Joanne Otis

La 4e edition francaise du « Net Gay Barometre » (NGB) a interroge les HRSH utilisateurs sur leur sexualite, leur sante et la prevention. Cet article vise a dresser le portrait des repondants dont la consommation concerne des substances psychoactives associees au « chemsex ». Methode : Parmi les repondants du NGB (N.=17 385), 68,1 % ont rapporte avoir consomme, dans les 12 derniers mois, une ou plusieurs substances (alcool ou drogue), quel qu’en soit le contexte. Quatre categories de substances sont degagees par analyse factorielle : A (alcool et cannabis, pour 89,9 % de l’echantillon), B (Viagra/poppers, pour 58,1 %), C (cocaine, MDMA, GHB, ecstasy, amphetamines, ketamine, crystal et cathinones, pour 18,7 %) et D (crack, heroine et produits pharmacologiques, pour 7,3 %). Pour dresser un portrait des repondants qui consomment au moins une des substances de categorie C de maniere peu frequente ou plus regulierement, nous avons cree trois groupes a des fins d’analyse. Le premier group...

Basee sur les resultats du Net Gay Barometre quebecois cette l’etude vise a d’optimiser l’utilisation des donnees extraites du sondage pour soutenir les decisions et les actions dans la lutte contre le VIH et les ITSS aupres des hommes qui ont des relations sexuelles avec d’autres hommes au Quebec. Suite a diverses reunions et discussions sur la presentation thematique des resultats de l’enquete, nous avons effectue : un recodage de certaines donnees, une segmentation de l’echantillon complet selon le statut serologique. Le rapport general, en cours de redaction, suit les thematiques de l’enquete et presente les resultats par tranches d’âges pour les repondants seronegatifs et seroinconnus. Ces donnees permettront de produire une cartographie par region sociosanitaire. Ce rapport de 124 pages se trouvent divisees en deux parties : la premiere contraste les 3 475 participants de statut seronegatif et sero-inconnu selon quatre groupes d’âge d’appartenance (16-24 ans, 25-39 ans, 40-59 ...

We developed and validated a set of self-administered, multi-dimensional indicators of sexual health among Canadians aged 16-24 years. This study used a mixed-method qualitative and quantitative approach to develop and validate indicators of sexual health. We used the four-stage Dillman method to identify, focus-test, pilot-test, and validate key metrics to measure sexual health. We collected quantitative data to validate the measures through a computer-assisted self-interviewing program among a purposive sample of 1,158 people aged 16-24 years recruited from four Canadian provinces. The survey contained 75 items measuring five dimensions of sexual health: (1) physical, mental, emotional, and social well-being in relation to sexuality; (2) approach to sexuality; (3) sexual relationships; (4) sexual experiences; and (5) discrimination, coercion, and violence. Principal components analysis for composite measures found seven components with eigenvalues ≥1. The factor structure was stab...

Dans le cas de la transmission de la mère à l’enfant du VIH, l’un des principaux enjeux concerne le dévoilement du diagnostic aux jeunes infectés (Champion et al., 1999; Murphy et al., 2002; Wiener et al., 2007), qui pourrait être vécu comme un point de bifurcation biographique. L’objectif est d’explorer l’expérience du dévoilement du diagnostic du point de vue d’adolescents vivant avec le VIH depuis la naissance. Vingt-neuf jeunes (10-18 ans) VIH+ ont accordé une entrevue individuelle semi-dirigée portant sur le dévoilement du statut sérologique. Les données recueillies ont fait l’objet d’une analyse de contenu (Paillé et Mucchielli, 2005; Sabourin, 2008). Le dévoilement du statut sérologique s’inscrit dans une trajectoire en trois temps : 1) une réalité cachée où les adolescents ignorent leur statut sérologique; 2) une réalité enfin dévoilée où ils apprennent, vers l’âge de 11 ans, qu’ils sont infectés par le VIH et; 3) une réalité à intégrer progressivement où le dévoilement part...

The HIV infection of a family member can impact family quality of life (FQoL). The objectives of this study are to (1) describe patterns of FQoL among mothers living with HIV (MLHIV) and (2) identify key factors associated with FQoL in families affected by HIV. Recruitment took place in HIV-specialized clinics and community organizations. A 100 MLHIV and 67 of their children participated in this study. Mothers were on average 40.8 years old and reported having an average of two dependent children at home (M = 2.1, SD = 1.0). Participating children were 16.2 years old, on average. Half of the children were boys (50.8%). More than half were aware of their mother's positive HIV status (68.2%) and 19.7% were diagnosed with HIV. All HIV-positive children were aware of their status. A latent profile analysis was performed on the five continuous indicators of FQoL, and three main profiles of self-reported FQoL among MLHIV were established: high FQoL (33%), moderate FQoL (58%), and low FQoL (9%). Among the mothers' characteristics, education, physical functioning, social support, and resilience increased FQoL, while anxiety and irritability decreased FQoL. Among the children's characteristics, resilience followed the FQoL profile. A trend was observed toward children's greater awareness of the mother's HIV status in high and low FQoL profiles. Additionally, irritability tended to be higher within the lower FQoL profile. FQoL profiles can be used to identify families needing special care, particularly for family interventions with both parents and children. Other relevant indicators must be studied (e.g., closeness and support between family members, availability and accessibility of care, family structure, father-child relationships, and medical condition of the mother) and longitudinal research conducted to estimate the direction of causality between FQoL profile and individual family member characteristics.

Self-determination was examined as a protective factor against the detri-mental impact of negative life events on suicide ideation in adolescents. It is pos-tulated that for highly self-determined adolescents, negative life events have a weaker impact on both hopelessness and suicide ideation than for non-self-deter-mined adolescents. In turn, hopelessness is hypothesized to generate less suicide ideation for highly self-determined individuals. Results from multigroup analyses confirm that both the direct and indirect links between negative life events and suicide ideation were significantly weaker among participants high in self-deter-mination. The protective role of self-determination against negative life events is discussed. Adolescents represent the future of societies. The high prevalence of suicide and suicidal behavior among this population is therefore alarming. In a survey of 15,000 adolescents (12–17 year olds) in British Columbia, 16%

Au Quebec, 19 % des adolescents sont fumeurs, 23 % des enfants presentent un surplus de poids, trois jeunes sur cinq ne font pas suffisamment d'activite physique pour en obtenir des bienfaits et 15 % presentent des symptomes relies a des troubles de sante mentale. Constat alarmant ou defis motivants pour le milieu scolaire, a qui on a confie le mandat de l'education a la sante ? Au primaire, au secondaire, au collegial et a l'universite, des gens engages dans l'education a la sante ont developpe des outils, imagine des methodes et explore des pistes pour contribuer, selon leurs moyens, a l'education a la sante en milieu scolaire. Cet ouvrage collectif, qui presente leurs projets, leurs recherches et leurs reflexions, demontre l'importance de faire participer parents, eleves, personnel enseignant et non enseignant, et autres acteurs des milieux communautaire et de la sante publique. Les intervenants des milieux scolaires de tous les ordres d'enseignement y...

Contemporary studies have shown the existence of differences between men and women and ethnocultural groups on attitudes towards power relations in the sexual sphere sociosexual roles and the control of sexual drives. This study wanted to verify if these hypotheses are confirmed in the province of Quebec (Canada). Responses to a self-administered questionnaire of 114 Latin American respondents (59 men and 55 women) were compared to an equivalent number of Quebeckers enrolled in the same post-secondary schools in the Montreal area. An analysis of variance with two criteria of classification (gender and ethnocultural group) indicates significant differences between men and women on the three dimensions and one difference between groups towards equality in the sociosexual context. These data seem to question the existence of specific sexual scripts among young Latin-Americans adults which can help direct sexual education. (authors)

Pre-exposure prophylaxis (PrEP) became publicly available in Quebec for gay, bisexual and other men who have sex with men (GBM) in 2013. We used baseline data from Engage, a cohort of GBM recruited by respondent-driven sampling, to examine patterns of combination HIV prevention use among Montreal GBM since PrEP became available. Latent class analysis, stratified by HIV status, was used to categorize GBM by self-reported use of biomedical and behavioural prevention strategies. Correlates of resulting classes were identified using multinomial logistic regression. Among HIV-negative/unknown GBM (n = 968), we identified four classes: low use of prevention (32%), condoms (40%), seroadaptive behaviour (21%), and biomedical (including PrEP; 7%). Those using prevention (condoms, seroadaptive behaviour, and biomedical) had a higher number of anal sex partners and were more likely to report a recent sexually transmitted infection diagnosis. GBM using biomedical prevention also had a higher le...

The current study aimed to document intervention practices, challenges, and training needs concerning the intersections between HIV and intimate partner violence (IPV) among community service providers (n = 12). A direct content analysis using the Trauma-Informed Approach was performed. Results revealed that community service providers need to create a safe, trusting, and mutually collaborative environment in which the intersections between HIV and IPV trauma are recognized, screened, and discussed with women. These results also highlight the need to consolidate partnerships between HIV and IPV organizations to provide relevant services that consider traumatic experiences. Overall, these findings support the urgent need to develop, implement, and evaluate targeted community interventions that jointly address HIV and IPV.

The web currently offers a large spectrum of interactive tools enabling the dissemination of health-related messages aimed at prevention. The REZO programme, developed by the community-based organization Action Sero Zero (based in Montreal, Quebec), provides a good example of how the Internet can be used to promote healthcare and health promotion among sexually active male homosexuals in Quebec. A recent assessment of this program suggests that the organization appears to be meeting the challenge of adapting to an exponential increase of knowledge in the field of sexual health and health prevention as well as to rapid changes in communication technologies.

Background Blood donation policy in Canada for gay, bisexual and other men who have had sex with men (gbMSM) has changed progressively in the last decade from indefinite deferral to 3-month deferral from last male-to-male sex. Driven by safety data and overseen by the national regulator, more inclusive policies continue to redress the disparity in donation for gbMSM. At the same time, the need for source plasma to prepare fractionated blood products is growing worldwide. The collection and processing of source plasma ensures greater safety compared to whole blood donation with respect to transfusion-transmitted infection. This greater safety offers an opportunity to evolve policies for gbMSM from time-based to behaviour-based deferral using revised eligibility criteria. However, changing policies does not in itself necessarily guarantee that gbMSM will donate or that staff in donor clinics are ready to support them to do so. In anticipation of a move to behaviour-based donation scre...

An exciting new direction in HIV research is centered on using molecular phylogenetics to understand the social and behavioral drivers of HIV transmission. SPOT was an intervention designed to offer HIV point of care testing to men who have sex with men at a community-based site in Montreal, Canada; at the time of testing, a research questionnaire was also deployed to collect data on socio-demographic and behavioral characteristics of participating men. The men taking part in SPOT could be viewed, from the research perspective, as having been recruited via a convenience sample. Among men who were found to be HIV positive, phylogenetic cluster size was measured using a large cohort of HIV-positive individuals in the province of Quebec. The cluster size is likely subject to under-estimation. In this paper, we use SPOT data to evaluate the association between HIV transmission cluster size and the number of sex partners for MSM, after adjusting for the SPOT sampling scheme and correctin...

L’entraîneur de hockey est un acteur qui peut intervenir dans des actions de promotion de la santé. Son implication dans ce type d’action sera conditionnelle à la représentation sociale de ce groupe sur ce qu’est la santé. L’objectif de l’article est de documenter la représentation sociale (RS) de la santé d’entraîneurs de hockey, documenté et exploité dans le cadre d’un processus de légitimation des savoirs avec Hockey Québec. La méthodologie s’appuie sur un dispositif de triangulation des données obtenues par un questionnaire et des entrevues individuelles. Un échantillon de 330 personnes a répondu au questionnaire et de ce nombre, 12 entraîneurs ont participé aux entrevues. Des analyses catégorielles et prototypiques ont été réalisées sur des associations de mots tirés du questionnaire ainsi qu’une analyse thématique pour les entrevues. L’étude permet de faire ressortir la structure de la RS avec trois conceptions différentes et six dimensions qui offrent des éléments pour juger ...

Spot est une recherche-intervention qui a permis l’implantation d’un service de dépistage rapide du VIH dans la communauté gaie montréalaise. Afin de décrire le processus d’implantation de Spot et les facteurs contextuels qui l’ont affecté, une étude de cas a été menée. Les analyses qualitatives ont permis d’identifier un processus d’implantation en plusieurs phases, modulé par des facteurs liés aux motivations des acteurs à s’engager dans le projet, à la complexité des dynamiques partenariales, aux défis de la coordination en contexte de recherche-intervention multidisciplinaire et intersectorielle et à l’organisation de l’équipe terrain au quotidien.Spot is an intervention research project that led to the implementation of a community-based rapid HIV testing service in Montreal’s gay community. A case study was undertaken to describe the process through which Spot was implemented and the contextual factors that affected this process. Qualitative analysis allowed an implementation ...

The objective of this study was to assess the short-term effects of Gundo-So-a program aimed at empowering Malian women living with HIV (WLHIV) regarding serostatus disclosure management. A pre-experimental study with two measures (one week before and four weeks after Gundo-So) was carried out. A 35-item questionnaire was administered to a convenience sample of 210 WLHIV. Six outcomes were considered: ability to decide whether or not to disclose HIV status, self-efficacy to keep HIV status a secret, self-efficacy to disclose HIV status, feeling crushed by the weight of secrecy, perceived physical health, and perceived psychological health. For each outcome, temporal changes associated with the intervention were assessed using linear regressions with random intercepts. Statistically significant change was observed for all six outcomes between the pre- and post-intervention measures. Furthermore, several variables were associated with the baseline levels of the outcomes and the intervention effect. The results suggest that Gundo-So empowers Malian WLHIV with regard to serostatus disclosure management, thus improving their perceived physical and psychological health. These results highlight the need for programs to empower WLHIV regarding serostatus disclosure, so that WLHIV can make free and informed decisions regarding serostatus disclosure.

This study explores how family, secrecy and silence contribute to the adoption of stigma management strategies among youth with perinatally acquired HIV (PAHIV). A qualitative method was used. Eighteen youths with PAHIV aged 13-22 years old took part in a semi-structured interview. An exploratory content analysis was performed. Analyses of interviews allowed identification of two HIV stigma management trajectories, both sensitive to the family context: [1] a consolidation of family ties, which contributes to solidarity in stigma management; and [2] a weakening or dissolution of family ties, which contributes to solitary stigma management strategy. Family conditions that support the children in their efforts to develop active stigma management strategies are described. Children likely to experience weakening or dissolution family ties must build strong bonds in the clinical environment and maintain these into adulthood so as to afford them the support they need.

The level of implementation, degree of program satisfaction and effectiveness of an AIDS peer education program on multiethnic adolescents attending an urban high school in Quebec, Canada were examined. Two 50-minute sessions were presented to four classes of secondary three students (ages 14-15 years) by well-trained peers. The pretest and posttests were administered three weeks apart. Peer educators presented 62%-89% of the content planned and respondents were highly satisfied with the program. When one class of students was excluded because of disruptions during the intervention, the intervention group had more positive attitudes toward abstinence and condom use, particularly the cognitive component related to condom use, and was more likely to intend to use condoms when the female partner takes oral contraceplives than the comparison group. Short-term results sussest this well-implemented program had a positive effect on attitudes and intentions associated with AIDS prevention.

The present study aimed to identify social and individual factors associated with satisfaction with sexual life (SSL) in people living with HIV (PLHIV) in contact with a community-based organisation in Romania. A standardised questionnaire was administered (N = 300) in a community-based research study. Multivariate analysis (using a weighted logistic regression restricted to the 291 respondents who answered a question about SSL) was used to determine factors associated with SSL. Sixty-eight per cent of the participants declared that they were satisfied with their sexual life. The following individual factors were associated with SSL: being over 36 years old (Odds Ratio [95% CI]: 0.27 [0.13-0.55]), having ceased sexual intercourse because of HIV (0.33 [0.14-0.76]), not knowing how infection had occurred (0.29 [0.15-0.59]), being officially registered with a level of disability lower than "severe" (0.47 [0.23-0.98]) and having a higher self-efficacy score (1.36 [1.14-1.61]). Living in a couple (7.60 [3.69-15.66]), knowing at least one HIV-infected person who had publicly disclosed his/her seropositivity (2.23 [1.03-4.84]), and having a higher social exclusion score (0.91 [0.82-1]) were social factors associated with SSL. The results suggest that HIV service providers must be sensitised to the necessity of systematically including the topic of PLHIV SSL in field interventions. Self-empowerment, positive examples of public disclosure, promoting the benefits of living in a couple, and supporting social integration can all improve the well-being of PLHIV, including their SSL.

Objectifs : Décrire les comportements sexuels à risque chez les jeunes admis dans des centres jeunesse (CJ) du Québec selon leur niveau de consommation de substances psychoactives. Méthode : Entre juillet 2008 et mai 2009, une enquête de surveillance de deuxième génération a été menée auprès d’adolescents admis dans six centres jeunesse. Lors d’une entrevue face à face, ceux-ci ont rempli un questionnaire portant notamment sur leurs conduites sexuelles et leur consommation de substances psychoactives (au cours des 12 mois précédents l’admission en CJ). Un prélèvement urinaire a été recueilli afin d’estimer la prévalence de la chlamydiose et de l’infection gonococcique. Des analyses décrivant les comportements sexuels à risque selon le niveau de consommation (tel qu’établi par la grille DEP-ADO) ont été effectuées. Résultats: Parmi les participants âgés de 14 à 17 ans (n= 499, filles= 205 et garçons= 294), une forte proportion (60 %) a rapporté une consommation problématique de subst...

ABSTRACT Aim: The 2013 edition of the online French survey Net Gay Baromètre is compared to its 2009 edition on the main risk factors for HIV and HCV transmission according to HIV-status of respondents. The objective is to highlight the possible changes in the way these groups of respondents live their relation to prevention in the context of sexual intercourse with casual partners. Method / Issue: Net Gay Baromètre recruits respondents from gay dating sites representative of the diversity of sex cultures of MSM. The 2013 edition has expanded the population to the social networks as well as to the gay media this group was excluded from this analysis as to make the data comparable. Over 14,000 fully completed questionnaires were combined at the time of writing of this abstract and were compared with 17,500 questionnaires completed in 2009. The comparison is limited to respondents tested for HIV/AIDS and reporting at least one male casual sexual partner, meaning 8284 respondents in 2013 versus 14,909 in 2009. These respondents were divided into three groups: HIV-negative (HIV-), HIV-positive (HIV+) and unsure of still being HIV-negative (HIV?). The statistical significance of the differences between survey years is evaluated by Pearson?s chi-square analysis. Results / Comments: The analyses show a higher proportion in risk-taking for the 2013 survey, reflected in this sample of indicators: reports of regular unprotected anal sex are higher among HIV- respondents (12.9% vs. 24.4% p ≤ 0.001), HIV? respondents (32.0% vs. 48.9% p ≤ 0.001) as for HIV+ respondents (57.0% vs. 76.4% p ≤ 0.001). The declaration of unprotected anal intercourse with serodifferent partners or partners of unknown HIV status is higher among HIV- respondents (15.9% vs. 20.8%, p ≤ 0.001), HIV? respondents (61.7% vs. 72.3% p ≤ 0.001) and HIV+ respondents (73.4% vs 86.5% p ≤ 0.001). STIs are also more common among HIV- respondents (6.8% vs. 19.1% p ≤ 0.001), HIV? respondents (13.4% vs. 30.3% p ≤ 0.001) and HIV+ respondents (23.3% vs. 54.3% p ≤ 0.001) infection with hepatitis C follows this trend, for HIV- respondents (0.9% vs. 3.5% p ≤ 0.001), HIV? respondents (0.6% vs. 2.5% p ≤ 0.001) and among HIV+ respondents (7.8% vs 15.5% p ≤ 0.001). We also notice a higher proportion of declaration of marginal sexual practices in HIV- respondents (44.5 vs. 59.5 p ≤ 0.001), HIV? respondents (55.7% vs. 71.3% p ≤ 0.001) and HIV+ respondents (76.3% vs. 82.7% p ≤ 0.001). Consumption of sex drugs (poppers, cocaine, GHB and viagra) is also higher among HIV- (41.4% vs. 48.0% p ≤ 0.001), HIV? respondents (57.8% vs. 66.1% p ≤ 0.001) and HIV+ respondents (76.6% vs 84.7% p ≤ 0.001). Discussion: The consistent and nearly systematic trend toward an increase in all types of risk factors, regardless of the HIV status of respondents, points to issues with regards to prevention that stakeholders and community leaders must address. Indeed, in a convincing manner, these results challenge the discourses and predominant prevention practices promoted in recent years, and probably the underestimation of the consequences of seroconversion on quality of life.

To describe the profile of people living with HIV/AIDS (PLHA) who contact HIV/AIDS associations in Ecuador and to identify the factors related to that contact. In 2011, a cross-sectional community study was conducted in two hospitals in Guayaquil. Based on a 125-question survey administered to 300 adult PLHA, a weighted multivariate regression analysis was performed to identify the factors related to contact with an association Of the 300 participants, 34 (11.3%) were in contact with an association. Being over the age of 35, scoring high on the self-efficacy scale, having suffered serious social consequences after disclosing their HIV status, being able to talk to friends about living with HIV, expressing the need to talk about living with HIV with a health professional, and scoring low on the index of the HIV status disclosure control effort were related to that contact. The characteristics of the PLHA in contact with an association were: being over the age of 35, having suffered s...

Introduction : Le VIH impacte la condition physique et psychosociale des PVVIH et peut compromettre l'estime de soi qui, liée à la santé globale, joue un rôle fondamental dans la dynamique adaptative de l´individu face à son environnement. L´objectif de ce travail était d'étudier les facteurs associés à l'estime de soi parmi des PVVIH au Maroc. Méthodes : Une enquête transversale a été menée, en 2011 auprès de 300 PVVIH bénéficiant des services de l´Association de Lutte Contre le Sida (ALCS) au Maroc et connaissant leur statut sérologique depuis au moins 6 mois. Une échelle d´estime de soi validée (alpha ordinal=0,88) a servi de variable dépendante dans un modèle de régression linéaire multiple. Résultats : Les facteurs positivement et indépendamment associés à l'estime de soi sont l'échelle de l'efficacité perçue du traitement (β=0,14 ; p=0,009), la satisfaction sexuelle (β =0,13 ; p=0,019) et l'orientation sexuelle (hétérosexuels vs autres orientations ...

ABSTRACT Failure to control HIV among men who have sex with men (MSM) in Montreal, Canada, (15% seroprevalence), despite widespread antiretroviral therapy coverage, has raised concerns about the effect of early-stage infection, which is frequently undiagnosed, on the size and duration of HIV outbreaks. We used viral phylogenetics to capture the underlying structure of MSM transmission networks (2002–12).

... que sumábamos un centenar 20 años después, en que el Ministerio de Educación y Ciencia ... las que organizaba el equipo del Dr. Salgado en el Hospital Central de la Cruz Roja de ... habían aceptado una reali-dad que la sociedad y las ciencias habían admitido hace años. ...

Cette étude vise à examiner les pratiques pédagogiques d’éducateurs physiques afin de mieux comprendre comment s’opérationnalise l’inclusion de l’éducation à la santé en éducation physique. La méthodologie relève de l’étude de cas multiples faisant référence à 10 enseignants et combinant plusieurs méthodes de cueillette de données pour chacun des cas, à savoir un questionnaire auto-administré, de l’observation en différé et une entrevue semi-dirigée. L’examen des caractéristiques des pratiques pédagogiques des enseignants révèle qu’elles constituent une juxtaposition entre le champ disciplinaire de l’éducation à la santé et celui de l’éducation physique, plutôt qu’un véritable processus d’intégration des cadres théoriques et des pratiques propres à l’éducation à la santé.