ABSTRACT
INTRODUCTION: The role of pre- and post-test counselling in new HIV testing strategies to reduce delayed diagnosis has been debated. Data on time devoted to counselling are scarce. One approach to this problem is to explore patients' views on the time devoted to counselling by venue of their last HIV test. Methods We analysed data from 1568 people with a previous HIV test who attended a mobile HIV testing program in Madrid between May and December 2008.ResultsThe majority (71%) were men (48% had had sex with other men), 51% were <30 years, 40% were foreigners, 56% had a university degree, and 40% had the most recent HIV test within the last year. As regards pre-test counselling, 30% stated they were told only that they would receive the test; 26.3% reported <10 min; 20.4% about 10 min; and 24.2%, 15 min or more. For post-test counselling: 40.2% stated they were told only that the test was negative; 24.9% reported 2-6 min; 16.4% about 10 min; and 18.5%, 15 min or more. The percentage of participants who reported no counselling time was higher among those tested in general health services: primary care, hospital settings and private laboratories (over 40% in pre-test, over 50% in post-test counselling). Women received less counselling time than men in almost all settings. Conclusion Policies to expand HIV testing in general health services should take this current medical behaviour into account. Any mention of the need for counselling can be a barrier to expansion, because HIV is becoming less of a priority in developed countries. Oral consent should be the only requirement
INTRODUCCIÓN: Las nuevas estrategias para reducir el diagnóstico tardío de VIH ponen en entredicho el papel del consejo pre-post test. Existe poca información sobre el tiempo dedicado al consejo. Un posible enfoque es explorar las opiniones de los pacientes sobre el tiempo dedicado al consejo según el lugar de la última prueba MÉTODOS: Se analizan 1568 personas con prueba previa de VIH que acuden a un programa móvil en Madrid entre Mayo y Diciembre de 2008. RESULTADOS: 71% eran hombres (48% hombres que tienen sexo con hombres), 51% < 30 años, 40% extranjeros, 56% universitarios y el 40% se hizo la última prueba en el ultimo año. Con respecto al consejo pre-test, el 30% refirió que únicamente se les comunicó que se les iba a realizar la prueba, el 26,3% reportó < 10 minutos, 20,4% alrededor de 10 y 24,2% 15 o más. Para el consejo post-test: el 40% refirió que únicamente se les comunicó el resultado negativo, 24,9% entre 2-6 minutos, 16,4% alrededor de 10 y 18,5% 15 o más. El porcentaje de participantes que dijo no recibir consejo fue mayor entre quienes se la habían hecho en servicios generales: atención primaria, hospitales y laboratorios privados (más del 40% en pre-test y más del 50% en post-test). En prácticamente todas las localizaciones, a las mujeres se les dedicó menos tiempo. CONCLUSIÓN: Las políticas para expandir la prueba de VIH en servicios generales deben considerar el comportamiento médico actual. Cualquier mención a la necesidad de consejo puede resultar una barrera a la expansión puesto que el VIH ya no es prioridad en los países desarrollados. El consentimiento verbal debiera ser el único requisito
Subject(s)
Humans , HIV Infections/prevention & control , Directive Counseling , Evaluation of Results of Preventive Actions , 50207 , AIDS Serodiagnosis/methodsABSTRACT
INTRODUCTION: The role of pre- and post-test counselling in new HIV testing strategies to reduce delayed diagnosis has been debated. Data on time devoted to counselling are scarce. One approach to this problem is to explore patients' views on the time devoted to counselling by venue of their last HIV test. METHODS: We analysed data from 1568 people with a previous HIV test who attended a mobile HIV testing program in Madrid between May and December 2008. RESULTS: The majority (71%) were men (48% had had sex with other men), 51% were <30 years, 40% were foreigners, 56% had a university degree, and 40% had the most recent HIV test within the last year. As regards pre-test counselling, 30% stated they were told only that they would receive the test; 26.3% reported <10 min; 20.4% about 10 min; and 24.2%, 15 min or more. For post-test counselling: 40.2% stated they were told only that the test was negative; 24.9% reported 2-6 min; 16.4% about 10 min; and 18.5%, 15 min or more. The percentage of participants who reported no counselling time was higher among those tested in general health services: primary care, hospital settings and private laboratories (over 40% in pre-test, over 50% in post-test counselling). Women received less counselling time than men in almost all settings. CONCLUSION: Policies to expand HIV testing in general health services should take this current medical behaviour into account. Any mention of the need for counselling can be a barrier to expansion, because HIV is becoming less of a priority in developed countries. Oral consent should be the only requirement.
Subject(s)
AIDS Serodiagnosis , Counseling/statistics & numerical data , HIV Seropositivity/psychology , Mobile Health Units , Adult , Delayed Diagnosis/prevention & control , Educational Status , Emigrants and Immigrants/statistics & numerical data , Employment , Female , HIV Infections/epidemiology , HIV Infections/prevention & control , HIV Seronegativity , HIV Seropositivity/diagnosis , Humans , Informed Consent , Male , Middle Aged , Primary Health Care , Sex Work/statistics & numerical data , Sexual Behavior , Spain , Surveys and Questionnaires , Time FactorsABSTRACT
OBJECTIVES: To determine the prevalence of chronic wounds in patients in a specific region and their distribution according to health resources. To classify wound typologies and the treatment provided. To examine the use of risk assessment scales and preventive measures. METHOD: A cross sectional study was performed between June 2 and 8, 2004 that included all the health centers of the distinct health areas of Osona County (Barcelona), with a population of 128,309 persons aged more than 14 years. Data were collected on patients diagnosed with chronic wounds and on the characteristics of these wounds. RESULTS: We studied 251 patients with a mean age of 77.5 years. A total of 377 chronic wounds were identified and there were 168 pressure ulcers. The prevalence of chronic wounds was 0.29% and that of pressure ulcers was 0.13%. The proportion of patients with lower limb ulcers was significantly higher in primary care than in acute and geriatric care (p<0.005). The proportion of patients with pressure ulcers was higher in acute and geriatric care than in primary care (p<0.005). Preventive scales were applied in 81 patients (92%) with pressure ulcers. CONCLUSIONS: Applying the concept of chronic wound was useful in identifying the high prevalence of lower limb ulcers. The distribution of wounds varied according to the health resources available.
Subject(s)
Wounds and Injuries/epidemiology , Aged , Aged, 80 and over , Chronic Disease , Cross-Sectional Studies , Female , Humans , Male , Prevalence , Spain/epidemiologyABSTRACT
Objetivos. Conocer la prevalencia de pacientes con heridas crónicas en una comarca y su distribución según el tipo de recursos asistenciales. Clasificar la tipología de dichas heridas y la terapéutica utilizada. Revisar la utilización del uso de las escalas de valoración de riesgo y las medidas de prevención. Método. Se presenta un estudio transversal, realizado entre el 2 y el 8 de junio de 2004, que comprende a todos los centros de los diferentes ámbitos asistenciales sanitarios de la comarca de Osona (Barcelona), con una población de mayores de 14 años de 128.309. Se recogió información acerca de los pacientes diagnosticados de heridas crónicas y las características de éstas. Resultados. Se estudiaron 251 pacientes con una edad media de 77,5 años. Se identificaron 377 heridas crónicas, concretamente 168 úlceras por presión. La prevalencia de las heridas crónicas fue de 0,29% y de las úlceras por presión de 0,13%. La proporción de pacientes atendidos de úlceras de extremidades inferiores en atención primaria era significativamente superior a la de los atendidos en los centros de agudos y sociosanitarios (p<0,005). La proporción de los atendidos en los centros sociosanitarios y de agudos, por úlceras por presión, era superior a la de los atendidos en atención primaria (p<0,005). Se aplicaron escalas de prevención a 81 (92%) de los pacientes que presentaron úlceras por presión. Conclusiones. La utilización del concepto de herida crónica evidencia una alta prevalencia de úlceras en extremidades inferiores, observándose una distribución diferente de ellas según los recursos asistenciales (AU)
Objectives. To determine the prevalence of chronic wounds in patients in a specific region and their distribution according to health resources. To classify wound typologies and the treatment provided. To examine the use of risk assessment scales and preventive measures. Method. A cross sectional study was performed between June 2 and 8, 2004 that included all the health centers of the distinct health areas of Osona County (Barcelona), with a population of 128,309 persons aged more than 14 years. Data were collected on patients diagnosed with chronic wounds and on the characteristics of these wounds. Results. We studied 251 patients with a mean age of 77.5 years. A total of 377 chronic wounds were identified and there were 168 pressure ulcers. The prevalence of chronic wounds was 0.29% and that of pressure ulcers was 0.13%. The proportion of patients with lower limb ulcers was significantly higher in primary care than in acute and geriatric care (p<0.005). The proportion of patients with pressure ulcers was higher in acute and geriatric care than in primary care (p<0.005). Preventive scales were applied in 81 patients (92%) with pressure ulcers. Conclusions. Applying the concept of chronic wound was useful in identifying the high prevalence of lower limb ulcers. The distribution of wounds varied according to the health resources available (AU)
