RESUMO
Early sexual partnerships place young women in sub-Saharan Africa at high risk for HIV. Few studies have examined both individual- and partnership-level characteristics of sexual relationships among adolescent girls. A cross-sectional survey of sexual history and partnerships was conducted among 761 adolescent girls aged 15-19 years in Nairobi, Kenya. Rapid HIV testing was conducted and correlates of HIV infection were determined using multivariate logistic regression. The HIV prevalence was 7% and seropositive adolescents had a younger age at sexual debut (P < 0.01), more sexual partners in 12 months (P = 0.03), and were more likely to report transactional or non-consensual sex (P < 0.01). Girls who reported not knowing their partner's HIV status were 14 times as likely to be HIV-seropositive than girls who knew their partner's status (adjusted odds ratio: 14.2 [1.8, 109.3]). Public health messages to promote HIV testing and disclosure within partnerships could reduce sexual risk behaviours and HIV transmission among adolescents.
Assuntos
Infecções por HIV/epidemiologia , Comportamento Sexual/estatística & dados numéricos , Adolescente , Estudos Transversais , Feminino , Humanos , Quênia/epidemiologia , Modelos Logísticos , Fatores de Risco , Parceiros Sexuais , Adulto JovemAssuntos
Anormalidades Induzidas por Medicamentos/etiologia , Antagonistas do Ácido Fólico/efeitos adversos , Infecções por HIV/tratamento farmacológico , Complicações Infecciosas na Gravidez/tratamento farmacológico , Combinação Trimetoprima e Sulfametoxazol/efeitos adversos , Anti-Infecciosos/efeitos adversos , Fenda Labial/induzido quimicamente , Feminino , Cardiopatias Congênitas/induzido quimicamente , Humanos , Gravidez , Sistema Urinário/anormalidadesRESUMO
CONTEXT: The 1992 peace settlement that ended the civil war in El Salvador included land redistribution and other provisions designed to improve the socioeconomic status of ex-combatants and vulnerable civilians. OBJECTIVE: To describe associations between postwar social and economic assistance programs, especially land reform, and current child health status as reflected by nutrition in a population of resettled rural refugees. DESIGN: A population-based cross-sectional survey of child nutritional status and principal elements of the reconstruction process. SETTING: A single rural municipality in northern El Salvador. PARTICIPANTS: A representative sample of 761 children younger than 5 years, living in 27 villages. MAIN OUTCOME MEASURE: Prevalence of stunting (low height for age) in children younger than 5 years. RESULTS: Prevalence of stunting was 32.4%. Stunting was significantly more prevalent among children whose families cultivated less land (odds ratio [OR] for stunting per additional hectare of redistributed land cultivated, 0.64; 95% confidence interval [CI], 0.44-0.93). Less than half of newly transferred land was being cultivated by its owners. Most of the children (84.7%) lived in families cultivating 2 hectares or less of redistributed land. Stunting was also more prevalent among children whose households lacked piped water (adjusted OR, 2.72; 95% CI, 1.87-3.96) vs those who had had piped water since before the cease-fire. CONCLUSIONS: Malnutrition, particularly stunting, persisted at high levels and was strongly associated with delay in full cultivation of redistributed land and in provision of water.
Assuntos
Nível de Saúde , Distúrbios Nutricionais/epidemiologia , Saúde da População Rural , Guerra , Estatura , Pré-Escolar , El Salvador/epidemiologia , Humanos , Lactente , População Rural , Fatores SocioeconômicosAssuntos
Serviços de Saúde Materna , Tocologia , Resultado da Gravidez , Guerra , Adolescente , Adulto , El Salvador , Feminino , Humanos , Mortalidade Materna , Gravidez , População RuralRESUMO
During the recent civil war in E1 Salvador, as in other modern wars, human rights abuses adversely affected health workers, patients, and medical facilities. The abuses themselves have been described in reports of human rights advocacy organisations but health sector adaptations to a hostile wartime environment have not. Agencies engaged in health work during the civil war adapted parties such as training of community based lay health workers, use of simple technology, concealment of patients and medical supplies, denunciation of human rights abuses, and multilevel negotiations in order to continue providing services. The Salvadorean experience may serve as a helpful case study for medical personnel working in wars elsewhere.