Search

Background: To explore any association between the timing of the initiation of sexual activity and sexual behaviors and risks among university students in China.Methods: Data were derived from a cross-sectional study on sexual behavior among university students conducted in Ningbo municipality, China, at the end of 2003. Students completed a self-administered, structured questionnaire. Of 1981 sexually active male students, 1908 (96.3%) completed the item for timing of the initiation of sexual activity and were included in bivariate trend analyses and multiple logistic regression analyses to compare the association between this timing and sexual behavior and risks.Results: Male early sexual initiators had a significantly higher risk profile, including a significantly higher proportion reporting non-regular partners (i.e., casual or commercial partners), multiple partners, diagnosis with a sexually transmitted disease (STD), partner history of pregnancy, partner history of induced abortion, and less condom and oral contraceptive use, compared with late initiators. Multivariate analyses confirmed the increased likelihood of these risks in early initiators versus late initiators, other than partner type during the last year.Conclusion: Our results showed that, compared to late initiators, people who initiated sexual activity early engaged in more risky behaviors that could lead to elevated risks of unwanted pregnancies and STDs or human immunodeficiency virus infection. Sex-education strategies should be focused on an earlier age, should include advice on delaying the age of first sexual activity, and should target young people who continue to take sexual risks. [ABSTRACT FROM AUTHOR]

Background: Due to the rapid development of information and communication technologies, cyberbullying has emerged as a threat to adolescents. This study aimed to investigate the prevalence and correlates among profiles of traditional bullying, cyberbullying, and combined bullying among Taiwanese high school students., Methods: This cross-sectional study employed two-stage cluster sampling in Taipei City, Taiwan. In total, 2028 high school students completed an anonymous questionnaire between March and May 2018. Nominal logistic regression analysis was performed, adjusting for clustering, to examine the correlates of each type-role category of bullying., Results: The prevalence rates of cyberbullying, traditional bullying, and combined bullying were 9.9, 13.3, and 9.4%, respectively, indicating that one-third of students were involved in one of these types of bullying; 48.7% of those involved in cyberbullying also experienced traditional bullying, and 41.5% of those involved in traditional bullying also experienced cyberbullying. In any type of bullying, not only being a victim but also being a bully/bully-victim was significantly associated with at least one mental health problem (serious psychological distress, self-harm, or suicidal ideation), except in the case of cyberbullying bullies/bully-victims. Internet abuse and alcohol use were more concentrated among bullies/bully-victims than victims for all types of bullying, and a similar trend was observed among types of schools and school climates, suggesting that specific behavioural circumstances or school backgrounds are associated with bullying perpetration., Conclusions: Bullying is a prevalent and complex phenomenon among adolescents in Taiwan, where traditional bullying and cyberbullying frequently overlap and are likely to occur against specific backgrounds. These facts should be taken into account in future bullying prevention and support programmes in Taiwan.

Background: Cyberbullying is a growing public health concern threatening the well-being of adolescents in both developed and developing countries. In Taiwan, qualitative research exploring the experiences and perceptions of cyberbullying among Taiwanese young people is lacking., Methods: We conducted in-depth interviews with a convenience sample of high school students (aged 16 to 18) from five schools in Taipei, Taiwan, without prior knowledge of their cyberbullying experiences. In total, 48 participants were interviewed., Results: We found that the experience of cyberbullying is common, frequently occurs anonymously and publicly on unofficial school Facebook pages created by students themselves, and manifests in multiple ways, such as name-calling, uploading photos, and/or excluding victims from online groups of friends. Exclusion, which may be a type of cyberbullying unique to the Asian context, causes a sense of isolation, helplessness, or hopelessness, even producing mental health effects in the victims because people place the utmost importance on interpersonal harmony due to the Confucian values in collectivistic Asian societies. In addition, our study revealed reasons for cyberbullying that also potentially reflect the collectivistic values of Asian societies. These reasons included fun, discrimination, jealousy, revenge, and punishment of peers who broke school or social rules/norms, for example, by cheating others or being promiscuous., Conclusions: Our findings reveal the pressing need for the Taiwanese school system to develop cyberbullying prevention programmes considering the nature and sociocultural characteristics of cyberbullying.

Background: Women who use drugs are extremely vulnerable to HIV and sexually transmitted infections (STIs), but studies on risk behaviours and HIV infection among female drug users are limited in Nepal., Methods: In this cross-sectional study conducted between September 2010 and May 2011, HIV prevalence and risk factors for HIV infection were investigated among female drug users recruited in drop-in centres, parks and streets in the Kathmandu Valley. The participants completed face-to-face interviews for a structured questionnaire, HIV pre-test counselling, specimen collection for HIV test and they were provided with their results at post-test counselling., Results: A total of 269 female drug users were recruited, of whom 28% (n=77) were found HIV positive; the majority (78%, n=211) being injecting drug users and aged below 25 years (57%, n = 155). Nearly half (n = 137) of the total participants had shared needles or syringes in the past month, and 131 and 102 participants were involved in commercial or casual sex respectively with only half or less of them having had used condoms in the last 12 months. In multivariate analysis the variables associated with HIV infection included: (a) older age; (b) history of school attendance; (c) frequency of sharing of injection instruments; and (d) unsafe sex with commercial or casual partners., Conclusions: HIV was highly prevalent among female drug users in the Kathmandu Valley, with its risk being strongly associated not only with unsafe injection practice but also with unsafe sexual behaviours. Awareness raising programmes and preventive measures such as condom distribution, needle or syringe exchange or methadone maintenance therapy should be urgently introduced in this neglected subpopulation.

Background: This study was conducted to determine the prevalence of HIV antibody testing and associated factors among heterosexual sexually transmitted disease (STD) clinic attendees in China., Methods: A self-administered questionnaire was administered among 823 attendees of 4 STD clinics of Zhejiang Province, China in October to December 2007. Psychosocial and behavioural factors associated with HIV antibody testing were identified in both genders using univariate and multivariate analyses., Results: Of all 823 STD clinic attendees, 9.3% of male and 18.0% of female attendees underwent HIV antibody testing in the most recent 6 months, and 60% of the participants had gotten no educational/behavioral intervention related to HIV prevention. The correlates for HIV antibody testing in the most recent 6 months as identified by multivariate analysis were ever condom use [odds ratio (OR), 10.37; 95% confidence interval (CI), 1.32-81.22]; ever anal/oral sex (OR, 3.13; 95% CI, 1.03-9.50) during their lifetime; having ever received three to seven types of behavioural interventions in the most recent 6 months (OR, 3.70; 95% CI, 1.32-10.36) among male subjects; and ever condom use (OR, 12.50; 95% CI, 2.20-71.01), STD history (OR, 3.86; 95% CI, 1.26-11.86) over their lifetime, or having ever received three to seven types of behavioural interventions in the most recent 6 months (OR, 8.68; 95% CI, 2.39-31.46) in female subjects. A lifetime experience of casual/commercial sex partners was strongly negatively associated with HIV testing in female subjects (OR, 0.08; 95% CI, 0.01-0.83)., Conclusion: The low prevalence of HIV antibody testing and behavioural intervention among STD clinic attendees indicates a need for more targeted, intensive behavioural interventions to promote HIV antibody testing in this population.

Background: Japan provides universal health insurance to all legal residents. Prior research has suggested that immigrants to Japan disproportionately lack health insurance coverage, but no prior study has used rigorous methodology to examine this issue among Latin American immigrants in Japan. The aim of our study, therefore, was to assess the pattern of health insurance coverage and predictors of uninsurance among documented Latin American immigrants in Japan., Methods: We used a cross sectional, mixed method approach using a probability proportional to estimated size sampling procedure. Of 1052 eligible Latin American residents mapped through extensive fieldwork in selected clusters, 400 immigrant residents living in Nagahama City, Japan were randomly selected for our study. Data were collected through face-to-face interviews using a structured questionnaire developed from qualitative interviews., Results: Our response rate was 70.5% (n = 282). Respondents were mainly from Brazil (69.9%), under 40 years of age (64.5%) and had lived in Japan for 9.45 years (SE 0.44; median, 8.00). We found a high prevalence of uninsurance (19.8%) among our sample compared with the estimated national average of 1.3% in the general population. Among the insured full time workers (n = 209), 55.5% were not covered by the Employee's Health Insurance. Many immigrants cited financial trade-offs as the main reasons for uninsurance. Lacking of knowledge that health insurance is mandatory in Japan, not having a chronic disease, and having one or no children were strong predictors of uninsurance., Conclusions: Lack of health insurance for immigrants in Japan is a serious concern for this population as well as for the Japanese health care system. Appropriate measures should be taken to facilitate access to health insurance for this vulnerable population.

Background: Although number of sexually transmitted infections (STIs) reported in STI surveillance increased rapidly for women in Japan during the 1990s, the sexual behavior of women potentially at risk of STI infection remains unknown., Methods: In order to determine the demographic and behavioral characteristics of non-sex worker (SW) females attending STI clinics, female attendees (n = 145), excluding SW, from nine clinics across Japan and female controls from the general population (n = 956), both aged 18-50 years, were compared using two data sets of nationwide sexual behavior surveys conducted in 1999., Results: Although the occupation-type and education level were unrelated to STI clinic attendance in multivariate analysis, non-SW females attending STI clinics were younger (adjusted odds ratios [AOR] = 0.94, 95%CI: 0.89, 0.99), and more likely to be unmarried (AOR = 4.11, 95% CI: 1.73, 9.77) than the controls from the general population. In the previous year, STI clinic attendees were more likely to have had multiple partnerships (AOR = 3.09, 95% CI: 1.42, 6.71) and unprotected vaginal sex with regular partners (AOR = 3.59, 95% CI: 1.49, 8.64), and tended to have had their first sexual intercourse at a younger age (AOR = 1.77, 95%CI: 0.89, 3.54) and more unprotected vaginal and/or oral sex with casual partners (AOR = 2.08, 95%CI: 0.75, 5.71). Identical sexual behavior patterns were observed between the female attendees with a current diagnosis of STI (n = 72) and those before diagnosis (n = 73) and between those with a past history of STI (n = 66) and those without (n = 79)., Conclusion: These results indicate that not only multiple partnerships or unprotected sex with casual partners, but also unprotected vaginal sex within a regular partnership is prevalent among non-SW female STI clinic attendees. The identical sexual behavior patterns observed between female attendees with a current STI diagnosis and those without, and between those attendees with a past history of STI diagnosis and those without, indicate that the result are unlikely confounded with the cases of non-STI infection. This sexual behavior pattern may be predictive of STI infection among young Japanese women and could have contributed to the STI epidemic in women in Japan during the 1990s.

Background: National HIV serological and behavioural surveillance of Bangladesh repeatedly demonstrated a very high proportion of rickshaw pullers in Dhaka city, having sex with female sex workers (FSWs) and using illicit substances. However, no study has been conducted to identify the correlates of having sex with FSWs among this population. This study aimed to describe behavioural profile of rickshaw pullers in Dhaka city using probability samples and to identify the correlates for having sex with FSWs in order to focus HIV prevention intervention., Methods: Six hundred rickshaw pullers were randomly selected from rickshaw garages in the Kamrangirchar area, the single largest slum cluster of Dhaka, Bangladesh, during March-April 2008 using the Proportion Probability to Size method. Participants were interviewed, with a response rate of 99.2% (n = 595), using a structured questionnaire and asked about illicit substance use, sexual behaviour and risk perception for HIV and sexually transmitted diseases. Independent predictors of having sex with FSWs were analysed by multivariate analysis. A qualitative study was subsequently conducted with 30 rickshaw pullers to supplement the findings of the initial survey., Results: The proportion of survey respondents who had sex with FSWs and those who used illicit substances in the previous 12 months period were 7.9% and 24.9%, respectively, much lower than the results achieved in the 2003-04 behavioural surveillance (72.8% and 89.9%, respectively). Multivariate analysis revealed the characteristics of younger age, being never married, living alone with family remaining in other districts and using illicit substances in the previous 12 months were significantly associated with having sex with FSWs., Conclusion: HIV-related risk behaviour of our study population of the rickshaw pullers was lower than what has been suggested by the results of behavioural surveillance. While this discrepancy should be addressed in further studies, our study emphasizes the importance of focused HIV prevention programs for rickshaw pullers as high-risk behaviour is displayed at an unacceptable level and concentrated in identifiable sub-populations.

Background: The risks for Chinese male university students who have sex with other men (MSM) have not been compared with those for non-MSM students. This information is important for the development of targeted HIV prevention programmes for this population., Methods: Sexually active MSM and non-MSM students were compared for demographic characteristics, sexual behaviour, and related psychosocial variables using bivariate analyses. The data were a subset drawn from a large-scale cross-sectional questionnaire survey of sexually active male students conducted at two universities in a large city in Zhejiang Province, China, in 2003., Results: Of 1824 sexually active male students, 68 (3.7%) reported having had sex with a man at least once; 33.8% of these 68 men had also had female partners. Compared with non-MSM students, MSM students were 3-6.5 times more likely to have had sexual encounters with casual or commercial sex partners and were three times less likely to have protected sex in the past year or during their lifetime. They were three to five times more likely to have had multiple partners and 15 times more likely to have had a sexually transmitted disease (STD). In addition, the MSM students knew half as much about HIV and had less condom-decision than did non-MSM students and were two times more accepting of commercial sex. However, the MSM students were twice as aware of the risks for HIV infection., Conclusion: MSM composed 3-4% of the male sexually active university student population studied and was found to be at greater risk than non-MSM students for STD/HIV infection. There is an urgent need for STD/HIV programmes in university health services that take into consideration the sexuality and psychosocial issues of MSM students.

Background: Japanese men who have sex with men (MSM), especially those living in large metropolitan areas such as Tokyo and Osaka, are facing a growing HIV/AIDS epidemic. Although the Internet is used as a new venue for meeting sex partners, it can also serve as a useful research tool for investigating the risk behaviours of Japanese MSM. This Internet survey explored the extent of substance use and its association with sexual risk behaviours among Japanese MSM., Methods: Between 28 February 2003 and 16 May 2003 MSM were recruited through 57 Japanese gay-oriented Web sites, gay magazines, and Internet mailing lists. Participants completed a structured questionnaire anonymously through the Internet., Results: In total, 2,062 Japanese MSM completed the questionnaire. The average age of participants was 29.0 years and 70.5% identified as gay, 20.8% as bisexual, and 8.7% as other. Overall, 34.5% reported never using a substance, 45% reported ever using one type of substance (lifetime reported single substance users), and 19.6% had used more than 1 type of substance (lifetime reported multiple substance users) in their lifetimes. The substances most commonly used were amyl nitrite (63.2%), 5-methoxy-N, N-diisopropyltryptamine (5MEO-DIPT) (9.3%), and marijuana (5.7%). In the multivariate analysis, unprotected anal intercourse, having had 6 or more sexual partners, visiting a sex club/gay venue in the previous 6 months, a lower education level, and being 30 to 39 years of age were associated with both lifetime single and lifetime multiple substance use. Lifetime reported multiple substance use was also correlated with having a casual sex partner, having symptoms of depression, being diagnosed as HIV-positive, and greater HIV/AIDS-related knowledge., Conclusion: This is the first Internet-based research focused on the sexual and substance use behaviours of MSM in Asia. Our findings suggest a compelling need for prevention interventions to reduce HIV risk-related substance use behaviours among Japanese MSM. The results also suggest that the Internet is potentially a useful tool for collecting behavioural data and promoting prevention interventions among this population.

Background: The vulnerability of young people to HIV and the recent emergence of the HIV epidemic in China have made it urgent to assess and update the HIV/STD risk profile of Chinese young people., Methods: A self-administered questionnaire survey with cross-sectional design was conducted among 22,493 undergraduate students in two universities in Ningbo, China. Bivariate trend analysis and multiple logistic regression analysis were used to compare sexual behaviors and awareness between grades., Results: Of respondents, 17.6% of males and 8.6% of females reported being sexually active. Condom was reported never/rarely used by 35% of sexually active students in both genders in the previous year. Pregnancy and induced abortion had each been experienced by about 10% of sexually active female students and the female partners of male students, and about 1.5% of sexually active students of both genders reported being diagnosed with an STD. Multivariate analysis revealed that students in lower grades, compared to those in higher grades, were more likely to have become sexually active before university, to have become aware of sex before high school, and to have been exposed to pornographic media before the age of 17 years, and for sexually active respondents of both genders, to have engaged in sex without using a condom., Conclusion: Sexual behaviors of Chinese university students are poorly protected and sexual behaviors and awareness may have been undergoing rapid change, becoming active earlier and more risky. If this trend continues, vulnerable sexual network will grow among them that allow more expansion of sexually transmitted diseases and HIV.