RESUMO
Although the Central American HIV epidemic is concentrated in high-risk groups, HIV incidence is increasing in young women. From 2005 to 2007, we conducted a cross-sectional study of pregnant women in a large public hospital and an HIV clinic in Guatemala City to describe risk factors for HIV infection and inform prevention strategies. For 4629 consenting patients, HIV status was laboratory-confirmed and participant characteristics were assessed by interviewer-administered questionnaires. Lifetime number of sexual partners ranged from 1 to 99, with a median (interquartile range) of 1 (1, 2). 2.6% (120) reported exchanging sex for benefits; 0.1% (3) were sex workers, 2.3% (106) had used illegal drugs, 31.1% (1421) planned their pregnancy and 31.8% (1455) experienced abuse. In logistic regression analyses, HIV status was predicted by one variable describing women's behaviour (lifetime sexual partners) and three variables describing partner risks (partner HIV+, migrant worker or suspected unfaithful). Women in our sample exhibited few behavioural risks for HIV but significant vulnerability via partner behaviours. To stem feminization of the epidemic, health authorities should complement existing prevention interventions in high-risk populations with directed efforts towards bridging populations such as migrant workers. We identify four locally adapted HIV prevention strategies.
Assuntos
Infecções por HIV/epidemiologia , Complicações Infecciosas na Gravidez/epidemiologia , Adolescente , Estudos Transversais , Feminino , Guatemala/epidemiologia , Humanos , Gravidez , Fatores de Risco , Comportamento Sexual , Parceiros Sexuais , Inquéritos e Questionários , Virologia/métodosRESUMO
We aimed to determine the prevalence of HIV infection and associated risk factors among Montrealers of Haitian origin. We carried out a voluntary, anonymous survey in 7 primary care medical clinics in Montreal among 5039 persons aged 15 to 49 years born in Haiti or with at least one parent born in Haiti. The participation rate was 94.3%. Overall, HIV prevalence was 1.3% (1.6% in men and 1.1% in women). The HIV prevalence was lower among those born in Canada or who had resided in Canada longer. The prevalence among subjects who had travelled to Haiti in the previous 5 years was 2.0%, twice the rate of those who had not. The adjusted population attributable fraction of HIV infections associated with having had unprotected sex in Haiti was 10.2%. This study identified risk factors which will help in the design of more effective prevention programmes among Montrealers of Haitian origin.
Assuntos
Emigração e Imigração/estatística & dados numéricos , Infecções por HIV/epidemiologia , Infecções por HIV/etiologia , Adolescente , Adulto , Distribuição por Idade , Feminino , Haiti/etnologia , Humanos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Prevalência , Atenção Primária à Saúde/estatística & dados numéricos , Quebeque/epidemiologia , Fatores de Risco , Comportamento Sexual/estatística & dados numéricosRESUMO
The objectives of the study were to determine knowledge levels regarding AIDS and its modes of transmission, and to describe sexual behaviour of Montrealers of Haitian origin. A serial cross-sectional study was conducted in three phases between 1987 and 1990. A questionnaire was administered in a face-to-face interview with the exception of the section concerning sexual practices which was self-administered for those respondents who were literate in French. The study was conducted among 775 men and women residing in the metropolitan Montreal region. These individuals were aged 15 to 39, were born in Haiti or had at least one parent born in Haiti. Knowledge levels were high except for misconceptions about HIV transmission through casual contact and mosquito bites. There was a significant association between high risk sexual behaviour and marital status with the odds of having had multiple partners significantly raised for previously married individuals (OR = 5.96, 95% CI = 3.09; 11.50). High risk behaviour was also associated with being under 25 years of age (OR = 2.83, 95% CI = 1.40; 5.74), knowing someone with HIV/AIDS (OR = 1.88, 95% CI = 1.05; 3.37), being male (OR = 6.81, 95% CI = 3.99; 11.60) and earlier year of interview. Montrealers of Haitian origin, with their specific AIDS-related socio-cultural characteristics, constitute a community which is intermediate between their country of origin, Haiti, and their host country, Canada.
Assuntos
Síndrome da Imunodeficiência Adquirida/psicologia , Etnicidade , Conhecimentos, Atitudes e Prática em Saúde , Síndrome da Imunodeficiência Adquirida/transmissão , Adolescente , Adulto , Intervalos de Confiança , Estudos Transversais , Demografia , Emigração e Imigração , Feminino , Haiti/etnologia , Humanos , Masculino , Razão de Chances , Quebeque , Comportamento Sexual/etnologia , Parceiros Sexuais , Inquéritos e QuestionáriosRESUMO
To determine attitudes and beliefs related to AIDS among the population of metropolitan Montreal of Haitian origin, we conducted serial cross-sectional surveys between 1987 and 1990 among a random sample of 777 men and women aged 15 to 39. Data on perceived risk of AIDS and attitudes towards HIV testing were collected in home settings using a combination of face-to-face structured interviews and a self-administered questionnaire. Multivariate analysis was conducted to determine predictors of attitudes towards people with HIV. The fear of being infected with HIV is great in this population. The social representation of illness in this community is very much influenced by religious beliefs. Scores for the five-item scale suggest only moderately favourable attitudes towards persons with HIV compared to Montrealers in general. Attitudes towards persons with AIDS were positively associated with years of schooling and a higher perceived risk of getting infected (p < or = 0.01).
Assuntos
Síndrome da Imunodeficiência Adquirida/prevenção & controle , Conhecimentos, Atitudes e Prática em Saúde , Síndrome da Imunodeficiência Adquirida/epidemiologia , Síndrome da Imunodeficiência Adquirida/transmissão , Adolescente , Adulto , Estudos Transversais , Escolaridade , Medo , Feminino , Haiti/etnologia , Humanos , Masculino , Análise Multivariada , Quebeque/epidemiologia , Distribuição Aleatória , Religião e Psicologia , Projetos de Pesquisa , Fatores de Risco , Percepção SocialRESUMO
We used interviews of 268 subjects to ascertain knowledge, attitudes, beliefs and practices related to AIDS among Montrealers of Haitian origin, from November 1987 through October 1988. The questions on knowledge included items on general knowledge about the disease (prevention of AIDS, treatment, nature and manifestations of the disease, screening and high-risk groups), and more specific questions about modes of HIV-1 transmission. The average correct answers to questions on general knowledge about AIDS was 81%. The questions on HIV-1 transmission concerned both modes of infection that are scientifically established, and other modes that are not scientifically recognized. The average correct answers to questions on scientifically recognized modes of infection was 94% and the average correct answers for modes of transmission that are not scientifically accepted was 74%. The attitudes and beliefs of Montrealers of Haitian origin toward persons with AIDS was only moderately favourable. Attitudes and beliefs toward condom promotion were very positive. The percentage of subjects reporting male homosexuality or injection drug use was extremely small. 23% of subjects who had experienced sexual intercourse reported that they had two or more partners during the 12 months preceding the survey.
PIP: The authors used interviews from 268 patients to ascertain knowledge, attitudes, beliefs, and practices related to AIDS among Montrealers of Haitian origin. Interviews were conducted between November 1987-October 1988 and questions queried general knowledge about the disease (prevention of AIDS, treatment, nature, and manifestations of the disease, screening, high-risk groups), and more specific questions on the modes of HIV-1 transmission. The average % of correct answers on general knowledge about AIDS was about 81%. The questions on HIV-1 transmission concerned both modes of infection that are scientifically established, and other modes that are not. The average % of correct answers to questions on scientifically recognized modes of infection was 94% and for those answers on those which are not scientifically accepted was 74%. The attitudes and beliefs of these Montrealers towards those with AIDS was only moderately favorable. Attitudes and beliefs toward condom promotion were, on the other hand, very positive. The % of subjects reporting male homosexuality or injection drug use was extremely small. 23% of subjects who had experienced sexual intercourse reported that they had 2 or more partners in the 12 months preceding the survey. (author's)