The role of social determinants on unhealthy eating habits in an urban area in Mexico: A qualitative study in low-income mothers with a young child at home.

Overweight and obesity are a severe public health problem in Mexico. National policies to fight unhealthy eating have been implemented but they don't target social and family environment determinants. Our study aimed to gain a deeper understanding of the determinants of unhealthy eating by exploring the perspectives and experiences of low-income Mexican women with a young child at home. We conducted a purposeful sampling to include participating kindergartens in Morelos, México. Women with a child enrolled in the kindergarten were invited to focus group discussions. Afterward, women with specific profiles were invited to in-depth interviews. During analysis we applied Dahlgren and Whitehead's model of social determinants of health (SDH). Overall, we found that participants have unhealthy habits, for example: low variability in consumption patterns, regular sugar-sweetened beverages intake and insufficient fruit and vegetable intake. By low variability we mean frequently consumed products (on most days of the week) limited to a restricted food set. As for the determinants of unhealthy habits, we found at the community level that families encourage unhealthy eating. At the household and work level, tight schedules for food preparation determine unhealthy eating. And, at a socio-economic level, lack of access and money constraints shape unhealthy habits. Unhealthy habits are determined by factors on multiple levels and using an SDH approach can be an effective way to inform comprehensive strategies targeting the overweight and obesity epidemic in Mexico and other low- and middle-income countries.

Barreras de acceso a los servicios de salud para mujeres transgénero / Barriers to access to health services for transgender women

Resumen Objetivo: Identificar y clasificar, a partir de una revisión de textos científicos publicados, las barreras y algunos factores asociados con el acceso a los servicios de salud en las mujeres transgénero o MT. Material y Método: Se realizó una revisión de literatura en bases electrónicas: LILACS, PubMed y SciELO, para el periodo 2005- 2019. Se determinaron palabras clave a partir de los modelos de acceso a servicios de salud de Andersen y Levesque. Además, se retomaron resultados de dos encuestas realizadas a mujeres transgénero (MT) en México, durante 2012 y 2013. Para el análisis de los artículos se consideró: título, autores, diseño de estudio, objetivo, abordaje metodológico y resultados obtenidos y discusión. Resultados: Inicialmente se identificaron 143 artículos, de los cuales 59 abordaban el tema de interés. Los 59 artículos y ambos reportes de encuestas fueron incorporados a una matriz de Excel para ser analizados. Se identificaron cuatro principales categorías para las barreras de acceso a los servicios de salud en MT: individuales, interpersonales, estructurales y financieras. Conclusiones: Se concluye que es posible agrupar las barreras de acceso a los servicios de salud en MT en cuatro grandes categorías: individuales, interpersonales, estructurales y financieras. Lo anterior resalta al estigma como un eje importante que atraviesa por las cuatro categorías, por lo que abordarlas requiere un cierto grado de sensibilidad sobre la deuda histórica, consecuencia de estigma y discriminación, que existe hacia esta población.

Abstract Objective: To identify and classify, based on a review of published scientific texts, the barriers and some factors associated with access to health services in the TM. Material and method: A review of literature in electronic databases was carried out: LILACS, PubMed y SciELO, for the 2005-2019 period. Key words were determined from the models of access to health services of Andersen and Levesque. In addition, the results of two surveys carried out on transgender women (MT) in Mexico were taken again during 2012 and 2013. For the analysis of the articles, the following were considered: title, authors, study design, objective, methodological approach and results obtained and discussion. Results: Initially, 143 articles were identified, of which 59 addressed the topic of interest. The 59 articles and both survey reports were incorporated into an Excel matrix to be analyzed. Four main categories were identified for barriers to access to health services in MT: individual, interpersonal, structural and financial. Conclusions: It is concluded that it is possible to group the barriers of access to health services in MT in four broad categories: individual, interpersonal, structural and financial. The foregoing highlights the stigma as an important axis that runs through the four categories, so addressing them requires a certain degree of sensitivity to the historical debt, a consequence of stigma and discrimination, which exists towards this population.

Developing HIV assisted partner notification services tailored to Mexican key populations: a qualitative approach.

BACKGROUND: Assisted partner notification services (APNS) may increase HIV testing, early diagnosis, and treatment, but they are not formally implemented in Mexico, where the HIV epidemic is concentrated in men who have sex with men (MSM) and transwomen (TW). This study aimed to explore the awareness of and need for HIV partner notification, as well as to outline potential strategies for APNS based on identified barriers and facilitators. METHODS: We conducted semi-structured interviews to explore partner notification with MSM, TW, and counselors. Afterwards, brainstorm sessions were carried out to produce strategies for implementing APNS. RESULTS: Most participants reported experiences with informal partner notification and serostatus disclosure, but not with APNS. Only one counselor indicated assisting notification systematically. The main barriers for notifying or disclosing mentioned by both MSM and TW included fear of (violent) reactions, discrimination and lacking contact information of casual partners. Participants thought it was easier to inform a formal partner, conditional of being well informed about HIV. Given current stigma and lack of awareness, it was suggested that APNS should be preceded by HIV awareness efforts, and be provided by counselors or peers to mitigate potential rejection or violent reactions. CONCLUSIONS: While APNS are not formally implemented in Mexico, all participants supported the service, indicating that APNS could potentially enhance early HIV diagnosis in Mexico. Strategies to implement such services need to be flexible addressing the individual needs of participants, guaranteeing the safety of more vulnerable participants.

Complete Genome Sequences, before and after Mammalian Cell Culture, of Zika Virus Isolated from the Serum of a Symptomatic Male Patient from Oaxaca, Mexico.

Zika virus (ZIKV) is an emerging arthropod-borne flavivirus associated with severe congenital malformations and neurological complications. Although the ZIKV genome is well characterized, there is limited information regarding changes after cell isolation and culture adaptation. We isolated, and passaged in Vero cells, ZIKV from the serum of a symptomatic male patient and compared the viral genomes before and after culture. Single nucleotide polymorphisms were characteristic among serum-circulating genomes, while such diversity decreased after cell culture.