Guud ahaan Qalalaasaha Shaqaynta ee Dhallinta, Ragga Ragga ah ee Jooga oo Ha Usheega Dhibaatooyinka Ka Hortagga Kondom-Dhibaatada (CAEP) (2015)

Faallooyin: Fiiri falanqaynta daraasaddan

Stephanie A. Sanders PhD^1,2,3, Brandon J. Hill PhD^1,4, Erick Janssen PhD^1,5, Cynthia A. Graham PhD^{1,2,6, *}, Richard A. Crosby PhD^1,2,7, Robin R. Milhausen PhD^1,2,8 iyo William L. Yarber HSD^1,2,3,9

Qodobka koowaad ee la daabacay internetka: 17 AUG 2015

DOI: 10.1111 / jsm.12964

Cilmi-baarista lagu soo daabacay qoraalkan waxaa taageeray Machadka Qaran ee Caafimaadka Ilmaha iyo Horumarka Aadanaha (NICHD) ee Machadyada Qaranka ee Caafimaadka oo hoos timaad Lambarka Award R21 HD 060447, E. Janssen iyo SA Sanders (PIs). Waxyaabaha ay ka kooban tahay waa masuuliyada qoraaga, mana ahan mid ka turjumaya aragtida rasmiga ah ee Hay'adaha Qaranka ee Caafimaadka.

aan la taaban karin

Hordhac

Dhibaatooyinka kacsiga ee kondhom-la xiriirta (CAEP) ayaa ah arrin aan loo baahnayn oo la xariira isticmaalka isticmaalka galmada ee aan habooneyn ama aan dhammeystirneyn. Hababka hoosta ee CAEP lama fahmayo, iyo haddii ragga ay soo sheegaan dhibaatooyinkan ay sidoo kale u badan tahay in ay la kulmaan dhibaatooyin qalafsan marka xaaladaha aysan isticmaalin cinjirrada aan la darsin.

Aim

Ujeedada daraasadani waxay ahayd in la baaro, tusaale ahaan muunad ka mid ah ragga da 'yar oo rag ah (rag da'doodu tahay 18-24), ragga ragga u sheegi kara CAEP waxay u badantahay (i) inay yeeshaan dhibaatooyin kacsan marka aan la isticmaalin cinjirrada (ii) ) waxay ka soo baxaan shuruudaha cillad aan caadi ahayn.

Dariiqooyinka

Guud ahaan ragga 479 waxay soo qoreen online dhamaystiran ee Index of International Functional Elemental (IIEF-5) waxayna ka jawaabeen su'aalaha ku saabsan dhibaatooyinka dhirta marka la isticmaalayo oo aan isticmaalin cinjirka inta lagu jiro maalmaha 90 ee ugu dambeeyay. Daraasada, khibradda jinsiga, iyo isbeddelada xaaladda caafimaad ayaa la baaray iyada oo xidhiidh la leh.

Cabbiraadaha Guud ee Ugu Muhiimsan

Iskudhinta isdaba-joogga ah ee luminta kacsiga inta lagu jiro codsiga kondhomka ama inta lagu jiro galmada galmada (PVI) maalmaha 90 ee hore iyo dhibcaha IIEF-5.

Natiijooyinka

Ragga, 38.4% waxaa lagu sifeeyay kooxda CAEP ee aan lahayn, 13.8% iyadoo leh CAEP inta lagu jiro codsiga kondhomka, 15.7% iyadoo leh CAEP inta lagu guda jiro PVI, iyo 32.2% iyadoo leh CAEP inta lagu jiro codsiga labadaba iyo PVI. Ragga oo ka warbixinaya nooc kasta oo ka mid ah CAEP waxay u badanyihiin inay ka yaryihiin ragga ka warramaya CAEP inay sidoo kale soo sheegaan dhibaatooyinka dhirta inta lagu jiro waxqabadka galmada marka aysan isticmaalin cinjirka. Ragga sheeganaya CAEP inta lagu jiro PVI kaliya ama inta lagu jiro labada codsi iyo PVI ayaa si weyn uga hooseeya heerka IIEF-5 ragga oo aan lahayn CAEP.

Ugu Dambeyn

Natiijooyinka waxay soo jeedinayaan in ragga sheeganaya CAEP ay sidoo kale u badan tahay in ay dareemaan dhibaatooyin dhameeystiran. Rugaha caafimaadku waa in ay qiimeeyaan in ragga isticmaala cinjirrada ay la kulmaan CAEP iyo halka ay ku habboon tahay, tixraacaan daaweynta nafsaaniga ah ama bixinta xirfadaha kondhomka.

Hordhac

Qiyaasta ka soo horjeeda cillad la'aanta erectile (ED) way ku kala duwan tahay daraasadaha, iyada oo ku xiran qayb ka mid ah qeexidda iyo qiyaasaha loo isticmaalo [1-3]. Mid ka mid ah saadaalinta ugu caansan ee dhibaatooyinka ciribtirka ah waa da '. Inkasta oo ay ED-du korodhadu ka weyn tahay raga waaweyn [4], dhibaatooyinka erectile waxaa soo sheega rag da 'yar. Mid ka mid ah cilmi-baarista cudurrada faafa ayaa lagu qiyaasay in ku dhowaad 2% ragga da'doodu ka yartahay da'da 40-50 sano ka cabatay dhibaatooyin soo noqnoqoshada ah (EPs) [2]. Daraasad dhowaan lagu sameeyey shanta waddan ee Yurub ayaa sheegay in 5% ragga da'doodu u dhaxayso 18 iyo 29 da'da da'doodu ka yartahay da'da ED ay ka soo haysay bilihii hore ee 6 [5]. Qaybta ragga dhalinyarada ah ee la kulma dhibaatooyin macquul ah, si kastaba ha ahaatee, si kastaba ha ahaatee, way ka badan yihiin, taas oo ka bilaabmaysa 16% tusaale muwaadiniin Maraykan ah 40 sano [6] ilaa 30% ee tijaabada Swiss ee ragga da'doodu tahay 18-25 sano [7].

Dhibaatooyinka caadiga ah ee dhibaatooyinka cilladaysan ee joogtada ah waxay soo jeedinayaan in xaaladaha xaaladaha taagan ay ka ciyaari karaan kaalin muhiim ah oo ku saabsan nafsaha. Isticmaalka cinjirrada labka ah waxay noqon kartaa mid tusaale u ah xaalad soo saarta ragga qaarkood si ay ula kulmaan dhibaatooyinka dhirta. Daraasaddan oo ah ardayda caafimaadka ee Brazilka ah (da'da da'da: 21.2 sano), 13.3% ayaa lagu ogaadey in ay leeyihiin ED, iyadoo la adeegsanayo Index-ka caalamiga ah ee shaqo-joojinta (IIEF-5) [8]. Ragga da 'yar ee daraasaddan isticmaala cinjirrada ayaa laba jeer u muuqda inay soo sheegaan dhibaatooyin cilladaysan. Tijaabada dhalinyarada da 'yarta ah ee galmada la isugu gudbiyo (STI) [9], 37.1%% ragga ayaa sheegay in dhibaatooyinka dhirta la xidhiidha kicinta (CAEP) ugu yaraan hal mar. Daraasado dhowr ah, oo ku lug leh rag iyo dumarro labadaba, ayaa hadda qoray oo sheegaya in CAEP laga yaabo inay caadi tahay [10]. Inkastoo hababka hoos yimaada CAEP weli aan si fiican loo fahmin, daraasad cilmi-nafsiyeed oo cilmi-nafsiyeed oo dhowaan lagu sameeyay hababka jinsiga ah, ragga qaba CAEP waxay u baahanyihiin wakhti dheeraad ah iyo / ama kicin dheeraad ah si ay uga noqdaan ragga oo aan lahayn CAEP [11]. Waa arrin muhiim ah, si kastaba ha ahaatee, jawaab-celinta qaloocan ayaa hoos udhacay kooxda CAEP oo kaliya kaliya daqiiqaddii ugu horeysay ee soo-gaadhista dareenka jinsiga, iyada oo aan jirin kala duwanaansho muhiim ah ka dib.

Dhibaatooyinka adag ee kondhomka waxaa laga yaabaa inay noqoto mid aan la qiyaasi karin oo la xidhiidha isticmaalka aan caadiga ahayn, raggaas oo sheegaaya CAEP waxay u badan tahay inay soo sheegaan noocyo kale oo khalad ah oo isticmaala cinjirka kondhomka kale, [12], isticmaalka kondhamka aan dhamaystirneyn (codsiyada goor dambe iyo ka saarista hore) [9,13], iyo isticmaalka kondhamka aan habooneyn [14,15]. Hal daraasad mustaqbalka ah oo ku lug leh ragga 1,875, fikradaha ah "tayada" (oo ay ku jirto qiyaasta dhererka, dhererka farqiga, iyo xajmiga, iyo sidoo kale adkeynta ilaalinta) waxay la xiriirtay suurtagalnimada in la isticmaalo isticmaalka kondhamka aan dhammeystirnayn [13]. Ragga waxaa laga yaabaa in ay dareemaan inay la kulmaan CAEP haddii ay kalsooni la'aan u isticmaalaan inay isticmaalaan kondhom si sax ah, haddii ay la kulmaan dhibaatooyin ka yimaadda habka kondhomku u habboon yahay ama dareemaan, iyo haddii ay galmo la yeeshaan lammaanayaal badan [9].

ahdaafta

Hal su'aal oo, weli, aan la baarin waa ragga sheegaaya CAEP waxay u badan tahay inay la kulmaan dhibaatooyin adag oo ku yimaada xaaladaha galmada ee aan loo isticmaalin. Sidaa darteed, ujeeddada daraasadani waxay tahay in la baaro, tusaale ahaan, raajada dhallinyarada ragga ah, ragga da 'yar (18-24), haddii ay soo sheegaan CAEP (ama inta lagu jiro codsiga suuska, inta lagu jiro galmada galmada [PVI], ama labada xaaladoodba) waxay u badan tahay inay: (i) leeyihiin EPs marka aysan isticmaalin cinjirka; iyo (ii) dhibcaha kala duwan ee IIEF. Hadafkeenu ma ahayn in la qiyaaso dhibaatada qalafsan ee laakinse si loo aqoonsado xiriirka CAEP ee muunad ahaan aan la taaban karin ee dhalinyarada, ragga isticmaalaya.

Dariiqooyinka

Ka qaybgalayaashu

Ka qaybqaatayaashu waxay ahaayeen rag dhallinyaro ah, ragga ragga ku takhasusay liiska jaamacadaha (tusaale ahaan, kooxaha ardayda jaamacadda iyo liisaska waaxda) iyo waraaqo elektaroonik ah oo faafinaya on Facebook. Ogolaashaha waxaa laga helay liiska maamulayaasha liistada iyo tilmaamaha Facebook-ka ee la raacay. Waxaanu ku talineynay ragga xayeysiiska ah ee CAEP ee la soo xawilay oo la waydiiyay: "Kondhom ma faragalinayaan ereyadaada?" Iyo "Kondhomka ma fara galiyaan arooska?" Xaqiijinta xaq u yeelashada waxaa ka mid ah helista Internetka, oo u dhaxeeya 18 iyo 24, sida heterosexual, oo isticmaala cinjirka loogu talagalay PVI gudaha 90 ee la soo dhaafay, iyo kartida akhrinta Ingiriisiga. Intaa waxaa dheer, ragga waa laga reebay haddii ay ku jireen xiriir galmo ah oo gaar ah (monogamous) ee bisha 1 ama ka badan, sababtoo ah isticmaalka kondomka ayaa la ogaadey in uu hoos u dhaco bisha koowaad ee xiriirka [16]. Ragga la wargeliyay CAEP ayaa la fajacay. Waxaan waydiinay jawaab-celiyeyaasha su'aal gaar ah dhammaadka baaritaanka ku saabsan in ay su'aalaha ku waydiiyeen iyo in xogta loo isticmaalay; keliya 1.2% ayaa ka jawaabey in aysan baaritaanno u qaadin si dhab ah waxaanan ka reebnay xogtooda.

Sambalka ugu dambeeya wuxuu ka koobnaa 479 rag dhalinyaro ah. Ogolaansho qoraal ah oo la ogeysiiyay ayaa laga helay dhamaan kaqeybgalayaasha waxaana guddiga dib u eegista hay'adda ee jaamacadda ay ansixiyeen dhammaan habraacyada daraasadda.

Cabbiraadaha

Cabbirka Natiijada Aasaasiga ah

EPs Marka Aan Isticmaalin Kondhom

Laba su'aalood ayaa lagu qiimeeyay 'EP' markii aysan ragga isticmaalin cinjirka galmada. Kaqeybgalayaasha waxaa la weeydiiyay inay "Ka fikiraan waqtiyadii aad sameysay galmada xubinta taranka xubinta taranka '90 maalmood ee la soo dhaafay oo aadan isticmaalin kondhom." Tan waxaa xigtay laba su'aalood, "Immisa jeer ayaad lumisay ama bilawday inaad kacsato kacsigaaga kahor intaadan galin (ka hor intaadan guska gelin siilka)?" iyo "Immisa jeer ayaad lumisay ama bilawday inaad kacsato kacsigaaga markii aad galmo samaynaysay (ka hor intaadan bilaabin)?" Waxkaqabadyada jawaabta waxay ahaayeen: “marna,” “marmar,” “in kayar waqtiga nuskiisa,” “inta badan,” “had iyo jeer,” iyo “kama jawaabi karo maxaa yeelay marwalba waxaan isticmaali jiray kondhom.” Labadan doorsoome waxaa loo yaqaan EP-yada kahor intaan la galin (EP-Kahor) iyo EP-yada inta lagu jiro PVI (EP-PVI), siday u kala horreeyaan. Beddel kasta, ragga waxaa loo kala saaray "Haa" haddii ay marmar jawaabaan ama in ka badan iyo "Maya" haddii aysan weligood ka jawaabin.

IIEF-5 [17]

IIEF-5 waa nuqul gaaban oo ka mid ah 15-item IIEF, oo loo isticmaalo qalab baaritaan kooban oo lagu qiimeeyo ED. Dhibcane sumcad ah ayaa loo soo saaray mid kasta oo ka mid ah shanta shay oo loo isticmaalo falanqaynta. Iyadoo lagu saleynayo dhibcahan, ragga waxaa loo kala saarey in aysan jirin ED (22-25), ED (17-21), khafiif ah ilaa ED (12-16), ED-8-11, ama ED-XID -5), ka dib shuruudaha soo jeediyay Rosen iyo jalayaashiisa [17].

Ka Qeybgalaha Koowaad ee Iskuduwaha

CAEPs

Labo nooc oo CAEP ah ayaa mid waliba qiimaynay alaab kaliya. Ugu horreyn, ragga waxaa la weydiiyay, "Intee jeer ayaa laga yaabaa in maalmaha 90 ay kaa lumeen ama bilaabaan inay kaa lumaan qoyaankaaga markaad kondhom ku shubtid ka hor intaan siilka la galmoonin?" Beddelka jawaabtu waxay ahaayeen: "marnaba," marmar, "" in ka yar kala bar "Inta badan," iyo "marwalba." Kadib, ragga ayaa la weydiiyay, "Intee jeer ayaa la soo dhaafay maalmo 90 miyaad ka luntay ama bilowday inaad lumiso dhirtaada adigoo xiran kondhom marka aad galmada gudniinka ku jirto?" "Marnaba," "mar mar," "in ka yar nus wakhtiga," "inta badan," iyo "marwalba". Labadan doorsoome waxaa loo soo gudbiyaa sida CAEP-Codsiga (CAEP inta lagu jiro codsiga suuska) iyo CAEP-PVI ( CAEP markaad isticmaaleyso cinjirka PVI), siday u kala horreeyaan. Isbedel kasta, ragga waxaa lagu magacaabay "Haa" haddii ay ku jawaabaan marmar ama marar badan iyo "Maya" haddii aysan weligood ku jawaabin. Afar kooxood ayaa la abuuray iyadoo la adeegsanayo labadan doorsoomayaal: Looma baahna CAEP, CAEP-Codsiga keliya, CAEP-PVI oo keliya, iyo CAEP-Labada.

Tusaaleyaal Tusaaleyaal ah iyo Iskudhicin Maskaxeed

Ka sokow shuruudaha u-qalmitaanka iyo ka-saaris la'aanta ee lagu sharraxay horraanteedii, isbeddellada tusaalaha ee soo socda iyo isku-dhacyada khilaafaadka ee la helay ayaa la qiimeeyay: jinsiyadda, asalka / Hispanic / Latino jinsiyad, waxbarsho, diidmo, dakhliga, xajmiga tuulada, xaaladda gudniinka, ka-qaybqaataha ayaa weligiis si aan qarsoodi lahayn loo ogaan waayey qof, iyo in uu weligiis baray inuu isticmaalo guska labka ah. Dhibaatooyinka caafimaad ee hadda jira (sonkorowga, suuxdinta, niyadjabka / welwelka, sclerosis badan, murqaha muruqyada, cadaadiska sare ee dhiigga, xaaladda wadnaha iyo kuwa kale) iyo isticmaalka daawooyinka (fiirsashada maqnaanshaha cilladda maqaarka / maqnaanshaha feejignaanta [ADHD / ADD], sonkorowga, wadnaha , niyad-jabka, walwalka, hormoonka, kuwa kale) ayaa sidoo kale la qiimeeyay iyo sidoo kale in ka-qaybgalaha loo daaweeyay dhibaatada galmada ee hore 12. Iyadoo la adeegsanayo waqtiga 90-maalin, dib ayaa loo cabbiray: haddii uu ka qaybqaatay barnaamijka inuu bedelo habdhaqanka isticmaalka condom ama mid ka mid ah inuu beddelo habdhaqanka galmada, isticmaalka habab kale oo looga hortago, haddii uu isku dayayay in uu la jaro lammaanihiisa ( s), iyo inta jeer ee uu isticmaalay fosfodiesterase nooca 5 (PDE-5i) intii lagu guda jiray dhaqdhaqaaqa galmada markuu ahaa oo uusan isticmaalin kondom.

Falanqaynta Xogta

Baaritaanada Chi-squared ayaa loo isticmaalay si loo go'aamiyo ururada udhaxeeya kooxaha CAEP-ga (No-CAEP, CAEP-Codsiga oo kaliya, CAEP-PVI oo keliya, iyo CAEP-Both) iyo sidoo kale jawaabaha labada su'aalood ee ku saabsan erections marka aan la isticmaalin kondoom, Qaybaha IIEF-5 (ED ee ED ee daran), iyo doorsoomayaal kale. Marka la eego tirooyinka yaryar iyo kuwa aan la ogaan karin ee unugyada qaarkood waxay ku xad gudbeen falanqaynta falanqaynta shiishka, waxaanu fulinay 4 × 2 (marnaba wixii khibrad ah ee DDH ee muddada warbixinta). Taas ka dib, isbarbar-dhigista kaddib waxaa la sameeyay iyadoo la isticmaalayo imtixaanada 2 2 chi-squared.

Falanqaynta kala duwanaanta waxaa loo isticmaalay in la isbarbar dhigo IIEF-5 iyo dhibcaha kale ee joogtada ah ee kooxaha oo dhan iyadoo tijaabooyinka Scheffé loo isticmaalay isbarbardhiga ka dib. Muhiimad ayaa lagu aasaasay P <0.05. Falanqaynta waxaa lagu sameeyay iyadoo la adeegsanayo SPSS Version 21 (IBM SPSS statistics for Windows, version 21.0; IBM Corp., Armonk, NY, USA).

Natiijooyinka

Da'da celceliska waxay ahaayeen sanado 20.43 (isbedelka heerka = 1.63). Inta badan inta badan ayaa loo aqoonsaday caddaan (80.1%), 6.8% sida Asiya, 4.7% Afrikanka Ameerika / madow, iyo inta soo hartey kooxo kale. Hispanic / Latino qowmiyadeed ayaa lagu soo wariyay 4.2% ragga. Aqlabiyadda (66.5%) waxay muujiyeen heerkooda ugu sarreeya ee waxbarashada sida koleejka / farsamada, 3.8% heerka sare, 29.4% dugsiga sare, iyo 0.4% ma dhammaystirin dugsiga sare. Kaliya badh ka mid ah (54.7%) ayaa muujiyay heerkoodii dakhliga shakhsiyadeed uu ahaa heerka hoose ama ka hooseeya iyo 53.0% koray magaalooyinka waaweyn iyo kuwa waaweyn. Inta badan waxaa la guday (87.3%), waligood laguma sheegin STI (97.3%), waxaana la baray sida loo isticmaalo cinjirka ragga (63.0%). Maqnaanshaha aan loo baahneyn ayaa lagu soo wariyay 9.2%.

479, 184 (38.4%) waxaa loo aqoonsaday inay yihiin CA-CAEP, 66 (13.8%) sida CAEP-Codsiga kaliya, 75 (15.7%) sida CAEP-PVI oo kaliya, 154 (32.2%) oo ah CAEP-Labada. Khilaafaad kooxeed laguma helin da'da, jinsiga, jinsiga Hispanic / Latino, waxbarashada, dareenka, dakhliga, xajmiga tuulada, xaaladda gudniinka, taariikhda nolosha STI, iyo haddii qofku si aan qarsoodi lahayn loo xakameeyo, iyo haddii loo baray isticmaalka cinjirka ragga.

Iyadoo la tixgelinayo hoos u dhac ku yimaada dhibaatooyinka caafimaad iyo dawooyinka, xogta laga helo dhammaan ragga oo ka warbixinaya CAEP ayaa la isku daray (koox kasta oo ka mid ah CAEP) oo lagu barbardhigo kuwa ragga ka warbixinaya CAEP. Kaliya kala duwanaanshaha kooxeed ee la helay waxay ahayd niyadjab / walaac, iyadoo 12.9% ragga ka tirsan kooxda CAEP ee ka warbixinaya taas marka la barbar dhigo 4.9% ragga ragga ee CAEP² = 8.14, darajooyinka xorriyadda [df] 1, P = 0.004). Si kastaba ha noqotee, ma jirin kala duwanaansho kooxeed oo ku saabsan soo sheegida isticmaalka daawada ee niyad-jabka (3.2%) ama walaac (2.9%). Farqiga kaliya ee kooxeed ee isticmaalka daawada ayaa loogu talagalay ADHD / ADD daawo, oo leh 3.3% ee kooxda No-CAEP iyo 8.9% ee koox kasta oo CAEP ah oo ka warbixisay isticmaalka daawooyinkan (χ² = 5.62, df 1, P = 0.018). In ka yar 1% ayaa la sheegay sonkorow (0.8%), suuxdin (0.8%), sclerosis badan (0.2%), murqaha dystrophy (0.2%), xaalada wadnaha (0.9%); saamiga hooseeya ee la midka ah ayaa loo isticmaalay daawada sonkorowga (0.8%), daaweynta wadnaha (0.4%), iyo daawooyinka hoormoonka (0.9%). In yar oo kaqeybgalayaashu waxay muujiyeen cadaadis dhiig oo sareeya (2.1%), dhibaatooyinka kale ee caafimaad (1.7%), iyo daaweynta dhibaatooyinka galmada 12kii bilood ee lasoo dhaafay (1.5%).

Waqtiyada 90 ee la soo dhaafay, ka-qaybgalayaashu waxay ku jireen barnaamijyo lagu beddelo isticmaalka kondhomka (1.7%) ama dabeecada galmada (1.3%), qaar yarna waxay u adeegsadeen PDE-5i waxqabadka galmada (1.9%) ama aan lahayn cinjir (1.9%) . Midkoodna iskuma dayin in uu helo uur yeelasho. In kabadan nus ka mid ah ragga ayaa muujiyay inay ku tiirsan yihiin cinjirrada lab ah ee xakameynta dhalmada (54.9%) iyo / ama inay isticmaalaan cinjirro lab ah oo leh noocyada kale ee dhalmada (59.1%) ugu yaraan qaar ka mid ah maalmaha 90 ee la soo dhaafay. Ma jiro kala duwanaansho kooxeed oo laga helay mid ka mid ah doorsoomayaashaas. Ragga oo aad u sarreeya oo ka mid ah koox kasta oo ka mid ah CAEP (17.3%) marka loo eego kooxda Xubinta CAEP (9.8%) waxay soo sheegeen in ay ku tiirsanaanayeen qaabka koontaroolka dhalmada ee aan ahayn cinjirada ugu yaraan mararka qaar 90 ee hore² = 5.18, df 1, P = 0.023).

Tirada celceliska wakhtiyada ragga ayaa isticmaala cinjirrada xilliga 90-day ee dayac tira waxay ahayd 10.8 (is-beddelka heerka = 14.3) oo tanina si weyn ugama duwaneyn afarta kooxood. Si kastaba ha ahaatee, isticmaalka kondhomka, si kastaba ha ahaatee, si weyn ayuu hoos ugu dhacay CAEP-Labada kooxood (73.4%) marka la barbar dhigo kooxda Xubinta CAEP (82.4%) (F (3,471) = 3.44, P = 0.017), kooxaha kale dhex dhexaad ah oo aan si weyn uga duwaneyn midba midka kale (CAEP-Codsiga Kaliya 82.1%; CAEP-PVI Kaliya 77.7%).

EPs Marka Aan Isticmaalin Kondhom

Qiyaastii rubuc ka mid ah muunadda (23.0%) ayaa tilmaamtay inaysan ka jawaabi karin su'aalahan maxaa yeelay weligoodba waxay isticmaaleen cinjirka galmada. Miis 1 waxay soo bandhigaysaa falanqaynta ragga ragga ah. Sababtoo ah ragga yar ayaa muujiyay waayo-aragnimada badan ee EP-yada marka aan kondhomka la isticmaalin, falanqaynta qiyaasta ee la barbar dhigo afarta kooxood ee CAEP ee ku saabsan boqolleyda lagu qeexay "Haa" iyo "Maya" ee EP-Ka hor iyo EP-PVI. Kooxaha CAEP waxay si aad ah ugu kala duwan yihiin isbeddelka EP-ka hor (χ² = 40.14, df 3, P <.001). Boqolleyda ragga ah ee soo sheega ugu yaraan mararka qaarkood EP kahor intaanay galin gudaha-CAEP, CAEP-Codsiga kaliya, CAEP-PVI kaliya, iyo CAEP-Labada kooxba, waxay ahaayeen 9.9, 35.7, 23.6, iyo 43.0, siday u kala horreeyaan. Falanqaynta post-hoc, kooxda No-CAEP waxay si aad ah uga yaraayeen ragga soo sheega EP ka hor intaan la gelin marka aan la isticmaalin cinjirka galmada marka la barbar dhigo kooxaha kale. Miis 1 wuxuu soo bandhigaa natiijooyinka dhammaan isbarbardhigyada dambe.

Jadwalka 1. Soo noqnoqoshada dhibaatooyinka kacsiga marka aan la isticmaalin cinjirka galmada marka la barbar dhigo kooxaha CAEP oo dhan

Dhibaatooyinka kacsiga marka aan la isticmaalin kondoom	Kooxaha
Dhibaatooyinka kacsiga marka aan la isticmaalin kondoom	No-CAEP (n = 142)	Codsiga CAEP-Codsiga kaliya (n = 42)	CAEP-PVI kaliya (n = 55)	CAEP-Labada (labadaba)n = 128)
*P <0.001 Superscripts waxay muujinayaan natiijooyinka isbarbar-dhigista kaddib marka la isticmaalo P <0.05 shuruudaha. Kooxaha wadaaga warqad si weyn ugama duwana. Kuwa aan warqad wadaagin way kala duwan yihiin. CAEP = dhibaatada dhirta kondhamka la xidhiidha; PVI = galmo-galmada siilka.
Ka hor inta aanad gelin
Marna (%)	90.1^a	64.3^{b, c}	75.4^b	57.0 ^c
Marmarka qaarkood (%)	4.9	28.6	16.4	30.5
Wax ka yar wakhtiga nuska (%)	3.5	7.1	5.5	8.6
Inta badan wakhtiga (%)	1.4	0	1.8	3.9
Had iyo jeer (%)	0	0	0	0
Inta lagu jiro PVI
Marna (%)	95.1^a	85.7^b	43.6 ^c	54.6 ^c
Marmarka qaarkood (%)	3.5	11.9	40.0	33.1
Wax ka yar wakhtiga nuska (%)	1.4	2.4	12.7	7.7
Inta badan wakhtiga (%)	0	0	1.8	4.6
Had iyo jeer (%)	0	0	1.8	0

Kooxaha CAEP waxay sidoo kale si wayn u kala duwan yihiin EP-PVI (χ² = 8 3.00, df 3, P <.001). Boqolkiiba kaqeybgalayaasha ka warbixiya ugu yaraan mararka qaarkood EP inta lagu guda jiro PVI waxay ahaayeen 4.9, 14.3, 56.4, iyo 45.4 oo loogu talagalay No-CAEP, CAEP-Codsiga oo keliya, CAEP-PVI kaliya, iyo CAEP-Labada kooxba, siday u kala horreeyaan. Falanqaynta post-hoc, ragga aad uga tiro yar kooxda No-CAEP ayaa soo sheegay inay qabaan EPs inta lagu jiro PVI marka aan la isticmaalin kondhom marka la barbar dhigo kooxaha kale oo dhan. CAEP-PVI Kaliya iyo CAEP-Labada kooxba waxay lahaayeen boqolleyda ugu sarreeya oo si weyn ugama duwana midba midka kale. Boqolkiiba ragga ku jira CAEP-Codsiga Kaliya kooxda haysata ugu yaraan mararka qaarkood EP inta lagu jiro PVI waxay ahayd mid dhexdhexaad ah oo si weyn uga duwan dhamaan kooxaha kale.

IIEF-5

Alfa Cronbach ee IIEF-5 ee tusaalahan wuxuu ahaa 0.76. Sida ku cad Jadwalka 2, Dhibcaha IIEF-5 ayaa si weyn uga duwan kooxaha CAEP (F(3,475) = 15.40, P <.001). Dhibcaha celceliska kooxaha oo dhan waxay ka sarreeyeen 21 (qiyaasta aan caadiga ahayn) [17]. Kooxda CAEP ee aan lahayn CAEP waxay leeyihiin dhibcaha ugu sarreeya (23.92) (oo muujinaya shaqo fiican oo qalafsan), oo si aad ah uga duwan kan CAEP-PVI oo kaliya (22.93) iyo CAEP - Labada kooxood (22.12), laakiin aan ka ahayn CAEP-Codsiga kaliya (23.20) . Celceliska celceliska ee CAEP - Labada kooxoodba aad ugama duwaneyn kuwa ka mid ah kooxda CAEP-PVI oo keliya, laakiin waxay si aad ah uga duwanayd labada kooxood. Dhibcaha celceliska ee CAEP-Codsiga oo kaliya iyo kooxaha CAEP-PVI-ka keliya ma aha kuwo aad uga duwan.

Shaxda 2. Dhibcaha IIEF-5 iyo kala-saaridda ED ee kooxaha CAEP

	No-CAEP (n = 184)	Codsiga CAEP-Codsiga kaliya (n = 66)	CAEP-PVI kaliya (n = 75)	CAEP-Labada (labadaba)n = 154)
*P <0.001 Superscripts waxay muujinayaan natiijooyinka isbarbar-dhigista kaddib marka la isticmaalo P <0.05 shuruudaha. Kooxaha wadaaga warqad si weyn ugama duwana. Kuwa aan warqad wadaagin way kala duwan yihiin. CAEP = dhibaatada dhirta kondhamka la xidhiidha; ED = xanuujinta erectile; IIEF-5, Indha-indheynta Caalamiga ah ee Shaqada; PVI = galmo-galmada siilka; SD = isdhaafsiga caadiga ah.
Mean (SD) dhibcaha IIEF-5*	23.92 (2.24)^a	23.20 (2.51)^{a, b}	22.93 (2.56)^{b, c}	22.12 (2.54)^c
Qeybinta Heerka IIEF-5*
Maya ED (%)	91.3^a	81.8^b	77.3^{b, c}	68.2 ^c
ED Hin (%)	7.1	15.2	20.0	28.6
EDIT ilaa dhexdhexaad ah (%)	0.5	3.0	1.3	3.2
Dhexdhexaad ED (%)	1.1	0	1.3	0
Daran (%)	0	0	0	0

Iyadoo la adeegsanayo dhibcaha IIEF-5, ragga ayaa markaa laga soo xigtey ED-ga oo aan ED u isticmaalin shuruudaha ay soo sheegaan Rosen et al. [17] (eeg Shaxda 2). Sababtoo ah tiro yar ayaa lagu tilmaamay inay yihiin mid fudud ama dhexdhexaad ah oo ED ama ka sarreeya, waxaan niman u la nimid ED oo ah hal koox. Isbarbardhigga afarta kooxood ee CAEP ee ku saabsan boqolleyda lagu tilmaamay in aysan jirin ED iyo ED, waxaa jiray ururo muhiim ah (χ² = 28.98, df 3, P <.001). Boqolleyda kaqeybgalayaasha ee loo qoondeeyay sida ED kasta waxay ahaayeen 8.7, 18.2, 22.7, iyo 31.8 oo loogu talagalay No-CAEP, CAEP-Codsiga kaliya, CAEP-PVI kaliya, iyo CAEP-Labada kooxba, siday u kala horreeyaan. Miis 2 Mawduucyada hoose waxay muujinayaan natiijooyinka baaritaankii hore ee muujinaya in kooxa-ka-CAEP aysan ku jirin ragga aadka u yar leh ED kasta oo ka badan kooxaha kale.

Dood

Tusaalahan yar ee dhalinyarada, heterosexual, ragga isticmaala ragga, CAEPs waxay la xidhiidheen heerar badan oo guud ahaan, laakiin inta badan heerarka hoose ee dhibaatooyinka qalafsan. Ragga oo ka warbixinaya nooc kasta oo ka mid ah CAEP (inta lagu jiro codsiyada iyo / ama inta lagu jiro PVI) waxay u badan tahay inay u badan tahay inay ka badan tahay kooxda Xubinta CAEP inay sidoo kale soo sheegaan dhibaatooyinka dhirta ka hor inta aan la galin iyo marka la galmoonayo marka aan la isticmaalin kondhomka. Ragga sheeganaya CAEP inta lagu jiro PVI kaliya ama inta lagu jiro labada codsi iyo PVI waxay si aad ah ugu hooseeyaan heerka IIEF-5 marka laga reebo ragga aan soo sheegin CAEP. Dhammaan kooxihii soo sheega CAEP waxay si aad ah ugu dhowdahay in lagu cadeeyo inay haystaan EDT dhexdhexaad ah ama dhexdhexaad ah marka loo eego kooxda Xubinta CAEP. Si kastaba ha noqotee, xitaa CAEP - Labada kooxood, oo leh heerka ugu sarreeya ee IIEF-5-lagu aqoonsaday ED, badankood (68.2%) ragga ma aysan buuxin shuruudaha bukaan-socodka ee ku saabsan ED.

Waxaa jira dhowr sharaxaad oo suurtagal ah oo ku saabsan natiijooyinkaas. Marka hore, ma aha wax la yaab leh haddii ragga qaba ED ay leeyihiin EPs marka la isticmaalo cinjirka. Marka labaad, inta badan, waxaa suurtagal ah in ragga horay u soo dhacaan kacsan marka ay isticmaalaan cinjiradu inay ka werwersanyihiin in ay dareemaan guud ahaan dhirta guud ahaan sidaas awgeedna waxay u nugul yihiin inay la kulmaan ED ka badan [18]. Tani waxay ku haboonaan lahayd cilmi-baaris kale oo soo jeedinaysa muhiimada ay leedahay garashada iyo dareenka dareenka sida welwelka iyo wax-ka-qabashada ee hab-dhaqanka iyo dayactirka ED [19].

Ragga sheegey in ay isticmaalaan daawada ADHD waxay aad u badan tahay inay sheegaan CAEP. Daraasado horay u soo baxay ayaa sheegay in heerarka sare ee dhaqanka galmada ee khatarta ah ee dhalinyarada qaangaarka ah ee ADHD [20] iyo ragga isticmaala daawada ADHD waxay mararka qaarkood u sheegaan dhibaatooyinka cilladaysan sida daaweyntu saameynayso [21].

Xaddidaadda

Jiritaan la'aanta natiijooyinkayaga ayaa laga yaabaa inay xaddidan tahay. Shaybaarku wuxuu xaddidey naqshadaynta dhallinta qaangaarka ah, heterosexual, ragga isticmaala ragga hadda aan ku jirin xiriir jinsiyeed oo muddo dheer ah, oo ku hadlaya Ingiriisi, iyo helitaanka internetka. Sidaa awgeed, natiijooyinka laga yaabo inaysan aheyn mid guud ee ragga ka baxsan shuruudahan xaq u yeelashada. Fikradaha noocan ah ee looga saaray ragga oo ku jiray cilaaqaad gaar ah oo jinsi ah hal bil ama ka badan ayaa ah cilmi-baaristan ay muujisay in ragga da'doodu tahay 18-24 ay ku wargeliyaan isticmaalka kondhomka inta badan la-hawlgalayaasha la aasaasay marka loo eego lamaanayaasha casriga ah [22]. Ragga ku jira da'da 18-24 ayaa sidoo kale halis weyn ugu jira inay gudbiyaan HIV iyo HIV [23], inkastoo ay isticmaalaan isticmaalka kondhomka [24].

Marka la eego isticmaalka kondhomku inuu ahaa shuruudaha u qalmitaanka, ragga horey u isticmaali jiray cinjirka galmada laakiin joojiyey isticmaalka, laga yaabee inay sabab u tahay CAEP ama dhibaatooyin kale, laguma matalin muunadeena. Xaddid dheeri ah ayaa ah inta aan adeegsanay qalab la ansaxiyay si aan u qiimeyno darnaanta dhibaatooyinka erectile, ma aanan qiimeynin dhibaatada shaqsi ka haysato dhibaatada; shuruudaha lagu garto cillad la'aanta xubinta taranka ragga waxay u baahan tahay jiritaanka xaalad caafimaad oo muhiim ah oo ku saabsan astaamaha [25]. Ujeeddadayada daraasadani maaha, si kastaba ha noqotee, in la soo sheego heerka cudurrada qalalaasaha, laakiin in la ogaado ragga sheegaaya CAEP inay sidoo kale soo sheegaan EPs marka aysan isticmaalin cinjirka iyo in dhibcooyinka IIEF ay ka duwan yihiin ragga aan sheegin CAEP.

Natiijooyinkeenu waxay soo jeedinayaan in ragga ay ka waramayaan CAEP-ga tusaalahayaga, qiyaastii 18-32% waxay gaarsiisay shuruudaha IIEF ee khafiifka ah illaa heer dhexdhexaad ah (waxay ku xiran tahay haddii ay soo sheegaan CAEP inta lagu jiro isticmaalka kondhom oo keliya, inta lagu jiro PVI, ama labada codsi iyo PVI). Inkasta oo inta badan ka qaybgalayaashan lagu cadeeyay category "khafiifsan" ED, waxaa jira waxyaabo aan caddayn kufilan oo ku saabsan baaritaanyadaas. EP-yada ayaa lala xiriiriyay isticmaalka kondhomka oo aan joogto ahayn oo aan dhamaystirnayn, [9] taas oo iyana la xiriirta halista helitaanka STI / HIV; sidaas awgeed, hagaajinta khibradaha ragga ee isticmaalka kondhomku waa muhiim. Kooxdan ragga ah waxay ka faa'iideysan karaan nooc ka mid ah faragelinta habdhaqanka oo kooban si loo yareeyo dhibaatooyinkooda kacsiga. In kasta oo daaweynta dawooyinka dawooyinka ee 'ED' ay badanaa tahay habka "safka koowaad" ee loogu talagalay ragga leh dhibaatooyinka kacsiga, daraasadihii hore waxay soo jeediyeen in PDE-5i aysan daruuri ka ahayn CAEP [26]. Waxaa intaa sii dheer, isticmaalka PDE-5i wuxuu noqon karaa halis u ah kondhom jabista [27].

Marka la eego natiijooyinka ragga oo leh CAEP waxay u baahnaan karaan wakhti dheeraad ah si ay u noqdaan kuwo ka kacsan ragga aan ka warhayn CAEP, Janssen iyo asxaabta [11] waxay ku talisay in ragga qaba CAEP lagu dhiiri geliyo inay qaataan waqti ku filan si ay u kiciyaan una hubiyaan inay helaan kicinta ku filan, gaar ahaan markay isticmaalayaan cinjirka galmada. Daraasadihii ugu dambeeyay ee tijaabada ah ee faragelinta ku-saleysan guriga ee lagu dhiirrigelinayo isticmaalka kondhomka ragga dhallinyarada ah (oo u baahan oo keliya soo-jeedinta takhtarka ugu yar) ayaa soo warisay kalsooni kordhinta awoodda ragga ee isticmaalka cinjirrada, isku-kalsoonaanta isticmaalka kondhomka, iyo raaxada cinjirka 'condom' iyo sidoo kale a hoos u dhaca burburka iyo EP-ka-dib wax ka-qabashada [28,29]. Waxaa sidoo kale jira baahi loo qabo barista wanaagsan ee isticmaalka kondhomka saxda ah. In ka badan saddex-meelood meel (37%) ee tijaabada hadda ee ragga isticmaala ragga aan marna la barin sida loo isticmaalo kondhom si sax ah. Rugaha caafimaadku waa inay qiimeeyaan haddii ragga isticmaala cinjirada ay kufilan yihiin CAEP iyo halka ay ku habboon tahay, samaynta gudbinta daaweynta nafsaaniga ah ama bixinta tacliinta kondhomka [28,29].

Ugu Dambeyn

Natiijooyinka waxay soo jeedinayaan in ragga sheeganaya CAEP ay sidoo kale u badan tahay in ay dareemaan dhibaatooyin dhameeystiran. Inkasta oo EP-yadu aysan ku qancin shuruudaha rugta caafimaad ee ED, rugaha caafimaadku waa in ay qiimeeyaan in ragga isticmaala cinjirrada ay la kulmaan CAEP iyo halka ay ku haboon tahay, tixraacaan daaweynta nafsaaniga ah ama bixinta xirfadaha kondhomka.

Khilaafka Xiisaha: Qoraaga (yada) wax war ah kama soo bixin khilaafka xiisaha leh.

Qoraalka Awooda

Category 1

(A) Fikradda iyo NaqshadeyntaStephanie Sanders; Erick Janssen; Brandon Hill
(B) Helitaanka XogtaStephanie Sanders; Erick Janssen; Brandon Hill
(C) Falanqaynta iyo Tarjumida MacluumaadkaStephanie Sanders; Erick Janssen

Category 2

(A) Qorista QodobkaStephanie Sanders; Cynthia Graham; Bill Yarber; Rick Crosby; Robin Milhausen
(B) Dib-u-eegis Miisaaniyadda AqoontaStephanie Sanders; Cynthia Graham; Bill Yarber; Rick Crosby; Robin Milhausen; Erick Janssen; Brandon Hill

Category 3

(A) Oggolaanshaha kama dambaysta ah ee Qodobka DhameystiranStephanie Sanders; Cynthia Graham; Bill Yarber; Rick Crosby; Robin Milhausen; Erick Janssen; Brandon Hill

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Guud ahaan Qalalaasaha Dhexdhexaadinta ee Dhallin-yarada, Ragga Ragga ah ee Jooga oo Ha Usheegin Dhibaatooyinka Ka-Hoos-u-Celinta Cunnooyinka (CAEP) (2015)