RESUMO

OBJECTIVE: To assess a program in which community health workers (CHWs) provided women with self-sampling devices to detect high-risk human papillomavirus (HPV). METHODS: In a cross-sectional study, 13 CHWs visited homes in a rural area in Haiti's Central Plateau to recruit premenopausal women aged 30-50 years between July 2009 and April 2010. Eligible women had not undergone a cervical smear in the previous 3 years. Participants learned about cervical cancer and self-sampling for HPV testing before using a self-sampler in private. They then completed a questionnaire. CHWs later returned to provide results and advice about follow-up care. RESULTS: CHWs enrolled 493 women. Among the 485 women for whom questionnaires were received, 468 (96.5%) were comfortable using the self-sampler and 484 (99.8%) stated they would recommend it to others. Among 426 analyzed samples, 54 (12.7%) were positive for high-risk HPV, of whom 46 (85.2%) received follow-up care and 17 (31.5%) had precursor lesions and were treated. CONCLUSION: Using a CHW-led intervention, women at high risk for developing cervical cancer were identified and navigated to preventive care. Therefore, pairing CHWs with HPV self-sampling is a promising strategy to combat cervical cancer in rural Haiti and similar settings.

Assuntos

Agentes Comunitários de Saúde/organização & administração , Infecções por Papillomavirus/diagnóstico , Autocuidado/métodos , Neoplasias do Colo do Útero/prevenção & controle , Adulto , Estudos Transversais , Feminino , Haiti , Humanos , Programas de Rastreamento/métodos , Pessoa de Meia-Idade , Infecções por Papillomavirus/complicações , Aceitação pelo Paciente de Cuidados de Saúde , População Rural , Manejo de Espécimes/métodos , Inquéritos e Questionários , Neoplasias do Colo do Útero/virologia , Esfregaço Vaginal

RESUMO

In January 2010, a massive earthquake struck Haiti resulting in unprecedented damage. Little attention, however, has focused on the earthquake's mental health impact in the Haitian diaspora community. As part of an established community-based participatory research initiative in Little Haiti, the predominately Haitian neighborhood in Miami, FL, USA, community health workers conducted surveys with neighborhood residents about earthquake-related losses, coping strategies, and depressive/traumatic symptomology. Findings reveal the earthquake strongly impacted the diaspora community and highlights prominent coping strategies. Following the earthquake, only a small percentage of participants self-reported engaging in any negative health behaviors. Instead, a majority relied on their social networks for support. This study contributes to the discourse on designing culturally-responsive mental health initiatives for the Haitian diaspora and the ability of existing community-academic partnerships to rapidly adapt to community needs.

Assuntos

Adaptação Psicológica , Desastres , Terremotos , Adulto , Feminino , Florida , Haiti/etnologia , Humanos , Masculino , Saúde Mental , Pessoa de Meia-Idade , Apoio Social , Inquéritos e Questionários

RESUMO

Background. Haitian immigrant women residing in Little Haiti, a large ethnic enclave in Miami-Dade County, experience the highest cervical cancer incidence rates in South Florida. While this disparity primarily reflects lack of access to screening with cervical cytology, the burden of human papillomavirus (HPV) which causes virtually all cases of cervical cancer worldwide, varies by population and may contribute to excess rate of disease. Our study examined the prevalence of oncogenic and nononcogenic HPV types and risk factors for HPV infection in Little Haiti. Methods. As part of an ongoing community-based participatory research initiative, community health workers recruited study participants between 2007 and 2008, instructed women on self-collecting cervicovaginal specimens, and collected sociodemographic and healthcare access data. Results. Of the 242 women who contributed adequate specimens, the overall prevalence of HPV was 20.7%, with oncogenic HPV infections (13.2% of women) outnumbering nononcogenic infections (7.4%). Age-specific prevalence of oncogenic HPV was highest in women 18-30 years (38.9%) although the prevalence of oncogenic HPV does not appear to be elevated relative to the general U.S. population. The high prevalence of oncogenic types in women over 60 years may indicate a substantial number of persistent infections at high risk of progression to precancer.