RESUMO
Rapid oral HIV self-tests (HIVST) have potential to increase the proportion of people who know their HIV status, especially among stigmatised populations. This study was embedded in two cohorts of female sex workers (FSW) in the Dominican Republic (DR) and Tanzania. Qualitative interviews with 40 FSW were conducted to explore perceived acceptability of HIVST. Interviews were analysed using inductive and deductive thematic coding. Emergent themes were organised by socio-ecological framework levels. FSW in both settings responded positively to the ease of use of HIVST but questioned test accuracy due to the use of saliva rather than blood. FSW in the DR had a more cautious response, while women in Tanzania had favourable perceptions expressing eagerness to use it. At the individual level, themes shaping participants' interest included autonomy, HIV risk perception, and emotional well-being for those with reactive test results, and self-efficacy. At the interpersonal level, privacy, confidentiality, sex work and HIV stigma and social support were salient. Structural level themes focused on health systems including linkages to HIV treatment, provider roles, and access (cost, travel, distribution). Understanding FSW's perceptions and acceptability of HIVST is essential to its integration into health systems and programmes using a community-driven approach.
Assuntos
Infecções por HIV , Profissionais do Sexo , República Dominicana , Feminino , Infecções por HIV/diagnóstico , Infecções por HIV/psicologia , Humanos , Programas de Rastreamento/psicologia , Autoteste , Profissionais do Sexo/psicologia , TanzâniaRESUMO
Este estudo é uma revisão de literatura desenvolvida para investigar o uso de instrumentos de vigilância e rastreio para atraso do desenvolvimento infantil por meio de tecnologia móvel. Além disso, objetivou-se caracterizar as metodologias utilizadas, amostras de participantes, se clínicas ou não, contexto de pesquisa, bem como a finalidade do uso instrumento. Foi realizada a busca de artigos, por três juízes, nas bases de dados indexadas na BVS, PUBMED/MEDLINE e APA PsyNET. Utilizaram-se as recomendações do PRISMA para essa revisão. A partir de critérios de inclusão/exclusão, foram recuperados e analisados cinco artigos. As duas modalidades de instrumentos: vigilância e rastreio, apresentaram-se em três categorias de estudo: 1) descritivo 2) viabilidade/usabilidade 3) validade. Conclui-se que mais estudos sejam necessários, especialmente para avaliar o impacto e eficácia do uso de instrumentos de vigilância e rastreio para atraso no desenvolvimento infantil em formato de tecnologia móvel. (AU)
This study is a literature review designed to investigate the use of monitoring and screening instruments for child developmental delay using mobile technology. In addition, the aim was to characterize the methodologies used, samples of participants, whether clinical or not, the research context and the purpose of the instrument use. Articles were searched by three judges in the databases indexed in the BVS, PUBMED/MEDLINE and APA PsyNET. The PRISMA recommendations were used for this review. After applying the inclusion/exclusion criteria, five articles were retrieved and analyzed. The two types of instruments: monitoring and screening, were presented in three study categories: 1) descriptive 2) viability/usability 3) validity. Further studies are needed to assess the impact and effectiveness of the use of mobile format instruments for the monitoring and screening for childhood developmental delays. (AU)
Este estudio es una revisión de la literatura desarrollada para investigar el uso de instrumentos de vigilancia y rastreo del retraso del desarrollo infantil a través de la tecnología móvil. Asimismo, el objetivo fue caracterizar las metodologías utilizadas, muestras de participantes, ya sean clínicas o no; además del contexto de investigación y la finalidad del uso del instrumento. Tres jueces realizaron una búsqueda de artículos en las bases de datos indexadas en la BVS, PUBMED/MEDLINE y APA PsyNET. Las recomendaciones de PRISMA se utilizaron para esta revisión. Según los criterios de inclusión/exclusión, cinco artículos fueron recuperados y analizados. Los dos tipos de instrumentos fueron: vigilancia y detección, se presentaron en tres categorías de estudio: 1) descriptivo 2) viabilidad/usabilidad 3) validez. Se concluyó que son necesarios más estudios, especialmente para evaluar el impacto y la efectividad del uso de instrumentos de vigilancia y rastreo del retraso en el desarrollo infantil en formato de tecnología móvil. (AU)
Assuntos
Desenvolvimento Infantil , Deficiências do Desenvolvimento/psicologia , Programas de Rastreamento/psicologia , Aplicativos Móveis , Bases de Dados BibliográficasRESUMO
BACKGROUND: In Perú, HIV disproportionately affects men who have sex with men (MSM). Despite widespread access to treatment, the high rate of new HIV infections has remained unchanged over the last decade. Low knowledge of HIV status associated with late diagnosis is a key factor underlying the high HIV incidence observed in this setting, creating conditions for efficient onward transmission. Improving access to HIV testing and prevention services for those at highest risk is an important public health priority. Sex-on-premise venues (SOPVs) - saunas, sex clubs, pornographic movie theaters, hourly hotels, and bars/discos with areas where sex is permitted - may be opportune sites for outreach; however, further research on SOPVs and the populations who frequent them is needed to inform such efforts. METHODS: We conducted a cross-sectional online survey of adult MSM in Lima, Perú to evaluate patterns of SOPV attendance, associated sexual risk behaviors, and attitudes toward SOPV-based interventions. Participants were recruited through outreach to social media networks affiliated with local LGBTQ-aligned community groups. Our primary analytic objective was to estimate the association of HIV-related sexual risk behaviors and SOPV attendance. Additionally, we performed exploratory analyses to describe risk behavior stratified by SOPV category and to examine the relationship between SOPV attendance and the use of online platforms to meet sex partners. RESULTS: Overall, 389 MSM completed the survey from November 2018 through May 2019, of whom 68% reported attending an SOPV in the last 3 months. SOPV attendance was associated with multiple sexual risk behaviors, including transactional sex, group sex, substance use around the time of sex, and higher number of partners. Over two thirds of SOPV attendees indicated they would accept HIV testing if offered at SOPVs. CONCLUSIONS: SOPV attendance was common among MSM in Lima who participated in our survey, and SOPV attendees reported significantly greater engagement in sexual risk behaviors related to HIV transmission. Attitudes toward hypothetical SOPV-based interventions were generally favorable. These findings suggest that outreach at SOPVs may be an effective mechanism for reaching a particularly high-risk sub-population of MSM in Perú to deliver targeted HIV testing and prevention interventions.
Assuntos
Infecções por HIV/psicologia , Programas de Rastreamento/psicologia , Comportamento Sexual/psicologia , Minorias Sexuais e de Gênero/psicologia , Infecções Sexualmente Transmissíveis/psicologia , Adolescente , Adulto , Estudos Transversais , HIV , Infecções por HIV/epidemiologia , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Peru/epidemiologia , Fatores de Risco , Assunção de Riscos , Comportamento Sexual/estatística & dados numéricos , Parceiros Sexuais/psicologia , Minorias Sexuais e de Gênero/estatística & dados numéricos , Infecções Sexualmente Transmissíveis/epidemiologia , Infecções Sexualmente Transmissíveis/virologia , Rede Social , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Transtornos Relacionados ao Uso de Substâncias/psicologia , Transtornos Relacionados ao Uso de Substâncias/virologia , Inquéritos e Questionários , Adulto JovemRESUMO
Despite a high number of cases, the awareness of breast and cervical cancer in Haiti and other low and middle-income countries (LMICs) remains relatively unknown. The objective of the research was to understand perceptions and attitudes towards breast and cervical cancer in Haiti through community-engaged research. We report Haitians perceptions of breast and cervical cancer symptoms, diagnosis, complications, treatment, community support and access to medical services. Five non-governmental Haitian organisations performed a large survey across the country of Haiti in 2015. The survey and focus groups addressed demographics, reported knowledge of women's cancer, infrastructural issues and barriers to care, communication and media channels. The mixed quantitative and qualitative surveys with open- and closed-ended questions were administered to 414 participants aged 13-65 (75% of whom were women). A separate, smaller survey on community support and gender-based violence was conducted in 50 breast cancer patients and survivors as well. The quantitative data indicate low levels of knowledge about cancer across all geographic regions of the country amongst men and women. After coding participants' qualitative responses as "accurate" or "not accurate", we determined the percentage of accurate responses related to knowledge. Data are reported broken down by geographic region, education, economic status and sex. Approximately one in five respondents reported knowing how a woman contracts breast or cervical cancer. Only 30% reported to know complications of breast cancer and 22% the complications of cervical cancer. When asked if they knew where to get a test for breast cancer, 20% said yes and 33% said they knew where to get a test for cervical cancer. The wealthiest and best educated generally had the most knowledge, but the poorest consistently had the second best. Forty percent of cancer patients reported to be victims of on-going gender-based violence. Further investigation should be undertaken examining the role of gender-based violence and to address the knowledge of the working poor.
Assuntos
Neoplasias da Mama/psicologia , Conhecimentos, Atitudes e Prática em Saúde , Programas de Rastreamento/psicologia , Exame Físico/psicologia , Neoplasias do Colo do Útero/psicologia , Adolescente , Adulto , Idoso , Neoplasias da Mama/diagnóstico , Autoexame de Mama/psicologia , Feminino , Grupos Focais , Haiti , Humanos , Pessoa de Meia-Idade , Fatores Socioeconômicos , Inquéritos e Questionários , Neoplasias do Colo do Útero/diagnóstico , Esfregaço Vaginal/psicologia , Saúde da Mulher , Adulto JovemRESUMO
OBJECTIVE: to identify the lifetime use of alcohol and other drugs among users of the Family Health Strategy and apply Brief Intervention to problems related to the use of these substances. METHOD: a descriptive cross-sectional study where 1,031 users of the Family Health Strategy of the city of Rio de Janeiro answered a form with socio-demographic information and the Alcohol, Smoking and Substance Involvement Screening Test. Statistical analysis with simple frequency distribution was performed. RESULTS: the most commonly used drugs in lifetime were alcohol and tobacco; among the illegal drugs, marijuana, hypnotics and cocaine/crack stood out. Those who received most Brief Intervention were users of tobacco, hypnotics, marijuana, cocaine/crack and alcohol. CONCLUSION: it is important to detect early problems associated with the use of alcohol and other drugs in Primary Care, since it has the promotion/protection of health and the prevention of diseases as priority health practices.
Assuntos
Programas de Rastreamento/métodos , Transtornos Relacionados ao Uso de Substâncias/diagnóstico , Adolescente , Adulto , Brasil , Estudos Transversais , Feminino , Humanos , Masculino , Programas de Rastreamento/psicologia , Programas de Rastreamento/normas , Pessoa de Meia-Idade , Atenção Primária à Saúde/métodos , Atenção Primária à Saúde/normas , Psicometria/instrumentação , Psicometria/métodos , Classe Social , Transtornos Relacionados ao Uso de Substâncias/psicologia , Inquéritos e QuestionáriosRESUMO
Objectives: To study the prevalence of psychiatric disorders in adolescents with and without type 1 diabetes, the factors associated with its presence, and to test the reliability of a screening tool for use in clinical settings. Methods: Eighty-one adolescents were enrolled in this case-control study, including 36 diabetic participants and 45 controls. Clinical and sociodemographic data were collected and psychiatric symptoms and diagnoses were obtained from adolescents and their parents using a screening tool (Strengths & Difficulties Questionnaire) and a semi-structured interview (Development and Well-Being Assessment). Results: Psychiatric disorders were identified in 22.2% of the sample (30.56% among diabetic adolescents vs. 15.56% of controls: OR = 2.39, 95%CI 0.82-6.99; p = 0.11). Overweight (body mass index percentile ≥ 85) was the only factor associated with psychiatric disorder (OR = 3.07; 95%CI 1.03-9.14; p = 0.04). Compared to the semi-structured interview, the screening instrument showed 80% sensitivity, 96% specificity, 88.9% positive predictive value and 92.3% negative predictive value for the presence of psychiatric diagnoses in adolescents. Conclusion: Psychiatric morbidity was high in this sample of adolescents, especially among those with diabetes. Routine use of the Strengths and Difficulties Questionnaire can help with early detection of psychiatric disorders in this at-risk group.
Assuntos
Humanos , Masculino , Feminino , Criança , Adolescente , Programas de Rastreamento/métodos , Diabetes Mellitus Tipo 1/psicologia , Transtornos Mentais/epidemiologia , Transtornos de Ansiedade/diagnóstico , Transtornos de Ansiedade/epidemiologia , Fatores Socioeconômicos , Brasil/epidemiologia , Estudos de Casos e Controles , Programas de Rastreamento/psicologia , Prevalência , Inquéritos e Questionários , Transtorno Depressivo/diagnóstico , Transtorno Depressivo/epidemiologia , Entrevista Psicológica , Transtornos Mentais/psicologiaRESUMO
OBJECTIVE: Learn about the perception of health professionals who perform rapid tests in Health Centers (HCs). METHOD: This is a descriptive and qualitative study conducted in nine HCs in Recife. Data were collected through individual interviews and evaluated using Bardin's content analysis, in its thematic category. RESULTS: Challenges were observed in rapid tests related to the supply of products, physical structure, training for pre- and post-test counseling, and the need for improvements in permanent education actions. FINAL CONSIDERATIONS: These issues can be resolved with management improvements, systematization of permanent education activities, and definition of care flows that enable early diagnosis. Besides the diagnosis, care lines should be created for people living with HIV and AIDS who use the HCs for early health care process.
Assuntos
Programas de Rastreamento/normas , Enfermeiras e Enfermeiros/psicologia , Percepção , Brasil , Centros Comunitários de Saúde/organização & administração , Equipamentos e Provisões/provisão & distribuição , Humanos , Programas de Rastreamento/instrumentação , Programas de Rastreamento/psicologia , Pesquisa Qualitativa , Recursos HumanosRESUMO
OBJECTIVE: To identify social, clinical and behavioral factors of tuberculosis patients that are associated with delay in the search for primary health care. METHOD: This is a cross-sectional, quantitative study conducted with 56 people on treatment for pulmonary tuberculosis in the city of Natal, in the state of Rio Grande do Norte, Brazil. The data were collected through a structured instrument. The Chi-square and Fisher tests were applied to test the association between independent and dependent variables (search time). A value of p <0.05 was set as statistically significant. RESULTS: No social or clinical variables were statistically associated with patient delays in the search for primary health care. Among the behavioral variables, self-medication and the first health service sought had a statistically significant association with the time for seeking care (p = 0.020, and p = 0.033, respectively). CONCLUSION: Self-medication contributes to the delay in the search for primary health care by tuberculosis patients.
Assuntos
Comportamento de Busca de Ajuda , Programas de Rastreamento/psicologia , Fatores de Tempo , Tuberculose Pulmonar/psicologia , Adulto , Brasil , Estudos Transversais , Diagnóstico Tardio/psicologia , Escolaridade , Feminino , Humanos , Renda/estatística & dados numéricos , Masculino , Programas de Rastreamento/tendências , Pessoa de Meia-Idade , Aceitação pelo Paciente de Cuidados de Saúde/psicologia , Fatores Sexuais , Fatores Socioeconômicos , Inquéritos e Questionários , Tuberculose Pulmonar/diagnósticoRESUMO
OBJECTIVES: To study the prevalence of psychiatric disorders in adolescents with and without type 1 diabetes, the factors associated with its presence, and to test the reliability of a screening tool for use in clinical settings. METHODS: Eighty-one adolescents were enrolled in this case-control study, including 36 diabetic participants and 45 controls. Clinical and sociodemographic data were collected and psychiatric symptoms and diagnoses were obtained from adolescents and their parents using a screening tool (Strengths & Difficulties Questionnaire) and a semi-structured interview (Development and Well-Being Assessment). RESULTS: Psychiatric disorders were identified in 22.2% of the sample (30.56% among diabetic adolescents vs. 15.56% of controls: OR = 2.39, 95%CI 0.82-6.99; p = 0.11). Overweight (body mass index percentile ≥ 85) was the only factor associated with psychiatric disorder (OR = 3.07; 95%CI 1.03-9.14; p = 0.04). Compared to the semi-structured interview, the screening instrument showed 80% sensitivity, 96% specificity, 88.9% positive predictive value and 92.3% negative predictive value for the presence of psychiatric diagnoses in adolescents. CONCLUSION: Psychiatric morbidity was high in this sample of adolescents, especially among those with diabetes. Routine use of the Strengths and Difficulties Questionnaire can help with early detection of psychiatric disorders in this at-risk group.
Assuntos
Diabetes Mellitus Tipo 1/psicologia , Programas de Rastreamento/métodos , Transtornos Mentais/epidemiologia , Adolescente , Transtornos de Ansiedade/diagnóstico , Transtornos de Ansiedade/epidemiologia , Brasil/epidemiologia , Estudos de Casos e Controles , Criança , Transtorno Depressivo/diagnóstico , Transtorno Depressivo/epidemiologia , Feminino , Humanos , Entrevista Psicológica , Masculino , Programas de Rastreamento/psicologia , Transtornos Mentais/psicologia , Prevalência , Fatores Socioeconômicos , Inquéritos e QuestionáriosRESUMO
ABSTRACT Objective: To identify proximal, intermediary and individual social determinants related to mammography adherence, according to the Social Determinants of Health model proposed by Dahlgren and Whitehead. Method: Correlational cross-sectional study, carried out with a sociodemographic and clinical data questionnaire and the Champion's Health Belief Model Scale, translated and adapted for use in Brazil. Data analyzed by multiple linear regression, from the domains scale, and sociodemographic and clinical variables were used as predictors. Results: The age group of 60-64 years (55.0%) was highlighted, 22 (55.0%) women had a stable partner; and 14 (65.0%) completed higher education. The domain with the greatest influence on adhesion to mammography was perceived barriers. Conclusion: The social determinants of health are directly related to the levels of adherence to the exam among women, as well as the perceived benefits, susceptibilities and barriers.
RESUMEN Objetivo: identificar determinantes sociales proximales, intermediarios y distales relacionados a la adhesión a la mamografía, según el modelo de determinantes sociales de salud, propuesto por Dahlgren y Whitehead. Método: estudio transversal correlacionado, realizado con la aplicación de un cuestionario de datos socio demográficos y clínicos y de Champion's Health BeliefModelScale, traducida y adaptada para el uso en Brasil. Datos analizados por regresión linear múltipla, a partir de los dominios de la escala, y usadas, como predictores, las variables socio demográficas y clínicas. Resultados: Se destacó el grupo de edad de 60-64 años (55,0%), 22 (55,0%) mujeres poseían pareja estable; y 14 (65,0%) concluyeron la enseñanza superior. El dominio con mayor influencia en la adhesión a la mamografía fue barreras notadas. Conclusión: Los determinantes sociales de salud tiene relación directa con los niveles de adhesión examen entre las mujeres, así como con los beneficios, las susceptibilidades y las barreras notadas.
RESUMO Objetivo: identificar determinantes sociais proximais, intermediários e distais relacionados à adesão à mamografia, segundo o modelo de determinantes sociais de saúde, proposto por Dahlgren e Whitehead. Método: estudo transversal correlacional, realizado com a aplicação de um questionário de dados sociodemográficos e clínicos e da Champion's Health Belief Model Scale, traduzida e adaptada para o uso no Brasil. Dados analisados por regressão linear múltipla, a partir dos domínios da escala, e usadas, como preditores, as variáveis sociodemográficas e clínicas. Resultados: destacou-se a faixa etária de 60-64 anos (55,0%), 22 (55,0%) mulheres possuíam companheiro fixo; e 14 (65,0%) concluíram o ensino superior. O domínio com maior influência na adesão à mamografia foi barreiras percebidas. Conclusão: os determinantes sociais de saúde têm relação direta com os níveis de adesão ao exame entre as mulheres, bem como com os benefícios, as suscetibilidades e as barreiras percebidas.