Connaissances et utilisation de la contraception d'urgence chez les adolescentes

Objectifs. Evaluer l'etendue des connaissances; les attitudes et la pratique de la contraception d'urgence chez les jeunes filles eleves en Cote d'Ivoire; ainsi que les facteurs influencant sa connaissance et sa perception. Methode. Il s'agissait d'une etude transversale descriptive realisee au Lycee Classique d'Abidjan; un etablissement d'enseignement general. Seules les filles de terminale ont ete selectionnees car; a la fois les plus exposees aux grossesses precoces et ayant une activite sexuelle averee. La collecte des donnees s'est deroulee sur un mois; en mars 2010. Resultats. Cinquatre-quatre pour cent (54%) ignoraient l'existence de la contraception d'urgence. Parmi celles qui en avaient entendu parler; 41;7% ne possedaient guere de connaissances precises sur la methode de contraception d'urgence. Les sources d'informations formelles etaient associees a une bonne connaissance de cette methode. Globalement; 78;1% avaient une attitude favorable. Cependant il existait une crainte chez certaines participantes de voir cette methode se substituer au preservatif. Son usage etait faible pour 5;5% des enquetes. Le premier obstaclea son utilisation semble etre du au manque d'information du public. Conclusion. Il existe un besoin urgent de sensibilisation des jeunes ivoiriennes a la contraception d'urgence; et surtout aux methodes disponibles; ainsi qu'au delai correct d'emploi. Ainsi; elles pourront y avoir recours beaucoup plus facilement

Perceived susceptibility to HIV infection among Asian and Pacific Islander women in San Diego.

Recent reports indicate that AIDS is increasing among Asian and Pacific Islander populations. Data from 249 women sampled from nine Asian and Pacific Islander communities in San Diego County from 1993 to 1995 were examined to determine what factors contributed to perceived susceptibility to HIV infection and having had an HIV test. Thirteen percent of women sampled were classified as high risk for HIV infection, while half of the women reported perceived susceptibility to HIV. Years in the United States and ethnicity appeared to be effect modifiers of the relationship between risk behaviors and perceived susceptibility. In the multivariate model, high school education or greater, age of 30 or more, participation in risk behaviors, and knowing an HIV-positive person were significantly associated with perceived susceptibility. Reliability of self-reported sexual behavior was somewhat low, while the reliability of data relating to injection drug use and needle sharing was high.

HIV prevention among detained immigrants: report of a program of the Immigration and Naturalization Service.

HIV prevention programs have been developed for a wide variety of populations and settings through which those target populations can be reached. However, no program to date has targeted immigrants in Immigration and Naturalization Service (INS) detention facilities. This study examines the risk factors identified among detainees in detention facilities in San Diego, and the development and implementation of an HIV prevention program. Given the success of this program, the INS approved filming a video and a peer training program for detainees to serve as peer educators so that the program will continue.

Determining needs and setting priorities for HIV-affected and HIV-infected persons: northeast Ohio and San Diego.

The Ryan White Comprehensive AIDS Resources Emergency (CARE) Act of 1991 requires that communities receiving Title I funding engage in a needs assessment and priority process to guide the allocation of those funds to various services within the local community. This paper reports on the process and results of the needs assessments in northeast Ohio and San Diego County for 1996-1997 and 1998. Data from northeast Ohio's 1998 needs assessment indicated significant differences between whites and nonwhites in the utilization of HIV specialist care, HIV-related prescription medications such as antiretrovirals, and health insurance. A need for additional dental care, complementary therapies, housing, and assistance with utility payments was found in both geographic areas. Consumer participation in San Diego's health department-based needs assessment process was more extensive than in northeast Ohio's academic-based approach but was also related to increased community-borne expense.

The effect of immigration and welfare reform legislation on immigrants' access to health care, Cuyahoga, and Lorain Counties.

This study examined the effect of the passage of the Personal Responsibility and Work Opportunity Reconciliation Act of 1996 and the Illegal Immigration Reform and Immigrant Responsibility Act of 1996 on immigrants' ability to access health care in two counties in Northeastern Ohio. Semistructured interviews were conducted with 251 individuals of varying immigration status and ethnicity. Data collected included type of recent illness, type and location of care received, type of health insurance, if any, and problems encountered. Significant associations were found between birth in a former Soviet-controlled area and use of public insurance. We did not detect an adverse effect of the welfare and immigration reform laws on ability to access care, most likely because a large proportion of respondents were permanent residents or asylees and were eligible for publicly funded medical care under the reform laws. The most common problems in obtaining medical care included lack of insurance and/or money, transportation, language, dissatisfaction with the doctor's care, and long waits. Individuals born in former Soviet-controlled areas as well as those who spoke Spanish or Slavic languages at home or work reported more difficulties in accessing care. Many undocumented individuals indicated that they would delay or refrain from seeking care due to fear of immigration consequences.

The assessment of immigration status in health research.

OBJECTIVE: This report examines methodological issues relating to immigrant health, definition of immigrant, the assessment of immigrant status, and sampling strategies with immigrant populations. METHODS: A literature review was conducted for the period 1977-98, utilizing various computer data bases to identify relevant studies. A total of 179 separate U.S.-based studies were reviewed. Twenty-two sample instruments and two revised versions of instruments for the assessment of immigration status were evaluated. RESULTS: In general, research relating to immigrants and their health has not attended to methodological issues inherent in such investigations. Instruments utilized to assess immigration status differ across studies, making cross-study comparisons difficult. Few studies have relied on probability sampling. Almost no data are available on field performance of instruments developed to assess immigration status. CONCLUSIONS: Development of an appropriate instrument requires consideration of the definition of immigrant to be used, the level of respondent knowledge to be presumed, the political and social climate that exists at the time of the survey administration, the populations and geographic locales with which the instrument will be utilized, the complexity of the instrument, and methods of the instrument administration. In view of the paucity of data pertaining to the field performance of instruments used to assess immigration status, any instrument considered for use must be field tested and revised appropriately before incorporation into a national survey. The appropriateness of any particular sampling strategy should be evaluated in the context of the field testing.

Integrating Buddhism and HIV prevention in U.S. southeast Asian communities.

Asian Pacific Islander communities in the United States have experienced an alarming increase in HIV infection over the past few years, possibly due to a lack of knowledge and the relative absence of appropriate educational interventions. The authors propose a new approach to the development of HIV prevention programs in U.S. southeast Asian communities. This article reviews the cultural and economic factors that may facilitate HIV transmission within these communities. Relying on the basic precepts of Buddhism, the dominant religion of many southeast Asian populations in the United States, the health belief model is utilized to demonstrate how recognizable, acceptable religious constructs can be integrated into the content of HIV prevention messages. This integration of religious concepts with HIV prevention messages may increase the likelihood that the message audience will accept the prevention messages as relevant. This nuanced approach to HIV prevention must be validated and refined through field research.

A pilot study of immigration status, homosexual self-acceptance, social support, and HIV reduction in high risk Asian and Pacific Islander men.

This article reports the results of a cross-sectional study that was conducted to describe the sexual behavior and HIV risk reduction behaviors of homosexual and bisexual Asian and Pacific Islander men and to relate immigration status, self-acceptance as a homosexual, and levels of social support to the adoption of safe sexual behaviors in this population. Thirty-one gay and bisexual Asian and Pacific Islander men in San Diego County, California, participated. Generally high levels of knowledge about HIV and transmission risks as well as self-acceptance and social support were found. While most (84%) reported some attempts to increase condom use in the previous 6 months, 42% reported engaging in unprotected intercourse during that same time period. An inverse relationship between self-acceptance and utilization of risk reduction strategies was found. No association was found between immigration status or self-reported HIV status and level of HIV knowledge, level of HIV risk behavior, or level of HIV risk reduction efforts. The findings are discussed within the context of other social network studies and HIV prevention programs for gay and bisexual Asian and Pacific Islander men.

Knowledge of HIV by health professionals in Kampala, Uganda.

Deficiencies in HIV knowledge among health care professionals is of concern because they play an instrumental role in counseling patients to reduce risk behaviors. We report here on the results of a pretest questionnaire which we administered to assess baseline levels of HIV knowledge among a group of health care providers in Kampala, Uganda, our educational intervention, and the results of the post-test questionnaire which we administered to detect changes in the level of HIV knowledge following intervention. Pre-test results indicated that the greater deficiencies in knowledge related to transmission and prevention and clinical manifes nottations of disease. Scores on the post-test, administered following a 15-hour course, indicated a significant improvement in knowledge of clinical manifestations and overall knowledge. Our findings underscore the need for ongoing HIV educational programs for health care workers.

Knowledge of HIV by Health Professionals in Kampala; Uganda

Deficiencies in HIV knowledge among health care professionals is of concern because they play an instrumental role in counseling patients to reduce risk behaviors. We report here on the results of a pretest questionnaire which we administered to assess baseline levels of HIV knowledge among a group of health care providers in Kampala; Uganda; our educational intervention; and the results of the post-test questionnaire which we administered to detect changes in the level of HIV knowledge following intervention. Pre-test results indicated that the greater deficiencies in knowledge related to transmission and prevention and clinical manifes nottations of disease. Scores on the post-test; administered following a 15-hour course; indicated a significant improvement in knowledge of clinical manifestations and overall knowledge. Our findings underscore the need for ongoing HIV educational programs for health care workers

Assessing immigration status and eligibility for publicly funded medical care: a questionnaire for public health professionals.

OBJECTIVES: After reviewing the requirements for establishing a legal presence in the United States and securing health care services under Medicaid and Medicare, this article reports on a questionnaire developed to determine patients' documentation status and eligibility for publicly funded medical care. METHODS: The questionnaire was developed based on an integration of the relevant provisions of the Immigration and Nationality Act and the Social Security Act. RESULTS: The questionnaire is both valid and reliable when compared with an instrument currently used by immigration attorneys. CONCLUSIONS: This assessment is useful provided there is no requirement that undocumented individuals be reported to the Immigration and Naturalization Service.

HIV prevention in U.S. Asian Pacific Islander communities: an innovative approach.

Few HIV prevention efforts have focused on Asian Pacific Islander communities in the United States. Prevention messages developed for the general U.S. population have failed to reach many Asian Pacific Islanders. This article describes the development of an HIV prevention strategy for Asian Pacific Islanders through health care workers. This strategy was based on the ecological disease theory and action research methodology. The prevention program comprised four components: (1) a symposium for the health care workers, (2) a culturally sensitive and appropriate HIV-related video for the health care workers and their patients, (3) ongoing training of the health care providers, and (4) ongoing liaison and consultative services for the health care providers. The intervention is intended to encourage HIV risk-reduction behaviors among the patients, to encourage the HIV testing of those who may be at risk for HIV, and to facilitate access to services for those found to be infected.

Organizing Asian Pacific Islanders in an urban community to reduce HIV risk: a case study.

We present a case study of community organization efforts within the Asian Pacific Islander communities of San Diego County to reduce the risk of HIV transmission. We utilized a five-phase process to implement the strategies of locality development, social planning, and social action: community analysis, program design and initiation, program implementation, program maintenance and consolidation, and program reassessment. An evaluation of the process indicates that there were increases over time in the project's activities as well as in the levels of interagency connectedness. This is one of the few reported efforts to organize Asian Pacific Islander groups to address HIV transmission. Key elements that led to the successful organization of the original project into a tax-exempt nonprofit entity (the Asian Pacific Islander Community AIDS Project) were emphasis on community ownership, reliance on group consensus, use of "gatekeepers" to access communities, simultaneous multilevel programming, and service to the community as a "coordinating" entity.

PIP: This case study describes a project begun in March 1993 which sought to reduce the risk of HIV transmission among the Asian Pacific Islander communities of San Diego County, California. The project involved the community organization strategies of locality development, social planning, and social action which were implemented through five phases: community analysis, program design and initiation, program implementation, program maintenance and consolidation, and program reassessment. This report describes each stage in depth and includes figures which illustrate 1) the time line of organizational, funding, and programmatic development from March 1993 to February 1995; 2) a schematic representing organizational efforts within the Asian Pacific Islander communities to reduce HIV risk and to provide HIV education; and 3) the percentage of agencies engaging in cooperative activities at baseline, 12 months, and 18 months. A table summarizes the organizational activities which took place within the community during the first year of the project. The success of the project in increasing both its activities and the levels of interagency cooperation over time is attributed to the accuracy of the initial community assessment and to a reliance on the basic principles of community organization with an emphasis on Asian Pacific Islander ownership of the initial project and the nonprofit program into which it evolved. Other key elements in the strategy were reliance on group consensus as the basis for decision-making, collection of data from the community as the basis for program planning, use of "gatekeepers" to access linguistically and culturally insular communities, simultaneous multilevel programming, and service to the community as a "coordinating" entity. To date, no assessment has been made of any changes in HIV seroprevalence rates in the target community.