Factores de riesgo en Canadá para enfermedades de transmisión sexual y sus variaciones / Risk Factors For Sexually Transmitted Diseases in Canada and Provincial Variations

Bajaj Sameer, Ramayanam Shravan, Stanley Enebeli, Hortense Nosh Tabien, Mustafa Andkhoie, Mohsen Yaghoubi, Gall Spencer, Szafron Michael, Marwa Farag

Resumen


Objetivos:

Este estudio exploró los factores asociados con los reportes que indican haber tenido alguna vez una enfermedad de transmisión sexual (STI-Sexually Transmitted Disease) en Canadá y las variaciones regionales de estas asociaciones.

Métodos:

Se tomó una muestra de 35,099 canadienses adultos de la Encuesta de Salud de la Comunidad Canadiense de 2009-2010, la cual se analizó mediante regresión logística binaria para modelar las relaciones entre estado civil, sexo, ingreso familiar, educación, frecuencia de consumo de alcohol, consumo de tabaco, estatus inmigratorio y región canadiense de residencia, con haber sido diagnosticado alguna vez con una STI. El modelo controló la edad del encuestado.

Resultados:

Las personas que vivían en los Territorios tuvieron las probabilidades más altas de haber sido diagnosticadas alguna vez con una STI (OR = 2.03, 95% CI (1.19, 3.48)) y los residentes de las provincias Marítimas (OR = 0.71, 95 % CI (0.59, 0.85)) y Ontario (OR = 0.79, 95 % CI (0.70, .89)) tuvieron las probabilidades más bajas de haber sido diagnosticados con una STI. Ser mujer fue un factor de riesgo con un índice de probabilidad de 1.74 (95% CI (1.60, 1.88)). En nuestro estudio, se encontraron como factores protectores el ingreso familiar, el matrimonio y la educación. Los factores de comportamiento tales como tabaquismo y el consumo excesivo de alcohol tuvieron efectos nocivos significativos en la salud sexual. Los fumadores actuales tuvieron una probabilidad 1.95 (95% CI (1.75, 2.18)) veces más alta que los no fumadores de haber sido diagnosticados con una STI. De manera similar, los individuos con consumo excesivo de alcohol con una frecuencia de más de una vez por semana tuvieron 1.77 (95% CI (1.57,1.99)) mayores probabilidades de haber tenido alguna vez una STI.

Conclusiones:
Tanto los factores demográficos como los de comportamiento influyen en la probabilidad de haber sido diagnosticado alguna vez con una STI en Canadá. Es más probable que las mujeres, las personas con más bajos ingresos, más bajo nivel de educación o solteras, alguna vez hayan tenido una STI. El tabaquismo y el consumo excesivo de alcohol están asociados de manera significativa con un incremento en la probabilidad de alguna vez haber tenido una STI en Canadá. Las intervenciones políticas, como el suministro de información relevante y precisa para las poblaciones en mayor riesgo, identificadas en este estudio, podrían resultar beneficiosas. Las intervenciones de detección en contextos clínicos y no clínicos también son una parte importante de cualquier estrategia de prevención de las STI. Igualmente, es más probable que las intervenciones de promoción de la salud específicas de género sean más eficaces.

Abstract

Objectives: This study explored factors associated with reporting ever having had a sexually transmitted disease (STI) in Canada and the provincial variations in these associations.

Methods:A sample of 35,099 Canadian adults was drawn from the 2009-2010 Canadian Community Health Survey, and analyzed using binary logistic regression to model the relationships that marital status, sex, household income, education, frequency of risky drinking, smoking status, immigration status, and Canadian region of residence have with ever being diagnosed with an STI. The model controlled for the age of the respondent.

Results: People living in the Territories had the highest odds of having ever been diagnosed with an STI (OR = 2.03, 95% CI (1.19,3.48)) and residents from the Maritime provinces (OR = 0.71, 95 % CI (0.59, 0.85)) and Ontario (OR = 0.79, 95 % CI (0.70, .89)) had the lowest odds for having been diagnosed with an STI. Being female was a risk factor with an odds ratio of 1.74 (95% CI (1.60, 1.88)). In our study, income, marriage and education were found to be protective factors. Behavioral factors such as smoking and binge drinking had significant harmful effects on sexual health. Current smokers had an odds 1.95 (95% CI (1.75, 2.18)) times higher than non-smokers of ever being diagnosed with an STI. Similarly, individuals with a binge drinking frequency of more than once per week had 1.77 (95% CI (1.57,1.99)) higher odds of having ever had an STI.

Conclusions:Both demographic and behavioral factors influence the likelihood of having ever been diagnosed with an STI in Canada. Women, people with lower income, lower education, or unmarried are more likely to have ever had an STI. Smoking and binge drinking are significantly associated with an increase in the likelihood of ever having an STI in Canada. Policy interventions such as providing accurate relevant information to higher risk populations, identified in this study, could prove beneficial. Screening interventions in clinic-based and non-clinical settings are also an important part of any STI prevention strategy. Tailored gender-specific health promotions interventions are also likely be more efficacious.

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