Biological, psychosocial, therapeutic and quality of life inequalities between HIV-positive men and women - a review from a gender perspective.

The proportion of women infected with HIV worldwide has grown in recent years. From a transmission pattern that was once predominantly homosexual men and through intravenous use of drugs, the current pattern has become, to a large extent, heterosexual. Women are more vulnerable to be infected with HIV due to anatomical and psychosocial differences. In spite of this changing gender trend in the HIV pandemic, biological, psychosocial, therapeutic, and quality of life aspects have not been examined in detail in women. Moreover, this lack of investigation has relevance in terms of vertical transmission of the infection to newborns. Herein, we review gender differences in HIV, identifying from a gender perspective the biological and social factors with a greater influence on vulnerability to infection, and, on the other hand, examining gender differences with respect to the use of services, treatment, survival, and quality of life.

Cómo redactar un resumen para una publicación comunicación científica / No disponible

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[Factors related to refuse antiretroviral therapy in prison]. / Factores relacionados con rehusar el tratamiento antirretroviral en prisión.

INTRODUCTION: Despite the benefits of highly-active antiretroviral therapy (HAART) on morbidity and mortality, some seropositive patients refuse to accept this treatment. Prisons provide easier access to this population. OBJECTIVE: To determine the psychosocial characteristics of prisoners who refuse HAART. METHODS: We performed a cross-sectional study in 580 seropositive prisoners in 3 hospitals in Andalusia (Spain). The dependent variable was being under treatment or refusal to be so. The independent variables were sociodemographic and psychosocial factors related to the prison environment and clinical factors related to health status and drug addiction. A logistic regression analysis was performed to determine which factors were related with refusal to accept HAART. RESULTS: HAART was recommended to 73.1% of seropositive prisoners. This treatment was refused by 23.1% of these prisoners and was accepted by 76.9%. The factors related to refusal to accept HAART were high viral load, worse self-perceived health status, a greater number of stays in prison, and being visited by persons other than relatives. CONCLUSIONS: There is a group of prisoners with specific characteristics that refuse HAART. Specific interventions should be performed in these prisoners to make them aware of the effects of their decision on the course of their disease.

Factores relacionados con rehusar el tratamiento antirretroviral en prisión / Factors related to refuse antiretroviral therapy in prison

Introducción: A pesar de los beneficios sobre la morbilidad y la mortalidad que tiene el tratamiento antirretroviral de gran actividad, hay pacientes seropositivos que rehúsan tomarlo. Las prisiones nos permiten acceder con más facilidad a esta población. Objetivo: Determinar las características psicosociales de los reclusos que rehúsan el tratamiento antirretroviral. Metodología: Estudio transversal realizado a 580 reclusos seropositivos de 3 cárceles andaluzas. Como variable dependiente se estableció estar en tratamiento o rehusarlo. Las variables independientes fueron: sociodemográficas, psicosociales, relacionadas con el medio penitenciario, clínicas, y relacionadas con el estado de salud y con las drogodependencias. Se realizó un análisis de regresión logística para determinar qué factores se relacionaban con rehusar el tratamiento antirretroviral. Resultados: Al 73,1% de los reclusos seropositivos se les recomendaba el tratamiento con antirretrovirales. De éstos, el 23,1% rechazaba tomarlo, mientras el 76,9% lo tomaba. Los factores relacionados con los reclusos que rehusaban el tratamiento antirretroviral fueron una carga viral elevada, una peor salud autopercibida, un mayor número de entradas en la cárcel y ser visitados por personas diferentes a los familiares. Conclusiones: Hay un grupo de reclusos con características propias que rechazan el tratamiento antirretroviral, sobre el que deben realizarse intervenciones específicas encaminadas a que conozcan las consecuencias de su decisión sobre la evolución de su enfermedad (AU)

Introduction: Despite the benefits of highly-active antiretroviral therapy (HAART) on morbidity and mortality, some seropositive patients refuse to accept this treatment. Prisons provide easier access to this population. Objective: To determine the psychosocial characteristics of prisoners who refuse HAART. Methods: We performed a cross-sectional study in 580 seropositive prisoners in 3 hospitals in Andalusia (Spain). The dependent variable was being under treatment or refusal to be so. The independent variables were sociodemographic and psychosocial factors related to the prison environment and clinical factors related to health status and drug addiction. A logistic regression analysis was performed to determine which factors were related with refusal to accept HAART. Results: HAART was recommended to 73.1% of seropositive prisoners. This treatment was refused by 23.1% of these prisoners and was accepted by 76.9%. The factors related to refusal to accept HAART were high viral load, worse self-perceived health status, a greater number of stays in prison, and being visited by persons other than relatives. Conclusions: There is a group of prisoners with specific characteristics that refuse HAART. Specific interventions should be performed in these prisoners to make them aware of the effects of their decision on the course of their disease (AU)

Cómo elaborar un protocolo de investigación en salud / How to elaborate a protocol on health research

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