Medikamentenkonsum bei Studierenden

Im Rahmen der vorliegenden Studie wurde der Konsum verschiedener Medikamentengruppen, welche Abhängigkeiten hervorrufen oder potentiell missbräuchlich angewendet werden können, erhoben (Göbel, 2009). Im Folgenden wird der Medikamentenkonsum von Studierenden dargestellt und Zusammenhänge mit gesundheitlichen Beschwerden werden analysiert

Die gesundheitliche Situation von Pflegenden in der Bundesrepublik Deutschland: eine Auswertung des Lebenserwartungssurveys des BiB

In der Bundesrepublik Deutschland leben ungefähr zwei Millionen pflegebedürftige Personen. Davon werden 1,4 Millionen in Privathaushalten versorgt. Die überwiegende Mehrheit dieser Pflegebedürftigen wird nicht professionell, sondern von Familienangehörigen betreut; dabei stellt die Pflegesituation für diese pflegenden Familienangehörigen in der Regel eine Belastung dar, die negative emotional/psychische, soziale, finanzielle und körperliche Auswirkungen haben kann. Inwiefern die Gesundheit von pflegenden Angehörigen durch ihre Pflegetätigkeit beeinträchtig wird, ist Gegenstand dieser Analyse. Dazu werden im Folgenden die Probanden des Lebenserwartungssurveys 1998 des Bundesinstituts für Bevölkerungsforschung, die angaben, eine pflegebedürftige Person zu betreuen, näher untersucht. In einem ersten Schritt wird die Pflegesituation eingehender betrachtet, danach wird die Gruppe der Pflegenden anhand ihrer soziodemographischen Charakteristika beschrieben. Im Weiteren werden der gesundheitliche Zustand und das Gesundheitsverhalten anhand der vielfältigen dazu im Lebenserwartungssurvey erhobenen Variablen analysiert und auf Unterschiede zu einer nach Alter und Geschlecht parallelisierten Stichprobe von nichtpflegenden Probanden hin untersucht. Zusammenfassend wird festgestellt, dass der Gesundheitszustand von Pflegenden in der Bundesrepublik Deutschland tatsächlich schlechter ist als der von Personen, die keine Pflegetätigkeit ausüben. (ICA2

results from a cross-sectional internet survey

Background Recent evidence suggests that the majority of HIV transmissions among men who have sex with men (MSM) occur between steady partners. We sought to determine factors associated with HIV transmission risks in steady partnerships. Methods Data is from the German cross-sectional 2013 Gay Men and AIDS survey. The study population was HIV-negative or untested men reporting a steady partnership and at least one non-steady anal sex partner in the previous year. Bivariate and multivariate logistic regression was used to determine which of several independent variables best predicted both unprotected anal intercourse (UAI) with a non-steady partner and lack of HIV testing in the past year (high-risk outcome group). Results The study population consisted of 1731 men. Among individuals in the outcome group (n = 271), 67 % reported UAI with a non-steady partner of unknown status and 9 % reported UAI with a non-steady HIV-positive partner in the past 12 months; 55 % considered themselves to be at low risk for HIV acquisition. In multivariate analyses (n = 1304), participants were statistically more likely to belong to the outcome group if they reported UAI with their steady partner in the past year (OR = 2.21), did not know their steady partner’s HIV status (OR = 1.98), or agreed that condoms were disruptive during sex (OR = 3.82 (strongly agree), OR = 2.19 (agree)). Participants were less likely to belong to the outcome group if they were out to their primary doctor (OR = 0.54), were well-educated about post-exposure prophylaxis (OR = 0.46), had sought information on HIV in the past year and kept condoms in an accessible place (OR = 0.20), or believed that insisting on condoms would lead partners to assume they were HIV-negative (OR = 0.20). Participants in the outcome group were more likely to say they would use HIV home tests (OR = 1.58) or pre-exposure prophylaxis (OR = 2.11). Conclusions Based on our results, we reflect on HIV prevention measures that should be improved in order to better target behaviors that may lead to HIV transmission between MSM in steady relationships. In particular, we highlight the need for multifaceted interventions focusing not only on members of the at-risk community themselves, but on communities as a whole

Associations Between Experienced and Internalized HIV Stigma, Adversarial Growth, and Health Outcomes in a Nationwide Sample of People Aging with HIV in Germany

HIV-related stigmatization and adversarial growth are known to influence health outcomes in people living with HIV. But not much is known how these psychosocial factors are related to each other and how they interact to influence health outcomes. We tested whether the effect of experienced and internalized stigma on mental health and self-rated health is mediated by adversarial growth, and whether each of these factors is uniquely associated with health outcomes. In our sample of 839 people aging with HIV in Germany based on a cross-sectional study design we did not find an indirect effect of experienced HIV stigma on health outcomes and a very small indirect effect of internalized HIV stigma. All variables were significant predictors of health outcomes in multiple regression analyses

Increased incidence of syphilis in men who have sex with men and risk management strategies, Germany, 2015.

In Germany, the number of reported syphilis cases increased between 11% and 22% per year between 2010 and 2014. We analysed syphilis surveillance data and data of four behavioural surveys on men who have sex with men (MSM) in Germany (2003, 2007, 2010, 2013) to assess if this rise is ongoing and to find possible explanations for it. Syphilis notifications increased in 2015 by 19% to a total of 6,834. This was mainly due to increasing notifications in MSM of all age groups in larger German cities. Data from the behavioural surveys on MSM in Germany showed a simultaneous increase of selective condom use as HIV-status-bases risk management strategy and the number of syphilis cases. MSM diagnosed with HIV reported condomless anal intercourse with non-steady partners more frequent than MSM not diagnosed with HIV or untested for HIV, but the latter also reported higher frequencies of this behaviour in the more recent surveys. Transmission in HIV-positive MSM probably plays an important, but not exclusive role, for the syphilis dynamics in Germany. A risk adapted routine screening for sexually active MSM and potentially innovative approaches to increase early screening and treatment of syphilis such as internet counselling, home sampling, home testing and broadening venue-based (rapid) testing, should be critically evaluated to effectively reduce syphilis infections

an experimental study on the contribution of antiretroviral therapy to the destigmatisation of HIV/AIDS

Hintergrund Das zunehmende Wissen über die negativen individuellen und gesellschaftlichen Konsequenzen der Stigmatisierung von Menschen mit HIV/AIDS (PWA) führt in den letzten Jahren zu einer verstärkten Suche nach wirksamen Strategien zur Entstigmatisierung von HIV/AIDS. Ein aktueller Ansatz besteht in der Untersuchung des diesbezüglichen Potenzials der antiretroviralen Therapie (ART), die zu einem tief greifenden Wandel des Krankheitsbilds HIV/AIDS geführt hat. Bisherige Studien zu diesem Ansatz konzentrierten sich auf die Auswirkung des ART-bedingten veränderten Schweregrads von HIV auf HIV- Stigma, zeigen aber inkonsistente Ergebnisse. Eine effektive ART senkt auch die Viruslast und damit die Infektiosität einer Person mit HIV/AIDS (PWA). Auch diese verminderte Infektiosität kann zu einer Entstigmatisierung beitragen, wie theoretische und empirische Vorarbeiten zeigen. Methoden Um den Zusammenhang zwischen antiretroviraler Therapie, Viruslast, Infektiosität und Stigmatisierung zu untersuchen, wurde eine experimentelle Online-Studie durchgeführt. 752 Teilnehmer wurden zufällig entweder über den Zusammenhang zwischen Viruslast und Infektiosität aufgeklärt oder nicht. Soziale und intime/sexuelle Distanz gegenüber einer in einer Vignette beschriebenen PWA, die entweder eine hohe oder eine niedrige Viruslast aufwies, sowie instrumentelles und symbolisches Stigma wurden als abhängige Variablen erfasst. Vier Gruppen von Teilnehmern entstanden: IH (Information/hohe Viruslast), IN (Information/niedrige Viruslast), KH (keine Information/hohe Viruslast), KN (keine Information/niedrige Viruslast). Vier Hypothesen zu Mittelwertunterschiede zwischen den Gruppen wurden gebildet und anhand einfaktorieller Varianzanalysen mit Kontrasten geprüft. Ergebnisse Die soziale Distanzierung und das symbolische Stigma waren in der Stichprobe vergleichsweise gering, die intime/sexuelle Distanzierung und das instrumentelle Stigma hingegen stark ausgeprägt. Es fanden sich keine Effekte der Viruslasthöhe auf die soziale Distanz, instrumentelles und symbolisches Stigma. Intime/sexuelle Distanz war signifikant niedriger in der Gruppe IN im Vergleich zu der Gruppe IH sowie den Gruppen KH und KN. Unterschiede zwischen den Gruppen IH, KH und KN fanden sich nicht. Frauen zeigten eine geringere soziale Distanzierung, aber eine höhere intime/sexuelle Distanzierung als Männer. Nur für die Hälfte der Mitglieder der Gruppen IH und IN hat die Viruslasthöhe bei der Beantwortung der Stigma-Items eine Rolle gespielt. Zur Begründung wird auf ein Restrisiko verwiesen oder darauf, dass die Tatsache, dass eine HIV-Infektion vorlag, alle weiteren Aspekte ausgeblendet hat. Außerdem wurden explizite und implizite Zweifel am Informationstext geäußert. Schlussfolgerungen In dieser Studie konnte ein kausaler Effekt zwischen der Höhe der Viruslast einer PWA und dem Ausmaß der Stigmatisierung, die diese Person erfährt, demonstriert werden. Damit zeigt sich empirisch, dass die ART ein Potenzial für die Entstigmatisierung von HIV/AIDS besitzt.Background The increasing knowledge on the negative individual and societal consequences that stigmatization imposes on people living with HIV/AIDS (PWA), has recently led to an intensified search for effective strategies to destigmatize this disease. Since antiretroviral therapy (ART) has changed the picture of HIV/AIDS dramatically, the potential of ART in the destigmatization of HIV/AIDS has evolved as a current research approach. Hitherto studies focussed on the effect of the perception of a reduced severity of HIV after the introduction of ART, however these showed mixed results. Effective ART is also known to reduce the viral load and infectivity of PWA. Existing theoretical understandings and empirical research results conclude that perceived (sexual) infectivity can also predict the stigmatization of PWA. Methods In order to analyze the relationship between ART, viral load, infectivity and stigmatization, an online-experiment was conducted. 752 participants were either informed about the viral load-infectivity connection or not. A vignette-based description of a PWA with either a high or a low viral load was presented to the participants. Subsequently, measures of social and intimate/sexual distance as well as instrumental and symbolic stigmatization towards this PWA were assessed as dependent variables. Thus, participants were randomly assigned to one of four groups IH (information/high viral load), IN (information/low viral load), KH (no information/high viral load), KN (no information/low viral load). Four hypotheses regarding differences between group means were constructed and tested via ANOVA with contrast tests. Results Levels of social distance and symbolic stigma were low in this sample, while intimate/sexual distance and instrumental stigma were high. Height of viral load showed no effect on social distance, instrumental and symbolic stigma. Intimate/sexual distance was significantly lower in group IN compared to group IH, as well as compared to groups KH und KN. There were no mean differences observed between groups IH, KH und KN. Female participants showed lower social distancing but higher intimate/sexual distancing compared to male participants. Only half of the participants in groups IH and IN indicated that the height of the viral load influenced their answers to the stigma items. Negation of influence was explained by references to a remaining risk or the view that the pure existence of HIV suppressed all other arguments. Participants expressed explicit and implicit doubts regarding the information text. Conclusions This study provides experimental proof for the hypothesis, that the perception of a PWA’s viral load influences the stigmatization this person is subjected to. It can be concluded that ART holds a potential for the destigmatization of PWA

Recency and frequency of HIV testing among men who have sex with men in Germany and socio-demographic factors associated with testing behaviour

Background: Testing for presence of HIV infection is a pre-requisite to qualify for antiretroviral treatment. A considerable proportion of German men who have sex with men (MSM) infected with HIV have a CD4 cell count below 350 cells/μl at time of diagnosis and are thus defined as “late presenters”. Late presentation increases the risk of adverse disease outcomes. In addition, knowledge and assessment of HIV status is often used for decisions about condom use and anal intercourse with steady and non-steady partners. Incorrect assumptions may result in high risk for HIV transmission. Methods: Between 11/2013 and 01/2014 MSM were recruited to an online survey predominantly by personalized invitation messages from MSM social networking and dating websites. Respondents were asked about demographic characteristics, HIV testing history, reasons for testing decisions, and sexual behaviours. We describe reasons for not testing and analyse factors associated with not or infrequent testing using univariable and multivariable multinomial regression. Results: Questions on HIV testing history were answered by 15,297 respondents. An HIV test within the last 12 months was reported by 38 %, a test more than 12 months ago by 27 % and 35 % had never been tested for HIV. Compared to recently tested, respondents who had never tested were more likely to be younger than 25 years (adjusted relative risk ratio (aRRR) 2.90, 95 % CI 2.11-3.99), living in a settlement with less than 100,000 inhabitants (aRRR 1.47, 95 % CI 1.18-1.83), being less open about their sexual orientation to their co-workers/classmates, and particularly to their primary care provider (aRRR 4.54, 95 % CI 4.02-5.11). Untested and less frequently tested respondents reported less sex partners and a lower proportion reported unprotected anal intercourse (UAI) with a non-steady partner (24 % compared to 38 % among those recently tested). Conclusions: MSM who were younger, who did not live in large cities, and who were not out about their sexual orientation tested less frequently for HIV. Apart from strengthening protection from sexual orientation-related discrimination and empowering MSM who conceal their orientation, more opportunities to test anonymously and without revealing one’s sexual orientation should be provided

HIV risk perception and testing behaviours among men having sex with men (MSM) reporting potential transmission risks in the previous 12 months from a large online sample of MSM living in Germany

Abstract Background HIV testing and serostatus awareness are essential to implement biomedical strategies (treatment as prevention; oral chemoprophylaxis), and for effective serostatus-based behaviours (HIV serosorting; strategic positioning). The analysis focuses on the associations between reported sexual risks, the perceived risk for HIV infection, and HIV testing behaviour in order to identify the most relevant barriers for HIV test uptake among MSM living in Germany. Methods MSM were recruited to a nationwide anonymous online-survey in 2013 on MSM social networking/dating sites. Questions covered testing behaviours, reasons for testing decisions, and HIV risk perception (5-point scale). Additional questions addressed arguments in favour of home/ home collection testing (HT). Using descriptive statistics and logistic regression we compared men reporting recent HIV testing (RT; previous 12 month) with men never tested (NT) in a subsample not previously diagnosed with HIV and reporting ≥2 episodes of condomless anal intercourse (CLAI) with a non-steady partner of unknown HIV serostatus in the previous 12 months. Results The subsample consisted of 775 RT (13 % of RT) and 396 NT (7 % of NT). The number of CLAI episodes in the last 12 months with non-steady partners of unknown HIV status did not differ significantly between the groups, but RT reported significantly higher numbers of partners (>5 AI partners: 65 vs. 44 %). While perceived risks regarding last AI were comparable between the groups, 49vs. 30 % NT were <30 years, lived more often in towns/villages <100,000 residents (60 vs. 39 %), were less out-particularly towards care providers-about being attracted to men (aOR 10.1; 6.9–14.8), more often identified as bisexual (aOR 3.5; 2.5–4.8), and reported lower testing intentions (aOR 0.08; 0.06–0.11). Perceived risks (67 %) and routine testing (49 %) were the most common testing reasons for RT, while the strong belief not to be infected (59 %) and various worries (41 %) and fears of testing positive (35 %) were predominant reasons of NT. Greater anonymity (aOR 3.2; 2.4–4.4), less embarrassment, (aOR 2.8; 1.9–4.1), and avoiding discussions on sexual behaviour (aOR 1.6; 1.1–2.2) were emphasized in favour of HT by NT. Conclusions Perceived partner knowledge and reasons reflecting perceived gay- and HIV-related stigma predicted testing decisions rather than risk perception. Access barriers for testing should be further lowered, e.g. by making affordable HT available, addressing structural barriers (stigma), and emphasizing beneficial aspects of serostatus awareness