Factores de riesgo en Canadá para enfermedades de transmisión sexual y sus variaciones / Risk Factors For Sexually Transmitted Diseases in Canada and Provincial Variations

Autores/as

  • Bajaj Sameer Escuela de Salud Pública, Universidad de Saskatchewan, Canada
  • Ramayanam Shravan Escuela de Salud Pública, Universidad de Saskatchewan, Canada
  • Stanley Enebeli Escuela de Salud Pública, Universidad de Saskatchewan, Canada
  • Hortense Nosh Tabien Escuela de Salud Pública, Universidad de Saskatchewan, Canada
  • Mustafa Andkhoie Estudiante de Doctorado en Epidemiología. Escuela de Salud Pública y Epidemiología, Universidad de Saskatchewan, Canadá.
  • Mohsen Yaghoubi Universidad de Saskatchewan, Canada
  • Gall Spencer Escuela de Salud Pública, Universidad de Saskatchewan, Canada
  • Szafron Michael Escuela de Salud Pública, Universidad de Saskatchewan, Canada
  • Marwa Farag Asistente de profesor de la Escuela de Salud Publica de la Universidad de Saskatchewan

Resumen

Objetivos: Este estudio exploró los factores asociados con los reportes que indican haber tenido alguna vez una enfermedad de transmisión sexual (STI-Sexually Transmitted Disease) en Canadá y las variaciones regionales de estas asociaciones. Métodos: Se tomó una muestra de 35,099 canadienses adultos de la Encuesta de Salud de la Comunidad Canadiense de 2009-2010, la cual se analizó mediante regresión logística binaria para modelar las relaciones entre estado civil, sexo, ingreso familiar, educación, frecuencia de consumo de alcohol, consumo de tabaco, estatus inmigratorio y región canadiense de residencia, con haber sido diagnosticado alguna vez con una STI. El modelo controló la edad del encuestado. Resultados: Las personas que vivían en los Territorios tuvieron las probabilidades más altas de haber sido diagnosticadas alguna vez con una STI (OR = 2.03, 95% CI (1.19, 3.48)) y los residentes de las provincias Marítimas (OR = 0.71, 95 % CI (0.59, 0.85)) y Ontario (OR = 0.79, 95 % CI (0.70, .89)) tuvieron las probabilidades más bajas de haber sido diagnosticados con una STI. Ser mujer fue un factor de riesgo con un índice de probabilidad de 1.74 (95% CI (1.60, 1.88)). En nuestro estudio, se encontraron como factores protectores el ingreso familiar, el matrimonio y la educación. Los factores de comportamiento tales como tabaquismo y el consumo excesivo de alcohol tuvieron efectos nocivos significativos en la salud sexual. Los fumadores actuales tuvieron una probabilidad 1.95 (95% CI (1.75, 2.18)) veces más alta que los no fumadores de haber sido diagnosticados con una STI. De manera similar, los individuos con consumo excesivo de alcohol con una frecuencia de más de una vez por semana tuvieron 1.77 (95% CI (1.57,1.99)) mayores probabilidades de haber tenido alguna vez una STI. Conclusiones: Tanto los factores demográficos como los de comportamiento influyen en la probabilidad de haber sido diagnosticado alguna vez con una STI en Canadá. Es más probable que las mujeres, las personas con más bajos ingresos, más bajo nivel de educación o solteras, alguna vez hayan tenido una STI. El tabaquismo y el consumo excesivo de alcohol están asociados de manera significativa con un incremento en la probabilidad de alguna vez haber tenido una STI en Canadá. Las intervenciones políticas, como el suministro de información relevante y precisa para las poblaciones en mayor riesgo, identificadas en este estudio, podrían resultar beneficiosas. Las intervenciones de detección en contextos clínicos y no clínicos también son una parte importante de cualquier estrategia de prevención de las STI. Igualmente, es más probable que las intervenciones de promoción de la salud específicas de género sean más eficaces. Abstract Objectives: This study explored factors associated with reporting ever having had a sexually transmitted disease (STI) in Canada and the provincial variations in these associations. Methods:A sample of 35,099 Canadian adults was drawn from the 2009-2010 Canadian Community Health Survey, and analyzed using binary logistic regression to model the relationships that marital status, sex, household income, education, frequency of risky drinking, smoking status, immigration status, and Canadian region of residence have with ever being diagnosed with an STI. The model controlled for the age of the respondent. Results: People living in the Territories had the highest odds of having ever been diagnosed with an STI (OR = 2.03, 95% CI (1.19,3.48)) and residents from the Maritime provinces (OR = 0.71, 95 % CI (0.59, 0.85)) and Ontario (OR = 0.79, 95 % CI (0.70, .89)) had the lowest odds for having been diagnosed with an STI. Being female was a risk factor with an odds ratio of 1.74 (95% CI (1.60, 1.88)). In our study, income, marriage and education were found to be protective factors. Behavioral factors such as smoking and binge drinking had significant harmful effects on sexual health. Current smokers had an odds 1.95 (95% CI (1.75, 2.18)) times higher than non-smokers of ever being diagnosed with an STI. Similarly, individuals with a binge drinking frequency of more than once per week had 1.77 (95% CI (1.57,1.99)) higher odds of having ever had an STI. Conclusions:Both demographic and behavioral factors influence the likelihood of having ever been diagnosed with an STI in Canada. Women, people with lower income, lower education, or unmarried are more likely to have ever had an STI. Smoking and binge drinking are significantly associated with an increase in the likelihood of ever having an STI in Canada. Policy interventions such as providing accurate relevant information to higher risk populations, identified in this study, could prove beneficial. Screening interventions in clinic-based and non-clinical settings are also an important part of any STI prevention strategy. Tailored gender-specific health promotions interventions are also likely be more efficacious.

Biografía del autor/a

Bajaj Sameer, Escuela de Salud Pública, Universidad de Saskatchewan, Canada

Escuela de Salud Pública, Universidad de Saskatchewan, Canada

Ramayanam Shravan, Escuela de Salud Pública, Universidad de Saskatchewan, Canada

Escuela de Salud Pública, Universidad de Saskatchewan, Canada

Stanley Enebeli, Escuela de Salud Pública, Universidad de Saskatchewan, Canada

Escuela de Salud Pública, Universidad de Saskatchewan, Canada

Hortense Nosh Tabien, Escuela de Salud Pública, Universidad de Saskatchewan, Canada

Escuela de Salud Pública, Universidad de Saskatchewan, Canada

Mustafa Andkhoie, Estudiante de Doctorado en Epidemiología. Escuela de Salud Pública y Epidemiología, Universidad de Saskatchewan, Canadá.

Estudiante de Doctorado en Epidemiología. Escuela de Salud Pública, Universidad de Saskatchewan, Canada

Mohsen Yaghoubi, Universidad de Saskatchewan, Canada

Escuela de Salud Pública, Universidad de Saskatchewan, Canada

Gall Spencer, Escuela de Salud Pública, Universidad de Saskatchewan, Canada

Universidad de Saskatchewan, Canada

Szafron Michael, Escuela de Salud Pública, Universidad de Saskatchewan, Canada

Escuela de Salud Pública, Universidad de Saskatchewan, Canada

Marwa Farag, Asistente de profesor de la Escuela de Salud Publica de la Universidad de Saskatchewan

MSc., Ph.D. Asistente de profesor de la Escuela de Salud Publica de la Universidad de Saskatchewan

Citas

Catania JA, Kegeles SM, Coates TJ. Towards an Understanding of Risk Behavior: An AIDS Risk Reduction Model (ARRM). Heal Educ Behav. 1990;17(1):53-72. doi:10.1177/109019819001700107.

Lu W, Zeng G, Luo J, et al. HIV transmission risk among serodiscordant couples: a retrospective study of former plasma donors in Henan, China. J Acquir Immune Defic Syndr. 2010;55(2):232-238. doi:10.1097/QAI.0b013e3181e9b6b7.

Boyer CB, Tschann JM, Shafer M-A. Predictors of risk for sexually transmitted diseases in ninth grade urban high school students. J Adolesc Res. 1999;14(4):448-465. doi:10.1177/0743558499144004.

Da Ros CT, Da Silva Schmitt C. Global epidemiology of sexually transmitted diseases. Asian J Androl. 2008;10(1):110-114. doi:10.1111/j.1745-7262.2008.00367.x.

Gilson, R. J., & Mindel A. Sexually transmitted infections. BMJ. 2001;322(7295):1160-1164.

Coker a L, Richter DL, Valois RF, McKeown RE, Garrison CZ, Vincent ML. Correlates and consequences of early initiation of sexual intercourse. J Sch Health. 1994;64(9):372-377.

Rosenthal SL, Biro FM, Succop PA, Bernstein DI, Stanberry LR. Impact of demographics, sexual history, and psychological functioning on the acquisition of STDS in adolescents. Adolescence. 1997;32(128):757-769.

Anderson JE, Dahlberg LL. High-risk sexual behavior in the general population. Results from a national survey, 1988-1990. Sex Transm Dis. 1992;19(6):320-325.

Wasserheit JN, Aral SO. The dynamic topology of sexually transmitted disease epidemics: implications for prevention strategies. J Infect Dis. 1996;174 Suppl:S201-13.

Michelson KN1, Thomas JC, Boyd C JA. Chlamydia trachomatis infection in a rural population: the importance of screening men. Int J STD AIDS. 1999;10(1):32-37. doi:10.1258/0956462991913051

StatiETScs Canada .Weighted eETSmation and bootstrap variance eETSmation for analyzing survey data: How to implement in selected software. Availabel online at : http://www.statcan.gc.ca/pub/12-002-x/2014001/article/11901-eng.htm#a13.(Last accessed 10 Nov, 2016)

Canadian Community Health Survey - Annual Component (CCHS). Availabel online at :http://www23.statcan.gc.ca/imdb/p2SV.pl?Function=getSurvey&SurvId=50653&InstaId=81424&SDDS=3226 (Last accessed 10 Nov, 2016)

Public Health Agency of Canada. Report on Sexually Transmitted Infections in Canada.; 2010. Availabel online at :http://publications.gc.ca/site/archiveearchived.html?url=http://publications.gc.ca/collections/collection_2013/aspc-phac/HP37-10-2010-eng.pdf.(Last accessed 8 Oct, 2016)

Weinstock H, Berman S, Cates W. Sexually transmitted diseases among American youth: incidence and prevalence eETSmates, 2000. Perspect Sex Reprod Health. 2000;36(1):6-10. doi:10.1363/psrh.36.6.04.

Warszawski J ML. Gender difference in persistent at-risk sexual behavior after a diagnosed sexually transmitted disease. Sex Transm Dis. 1998;25(8):437-442.

Padian NS, Shiboski SC, Glass SO, Vittinghoff E. Heterosexual transmission of human immunodeficiency virus (HIV) in northern California: results from a ten-year study. Am J Epidemiol. 1997;146(4):350-357. doi:10.1093/oxfordjournals.aje.a009276.

Tyndall M, Patrick D, Spittal P. Risky sexual behaviours among injection drugs users with high HIV prevalence: implications for STD control. Sex Transm .2002;78 Suppl 1:i170-i175.

Rakwar J, Kidula N, Fonck K, Kirui P, Ndinya-Achola J TM. HIV/STD: the women to blame? Knowledge and attitudes among STD clinic attendees in the second decade of HIV/AIDS. Int J STD AIDS. 1999;10(8):543-547.

Mayer KH, Beyrer C. HIV Epidemiology Update and Transmission Factors: Risks and Risk Contexts--16th International AIDS Conference Epidemiology Plenary. Clin Infect Dis. 2007;44(7):981-987. doi:10.1086/512371.

Whyte ,IV J, Standing T, Madigan E. The relationship between HIV-related knowledge and safe sexual behavior in African American women dwelling in the rural Southeast. JANAC J Assoc Nurses AIDS Care. 2004;15(2):51-58. doi:10.1177/1055329003256415.

Crystal S, Akincigil A, Sambamoorthi U, et al. The diverse older HIV-positive population: a national profile of economic circumstances, social support, and quality of life. J Acquir Immune Defic Syndr. 2003;33 Suppl 2(Suppl 2):S76-S83. doi:10.2215/CJN.10581014.

Kass NE, Munoz A, Chen B, Zucconi SL, Bing EG, Hennessy M. Changes in employment, insurance, and income in relation to HIV status and disease progression. JAIDS J Acquir Immune Defic Syndr. 1994;7(1):86–91.

Buttmann N, Nielsen A, Munk C, Liaw KL, Kjaer SK. Sexual risk taking behaviour: prevalence and associated factors. A population-based study of 22,000 Danish men. BMC Public Health. 2011;11:764. doi:10.1186/1471-2458-11-764.

Marshall MM, McCormack MC, Kirk GD. Effect of cigarette smoking on HIV acquisition, progression, and mortality. In: AIDS Education and Prevention. Vol 21. ; 2009:28-39. doi:10.1521/aeap.2009.21.3_supp.28.

Kermode M, Sono CZ, Songput CH, Devine A. Falling through the cracks: a qualitative study of HIV risks among women who use drugs and alcohol in Northeast India. BMC Int Health Hum Rights. 2013;13:9. doi:10.1186/1472-698X-13-9.

Hendershot CS, Magnan RE BA. Associations of marijuana use and sex-related marijuana expectancies with HIV/STD risk behavior in high-risk adolescents. Psychol Addict Behav. 2010; 24(3):404-414. doi:10.1037/a0019844.

Citizenship and Immigration Canada. Syphilis screening and management . Availabel at :http://www.cic.gc.ca/english/department/partner/pp/pdf/IMEI_Syphilis.pdf. 2014.

Ross MW, Williams ML. Sexual behavior and illicit drug use. Annu Rev Sex Res. 2001;12:290-310.

Wight D, Plummer M RD. The need to promote behaviour change at the cultural level: one factor explaining the limited impact of the MEMA kwa Vijana adolescent sexual health intervention in rural Tanzania. A process evaluation. BMC Public Heal. 2012;14(12):788. doi:10.1186/1471-2458-12-788.

World Health Organization. Global strategy for the prevention and control of sexually transmitted infections: 2006-2015: breaking the chain of transmission.

Workowski, K.A. and Berman, S., 2010. Sexually transmitted diseases treatment guidelines, 2010.

Lewis FM, Dittus P, Salmon ME, Nsuami MJ. School-based sexually transmitted disease screening: review and programmatic guidance. Sexually transmitted diseases. 2016;1;43(2S):S18-27. doi: 10.1097/OLQ.0000000000000283.

Hogben M, Collins D, Hoots B, O’Connor K. Partner Services in Sexually Transmitted Disease Prevention Programs: A Review. Sexually transmitted diseases. 2016;1;43(2S):S53-62. 10.1097/OLQ.0000000000000328

Friedman AL, Kachur RE, Noar SM, McFarlane M. Health communication and social marketing campaigns for sexually transmitted disease prevention and control: What is the evidence of their effectiveness?. Sexually transmitted diseases. 2016 ;1;43(2S):S83-1. doi: 10.1097/OLQ.0000000000000286.

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Publicado

2017-07-04

Cómo citar

Sameer, B., Shravan, R., Enebeli, S., Nosh Tabien, H., Andkhoie, M., Yaghoubi, M., … Farag, M. (2017). Factores de riesgo en Canadá para enfermedades de transmisión sexual y sus variaciones / Risk Factors For Sexually Transmitted Diseases in Canada and Provincial Variations. Medicina Social Social Medicine, 11(2), 58–65. Recuperado a partir de https://medicinasocial.info/index.php/medicinasocial/article/view/943

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