Sexualidad y salud en jóvenes universitarios-as : actitudes, actividad sexual y percepción de riesgo de la transmisión heterosexual del V.I.H.

Resumen basado en el de la revista

Contenidos y estructuras básicas para la elaboración de spots publicitarios para la prevención del sida heterosexual en campañas y programas informativos y educativos para menores.

El estudio se destina a definir los contenidos y estructuras básicas para la elaboración de programas audiovisuales de prevención del SIDA, destinados a jóvenes adolescentes. Se realizan dos estudios con el objetivo de identificar conocimientos, creencias y actitudes sobre el SIDA y los infectados, además de evaluar las campañas audiovisuales de prevención del mismo. Se pretende conocer el nivel de experiencias sexuales de los encuestados, diagnosticar sus conocimientos y demostrar cuáles de estos conocimientos, creencias y actitudes están relacionados con los posibles comportamientos sexuales de riesgo. En cuanto a las campañas de prevención, se pretende saber si éstas poseen componentes cognitivos y persuasivos que contribuyan al cambio o adecuación del comportamiento sexual para evitar la infección por el VIH. En el primer estudio 'Conocimientos, creencias y actitudes de prevención del SIDA y afectados', para una mejora adecuación de las propuestas posibles en los diseños de campañas de prevención del SIDA se procede a la evaluación sobre los conocimientos, creencias y actitudes sobre el SIDA y los infectados por el VIH de 1000 jóvenes portugueses de edades comprendidas entre los 14 y 16 años. Se evalúan todos los niveles de experiencia sexual de cada uno de los encuestados y las precauciones que tienen o piensar tener. Se aplican dos cuestionarios. Uno con los factores de actitud ante el SIDA y los infectados y otro con las creencias sobre los beneficios y costes del uso del preservativo. En el segundo estudio 'Evaluación de campañas audiovisuales de prevención del SIDA' se analiza la historia audiovisual de una muestra de 44 anuncios de prevención, difundidos en las cadenas de televisión portuguesas, durante el periodo comprendido de 1990 a 2000. Este estudio está formado por un análisis de contenido cualitativo, en el que las campañas se encuentran divididas en tres unidades: solidaridad, información y prevención. Se identifican los adjetivos, verbos y el significado contextual de las palabras e imágenes, además de las técnicas de persuasión asociadas a cada una de las unidades. Se elaboran fichas de análisis de contenidos de cada una de las variables: aspectos relacionados con el mensaje preventivo, la estrategia persuasiva y la estrategia de realización. Por último se procede a la comparación de los resultados obtenidos en cada uno de los estudios para determinar la estructura de las campañas de prevención del SIDA y si los contenidos de los mensajes suministrados permiten modelar las habilidades cognitivas de los sujetos y adecuen los comportamientos . Existen cuatro perfiles de creencias y actitudes diferentes sobre el SIDA y los infectados por la enfermedad. Aquellos individuos que perciben la gravedad de la enfermedad y se preocupan por su salud, con una percepción subjetiva de no ser vulnerables y una actitud de rechazo y discriminación hacia los seropositivos. Son personas con un bajo nivel de conocimiento, que perciben que no están informados, aunque no desean aprender nada que se relacione con la enfermedad. El segundo perfil está formado por sujetos que confían en sus capacidades para evitar la infección y son conscientes de los comportamientos que pueden conducir a la infección, son además tolerantes y comprensivos hacia los infectados por el VIH. El tercer grupo de sujetos son los que perciben mínimamente la gravedad de la enfermedad, piensan que están informados y toman precauciones incorrectas. Por último los sujetos que tienen la percepción de la gravedad de la enfermedad y actitudes de rechazo social, son aquellas personas que carecen de información, con un nivel bajo de conocimientos además de no estar motivadas para aprender nada en relación a la enfermedad. En el conjunto de los mensajes, el SIDA es presentado con un lenguaje que asocia la enfermedad con la muerte, discriminación, pecado, silencio, odio, miedo, infidelidad, por el contrario la prevención es sinónimo de usar preservativo, protección, placer y aventura. Los mensajes informativos son confusos, ambiguos y poco esclarecedores, no apuntan a soluciones o caminos para aquellos que quieran informarse por sí mismos.

Ventajas e inconvenientes del uso del preservativo con una pareja afectiva heterosexual

Se analiza la validez de constructo y la consistencia interna de un cuestionario sobre ventajas e inconvenientes del uso del preservativo con una pareja afectiva heterosexual, así como su capacidad para predecir el uso del preservativo en el pasado y la intención de uso en los próximos tres meses. Participan en el estudio 1711 estudiantes universitarios (46.3% varones y 60% menores de 21 años) elegidos mediante muestreo de conveniencia. Se emplea un diseño transversal y los datos se recogen mediante autoinforme voluntario y anónimo. Los resultados muestran que la consistencia interna del cuestionario es equiparable a la de otros instrumentos semejantes (alfas de Cronbach en escala de ventajas: .605 y en escala de inconvenientes: .725). Tanto las ventajas como los inconvenientes del uso del preservativo predicen significativamente su uso sistemático en el pasado, con un mayor peso de las ventajas. Entre los jóvenes que no lo han utilizado siempre, y únicamente en los varones, las ventajas predicen la intención de uso en los próximos tres meses. Los resultados apoyan la realización de programas preventivos que destaquen los beneficios derivados del uso de preservativo y, así mismo, reduzcan las percepciones negativas asociadas a su empleo, con una atención preferente a los primeros

Disease progression in heterosexual patients infected with closely related subtype B strains of HIV type 1 with differing coreceptor usage properties

Previously we described a heterosexual outbreak of HIV-1 subtype B in a town in the north of England (Doncaster) where 11 of 13 infections were shown to be linked by phylogenetic analysis of the env gp120 region. The 11 infections were related to a putative index case, Don1, and further divided into two groups based on the patients' disease status, their viral sequences, and other epidemiological information. Here we describe two further findings. First, we found that viral isolates and gp120 recombinant viruses derived from patients from one group used the CCR5 coreceptor, whereas viruses from the other group could use both the CCR5 and CXCR4 coreceptors. Patients with the X4/R5 dual tropic strains were symptomatic when diagnosed and progressed rapidly, in contrast to the other patient group that has remained asymptomatic, implying a link between the tropism of the strains and disease outcome. Second, we present additional sequence data derived from the index case, demonstrating the presence of sequences from both clades, with an average interclade distance of 9.56%, providing direct evidence of a genetic link between these two groups. This new study shows that Don1 harbored both strains, implying he was either dually infected or that over time intrahost diversification from the R5 to R5/X4 phenotype occurred. These events may account for/have led to the spread of two genetically related strains with different pathogenic properties within the same heterosexual community.

Association between cannabis use and sexual risk behavior among young heterosexual adults

To study the association between cannabis use and frequent sexual risk behavior, we tested the hypothesis of a situational influence of cannabis use in sexual encounters using a combination of global association study and event-level analysis and examined possible mediator variables, including the personality trait of hedonism/risk preference, psychosocial stress, and HIV-related beliefs, using mediation models. The results of a computer-assisted telephone interview of a random sample of 2790 heterosexual men and women aged 16-24 years showed that risky sexual behavior was more frequent in cannabis-using men and women than in non-using persons. The results did not support a situational effect of cannabis intoxication on sexual risk behavior. The more frequent sexual risk behavior among cannabis users was mediated by decreased intentions to use HIV protection, by lower HIV-self-efficacy, and higher risk preference/hedonism. Only among women psychosocial stress was a partial mediator. The findings show that HIV prevention programs for cannabis-using young adults should emphasize the role of person variables instead of situation variables.

[Bisexuality and AIDS. Implications for heterosexual HIV infections in women]

One of the possible pathways into heterosexual population is the transfer of HIV-virus from bisexual men to their female partners. Therefore sexual behaviour of HIV-positive and -negative bisexual men (n = 31) before and after Aids-disease was analysed. Prior to the Aids-epidemic promiscuous behavior towards male partners (about one female partner per year versus 10 male partners per year). Relatively common contacts to woman occurred within steady relationships. After contact with HIV-test and personal counselling sexual practice became significantly different. The number of female and male contacts was markedly reduced, especially female chance acquaintances were avoided; safer sex was preferred and readiness to inform female partners about bisexuality was increased. This study suggests that reduction of risk for HIV-infection of female partners by homosexual men can be achieved by means of a HIV-test and personal counselling, a possibility that should be considered in preventive concepts.

Speech features of the domain of the word in heterosexual twins during the second yeard of life

Speech is the major function, emergence and which development radically changes all course of formation of the identity of the child already in the early childhood. If language and speech development in solitary born children is investigated today quite well, at twin children this process practically is not studied. Our research was carried out for the purpose of studying of an originality of mastering by speech by heterosexual children of pair of twins within communicative and pragmatist approach (T.N. Ushakov,G. V. Chirkina). Application of this approach to the analysis of process of communication at twin children allowed us to allocate those peculiar receptions and means of communication which they functionally develop in a situation of pair of twins, as allows them to show the phenomena of the speech which are not meeting at solitary born contemporaries. In this work results of supervision and research of pair of heterosexual twins of the second year of the life, carried out by a technique developed by us under the scientific guide of G. V. Chirkina

Choosing to have children or choosing to be childfree: Australian students' attitudes towards the decisions of heterosexual and lesbian women

Research has demonstrated that voluntarily childless heterosexual women, and lesbian women choosing to become mothers, are negatively stereotyped. However, there is little recent Australian research, and attitudes may have changed in line with changing family formation patterns. This study assessed young Australians' attitudes towards either a lesbian or a heterosexual woman who was planning, or not planning, to have children. One hundred and nineteen first year psychology students, and members of the general public, participated. The majority of participants were under 20, female, European Australian and single. Participants read a brief description of a woman who was variously described as having a male or a female partner, and as planning or not planning to have children. As expected, participants rated the heterosexual woman more favourably than the lesbian, and the woman wanting children more positively than the woman not wanting children. However, there was a trend for the lesbian woman planning to have children to be rated as happier, more mature and more individualistic than others. The legal and social implications associated with wanting to be a lesbian mother in Australia make motherhood a more difficult process for lesbian women than it does for heterosexual women, and may explain why lesbian women who have decided to take this difficult path are seen as happier and more mature, than women making more conventional life choices. While the predominantly young, female student sample limits the generality of the findings, they suggest that social attitudes towards female sexual orientation and women's childbirth decisions are changing.

Chronic illness in non-heterosexual contexts: towards a critical LGBTQ health psychology

In this thesis, I contribute to the expansion of lesbian, gay, bisexual, trans and queer (LGBTQ) psychology by examining chronic illness within non-heterosexual contexts. Chronic illness, beyond the confines of HIV/AIDS, has been a neglected topic in LGBTQ psychology and sexual identity is often overlooked within health psychology. When the health of lesbian, gay and bisexual (LGB) people has been considered there has been an over-reliance on quantitative methods and comparative approaches which seek to compare LGB people?s health to their heterosexual counterparts. In contrast, I adopt a critical perspective and qualitative methods to explore LGBTQ health. My research brings together ideas from LGBTQ psychology and critical health psychology to explore non-heterosexuals? experiences of chronic illness and the discursive contexts within which LGB people live with chronic health conditions. I also highlight the heteronormativity which pervades academic health psychology as well as the „lay? health literature. The research presented in this thesis draws on three different sources of qualitative data: a qualitative online questionnaire (n=190), an online discussion within a newsgroup for people with diabetes, and semi-structured interviews with 20 LGB people with diabetes. These data are analysed using critical realist forms of thematic analysis and discourse analysis. In the first analytic chapter (Chapter 3), I report the perspectives of LGB people living with many different chronic illnesses and how they felt their sexuality shapes their experiences of illness. In Chapter 4, I examine heterosexism within an online discussion and consider the ways in which sexuality is constructed as (ir)relevant to a diabetes support forum. In Chapter 5, I analyse LGB people?s talk about the support family and partners provide in relation to their diabetes and how they negotiate wider discourses of gender, sexuality and individualism. In Chapter 6 I explore how diabetes intersects with gay and bisexual men?s sex lives. In the concluding chapter, I discuss the contributions of my research for a critical LGBTQ health psychology and identify some possible areas for future research.

Chronic illness in non-heterosexual contexts: an online survey of experiences

In this article we contribute to the expansion of lesbian, gay, bisexual, transgender and queer (LGBTQ) health psychology beyond the confines of sexual health by examining the experiences of lesbian, gay and bisexual people living with non-HIV related chronic illness. Using a (predominantly) qualitative online survey, the perspectives of 190 LGB people with 52 different chronic illnesses from eight countries were collected. The five most commonly reported physical conditions were arthritis, hypertension, diabetes, asthma and chronic fatigue syndrome. Our analysis focuses on four themes within participants’ written comments: (1) ableism within LGBT communities; (2) isolation from LGBT communities and other LGB people living with chronic illness; (3)heteronormativity within sources of information and support and; (4) homophobia from healthcare professionals. We conclude by suggesting that LGBTQ psychology could usefully draw on critical health psychology principles and frameworks to explore non-heterosexual’s lived experiences of chronic illness, and also that there remains a need for specifically targeted support groups and services for LGB people with chronic illnesses.