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Biomedical subjects

C F Cáceres

Publications and source records attributed to C F Cáceres.

6 recordsLinked to original sources
PubMed2004

Monitoring trends in sexual behaviour and HIV/STIs in Peru: are available data sufficient?

OBJECTIVES: To review and summarise various types of Peruvian evidence on sexual behaviour, HIV/STI exposure and risk, and discuss how to increase its usefulness for HIV/STI risk trend monitoring in Peru. METHODS: Review HIV sentinel surveillance conducted by the Ministry of Health; data from the Demographic and Health Surveys (DHS); and academic publications on sexual behaviour in combination with biological markers. Changes over time, quality of data, size of studies, and intended audience are discussed. RESULTS: Data from HIV sentinel surveillance showed very high (8-23%) HIV seroprevalence among men having sex with men, but stable, relatively low figures among female sex workers (1%) and antenatal clinic patients (under 0.5%). DHS data suggest that single women increased their sexual activity throughout the 1990s but did not raise their contraceptive use accordingly, resulting in increased early conceptions. The contribution of condoms to overall contraceptive protection increased threefold in 1992-2000. According to the 1996 survey, men become sexually active 2.5 years earlier than women, but marry or cohabit four years later than women; women marry or cohabit 1.5-2.5 years after first sex, whereas men take eight years to do so. Finally, published studies confirmed dramatic differences in HIV prevalence between men who have sex with men and other populations, and also suggested patterns of bridging from men to women. CONCLUSIONS: Data available from the three sources are numerous, although limitations of each approach reduce their monitoring utility: Ministry of Health studies should select better sentinel populations and timely process behavioural data. Future demographic surveys should incorporate an AIDS risk perspective and include men.

Adolescent↗
PubMed2000

Sexual coercion among youth and young adults in Lima, Peru.

PURPOSE: To determine the prevalence and correlates of sexual coercion in young adults in Lima, Peru. METHODS: Lifetime sexual coercion and that at first sexual experience were studied in 629 sexually active young people, drawn from representative samples of 611 adolescents and 607 young adults. RESULTS: Almost half of the young women and a quarter of the young men in the study reported sexual coercion. In multiple logistic regression analyses, men and women who reported having been coerced at heterosexual initiation also reported more lifetime sexually transmitted diseases and a lower age at first sex than those not reporting coercion. Men who reported coercion at heterosexual initiation also reported a lower number of lifetime heterosexual partners and less sexual knowledge than men not coerced. CONCLUSION: Experiencing heterosexual initiation as coercive appears to be a marker for a riskier sexual career for both genders and for future homosexual behavior in men.

Adolescent↗
PubMed1997

The correlates of safer behavior among homosexually active men in Lima.

OBJECTIVE: To describe sexual behavior patterns and identify psychosocial and situational correlates of safer practices among men who have sex with other men in Lima. DESIGN: A cross-sectional survey. SUBJECTS AND METHODS: In 1992, 223 mostly young, working- and middle-class homosexually active men in Lima, who reported either being seronegative or not knowing their HIV status, were recruited from public places, gay organizations and through snowballing techniques. Measurements included patterns of sexual behavior and socialization with other homosexually active men, and psychosocial and situational factors. Three risk behavior indicators were used: the practice of unprotected receptive anal intercourse, the practice of unprotected anal intercourse (insertive or receptive) and an index of behavioral risk based on numbers of sexual partners for different risk practices. RESULTS: The subjects (mean age 24.9 years, SD 6.3) were mostly exclusively homosexual (74%) and self-identified as gay/homosexual (73%); 41% had had unprotected anal intercourse during the last 4 months (75% of them in the receptive role). Reporting sex in public places consistently predicted riskier behavior by any of the three indices, whereas a lower perception of benefits of condoms/safer sex, poor AIDS knowledge, participation in a steady relationship and higher self-efficacy were associated with one or two of the indices. CONCLUSIONS: Besides considering basic AIDS information and the promotion of condoms and safer sex, intervention programs for homosexually active men in Lima should emphasize the need for open discussions on safety in steady relationships, promote accurate perceptions of personal risk and sensitively address the special difficulties posed by sexual activity in public places.

Acquired Immunodeficiency Syndrome↗
PubMed1997

Young people and the structure of sexual risks in Lima.

OBJECTIVES: (1) To describe psychosocial variables related to sexual activity and the prevalence of contextual factors (e.g. coercion, paid sex and drug/alcohol use) and various sexual experiences among young men and women in Lima; and (2) to assess the relationship between psychosocial, contextual and behavioral factors on one hand and negative sexual health events such as unplanned pregnancies and sexually transmitted diseases (STDs) on the other hand. DESIGN: A cross-sectional serosurvey complemented with focus groups and in-depth interviews. SUBJECTS AND METHODS: A total of 611 adolescents (16-17 years old) and 607 young adults (19-30 years old) were recruited randomly from among those registering for military service (adolescents) or seeking work/study permits (young adults). These subjects were asked to fill out a self-administered questionnaire with detailed information on sexual experiences and psychosocial variables. The response rates were 98% (adolescents) and 82% (young adults). A subsample of 858 subjects provided blood specimens, which were analyzed for antibodies to HIV-1, the hepatitis B virus and syphilis. The relationship between the main study variables and sociodemographic indicators was also assessed, and multivariate analysis was used to identify those variables associated with sexual health problems. A preliminary qualitative phase helped in the questionnaire design and in interpreting survey findings. RESULTS: Thirty-four percent of adolescents and 75% of young adults were sexually experienced. The prevalence of bisexual behavior was high, particularly among males (12%). The males often reported paid sex (47%) and the females often reported sexual coercion (47%). Among the heterosexually active, only 11% reported consistent use of condoms. While 22% of the heterosexually active reported an unplanned pregnancy in self (females) or partner (males), 18% of the sexually active reported a history of STD symptoms or diagnoses. Among the sexually active who gave a blood sample, 0.2% were positive for HIV, 6.7% for hepatitis B and 1.5% for syphilis. Those who experienced an unplanned pregnancy or STD symptoms or, for the subsample, were seropositive for HIV or other STDs, were more likely to perceive social norms as restricting condom use to casual sex, to be older, to combine sex with alcohol or drugs and to report a history of sexual coercion or of having paid or been paid for sex. For females only, engaging in sex at a younger age was a risk marker, while engaging in any homosexual activity was protective. CONCLUSIONS: Cultural norms that restrict condoms to casual sex may place many young people in Lima at risk of an unplanned pregnancy or STDs. Sexual behavior may be especially risky in a context of sexual coercion and paid sex, when sex is combined with drugs and alcohol, and when engaged in by younger females. Sexual health education should work to change such cultural norms and these risky contexts.

Adolescent↗
PubMed1994

Evaluating a school-based intervention for STD/AIDS prevention in Peru.

PURPOSE: In a context of increasing HIV/STD risks among adolescents in Latin America, new conceptions of sequential "sex education" are needed. However, older adolescents must be reached through shorter programs. A quasi-experimental study was conducted to evaluate the impact of a short school-based STD/AIDS prevention program on knowledge, attitudes, and intended behavior among secondary students in Lima. METHODS: Aimed at empowering adolescents regarding their sexuality, improving knowledge and attitudes, and developing skills and prevention-oriented behavioral intentions, the program consisted of seven weekly two-hour sessions. Cost exclusive of research expenses was $3 per student reached. RESULTS: 1213 students from 14 schools participated in either the intervention or control groups. Significant changes in knowledge on sexuality and AIDS, erotophilia, acceptance of contraception, machismo, and discrimination against persons with HIV/AIDS were found in the intervention group, as compared to the control group. Self-efficacy and prevention-oriented behavioral intentions were significantly better in the intervention group. CONCLUSIONS: Owing to its effectiveness, acceptability, and low cost, this program may become useful in reaching adolescents unable to participate in longer-term sex education programs in Peru and elsewhere.

Acquired Immunodeficiency Syndrome↗