Knowledge, attitude and practice study of HIV in female adolescents presenting for contraceptive services in a rural health district in the north-east of Namibia

Background: Namibia bears a large burden of Human Immunodeficiency Virus (HIV); and the youth are disproportionately affected. Objectives: To explore the current knowledge; attitudes and behaviour of female adolescents attending family planning to HIV prevention. Methods: A cross-sectional study design was used on a sample 251 unmarried female adolescents aged from 13 years to 19 years accessing primary care services for contraception using an interviewer-administered questionnaire. Data were analysed using Epi Info 2002. Crude associations were assessed using cross-tabulations of knowledge; attitude and behaviour scores against demographic variables. Chi-square tests and odds ratios were used to assess associations from the cross-tabulations. All p-values 0.05 were considered statistically significant. Results: A quarter of sexually active teenagers attending the family-planning services did not have adequate knowledge of HIV prevention strategies. Less than a quarter (23.9) always used a condom. Most respondents (83.3) started sexual intercourse when older than 16 years; but only 38.6used a condom at their sexual debut. The older the girls were at sexual debut; the more likely they were to use a condom for the event (8did so at age 13 years and 100at age 19 years). Conclusions: Knowledge of condom use as an HIV prevention strategy did not translate into consistent condom use. One alternate approach in family-planning facilities may be to encourage condom use as a dual protection method. Delayed onset of sexual activity and consistent use of condoms should be encouraged amongst schoolchildren; in the school setting

Pain as a Reason for Primary Care Visits: Cross-Sectional Survey in a Rural and Periurban Health Clinic in the Eastern Cape; South Africa

Background: The burden of pain in primary care has not been described for South Africa. This study aimed to determine the prevalence of pain in primary care and to characterise pain among adult patients attending a rural and a periurban clinic in the Eastern Cape (EC) Province.Method: A cross-sectional descriptive survey was conducted among adult patients attending a rural and periurban clinic over four days. Consecutive patients were asked whether they were in the clinic because of pain and whether the pain was the major reason for their visit. Pain was characterised using an adaptation of the Brief Pain Inventory and the Pain Disability Index. The prevalence percentage and the 95 confidence interval (CI) of pain were estimated; and the relationship with demographic variables was determined at a significance level of P 0.05.Results: Seven hundred and ninety-six adult patients were interviewed; representing a response rate of 97.4. Almost three-quarters (74.6; 95 CI: 63.2-81.4) reported visiting the clinic because of pain. Pain was the primary reason for 393 (49.4; 95 CI: 32.1-61.0) visits and was secondary in 201 (25.3; 95 CI: 12.8-33.7) visits. The common sites of pain were the head; back and chest. The median pain score was eight on a scale of 0-10 (interquartile range: 6-8). Respondents experienced limitations in a number of activities of daily living as a result of pain.Conclusion: Pain is a central problem in public primary care settings in the EC Province and must therefore be a priority area for primary care research. Strategies are needed to develop to improve pain management at primary care level in the province