Contraceptive use Among Hispanic Women Living in Puerto Rico.

OBJECTIVE: To assess the contraceptive methods used by sexually active Hispanic women living in Puerto Rico. METHODS: From October 2016 through February 2018, 518 patients completed a self-administered questionnaire. The inclusion criteria were being over the age of 21 and having visited San Juan City Hospital or University District Hospital. The results were analyzed using descriptive statistics and a 2-sample t test, where P < .05 was considered significant. RESULTS: A total of 518 participants completed the questionnaire. Of the 518, 413 (81.0%) reported having used at least 1 form of contraception; 252 (49.4%) used OCPs, 305 (60.8%) used male condoms, 92 (33.8%) used the rhythm method, 83 (30.6%) undergone female sterilization, 98 (19.9%) used the withdrawal method, 92 (18.9%%) used an implant, 67 (13.5%) received progesterone injections, 41 (8.3%) used female condoms, 13 (4.9%) had partners who undergone male sterilization, 20 (4.1%) used the transdermal patch, 16 (3.2%) used a vaginal ring, and 26 (5.3%) used an intrauterine device. CONCLUSION: Of the 518 women, 24.2% used LARC, representing an increase in the usage by this population; this increase is likely linked to LARC's being easily accessible and free of charge. Public health interventions should be developed to increase knowledge about sexual health, educate about the effectiveness of different contraceptive methods and the prevention of sexually transmitted diseases, and reduce both the barriers to acquiring contraception and, thereby, the number of unintended pregnancies in this population.

Bleeding assessment in female patients with the Hermansky-Pudlak syndrome-A case series.

INTRODUCTION: The Hermansky-Pudlak syndrome (HPS) is an autosomal recessive rare disorder characterized by oculocutaneous albinism, bleeding diathesis, chronic granulomatous colitis and/or pulmonary fibrosis. HPS is the most common single-gene disorder in Puerto Rico with a prevalence of 1:1,800 in the Northwest of the island. Risk of menorrhagia and post-partum hemorrhage (PPH) in cases of women with HPS have been described in the medical literature, but data regarding comprehensive description of bleeding diathesis remains lacking. For this reason, we aim to identify bleeding events using the International Society on Thrombosis and Hemostasis Bleeding Assessment Tool (ISTH-BAT), a standardized quantitative tool that translates the range of severity of bleeding symptoms into a cumulative bleeding score (BS). OBJECTIVE: To use the ISTH-BAT in HPS in order to describe bleeding symptoms and allow for comparison with other inherited bleeding disorders. METHODS: Puerto Rican females and adult participants with HPS based on genetic linkage were enrolled. The ISTH-BAT was administered and results were identified using descriptive statistical analysis. RESULTS: Questionnaire answers of twelve women with HPS-1 and HPS-3 were evaluated. Participants' mean BS was HPS-1 (11.4) and HPS-3 (8.0) Participants with HPS-1 and HPS-3 reported abnormal bleeding events that presented during dental extractions, menorrhagia, surgical interventions, gastrointestinal, oral cavity and post-partum. Patients with history of pulmonary fibrosis (PF) showed a higher mean bleeding score than those who had no history of PF. CONCLUSIONS: Female patients with HPS type 1 and 3 experienced abnormal bleeding events according to the ISTH-BAT bleeding score. Bleeding medications were inconsistently used and varied independently from healthcare professionals. The benefits of this study were to understand the history of bleeding complications in patients with HPS type 1 and 3 using an international validated system. The results of this study will help design strategies to improve the care we provide to this population.

Zika-prevention Knowledge among Hispanic Women Living in Puerto Rico: A Cross-sectional Study.

OBJECTIVE: To describe the level of knowledge about Zika virus exposure, symptoms, complications, and transmission prevention in Hispanic women living in Puerto Rico. METHODS: A sample of 168 women aged 21 to 64 at the general community, consented to complete a self-administered questionnaire of 112 questions from October 2016 to July 2017. RESULTS: A univariate analysis showed that the participating women recognized that the Zika virus was transmitted through mosquito bites (95.2%), sexual intercourse (78.0%), and from a mother to her fetus (41.1%); participants also believed that other, incorrect, routes of transmission were plausible. Regarding their knowledge of Zika infection prevention, the participants' correct answers included the following: using mosquito repellent (94.1%), eliminating standing water (83.9%), and using condoms (83.3%). When asked about fetal risks associated with Zika, they believed that the fetus would not develop normally (75.6%), would be born with a disability (69.6%), or would experience nervous system problems (54.2%). Only 22.6% of the participants had taken precautions to prevent pregnancy during the Zika outbreak, of which 65.8% reported that they had used condoms during all sexual relationships. CONCLUSION: There is a need to educate the general population about the Zika virus to reduce the misconceptions about disease prevention and transmission as well as about the complications associated with Zika during pregnancy. Awareness efforts should emphasize the prevention of infections during pregnancy and the use of available contraceptive methods.