Safe-Sex Knowledge, Self-Assessed HIV Risk, and Sexual Behaviour of Young Portuguese Women

Abstract

Background: Young women make up most cases of HIV infection in Portugal (e.g., 26% in 2012), but their sexual behaviour, ability to recognize sexually transmitted disease (STD) risk in partners, and knowledge and practice of safe sex are underresearched. Methods: We studied these issues in a group of 177 women from Northern Portugal, together with their social, educational, and religious background. The women filled out several self-report questionnaires developed in the USA that have been adapted and validated for use in Portugal. They assess HIV knowledge, risk perception, and sexual risk behaviour. Results: We documented good knowledge about HIV transmission and prevention, although there are still some myths; 79.9% of the women knew that condoms prevent HIV transmission, but only 46% of them declared to use them regularly. Thus, knowledge does not imply adequate preventive behaviour. Women lacking higher education had poorer knowledge of HIV biology and of partner HIV risk. Despite being aware of HIV cases in their communities, most women deemed themselves at little risk, especially those lacking higher education, with many arguing that monogamy protects them, and, importantly, many preferring to ignore their partners' current and past behaviour when assessing their exposure. Conclusion: These results point to important intervention targets for campaigns to curb STD infections among young women. reconhecer o risco de IST em parceiros e o conhecimento e a prática de sexo seguro são pouco investigados. Méto-dos: Estudaram-se essas questões num grupo de 177 mulheres do Norte de Portugal, juntamente com seus antecedentes sociais, educacionais e religiosos. As mulheres em estudo preencheram vários questionários de auto relato desenvolvidos nos Estados Unidos da América e que foram adaptados e validados para uso em Portugal. Foi avaliado o conhecimento sobre o VIH, a perceção de risco e o comportamento sexual de risco. Resultados: Documentaram-se bons conhecimentos sobre a transmissão e a prevenção do VIH, embora haja alguns mitos; 79,9% das mulheres sabem que os preservativos impedem a transmissão do VIH, mas apenas 46% declara usá-los regularmente. O conhecimento não implica o comportamento preventivo adequado. As mulheres que não possuíam escolaridade de nível superior tinham um conhecimento mais pobre no que se refere à biologia do VIH e ao risco de VIH no parceiro. Apesar de estarem cientes dos casos de VIH em suas comunidades, a maioria das mulheres considerou-se com pouco risco, especialmente aquelas que não possuem ensino superior, argumentando que a monogamia as protege e, principalmente, muitas preferem ignorar o comportamento atual e passado de seus parceiros ao avaliar a sua exposição. Conclusão: Os resultados identificam importantes alvos de intervenção para as campanhas de prevenção de ISTs na população feminina.

Regulatory Focus and Sexual Health: Motives for Security and Pleasure in Sexuality are Associated with Distinct Protective Behaviors

“…For example, medical history (e.g., past STI testing and diagnosis) has been associated with STI knowledge (Andersson-Ellström & Milsom, 2002;de Visser & O'Neill, 2013;Martin-Smith et al, 2018). However, knowing more about STIs is not necessarily predictive of condom use or STI testing intentions (Costa et al, 2018;Espada et al, 2016;Martin-Smith et al, 2018). For example, Reis and colleagues (2013) found that only one-third of their sample indicated having used condoms in the past year, even though they had good knowledge about HIV transmission and prevention (for similar results with STI knowledge, see Perera & Abeysena, 2018).…”

Personal and Lifestyle Determinants of HIV Transmission Risk in Spanish University Students

“…Several mechanisms have been proposed to understand the higher risk of transmission of sexually transmitted diseases (STDs) and HIV in youth [ 4 ]. In this regard, higher sexual experimentation, a greater probability of spontaneous sexual encounters, and less knowledge about HIV and the risk factors of sexual partners have been identified as possible explanations for the higher prevalence of STD diagnoses in this population [ 4 ].…”

“…Several mechanisms have been proposed to understand the higher risk of transmission of sexually transmitted diseases (STDs) and HIV in youth [ 4 ]. In this regard, higher sexual experimentation, a greater probability of spontaneous sexual encounters, and less knowledge about HIV and the risk factors of sexual partners have been identified as possible explanations for the higher prevalence of STD diagnoses in this population [ 4 ]. Hence, having sexual intercourse at an early age has been related to a greater number of sexual partners during the life cycle and less condom use, which increases the risk of STD transmission and acquisition [ 5 , 6 ].…”

“…Hence, men in stable romantic relationships, based on the trust of their partner, consider it unnecessary to use a condom [ 6 ]. Moreover, females show less assertiveness when requesting and using condoms in sexual relationships [ 4 ].…”

“…In addition to personal and contextual characteristics, lifestyle plays a significant role in the development of risky sexual behaviors. Previous studies have established a significant association between alcohol consumption and higher risks of transmission of HIV and other STDs [ 17 , 18 , 19 ], especially in women [ 4 , 20 ]. Similar results have been found in specific populations, such as MSM, who reduce the use of condoms during anal penetration when they are under the influence of alcohol [ 21 ].…”