ABSTRACT
PURPOSE: High-risk types of human papillomavirus (HPV) are a critical etiologic factor behind cervical cancer. Adolescents are a vulnerable group for HPV infection. However, the literature on adolescent women for HPV infection and cervical cancer is limited. This study was to investigate HPV-related knowledge and perceived risk of HPV infection and cervical cancer among Taiwanese adolescent women in order to assess intervention strategies for prevention of cervical cancer and maintenance of reproductive health. METHODS: A descriptive cross-sectional study design was implemented. There were 610 adolescent women from three colleges in Southern Taiwan who participated in this study. Data were collected using an anonymous self-administered questionnaire survey. RESULTS: The results showed that the percentage of appropriate answers to HPV-related knowledge questions was only 36.8%, and smoking as the leading cause of cervical cancer received the lowest mean score for appropriate answers among the HPV-related knowledge items. The perceived risk of HPV infection and cervical cancer were moderate, with relatively lower susceptibility to infection with HPV than to cervical cancer (P < .001). Only 11.5% of the participants reported that they had received information about HPV vaccination from healthcare professionals. CONCLUSIONS: Participants lacked a comprehensive understanding of cervical cancer prevention and were not aware of their susceptibility to HPV infection. Adolescent women rarely obtained HPV-related information from healthcare professionals. Appropriate education strategies should be developed and conducted by healthcare professionals to reduce the risk of cervical cancer threat from adolescence.
Subject(s)
Adolescent , Female , Humans , Adolescent Behavior/psychology , Cross-Sectional Studies , Health Knowledge, Attitudes, Practice , Papillomavirus Infections/epidemiology , Risk Factors , Sexually Transmitted Diseases, Viral/psychology , Students/psychology , Surveys and Questionnaires , Taiwan , Uterine Cervical Neoplasms/epidemiologyABSTRACT
OBJECTIVE: This exploratory study conducted in 2008 aimed at gathering the views and opinions of leaders of the faith-based community (FBC) in Grenada about the increased incidence of HIV/AIDS in the Caribbean region including their beliefs and attitudes towards persons living with HIV/AIDS (PLHIV/AIDS). DESIGN AND METHODS: The study followed a cross-sectional design and used a qualitative approach. Telephone surveys were conducted with all faith-based organizations and semi-structured interviews done with key leaders representing the faith-based community in Grenada. RESULTS: Findings showed that perceptions of HIV/AIDS are embedded in a socio-political-cultural context where many risk behaviours and factors intertwine in complex ways. Religious beliefs are based on love, compassion and acceptance. The most prominent risk behaviours associated with the spread of HIV/AIDS identified by leaders are homosexuality, prostitution, promiscuity and substance abuse which are in direct contradiction to their beliefs and teachings. Leaders felt that these risk behaviours were exacerbated by changes in family structure and the absence of a common moral discourse shared by all sectors of society. CONCLUSION: The faith-based community has a significant presence across Grenada and it can be an effective partner in helping communities understand and prevent HIV/AIDS and overcome the stigma and discrimination associated with this disease. Training and effective strategies are needed to engage them in the national response to HIV/AIDS without threatening their ideologies and practices.
OBJETIVO: Este estudio exploratorio realizado en 2008 tuvo por objetivo recoger los puntos de vistas y opiniones de líderes de la comunidad de fe en Granada, acerca del aumento de la incidencia de VIH/SIDA en la región caribena, incluyendo sus creencias y actitudes hacia personas que viven con VIH/SIDA (PLVIH/SIDA). DISEÑO Y MÉTODOS: El estudio tuvo por base un diseno transversal y un enfoque cualitativo. Se llevaron a cabo encuestas telefónicas con todas las organizaciones de fe y se realizaron entrevistas semiestructuradas a líderes importantes, representantes de la comunidad defe en Granada. RESULTADOS: Los hallazgos mostraron que las percepciones del VIH/SIDA se hallan embebidas en un contexto socio-político-cultural en el que múltiples comportamientos y factores de riesgo se entrelazan deformas complejas. Las creencias religiosas se basan en el amor, la compasión y la aceptación. Los comportamientos de riesgo más sobresalientes asociados con la diseminación del VIH/SIDA, identificados por los líderes fueron la homosexualidad, la prostitución, la promiscuidad, y el abuso de substancias que están en la contradicción directa con sus creencias y ensenanzas. Los líderes sentían que estas conductas de riesgo se hallaban exacerbadas por los cambios en la estructura de la familia y la ausencia de un discurso moral común compartido por todos los sectores de la sociedad. CONCLUSIÓN: La comunidad de fe tiene una presencia significativa en toda Granada y puede ser un aliado eficaz a la hora de ayudar a las comunidades a entender y prevenir el VIH/SIDA, así como a superar el estigma y la discriminación asociados con esta enfermedad. Se necesitan entrenamiento y estrategias efectivas para comprometer a las comunidades de fe a una respuesta nacional frente al VIH/SIDA, sin amenazar sus prácticas e ideologías.
Subject(s)
Female , Humans , Male , HIV Infections/psychology , Religion and Psychology , Sexually Transmitted Diseases, Viral/psychology , Cross-Sectional Studies , Cultural Characteristics , Grenada/epidemiology , HIV Infections/epidemiology , Homosexuality/psychology , Incidence , Interviews as Topic , Sex Work/psychology , Risk-Taking , Sexual Behavior/psychology , Sexually Transmitted Diseases, Viral/epidemiology , Socioeconomic Factors , Substance-Related Disorders/psychologyABSTRACT
OBJECTIVE: To characterize the clinicopathological manifestations and outcomes of a cohort of HIV-infected Jamaican adolescents. METHODS: This is a retrospective cohort study to determine demographic, clinical, immunological characteristics, antiretroviral uptake and mortality in 94 adolescents aged 10-19 years followed in the Kingston Paediatric and Perinatal HIV/AIDS Programme (KPAIDS) between September 2002 and May 2007. Parametric and non-parametric tests are used to compare variables. RESULTS: The median age at initial presentation was 10.0 years (interquartile range (IQR) 7.0-12.0 years), 54.3% (51) were female (p = 0.024), transmission was primarily mother-to-child (70, 73.4%), with 87% (61) of the latter presenting as slow progressors. Sexual transmission accounted for 19.1% and there was significant female predominance (n = 15; p = 0.024). At most recent visit, perinatally infected adolescents were more likely (p < 0.0001) to reside with a non-parent (n = 42) than a biological parent (n = 19) and most had Centers for Disease Control and Prevention (CDC) category C (35/50%) disease, whereas the majority of non-perinatally infected children were classified CDC category A. Mean z scores for height-for-age was -1.47 ± 1.21 (n = 77), weight-for-age -1.06 ± 1.44 (n = 80) and BMI-for-age -0.34 ± 1.21 (n = 76) respectively; females (n = 41) were taller than males (n = 36) at their current height (p = 0.031). Lymphadenopathy (82%), dermatitis (72.0%), hepatomegaly (48%) and parotitis (48%) were the most common clinical manifestations, with significant predilection for lymphadenopathy (p # 0.0001), dermatitis (p = 0.010), splenomegaly (p = 0.008), hepatomegaly (p = 0.001) and parotitis (p = 0.007) among perinatally infected children. Median baseline CD4+ cell count was 256.0/µL (IQR 71.0 - 478.0 cells/µL); median most recent CD4+ cell count was 521/µL (IQR 271.0 - 911.0 cells/µL). Seventy-six per cent (n = 71) were initiated with highly active antiretroviral therapy (HAART) and 62 (87.3%) were currently receiving first-line therapy. Six behaviourally infected females became pregnant, resulting in five live births. There were seven deaths (7.4%). CONCLUSIONS: This study comprehensively characterizes HIV infection among perinatally infected teens with predominantly slow-progressor disease and an increasing population of sexually-infected adolescents. As the cohort transitions to adulthood, adolescent developmental, mental health and life planning issues must be emergently addressed.
OBJETIVO: Caracterizar las manifestaciones clínico-patológicas y la evolución clínica de una cohorte de adolescentes jamaicanos infectados por el VIH. MÉTODOS: El presente es un estudio de cohorte retrospectivo con el fin de determinar las características demográficas, clínicas, inmunológicas, así como el consumo de antiretrovirales y la mortalidad en 94 adolescentes de 10 a 19 años de edad, llevado a cabo como parte del Programa VIH/SIDA perinatal y pediátrico de Kingston (KPAIDS) entre septiembre de 2002 y mayo de 2007. Se usan pruebas paramétricas y no paramétricas para comparar las variables. RESULTADOS: La edad mediana en la presentación inicial fue 10.0 años (rango intercuartil (IQR) 7.0-12.0 años), 54.3% (51) eran hembras (p = 0.024), la transmisión fue fundamentalmente de madre a hijo (70, 73.4%), presentándose el 87% (61) de los últimos como progresores lentos. La transmisión sexual representó el 19.1% y hubo un predominio significativo de las hembras (n = 15; p = 0.024). En la visita más reciente, los adolescentes infectados perinatalmente presentaron una mayor probabilidad (p < 0.0001) de residir con personas distintas de sus padres (n = 42) que con un progenitor biológico (n = 19), y la mayor parte tenía la enfermedad categoría C (35/50%) de acuerdo con los Centros para el Control y la Prevención de las Enfermedades (CCPE), mientras que la mayoría de los niños infectados no perinatalmente fueron clasificados con la categoría A del CCE. Las puntuaciones z medias para altura por edad fue - 1.47 ± 1.21 (n = 77), peso por edad -1.06 ± 1.44 (n = 80), y el IMC por edad -0.34 ± 1.21 (n = 76) respectivamente; las hembras (n = 41) fueron más altas que los varones (n = 36) en altura corriente (p = 0.031). La linfadenopatía (82%), la dermatitis (72.0%), la hepato-megalia (48%) y la parotitis (48%) fueron las manifestaciones clínicas más comunes, con predilección significativa de la linfadenopatía (p # 0.0001), la dermatitis (p = 0.010), la esplenomegalia (p = 0.008), la hepatomegalia (p = 0.001) y la parotitis (p = 0.007) entre los niños perinatalmente infectados. La mediana de la línea de base del conteo celular CD4+ fue 256.0/µL (IQR 71.0 - 478.0 células/µL); la mediana del conteo celular CD4+ más reciente fue 521 /µL (IQR 271.0 - 911.0 células/µL). El setenta y seis por ciento (n = 71) fueron iniciadas con terapia antiretroviral altamente activa (TARAA) y 62 (87.3%) estuvieron corrientemente recibiendo terapia de primera línea. Seis hembras infectadas conductualmente fueron embarazadas, produciéndose como resultado cinco nacimientos. Hubo siete muertes (7.4%). CONCLUSIÓN: Este estudio presenta una caracterización integral de la infección por VIH entre adolescentes infectados perinatalmente predominantemente con la enfermedad de progresores lentos, y una población creciente de adolescentes infectados sexualmente. En la medida en que la cohorte transita a la adultez, el desarrollo del adolescente, la salud mental y los problemas de la planificación de la vida tienen que ser abordados con urgencia.