Inmaculada Teva

Situación epidemiológica actual del VIH/SIDA en Latinoamérica en la primera década del siglo XXI: Análisis de las diferencias entre países

Background: There is a great regional heterogeneity in the prevalence of HIV/ AIDS. Aim: To analyze the current situation of HIV/AIDS in Latin America by means of a comparative analysis among countries. Material and Methods: In a descriptive study (document analysis), epidemiological data about HIV/AIDS in Latin America as well as population data were used. Prevalence indexes and the distribution of HIV/AIDS cases were compared according to gender, age and transmission mode. Results: Dominican Republic, Panama, El Salvador and Honduras are the countries with the highest prevalence indexes. Colombia is in the first position in percentage of young men with HIV/AIDS and it is in the second position in percentage of children. Costa Rica is the second country for percentage of young men and male adults infected with HIV/AIDS. Paraguay is in the second place for children with HIV/AIDS and it is the third country in young men living with HIV/AIDS. Dominican Republic is in the first position in the percentage of young and adult females living with HIV/AIDS. The main transmission mode in all Latin American countries is sexual intercourse (heterosexual and homo/bisexual). Conclusions: Latin America is a heterogeneous region in HIV/AIDS which should be considered in the development and establishment of prevention strategies.

Sexual sensation seeking, social stress, and coping styles as predictors of HIV/STD risk behaviors in adolescents.

The aim of this study was to assess whether coping styles, social stress, and sexual sensation seeking were predictors of HIV/STD risk behaviours in adolescents. A representative sample of 4,456 female and male Spanish high school students aged 13 to 18 years participated. A stratified random sampling procedure was used. Self-report questionnaires on coping styles, social stress, sexual sensation seeking, and sexual behavior were administered to participants at their high schools. Sexual sensation seeking predicted whether sex was with a casual partner and whether drugs were used at the last sexual intercourse in males and females. Nonproductive coping was a risk factor in the use of drugs at the last sexual intercourse in males. Problem-solving coping style was related to a lower likelihood in the use of drugs at the last sexual encounter in females and to a higher likelihood of condom use at last sexual intercourse in males. Social stress increased the likelihood of having used drugs at last sexual intercourse in females. This study highlights the need to incorporate sexual sensation seeking, social stress, and coping styles in HIV/STD prevention programs aimed at adolescents.

Social support, self-esteem and depression: Relationship with risk for sexually transmitted infections/HIV transmission

Sexually transmitted infections (STIs) and HIV are important health problems that affect adolescents. The aim of the present study was to analyze the relationship between 1) depression, self-esteem and perceived social support and 2) sexual risk behaviors according to gender. The sample used in this ex post facto study was composed of 1,005 adolescents of both sexes aged between 14 and 18 years. Participants completed several questionnaires in the classrooms of their secondary education schools. The questionnaires assessed depression, self- esteem and perceived social support and recorded information on sexual behavior and socio- demographic issues. Results showed that, among males, self-esteem predicted higher vaginal risk, depression was related to higher vaginal, anal and oral sexual risk, and perceived support from the family predicted lower vaginal and anal sexual risk. Among females, self-esteem was found to be associated with lower anal sexual risk and perceived support from friends predicted lower anal and oral sexual risk. The study highlights the importance of considering family and friends as well as gender differences in the prevention of STIs/HIV.

Variables sociodemográficas y conductas de riesgo en la infección por el VIH y las enfermedades de transmisión sexual en adolescentes: España, 2007

Fundamento: Conocer las conductas sexuales es primordial para el desarrollo de programas de prevencion del VIH y las ETS. El objetivo principal de este estudio es analizar si existen en adolescentes diferencias en conductas de riesgo para la infeccion por el VIH y las ETS de acuerdo al tipo de centro educativo (publico/privado o concertado), el sexo y la edad. Metodos: Participaron 4.456 adolescentes. Se empleo un muestreo aleatorio estratificado con afijacion proporcional siendo los estratos la comunidad autonoma y el tipo de centro educativo (publico/privado o concertado). La muestra es representativa a nivel nacional con un nivel de confianza del 95,5%. Es un estudio descriptivo de poblaciones mediante encuestas con muestras probabilisticas de tipo transversal. Resultados: El porcentaje de adolescentes de centros privados que no utilizo el preservativo en la primera relacion sexual era superior al de los adolescentes de centros publicos (X² (1)=5,06; p=0,02). Los adolescentes de entre 17 y 18 anos eran los que informaron en mayor porcentaje que no utilizaron el preservativo en la ultima relacion sexual (X² (2)= 6,90; p=0,03). Un mayor porcentaje de varones que de mujeres tuvo una pareja ocasional en la ultima relacion sexual (X² (1)=127,79; p=0,00). Los adolescentes de centros privados informaron en mayor porcentaje que los adolescentes de centros publicos sobre el consumo de drogas en la ultima relacion sexual (X² (1)=5,72; p=0,02) asi como los varones en comparacion con las mujeres (X² (1)=36,37; p=0,00). Conclusiones: Se muestran diferencias en conductas de riesgo para la infeccion por el VIH en funcion de variables sociodemograficas que hacen reflexionar sobre la necesidad de considerar estos aspectos en los programas de educacion sexual dirigidos a adolescentes.

Analysis of sexual behavior in adolescents.

The aim of this study was to describe some characteristics of vaginal, anal and oral sexual behavior in Spanish adolescents. It was a cross-sectional descriptive population study conducted using a probabilistic sample survey. The sample was composed of 4,612 male and female adolescents, of whom 1,686 reported having penetrative sexual experience. Sample size was established with a 97% confidence level and a 3% estimation error. Data collection took place in secondary education schools. Mean age of vaginal sex initiation was 15 years. Compared to females, males reported an earlier age of anal and oral sex initiation and a larger number of vaginal and anal sexual partners. Males also reported a higher frequency of penetrative sexual relations under the influence of alcohol or other drugs. A higher percentage of females than males reported not using a condom in their first anal sexual experience. This study provides a current overview of the sexual behavior of adolescents that can be useful for the design of future programs aimed at preventing HIV and sexually transmitted infections (STIs).

Psychological and socio-demographic variables associated with sexual risk behavior for sexually transmitted infections/HIV

New diagnoses of sexually transmitted infections (STIs) and HIV are rising in the adult population. The main objective of this study was to analyze whether knowledge of STIs/HIV, worry about STIs/HIV and pregnancy, and self-efficacy to refuse sex are predictors of sexual risk behaviors among Spanish young and adults. The study sample was composed of 1,106 young and adults of both sexes aged between 17 and 55 years. Results showed that being single, homosexual, having been tested for HIV, having previously contracted an STI, having a college education and earning a monthly income of €900 or more were the characteristics associated with higher scores in knowledge of STIs/HIV. Self-efficacy to refuse sex predicted most vaginal and anal sexual behaviors (i.e., age at vaginal and anal sex initiation and the number of couples that have remained vaginal sex). We also found that participants with greater knowledge of STIs/HIV reported older age at vaginal sex initiation and higher condom use in the first vaginal sexual contact. We consider that these findings can be useful for the development of STI/HIV prevention programs.

Satisfacción sexual y actitudes hacia el uso del preservativo en adolescentes: evaluación y análisis de su relación con el uso del preservativo

La satisfaccion sexual y las actitudes positivas hacia el uso del preservativo favorecen el uso del mismo. El objetivo general de este estudio es la evaluacion y analisis de la relacion entre la satisfaccion sexual, las actitudes hacia el uso del preservativo y el uso del preservativo en adolescentes. Los participantes son 1504 adolescentes espanoles escolarizados de ambos sexos (48.40% varones, 51.60% mujeres). Se trata de un estudio descriptivo de poblaciones mediante encuestas con muestras probabilisticas, de tipo transversal. En varones, una mayor actitud positiva hacia el uso del preservativo predice una mayor probabilidad de uso del mismo en la primera relacion sexual vaginal y anal. La satisfaccion sexual de la pareja predice una mayor probabilidad de uso del preservativo en la primera relacion sexual oral, y la satisfaccion sexual sobre la sintonia de la pareja se asocia con una menor probabilidad de uso del preservativo en la primera relacion sexual oral. En mujeres, una mayor satisfaccion sexual personal predice una mayor probabilidad de no haber utilizado el preservativo en la primera relacion sexual vaginal. Ademas, en las mujeres, una mayor satisfaccion sexual sobre la sintonia de la pareja incrementa las probabilidades de haber utilizado el preservativo en el debut sexual vaginal. Los porcentajes de varianza explicada son bajos. Se recomienda que en futuros estudios se analicen factores socioculturales relacionados con los roles de genero que pudieran estar influyendo en las asociaciones entre la satisfaccion sexual, las actitudes hacia el uso del preservativo y el riesgo sexual en adolescentes

Analysis of cognitive variables and sexual risk behaviors among infected and HIV-uninfected people from Spain

ABSTRACT The wider availability of anti-retroviral treatment has brought about an improvement in the immunological situation of human immunodeficiency virus (HIV)-positive individuals, which in turn has led to significant reductions in AIDS-related morbidity and mortality and better quality of life for patients. However, the rate of diagnosis of new cases of HIV among the adult population is on the increase due to high-risk sexual behavior practices, particularly not using condoms, sexual relations with a large number of partners and starting sexual relations at a younger age, with unplanned pregnancies and sexually transmitted infections (STIs), including HIV. For this reason, public health managers have invested considerable effort in recent years in creating STI and HIV prevention programs. Yet, in spite of the implementation of measures for reducing the rates of infection, few studies have been published in Spain comparing individuals living with HIV with the general population about cognitive variables and the link between these variables and high-risk sexual behavior. The objective was to compare a group of individuals living with HIV with another group from the general population in terms of cognitive variables (knowledge about STIs and HIV, concern about STI/HIV and pregnancy, self-efficacy to refuse sexual relations and resilience) and sexual behavior. The sample consisted of 318 adults, 159 were from the general population and 159 were individuals living with HIV. Individuals living with HIV had higher scores for concern about HIV/AIDS, STIs, pregnancy and knowledge of STI/HIV compared with the general population. We concluded that uninfected people who had low and high level of concern about HIV/AIDS began having anal sex at a younger age than those with a medium level of concern. Overall, results indicate that the concern about HIV/AIDS should be addressed in preventive health interventions to minimize the risks of sexual behavior.

Knowledge and Concern about STIs/HIV and Sociodemographic Variables Associated with Getting Tested for HIV Among the General Population in Spain

ABSTRACT HIV testing is important in terms of prevention and treatment. However, HIV testing rates in the Spanish general population remains low. Therefore, HIV testing promotion constitutes a key issue. A high level of knowledge about HIV/AIDS is associated with having been tested for HIV. The general aim of this study was to determine the prevalence of people who had ever been tested for HIV in Spain. The sample consisted of 1,106 participants from the general population — 60.0% females and 40.0% males — aged between 17 and 55 years old. The assessment instruments were a questionnaire on sociodemographic data and HIV testing, a scale of knowledge about STIs and HIV/AIDS, and a scale of concern about STIs/HIV. Results showed that greater knowledge about STIs and HIV was associated with a greater likelihood of being tested for HIV (OR = .77; 95.0% CI = .73–.82; p < .05). In addition, higher concern about HIV/AIDS decreased the likelihood of not having been tested for HIV (OR = .87; 95.0% CI = .83–.92; p < .05). In fact, the higher participants concern about STIs was, the lower their likelihood of not having been tested for HIV was (OR = .87; 95.0% CI = .83–.91; p < .05). It is necessary to promote HIV testing in the general population as well as to consider their socio-demographic and psychological characteristics.

Conocimiento y fuentes de información sobre las ITS/VIH, comunicación sobre sexo y actitud hacia el uso del preservativo en adolescentes y padres/madres salvadoreños

espanolEl objetivo general de este estudio fue examinar el conocimiento de padres/madres e hijos acerca de la prevencion y la transmision de las infecciones de transmision sexual (ITS)/VIH, la comunicacion familiar sobre la sexualidad y la actitud hacia el uso del preservativo. Participaron 326 pr ogenitores y 326 hijos adolescentes salvadorenos. L os progenitores tenian un mayor conocimiento que sus hijos ( p = . 04), mientras que estos mostraban una mayor actitud positiva hacia el uso del preservativo ( p =. 00). L os padres informaban de una mayor frecuen cia de comunicacion (Media padre=11. 65; DT =4.07; Media madres= 11. 75; DT = 3. 99) de la que indicaban sus hijos (Medi a comunicacion con el padre =8. 92; p = . 00; med ia comunicacion con la madre 10. 78; p =. 01). Estos resultados indican la necesidad de intervenciones sobre salud sexual en adolescentes latinos desde una perspectiva socio - ecologica. EnglishThe general aim of this study was to make a comparative analysis between parents and adolescents regarding knowledge about prevention and transmission of Sexually Transmitted Infections (STI) and HIV, communication about sexuality and attitude towards cond om use. Participants were 326 parents and 326 adolescents from El Salvador. Results showed that parents had a higher knowledge compared to adolescents ( p = .04). Adolescents showed a higher positive attitude towards condom use compared to their parents ( p =.0 0). Fathers (Mean= 11.65; SD =4.07) and mothers (Mean = 11.75; SD = 3.99) reported a higher frequency of communication with adolescents than they did (Mean in communication with father = 8.92; p =.00; mean in communication with mother 10.78; p = .01). These results indicate the need on sexual health interventions in Latino teens from a socio - ecological perspective.