ABSTRACT
Sexual and gender identity minorities in Guatemala are disproportionally affected by HIV and other sexually transmitted infections (STI). However, little is known about the health determinants among these minorities that contribute to infection risk. Health researchers from the United States and Guatemala sought to explore sexual health needs and identify characteristics of HIV/STI prevention programs for these minorities.Our partnership conducted 8 focus groups with gay and bisexual men, men who have sex with men, and transgender women; and 10 in-depth interviews with community leaders. We analyzed transcripts of the focus groups and in-depth interviews using constant comparison.We identified 24 factors that influence sexual health which we organized into 5 ecological domains and 16 characteristics of potentially successful programs to reduce HIV/STI risk.The identification of sexual risk factors and characteristics of potentially successful programs offers great potential to develop interventions to help reduce the risk of HIV/STI infection among these minorities in Guatemala.
ABSTRACT
Guatemalan gay and bisexual men, men who have sex with men (MSM), and transgender persons carry disproportionate burden of HIV and other sexually transmitted infections compared with other Guatemalan subgroups. However, little is known about the determinants of sexual health to inform health promotion and disease prevention interventions among these sexual minorities. We sought to explore sexual health and HIV risk among Guatemalan sexual minorities, using a community-based participatory research approach. We conducted 8 focus groups (n = 87 participants total) and 10 individual in-depth interviews with gay and bisexual men, MSM, and transgender persons. Using constant comparison, an approach to grounded theory, we analyzed verbatim transcripts and identified 24 themes that we organized into five ecological factors influencing sexual health: intrapersonal (e.g. misconceptions about HIV transmission, low perceived susceptibility and lack of condoms use skills); interpersonal (e.g. family rejection and condom use as a barrier to intimacy); community (e.g. discrimination and stigma); institutional (e.g. limited access to health promotion resources); and public policy (e.g. perceived lack of provider confidentiality and anti-gay rhetoric). There is profound need for multiple-level interventions to ensure that Guatemalan sexual minorities have the knowledge and skills needed to reduce sexual risk. Interventions are warranted to increase social support among sexual minorities, reduce negative perspectives about sexual minorities, develop institutional resources to meet the needs of sexual minorities and reduce harmful anti-gay rhetoric. Understanding and intervening on the identified factors is especially important given that the health of Guatemalan sexual minorities has been to-date neglected.
Subject(s)
Homosexuality, Male , Reproductive Health , Transgender Persons , Adolescent , Adult , Community-Based Participatory Research , Focus Groups , Grounded Theory , Guatemala , HIV Infections/prevention & control , HIV Infections/transmission , Health Knowledge, Attitudes, Practice , Health Promotion , Humans , Male , Middle Aged , Minority Groups , Risk Factors , Sexual Behavior/psychology , Young AdultABSTRACT
The burden of HIV is disproportionate for Guatemalan sexual minorities (e.g., gay and bisexual men, men who have sex with men [MSM], and transgender persons). Our bi-national partnership used authentic approaches to community-based participatory research (CBPR) to identify characteristics of potentially successful programs to prevent HIV and promote sexual health among Guatemalan sexual minorities. Our partnership conducted Spanish-language focus groups with 87 participants who self-identified as male (n=64) or transgender (n=23) and individual in-depth interviews with ten formal and informal gay community leaders. Using constant comparison, an approach to grounded theory, we identified 20 characteristics of potentially successful programs to reduce HIV risk, including providing guidance on accessing limited resources; offering supportive dialogue around issues of masculinity, socio-cultural expectations, love, and intimacy; using Mayan values and images; harnessing technology; increasing leadership and advocacy skills; and mobilizing social networks. More research is clearly needed, but participants reported needing and wanting programming and had innovative ideas to prevent HIV exposure and transmission.
Subject(s)
Bisexuality , HIV Infections/prevention & control , Health Promotion/methods , Homosexuality, Male , Reproductive Health , Transgender Persons , Adolescent , Adult , Community-Based Participatory Research , Focus Groups , Guatemala , HIV Infections/transmission , Health Knowledge, Attitudes, Practice , Health Promotion/trends , Hispanic or Latino/psychology , Hispanic or Latino/statistics & numerical data , Humans , Interviews as Topic , Male , Middle Aged , North Carolina , Risk-Taking , Sexual Partners , Young AdultABSTRACT
Objetivo: Describir las complicaciones obstétricas más frecuentes y la tasa de transmisión vertical en los recién nacidos de embarazos de las mujeres VIH positivas que se atienden en la Clínica de Enfermedades infecciosas del Hospital Roosevelt. Material y Métodos: Se realizó un estrudio retrospectivo, observacional, transversal, en el cual se revisó la base de datos de casos obstétricos y pediátricos que se atendieron regularmente desde el año 2003 de la Clínica de Enfermedades Infecciosas del Hospital Roosevelt...
Subject(s)
Humans , Female , Pregnancy Complications/diagnosis , HIV Seropositivity/complications , HIV Seropositivity/diagnosis , Infectious Disease Transmission, Vertical/prevention & controlABSTRACT
Se presenta el primer caso de hipoglicemia, hiperinsulinémica persistente de la infancia (HHPI) diagnosticado y operado en el Hospital de Especialidades del Instituto Hondureño de Seguridad Social (IHSS) en Tegucigalpa. El motivo de estudio fue convulsiones persistentes. Su diagnóstico se basó en la historia clínica y la relación de los níveles séricos de glucosa/insulina. El HHPI es un trastorno del metabolismo de la glucosa. Se sabe que existen dos formas diferentes de la enfermedad: focal y difusa; en ambas, el tratamiento de elección es la pancreatectomía del 95 por ciento. La evolución post-operatoria del caso clínico ha sido excelente
Subject(s)
Pancreatectomy , Hyperinsulinism , Hypoglycemia , Blood GlucoseABSTRACT
Se presenta el primer caso de hipoglicemia, hiperinsulinémica persistente de la infancia (HHPI) diagnosticado y operado en el Hospital de Especialidades del Instituto Hondureño de Seguridad Social (IHSS) en Tegucigalpa. El motivo de estudio fue convulsiones persistentes. Su diagnóstico se basó en la historia clínica y la relación de los níveles séricos de glucosa/insulina. El HHPI es un trastorno del metabolismo de la glucosa. Se sabe que existen dos formas diferentes de la enfermedad: focal y difusa; en ambas, el tratamiento de elección es la pancreatectomía del 95 por ciento. La evolución post-operatoria del caso clínico ha sido excelente
