HIV coping self-efficacy: a key to understanding stigma and HIV test acceptance among incarcerated men in Jamaica.

Although prisons have been noted as important venues for HIV testing, few studies have explored the factors within this context that may influence HIV test acceptance. Moreover, there is a dearth of research related to HIV and incarcerated populations in middle and low-income countries, where both the burden of HIV and the number of people incarcerated is higher compared to high-income countries. This study explores the relationship between HIV coping self-efficacy, HIV-related stigma, and HIV test acceptance in the largest prisons in Jamaica. A random sample of inmates (n=298) recruited from an HIV testing demonstration project were asked to complete a cross-sectional quantitative survey. Participants who reported high HIV coping self-efficacy (adjusted odds ratio (AOR) 1.86: 95% confidence interval CI 1.24-2.78, p-value=0.003), some perceived risk of HIV (AOR 2.51: 95% (CI) 1.57-4.01, p-value=0.000), and low HIV testing stigma (AOR 1.71: 95% CI 1.05-2.79, p-value=0.032) were more likely to test for HIV. Correlates of HIV coping self-efficacy included external and internal HIV stigma (AOR 1.28: 95% CI 1.25-1.32, p-value=0.000 and AOR 1.76: 95% CI 1.34-2.30, p-value=0.000, respectively), social support (AOR 2.09: 95% CI 1.19-3.68, p-value=0.010), and HIV knowledge (AOR 2.33: 95% CI 1.04-5.22, p-value=0.040). Policy and programs should focus on the interrelationships of these constructs to increase participation in HIV testing in prison.

Macromastia and carpal tunnel syndrome: is there an association?

Macromastia is a disorder commonly reported by women. The prevalence of electrophysiologically confirmed, symptomatic carpal tunnel syndrome is 3% among women. A consecutive series of 31 patients with macromastia requesting breast reduction between August 2002 and April 2003 was recruited. The physical characteristics recorded included age, body mass index, and breast size. Clinical and electrophysiologic assessments of the upper limb were performed. Electrophysiologic testing showed that 7 (22%) of the 31 women had a prolonged median nerve latency conduction time longer than 0.40 ms. Age, chest circumference, and the ratio of nipple-to-inframammary line to chest circumference was associated with carpal tunnel syndrome. The prevalence of carpal tunnel syndrome among patients with macromastia was shown to be higher than in previous epidemiologic studies investigating the prevalence of carpal tunnel syndrome among women. Age, chest circumference, and breast size, but not body mass index, have a positive correlation with the increased prevalence of carpal tunnel syndrome in macromastia cases.