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1.
J Cancer Educ ; 38(2): 467-475, 2023 04.
Article in English | MEDLINE | ID: mdl-35112296

ABSTRACT

Ideal efforts for cancer prevention would include lifestyle modifications along with routine, age-eligible cancer screening. Employing an asset-based approach within vulnerable populations already engaging in at least one healthy behavior (i.e., physical activity) may be an ideal way to further reduce cancer risk across peer groups with low cancer screening rates. Guided by the theory of planned behavior (TPB), the aim of this study was to identify constructs associated with cancer screening intentions among young to middle aged adults for influencing educational and behavioral interventions designed to promote cancer prevention. A cross-sectional, web-based survey was utilized to assess attitudes, subjective norms, perceived behavioral control, and intention to screen for cancer among physically active adults aged 18-49 years. Descriptive and bivariate analyses were conducted to characterize the sample, and hierarchical linear regression analyses were conducted to assess the influence of sociodemographic variables and TPB constructs on cancer screening intentions. Age, female sex, reporting a routine doctor's visit, reported knowledge of physical activity as a lifestyle behavior to reduce cancer risk, and an increased number of motivating factors for engaging in physical activity were significantly associated with higher cancer screening intention (P < 0.001). With the addition of TPB constructs (i.e., subjective norms and perceived behavioral control), the final analytic model accounted for 31% of the variance in intention to screen for cancer. Findings suggest that the TPB could be used to tailor or design asset-based, cancer education interventions to effectively promote age-eligible cancer screenings among physically active adults. Educational content to increase social support for cancer screening and enhance perceived behavioral control to complete screening is essential in this population.


Subject(s)
Intention , Neoplasms , Middle Aged , Adult , Humans , Female , Early Detection of Cancer , Cross-Sectional Studies , Surveys and Questionnaires , Neoplasms/diagnosis , Neoplasms/prevention & control
2.
Prev Med Rep ; 30: 101978, 2022 Dec.
Article in English | MEDLINE | ID: mdl-36157713

ABSTRACT

To achieve the lowest risk level for various cancers, individuals would engage in several healthy lifestyle behaviors and age-eligible cancer screenings as recommended. Nonetheless, research has largely omitted exploration of concurrent primary and secondary prevention behaviors. This study was designed to explore influences of cervical cancer screening among physically active women who reported participation in recreational sports. U.S. based women between the ages of 21-49, who had never been diagnosed with cancer, were eligible to complete a web-based survey. Logistic regression analyses were conducted using SAS 9.4. On average, women were 31 years of age (N = 394) and self-identified as Black (51.3 %). Although low overall (30.7 %), higher odds of cervical cancer screening were associated with age (OR = 1.06, 95 % CI = 1.03-1.10), employment (OR = 2.43, 95 % CI = 1.14-5.18), knowledge of cancer-related risk behaviors (OR = 4.04, 95 % CI = 1.33-12.28), routine doctor's visit (OR = 4.25, 95 % CI = 1.56-11.54), and team-based vs individual-based sport participation (OR = 1.95, 95 % CI = 1.13-3.34). Our study provides insight into the health profile of physically active women, ages 21-49, as it relates to risks for cervical cancer. Screening uptake among this diverse sample was much lower than the general population and national goals set by Healthy People 2030. Interventions should be tailored to increase knowledge of cancer-related risk behaviors, access to healthcare, and recommended cervical cancer screenings among even assumed-to-be healthy populations.

3.
Bone Marrow Transplant ; 49(2): 299-303, 2014 Feb.
Article in English | MEDLINE | ID: mdl-24121210

ABSTRACT

Quality of life (QOL) is increasingly recognized as an important clinical outcome of hematopoietic cell transplantation (HCT), but patient education is often overlooked. The aim of the current qualitative study was to examine education regarding post-HCT QOL from the patient's perspective. Allogeneic HCT recipients participated in one of four focus groups. Participants were asked to recall what they had been told about post-HCT QOL as they were preparing for transplant, how their QOL differed from what they expected and how to educate future patients about post-HCT QOL. Verbatim transcripts were coded for both a priori and emergent themes using content analysis. A total of 24 patients participated (54% female, mean age 51, range 23-73 years). Participants frequently expressed the desire for additional education regarding post-HCT QOL, particularly late complications. They noted that late complications were often unexpected, had a profound impact on their QOL and threatened their ongoing sense of recovery. They emphasized that the timing, content and format of education regarding QOL should be flexible to meet their diverse needs. Findings from the current study draw attention to the importance of patient education regarding post-HCT QOL as well as additional QOL research designed with patient education in mind.


Subject(s)
Hematopoietic Stem Cell Transplantation/psychology , Patient Education as Topic/methods , Transplantation Conditioning/psychology , Female , Hematopoietic Stem Cell Transplantation/methods , Humans , Male , Patient Education as Topic/ethics , Patient Education as Topic/standards , Quality of Life , Transplantation Conditioning/methods , Transplantation, Homologous
5.
Cancer Treat Rev ; 36(8): 621-8, 2010 Dec.
Article in English | MEDLINE | ID: mdl-20444550

ABSTRACT

PURPOSE: To conduct a systematic review and meta-analysis of all phase III randomized controlled trials comparing efficacy of early versus late first-line or initial treatments for cancer. METHODS: A comprehensive literature search of MEDLINE and Cochrane library databases was performed (1966-2008). Data was extracted and pooled as per the methods recommended by the Cochrane Collaboration. RESULTS: Of the 570 identified studies, 10 (3811 patients) met inclusion criteria: three each in prostate cancer and multiple myeloma (MM), two in chronic lymphocytic leukemia (CLL), and one each in lung cancer, and follicular lymphoma. The analyses showed no survival benefit with early treatment except in prostate cancer (hazard ratio [HR]=1.23, 95% CI 1.11-1.37 p<0.001). There was no survival difference in MM (HR=0.92, 95% CI 0.56-1.52 p=0.74), CLL (HR=0.76, 95% CI 0.56-1.04 p=0.09), lung cancer (HR=0.95, 95% CI 0.72-1.24 p=0.71), or follicular lymphoma (HR=1, 95% CI 0.55-1.83 p=0.99). No statistically significant difference in response rate between early and late treatment was detected in any cancer type. CONCLUSIONS: Data shows that delaying cancer treatments does not necessarily compromise therapeutic outcomes except possibly in locally advanced prostate cancer. These findings provide a unique window to oncologists and patients to address time-sensitive issues if desired by patients.


Subject(s)
Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Neoplasms/mortality , Neoplasms/therapy , Clinical Trials, Phase III as Topic , Disease-Free Survival , Female , Humans , Leukemia, Lymphocytic, Chronic, B-Cell/mortality , Leukemia, Lymphocytic, Chronic, B-Cell/pathology , Leukemia, Lymphocytic, Chronic, B-Cell/therapy , Lung Neoplasms/mortality , Lung Neoplasms/pathology , Lung Neoplasms/therapy , Male , Multiple Myeloma/mortality , Multiple Myeloma/pathology , Multiple Myeloma/therapy , Neoplasms/pathology , Prognosis , Prostatic Neoplasms/mortality , Prostatic Neoplasms/pathology , Prostatic Neoplasms/therapy , Radiotherapy, Adjuvant , Risk Assessment , Survival Analysis , Time Factors , United States
6.
Health Educ Behav ; 28(5): 608-23, 2001 Oct.
Article in English | MEDLINE | ID: mdl-11575689

ABSTRACT

A socioculturally appropriate health risk behavior instrument, modeled after the U.S. Centers for Disease Control and Prevention's Youth Risk Behavior Survey (YRBS), was administered to 717 secondary school students in a rural area of Zimbabwe. Comparisons of risk behaviors by gender and school grade were made using univariate procedures and multiple logistic regression. Males were significantly more likely than females to have had sexual intercourse (odds ratio = 5.02, p < .0001) and to report drug use behaviors. Males also were significantly more likely to report early initiation (by age 13 years) of alcohol use, cigarette smoking, and marijuana use. School site violence and drug use behaviors also were prevalent in this sample. An interaction between gender and grade was evident for some behaviors. Additional research may further the understanding of these risk behaviors and facilitate development of effective, culturally relevant risk reduction programs.


Subject(s)
Adolescent Behavior/psychology , Health Status Indicators , Risk-Taking , Students/psychology , Adolescent , Adult , Female , Health Knowledge, Attitudes, Practice , Humans , Logistic Models , Male , Prevalence , Rural Population/statistics & numerical data , Sexual Behavior/statistics & numerical data , Socioeconomic Factors , Students/statistics & numerical data , Substance-Related Disorders/epidemiology , Violence/statistics & numerical data , Zimbabwe/epidemiology
7.
Oncol Nurs Forum ; 28(5): 855-62, 2001 Jun.
Article in English | MEDLINE | ID: mdl-11421145

ABSTRACT

PURPOSE/OBJECTIVES: To determine whether music moderates the level of anxiety that patients experience during radiation therapy. DESIGN: Experimental, longitudinal, random assignment to music or no music therapy. SETTING: Urban radiation oncology center in a Department of Veterans Affairs hospital in the southeastern United States. SAMPLE: Forty-two men (19 in the experimental group, 23 in the control group) aged 39-80 years (74% white, 12% African American, 12% Hispanic, and 2% other) receiving definitive external beam radiation therapy for pelvic or abdominal malignancies. METHODS: Patients in the experimental group listened to music of their choice provided via audiotapes and headphones before and during their simulation and daily treatments for the duration of the planned course of therapy. The control group received standard care. The State-Trait Anxiety Inventory was administered initially to participants in both groups at the time of evaluation (time 1), post-simulation (time 2), at the end of the first week (time 3), at the end of the third week (time 4), and at the end of the fifth week or end of radiation therapy (time 5). MAIN RESEARCH VARIABLE: State anxiety. FINDINGS: No significant difference existed between the two groups to suggest that music moderated the level of anxiety during radiotherapy. However, post-hoc analyses identified changes and trends in state anxiety scores, suggesting a possible benefit of music therapy during radiotherapy. CONCLUSIONS: Despite a lack of group differences, early intervention with music therapy for patients with high levels of anxiety may be beneficial. IMPLICATIONS FOR NURSING PRACTICE: Nurses and other clinicians may administer state anxiety scales at the initial visit or prior to pretreatment radiation planning (simulation). Individuals who have high state anxiety scores may receive nursing interventions tailored to reduce anxiety during simulation and the early part of radiotherapy.


Subject(s)
Anxiety/prevention & control , Music Therapy , Neoplasms/radiotherapy , Adult , Aged , Aged, 80 and over , Analysis of Variance , Anxiety/etiology , Female , Humans , Longitudinal Studies , Male , Middle Aged , Neoplasms/nursing , Radiotherapy/nursing , Radiotherapy/psychology , Southeastern United States , Statistics, Nonparametric
8.
Int J Radiat Oncol Biol Phys ; 50(2): 465-72, 2001 Jun 01.
Article in English | MEDLINE | ID: mdl-11380235

ABSTRACT

PURPOSE: The purpose of this study was to assess the need for obtaining weekly complete blood count (CBC) values and to identify the pattern of changes in CBC during regional conventional fractionated radiotherapy. METHODS AND MATERIALS: A retrospective analysis of CBC data on 299 adult cancer patients who received definitive conventional radiotherapy to head and neck (n = 95), chest (n = 96), and pelvis (n = 108) was performed. Temporal patterns and magnitude of change in white blood cells, neutrophils, lymphocytes, and platelets during radiotherapy were examined. RESULTS: There were statistically significant declines in all counts, albeit not clinically significant. Notable differences between disease sites were found. The greatest weekly interval change in counts occurred during the first week of radiotherapy for all groups of patients. The mean WBC nadir values during treatment were 5.8 for head & neck, 6.8 for chest, and 5.4 for pelvis. The nadirs for all counts occurred toward the middle-to-end of radiotherapy. Lymphocytes were found to be more sensitive to radiotherapy than other leukocyte subcomponents. CONCLUSION: Our study suggests that weekly CBC monitoring is not necessary for all patients undergoing standard fractionated radiotherapy. Baseline blood counts may be used to determine an optimal schedule for monitoring CBCs in patients receiving conventional radiation alone. Reduced monitoring of CBC may result in significant financial savings.


Subject(s)
Blood Platelets/radiation effects , Lymphocytes/radiation effects , Neoplasms/blood , Neoplasms/radiotherapy , Neutrophils/radiation effects , Adult , Blood Platelets/cytology , Dose Fractionation, Radiation , Humans , Leukocyte Count , Lymphocytes/cytology , Neutrophils/cytology , Platelet Count , Retrospective Studies
9.
Int J Radiat Oncol Biol Phys ; 47(1): 13-47, 2000 Apr 01.
Article in English | MEDLINE | ID: mdl-10758303

ABSTRACT

In 1997, the National Cancer Institute (NCI) led an effort to revise and expand the Common Toxicity Criteria (CTC) with the goal of integrating systemic agent, radiation, and surgical criteria into a comprehensive and standardized system. Representatives from the Radiation Therapy Oncology Group (RTOG) participated in this process in an effort to improve acute radiation related criteria and to achieve better clarity and consistency among modalities. CTC v. 2.0 replaces the previous NCI CTC and the RTOG Acute Radiation Morbidity Scoring Criteria and includes more than 260 individual adverse events with more than 100 of these applicable to acute radiation effects. One of the advantages of the revised criteria for radiation oncology is the opportunity to grade acute radiation effects not adequately captured under the previous RTOG system. A pilot study conducted by the RTOG indicated the new criteria are indeed more comprehensive and were preferred by research associates. CTC v. 2.0 represents an improvement in the evaluation and grading of acute toxicity for all modalities.


Subject(s)
Neoplasms/therapy , Radiation Injuries/classification , Severity of Illness Index , Antineoplastic Agents/adverse effects , Digestive System/drug effects , Digestive System/radiation effects , Humans , Medical Records , Mucous Membrane/drug effects , Mucous Membrane/radiation effects , Neoplasms/drug therapy , Neoplasms/radiotherapy , Pilot Projects , Radiodermatitis/classification , Reference Standards , Stomatitis/classification
10.
Int J Radiat Oncol Biol Phys ; 42(2): 257-61, 1998 Sep 01.
Article in English | MEDLINE | ID: mdl-9788402

ABSTRACT

PURPOSE/OBJECTIVE: A review of available head and neck quality of life (QOL) instruments reveals them to inadequately address important radiation related side effects, or to be too cumbersome for routine use. The purpose of this study was to develop a head and neck disease specific module as a companion to the previously developed quality of life - radiation therapy instrument (QOL-RTI). The goal was to create a more complete, yet concise, head and neck site-specific module geared toward patients receiving radiation therapy for head and neck cancer. METHODS AND MATERIALS: This exploratory study included 34 consecutive patients undergoing definitive radiotherapy over a 6-7 week course (60-79.8 Gy). We developed and administered a 14-item questionnaire to all eligible patients treated with radiotherapy for head and neck cancer who were not already registered in another research study assessing quality of life (e.g., RTOG). During the treatment period, the QOL-RTI general tool and the head and neck (H&N) module were administered as follows: at baseline, at week four (for test-retest), and at the end of the treatment period. For validation purposes the QOL-RTI/H&N was compared to the functional assessment cancer tool head and neck (FACT-H&N) questionnaire. The FACT-H&N was administered one time at week 4, on the same day as the QOL-RTI/H&N. This report includes the treatment phase of the study (during the course of radiation). RESULTS: Mean age was 62 years (range 40-75). Internal consistency of the module was satisfactory (Chronbach's alpha = 0.85). Test-retest yielded a correlation coefficient of 0.90 (p < 0.001). Concurrent validity, established by comparing the module to the FACT/H&N , yielded a correlation coefficient of 0.85. Significant changes in quality of life scores during a course of radiation was noted for both general quality of life tool and the site specific module. For the head and neck module, the difference in the mean baseline (7.17) and end of treatment scores (4.20) was 2.94, or 42% change (p < 0.0001). A smaller, yet still significant, difference in scores was seen in the general QOL tool (22 % change, p = 0.001). Item analysis of the module revealed statistically significant (p < 0.05) worsening in quality of life scores in the following areas: pain in throat, swallowing difficulty (meat/bread and liquids), changes in mucous and saliva, changes in taste, difficulty chewing, trouble with coughing, and speech difficulties. Items that were not significant were pain in the mouth, and appearance. CONCLUSION: These initial results suggest that the H&N companion module to the QOL-RTI is a valid and reliable tool that is responsive to changes in QOL during a course of H&N radiation therapy. This tool differs from existing H&N tools by including specific assessments of mucous, saliva, taste, cough, and local pain in a concise format. Significant changes in QOL scores were noted in all of these items. Evaluation of the tool in the post-treatment period (follow-up) is ongoing.


Subject(s)
Head and Neck Neoplasms/radiotherapy , Quality of Life , Sickness Impact Profile , Adult , Aged , Humans , Middle Aged , Psychometrics , Reproducibility of Results , Surveys and Questionnaires
11.
Laryngoscope ; 107(3): 391-5, 1997 Mar.
Article in English | MEDLINE | ID: mdl-9121320

ABSTRACT

Soft tissue or mucosal injuries following radiotherapy of head and neck cancer include ulceration (necrosis), fibrosis, pain, and atrophy. Current management includes analgesics, wound debridement, antibiotics, and physical therapy depending on the type of injury. Pentoxifylline is a methylxanthine derivative that produces dose-related hemorrheologic effects, lower blood viscosity, improved erythrocyte flexibility, and increased tissue oxygen levels. Twenty-six patients with late radiation complications (occurring more than two months after x-ray therapy) were given treatment with oral pentoxifylline: 15 for soft tissue necrosis (STN), six for fibrosis, and five for mucosal pain. Nine of 12 patients with STN completely healed. In all three failures osteoradionecrosis developed. Mucosal pain resolved in all five patients. Fibrosis improved in 67% of those patients. Pentoxifylline appears to accelerate healing of STN and reverse some late radiation injuries. This is the first series to our knowledge that documents activity of this agent in moderate radiotherapy complications such as fibrosis, pain, or mucosal fragility.


Subject(s)
Head and Neck Neoplasms/radiotherapy , Mouth Diseases/drug therapy , Pentoxifylline/therapeutic use , Radiation Injuries/drug therapy , Vasodilator Agents/therapeutic use , Administration, Oral , Aged , Analgesics/therapeutic use , Anti-Bacterial Agents/therapeutic use , Atrophy , Debridement , Dose-Response Relationship, Drug , Erythrocyte Deformability/drug effects , Female , Fibrosis , Hemorheology/drug effects , Humans , Male , Middle Aged , Mouth Diseases/etiology , Mouth Mucosa/pathology , Mouth Mucosa/radiation effects , Necrosis , Oral Ulcer/drug therapy , Osteoradionecrosis/etiology , Oxygen Consumption/drug effects , Pain/drug therapy , Pentoxifylline/administration & dosage , Physical Therapy Modalities , Remission Induction , Soft Tissue Injuries/drug therapy , Vasodilator Agents/administration & dosage , Wound Healing/drug effects
12.
AIDS Educ Prev ; 8(1): 1-10, 1996 Feb.
Article in English | MEDLINE | ID: mdl-8703636

ABSTRACT

Current patterns of HIV/AIDS in Zimbabwe are examined using national surveillance data reflecting four main variables: age, gender, marital status, and residence. The data show that the distribution of cases by age and gender is consistent with the literature on the rest of sub-Sahara Africa. Distribution of cases by age is bimodal with incidence highest among sexually active young adults (20-39 years) and the very young (0-4 years), and the male-to-female ratio is nearly 1:1 among adults. However, among adolescents 15-19, the incidence among females is six times greater than their male counterparts. The data also show that married persons have the highest rate of HIV infection (51%), greater than single persons (34%). These patterns highlight the significance of heterosexual and perinatal transmission. These data suggest a need for expanded HIV testing, counseling, and education across gender and marital status in order to detect HIV infection earlier in the spectrum of the disease. Promotion of monogamy and proper condom use should be a major focus of the empowerment process. Further recommendations are provided for planning, implementation, evaluation, and coordination of a comprehensive national prevention strategy.


Subject(s)
Acquired Immunodeficiency Syndrome/epidemiology , Acquired Immunodeficiency Syndrome/prevention & control , HIV Infections/epidemiology , HIV Infections/prevention & control , Health Education , Acquired Immunodeficiency Syndrome/transmission , Adolescent , Adult , Age Factors , Child, Preschool , Cohort Studies , Female , HIV Infections/transmission , HIV Seropositivity/epidemiology , Humans , Infant , Infant, Newborn , Male , Marital Status , Risk Factors , Sex Factors , Zimbabwe/epidemiology
13.
Int J Nurs Stud ; 32(1): 27-38, 1995 Feb.
Article in English | MEDLINE | ID: mdl-7730003

ABSTRACT

This demonstration project used student nurses (n = 12) on community deployment to provide health instruction among rural school-age populations in Zimbabwe. A quasi-experimental (pre- and post-test), non-equivalent control group design was used and consisted of 141 school pupils in the intervention group and 144 pupils in the comparison group (N = 285). The curriculum focused on prevention of STDs, HIV/AIDS and drugs (alcohol, tobacco and marijuana). A gain in health knowledge scores among the intervention group was reported at post-test. More than 70% of the pupils who received health instruction from student nurses gave a high approval rating of student nurses' performance. Further, student nurses, teachers and tutors all support school health instruction by student nurses although tutors and teachers differ on teaching about condoms.


PIP: In Zimbabwe, as part of a demonstration project, nursing schools sent 12 student nurses to five rural secondary schools in Masvingo Province to provide health education over a seven-week period to 141 students (9.33 hours/student). Community deployment of student nurses to rural areas, aiming to provide them with primary health care experience, is required for graduation in Zimbabwe. 144 students comprised the control group. Curriculum topics included AIDS, other sexually transmitted diseases (STDs), and drugs (alcohol, tobacco, and marijuana). AIDS/STD educational materials concentrated on modes of transmission, prevention methods, control of transmission, psychosocial issues, responsible sexual behavior, and problem-solving and decision-making strategies. Drug use and abuse materials focused on short- and long-term effects; social influences of acquisition, maintenance, and cessation; and social pressure resistance training through problem-solving and decision-making strategies. Students in the intervention group increased their post-test scores in 24 of 27 health knowledge items (for 14 of 24 items, p 0.01). More than 70% of students rated the student nurses' performance in health education high. Both the student nurses' tutors and the school teachers supported the concept of using student nurses to provide health education in schools while on community deployment. Tutors were more likely than teachers to support student nurses' teaching about condom use.


Subject(s)
Health Education/methods , Rural Health , School Nursing/methods , Students, Nursing , Adolescent , Adult , Analysis of Variance , Attitude to Health , Chi-Square Distribution , Condoms , Curriculum , Feasibility Studies , Female , HIV Infections/prevention & control , Humans , Male , Psychometrics , Sexually Transmitted Diseases/prevention & control , Substance-Related Disorders/prevention & control , Zimbabwe
14.
J Sch Health ; 62(10): 471-4, 1992 Dec.
Article in English | MEDLINE | ID: mdl-1289658

ABSTRACT

Study participants included 285 secondary school pupils in Zimbabwe who responded to a questionnaire assessing alcohol, tobacco, and marijuana use, and anticipated parental reaction to the pupil's drug-taking behavior. Results showed nearly 17% of the sample had used alcohol, 8% used tobacco, and 5% had used marijuana during the past seven days prior to questionnaire administration. Results regarding intentions to use alcohol, tobacco, and marijuana in the future show pupils' interest highest in using alcohol. Nearly 34% indicated intentions to use alcohol during the next year, while 16% reported intentions to use tobacco, and 12.9% indicated intentions to use marijuana. Nearly 17% reported they felt their parents would be favorable to their use of alcohol. Anticipated parental approval for tobacco and marijuana was 13.6% and 10.8%, respectively. Though current use and future intentions among the sample are not as high compared to similar populations in developed countries, this study suggests Zimbabwe should consider expanding its drug education effort in the school setting. Research to identify effective educational strategies to curb further increases in adolescent drug taking behavior also needs to be explored and identified.


Subject(s)
Alcohol Drinking/epidemiology , Marijuana Smoking/epidemiology , Parents , Smoking/epidemiology , Adolescent , Cross-Sectional Studies , Female , Humans , Male , Rural Population , Zimbabwe/epidemiology
15.
AIDS Educ Prev ; 4(4): 350-61, 1992.
Article in English | MEDLINE | ID: mdl-1472421

ABSTRACT

This paper reviews the current epidemiologic status of AIDS in sub-Saharan Africa, focusing on what is currently understood about the distinctive features of heterosexual transmission in young men, women, and children. Epidemiologic data show that AIDS is transmitted primarily through heterosexual vaginal intercourse. Heterosexual transmission is highlighted both as the principal mode of spread of AIDS in east, central, and southern Africa and as the primary focus for AIDS education and control of the epidemic. The transmission of AIDS, like that of other sexually transmissible diseases, results from sexual behaviors that are rooted in social and cultural values that are not easily changed. The primary risk factors--including multiple sex partners, prostitution, and unprotected intercourse--are examined. The perceived obstacles to control of the epidemic include unfavorable government reactions to the epidemic, poor public knowledge, prevailing sexual attitudes, and reluctance to use condoms. These and other immediate and competing risk factors like unemployment and poverty combine to complicate the task of AIDS education.


Subject(s)
Acquired Immunodeficiency Syndrome/epidemiology , Health Education/standards , Acquired Immunodeficiency Syndrome/prevention & control , Acquired Immunodeficiency Syndrome/transmission , Africa/epidemiology , Cultural Characteristics , Female , Health Education/methods , Health Knowledge, Attitudes, Practice , Humans , Incidence , Male , Marriage , Prevalence , Primary Prevention/methods , Risk Factors , Seroepidemiologic Studies , Sex Work , Sexual Behavior , Sexual Partners , Social Values
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