ABSTRACT Objective To analyse sexual behaviour, HIV testing, HIV testing intentions and reasons for not testing for HIV in university students from Cuzco (Peru). Methods The sample comprised 1,377 university students from several institutions from Cuzco (Peru). The size of the sample was set according to a maximum 3% error estimation and a 97% confidence interval. Ages ranged from 16 to 30 years old. The data were collected through a self-administered, anonymous and voluntary questionnaire regarding sexual behaviour and HIV testing. The data were collected in classrooms during teaching hours. Results A higher percentage of males than females reported having had vaginal, anal and oral sex, a higher number of sexual partners and an earlier age at first vaginal and oral sex. A higher percentage of females than males did not use condoms when they first had anal sex and had a higher anal sex-risk index. Most of the participants had never been HIV tested. The main reason was that they were sure that they were not HIV infected. Conclusions It seems that there was a low HIV risk perception in these participants despite the fact that they had been involved in sexual risk behaviours. Prevention campaigns focused on the general population as well as the at-risk populations and young people are needed.

RESUMEN Objetivo El objetivo era analizar la conducta sexual, la realización de la prueba del virus de la inmunodeficiencia humana (VIH), las intenciones para hacérsela y los motivos para no realizársela en jóvenes estudiantes en la universidad en Cuzco (Perú). Método Participaron 1377 estudiantes universitarios/as de diversas instituciones de educación superior de Cuzco (Perú). El rango de edad era de 16 a 30 años. Se aplicó un cuestionario sobre conducta sexual y realización de la prueba del VIH. El tamaño de la muestra se estableció considerando un nivel de confianza del 97% y un error de estimación del 3%. El cuestionario se cumplimentó en las aulas durante las horas lectivas. Resultados Un mayor porcentaje de varones que de mujeres ha tenido sexo vaginal, anal y oral, un mayor número de parejas sexuales y un inicio a una edad más temprana en el sexo vaginal y oral. Un mayor porcentaje de mujeres que de varones no utilizó el preservativo en la primera relación sexual anal y tenía un mayor índice de riesgo anal. La mayoría de los/las jóvenes no se había realizado nunca la prueba del VIH. El principal motivo para no hacérsela era la seguridad de no estar infectados/as. Conclusiónes Parece existir una baja percepción de riesgo frente al VIH en los/las jóvenes a pesar de implicarse en conductas sexuales de riesgo. Es necesaria la realización de campañas de prevención dirigidas tanto a la población general como a las poblaciones clave, y considerar especialmente a la juventud.

ABSTRACT Objective To analyse sexual behaviour, HIV testing, HIV testing intentions and reasons for not testing for HIV in university students from Cuzco (Peru). Methods The sample comprised 1,377 university students from several institutions from Cuzco (Peru). The size of the sample was set according to a maximum 3% error estimation and a 97% confidence interval. Ages ranged from 16 to 30 years old. The data were collected through a self-administered, anonymous and voluntary questionnaire regarding sexual behaviour and HIV testing. The data were collected in classrooms during teaching hours. Results A higher percentage of males than females reported having had vaginal, anal and oral sex, a higher number of sexual partners and an earlier age at first vaginal and oral sex. A higher percentage of females than males did not use condoms when they first had anal sex and had a higher anal sex-risk index. Most of the participants had never been HIV tested. The main reason was that they were sure that they were not HIV infected. Conclusions It seems that there was a low HIV risk perception in these participants despite the fact that they had been involved in sexual risk behaviours. Prevention campaigns focused on the general population as well as the at-risk populations and young people are needed.

RESUMEN Objetivo El objetivo era analizar la conducta sexual, la realización de la prueba del virus de la inmunodeficiencia humana (VIH), las intenciones para hacérsela y los motivos para no realizársela en jóvenes estudiantes en la universidad en Cuzco (Perú). Método Participaron 1377 estudiantes universitarios/as de diversas instituciones de educación superior de Cuzco (Perú). El rango de edad era de 16 a 30 años. Se aplicó un cuestionario sobre conducta sexual y realización de la prueba del VIH. El tamaño de la muestra se estableció considerando un nivel de confianza del 97% y un error de estimación del 3%. El cuestionario se cumplimentó en las aulas durante las horas lectivas. Resultados Un mayor porcentaje de varones que de mujeres ha tenido sexo vaginal, anal y oral, un mayor número de parejas sexuales y un inicio a una edad más temprana en el sexo vaginal y oral. Un mayor porcentaje de mujeres que de varones no utilizó el preservativo en la primera relación sexual anal y tenía un mayor índice de riesgo anal. La mayoría de los/las jóvenes no se había realizado nunca la prueba del VIH. El principal motivo para no hacérsela era la seguridad de no estar infectados/as. Conclusiónes Parece existir una baja percepción de riesgo frente al VIH en los/las jóvenes a pesar de implicarse en conductas sexuales de riesgo. Es necesaria la realización de campañas de prevención dirigidas tanto a la población general como a las poblaciones clave, y considerar especialmente a la juventud.

Abstract The main objective of this study was to evaluate ex post facto resilience in persons with HIV infection and its relationship to socio-demographic and sexual behavior variables. Participants included 159 persons with HIV infection, of both sexes, aged between 19 and 55 years. Fifty-one percent of patients were infected through homosexual means. Sixty-seven percent were in the asymptomatic phase of infection. Assessment instruments used were the following: a questionnaire on socio-demographic data and sexual behavior and the Connor-Davidson Resilience Scale. The evaluation was individual, voluntary, and anonymous. The results showed that 49.05% of patients had average resilience, 27.68% had high resilience, and 23.37% had low resilience. They found that heterosexual patients infected with HIV, diagnosed between 1985 and 1990 (23 and 28 years of diagnosis) and those who had disclosed their HIV status to more than 30 people, had greater resilience than homosexual patients, diagnosed between 1996 and 2000 (13 and 17 years of diagnosis) and those who had disclosed their HIV status to 1–5 people. Finally, resilience was not a predictor of sexual risk factor. It is suggested that health interventions take into account the resilience and psychological variables that may be beneficial to improve coping with the disease.

La satisfacción sexual y las actitudes positivas hacia el uso del preservativo favorecen el uso del mismo. El objetivo general de este estudio es la evaluación y análisis de la relación entre la satisfacción sexual, las actitudes hacia el uso del preservativo y el uso del preservativo en adolescentes. Los participantes son 1504 adolescentes españoles escolarizados de ambos sexos (48.40% varones, 51.60% mujeres). Se trata de un estudio descriptivo de poblaciones mediante encuestas con muestras probabilísticas, de tipo transversal. En varones, una mayor actitud positiva hacia el uso del preservativo predice una mayor probabilidad de uso del mismo en la primera relación sexual vaginal y anal. La satisfacción sexual de la pareja predice una mayor probabilidad de uso del preservativo en la primera relación sexual oral, y la satisfacción sexual sobre la sintonía de la pareja se asocia con una menor probabilidad de uso del preservativo en la primera relación sexual oral. En mujeres, una mayor satisfacción sexual personal predice una mayor probabilidad de no haber utilizado el preservativo en la primera relación sexual vaginal. Además, en las mujeres, una mayor satisfacción sexual sobre la sintonía de la pareja incrementa las probabilidades de haber utilizado el preservativo en el debut sexual vaginal. Los porcentajes de varianza explicada son bajos. Se recomienda que en futuros estudios se analicen factores socioculturales relacionados con los roles de género que pudieran estar influyendo en las asociaciones entre la satisfacción sexual, las actitudes hacia el uso del preservativo y el riesgo sexual en adolescentes.

Sexual satisfaction and positive attitudes toward condom use promote its use. The main aim of this paper is to assess and analyze the relationship between sexual satisfaction, attitudes toward condom use, and condom use amongst adolescents. The participants were 1504 Spanish school adolescents of both sexes (48.40% male, 51.60% female). A descriptive study was conducted using cross-sectional surveys with probabilistic samples. An increased positive attitude towards condom use in males predicts higher likelihood of condom use in the first vaginal and anal intercourse. Partner sexual satisfaction predicts an increased likelihood of condom use in the first oral sexual intercourse. In addition, sexual satisfaction related to harmony with the partner is associated with a lower likelihood of condom use in the first oral sexual relationship. In females, greater personal sexual satisfaction predicts higher likelihood of not having used a condom in the first vaginal intercourse. Furthermore, higher sexual satisfaction in females - related to harmony with the partner - increased the likelihood of having used a condom during the first vaginal intercourse. The percentages of explained variance are low. It is recommended that future studies analyze sociocultural factors related to gender roles that may be influencing the associations between sexual satisfaction, attitudes toward condom use, and sexual risk amongst adolescents.

Background: There is a great regional heterogeneity in the prevalence of HIV/ AIDS. Aim: To analyze the current situation of HIV/AIDS in Latin America by means of a comparative analysis among countries. Material and Methods: In a descriptive study (document analysis), epidemiological data about HIV/AIDS in Latin America as well as population data were used. Prevalence indexes and the distribution of HIV/AIDS cases were compared according to gender, age and transmission mode. Results: Dominican Republic, Panama, El Salvador and Honduras are the countries with the highest prevalence indexes. Colombia is in the first position in percentage of young men with HIV/AIDS and it is in the second position in percentage of children. Costa Rica is the second country for percentage of young men and male adults infected with HIV/AIDS. Paraguay is in the second place for children with HIV/AIDS and it is the third country in young men living with HIV/AIDS. Dominican Republic is in the first position in the percentage of young and adult females living with HIV/AIDS. The main transmission mode in all Latin American countries is sexual intercourse (heterosexual and homo/bisexual). Conclusions: Latin America is a heterogeneous region in HIV/AIDS which should be considered in the development and establishment of prevention strategies.

El objetivo de este estudio fue evaluar algunas características de las conductas sexuales precoitales y el tipo de contacto sexual, en adolescentes españoles. Participó una muestra representativa de 4.456 estudiantes españoles de enseñanza secundaria obligatoria. Se administró un cuestionario sobre conducta sexual. Es un estudio transversal descriptivo de poblaciones, mediante encuestas con muestras probabilísticas. Los adolescentes fueron seleccionados mediante un muestreo aleatorio estratificado, en función del tipo de centro educativo y de la comunidad autónoma. En comparación con las mujeres, los varones comenzaron las experiencias sexuales sin penetración a una edad más temprana, tenían un mayor número de parejas y un mayor porcentaje de ellos manifestó tener parejas ocasionales. Este estudio no solo contribuye al conocimiento sobre la conducta sexual de los adolescentes antes del inicio de las relaciones sexuales con penetración, sino que en él se destaca la importancia de desarrollar estrategias de prevención sexual en los adolescentes.

The aim of this study was to examine characteristics of precoital sexual behaviors and types of sexual contact in adolescent. A representative sample of 4,456 Spanish high school students participated. These participants were selected by means of a stratified random sampling procedure. They completed a questionnaire about their sexual behaviour. It is a cross-sectional survey study. Differences according to age and gender in characteristics of sexual behaviour before the onset of sexual intercourse were found. Compared to females, males started non penetrative sexual experiences earlier, had a higher number of sexual partners and a higher percentage of males reported having had casual sexual partner. This study not only adds to knowledge about sexual behaviour before the initiation of sexual intercourse among adolescents, it also highlights the importance of developing sexual prevention strategies for young adolescents.

Background: The development of HIV and STD prevention programs needs information about sexual behaviour. The aim of this study is to analyze whether there were differences in HIV/STD risk behaviours according to type of high school (public/private), gender and age in adolescents. Methods: A representative sample of 4.456 adolescents participated. To select the participants, a stratified random sampling considering Spanish regions and type of high school was used. It is a cross-sectional survey study. Results: The percentage of adolescents that did not use condoms at first sexual intercourse was higher in private than in public high schools (χ² (1)=5,06; p=0,02). Adolescents who were between 17 and 18 years old had the highest percentage of non condom use at last sexual intercourse (χ² (2)= 6,90; p=0,03). A higher percentage of males than females had a casual partner at last sexual intercourse (χ² (1)=127,79; p=0,00). A higher number of adolescents of private high schools than adolescents of public high schools had used drugs at last sexual intercourse (χ² (1)=5,72; p=0,02), as well as males compared to females (χ² (1)=36,37; p=0,00). Conclusions: Differences in HIV risk behaviours according to sociodemographic variables are shown. Therefore, taking into account sociodemographic factors in sexual education programs focused on adolescents seems to be necessary.

Fundamento: Conocer las conductas sexuales es primordial para el desarrollo de programas de prevención del VIH y las ETS. El objetivo principal de este estudio es analizar si existen en adolescentes diferencias en conductas de riesgo para la infección por el VIH y las ETS de acuerdo al tipo de centro educativo (público/privado o concertado), el sexo y la edad. Métodos: Participaron 4.456 adolescentes. Se empleó un muestreo aleatorio estratificado con afijación proporcional siendo los estratos la comunidad autónoma y el tipo de centro educativo (público/privado o concertado). La muestra es representativa a nivel nacional con un nivel de confianza del 95,5%. Es un estudio descriptivo de poblaciones mediante encuestas con muestras probabilísticas de tipo transversal. Resultados: El porcentaje de adolescentes de centros privados que no utilizó el preservativo en la primera relación sexual era superior al de los adolescentes de centros públicos (X² (1)=5,06; p=0,02). Los adolescentes de entre 17 y 18 años eran los que informaron en mayor porcentaje que no utilizaron el preservativo en la última relación sexual (X² (2)= 6,90; p=0,03). Un mayor porcentaje de varones que de mujeres tuvo una pareja ocasional en la última relación sexual (X² (1)=127,79; p=0,00). Los adolescentes de centros privados informaron en mayor porcentaje que los adolescentes de centros públicos sobre el consumo de drogas en la última relación sexual (X² (1)=5,72; p=0,02) así como los varones en comparación con las mujeres (X² (1)=36,37; p=0,00). Conclusiones: Se muestran diferencias en conductas de riesgo para la infección por el VIH en función de variables sociodemográficas que hacen reflexionar sobre la necesidad de considerar estos aspectos en los programas de educación sexual dirigidos a adolescentes.

Background: The development of HIV and STD prevention programs needs information about sexual behaviour. The aim of this study is to analyze whether there were differences in HIV/STD risk behaviours according to type of high school (public/private), gender and age in adolescents. Methods: A representative sample of 4.456 adolescents participated. To select the participants, a stratified random sampling considering Spanish regions and type of high school was used. It is a cross-sectional survey study. Results: The percentage of adolescents that did not use condoms at first sexual intercourse was higher in private than in public high schools (χ² (1)=5,06; p=0,02). Adolescents who were between 17 and 18 years old had the highest percentage of non condom use at last sexual intercourse (χ² (2)= 6,90; p=0,03). A higher percentage of males than females had a casual partner at last sexual intercourse (χ² (1)=127,79; p=0,00). A higher number of adolescents of private high schools than adolescents of public high schools had used drugs at last sexual intercourse (χ² (1)=5,72; p=0,02), as well as males compared to females (χ² (1)=36,37; p=0,00). Conclusions: Differences in HIV risk behaviours according to sociodemographic variables are shown. Therefore, taking into account sociodemographic factors in sexual education programs focused on adolescents seems to be necessary.

Fundamento: Conocer las conductas sexuales es primordial para el desarrollo de programas de prevención del VIH y las ETS. El objetivo principal de este estudio es analizar si existen en adolescentes diferencias en conductas de riesgo para la infección por el VIH y las ETS de acuerdo al tipo de centro educativo (público/privado o concertado), el sexo y la edad. Métodos: Participaron 4.456 adolescentes. Se empleó un muestreo aleatorio estratificado con afijación proporcional siendo los estratos la comunidad autónoma y el tipo de centro educativo (público/privado o concertado). La muestra es representativa a nivel nacional con un nivel de confianza del 95,5%. Es un estudio descriptivo de poblaciones mediante encuestas con muestras probabilísticas de tipo transversal. Resultados: El porcentaje de adolescentes de centros privados que no utilizó el preservativo en la primera relación sexual era superior al de los adolescentes de centros públicos (X² (1)=5,06; p=0,02). Los adolescentes de entre 17 y 18 años eran los que informaron en mayor porcentaje que no utilizaron el preservativo en la última relación sexual (X² (2)= 6,90; p=0,03). Un mayor porcentaje de varones que de mujeres tuvo una pareja ocasional en la última relación sexual (X² (1)=127,79; p=0,00). Los adolescentes de centros privados informaron en mayor porcentaje que los adolescentes de centros públicos sobre el consumo de drogas en la última relación sexual (X² (1)=5,72; p=0,02) así como los varones en comparación con las mujeres (X² (1)=36,37; p=0,00). Conclusiones: Se muestran diferencias en conductas de riesgo para la infección por el VIH en función de variables sociodemográficas que hacen reflexionar sobre la necesidad de considerar estos aspectos en los programas de educación sexual dirigidos a adolescentes.

Summary Introduction. HIV infection is a chronic-character illness which implies a high level of uncertainty for patients. Indeed, HIV infection involves confronting an illness surrounded by social stigma and refusal. There following are some of the situations that suppose big emotional repercussions: When an individual does not know whether he/she is infected, when he/she receives HIV diagnosis, or when he/she must say to other people that he/ she is HIV positive. The emotional effects are depression, anxiety, and anger, which are frecuent emotional reactions among HIV infected patients. These reactions disappear when the patient adapts to his/her condition of HIV infected. Likewise, the uncertainty that produces HIV infection is related both to high levels of anxiety and depression because patients do not know how their infection will evolve. Anger and depression constitute other emotional factors related to a faster evolution of HIV infection. In addition to that, depression has effects over the fullfillment of the HIV infection treatment guidelines. Considering the importance of emotional aspects in HIV infection, this research's aims were to verify the differences in the sample of patients with HIV that has been evaluated regarding characteristics of depression, state of anxiety, state of anger, trait of anger, and expression of anger according to gender, stage of HIV infection, CD4 cells, viral load, transmission way, and the presence of lipodystrophy. Another aim was to verify if there were any differences between the sample of persons with HIV/AIDS that has been evaluated and the normative group in symptoms of depression, state of anxiety, state of anger, trait of anger, and expression of anger. Method. In the present research paticipated 100 HIV/AIDS-infected patients; 37 of them were women and 63 were men. The patients attended medical visits in different hospitals of Andalusia (Spain). The age rank of these patients was between 18 and 70 years. The average age was 39.55 years and the standard deviation was 7.49. The instruments used for the assessment were the Beck Depression Inventory (BDI), the subscale of state of anxiety of the State-Trait Anxiety Inventory (STAI), and the State-Trait Anger Expression Inventory (STAXI-2). The data were collected in three hospitals of the Andalusian region by the same investigator and the confidentiality of the data was guaranteed. Another information collected were clinical data of the patients from the case histories. The statistic program SPSS 11.0 was used for the analysis of the data. This study has an ex post facto retrospective design. Results. The results showed statistically significant differences in state of anxiety according to the viral load and lipodystrophy, with higher levels of state of anxiety in the group that had a halfway point in viral load and in the group that did not show lypodistrophy. On the other hand, there were statistically significant differences in the state of anger according to the stage of HIV infection, with higher levels of anger in the group that was in the symptomatic stage of HIV infection. In this study it has been found that most men with HIV/AIDS showed symptoms of depression that were between slight, moderate, and severe depression. In contrast, a big part of the group of women did not show characteristics of depression. With regard to anxiety, an important proportion of men showed a state of anxiety, while women did not show it in most cases. Most men and women presented a low level of state of anger. In the variable trait of anger, it has been found that approximately half of the men was in the normal rank. In the group of women, the majority was in the normal rank of trait of anger too. Finally, with regard to expression of anger, more of a third of the men and women with HIV/AIDS did not express anger. Discussion. The stage of the HIV infection could be a factor that explains the high presence of characteristics of depression in men. Women could have better ways to confront the illness than men. The high levels of depression symptoms and anxiety in the group of men could be explained by the ignorance about how the infection will evolve. Other results indicated that patients infected by heterosexual relationships showed higher anxiety than patients infected by the intravenous use of drugs. This fact could be explained by a higher presence of cognitions related to the evolution of the HIV infection or risk behaviors in people who were infected by heterosexual intercourse. Patients with a halfway point in viral load showed higher levels of state of anxiety and state of anger than patients with low viral load, because people with halfway point in viral load were more aware of the deterioration produced by the HIV infection and they did not assume it. The stage of HIV infection could be a factor that explains the higher levels of state of anger in patients in the symptomatic stage. The presence of lipodystrophy implies a deterioration of corporal image in patients that suffer this syndrome. It has been found that patients who did not have lipodystrophy showed higher levels of state of anxiety than the patients with lipodystrophy. This result is incongruent with other studies that have been made. It is suggested that this is an effect of a small sample. However, two explanations can be advanced about this result. On the one hand, lipodystrophy has nowadays a subjective diagnosis, and it could be the case that many patients’ lipodystrophy has not being diagnosed, when they actually have the syndrome. On the other, it has been observed that there are delays when the data related to lipodystrophy must be gathered in case histories and thus it is not known if a patient endures lipodystrophy exactly. It could be the case that a patient suffers lipodystrophy and this fact does not appear in the case history. Considering that depression and anxiety are frequent disorders in patients with HIV/AIDS and that these factors influence the immune system, the results obtained could be used for the design of intervention programs whose aims would be the assessment and the intervention of depression and anxiety. Some aspects which would be important to assess in future researches with HIV/AIDS patients are social support, levels of perceived stigma, and the perception of health control.

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