Rabu, 26 Desember 2007

Kanker Paru & Rokok

Tentang Kanker
Anak-anak yang lahir tahun 1985, diperkirakan sepertiganya akan pernah menderita kanker, dan kira-kira seperempatnya akan meninggal karena kanker. Kita semua memiliki keluarga atau teman yang mengidap kanker. Tabel berikut memaparkan jumlah pengidap kanker di US tahun 1993.

Kanker pembunuh terbesar, yaitu kanker paru-paru, membunuh hampir 90% penderitanya, atau hampir 30% dari seluruh kematian akibat kanker. Namun sesungguhnya justru kanker paru-parulah yang paling mudah dicegah. Surver dalam beberapa dekade menunjukkan bahwa satu-satunya penyebab mayoritas kanker paru-paru adalah asap rokok.

Karsinogen
Zat-zat karsinogen (pemicu kanker) yang terkandung pada rokok adalah:
vinyl chloride
benzo (a) pyrenes
nitroso-nor-nicotine
Satu-satunya zat yang lebih berbahaya daripada asap rokok dalam memicu kanker paru-paru adalah zat-zat radioaktif. Itu pun jika dimakan atau dihidap dalam kadar yang cukup.

Efek Kanker Paru-Paru
Gambar di bawah menunjukkan paru-paru yang dirusak oleh kanker. Gambar di kanan (diperbesar) menunjukkan alveoli yang terkena kanker.

Kematian umumnya bukan terjadi karena kesulitan bernafas yang diakibatkan oleh membesarnya kanker, tetapi karena posisi paru-paru dalam sistem peredaran darah menjadikan kanker mudah menyebar ke seluruh tubuh. Penyebaran metastase ke arah otak dan bagian kritis lainnya lah yang mengakibatkan kematian itu. 90% penderita meninggal dalam 3 tahun setelah diagnosis.

Korelasi Dengan Rokok
Industri rokok menganggap bahwa kaitan antara jumlah penderita kanker paru-paru dengan tingginya konsumsi rokok hanay merupakan kebetulan. Namun grafik-grafik di bawah, dari berbagai penelitian menunjukkan korelasi yang sangat positif dan sangat konsisten bahwa satu-satunya penyebab kanker paru-paru secara umum adalah konsumsi rokok.

ROKOK BIKIN Hidup LEBIH REDUP !!

FOR BETTER GENERATIONS

Awas, Rokok Bisa Rusak Sperma !!

Punya teman atau pacar yang ga bisa lepas dari rokok?


Ga tahu lagi bagaimana cara menghentikan kebiasaan buruk mereka?


Bagaimana jika Anda mulai mengatakan pada mereka bahwa rokok bisa menurunkan kualitas sperma bahkan merusak sperma.Sebuah penelitian terbaru yang dilakukan ilmuwan Kanada menyebutkan satu lagi alasan untuk tidak merokok, karena rokok terbukti bisa merusak sperma dan mewariskan kerusakan genetik dari seorang ayah ke anaknya.

Seperti dilansir dari Reuters, Minggu (03/06), studi yang dilakukan pada tikus ini menunjukkan bahwa rokok menyebabkan perubahan DNA pada sel sperma, di mana mutasi seperti itu diketahui bersifat permanen."

"Jika diwariskan, mutasi ini menunjukkan perubahan yang tidak dapat dikembalikan seperti semula dari komposisi genetiknya," jelas Carole Yauk dari Divisi Penanganan Racun dan Kesehatan Lingkungan Kanada, yang memimpin penelitian."Sebelumnya telah diketahui bahwa ibu hamil yang merokok bisa mencederai janin yang dikandungnya, dan di sini kami menunjukkan fakta bahwa seorang ayah pun secara potensial bisa merusak calon penerusnya bahkan sebelum bertemu pasangannya," tambah Yauk yang menulis hasil penelitiannya di Jurnal Penelitian Kanker.Yauk dan rekannya meneliti sel yang memproduksi sperma tikus yang secara kontinyu dipapar dengan asap rokok selama enam atau 12 minggu, dan seluruh mamalia terus melanjutkan memproduksi sperma.Hasilnya, mereka menemukan bahwa terjadi mutasi sebanyak 1,7 kali pada sel DNA tikus yang terpapar asap rokok dibandingkan pada tikus yang tidak terpapar asap rokok setelah 12 minggu, dan 1,4 kali mutasi setelah enam minggu."

Kesimpulan ini menunjukkan bahwa kerusakan tergantung pada lamanya durasi terpapar asap rokok, jadi semakin lama Anda merokok maka akumulasi mutasi akan makin besar dan makin besar potensi dampaknya pada sel sperma Anda," terang Yauk.Dalam sebuah penelitian lain juga menyebutkan hampir sebagian besar pria yang menjalani program bayi tabung adalah perokok. Lebih dari itu, studi juga mencatat bahwa suami perokok memiliki kemampuan lebih rendah untuk menghamili isterinya daripada suami yang tak merokok.



Karakteristik Perokok

Perokok awet muda, karena sebelum tua sudah pada mati.
Perokok rumahnya aman, karena tiap malam batuk melulu.
Perokok paling dermawan, karena rajin nyumbang ke dokter dan rumah sakit untuk pengobatan paru-paru, jantung, ginjal, dan lain-lain.


Perokok mempunyai musik seumur hidupnya (suara nafasnya ngik-ngiiik).
Perokok hidup bebas, nggak pernah baca doa sebelum ngerokok.
Perokok membuat suasana bioskop lebih rame. Yang tadinya full-ac, jadi full-asep.



Racun pada Rokok
Rokok mengandung kurang lebih 4000 elemen-elemen, dan setidaknya 200 diantaranya dinyatakan berbahaya bagi kesehatan. Racun utama pada rokok adalah tar, nikotin, dan karbon monoksida.
Tar adalah substansi hidrokarbon yang bersifat lengket dan menempel pada paru-paru.
Nikotin adalah zat adiktif yang mempengaruhi syaraf dan peredaran darah. Zat ini bersifat karsinogen, dan mampu memicu kanker paru-paru yang mematikan.
Karbon monoksida adalah zat yang mengikat hemoglobin dalam darah, membuat darah tidak mampu mengikat oksigen.

Efek Racun
Efek racun pada rokok ini membuat pengisap asap rokok mengalami resiko (dibanding yang tidak mengisap asap rokok):
14x menderita kanker paru-paru, mulut, dan tenggorokan
4x menderita kanker esophagus
2x kanker kandung kemih
2x serangan jantung
Rokok juga meningkatkan resiko kefatalan bagi penderita pneumonia dan gagal jantung, serta tekanan darah tinggi.

Batas Aman
Menggunakan rokok dengan kadar nikotin rendah tidak akan membantu, karena untuk mengikuti kebutuhan akan zat adiktif itu, perokok cenderung menyedot asap rokok secara lebih keras, lebih dalam, dan lebih lama.
TIDAK ADA BATAS AMAN BAGI ORANG YANG TERPAPAR ASAP ROKOK.


Nah, bagaimana dengan Anda?

Masihkah menjadikan rokok salah satu bagian dari gaya hidup Anda, atau sudah mulai berpikir untuk berhenti merokok?

Hidup adalah pilihan sayangi rokok dan menuai badai atau .....
jika Anda sayang kesehatan, ayo berhenti merokok sekarang juga!

Karena kontrol ada pada anda tidak rokok yang mengendalikan anda, setuju?!

Rokok Bikin Hidup Lebih Redup :(

Situasi Kasus AIDS


Kumulatif Kasus AIDS sd 30 September 2007


Sampai dengan 30 September 2007 secara kumulatif jumlah kasus AIDS yang dilaporkan adalah sebagai berikut :


Kasus AIDS : 10384

Provinsi yang melaporkan AIDS 32 provinsi

Kabupaten/Kota yang melaporkan AIDS 186 kab/kota


Pada triwulan ini terdapat 8 kab/kota baru yang melaporkan kasus AIDS, yaitu Kabupaten Bengkalis (Riau), Kabupaten Bogor, Kota Depok dan Kota Banjar (Jawa Barat), Kota Probolinggo (Jawa Timur), Kota Tarakan (Kalimantan Timur), Kabupaten Muna (Sulawesi Tenggara) Kabupaten Seram Bagian Barat (Maluku).


Ratio kasus AIDS antara laki-laki dan perempuan adalah 4,07:1.
Kasus AIDS terbanyak dilaporkan dari DKI Jakarta, Jawa Barat, Papua,Jawa Timur, Bali, Kalimantan Barat, Sumatera Utara, Jawa Tengah, Kepulauan Riau, dan Riau.


Rate kumulatif kasus AIDS Nasional sampai dengan 30 September 2007 adalah 4,57 per 100.000 penduduk (revisi berdasarkan data BPS 2005, jumlah penduduk Indonesia 227.132.350 jiwa).


Rate kumulatif kasus AIDS tertinggi dilaporkan dari provinsi Papua (15,1 kali angka nasional), DKI Jakarta (6,8 kali angka nasional), Kep. Riau (4,3 kali angka nasional), Bali (3,9 kali angka nasional), Kalimantan Barat (3 kali angka nasional), Maluku (2,5 kali angka nasional), Papua Barat (2,2 kali angka nasional), Bangka Belitung (1,4 kali angka nasional), dan Sulawesi Utara (1,2 kali angka nasional).


Cara penularan kasus AIDS kumulatif yang dilaporkan melalui IDU 49,5%, Heteroseksual 42%, dan Homoseksual 4%.


Proporsi kumulatif kasus AIDS tertinggi dilaporkan pada kelompok

umur 20-29 tahun (53,80%),

umur 30-39 tahun (27,99%)

umur 40-49 tahun (8,19%).


Proporsi kasus AIDS yang dilaporkan telah meninggal adalah 22,02%.
Infeksi oportunistik yang terbanyak dilaporkan adalah :
o TBC : 5327
o Diare kronis : 3301
o Kandidiasis oro-faringeal : 3097
o Dermatitis generalisata : 872
o Limfadenopati generalisata : 478

Changes in Female Student Sexual Behaviour




RACHEL FARROW & PAUL ARNOLD
ABSTRACT This study examines how female university students’ sexual behaviour
changes in the transitional stage of leaving home for university. Participants (n273)
were asked to rate how much change they had experienced in their sexual behaviour since
arriving on campus, and to describe this change. A Likert scale was used to measure
change. The most prevalent response indicated that 41 per cent of participants experienced
‘no change’. This was supported by a mean score of 4.07. However, 56 per cent
of participants reported some degree of change in their sexual behaviour since beginning
university. Nineteen per cent of participants experienced a decrease in change while 37
per cent experienced some degree of increase to their sexual behaviour. A thematic
analysis found emerging patterns of behaviour change. The use of alcohol to reduce
inhibitions was common and often associated with risk taking. Many changes were due
to the absence of parental guidance, newly found freedom and greater choice of potential
partners. Implications for a university’s role in sex education and support services
during university are discussed.



Introduction
The transition to university can affect many relationship and health issues, some
of which have been well studied—for example, parent–student relationships
(Wintre & Yaffe, 2000), mental health (Fisher & Hood, 1987) and lifestyle
adjustment (Larose & Boivin, 1998). Sexual development in adolescence and the
transition from celibacy to sexual activity has also been the focus of studies
(Graber et al., 1996; Brooks-Gunn & Paikoff, 1997). However, research has not
focused on how adjustment to a new university lifestyle might affect sexual
behaviour at the time of transition to university, despite going to university
being a major life-changing event that has an important role in the social and
educational development of young people.
It would be important to do so because, in order to prevent sexual risk taking,
we need to increase our understanding of what sex means to young people and
under what circumstances sex changes for them. Developmental psychologists
may argue that the onset of sexual behaviour occurs naturally when an individual
reaches a stage of maturity. However, it is argued here that the onset of this
stage may be significantly affected by external influences, such as peer group
pressure and a student lifestyle, to the extent that intimate sexual behaviours
may develop quicker than if the young woman stays in the family home, where
Rachel Farrow & Paul Arnold, University of Manchester, Department of Psychology, Oxford Road, Manchester
M13 9PL, UK. Email: racheljfarrow@btinternet.com
ISSN 1367–6261 print/1469-9680 online/03/040339-17  2003 Taylor & Francis Ltd
DOI: 10.1080/1367626032000162087
340 R. Farrow & P. Arnold
she may be more carefully supervised. This could lead to sexual activity
occurring before women are sexually mature or emotionally ready for such an
important event. The present research investigated such patterns of sexual
behaviour change in British women attending British universities. The majority
were white, sexually active young women aged 18–24 years.



Adjustment to University
Adjustment to change can have profound affects on a young person’s mental
health and academic achievement. For those with high expectations of the
university experience, better adjustment during the four years of university was
achieved. Those who were fearfulness of the transition reported more stress,
depression, and worse adjustment (Jackson et al., 2000). Parental relationships
and personality traits were dependant factors affecting university adjustment,
accounting for 35 per cent and 56 per cent of the variation (Wintre & Sugar,
2000). Intervention programmes such as those reported by Jackson et al. (2000)
have the potential to reduce depression and facilitate adjustment. Jackson et al.
(2000) reported those in the intervention group, covering the start to the middle
of the first year of university, showed better adjustment and fewer behavioural
problems. They were less likely to smoke or skip classes, and women were also
less likely to be depressed. Females also reported higher levels of social support
than those not participating in the intervention. Halamandaris & Power (1999)
also found psychosocial adjustment to university life was negatively affected by
dysfunctional attitudes.



Sexual Risk Taking
Brown & Minichiello (1994) investigated the interpersonal nature of young
people’s sexual relationships and condom use. They found young people to be
aware of the need for condoms in response to extensive health campaigning.
However, prevailing attitudes suggest that the need is not always strong enough
to result in use. Condoms are considered essential for protection against pregnancy
and infection but also a little awkward and annoying. Despite their
importance being socially recognized, studies showed that condoms were (and
still are) inconsistently used (for example, Dunne et al., 1993).
Moore et al. (1996) suggest that young people’s condom use is predominantly
influenced by situations within sexual encounters, such as high arousal, alcohol
or drug use, or partner reluctance; or judgements about partners and/or the
sexual situation.



Gender Effects
It seems that women are particularly likely to trust partners altering their risk
perception and consequent risk behaviour (Rosenthal & Moore, 1993). Men are
less concerned about their sexual reputations, while women still worry about
socially acceptable behaviour. Assuming that attitudes have not changed drastically
over the past few years, in casual affairs, women have been shown likely
to evaluate an encounter as more meaningful and long-term than men might,
and therefore interpret it as less risky. There is also a common belief that by
having regular partners health risks are limited (Rosenthal et al., 1990).



Student Sexual Behaviour 341
Galligan & Terry (1993) identified male and female narratives that suggested
emotional concerns largely determined condom use. The sense of intimacy and
‘flow of the moment’ was destroyed by having to put on a condom. Complaints
were made that condoms ‘would make sex seem more like a business contract
rather than a spontaneous affectionate act’ (Moore et al., 1996, p. 74). Once
commitment and trust has been established in a relationship, the need for
condoms appears less. Couples begin to use oral contraceptives and place more
importance in protecting themselves from pregnancy than infection. Gurien
(1994) noted that couples talk far more about pregnancy risks than infection.
Sobo’s (1995) research suggested that women feared the connotations of disease
and promiscuity that come with requesting a condom.



Cultural Effects
Sexual equality in this age group has resulted in the convergence of male and
female sexual attitudes and behaviours.
Rigby (1990) showed that cultural group membership affected the intention to
use condoms. Black and Hispanic males in the United States were found to
remain unprotected, although overall protective behaviours among all cultural
groups of teenagers had increased (Sonenstein et al., 1998).
Cultural comparisons show that both Western and Eastern culture have
evidence of optimism bias among society members. However, there is a greater
belief in self-control factors in Western society.
Pregnancy in adolescence may be perceived as unwanted and unintentional to
adults but may in fact be a choice that many young women make. Different
ethnic groups hold distinct cultural beliefs and value pregnancy differently,
which influences motivations for childbearing. Likewise economic opportunities
within social classes had a predictable effect on young women’s goals and
motivations (Adler & Tschann, 1993). In terms of a cost–benefit analysis, young
women with lower academic expectations did not consider there to be much loss
to their academic achievements when becoming pregnant. Adolescents from
lower socio-economic backgrounds, with lower academic ability, or who reside
with a single parent were more willing to consider non-marital pregnancy
(Abrahamse et al., 1988). Cultural values showed that adolescent pregnancy was
likely to occur most (because of its cultural acceptability) in young Black groups,
and then in Hispanic groups at a slightly older age. There were more pregnancies
in these two groups than in white groups, whom usually favoured later
childbearing or use the alternative of abortion. Asian young women valued a
delayed pregnancy and showed inconclusive evidence about their acceptance of
abortion. Cultural values such as these influence motivation to get pregnant or
to stay pregnant.



Social Factors
Leaving home for the first time can be an exciting and a worrying time for
teenagers. Holmstrom et al. (1998) found that as senior high school students
approached the time to leave home they experienced simultaneous longing and
fear about their pending separation. The adjustment to a new lifestyle with more
freedom can be unsettling and difficult for some; this is when problem
behaviours can arise.
342 R. Farrow & P. Arnold
During the transition, young people adopted behaviours synonymous with
students. They wore more casual dress, drank more alcohol and participated in
more social and sexual activities (Korte & Sylvester, 1982). Londono-Mcconnell
(1998) found that being female and of a younger college age was predictive of
having casual sex, numerous sexual partners, and sex under the influence of
alcohol and drugs. Unprotected intercourse was predicted by becoming intimate
early in a relationship. Good communication skills for discussing sexual history,
condom use and perceived peer sexual norms were imperative in student
safe-sex behaviours.
Teenage pregnancies have moved from a social norm to a more common delay
in childbearing of modern times. Reasons for such delay may be due to the
financial cost of having children, changing roles of women, loss of income when
giving up employment, women staying in education longer and marrying later
in life, and the greater availability of contraception (Spicker, 2002). Spicker
suggested that teenage pregnancy was more likely when these factors where less
applicable, accounting for the ‘apparent association of some social problems
with teenage pregnancy’.
Having successful relationships depends on a complex interaction of variables.
Vulnerability to loneliness, and a lack of intimate relationships once at university
accounted for high levels of self-criticism and low efficacy (Wiseman, 1997).
Self-criticism predicted a lack of frankness, sensitivity and trust with in an
intimate relationship. Self-criticism may develop from unrealistic expectations of
academic or social achievement, leaving the individual struggling to find the
right balance between personal relationships and academic success, resulting in
feelings of isolation, maladjustment and the potential to drop out of university
increases.
Women require a strong sense of self-efficacy to insist on safe sexual practices,
particularly condom use. Partner pressure to forgo condoms can be difficult to
stand up to when they fear rejection by someone they care about (Farrow, 2002).
A lack of efficacy may be enhanced by feelings of low self-worth, such as low
self-esteem or confidence with men. This experienced at such a transitional stage
while simultaneously dealing with other life-changes, as a result of leaving
home, can result in risky sexual behaviour. Moore et al (1996) suggested that
condom use was largely influenced by situations and judgements. Farrow (2002)
confirmed that partner reluctance and an increased sexual drive as result of
alcohol use influenced non-condom use. The National Union of Students have
reported that abortion rates increase as much as three-fold in the first couple of
months after ‘Fresher’s week’ at university, as female students find themselves
pregnant after not using condoms. This is often blamed on excessive alcohol use,
where both men and women are too drunk to consider the consequences of
unprotected sex.



Alcohol Use by Students and Women
Alcohol use is one factor that cannot be ignored when considering student
transitions to university. Current social trends show stereotyped ideas that a
student lifestyle involves promiscuous sex and heavy drinking, and this has in
fact become the accepted norm and even expected of both male and female
students in many Western countries. Increased alcohol consumption is causing
much concern on university campuses across Britain and America (Wechsler et
Student Sexual Behaviour 343
al., 1999; Webb et al., 1997, 1998). Binge drinking is recognized as one of the most
significant health risks to students and is cited as a potential cause of sexual risk
taking among adolescents (Flora & Thorensen, 1988). Alcohol can affect many
aspects of university life, and is considered an essential part of any university
experience. However, excessive use can limit academic success, strain relationships
and friendships and eventually have negative consequences for mental
health. Alcohol may also affect sexual choices such as partner, contraceptive use
and frequency of encounters.
Parks et al. (1998) reiterate that women’s alcohol drinking is on the increase,
with 90 per cent of college age women drinking alcohol, and a rise of 20 per cent
from less than 40 per cent to over 60 per cent of all women who consume alcohol
since World War 2. The increase can be attributed to the greater number of
women in the work force and the public acceptance of women drinking
(Johnson, 1982; Wilsnack et al., 1994). Like student drinkers, Celentano &
McQueen (1984) found that most women reported social reasons for drinking. In
line with the views of Alcohol Concern, women’s increased workload and
combining responsibilities of home and work is a common factor that contributes
to just over one in five women reporting they drink to escape their
problems (for a summary of alcohol’s relationship to stress, see Johnstone et al.,
1997).
In the present study the focus is the younger generations of alcohol users. It
is younger women (in particular university students) who are more likely than
older women to be excessive drinkers, because alcohol use features in their social
lives more. Bars are one of the most frequently used locations that young women
use to meet new friends and potential partners. College women are also more
likely to take more risks and have more sexual partners compared with older
women (Bowen & Michal-Johnson, 1995); therefore, it is important to isolate
them for specific study.



Conclusion



It is no surprise that sexual behaviour becomes more intimate with age and
maturity, that is just human nature. However, research does not often compare
sexual practices before, during and after attending university. Therefore, this
study aims to fill this gap to find out exactly how it changes, to what extent, and
what role going to university has on this. It will focus on characteristics
associated with a variety of degrees of sexual change. The study aims to identify
the factors involved in facilitating behaviour change and to gain greater understanding
of any sexual risk taking.
Sexual risk taking in the present study is defined as not using condoms with
new partners, having one-night stands, or sex without prior knowledge of a
partners sexual history.
Hypothesis
1. It is hypothesized that there will be evidence of change in young women
towards more liberal sexual attitudes, more frequent sexual activity and an
increased number of partners after transition to university.
2. Heavy alcohol use may significantly increase sexual risk taking in university
students.
344 R. Farrow & P. Arnold
3. Factors such as new personal freedom, social pressure to conform to peers
and social stereotypes might also contribute to behavioural change.



Method
Participants
Two hundred and seventy-three female participants were recruited (mean age
19.8 years). Participants were required to meet the criteria of being between 18
and 24 years old, heterosexual and sexually active during the past six months.
They were also all regular social alcohol drinkers (at the time the questionnaire
was completed).



Materials
The Sexual Behaviour and Alcohol Consumption Questionnaire (Farrow, 2002) was
used to ask participants about their personal details, alcohol consumption, and
sexual behaviour. Questions specifically relating to alcohol consumption were
taken with permission from an established questionnaire developed by Ruth
Engs (1990). Sexual behaviour questions were developed to meet the needs of
the study. Only the results detailing any changes to sexual behaviour since
arriving at university are discussed.



Procedure
As part of a larger study on alcohol use and sexual behaviour in young women,
a sample of British students were recruited using e-mail mailing lists and
requests for participants on student-orientated websites. Potential participants
were asked to take part in a study investigating student alcohol consumption
and sexual behaviour. Interested participants were directed to a website where
they were prompted to read information about the study and give their consent
before beginning the questionnaire (conforming to ethical requirements). Upon
completion, participants submitted their responses via the Internet.
Results were collated and checked for eligibility using the predetermined
criterion (detailed earlier). A total of 273 participants gave a rating for their
sexual behaviour change since beginning at university. Some participants provided
additional information about the changes they had experienced. These
written responses were used for thematic analysis.
The present study focuses on two questions in particular, which ask participants
to rate their sexual behaviour change since coming to university using a
Likert scale (where 1 corresponded to ‘decreased a lot’ and 7 to ‘increased a lot’).
Participants were given space to provide further details about the nature of the
change.



Results
Demographics
The majority of participants were White (92 per cent), aged 19 years (32
per cent), first-year students at British universities (34 per cent), living in
Halls of Residence (49 per cent), and belonging to a Christian religion (52 per
Student Sexual Behaviour 345
Table 1. Demographics of the international participants
Religious Year of Accommo- Behaviour
Ethnicity Age Religion activity study dation change
Mean 0.96 19.84 2.26 3.88 2.24 1.68 4.07
Mode White Church of First Halls of
British 19 years England Not at all year residence No change
Standard 1.31 1.48 1.46 1.37 1.20 0.82 1.71
deviation
cent) but practiced this ‘not at all’ (52 per cent). Table 1 presents the student’s
demographics.
Behaviour Change
The category with the greatest response, the mode, indicated that 41 per cent of
participants mostly experienced ‘no change’ (Fig. 1). However, 56 per cent of
participants reported some degree of change in their sexual behaviour since
beginning university. Nineteen per cent of participants experienced a decrease in
Figure 1. Sexual behaviour change at university.
346 R. Farrow & P. Arnold
Table 2. Descriptive statistics of sexual behaviour
change
Participants with
All participants additional response
n 273 138
Mode 4 4
Mean 4.07 4.43
Standard deviation 1.71 1.81
change while 37 per cent experienced some degree of increase to their sexual
behaviour.
When just those who answered the open-ended part of the question had their
sexual behaviour scores examined, the mode of the responses indicated that 26
per cent of participants experienced ‘no change’. In comparison with all participants,
74 per cent of participants who gave additional information experienced
some degree of change, 52 per cent of which experienced an increase in sexual
activity (see Table 2).
Fifty-one per cent of all participants (138 participants) gave additional information
(Table 2). The mean for those who gave extra detail increased to 4.43,
suggesting those who commented felt they had experienced an increase in
change to their sexual behaviour. The mode of change was the same for both
groups.



Thematic Analysis
It should be noted that the definitions of frequency and behaviour change are
those of the participants, no guidance was given, and it was left to them to
interpret whether they felt they had experienced change and to what degree.
Participants’ answers were collectively examined and eight topics were found
to be consistently used by participants to describe behaviour change patterns.
Relationship Status
With a long-term partner. When participants had moved away from the parental
home to go to university but continued with a long-term relationship they
enjoyed more personal freedom, leading to an increase in sexual activity.
Alternatively, the move caused a couple to see less of each other because of the
distance they were apart resulting in a drop in sexual activity.
‘I have a long-term boyfriend. I have been unfaithful to him once.’
‘Have had a boyfriend since being at university.’
‘Boyfriend back home who I’m faithful to so less sex!’
The participants who were in long-term relationships generally reported that
they had had only a few partners in their sexually active lives and were not
usually interested in leading a promiscuous lifestyle.
With a new partner. Some participants had developed relationships since starting
university. In these cases, the number of sexual partners is a little higher
Student Sexual Behaviour 347
than before but still quite low. These relationships can be more sexual from the
onset as there are no parental/opportunity issues to overcome.
‘Since coming to university I have found a boyfriend, I would no longer
consider a random sexual situation which I may have in the past.’
‘Since coming to university I broke up with my boyfriend back home
and now have a new boyfriend who is a lot more sexually active.’
Without a partner. Sexual encounters for those who were not in relationships at
the time of completing the questionnaire were more frequent. One participant
described how the temptation to ‘sleep around’ was great after splitting up with
her long-term boyfriend.
Conclusion. Whether in a relationship or not at the start of university can make
a difference to the amount of sexual activity a woman experiences. Those
developing new relationships appear to have the most change to their sexual
activities, as do those who date, but those who have continued existing relationships
generally experience less change.
Number of Sexual Partners
The obvious relationship between the increased number of partners and the
increased change suggests that the more times a person changes their partner,
the more likely it is they are experiencing a change from past behaviour.
Participants who have scored their sexual behaviour as ‘a great change’
reported as many as 30 new partners since beginning university.
‘My number of sexual partners would be on a slow but steady rise due
to the number of drunken nights students participate in.’
‘… Increased number of partners but this may also be due to a split
from my ex.’
For those with fewer partners, the majority of sexual encounters occur as part of
a relationship.
‘I have only ever entered into sexual activity with long-term partners.’
Good insight was given into the culture of sex at university. It seemed to echo
a sentiment that sex does not require a strong emotional bond and can exist
more for its physical rewards. There is less disapproval on campuses of ‘meaningless
sex’ that does not have to end in a relationship than perhaps might be
evident in the general public.
‘[There is] not so much stigma attached to one-night stands in [a]
campus environment.’
One-Night Stands
Participants did not disagree in principle with one-night stands. Many claimed
that they would not have even contemplated or done it before coming to
university. Perhaps exposure to a more liberal environment exposes them to
348 R. Farrow & P. Arnold
new possibilities, which suddenly appear more acceptable than back in their
home environment.
‘I never would have had a one-night stand before coming to university.
In fact I lost my virginity to a stranger on a drunken one-night stand
when I was 18.’
‘I’ve had about six one-night stands—two of which I had sex with.’
Some sought one-night stands intentionally because they were less emotionally
complicated and often thrilling.
‘It can be fun and exciting, sometimes more so than with a familiar
partner because of the added element of risk and danger.’
But often one-night stands were not premeditated and more likely the result of
too much to drink. Having a one-night stand is often a way to seek attention,
they can appear to be rebelling against their family or gain peer admiration.
However, whatever the motivation, only one participant who had engaged in
a one-night stand spoke of regret.
Sexual Involvement
‘Things move faster’. Sexual activities in a relationship developed from kissing to
intercourse much quicker for participants than it did when they were younger.
This may be because they are more comfortable getting physically involved at an
earlier stage in a relationship, reflecting sexual confidence.
‘Whenever I am involved in any sexual activity it tends to go further
since going to university.’
‘I am a bit more inclined to take things further with a partner (new or
otherwise).’
‘Going all the way’. Details about the types of sexual activities that participants
engaged in varied enormously. A lot of the sexual activity only involved ‘kissing
and petting’. But in most cases, however, participants suggested that they did
‘almost everything’. This suggests that most sexual acts occurred except penetration.
Participants also found themselves contemplating sexual behaviour that
they had not done before. For some this meant trying out new things, and for
others it meant having less sex.
‘We had sex after about a week, but we did pretty much everything else
on the first night.’
‘Before going to university I had never had sex and I thought I would
never get the opportunity to… I have now had sex with two people.’
‘Before university I’d only had sex once.’
Contraceptive Use
This subject is referred to as a concern and to report inconsistent use. Inconsistent
condom use is a risky practice as it can only take one time to get an STI
(sexually transmitted infection).
‘I have slept with eight people, not always with a condom…’
Student Sexual Behaviour 349
‘I am much more likely to have a one-night stand when drunk and also
worry less about the consequences of unprotected sex.’
However, some responsible contraceptive use was adopted: ‘even though we
were drunk I insisted we use a condom!’.
Personal Freedom
Parental supervision. There is often an increase in the quantity of personal
freedom that a person experiences when they leave home for university. The
reduction in parental supervision allows sexual activities to occur more often. It
can often lead to women having to learn to take responsibility for their own
behaviour, setting their own boundaries rather than those imposed by parents.
‘More freedom so have less reason to say no. I have my own place, so
more partners than if I lived at home.’
‘Have been able to do more than if I was at home. My parents are not
prudes, they just don’t encourage sex before marriage.’
Preference for relationships
Participants suggested that they felt that they preferred to engage in sexual
encounters as part of a relationship rather than as chance encounters. When a
young woman becomes sexually active perhaps she is more likely to make
uninformed or irrational sexual choices, but as she matures sexually she is able
to decide what she wants and has the emotional strength to stand by it.
‘I feel more comfortable in a relationship, I would sleep with someone
if I knew them well enough, and I knew they weren’t just sleeping with
me for sex, need the emotional side that goes with it.’
‘I would definitely say that I prefer not to have one-night stands…I
find it difficult not to become attached to these partners, which can lead
to unnecessary heartache. I enjoy the intimacy and emotional closeness
of a loving relationship.’
‘I find that I try to remind myself when I’m drunk that I am feeling less
inhibited with my behaviour so I use that to try and prevent myself
from making rash decisions such as having sex with a new partner.’
These young women are in retrospect able to realize what mistakes they have
made and how they will behave in the future.
‘Alcohol is so dangerous but we all seem to make the same mistakes on
it again and again.’
‘I’ve been quite sexually active since the age of 16 and consequently got
into some sticky situations because of stupid behaviour whilst being
drunk and naive, as I was at that age…With some people, like me,
situations like these make you think about the way you act and now
I’m not so sexually active anymore and I would prefer to have sex in
a meaningful relationship.’
350 R. Farrow & P. Arnold
Social Aspects
Being at university brings about opportunities to meet potential partners, not
only because there are usually more people to choose from than in their home
towns, but because they can go out whenever they what, until whatever time
they want, increasing exposure to new people all the more.
‘More availability of similar people.’
‘Living in a big city such as Manchester allows me to meet more people.
I am one person in a big city, it is not important to others what I do,
so it is highly unlikely that I will get a reputation.’
Sexual Concerns
Some participants discussed their concerns over getting pregnant or contracting
an STI. One participants described her ‘dread of getting pregnant or catching an
STD [sexually transmitted disease] or AIDS’, although she explained that she
had no idea why she still had unprotected sex. She knew she was putting herself
at risk and is frightened of the consequences but was unable to explain why she
did it or knew how to control the behaviour. Confusing behaviour like this is a
great problem for young women, who cannot express how or why they feel the
way they do.
Alcohol Use
Alcohol is widely associated with one-night stands and unprotected sex.
Participants indicated that they mostly had one-night stands as a result of too
much alcohol.
‘I have been more promiscuous when having had some alcohol.’
‘If [I was] single, alcohol would increase the likelihood of me engaging
in kissing. As for the other [sexual situations] I have been tempted
when drunk but always managed to resist at the last moment.’
Participants discussed how alcohol induced impulsive and spontaneous
behaviour, often manifesting in sexual acts that otherwise would not have
occurred.
‘Alcohol has made me do so many things I regret and behave in a risk
taking manner.’
‘Alcohol tends to give me a ‘who gives a f**k’ attitude, especially to
sex.’
‘I am much more likely to have a one-night stand when drunk.’
Alcohol use is often an avoidance tactic. Excessive drinking may mask feelings
of insecurity about meeting people and low self-confidence. Alcohol consumption
can become part of a pattern of disordered behaviour, where functioning
without it can become very difficult.
‘Having conducted all my adolescent sexual experiences heavily under
the influence of alcohol I now feel very inhibited in a sexual situation
which does not involve alcohol and continue to use it as a sexual
disinhibitor.’
Student Sexual Behaviour 351
‘Until last week I’d never had sex sober and I was scared of it until last
week when I did it for the first time sober. I know 2 other girls who
aren’t able to do it sober.’
Emerging Patterns
There were several patterns of behaviour that could be seen from the initial
analysis of behaviour change. The nature of the sexual behaviour change could
be generally characterized by one or more of the following (these are general
patterns and so do not apply in all cases).
Activity. Most participants became ever more sexually active or less sexually
active:
1. Participants who become more sexually active after entering university did so
because of an increase in opportunity to meet new partners, as a result of
more socializing or because of less parental supervision, which provided
more privacy.
2. Participants who become less sexually active did so because they are away
from a boyfriend, engaging in a long-distance relationship, or had split up
with a partner and not met a new one.
Attitudes. Most participants held one of these sexual attitudes:
3. Participant’s sexual attitudes change from being promiscuous to settling
down after finding one partner to commit to, showing a preference for sex as
part of a relationship.
4. Participant’s sexual attitudes change from being faithful in a relationship with
one partner to a more promiscuous behaviour after the relationship breaks
up, where they might have a number of partners over a short period of time.
5. Serial monogamists go from one long-term relationship to the next. Sexual
activity tends to be fairly static and the number of partners only rises slowly.
6. Participants who come to university as virgins begin sexual experiences at
university as they mature and feel ready for a sexual relationship.
Behaviour. The greater the reported sexual activity, the more frequently partners
changed:
7. There was more opportunity at university to meet potential partners.
8. Sex occurred at the early stages of a relationship, suggesting that sex happened
sooner for most than during high school days.
9. Most incidences of one-night stands occurred to those who experienced
greater sexual behaviour change, although not exclusively.
Discussion
Confounding Variables
The meaning of specific sexual terms used by the participant relies on interpretation
by the researcher and may cause some bias in the results. The frequency
with which a person has sex is a subjective issue; what may be regular for one
person may not be at all for another. The qualitative nature of this study dictates
352 R. Farrow & P. Arnold
the rate of change must be analysed using the participant’s definitions as they
see it, consequently grouping experiences.
It is probable that those who experienced more change are likely to say
something about it, perhaps as they feel that they could make some attempt to
rationalize it. Alternatively they may be experiencing some demand characteristics,
as they wish to portray themselves in a certain way or defend the amount
of change they report they have experienced. Those that did not choose to add
comment on their behaviour change either felt that the questionnaire elicited
everything they wished to be known about themselves or were not compelled to
justify or explain their behaviour further.
It is important to realize that, due to the criteria of participants, who all drank
alcohol, it was more likely to appear as an influence on the present sample than
in those who where excluded because they did not drink. The conclusions of the
present study should be examined within the context of the types of participants
it recruited.
The data collection technique used is a relatively new method in this field.
However, it was considered a very useful and accessible means to collect
information from a generation who are computer literate and have easy access
to the Internet. Participation was open to all, but careful scrutiny of the
responses and comments screened abusers and time-wasters. Potential timewasters
were eliminated by the time it would take to complete the questionnaire,
as they would probably give up quickly. Participation could occur anywhere the
Internet is accessible. From the honest and frank answers obtained this did not
appear to inhibit responses. Attempts to limit bias in the types of person who
might participate were addressed by not targeting specific groups, but rather
mass e-mailing all students registered at several Manchester universities,
thereby covering all ethnic and religious groups attending the universities. The
cohort would, however, only be able to reflect the ethnic or religious groups of
students attending these universities. Participation of students who were not
sexually active or did not drink alcohol for religious or cultural reasons was
restricted, thereby reducing the number of non-Christian or non-White participants.
Advertizing on university and student-targeted websites that did not
appeal to minority groups may have a similar discriminatory effect. Attempts
were made to reduce this effect by advertizing on websites that were not cultural
or ethnically specific.
Conclusions
The participants in this study challenged the promiscuous reputation that
students have as they seemed more interested in getting to know their partners
first. This might suggest that sex for these people was more about the emotional
bond than just the physical rewards. This is not to say that casual sex does not
happen, but in most cases the women are looking for it to lead to something
more permanent.
It can be concluded that sexual experiences do indeed become more adventurous
once students leave home. It is suggested that this is due to the increased
personal space and time to spend as they please, rather than following parental
rules.
There also appears to be some contradictory sexual behaviour by the participants.
Young women beginning to explore their sexuality during this time of
Student Sexual Behaviour 353
transition do so at a time where social expectations require them to appear
‘feminine’. This means portraying an image of sexual innocence and not promiscuousness.
Consequently young women in Britain often feel it will be considered
inappropriate for them to carry condoms, as they will be labelled ‘easy’ and
sexually available. AIDS discourse suggests condoms are easily available, yet
young women do not feel able to make them easily available to themselves when
they need them. This may explain how young women suggest a desire to have
and use condoms without actually having and using them. They prefer instead
to leave it to their male partners, which may lead them to ultimately practise
unsafe sex. To further understand the dynamic relationship between sexual
behaviour patterns and condom use it would be advantageous to investigate
male attitudes towards condoms.
There can be some debate as to whether it is actually the onset of university
life that causes the change in sexual behaviour or whether it is a coincidence that
sexual development occurs at the same time as leaving home. However, developmental
progress often happens when an individual is stimulated to adapt to
a new environment (Emde & Hewitt, 2001). If this is the case, leaving home and
starting university is certainly a significant enough change in a young adult’s life
to qualify as a factor that would stimulate development. The complex interaction
of sexual behaviour change, development and a student lifestyle is clear.
Implications
Further research is necessary to fully appreciate the impact that the transition
from home to university has on women and its consequence for their health. A
comparison with those who have not experienced university would support
further the extent to which university affects behaviour.
Alcohol use was relevant to the motivation of casual sexual relationships for
participants. Continued research into these sexual motivations can help health
professionals with sex education and STI treatment of university students
because greater understanding of how they got into the risky situations in the
first place would be achieved.
Further study of a university’s role in supporting and educating students of
the health risks in excessive recreational alcohol use and unprotected sexual
behaviour would be worthwhile and appropriate. In understanding the how the
transition affects students, universities can be more equipped to provide support
to those who need it.
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Senin, 17 Desember 2007

Generasi Terkuat Lahir dari REPRODUKSI SEHAT

Selamat datang :)

Kamu menemukan Blog yang tepat tentang Pembangunan negeri ini melalui hal yang mendasar pada Kesehatan Reproduksi & HIV/AIDS.

Nikmati selancarmu dengan browsing lewat FOR BETTER GENERATION yang memuat jurnal dan tulisan ilmiah serta ide cemerlang demi kemajuan negeri Indonesia tercinta....

Keep Fighting spirit

Aji :)






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Kamis, 13 Desember 2007

Efektifitas Suatu Intervensi dalam Mengurangi Risiko Penularan HIV Pada ODHA

Latar Belakang : SebanyMetodeak satu dari tiga orang dengan HIV positif melanjutkan perilaku seksual yang tidak aman setelah mereka mengetahui bahwa dirinya terinfeksi. Artikel ini membahas tentang hasil dari suatu intervensi berlandaskan teori, untuk mengurangi risiko penularan HIV pada orang yang hidup dengan HIV.
Metode: Laki-laki (n=233) dan perempuan (n=99) dengan HIV&AIDS diambil secara random untuk menerima intervensi berupa (1) 5 sesi pada kelompok intervensi diberikan materi tentang strategi untuk melakukan perilaku seks aman dan (2) 5 sesi pada kelompok dukungan pemeliharaan kesehatan diberikan materi bandingan dengan standard pelayanan. Partisipan akan diikuti dan dinilai sampai 6 bulan setelah intervensi.
Hasil: Intervensi yang dilakukan untuk mengurangi risiko penularan HIV memberi hasil yang signifikan yaitu berkurangnya perilaku seksual yang tidak aman dan meningkatnya penggunaan kondom setelah intervensi. Perilaku yang mempunyai risiko penularan dengan pasangan seks yang tidak berstatus HIV positif dan perkiraan angka penularan HIV setelah satu tahun berjalan ternyata juga menghasilkan signifikansi lebih rendah pada kelompok intervensi.
Kesimpulan: Penelitian ini merupakan yang pertama kali menggambarkan keberhasilan dalam mengurangi risiko penularan HIV dari suatu intervensi yang dilakukan pada perempuan dan laki-laki dengan HIV positif.

Latar Belakang

Penelitian menunjukkan bahwa kelompok minoritas orang hidup dengan HIV positif melanjutkan perilaku seksualnya yang tidak aman, sehingga menempatkan diri mereka dan pasangannya pada risiko tertular IMS lainnya. Sebanyak 33 % hubungan seks tidak aman terjadi diantara orang yang telah terinfeksi HIV.
Selama ini, upaya untuk mengurangi risiko penularan HIV berfokus pada strategi intervensi pada populasi orang yang belum terinfeksi memberikan hasil yang mengecewakan. Sedangkan test antibody HIV dan hasil konseling menyarankan bahwa dukungan sosial dan intervensi konseling kesehatan mental mungkin mempunyai efek positif yang tidak pernah diperkirakan sebelumnya dalam hal perilaku berisiko. Misalnya, Coates et al menemukan bahwa program manajemen stress untuk laki-laki HIV positif di San Fransisco, secara mengejutkan dapat mengurangi jumlah pasangan seksual yang dimilikinya.




Metode

n Pengambilan sampel dan randomisasi
Laki-laki dan perempuan diambil dari klinik IMS dan pelayanan AIDS di Atlanta, Georgia.
Kriteria partisipan adalah :
(1) Hidup dengan HIV/AIDS
(2) Secara sukarela bersedia melengkapi aktivitas penelitian
Partisipan terdiri atas 230 laki-laki dengan HIV positif, dan 98 perempuan HIV positif. Rata-rata umur mereka adalah 40.1 tahun. (52% dari sampel diidentifikasi sebagai gay, 9% biseksual, dan 39% heteroseksual )

Para partisipan melengkapi wawancara tentang perilaku seksual secara mendalam melalui telepon. Hal ini dilakukan untuk meningkatkan kenyamanan dan mengurangi potensi terjadinya bias.
n Pengukuran
Partisipan melengkapi kuesioner setelah diintervensi, dan 3 dan 6 bulan setelah intervensi.

q Penilaian terdiri atas:
(1) Karakteristik demografi dan status kesehatan,
Menilai umur, etnis, orientasi seksual, status pekerjaan, pendapatan, tingkat pendidikan tertinggi, tanggal pertama melakukan test HIV positif, dan jumlah CD4 dan viral load terakhir.
(2) Konstruksi SCT (Sosial Cognitif Theory)
Intervensi perilaku dirancang untuk membantu orang dengan infeksi HIV untuk mengurangi perilaku berisiko tertular HIV dengan menggunakan model teori sosial kognitif, diantaranya mencakup :
a Pentingnya membangun keterampilan berperilaku
b Mendorong kemampuan diri (self efficacy) untuk melakukan perilaku pengurangan risiko
c Mendukung niat untuk mengubah perilaku berisiko
d Mengembangkan strategi untuk merubah perilaku
Dari keempat hal di atas, konstruksi variabel SCT dijabarkan lebih rinci lagi sebagai berikut.
q Self efficacy / potensi diri
- Menawarkan kondom kepada pasangan baru
- Menggunakan kondom saat terinfeksi
- Memuaskan pasangan melalui perilaku seksual aman
- Memuaskan diri sendiri melalui perilaku seksual aman
q Niat Berperilaku
- Menyediakan kondom di sekitarnya
- Mempertimbangkan kerugian dan keuntungan pengungkapan status HIV kepada pasangan
- Menolak seks tak aman
- Mempraktekkan perilaku seksual aman dengan pasangan yang belum diketahui status HIV nya.

(3) Kepuasan perlakuan intervensi
Penilaian dilakukan dengan mengukur persepsi dari perlakuan dengan 12 pertanyaan. Sebanyak 7 item menilai persepsi tentang situasi lingkungan kelompok menyangkut rasa kebersamaan yang dibangun dalam kelompok. Sedangkan 5 item pertanyaan menilai persepsi tentang fasilitator dalam kelompok, mencakup perhatian ketua kelompok tentang komunitasnya.

(4) Perilaku berisiko seksual dan perlindungan diri
Menilai tentang : Status HIV pasangan seksualnya, dan jumlah praktek seksualnya. Partisipan yang mempunyai beberapa pasangan seks pada 3 bulam yang lalu, akan dilakukan interview satu per satu mengenai status dari masing-masing pasangan dan praktek sekssual dan penggunaan kondom untuk masing-masing pasangan selama 3 bulan secara retrospektif.

Hipotesis

n Intervensi perilaku dalam mengurangi risiko penularan akan menurunkan terjadinya perilaku seksual berisiko, terutama risiko terpapar pasangan seksual dengan HIV negatif, dibandingkan dengan kondisi kelompok dukungan sosial.

Prosedur intervensi

n Setiap partisipan dibagi secara random untuk menerima :
(1) 5 sesi pada kelompok intervensi diberikan materi tentang strategi untuk melakukan perilaku seks aman dan
(2) 5 sesi pada kelompok dukungan pemeliharaan kesehatan diberikan materi tentang perbandingan standard kepedulian.




@ 6-10 partisipan
fasilitator ♀♂
(salah satunya HIV+)


@ 6-10 partisipan
fasilitator ♀♂
(salah satunya HIV+)
Kelompok intervensi
N=185
Kelompok pembanding
N=143
5 sesi pada kelompok intervensi diberikan materi tentang strategi untuk melakukan perilaku seks aman
5 sesi pada kelompok dukungan pemeliharaan kesehatan diberikan materi tentang perbandingan standard kepedulian.







Intervensi untuk mengurangi risiko penularan HIV

n Pendalaman Teori Sosial Kognitif, intervensinya bertujuan untuk :
(1) Mengembangkan kemampuan untuk secara efektif mengatasi tekanan yang berhubungan dengan status HIV dan risiko seksual yang dihasilkan oleh situasi.
(2) Mendukung keterampilan pengambilan keputusan yang efektif untuk pengungkapan diri tentang perubahan status HIV kepada pasangan seksnya.
(3) Memfasilitasi pengembangan dan pemeliharaan praktek seks yang aman.

Sesi I, II, III
n Tiga sesi pertama diberikan materi untuk membangun keterampilan diri untuk mengungkapkan status HIV kepada orang lain, termasuk pasangan seksualnya.
n Partisipan merinci hambatan-hambatan untuk mengungkapkan status HIV kepada pasangan seksnya dalam beberapa tipe hubungan.
n Partisipan mengidentifikasi hambatan-hambatan untuk mengungkapkan status, menilai reaksi pasangan, dan strategi untuk mengungkap atau tidak mengungkap status HIVnya.
n Penelitian ini menggunakan beberapa scene film yang telah diedit dari film terkenal untuk melatih diri dalam pengungkapan status dalam suatu aktivitas bermain peran/ role play.
Sesi IV, V
n Dua sesi selanjutnya à fokus pada risiko penularan melalui hubungan seks pada hubungan pasangan dengan HIV positif dan HIV negatif.
n Kelompok mendiskusikan strategi untuk menjaga kepuasan suatu hubungan sekaligus juga melindungi dirinya dan pasangannya.
n Fasilitator menyediakan kesempatan kepada partisipan untuk mendalami sikap negatif terhadap kondom dan dilakukan pada sesi memakaikan kondom laki-laki dan kondom permepuan pada model anatomi.
n Scene film yang telah diedit dari film terkenal kembali digunakan untuk melatih partisipan mengurangi risiko penularan dan keterampilan berkomunikasi
n Partisipan mengidentifikasi dan menerapkan strategi pemecahan masalah untuk menghadapi hambatan dan tekanan dalam melakukan perilaku seks yang aman.

Intervensi pada kelompok pembanding, Health Maintenance Comparison
Kondisi kelompok pembanding dilihat dalam satu waktu dan contact-matched, Kelompok dukungan sosial (KDS) untuk orang dengan HIV positif digunakan setelah KDS diterjunkan ke masyarakat.
n Sesi mencakup informasi tentang :
1. Penyakit HIV terkini
2. Manajemen menghadapi masalah kesehatan
3. Keikutsertaan dalam pengobatan
4. Kepedulian kesehatan dan jaminan kesehatan
5. Nutrisi atau zat gizi.

Analisis awal dan prosedur analisis
n Partisipan laki-laki dan perempuan didistribusikan menurut beberapa kondisi sebagi berikut.

Jumlah
Kelompok intervensi pengurangan risiko
Kelompok pembanding/ kontrol
Laki-laki
67%
76%
Perempuan
33%
24%

86 % partisipan à melengkapi penilaian intervensi pada akhir intervensi
84% partisipan à mengikuti minimal 3 dari 5 sesi intervensi
82% partisipan à tersisa pada 3 bulan follow up
78% partisipan à melengkapi penilaian pada 6 bulan follow up
10 partisipan à meninggal selama periode follow up

n Hasil penelitian mengindikasikan dampak utama pada kategori umur partisipan yakni, partisipan yang tidak mengikuti follow up umurnya lebih muda (M=37.9) dari pada yang tersisa (M=40.7).
n Untuk semua analisis, peneliti menggunakan pendekatan intent -to­ treat dengan melibatkan partisipan yang terlibat dalam perlakuan tanpa menghiraukan jumlah sesi intervensi yang diikutinya.
n Partisipan yang tidak aktif secara seksual sejak awal, tetap dimasukkan dalam analisis untuk perilaku seksual berisiko denan memberi nilai 0 untuk semua perilaku.

HASIL
n Konstruksi Sosial Cognitive Theory
- Kelompok Intervensi pengurangan risiko, mempunyai self efficacy yang lebih besar untuk menggunakan kondom dengan pasangan seks barunya dan menjadi mampu untuk bisa memuaskan secara seksual bagi dirinya dan pasangannya melalui praktek seks aman daripada kelompok pembanding. (Wilks’ lambda = 0.95, F [5, 242]= 2.57, p < lambda =" 0.96,">