ABSTRACT
Background: Late diagnosis of HIV is a problem of international and national relevance. Despite the availability of HIV testing in primary health care, it is often performed too late. Aim: To identify facilitators and barriers to early HIV testing in primary health care. Methods: Four databases of nursing, psychological, biomedical, and health related professions areas were examined with a review protocol. Results were grouped into two main subjects: facilitators and barriers occurring among the population, among health care workers, and within primary health care centers. Results: Perception of risk behaviors, self-care, social support, trust, confidentiality of the examination, the offer of the examination, and the knowledge of early treatment have been recognized as facilitators for taking the exam. The lack of information about the test and the disease are recognized as the main barrier to access the test. This information is a cornerstone to design and implement strategies to increase the number of people taking voluntarily HIV testing.
Introducción: El diagnóstico tardío de la infección por VIH es un problema universal. A pesar de la disponibilidad del test de ELISA para el diagnóstico de esta infección en la atención primaria de salud, las personas continúan tomándoselo tardíamente. Objetivo: Conocer los factores que facilitan o dificultan que las personas accedan oportunamente al examen en la atención primaria de salud. Métodos: Cuatro bases de datos del área de la enfermería, psicológica, salud biomédica y profesiones afines (años 2001-2012) fueron examinadas con un protocolo de revisión. Resultados: De 195 artículos detectados, 15 cumplieron con los criterios de inclusión y fueron agrupados en dos grandes temas: elementos facilitadores y elementos obstaculizadores de la persona, de los profesionales y de los centros de atención primaria de salud. Percepción de conductas de riesgo, autocuidado, apoyo social, la confianza, confidencialidad del examen, el ofrecimiento del examen y el conocimiento de un tratamiento oportuno han sido reconocidos como uno de los elementos facilitadores para la toma del examen. La falta de información sobre el test y la enfermedad son reconocidas como los principales obstaculizadores para acceder al test. Discusión: La información obtenida es un pilar fundamental para diseñar e implementar estrategias destinadas a aumentar el número de personas que solicitan voluntariamente al examen.
Subject(s)
Humans , Health Knowledge, Attitudes, Practice , Health Services Accessibility , HIV Infections/diagnosis , Patient Acceptance of Health Care , Primary Health Care , HIV Infections/psychologyABSTRACT
Introduction: The human papilloma virus (HPV) is a common sexually transmitted infection in young people and recognized as the most important risk factor for cervical cancer (CC). Aim: To describe the degree of knowledge that a group of Chilean teenagers have of HPV infection, CC, and its relationship with preventive behavior. Methods: This is an analytical study, with a random sample of 226 adolescents from three public schools of the Metropolitan Region in Santiago. Results: A fifth of the interviewed students did not know there was a HPV vaccine. Multiple sexual partners was indicated as a risk factor of CC by 70.8% and of HPV infection by 78.3% of them; while 60.3% identified inheritance as a risk factor. HPV transmission through unprotected sexual relations was identified by 68.2% of the sample. Of sexually active adolescents, condom use during sexual relations was reported by 31.1%. The adolescents who use condoms significantly have more knowledge regarding the number of sexual partners and age of first sexual intercourse as a risk factor for CC. Conclusion: adolescents know about HPV transmission, however, the preventing conducts are not related to this information.
Introducción: El virus papiloma humano (VPH) es una infección de transmisión sexual frecuente en población joven, y reconocido como el factor de riesgo más importante para desarrollar cáncer cérvico-uterino (CC). Objetivo: Describir el grado de conocimiento que tiene un grupo de adolescentes chilenas en relación al CC, al VPH y su relación con las conductas preventivas. Métodos: Estudio analítico, con una muestra aleatoria de 226 adolescentes de tres colegios municipalizados de la Región Metropolitana. Resultados: El 20% de la muestra desconoce la presencia de una vacuna contra el VPH. Las adolescentes señalan como factor de riesgo para desarrollar CC tener múltiples parejas sexuales (70,8%), VPH (78,3%) y la herencia (60,3%). La transmisión del VPH mediante relaciones sexuales sin protección es reconocida por 68,2% de la muestra. El 31,1% de las adolescentes sexualmente activas usa condón durante las relaciones sexuales. Aquellas adolescentes que usan condón señalan un conocimiento significativamente mejor solamente en lo que respecta al número de parejas sexuales y edad de inicio de las relaciones sexuales como factor de riesgo de CC. Conclusión: Las adolescentes conocen sobre la transmisión del VPH; sin embargo, las conductas preventivas no se relacionan con dicho conocimiento.
Subject(s)
Adolescent , Female , Humans , Young Adult , Health Knowledge, Attitudes, Practice , Papillomavirus Infections/prevention & control , Sexual Behavior , Sexually Transmitted Diseases/prevention & control , Uterine Cervical Neoplasms/prevention & control , Chile , Cohort Studies , Cross-Sectional Studies , Uterine Cervical Neoplasms/virologyABSTRACT
Background: The Chilean Ministry of Health has been using standards for nutritional evaluation and weight gain recommendations during pregnancy in the last 25 years. In the meantime new standards have been developed. Aim: To study the combined infl uence of preconception maternal nutritional status and gestational weight gain, using new standards to classify those parameters, on perinatal outcomes. Material and Meihods: A cohort of 11,465 healthy pregnant women was prospectively followed until term. Their pre-gestational nutritional status was classified using the body mass Índex cut-offs in use in the United States (USA). Their gestational weight gain was classified using categories proposed in a Danish study. Perinatal outcomes included were risky birth weight, i.e. < 3000 g and ≥ 4000 g, and cesarean delivery. Relative risks for those perinatal outcomes were calculated for all combined categories of pre-gestational nutritional status and gestational weight gain. Results: Relative risks of almost all gestational weight gain results were statistically significant for women having a normal pre-gestational nutritional status meanwhile all of them were not significant for underweight women. Overweight and obese women had similar relative risks valúes as normal women. However, many of them were not significant, especially in obese women. Conclusions: There is an independent and combined infl uence of preconception nutritional status and gestational weight gain on perinatal outcomes, when using standards to classify those parameters developed in the USA and Denmark, respectively.