Revista Brasileira de Psiquiatria
Mofuta oa khatiso ISSN 1516-4446Mofuta oa inthanete ISSN 1809-452X
Moruti Bras. Psiquiatr., Pele ho khatiso Epub Phuptjane 07, 2018
http://dx.doi.org/10.1590/1516-4446-2017-2476
LIHLOOHO
Ana Ventuneac3
Carmita HN Abdo2
Hermano Tavares2
Maria LS Amaral1
Bruna Messina1
Martins ea João PLB1
1Ambulatório de Impulso Boitšoaro ba botona le botšehali ka Prevenção de Desfechos Negativos Associados ao Comportamento Thobalano (AISEP), Instituto de Psiquiatria (IPq), Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo (USP), São Paulo, SP, Brazil
2Departamento de Psiquiatria, Faculdade de Medicina, USP, São Paulo, SP, Brazil
3Setsi sa Lithuto le Koetliso ea HIV (CHEST), New York, NY, USA
4Lefapha la Psychology, Hunter College, University University ea New York (CUNY), New York, NY, USA
5Health Psychology le Clinical Science Doctoral Program, Setsi sa Boikoetliso, CUNY, New York, NY, USA
HO HLOKA
Morero:
Ho na le khaello ea lithuto lithutong tse mpe tsa boitšoaro bo bobe le boits'oaro bo botle ba thobalano ho banna ba nang le maikutlo ohle a thobalano ba batlang kalafo bakeng sa boitšoaro bo feteletseng ba thobalano (ESB). Re ikemiselitse ho sekaseka tlhekefetso ea thobalano (SC), matšoenyeho, khatello ea maikutlo le boits'oaro bo kotsing ea ho ba le thobalano molemong oa banna le taolo e batlang kalafo.
Mekhoa:
Re ngolisitse li-88 (37 [42%] gay kapa li-bisexual le 51 [58%] heterosexual) Lipallo tsa ESB le li-64. Litlhahlobo li kenyeletsa sekhahla sa thobalano ea batho ba nang le thobalano (SCS), Beck Anxcare Inventory (BAI), Beck Depression Inventory (BDI), le boits'oaro bo kotsing ea ho ba le thobalano.
Results:
Ha ho bapisoa le li-control, liketsahalo tsa ESB li ile tsa bonts'a ho eketseha ha SC, ho tšoenyeha le khatello ea maikutlo, tse ileng tsa lumellana. Mabapi le thobalano le baratuoa ba bong bo fapaneng, balekane ba ESB ba tlaleha thobalano e eketsehileng, palo e kholo ea balekane, likamano tsa botona le botšehali le thobalano e sa sirelitsoeng. Matšoenyeho, khatello ea maikutlo le SC li ne li amahanngoa le likamano tsa botšehali tse sirelelitsoeng le molekane ea ka sehloohong, athe li ne li amahanngoa le likamano tsa thobalano tse sa sireletsehang le molekane ea neng a sa robala le eena. Ho sithabela maikutlo ho ne ho amahanngoa le thobalano e sa sirelitsoeng ea botšehali le molekane ea sa jeleng paate. Ho etsa thobalano ntle le tšebeliso ea likhohlopo ho boletsoe esale pele ke SC mme ho boetse ho tlalehiloe ke balekane ba bong bo fapaneng ba ESB (36%).
fihlela qeto ena:
Lintlha li kenya letsoho tšimong ka ho fana ka tlhahisoleseling ho banna ba maikutlo ohle a thobalano ba batlang tlhokomelo ea bophelo bo botle ba kelello. Khokahano pakeng tsa lintlha tsena tsa psychopathological le boits'oaro bo bobe ba thobalano e na le litlamorao ho bophelo bo botle ba sechaba, lingaka le lipatlisiso.
mantsoe a sehlooho: Ho qobelloa ho kopanela liphate; ama; matšoenyeho; khatello ea maikutlo; HIV; boits'oaro bo kotsing ea ho kopanela likobo
Selelekela
Ho tloha 2013, ha mekhoa ea tlhahlobo ea tlhahlobo ea lefu la hypersexual e sa kenyelelitsoe ho DSM-5,1 palo e ntseng e eketseha ea lithuto e ikemiselitse ho etsa lipatlisiso tse ntlafalitsoeng ka batho ba batlang kalafo bakeng sa boitšoaro bo bobe ba botona le botšehali (ESB) molemong oa ho hlola litaba tse qabang tse potileng mehlala ea litlhaloso tsa ESB. Boithuto bo bonts'a hore phetoho e kholo ho batho ba nang le ESB ke bohlasoa,2,3 e ts'ehetsang litekanyetso tsa tlhahlobo ea drive ea thobalano e feteletseng ho ICD-10.2,4 Boithuto bo bong bo hlokometse hore liphetoho tsa mantlha tsa psychopathological li kenyelletsa ho theha khatello ea ho sebetsana le matšoenyeho, a ts'oanang le mochini oa obsessive-compive disorder (OCD),5,6 e lumellanang le litekanyetso tsa hona joale tsa tlhahlobo ea tlhahlobo ho ICD-11 e le khatello e qobelloang ea boitšoaro ba thobalano.7 Tse ling tsa datha li tšehetsa mohopolo oa ESB o sebetsang ka mokhoa o tšoanang le bokhobeng,8 e kenyelletsang litšusumetso tsa bobeli le ho susumetsa, ho rata litekanyetso tsa tlhahlobo ea bokhoba ba thobalano.9 Mekhoa e mecha ea hypersexual disorder e ile ea qaptjoa ho latela lithuto tsa liphoofolo moo tšebelisano-'ngoe ea liphetoho lipakeng tsa 'mala oa monoamine metabolism le testosterone li ileng tsa fella ka tšusumetso ea takatso ea thobalano,10 e tšehelitsoeng ke lithuto tse ncha.11 Leha ho na le phapang, likhopolo tsohle tsa ESB li hlokometse hore, ntle le ho hlahisa maikutlo le litakatso tsa botona kapa botšehali tse pheta-phetoang ka nako e ikhethileng, batho bana ba tlaleha ho sithabela ka lebaka la matšoao le ho ba le litholoana tse mpe likarolong tse kholo tsa bophelo, e le mosebetsi, bophelo bo botle le likamano.
Ka lebaka la tšusumetso le tahlehelo ea taolo ea eona,12 ESB e tšoailoe e le ponelo-pele ea boitšoaro bo kotsi ba thobalano ho batho ba fapaneng ba bangata United States, haholoholo hara banna ba ratanang le ba bong bo fapaneng.13,14 Ka ho khetheha, lithuto tsena li bontšitse khokahano lipakeng tsa khatello ea thobalano (SC) le litholoana tse ngata tse mpe tse amanang le thobalano, joalo ka thobalano e se nang thobalano le balekane ba bangata ba sa rateng, ketsahalo e phahameng ea vaerase ea HIV le mafu a mang a thobalano.15,16 le ka boomo ho batla thobalano e se nang thobalano.17 Leha ho le joalo, lithuto tsena li lekotse matšoao a SC ho palo e pharalletseng ea batho ho fapana le mehlala ea batho ba batlang kalafo.
Bakeng sa batho ba bang ba nang le ESB, boitšoaro ba bona ba thobalano ha bo kenyeletse batho ba kopanang le thobalano, empa ho e-na le hoo bo tsepamisitse maikutlo ho ho ipholla litho tsa botona kapa botšehali le / kapa tšebeliso ea litšoantšo tsa bootsoa. Leha ho le joalo, hangata ho feta halofo ea ba nang le ESB ba tlaleha mathata a amang thobalano e qobelloang le balekane ba sa batleng18 'me phuputsong e le' ngoe ea banna ba ratanang le ba bong bo fapaneng ba nang le SC, 92% e tlalehile hore thobalano le balekane ba neng ba sa kopanele liphate e ne e se taolong ea bona.19 Batho ba nang le ESB ba kopanelang liphate le batho ba baholo ba lumelang ba bangata ba kotsing e kholo ea bokuli bo tebileng le lefu le amanang le ESB, ke phetiso ea mafu a likobo, ho kenyeletsoa le HIV.17,20,21 Patlisiso United States e bonts'itse hore lintlha tse phahameng ka tekanyo e atisang ho sebelisoa ea ESB, Sekhahla sa Thobalano ea ho Kopanela Liphate, li bolela esale pele thobalano le balekane ba fetang tekano, boits'oaro bo boholo ba ho nka kotsi (mohlala, tšebeliso e tlase ea likhohlopo le ho eketsa thobalano). le ho fumana mafu a likobo.3,22 Ka bomalimabe, tlhaiso-leseling e haella likhokahanong lipakeng tsa ESB le boits'oaro bo bobe ba thobalano ho banna ba otlolohileng.13,23 Tlhahiso-leseling e nyane e sa kenyelletseng mehlala ea batho ba batlang kalafo mme e hlahisitse litlhaloso tse fokolang.
Maemo a feto-fetohang a litšila, haholo-holo a tšoenyehileng le a nyahamisang a maikutlo, a 'nile a amahanngoa le ESB.24 Ho ile ha tlaleheloa banna ba nang le bothata bona bo bobe ba ho ikoetlisa joalo ka ho kopana le batho ba bangata ba kopanang le balekane ba bangata ba thobalano le ho ipholla litho.25 Maemo a joalo a mabe a ho nahanoa hore a sebetsa e le lisosa tsa ESB26 hape e ka tsamaisa likarolo tse ngata tsa thobalano e se nang likhohlopo, ho eketsa kotsi ea ho fumana tšoaetso ea HIV le mafu a likobo. Leha ho le joalo, bafuputsi ba bang ba fumane hore ke batho ba fokolang feela (15-25%) ba batho ba tlalehang ba ileng ba eketsa boitšoaro ba thobalano ha ba na le matšoenyeho kapa khatello ea maikutlo.27
Boitsebiso bo bong bo fana ka maikutlo a hore ho ba le matšoenyeho, khatello ea maikutlo kapa khalefo li ka ama ho etsa liqeto tsa thobalano ka litsela tse mpe.28 Ka lehlakoreng le leng, liphuputso tse ling li fumane hore batho ba bang ba nang le maemo a mabe a maikutlo ba ka etsa liqeto ho qoba kotsi.29 Mabapi le ho ipeha kotsing ea ho ba le thobalano, datha tsena li ka fana ka maikutlo a hore batho ba nang le khatello ea maikutlo kapa matšoenyeho ba ka ba kotsing e fokolang ea ho ba le boitšoaro bo kotsing ba ho ba le thobalano. Leha ho le joalo, Mustanski28 e fumane hore keketseho ea matšoenyeho e ne e amana le kotsi e kholo ea thobalano le ho ts'oara banna ba bong bo tšoanang le ba maikutlo a matla a hore likarolo tse nyarosang tsa matšoenyeho li ka amahanngoa le maikutlo a menyaka a ka bang le boitšoaro bo kotsi.
Ha sehlopha sa lithuto tse mabapi le ESB se entsoe United States, tlhaiso-leseling e mabapi le ESB naheng ea Brazil le likarolo tse ling tsa lefats'e e fokola haholo, e sitisa tsebo e akaretsang, hobane boitšoaro ba thobalano bo amana le phapang ea setso. Ho na le khaello e itseng ea lithuto mabapi le litlamorao tsa ESB le maikutlo a mabe ka boitšoaro bo kotsing ea tšoaetso ea HIV ka har'a disampole tse batlang kalafo.
Morero oa thuto ea hona joale e ne e le ho hlahloba ESB, matšoenyeho, khatello ea maikutlo le boits'oaro bo kotsing ba ho ba le thobalano le batho ba tsoang mesebetsing ea ESB, toropong e kholo ea São Paulo, Brazil. Re ipapisitse le bopaki bo tsoang United States, re fane ka maikutlo a hore batho ba nang le ESB ba tla hlahisa khatello e matla le khatello ea maikutlo mme ba tlalehe boits'oaro bo eketsehileng ba ho ba le thobalano ho feta taolo. Re boetse re fane ka maikutlo a hore botebo ba matšoenyeho, khatello ea maikutlo le ESB li ka amahanngoa hantle le boitšoaro bo kotsi ba thobalano.
Method
Barupeluoa le lits'ebetso
Pampiri ena e fana ka datha ho tsoa thutong e entsoeng ho Ambulatório de Impulso Boitšoaro ba Botona le Botšehali ka Prevenção de Desfechos Negativos Associados ao Comportamento Boitšoaro (AISEP), Instituto de Psiquiatria (IPq), Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo (USP) . Barupeluoa ba ile ba hapuoa ka lipapatso setsing le sechabeng se haufi ka liphatlalatso tse 'maloa tse kang radio, limakasine le limakasine. Leqhubu la pele la ho hira barupeluoa le neng le lebisitse ho barupeluoa ba nang le matšoao a ESB, mme ba neng ba batla kalafo bakeng sa ESB ba ne ba tšoaneleha bakeng sa thuto haeba ba ne ba khethollotsoe ka hore ba na le khokahano ea thobalano e fetelletseng e ipapisitseng le mohopolo oa ICD-10 F52.7, ho bolelang hore ba tletleba ka thobalano e feteletseng. drive e atisang ho isa ESB,4 le tlhekefetso ea thobalano e thehiloeng hodima litekanyetso tsa Goodman, ho bolelang hore ho na le ESB e sa sebetseng hantle e lebisang ho senyeha kapa khatello ea maikutlo e bontšitsoeng ka nako e tšoanang ea khoeli ea 12 ke tse tharo kapa ho feta tse latelang: mamello (boitsoaro bo ntseng bo hola ba thobalano); ho tlohela (matšoao a mmele le / kapa a kelello, joalo ka ho ts'oaroa ke thipa); khafetsa boitšoaro ba thobalano; taolo e sa atleheng; ho senya nako ho itokisetsa ho etsa thobalano; fokotsa mesebetsi ea boiketlo ba sechaba kapa mesebetsi; le tsoelopele ntle le litlamorao tse mpe.9 Leqhubu la bobeli la ho hira barupeluoa ho lebisitsoe ho ba se nang matšoao a ESB. Batho ka bomong ba neng ba batla ho nka karolo e le taolo ba ne ba tšoaneleha haeba ba ne ba sa fihlelle litekanyetso tsa ho khanna ka ho feteletseng ka thobalano ho latela tlhahlobo ea ICD-10 F52.7 kapa tlhekefetso ea thobalano e ipapisitse le litekanyetso tsa Goodman. Ntle le moo, barupeluoa ba ne ba tlameha ho ba le lilemo tsa 18 kapa ho feta, ho tseba ho bala le ho ngola, 'me ba tlameha ho lula Brazil lilemo tse fetileng tsa 10. Mekhoa ea ho tlosoa thutong e kenyelletsa tlhahlobo ea mafu a latelang: paraphilias (ICD-10 F65), boitsebiso bo khethollo ea bong (ICD-10 F64), schizophrenia, schizotypal le delusional (ICD-10 F20-F29), manic ea hona joale kapa karolo ea hypomanic (F 30.0, F31.0, le F 31.1, F 31.2), le mathata a mang a kelello ka lebaka la ho se sebetse ha kelello kapa ho lemala kapa lefu la 'mele (ICD-10 F0.6).
Kakaretso ea batho ba 204 ba arabetse lipapatso tsa thuto nakong ea leqhubu la pele mme 130 e ile ea tla tlhahlobo ea tlhahlobo. Ho tsena, banna ba 114 le basali ba 10 ba ne ba nkuoa ba tšoaneleha mme ba ngolisitsoe thutong, empa banna ba 26 ha baa ka ba qeta liteko tsohle ka mabaka a fapaneng, ho kenyelletsa ho ea toropong e 'ngoe, ho ea batla kalafo bakeng sa boemo bo fapaneng ba comorbid, kapa ho thata ho utloisisa mekhoa ea ho ikarabela. Kakaretso ea batho ba 121 ba batlile ho nka karolo e le taolo mme 78 e ile ea tla bakeng sa tlhahlobo e hlahlobiloeng. Le ha ho le joalo, tse hlano ho tsena li ile tsa fihlella litekanyetso tsa ho khanna ka matla ho tsa thobalano le bokhoba ba thobalano mme tsa behelloa ka ntle ho sampole ea taolo. Bakhethoa ba 73 ba setseng, banna ba 64 le basali ba robong, ba ne ba nkuoa ba tšoaneleha e le taolo mme ba ngolisitsoe thutong. Tokomaneng ena, re tlaleha lintlha tse tsoang ho banna ba 88 ba phethahalitseng litekanyetso tsa ho khanna ka matla ho tsa thobalano le bokhoba ba thobalano, bao re tla ba bitsa lingoloa tsa ESB, le ba batona ba 64 ba sa kang ba phethahatsa mokhoa oa ho khanna ka thobalano le ho lemalla tlhekefetso ea thobalano, bao re tla ba rata taolo ea mohala. Litlhahlobo tsohle tsa ho ithuta li phethetsoe ho tloha ka Mphalane 2010 ho fihlela ka XXUMX.
Barupeluoa bohle ba ile ba fana ka tumello e nang le tsebo mme ba qeta tlhahlobo ea nako e le 'ngoe ea 2 ea hora e neng e e-na le litekanyetso tse ikhethileng tsa ho ikarabela le tlhahlobo ea kelello. Barupeluoa ba ile ba qeta mechini ba sebelisa pampiri le pensele. Basebeletsi ba lipatlisiso ba fane ka kakaretso ea mehato ea ho itlaleha le ho bokella lintlha tsa sechaba. Ngaka ea mafu a kelello e ile ea etsa tlhahlobo ea bongaka ho fumana lipatlisiso tsa ho tšoaneleha. Botsamaisi ba fumane tšehetso ea lichelete bakeng sa lipalangoang. Kalafo e ile ea fuoa ba nang le ESB. Phuputso ena e ile ea hlahlojoa le ho amoheloa ke komiti ea melao ea boitšoaro ea sepetlele das Clínicas, Faculdade de Medicina, USP.
Mehato
Barupeluoa ba ile ba botsoa ho tlaleha lilemo tsa bona, bong, boemo ba molao ba lenyalo, morabe, lilemo tsa thuto, mosebetsi, moputso oa lelapa oa khoeli le khoeli, maikutlo a botona le botšehali, le boemo ba lefutso la HIV.
Boitšoaro bo feteletseng ba thobalano (ESB)
SCS e ntlafalitsoe ho lekola tloaelo ea ho khetholla ho tsa thobalano le ho qobelloa.30 Sekala se na le polelo ea 10 (mohlala, "Menahano le boits'oaro ba ka ba thobalano li baka mathata bophelong ba ka.") Tse hakantsoeng ka lintlha tse 'ne ho tloha 1 = ha ho joalo ka nna, ho 4 = joalo ka nna. Ke tekanyo e sebelisoang haholo ho ESB. Mofuta oa Brazil o bontšitsoe hore o na le ts'epahalo e ntle (Cronbach's alpha ea 0.95).31
Mehato ea Psychopathology
Phetolelo ea Sepotoketsi ea Beck Anxcare Inventory (BAI) e ne e netefalitsoe hore e sebelisoe Brazil32 mme ho fumanoe hore e ka tšeptjoa (Cronbach's alpha = 0.76). Ena ke tekanyo ea boits'oaro ea 21-e ikhethileng ho lekola boholo ba matšoao a ho tšoenyeha ka tekanyo e latelang ea lintlha tse 'ne: 0 = ho hang, 1 = hanyane, 2 = ka boqhetseke, le 3 = ka matla. Phetolelo ea Sepotoketsi ea Beck Depression Inventory (BDI) e ne e netefalitsoe hore e sebelisoe Brazil (Cronbach's alpha = 0.81)33 Ena ke sekhechana se ipolelang sa 21 se etselitsoeng ho lekola ho teba ha matšoao a sithabetsang, joalo ka bonolo, tekano le ho teba.
Boits'oaro bo kotsing ba ho ba le thobalano
Tlhahlobo ea Kotsi ea Boitšoaro ba thobalano e hlahisitsoe ke mongoli oa pele oa pampiri ena ho latela lipatlisiso tsa nakong e fetileng34,35 Ho bokella tlhahisoleseling mabapi le boitšoaro ba thobalano le balekane ba mantlha le ba tloaelehileng, ho kenyelletsa le khafetsa ea khoeli le khoeli ea likamano tsa botona le botšehali, tšebeliso ea khohlopo, le palo ea balekane ba hlabanang ka thobalano. Tlhahlobo ea kotsi ea thobalano ka tsa thobalano e entsoe joalo ka potso ea ho itlaleha ho hlahloba boitšoaro ba kotsi ea thobalano likhoeling tse tšeletseng tse fetileng Pampiri ena ea lipotso e ile ea qaptjoa le batho ba 20 ho hlahloba litaba tsa semantic le litaba mme o bile le alpha ea Cronbach ea 83.35%. E boetse e kenyelletsa lintho tse tlatselletsang mabapi le ho etsa thobalano tlasa tšusumetso ea joala le lithethefatsi.
Tlhahlobo ea statistical
Litlhahlobo tsa Statistical li entsoe ho sebelisoa mofuta oa STATA 10 ka boemo ba bohlokoa ba p <0.05. Lipalo-palo tse hlalosang li hlahisoa e le litekanyo tsa mefuta-futa ea mekhahlelo le mekhoa le liphapang tse tloaelehileng bakeng sa mefuta-futa e tsoelang pele. Papiso ea sehlopha e entsoe ho sebelisoa liteko tsa chi-square kapa li-ratios tse fapaneng le 95% interval confidence (95% CI) bakeng sa mefuta-futa ea mekhahlelo, le tLiteko tsa ho feto-fetoha ho sa khaotseng.
Ho leka tlhahlobo ea rona ea pele ea hore sephetho sa ESB se tla tlaleha ho teba ha khatello ea maikutlo le khatello ea maikutlo le boits'oaro bo botle ba thobalano ho feta taolo, re ile ra hlahloba phapang lipapaling tsa motho ea nkang karolo, ho tšoenyeha, khatello ea maikutlo le lintlha tsa SC, le boitšoaro ba thobalano lipakeng tsa litlhahlobo le taolo ea ESB. Ho etsa tlhahlobo ea rona ea bobeli ea maikutlo a hore na ho teba ha khatello ea maikutlo, ho tepella maikutlong le SC ho ka amahanngoa le boitšoaro bo botle ba thobalano, re ile ra etsa tlhahlobo ea lipalo-palo mme ra latela mehlala ea maikutlo e le ho hlahloba liphallelo tse amanang le maemo a seng monate a maikutlo (ho tšoenyeha, khatello ea maikutlo ) le SC mabapi le boitšoaro bo kotsing ba ho ba le thobalano, e leng: 1) likamano tsa botona le botšehali ka thobalano le moratuoa e moholo; 2) likamano tsa botšehali tse se nang likhohlopo le molekane ea ka sehloohong; 3) likamano tsa botona le botšehali ka thobalano le moratuoa oa hao feela; le 4) likamano tsa botona le botšehali tse se nang thobalano le moratuoa feela. Mefuta eohle e ne e lekantsoe bakeng sa lilemo, morabe, boemo ba molao ba lenyalo, maikutlo a botona le botšehali, le boemo ba seriti.
Results
Litšobotsi tsa karolo li kenya letsoho ho Lethathamo 1. Lipallo tsa ESB li ne li le telele haholo ho feta li-control (t(150) = 2.53; p = 0.006). Nako ea lipallo tsa ESB e tsoa pakeng tsa 21 le 66 ea lilemo le lilemo tsa taolo li pakeng tsa 18 le 59 ea lilemo. Liphetho tse ling tsa ESB tse fetang taolo e ne e le tsa Caucasian (χ2(2) = 8.20; p = 0.01). Mabapi le boitsebahatso ba thobalano, batho ba tsoang kantle ho ESB ba tlalehiloe e le ba bong bo fapaneng kapa ba bisexual ho feta taolo (χ2(1) = 12.10; p = 0.001) le lingoloa tse ling tsa ESB li sebelisitsoe (χ2(2) = 16.66; P <0.001). Ho ne ho e-na le phapang e arohaneng maemong a lenyalo lipakeng tsa bakuli ba kantle ho naha ba ESB le litsamaiso, ha bakuli ba ESB ba ka bang lenyalong (to2(2) = 4.64; P <0.09).
Tafole ea 1 Boitsebiso ba maemo a bophelo ba bakuli ba ka ntle ba banna ba 88 ba ESB le taolo ea banna ba 64 São Paulo, Brazil
| Sephetho sa ESB (n = 88) | Controls (n = 64) | Kakaretso (n = 152) | χ2/t liteko tsa lipalo | |
|---|---|---|---|---|
| Race | ||||
| Caucasian | 70 (79.5) | 38 (59.4) | 108 (71.1) | |
| Litloholo tsa Afrika | 16 (18.2) | 25 (39.1) | 41 (27.0) | |
| Other | 2 (2.3) | 1 (1.6) | 3 (2.0) | 8.20* |
| Boemo ba lenyalo ba molao | ||||
| nyetse | 38 (43.2) | 17 (26.6) | 55 (36.2) | |
| Single | 42 (47.7) | 41 (64.1) | 83 (54.6) | |
| Ho hlalane | 9 (9.1) | 6 (9.4) | 15 (9.87) | 4.64† |
| Boikutlo ba thobalano | ||||
| Gay le bisexual | 37 (42.1) | 10 (15.0) | 47 (30.9) | |
| Heterosexual | 51 (58.0) | 54 (84.4) | 105 (69.1) | 12.10‡ |
| Boemo ba mosebetsi | ||||
| Ha ba sebetse | 14 (15.9) | 1 (1.6) | 15 (9.9) | |
| O sebelisitsoe | 69 (78.4) | 48 (75.0) | 117 (77.0) | |
| seithuti se | 5 (5.7) | 15 (23.4) | 20 (13.2) | 16.66‡ |
| Boemo ba Serological bo tlalehiloe | ||||
| Unknown | 15 (17.0) | 13 (20.3) | 28 (18.4) | |
| a fosahetseng | 64 (72.7) | 48 (75.0) | 112 (73.7) | |
| Positive | 9 (10.2) | 3 (4.7) | 12 (7.9) | 0.43 |
| Age, ho bolela (SD) | 38.17 (8.91) | 33.98 (11.41) | 36.40 (10.21) | 2.53* |
| Lilemo tsa thuto, ho bolela (SD) | 14.20 (4.18) | 13.47 (4.02) | 13.89 (4.12) | 1.09 |
| Chelete e kenang khoeli le khoeli (R $), Median (95% CI)§ | 3,000 (2,500-3,942) | 3,000 (2,700-4,000) | 3,000 (3,000-3,800) | 0.90 |
| Ho qobelloa thobalano, bolela (SD) | 31.93 (5.02) | 15.44 (5.44) | 24.99 (9.67) | 19.30‡ |
| Matšoenyeho, bolela (SD) | 13.43 (9.98) | 6.48 (8.42) | 10.51 (9.94) | 4.52‡ |
| Ho tetebela maikutlo, ho bolela (SD) | 16.51 (8.60) | 6.21 (5.66) | 12.18 (9.06) | 8.88‡ |
Lintlha li hlahisitsoe e le n (%), ntle le haeba ho boletsoe ka tsela e 'ngoe.
95% CI = 95% nako ea ho itšepa; ESB = Boitšoaro bo feteletseng ba thobalano; SD = ho kheloha ho tloaelehileng.
*p <0.05;
†p <0.10;
‡p <0.001.
§Mann Whitney U teko.
Lipallo tsa ESB li ne li e-na le SC e phahameng (t(150) = 19.30; p <0.001), matšoenyeho (t(150) = 4.51; p <0.001), le lintlha tsa khatello ea maikutlo (t(149) = 8.88; p <0.001) ho feta litsamaiso. Re fumane likamano tse kholo lipakeng tsa SC le khatello ea maikutlo (bakuli ba kantle ba ESB: r = 0.38; p <0.001; litsamaiso: r = 0.25; p = 0.04), SC le matšoenyeho (bakuli ba kantle ba ESB: r = 0.27; p = 0.01; litsamaiso: r = 0.33; p = 0.007), le khatello ea maikutlo le matšoenyeho (bakuli ba kantle ho ESB: r = 0.66; p <0.001; taolo: r = 0.70; p <0.001).
Ho bapisoa lipapatso le lithibelo tsa boitšoaro ba thobalano likhoeling tse tšeletseng tse fetileng ho hlahisoa Lethathamo 2. Lipapali tsa ESB li ne li na le menyetla e phahameng ea ho etsa thobalano tlasa tšusumetso ea lithethefatsi ho feta taolo. Sehlopha se laolang se tlaleha boitšoaro bo eketsehileng ba thobalano le balekane ba mantlha, likamano tsa botona le botšehali tse eketsehileng le balekane ba mantlha, le likamano tse sa sireletsehang tsa botona le botšehali le balekane ba ka sehloohong. Baitlami ba ESB ba tlalehiloe ka ho ba le likamano tsa botona le botšehali le balekane ba bangata le balekane ba bangata ba neng ba robala le bona. Sephetho sa ESB se tlaleha ho kopanela likamano tsa botona le botšehali le balekane ba sa kopaneleng le likamano tse sa sireletsehang tsa likamano tsa botona le bona. Ho ba tlalehileng likamano tsa thobalano tse se nang likhohlopo le balekane ba sa kopaneng (n = 28), 18 (64%) ba ikhethile e le basodoma kapa ba bisexual, ha 10 (36%) ba ikhethile e le ba nepahetseng. Lethathamo 3 e bonts'a phetiso ea boitšoaro ba thobalano ba li-ESB ka ntle ho litakatso tsa thobalano. Mabapi le likamano tsa botona le botšehali le baratuoa ba ka sehloohong, ba ikhethileng e le ba bong bo fapaneng ba tlaleha likamano tsa botona le botšehali ka ho feta, likamano tsa botšehali le thobalano e sa sireletsehang. Mabapi le likamano tsa botona le botšehali le balekane ba tloaetseng ho robala le balekane, ba ipitsitseng balekane ba tlaleha likamano tsa botona le botšehali tse eketsehileng tse sa sireletsehang, ha ba ikhethileng e le basodoma kapa ba bong bo fapaneng ba hlahisa palo e phahameng ea balekane le ba tlalehileng likamano tsa botona le botšehali tse eketsehileng.
Tafole ea 2 Boitšoaro ba thobalano ba bakuli ba kantle ba 88 ESB le litsamaiso tse 64, São Paulo, Brazil
| Sephetho sa ESB (n = 88) | Controls (n = 64) | OR | 95% CI | p-bohlokoa | |
|---|---|---|---|---|---|
| Ho etsa thobalano likhoeling tse tšeletseng tse fetileng | 74 (84.1) | 50 (78.1) | 1.48 | 0.65-3.37 | 0.350 |
| Ho kopanela liphate le moratuoa e moholo likhoeling tse tšeletseng tse fetileng | 39 (44.3) | 43 (67.2) | 0.39 | 0.20-0.76 | 0.006 |
| Thobalano ea thobalano le molekane oa sehlooho | 32 (36.4) | 39 (60.9) | 0.37 | 0.19-0.71 | 0.003 |
| Tšebeliso e sa lekanyetsoang ea likhohlopo nakong ea thobalano le balekane ba mantlha | 26 (29.6) | 29 (45.3) | 0.51 | 0.26-0.99 | 0.047 |
| Ho kopanela liphate le motho ea ka sehloohong | 21 (23.9) | 17 (26.6) | 0.87 | 0.41-1.82 | 0.710 |
| Tšebeliso e sa lekanyetsoang ea likhohlopo nakong ea thobalano le balekane ba mantlha | 14 (15.9) | 10 (15.6) | 1.02 | 0.42-2.47 | 0.960 |
| Ho etsa thobalano le moratuoa ea sa kopaneng likhoeling tse tšeletseng tse fetileng | 62 (70.5) | 22 (34.4) | 4.55 | 2.28-9.07 | <0.001 |
| Palo ea batho ba robalang le bona likhoeling tse tšeletseng tse fetileng, ho bolelang (SD) | 12.63 (27.98) | 0.86 (1.76) | t (150) = -3.36 | 0.001 | |
| 0 | 26 (29.6) | 42 (65.6) | 1 | ||
| 1 | 10 (11.4) | 12 (18.8) | 1.35 | 0.51-3.56 | 0.550 |
| 2 kapa ho feta | 52 (59.1) | 10 (15.6) | 8.4 | 3.64-19.36 | <0.001 |
| Ho kopanela likobo le motho ea hlabaneng le eena | 35 (39.8) | 18 (28.1) | 1.69 | 0.84-3.37 | 0.140 |
| Tšebeliso e sa lekanyetsoang ea likhohlopo nakong ea thobalano le balekane ba sa kopaneng | 23 (26.1) | 12 (18.8) | 0.62 | 0.70-3.37 | 0.290 |
| Ho kopanela liphate le motho ea hlabanang le eena | 46 (52.3) | 17 (26.6) | 3.03 | 1.51-6.07 | 0.020 |
| Tšebeliso e sa lekanyetsoang ea likhohlopo nakong ea likamano tsa botona le botšehali le balekane bao e seng balekane ba bona | 28 (31.8) | 9 (14.1) | 2.85 | 1.24-6.58 | 0.010 |
| Thobalano tlasa tšusumetso ea joala | |||||
| Che | 55 (63.2) | 38 (59.4) | 1 | ||
| Ka linako tse ling | 29 (32.9) | 25 (39.1) | 0.76 | 0.39-1.50 | 0.440 |
| Hangata | 4 (4.6) | 1 (1.6) | 1.14 | 0.58-2.21 | 0.700 |
| Thobalano tlasa tšusumetso ea lithethefatsi | |||||
| Che | 74 (84.1) | 63 (98.4) | 1 | ||
| Ka linako tse ling | 11 (12.8) | 1 (1.6) | 9.00 | 1.07-75.27 | 0.010 |
| Hangata | 3 (3.5) | 0 | - |
Lintlha li hlahisitsoe e le n (%), ntle le haeba ho boletsoe ka tsela e 'ngoe.
95% CI = 95% nako ea ho itšepa; ESB = Boitšoaro bo feteletseng ba thobalano; KAPA = karo-karolelano ea.
Ts'ebeliso e sa lekanyetsoang ea likhohlopo e bolela ho sebelisa likhohlopo ho 0-75% ea makhetlo.
Tafole ea 3 Boitšoaro ba thobalano ba bakuli ba 37 ba bong bo fapaneng / ba bong bo fapaneng le ba 51 ba ratanang le ba bong bo fapaneng ba ESB, São Paulo, Brazil
| Gay / bisexual | Heterosexual | p-bohlokoa | |
|---|---|---|---|
| Ho etsa thobalano likhoeling tse tšeletseng tse fetileng | 31 (83.8) | 43 (84.3) | 0.950 |
| Ho kopanela liphate le moratuoa e moholo likhoeling tse tšeletseng tse fetileng | 8 (21.6) | 31 (60.8) | <0.001 |
| Thobalano ea thobalano le molekane oa sehlooho | 2 (5.4) | 30 (58.8) | <0.001 |
| Tšebeliso e sa lekanyetsoang ea likhohlopo nakong ea thobalano le balekane ba mantlha | 1 (2.7) | 25 (49) | <0.001 |
| Ho kopanela liphate le motho ea ka sehloohong | 8 (21.6) | 13 (25.5) | 0.670 |
| Tšebeliso e sa lekanyetsoang ea likhohlopo nakong ea thobalano le balekane ba mantlha | 6 (16.2) | 8 (15.7) | 0.950 |
| Ho etsa thobalano le moratuoa ea sa kopaneng likhoeling tse tšeletseng tse fetileng | 31 (83.8) | 31 (60.8) | 0.020 |
| Palo ea batho ba robalang le bona likhoeling tse tšeletseng tse fetileng, ho bolelang (SD) | 23.8 (39.5) | 4.5 (8.9) | 0.006 |
| Ho kopanela likobo le motho ea hlabaneng le eena | 6 (16.2) | 29 (56.9) | <0.001 |
| Tšebeliso e sa lekanyetsoang ea likhohlopo nakong ea thobalano le balekane ba sa kopaneng | 4 (10.8) | 19 (37.6) | 0.007 |
| Ho kopanela liphate le motho ea hlabanang le eena | 29 (78.4) | 17 (33.3) | <0.001 |
| Tšebeliso e sa lekanyetsoang ea likhohlopo nakong ea likamano tsa botona le botšehali le baratuoa ba bang | 18 (48.7) | 10 (19.6) | 0.004 |
Lintlha li hlahisitsoe e le n (%), ntle le haeba ho boletsoe ka tsela e 'ngoe.
ESB = Boitšoaro bo feteletseng ba thobalano.
Ts'ebeliso e sa lekanyetsoang ea likhohlopo e bolela ho sebelisa likhohlopo ho 0-75% ea makhetlo.
Setšoantšo sa 1 e bonts'a mokhoa o fapaneng oa ho akola liphapang tsa psychopathological le likamano tsa thobalano le balekane ba mantlha le ba sa boneng. Ba tlalehang tšebeliso e sa lekanyetsoang ea likhohlopo le balekane ba ka sehloohong ba hlahisitse lintlha tse tlase tsa kelello ho feta tse fanang ka tlaleho ea tšebeliso ea likhohlopo hangata. Ka lehlakoreng le leng, ba tlalehang ts'ebeliso e sa tloaelehang ea likhohlopo le balekane ba tloaelehileng ba ile ba hlahisa lintlha tse ngata tsa kelello ho feta tsa tse sebelisang khafetsa tšebeliso ea likhohlopo.
Setšoantšo sa 1 Ts'ebeliso ea likhohlopo tse nang le balekane ba mantlha le ba sa tloaelaneng hara bakuli le taolo ea boits'oaro bo feteletseng ba thobalano (ESB) (n = 152). A: Ts'ebeliso ea likhohlopo ka thobalano le motho e moholo. Bao ba tlalehang tšebeliso ea likhohlopo khafetsa ba hlahisitsoeng ke khatello ea maikutlo e fokotsehileng (bolela [M] = 9.3; ho kheloha ho tloaelehileng [SD] = 7.5 vs. 13.8; SD = 9.5) (t[134.5] = 3.2; p = 0.001) le lintlha tsa ho tšoenyeha (M = 8.0; SD = 9.3 vs. M = 11.9; SD = 10.0) (t[150] = 2.4; p = 0.02); B: Ts'ebeliso ea likhohlopo ho etsa thobalano le molekane oa mantlha; C: Tšebeliso ea likhohlopo tsa botona le botšehali le molekane ea sa kopaneng le eena. Ts'ebeliso ea tšebeliso e mpe ea ts'ebeliso ea likhohlopo e hlahisitse lintlha tse ngata tsa khatello ea maikutlo (M = 14.8; SD = 9.0 vs. 11.4; SD = 9.0) (t[150] = -2.0; p = 0.05); D: Ts'ebeliso ea likhohlopo khokahanong ea botona le botšehali le moratuoa oa hau feela. Ts'ebeliso ea tšebeliso e mpe ea ts'ebeliso ea khohlopo e hlahisitsoeng e bonts'a ho eketsa khatello ea thobalano (SC) (M = 29.8; SD = 9.8 vs. 23.5; SD = 9.5) (t[150] = -3.6; p <0.001), khatello ea maikutlo (M = 17.6; SD = 8.9 vs M = 10.4; SD = 8.4) (t[150] = -4.4; p <0.001), le lipalo tsa matšoenyeho (M = 15.4; SD = 10.6 vs. M = 8.9; SD = 9.2) (t[150] = -3.6; P <0.001). Ha ho phapang ea lipalo-palo e ileng ea bonoa ho SC ho A, khatisong efe kapa efe ea psychopathological ho B, kapa ho matšoenyeho le SC ho C. khafetsa ho bolela makhetlo a 76-100%. Ha e bolele khafetsa 0-75% ea makhetlo.
Mehlala ea maikutlo a boitšoaro bo botle ba ho kopanela liphate e hlahisoa Lethathamo 4. SC e bonts'itsoe e le moetapele ea ikemetseng oa likamano tse sa sireletsehang tsa likamano tsa botona le botšehali kamora ho laola lilemo, morabe, maemo a molao a lenyalo, maikutlo a botona le botšehali. Keketseho e 'ngoe le e' ngoe ea SC e ile ea eketsa menyetla ea likamano tsa botona le botšehali tse se nang thobalano le balekane ba sa kopaneng ka 7%.
Letlapa la 4 Mefuta ea tšebeliso ea likhohlopo ka thobalano ka ho ngolisa bakuli le litlamorao tse feteletseng tsa boits'oaro (n = 152), São Paulo, Brazil
| Mohlala oa tšebeliso ea likhohlopo tsa botšehali le thobalano e kholo | Mohlala oa tšebeliso ea khohlopo ho kopanela liphate le molekane | Mohlala oa tšebeliso ea likhohlopo tsa botona le botšehali | Mohlala oa tšebeliso ea khohlopo likamano tsa botona le botšehali le moratuoa e mong | |||||
|---|---|---|---|---|---|---|---|---|
| khafetsa* | Bofokoli | khafetsa* | Bofokoli | khafetsa* | Bofokoli | khafetsa* | Bofokoli | |
| Ho qobella ho kopanela liphate | ||||||||
| OR | Reference | 1.00 | Reference | 1.04 | Reference | 0.98 | Reference | 1.07† |
| 95% CI | - | 0.94-1.06 | - | 0.98-1.11 | - | 0.91-1.05 | - | 1.01-1.14 |
| ho tepella maikutlo | ||||||||
| OR | Reference | 0.95 | Reference | 0.90† | Reference | 1.03 | Reference | 1.05 |
| 95% CI | - | 0.87-1.03 | - | 0.81-1.00 | - | 0.93-1.15 | - | 0.97-1.13 |
| ho Tšoenyeha | ||||||||
| OR | Reference | 1.00 | Reference | 1.03 | Reference | 1.00 | Reference | 1.02 |
| 95% CI | - | 0.95-1.07 | - | 0.96-1.11 | - | 0.92-1.09 | - | 0.96-1.08 |
95% CI = 95% nako ea ho itšepa; KAPA = karo-karolelano ea.
*76-100%.
†p <0.05.
Mefuta eohle e ne e hlophisitsoe bakeng sa lilemo, morabe, boemo ba lenyalo, maikutlo a botona le botšehali, le boemo ba seriti.
Puisano
Mefuta e 'meli ea boits'oaro bo bobe ba thobalano e ka khetholoha. Taba ea pele, mabapi le thobalano le moratuoa oa sehlooho, litataiso li tlaleha khafetsa likamano tsa botona le botšehali, tseo boholo ba tsona e neng e le ts'ireletso e sa sireletsehang. Mohlomong ke hobane ho na le banna ba otlolohileng ho sampole ea taolo, ba etsang thobalano le balekane ba bona ntle le likhohlopo, e leng ntho e tloaelehileng maemong a likamano tse tsitsitseng tsa nako e telele. Taba ea bobeli, malebana le thobalano le batho bao e seng balekane ba bona, balekane ba ESB ba tlaleha baratuoa ba bangata ba tloaetseng ho robala le bona, khafetsa likamano tsa botona le botšehali le balekane ba se nang thobalano, maqhubu a phahameng a likamano tsa botona le botšehali le likhahla tse phahameng tsa likamano tsa thobalano tse se nang likhohlopo ho feta taolo. Motsoako ona oa tšoenyeha ka lebaka la kotsi ea tšoaetso ea mafu a likobo le tšoaetso ea HIV. Tlhahlobo ea meta e ile ea lekola karolo ea karolo ea thobalano ka phetiso ea HIV mme ea fihlela qeto ea hore likamano tsa botona le botšehali ke tloaelo e kotsi ea phetiso ea tšoaetso ea HIV esita le nakong ea kalafo ea antiretroviral e sebetsang haholo.36 Ho feta moo, ba fumane karolo e eketsehang ea balekane ba bong bo fapaneng ba kopanelang liphate le litheko tse tlase tsa ts'ebeliso ea likhohlopo,36 e lumellanang le datha ea rona, eo ho eona 36% ea barupeluoa ba ESB ba tlalehileng likamano tsa botona le botšehali ho hloka thobalano le balekane ba hlonephileng e ne e le banna ba otlolohileng. Ha re shebana le boitšoaro ba thobalano ba bana ba ESB, re bone hape karolo e nepahetseng ea banna ba ratanang ba kopanelang liphate le balekane ba ka sehloohong ba se nang thobalano.
Ho bohlokoa ho supa hore 16% ea li-outpatients tsa ESB le 22% ea taolo ha ea ka ea etsa thobalano le balekane likhoeling tse tšeletseng tse fetileng. Ka hona, tlhahlobo ea boits'oaro bo bobe ba thobalano e ne e sa ikarabelle bakeng sa sampole eo eohle mme e kanna ea beha matla a eona a lipalo ho bona phapang. Ho ka etsahala hore ebe ke lona lebaka le entseng hore ho se be le phapang e kholo lipalo pakeng tsa lihlopha tse mabapi le khafetsa ea likamano tsa botona le botšehali le likamano tsa botšehali ntle le tšebeliso ea thobalano le balekane ba sa kopaneng, leha e le hore ESB, ntle haholo banna ba otlolohileng, ba tlaleha tse ngata tsa boits'oaro bona. ho feta taolo.
Mokhoa o fapaneng oa pontšo ea psychopathological o hlahile tlhahlobisong ea boitšoaro ba kotsi ea thobalano le balekane ba mantlha le ba sa boneng. Ka tšoenyeho e kholo, ba tlalehang tšebeliso e sa sebetseng ea tšebeliso ea khohlopo le balekane ba tloaelehileng ba ile ba hlahisa lintlha tse phahameng tsa kelello, haholo ha ba etsa thobalano ea anal. Liphumano tsena li lumellana le lithuto tse tlalehang phello e tobileng ea ama (khatello ea maikutlo, letsoalo)28,37 le SC17,30 ka boits'oaro ba HIV bo kotsing. Ka hona, ho tšoenyeha ho ka amahanngoa le ho nka kotsi ea ho ba le thobalano, haholo ha ho nahanoa ka maikutlo a phetisetso ea ho tšoenyeha, moo ho tšoenyeha le ho tsosa takatso ea botona le botšehali ho arolelanang likarolo tse itseng, le batho ba bang ba tsosang takatso ea thobalano ho fokotsa matšoao a ho tšoenyeha,38 ka tsela eo, o tloaela ho ipeha kotsing ea ho etsa thobalano.28 Ho sithabela maikutlo ho ka boela ha kenya letsoho ts'ebetsong ea boitšoaro ba thobalano,25 eo, le eona e bonahala haholo ha e etsahala ka nako e ts'oanang le SC e phahameng.39 Ho feta moo, lithuto tse 'maloa li tlalehile ts'ebetso e eketsehileng ea ts'ebetso ea thobalano ho batho ba nang le ESB,40 e amanang haholo le SC. Ba hlahisang ts'ebetso e matla ea thobalano hangata ba ipeha kotsing e kholo ka ho fetisoa ha HIV.26,28 Ka hona, SC e bonahala e na le phello e itseng boits'ebetsong ba kotsi ea thobalano, kaha e boletse esale pele likamano tsa botona le botšehali le balekane ba sa kopaneng thutong ea rona. Ho sithabela maikutlo le matšoenyeho ha lia ka tsa boloka setsoalle le boitšoaro bo kotsi ho regression ea thepa. Lebaka e ka ba hobane li amana le SC mme li ka bapala karolo e sa tobang boits'ebetsong ba kotsi ea thobalano, mohlala, ho eketsa botebo ba SC. Lintlha tsa rona li lumellana le lithuto tsa pejana tsa palo ea banna ba etsang thobalano le banna (MSM)17 le lithuto tsa bongaka mabapi le HIV,21 moo SC e boletseng esale pele boitšoaro bo kotsi ba thobalano.
Lintlha tsa rona li na le moelelo bakeng sa bophelo bo botle ba sechaba, lingaka le lipatlisiso. Kamano lipakeng tsa matšoenyeho, khatello ea maikutlo le SC le mekhatlo ea bona ea likamano tse se nang likhohlopo le balekane ba sa sebetseng ba ts'ehetsa lipatlisiso tsa morao-rao tse khothalletsang hore boitšoaro bo nang le tšoaetso ea HIV bo ka hlalosoa hamolemo ke conceptualization ea syndemic, ho bolelang hore kotsi ea ho fumana boemo e fella ka ho eketsehileng ke tšebelisano ea lintlha tse 'maloa tsa kotsi ho feta phello e ikemetseng ea lintlha ka bomong.22 Lintlha tsena li bohlokoa haholo bakeng sa bophelo bo botle ba sechaba, ka ho nka hore li amana le banna ba boitsebiso bohle ba thobalano sebakeng sa mafu a kelello. Khokahano pakeng tsa lintlha tsena le psychopathological e boetse e mabapi le sepheo sa bongaka, hobane e eketsa tsitsipano mme e etsa hore kalafo e be thata le ho feta,41 haholoholo ha ho nahanoa hore palo ea batho ba joalo e tlisa mathata a ho tiisetsa kalafo. Kamora nako, khokahano lipakeng tsa matšoao a psychopathological (ho tšoenyeha, khatello ea maikutlo, le SC) e kenya letsoho ho etsa lipatlisiso tšimong, hobane e tšehetsa mohopolo o le mong oa khatello ea maikutlo: "Ho pheta-pheta menahano ena ea thobalano, litakatso, le boits'oaro ho arabela maemong a maikutlo a dysphoric ( mohlala, ho tšoenyeha, khatello ea maikutlo, ho hlonama, ho teneha). "Ts'ebetso e ntseng e eketseha ea thobalano e amanang le matšoao ana a maikutlo e bonts'a bohlokoa ba lipatlisiso tsa nako e tlang lits'ebetsong tsa takatso ea thobalano le tsoalo ho batho ba nang le ESB ho ntlafatsa kutloisiso ea mantlha psychopathological and pathophysiological lintlha tse amehang.
Boithuto ba rona bo ipapisitse le sampole ea bonolo ea bongaka, e bileng teng kamora hore batho ba bang ba ileng ba ikopanya le rona ba se ke ba tsoelapele ts'ebetso ea tlhahlobo, ka hona, ra sitoa ho bokella data ho bona. Ba qetileng ts'ebetso ea tlhahlobo ba kenyelelitsoe, ha feela ba ne ba tseba ho bala. Lintlha tsena li thibela kakaretso ea data ea rona. Ka bomalimabe, ho na le liphapang tse 'maloa tsa sechaba ka har'a litaba tsa ESB le taolo. Ka ho khetheha, ho ka ba molemo ha re ka ba le teka-tekano e fetisisang ea ho arolelana maikutlo a thobalano har'a lihlopha, hobane banna ba ratanang le ba bong bo fapaneng hangata ba tlaleha ho tšoenyeha ho hoholo, khatello ea maikutlo le thobalano.17 Ntle le moo, re fetotse mokhoa o hlakileng oa ho beha kotsing ea thobalano bakeng sa boitšoaro ba lilemo, morabe, boemo ba molao ba lenyalo, boemo ba seriti le maikutlo a thobalano ho qoba litlamorao tse mpe. Ntho e 'ngoe e ka fokotsang thuto ena ke hore ha ho etsoa lipatlisiso tsa mathata a bongoana. Li-hypersexual outpatients li tlaleha tsietsi e kholo ea bongoana, e amanang le matšoao a sithabetsang,42 mme lintlha tsena ka bobeli li ka eketsa menyetla ea boitšoaro bo kotsing ba ho ba le thobalano. Ka tsebo eohle ea rona, sena ke thuto ea pele ho SC, maikutlo a mabe le boitšoaro bo botle ba thobalano sebakeng sa mafu a kelello se kenyeletsang banna ba bong bo fapaneng. Lintlha tsa rona li totobatsa bohlokoa ba ho etsa lipatlisiso ka SC, ho tšoenyeha le khatello ea maikutlo ho batho ba batlang kalafo ea ESB, kaha ho sebetsana le litaba tsena tsa kelello ho ka thusa ho thibela phetiso ea HIV.
Liteboho
Boithuto bona bo tšehelitsoe ke Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP; fa 2010 / 15921-6).
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E amohetse: August 30, 2017; E amohetsoe: December 07, 2017
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