Characteristics of Jamaicans who smoke marijuana before sex and their risk status for sexually transmitted diseases

Because of the high prevalence of marijuana smoking in Jamaica, it is important to know if this practice is associated with increased risk for STD infections. A national sample of 2,580 randomly selected Jamaicans, aged 15 to 49 years were administered a questionnaire to measure a number of health and behavioural variables. The results indicated that more persons who smoked marijuana before sex had a history of STD infections than non-marijuana smokers, the difference was significant among men (46 percent vs 26 percent, p < 0.001) but not among women (19 percent vs 8 percent, p = 0.09). There was no difference in age, however, more of the smokers were unmarried, poorly educated and unemployed than persons who did not smoke marijuana before sex. They were also more likely to engage in high risk sex behaviours and other risk taking behaviors than non-smokers. The results of multiple logistic analyses indicated that marijuana smoking before sex was an independent risk factor for STDs among men (Odd Ratio = 2.0, p = 0.04). Although it was not possible to determine if the association was causal, the increased risk for STDs among men who smoke marijuana before sex should be incorporated into the Jamaican STD/AIDS control programme by making special efforts to encourage condom use among marijuana smokers

Multisectoral approach to the delivery of health care in Jamaica

Examines the need for better integration of the public health sector with other sectors in the society. Critically examines the health status of the Jamaican population, the socio-economic environment and the development of health policy between 1950 and 1983. Five areas were researched for intersectoral co-ordination: Basic Services Programme for children jointly sponsored by UNICEF, PAHO and Government of Jamaica; the Pesticides Advisory Committee concerned with utilization of chemical and pesticides as it relates to plant protection, food storage and public health; the Nutrition Advisory Council which co-ordinates the development of food and nutrition policies; methods used for the efficient delivery of water; and methods used in the process of collaboration between the Ministries of Health and Education as attempts are made to include health concepts in school curricula and programmes. Concludes that almost all the projects and activities investigated have not performed as expected. Recommendations include the following: 1) clear goals and task specifications before the execution of any project or programme; 2) a common understanding and expectation of desired goals and objectives; 3) paying greater attention to the incorporation of potential beneficiaries into the planning and design stages of programmes.