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Pre-exposure Prophylaxis Adherence Among Men Who Have Sex With Men: A Systematic Review and Meta-analysis

  • Suchitra Hudrudchai;Charin Suwanwong;Pitchada Prasittichok;Kanu Priya Mohan;Nopphadol Janeaim
    • Journal of Preventive Medicine and Public Health
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    • v.57 no.1
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    • pp.8-17
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    • 2024
  • Objectives: The effectiveness and efficiency of pre-exposure prophylaxis (PrEP) in reducing the transmission of human immunodeficiency virus (HIV) among men who have sex with men (MSM) relies on how widely it is adopted and adhered to, particularly among high-risk groups of MSM. The meta-analysis aimed to collect and analyze existing evidence on various factors related to PrEP adherence in MSM, including demographic characteristics, sexual behaviors, substance use, and psychosocial factors. Methods: The meta-analysis followed the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. The search included articles published between January 2018 and December 2022, obtained from the PubMed, ScienceDirect, and Scopus databases. The studies that were included in the analysis reported the proportion of MSM who demonstrated adherence to PrEP and underwent quality appraisal using the Newcastle-Ottawa Scale. Results: Of the 268 studies initially identified, only 12 met the inclusion criteria and were included in the final meta-analysis. The findings indicated that education (odds ratio [OR], 1.64; 95% confidence interval [CI], 1.12 to 2.40), number of sexual partners (OR, 1.16; 95% CI, 1.02 to 1.31), engaging in sexual activities with an human immunodeficiency virus-positive partner (OR, 1.59; 95% CI, 1.16 to 2.26), substance use (OR, 0.83; 95% CI, 0.70 to 0.99), and lower levels of depression (OR, 0.55; 95% CI, 0.37 to 0.82) were associated with higher rates of PrEP adherence among MSM. Conclusions: Despite these findings, further research is necessary to investigate PrEP adherence more comprehensively. The findings of this meta-analysis can be utilized to inform interventions aimed at improving PrEP adherence among MSM and provide directions for future research in this area.

Relationship between the level of Sexual Contacts and Self-Esteem, Self-Assertiveness of Teenage Girls Who Have or Had Boyfriends (이성교제를 하는 십대여학생의 성접촉과 자아존중감.자기주장의 관계)

  • Lee, Sun-Kyoung
    • Women's Health Nursing
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    • v.7 no.2
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    • pp.212-228
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    • 2001
  • This is a cross-sectional descriptive correlation study that aimed to understand the relationship between the level of sexual contacts during the dates and psycho-social factors in teenage girls who have or had boyfriends. The purpose of this study was to describe the relationship between sexual contacts and self-esteem and self- assertiveness. The subjects of the study were 6,130 teenage girls who have or had boyfriends. They were selected convienently 12,733 teenage girls from 254 secondary schools located in 7 large cities and 9 provinces in Korea. A structured questionaire was used it included items one general characteristics, the levels of sexual contacts, self-esteem and self-assertiveness. Seven levels of sexual contacts were rated they were holding a hand, putting arms around each other's shoulders, kiss, french kiss, touching breast, petting genitalia, and sexual intercourse during the dates. Self-esteem and self-assertiveness were measured by the "Self-esteem scale" of Rogenberg (1971) and the questionaires developed by S. B. Chang et al(2000), respectively. The self-reported questionaires were collected from October 2, to October 28, 2000 and analyzed by using SPSS 10.0 Program. The data were analyzed by descriptive statistics, reliability, One-way ANOVA with Duncan method & Scheffe method. The results of the analysis were as follows. 1.An average Percentage of the respondents who have (46.1%) or had (53.9%) boyfriends was 48.1% (n=6,130) and the most common sexual contact during the dates was french kiss (26.7%, n=1,634). While 7.5%(458) of respondents had a sexual intercourse, 13.7%(842) of respondents didn't have any sexual contact during the dates. 2. Distribution of starting point of the first sexual contact demonstrates that 1,950 respondents (31.8%) held partner's hand at the first date and 1,367 respondents (22.3%) put arms around each other's shoulders at the 2nd or 3rd date. Sexual contacts such as kiss, french kiss, touching breast, petting genitalia, or sexual intercourse were experienced mostly at the later than the 10th date. However, surprisingly large number(1.7%) of respondents had genital contact and sexual intercourses at the first date. 3. The means of self-esteem and self-assertiveness socres of the respondents who have or had boyfriends are 27.43$({\pm}4.03)$ and 17.96$({\pm}2.55)$, respectively. The range of scores for self esteem was 10-40, 40 with most self esteem. The range of scores for self assertiveness was 7-21, 21 with most self assertiveness. 4. As sexual contacts proceeded, the means of self-esteem and self-assertiveness values decreased. In detail, the respondents having no or light sexual contacts (kiss, putting arms around each other's shoulder, holding a hand) had similar self-esteem values($p{\leq}0.05$). However, ones having relatively intensive sexual contacts (french kiss, touching breast) showed significantly lower self-esteem values($p{\leq}0.05$). Same trend has been obtained for self-assertiveness value. 5. The higher values of self-esteem and self-assertiveness values the respondents had, the later they started the moderate sexual contact (kiss, french kiss) during the dates. Interestingly, among the respondents having intensive sexual contacts (petting genitalia, sexual intercourse) during the dates, those who experienced the such contacts at the first date or later than 10th date have higher self-esteem and self-assertiveness values than one experienced the such contacts during the 2nd$\sim$9th dates, giving U-shape curve. 6. There was a significant relationship between self-esteem and self-assertiveness in girls who have or had boyfriends($P{\leq}.001$). In conclusion, the research shows that self-esteem and self-assertiveness values are significantly related with the sexual contacts of the teenage girls who have or had boyfriends. These results strongly suggest that proper sex education program for teenage girls should contain the program on improving the self-esteem and self-assertiveness. We believe that sex education program is the one of the best ways to prevent the unwanted sexual contacts and pregnancy of teenage girls.

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A Study on the costume Styles of Femme Fatale in Film Noir - focused on < Double Indemnity(1944) > - (필름 느와르에 나타난 팜므 파탈의 복식유형 연구 - <이중배상(1944)>을 중심으로 -)

  • Kim, Hye-Jeong
    • Journal of Fashion Business
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    • v.15 no.4
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    • pp.1-15
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    • 2011
  • Femme Fatale in Film Noir is a wicked woman character who seduces the male partner to a ruin. In the film, the dress style is of extreme importance for the personality creation of the character as well as the development of the plot. With this background, I have looked over the Femme Fatale dress style that appears in the movie . First, it expresses Femme Fatale which stresses the feminine trait by a dress style with enlarged chest and hip parts and long, slim silhouette with tight waist and knee line. Second, the Femme Fatale with pretended purity presents narcissistic satisfaction like a saint virgin by wearing a neck-high one-piece dress embellished with frills, but the use of mirror represents self-alienation and the vanity of purity. Third, the Femme Fatale with its military dress style presents authoritative sternness which leads seduced male into ruin with its destructive power. Fourth, wearing jersey type or knitted wear that sticks to the body presents sensual Femme Fatale. Fifth, the tulle, chiffon, and white handkerchief used for the creation of grotesque Femme Fatale represents harmlessness and prohibition of immoral behavior, and the black gloves, pillbox, and the number on the tulle present her uneasy psychological state from the fear of being discovered after murdering her husband. On the other hand, the see-through tulle presents alluring sensual beauty. Sixth, the combination of the dialogue in the final sequence and drapery type as in Greek goddess represents the saint virgin of salvation who acknowledges her own fault and returns to her purity again. In addition, accessories and others made from shining material represent hidden conspiracy through simple dress and contradictory dynamics, and shoes embellished with bonbon, etc represent sexual implications in connection with male.

Assessment of Cervical Cancer Risk in Women between 15 and 49 Years of Age: Case of Izmir

  • Sogukpınar, Neriman;Saydam, Birsen Karaca;Can, Hafize Ozturk;Hadımli, Aytul;Bozkurt, Ozlem Demirel;Yucel, Ummahan;Kocak, Yeliz Cakir;Akmese, Zehra Baykal;Demir, Dogan;Ceber, Esin;Ozenturk, Gulsun
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.3
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    • pp.2119-2125
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    • 2013
  • Background: The aim of the study was to determine risk factors for cervical cancer for women in Izmir. Methods: This cross-sectional, descriptive field covered a population of 4319 women of reproductive age (15-49) (household registration in the Mukhtar's office-2007). A total of 1,637 women were included in the sample given a four-part questionnaire through face-to-face interview by visiting the women in their homes in order to determine socio-demographic factors, obstetric history, genital hygiene and the use of family planning methods. In addition, during the data collection process, the women were given group training in order to raise awareness of cervical cancer. The number and percentage distributions of the data were calculated. Results: While the average age of the women was $31.9{\pm}9.77$ (Min: 15.00-Max: 49.00), education level of 43.4% of them was elementary school only. It was determined that 70.3% of the women experienced at least one pregnancy, 71.0% had vaginal delivery and 75.9% used a contraceptive method. In the study it was determined that among the cervical cancer related risks vaginal delivery, vaginal lavage and having three or more pregnancies had the highest rates, while having sexual intercourse before 16 years of age and having more than one sexual partner constituted lower rates. The rate of the women who stated not having a smear in the last three years was 82.4%. Conclusions: Considering the case in terms of having Pap smear test, women's awareness on the risk factors and early diagnosis of cervical cancer was found to be low. Due to this reason, awareness of women has to be raised through education.

An Analysis of the Relationship between Climacteric Symptoms and Management of Menopause in Middle-aged Women (일 지역 중년여성의 폐경증상과 폐경관리와의 관계에 대한 연구)

  • Song, Ae-Ri
    • The Journal of Korean Academic Society of Nursing Education
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    • v.7 no.2
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    • pp.308-322
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    • 2001
  • The purpose of this study was to investigate the relationship between climacteric symptoms and management of menopause of middle -aged women. The subjects of this study were 261 women(40 to 60 years old). Data were collected from Jun. 1 to Jul. 15, 2001 by a structured questionnaire. The instruments employed were : 1) The Climacteric Symptoms Scale developed by Aeri Song and Eun soon Chung(1998). 2) The Management of Menopause Scale developed by Aeri Song(1997). The data were analyzed by the SPSS p.c. program using t-test, ANOVA and Pearson correlation coefficient. The results of the study were as follows : 1. Mean score of climacteric symptoms was $2.18{\pm}0.39$(Maximum 4, Minimum 1). The mean scores among the categories of climacteric symptoms, in descending order, were : a) physical and physiological reactions ($2.62{\pm}0.53$), b) social and family relationships ($2.23{\pm}0.50$), c) psychiatric and psychological reactions ($2.08{\pm}0.49$), d) relationship with sexual partner($1.73{\pm}0.54$), e) genitourinary reactions ($1.72{\pm}0.55$). 2. Mean score of management of menopause was $1.79{\pm}0.45$ (Maximum 4, Minimum 1). The mean scores among the categories of management of menopause, in descending order, were : a) dietary management($2.57{\pm}0.52$), b) self control ($2.24{\pm}0.57$), c) management of exercise and physical activity($2.14{\pm}0.75$), d) management of sex life($1.71{\pm}0.47$), e) management of professional health maintenance($1.61{\pm}0.59$). 3. There were statistically significant differences in the score of middle-aged women's self reported climacteric symptoms according to : a) occupation (t=-2.79, p<0.001) b) marriage state (t=-2.29, p<0.05) c) age of menarche (F=4.66, p<0.001) d) method of Sanhujori (post natal care & treatment) (F=4.22, p<0.001) e) hormone replacement therapy (t=-3.09, p<0.05). From the above statistics, several significant findings were noted : a) There were more climacteric symptoms from those who were unemployed, those who had no partner or were divorced and those who started a menarche earlier. b) There were less climacteric symptoms reported from those on hormone replacement therapy and those who followed their parents or parents-in-law advice regarding Sanhujori (postnatal care) 4. There were statistically significant differences in the score of middle-aged women's self reported management of menopause according to : The educational background (F=7.63, p<0.001), religion (F=3.74, p<0.001), income (F=3.65, p<0.001), number of parity (F=4.87, p<0.001), method of Sanhujori(postnatal care) (F=5.73, p<0.001), period of Sanhujori (postnatal care) (F=2.81, p<0.05), hormone replacement therapy (t=3.81, p<0.001). Women with higher educational background, strong religion, higher income, large number of parity, managed their post natal care well, were on HRT, managed their menopause significantly better than the others who took part in the survey. 5. It will be noted from the above that women's degree of climacteric symptoms showed a negative correlation to the management of menopause(r=-0.2146, p<0.001). The findings shown above suggest the need to develop a variable management of menopause, in order to improve climacteric symptoms of middle-aged women. It is hoped that the above findings will stimulate more detailed research into this matter, and thereby enable guidance to be given to women going through the menopause to cope with it in a less stressful way.

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