Young people constitute a priority for sexual health research, policy and planning. Many studies, however, regard youth as a homogeneous group defined by developmental stages and their problems as inherent rather than factors resulting from structural vulnerability. Ethnographic data from this study provided strong evidence of the inappropriateness, in prevention interventions, of the concept of 'young people' as a group defined only by age and gender. When incorporating social resources and support into the analysis, specific segments of youth with diverse sexual practices and health seeking behaviours emerge. Thus, although most young people in urban areas show a similar level of HIV/STI knowledge, their exposure to risk varies according to their living conditions. Two population segments - "street guys" and "fast girls" - identified as vulnerable for sexual risk, are characterized. Both groups hang out on the streets, and most are involved in using alcohol and drugs, and/or practicing transactional sex. This study provided evidence for the need of various approaches according to level of poverty and social vulnerability in order to develop more effective HIV/AIDS and STI prevention programs to meet the needs of young men and women in low-income areas.
This paper presents the lessons learned through a process evaluation (PE) after one year of implementation of a two-year community intervention in Lima, Peru. The intervention consisted of training and motivating community popular opinion leaders (CPOLs) for three marginal population segments to disseminate prevention messages among their peers. PE data included: observations, qualitative interviews with CPOLS, conversations and messages delivered by CPOLs, training facilitators' perceptions about implementation, and a survey of CPOLs. The PE helped to document and enhance the intervention. CPOLs were motivated to talk to their peers. CPOLs perceived that their participation had an effect on their own risk behaviors and saw their role as beneficial to their community. The PE was helpful in examining training delivery and the feasibility and acceptability of the intervention in order to assess the elements related to program success necessary to replicate the CPOL model.
Objective. The epidemiology of Trichomonas vaginalis infection among sexually active socially-marginalized women in three urban, coastal Peruvian cities was examined in order to quantify the prevalence of trichomonas infection and identify associated risk factors. Methods. We conducted a cross-sectional, venue-based study of women from socially-marginalized populations in three coastal Peruvian cities. Results. Among the 319 women enrolled, the overall prevalence of trichomonal infection was 9.1% (95% CI, 5.9%–12.3%). The mean age was 26.3 years, and 35.5% reported having had unprotected intercourse with nonprimary partners and 19.8% reported two or more sex partners in the last three months. Trichomonal infection was associated with increased number of sex partners (PR 2.5, 95% CI 1.4–4.6) and unprotected sex with nonprimary partner in the last three months (PR 2.3, 95% CI 1.1–4.9). Conclusions. A moderately high prevalence of trichomonal infection was found among women in our study. Trichomonal infection was associated with unprotected sex and multiple sex partners. Efforts to control the continued spread of trichomonal infection are warranted.
This paper focuses on risk, conceived not as an individual action, but considering its social dimension, analyzing the various forms in the socio-cultural context related to internalized homophobia and hegemonic gender norms that allow barriers to be constructed in risk perception. Such barriers hinder negotiation and protection among homosexual men that have adopted a female gender identity, living in low-income barrios of Lima and Trujillo, Peru. Risk perception is analyzed on the socio-cultural plane, allowing one to explain the limited negotiating capacity of this population, even though they have extensive knowledge of HIV/AIDS and its consequences.
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