The paper aims to provide evidence on consistent condom use dynamics among sex workers in Central America between 1997 and 2000, and to examine the most important predictors of use behaviour important for policy and programme interventions in the region. Data on 3500 sex workers, 1500 from 1997 and 2000 from the year 2000, were analysed. The samples represented sex workers in low socioeconomic neighbourhoods who met their clients at known sex establishments or by the roadside. Sex workers were (...) more likely to have used condoms consistently in 2000 than in 1997 (Odds Ratio (OR)=1·4, p[less-than-or-equal]0·05). Sex workers who discussed condoms with their partners or lovers used them consistently with all clients more than those who did not (OR=1·3, p[less-than-or-equal]0·10). Knowledge of condom advantages had a positive influence on consistent use. Sex workers who reported using condoms to prevent pregnancy or STDs used them consistently with all clients more than those who did not (OR=1·2, and 1·3 respectively, p[less-than-or-equal]0·10). The source of condoms is an important predictor of consistent condom use. Sex workers who bought condoms from health establishments or from brothels used them consistently more than those who did not (both OR=1·3, p[less-than-or-equal]0·10, and p[less-than-or-equal]0·05, respectively). Self-efficacy had a positive effect on consistent condom use. Sex workers who reported that they would use condoms even if clients offered to pay more for unprotected sex used them consistently with all clients more than those who did not (OR=1·8, p[less-than-or-equal]0·001). The findings suggest that having condom skill is positively related to condom use. Sex workers who had all four skills used condoms more consistently than those who had none (OR=1·6, p[less-than-or-equal]0·01). In order to increase consistent condom use and avert more incidences of HIV/AIDS and other STIs, programme interventions need to use the most efficient way to provide quality information, and provide repeated training on condom negotiation and use skills to sex workers. (shrink)

Since the 1980s Catholic moralists have discussed whether the use of condoms to prevent the transmission of the virus that causes AIDS is morally permissible. In 2004 Rev. Martin Rhonheimer argued that the use of condoms by HIV-discordant married couples, although not prudent or advisable, was nevertheless not intrinsically wrong. Many other Catholic moralists strongly disagreed with him. This paper analyzes both sides of the argument and concludes that the practice is not morally permissible even for an infertile married couple (...) because the use of a non-perforated condom, by preventing male ejaculation into the vagina, deprives the act of its essential ordination to procreation. National Catholic Bioethics Quarterly 15.1 : 91–105. (shrink)

In this study, we elaborate connections among gender, structure, and practice to suggest how social structural relations shape social sexual practice and, in the process, reshape gender relations. Using survey data from a study of a community mobilization intervention, we investigate the connection between institutional arrangements and condom use practice in sexual encounters with commercial clients and intimate partners among 410 women engaged in sex trade in a semiurban town in southern India. Multinomial logistic regression analysis uncovers the effects (...) of 16 measures of gendered structural relations in three contexts—livelihood resources, household circumstances, and community mobilization intervention priorities. We compare women who practice either consistent or inconsistent condom use with both clients and partners with a reference group of women who practice consistent condom use with clients but not with partners. Results reveal the importance of household and community relations for consistent safer sex practice over and above the organization of sex trade. Our analysis advances gender theory in two interrelated ways: We contribute to gender theorizing in the implementation of health interventions, and to gender change more generally by thinking through possibilities emerging from recursive influences between reordered institutional configurations and altered expectations in interaction. (shrink)

Safer sex campaigns for heterosexuals have sometimes targeted women in particular to take responsibility for condom use. In this article, the authors question some of the assumptions underlying this strategy, for instance, the assumptions of women's relatively unproblematic relationship with condoms and women's control over condom use. The authors interviewed 14 women about their experiences and views of condoms and of heterosexual relationships more broadly. Using a feminist poststructuralist form of discourse analysis, they examine their accounts in relation (...) to gendered discourses of desire and a coital imperative. They argue that an appreciation of these kinds of discursive influences is important for understanding the complex ways in which women are constrained and enabled to employ condoms for safer heterosex. (shrink)

Does the position of the Roman Catholic Church on contraception also imply that the usage of condoms by HIV-discordant couples is illicit? A standard argument is to appeal to the doctrine of double effect to condone such usage, but this meets with the objection that there exists an alternative action that brings about the good effect—namely, abstinence. I argue against this objection, because an HIV-discordant couple does not bring about any bad outcome through condom usage—there is no disrespect displayed (...) for the generative function of sex. One might retort that the badness of condom usage consists in thwarting the unitive function of sex. I argue that also this objection cannot be upheld. In conclusion, if there are no in-principle objections against condom usage for HIV-discordant couples, then policies that deny access to condoms to such couples are indefensible. HIV-discordant couples have a right to continue consummating their marriage in a manner that is minimally risky and this right cannot be trumped by utilitarian concerns that the distribution of condoms might increase promiscuity and along with it the HIV infection rate. (shrink)

Male to male unprotected anal sex is the main route of HIV transmission in Australia. The Australian Study of Health and Relationships, a large, representative population survey of sexual health behaviors, found that six percent of males in the general population have engaged in homosexual activity. These findings were consistent with studies in Europeand North America. Condoms have been shown to reduce the transmission of HIV in the community. Barriers to the use of condoms include access,stigma,and cost? Nevertheless, increased (...) class='Hi'>condom use has been reported among homosexual males, sex workers and injecting drug users although recent declines in condom use among homosexuals has presented new challenges in HIV prevention.The prevalence of male to male sexual activity may be higher in prison than in the general population. Sexual activity in prison can be consensual and non-consensual involving both homosexual / bisexual and heterosexual men. (shrink)

Male to male unprotected anal sex is the main route of HIV transmission in Australia. The Australian Study of Health and Relationships, a large, representative population survey of sexual health behaviors, found that six percent of males in the general population have engaged in homosexual activity. These findings were consistent with studies in Europeand North America. Condoms have been shown to reduce the transmission of HIV in the community. Barriers to the use of condoms include access,stigma,and cost? Nevertheless, increased (...) class='Hi'>condom use has been reported among homosexual males, sex workers and injecting drug users although recent declines in condom use among homosexuals has presented new challenges in HIV prevention.The prevalence of male to male sexual activity may be higher in prison than in the general population. Sexual activity in prison can be consensual and non-consensual involving both homosexual / bisexual and heterosexual men. (shrink)

For most of the 20th century, the condom in the United States was a cheap, useful, but largely unmentionable product. Federal and state statutes prohibited the advertising and open display of condoms, their distribution by mail and across state lines, and their sale for the purpose of birth control; in some states, even owning or using condoms was illegal. By the end of World War I, condoms were increasingly acceptable for the prevention of sexually transmitted disease, but their unique (...) dual function—for disease prevention and contraception—created ongoing ambiguities for sellers, consumers, and distributors as well as for legal, political, health, and moral leaders. Not until the 1970s did condoms emerge from the shadows and join other personal hygiene products on open drugstore and supermarket shelves and in national advertisements. Then came the 1980s and AIDS when, despite the rise of Ronald Reagan, the radical right’s demonization of condoms, and the initial reluctance of condom merchants to market to gay constituencies, the HIV/AIDS epidemic slowly but inexorably propelled the condom to the top of the prevention agenda. The condom’s journey from lewd device to global superstar was fitful, but colorful. The Comstock Act of 1873, prohibiting birth control information and devices, created a vast underground operation—periodically illuminated, however, by arrests, protests, legal proceedings, and media coverage. This essay chronicles one such moment of illumination: the legal battle in the 1920s and 1930s over the legitimacy and legality of the Trojan Brand condom trademark and the unusual series of advertisements produced by the Youngs Rubber Corporation, makers of Trojans, to dramatize the ethical and economic issues of the trademark battle. Culminating in Youngs Rubber Corporation v. C.I. Lee & Co., Inc. , this landmark case in trademark law established the right of the Trojan Brand condom, despite its ambiguous dual function, to the protection of a federal trademark. I seek to show how the Youngs antipiracy ad series illuminates the paradox of visibility by illuminating the paradox of any binary division: to establish the one depends inevitably on invoking or making visible—even if to suppress—the other. This essay is a case study in the negotiation of such a dialectic. (shrink)

The most popular form of reversible contraception in the United States is the female-controlled hormonal birth control pill. Consequently, scholars and lay people have typically assumed that women take primary responsibility for contraceptive decision making in relationships. Although many studies have shown that men exert strong influence in couple’s contraceptive decisions in developing countries, very few studies have considered the gendered dynamic of contraceptive decision making in developed societies. This study uses in-depth interviews with 30 American opposite-sex couples to show (...) that contraceptive responsibility in long-term relationships in the United States often conforms to a gendered division of labor, with women primarily in charge. A substantial minority of men in this study were highly committed contraceptors. However, the social framing of contraception as being primarily in women’s “sphere,” and the technological constraints on their participation, made even these men reluctant to discuss contraception with their women partners. (shrink)

The response many gay men took to the HIV epidemic in the United States was largely informal, especially given distant state and federal governments. The condom code, a set of informal norms that encouraged the use of condoms, is one instance of this informal response, which was wholly uncoordinated. Yet, it is not clear why these informal norms emerged or why they have since eroded. This paper explores how gay men in particular generated expectations and normative beliefs regarding (...) class='Hi'>condom usage, which helped to establish the condom code as an informal norm. Furthermore, the erosion of the condom code is viewed as a result of changing expectations, which change as bio-medical means of HIV treatment and prevention develop and as online and digital communities facilitate serosorting, all of which provide alternatives to condoms as a means of prevention and their associated informal norms. Future HIV prevention campaigns should recognize the extent to which informal norms coordinate and encourage preventative behavior, as well as how beliefs and expectations alter the informal norms people adopt. (shrink)

Psychological determinants of contraceptive use were investigated in Great Britain and Germany, using national data obtained in 1992. It was hypothesised that current contraceptive use among sexually active, fertile women aged 15-45 was related to their attitude towards the various contraceptive methods, social influences, perceptions of being able to use a method correctly and consistently, a correct estimation of fertility, and communication with their partner. Effects of age and country were also taken into account.The attitude of respondents towards the various (...) contraceptive methods was ambivalent and no method was seen as ideal. On medical methods many respondents expressed doubts as to their safety for health. Social influences most frequently concerned the use of OCs. Respondents considered themselves able to use oral contraceptives correctly, but expressed general fear about intrauterine devices and sterilisation, and many women believed they were not able to use condoms and periodic abstinence consistently.Multifactorial analyses revealed that current contraceptive use was principally determined by social influences, attitude and self-efficacy with respect to medical methods. Age and country, and, for use of unreliable methods, fertility awareness also played a role. Communication with the partner was less relevant.Contraceptive choice depended greatly on encouragement to use and being in favour of medical methods. A lack of social support for use of medical methods and a negative attitude towards them was related to higher use rates of condoms, periodic abstinence, withdrawal and reliance on ‘luck’. In the case of withdrawal and/or no method, underestimation of fertility played an additional role.Contraceptive choice appears to be determined more by a general like or dislike of medical methods rather than on a weighing of the merits of individual available methods. (shrink)

This study aimed to determine the factors influencing the use of spacing contraceptive methods in India, particularly from men’s perspective. Data were obtained through a semi-structured interview schedule from 2687 married men aged between 18 and 40 years from central Mumbai City, India, during 1999. Chi-squared tests and binary logistic regression analysis was carried out to determine the relationship between various variables and the likelihood of a couple using spacing contraceptive methods. Of the 2687 couples, 1395 (51·9%) were using one (...) or other method of spacing contraceptives and 1292 (48·1%) were not using any method at the time of survey. Male participation in contraceptive use was 23% (condom and withdrawal). The results indicate that the use of spacing contraceptive methods was significantly higher among those couples where the men desired one or two children (OR=4·3), had knowledge of five or more contraceptive methods (OR=1·9) and discussed with their wives obtaining family planning information (OR=3·2), spacing (OR=2·7) and permanent (OR=2) contraceptive methods. Age, income, desired number of children, knowledge of a greater number of contraceptive methods, inter-spouse communication regarding obtaining family planning information, spacing and permanent methods were found to be strong predictors of the use of spacing contraceptive methods. The study underlines the importance of intervention programmes aimed at promoting a small family norm, increasing the number of contraceptive choices available and encouraging inter-spouse communication. Hence, policymakers and programme managers should encourage interventions in this direction, targeting couples to enhance the use of spacing contraceptive methods. (shrink)

Contraceptive prevalence is a key variable estimated from Demographic and Health Surveys. But the prevalence estimated from reports of husbands differs widely from that estimated for wives. In this research, using data from six Demographic and Health Surveys of sub-Saharan Africa, reports from spouses in monogamous couples with no other reported sex partners in the recent period are examined. Agreement ranged from 47% to 82%, but among couples in which one or both reported use, the category represented less than half (...) in all nations except Zimbabwe. Husbands generally had higher reports of condoms, periodic abstinence and pills but fewer reports of the IUD, injections and female sterilization. Either discussion of family planning with the spouse and/or higher socioeconomic status was associated with agreement in most of the surveys. Ambiguities in the survey question regarding current use need to be reduced, perhaps with an added probe question for non-permanent methods. (shrink)

HIV/AIDS prevention campaigns have been overshadowed by conflicting, competing, and contradictory views between those who support condom use as a last resort and those who are against it for fear of promoting sexual immorality. We argue that abstinence and faithfulness to one partner are the best available moral solutions to the HIV/AIDS pandemic. Of course, deontologists may argue that condom use might appear useful and effective in controlling HIV/AIDS; however, not everything that is useful is always good. In (...) principle, all schools of thought and faith seem to agree on the question of faithfulness for married couples and abstinence for those who are not married. But they differ on condom use. On the ground, the situation is far more complex. We simply lack a single, entirely reliable way to resolve all disagreements regarding HIV/AIDS prevention strategies. (shrink)

Condom use among college men in the United States is notoriously erratic, yet we know little about these men’s approaches to other contraceptives. In this paper, accounts from 44 men attending a university in the western United States reveal men’s reliance on culturally situated ideas about gender, social class, race, and age in assessing the risk of pregnancy and STI acquisition in sexual encounters with women. Men reason that race- and class-privileged college women are STI-free, responsible for contraception, and (...) will pursue abortion services if necessary. Since men expect women will take responsibility, they often stay silent about condoms and other contraceptives in sexual encounters—a process we term “strategic silence.” Men’s strategic silence helps uphold local constructions of hegemonic masculinity that prioritize men’s sexual desires and protects these constructions by subtly shifting contraceptive and sexual health responsibility onto women. Our analysis demonstrates the importance of men’s expectations of women for upholding constructions of hegemonic masculinity, which legitimate gender inequality in intimacy and are related to men’s underestimation of the risks associated with condom-free sex. (shrink)

Ong, Caroline There was once a strong belief amongst global HIV/AIDS organisations that the key to the prevention of the sexual transmission of HIV was condom use. Other measures such as abstinence and being loyal to one partner were seen as beneficial, but secondary. Thirty years later, the evidence is mounting that behavioural change is much more effective in halting the spread of HIV than condoms.

The ethics of safe sex in the gay community has, for many years, been focused on debates surrounding the responsibility regarding the use of condoms to prevent HIV transmission, once the only tool available. With the development of Truvada as a pre-exposure prophylaxis for HIV, for the first time in the history of the HIV/AIDS epidemic there is the potential to significantly reduce the risk of HIV transmission during sex without the use of condoms. The introduction of PrEP necessitates a (...) renewed discussion about the politics and ethics of safe sex for men who have sex with men. We present the arguments of authors who hold radically opposite positions with regard to the ethics of condom use by gay men, but who currently both criticize the use of PrEP. We offer a critique of their arguments and advance the position that the use of PrEP, even without condoms, can be acceptable and part of a safe sex ethics framework for MSM. (shrink)

Over the past two decades, the epidemic of HIV/AIDS has challenged the public health community to fundamentally rethink the framework for preventing infectious diseases. While much progress has been made on the biomedical front in treatments for HIV infection, prevention still relies on behaviour change. This book documents and explains the remarkable breakthroughs in behavioural research design that have emerged to confront this new challenge: the study of partnership networks.Traditionally, public health research focused on the "knowledge, attitudes, and practices " (...) of individuals, an approach designed for understanding health-related behaviour like seat-belt wearing and cigarette smoking. For HIV and other sexually transmitted infections, however, there are at least two people involved in transmission. This may not seem like a big difference, but in fact it changes everything. First, it means that your risk depends on your partners -- and on their partners, and their partners: it depends on your position in the network of partnerships. Consider, for example, the rise of infections among monogamous women. Second, it means that individuals are not free to simply change their behaviour -- condom use, or abstinence, needs to be negotiated with a partner. both the epidemiology of risk and constraints to behaviour are therefore a function of the partnership network. And our ability to design effective prevention strategies depends on our ability to measure and summarize that network. Using the traditional research designs, you would not see this network at all -- you would only see the unconnected nodes. They key to solving this problem lies in Network Analysis, before now a relatively obscure subfield in Sociology.For empirical studies of networks to become feasible, however, many problems had to be solved. This book documents the rapid progress that has been made. It brings together eight pioneering studies that have sought to map the networks that spread infection around the world. Each chapter reviews the questions that drove the study, the changes in methodology that were needed to implement the network survey, the mistakes and successes encountered, and the central findings that the network design made possible. An introduction provides an overview of network survey design, a glossary provides a summary of network terminology, and example questionnaires from each study provide a template for further research. This is a unique and valuable resource for the international public health research community. (shrink)

The reasons for judgment by the Supreme Court of Canada on the appeal in Mabior (2012 SCC 47) fail to address or resolve a number of significant questions. The reasons acknowledge the fundamental role of sexual consent in protecting sexual autonomy, equality, and human dignity, but do not use the law of consent as a tool to assist the Court in crafting a fresh approach to the issue on appeal. Instead the Court adopts the same general approach to analysis of (...) the elements of aggravated sexual assault committed by fraud it used in 1998 in Cuerrier. Fifteen years later, it should be possible to re-conceptualize the problem in a more straightforward manner that reflects Charter values, fundamental common law principles, recent developments in sexual assault law, and the limitations and uncertainties of current HIV treatment and diagnosis. -/- Ironically, the two pronged legal test ultimately proposed by the Court -- non-disclosure of HIV-positive status and a “realistic possibility of transmission,” is likely to give false confidence to individuals who adhere to a regime of anti-retroviral treatment, use good quality latex condoms, and routinely conceal their HIV-positive status from their sexual partners. Research shows that HIV viral loads fluctuate widely in response to a myriad of factors. An inevitable consequence of reliance on the Mabior test will be accused who are shocked to find themselves charged under s. 273, charges that would not apply had they disclosed their HIV-positive status to their sexual partner(s). There are further practical consequences. Non-disclosure will tend to increase the risk of transmission because non-HIV-positive sexual partner(s) will not fully appreciate the actual hazards of improper condom use. As a direct result, careless sexual practices will be more common. And finally, the decision will not contribute to reducing the social stigma that haunts the lives of those who are HIV-positive -- even those who are skilled at deceit. That stigma will not be reduced or eliminated by a ruling that can be seen as tacitly validating stigmatization and fear by appearing to permit infected individuals to pretend they are not HIV-positive when they know or suspect this to be false. Deceit harms the human dignity of the deceived and deceiver alike, and does nothing to build authentic social trust and cohesion. For all these reasons, the problem on appeal in Mabior requires a different approach. This article proposes one. (shrink)

Can the Catholic Church agree to condom use by HIV-discordant couples?In the paper with this title, Luc Bovens argues that the Catholic Church ought to allow HIV-discordant couples to use condoms. According to Catholic moral theology, intercourse is only permissible if it respects the natural purposes of sex, ie, the so-called “procreative” and “unitive” functions of sex. Condoms clearly thwart the procreative functions of sex and are therefore seen as morally illicit by the Church.However, Bovens argues that there are (...) special features of the situation faced by HIV-discordant couples that entail that their condom use is morally licit under the doctrine of double effect as accepted by the Church. If a HIV-discordant couple pursues the unitive function of sex without using condoms, they run a significant risk that the unaffected partner will become infected. Condom use can diminish that risk significantly, and, if that is what the couple intends, they can invoke the DDE. The main strand of Bovens’ argument …. (shrink)

How can we use our knowledge of how the mind works to help people act in ways that can prevent disaster, prepare for it, or at the very least, help them respond to a disaster in ways that will reduce its impact? This paper suggests that the most effective method for helping the public deal with disaster, and preventing denial, is to provide them with a concrete, doable, and effective strategy. A number of examples are discussed, including government warnings about (...) increased threat levels, the handling of the 9/11 cleanup by the EPA, the disaster relief problems during Hurricane Katrina and several social psychology experiments which used a "hypocrisy paradigm" to address condom use and water conservation among college students. The paper suggests that the best policy approach for dealing with disaster is one which not only convinces people to prepare for disasters by changing their behaviors through puncturing their rationalizations but also one where communication which produces high fear can lead to sensible action. (shrink)

In the Winter 2017 edition of JLME, Dr. Carson outlined an economic approach to the epidemiology of HIV transmission within the gay community, with a special emphasis on mobile apps. His conclusion is that HIV transmission amongst the gay community constitutes a collective action problem, which is resolved by the social norm of using a condom. This article critiques Dr. Carson's approach from an economic perspective. By utilizing classic law and economic theory, this article will argue that HIV transmission (...) may not, in fact, constitute a collective action problem in economic terms, and that instead condom use as a method of disease protection in theory can arise from purely rational, market driven actions. To do so, it borrows from transactional theory of information asymmetry to show the potential to alert counterparts as to serostatus. This conclusion provides an important supplement to Carson: rather than social norms being the core driver in condom usage to prevent HIV, instead condom use may arise solely as a result of rational, private decision making arising from market signaling. The article then critiques its own findings to demonstrate that it is unclear whether Carson's argument or the argument in this paper is, indeed, correct — which may represent a limitation in the analytical techniques advanced. (shrink)

This paper traces the development of policies dealing with HIV/AIDS in Botswana from their beginning in the late 1980s to the current programme to provide population-wide anti-retroviral therapy (ARV). Using a variety of source material, including long-term ethnographic research, it seeks to account for the failure of Western-inspired approaches in dealing with the pandemic. It does this by looking at the cultural and institutional features that have created resistance to the message and inhibited effective implementation. The negative response to the (...) first educational campaign stressing condom use is described and contextualized in terms of Tswana ideas of morality and illness. Nor, as was initially expected, did the introduction of free ARV therapy operate to break the silence and stigma that had developed around the disease. Take-up was very slow, and did not operate to encourage widespread testing. In 2003, key policymakers in Botswana began to argue for a break with the AIDS position, with its emphasis on voluntarism, confidentiality and the human rights of patients. This resulted in routine testing being introduced in 2004. This links to a major argument running through the paper which is that the failure of policy cannot be attributed solely to the nature of local populations. Western cultural assumptions about also require critical examination. (shrink)

As the Zika virus pandemic continues to bring worry and fear to health officials and medical scientists, Centers for Disease Control and Prevention (CDC) and World Health Organization (WHO) have recommended that residents of the Zika-infected countries, e.g., Brazil, and those who have traveled to the area should delay having babies which may involve artificial contraceptive, particularly condom. This preventive policy, however, is seemingly at odds with the Roman Catholic Church’s position on the contraceptive. As least since the promulgation (...) of Paul VI’s 1968 encyclical, Humanae Vitae, the Church has explicitly condemned artificial birth control as intrinsic evil. However, the current pontiff, Pope Francis, during his recent visit to Latin America, remarked that the use of artificial contraception may not be in contradiction to the teaching of Humanae Vitae while drawing a parallel between the current Zika Crisis and the 1960’s Belgian Congo Nun Controversy. The pope mentioned that the traditional ethical principle of the lesser of two evils may be the doctrine that justified the exceptions. The authors of this paper attempt to expand the theological rationale of the pope’s suggestion. In so doing, the authors rely on casuistical reasoning as an analytic tool that compares the Belgian Congo Nun case and the given Zika case, and suggest that the former is highly similar to, if not the same as, the latter in terms of normative moral feature. That is, in both cases the use of artificial contraception is theologically justified in reference to the criteria that the doctrine of the lesser of two evils requires. The authors wish that the paper would provide a solid theological-ethical ground based on which condom-use as the most immediate and effective preventive measure can be recommended in numerous Catholic hospitals as well as among Catholic communities in the world, particularly the most Zika-affected and largest Catholic community in the world, Brazil – 123 million present Brazilian citizens are reported to be Roman Catholic. (shrink)

Introducción: Camagüey ocupa el cuarto lugar nacional en cuanto al número de infectados con VIH/SIDA, después de La Habana, Santiago de Cuba y Holguín. Camagüey se encuentra dentro de los 45 municipios con mayor prevalencia en Cuba. Objetivo: identificar las actitudes socioculturales frente a las infecciones de transmisión sexual en estudiantes de primer año de Medicina. Método: en noviembre de 2011 se realizó un estudio analítico, de corte transversal, a una muestra de estudiantes de la Universidad de Ciencias Médicas "Carlos (...) J. Finlay". Se utilizó una encuesta para recoger información. Con el método no paramétrico de Kruskal Wallis se determinó el nivel de conocimiento de los mismos en cada uno de los componentes relacionados con las actitudes socioculturales. Se utilizó la técnica no paramétrica de ji cuadrado para evaluar si existían diferencias significativas entre los distintos grupos de edades, el sexo y el estado civil. Resultados: se valoró que el componente conductual se encuentra fortalecido, entre otras actitudes, por la tendencia de los estudiantes a mantener parejas estables. En el componente cognitivo sólo un 46 % supo reconocer las vías de transmisión del VIH/SIDA, y un 13,2 % no identificó las manifestaciones clínicas relacionadas con las infecciones de transmisión sexual. En el componente afectivo se destacó un 12 % de los encuestados como grupo de riesgo a los que no les gusta usar el preservativo. Conclusiones: como resultado de la encuesta se lograron identificar algunas actitudes socioculturales frente a las infecciones de transmisión sexual en estudiantes de Medicina de primer año, en los componentes valorados. Background: Camagüey has the fourth national place in the number of persons infected with VHI/AIDS, after Havana, Santiago and Holguín. Objetive: the aim of this work is identifying socio-cultural attitudes to face of the infections of sexual transmission in first year Medicine students. Methods: in November 2011, a group of students participated in a questionnaire. The non-parametric test Kruskal Wallis was made to find significant differences in the answers given by persons with different age, sex or civil status, Frequency of answers to each question was found out. The non parametric technique of Ji square was used to evaluate if there were significant differences among the different groups of ages, the sex and the civil status. Results: it was valued that the behavioral component is strengthened, among other attitudes, for the tendency of the students to maintain stable couples, only a 46 % know most of transmission ways of STD and a 13,2 % know the clinical symptoms, a 12 % said they did not like condom use. Conclusions: it was possible to find with this survey some socio-cultural attitudes to face of the infections of sexual transmission in first year Medicine students. (shrink)

A new multi-stage deterministic model for the transmission dynamics of syphilis, which incorporates disease transmission by individuals in the early latent stage of syphilis infection and the reversions of early latent syphilis to the primary and secondary stages, is formulated and rigorously analysed. The model is used to assess the population-level impact of preventive and therapeutic measures against the spread of the disease in a community. It is shown that the disease-free equilibrium of the model is globally-asymptotically stable whenever the (...) associated control reproduction number is less than unity. A special case of the model is shown to have a unique and globally-asymptotically stable endemic equilibrium whenever the associated reproduction number exceeds unity. Uncertainty and sensitivity analysis of the model, using parameter values and ranges relevant to syphilis transmission dynamics in Nigeria, show that the top three parameters that drive the syphilis infection are the disease transmission rate, compliance in condom use and efficacy of condom. Numerical simulations of the model show that the targeted treatment of secondary syphilis cases is more effective than the targeted treatment of individuals in the primary or early latent stage of syphilis infection. (shrink)

Male partner involvement in the prevention of mother-to-child transmission of human immunodeficiency virus is considered as one of the priority interventions in reducing paediatric HIV. However, there is neither a standard definition nor measurement for MPI in PMTCT. The study explored meanings of MPI in PMTCT programmes in Zimbabwe. Eight focus group discussions were conducted with men and women aged 18 years and above. Seven key informants from health institutions and organisations providing PMTCT services were interviewed. Eight in-depth interviews were (...) conducted with pregnant women at two public health facilities. Thematic analysis was used for data analysis. Five major themes were identified which facilitated our understanding of MPI. Male partner involvement was referred to as participation of male partners in HIV couple counselling and testing. Acceptance of condom use during pregnancy and breastfeeding was deemed vital as this prevents HIV transmission. Male partners were expected to have knowledge of administering antiretroviral drugs to an HIV-exposed child. Provision of financial support was another form of male involvement commonly expected during antenatal and postnatal periods. Faithfulness in marriage was a major theme that was highlighted, especially by respondents in marital relationships. Male partner presence in PMTCT community educational sessions was also considered. However, the provision of male-oriented educational programmes was identified as poor. The study suggested a definition for MPI in PMTCT in Zimbabwe. The merit of this definition was that it took a holistic approach to include activities beyond antenatal activities and HIV testing. Future research should explore how public health institutions could create male-oriented health services within PMTCT programmes, as this has the potential of increasing men’s involvement in PMTCT of HIV.Contribution: This article contributed to the knowledge on how world views, which is shaped by culture and religion, influenced the formation of meanings on MPI PMTCT programmes. (shrink)

This essay shows how South African Pentecostal teachings about sexuality, particularly HIV prevention and divorce, constrain women’s real and imagined choices. Institutional Review Board–approved fieldwork revealed the prevalence of wives remaining faithful to unfaithful husbands despite high risks of physical abuse and HIV infection. Maintaining the “ideal” of abstinence and faithfulness, male pastors actively oppose condom use and emphasize that “God hates divorce”. In this essay I engage and resist such hermeneutics. Using scripture as source and norm, I construct (...) an A-B-C-D prevention strategy to enhance women’s freedom: Abstain, Be faithful, use Condoms, or Divorce. (shrink)