James, Daniel; Wone, Abdoulaye; Bedford, Juliet; McClelland, Amanda

2017-01-01

Background Safely burying Ebola infected individuals is acknowledged to be important for controlling Ebola epidemics and was a major component of the 2013–2016 West Africa Ebola response. Yet, in order to understand the impact of safe burial programs it is necessary to elucidate the role of unsafe burials in sustaining chains of Ebola transmission and how the risk posed by activities surrounding unsafe burials, including care provided at home prior to death, vary with human behavior and geography. Methodology/Principal findings Interviews with next of kin and community members were carried out for unsafe burials in Sierra Leone, Liberia and Guinea, in six districts where the Red Cross was responsible for safe and dignified burials (SDB). Districts were randomly selected from a district-specific sampling frame comprised of villages and neighborhoods that had experienced cases of Ebola. An average of 2.58 secondary cases were potentially generated per unsafe burial and varied by district (range: 0–20). Contact before and after death was reported for 142 (46%) contacts. Caregivers of a primary case were 2.63 to 5.92 times more likely to become EVD infected compared to those with post-mortem contact only. Using these estimates, the Red Cross SDB program potentially averted between 1,411 and 10,452 secondary EVD cases, reducing the epidemic by 4.9% to 36.5%. Conclusions/Significance SDB is a fundamental control measure that limits community transmission of Ebola; however, for those individuals having contact before and after death, it was impossible to ascertain the exposure that caused their infection. The number of infections prevented through SDB is significant, yet greater impact would be achieved by early hospitalization of the primary case during acute illness. PMID:28640823

IPPF's strategic vision 2000.

PubMed

Mahler, H

1994-09-01

The International Planned Parenthood Federation (IPPF) supports the objectives of the International Conference on Population and Development. The draft conference document displays the linkages between women's rights, poverty, population, and sustainable development. In the next two to three decades the global population will grow by a staggering 50% and that reality requires sustained socioeconomic growth. The 6 components of IPPF's Strategic Vision 2000 and the action agenda for meeting these challenges are as follows: 1) The small family is rapidly becoming the cultural norm everywhere, as more than 60% of all fertile women and men are using safe and effective contraceptive methods. 2) Sexual and reproductive health is becoming an integral part of the physical, mental, and social health culture and not just the absence of pregnancy, disease or injury. The members of IPPF have been developing programs concentrating on adolescent sexuality. IPPF is also concerned about HIV, AIDS and sexually transmitted diseases as they relate to the work undertaken by family planning associations. 3) The quality of care has been heightened by the right of informed choice, service sustainability, and the maintenance of the highest standards. 4) Vigorous programs are in place to eliminate unsafe abortion and to increase access to safe abortion. 5) Young people are systematically supported to give voice to the need for understanding their sexuality and services. There are currently more than 500 million young women and men between the ages of 15 and 19, and their numbers increase for a long time to come. 6) Women are fast moving towards full participation in all aspects of local and global development demanding reproductive rights. IPPF and its associations, through Vision 2000, are committed to the objective of sexual and reproductive health at the national and international levels.

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).

77 FR 16907 - Special Conditions: Embraer S.A., Model EMB 505; Inflatable Side-Facing Seat Three-Point...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-03-23

... inflatable portion of the restraint system will rely on sensors to electronically activate the inflator for... inflatable restraint system relies on sensors to electronically activate the inflator for deployment. These sensors could be susceptible to inadvertent activation, causing deployment in a potentially unsafe manner...

Women and substance use: a qualitative study on sexual and reproductive health of women who use drugs in Delhi, India.

PubMed

Sharma, Vartika; Sarna, Avina; Tun, Waimar; Saraswati, Lopamudra Ray; Thior, Ibou; Madan, Ira; Luchters, Stanley

2017-11-19

To explore contextual factors that increase vulnerabilities to negative sexual and reproductive health (SRH) outcomes and possible differences in SRH-related behaviours and the needs of women who use drugs (WUD) through non-injecting and injecting routes. Qualitative study design using semi-structured in-depth interviews. Twenty women who injected drugs in the past 3 months and 28 women who reported using drugs through non-injecting routes in the past 1 month. Interviews were conducted at community-based, drop-in centres in Delhi, India. Study findings illustrate that WUD were sexually active and had multiple sex partners including clients of sex work. Transient relationships were reported and many participants engaged in unsafe sex. Factors which affected safe sex behaviours included: gender power imbalance, limited agency for decision-making, lack of accurate information for correct self-risk assessment, and being under the influence of drugs. Despite high awareness, low and inconsistent contraceptive use was reported. Some participants were coerced to conceive while a few others reported their inability to conceive. Violence was a key determinant for SRH outcomes. Perception of certain adverse health outcomes (such as infertility) to be 'common and expected among WUD' influenced access to healthcare. Further, healthcare providers' stigmatising attitudes and lack of women-centric services deterred women from uptake of healthcare services. Findings highlight that SRH-related behaviours and needs of this group are a complex interplay of multiple determinants which need to be addressed at all levels: individual, family, community and institutional. It is imperative to roll out a 'one-stop-shop' for a comprehensive package of health services. Expansion of existing drop-in-centres could be considered for setting-up community-based women-centric services with appropriate linkage to drug dependence treatment and reproductive health services. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Women and substance use: a qualitative study on sexual and reproductive health of women who use drugs in Delhi, India

PubMed Central

Sharma, Vartika; Sarna, Avina; Tun, Waimar; Saraswati, Lopamudra Ray; Thior, Ibou; Madan, Ira; Luchters, Stanley

2017-01-01

Objectives To explore contextual factors that increase vulnerabilities to negative sexual and reproductive health (SRH) outcomes and possible differences in SRH-related behaviours and the needs of women who use drugs (WUD) through non-injecting and injecting routes. Design Qualitative study design using semi-structured in-depth interviews. Participants Twenty women who injected drugs in the past 3 months and 28 women who reported using drugs through non-injecting routes in the past 1 month. Setting Interviews were conducted at community-based, drop-in centres in Delhi, India. Results Study findings illustrate that WUD were sexually active and had multiple sex partners including clients of sex work. Transient relationships were reported and many participants engaged in unsafe sex. Factors which affected safe sex behaviours included: gender power imbalance, limited agency for decision-making, lack of accurate information for correct self-risk assessment, and being under the influence of drugs. Despite high awareness, low and inconsistent contraceptive use was reported. Some participants were coerced to conceive while a few others reported their inability to conceive. Violence was a key determinant for SRH outcomes. Perception of certain adverse health outcomes (such as infertility) to be ‘common and expected among WUD’ influenced access to healthcare. Further, healthcare providers’ stigmatising attitudes and lack of women-centric services deterred women from uptake of healthcare services. Conclusion Findings highlight that SRH-related behaviours and needs of this group are a complex interplay of multiple determinants which need to be addressed at all levels: individual, family, community and institutional. It is imperative to roll out a ‘one-stop-shop’ for a comprehensive package of health services. Expansion of existing drop-in-centres could be considered for setting-up community-based women-centric services with appropriate linkage to drug dependence treatment and reproductive health services. PMID:29158326

The individual level cost of pregnancy termination in Zambia: a comparison of safe and unsafe abortion.

PubMed

Leone, Tiziana; Coast, Ernestina; Parmar, Divya; Vwalika, Bellington

2016-09-01

Zambia has one of the most liberal abortion laws in sub-Saharan Africa. However, rates of unsafe abortion remain high with negative health and economic consequences. Little is known about the economic burden on women of abortion care-seeking in low income countries. The majority of studies focus on direct costs (e.g. hospital fees). This article estimates the individual-level economic burden of safe and unsafe abortion care-seeking in Zambia, incorporating all indirect and direct costs. It uses data collected in 2013 from a tertiary hospital in Lusaka, (n = 112) with women who had an abortion. Three treatment routes are identified: (1) safe abortion at the hospital, (2) unsafe clandestine medical abortion initiated elsewhere with post-abortion care at the hospital and (3) unsafe abortion initiated elsewhere with post-abortion care at the hospital. Based on these three typologies, we use descriptive analysis and linear regression to estimate the costs for women of seeking safe and unsafe abortion and to establish whether the burden of abortion care-seeking costs is equally distributed across the sample. Around 39% of women had an unsafe abortion, incurring substantial economic costs before seeking post-abortion care. Adolescents and poorer women are more likely to use unsafe abortion. Unsafe abortion requiring post-abortion care costs women 27% more than a safe abortion. When accounting for uncertainty this figure increases dramatically. For safe and unsafe abortions, unofficial provider payments represent a major cost to women.This study demonstrates that despite a liberal legislation, Zambia still needs better dissemination of the law to women and providers and resources to ensure abortion service access. The policy implications of this study include: the role of pharmacists and mid-level providers in the provision of medical abortion services; increased access to contraception, especially for adolescents; and elimination of demands for unofficial provider payments. © The Author 2016. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

46 CFR 169.257 - Unsafe practices.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 46 Shipping 7 2011-10-01 2011-10-01 false Unsafe practices. 169.257 Section 169.257 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) NAUTICAL SCHOOLS SAILING SCHOOL VESSELS Inspection and Certification Inspections § 169.257 Unsafe practices. (a) At each inspection for certification...

46 CFR 169.257 - Unsafe practices.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 46 Shipping 7 2010-10-01 2010-10-01 false Unsafe practices. 169.257 Section 169.257 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) NAUTICAL SCHOOLS SAILING SCHOOL VESSELS Inspection and Certification Inspections § 169.257 Unsafe practices. (a) At each inspection for certification...

Unintended pregnancy and abortion in Uganda.

PubMed

Hussain, Rubina

2013-01-01

Unintended pregnancy is common in Uganda, leading to high levels of unplanned births, unsafe abortions, and maternal injury and death. Because most pregnancies that end in abortion are unwanted, nearly all ill health and mortality resulting from unsafe abortion is preventable. This report summarizes evidence on the context and consequences of unintended pregnancy and unsafe abortion in Uganda, points out gaps in knowledge, and highlights steps that can be taken to reduce levels of unintended pregnancy and unsafe abortion, and, in turn, the high level of maternal mortality.

Unintended pregnancy and unsafe abortion in the Philippines: context and consequences.

PubMed

Hussain, Rubina; Finer, Lawrence B

2013-04-01

Despite advances in reproductive health law, many Filipino women experience unintended pregnancies, and because abortion is highly stigmatized in the country, many who seek abortion undergo unsafe procedures. This report provides a summary of reproductive health indicators in the Philippines—in particular, levels of contraceptive use, unplanned pregnancy and unsafe abortion—and describes the sociopolitical context in which services are provided, the consequences of unintended pregnancy and unsafe abortion,and recommendations for improving access to reproductive health services.

Alcohol use and HIV sexual risk among MSM in Chennai, India

PubMed Central

Mimiaga, M J; Thomas, B; Mayer, K H; Reisner, S L; Menon, S; Swaminathan, S; Periyasamy, M; Johnson, C V; Safren, S A

2013-01-01

Summary Men who have sex with men (MSM) in India are a core risk group for HIV. Heavy alcohol consumption is associated with increased sexual risk-taking behaviours in many cultures, in particular among MSM. However, no studies to date have explored alcohol use and HIV risk among MSM in India. MSM in Chennai, India (n = 210) completed an interviewer-administered behavioural and psychosocial assessment. Bivariate and multivariable logistic regression procedures examined behavioural and demographic associations with weekly alcohol consumption. Twenty-eight percent of the sample (n = 58) reported using alcohol at least weekly to the point of being buzzed/intoxicated, which was associated with older age, being married to a woman, being panthi (masculine appearing, predominantly insertive partners) versus kothi (feminine acting/appearing and predominantly receptive partners), weekly tobacco use, unprotected anal sex and unprotected vaginal sex in the three months prior to study enrolment (all P < 0.05). In a multivariable model, unprotected vaginal sex in the previous three months and being married to a women were unique variables associated with weekly alcohol use (all P < 0.01). Further investigation of alcohol use within the context of sexual risk taking is warranted among Indian MSM. Panthis and MSM who are married to women may be particularly likely to benefit from interventions to decrease alcohol intake and concurrent unsafe sex. PMID:21464447

Project STYLE: a multisite RCT for HIV prevention among youths in mental health treatment.

PubMed

Brown, Larry K; Hadley, Wendy; Donenberg, Geri R; DiClemente, Ralph J; Lescano, Celia; Lang, Delia M; Crosby, Richard; Barker, David; Oster, Danielle

2014-03-01

The study examined the efficacy of family-based and adolescent-only HIV prevention programs in decreasing HIV risk and improving parental monitoring and sexual communication among youths in mental health treatment. A randomized controlled trial (RCT) with 721 adolescents (ages 13-18 years) and their caregivers from mental health settings in three U.S. cities were randomly assigned to one of three theory-based, structured group interventions: family-based HIV prevention, adolescent-only HIV prevention, and adolescent-only health promotion. Interventions were delivered during an all-day workshop. Assessments were completed at baseline and three months postintervention. Compared with those in the health intervention, adolescents in the HIV prevention interventions reported fewer unsafe sex acts (adjusted rate ratio=.49, p=.01), greater condom use (adjusted relative change=59%, p=.01), and greater likelihood of avoiding sex (adjusted odds ratio=1.44, p=.05). They also showed improved HIV knowledge (p<.01) and self-efficacy (p<.05). The family-based intervention, compared with the other interventions, produced significant improvements in parent-teen sexual communication (p<.01), parental monitoring (p<.01), and parental permissiveness (p=.05). This RCT found that the HIV prevention interventions reduced sexual risk behavior over three months in a large, diverse sample of youths in mental health treatment and that the family-based intervention improved parental monitoring and communication with teens about sex. These interventions show promise.

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.

Women and AIDS.

PubMed

Seghal, P N

1991-04-01

In this article, Dr. P.N. Sehgal, former director of the National Institute of Communicable Diseases in Delhi, explains the steps that women need to take to protect themselves against AIDS and discusses some issues facing women who have already contracted the disease. Because of women's lack of status in the family and society, it is harder for them to ensure their safety. Women based at home often lack information on AIDS, and those women who are informed sometimes depend on their male partner for financial support, which means that they are forced to engage in unsafe sexual practices. Safer sexual practices can reduce the risk for women. Though varying in degree of safety, some safer practices include: monogamous relationships between uninfected partners; the use of condoms for all types of sexual intercourse; non-penetrative sex practices (hugging, kissing, masturbating); reducing the number of sexual partners; avoiding sex when either of the partners has open sores or any STD. Pregnant women should also receive information concerning AIDS, including: a baby born from an HIV-infected mother has a 20-40% of being infected; the risk of transmission is higher when the mother already shows signs of AIDS; and an infected baby may die within the first few years of life. the HIV transmission may occur prepartum or during birth itself, but the risk of transmission from breastfeeding is extremely low. Dr. Sehgal stresses the need for privacy and confidentiality when dealing with carriers of the disease or when carrying out HIV testing. Above all, the rights of HIV-infected people must be protected.

[Evaluation of the theatre play Have Courage! A powerful play about feelings, boundaries and trust in the frame of the national campaign for the prevention of child sexual abuse].

PubMed

Firnges, Christiane; Amann, Stefanie

2016-01-01

This article reports on the evaluation of the effectiveness of a school-based preventive theatre play. The play is part of a national campaign for the prevention of child sexual abuse called Trau dich! (Have courage!). A total of 639 students in third to sixth grade from Schleswig-Holstein and Saxony participated in the study. Scenarios in the play imparted prevention messages and self-protective skills regarding situations of sexual assault or abuse, targeting children aged 8 to 12. Acquisition of knowledge about access to help systems and children's rights were measured pre- and post viewing as well as at a follow-up point two to six months later. Children estimated their competences regarding sensibility, sensing/setting boundaries, social support/to entrust oneself to somebody and knowledge. Based on cognitive empathy, children suggested self-protective skills for situations of conflict. The theatre play contributed to the acquisition of knowledge and an increase of children's self-assessed knowledge and competences. They estimated their competences of distinguishing between good and bad secrets, safe and unsafe touching, and disclosing oneself to somebody; their suggestions for self-protective skills improved compared to baseline data. The effects were still present at follow-up. Girls estimated their competences and self-protective skills to have improved more than boys. Measured negative effects were only temporary. The results indicate that the interactive educative theatre play contributed effectively to the prevention of child sexual abuse through imparting knowledge, self-protective skills, and sensitization.

Sexual risk behavior and viremia among men who have sex with men in the HIV Outpatient Study, United States, 2007-2010.

PubMed

Durham, Marcus D; Buchacz, Kate; Richardson, Jim; Yang, DerShung; Wood, Kathy; Yangco, Bienvenido; Brooks, John T

2013-07-01

Recent US data on unsafe sexual behaviors among viremic HIV-infected men who have sex with men (MSM) are limited. Using data abstracted from medical records of the participants in the HIV Outpatient Study (HOPS) and a supplemental behavioral survey, we assessed the frequency of high-risk sexual practices among HIV-infected MSM in care and examined the factors associated with risky sexual practices. We also compared the frequency of unprotected anal sex (UAS) with HIV-negative or unknown serostatus partners among viremic (HIV viral load ≥400 copies per milliliter) vs virologically suppressed (HIV viral load <400 copies per milliliter) MSM. Among 902 HIV-infected MSM surveyed, 704 (78%) reported having sex in the past 6 months, of whom 54% reported UAS (37% insertive, 42% receptive) and 40% UAS with a male partner who was HIV-negative or of unknown serostatus (24% insertive, 31% receptive). In multivariable regression with an outcome of engaging in any UAS with a male partner who was HIV-negative or of unknown serostatus, MSM aged <50 years, who reported injection drug use risk, had ≥2 sex partners, and who disclosed their HIV status to some but not to all of their sex partners were more likely to report this practice. Among MSM who reported any UAS, 15% were viremic; frequency of the UAS did not differ between viremic and virologically suppressed MSM. The high frequency of UAS with HIV-negative or unknown-status partners among HIV-infected MSM in care suggests the need for targeted prevention strategies for this population.

HIV risk practices sought by men who have sex with other men, and who use internet websites to identify potential sexual partners.

PubMed

Klein, Hugh

2008-09-01

Men who have sex with men (MSM) account for the largest number of persons diagnosed with AIDS in the USA, with higher than average rates of drug use and unprotected sex being cited as the principal reasons underlying their high rates of HIV infection. Recent evidence has suggested that the use of websites specifically designed to promote unsafe sexual practices may be particularly common among MSM, thereby fostering their risky behaviours. In light of these findings, the present study is based on a content analysis of 1316 ads/profiles posted on one of the most popular MSM websites that specifically fosters unprotected sex. Ads/profiles were selected randomly based on the American ZIP code of residence. Data were collected between September 2006 and January 2007. Rates of advertised for high-risk sexual behaviours were very high, particularly for oral sex involving ejaculation into the mouth (88.0% for receptive oral sex, 77.4% for insertive oral sex), anal sex involving ejaculation into the anus (79.7% for insertive anal sex, 69.4% for receptive anal sex), multiple partner sex (77.9%) and felching (16.5%). A multivariate analysis of the correlates of sexual risk preferences identified seven factors that were related to a propensity towards enhanced sexual risk: younger age (beta = 0.12, P = 0.0001), not being African American (beta = 0.05, P = 0.0341), self-identification as a sexual 'bottom' (beta = 0.20, P = 0.0001), not caring about one's potential sex partners' HIV serostatus (beta = 0.15, P = 0.0001), preferring to have sex while under the influence of drugs (beta = 0.08, P = 0.0022), a greater involvement in and commitment to the use of the website to locate potential unprotected sex partners (beta = 0.16, P = 0.0001) and not being HIV-negative (beta = 0.08, P = 0.0081). The HIV intervention-related implications of these findings are discussed.

Use of AUDIT, and measures of drinking frequency and patterns to detect associations between alcohol and sexual behaviour in male sex workers in Kenya.

PubMed

Luchters, Stanley; Geibel, Scott; Syengo, Masila; Lango, Daniel; King'ola, Nzioki; Temmerman, Marleen; Chersich, Matthew F

2011-05-25

Previous research has linked alcohol use with an increased number of sexual partners, inconsistent condom use and a raised incidence of sexually transmitted infections (STIs). However, alcohol measures have been poorly standardised, with many ill-suited to eliciting, with adequate precision, the relationship between alcohol use and sexual risk behaviour. This study investigates which alcohol indicator--single-item measures of frequency and patterns of drinking ( > = 6 drinks on 1 occasion), or the Alcohol Use Disorders Identification Test (AUDIT)--can detect associations between alcohol use and unsafe sexual behaviour among male sex workers. A cross-sectional survey in 2008 recruited male sex workers who sell sex to men from 65 venues in Mombasa district, Kenya, similar to a 2006 survey. Information was collected on socio-demographics, substance use, sexual behaviour, violence and STI symptoms. Multivariate models examined associations between the three measures of alcohol use and condom use, sexual violence, and penile or anal discharge. The 442 participants reported a median 2 clients/week (IQR = 1-3), with half using condoms consistently in the last 30 days. Of the approximately 70% of men who drink alcohol, half (50.5%) drink two or more times a week. Binge drinking was common (38.9%). As defined by AUDIT, 35% of participants who drink had hazardous drinking, 15% harmful drinking and 21% alcohol dependence. Compared with abstinence, alcohol dependence was associated with inconsistent condom use (AOR = 2.5, 95%CI = 1.3-4.6), penile or anal discharge (AOR = 1.9, 95%CI = 1.0-3.8), and two-fold higher odds of sexual violence (AOR = 2.0, 95%CI = 0.9-4.9). Frequent drinking was associated with inconsistent condom use (AOR = 1.8, 95%CI = 1.1-3.0) and partner number, while binge drinking was only linked with inconsistent condom use (AOR = 1.6, 95%CI = 1.0-2.5). Male sex workers have high levels of hazardous and harmful drinking, and require alcohol-reduction interventions. Compared with indicators of drinking frequency or pattern, the AUDIT measure has stronger associations with inconsistent condom use, STI symptoms and sexual violence. Increased use of the AUDIT tool in future studies may assist in delineating with greater precision the explanatory mechanisms which link alcohol use, drinking contexts, sexual behaviours and HIV transmission.

Maternal Near-Miss Due to Unsafe Abortion and Associated Short-Term Health and Socio-Economic Consequences in Nigeria

PubMed Central

Prada, Elena; Bankole, Akinrinola; Oladapo, Olufemi T.; Awolude, Olutosin A.; Adewole, Isaac F.; Onda, Tsuyoshi

2016-01-01

Little is known about maternal near-miss (MNM) due to unsafe abortion in Nigeria. We used the WHO criteria to identify near-miss events and the proportion due to unsafe abortion among women of childbearing age in eight large secondary and tertiary hospitals across the six geo-political zones. We also explored the characteristics of women with these events, delays in seeking care and the short-term socioeconomic and health impacts on women and their families. Between July 2011 and January 2012, 137 MNM cases were identified of which 13 or 9.5% were due to unsafe abortions. Severe bleeding, pain and fever were the most common immediate abortion complications. On average, treatment of MNM due to abortion costs six times more than induced abortion procedures. Unsafe abortion and delays in care seeking are important contributors to MNM. Programs to prevent unsafe abortion and delays in seeking postabortion care are urgently needed to reduce abortion related MNM in Nigeria. PMID:26506658

Maternal Near-Miss Due to Unsafe Abortion and Associated Short-Term Health and Socio-Economic Consequences in Nigeria.

PubMed

Prada, Elena; Bankole, Akinrinola; Oladapo, Olufemi T; Awolude, Olutosin A; Adewole, Isaac F; Onda, Tsuyoshi

2015-06-01

Little is known about maternal near-miss (MNM) due to unsafe abortion in Nigeria. We used the WHO criteria to identify near-miss events and the proportion due to unsafe abortion among women of childbearing age in eight large secondary and tertiary hospitals across the six geo-political zones. We also explored the characteristics of women with these events, delays in seeking care and the short-term socioeconomic and health impacts on women and their families. Between July 2011 and January 2012, 137 MNM cases were identified of which 13 or 9.5% were due to unsafe abortions. Severe bleeding, pain and fever were the most common immediate abortion complications. On average, treatment of MNM due to abortion costs six times more than induced abortion procedures. Unsafe abortion and delays in care seeking are important contributors to MNM. Programs to prevent unsafe abortion and delays in seeking postabortion care are urgently needed to reduce abortion related MNM in Nigeria.

Induced abortion among Brazilian female sex workers: a qualitative study.

PubMed

Madeiro, Alberto Pereira; Diniz, Debora

2015-02-01

Prostitutes are vulnerable to unplanned pregnancies and abortions. In Brazil, abortion is a crime and there is no data about unsafe abortions for this population. The study describes how prostitutes perform illegal abortions and the health consequences thereof. Semi-structured interviews with 39 prostitutes from three cities in Brazil with previous induced abortion experience were conducted. Sixty-six abortions, with between one and eight occurrences per woman, were recorded. The majority of the cases resulted from sexual activity with clients. The inconsistent use of condoms with regular clients and the consumption of alcohol during work were indicated as the main causes of unplanned pregnancies. The main method to perform abortion was the intravaginal and oral use of misoprostol, acquired in pharmacies or on the black market. Invasive measures were less frequently reported, however with more serious health complications. The fear of complaint to the police meant that most women do not inform the health team regarding induced abortion. The majority of prostitutes aborted with the use of illegally-acquired misoprostol, ending abortion in a public hospital with infection and hemorrhagic complications. The data indicate the need for a public policy focusing on the reproductive health of prostitutes.

Triangular Assessment of the Etiology of Induced Abortion in Iran: A Qualitative Study

PubMed Central

Motaghi, Zahra; Keramat, Afsaneh; Shariati, Mohammad; Yunesian, Masud

2013-01-01

Background About 46 million induced abortions occur in the world annually. The studies have reported 80000 cases of induced abortions in Iran annually. Objectives This qualitative study was conducted to identify the causes of unsafe abortion in Iran from the standpoint of three groups of experts, women with a history of abortion or unwanted pregnancy and service providers. Patients and Methods A total of 72 in-depth semi structured interviews were conducted in 2012 in Tehran and Shahroud. After coordination with 8 experts, sampling from them was done using the Snowballing method in their offices. Sampling from 28 married and 10 engaged women with a history of unwanted pregnancy or unsafe abortion and 12 providers was done in health care centers and a in number of gynecologists’ and midwives’ offices. Sampling from women with a history of unwanted pregnancy or unsafe abortion such as single women, HIV positive women and drug users, and women who had sexual intercourse for money was started by referring to the social rehabilitation center for women and continued using the snowballing method due to difficulties in accessing them. Participants were from different ethnic groups including Fars, Gilaks, Mazandarani, Arab, Azerbaijani, and Lor. Content analysis was performed on collected data. Results Based on the results of the interviews, participants have abortion for following reasons: 1. Wanted pregnancy (sub categories: fetal abnormalities, Concern about fetal health and lack of trust to prenatal diagnostic methods, Fetal sex, Lack of independent and free decision making regarding pregnancy in women, 2. Unwanted pregnancy (sub-categories: Socio-economic factors, Beliefs and feelings, Lack of information about family planning) 3. Predisposing factors (sub-categories: Lack of information on religious aspects of abortion, Easy access to easy abortion methods). Some people, despite having unwanted pregnancy due to social, economic, cultural and family grounds, continued their pregnancy and did not have an abortion for the following reasons: Religious beliefs, Beliefs (fear of punishment in the afterlife and believing in fate) , Attachment to the unborn baby, Influence of the other people’s opinions (physician, mother or spouse) Late diagnosis of pregnancy, Unsuccessful abortion attempts (Self-treatment, Unsuccessful medical abortion), Economic weakness and arbitrary treatment. Conclusions In the present study, women who continued their pregnancy despite being unwanted were also interviewed. Although they had the same social, economic, cultural, and family problems as women with a history of unsafe abortion and had easy access to abortion, analysis showed that the difference in religious beliefs between the two groups was the most important factor that led women to choose two different approaches. The authors believe that in-depth analysis of people’s beliefs and opinions in this regard and correction of false beliefs plays a crucial role in decreasing the rate of unsafe abortion. PMID:24719694

Health services fail women who suffer unsafe abortion.

PubMed

1994-02-01

Physicians, medical schools, and health systems are failing, respectively, to provide the treatment, training, and facilities necessary for proper care of women suffering from the complications of unsafe abortions. Family planning services, also, are failing to reach the women at risk. Thousands of women are dying because of this. In some countries, unsafe abortions may account for as many as half of maternal deaths; however, due to social attitudes, information is hard to obtain. The report of the World Health Organization Technical Working Group on the Prevention and Management of Unsafe Abortion has been released. This report states that treatment of these complications should be extended throughout the health care system; more training and facilities, especially at the primary care level, are necessary; physicians should give higher priority to complications due to unsafe abortions; "punitive attitudes" or health care workers should not effect treatment; more research on the management of complications of unsafe abortions and on the use of contraception after abortion is necessary; family planning advice and assistance should be offered after treatment for complications; and family planning services should be designed with women's preferences in mind. The report also lists tests, treatments, and services necessary at primary care and first referral levels for women with complications from unsafe abortions.

Neuropsychological deficits associated with driving performance in Parkinson’s and Alzheimer’s disease

PubMed Central

GRACE, JANET; AMICK, MELISSA M.; D’ABREU, ANELYSSA; FESTA, ELENA K.; HEINDEL, WILLIAM C.; OTT, BRIAN R.

2012-01-01

Neuropsychological and motor deficits in Parkinson’s disease that may contribute to driving impairment were examined in a cohort study comparing patients with Parkinson’s disease (PD) to patients with Alzheimer’s disease (AD) and to healthy elderly controls. Nondemented individuals with Parkinson’s disease [Hoehn & Yahr (H&Y) stage I–III], patients with Alzheimer’s disease [Clinical Demetia Rating scale (CDR) range 0–1], and elderly controls, who were actively driving, completed a neuropsychological battery and a standardized road test administered by a professional driving instructor. On-road driving ability was rated on number of driving errors and a global rating of safe, marginal, or unsafe. Overall, Alzheimer’s patients were more impaired drivers than Parkinson’s patients. Parkinson’s patients distinguished themselves from other drivers by a head-turning deficiency. Drivers with neuropsychological impairment were more likely to be unsafe drivers in both disease groups compared to controls. Compared to controls, unsafe drivers with Alzheimer’s disease were impaired across all neuropsychological measures except finger tapping. Driving performance in Parkinson’s patients was related to disease severity (H&Y), neuropsychological measures [Rey Osterreith Complex Figure (ROCF), Trails B, Hopkins Verbal List Learning Test (HVLT)-delay], and specific motor symptoms (axial rigidity, postural instability), but not to the Unified Parkinson Disease Rating Scale (UPDRS) motor score. Multifactorial measures (ROCF, Trails B) were useful in distinguishing safe from unsafe drivers in both patient groups. PMID:16248912

Influence of Permissive Parenting on Youth Farm Risk Behaviors.

PubMed

Jinnah, Hamida A; Stoneman, Zolinda

2016-01-01

Farm youth continue to experience high rates of injuries and premature deaths as a result of agricultural activities. Increased parental permissiveness is positively associated with many different types of high-risk behaviors in youth. This study explored whether permissive parenting (fathering and mothering) predicts youth unsafe behaviors on the farm. Data were analyzed for 67 youth and their parents. Families were recruited from a statewide farm publication, through youth organizations (i.e., FFA [Future Farmers of America]), local newspapers, farmer referrals, and through the Cooperative Extension Network. Hierarchical multiple regression was completed. Results revealed that fathers and mothers who practiced lax-inconsistent disciplining were more likely to have youth who indulged in unsafe farm behaviors. Key hypotheses confirmed that permissive parenting (lax-inconsistent disciplining) by parents continued to predict youth unsafe farm behaviors, even after youth age, youth gender, youth personality factor of risk-taking, and father's unsafe behaviors (a measure associated with modeling) were all taken into account. A key implication is that parents may play an important role in influencing youth farm safety behaviors. Parents (especially fathers) need to devote time to discuss farm safety with their youth. Farm safety interventions need to involve parents as well as address and respect the culture and values of families. Interventions need to focus not only on safe farm practices, but also promote positive parenting practices, including increased parent-youth communication about safety, consistent disciplining strategies, and increased monitoring and modeling of safe farm behaviors by parents.

[Abortion and medical education in Mexico].

PubMed

de León-Aguirre, Deyanira González; Billings, Deborah L; Ramírez-Sánchez, Rubén

2008-01-01

Medical education in Mexico has significant deficiencies in the area of sexual and reproductive health and does not offer students the information needed for dealing with abortion as a relevant problem in the professional practice of medicine. Medical education does not offer options for the clinical training of future physicians in integrated models for abortion care, which include the use of safe and effective technologies as well as a range of services to respond to women's needs. These limitations are especially relevant in countries such as Mexico where unsafe abortion continues to be a significant public health problem. In addition, the legal context for abortion has begun to change during the current decade; therefore, the search for alternatives to incorporate a broad approach to abortion in medical school programs is a task that cannot be postponed.

Evolution of the global use of unsafe medical injections, 2000-2010.

PubMed

Pépin, Jacques; Abou Chakra, Claire Nour; Pépin, Eric; Nault, Vincent

2013-01-01

Since 1999, substantial efforts have been made by the international community to reduce the risks associated with unsafe injections, through ministries of health, international donors, the World Health Organization and the Safe Injection Global Network. The present study attempted to measure the progress, or lack thereof, made over the 2000-2010 decade in reducing unsafe injections in ten regions of the world corresponding to developing and transitional economies. Data about the number of injections per person per year and the proportion of re-use of syringes and needles were obtained for 2010, mainly from population surveys, and compared with previous estimates for 2000 which had used various sources of information including injection safety assessments, population surveys and published studies on injection practices. From 2000 to 2010, in developing countries and transitional economies, the average number of injections per person per year decreased from 3.40 to 2.88, while the proportion of re-use of injection devices dropped from 39.8% to 5.5%. Combining both factors the number of unsafe injections per person per year decreased from 1.35 to 0.16. Even if substantial progress has been made, the Eastern Mediterranean region remains problematic, with 0.57 unsafe injections per person per year. In sub-Saharan Africa and Latin America, people now receive on average only 0.04-0.05 unsafe injections per year. Substantial progress has been made in reducing the number of unsafe injections in developing countries and transitional economies, essentially through a reduction in the re-use of injection devices. In some regions, elimination of unsafe injections might become a reasonable goal.

49 CFR 453.1 - Unsafe and noncomplying containers subject to detention or control.

Code of Federal Regulations, 2011 CFR

2011-10-01

... (Continued) COAST GUARD, DEPARTMENT OF HOMELAND SECURITY SAFETY APPROVAL OF CARGO CONTAINERS CONTROL AND ENFORCEMENT § 453.1 Unsafe and noncomplying containers subject to detention or control. (a) Any container used... 49 Transportation 6 2011-10-01 2011-10-01 false Unsafe and noncomplying containers subject to...

49 CFR 453.1 - Unsafe and noncomplying containers subject to detention or control.

Code of Federal Regulations, 2010 CFR

2010-10-01

... (Continued) COAST GUARD, DEPARTMENT OF HOMELAND SECURITY SAFETY APPROVAL OF CARGO CONTAINERS CONTROL AND ENFORCEMENT § 453.1 Unsafe and noncomplying containers subject to detention or control. (a) Any container used... 49 Transportation 6 2010-10-01 2010-10-01 false Unsafe and noncomplying containers subject to...

49 CFR 453.1 - Unsafe and noncomplying containers subject to detention or control.

Code of Federal Regulations, 2013 CFR

2013-10-01

... (Continued) COAST GUARD, DEPARTMENT OF HOMELAND SECURITY SAFETY APPROVAL OF CARGO CONTAINERS CONTROL AND ENFORCEMENT § 453.1 Unsafe and noncomplying containers subject to detention or control. (a) Any container used... 49 Transportation 6 2013-10-01 2013-10-01 false Unsafe and noncomplying containers subject to...

49 CFR 453.1 - Unsafe and noncomplying containers subject to detention or control.

Code of Federal Regulations, 2014 CFR

2014-10-01

... (Continued) COAST GUARD, DEPARTMENT OF HOMELAND SECURITY SAFETY APPROVAL OF CARGO CONTAINERS CONTROL AND ENFORCEMENT § 453.1 Unsafe and noncomplying containers subject to detention or control. (a) Any container used... 49 Transportation 6 2014-10-01 2014-10-01 false Unsafe and noncomplying containers subject to...

49 CFR 453.1 - Unsafe and noncomplying containers subject to detention or control.

Code of Federal Regulations, 2012 CFR

2012-10-01

... (Continued) COAST GUARD, DEPARTMENT OF HOMELAND SECURITY SAFETY APPROVAL OF CARGO CONTAINERS CONTROL AND ENFORCEMENT § 453.1 Unsafe and noncomplying containers subject to detention or control. (a) Any container used... 49 Transportation 6 2012-10-01 2012-10-01 false Unsafe and noncomplying containers subject to...

46 CFR 109.419 - Report of unsafe machinery.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 46 Shipping 4 2014-10-01 2014-10-01 false Report of unsafe machinery. 109.419 Section 109.419 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) A-MOBILE OFFSHORE DRILLING UNITS OPERATIONS Reports, Notifications, and Records Reports and Notifications § 109.419 Report of unsafe machinery. If a boiler, unfired pressure vessel, or...

20 CFR 670.935 - How are students protected from unsafe or unhealthy situations?

Code of Federal Regulations, 2013 CFR

2013-04-01

... 20 Employees' Benefits 4 2013-04-01 2013-04-01 false How are students protected from unsafe or unhealthy situations? 670.935 Section 670.935 Employees' Benefits EMPLOYMENT AND TRAINING ADMINISTRATION... and Management Provisions § 670.935 How are students protected from unsafe or unhealthy situations? (a...

20 CFR 670.935 - How are students protected from unsafe or unhealthy situations?

Code of Federal Regulations, 2011 CFR

2011-04-01

... 20 Employees' Benefits 3 2011-04-01 2011-04-01 false How are students protected from unsafe or unhealthy situations? 670.935 Section 670.935 Employees' Benefits EMPLOYMENT AND TRAINING ADMINISTRATION... Provisions § 670.935 How are students protected from unsafe or unhealthy situations? (a) The Secretary...

20 CFR 670.935 - How are students protected from unsafe or unhealthy situations?

Code of Federal Regulations, 2014 CFR

2014-04-01

... 20 Employees' Benefits 4 2014-04-01 2014-04-01 false How are students protected from unsafe or unhealthy situations? 670.935 Section 670.935 Employees' Benefits EMPLOYMENT AND TRAINING ADMINISTRATION... and Management Provisions § 670.935 How are students protected from unsafe or unhealthy situations? (a...

20 CFR 670.935 - How are students protected from unsafe or unhealthy situations?

Code of Federal Regulations, 2012 CFR

2012-04-01

... 20 Employees' Benefits 4 2012-04-01 2012-04-01 false How are students protected from unsafe or unhealthy situations? 670.935 Section 670.935 Employees' Benefits EMPLOYMENT AND TRAINING ADMINISTRATION... and Management Provisions § 670.935 How are students protected from unsafe or unhealthy situations? (a...

Sex practices and awareness of Ebola virus disease among male survivors and their partners in Guinea

PubMed Central

Kondé, Mandy Kader; Diop, Moustapha Keita; Curtis, Marie Yvonne; Barry, Abdoulaye; Kouyaté, Saidou; Ghilardi, Ludovica; Kouyaté, Sékou; Diallo, Aissatou Malal; Magassouba, N’faly; Quick, Isadora; Keïta, Mory; Carroll, Miles W; Jansa, Josep

2017-01-01

Introduction Towards the end of the 2013–2016 West African outbreak, sexually-transmitted Ebola virus re-emerged from Ebola virus disease (EVD) survivors in all three hardest hit countries. We explore sex practices and awareness of the risk of Ebola virus transmission among EVD survivors and their partners. Methods In this cross-sectional study, we recruited a convenience sample of study participants aged >15 years who were male EVD survivors, their sexual partners and a comparison group. We administered a questionnaire to all respondents, estimated self-reported sexual practices and risk awareness and conducted in-depth interviews. Results We recruited 234 EVD survivors, 256 sexual partners of survivors and 65 individuals in the comparison group from five prefectures in Guinea. The prevalence of safe sexual behaviour (regular condom use or sexual abstinence >12 months) and regular condom use in EVD survivors was 38% (95% CI 31% to 44%) and 21% (95% CI 16% to 27%), respectively. Among partners, these prevalences were lower (11%, 95% CI 7% to 15% and 9%, 95% CI 5% to 12%, respectively). EVD survivors were more than five times as likely to engage in safe sexual behaviour compared with the comparison group (aOR 5.59, 95% CI 2.36 to 13.2). One-hundred and thirty one EVD survivors (57%) and 94 partners (37%) were aware of the risk of Ebola virus re-emergence associated with having unsafe sex. Partners who reported not being informed by their husband/boyfriend (EVD survivor) were more likely to be unaware of this risk (aOR 20.5, 95% CI 8.92 to 47.4). Conclusions We disclose here a need to improve knowledge of the disease and close the gap between knowledge and practice found in EVD survivors and their partners. Current and future survivors’ follow-up programmes should include partners and be more effective at communicating sex-related risks. Community-level fears and attitudes that enable stigmatisation should be addressed. Safe sex interventions targeting EVD survivors and their partners should be prioritised. PMID:29018586

12 CFR 584.2a - Exempt savings and loan holding companies and grandfathered activities.

Code of Federal Regulations, 2010 CFR

2010-01-01

..., unless such overdraft results from an inadvertent computer or accounting error that is beyond the control... determination that such action is necessary: (1) To prevent conflicts of interest; (2) To prevent unsafe or...

Use of traffic channelization devices at highway-rail grade crossings

DOT National Transportation Integrated Search

2012-08-31

Traffic channelization devices have found new application at highway-rail grade crossings with active warning devices. Numerous studies conducted at locations where they have been installed show positive changes in unsafe driver behavior as a result ...

Analysis 320 coal mine accidents using structural equation modeling with unsafe conditions of the rules and regulations as exogenous variables.

PubMed

Zhang, Yingyu; Shao, Wei; Zhang, Mengjia; Li, Hejun; Yin, Shijiu; Xu, Yingjun

2016-07-01

Mining has been historically considered as a naturally high-risk industry worldwide. Deaths caused by coal mine accidents are more than the sum of all other accidents in China. Statistics of 320 coal mine accidents in Shandong province show that all accidents contain indicators of "unsafe conditions of the rules and regulations" with a frequency of 1590, accounting for 74.3% of the total frequency of 2140. "Unsafe behaviors of the operator" is another important contributory factor, which mainly includes "operator error" and "venturing into dangerous places." A systems analysis approach was applied by using structural equation modeling (SEM) to examine the interactions between the contributory factors of coal mine accidents. The analysis of results leads to three conclusions. (i) "Unsafe conditions of the rules and regulations," affect the "unsafe behaviors of the operator," "unsafe conditions of the equipment," and "unsafe conditions of the environment." (ii) The three influencing factors of coal mine accidents (with the frequency of effect relation in descending order) are "lack of safety education and training," "rules and regulations of safety production responsibility," and "rules and regulations of supervision and inspection." (iii) The three influenced factors (with the frequency in descending order) of coal mine accidents are "venturing into dangerous places," "poor workplace environment," and "operator error." Copyright © 2016 Elsevier Ltd. All rights reserved.

Restructuring supervision and reconfiguration of skill mix in community pharmacy: Classification of perceived safety and risk.

PubMed

Bradley, Fay; Willis, Sarah C; Noyce, Peter R; Schafheutle, Ellen I

2016-01-01

Broadening the range of services provided through community pharmacy increases workloads for pharmacists that could be alleviated by reconfiguring roles within the pharmacy team. To examine pharmacists' and pharmacy technicians (PTs)' perceptions of how safe it would be for support staff to undertake a range of pharmacy activities during a pharmacist's absence. Views on supervision, support staff roles, competency and responsibility were also sought. Informed by nominal group discussions, a questionnaire was developed and distributed to a random sample of 1500 pharmacists and 1500 PTs registered in England. Whilst focused on community pharmacy practice, hospital pharmacy respondents were included, as more advanced skill mix models may provide valuable insights. Respondents were asked to rank a list of 22 pharmacy activities in terms of perceived risk and safety of these activities being performed by support staff during a pharmacist's absence. Descriptive and comparative statistic analyses were conducted. Six-hundred-and-forty-two pharmacists (43.2%) and 854 PTs (57.3%) responded; the majority worked in community pharmacy. Dependent on agreement levels with perceived safety, from community pharmacists and PTs, and hospital pharmacists and PTs, the 22 activities were grouped into 'safe' (n = 7), 'borderline' (n = 9) and 'unsafe' (n = 6). Activities such as assembly and labeling were considered 'safe,' clinical activities were considered 'unsafe.' There were clear differences between pharmacists and PTs, and sectors (community pharmacy vs. hospital). Community pharmacists were most cautious (particularly mobile and portfolio pharmacists) about which activities they felt support staff could safely perform; PTs in both sectors felt significantly more confident performing particularly technical activities than pharmacists. This paper presents novel empirical evidence informing the categorization of pharmacy activities into 'safe,' 'borderline' or 'unsafe.' 'Borderline' activities will deserve particular attention, especially where they are part of processes, e.g. dispensing. This categorization could help inform reconfiguration of skill mix in community pharmacy and thus make an important contribution to the rebalancing medicines legislation agenda and pharmacist supervision. Copyright © 2015 Elsevier Inc. All rights reserved.

49 CFR 234.303 - Emergency notification systems for telephonic reporting of unsafe conditions at highway-rail and...

Code of Federal Regulations, 2013 CFR

2013-10-01

... reporting of unsafe conditions at highway-rail and pathway grade crossings. 234.303 Section 234.303... at Highway-Rail and Pathway Grade Crossings § 234.303 Emergency notification systems for telephonic reporting of unsafe conditions at highway-rail and pathway grade crossings. (a) Duty of dispatching railroad...

49 CFR 234.303 - Emergency notification systems for telephonic reporting of unsafe conditions at highway-rail and...

Code of Federal Regulations, 2014 CFR

2014-10-01

... reporting of unsafe conditions at highway-rail and pathway grade crossings. 234.303 Section 234.303... at Highway-Rail and Pathway Grade Crossings § 234.303 Emergency notification systems for telephonic reporting of unsafe conditions at highway-rail and pathway grade crossings. (a) Duty of dispatching railroad...

49 CFR 234.303 - Emergency notification systems for telephonic reporting of unsafe conditions at highway-rail and...

Code of Federal Regulations, 2012 CFR

2012-10-01

... reporting of unsafe conditions at highway-rail and pathway grade crossings. 234.303 Section 234.303... at Highway-Rail and Pathway Grade Crossings § 234.303 Emergency notification systems for telephonic reporting of unsafe conditions at highway-rail and pathway grade crossings. (a) Duty of dispatching railroad...

Students Feeling Unsafe in School: Fifth Graders' Experiences

ERIC Educational Resources Information Center

Jacobson, Gloria; Riesch, Susan K.; Temkin, Barbara Myers; Kedrowski, Karen M.; Kluba, Nina

2011-01-01

Children of late elementary school age (fifth grade) provide evidence that many do not feel safe in their schools. The purpose of this study was to examine how children express their experiences of feeling unsafe in school. Questions guiding the study were What percentage of children in this sample report feeling unsafe at school? What are the…

12 CFR 563g.10 - Unsafe or unsound practices.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 12 Banks and Banking 5 2010-01-01 2010-01-01 false Unsafe or unsound practices. 563g.10 Section 563g.10 Banks and Banking OFFICE OF THRIFT SUPERVISION, DEPARTMENT OF THE TREASURY SECURITIES OFFERINGS § 563g.10 Unsafe or unsound practices. (a) No person shall directly or indirectly, (1) Employ any device...

Alcohol and marijuana use patterns associated with unsafe driving among U.S. high school seniors: high use frequency, concurrent use, and simultaneous use.

PubMed

Terry-McElrath, Yvonne M; O'Malley, Patrick M; Johnston, Lloyd D

2014-05-01

This article examines noncausal associations between high school seniors' alcohol and marijuana use status and rates of self-reported unsafe driving in the past 12 months. Analyses used data from 72,053 students collected through annual surveys of nationally representative cross-sectional samples of U.S. 12th-grade students from 1976 to 2011. Two aspects of past-12-month alcohol and marijuana use were examined: (a) use frequency and (b) status as a nonuser, single substance user, concurrent user, or simultaneous user. Measures of past-12-month unsafe driving included any tickets/warnings or accidents, as well as tickets/warnings or accidents following alcohol or marijuana use. Analyses explored whether an individual's substance use frequency and simultaneous use status had differential associations with their rate of unsafe driving. Higher substance use frequency (primarily alcohol use frequency) was significantly and positively associated with unsafe driving. The rate of engaging in any unsafe driving was also significantly and positively associated with simultaneous use status, with the highest rate associated with simultaneous use, followed by concurrent use, followed by use of alcohol alone. Individuals who reported simultaneous use most or every time they used marijuana had the highest likelihood of reporting unsafe driving following either alcohol or marijuana use. This article expands the knowledge on individual risk factors associated with unsafe driving among teens. Efforts to educate U.S. high school students (especially substance users), parents, and individuals involved in prevention programming and driver's education about the increased risks associated with various forms of drug use status may be useful.

Evolution of the Global Use of Unsafe Medical Injections, 2000–2010

PubMed Central

Pépin, Jacques; Abou Chakra, Claire Nour; Pépin, Eric; Nault, Vincent

2013-01-01

Objective Since 1999, substantial efforts have been made by the international community to reduce the risks associated with unsafe injections, through ministries of health, international donors, the World Health Organization and the Safe Injection Global Network. The present study attempted to measure the progress, or lack thereof, made over the 2000–2010 decade in reducing unsafe injections in ten regions of the world corresponding to developing and transitional economies. Methods Data about the number of injections per person per year and the proportion of re-use of syringes and needles were obtained for 2010, mainly from population surveys, and compared with previous estimates for 2000 which had used various sources of information including injection safety assessments, population surveys and published studies on injection practices. Results From 2000 to 2010, in developing countries and transitional economies, the average number of injections per person per year decreased from 3.40 to 2.88, while the proportion of re-use of injection devices dropped from 39.8% to 5.5%. Combining both factors the number of unsafe injections per person per year decreased from 1.35 to 0.16. Even if substantial progress has been made, the Eastern Mediterranean region remains problematic, with 0.57 unsafe injections per person per year. In sub-Saharan Africa and Latin America, people now receive on average only 0.04–0.05 unsafe injections per year. Conclusion Substantial progress has been made in reducing the number of unsafe injections in developing countries and transitional economies, essentially through a reduction in the re-use of injection devices. In some regions, elimination of unsafe injections might become a reasonable goal. PMID:24324650

Patients' identification and reporting of unsafe events at six hospitals in Japan.

PubMed

Hasegawa, Tomonori; Fujita, Shigeru; Seto, Kanako; Kitazawa, Takefumi; Matsumoto, Kunichika

2011-11-01

Hospitals and other health care organizations have increasingly recognized the need to engage patients as participants in patient safety. A study was conducted to compare patients' and health care staff's identification and reporting of such events. A questionnaire was administered at six hospitals in Japan to outpatients and inpatients from November 2004 through February 2007. Patients were asked to respond to questions about experiences of possibly unsafe events. Patients experiencing such events were then asked about the events and whether they had reported their experience to health care staff. A specialist panel classified reported events as "uneasy-dissatisfying" or "unsafe." The response rates of outpatients and inpatients were 85.4% (1,506/1,764) and 54.3% (1,738/3,198), respectively. Among the respondents (> or = 20 years of age), 125 (8.7%) of the outpatients and 185 (10.9%) of the inpatients experienced uneasy-dissatisfying or unsafe events; 35 (2.4%) of the outpatients and 67 (4.0%) of the inpatients experienced unsafe events, the percent increasing with hospital stay. Only 38 (30.4%) of the outpatients and 62 (33.5%) of the inpatients reported the unsafe events to health care staff Only 17.1% of unsafe events reported by inpatients were identified by the in-house reporting systems of adverse events and near misses. For the uneasy-dissatisfying or unsafe events that patients did not think necessary to report, the patients often felt they were self-evident or easily identifiable by health care staff, had difficulty evaluating the event, did not expect their report to bring any improvement, or even felt that reporting it would create some disadvantage in their medical treatment. Patient reporting programs and in-house reporting systems, among other detection methods, should be regarded as complementary sources of information.

Advocating for safe abortion in Rwanda: how young people and the personal stories of young women in prison brought about change.

PubMed

Umuhoza, Chantal; Oosters, Barbara; van Reeuwijk, Miranda; Vanwesenbeeck, Ine

2013-05-01

In June 2012, a new abortion law came into effect in Rwanda as part of a larger review of Rwanda's penal code. This was a significant step in a country where it was previously taboo even to discuss abortion. This article describes some of the crucial elements in how this success was achieved in Rwanda, which began through a project launched by Rutgers WPF on "sensitive issues in young people's sexuality" in several countries. This paper describes how the Rwandan Youth Action Movement decided to work on unsafe abortion as part of this project. They gathered data on the extent of unsafe abortion and testimonies of young Rwandan women in prison for abortions; organized debates, values clarification exercises, interviews and a survey in four universities; launched a petition for law reform; produced awareness-raising materials; worked with the media; and met with representatives from government ministries, the national women's and youth councils, and parliamentarians - all of which played a significant role in the advocacy process for amendment of the law, which was revised when the penal code came up for review in June 2012. This history shows how important the role of young people can be in producing change and exposes, through personal stories, the need for a better abortion law, not only in Rwanda but also elsewhere. Copyright © 2013 Reproductive Health Matters. Published by Elsevier Ltd. All rights reserved.

Women's injection drug practices in their own words: a qualitative study.

PubMed

Tuchman, Ellen

2015-03-07

There are significant gender differences in injection drug practices and relative risks involved for women who inject drug compared with men. This qualitative study aims to explore the social, contextual, and behavioral dimensions of injecting practices among women who inject drugs. Participants were selected by purposive venue-based sampling from a syringe exchange program in 2012-2013. In-depth interviews were conducted with 26 women to elicit detailed perspectives regarding injection drug use practices and women-focused decision-making. All interviews were transcribed verbatim and analyzed with Atlas.ti. Participant's mean age was 43.2 years, 48% Caucasian, 36% African American, and 16% Latina, poorly educated, mostly single, and heroin self-injectors. Three themes emerged; a) transitioning from non-injection to injection drug use; b) patterns and variations of initiation to injecting; and c) shifting toward autonomy or reliance on others. Women were predominantly influenced to transition to injection drug use by other women with their claims that injecting was a way to curtail their daily drug expenditure. More than half the women received their first injection from another woman in their social network rather than a male sexual partner. Self-injecting women exhibited agency around the circumstances of injection safety and potential risks. Other women revealed that their inability to inject themselves could and did make them dependent on others for unsafe injection practices. The finding that many women were influenced to transition to injection drug use and receive the first injection from a woman is contrary to literature claims that male sexual partners introduce and initiate women to injection drug use. Self-injecting women possessed capacity to act in a way that produced the results they wanted, not sharing prepared drugs or injecting equipment. In stark contrast, women assisted with injections could and did make them vulnerable to unsafe injecting. Findings support early prevention strategies that discourage women's transition from non-injection to injection and development of female peer-driven experiential interventions to dispel myths for non-injection women and to increase personal capability to self-inject for women who require assistance with injecting, to reduce injection-related harm.

Predictors of Sexually Transmitted Infections among Female Sex Workers (FSWs) in a City of Northern India.

PubMed

Shukla, Pallavi; Masood, Jamal; Singh, J V; Singh, V K; Gupta, Abhishek; Krishna, Asuri

2015-01-01

Sexually transmitted infections (STIs) and Reproductive tract infections RTIs are important public health problems in India. The prevalence of these infections is considerably higher among high risk groups (HRGs) ranging from 20-30%. It is high time that a study should be conducted to explore different factors and conditions responsible for the practice of unsafe sex among female sex workers (FSWs) in Uttar Pradesh (UP) and the impact of this on social life and health of FSWs. As Lucknow provides a comprehensive opportunity in terms of tourism, occupation, and economy, it becomes a potential hub for sex work. Studying FSW in Lucknow can thus be considered as a yardstick for the entire FSW population of UP population. The present study was thus planned with the objective of knowing the STI prevalence and its determinants among FSWs. A cross-sectional descriptive study was conducted on FSWs registered with Targeted Intervention-Non-government Organization (TI-NGO), registered with Uttar Pradesh State Acquired Immuno Deficiency Syndrome (AIDS) Control Society (UPSACS) of Lucknow city. Total 288 subjects were studied. The average age of FSWs was 31 years. FSWs were mostly Hindus and illiterate. The overall prevalence of STI as per Syndromic diagnosis was found to be 35.8%. However, the percentage of FSWs with STI was higher in street-based (50.6%) than home-based (29.8%). Majority (42.7%) of sex workers with STI had non-regular partners only while majority (52.4%) of sex workers without any STI had only regular partners. Condom usage with regular partners was poor. However, with the non-regular partners the condom usage was better. On multivariate analysis being single, having sex work as a sole means of earning, duration of sex work > 2 years, having pallor, and giving in to client's demand for unsafe sex were found to be significant in causing STI. Prevalence of STI among the female sex workers as per Syndromic diagnosis was found to be 35.8%. Unemployment, anemia, and having sex without condom for extra money, failure to persuade the client and not doing anything were found to be important predictors for presence of STI.

Sociotechnical factors influencing unsafe use of hospital information systems: A qualitative study in Malaysian government hospitals.

PubMed

Salahuddin, Lizawati; Ismail, Zuraini; Hashim, Ummi Rabaah; Raja Ikram, Raja Rina; Ismail, Nor Haslinda; Naim Mohayat, Mohd Hariz

2018-03-01

The objective of this study is to identify factors influencing unsafe use of hospital information systems in Malaysian government hospitals. Semi-structured interviews with 31 medical doctors in three Malaysian government hospitals implementing total hospital information systems were conducted between March and May 2015. A thematic qualitative analysis was performed on the resultant data to deduce the relevant themes. A total of five themes emerged as the factors influencing unsafe use of a hospital information system: (1) knowledge, (2) system quality, (3) task stressor, (4) organization resources, and (5) teamwork. These qualitative findings highlight that factors influencing unsafe use of a hospital information system originate from multidimensional sociotechnical aspects. Unsafe use of a hospital information system could possibly lead to the incidence of errors and thus raises safety risks to the patients. Hence, multiple interventions (e.g. technology systems and teamwork) are required in shaping high-quality hospital information system use.

Behavioral and community correlates of adolescent pregnancy and Chlamydia rates in rural counties in Minnesota.

PubMed

Kozhimannil, Katy B; Enns, Eva; Blauer-Peterson, Cori; Farris, Jill; Kahn, Judith; Kulasingam, Shalini

2015-06-01

Identifying co-occurring community risk factors, specific to rural communities, may suggest new strategies and partnerships for addressing sexual health issues among rural youth. We conducted an ecological analysis to identify the county-level correlates of pregnancy and chlamydia rates among adolescents in rural (nonmetropolitan) counties in Minnesota. Pregnancy and chlamydia infection rates among 15-19 year-old females were compared across Minnesota's 87 counties, stratified by rural/urban designations. Regression models for rural counties (n = 66) in Minnesota were developed based on publicly available, county-level information on behaviors and risk exposures to identify associations with teen pregnancy and chlamydia rates in rural settings. Adolescent pregnancy rates were higher in rural counties than in urban counties. Among rural counties, factors independently associated with elevated county-level rates of teen pregnancy included inconsistent contraceptive use by 12th-grade males, fewer 12th graders reporting feeling safe in their neighborhoods, more 9th graders reporting feeling overweight, fewer 12th graders reporting 30 min of physical activity daily, high county rates of single parenthood, and higher age-adjusted mortality (P < .05 for all associations). Factors associated with higher county level rates of chlamydia among rural counties were inconsistent condom use reported by 12th-grade males, more 12th graders reporting feeling overweight, and more 12th graders skipping school in the past month because they felt unsafe. This ecologic analysis suggests that programmatic approaches focusing on behavior change among male adolescents, self-esteem, and community health and safety may be complementary to interventions addressing teen sexual health in rural areas; such approaches warrant further study.

Behavioral and Community Correlates of Adolescent Pregnancy and Chlamydia Rates in Rural Counties in Minnesota1

PubMed Central

Kozhimannil, Katy B.; Enns, Eva; Blauer-Peterson, Cori; Farris, Jill; Kahn, Judith; Kulasingam, Shalini

2014-01-01

Purpose Identifying co-occurring community risk factors, specific to rural communities, may suggest new strategies and partnerships for addressing sexual health issues among rural youth. We conducted an ecological analysis to identify the county-level correlates of pregnancy and chlamydia rates among adolescents in rural (nonmetropolitan) counties in Minnesota. Methods Pregnancy and chlamydia infection rates among 15–19 year-old females were compared across Minnesota’s 87 counties, stratified by rural/urban designations. Regression models for rural counties (n=66) in Minnesota were developed based on publicly available, county-level information on behaviors and risk exposures to identify associations with teen pregnancy and chlamydia rates in rural settings. Findings Adolescent pregnancy rates were higher in rural counties than in urban counties. Among rural counties, factors independently associated with elevated county-level rates of teen pregnancy included inconsistent contraceptive use by 12th-grade males, fewer 12th graders reporting feeling safe in their neighborhoods, more 9th graders reporting feeling overweight, fewer 12th graders reporting 30 min of physical activity daily, high county rates of single parenthood, and higher age-adjusted mortality (P < .05 for all associations). Factors associated with higher county level rates of chlamydia among rural counties were inconsistent condom use reported by 12th-grade males, more 12th graders reporting feeling overweight, and more 12th graders skipping school in the past month because they felt unsafe. Conclusions This ecologic analysis suggests that programmatic approaches focusing on behavior change among male adolescents, self-esteem, and community health and safety may be complementary to interventions addressing teen sexual health in rural areas; such approaches warrant further study. PMID:25344773

46 CFR 167.65-70 - Reports of accidents, repairs, and unsafe boilers and machinery by engineers.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 46 Shipping 7 2010-10-01 2010-10-01 false Reports of accidents, repairs, and unsafe boilers and... of accidents, repairs, and unsafe boilers and machinery by engineers. (a) Before making repairs to a boiler of a nautical school ship the engineer in charge shall report, in writing, the nature of such...

46 CFR 167.65-70 - Reports of accidents, repairs, and unsafe boilers and machinery by engineers.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 46 Shipping 7 2012-10-01 2012-10-01 false Reports of accidents, repairs, and unsafe boilers and machinery by engineers. 167.65-70 Section 167.65-70 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) NAUTICAL SCHOOLS PUBLIC NAUTICAL SCHOOL SHIPS Special Operating Requirements § 167.65-70 Reports of accidents, repairs, and unsafe...

Comparison of Unsafe Driving Across Medical Conditions.

PubMed

Moon, Sanghee; Ranchet, Maud; Tant, Mark; Akinwuntan, Abiodun E; Devos, Hannes

2017-09-01

To compare risks of unsafe driving in patients with medical conditions. This large population-based study included all patients who were referred for a fitness-to-drive evaluation at an official driving evaluation center in 2013 and 2014. Risks of unsafe driving included physician's fitness-to-drive recommendation, comprehensive fitness-to-drive decision, motor vehicle crash history, and traffic violation history. A total of 6584 patients were included in the study. Risks of unsafe driving were significantly different across medical conditions (P<.001 for all outcome measures). Patients with neurological conditions comprised the majority of the database (4837; 74%), but were not at the highest risk for unsafe driving. Patients with psychiatric conditions or substance abuse did worse on most driving safety outcomes, despite their low representation in the total sample (359 [6%] and 46 [1%], respectively). The risk of unsafe driving varied greatly across medical conditions. Sensitization campaigns, education, and medical guidelines for physicians and driver licensing authorities are warranted to identify patients at risk, especially for those with psychiatric conditions and substance abuse problems. Copyright © 2017 Mayo Foundation for Medical Education and Research. Published by Elsevier Inc. All rights reserved.

The attitude of Canadian university students toward a behavior-based blood donor health assessment questionnaire.

PubMed

Go, Stephanie L; Lam, Cindy T Y; Lin, Yahui T; Wong, Deborah J; Lazo-Langner, Alejandro; Chin-Yee, Ian

2011-04-01

In Canada, all men who have sex with men (MSM) are indefinitely deferred from donating blood. The purpose of this study was to determine the acceptability of an alternative behavior-based donor health questionnaire among Canadian university students. Further we sought to determine the perception of blood safety associated with specific risk behaviors. Questions found on the Canadian Blood Services' donor health assessment questionnaire as well as from studies assessing high-risk behavior for human immunodeficiency virus infection were included. For each question participants were asked to rate the acceptability, comfort in answering, perceived effect on blood safety, and whether the question would deter them from donating blood. Data were analyzed using nonparametric tests. A total of 741 students participated in the study. Questions regarding sexual practices of the donor were rated less important for blood safety compared to those assessing for sexually transmitted infections, sex for money, and injection drug use (30%-62% vs. 69%-95% unsafe). A total of 24.4% of students rated both questions on MSM status and a behavior-based alternative as equally unacceptable. We found an inverse correlation between perception of safety and acceptability of questions. Our findings suggest that a behavior-based screening modification is unlikely to change opinions or satisfy those who object to the MSM current policy in place. Acceptability of these questions might be related to a poor understanding of the effect of sexual practices on blood supply safety. © 2010 American Association of Blood Banks.

‘On the same level’: facilitators’ experiences running a drug user-led safer injecting education campaign

PubMed Central

2013-01-01

Background Unsafe injection practices play a major role in elevated rates of morbidity and mortality among people who inject drugs (IDU). There is growing interest in the direct involvement of IDU in interventions that seek to address unsafe injecting. This study describes a drug user-led safer injecting education campaign, and explores facilitators’ experiences delivering educational workshops. Methods We conducted semi-structured qualitative interviews with 8 members of the Injection Support (IS) Team who developed and facilitated a series of safer injecting education workshops. Interviews explored facilitator’s perceptions of the workshops, experiences being a facilitator, and perspectives on the educational campaign. Interviews were transcribed verbatim and a thematic analysis was conducted. Results IS Team facilitators described how the workshop’s structure and content enabled effective communication of information about safer injecting practices, while targeting the unsafe practices of workshop participants. Facilitators’ identity as IDU enhanced their ability to relate to workshop participants and communicate educational messages in language accessible to workshop participants. Facilitators reported gaining knowledge and skills from their involvement in the campaign, as well as positive feelings about themselves from the realization that they were helping people to protect their health. Overall, facilitators felt that this campaign provided IDU with valuable information, although facilitators also critiqued the campaign and suggested improvements for future efforts. Conclusions This study demonstrates the feasibility of involving IDU in educational initiatives targeting unsafe injecting. Findings illustrate how IDU involvement in prevention activities improves relevance and cultural appropriateness of interventions while providing individual, social, and professional benefits to those IDU delivering education. PMID:23497293

Epidemiology of Mycoplasma genitalium in British men and women aged 16–44 years: evidence from the third National Survey of Sexual Attitudes and Lifestyles (Natsal-3)

PubMed Central

Sonnenberg, Pam; Ison, Catherine A; Clifton, Soazig; Field, Nigel; Tanton, Clare; Soldan, Kate; Beddows, Simon; Alexander, Sarah; Khanom, Rumena; Saunders, Pamela; Copas, Andrew J; Wellings, Kaye; Mercer, Catherine H; Johnson, Anne M

2015-01-01

Background: There are currently no large general population epidemiological studies of Mycoplasma genitalium (MG), which include prevalence, risk factors, symptoms and co-infection in men and women across a broad age range. Methods: In 2010-–12, we conducted the third National Survey of Sexual Attitudes and Lifestyles (Natsal-3), a probability sample survey in Britain. Urine from 4507 sexually-experienced participants, aged 16–44 years, was tested for MG. Results: MG prevalence was 1.2% [95% confidence interval (CI): 0.7–1.8%] in men and 1.3% (0.9–1.9%) in women. There were no positive MG tests in men aged 16–19, and prevalence peaked at 2.1% (1.2–3.7%) in men aged 25–34 years. In women, prevalence was highest in 16–19 year olds, at 2.4% (1.2–4.8%), and decreased with age. Men of Black ethnicity were more likely to test positive for MG [adjusted odds ratio (AOR) 12.1; 95% CI: 3.7–39.4). For both men and women, MG was strongly associated with reporting sexual risk behaviours (increasing number of total and new partners, and unsafe sex, in the past year). Women with MG were more likely to report post-coital bleeding (AOR 5.8; 95%CI 1.4–23.3). However, the majority of men (94.4%), and over half of women (56.2%) with MG did not report any sexually transmitted infection (STI) symptoms. Men with MG were more likely to report previously diagnosed gonorrhoea, syphilis or non-specific urethritis, and women previous trichomoniasis. Conclusions: This study strengthens evidence that MG is an STI. MG was identified in over 1% of the population, including in men with high-risk behaviours in older age groups that are often not included in STI prevention measures. PMID:26534946

The correlates of HIV testing and impacts on sexual behavior: evidence from a life history study of young people in Kisumu, Kenya

PubMed Central

2010-01-01

Background HIV counseling and testing is considered an important component of HIV prevention and treatment. This paper examines the characteristics of young males and females at the time of first reported HIV test, including the influence of recent sexual partnerships, and investigates how HIV testing and the cumulative number of tests are associated with sexual behaviors within six months of testing. Methods The study uses data from a random sample of youth aged 18-24 years living in Kisumu, Kenya, who were interviewed using a 10-year retrospective life history calendar. Cox regression models were used to examine the correlates of the timing of first HIV test. Variance-correction models for unordered repeated events were employed to examine whether having an HIV test in the previous six months and the cumulative number of tests predict unsafe sexual practices in a given month. Results Sixty-four percent of females and 55% of males reported at least one HIV test in the last 10 years and 40% of females were pregnant the month of first test. Significant correlates of first HIV test included marital aspirations among non-pregnant females, unprotected sex in the previous six months among pregnant females, and concurrency in the previous six months among males. Having a recent HIV test was associated with a decreased likelihood of unprotected sex among ever-pregnant females, an increased likelihood of unprotected sex and "risky" sexual partnerships among never-pregnant females, and an increased likelihood of concurrency among males. Repeated HIV testing was associated with a lower likelihood of concurrency among males and involvement in "risky" sexual partnerships among males and never-pregnant females. Conclusions The high rate of pregnancy at first test suggests that promotion of HIV testing as part of prevention of mother-to-child transmission is gaining success. Further research is warranted to examine how and why behavior change is influenced by client- versus provider-initiated testing. The influence of different sexual partnership variables for males and females suggests that interventions to assess risk and promote testing should be gender- and relationship-specific. The findings also suggest that encouraging repeat or routine testing could potentially increase the uptake of safer sexual behaviors. PMID:20624323

The correlates of HIV testing and impacts on sexual behavior: evidence from a life history study of young people in Kisumu, Kenya.

PubMed

Kabiru, Caroline W; Luke, Nancy; Izugbara, Chimaraoke O; Zulu, Eliya M

2010-07-13

HIV counseling and testing is considered an important component of HIV prevention and treatment. This paper examines the characteristics of young males and females at the time of first reported HIV test, including the influence of recent sexual partnerships, and investigates how HIV testing and the cumulative number of tests are associated with sexual behaviors within six months of testing. The study uses data from a random sample of youth aged 18-24 years living in Kisumu, Kenya, who were interviewed using a 10-year retrospective life history calendar. Cox regression models were used to examine the correlates of the timing of first HIV test. Variance-correction models for unordered repeated events were employed to examine whether having an HIV test in the previous six months and the cumulative number of tests predict unsafe sexual practices in a given month. Sixty-four percent of females and 55% of males reported at least one HIV test in the last 10 years and 40% of females were pregnant the month of first test. Significant correlates of first HIV test included marital aspirations among non-pregnant females, unprotected sex in the previous six months among pregnant females, and concurrency in the previous six months among males. Having a recent HIV test was associated with a decreased likelihood of unprotected sex among ever-pregnant females, an increased likelihood of unprotected sex and "risky" sexual partnerships among never-pregnant females, and an increased likelihood of concurrency among males. Repeated HIV testing was associated with a lower likelihood of concurrency among males and involvement in "risky" sexual partnerships among males and never-pregnant females. The high rate of pregnancy at first test suggests that promotion of HIV testing as part of prevention of mother-to-child transmission is gaining success. Further research is warranted to examine how and why behavior change is influenced by client- versus provider-initiated testing. The influence of different sexual partnership variables for males and females suggests that interventions to assess risk and promote testing should be gender- and relationship-specific. The findings also suggest that encouraging repeat or routine testing could potentially increase the uptake of safer sexual behaviors.

EXERCISE IMPROVES SEXUAL FUNCTION IN WOMEN TAKING ANTIDEPRESSANTS: RESULTS FROM A RANDOMIZED CROSSOVER TRIAL

PubMed Central

Lorenz, Tierney Ahrold; Meston, Cindy May

2014-01-01

Background In laboratory studies, exercise immediately before sexual stimuli improved sexual arousal of women taking antidepressants [1]. We evaluated if exercise improves sexual desire, orgasm, and global sexual functioning in women experiencing antidepressant-induced sexual side effects. Methods Fifty-two women who were reporting antidepressant sexual side effects were followed for 3 weeks of sexual activity only. They were randomized to complete either three weeks of exercise immediately before sexual activity (3×/week) or 3 weeks of exercise separate from sexual activity (3×/week). At the end of the first exercise arm, participants crossed to the other. We measured sexual functioning, sexual satisfaction, depression, and physical health. Results Exercise immediately prior to sexual activity significantly improved sexual desire and, for women with sexual dysfunction at baseline, global sexual function. Scheduling regular sexual activity significantly improved orgasm function; exercise did not increase this benefit. Neither regular sexual activity nor exercise significantly changed sexual satisfaction. Conclusions Scheduling regular sexual activity and exercise may be an effective tool for the behavioral management of sexual side effects of antidepressants. PMID:24754044

Exercise improves sexual function in women taking antidepressants: results from a randomized crossover trial.

PubMed

Lorenz, Tierney Ahrold; Meston, Cindy May

2014-03-01

In laboratory studies, exercise immediately before sexual stimuli improved sexual arousal of women taking antidepressants [1]. We evaluated if exercise improves sexual desire, orgasm, and global sexual functioning in women experiencing antidepressant-induced sexual side effects. Fifty-two women who were reporting antidepressant sexual side effects were followed for 3 weeks of sexual activity only. They were randomized to complete either three weeks of exercise immediately before sexual activity (3×/week) or 3 weeks of exercise separate from sexual activity (3×/week). At the end of the first exercise arm, participants crossed to the other. We measured sexual functioning, sexual satisfaction, depression, and physical health. Exercise immediately prior to sexual activity significantly improved sexual desire and, for women with sexual dysfunction at baseline, global sexual function. Scheduling regular sexual activity significantly improved orgasm function; exercise did not increase this benefit. Neither regular sexual activity nor exercise significantly changed sexual satisfaction. Scheduling regular sexual activity and exercise may be an effective tool for the behavioral management of sexual side effects of antidepressants

Identification and treatment of intra-abdominal fetal skeletal remains: A consequence of illicit and unsafe abortion.

PubMed

Rohilla, Minakshi; Kalpdev, Arun; Jain, Vanita

2015-06-01

The safety of abortions has always been a matter of concern for women's health. Unsafe abortion is one of the most neglected health-care problems in developing countries due to lack of awareness of the legal issues and limited access to authorised services often leading the women to poor quality of abortion in unsafe settings through untrained health personnel. Two rare cases of second trimester unsafe abortions are reported here in which women presented after several weeks with well-preserved remains of fetal skeleton in their abdomen along with complicated multiple visceral injuries. Both these second trimester abortions were performed by untrained village abortionists for sex selection and unwanted pregnancy in an unmarried adolescent girl. The management in the unmarried girl was further complicated due to undisclosed history of abortion. These reports of unsafe abortion highlight the need for clinicians to have a high index of suspicion for an undisclosed abortion when treating any morbid woman of reproductive age with a bizarre abdominal clinical picture.

Unsafe abortion as a birth control method: maternal mortality risks among unmarried cambodian migrant women on the Thai-Cambodia border.

PubMed

Hegde, Shalika; Hoban, Elizabeth; Nevill, Annemarie

2012-11-01

Reproductive health research and policies in Cambodia focus on safe motherhood programs particularly for married women, ignoring comprehensive fertility regulation programs for unmarried migrant women of reproductive age. Maternal mortality risks arising due to unsafe abortion methods practiced by unmarried Cambodian women, across the Thai-Cambodia border, can be considered as a public health emergency. Since Thailand has restrictive abortion laws, Cambodian migrant women who have irregular migration status in Thailand experimented with unsafe abortion methods that allowed them to terminate their pregnancies surreptitiously. Unmarried migrant women choose abortion as a preferred birth control method seeking repeat "unsafe" abortions instead of preventing conception. Drawing on the data collected through surveys, in-depth interviews, and document analysis in Chup Commune (pseudonym), Phnom Penh, and Bangkok, the authors describe the public health dimensions of maternal mortality risks faced by unmarried Cambodian migrant women due to various unsafe abortion methods employed as birth control methods.

Part-time farmers and accidents with agricultural machinery: a moderated mediated model on the role played by frequency of use and unsafe beliefs.

PubMed

Caffaro, Federica; Roccato, Michele; Micheletti Cremasco, Margherita; Cavallo, Eugenio

2018-01-25

We aimed at testing a model of the direct and indirect effects of being a part-time farmer on the probability of being involved in an agricultural machinery-related accident, considering the role played by unsafe beliefs and the frequency of use of machinery. Two-hundred and fifty-two Italian men, regular users of agricultural machinery (age: Mean = 45.1 years, standard Deviation = 17.5), were administered a paper-and-pencil questionnaire addressing their relation with work, unsafe beliefs, and previous experience of machinery-related accidents. Being a part-time farmer showed a positive association with unsafe beliefs only among occasional machinery users. Unsafe beliefs in turn showed a positive association with accidents. The study gave a novel contribution to the knowledge of the chain of events connecting part-time farmers with machinery-related accidents. Preventive training interventions targeting part-timer farmers using agricultural machinery just occasionally should be developed.

Part-time farmers and accidents with agricultural machinery: a moderated mediated model on the role played by frequency of use and unsafe beliefs

PubMed Central

Caffaro, Federica; Roccato, Michele; Micheletti Cremasco, Margherita; Cavallo, Eugenio

2017-01-01

Objectives: We aimed at testing a model of the direct and indirect effects of being a part-time farmer on the probability of being involved in an agricultural machinery-related accident, considering the role played by unsafe beliefs and the frequency of use of machinery. Methods: Two-hundred and fifty-two Italian men, regular users of agricultural machinery (age: Mean = 45.1 years, standard Deviation = 17.5), were administered a paper-and-pencil questionnaire addressing their relation with work, unsafe beliefs, and previous experience of machinery-related accidents. Results: Being a part-time farmer showed a positive association with unsafe beliefs only among occasional machinery users. Unsafe beliefs in turn showed a positive association with accidents. Conclusions: The study gave a novel contribution to the knowledge of the chain of events connecting part-time farmers with machinery-related accidents. Preventive training interventions targeting part-timer farmers using agricultural machinery just occasionally should be developed. PMID:29093365

[Experimental intervention study of safe injection in basic-level hospitals in Hunan by medical staff].

PubMed

Li, Li; Li, Yinglan; Long, Yanfang; Zhou, Yang; Lu, Jingmei; Wu, Ying

2013-07-01

To experimentally intervene safe injection by medical staff in basic-level hospitals and observe the recent and long-term effect after the intervention and to provide practical measures to improve safe injection. We used random sampling methods to set up groups in county hospitals and township hospitals of Hunan Province, and offered lectures, delivered safe injection guide, brochure and on-site guidance in the experimental group. We surveyed the 2 groups after the intervention at 1 month and 6 months to compare the effect of unsafe injection behaviors and safe injection behaviors. One month after the intervention, the unsafe injection rate in the experimental group decreased from 27.8% to 21.7%, while in the control group injection the unsafe injection rate rose from 26.0% to 27.9%, with significant difference (P<0.01). Six months after the intervention, the unsafe injection rate in the experimental group declined to 18.4% while the unsafe injection rate in the control group also dropped to 22.4%, with significant difference (P<0.01). Unsafe injection rate was decreased in the experimental group at different intervention points, with significant difference (P<0.01). The safe injection behavior scores in the experimental group were higher than those in the control group after the intervention of 1 month and 6 month intervention (P<0.01); the experimental group got higher scores after the intervention (P<0.01). Training of safe injection, distribution of safe injection guide, and comprehensive intervention model can significantly change the primary care practitioners' behaviors in unsafe injections and it is worth promoting.

"Feeling unsafe": a photovoice analysis of factors influencing physical activity behavior among Malaysian adolescents.

PubMed

Saimon, Rosalia; Choo, Wan Yuen; Bulgiba, Awang

2015-03-01

Understanding the factors influencing physical activity (PA) in the Asia-Pacific region is critical, given the high prevalence of inactivity in this area. The photovoice technique explores the types of PA and factors influencing PA among adolescents in Kuching, Sarawak. A total of 160 photographs were collected from participants (adolescents, n = 22, mean age = 14.27 ± 0.7 years, and parents, n = 8, mean age = 48 ± 6.8 years). Data analysis used constant comparison methods of a grounded theory. The Analysis Grid for Environments Linked to Obesity was used to categorize PA factors. Study findings were centered on the concept of safety, facilities, parental restriction, friends, cultural traits, media, community cohesiveness, and weather. The central theme was "feeling unsafe" when being outdoors. To promote PA behavior, provision of PA facilities needs to be supported by other programs that build on peer support, crime prevention, and traffic safety, together with other educational campaigns. © 2013 APJPH.

Frequency of unsafe storage, use, and disposal practices of opioids among cancer patients presenting to the emergency department.

PubMed

Silvestre, Julio; Reddy, Akhila; de la Cruz, Maxine; Wu, Jimin; Liu, Diane; Bruera, Eduardo; Todd, Knox H

2017-12-01

Approximately 75% of prescription opioid abusers obtain the drug from an acquaintance, which may be a consequence of improper opioid storage, use, disposal, and lack of patient education. We aimed to determine the opioid storage, use, and disposal patterns in patients presenting to the emergency department (ED) of a comprehensive cancer center. We surveyed 113 patients receiving opioids for at least 2 months upon presenting to the ED and collected information regarding opioid use, storage, and disposal. Unsafe storage was defined as storing opioids in plain sight, and unsafe use was defined as sharing or losing opioids. The median age was 53 years, 55% were female, 64% were white, and 86% had advanced cancer. Of those surveyed, 36% stored opioids in plain sight, 53% kept them hidden but unlocked, and only 15% locked their opioids. However, 73% agreed that they would use a lockbox if given one. Patients who reported that others had asked them for their pain medications (p = 0.004) and those who would use a lockbox if given one (p = 0.019) were more likely to keep them locked. Some 13 patients (12%) used opioids unsafely by either sharing (5%) or losing (8%) them. Patients who reported being prescribed more pain pills than required (p = 0.032) were more likely to practice unsafe use. Most (78%) were unaware of proper opioid disposal methods, 6% believed they were prescribed more medication than required, and 67% had unused opioids at home. Only 13% previously received education about safe disposal of opioids. Overall, 77% (87) of patients reported unsafe storage, unsafe use, or possessed unused opioids at home. Many cancer patients presenting to the ED improperly and unsafely store, use, or dispose of opioids, thus highlighting a need to investigate the impact of patient education on such practices.

Complicated unsafe abortion in a Nigerian teaching hospital: pattern of morbidity and mortality.

PubMed

Akinlusi, Fatimat Motunrayo; Rabiu, Kabiru Afolarin; Adewunmi, Adeniyi Abiodun; Imosemi, Oreose Donald; Ottun, Tawaqualit Abimbola; Badmus, Saidah Adetokunbo

2018-03-25

Addressing unsafe abortion in developing countries may propel a rapid decline in overall maternal death. A retrospective review of patients with complicated unsafe abortion was conducted in a Nigerian Tertiary Hospital. In order to provide evidence that may inform policy changes, we describe patients' clinical profiles, abortion providers, and morbidity and mortality patterns. Of 3122 gynaecological admissions, 231 (7.4%) had unsafe abortion-related complications. The majority (53.2%) of admissions were between 16 and 25 years. Single women constituted 51% while 57% were nulliparous. Common presentations were abdominal pain (62%), fever (54%) and vaginal bleeding (53%). The most frequent complications were anaemia (55%) and retained products of conception (47%). Doctors reportedly performed 42% of abortions. There were 392 maternal mortalities; 39 (9.9%) from unsafe abortions and sepsis was responsible in 31 (80%) patients. Abortion remains a major public health issue. Youths are mostly involved. Doctors were reportedly the highest abortion providers. Mortality is high, occurring mostly from sepsis. Impact Statement What is already known on this subject? Doctors are reported as being involved in a high proportion of unsafe abortions in low and middle income countries where abortion remains a significant contributor to maternal mortality and morbidity. What the results of this study add? Our study agrees with existing literature that doctors reportedly performed most of the unsafe abortions. It also found that doctors were reported as abortion providers in the majority (35.9%) of those unsafe abortions that ended in mortality. What the implications are of these findings for clinical practice and/or further research? There is a need to conduct studies that will verify the status of abortion providers rather than rely on clients' report; and also inspect facilities to confirm adherence to minimum medical standards. Such research findings will be needed prior to local and possibly national healthcare interventions and policy changes.

76 FR 18960 - Airworthiness Directives; Airbus Model A300 B4-600, B4-600R, and F4-600R Series Airplanes, and...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-04-06

... unsafe condition is damage to wiring in the wing, center, and trim fuel tanks, due to failed P-clips used..., center, or trim fuel tanks. The proposed AD would require actions that are intended to address the unsafe..., 2009]. The unsafe condition is damage to wiring in the wing, center, and trim fuel tanks, due to failed...

Complications of unsafe abortion: case reports and the need for curriculum review in Nigeria.

PubMed

Umoh, A V; Umoiyoho, A J

2009-09-01

Unsafe abortion remains a major reproductive health problem in Nigeria. These are 2 case reports of unsafe abortion, one performed by a patent medicine dealer where a false passage was created in the substance of the cervix to evacuate the uterus using a cannula. A piece of the cannula was left in situ for five years leading to chronic infection and infertility. The second case was performed by a medical practitioner for a second trimester abortion. He deliberately created a false passage in the substance of the cervix to evacuate the uterus leading to severe haemorrhage. We conclude that there is a need to review and improve the training of medical practitioners in termination of pregnancies to avoid unsafe abortion.

Results of implementing programmes for modifying unsafe behaviour in Polish companies.

PubMed

Pęciłło, Małgorzata

2012-01-01

This article presents the results of 3 Polish companies implementing programmes for modifying unsafe behaviour. Those programmes involved training workers and supervisors, and observing, registering and analysing the workers' behaviour. They focused on the quality of life and safety culture as factors key to the level of unsafe behaviour and, thus, to the level of safety in an organisation. To assess the effectiveness of the programmes, the quality of life and safety culture were studied before, during and after the intervention. The implementation of the programmes resulted in a higher level of safety culture and workers' well-being and fewer cases of unsafe behaviour. The improved level of safety culture and well-being was different in each company.

Sexual knowledge, attitudes and activity of older people in Taipei, Taiwan.

PubMed

Wang, Tze-Fang; Lu, Chwen-Hwa; Chen, I-Ju; Yu, Shu

2008-02-01

We examined sexual activity and predictive factors among older people in Taipei, Taiwan. We aimed to characterize the older population engaged in sexual activity and determine influencing factors, exploring aspects of sexuality that may influence elders' health and quality of life (QOL). Studies of sexual attitudes and behaviour have found that sexual difficulties are common among mature adults worldwide, influenced in men and women by physical health, ageing, psychosocial and cultural factors. We conducted a community-based retrospective study involving a random sample of 412 men and 204 women over age 65. A questionnaire on demographics and social situations was administered, along with a Sexuality Knowledge and Attitudes Scale; 34 questions evaluated sexual knowledge and 18 evaluated sexual attitudes. Two-hundred and twenty participants were sexually active (35.7%), 185 mainly with spouses (84.1%); frequency was 21.4 (SD 16.9) times per year (range: 1-120). Multiple logistic regressions identified five significant predictors of sexual activity: gender, age, being with spouse, sexual knowledge and sexual attitudes. Sexual activity was significantly associated with higher education levels, lower stress and more self-reported daily activities. Our results agreed with Western studies linking sexual activity with better health and higher QOL in older adults. Older peoples' stress and daily activity levels are recognized quality-of-life measures; lower stress and more daily activities among sexually active older people suggests a connection between sexual activity and higher QOL. Increasing knowledge and improving attitudes about sexuality may help older people build healthier relationships and enhance health and QOL. Relevance to clinical practice. If healthcare professionals possess greater understanding of older peoples' sexuality, healthcare systems may find ways to increase sexual knowledge and foster healthier attitudes and relationships to improve older peoples' overall health and QOL.

14 CFR 29.672 - Stability augmentation, automatic, and power-operated systems.

Code of Federal Regulations, 2013 CFR

2013-01-01

..., DEPARTMENT OF TRANSPORTATION AIRCRAFT AIRWORTHINESS STANDARDS: TRANSPORT CATEGORY ROTORCRAFT Design and Construction Control Systems § 29.672 Stability augmentation, automatic, and power-operated systems. If the... unsafe condition if the pilot is unaware of the failure. Warning systems must not activate the control...

14 CFR 27.672 - Stability augmentation, automatic, and power-operated systems.

Code of Federal Regulations, 2013 CFR

2013-01-01

..., DEPARTMENT OF TRANSPORTATION AIRCRAFT AIRWORTHINESS STANDARDS: NORMAL CATEGORY ROTORCRAFT Design and Construction Control Systems § 27.672 Stability augmentation, automatic, and power-operated systems. If the... unsafe condition if the pilot is unaware of the failure. Warning systems must not activate the control...

Health status and years of sexually active life among older men and women in South Africa.

PubMed

Chirinda, Witness; Zungu, Nompumelelo

2016-11-01

Little is known about sexual activity in old age, particularly in Africa. The objective of this paper is to estimate years of sexually active life for older men and women, and examine the association between sexual activity and self-rated health status. Data were extracted from two large cross sectional HIV household surveys conducted in 2005 and 2012 in South Africa. The Sullivan method was used to estimate sexually active life expectancy, whilst logistic regression was used to assess associations with sexual activity. Sexually active life expectancy was higher among men across all the age groups in both surveys. At age 50, the sexually active life expectancy for men was double that for women - 2005 (12.6 vs. 5.9 years), 2012 (12.7 vs. 7.2 years). Self-rated health was significantly associated with sexual activity in men (adjusted Odds Ratio (aOR) 1.56; 95% CI 1.11-2.19; p<0.001). Among older women, moderate exercise was associated with being sexual active, while HIV infection was significantly associated with reduced sexual activity. The presence of chronic conditions was also significantly associated with reduced sexual activity among men. The results confirm that older adults are sexually active, and that factors associated with sexual activity are different for men and women. HIV among women and chronic conditions among men are areas of intervention to improve sexual activity in older people. Copyright © 2016 Elsevier Inc. All rights reserved.

ASW Reach-Back Cell Oceanography Analysis System (ARCOAS) Version 3 User’s Guide

DTIC Science & Technology

2012-02-24

65 Table of Figures Figure 2.1: Warning dialog box indicating ActiveX ...Click OK in response to the message box indicating that ActiveX controls are being used by the application (Figure 2.1). Figure 2.1: Warning...dialog box indicating ActiveX controls could be unsafe. 3. Open an existing map or create a new empty map. 4. Start ARCOAS by clicking the ARCOAS

Unsafe disposal of feces of children <3 years among households with latrine access in rural Bangladesh: Association with household characteristics, fly presence and child diarrhea

PubMed Central

Ercumen, Ayse; Ashraf, Sania; Rahman, Mahbubur; Shoab, Abul K.; Luby, Stephen P.; Unicomb, Leanne

2018-01-01

Background Young children frequently defecate in the living environment in low-income countries. Unsafe child feces disposal has been associated with risk of diarrhea. Additionally, reported practices can underestimate socially undesirable unhygienic behaviors. This analysis aimed to assess (1) the sensitivity of reported child feces disposal practices as an indicator for observed presence of human feces in the domestic environment, (2) household characteristics associated with reported unsafe feces disposal and (3) whether unsafe feces disposal is associated with fly presence and diarrhea among children <3 years. Methods We recorded caregiver-reported feces disposal practices for children <3 years; unsafe disposal was defined as feces put/rinsed into a drain, ditch, bush or garbage heap or left on the ground and safe disposal as feces put/rinsed into latrine or specific pit or buried. We conducted spot checks for human feces, counted flies in the compound and recorded caregiver-reported child diarrhea prevalence among 803 rural Bangladeshi households. We assessed associations using generalized estimating equations (GEE) and generalized linear models (GLM) with robust standard errors. Results Unsafe disposal of child feces was reported by 80% of households. Reported disposal practices had high sensitivity (91%) but low positive predictive value (15%) as an indicator of observed feces in the compound. Unsafe disposal was more common among households that reported daily adult open defecation (PR: 1.13, 1.02–1.24) and had children defecating in a nappy or on the ground versus in a potty (PR: 2.92, 1.98–4.32), and less common in households where adults reported always defecating in latrines (PR: 0.91, 0.84–0.98). The presence of observed human feces was similarly associated with these household characteristics. Reported unsafe feces disposal or observed human feces were not associated with fly detection or child diarrhea. Conclusion Despite access to on-site sanitation, unsafe child feces disposal was reported by the majority of households. However, this practices was not associated with diarrhea; suggesting that child feces may not be the most important fecal exposure. Before resources are invested to improve child feces management practices, studies should explore whether these contribute meaningfully to risk of enteric disease. PMID:29621289

Metabolic Syndrome and Sexual Function in Postmenopausal Women.

PubMed

Trompeter, Susan E; Bettencourt, Ricki; Barrett-Connor, Elizabeth

2016-12-01

Limited literature suggests that sexual dysfunction in women covaries with the metabolic syndrome. This study examined the association of sexual function with metabolic syndrome and cardiovascular disease in healthy older women. There were 376 postmenopausal, community-dwelling women from the Rancho Bernardo Study (mean baseline age = 73 years) that completed a clinic visit during 1999-2002 and returned the Female Sexual Function Index (FSFI) questionnaire mailed in 2002. Thirty-nine percent reported being sexually active; 41.5% met a diagnosis of metabolic syndrome. The number of metabolic syndrome components was strongly associated with decreased sexual activity, desire, and low sexual satisfaction. Waist girth, diabetes, and hypertension were associated with decreased sexual activity. Elevated triglycerides were associated with low desire. Among the cardiovascular endpoints, heart attack, coronary artery bypass, and angina were associated with decreased sexual activity, but not with sexual desire or satisfaction. Past diagnosis of heart failure, poor circulation, and stroke were not associated with sexual function. Sexually active women with metabolic syndrome met criteria for sexual dysfunction in desire, arousal, orgasm, and satisfaction domains. The FSFI Total Score did not differ significantly between sexually active and inactive women. Metabolic syndrome was associated with decreased sexual activity, desire, and satisfaction in all women and with sexual dysfunction in most domains in sexually active women. Coronary artery disease was more prevalent in women with low sexual activity. Copyright © 2016 Elsevier Inc. All rights reserved.

Unsafe abortion: a neglected tragedy. Review from a tertiary care hospital in India.

PubMed

Jain, Vanita; Saha, Subhas C; Bagga, Rashmi; Gopalan, Sarala

2004-06-01

With 16% of the world's population, India accounts for over 20% of the world's maternal deaths. The maternal mortality ratio, defined as the number of maternal deaths per 100 000 live births is incredibly high at 408 per 100 000 live births for the country. Abortion has been legalized in India for the past three decades. However, the share of unsafe abortion as a cause of maternal mortality continues to be alarming. The objective of the present study is to identify the magnitude of problem of unsafe abortion in India. Emergency gynecologic admissions to a tertiary care center in North India over a 15-year period (1988-2002) were reviewed to evaluate the demographic and clinical profile of patients admitted as a result of unsafe abortion. The records were analyzed with regard to the age group, parity and marital status of the abortion seekers, the indication of abortion, the methods used, qualification of abortion providers, complications and fatality rate. The majority of women who were admitted with diagnosis of unsafe abortion were in the third decade of their lives. They were married, multiparous women living with their spouses. Sixty percent of the women had approached unqualified abortion providers who used primitive methods of pregnancy termination. All the women were admitted with serious complications of unsafe abortions and one-fourth of them succumbed to the complications. Unsafe abortion constitutes a major threat to the health and lives of women. This study highlights the need to focus more directly on the needs and preferences of women who seek abortion as well as on the accessibility of contraceptives and skills of the providers of abortion services, in order to improve the quality of abortion care.

Post-abortion care: a women's health initiative to combat unsafe abortion.

PubMed

Greenslade, F C; Mckay, H; Wolf, M; Mclaurin, K

1994-01-01

Improving postabortion care can reduce the negative impact of unsafe abortion. Of the 53 million estimated induced abortions occurring annually about two out of five involve unsafe procedures. About one abortion occurs for every three births annually. 96% of abortions in Africa and 85% of abortions in Latin America are unsafe. About 100,000 to 200,000 women die every year from unsafe abortion, or 1 out of 400 women. Family planning is unavailable to over 120 million women in developing countries who desire contraception. Past moral and political controversies divert attention away from death and injury. The international community can take the opportunity to change affairs by adopting a women's health initiative globally. Improvements are needed in quality of care and accessibility of emergency treatment services. Emergency treatment services are usually only available at the tertiary level of care in urban areas. Poor transportation systems limit access. Access is also impaired by women's attitudes toward treatment centers. Availability of services needs to increased through decentralized centers. Clear protocols and comprehensive, systematic training must be accomplished in tandem with improvements in quality. Provision of technology such as manual vacuum aspiration is cost effective and an easy way to improve quality in primary care or outpatient settings. Unsafe abortion is a byproduct of the failure to provide adequate family planning for prevention of unwanted pregnancy. The obstacles, that interfere with provision of family planning to abortion users, should be removed. These obstacles include providers' lack of understanding of women's needs and motivations, separation between abortion and family planning services, misinformation about contraception following abortion, lack of acknowledgement about unsafe abortion, and women's low status. National and international policies also interfere with provision of contraception. Complete reproductive health care is a necessity for improvement in maternal health and mortality.

Sexual Activity and Contraceptive Use among Low-Income Urban Black Adolescent Females.

ERIC Educational Resources Information Center

Keith, Judith B.; And Others

1991-01-01

Examined sexual activity and contraception among urban, low-income African-American adolescent female clients who were not sexually active (n=50), sexually active/noncontracepting (n=20), or sexually active/contracepting (n=72). Not sexually active group was younger, more career motivated, had father at home, was more influenced by family values,…

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.

Clinical presentation and complications in patients with unsafe abortions in University of Calabar Teaching Hospital, Calabar, Nigeria.

PubMed

Ekanem, E I; Etuk, S J; Ekabua, J E; Iklaki, C

2009-01-01

Unsafe abortion still contributes significantly to high maternal morbidity and mortality particularly in developing countries despite concerted efforts being made to reduce it. Our objective is to determine the incidence, mode presentation and complications of Unsafe abortion. This prospective study was carried out by directly interviewing patients managed for unsafe abortion over one and half years period (1" June 2003, to 31st' December, 2004) in Maternity Annex of the University of Calabar Teaching Hospital Calabar, Nigeria. Incidence of Unsafe abortion of 27.6% of all gynaecological admissions was established. Most Patients (55.7%) were age 20 30 years while 25.4% were teenagers. There were 33(27.1%) students, 38.2% were single women and 38.5% had secondary education. The major reasons given for terminating the pregnancy included completion of education (25.4%), fear of parental action (18.8%) and in 17.2% the father of the pregnancy was unknown. Medical officers (32.8%) performed majority of the abortions while 10.7% were self induced by the patients themselves. Main complications encountered included retained product of conceptions, haemorrhage, sepsis, injuries to genital tracts and intra-abdomal organs. Unsafe abortion and it complications occurs in all socioeconomic groups. Efforts directed at reducing unintended pregnancy by comprehensive family planning programs and effective emergency post abortal care services will reduce the problem while the legal status of abortion is being debated.

Global consequences of unsafe abortion.

PubMed

Singh, Susheela

2010-11-01

Unsafe abortion is a significant cause of death and ill health in women in the developing world. A substantial body of research on these consequences exists, although studies are of variable quality. However, unsafe abortion has a number of other significant consequences that are much less widely recognized. These include the economic consequences, the immediate costs of providing medical care for abortion-related complications, the costs of medical care for longer-term health consequences, lost productivity to the country, the impact on families and the community, and the social consequences that affect women and families. This article will review the scientific evidence on the consequences of unsafe abortion, highlight gaps in the evidence base, suggest areas where future research efforts are needed, and speculate on the future situation regarding consequences and evidence over the next 5-10 years. The information provided is useful and timely given the current heightened interest in the issue of unsafe abortion, growing from the recent focus of national and international agencies on reducing maternal mortality by 75% by 2015 (as one of the Millennium Development Goals established in 2000).

Perception of risk of HIV and sexual risk behaviors among University students: implication for planning interventions.

PubMed

Shiferaw, Yitayal; Alemu, Abebe; Assefa, Abate; Tesfaye, Berihun; Gibermedhin, Etsegenet; Amare, Misiker

2014-03-19

The university environment offers great opportunity for HIV high-risk behaviors, including unsafe sex and multiple partnerships. Despite recently gained decline of the overall incidence of HIV infection, still significant proportion of youth population are at high risk of HIV infection. The aims of this study were to assess the perception of HIV risk and factors associated with risk perception among students at University of Gondar, Northwest Ethiopia. A cross sectional study was conducted between February and April, 2012 among health science students. A total of 384 students were involved in the study using stratified sampling technique. Chi-square test and logistic regression analysis were employed. P-value < 0.05 was considered statistically significant for all cases. Of the total 384 participated students, 200(52.1%) were females. Out of the total study respondents, 202(52.6%) were sexually experienced. One hundred and nine (59.2%) out of 184 males and 93(46.5%) out of 200 females had had sexual experience. About 23(57.5%) of those age below 20 years, 70(52.2%) of 20-24 years old, and 13(61.9%) of those ages of 25 years or older were perceived themselves as if they have no chance of acquiring HIV infection. Students initiated sexual intercourse at early age (≤8 years) were significantly associated with having multiple partnerships (crude OR =3.6, p = 0.002 for male and crude OR = 1.7, p = 0.04 for female). Statistically significant difference was observed in the distribution of condom use during sexual intercourse among various age groups (p-value = 0.001). Sexual initiation at younger age, having multiple partnerships, inconsistent condom use and alcohol and/or drug abuse were significantly perceived as predictor for an increased risks for HIV infection. Students were engaged in various HIV risk behaviors. Early sexual initiation and alcohol and/or drug abuse were important factors for having multiple partnerships. Poor agreement between having HIV risk behaviors and perception of HIV risk were observed. Attention has to be given on the role of alcohol and/or drug abuse in the participation of HIV risk behaviors in the design and implementation of HIV prevention for university students.

A qualitative study of perceived risk for HIV transmission among police officers in Dar es Salaam, Tanzania

PubMed Central

2013-01-01

Background Understanding people’s views about HIV transmission by investigating a specific population may help to design effective HIV prevention strategies. In addition, knowing the inherent sexual practices of such a population, as well as the risky circumstances that may facilitate HIV transmission, is crucial for the said strategies to become effective. In this article, we report how police officers in Dar es Salaam, Tanzania, perceived the problem of HIV and AIDS in their local context, particularly in relation to unsafe sexual practices. The study was done with the view to recommending ways by which HIV transmission could be minimised within the police force. Methods The study was conducted among members of the police force in Dar es Salaam, Tanzania. Eight focus group discussions (FGDs) were conducted, with a total of 66 participants who were mixed in terms of age, gender, and marital status. Some of these were caregivers to patients with AIDS. Data were analysed using the interpretive description approach. Results The participants believed that both individual sexual behaviour and work-related circumstances were sources of HIV infection. They also admitted that they were being tempted to engage in risky sexual practices because of the institutional rules that prohibit officers from getting married during their training and for three years after. Nevertheless, as members of the Police Force, they stressed the fact that the risky sexual behaviour that exposes them to HIV is not limited to the force; it is rather a common problem that is faced by the general population. However, they complained, the nature of their job exposes them to road accident victims, subjecting them further to possible infection, especially when they have to handle these road accident casualties without proper protective gear. Conclusion Individual sexual behaviour and job-related circumstances are worth investigating if proper advice is to be given to the police regarding HIV prevention strategies. In order to improve the lives of these police officers, there is a need to review the existing institutional rules and practices to accommodate individual sexual needs. In addition, improving their working environment may minimize the risk of HIV transmission from handling casualties in emergency situations. PMID:23984994

"Injection first": a unique group of injection drug users in Tijuana, Mexico.

PubMed

Morris, Meghan D; Brouwer, Kimberly C; Lozada, Remedios M; Gallardo, Manuel; Vera, Alicia; Strathdee, Steffanie A

2012-01-01

Using baseline data from a study of injection drug users (IDUs) in Tijuana, Mexico (N = 1,052), we identified social and behavioral factors associated with injecting at the same age or earlier than other administration routes of illicit drug use (eg, "injection first") and examined whether this IDU subgroup had riskier drug using and sexual behaviors than other IDUs. Twelve-percent "injected first." Characteristics independently associated with a higher odds of "injection first" included being younger at first injection, injecting heroin as their first drug, being alone at the first injection episode, and having a sexual debut at the same age or earlier as when they initiated drug use; family members' illicit drug use was associated with lower odds of injecting first. When adjusting for age at first injection and number of years injecting, "injection first" IDUs had lower odds of ever overdosing, and ever trading sex. On the other hand, they were less likely to have ever been enrolled in drug treatment, and more commonly obtained their syringes from potentially unsafe sources. In conclusion, a sizable proportion of IDUs in Tijuana injected as their first drug using experience, although evidence that this was a riskier subgroup of IDUs was inconclusive.  Copyright © American Academy of Addiction Psychiatry.

Implications of No Recent Sexual Activity, Casual Sex, or Exclusive Sex for College Women's Sexual Well-Being Depend on Sexual Attitudes

ERIC Educational Resources Information Center

Kaestle, Christine E.; Evans, Larissa M.

2018-01-01

Objective: We examine how sexual activity relates to sexual well-being within the context of sexual attitudes, sexual agency, and sexual desire. Participants/Methods: We surveyed 471 college women in 2012-2014 who had ever had sex. Results: Sexual agency and sexual desire consistently predicted well-being, regardless of recent sexual activity.…

Predictors of change in sexual activity after cardiac diagnosis: Elements to inform sexual counseling.

PubMed

Mosack, Victoria; Hill, Twyla J; Steinke, Elaine E

2017-06-01

Safely returning to sexual activity after being diagnosed with a cardiac condition is at the core of sexual counseling strategies. To further inform sexual counseling, this study examined changes in sexual activity before and after a cardiac diagnosis. Logistic analysis was used to suggest factors that can contribute to a change in sexual activity among cardiac patients. Reduced frequency in sexual activity after a cardiac diagnosis was influenced by greater sexual concerns and a history of smoking, as well as by education and employment status. These findings suggest that cardiac patients experiencing significant concerns about resuming sexual activity need added support through the mental health system.

Routes to failure: analysis of 41 civil aviation accidents from the Republic of China using the human factors analysis and classification system.

PubMed

Li, Wen-Chin; Harris, Don; Yu, Chung-San

2008-03-01

The human factors analysis and classification system (HFACS) is based upon Reason's organizational model of human error. HFACS was developed as an analytical framework for the investigation of the role of human error in aviation accidents, however, there is little empirical work formally describing the relationship between the components in the model. This research analyses 41 civil aviation accidents occurring to aircraft registered in the Republic of China (ROC) between 1999 and 2006 using the HFACS framework. The results show statistically significant relationships between errors at the operational level and organizational inadequacies at both the immediately adjacent level (preconditions for unsafe acts) and higher levels in the organization (unsafe supervision and organizational influences). The pattern of the 'routes to failure' observed in the data from this analysis of civil aircraft accidents show great similarities to that observed in the analysis of military accidents. This research lends further support to Reason's model that suggests that active failures are promoted by latent conditions in the organization. Statistical relationships linking fallible decisions in upper management levels were found to directly affect supervisory practices, thereby creating the psychological preconditions for unsafe acts and hence indirectly impairing the performance of pilots, ultimately leading to accidents.

The Wechsler Digit Symbol Substitution Test as the best indicator of the risk of impaired driving in Alzheimer disease and normal aging.

PubMed

Lafont, Sylviane; Marin-Lamellet, Claude; Paire-Ficout, Laurence; Thomas-Anterion, Catherine; Laurent, Bernard; Fabrigoule, Colette

2010-01-01

Our purpose was to identify cognitive tools associated with unsafe driving among elderly drivers of varying cognitive levels. Twenty drivers with early-stage dementia of the Alzheimer type and 56 nondemented drivers aged 65-85 were recruited. Various cognitive processes were measured and unsafe driving was evaluated during an in-traffic road test with 3 different indicators and a composite indicator. The Wechsler Digit Symbol Substitution Test score was the best cognitive measure to detect unsafe drivers using the composite driving indicator. The Digit Symbol Substitution Test may be used by physicians for the evaluation and follow-up of older patients, with or without Alzheimer-type dementia, as a screening tool of unsafe driving.

Accident Report: Pupils -- Employees, School Jurisdiction, 1972-1973.

ERIC Educational Resources Information Center

O'Hara, James M., Comp.; Conklin, Robert L., Comp.

This report is intended to provide principals, department heads, teachers, and parents with specific information designed to assist them in isolating unsafe conditions, activities, and behavioral problems. The document is divided into three parts: (1) a pupil section, with tables showing where accidents occurred, what parts of the body were…

27 CFR 19.79 - Discontinuance of storage facilities.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 27 Alcohol, Tobacco Products and Firearms 1 2010-04-01 2010-04-01 false Discontinuance of storage... Provisions Activities Not Subject to This Part § 19.79 Discontinuance of storage facilities. When the appropriate TTB officer finds that any facilities for the storage of spirits on bonded premises are unsafe or...

[Tensions between the (il)legal and the (il)legitimate in professional health practices regarding women who seek abortion].

PubMed

López Gómez, Alejandra

2016-01-01

The implementation of a pre- and post-abortion health care strategy, adopted in 2004 in Uruguay within a restrictive legal context prior to the decriminalization of abortion in 2012, opened a window of opportunity to link women facing unwanted pregnancies and abortion to health services in order to prevent unsafe abortion practices. This article looks into the tensions generated by the change of focus from maternal-child health to health and sexual and reproductive rights, and how those tensions operate. Using semi-structured interviews and focus groups, the practices and perception and assessment frameworks of professionals in their care of women facing unwanted pregnancy and abortion in the National Integrated Health System in Montevideo are analyzed. The results offer insights into some of the barriers and difficulties that can currently be observed in the implementation of the new law.

Social Influence and Individual Risk Factors of HIV Unsafe Sex among Female Entertainment Workers in China

PubMed Central

Yang, Xiushi; Xia, Guomei; Li, Xiaoming; Latkin, Carl; Celentano, David

2010-01-01

Female entertainment workers in China are at increased sexual risk of HIV, but causes of their unprotected sex remain poorly understood. We develop a model that integrates information-motivation-behavioral skills (IMB) with social influences and test the model in a venue-based sample of 732 female entertainment workers in Shanghai. Most IMB and social influence measures are statistically significant in bivariate relationships to condom use; only HIV prevention motivation and behavioral self-efficacy remain significant in the multiple regressions. Self-efficacy in condom use is the most proximate correlate, mediating the relationship between information and motivation and condom use. Both peer and venue supports are important, but their influences over condom use are indirect and mediated through prevention motivation and/or self-efficacy. Behavioral intervention is urgently needed and should take a multi-level approach, emphasizing behavioral skills training and promoting a supportive social/working environment. PMID:20166789

Sexual Health and Well-being Among Older Men and Women in England: Findings from the English Longitudinal Study of Ageing.

PubMed

Lee, David M; Nazroo, James; O'Connor, Daryl B; Blake, Margaret; Pendleton, Neil

2016-01-01

We describe levels of sexual activity, problems with sexual functioning, and concerns about sexual health among older adults in the English Longitudinal Study of Ageing (ELSA), and associations with age, health, and partnership factors. Specifically, a total of 6,201 core ELSA participants (56 % women) aged 50 to >90 completed a comprehensive Sexual Relationships and Activities questionnaire (SRA-Q) included in ELSA Wave 6 (2012/13). The prevalence of reporting any sexual activity in the last year declined with age, with women less likely than men at all ages to report being sexually active. Poorer health was associated with lower levels of sexual activity and a higher prevalence of problems with sexual functioning, particularly among men. Difficulties most frequently reported by sexually active women related to becoming sexually aroused (32 %) and achieving orgasm (27 %), while for men it was erectile function (39 %). Sexual health concerns most commonly reported by women related to their level of sexual desire (11 %) and frequency of sexual activities (8 %). Among men it was level of sexual desire (15 %) and erectile difficulties (14 %). While the likelihood of reporting sexual health concerns tended to decrease with age in women, the opposite was seen in men. Poor sexual functioning and disagreements with a partner about initiating and/or feeling obligated to have sex were associated with greater concerns about and dissatisfaction with overall sex life. Levels of sexual activity decline with increasing age, although a sizable minority of men and women remain sexually active until the eighth and ninth decades of life. Problems with sexual functioning were relatively common, but overall levels of sexual health concerns were much lower. Sexually active men reported higher levels of concern with their sexual health and sexual dissatisfaction than women at all ages. Older peoples' sexual health should be managed, not just in the context of their age, gender, and general health, but also within their existing sexual relationship.

Correlates of Sexual Activity and Satisfaction in Midlife and Older Women.

PubMed

Thomas, Holly N; Hess, Rachel; Thurston, Rebecca C

2015-01-01

Sexual activity is an important component of quality of life for women across their lifespan. Prior studies show a decline in sexual activity with age, but these studies often fail to consider the role of sexual satisfaction. The aim of this study is to give updated prevalence estimates of sexual activity among women and to elucidate factors associated with sexual activity and sexual satisfaction. We report a cross-sectional analysis of the second wave of a nationally representative sample of US adults aged 28 to 84 years, the Survey of Midlife Development in the United States. The survey used self-administered questionnaires to assess demographic data, self-rated physical and mental health, medical problems and medication use, relationship factors, and sexual activity and satisfaction. Of 2,116 women who answered the questions regarding sexuality, 1,345 (61.8%) women were sexually active in the previous 6 months. The proportion of women who were sexually active decreased with advancing age. Women who were married or cohabitating had approximately 8 times higher odds of being sexually active (odds ratio = 7.91, 95% CI, 4.16-15.04; P <.001). Among women aged 60 years and older who were married or cohabitating, most (59.0%) were sexually active. Among women who were sexually active, higher relationship satisfaction (P <.001), better communication (P = .011), and higher importance of sex P = .040) were related to higher sexual satisfaction, but age was not (P = .79). A considerable proportion of midlife and older women remain sexually active if they have a partner available. Psychosocial factors (relationship satisfaction, communication with romantic partner, and importance of sex) matter more to sexual satisfaction than aging among midlife and older women. © 2015 Annals of Family Medicine, Inc.

Correlates of Sexual Activity and Satisfaction in Midlife and Older Women

PubMed Central

Thomas, Holly N.; Hess, Rachel; Thurston, Rebecca C.

2015-01-01

PURPOSE Sexual activity is an important component of quality of life for women across their lifespan. Prior studies show a decline in sexual activity with age, but these studies often fail to consider the role of sexual satisfaction. The aim of this study is to give updated prevalence estimates of sexual activity among women and to elucidate factors associated with sexual activity and sexual satisfaction. METHODS We report a cross-sectional analysis of the second wave of a nationally representative sample of US adults aged 28 to 84 years, the Survey of Midlife Development in the United States. The survey used self-administered questionnaires to assess demographic data, self-rated physical and mental health, medical problems and medication use, relationship factors, and sexual activity and satisfaction. RESULTS Of 2,116 women who answered the questions regarding sexuality, 1,345 (61.8%) women were sexually active in the previous 6 months. The proportion of women who were sexually active decreased with advancing age. Women who were married or cohabitating had approximately 8 times higher odds of being sexually active (odds ratio = 7.91, 95% CI, 4.16–15.04; P <.001). Among women aged 60 years and older who were married or cohabitating, most (59.0%) were sexually active. Among women who were sexually active, higher relationship satisfaction (P <.001), better communication (P = .011), and higher importance of sex P = .040) were related to higher sexual satisfaction, but age was not (P = .79). CONCLUSIONS A considerable proportion of midlife and older women remain sexually active if they have a partner available. Psychosocial factors (relationship satisfaction, communication with romantic partner, and importance of sex) matter more to sexual satisfaction than aging among midlife and older women. PMID:26195678

"Macho" Beliefs Moderate the Association Between Negative Sexual Episodes and Activation of Incompetence Schemas in Sexual Context, in Gay and Heterosexual Men.

PubMed

Peixoto, Maria Manuela; Nobre, Pedro

2017-04-01

Despite the existence of conceptual models of sexual dysfunction based on cognitive theory, few studies have tested the role of vulnerability factors such as sexual beliefs as moderators of the activation of cognitive schemas in response to negative sexual events. To test the moderator role of dysfunctional sexual beliefs in the association between the frequency of negative sexual episodes and the activation of incompetence schemas in gay and heterosexual men. Five-hundred seventy-five men (287 gay, 288 heterosexual) who completed an online survey on cognitive-affective dimensions and sexual functioning were selected from a larger database. Hierarchical regression analyses were conducted to test the hypothesis that dysfunctional sexual beliefs moderate the association between the frequency of unsuccessful sexual episodes and the activation of incompetence schemas. Participants completed the Sexual Dysfunctional Beliefs Questionnaire and the Questionnaire of Cognitive Schemas Activated in Sexual Context. Findings indicated that men's ability for always being ready for sex, to satisfy the partner, and to maintain an erection until ending sexual activity constitute "macho" beliefs that moderate the activation of incompetence schemas when unsuccessful sexual events occur in gay and heterosexual men. In addition, activation of incompetence schemas in response to negative sexual events in gay men was moderated by the endorsement of conservative attitudes toward moderate sexuality. The main findings suggested that psychological interventions targeting dysfunctional sexual beliefs could help de-catastrophize the consequences of negative sexual events and facilitate sexual functioning. Despite being a web-based study, it represents the first attempt to test the moderator role of dysfunctional sexual beliefs in the association between the frequency of unsuccessful sexual episodes and the activation of incompetence schemas in gay and heterosexual men. Overall, findings support the role of sexual beliefs as facilitators of the activation of incompetence schemas in the face of negative sexual events in gay and heterosexual men, emphasizing the need to develop treatment and prevention strategies aimed at challenging common male beliefs about sexuality. Peixoto MM, Nobre P. "Macho" Beliefs Moderate the Association Between Negative Sexual Episodes and Activation of Incompetence Schemas in Sexual Context, in Gay and Heterosexual Men. J Sex Med 2017;14:518-525. Copyright © 2017 International Society for Sexual Medicine. Published by Elsevier Inc. All rights reserved.

Blood Pressure, Sexual Activity, and Dysfunction in Women With Hypertension: Baseline Findings From the Systolic Blood Pressure Intervention Trial (SPRINT).

PubMed

Foy, Capri G; Newman, Jill C; Berlowitz, Dan R; Russell, Laurie P; Kimmel, Paul L; Wadley, Virginia G; Thomas, Holly N; Lerner, Alan J; Riley, William T

2016-09-01

Sexual function, an important component of quality of life, is gaining increased research and clinical attention in older women with hypertension. To assess the association between systolic blood pressure (SBP) and other variables, and sexual activity and sexual dysfunction in hypertensive women. Baseline analysis of 635 women participants of a larger randomized clinical trial of 9361 men and women. Self-reported sexual activity (yes/no), and sexual function using the Female Sexual Function Inventory (FSFI). 452 participants (71.2%) reported having no sexual activity during the previous 4 weeks. The mean (SD) FSFI score for sexually active participants was 25.3 (6.0), and 52.6% of the sample reported a FSFI score ≤26.55 designating sexual dysfunction. In logistic regression models, SBP was not significantly associated with sexual activity (AOR = 1.002; P > .05). Older age (AOR = 0.95, P < .05), and lower education (AOR for < high school vs college degree = 0.29, P < .05) were associated with lower odds of being sexually active, as was living alone versus living with others (AOR = 0.56, P < .05). Higher weekly alcohol consumption was associated with increased odds of being sexually active (AOR = 1.39; P < .05). In logistic regression models among sexually active participants, SBP was not associated with sexual dysfunction (AOR = 1.01; P > .05). Higher depressive symptoms from the Patient Health Questionnaire-9 (PHQ-9) was associated with higher odds of sexual dysfunction (AOR = 1.24, P < .05), as was increased number of physical comorbidities (AOR = 1.25, P < .05). Diuretic use was associated with lower odds of being sexually active in participants with chronic kidney disease (AOR = 0.33, P < .05). Younger age, higher education, living with others, and higher weekly alcohol consumption were significantly associated with higher odds of being sexually active in a sample of middle-aged and older women with hypertension. Increased depressive symptoms and increased physical comorbidities were significantly associated with increased odds of sexual dysfunction. SBP was not significantly associated with sexual activity or sexual dysfunction. Copyright © 2016 International Society for Sexual Medicine. Published by Elsevier Inc. All rights reserved.

Sexual self-concept and intended sexual behavior of young adolescent Taiwanese girls.

PubMed

Pai, Hsiang-Chu; Lee, Sheuan; Chang, Ting

2010-01-01

People begin to become aware of their sexual drive and erotic feelings as young adolescents. Such activity often has been overlooked in Taiwan, a traditional society, because sexuality is viewed as a private issue. The purpose of this study was to explore the sexual self-concept and intended sexual behavior of young adolescent girls in Taiwan. Participants included 372 girls, 12 to 14 years old, from junior high schools in Taiwan who completed two questionnaires on sexual experience and sexually related items: the Sexual Self-Concept Inventory, the Parental Approval of Sexual Behavior Scale, and the Friends' Approval of Sexual Behavior Scale, which were combined into one scale, with separate scores. Girls' self-reports showed low (negative) sexual self-concept, high perceived parental disapproval, and somewhat high perceived friends' disapproval of sexual activities. Sexual self-concept is associated with perceived parental and peer approval of sexual activities, and it is associated with sexual experience and intended sexual activities as well. A young adolescent girl who has a high score on the perceived sexual arousability factor of the Sexual Self-Concept Inventory is more likely to report the strongest intention toward sexual behavior. Sexual self-concept may play a key role in girls' intended sexual activities, including engaging in low-level sexual activities (e.g., kissing and breast fondling) that occur before intercourse, even when associated with intercourse intention. The research suggests that addressing sexual self-concept needs to be a priority to prevent young girls from engaging in sexual intercourse.

Development and validation of the Female Sexual Function Index adaptation for breast cancer patients (FSFI-BC).

PubMed

Bartula, Iris; Sherman, Kerry A

2015-08-01

Sexual dysfunction following breast cancer treatment is common and screening for this is recommended. This study determined the reliability, validity, and acceptability of a breast cancer-specific adaptation of the Female Sexual Function Index, the FSFI-BC. This new measure addresses limitations in the FSFI when assessing sexual dysfunction of women with breast cancer regarding applicability to non-sexually active women, measuring distress and changes after cancer. Female breast cancer survivors (n = 596; 429 sexually active, 166 non-sexually active) completed an online survey including demographic/medical information, the FSFI-BC, and scales measuring sexual functioning, fatigue, body image, physical and mental health, and relationship adjustment (Time 1). Three weeks later, 326 women (245 sexually active; 81 non-sexually active) completed the Time 2 survey including the FSFI-BC, and questions regarding its acceptability and perceived change in sexual functioning. Reliability, construct validity, and acceptability were examined using standard scale validation techniques. Exploratory factor analysis delineated seven factors: Changes after cancer, desire/arousal, lubrication, orgasm, pain, satisfaction, and distress, accounting for 79.98 % (sexually active) and 77.19 % (non-active) variance in responses. Acceptable internal consistencies (non-active: α = 0.71-0.96; sexually active: α = 0.89-0.96) and test-retest reliabilities (non-active: r = 0.63-0.86; sexually active: r = 0.71-0.88) were evident. Inter-scale correlations provided evidence for convergent and divergent validities of the FSFI-BC. Both sexually active and non-active women provided positive feedback about the FSFI-BC. The optional partner questions demonstrated clinical utility. With desirable psychometric properties and acceptability to participants, the FSFI-BC is suitable for screening for sexual dysfunction in women with breast cancer.

Fire and Explosion Hazards Expected in a Laboratory

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

Rasool, Shireen R.; Al-Dahhan, Wedad; Al-Zuhairi, Ali Jassim

Scientists at universities across Iraq are actively working to report actual incidents and accidents occurring in their laboratories, as well as structural improvements made to improve safety and security, to raise awareness and encourage openness, leading to widespread adoption of robust Chemical Safety and Security (CSS) practices. This manuscript is the fifth in a series of five case studies describing laboratory incidents, accidents, and laboratory improvements. In this study, we summarize unsafe practices involving the improper installation of a Gas Chromatograph (GC) at an Iraqi university which, if not corrected, could have resulted in a dangerous fire and explosion. Wemore » summarize the identified infractions and highlight lessons learned. By openly sharing the experiences at the university involved, we hope to minimize the possibility of another researcher being injured due to similarly unsafe practices in the future.« less

Sexual Activity and Cognitive Decline in Older Adults.

PubMed

Allen, Mark S

2018-05-16

This prospective study tested whether sexual activity and emotional closeness during partnered sexual activity relate to cognitive decline (episodic memory performance) in older adulthood. In total, 6016 adults aged 50 and over (2672 men, 3344 women; M age = 66.0 ± 8.8 years) completed an episodic memory task and self-report questions related to health, sexual activity, and emotional closeness. Two years later, participants again completed the episodic memory task. After controlling for demographic and health-related lifestyle factors, more frequent sexual activity and greater emotional closeness during partnered sexual activity were associated with better memory performance. The association between sexual activity and memory performance was stronger among older participants in the sample. Memory performance worsened over 2 years, but change in memory performance was unrelated to sexual activity or emotional closeness during partnered sexual activity. These findings build on experimental research that has found sexual activity enhances episodic memory in non-human animals. Further research using longer timeframes and alternative measures of cognitive decline is recommended.

Psychological Factors Involved in Sexual Desire, Sexual Activity, and Sexual Satisfaction: A Multi-factorial Perspective.

PubMed

Dosch, Alessandra; Rochat, Lucien; Ghisletta, Paolo; Favez, Nicolas; Van der Linden, Martial

2016-11-01

This study explored the role of psychological trait factors in sexual desire and sexual activity. In particular, it investigated how these factors may contribute to maintaining a balance between motivational aspects and self-control abilities, as both have been considered important in relation to adaptive sexuality. Moreover, the study explored the relationship between sexual desire, activity, and satisfaction. Participants completed questionnaires assessing sexual desire (dyadic, solitary), sexual activity (with a partner, alone), sexual satisfaction, approach and avoidance motivation, attachment, self-control, sensation seeking, and mindfulness. Cluster analyses, based on participants' level of sexual desire and sexual activity, highlighted three distinct profiles for each gender related to different types of psychological functioning: (a) participants with high dyadic sexual desire and activity were the most sexually satisfied, showed optimal psychological functioning, and were characterized by a balance between motivational tendencies to seek positive rewards and self-control abilities (high approach motivation, secure attachment, high self-control, high mindfulness); (b) participants with high dyadic and solitary sexual desire and activity were moderately satisfied and showed a type of psychological functioning predominantly characterized by impulsivity (an overly high motivation to obtain rewards in women, and low self-control in men); (c) participants with low dyadic sexual desire and activity were the least sexually satisfied and were characterized by high motivation to avoid negative consequences and low self-control (high avoidance motivation, insecure attachment, and poor mindfulness). These results shed further light on how fundamental psychological factors contribute to explain the individual variability in sexual desire, activity, and satisfaction.

On the Identification of Associations between Five World Health Organization Water, Sanitation and Hygiene Phenotypes and Six Predictors in Low and Middle-Income Countries.

PubMed

Ellis, Hugh; Schoenberger, Erica

2017-01-01

According to the most recent estimates, 842,000 deaths in low- to middle-income countries were attributable to inadequate water, sanitation and hygiene in 2012. Despite billions of dollars and decades of effort, we still lack a sound understanding of which kinds of WASH interventions are most effective in improving public health outcomes, and an important corollary-whether the right things are being measured. The World Health Organization (WHO) has made a concerted effort to compile comprehensive data on drinking water quality and sanitation in the developing world. A recent 2014 report provides information on three phenotypes (responses): Unsafe Water Deaths, Unsafe Sanitation Deaths, Unsafe Hygiene Deaths; two grouped phenotypes: Unsafe Water and Sanitation Deaths and Unsafe Water, Sanitation and Hygiene Deaths; and six explanatory variables (predictors): Improved Sanitation, Unimproved Water Source, Piped Water To Premises, Other Improved Water Source, Filtered and Bottled Water in the Household and Handwashing. Regression analyses were performed to identify statistically significant associations between these mortality responses and predictors. Good fitted-model performance required: (1) the use of population-normalized death fractions as opposed to number of deaths; (2) transformed response (logit or power); and (3) square-root predictor transformation. Given the complexity and heterogeneity of the relationships and countries being studied, these models exhibited remarkable performance and explained, for example, about 85% of the observed variance in population-normalized Unsafe Sanitation Death fraction, with a high F-statistic and highly statistically significant predictor p-values. Similar performance was found for all other responses, which was an unexpected result (the expected associations between responses and predictors-i.e., water-related with water-related, etc. did not occur). The set of statistically significant predictors remains the same across all responses. That is, Unsafe Water Source (UWS), Improved Sanitation (IS) and Filtered and Bottled Water in the Household (FBH) were the only statistically significant predictors whether the response was Unsafe Sanitation Death Fraction, Unsafe Hygiene Death Fraction or Unsafe Water Death Fraction. Moreover, the fraction of variance explained for all fitted models remained relatively high (adjusted R2 ranges from 0.7605 to 0.8533). We find that two of the statistically significant predictors-Improved Sanitation and Unimproved Water Sources-are particularly influential. We also find that some predictors (Piped Water to Premises, Other Improved Water Sources) have very little explanatory power for predicting mortality and one (Other Improved Water Sources) has a counterintuitive effect on response (Unsafe Sanitary Death Fraction increases with increases in OIWS) and one predictor (Hand Washing) to have essentially no explanatory usefulness. Our results suggest that a higher priority may need to be given to improved sanitation than has been the case. Nevertheless, while our focus in this paper is mortality, morbidity is a staggering consequence of inadequate water, sanitation and hygiene, and lower impact on mortality may not mean a similarly low impact on morbidity. More specifically, those predictors that we found uninfluential for predicting mortality-related responses may indeed be important when morbidity is the response.

Specificity of sexual arousal for sexual activities in men and women with conventional and masochistic sexual interests.

PubMed

Chivers, Meredith L; Roy, Carolyn; Grimbos, Teresa; Cantor, James M; Seto, Michael C

2014-07-01

Prior studies consistently report that men's genital responses correspond to their sexual activity interests (consenting vs. coercive sex) whereas women's responses do not. For women, however, these results may be confounded by the sexual activities studied and lack of suitable controls. We examined the subjective and genital arousal responses of men and women with conventional (22 men and 15 women) or masochistic sexual interests (16 men and 17 women) to narratives describing conventional sex or masochistic sex. The aims of the studies were twofold: (1) to examine whether gender differences in the specificity of sexual arousal previously observed for gender also exist for sexual activity interests; and (2) to examine whether men and women with masochistic sexual interests demonstrate specificity of sexual response for their preferred sexual activities. Surprisingly, the pattern of results was very similar for men and women. Both men and women with conventional sexual interests (WCI) reported more sexual arousal, and responded more genitally, to conventional than to masochistic sex, demonstrating specificity of sexual arousal for their preferred sexual activities. Despite showing specificity for conventional sexual activities, the genital responses of WCI were still gender nonspecific. In contrast, women and men with masochistic sexual interests demonstrated nonspecific subjective and genital responses to conventional and masochistic sex. Indices of genital and subjective sexual arousal to masochistic versus conventional stimuli were positively and significantly correlated with self-reported thoughts, fantasies, interests, and behaviors involving masochism. The results suggest that gender similarities in the specificity of sexual arousal for sexual activity exist despite consistent gender differences in the specificity of sexual arousal for gender.

The Research on the Impact of Management Level's Charismatic Leadership Style on Miners' Unsafe Behavior.

PubMed

Li, Hongxia; Di, Hongxi; Tian, Shuicheng; Li, Jian

2015-01-01

The aim of this study is research the impact of management level's charismatic leadership style on miners' unsafe behavior by using the questionnaires on charismatic leadership style, safety attitude and the miners' unsafe behavior measurement to investigate 200 employees in Shen Dong Company. The research results suggest that management level's charismatic leadership style have very important influence on miners' unsafe behavior and the influence is affected by the safety attitude which is the intermediary function. In the end, this study propose advice on how to improve the coal mine enterprise managers charismatic leadership style in the coal mine enterprise's safety management work, including attach great importance to a variety of incentive methods, set up safety moral models, practice of inductive leadership concept, create a good atmosphere of safety, etc for reference for coal mining enterprises.

Medium and long-term adherence to postabortion contraception among women having experienced unsafe abortion in Dar es Salaam, Tanzania

PubMed Central

Rasch, Vibeke; Yambesi, Fortunata; Massawe, Siriel

2008-01-01

Background Postabortion contraceptive service is considered an effective means in addressing the problem of unsafe abortion; in spite this fact this component remains one of the weakest parts of postabortion care. In this context, the paper aims to describe the impact of a postabortion contraceptive service intervention among women admitted with complications from unsafe abortions and to explore the women's long-term contraceptive adherence. Methods 392 women having experienced unsafe abortion were identified by an empathetic approach and offered postabortion contraceptive service, which included counselling on HIV and condom use. Questionnaire interviews about contraceptive use were conducted at the time of inclusion and 12 months after the abortion. Additionally, in-depth interviews were performed 6–12 months after the abortion. Results Eighty-nine percent of the women accepted postabortion contraception. Follow-up information was obtained 12 months after the abortion among 59 percent of the women. Among these, 79 percent of the married women and 84 percent of the single women stated they were using contraception at 12 months. Condom use among the single women increased significantly during the 12 months follow up. Conclusion Postabortion contraceptive services appear to be well accepted by women who are admitted with complications after an unsafe abortion and should thus be recognized as an important means in addressing the problem of unsafe abortion. In addition, counselling about HIV and condom use should be considered an essential aspect of postabortion care. PMID:18667094

Adolescent males and young females in tehran: differing perspectives, behaviors and needs for reproductive health and implications for gender sensitive interventions.

PubMed

Farahani, Farideh Khalaj Abadi; Shah, Iqbal; Cleland, John; Mohammadi, Mohammad Reza

2012-04-01

Despite cultural and religious prohibitions against premarital heterosexual relationships and intimacy, some recent evidence suggests some rise in premarital heterosexual interactions and relationships among young people. On the other hand, although HIV in Iran is a concentrated epidemic and mainly reported among high risk groups such as injecting drug users (IDUs), but there are evidences that the mode of transmission is shifting towards sexual contacts. This trend has caused concern among health policy makers in terms of prevention of STDs and HIV/AIDS particularly, among young people. This paper was prepared with the aim of highlighting how gender contributes to variation in reproductive health needs and conduct of young people in Iran. This paper is based on a secondary analysis and compares comparable reproductive beliefs and conducts of women and men based on the data of two surveys conducted in Tehran in 2002 and 2005. A survey among 1385 adolescent males and another survey among 1743 female undergraduate students in four multidisciplinary universities in Tehran. Both surveys used anonymous self-administered questionnaires. To make the two samples comparable, the data of unmarried female university undergraduate students who resided in Tehran were merged with the data of adolescent male students who intended to pursue higher education. Common variables of the two surveys were identified, homogenized, merged and analysed. Reproductive health knowledge among male adolescents was poor compared to that of their female peers. Although premarital friendships were moderately acceptable from view points of both males and females, the majority were against premarital sex, particularly among female participants. There were evidences of gender-based double standards in perceptions of premarital sexuality among both males and females; particularly, it was stronger among males than females. Male adolescents reported earlier and greater experiences of premarital heterosexual intimacy and sexual contact than females. Multiple partners were also more common among males than females. Females had a tendency to regret first sexual contact more than males, which reflects that first sex is more likely to be unplanned and unwanted among females compared to males. Significant gender-based double standards prevailed current sexual attitudes and conduct of young people in Iran. Gender norms which encourage unmarried men to practice premarital sex lead to an earlier transition of men to sexual relations and multiple sexual partners. Due to poor knowledge and various misconceptions about sexual health and lack of consistent contraceptive and condom use among adolescents and young people in Iran, both young men and women are susceptible to sexual and reproductive health hazards such as sexually transmitted infections (STIs), HIV/AIDS, pregnancy and unsafe abortion. Changing gender norms associated with sexuality may lead to promotion of safer sexual behaviors particularly among young people. Current reproductive health and HIV prevention programs should take into account gender-based double standards among young people and their unmet reproductive health needs.

Adolescent Males and Young Females in Tehran: Differing Perspectives, Behaviors and Needs for Reproductive Health and Implications for Gender Sensitive Interventions

PubMed Central

Farahani, Farideh Khalaj Abadi; Shah, Iqbal; Cleland, John; Mohammadi, Mohammad Reza

2012-01-01

Background Despite cultural and religious prohibitions against premarital heterosexual relationships and intimacy, some recent evidence suggests some rise in premarital heterosexual interactions and relationships among young people. On the other hand, although HIV in Iran is a concentrated epidemic and mainly reported among high risk groups such as injecting drug users (IDUs), but there are evidences that the mode of transmission is shifting towards sexual contacts. This trend has caused concern among health policy makers in terms of prevention of STDs and HIV/AIDS particularly, among young people. This paper was prepared with the aim of highlighting how gender contributes to variation in reproductive health needs and conduct of young people in Iran. Method This paper is based on a secondary analysis and compares comparable reproductive beliefs and conducts of women and men based on the data of two surveys conducted in Tehran in 2002 and 2005. A survey among 1385 adolescent males and another survey among 1743 female undergraduate students in four multidisciplinary universities in Tehran. Both surveys used anonymous self-administered questionnaires. To make the two samples comparable, the data of unmarried female university undergraduate students who resided in Tehran were merged with the data of adolescent male students who intended to pursue higher education. Common variables of the two surveys were identified, homogenized, merged and analysed. Results Reproductive health knowledge among male adolescents was poor compared to that of their female peers. Although premarital friendships were moderately acceptable from view points of both males and females, the majority were against premarital sex, particularly among female participants. There were evidences of gender-based double standards in perceptions of premarital sexuality among both males and females; particularly, it was stronger among males than females. Male adolescents reported earlier and greater experiences of premarital heterosexual intimacy and sexual contact than females. Multiple partners were also more common among males than females. Females had a tendency to regret first sexual contact more than males, which reflects that first sex is more likely to be unplanned and unwanted among females compared to males. Conclusion Significant gender–based double standards prevailed current sexual attitudes and conduct of young people in Iran. Gender norms which encourage unmarried men to practice premarital sex lead to an earlier transition of men to sexual relations and multiple sexual partners. Due to poor knowledge and various misconceptions about sexual health and lack of consistent contraceptive and condom use among adolescents and young people in Iran, both young men and women are susceptible to sexual and reproductive health hazards such as sexually transmitted infections (STIs), HIV/AIDS, pregnancy and unsafe abortion. Changing gender norms associated with sexuality may lead to promotion of safer sexual behaviors particularly among young people. Current reproductive health and HIV prevention programs should take into account gender-based double standards among young people and their unmet reproductive health needs. PMID:23926532

Sexual activity and contraceptive use among low-income urban black adolescent females.

PubMed

Keith, J B; McCreary, C; Collins, K; Smith, C P; Bernstein, I

1991-01-01

A modified form of Nathanson and Becker's (1983) Health Belief Model Questionnaire and other measures designed to assess cognitive processing were administered to low-income black adolescent female clients of an inner-city comprehensive health care clinic. The purpose of the study was to explore determinants of sexual activity and contraceptive use. Subjects were classified as not sexually active (n = 50), sexually active/noncontracepting (n = 20), or sexually active/contracepting (n = 72). Not sexually active subjects tended to be younger, more career motivated, to have a father at home, to be more influenced by family values, and to have more conservative attitudes regarding adolescent sexuality than did sexually active subjects. Sexually active/noncontracepting subjects tended to report fewer benefits and more barriers to the use of contraception. Level of cognitive processing did not differ among the three groups, but was at a lower-than-expected level for age. Finally, inconsistent contraceptive use was common to both sexually active groups.

Exploring factors associated with sexual activity in community-dwelling older adults.

PubMed

Killinger, Kim A; Boura, Judith A; Diokno, Ananias C

2014-01-01

Sexuality is an important, yet often overlooked, aspect of successful aging. The current article explores potential relationships between sexual activity in older adults and marital status, health, mobility, urinary incontinence, and caffeine and alcohol use, as well as sexual desire and erectile function in women and men, respectively. A survey was mailed to community-dwelling older adults 60 and older. Of 242 respondents (79% ages 60 to 74, 53% male), 159 (65.7%) were sexually active. A higher proportion of sexually active adults were married (p = 0.0005), had better health (p = 0.0003), and drank alcohol (p = 0.007). A lower proportion of sexually active adults had urinary incontinence (p = 0.006). Similar proportions of men and women were sexually active (62.8% and 68.2%, respectively; p = 0.38). Sexually active women had better sexual desire scores (p < 0.0001) and more drank alcohol (p = 0.0013). Sexually active men had better mobility (p = 0.012) and erectile function (p < 0.0001). Fewer sexually active men had incontinence (p < 0.0001). Only alcohol use and no urinary incontinence were predictors unique to women and men, respectively. Health care providers must be aware of factors that may impact sexual health in older adults. Copyright 2014, SLACK Incorporated.

Unsafe abortion: a cruel way of birth control.

PubMed

Shrivastava, Saurabh RamBihariLal; Shrivastava, Prateek Saurabh; Ramasamy, Jegadeesh

2014-06-01

Unsafe abortion refers to a procedure for terminating an unintended pregnancy performed either by persons lacking the necessary skills or in an environment that does not conform to minimal medical standards, or both. The objectives of the study are to assess the factors attributing to practice of unsafe abortion and to suggest feasible and cost-effective measures to counter the same. An extensive search of all materials related to the topic was made using library sources including Pubmed, Medline and World Health Organization. Keywords used in the search include unsafe abortion and unintended pregnancy. Multiple socio-demographic determinants and barriers such as illiterate women, poor socio-economic status, poor awareness about abortion services, associated stigma, and untrained health professionals have been identified resulting in restricted utilization/access of women to safe abortion services. Consequences of unsafe abortion have been alarming, seriously questioning the quality of health care delivery system. Concerted and dedicated efforts of government in collaboration with the private sector, community members and non-governmental organizations are needed to ensure that women have a better access to contraceptives, abortion services, and post-abortion care that are safe, affordable, and free from stigma.

Cost of abortions in Zambia: A comparison of safe abortion and post abortion care.

PubMed

Parmar, Divya; Leone, Tiziana; Coast, Ernestina; Murray, Susan Fairley; Hukin, Eleanor; Vwalika, Bellington

2017-02-01

Unsafe abortion is a significant but preventable cause of maternal mortality. Although induced abortion has been legal in Zambia since 1972, many women still face logistical, financial, social, and legal obstacles to access safe abortion services, and undergo unsafe abortion instead. This study provides the first estimates of costs of post abortion care (PAC) after an unsafe abortion and the cost of safe abortion in Zambia. In the absence of routinely collected data on abortions, we used multiple data sources: key informant interviews, medical records and hospital logbooks. We estimated the costs of providing safe abortion and PAC services at the University Teaching Hospital, Lusaka and then projected these costs to generate indicative cost estimates for Zambia. Due to unavailability of data on the actual number of safe abortions and PAC cases in Zambia, we used estimates from previous studies and from other similar countries, and checked the robustness of our estimates with sensitivity analyses. We found that PAC following an unsafe abortion can cost 2.5 times more than safe abortion care. The Zambian health system could save as much as US$0.4 million annually if those women currently treated for an unsafe abortion instead had a safe abortion.

Sensorimotor and postural control factors associated with driving safety in a community-dwelling older driver population.

PubMed

Lacherez, Philippe; Wood, Joanne M; Anstey, Kaarin J; Lord, Stephen R

2014-02-01

To establish whether sensorimotor function and balance are associated with on-road driving performance in older adults. The performance of 270 community-living adults aged 70-88 years recruited via the electoral roll was measured on a battery of peripheral sensation, strength, flexibility, reaction time, and balance tests and on a standardized measure of on-road driving performance. Forty-seven participants (17.4%) were classified as unsafe based on their driving assessment. Unsafe driving was associated with reduced peripheral sensation, lower limb weakness, reduced neck range of motion, slow reaction time, and poor balance in univariate analyses. Multivariate logistic regression analysis identified poor vibration sensitivity, reduced quadriceps strength, and increased sway on a foam surface with eyes closed as significant and independent risk factors for unsafe driving. These variables classified participants into safe and unsafe drivers with a sensitivity of 74% and specificity of 70%. A number of sensorimotor and balance measures were associated with driver safety and the multivariate model comprising measures of sensation, strength, and balance was highly predictive of unsafe driving in this sample. These findings highlight important determinants of driver safety and may assist in developing efficacious driver safety strategies for older drivers.

The Activation of Incompetence Schemas in Response to Negative Sexual Events in Heterosexual and Lesbian Women: The Moderator Role of Personality Traits and Dysfunctional Sexual Beliefs.

PubMed

Peixoto, Maria Manuela; Nobre, Pedro

2017-01-01

Personality traits and dysfunctional sexual beliefs have been described as vulnerability factors for sexual dysfunction in women, and have also been proposed as dispositional variables for the activation of incompetence schemas in response to negative sexual events. However, no study has tested the role of personality traits and dysfunctional sexual beliefs in the activation of incompetence schemas. The current study aimed to assess the moderator role of neuroticism, extraversion, and dysfunctional sexual beliefs in the association between frequency of unsuccessful sexual episodes and activation of incompetence schemas in heterosexual and lesbian women. An online survey was completed by 1,121 women (831 heterosexual; 290 lesbian). Participants completed the NEO Five-Factor Inventory (NEO-FFI), the Sexual Dysfunctional Beliefs Questionnaire-Female Version (SDBQ), and the Questionnaire of Cognitive Schemas Activated in Sexual Context (QCSASC). Findings indicate that neuroticism moderates the association between frequency of negative sexual events and activation of incompetence schemas in heterosexual women. Moreover, several sexual beliefs also act as moderators of the relationship between negative sexual episodes and the activation of cognitive schemas in both heterosexual and lesbian women. Overall, findings support the cognitive-emotional model of sexual dysfunctions, emphasizing the role of personality traits and dysfunctional sexual beliefs as facilitators of the activation of incompetence schemas in response to negative events in women.

77 FR 27144 - Airworthiness Directives; Agusta S.p.A. Helicopters

Federal Register 2010, 2011, 2012, 2013, 2014

2012-05-09

... that resulted from ``inadequate functioning of the 35 amperes (amps) BATT BUS circuit breaker.'' The.... (b) Unsafe Condition This AD defines the unsafe condition as failure of the 35 ampere (amp) ``BATT...

Sexual health and sexual trauma in women with severe mental illness: An exploratory survey of Western Australian community mental health services.

PubMed

Nguyen, Thinh; Hauck, Yvonne L; Pedruzzi, Rebecca A; Frayne, Jacqueline; Rock, Daniel; Dragovic, Milan

2017-07-01

Australian women attending community mental health services were surveyed to determine the relationship between sexual trauma, sexual activity, and sexual health seeking behaviors. Self-reported history of "forced sex" was 58.4% (n = 122 out of 220). Latent class analysis revealed a three-class model: "sexually active and health seeking," "low sexual activity and health seeking" and "low sexual activity and not health seeking." An association with general practitioner engagement and sexual health seeking behaviors was found. Rates of self-reported sexual trauma reinforce the need for screening and trauma informed care. Groupings may reflect different aspects of recovery associated with sexual health behaviors.

Predictors of Sexually Transmitted Infections among Female Sex Workers (FSWs) in a City of Northern India

PubMed Central

Shukla, Pallavi; Masood, Jamal; Singh, J. V.; Singh, V. K.; Gupta, Abhishek; Krishna, Asuri

2015-01-01

Introduction: Sexually transmitted infections (STIs) and Reproductive tract infections RTIs are important public health problems in India. The prevalence of these infections is considerably higher among high risk groups (HRGs) ranging from 20-30%. It is high time that a study should be conducted to explore different factors and conditions responsible for the practice of unsafe sex among female sex workers (FSWs) in Uttar Pradesh (UP) and the impact of this on social life and health of FSWs. As Lucknow provides a comprehensive opportunity in terms of tourism, occupation, and economy, it becomes a potential hub for sex work. Studying FSW in Lucknow can thus be considered as a yardstick for the entire FSW population of UP population. The present study was thus planned with the objective of knowing the STI prevalence and its determinants among FSWs. Materials and Methods: A cross-sectional descriptive study was conducted on FSWs registered with Targeted Intervention-Non-government Organization (TI-NGO), registered with Uttar Pradesh State Acquired Immuno Deficiency Syndrome (AIDS) Control Society (UPSACS) of Lucknow city. Total 288 subjects were studied. Results: The average age of FSWs was 31 years. FSWs were mostly Hindus and illiterate. The overall prevalence of STI as per Syndromic diagnosis was found to be 35.8%. However, the percentage of FSWs with STI was higher in street-based (50.6%) than home-based (29.8%). Majority (42.7%) of sex workers with STI had non-regular partners only while majority (52.4%) of sex workers without any STI had only regular partners. Condom usage with regular partners was poor. However, with the non-regular partners the condom usage was better. On multivariate analysis being single, having sex work as a sole means of earning, duration of sex work > 2 years, having pallor, and giving in to client's demand for unsafe sex were found to be significant in causing STI. Conclusions: Prevalence of STI among the female sex workers as per Syndromic diagnosis was found to be 35.8%. Unemployment, anemia, and having sex without condom for extra money, failure to persuade the client and not doing anything were found to be important predictors for presence of STI. PMID:25861174

Sexual activity in Brazilian women aged 50 years or older within the framework of a population-based study.

PubMed

Valadares, Ana Lúcia Ribeiro; Santos Machado, Vanessa S; da Costa-Paiva, Lúcia S; de Souza, Maria Helena; Osis, Maria José; Pinto-Neto, Aarão M

2014-03-01

This study aims to evaluate the prevalence of sexual activity, factors associated with being sexually active, and sexual self-perception in women 50 years or older living in a Brazilian city. This population-based study applied a questionnaire to a random sample of 622 Brazilian women 50 years or older, representative of a population of 131,800 women, to obtain data on sexual activity and women's perception of their sexual life as part of a broader study that dealt with women's health. Associations between sexual activity, women's perception of their sexual life, and demographic, behavioral, and medical characteristics were determined. Overall, 36.7% of the participants reported being sexually active. Of these, 53.5% classified their sexual life as very good or good. Multiple regression analysis showed that the main factors associated with the absence of sexual activity were not having a partner (prevalence ratio [PR], 0.16; 95% CI, 0.12-0.23; P < 0.001), aging (PR, 0.95; 95% CI, 0.94-0.96; P < 0.001), and current or past smoking of five or more cigarettes per day (PR, 0.79; 95% CI, 0.63-0.98; P = 0.034), whereas being sexually active was associated with the practice of physical activity (PR, 1.20; 95% CI, 1.02-1.41; P = 0.032). A woman's classification of her sexual life as very poor, poor, or fair was associated with current or past use of natural remedies to treat menopausal symptoms (PR, 1.38; 95% CI, 1.06-1.81; P = 0.020). The main factors associated with the absence of sexual activity are not having a sexual partner, aging, and smoking, whereas weekly physical activity is associated with being sexually active. A poorer classification of a woman's sexual life is associated with her having used natural remedies to treat menopausal symptoms.

Time Out from Sex or Romance: Sexually Experienced Adolescents' Decisions to Purposefully Avoid Sexual Activity or Romantic Relationships.

PubMed

Byers, E Sandra; O'Sullivan, Lucia F; Brotto, Lori A

2016-05-01

Researchers have given significant attention to abstinence among adolescents, but far less is known about purposeful avoidance of sexual activity (and relationship involvement). Typically, it is assumed that, once adolescents have initiated sexual activity, they will thereafter engage in sexual activity if given the opportunity. However, it is unclear whether that is true as some research indicates that many adolescents engage in sexual activity intermittently. Sexually experienced adolescents may purposefully avoid engaging in sexual activity for a period of time and, if so, this has implications for understanding their sexual decision-making. We used a mixed methods approach to investigate sexually experienced adolescents' decisions to purposefully avoid further sexual activity and/or romantic relationships with a focus on how common these decisions are and factors influencing them. Participants were 411 (56 % female) adolescents (16-21 years old) who completed an on-line survey that assessed reasons for each type of avoidance, religiosity, sexual esteem, sexual distress, sexual coercion, and dysfunctional sexual beliefs. Overall, 27 % of participants had engaged in sexual avoidance and 47 % had engaged in romantic avoidance. Significantly more female than male adolescents reported sexual and romantic avoidance. Adolescents' reasons for sexual avoidance included: lack of sexual pleasure or enjoyment, relationship reasons, negative emotions, values, fear of negative outcomes, negative physical experience, and other priorities. Reasons for romantic avoidance included: effects of previous relationship, not interested in commitment, wrong time, other priorities, negative emotions, no one was good enough, and sexual concerns. Logistical regressions were used to assess associations between age, religiosity, sexual esteem, sexual distress, experience of sexual coercion, and dysfunctional sexual beliefs and having engaged in romantic and/or sexual avoidance. The female adolescents who had avoided sexual activity were more likely to have experienced sexual coercion. The male adolescents who had avoided sexual activity were more religious and likely to have experienced sexual coercion. The male adolescents who had avoided romantic relationships were more sexually distressed and likely to have experienced sexual coercion. No associations were found for romantic avoidance among female adolescents. These results reflect considerable agency in the decision-making of adolescents in intimate contexts. They are discussed in terms of their challenge to current discourses about rampant adolescent sexuality as well as their implications for education and prevention interventions that incorporate personal choice and decision-making into their protocols.

What Is the Message in the Medium? Mixed Signals for National Park and Wilderness Users.

ERIC Educational Resources Information Center

Huffman, Michael G.; Fickle, James E.

Mass media portrayals of unsafe, irresponsible outdoor activities encourage many people using national parks, forests, wilderness areas, and other public lands to exhibit little concern about environmental responsibility, safety, and the rights of other people. Such behavior threatens natural resources and the opportunity for others to enjoy them…

3 CFR 8507 - Proclamation 8507 of April 28, 2010. Workers Memorial Day, 2010

Code of Federal Regulations, 2011 CFR

2011-01-01

... and activities in memory of those who have been killed due to unsafe working conditions. IN WITNESS... done, and my Administration is dedicated to renewing our Nation’s commitment to achieve safe working... their memory, we rededicate ourselves to preventing such tragedies, and to securing a safer workplace...

Sexual compulsivity, state affect, and sexual risk behavior in a daily diary study of gay and bisexual men.

PubMed

Grov, Christian; Golub, Sarit A; Mustanski, Brian; Parsons, Jeffrey T

2010-09-01

Researchers have identified a strong link between sexual compulsivity (SC) and risky sexual behavior among men who have sex with men (MSM). Meanwhile, affect/mood has also been connected with negative sexual health outcomes (sexually transmitted infection/human immunodeficiency virus [HIV] transmission, sexual risk, sex under the influence of drugs/alcohol). Given that SC is characterized by marked distress around one's own sexual behavior, affect may play a central role in SC and HIV risk behavior. Data were taken from the Pillow Talk Project, a pilot study conducted in 2008-2009 with 50 highly sexually active MSM (9 or more male sex partners, ≤ 90 days), of which half displayed SC symptoms and half did not. Forty-seven men completed a daily diary online for 30 days (n = 1,060 diary days), reporting on their sexual behavior and concurrent affect: positive activation, negative activation, anxious arousal, and sexual activation. We conducted HLM analyses using daily affect (Level 1, within subjects) and SC and HIV status (Level 2, between subjects) to predict sexual behavior outcomes. Increased negative activation (characterized by fear, sadness, anger, and disgust) was associated with reduced sexual risk behavior, but less so among sexually compulsive MSM. Sexual activation was associated with increased sexual risk taking, but less so among sexually compulsive MSM. Anxious arousal was associated with increased sexual behavior, but not necessarily sexual risk taking. Findings indicate that affect plays key roles in sexual behavior and sexual risk taking; however, the association between affect and behavior may be different for sexually compulsive and non-sexually compulsive MSM.

Sensory Dysfunction and Sexuality in the U.S. Population of Older Adults.

PubMed

Zhong, Selena; Pinto, Jayant M; Wroblewski, Kristen E; McClintock, Martha K

2018-04-01

The sexual experience is shaped by sensory function; with aging, sensory dysfunction may interfere with sexuality and sexual behavior between partners. Specifically, older adults with age-related sensory dysfunction may have less sexual activity than those with better sensory function. In addition, since sexual desire and attraction rests in part upon sensory function, sensory dysfunction may also be associated with less sexual motivation. To test the association between sexual activity and motivation in older adults and their sensory dysfunction. Sensory dysfunction was measured both by global sensory impairment (a validated measure of dysfunction shared among the 5 classic senses: olfaction, vision, taste, touch, hearing) and by total sensory burden (cumulative sensory loss). Sexual activity was quantified by frequency and type of sexual behavior. Sexual motivation was measured by the frequency of sexual ideation and the importance of sex to the respondent. We used cross-sectional data from a nationally representative sample of community-dwelling older adults (aged 57-85 years) in the United States (National Social Life, Health, and Aging Project, N = 3,005) in logistic regression analyses. Sexual activity, sexual motivation, and satisfaction with the sexual relationship were self-reported. Older adults with sensory dysfunction were less likely to be sexually active-an association that persisted when accounting for other factors that also affected sexual activity (age, gender, partnered status, mental and physical health, and relationship satisfaction). Nonetheless, sensory dysfunction did not impair sexual motivation, nor affect the physical and emotional satisfaction with the sexual relationship. Among currently sexually active older adults, sensory dysfunction did not affect the frequency of sex or the type of sexual activity (foreplay, vaginal intercourse, or oral sex). These results were the same for 2 different measures of sensory dysfunction. This is the first nationally representative study of sexuality and multisensory dysfunction in community-dwelling older adults. 4 of the 5 classic senses were measured with objective tests, and hearing was rated by interviewers in the context of their conversation. Medical and health care interventions that can reduce the burden of sensory dysfunction may improve older adults' sexual experience. Sensory dysfunction is associated with sexual inactivity, but not with sexual motivation. Among those who are sexually active, sensory dysfunction did not interfere with sexual expression. Improving the sexual experience of older adults requires a focus on sensory dysfunction as an impediment to sexual activity given that older adults remain sexually motivated. Zhong S, Pinto JM, Wroblewski KE, et al. Sensory Dysfunction and Sexuality in the U.S. Population of Older Adults. J Sex Med 2018;15:502-509. Copyright © 2018 International Society for Sexual Medicine. Published by Elsevier Inc. All rights reserved.

HIV epidemic in Far-Western Nepal: effect of seasonal labor migration to India

PubMed Central

2011-01-01

Background Because of limited work opportunities in Nepal and the open-border provision between Nepal and India, a seasonal labor migration of males from Far-Western Nepal to India is common. Unsafe sexual activities of these migrants in India, such as frequent visits to brothels, lead to a high HIV prevalence among them and to a potential transmission upon their return home to Nepal. The present study aims to evaluate the role of such seasonal labor-migration to India on HIV transmission in Far-Western Nepal and to assess prevention programs. Methods An HIV epidemic model was developed for a population in Far-Western Nepal. The model was fitted to the data to estimate the back and forth mobility rates of labor-migrants to India, the HIV prevalence among migrants and the HIV transmission rate in Far-Western Nepal. HIV prevalence, new infections, disease deaths and HIV infections recruited from India were calculated. Prevention programs targeting the general population and the migrants were evaluated. Results Without any intervention programs, Far-Western Nepal will have about 7,000 HIV infected individuals returning from India by 2015, and 12,000 labor-migrants living with HIV in India. An increase of condom use among the general population from 39% to 80% will reduce new HIV infections due to sexual activity in Far-Western Nepal from 239 to 77. However, such a program loses its effectiveness due to the recruitment of HIV infections via returning migrants from India. The reduction of prevalence among migrants from 2.2% to 1.1% can bring general prevalence down to 0.4% with only 3,500 recruitments of HIV infections from India. Conclusion Recruitment of HIV infections from India via seasonal labor-migrants is the key factor contributing to the HIV epidemic in Far-Western Nepal. Prevention programs focused on the general population are ineffective. Our finding highlights the urgency of developing prevention programs which reduce the prevalence of HIV among migrants for a successful control of the HIV epidemic in Far-Western Nepal. PMID:21569469

Why is impaired sexual function distressing to women? The primacy of pleasure in female sexual dysfunction.

PubMed

Stephenson, Kyle R; Meston, Cindy M

2015-03-01

Recent research has highlighted a complex association between female sexual function and subjective distress regarding sexual activity. These findings are difficult to explain given limited knowledge as to the mechanisms through which impaired sexual function causes distress. The current study assessed whether a number of specific consequences of impaired sexual function, including decreased physical pleasure, disruption of sexual activity, and negative partner responses, mediated the association between sexual function and distress. Eighty-seven women in sexually active relationships reporting impairments in sexual function completed validated self-report measures and daily online assessments of sexual experiences. Participants completed the Sexual Satisfaction Scale for Women, the Female Sexual Function Index, and the Measure of Sexual Consequences. Results suggested that decreased physical pleasure and disruption of sexual activity, but not partner responses, statistically mediated the association between sexual function and distress. Sexual consequences represent potential maintaining factors of sexual dysfunction that are highly distressing to women. Results are discussed in the context of theoretical models of sexual dysfunction and related treatments. © 2014 International Society for Sexual Medicine.

Hypersexuality and high sexual desire: exploring the structure of problematic sexuality.

PubMed

Carvalho, Joana; Štulhofer, Aleksandar; Vieira, Armando L; Jurin, Tanja

2015-06-01

The concept of hypersexuality has been accompanied by fierce debates and conflicting conclusions about its nature. One of the central questions under the discussion is a potential overlap between hypersexuality and high sexual desire. With the relevant research in its early phase, the structure of hypersexuality remains largely unknown. The aim of the present study was to systematically explore the overlap between problematic sexuality and high sexual desire. A community online survey was carried out in Croatia in 2014. The data were first cluster analyzed (by gender) based on sexual desire, sexual activity, perceived lack of control over one's sexuality, and negative behavioral consequences. Participants in the meaningful clusters were then compared for psychosocial characteristics. To complement cluster analysis (CA), multigroup confirmatory factor analysis (CFA) of the same four constructs was carried out. Indicators representing the proposed structure of hypersexuality were included: sexual desire, frequency of sexual activity, lack of control over one's sexuality, and negative behavioral outcomes. Psychosocial characteristics such as religiosity, attitudes toward pornography, and general psychopathology were also evaluated. CA pointed to the existence of two meaningful clusters, one representing problematic sexuality, that is, lack of control over one's sexuality and negative outcomes (control/consequences cluster), and the other reflecting high sexual desire and frequent sexual activity (desire/activity cluster). Compared with the desire/activity cluster, individuals from the control/consequences cluster reported more psychopathology and were characterized by more traditional attitudes. Complementing the CA findings, CFA pointed to two distinct latent dimensions-problematic sexuality and high sexual desire/activity. Our study supports the distinctiveness of hypersexuality and high sexual desire/activity, suggesting that problematic sexuality might be more associated with the perceived lack of personal control over sexuality and moralistic attitudes than with high levels of sexual desire and activity. © 2015 International Society for Sexual Medicine.

Systematic screening for unsafe driving due to medical conditions: Still debatable

PubMed Central

Leproust, Sandy; Lagarde, Emmanuel; Salmi, L Rachid

2008-01-01

Background Assessing people's ability to drive has become a public health concern in most industrialized countries. Although age itself is not a predictive factor of an increased risk for dangerous driving, the prevalence of medical conditions that may impair driving increases with age. Because the implementation of a screening for unsafe driving due to medical conditions is a public health issue, its usefulness should be judged using standardised criteria already proposed for screening for chronic disease. The aim of this paper is to propose standardised criteria suitable to assess the scientific validity of screening for unsafe driving due to medical conditions, and identify potential issues to be clarified before screening can be implemented and effective. Discussion Using criteria developed for screening for chronic diseases and published studies on driving with medical conditions, we specify six criteria to judge the opportunity of screening for unsafe driving due to medical conditions. This adaptation was needed because of the complexity of the natural history of medical conditions and their potential consequences on driving and road safety. We then illustrate that published studies pleading for or against screening for unsafe driving due to medical conditions fail to provide the needed documentation. Individual criteria were mentioned in 3 to 72% of 36 papers pleading for or against screening. Quantitative estimates of relevant indicators were provided in at most 42% of papers, and some data, such as the definition of an appropriate unsafe driving period were never provided. Summary The standardised framework described in this paper provides a template for assessing the effectiveness (or lack of effectiveness) of proposed measures for screening for unsafe driving due to medical conditions. Even if most criteria were mentioned in the published literature pleading for or against such a screening, the failure to find quantitative and evidence-based estimates of relevant indicators provides useful insight for further research. PMID:18215269

Which "broken windows" matter? School, neighborhood, and family characteristics associated with youths' feelings of unsafety.

PubMed

Mijanovich, Tod; Weitzman, Beth C

2003-09-01

Young people's fears of victimization and feelings of unsafety constitute a serious and pervasive public health problem and appear to be associated with different factors than actual victimization. Our analysis of a population-based telephone survey of youths aged 10-18 years in five economically distressed cities and their suburbs reveals that a substantial minority of youths feel unsafe on any given day, and that an even greater number feel unsafe in school. While some traditional predictors of victimization (such as low socioeconomic status) were associated with feeling unsafe, perceived school disorder was the major factor associated with such feelings. Disorderliness may thus be the school's version of "broken windows," which serve to signal to students a lack of consistent adult concern and oversight that can leave them feeling unsafe. We suggest that fixing the broken windows of school disorderliness may have a significant, positive impact on adolescents' feelings of safety.

Performing aggressive code optimization with an ability to rollback changes made by the aggressive optimizations

DOEpatents

Gschwind, Michael K

2013-07-23

Mechanisms for aggressively optimizing computer code are provided. With these mechanisms, a compiler determines an optimization to apply to a portion of source code and determines if the optimization as applied to the portion of source code will result in unsafe optimized code that introduces a new source of exceptions being generated by the optimized code. In response to a determination that the optimization is an unsafe optimization, the compiler generates an aggressively compiled code version, in which the unsafe optimization is applied, and a conservatively compiled code version in which the unsafe optimization is not applied. The compiler stores both versions and provides them for execution. Mechanisms are provided for switching between these versions during execution in the event of a failure of the aggressively compiled code version. Moreover, predictive mechanisms are provided for predicting whether such a failure is likely.

Modeling the factors affecting unsafe behavior in the construction industry from safety supervisors' perspective.

PubMed

Khosravi, Yahya; Asilian-Mahabadi, Hassan; Hajizadeh, Ebrahim; Hassanzadeh-Rangi, Narmin; Bastani, Hamid; Khavanin, Ali; Mortazavi, Seyed Bagher

2014-01-01

There can be little doubt that the construction is the most hazardous industry in the worldwide. This study was designed to modeling the factors affecting unsafe behavior from the perspective of safety supervisors. The qualitative research was conducted to extract a conceptual model. A structural model was then developed based on a questionnaire survey (n=266) by two stage Structural Equation Model (SEM) approach. An excellent confirmed 12-factors structure explained about 62% of variances unsafe behavior in the construction industry. A good fit structural model indicated that safety climate factors were positively correlated with safety individual factors (P<0.001) and workplace safety condition (P<0.001). The workplace safety condition was found to play a strong mediating role in linking the safety climate and construction workers' engagement in safe or unsafe behavior. In order to improve construction safety performance, more focus on the workplace condition is required.

The Research on the Impact of Management Level’s Charismatic Leadership Style on Miners' Unsafe Behavior

PubMed Central

Li, Hongxia; Di, Hongxi; Tian, Shuicheng; Li, Jian

2015-01-01

The aim of this study is research the impact of management level’s charismatic leadership style on miners' unsafe behavior by using the questionnaires on charismatic leadership style, safety attitude and the miners' unsafe behavior measurement to investigate 200 employees in Shen Dong Company. The research results suggest that management level’s charismatic leadership style have very important influence on miners' unsafe behavior and the influence is affected by the safety attitude which is the intermediary function. In the end, this study propose advice on how to improve the coal mine enterprise managers charismatic leadership style in the coal mine enterprise's safety management work, including attach great importance to a variety of incentive methods, set up safety moral models, practice of inductive leadership concept, create a good atmosphere of safety, etc for reference for coal mining enterprises. PMID:26628936

Why is impaired sexual function distressing to women? The primacy of pleasure in female sexual dysfunction

PubMed Central

Stephenson, Kyle R.; Meston, Cindy M.

2015-01-01

Introduction Recent research has highlighted a complex association between female sexual function and subjective distress regarding sexual activity. These findings are difficult to explain given limited knowledge as to the mechanisms through which impaired sexual function causes distress. Aim The current study assessed whether a number of specific consequences of impaired sexual function, including decreased physical pleasure, disruption of sexual activity, and negative partner responses, mediated the association between sexual function and distress. Methods Eighty seven women in sexually active relationships reporting impairments in sexual function completed validated self-report measures and daily online assessments of sexual experiences. Main Outcome Measures Participants completed the Sexual Satisfaction Scale for Women (SSS-W), the Female Sexual Function Index (FSFI), and the Measure of Sexual Consequences (MSC). Results Results suggested that decreased physical pleasure and disruption of sexual activity, but not partner responses, statistically mediated the association between sexual function and distress. Conclusion Sexual consequences represent potential maintaining factors of sexual dysfunction that are highly distressing to women. Results are discussed in the context of theoretical models of sexual dysfunction and related treatments. PMID:25556719

Poverty, Food Insufficiency and HIV Infection and Sexual Behaviour among Young Rural Zimbabwean Women

PubMed Central

Pascoe, Sophie J. S.; Langhaug, Lisa F.; Mavhu, Webster; Hargreaves, James; Jaffar, Shabbar; Hayes, Richard; Cowan, Frances M.

2015-01-01

Background Despite a recent decline, Zimbabwe still has the fifth highest adult HIV prevalence in the world at 14.7%; 56% of the population are currently living in extreme poverty. Design Cross-sectional population-based survey of 18–22 year olds, conducted in 30 communities in south-eastern Zimbabwe in 2007. Objective To examine whether the risk of HIV infection among young rural Zimbabwean women is associated with socio-economic position and whether different socio-economic domains, including food sufficiency, might be associated with HIV risk in different ways. Methods Eligible participants completed a structured questionnaire and provided a finger-prick blood sample tested for antibodies to HIV and HSV-2. The relationship between poverty and HIV was explored for three socio-economic domains: ability to afford essential items; asset wealth; food sufficiency. Analyses were performed to examine whether these domains were associated with HIV infection or risk factors for infection among young women, and to explore which factors might mediate the relationship between poverty and HIV. Results 2593 eligible females participated in the survey and were included in the analyses. Overall HIV prevalence among these young females was 7.7% (95% CI: 6.7–8.7); HSV-2 prevalence was 11.2% (95% CI: 9.9–12.4). Lower socio-economic position was associated with lower educational attainment, earlier marriage, increased risk of depression and anxiety disorders and increased reporting of higher risk sexual behaviours such as earlier sexual debut, more and older sexual partners and transactional sex. Young women reporting insufficient food were at increased risk of HIV infection and HSV-2. Conclusions This study provides evidence from Zimbabwe that among young poor women, economic need and food insufficiency are associated with the adoption of unsafe behaviours. Targeted structural interventions that aim to tackle social and economic constraints including insufficient food should be developed and evaluated alongside behaviour and biomedical interventions, as a component of HIV prevention programming and policy. PMID:25625868

Alcohol production as an adaptive livelihood strategy for women farmers in Tanzania and its potential for unintended consequences on women's reproductive health.

PubMed

McCoy, Sandra I; Ralph, Lauren J; Wilson, Wema; Padian, Nancy S

2013-01-01

Although women occupy a central position in agriculture in many developing countries, they face numerous constraints to achieving their full potential including unequal access to assets and limited decision-making authority. We explore the intersection of agricultural livelihoods, food and economic security, and women's sexual and reproductive health in Iringa Region, Tanzania. Our goal was to understand whether the benefits of supporting women in the agricultural sector might also extend to more distal outcomes, including sexual and reproductive health. Using the Sustainable Livelihoods Framework to guide data collection, we conducted 13 focus group discussions (FGD) with female (n = 11) and male farmers (n = 2) and 20 in-depth interviews with agricultural extension officers (n = 10) and village agro-dealers (n = 10). Despite providing the majority of agricultural labor, women have limited control over land and earned income and have little bargaining power. In response to these constraints, women adopt adaptive livelihood strategies, such as alcohol production, that allow them to retain control over income and support their households. However, women's central role in alcohol production, in concert with the ubiquitous nature of alcohol consumption, places them at risk by enhancing their vulnerability to unsafe or transactional sex. This represents a dangerous confluence of risk for female farmers, in which alcohol plays an important role in income generation and also facilitates high-risk sexual behavior. Alcohol production and consumption has the potential to both directly and indirectly place women at risk for undesirable sexual and reproductive health outcomes. Group formation, better access to finance, and engaging with agricultural extension officers were identified as potential interventions for supporting women farmers and challenging harmful gender norms. In addition, joint, multi-sectoral approaches from health and agriculture and alternative income-generating strategies for women might better address the complexities of achieving safe and sustainable livelihoods for women in this context.

Alcohol Production as an Adaptive Livelihood Strategy for Women Farmers in Tanzania and Its Potential for Unintended Consequences on Women’s Reproductive Health

PubMed Central

McCoy, Sandra I.; Ralph, Lauren J.; Wilson, Wema; Padian, Nancy S.

2013-01-01

Background Although women occupy a central position in agriculture in many developing countries, they face numerous constraints to achieving their full potential including unequal access to assets and limited decision-making authority. We explore the intersection of agricultural livelihoods, food and economic security, and women’s sexual and reproductive health in Iringa Region, Tanzania. Our goal was to understand whether the benefits of supporting women in the agricultural sector might also extend to more distal outcomes, including sexual and reproductive health. Methods Using the Sustainable Livelihoods Framework to guide data collection, we conducted 13 focus group discussions (FGD) with female (n = 11) and male farmers (n = 2) and 20 in-depth interviews with agricultural extension officers (n = 10) and village agro-dealers (n = 10). Results Despite providing the majority of agricultural labor, women have limited control over land and earned income and have little bargaining power. In response to these constraints, women adopt adaptive livelihood strategies, such as alcohol production, that allow them to retain control over income and support their households. However, women’s central role in alcohol production, in concert with the ubiquitous nature of alcohol consumption, places them at risk by enhancing their vulnerability to unsafe or transactional sex. This represents a dangerous confluence of risk for female farmers, in which alcohol plays an important role in income generation and also facilitates high-risk sexual behavior. Conclusions Alcohol production and consumption has the potential to both directly and indirectly place women at risk for undesirable sexual and reproductive health outcomes. Group formation, better access to finance, and engaging with agricultural extension officers were identified as potential interventions for supporting women farmers and challenging harmful gender norms. In addition, joint, multi-sectoral approaches from health and agriculture and alternative income-generating strategies for women might better address the complexities of achieving safe and sustainable livelihoods for women in this context. PMID:23527167

"When you get old like this … you don't run those risks anymore": influence of age on sexual risk behaviors and condom use attitudes among methamphetamine-using heterosexual women with a history of partner violence.

PubMed

Ludwig-Barron, Natasha; Wagner, Karla D; Syvertsen, Jennifer L; Ewald, Ivy J; Patterson, Thomas L; Semple, Shirley J; Stockman, Jamila K

2014-01-01

Drug use and partner violence affect older women, yet few studies highlight age-specific HIV risks and prevention strategies. This study compares sexual risk behaviors, condom use attitudes, and HIV knowledge between midlife/older women (ages 45+) and younger women (ages 18-44) reporting methamphetamine use and partner violence in San Diego, California. Our mixed methods study used themes from a qualitative substudy (n = 18) to inform logistic regression analysis of baseline data from an HIV behavioral intervention trial (n = 154). Age-related qualitative themes included physiologic determinants, HIV knowledge, and "dodging the bullet," referring to a lifetime of uncertainty surrounding HIV serostatus after engaging in unsafe drug and sex practices. Midlife/older age was associated with never being married (24.2% vs. 51.2; p = .03), having less than a high school education/GED (12.1% vs. 34.7%; p = .04), lower condom use self-efficacy (2.87 vs. 3.19; p = .03), lower positive outcome expectancies (1.9 vs. 2.1; p = .04), and lower HIV knowledge (85.3% vs. 89.7%; p = .04); however, sexual risk behaviors were not associated with age group. In the multivariate analysis, midlife/older age remained independently associated with lower condom use self-efficacy (adjusted odds ratio, 0.49; 95% CI, 0.27-0.87) and lower HIV knowledge (adjusted odds ratio, 0.96; 95% CI, 0.93-0.99). Midlife/older methamphetamine-using women with experiences of partner violence present similar sexual risk profiles, but possess different HIV-related knowledge and attitudes toward prevention methods compared with their younger counterparts. Clinicians and public health practitioners can have a positive impact on this overlooked population by assessing HIV risks during routine screenings, encouraging HIV testing, and providing age-appropriate HIV prevention education. Copyright © 2014 Jacobs Institute of Women's Health. Published by Elsevier Inc. All rights reserved.

Communicating with School Staff about Sexual Identity, Health and Safety: An Exploratory Study of the Experiences and Preferences of Black and Latino Teen Young Men who have Sex with Men

PubMed Central

Lesesne, Catherine A.; Rasberry, Catherine N.; Kroupa, Elizabeth; Topete, Pablo; Carver, Lisa H.; Morris, Elana; Robin, Leah

2015-01-01

Purpose This exploratory study examined the experiences of black and Latino teen young men who have sex with men (YMSM) and their preferences for communication with school staff about matters related to sexual orientation. Methods Participants for this study were recruited in three urban centers in the United States and by multiple community-based organizations serving black and Latino YMSM. Eligible youth were male, black or Latino, ages 13-19, enrolled in 90 days of school in the previous 18 months, and reported attraction to or sexual behavior with other males, or identified as gay or bisexual. Participants completed Web-based questionnaires (n=415) and/or in-depth interviews (n=32). Results Questionnaire participants reported willingness to talk to at least one school staff member about: safety, dating and relationships, and feeling attracted to other guys (63.4%, 58.4%, and 55.9%, respectively). About one-third of the sample reported they would not talk with any school staff about these topics. Exploratory analyses revealed youth who experienced feeling unsafe at school and who had higher levels of trust in the information provided by school staff were more likely to be willing to talk with school staff about safety issues, dating, or same sex attraction (aOR=2.80 and aOR=4.85, respectively). Interview participants reported being most willing to talk to staff who (1) were able and willing to help them; (2) would keep discussions confidential, and (3) expressed genuine care. Preferences for confiding in school staff perceived to be LGBT and having similar racial/ethnic background were also noted. Conclusion Findings suggest school staff can serve as points of contact for reaching YMSM and professional development and interventions can be tailored to reach YMSM and connect them to services they need. Additional research is needed to understand how to increase YMSM comfort talking with school staff about sexual health or sexual identity concerns. PMID:26436114

Communicating with School Staff About Sexual Identity, Health and Safety: An Exploratory Study of the Experiences and Preferences of Black and Latino Teen Young Men Who Have Sex with Men.

PubMed

Lesesne, Catherine A; Rasberry, Catherine N; Kroupa, Elizabeth; Topete, Pablo; Carver, Lisa H; Morris, Elana; Robin, Leah

2015-09-01

This exploratory study examined the experiences of black and Latino teen young men who have sex with men (YMSM) and their preferences for communication with school staff about matters related to sexual orientation. Participants for this study were recruited in three urban centers in the United States and by multiple community-based organizations serving black and Latino YMSM. Eligible youth were male, black and Latino, ages 13–19, enrolled in 90 days of school in the previous 18 months, and reported attraction to or sexual behavior with other males, or identified as gay or bisexual. Participants completed web-based questionnaires (n=415) and/or in-depth interviews (n=32). Questionnaire participants reported willingness to talk to at least one school staff member about: safety, dating and relationships, and feeling attracted to other guys (63.4%, 58.4%, and 55.9%, respectively). About one-third of the sample reported they would not talk with any school staff about these topics. Exploratory analyses revealed youth who experienced feeling unsafe at school and who had higher levels of trust in the information provided by school staff were more likely to be willing to talk with school staff about safety issues, dating, or same sex attraction (adjusted odds ratio [AOR]=2.80 and AOR=4.85, respectively). Interview participants reported being most willing to talk to staff who were able and willing to help them, who would keep discussions confidential, and who expressed genuine care. Preferences for confiding in school staff perceived to be lesbian, gay, bisexual, and transgender (LGBT) and having similar racial/ethnic background were also noted. Findings suggest school staff can serve as points of contact for reaching YMSM and professional development and interventions can be tailored to reach YMSM and connect them to services they need. Additional research is needed to understand how to increase YMSM comfort talking with school staff about sexual health or sexual identity concerns.

Correlates of Sex Frequency and Sexual Satisfaction Among Partnered Older Adults.

PubMed

Gillespie, Brian Joseph

2017-07-04

This study examines behaviors associated with sex frequency and sexual satisfaction in a national sample of partnered older adults, age 50 to 85 (N = 9,164), together for over one year. The results indicate that older adults with active and satisfying sex lives engage more frequently in open sexual communication and setting the mood for sexual activity. Additionally, synchronicity in sexual desire and activities is related to a high-frequency and highly satisfying sex life in older adulthood. An expansive sexual repertoire, as measured by the number of sexual activities used during the last sexual encounter and the incorporation of sexual variety, is also associated with greater sex frequency and sexual satisfaction.

Sexual behaviors among older adults in Spain: results from a population-based national sexual health survey.

PubMed

Palacios-Ceña, Domingo; Carrasco-Garrido, Pilar; Hernández-Barrera, Valentín; Alonso-Blanco, Cristina; Jiménez-García, Rodrigo; Fernández-de-las-Peñas, César

2012-01-01

The Spanish National Sexual Health Survey (SNSHS) is designed to examine sexual activity, sexual behaviors, and sexual health among the Spanish population. To describe sexual activity and behaviors of Spaniards aged ≥ 65 years old focusing on gender differences. A population-based descriptive study was conducted using individual data from the SNSHS. The number of subjects aged ≥ 65 years included was 1,939 (1,118 women, 821 men). Sexual activity, frequency, sexual behaviors, sexual practices, and reasons for lack of sexual activity were assessed from questions included in the survey. Subjects who reported having any sexual practice including giving or receiving kissing and hugging, vaginal intercourse, oral sex, or masturbation, with at least one partner in the previous 12 months were considered as sexually active. We analyzed sociodemographic characteristics, self-rated physical and sexual health, comorbid conditions, and medications using multivariate logistic regression models. Overall, 62.3% of men and 37.4% of elderly women were sexually active (P < 0.01). The prevalence of sexual inactivity significantly increased with age (P < 0.01, odds ratio [OR] 5.8, 95% confidence interval 3.8-9.05 men; 6.37, 3.9-10.4 women). Not having a partner was a predictor of sexual inactivity (OR 5.79, 3.98-8.42 men; OR 12.0, 8.4-17.2 women). Worse self-rated sexual health, suffering ≥ 2 comorbid conditions, and taking ≥ 2 medications were associated with higher probability of reporting no sexual activity in both men and women. The most common sexual practices were kissing, hugging, and vaginal intercourse. The most common reasons for sexual inactivity were: partner was physically ill (23%), lack of interest (21%), and the man was a widower (23%). This study provided data on sexual activity in older Spanish adults and has identified potential factors that appear to influence sexuality in the elderly with some gender differences. Current results can have implications for healthcare providers for addressing these concerns in an effective manner. © 2011 International Society for Sexual Medicine.

Unsafe acts and unsafe outcomes in aircraft maintenance

NASA Technical Reports Server (NTRS)

Hobbs, Alan; Williamson, Ann

2002-01-01

Road safety studies using the Driver Behaviour Questionnaire (DBQ) have provided support for a three-way distinction between violations, skill-based errors and mistakes, and have indicated that a tendency to commit driving violations is associated with an increased risk of accident involvement. The aims of this study were to examine whether the three-way distinction of unsafe acts is applicable in the context of aircraft maintenance, and whether involvement in maintenance safety occurrences can be predicted on the basis of self-reported unsafe acts. A Maintenance Behaviour Questionnaire (MBQ) was developed to explore patterns of unsafe acts committed by aircraft maintenance mechanics. The MBQ was completed anonymously by over 1300 Australian aviation mechanics, who also provided information on their involvement in workplace accidents and incidents. Four factors were identified: routine violations, skill-based errors, mistakes and exceptional violations. Violations and mistakes were related significantly to the occurrence of incidents that jeopardized the quality of aircraft maintenance, but were not related to workplace injuries. Skill-based errors, while not related to work quality incidents, were related to workplace injuries. The results are consistent with the three-way typology of unsafe acts described by Reason et al. (1990) and with the DBQ research indicating an association between self-reported violations and accidents. The current findings suggest that interventions addressed at maintenance quality incidents should take into account the role of violations and mistakes, and the factors that promote them. In contrast, interventions directed at reducing workplace injury are likely to require a focus on skill-based errors.

Access to safe abortion: progress and challenges since the 1994 International Conference on Population and Development (ICPD).

PubMed

Shah, Iqbal H; Åhman, Elisabeth; Ortayli, Nuriye

2014-12-01

The 1994 International Conference on Population and Development (ICPD) viewed access to safe abortion as imperative for public health. Globally, the number of induced abortions (safe and unsafe) per 1000 women aged 15-44 years declined from 35 in 1995 to 28 in 2008. The number of deaths due to unsafe abortion declined from 69,000 in 1990 to 47,000 in 2008, as safe and effective methods of abortion, including manual vacuum aspiration and medical abortion, became more widely available. During the same period, there was a slight increase in the number of countries where abortion is permitted on request, and 70 countries made grounds for abortion more liberal. Since ICPD, the decline in unsafe abortion was slower than that in safe abortion, and unsafe-abortion-related mortality continued to be a problem. Nearly all unsafe abortions and mortality occur in developing countries. While more must be done to ensure universal access to safe, acceptable and affordable contraception to reduce the need for abortion, this need will always exist. Information on grounds for safe abortion should be made widely available for women to access services to which they are legally entitled to. As recommended by ICPD, quality postabortion care including contraception counseling and provision should be available to all women, regardless of the legal grounds for abortion. The paper provides the evidence on unsafe abortion, a reproductive health issue that is entirely preventable but has been largely neglected or tarnished by emotional and contentious debates. Copyright © 2014 Elsevier Inc. All rights reserved.

Using spacecraft trace contaminant control systems to cure sick building syndrome

NASA Technical Reports Server (NTRS)

Graf, John C.

1994-01-01

Many residential and commercial buildings with centralized, recirculating, heating ventilation and air conditioning systems suffer from 'Sick Building Syndrome.' Ventilation rates are reduced to save energy costs, synthetic building materials off-gas contaminants, and unsafe levels of volatile organic compounds (VOC's) accumulate. These unsafe levels of contaminants can cause irritation of eyes and throat, fatigue and dizziness to building occupants. Increased ventilation, the primary method of treating Sick Building Syndrome is expensive (due to increased energy costs) and recently, the effectiveness of increased ventilation has been questioned. On spacecraft venting is not allowed, so the primary methods of air quality control are; source control, active filtering, and destruction of VOC's. Four non-venting contaminant removal technologies; strict material selection to provide source control, ambient temperature catalytic oxidation, photocatalytic oxidation, and uptake by higher plants, may have potential application for indoor air quality control.

Risk factors for negative impacts on sexual activity and function in younger breast cancer survivors.

PubMed

Lee, Maria; Kim, Yun Hwan; Jeon, Myung Jae

2015-09-01

We aim to examine changes in sexual activity and function among younger breast cancer survivors who were sexually active before diagnosis and to investigate risk factors for negative impacts on them. An observational cohort study enrolled 304 premenopausal and sexually active women diagnosed with early stage breast cancer. Questionnaires were completed, and sexual activity was measured at two time points: after surgery, to assess sexual activity and function before diagnosis, and then at least 12 months after the completion of chemotherapy or endocrine therapy. For each domain of the Female Sexual Function Index, a score below 3 was classified as indicative of a sexual problem. Each sexual problem was considered to be dysfunctional if it was associated with distress. The median age at the last survey was 46.0 years (range: 23-57). Of the participants, 35 (11.5%) became sexually inactive after treatment. Among the 269 women who remained sexually active, 31.6% were currently experiencing sexual dysfunction, which was significantly higher compared with the frequency before diagnosis. In the multivariate logistic regression model, chemo-related menopause, thyroid dysfunction, and depression were independent risk factors for sexual inactivity. Chemo-related menopause was a significant risk factor for sexual dysfunction. Chemo-related menopause was significantly associated with both sexual inactivity and dysfunction after treatment. Thyroid dysfunction and depression were risk factors for sexual inactivity in younger breast cancer survivors. Copyright © 2015 John Wiley & Sons, Ltd.

Identification of motivations for unsafe driving actions and potential countermeasures

DOT National Transportation Integrated Search

1982-03-01

This report presents the findings of a preliminary investigation of drivers' motivations for selected unsafe driving actions (UDAs). The general objective of the study was to develop the test methods, procedures, and materials for collecting data for...

National survey of speeding and other unsafe driving actions. Volume 3, Countermeasures

DOT National Transportation Integrated Search

1998-09-15

The National Highway Traffic Safety Administration (NHTSA) commissioned the research firm of Schulman, Ronca & Bucuvalas, Inc. (SRBI) to conduct the Nationwide Survey Regarding Speeding and Other Unsafe Driving Actions. Between February 20 and April ...

Oxytocin increases VTA activation to infant and sexual stimuli in nulliparous and postpartum women

PubMed Central

Gregory, Rebecca; Cheng, Hu; Rupp, Heather A.; Sengelaub, Dale R.; Heiman, Julia R.

2015-01-01

After giving birth, women typically experience decreased sexual desire and increased responsiveness to infant stimuli. These postpartum changes may be viewed as a trade-off in reproductive interests, which could be due to alterations in brain activity including areas associated with reward. The goal of this study was to describe the roles of oxytocin and parity on reward area activation in response to reproductive stimuli, specifically infant and sexual images. Because they have been shown to be associated with reward, the ventral tegmental area (VTA) and nucleus accumbens (NAc) were targeted as areas of expected alterations in activity. Oxytocin was chosen as a potential mediator of reproductive trade-offs because of its relationship to both mother–infant interactions, including breastfeeding and bonding, and sexual responses. We predicted that postpartum women would show higher reward area activation to infant stimuli and nulliparous women would show higher activation to sexual stimuli and that oxytocin would increase activation to infant stimuli in nulliparous women. To test this, we measured VTA and NAc activation using fMRI in response to infant photos, sexual photos, and neutral photos in 29 postpartum and 30 nulliparous women. Participants completed the Sexual Inhibition (SIS) and Sexual Excitation (SES) Scales and the Brief Index of Sexual Function for Women (BISF-W), which includes a sexual desire dimension, and received either oxytocin or placebo nasal spray before viewing crying and smiling infant and sexual images in an fMRI scanner. For both groups of women, intranasal oxytocin administration increased VTA activation to both crying infant and sexual images but not to smiling infant images. We found that postpartum women showed lower SES, higher SIS, and lower sexual desire compared to nulliparous women. Across parity groups, SES scores were correlated with VTA activation and subjective arousal ratings to sexual images. In postpartum women, sexual desire was positively correlated with VTA activation to sexual images and with SES. Our findings show that postpartum decreases in sexual desire may in part be mediated by VTA activation, and oxytocin increased activation of the VTA but not NAc in response to sexual and infant stimuli. Oxytocin may contribute to the altered reproductive priorities in postpartum women by increasing VTA activation to salient infant stimuli. PMID:25562711

Strategies and challenges for safe injection practice in developing countries.

PubMed

Gyawali, Sudesh; Rathore, Devendra Singh; Shankar, P Ravi; Kumar, Kc Vikash

2013-01-01

Injection is one of the important health care procedures used globally to administer drugs. Its unsafe use can transmit various blood borne pathogens. This article aims to review the history and status of injection practices, its importance, interventions and the challenges for safe injection practice in developing countries. The history of injections started with the discovery of syringe in the early nineteenth century. Safe injection practice in developed countries was initiated in the early twentieth century but has not received adequate attention in developing countries. The establishment of "Safe Injection Global Network (SIGN)" was an milestone towards safe injection practice globally. In developing countries, people perceive injection as a powerful healing tool and do not hesitate to pay more for injections. Unsafe disposal and reuse of contaminated syringe is common. Ensuring safe injection practice is one of the greatest challenges for healthcare system in developing countries. To address the problem, interventions with active involvement of a number of stakeholders is essential. A combination of educational, managerial and regulatory strategies is found to be effective and economically viable. Rational and safe use of injections can save many lives but unsafe practice threatens life. Safe injection practice is crucial in developing countries. Evidence based interventions, with honest commitment and participation from the service provider, recipient and community with aid of policy makers are required to ensure safe injection practice.

Strategies and challenges for safe injection practice in developing countries

PubMed Central

Gyawali, Sudesh; Rathore, Devendra Singh; Shankar, P Ravi; Kumar, KC Vikash

2013-01-01

Injection is one of the important health care procedures used globally to administer drugs. Its unsafe use can transmit various blood borne pathogens. This article aims to review the history and status of injection practices, its importance, interventions and the challenges for safe injection practice in developing countries. The history of injections started with the discovery of syringe in the early nineteenth century. Safe injection practice in developed countries was initiated in the early twentieth century but has not received adequate attention in developing countries. The establishment of “Safe Injection Global Network (SIGN)” was an milestone towards safe injection practice globally. In developing countries, people perceive injection as a powerful healing tool and do not hesitate to pay more for injections. Unsafe disposal and reuse of contaminated syringe is common. Ensuring safe injection practice is one of the greatest challenges for healthcare system in developing countries. To address the problem, interventions with active involvement of a number of stakeholders is essential. A combination of educational, managerial and regulatory strategies is found to be effective and economically viable. Rational and safe use of injections can save many lives but unsafe practice threatens life. Safe injection practice is crucial in developing countries. Evidence based interventions, with honest commitment and participation from the service provider, recipient and community with aid of policy makers are required to ensure safe injection practice. PMID:23662018

Vagal Activity During Physiological Sexual Arousal in Women With and Without Sexual Dysfunction.

PubMed

Stanton, Amelia M; Pulverman, Carey S; Meston, Cindy M

2017-01-02

Recently, heart rate variability (HRV) level has been found to be a risk factor for female sexual dysfunction. Low HRV was a significant predictor of female sexual arousal dysfunction and overall sexual dysfunction. Building upon this finding, the present study examined whether differences in vagal activity between sexually functional and sexually dysfunctional women may be driving the association between low HRV and female sexual dysfunction. Specifically, respiratory sinus arrhythmia (RSA) was assessed before, during, and after physiological sexual arousal in 84 women, aged 18 to 47, to examine potential differences in vagal activity between sexually functional and sexually dysfunctional women. Significant differences in vagal activity between these two groups were observed (p =.02). These findings provide additional specificity to the recently established relationship between HRV and female sexual function while also proposing a mechanism to target during treatments for sexual dysfunction.

Profiles of African American College Students' Alcohol Use and Sexual Behaviors: Associations With Stress, Racial Discrimination, and Social Support.

PubMed

Metzger, Isha W; Cooper, Shauna M; Ritchwood, Tiarney D; Onyeuku, Chisom; Griffin, Charity Brown

2017-01-01

Though studies show that alcohol use and sexual activity increase during emerging adulthood, few studies examine within-ethnic group differences, particularly among African American college students. This investigation utilized a latent class analytic methodology to identify risk behavior profiles of alcohol use (frequency and amount of alcohol consumed), sexual activity (number of intimate partners), and co-occurring risk behaviors (drinking before sexual intercourse) among 228 African American college students. This investigation also examined whether identified risk behavior profiles were associated with stress (interpersonal, intrapersonal, academic, and environmental), experiences of racial discrimination, and social support (from family, friends, and the college community). Results identified five distinct profiles within this sample: (a) High Sexual Risk-above-average sexual activity; (b) Abstainers-below-average alcohol use and sexual activity; (c) Low Risk-average alcohol use and sexual activity; (d) Alcohol Risk-above-average alcohol use and below-average sexual activity; and (e) Co-Occurring Risk-above-average alcohol use and sexual activity. Identified profiles differed across interpersonal and environmental stress, and self-reported frequency of experiences with racial discrimination. Implications for prevention programs and interventions aimed at reducing alcohol and sexual activity for African American college students are discussed.

Beyond lesbian bed death: enhancing our understanding of the sexuality of sexual-minority women in relationships.

PubMed

Cohen, Jacqueline N; Byers, E Sandra

2014-01-01

The goal of this study was to characterize the sexuality of sexual-minority (i.e., lesbian, bisexual, queer, unlabeled, questioning) women. Participants were 586 women (87% White) in a same-sex relationship of 1 to 36 years in duration. They completed measures assessing their sexual behavior (frequency of nongenital and genital sexual activities), motivation (sexual desire), and cognitive-affective responses (sexual satisfaction, sexual esteem, sexual anxiety, negative automatic thoughts). On average, the women reported experiencing their sexuality positively across all domains. Regardless of relationship duration, most of the women reported engaging in both genital and nongenital sexual behaviors with their partner once a week or more; few reported that they had not engaged in sexual activity in the previous month. A multiple regression analysis indicated that frequency of genital sexual activity, sexual desire, sexual anxiety, and automatic thoughts contributed uniquely to the prediction of sexual satisfaction over and above the other sexuality variables. The findings are discussed in terms of the idea that lesbians have sex less frequently than other couple types and that sexual frequency declines rapidly in lesbian relationships (i.e., "lesbian bed death") and descriptions of sexual-minority women's sexuality that suggest that genital sexual activity is not important to sexual satisfaction.

Access to safe abortion: building choices for women living with HIV and AIDS

PubMed Central

2011-01-01

In many areas of the world where HIV prevalence is high, rates of unintended pregnancy and unsafe abortion have also been shown to be high. Of all pregnancies worldwide in 2008, 41% were reported as unintended or unplanned, and approximately 50% of these ended in abortion. Of the estimated 21.6 million unsafe abortions occurring worldwide in 2008 (around one in 10 pregnancies), approximately 21.2 million occurred in developing countries, often due to restrictive abortion laws and leading to an estimated 47,000 maternal deaths and untold numbers of women who will suffer long-term health consequences. Despite this context, little research has focused on decisions about and experiences of women living with HIV with regard to terminating a pregnancy, although this should form part of comprehensive promotion of sexual and reproductive health rights. In this paper, we explore the existing evidence related to global and country-specific barriers to safe abortion for all women, with an emphasis on research gaps around the right of women living with HIV to choose safe abortion services as an option for dealing with unwanted pregnancies. The main focus is on the situation for women living with HIV in Brazil, Namibia and South Africa as examples of three countries with different conditions regarding women's access to safe legal abortions: a very restrictive setting, a setting with several indications for legal abortion but non-implementation of the law, and a rather liberal setting. Similarities and differences are discussed, and we further outline global and country-specific barriers to safe abortion for all women, ending with recommendations for policy makers and researchers. PMID:22078463

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

The GAy MEn Sex StudieS: Anodyspareunia Among Belgian Gay Men.

PubMed

Vansintejan, Johan; Vandevoorde, Jan; Devroey, Dirk

2013-12-01

Anal intercourse is commonly associated with male homosexuality, but not all gay males engage in anal sex. Receptive anal intercourse can cause pain. Little is known about this sexual dysfunction. This study aims to determine the 4-week incidence of anodyspareunia (AD) in a sample of Belgian men who have sex with men (MSM) population and to assess the relevance of possible predictors such as age, relationship, and sexual behavior. An internet-based survey on sexual behavior and sexual dysfunctions, called GAy MEn Sex StudieS, was administered to the MSM aged 18 years or older, between April and December 2008. A part of the questionnaire was focusing on anal eroticism. The participants, who self-reported being human immunodeficiency virus-positive or not having anal intercourse, were excluded. Female Sexual Function Index questions on pain domain adapted for anal intercourse. A total of 1,752 Belgian MSM completed the questionnaire. Of the 1,190 (68%) participants who reported engaging in receptive anal sex in the last 4 weeks, 59% indicated having some degree of anal pain during and after sexual intercourse. For 44%, the level of pain was acceptable. Mild AD was reported by 32%, 17% had mild to moderate AD, 4% had moderate AD, and 2% had severe AD. Independent predictors for the presence of AD were age, having a steady relationship, frequency of sex with their partner, number of sex partners, number of sex partners at the same time, and massaging the anal sphincter before anal sex. The prevalence and severity of AD among the MSM were lower among older participants, the MSM who more frequently had sex with their partner, and participants with a higher number of sex partners. Inadequate lubrication and lack of oral or digitoproctic stimulation prior to penetration were the most important factors predicting pain. Unsafe anal sex was performed by 28%. One-third of the participants reported not engaging in receptive nor penetrative anal sex. The 59% of participating Belgian MSM, who had anal receptive intercourse, reported some degree of AD. These findings highlight the need for more education about anal eroticism for MSM, and more research into AD is needed. Vansintejan J, Vandevoorde J, and Devroey D. The GAy MEn Sex StudieS: Anodyspareunia among Belgian gay men. Sex Med 2013;1:87-94.

The GAy MEn Sex StudieS: Anodyspareunia Among Belgian Gay Men

PubMed Central

Vansintejan, Johan; Vandevoorde, Jan; Devroey, Dirk

2013-01-01

Introduction Anal intercourse is commonly associated with male homosexuality, but not all gay males engage in anal sex. Receptive anal intercourse can cause pain. Little is known about this sexual dysfunction. Aim This study aims to determine the 4-week incidence of anodyspareunia (AD) in a sample of Belgian men who have sex with men (MSM) population and to assess the relevance of possible predictors such as age, relationship, and sexual behavior. Methods An internet-based survey on sexual behavior and sexual dysfunctions, called GAy MEn Sex StudieS, was administered to the MSM aged 18 years or older, between April and December 2008. A part of the questionnaire was focusing on anal eroticism. The participants, who self-reported being human immunodeficiency virus-positive or not having anal intercourse, were excluded. Main Outcome Measure Female Sexual Function Index questions on pain domain adapted for anal intercourse. Results A total of 1,752 Belgian MSM completed the questionnaire. Of the 1,190 (68%) participants who reported engaging in receptive anal sex in the last 4 weeks, 59% indicated having some degree of anal pain during and after sexual intercourse. For 44%, the level of pain was acceptable. Mild AD was reported by 32%, 17% had mild to moderate AD, 4% had moderate AD, and 2% had severe AD. Independent predictors for the presence of AD were age, having a steady relationship, frequency of sex with their partner, number of sex partners, number of sex partners at the same time, and massaging the anal sphincter before anal sex. The prevalence and severity of AD among the MSM were lower among older participants, the MSM who more frequently had sex with their partner, and participants with a higher number of sex partners. Inadequate lubrication and lack of oral or digitoproctic stimulation prior to penetration were the most important factors predicting pain. Unsafe anal sex was performed by 28%. Conclusion One-third of the participants reported not engaging in receptive nor penetrative anal sex. The 59% of participating Belgian MSM, who had anal receptive intercourse, reported some degree of AD. These findings highlight the need for more education about anal eroticism for MSM, and more research into AD is needed. Vansintejan J, Vandevoorde J, and Devroey D. The GAy MEn Sex StudieS: Anodyspareunia among Belgian gay men. Sex Med 2013;1:87–94. PMID:25356292

Sexual Activity and Satisfaction in Healthy Community-dwelling Older Women

PubMed Central

Trompeter, Susan E.; Bettencourt, Ricki; Barrett-Connor, Elizabeth

2011-01-01

BACKGROUND Female sexual dysfunction is a focus of medical research but few studies describe the prevalence and covariates of recent sexual activity and satisfaction in older community-dwelling women. METHODS 1303 older women from the Rancho Bernardo Study were mailed a questionnaire on general health, recent sexual activity, sexual satisfaction, and the Female Sexual Function Index (FSFI). RESULTS 806 of 921 respondents (87.5%) age ≥40 years answered questions about recent sexual activity. Their median age was 67; mean years since menopause, 25; most were upper-middle class; 57% had attended at least one year of college; 90% reported good to excellent health. Half (49.8%) reported sexual activity within the past month with or without a partner, the majority of whom reported arousal (64.5%), lubrication (69%), and orgasm (67.1%) at least most of the time, although one-third reported low, very low, or no sexual desire. Although frequency of arousal, lubrication, and orgasm decrease with age, the youngest (<55 yrs) and oldest (>80 yrs) women reported a higher frequency of orgasm satisfaction. Emotional closeness during sex was associated with more frequent arousal, lubrication, and orgasm; estrogen therapy was not. Overall, two-thirds of sexually active women were moderately or very satisfied with their sex life, as were almost half of sexually inactive women. CONCLUSION Half these women were sexually active, with arousal, lubrication, and orgasm maintained into old age, despite low libido in one-third. Sexual satisfaction increased with age and did not require sexual activity. PMID:22195529

Club Drugs and HIV/STD Infection: An Exploratory Analysis among Men Who Have Sex with Men in Changsha, China.

PubMed

Chen, Xi; Li, Xingli; Zheng, Jun; Zhao, Junshi; He, Jianmei; Zhang, Guoqiang; Tang, Xuemin

2015-01-01

To evaluate current club drug use and its potential association with the transmission of HIV/STD among Changsha men who have sex with men (MSM). A cross-sectional survey was conducted by using self-administered questionnaires including information regarding socio-demographics, club drug use, high-risk behaviors, and HIV/STD infections. Multiple methods including venue-based, peer referral using "snowball" techniques, and internet advertisements were used to recruit study participants. Of the 826 participants, 177 (21.4%) reported that they had used club drugs at some time before or during sex in the past six months. MSM with young age, low education level, and seeking partners through the internet or bars were the main population who used drugs. Poppers were the most common drug used among Changsha MSM. The prevalence of HIV, syphilis, and herpes simplex virus-2 were higher among drug users. There were no significant differences in unprotected sexual intercourse and condom use between drug users and non-users. Compared with non-users, risk behaviors such as group sex, multiple sex partners, and sex with foreigners were more frequent among drug users. Club drug use is common among Changsha MSM, and is related to unsafe sex activities and HIV/STD infection. It is necessary to build novel targeted HIV prevention strategies to monitor and reduce club drug use among MSM.

Cognitive-Affective Dimensions of Female Orgasm: The Role of Automatic Thoughts and Affect During Sexual Activity.

PubMed

Tavares, Inês M; Laan, Ellen T M; Nobre, Pedro J

2017-06-01

Cognitive-affective factors contribute to female sexual dysfunctions, defined as clinically significant difficulties in the ability to respond sexually or to experience sexual pleasure. Automatic thoughts and affect presented during sexual activity are acknowledged as maintenance factors for these difficulties. However, there is a lack of studies on the influence of these cognitive-affective dimensions regarding female orgasm. To assess the role of automatic thoughts and affect during sexual activity in predicting female orgasm occurrence and to investigate the mediator role of these variables in the relation between sexual activity and orgasm occurrence. Nine hundred twenty-six sexually active heterosexual premenopausal women reported on frequency of sexual activities and frequency of orgasm occurrence, cognitive factors, and social desirability. Participants completed the Sexual Modes Questionnaire-Automatic Thoughts Subscale, the Positive and Negative Affect Schedule, and the Socially Desirable Response Set. Multiple linear regressions and mediation analyses were performed, controlling for the effect of covariates such as social desirability, sociodemographic and medical characteristics, and relationship factors. The main outcome measurement was orgasm frequency as predicted and mediated by automatic thoughts and affect experienced during sexual activities. The presence of failure thoughts and lack of erotic thoughts during sexual activity significantly and negatively predicted female orgasm, whereas positive affect experienced during sexual activity significantly and positively predicted female orgasm. Moreover, negative automatic thoughts and positive affect during sexual activity were found to mediate the relation between sexual activity and female orgasm occurrence. These data suggest that the cognitive aspects of sexual involvement are critical to enhancing female orgasm experience and can aid the development of strategies that contemplate the central role of automatic thoughts and of positive emotions experienced during sexual activity. Data were not collected face to face, which constitutes a strength of this study, because it is known that social desirability is lower in self-administered online questionnaires compared with traditional paper-and-pencil questionnaires, particularly for more sensitive sexual issues. The fact that the sample was composed of heterosexual, premenopausal, and relatively young women demands some caution regarding generalization of the present results. The findings support the contribution of cognitive and affective factors to female orgasmic functioning. It is recommended that future research confirm these findings with other samples, particularly clinical samples of women with orgasmic difficulties. Tavares IM, Laan ETM, Nobre PJ. Cognitive-Affective Dimensions of Female Orgasm: The Role of Automatic Thoughts and Affect During Sexual Activity. J Sex Med 2017;14:818-828. Copyright © 2017 International Society for Sexual Medicine. Published by Elsevier Inc. All rights reserved.

National survey of speeding and other unsafe driving actions. Volume 2, Driver attitudes and behavior

DOT National Transportation Integrated Search

1998-09-15

The National Highway Traffic Safety Administration (NHTSA) commissioned the research firm of Schulman, Ronca & Bucuvalas, Inc. (SRBI) to conduct the Nationwide Survey Regarding Speeding and Other Unsafe Driving Actions. Between February 20 and April ...

Identification of general risk-management countermeasures for unsafe driving actions. Volume 1, Description and analysis of promising countermeasures

DOT National Transportation Integrated Search

1981-02-01

A series of general risk-management countermeasures for speed Unsafe Driving Actions (UDAs) are described. First, countermeasure elements in three functional areas, detection, information, and action, are identified. Three comprehensive countermeasur...

The relative frequency of unsafe driving acts in serious traffic crashes

DOT National Transportation Integrated Search

2001-01-01

This study was conducted to determine the specific driver behaviors and unsafe driving acts that lead to crashes, and the situational, driver and vehicle characteristics associated with these behaviors. A sample of 723 crashes involving 1284 drivers ...

National survey of speeding and other unsafe driving actions. Volume 1, Methodology

DOT National Transportation Integrated Search

1998-09-15

The National Highway Traffic Safety Administration (NHTSA) commissioned the research firm of Schulman, Ronca & Bucuvalas, Inc. (SRBI) to conduct the National Survey of Speeding and Other Unsafe Driving Actions. Between February 20 and April 11, 1997,...

Effect of STOP technique on safety climate in a construction company.

PubMed

Darvishi, Ebrahim; Maleki, Afshin; Dehestaniathar, Saeed; Ebrahemzadih, Mehrzad

2015-01-01

Safety programs are a core part of safety management in workplaces that can reduce incidents and injuries. The aim of this study was to investigate the influence of Safety Training Observation Program (STOP) technique as a behavior modification program on safety climate in a construction company. This cross-sectional study was carried out on workers of the Petrochemical Construction Company, western Iran. In order to improve safety climate, an unsafe behavior modification program entitled STOP was launched among workers of project during 12 months from April 2013 and April 2014. The STOP technique effectiveness in creating a positive safety climate was evaluated using the Safety Climate Assessment Toolkit. 76.78% of total behaviors were unsafe. 54.76% of total unsafe acts/ at-risk behaviors were related to the fall hazard. The most cause of unsafe behaviors was associated with habit and unavailability of safety equipment. After 12 month of continuous implementation the STOP technique, 55.8% of unsafe behaviors reduced among workers. The average score of safety climate evaluated using of the Toolkit, before and after the implementation of the STOP technique was 5.77 and 7.24, respectively. The STOP technique can be considered as effective approach for eliminating at-risk behavior, reinforcing safe work practices, and creating a positive safety climate in order to reduction incidents/injuries.

Preceptorship: using an ethical lens to reflect on the unsafe student.

PubMed

Earle-Foley, Vicki; Myrick, Florence; Luhanga, Florence; Yonge, Olive

2012-01-01

Patient safety has become a worldwide health concern, and health care professionals have a moral and ethical responsibility to promote patient safety. The clinical education of many health care professionals often involves a preceptorship or field experience wherein students are assigned to work one-to-one with a preceptor or field educator so that they can be socialized into the profession and receive a reality-oriented experience. Health care professionals who accept the responsibility of being a preceptor face additional workload and stress, especially when the students to whom they are assigned are not meeting the expectations of safe, professional practice. Taking a stand against unsafe students is an important way for preceptors to promote patient safety. Given the nature of the stress and the inherent ethical issues associated with precepting an unsafe student, it is useful to examine this experience through an ethical lens. Included in this article is a brief overview of preceptorship as a model of clinical education, together with a discussion of the nature of the ethical decisions that preceptors face when precepting an unsafe student. Ethical theories, namely, virtue ethics and utilitarianism, are also explored and serve to provide the ethical lens through which preceptors can reflect upon their experiences with unsafe students. Copyright © 2012 Elsevier Inc. All rights reserved.

Unsafe abortion requiring hospital admission in the Eastern Highlands of Papua New Guinea--a descriptive study of women's and health care workers' experiences.

PubMed

Vallely, Lisa M; Homiehombo, Primrose; Kelly-Hanku, Angela; Whittaker, Andrea

2015-03-21

In Papua New Guinea induced abortion is restricted under the Criminal Code Law. Unsafe abortions are known to be widely practiced and sepsis due to unsafe abortion is a leading cause of maternal mortality. We undertook a six month, prospective, mixed methods study at the Eastern Highlands Provincial Hospital. Semi structured and in depth interviews were undertaken with women presenting following induced abortion. This paper describes the reasons why women resorted to unsafe abortion, the techniques used, decision to seek post abortion care and women's reflections post abortion. 28 women were admitted to hospital following an induced abortion. Reasons for inducing an abortion included: wanting to continue with studies, relationship problems and socio-cultural factors. Misoprostol was the most frequently used method to end the pregnancy. Physical and mechanical means, traditional herbs and spiritual beliefs were also reported. Women sought care post abortion due to excessive vaginal bleeding, and severe abdominal pain with some afraid they would die if they did not seek help. In the absence of contraceptive information and services to avoid, postpone or space pregnancies, women in this setting are resorting to unsafe means to end an unwanted pregnancy, putting their lives at risk. Women need access to safe, effective means of abortion.

Persistence of unsafe practice in everyday work: an exploration of organizational and psychological factors constraining safety in the operating room.

PubMed

Espin, S; Lingard, L; Baker, G R; Regehr, G

2006-06-01

This paper explores the factors that influence the persistence of unsafe practice in an interprofessional team setting in health care, towards the development of a descriptive theoretical model for analyzing problematic practice routines. Using data collected during a mixed method interview study of 28 members of an operating room team, participants' approaches to unsafe practice were analyzed using the following three theoretical models from organizational and cognitive psychology: Reason's theory of "vulnerable system syndrome", Tucker and Edmondson's concept of first and second order problem solving, and Amalberti's model of practice migration. These three theoretical approaches provide a critical insight into key trends in the interview data, including team members' definition of error as the breaching of standards of practice, nurses' sense of scope of practice as a constraint on their reporting behaviours, and participants' reports of the forces influencing tacit agreements to work around safety regulations. However, the relational factors underlying unsafe practice routines are poorly accounted for in these theoretical approaches. Incorporating an additional theoretical construct such as "relational coordination" to account for the emotional human features of team practice would provide a more comprehensive theoretical approach for use in exploring unsafe practice routines and the forces that sustain them in healthcare team settings.

Demographic and psychosocial correlates of sexual activity in older Chinese people.

PubMed

Yang, Shuyan; Yan, Elsie

2016-03-01

This study examines sexual activity and associated psychosocial factors in older Chinese people. Sexuality continues to play a pivotal role in our lives even as we grow old. There is, however, very limited research on the topic in older populations. Cross-sectional survey. A representative sample of 688 older Chinese people (>60 years old) were individually interviewed on their demographic characteristics; their interest in, knowledge of and perceived control over sexual activities; and their engagement in sexual activity. The results show that 51·32% of men and 41·26% of women reported engaging in some form of sexual activity. Sexual intercourse and caressing were commonly reported. A multiple regression analysis also showed that a higher level of sexual activity was associated with being younger, living with a spouse, having a strong interest in sex, having sufficient knowledge of elder sexuality and a high perceived control over sex. Distinct predictive factors in each gender were observed. A high level of perceived control was associated with a higher level of sexual activity in males but not females. A series of binary logistic regression analyses were conducted to determine the demographic and psychosocial correlates of sexual activity. With the exception of the use of objects (sex toys), sexual activities were consistently associated with being younger; living with a spouse; and having high levels of interest, knowledge and perceived control. A sizable amount of older Chinese people engage in varying degrees of sexual activity, and most are still interested in sex. Frontline health professionals need to be aware of the growing needs for sex education in older persons, particular attention should be paid to discuss the limitations brought about by various chronic conditions associated with ageing and their relevance to elder sexuality. © 2015 John Wiley & Sons Ltd.

Sexual functioning of people with rheumatoid arthritis: a multicenter study.

PubMed

van Berlo, Willy T M; van de Wiel, Harry B M; Taal, Erik; Rasker, Johannes J; Weijmar Schultz, Willibrord C M; van Rijswijk, Martin H

2007-01-01

The objective of this study is to compare men and women with rheumatoid arthritis (RA) to controls regarding sexual motivation, activity, satisfaction, and specific sexual problems, and to determine the correlation of physical aspects of the disease with sexual functioning. Questionnaire for screening sexual dysfunctions (QSD), self-constructed questionnaire on experienced distress with joints during sexual activities, arthritis impact measurements scales 2 (AIMS2), and the modified disease activity score 28 (DAS 28) were the methods used. RA patients were recruited from a registration base in three Dutch hospitals. Controls were age and sex matched healthy volunteers. A completed questionnaire was sent back by 271 patients (response 23%). Forty-seven men and 93 women were clinically examined to obtain the DAS 28. Male patients felt less sexual desire, and female patients masturbated and fantasized less than controls. Differences in satisfaction were not found. Male and female patients did not experience more sexual problems than controls. Among the women, correlations were predominantly found between age and sexual motivation and activities, among the men between physical health and sexual problems. Up to 41% of the men (4-41 depending on the joints), and up to 51% of the women (10-51 depending on the joints) have troubles with several joints during sexual activities. Medications influencing ejaculation in men correlated with distress with orgasm. Conclusions are that patients are less sexually active than controls and a considerable number of both male and female patients have trouble with their joints during sexual activities. However, patients do not differ from controls regarding sexual satisfaction. Physiological changes due to RA are apparently independent from those on psychological level. It is argued that sexual satisfaction also depends on personal and social factors. In men, physical health and disease activity are more related with sexual problems than in women.

A cross-sectional study on attitudes toward gender equality, sexual behavior, positive sexual experiences, and communication about sex among sexually active and non-sexually active adolescents in Bolivia and Ecuador

PubMed Central

De Meyer, Sara; Jaruseviciene, Lina; Zaborskis, Apolinaras; Decat, Peter; Vega, Bernardo; Cordova, Kathya; Temmerman, Marleen; Degomme, Olivier; Michielsen, Kristien

2014-01-01

Background It is widely agreed upon that gender is a key aspect of sexuality however, questions remain on how gender exactly influences adolescents’ sexual health. Objective The aim of this research was to study correlations between gender equality attitudes and sexual behavior, sexual experiences and communication about sex among sexually active and non-sexually active adolescents in 2 Latin American countries. Design In 2011, a cross-sectional study was carried out among 5,913 adolescents aged 14–18 in 20 secondary schools in Cochabamba (Bolivia) and 6 secondary schools in Cuenca (Ecuador). Models were built using logistic regressions to assess the predictive value of attitudes toward gender equality on adolescents’ sexual behavior, on experiences and on communication. Results The analysis shows that sexually active adolescents who consider gender equality as important report higher current use of contraceptives within the couple. They are more likely to describe their last sexual intercourse as a positive experience and consider it easier to talk with their partner about sexuality than sexually experienced adolescents who are less positively inclined toward gender equality. These correlations remained consistent whether the respondent was a boy or a girl. Non-sexually active adolescents, who consider gender equality to be important, are more likely to think that sexual intercourse is a positive experience. They consider it less necessary to have sexual intercourse to maintain a relationship and find it easier to communicate with their girlfriend or boyfriend than sexually non-active adolescents who consider gender equality to be less important. Comparable results were found for boys and girls. Conclusions Our results suggest that gender equality attitudes have a positive impact on adolescents’ sexual and reproductive health (SRH) and wellbeing. Further research is necessary to better understand the relationship between gender attitudes and specific SRH outcomes such as unwanted teenage pregnancies and sexual pleasure among adolescents worldwide. PMID:25024066

A cross-sectional study on attitudes toward gender equality, sexual behavior, positive sexual experiences, and communication about sex among sexually active and non-sexually active adolescents in Bolivia and Ecuador.

PubMed

De Meyer, Sara; Jaruseviciene, Lina; Zaborskis, Apolinaras; Decat, Peter; Vega, Bernardo; Cordova, Kathya; Temmerman, Marleen; Degomme, Olivier; Michielsen, Kristien

2014-01-01

It is widely agreed upon that gender is a key aspect of sexuality however, questions remain on how gender exactly influences adolescents' sexual health. The aim of this research was to study correlations between gender equality attitudes and sexual behavior, sexual experiences and communication about sex among sexually active and non-sexually active adolescents in 2 Latin American countries. In 2011, a cross-sectional study was carried out among 5,913 adolescents aged 14-18 in 20 secondary schools in Cochabamba (Bolivia) and 6 secondary schools in Cuenca (Ecuador). Models were built using logistic regressions to assess the predictive value of attitudes toward gender equality on adolescents' sexual behavior, on experiences and on communication. The analysis shows that sexually active adolescents who consider gender equality as important report higher current use of contraceptives within the couple. They are more likely to describe their last sexual intercourse as a positive experience and consider it easier to talk with their partner about sexuality than sexually experienced adolescents who are less positively inclined toward gender equality. These correlations remained consistent whether the respondent was a boy or a girl. Non-sexually active adolescents, who consider gender equality to be important, are more likely to think that sexual intercourse is a positive experience. They consider it less necessary to have sexual intercourse to maintain a relationship and find it easier to communicate with their girlfriend or boyfriend than sexually non-active adolescents who consider gender equality to be less important. Comparable results were found for boys and girls. Our results suggest that gender equality attitudes have a positive impact on adolescents' sexual and reproductive health (SRH) and wellbeing. Further research is necessary to better understand the relationship between gender attitudes and specific SRH outcomes such as unwanted teenage pregnancies and sexual pleasure among adolescents worldwide.

Changes in women's sexual behavior following sexual assault.

PubMed

Deliramich, Aimee N; Gray, Matt J

2008-09-01

The present study examines changes in women's sexual activity and behavior following sexual assault and the relationship between alcohol abuse and postassault promiscuity. Although many researchers have focused on avoidance of sexual activity following an assault, some have suggested that women may exhibit an increase in sexual activity postassault. Such outcomes are not mutually exclusive possibilities but may instead reflect subtypes of sexual assault victims. A significant percentage of assault survivors did report increases in sexual activity following trauma. Assault survivors also reported increases in posttraumatic alcohol consumption relative to a comparison sample of motor vehicle accident survivors. In both groups, increases in posttraumatic alcohol usage predicted increases in posttraumatic sexual activity, suggesting that use of alcohol as a coping strategy may result in an increased likelihood of engaging in risky sexual behavior. If true, this maladaptive coping mechanism could help to account for some instances of revictimization.

Kitchen Magic: A Nutrition and Cooking Activities Handbook.

ERIC Educational Resources Information Center

Crist, Mary Jo; And Others

This handbook on nutrition and cooking is one of a series written especially for parents and other caregivers. Contents include: (1) the importance of nutrition, (2) the four basic food groups in terms of serving size, menu planning, and major nutrients, (3) ways to build healthy attitudes toward food, (4) unsafe foods which have the potential to…

75 FR 2867 - Agency Information Collection Activities; Submission for Office of Management and Budget Review...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-01-19

... Request; Food Additive Petitions AGENCY: Food and Drug Administration, HHS. ACTION: Notice. SUMMARY: The... collection of information to OMB for review and clearance. Food Additive Petitions (OMB Control Number 0910...)) provides that a food additive shall be deemed to be unsafe unless its use is permitted by a regulation...

School-Police Partnership Effectiveness in Urban Schools: An Analysis of New York City's Impact Schools Initiative

ERIC Educational Resources Information Center

Brady, Kevin P.; Balmer, Sharon; Phenix, Deinya

2007-01-01

Despite nationwide decreases in school crime and violence, a relatively high and increasing number of students report feeling unsafe at school. In response, some school officials are implementing school-police partnerships, especially in urban areas, as an effort to deter criminal activity and violence in schools. This article examines the initial…

75 FR 48620 - Airworthiness Directives; The Boeing Company Model 737-100, -200, -200C, -300, -400, and -500...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-08-11

... operations. This proposed AD results from a design change in the cabin altitude warning system that would... warning system that would address the identified unsafe condition(s), and that once this design change was... altitude warning and takeoff configuration warning lights. The activation includes changing the wiring in...

Sexual Health and Positive Subjective Well-Being in Partnered Older Men and Women

PubMed Central

Vanhoutte, Bram; Nazroo, James; Pendleton, Neil

2016-01-01

Objectives: We examine the associations between different patterns of sexual behavior and function and three indicators of subjective well-being (SWB) covering eudemonic, evaluative, and affective well-being in a representative sample of partnered older people. Method: Using data from a Sexual Relationships and Activities Questionnaire (SRA-Q) in Wave 6 of the English Longitudinal Study of Ageing, latent class analysis identified groups characterized by distinctive patterns of sexual behavior and function and then examined their link to SWB. Eudemonic SWB was measured using a revised 15-item version of the CASP-19, evaluative SWB using the Satisfaction With Life Scale, and affective SWB using the 8-item version of the Centre for Epidemiologic Studies-Depression scale. Results: Sexual behavior and function was best described by six classes among men and five classes among women. These ranged from high sexual desire, frequent partnered sexual activities, and few sexual problems (Class 1) to low sexual desire, infrequent/no sexual activity, and problems with sexual function (Class 5[women]/6[men]). Men and women who reported either infrequent/no sexual activity, or were sexually active but reported sexual problems, generally had lower SWB than those individuals identified in Class 1. Poorer SWB in men was more strongly associated with sexual function difficulties, whereas in women desire and frequency of partnered activities appeared more important in relation to SWB. Discussion: Within the context of a partnered relationship continuing sexual desire, activity and functioning are associated with higher SWB, with distinctive patterns for women and men. PMID:26993519

Sexual functioning among early post-treatment breast cancer survivors.

PubMed

Avis, Nancy E; Johnson, Aimee; Canzona, Mollie Rose; Levine, Beverly J

2018-02-17

This study aims (1) to estimate percentages of partnered women who are sexually active over the first 2 years post-breast cancer diagnosis; (2) to identify factors related to sexual inactivity; and (3) to evaluate separately, among both sexually active and inactive survivors, the relation between sexual problems and treatment-related variables, symptoms, and psychosocial factors. Longitudinal observational study of breast cancer survivors recruited within 8 months of cancer diagnosis and followed for 18 months. The main outcome measures were (1) being sexually active/inactive in the past month and (2) sexual problems assessed with the four-item sexual problem domain of the Quality of Life in Adult Cancer Survivors (QLACS) scale. At baseline, 52.4% of women reported being sexually active in the past month. This percentage increased to 60.7% 18 months later. In multivariable repeated-measures analyses, age, past chemotherapy, depressive symptoms, and lower perceived attractiveness were related to inactivity. Sexually inactive women reported more problems on the QLACS than sexually active women. In stratified multivariable analyses, depressive symptoms were related to greater sexual problems for both sexually active and inactive women, as was vaginal dryness. Among the sexually active women, younger age at diagnosis, less illness intrusiveness, and lower perceived attractiveness were related to more problems. Research has shown that sexual functioning/sexual health are key aspects of quality of life for many cancer survivors, and are often not addressed by health care providers. Future studies should examine how such topics are handled by clinicians in their interactions with survivors.

More than a dance: the production of sexual health risk in the exotic dance clubs in Baltimore, USA.

PubMed

Sherman, Susan G; Lilleston, Pamela; Reuben, Jacqueline

2011-08-01

Women who exchange sex for money, drugs, or goods are disproportionately infected with HIV and have high rates of illicit drug use. A growing body of research has underscored the primacy of environmental factors in shaping individual behaviors. HIV/STI rates among sex workers are influenced by environmental factors such as the physical (e.g., brothel) and economic (e.g., increased pay for unsafe sex) context in which sex work occurs. Exotic dance clubs (EDCs) could be a risk environment that is epidemiologically significant to the transmission of HIV/STIs among vulnerable women, but it is a context that has received scant research attention. This study examines the nature of the physical, social, and economic risk environments in promoting drug and sexual risk behaviors. Structured observations and semi-structured qualitative interviews (N = 40) were conducted with club dancers, doormen, managers, and bartenders from May through August, 2009. Data were analyzed inductively using the constant comparative method common to grounded theory methods. Atlas-ti was used for data analysis. Dancers began working in exotic dance clubs primarily because of financial need and lack of employment opportunities, and to a lesser extent, the need to support illicit drug habits. The interviews illuminated the extent to which the EDCs' physical (e.g., secluded areas for lap dances), economic (e.g., high earnings from dancers selling sex), and social (e.g., prevailing social norms condoning sex work) environments facilitated dancers' engaging in sex work. Drug use and alcohol use were reported as coping mechanisms in response to these stressful working conditions and often escalated sexual risk behaviors. The study illuminated characteristics of the environment that should be targeted for interventions. Copyright © 2011 Elsevier Ltd. All rights reserved.

More than a dance: The production of sexual health risk in the exotic dance clubs in Baltimore, USA

PubMed Central

Sherman, Susan G.; Lilleston, Pamela; Reuben, Jacqueline

2011-01-01

Women who exchange sex for money, drugs, or goods are disproportionately infected with HIV and have high rates of illicit drug use. A growing body of research has underscored the primacy of environmental factors in shaping individual behaviors. HIV/STI rates among sex workers are influenced by environmental factors such as the physical (e.g., brothel) and economic (e.g., increased pay for unsafe sex) context in which sex work occurs. Exotic dance clubs (EDCs) could be a risk environment that is epidemiologically significant to the transmission of HIV/STIs among vulnerable women, but it is a context that has received scant research attention. This study examines the nature of the physical, social, and economic risk environments in promoting drug and sexual risk behaviors. Structured observations and semi-structured qualitative interviews (N=40) were conducted with club dancers, doormen, managers, and bartenders from May through August, 2009. Data were analyzed inductively using the constant comparative method common to grounded theory methods. Atlas-ti was used for data analysis. Dancers began working in exotic dance clubs primarily because of financial need and lack of employment opportunities, and to a lesser extent, the need to support illicit drug habits. The interviews illuminated the extent to which the EDCs’ physical (e.g., secluded areas for lap dances), economic (e.g., high earnings from dancers selling sex), and social (e.g., prevailing social norms condoning sex work) environments facilitated dancers’ engaging in sex work. Drug use and alcohol use were reported as coping mechanisms in response to these stressful working conditions and often escalated sexual risk behaviors. The study illuminated characteristics of the environment that should be targeted for interventions. PMID:21724311

Effectiveness of "shifting boundaries" teen dating violence prevention program for subgroups of middle school students.

PubMed

Taylor, Bruce G; Mumford, Elizabeth A; Stein, Nan D

2015-02-01

We examine whether the Shifting Boundaries (SB) intervention, a primary intervention to prevent youth dating violence and sexual harassment (DV/H), is differentially effective for girls compared with boys or for youth with a history of DV/H experiences. We randomly assigned SB to 30 public middle schools in New York City, enrolling 117 sixth and seventh grade classes to receive a classroom, building, combined, or neither intervention. The SB classroom intervention included six sessions emphasizing the laws/consequences of DV/H, establishing boundaries and safe relationships. The SB schoolwide/building intervention included the use of school-based restraining orders, greater faculty/security presence in unsafe "hot spots" mapped by students, and posters to increase DV/H awareness and reporting. Student surveys were implemented at baseline, immediately after intervention, and 6 months after intervention. At 6 months after intervention, the SB building-level intervention was associated with significant reductions in the frequency of sexual harassment (SH) perpetration and victimization; the prevalence and frequency of sexual dating violence victimization; and the frequency of total dating violence victimization and perpetration. We also had one anomalous finding that the interventions were associated with an increase in the prevalence of SH victimization. These results were consistent for girls and boys, and those with or without a history of DV/H, with the one exception for those exposed to the SB building condition who had earlier reported perpetrating SH had a significantly lower frequency of perpetrating SH at the follow-up than those without such a history. SB can provide effective universal prevention of middle school DV/H experiences, regardless of students' prior exposure histories, and for boys and girls. Copyright © 2015 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

Alcohol use and HIV serostatus of partner predict high-risk sexual behavior among patients receiving antiretroviral therapy in South Western Uganda.

PubMed

Bajunirwe, Francis; Bangsberg, David R; Sethi, Ajay K

2013-05-03

Antiretroviral treatment restores the physical and immunological function for patients with HIV/AIDS and the return of sexual desire. The frequency and correlates of sexual activity among patients receiving ART have not been widely studied. There is concern that widespread availability of ART may result in sexual disinhibition including practice of high-risk sexual behavior. We determined the correlates of sexual activity and high-risk sexual behavior in an ART-treated population in rural and urban Uganda. We conducted a cross-sectional study among 329 ART-treated adult patients at two hospitals, one located in rural and another in urban western Uganda. We collected data on sexual activity, frequency of condom use, pregnancy, viral load (VL) and CD4. Patients were considered sexually active if they had had sexual intercourse in the last 6 months. Any unprotected sex was considered high-risk sex. A two-stage logistic regression was performed to determine factors associated with sexual activity and high-risk sex among those sexually active. Overall, 222 (67%) patients were women, 138 (41.2%) had been on ART for at least one year, and 168 (51.4%) were sexually active of whom 127 (75.6%) used condoms at the last intercourse. Younger age (<=30 years) (Odds ratio; OR=2.3, 95% CI 1.2, 4.2), higher monthly income (OR=4.1, 95% CI 2.4, 7.4), and being married (OR=22.7, 95% CI 8.2, 62.9) were associated with being sexually active. Undetectable VL, CD4 count and treatment duration were not significantly associated with sexual activity. Among the sexually active, alcohol consumption (OR=3.3, 95% CI 1.2, 9.1) and unknown serostatus of partner (OR=5.8, 95% CI 1.5, 21.4) were significant predictors of high-risk sexual behavior. The frequency of unprotected sex at the last intercourse was 25.9% and 22.1% among the men and women respectively and was not significantly different (p value for chi square test =0.59). Younger persons receiving ART are more likely to be sexually active. ART clients are more likely to engage in unprotected sex when sero-status of partner is unknown or report use of alcohol. Counseling on alcohol use and disclosure of sero-status may be useful in reducing high risk sexual behavior.

Water management practices in rural and urban homes: a case study from Bangladesh on ingestion of polluted water.

PubMed

Ahmed, S A; Hoque, B A; Mahmud, A

1998-09-01

Although Bangladesh has achieved remarkable success in extending the availability of hand pumped and piped water, unsafe water is still ingested. This brief study attempted to assess water management practices in rural and urban homes in Bangladesh so as to establish the routes by which unsafe water is ingested, to examine methods of collection and storage, and determine why unsafe water sources are used when unsafe supplies are available. Forty-eight rural and forty-five urban slum households were studied. Observations, interviews and water quality investigations were conducted. The results show that the respondents were aware that hand pump/tap water is safe and took care to use these safe sources for drinking purposes. However, they continued to use surface water for non-drinking activities such as bathing, washing and rinsing their mouths. Reasons were given that it was a traditional practice to bathe in surface water and was more enjoyable. One of the reasons given for not using hand pumped water to wash clothing and food was that such groundwater caused staining. Bacteriological results from such ingested water showed the quality, especially in rural areas, to be poor. Results also showed the internal surfaces of the base of storage containers to be heavily contaminated with bacteria. This showed that water that was safe when it was first drawn would became contaminated during storage. This study had a limited scope; much further research is needed to find what determines and how water becomes contaminated in containers. These factors include how to reduce contamination of water, in particular the relationship between growth of bacteria in stored water and the material from which the container is made and how to improve the overall quality of water. On the management side, studies could be conducted as to how to improve people's understanding of the use of water for domestic purposes and its safe management.

AIDS knowledge and sexual activity among Flemish secondary school students: a multilevel analysis of the effects of type of education.

PubMed

Van Rossem, Ronan; Berten, Hans; Van Tuyckom, Charlotte

2010-01-21

The behavior of adolescents puts them at an increased risk for HIV and other STIs, and their knowledge about HIV/AIDS is often inadequate. An understanding of how AIDS knowledge and sexual activity co-vary among Flemish secondary school students and of how education type, specifically, affects these students is limited. This study addresses the question of whether the effects of education type on HIV/AIDS knowledge and sexual activity are independent of the socio-demographic characteristics of the students. Data from the Flemish Educational Assessment survey, which collected data from a large representative sample of third- and fifth-grade high school students (N = 11,872), were used. Data were analyzed using multilevel logistic and Poisson regression techniques. There is an indication that type of education affects both an adolescent's sexual activity and his/her AIDS knowledge; these effects prove robust for differences in socio-economic backgrounds. Students in lower status education types are more likely to be sexually active and to have poorer AIDS knowledge. The relationship between AIDS knowledge and sexual activity is, however, more complex. Although students in education types with poorer AIDS knowledge are more sexually active, within each of these groups the sexually active have better AIDS knowledge than the non-sexually active. There is also evidence of active information seeking by sexually active students, which leads to improved AIDS knowledge. These findings are consistent with the literature on the role of the educational system in the reproduction of social inequalities. Students from lower status education types are at increased sexual risk compared to those from higher status types. There is also evidence of active information seeking by sexually active students, which leads to improved AIDS knowledge.

Social and emotional consequences of refraining from sexual activity among sexually experienced and inexperienced youths in California.

PubMed

Brady, Sonya S; Halpern-Felsher, Bonnie L

2008-01-01

We examined the social and emotional consequences among adolescents of refraining from sexual activity (oral or vaginal sex) and whether these consequences differed over time and by gender and sexual experience. Adolescents (N=612; 58% female) recruited from 2 schools were assessed at 4 time points separated by 6-month intervals, beginning in fall of ninth grade. The percentage of adolescents who reported only positive consequences (e.g., they felt responsible, friends were proud) dramatically decreased over time, whereas the percentage that reported negative consequences (e.g., they felt left out, partners became angry) steadily increased. Adolescent girls and sexually experienced adolescents were more likely to report both positive and negative consequences than were adolescent boys and sexually inexperienced adolescents. Adolescents who began the study with sexual experience were more likely to report positive consequences of refraining from sexual activity by the end of the study than those who initiated sexual activity later. Sexual education programs should address how adolescents can cope with or prevent negative consequences of refraining from sexual activity, so that decisions to abstain are rewarding and decisions to engage in sexual activity are motivated by maturity and readiness.

Colocalization of Mating-Induced Fos and D2-Like Dopamine Receptors in the Medial Preoptic Area: Influence of Sexual Experience.

PubMed

Nutsch, Victoria L; Will, Ryan G; Robison, Christopher L; Martz, Julia R; Tobiansky, Daniel J; Dominguez, Juan M

2016-01-01

Dopamine in the medial preoptic area (mPOA) stimulates sexual activity in males. This is evidenced by microdialysis and microinjection experiments revealing that dopamine receptor antagonists in the mPOA inhibit sexual activity, whereas agonists facilitate behavior. Microdialysis experiments similarly show a facilitative role for dopamine, as levels of dopamine in the mPOA increase with mating. While the majority of evidence suggests an important role for dopamine receptors in the mPOA in the regulation of male sexual behaviors, whether sexual activity or sexual experience influence dopamine receptor function in the mPOA has not been previously shown. Here we used immunohistochemical assays to determine whether varying levels of sexual activity or experience influence the number of cells containing Fos or D2 receptor immunoreactivity. Results show that sexual experience facilitated subsequent behavior, namely experience decreased latencies. Moreover, the number of cells with immunoreactivity for Fos or D2 correlated with levels of sexual experience and sexual activity. Sexual activity increased Fos immunoreactivity. Sexually experienced animals also had significantly more D2-positive cells. Sexually inexperienced animals copulating for the first time had a larger percentage of D2-positive cells containing Fos, when compared to sexually experienced animals. Finally, regardless of experience, animals that had sex prior to sacrifice had significantly more D2-positive cells that contained Fos, vs. animals that did not copulate. These findings are noteworthy because sexually experienced animals display increased sexual efficiency. The differences in activation of D2 and changes in receptor density may play a role in this efficiency and other behavioral changes across sexual experience.

Opioid receptor and β-arrestin2 densities and distribution change after sexual experience in the ventral tegmental area of male rats.

PubMed

Garduño-Gutiérrez, René; León-Olea, Martha; Rodríguez-Manzo, Gabriela

2018-05-15

Sexual experience modifies brain functioning and copulatory efficiency. Sexual activity, ejaculation in particular, is a rewarding behavior associated with the release of endogenous opioids, which modulate the activity of the mesolimbic dopaminergic system (MLS). In sexually exhausted rats, repeated ejaculation produces μ (MOR) and δ opioid receptor (DOR) internalization in ventral tegmental area (VTA) neurons, as well as long-lasting behavioral changes suggestive of brain plasticity processes. We hypothesized that in sexually naïve rats the endogenous opioids released during sexual experience acquisition, might contribute to brain plasticity processes involved in the generation of the behavioral changes induced by sexual experience. To this aim, using double immunohistochemistry and confocal microscopy, we compared in vivo MOR, DOR and β-arrestin2 densities and activation in the VTA of sexually naïve males, sexually experienced rats not executing sexual activity prior to sacrifice and sexually experienced animals that ejaculated once before sacrifice. Results showed that sexual experience acquisition improved male's copulatory ability and induced persistent changes in the density, cellular distribution and activation of MOR and β-arrestin2 in VTA neurons. DOR density was not modified, but its cellular location changed after sexual experience, revealing that these two opioid receptors were differentially activated during sexual experience acquisition. It is concluded that the endogenous opioids released during sexual activity produce adjustments in VTA neurons of sexually naïve male rats that might contribute to the behavioral plasticity expressed as an improvement in male copulatory parameters, promoted by the acquisition of sexual experience. Copyright © 2018 Elsevier Inc. All rights reserved.

Profiles of African American College Students’ Alcohol Use and Sexual Behaviors: Associations With Stress, Racial Discrimination, and Social Support

PubMed Central

Metzger, Isha W.; Cooper, Shauna M.; Ritchwood, Tiarney D.; Onyeuku, Chisom; Griffin, Charity Brown

2017-01-01

Though studies show that alcohol use and sexual activity increase during emerging adulthood, few studies examine within–ethnic group differences, particularly among African American college students. This investigation utilized a latent class analytic methodology to identify risk behavior profiles of alcohol use (frequency and amount of alcohol consumed), sexual activity (number of intimate partners), and co-occurring risk behaviors (drinking before sexual intercourse) among 228 African American college students. This investigation also examined whether identified risk behavior profiles were associated with stress (interpersonal, intraperso-nal, academic, and environmental), experiences of racial discrimination, and social support (from family, friends, and the college community). Results identified five distinct profiles within this sample: (a) High Sexual Risk—above-average sexual activity; (b) Abstainers—below-average alcohol use and sexual activity; (c) Low Risk—average alcohol use and sexual activity; (d) Alcohol Risk—above-average alcohol use and below-average sexual activity; and (e) Co-Occurring Risk—above-average alcohol use and sexual activity. Identified profiles differed across interpersonal and environmental stress, and self-reported frequency of experiences with racial discrimination. Implications for prevention programs and interventions aimed at reducing alcohol and sexual activity for African American college students are discussed. PMID:27215314

National survey of speeding and unsafe driving attitudes and behaviors : 2002. Volume 2, Findings

DOT National Transportation Integrated Search

2004-05-01

This report represents findings from a survey on speeding and unsafe driving attitudes and behaviors. The data come from a pair of studies undertaken by the National Highway Traffic Safety Administration (NHTSA) to better understand drivers' behavior...

Unsafe Sexual Behavior Among Gay/Bisexual Men in the Era of Combination Antiretroviral Therapy (cART).

PubMed

Surkan, Pamela J; Li, Ying; Jacobson, Lisa P; Cox, Christopher; Silvestre, Anthony; Gorbach, Pamina; Teplin, Linda; Plankey, Michael

2017-10-01

The aim of this study was to determine the association between psychosocial determinants of unprotected receptive anal intercourse (URAI) and unprotected insertive anal intercourse (UIAI). Data from 417 HIV positive men who have sex with men (MSM) in the Multicenter AIDS Cohort Study from April 1999 to March 2012 were analyzed and adjusted odds were calculated. It was found that 66% (n = 277) and 72% (n = 299) reported any UIAI or URAI over follow-up, respectively. Cumulative cART-years (median = 5.30 years) was associated with 33 and 47% increases in UIAI and URAI, respectively. Not having reduced concern about HIV transmission (UIAI: OR 0.37, p-value = 0.0004; URAI: OR 0.57, p-value = 0.04), increased safe sex fatigue (UIAI: OR 2.32, 95% p-value = 0.0002; URAI: OR 1.94, p-value = 0.003), and sexual sensation seeking (UIAI: OR 1.76, p-value = 0.002; URAI: OR 1.56, p-value = 0.02) were associated with UIAI and URAI. Serosorting was associated with UIAI (OR 6.11, p-value < 0.0001) and URAI (OR 6.80, p-value < 0.0001). Findings suggest that negative attitudes about HIV transmission are sustained among older men who have sex with men.

Knowledge, Attitude, and Preventive Practices among Prison Inmates in Ogbomoso Prison at Oyo State, South West Nigeria

PubMed Central

Saliu, Abdulsalam; Akintunde, Babatunde

2014-01-01

Prisoners are at special risk for infection with human immunodeficiency virus (HIV) because of overcrowded prisons, unprotected sex and sexual assault, occurrence of sexual practices that are risky to health, unsafe injecting practices, and inadequate HIV prevention, care, and support services. This study aimed to describe the knowledge, attitude, and preventive practices towards HIV/AIDS by male inmates in Ogbomoso Prison at Oyo State, South West Nigeria. This was a cross-sectional study. A simple random sampling method was employed to select 167 male participants and data were collected using pretested structured interviewer-administered questionnaire. The data were collated and analyzed using the Statistical Package for Social Sciences version 17. Fifty (29.9%) were in the age group 20–24 years with mean age of 30.99 ± 11.41. About half (50.3%) had been married before incarceration. Family and friends (30%), health care workers (25%), prison staff (20%), and mass media (25%) were the commonest sources of information on HIV/AIDS. Knowledge about HIV was found to be high (94.6%). About 68.9% believed that people with the disease should be avoided. The knowledge about HIV/AIDS among inmates was high, but misconceptions about HIV/AIDS are still rife among the prisoners and educational programs would be required to correct this. PMID:25763397

Correlates of Sexual Satisfaction Among Sexually Active Postmenopausal Women in the Women’s Health Initiative-Observational Study

PubMed Central

Jaramillo, Sarah A.; Legault, Claudine; Freund, Karen M.; Cochrane, Barbara B.; Manson, JoAnn E.; Wenger, Nanette K.; Eaton, Charles B.; Rodriguez, Beatriz L.; McNeeley, S. Gene; Bonds, Denise

2008-01-01

BACKGROUND Satisfaction with sexual activity is important for health-related quality of life, but little is known about the sexual health of postmenopausal women. OBJECTIVE Describe factors associated with sexual satisfaction among sexually active postmenopausal women. DESIGN Cross-sectional analysis. PARTICIPANTS All members of the Women’s Health Initiative-Observational Study (WHI-OS), ages 50–79, excluding women who did not respond to the sexual satisfaction question or reported no partnered sexual activity in the past year (N = 46,525). MEASUREMENTS Primary outcome: dichotomous response to the question, “How satisfied are you with your sexual activity (satisfied versus unsatisfied)?” Covariates included sociodemographic factors, measures of physical and mental health, and gynecological variables, medications, and health behaviors related to female sexual health. RESULTS Of the cohort, 52% reported sexual activity with a partner in the past year, and 96% of these answered the sexual satisfaction question. Nonmodifiable factors associated with sexual dissatisfaction included age, identification with certain racial or ethnic groups, marital status, parity, and smoking history. Potentially modifiable factors included lower mental health status and use of SSRIs. The final model yielded a c-statistic of 0.613, reflecting only a modest ability to discriminate between the sexually satisfied and dissatisfied. CONCLUSIONS Among postmenopausal women, the variables selected for examination yielded modest ability to discriminate between sexually satisfied and dissatisfied participants. Further study is necessary to better describe the cofactors associated with sexual satisfaction in postmenopausal women. PMID:18839256

Changes in Sexual Activity in Male Patients Surgically Treated for Kyphosis due to Ankylosing Spondylitis.

PubMed

Yao, Ziming; Du, Jianwei; Wang, Zheng; Zheng, Guoquan; Zhang, Xuesong; Cui, Geng; Wang, Yan

2016-09-01

A retrospective study. The aim of this study was to assess the changes in sexual activities in male patients surgically treated for ankylosing spondylitis (AS)-induced kyphosis and the correlation between these changes and spinal sagittal realignment. Sexual function may be affected by AS. However, little is known about the effect of spinal surgery on the sexual activity of patients with AS-induced kyphosis. Data of 45 male patients who had been surgically treated for AS-induced kyphosis were retrospectively reviewed. Changes in sexual activity were evaluated by the international index of erectile function (IIEF), frequency of sexual activity, and time point at which sexual activity began postoperatively. We compared the above-mentioned parameters before and 24 months postoperatively and analyzed the correlation of the changes in the IIEF with the changes in radiological characteristics. Each domain of the IIEF and the total IIEF were increased postoperatively. Improved sexual function was correlated with changes in spinal sagittal characteristics, among which lumbar lordosis (LL) and the chin-brow vertical angle (CBVA) were the most significant causes (P < 0.05). Most patients (71.1%) resumed their sexual activity 5 to 12 weeks after surgery. At the 24-month follow-up, the frequency of patients' sexual activity was higher than that before surgery (P < 0.05). Surgical correction of spinal deformity may improve sexual function and increase the frequency of sexual activity in men with AS. Spinal sagittal realignment and pelvic rotation may be correlated with improvement of sexual function. 4.

A strong pelvic floor is associated with higher rates of sexual activity in women with pelvic floor disorders

PubMed Central

Kanter, Gregg; Rogers, Rebecca G; Pauls, Rachel N; Kammerer-Doak, Dorothy; Thakar, Ranee

2015-01-01

Introduction and Hypothesis We evaluated the associations between pelvic floor muscle strength and tone with sexual activity and sexual function in women with pelvic floor disorders. Methods This was a secondary analysis of a multicenter study of women with pelvic floor disorders from the US and UK performed to validate the Pelvic Organ Prolapse/Incontinence Sexual Questionnaire, IUGA-Revised (PISQ-IR). Participants were surveyed about whether they were sexually active and completed the PISQ-IR and Female Sexual Function Index (FSFI) questionnaires to assess sexual function. Physical exams included assessment of pelvic floor strength by the Oxford Grading Scale, and assessment of pelvic floor tone per ICS guidelines. Results The cohort of 585 women was middle aged (mean age 54.9 +/−12.1) with 395 (67.5%) reporting sexual activity. Women with a strong pelvic floor (n=275) were more likely to report sexual activity than women with weak strength (n=280) (75.3 vs. 61.8%, p<0.001), but normal or hypoactive pelvic floor tone was not associated with sexual activity (68.8 vs. 60.2%, normal vs. hypoactive, p=0.08). After multivariable analysis, a strong pelvic floor remained predictive of sexual activity (OR 1.89, CI 1.18–3.03, p<0.01). Among sexually active women (n=370), a strong pelvic floor was associated with higher scores on the PISQ-IR domain of condition impact (Parameter Estimate 0.20+/−0.09, P=0.04), and FSFI orgasm domain (PE 0.51+/−0.17, P=0.004). Conclusion A strong pelvic floor is associated with higher rates of sexual activity as well as higher sexual function scores on the condition impact domain of the PISQ-IR and orgasm domain of the FSFI. PMID:25994625

Fos Expression in the Olfactory Pathway of High- and Low-Sexually Performing Rams Exposed to Urine from Estrous or Ovariectomized Ewes

PubMed Central

Mirto, AJ; Austin, KJ; Uthlaut, VA; Roselli, CE; Alexander, BM

2015-01-01

Exposure to estrous ewe urine stimulates investigation and mounting activity in sexually active but not sexually inactive rams. It was hypothesized sexual indifference may result from an inability to detect olfactory cues or an interruption of the pathway from detection of the olfactory stimulus to the motor response. Sexually active (n=4) and inactive (n=3) rams were exposed to urine from estrous ewes. An additional group of sexually active rams (n=3) were exposed to urine from ovariectomized ewes. Rams were exsanguinated following 1 h of exposure to stimulus. Neural activity was determined in tissues of interest by the presence of fos and fos-related proteins detected by immunohistochemistry procedures. Sexually active rams exposed to urine from ovariectomized ewes had more (P ≤ 0.05) fos-positive cells in the olfactory bulb, but fewer (P = 0.03) fos-positive cells in the cortical amygdala compared to sexually active rams exposed to urine from estrous ewes. Sexually inactive rams had similar (P ≥ 0.13) numbers of fos positive neurons in the olfactory bulb and medial amygdala but fewer (P ≤ 0.04) in the central amygdala, bed nucleus of the stria terminalis and the medial preoptic area compared to sexually active rams exposed to urine from estrous ewes. Sexual inactivity was not associated with decreased hypothalamic function since fos activity was similar (P ≥ 0.14) among groups in the suprachiasmatic and ventral medial nucleus. Sexual inactivity is not likely due to an impaired ability to detect or process olfactory stimuli by the main olfactory bulb and medial-cortical amygdala. Sexually inactive rams may have reduced attentiveness to sexual stimuli and/or decreased responsiveness of regions in the brain which regulate reproductive behaviors. PMID:28348447

A Classroom Activity Exploring the Complexity of Sexual Orientation.

ERIC Educational Resources Information Center

Madson, Laura

2001-01-01

Describes an activity in which students categorize the sexual orientation (heterosexual, bisexual, homosexual) of 10 fictional people. Students study aspects of sexual orientation, including its resistance to rigid and consistent definitions. The activity has been used in Psychology of Women, Sexual Behavior, and Psychology of Sexual Orientation…

Tackling unsafe abortion in Mauritius.

PubMed

Nyong'o, D; Oodit, G

1996-01-01

Despite a contraceptive prevalence rate of 75% Mauritius has a high incidence of unsafe abortions because of unprotected intercourse experienced by many young women in a rapidly industrializing environment. The Mauritius Family Planning Association (MFPA) tackled the issue of unsafe abortion in 1993. Abortion is illegal in the country, and the Catholic Church also strongly opposes modern family planning methods, thus the use of withdrawal and/or calendar methods have been increasing. The MFPA organized an advocacy symposium in 1993 on unsafe abortion with the result of revealing the pressure the Church was exerting relative to abortion and contraceptives. The advocacy campaign of the MFPA consists of having abortion legalized on health grounds and improving family planning services, especially for young unmarried women and men. The full support of the media was secured on the abortion issue: articles appeared, meetings were attended by the press, and public relations support was also received from them. The MFPA worked closely with parliamentarians. A motion was tabled in 1994 in the National Assembly which called for legalization of abortion on health grounds, but the Church squelched its debate. In March 1994 MFPA hosted the IPPF African Regional Conference on Unsafe Abortion in Mauritius with the participation of over 100 representatives from 20 countries, and subsequently a second motion was tabled without parliamentary debate. The deliberations were covered by the media and the Ministry of Women's Rights recognized abortion as an urgent issue as outlined in a white paper prepared for the Fourth World Conference on Women held in Beijing in 1995. The campaign changed the policy climate favorably making the public more conscious of unsafe abortion. The Ministry of Health decided to collect more data and the newly elected government seems to be more open about this issue.

Sexual practices among unmarried adolescents in Tanzania.

PubMed

Kazaura, Method R; Masatu, Melkiory C

2009-10-06

Sexual activities are increasingly changing from the cultural point of view what they used to be. Knowledge of these practices among adolescents may be a basis to create awareness among adolescents on practices that involve risks. This study aims to assess sexual practices among unmarried adolescents in Tanzania. A cross-sectional survey was conducted among in-school and out-of-school but unmarried adolescents aged 10 to 19 in five locations in Tanzania. A questionnaire was used to collect information and to characterize sexual practices among these adolescents. About 32% of adolescents reported being sexually active; a higher proportion being males than females. The only inquired and reported sexual practices include vaginal sex, masturbation, oral and anal sex. About 15% of sexually active adolescents reported having multiple sexual partners. Significantly more males reported having multiple partners than females. Nearly 42% of sexually active adolescents reported having used a condom during most recent sexual act. Females reported older partners at first sexual act. Adolescents experience several sexual practices that include penetrative and non-penetrative. More males reported being sexually active than females. Despite adolescents reporting having multiple sexual partners, reported condom use during the most recent sexual act was low. We advocate for a more enhanced approach of reproductive health education that includes safer sex to adolescents without forgetting those in-schools.

Could Intelligent Speed Adaptation make overtaking unsafe?

PubMed

Jamson, Samantha; Chorlton, Kathryn; Carsten, Oliver

2012-09-01

This driving simulator study investigated how mandatory and voluntary ISA might affect a driver's overtaking decisions on rural roads, by presenting drivers with a variety of overtaking scenarios designed to evaluate both the frequency and safety of the manoeuvres. In half the overtaking scenarios, ISA was active and in the remainder ISA was switched off. A rural road was modelled with a number of 2+1 road sections, thus allowing drivers a protected overtaking opportunity. The results indicate that drivers became less inclined to initiate an overtaking manoeuvre when the mandatory ISA was active and this was particularly so when the overtaking opportunity was short. In addition to this, when ISA was activated drivers were more likely to have to abandon an overtaking, presumably due to running out of road. They also spent more time in the critical hatched area-a potentially unsafe behaviour. The quality of the overtaking manoeuvre was also affected when mandatory ISA was active, with drivers pulling out and cutting back in more sharply. In contrast, when driving with a voluntary ISA, overtaking behaviour remained mostly unchanged: drivers disengaged the function in approximately 70% of overtaking scenarios. The results of this study suggest that mandatory ISA could affect the safety of overtaking manoeuvres unless coupled with an adaptation period or other driver support functions that support safe overtaking. Copyright © 2010 Elsevier Ltd. All rights reserved.

Sexual Function and Pessary Management among Women Using a Pessary for Pelvic Floor Disorders.

PubMed

Meriwether, Kate V; Komesu, Yuko M; Craig, Ellen; Qualls, Clifford; Davis, Herbert; Rogers, Rebecca G

2015-12-01

Pessaries are commonly used to treat pelvic floor disorders, but little is known about the sexual function of pessary users. We aimed to describe sexual function among pessary users and pessary management with regard to sexual activity. This is a secondary analysis of a randomized trial of new pessary users, where study patients completed validated questionnaires on sexual function and body image at pessary fitting and 3 months later. Women completed the Pelvic Organ Prolapse-Urinary Incontinence Sexual Function Questionnaire, International Urogynecological Association Revised (PISQ-IR), a validated measure that evaluates the impact of pelvic floor disorders on sexual function, a modified female body image scale (mBIS), and questions regarding pessary management surrounding sexual activity. Of 127 women, 54% (68/127) were sexually active at baseline and 42% (64/114) were sexually active at 3 months. Sexual function scores were not different between baseline and 3 months on all domains except for a drop of 0.15 points (P = 0.04) for sexually active women, and a drop of 0.34 points for non-sexually active women (P = 0.02) in the score related to the sexual partner. Total mBIS score did not change (P = 0.07), but scores improved by 0.2 points (P = 0.03) in the question related to self-consciousness. Pessary satisfaction was associated with improved sexual function scores in multiple domains and improved mBIS scores. The majority (45/64, 70%) of sexually active women removed their pessary for sex, with over half stating their partner preferred removal for sex (24/45, 53%). Many women remove their pessary during sex for partner considerations, and increased partner concerns are the only change seen in sexual function in the first 3 months of pessary use. Pessary use may improve self-consciousness and pessary satisfaction is associated with improvements in sexual function and body image. © 2015 International Society for Sexual Medicine.

A Study of Sexuality and Health among Older Adults in the United States

PubMed Central

Lindau, Stacy Tessler; Schumm, L. Philip; Laumann, Edward O.; Levinson, Wendy; O’Muircheartaigh, Colm A.; Waite, Linda J.

2008-01-01

BACKGROUND Despite the aging of the population, little is known about the sexual behaviors and sexual function of older people. METHODS We report the prevalence of sexual activity, behaviors, and problems in a national probability sample of 3005 U.S. adults (1550 women and 1455 men) 57 to 85 years of age, and we describe the association of these variables with age and health status. RESULTS The unweighted survey response rate for this probability sample was 74.8%, and the weighted response rate was 75.5%. The prevalence of sexual activity declined with age (73% among respondents who were 57 to 64 years of age, 53% among respondents who were 65 to 74 years of age, and 26% among respondents who were 75 to 85 years of age); women were significantly less likely than men at all ages to report sexual activity. Among respondents who were sexually active, about half of both men and women reported at least one bothersome sexual problem. The most prevalent sexual problems among women were low desire (43%), difficulty with vaginal lubrication (39%), and inability to climax (34%). Among men, the most prevalent sexual problems were erectile difficulties (37%). Fourteen percent of all men reported using medication or supplements to improve sexual function. Men and women who rated their health as being poor were less likely to be sexually active and, among respondents who were sexually active, were more likely to report sexual problems. A total of 38% of men and 22% of women reported having discussed sex with a physician since the age of 50 years. CONCLUSIONS Many older adults are sexually active. Women are less likely than men to have a spousal or other intimate relationship and to be sexually active. Sexual problems are frequent among older adults, but these problems are infrequently discussed with physicians. PMID:17715410

Sexual Health and Positive Subjective Well-Being in Partnered Older Men and Women.

PubMed

Lee, David M; Vanhoutte, Bram; Nazroo, James; Pendleton, Neil

2016-07-01

We examine the associations between different patterns of sexual behavior and function and three indicators of subjective well-being (SWB) covering eudemonic, evaluative, and affective well-being in a representative sample of partnered older people. Using data from a Sexual Relationships and Activities Questionnaire (SRA-Q) in Wave 6 of the English Longitudinal Study of Ageing, latent class analysis identified groups characterized by distinctive patterns of sexual behavior and function and then examined their link to SWB. Eudemonic SWB was measured using a revised 15-item version of the CASP-19, evaluative SWB using the Satisfaction With Life Scale, and affective SWB using the 8-item version of the Centre for Epidemiologic Studies-Depression scale. Sexual behavior and function was best described by six classes among men and five classes among women. These ranged from high sexual desire, frequent partnered sexual activities, and few sexual problems (Class 1) to low sexual desire, infrequent/no sexual activity, and problems with sexual function (Class 5([women])/6([men])). Men and women who reported either infrequent/no sexual activity, or were sexually active but reported sexual problems, generally had lower SWB than those individuals identified in Class 1. Poorer SWB in men was more strongly associated with sexual function difficulties, whereas in women desire and frequency of partnered activities appeared more important in relation to SWB. Within the context of a partnered relationship continuing sexual desire, activity and functioning are associated with higher SWB, with distinctive patterns for women and men. © The Author 2016. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Comparing Subjective Ratings of Sexual Arousal and Desire in Partnered Sexual Activities from Women of Different Sexual Orientations.

PubMed

Persson, Tonje J; Ryder, Andrew G; Pfaus, James G

2016-08-01

Little is known about non-monosexual women's sexual arousal and desire. Typically, bisexual women have been excluded from research on sexual arousal and desire, whereas mostly heterosexual and mostly lesbian women have been placed into monosexual categories. This research (1) compared the subjective sexual arousal and desire of self-identified heterosexual, mostly heterosexual, bisexual, mostly lesbian, and lesbian women in partnered sexual activities with men and with women, and (2) compared within-group differences for subjective sexual arousal and desire with men versus women for the five groups. Participants included 388 women (M age = 24.40, SD = 6.40, 188 heterosexual, 53 mostly heterosexual, 64 bisexual, 32 mostly lesbian, 51 lesbian) who filled out the Sexual Arousal and Desire Inventory (SADI). Sexual orientation was associated with sexual arousal and desire in sexual activities with both men and with women. Bisexuals reported higher sexual arousal and desire for women than heterosexuals and lesbians, while lesbians reported lower sexual arousal and desire with men than the other groups. Heterosexuals and mostly heterosexuals scored higher on the male than on the female motivational dimension of the SADI, while the reverse was found for lesbians and mostly lesbians. Findings indicate that non-monosexuals have higher sexual arousal and desire in sexual activities with women than monosexuals. Further, bisexual women did not differentiate their sexual arousal with men versus women, while the other sexual orientation groups differentiated in terms of their motivation to engage in sexual activity. These findings may have implications for how female sexual orientation is conceptualized.

Motor carrier safety : commercial vehicle registration program has kept unsafe carriers from operating, but effectiveness is difficult to measure.

DOT National Transportation Integrated Search

2009-05-01

To reduce the number of crashes : involving commercial motor : carriers, the Federal Motor Carrier : Safety Administration (FMCSA) : within the Department of : Transportation orders unsafe : carriers out of service. To help : keep these carriers off ...

Identification of countermeasures for unsafe driving actions. Volume 2, A review of selected literature

DOT National Transportation Integrated Search

1981-02-01

Literature on decision-making and social control was reviewed to identify key principles of human behavior that have potential for reducing the incidence of speed-too-fast and other conscious and intentional unsafe driving actions (UDAs). The review ...

36 CFR 4.22 - Unsafe operation.

Code of Federal Regulations, 2010 CFR

2010-07-01

... VEHICLES AND TRAFFIC SAFETY § 4.22 Unsafe operation. (a) The elements of this section constitute offenses... which is reasonable and prudent considering wildlife, traffic, weather, road and light conditions and road character. (2) Operating a motor vehicle in a manner which unnecessarily causes its tires to...

36 CFR 4.22 - Unsafe operation.

Code of Federal Regulations, 2011 CFR

2011-07-01

... VEHICLES AND TRAFFIC SAFETY § 4.22 Unsafe operation. (a) The elements of this section constitute offenses... which is reasonable and prudent considering wildlife, traffic, weather, road and light conditions and road character. (2) Operating a motor vehicle in a manner which unnecessarily causes its tires to...

Unsafe abortion - the current global scenario.

PubMed

Faúndes, Anibal

2010-08-01

Unsafe abortion is prevalent in many developing countries, mostly in sub-Saharan Africa, Latin America and South and Southeast Asia, where abortion laws are more restrictive, the unmet need for contraception high and the status of women in society low. The main interventions for reducing the prevalence of unsafe abortion are known: better and more widely available family planning services, comprehensive sex education, improved access to safe abortion and high-quality post-abortion care, including contraceptive counselling and on-site services. Although these proposals have been included in statements and recommendations drawn up at several international conferences and adopted by the vast majority of nations, they have either been inadequately implemented or not implemented at all in the countries in which the need is greatest. A well-coordinated effort by both national and international organisations and agencies is required to put these recommendations into practice; however, the most important factor determining the success of such efforts is the commitment of governments towards preventing unsafe abortion and reducing its prevalence and consequences. 2010 Elsevier Ltd. All rights reserved.

Sisters’ and Girlfriends’ Sexual and Childbearing Behavior: Effects on Early Adolescent Girls’ Sexual Outcomes

PubMed Central

East, Patricia L.; Felice, Marianne E.; Morgan, Maria C.

2013-01-01

This study examined three key issues related to the effects of sisters’ and girlfriends’ sexual and childbearing behavior on early adolescent girls’ sexual outcomes. Subjects were 455 girls from predominantly minority racial backgrounds. Results indicated that number of sexually active girlfriends, number of sexually active sisters, and presence of an adolescent childbearing sister were positively associated with permissive sexual attitudes, positive intentions for future sexual activity, and a greater likelihood of being a nonvirgin. The strength of these relationships did not vary by race, but there was a greater presence of permissive social influences for African American girls than for nonblack girls. Results from multiple hierarchical regression analyses indicated that having both many sexually active girlfriends and an adolescent childbearing sister had particularly strong effects on permissive sexual attitudes and a nonvirgin status. PMID:24353349

Reactions to Humorous Sexual Stimuli as a Function of Sexual Activeness and Satisfaction.

ERIC Educational Resources Information Center

Prerost, Frank J.

1984-01-01

Assessed male (N=60) and female (N=60) responses to pictorial humorous sexual material in relationship to degree of sexual expression and personal satisfaction with sexual behavior. Results showed persons with active and satisfying sexual expression enjoyed sexually explicit cartoons and showed less preference for aggressive themes. (LLL)

Relationship of family formation characteristics with unsafe abortion: is it confounded by women's socio-economic status? - A case-control study from Sri Lanka.

PubMed

Arambepola, Carukshi; Rajapaksa, Lalini C; Attygalle, Deepika; Moonasinghe, Loshan

2016-06-17

Literature shows that choice for unsafe abortion is often driven by poverty. However, factors related to the family formation behaviour of women are also implied as determinants of this decision. This study assessed which family formation characteristics of women are associated with the risk of unsafe abortion, without being confounded by their low socio-economic status among Sri Lankan women admitted to hospital following post-abortion complications. An unmatched case-control study was conducted in nine hospitals in eight districts in Sri Lanka among 171 women with post-abortion complications following unsafe abortion (Cases) and 600 postpartum mothers admitted to same hospitals during the same period for delivery of term unintended pregnancies (Controls). Interviewer-administered-questionnaires obtained demographic, socio-economic and family formation related characteristics. Risk factors of abortion were assessed by odds-ratio (OR), adjusted for their socio-economic status in logistic regression analysis. Low socio-economic status, characterised by low-education (adjusted OR = 1.5; 95 % CI = 1.1-2.4) and less/unskilled occupations (2.3; 1.4-3.6) was a significant risk factor for unsafe abortion. Independent of this risk, being unmarried (9.3; 4.0-21.6), failure in informed decisions about desired family size (2.2; 1.4-3.5), not having a girl-child (2.2; 1.4-3.4) and longer average birth intervals (0.7 years; 0.6-0.8) signified the vulnerability of women for unsafe abortion. Cases were as fast as the controls in their family completion (4.3 versus 4.5 years; p = 0.4), but were at increased risk for abortion, if their average birth intervals (including the last one) were longer. Previous contraceptive use, age at reproductive events or partners' characteristics did not impart any risk for abortion. Low socio-economic status is not the most influencing risk factor for unsafe abortions leading to complications, but many other factors in relation to their family formation characteristics that are independent of their low socio-economic status.

Sexual Activity and Physical Tenderness in Older Adults: Cross-Sectional Prevalence and Associated Characteristics.

PubMed

Freak-Poli, Rosanne; Kirkman, Maggie; De Castro Lima, Gustavo; Direk, Nese; Franco, Oscar H; Tiemeier, Henning

2017-07-01

Despite a common misconception, older adults engage in sexual behavior. However, there is limited sexual behavior research in older adults, which is often restricted to small samples, to cohorts recruiting adults from 45 years old, and to questions regarding only sexual intercourse. To assess the cross-sectional prevalence of and characteristics associated with sexual activity and physical tenderness in community-dwelling older adults. From the Rotterdam Study, sexual activity and physical tenderness were assessed in 2,374 dementia-free, community-dwelling men and women at least 65 years old from 2009 through 2012 in the Netherlands. Analyses were stratified by sex and partner status. Sexual activity and physical tenderness (eg, fondling or kissing) in the last 6 months. Potential associated characteristics included measurements of demographics, socioeconomic position, health behavior, and health status. The vast majority of partnered participants (men, n = 858; women, n = 724) had experienced physical tenderness in the previous 6 months (83.7% of men and 82.9% of women) and nearly half had engaged in sexual activity (49.5% and 40.4% respectively). Very few unpartnered women (n = 675) had engaged in sexual activity (1.3%) or physical tenderness (5.2%), whereas prevalence rates were slightly higher for unpartnered men (n = 117; 13.7% or 17.1%). Engaging in sexual behavior was generally associated with younger age, greater social support, healthier behaviors, and better physical and psychological health. Findings show that older adults engage in sexual activity. It is important not to assume that an older person is not interested in sexual pleasure or that an older person is unhappy with not having a sexual partner. Offering an opportunity for open discussion of sexuality and medical assistance without imposing is a difficult balance. We encourage health care professionals to proactively address sexuality and extend knowledge about safe sex and sexual function to older adults. Thus far, this is one of the largest samples of sexual behavior assessment in adults older than 60 years. Limitations of this study are common in sexual behavior research, including low sexual behavior engagement among unpartnered older adults and a small sample of unpartnered men, which restricted sex- and age-specific implications. Almost half of partnered older adults engaged in sexual activity and more than two thirds engaged in physical tenderness, but very few unpartnered older adults engaged in these behaviors. The greatest barrier to being sexually active at an older age is lack of a partner, which particularly affects women. Sexuality is an important aspect of active aging. Freak-Poli R, Kirkman M, De Castro Lima G, et al. Sexual Activity and Physical Tenderness in Older Adults: Cross-Sectional Prevalence and Associated Characteristics. J Sex Med 2017;14:918-927. Copyright © 2017 International Society for Sexual Medicine. Published by Elsevier Inc. All rights reserved.

Reexamining issues of conceptualization and willing consent: the hidden role of coercion in experiences of sexual acquiescence.

PubMed

Conroy, Nicole E; Krishnakumar, Ambika; Leone, Janel M

2015-07-01

This study problematizes the literature's conceptualization of sexual compliance, predominantly defined as willing participation in, and consent to, unwanted sexual activity in the absence of immediate partner pressure. Using a feminist theoretical framework, we argue that covert forms of social coercion, including normalized expectations for heterosexual women to participate in sexual activity and maintain relationship satisfaction, ultimately pressure women into participating in unwanted sexual activity. In other words, immediate partner pressure is not necessary for a sexually coercive experience to occur. Results of the current study indicate that relationship control and media influence significantly predict sexual acquiescence, and women acquiesce to unwanted sexual activity in an effort to maintain relationships and partner satisfaction as well as to avoid negative outcomes. Women cite various forms of social coercion, such as fulfilling sexual scripts and relationship obligations, as primary reasons for participating in unwanted sexual activity without resisting their partners. © The Author(s) 2014.

[Sexual counseling is important in cardiovascular disease. Returning to sexual activity is a common concern].

PubMed

Mårtensson, Jan; Fridlund, Bengt; Jaarsma, Tiny

2014-12-02

Decreased sexual activity among cardiac patients is frequently reported. Rates of erectile dysfunction among men with cardiovascular disease (CVD) are twice as high as those in the general population with similar rates of sexual dysfunction in females with CVD. Returning to sexual activity is a common concern, and patients frequently request information on how to resume sexual activity. Partners also have considerable concerns, often more so than patients; why sexual counseling is important for both cardiac patients and their partners. In general, healthcare professionals, in caring for patients recognize the importance of discussing sexual function and activity and also express their responsibility to do so, although many healthcare professionals do not know what specific advice to give. Therefore, the intent of a consensus statement made by the American and European heart associations is to summarize current evidence related to sexual counseling in cardiovascular disease, and to provide direction to physicians, nurses, and other healthcare professionals in the practice of sexual counseling. 

Low temperature safety of lithium-thionyl chloride cells

NASA Technical Reports Server (NTRS)

Subbarao, S.; Deligiannis, F.; Shen, D. H.; Dawson, S.; Halpert, G.

1988-01-01

The use of lithium thionyl chloride cells for low-temperature applications is presently restricted because of their unsafe behavior. An attempt is made in the present investigation to identify the safe/unsafe low temperature operating conditions and to understand the low temperature cell chemistry responsible for the unsafe behavior. Cells subjected to extended reversal at low rate and -40 C were found to explode upon warm-up. Lithium was found to deposit on the carbon cathodes during reversal. Warming up to room temperature may be accelerating the lithium corrosion in the electrolyte. This may be one of the reasons for the cell thermal runaway.

[Sexuality of our seniors: happy end or new beginning?].

PubMed

Degauquier, C; Absil, A S; Meuris, S; Psalti, I; Jurysta, F

2012-01-01

Comparing surveys from successive periods demonstrates that elderly people now enjoy a better and more varied sexual life than previous generations. The proportion of older people who remain sexually active has significantly increased, and the practices of masturbation or oral sex have spread considerably. The generation effect has an incidence upon sexual behaviour: older people's repertoire of sexual practices differs from that of younger people, in the sense that it focuses less on sexual intercourse and oral sex. Women and men, beyond the common trends towards sexuality characterised by a more open repertoire of sexual practices, differ in terms of sexual interest and subjective sexual wellbeing. The cessation of sexual activity by individuals who had previously been sexually active is often the result of a cascade of reactions, such as the occurrence of a sexual dysfunction in one or both partners, anticipation of failure, increased anxiety, lack of adaptation of sexuality and/or avoidance behaviour.

The role of social drinking factors in the relationship between incapacitated sexual assault and drinking before sexual activity.

PubMed

Bird, Elizabeth R; Gilmore, Amanda K; George, William H; Lewis, Melissa A

2016-01-01

White House Council on Women and Girls (2014) highlighted sexual assault prevention as a high priority issue in need of immediate attention. A risk factor associated with sexual assault victimization and revictimization is drinking before sexual activity. The current study examined the relationship between incapacitated sexual assault (ISA) and drinking before sexual activity. Given the typical social context of both drinking before sexual activity and sexual assault in college settings, social-related drinking factors including drinking to conform motives, social drinking motives, and perceived drinking norms were examined. Six hundred and three undergraduate college women completed a survey online assessing history of ISA, social factors associated with drinking, and frequency of drinking before sexual activity. Path analysis indicated that both ISA before college and since entering college were associated with higher perceived drinking norms, more social drinking motive endorsement, and more drinking to conform. However, only higher perceived drinking norms and more social drinking motive endorsement were associated with both more severe ISA histories and more frequent drinking before sexual activity. Thus, a more severe ISA history was indeed associated with more frequent drinking before sexual activity and social factors related to drinking played a significant role in this relationship. Social factors can be easily targeted through brief interventions and these findings can inform future programming to promote more careful use of alcohol in social and sexual situations. Copyright © 2015 Elsevier Ltd. All rights reserved.