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1.
Salud Publica Mex ; 63(2, Mar-Abr): 316-323, 2021 Jan 15.
Article in Spanish | MEDLINE | ID: covidwho-1272145

ABSTRACT

Este artículo propone intervenciones estructurales dirigidas a la reorganización del trabajo para evitar un repunte de casos de Covid-19, permitiendo la continuidad de la actividad económica. Se resume la evidencia disponible acerca de los ciclos de trabajo-confinamiento y la posible aplicación de ciclos de cuatro días de trabajo por tres de confinamiento (4x3) en el contexto mexicano. También se discuten otras intervenciones como la continuación del teletrabajo en algunos sectores y el escalonamiento de las jornadas de trabajo como medidas complementarias a los ciclos de trabajo-confinamiento. Esta discusión se da en el contexto de alta informalidad y escasos recursos para absorber una pérdida importante de la productividad por las empresas medianas y pequeñas en México. Se considera la necesidad de implementar apoyos para que personas y empresas puedan mitigar pérdidas en salarios y ganancias tanto del sector formal como informal.


Subject(s)
COVID-19/prevention & control , Employment/organization & administration , Quarantine , COVID-19/epidemiology , COVID-19/transmission , Guidelines as Topic , Humans , Mexico/epidemiology
2.
J Int AIDS Soc ; 25(7): e25967, 2022 07.
Article in English | MEDLINE | ID: covidwho-1958775

ABSTRACT

INTRODUCTION: Globally, over half of the estimated new HIV infections now occur among key populations, including men who have sex with men, sex workers, people who inject drugs, transgender individuals, and people in prisons and other closed settings, and their sexual partners. Reaching epidemic control will, for many countries, increasingly require intensified programming and targeted resource allocation to meet the needs of key populations and their sexual partners. However, insufficient funding, both in terms of overall amounts and the way the funding is spent, contributes to the systematic marginalization of key populations from needed HIV services. DISCUSSION: The Joint United Nations Programme on HIV/AIDS (UNAIDS) has recently highlighted the urgent need to take action to end inequalities, including those faced by key populations, which have only been exacerbated by the COVID-19 pandemic. To address these inequalities and improve health outcomes, key population programs must expand the use of a trusted access platform, scale up differentiated service delivery models tailored to the needs of key populations, rollout structural interventions and ensure service integration. These critical program elements are often considered "extras," not necessities, and consequently costing studies of key population programs systematically underestimate the total and unitary costs of services for key populations. Findings from a recent costing study from the LINKAGES project suggest that adequate funding for these four program elements can yield benefits in program performance. Despite this and other evidence, the lack of data on the true costs of these elements and the costs of failing to provide them prevents sufficient investment in these critical elements. CONCLUSIONS: As nations strive to reach the 2030 UNAIDS goals, donors, governments and implementers should reconsider the true, but often hidden costs in future healthcare dollars and in lives if they fail to invest in the community-based and community-driven key population programs that address structural inequities. Supporting these efforts contributes to closing the remaining gaps in the 95-95-95 goals. The financial and opportunity cost of perpetuating inequities and missing those who must be reached in the last mile of HIV epidemic control must be considered.


Subject(s)
COVID-19 , HIV Infections , Sexual and Gender Minorities , HIV Infections/drug therapy , HIV Infections/epidemiology , HIV Infections/prevention & control , Homosexuality, Male , Humans , Male , Pandemics/prevention & control
3.
AIDS Behav ; 26(10): 3451-3458, 2022 Oct.
Article in English | MEDLINE | ID: covidwho-1941981

ABSTRACT

This study aimed to explore the impact of COVID-19 lockdown on sexual behavior and PrEP use among a sample of men who have sex with men (MSM) in Mexico. Between April 20th and 27th, 2020 - well into Mexico's lockdown - we conducted a virtual survey among 637 MSM exploring sexual behavior during the first month of the COVID-19 epidemic in Mexico and the impact of lockdown on PrEP use. We applied logistic regression models to assess predictors of PrEP use continuation. Over half the participants (52%) reported having a sexual encounter in the last two weeks. 75% of participants reported a decrease in the number of sexual partners because of COVID-19. The use of PrEP dropped from 90% to 64% during the first month of lockdown. Multivariate logistic regression models showed that younger participants were less likely to continue using PrEP than those 25 + years. Also, those who perceived themselves as not likely to acquire COVID-19 and those who reported using a condom in their last sexual encounter were more likely to continue using PrEP during the lockdown. This study provides evidence of the impact of COVID-19 on sexual behavior and PrEP use among MSM in Mexico during the lockdown. Sexual and reproductive health services will need to consider the risk of COVID-19 in providing HIV and PrEP programs to guarantee participants' and health care providers' safety.


Subject(s)
Anti-HIV Agents , COVID-19 , HIV Infections , Pre-Exposure Prophylaxis , Sexual and Gender Minorities , Anti-HIV Agents/therapeutic use , COVID-19/epidemiology , COVID-19/prevention & control , Communicable Disease Control , HIV Infections/drug therapy , HIV Infections/epidemiology , HIV Infections/prevention & control , Homosexuality, Male , Humans , Male , Mexico/epidemiology , Sexual Behavior , Sexual Partners
4.
Salud Publica Mex ; 63(6, Nov-Dic): 813-818, 2021 Nov 05.
Article in Spanish | MEDLINE | ID: covidwho-1551997

ABSTRACT

Objetivo. Describir el diseño de la Encuesta Nacional de Salud y Nutrición 2021 (Ensanut 2021). Material y métodos. La Ensanut 2021 es una encuesta probabilística de hogares que forma parte de la serie de Ensanut Continua 2020-2024. En esta ocasión se describen el alcance, el muestreo, la medición y la organización logística. Resultados. Se planea obtener al menos 12 060 entrevistas de hogar completas a nivel nacional y 9 837 muestras para determinar seropositividad a SARS-CoV-2 a nivel nacional. Conclusiones. La Ensanut 2021 permitirá realizar inferencias regionales sobre la prevalencia de seropositividad a SARS-CoV-2 y también acumular información para realizar inferencias estatales en el año 2024.


Subject(s)
COVID-19 , Humans , Nutritional Status , SARS-CoV-2
5.
Salud Publica Mex ; 63(6, Nov-Dic): 743-750, 2021 Nov 05.
Article in English | MEDLINE | ID: covidwho-1515707

ABSTRACT

OBJECTIVE: The objective of the study is to describe trends in selected services offered at public health facilities and utilization patterns during the Covid-19 epidemic in Mexico. MATERIALS AND METHODS: We used administrative data and the National Health and Nutrition Survey Covid-19, 2020. RESULTS: We found a reduction in the rates of diabetes and detection screening during 2020 compared to 2014-2019. From the demand side, we found that 18.6% of the population reported health needs, and only 34% of them received care in public health facilities. The use of private health services was extensive even among the population with social security. The uninsured and the population with high and medium socioeconomic status had a lower probability of receiving care in public health facilities. CONCLUSION: We document trends in selected services, as well as the cascade of care during the Covid-19 epidemic in Mexico and its potential impact on displaced health care.


Subject(s)
COVID-19 , Delivery of Health Care , Humans , Mexico/epidemiology , Pandemics , Patient Acceptance of Health Care , SARS-CoV-2
6.
Salud Publica Mex ; 63(6, Nov-Dic): 734-742, 2021 Nov 05.
Article in English | MEDLINE | ID: covidwho-1515705

ABSTRACT

OBJECTIVE: The study describes health care services utilization contextualized by the needs of the Mexican population during the Covid-19 pandemic. MATERIALS AND METHODS: We used data from the National Health and Nutrition Survey, Covid-19. Among the population with symptoms compatible with Covid-19, we describe the proportion who sought care, received care, were tested, were diagnosed positive, and survived, and whether they received care in public or private services. We estimated factors associated with the probability of seeking and receiving care. RESULTS: Out of 7.1% of the population with symptoms compatible with Covid-19, 64.4% received care, and 15.4% tested positive; 74.5% received care in the private sector, even among the population with social security. Those with social security, in contact with a suspected or confirmed Covid-19 case, and with at least one comorbidity had a higher probability of seeking and receiving care. CONCLUSIONS: The most relevant finding of our study is the large proportion of the population with Covid-19 symptoms who sought and received care in private facilities an essential aspect for decision-makers to consider as the current health reform moves forward in Mexico.


Subject(s)
COVID-19 , Pandemics , Health Care Reform , Humans , Mexico/epidemiology , SARS-CoV-2
7.
Salud Publica Mex ; 63(5): 598-606, 2021 Sep 03.
Article in English | MEDLINE | ID: covidwho-1404208

ABSTRACT

OBJECTIVE: To estimate the willingness to vaccinate against Covid-19 (acceptance) in the Mexican population and to iden-tify socioeconomic factors associated with vaccine hesitancy and refusal. MATERIALS AND METHODS: We estimated the acceptance, refusal and hesitancy proportions using data from the Covid-19 National Health and Nutrition Survey conducted from August to November 2020. Factors associated with re-fusal and hesitancy were explored using multinomial logistic regression. RESULTS: Covid-19 vaccination acceptance was 62.3%, refusal 28.2% and hesitancy 9.5%. Refusal and hesitancy were associated with being female, having older age, lower educational level, lower socioeconomic status and working in the informal sector. CONCLUSION: National campaigns to incentivize vaccine acceptance need to consider specific subgroups were the likelihood of hesitancy and refusal is high. In Mexico, refusal and hesitancy were higher in vulnerable groups, and people at a higher risk of Covid-19 complica-tions and death.


Subject(s)
COVID-19 Vaccines , COVID-19 , Aged , Female , Humans , Mexico , Patient Acceptance of Health Care , SARS-CoV-2 , Vaccination
8.
Front Public Health ; 9: 598921, 2021.
Article in English | MEDLINE | ID: covidwho-1282419

ABSTRACT

The impact of the COVID-19 outbreak on mental health among HIV high-risk populations is not known. We assess the prevalence of depressive symptoms (DS) and explore the association with characteristics related to the COVID-19 pandemic. We conducted an online survey among 881 men who have sex with men (MSM) and transgender women (TGW) assessing the presence of DS using the Center for Epidemiological Studies Depression Scale (CESD-10); results were compared with previously self-reported DS and national data. We applied latent class analysis (LCA) to identify classes of participants with similar COVID-19 related characteristics. The overall prevalence of significant DS was 53.3%. By LCA posterior probabilities we identified three classes: (1) minimal impact of COVID-19 (54.1%), (2) objective risk for COVID-19 (41.5%), and (3) anxiety and economic stress caused by COVID-19 (4.4%). Multivariate logistic regression showed that compared with those in class one, the odds to have significant DS were almost five times higher for those in class three. Our findings suggest high levels of depression among MSM and TGW in Mexico during the COVID-19 pandemic and highlight the need for the provision of targeted psychological interventions to minimize the impacts of COVID-19 on the mental health.


Subject(s)
Depression , Sexual and Gender Minorities , Transgender Persons , COVID-19 , Depression/epidemiology , Female , Homosexuality, Male , Humans , Latent Class Analysis , Male , Mexico/epidemiology , Pandemics , Sexual and Gender Minorities/psychology , Transgender Persons/psychology
9.
Salud Publica Mex ; 63(3 May-Jun): 444-451, 2021 May 03.
Article in Spanish | MEDLINE | ID: covidwho-1259814

ABSTRACT

Objetivo. Describir el diseño y los resultados de campo de la Encuesta Nacional de Salud y Nutrición (Ensanut) 2020 so-bre Covid-19. Material y métodos. La Ensanut Covid-19 es una encuesta probabilística de hogares. En este artículo se describen los siguientes elementos del diseño: alcance, muestreo, medición, inferencia y logística. Resultados. Se obtuvieron 10 216 entrevistas de hogar completas y 9 464 resultados sobre seropositividad a SARS-CoV-2. La tasa de respuesta de hogar fue 80% y la de prueba de seropositividad de 44%. Conclusiones. El diseño probabilístico de la Ensa-nut Covid-19 permite hacer inferencias estadísticas válidas sobre parámetros de interés para la salud pública a nivel nacional y regional; en particular, permitirá hacer inferencias de utilidad práctica sobre la prevalencia de seropositividad a SARS-CoV-2 en México. Además, la Ensanut Covid-19 podrá ser comparada con Ensanut previas para identificar potenciales cambios en los estados de salud y nutrición de la población mexicana.


Subject(s)
COVID-19/epidemiology , Health Status Indicators , Nutrition Surveys/methods , Age Distribution , COVID-19/transmission , Censuses , Humans , Mexico/epidemiology , Nutrition Surveys/statistics & numerical data , Prevalence , Rural Health/statistics & numerical data , Sample Size , Urban Health/statistics & numerical data
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