印尼：东部巴布亚教友赞成安装避孕套售卖机防治艾滋病

[天亚讯·印尼马老奇讯]印尼最东面的巴布亚省据报是为全国艾滋病感染人数最多的地区,本地教会支持利用避孕套售卖机来保护居民免受艾滋病毒感染。政府最近巴布亚七个地区设置了避孕套售卖机。若望·坎达姆(JohnKandam)神父7月29日向天亚社说,避孕套是拯救性命及避免人性尊严不获尊重的工具。     

中国未婚青年首次性行为时的避孕选择——基于赫克曼选择模型的分析

尽管未婚青年有遭遇意外妊娠和罹患性传播疾病的极大风险,但由于缺乏全国代表性数据,迄今,我们对这一群体的性行为特征仍一无所知。本文基于捕捉了全国超过22,000名未婚青年性与生殖健康相关信息的第一次中国青少年生殖健康调查数据,首先采用描述统计的方法来考察未婚青年首次性行为时的避孕选择情况;然后根据数据及研究问题特点,为控制统计上的选择性偏误问题,采用赫克曼选择模型进行计量研究;探讨了中国未婚青年首次性行为时避孕套使用的社会与人口相关因素及首次性行为发生时的环境要素对其是否使用避孕套的影响。结果显示,中国未婚青年首次性行为时避孕套使用率很低,而年龄与教育是决定未婚青年是否在性行为时使用避孕套的首要指标:较早年龄开始性行为代表着不安全性行为发生的风险性越高,较高教育程度的获取有助于提高未婚青年在首次性行为时采取保护措施的可能性。特别地,从基于首次性行为发生时的环境要素的赫克曼选择模型结果来看,中国未婚青年对于其首次性行为是"有准备的发生"以及"发生之前能与其性伴侣讨论避孕方式的采用"增加了他们在性行为时采取保护措施的可能性。研究表明,通过学校性教育课程的合适开展及家庭亲子交流的加强,从而提供给中国未婚青年合适的避孕知识应是作为青少年性与生殖健康干预政策构建的一个核心内容。     

艾滋病研究中的常见伦理问题及其对策

为遏制艾滋病病毒 (HIV )和艾滋病 (AIDS)的迅速蔓延 ,在世界范围内广泛开展了预防控制HIV /AIDS的研究工作 ,研究包括流行病学研究、社会科学研究、教育学研究以及社会干预研究等[1] ,科研引发的伦理问题存在于研究对象选择、研究方法设计和研究实施等环节 ,常见的伦理问题表现为侵犯研究对象的自治权、导致对某些社会群体的歧视、损害研究对象的利益等 ,如何在艾滋病研究伦理审查委员会 (IRB)的监督和指导下 ,在公平、受益和尊重个人的科研伦理学基本原则[2 ] 的基础上 ,采取有效措施消除艾滋病科研中存在的伦理问题已成为预防控制…     

HPV疫苗预防子宫颈癌的临床应用进展及思考

子宫颈癌是引起女性死亡的第二大癌症.研究证实人乳头瘤病毒(HPV)感染与子宫颈癌有着十分密切的关系.近年来,HPV疫苗在预防和治疗子宫颈癌方面备受关注,多种新型预防性HPV疫苗已在部分国家上市.但是HPV疫苗的研制、使用、推广仍面临许多难题,有待广大医疗工作者共同思考和解决.     

走出疾病隐喻的迷沼--评苏珊·桑塔格《疾病的隐喻》

上海译文出版社最近翻译出版了2000年美国国家图书奖得主苏珊·桑塔格(Susan Sontag)的<疾病的隐喻>一书,该书是由苏珊·桑塔格写于1978年的<作为疾病的隐喻>(Illness as Metaphor)和完成于1989年的<艾滋病及其隐喻>(AIDS and Its Metaphor)两篇重要文章组成.文章反思并批判了诸如结核病、癌症及艾滋病是如何在社会的演绎中被一步步隐喻化,从"仅仅是身体的一种病"转换成一种道德评判或者政治态度,一种疾病的隐喻如何进入另一种疾病的隐喻.     

克伦特罗的药理作用、滥用危害及其伦理思考

前不久,新闻媒体曝光了双汇在食品制作过程中使用“瘦肉精”猪肉,一时间市场哗然,也再次将“瘦肉精”带人大众的视线.自1990年第一例瘦肉精中毒事件发生在西班牙以后,国内外发生的多起瘦肉精中毒事件让人触目惊心.诸多案例说明,原来作为一种解痉平喘药物——克伦特罗(俗称“瘦肉精”)的滥用已成为重大的食品安全问题及社会问题.     

艾滋病防治之伦理原则的几点再认识

艾滋病 (AIDS)是一种威胁全社会的严重传染病 ,它侵蚀着人类的健康 ,阻碍着经济的发展 ,给社会造成严重的危害。对于我国 ,甚至全世界 ,艾滋病的传播都带来极大的害处。有效阻断艾滋病的传播 ,必然要管理艾滋病患者和高危人群 ,限制他们的某些权利 ,这就产生一些社会伦理问题。艾滋病的防治 ,虽然可以使用有利 (无伤 )、尊重 (宽容 )、公正、互助等伦理原则[1] ,卫生部下发的《关于艾滋病病毒感染者和艾滋病患者的管理意见》(以下简称《管理意见》)也考虑了这些伦理理念 ,但是这些原则和理念高度抽象和概括 ,缺乏可操作性 ,实践中 ,往往遇…     

辽宁省临床医师认知和使用循证医学情况调查

为了解临床医师使用循证医学(Evidence-Based Medicine)的知晓度,获得基线资料,为卫生部门提供决策依据,课题组对辽宁省三级甲等医院的243名临床医师采用问卷调查.结果显示,临床医师受经验医学的束缚,未能将循证医学运用到医疗实践当中.为提高我国临床医学水平,在临床医师中推广循证医学非常必要.     

HIV/AIDS防治:中国MDGs/全面小康的困境与出路

联合国千年发展目标(MDGs)与全面小康目标的一致性使其从独特角度审视当代中国小康进程.中国MDGs实施状况表明,艾滋病病毒/艾滋病(HIV/AIDS)防治是发展薄弱环节,这将对中国小康进程带来诸如贫困等问题.歧视和羞辱是艾滋病病毒/艾滋病防治目标的最大社会障碍,而现存法律因素更无意识强化了这种歧视.建立有效的沟通策略与法律支持、"让艾滋病人群更大地参入到目标中来"(GIPA)可能是当前的出路.关注艾滋病病毒/艾滋病防治,实现中国MDGs,是中国全面小康社会的必经之路.     

中文版无手机恐惧量表的修订

该研究以国外学者Caglar Yildirim和Ana-Paula Correia于2015年编制的Nomophobia量表为基础,修订出了适用于国内的中文版无手机恐惧量表。研究首先使用探索性结构方程模型对量表结构进行初探; 其次使用项目反应模型进行项目分析并根据其分析结果对项目进行修改和筛选,最终形成正式版量表; 最后对正式版量表其进行信效度检验,并再次对量表题目进行项目分析。最终量表共16道题目,包括害怕无法获得信息、害怕失去便利、害怕失去联系和害怕失去网络连接4个维度; 总量表的Cronbach α系数为0.931,四维度的α系数分别为:0.789,0.816,0.887和0.896。CFA验证性结果显示量表结构较好(χ2/df=3.91,RMSEA=0.067,TLI=0.941,CFI=0.952,SRMR=0.04); 使用手机成瘾倾向量表作为校标的结果显示二者之间相关为0.626,效度良好。最终量表项目区分度在[1.734,4.806]之间,四维度区分度均值为2.1765,2.72,3.2925和3.883,项目难度参数在[-1.830,4.806]之间。综上结果显示该研究编制的无手机恐惧量表各项指标均达到了心理测量学要求,可供后续研究使用     

Questions of condom use in the Muslim and Catholic response to HIV and AIDS in Nairobi,Kenya

Religious leaders in Roman Catholic and Sunni Muslim communities in Kenya’s capital city of Nairobi are charged with responding in an official capacity to the pressing concerns facing their respective communities both theologically and practically. However, speaking about sexuality from a religious perspective particularly on the use of condoms in AIDS prevention has been rather troublesome topic many leaders and clergy find problematic discussing openly. This paper offers a comparative analysis of Muslim and Catholic views on sexuality by establishing the parameters within which to consider the presence and activity of Catholic and Muslim leaders in Kenya and the holistic, grassroots approach in responding to the AIDS epidemic in Nairobi regarding condom use.     

Predicting Intentions of AIDS-Preventive Behavior Among Adolescents

The aim was to predict adolescents' i]ntentions of regular condom use on the basis of an extended version of Ajzen and Fishbein's (1980) theory of reasoned action. Attitude and subjective norm concerning regular condom use were measured along with their antecedent beliefs and evaluations, with fear of AIDS and knowledge about AIDS included as additional variables. A mixed-gender sample comprising both sexually active and sexually inexperienced adolescents was studied. The results strongly support the impact of attitude toward regular condom use as a determinant of a corresponding behavioral intention. Normative pressures failed to predict intentions of regular condom use, as did fear of AIDS and knowledge about AIDS. The findings are discussed with respect to intervention campaigns aimed at promoting condom use among adolescents as an AIDS-preventive measure.     

The Effects of Fear of AIDS and Gender on Responses to Fear-Arousing Condom Advertisements

The effects of message fear arousal, fear of AIDS, and gender on attitudinal responses to condom advertisements were tested in a laboratory experiment. Ninety-five male and 96 female college students, previously assessed for fear of getting AIDS, rated the effectiveness of 1 of 4 high-fear or 4 low-fear condom ads in motivating them to buy the product. Contrary to prediction, the high-fear condom ads did not significantly differ from low-fear ads in effectiveness. The prediction that subjects' fear of AIDS would interact with ad fear level was also not supported. However, subjects with a high fear of getting AIDS viewed ads as more effective than did low-fear subjects. As predicted, male subjects viewed ads as more effective than did women. Results support the health belief model's tenet that a sense of vulnerability facilitates acceptance of a message. Implications of the results for condom use promotion in AIDS prevention materials are discussed.     

The role of risk perception and efficacy cognitions in the prediction of HIV-related preventive behavior and condom use

The salience of the Protection Motivation Theory to HIV preventive behavior was investigated in a sample of 468 heterosexual men 20-45 years of age recruited in Germany and at vacation spots in Spain. This theory conceptualizes self-protective behaviors as a function of the severity of the threat, perceived personal vulnerability to this threat, the availability of coping responses, and the effectiveness of these responses. Cognitive variables measured included perceived severity of the threat of AIDS, sexual self-efficacy expectancy, self-efficacy expectations in terms of sexual communication skills, response efficacy, and attitude toward condom use. On a scale of 1 (low) to 6 (high), perceived severity of the AIDS threat averaged 5.3, individual susceptibility ratings averaged 3.5, and susceptibility of peers had a mean of 4.9. Although 33% of respondents had made behavioral changes in response to the AIDS epidemic, only 15% always used condoms while 12% used them occasionally. Self-efficacy expectancy with regard to assertiveness and use of preventive measures emerged as the most significant predictor of HIV-related behaviors. The causal analyses indicated that high communicative self-efficacy expectancy is associated with high-risk sexual behaviors, while self-efficacy expectancy regarding assertiveness and the use of preventive measures promotes risk reduction. These associations were strongest in men over 26 years of age, singles, and tourists. These findings suggest a need for interventions for couples such as assertiveness training and guidance on communicating about sex and AIDS. Also demonstrated was the need for AIDS education programs to identify where participants are in terms of perceiving the threat of and coping with the AIDS epidemic and promote conditions that will help people advance to the next stage.     

Factors affecting behaviors that address HIV risk among senior secondary school pupils in South Africa.

The purpose of this study was to identify factors affecting HIV risk reduction among senior secondary school pupils in South Africa. The sample included 460 Grade 12, Secondary School pupils whose ages ranged from 16 to 30 years (M = 19.7 yr., SD = 2.5) and who were chosen at random from the total Grade 12 population throughout one region in the Northern Province of South Africa. Measures were of sexual behavior and condom use, knowledge about correct condom use, intention of condom use, behavioral norms, attitudes, normative beliefs, and subjective norms about condoms, HIV/AIDS vulnerability (likelihood to get it) and severity of the illness in the country, and condom use self-efficacy. Bivariate analysis gave positive significant relations among normative beliefs, subjective norms, and attitudes towards condom use as well as HIV/AIDS vulnerability and HIV risk behavior. Regression analysis indicated that for boys, younger age at first vaginal intercourse, less intention for condom use, and HIV/AIDS vulnerability were predictive for HIV/AIDS risk behavior and explained 39% of the variance. It is suggested that these predictors should be included in intervention programs for HIV prevention.     

Predictors of Intention to Take Precautions Against AIDS Among Black College Students1

This research explored the relationship between behavioral intentions to engage in AIDS-risky sexual practices and a variety of variables that are theoretically and/or popularly assumed to be important factors in AIDS prevention. These variables included beliefs and knowledge about AIDS, fear of AIDS, perceived vulnerability of self and others, as well as probability that self and others on one's campus would contract AIDS, perceived efficacy to control exposure to AIDS, self-esteem, general locus of control, and past behavioral reaction to the threat of AIDS. General intention to “do something to protect oneself against AIDS,” and specific behavioral intention to use condoms in vaginal sex were measured and considered as possible proxies for future behavior. Data were collected from 124 black respondents in a southeastern university. In a series of multiple regression analyses, each of these measures of behavioral intentions was “predicted” from the other variables. Results showed that situational efficacy (to protect oneself from AIDS) was the best predictor of general intention, followed by reports of past behavioral changes as a result of the AIDS epidemic, and by knowledge. Proximal fear of AIDS was a negative predictor. For specific intentions, a specific belief about inconvenience in condom use was the best predictor, followed by past behavioral change, followed by knowledge. Normative beliefs, a belief that condoms would prevent disease, and distant threat of AIDS were also significant predictors. Theoretical and policy implications of the findings are discussed.     

Social Comparison,the Threat of AIDS,and Adolescent Condom Use1

This study tested hypotheses from social comparison theory about adolescent condom use. Questionnaires were administered to 457 twelfth-grade students (284 sexually active). Three different operationalizations of social comparison were used—comparative ratings, affiliative preferences, and derogation; each produced different results. Low condom users who felt threatened by AIDS made more downward comparative ratings regarding condom use than did unthreatened low users. In contrast, low users preferred upward affiliations with high users. Adolescents with higher self-esteem derogated adolescents with AIDS less as threat increased. Adolescents with lower self-esteem who made downward comparative ratings were more satisfied with their own past condom use. Satisfied low condom users were less likely to intend condom use in the future. The results provide evidence that downward comparison may act indirectly to deter behavioral change.     

Predictors of Condom Use in Mexican Migrant Laborers

The purpose of this study was to explore predictors of condom use with occasional sex partners and regular sex partners, as well as carrying condoms in a new high-risk group for HIV infection, Mexican migrant laborers. This study extends previous findings by (1) exploring additional predictors not previously examined, (2) utilizing a large sample of male and female Mexican migrant laborers, (3) carefully controlling for the effects of various demographic and lifestyle variables related to condom use, and (4) assessing the interactive effects of gender on predictors of condom use. Snowball sampling was used to survey 501 adult Mexican migrant laborers. Results revealed that condom use with occasional sex partners was predicted by carrying condoms and condom self-efficacy and that women were more likely to use condoms with occasional partners when both men and women knew someone with HIV/AIDS. Condom use with regular sex partners was predicted by procondom social norms, less negative attitudes toward condoms, not knowing someone with HIV/AIDS, and condom self-efficacy. Carrying condoms was predicted by procondom social norms, less negative attitudes toward condoms, condom self-efficacy, worry about contracting HIV/AIDS, and women were more likely than men to carry condoms when both men and women were married. Understanding these findings, future research directions, and implications for condom promotion strategies with Mexican migrant laborers are discussed.     

AIDS and Perceived Change in Sexual Practice: An Analysis of a College Student Sample from California and Iowa1

The objective of this study was to examine the impact of belief about transmissibility of AIDS and concern about the disease on perceived changes in premarital sexual practices. It was posited that changes in sexual practices are most likely to occur when college students have more certainty about AIDS transmission and greater concern about AIDS. Based on this proposition, dating patterns, premarital sexual permissiveness, attitudes toward homosexuality, sexual orientation, and students' objective perception of AIDS as a problem were used as predictors of concern about AIDS and certainty of sexual transmission. Using a sample of 587 students in the state universities of California and Iowa and focusing on one type of sexual practices (i.e., condom use), it was found that concern about AIDS strongly increases the likelihood of using condoms. Contrary to our prediction, certainty about sexual transmission of AIDS was found to have a marginal effect on students' likelihood of condom use. Furthermore, it was found that monogamous dating, sexual permissiveness, and the degree of perception of AIDS as a problem significantly increase the likelihood of condom use if they are mediated by personal concern about AIDS. The implications are discussed with respect to the usefulness of a theoretical approach and its findings for education on AIDS prevention among college students.     

Effect of Persuasive Appeals in AIDS PSAs and Condom Commercials on Intentions to Use Condoms1

The study compared the effect of five persuasive appeals used in AIDS PSAs and condom commercials (fear arousal-no sex/condom theme; fear arousal-sex/condom theme; erotic; humorous; factual) on 122 male and 114 female college students' i]ntentions to use and taking of condoms. Results showed that the two fear appeals were more effective than other appeals in increasing intentions to use condoms with a new partner. The fear appeal–no sex/condom theme was more effective than other appeals for increasing intentions to use condoms with a steady partner. Compared to men, women rated commercials as more effective for increasing intentions to use condoms with a new partner. Persuasive appeals had no effect on the taking of free condoms. The best predictor of commercial effectiveness was the degree to which a commercial evoked a high fear of AIDS. Other significant predictors were subjects' a]ttitude toward condom use and commercial qualities of being humorous, romantic, credible, and factual. Implications are that all five types of appeals are potentially effective for use in AIDS PSAs. Recommendations include combining appeals (e.g. fear with erotic) and emphasizing the positive features of condom use.