1
|
Are Opportunities Being Missed? Burden of HIV, STI and TB, and Unawareness of HIV among African Migrants. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16152710. [PMID: 31366010 PMCID: PMC6696163 DOI: 10.3390/ijerph16152710] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/03/2019] [Revised: 07/26/2019] [Accepted: 07/28/2019] [Indexed: 01/09/2023]
Abstract
Sub-Saharan African migrants (SSAMs) have been disproportionately affected by infectious disease burden. We aimed to identify correlates of HIV, past sexually transmitted infection (STI) and past Tuberculosis infection (TB), as well as examine HIV seropositivity unawareness and testing history among SSAMs. A venue-based sample of 790 SSAMs completed a cross-sectional biobehavioral survey on sexual practices, HIV testing and self-reported infectious diseases; an HIV rapid test was offered. Overall, 5.4% of participants were HIV-positive and 16.7% reported a past STI. Odds of being HIV positive or having a past STI were higher among participants with low socioeconomic status and who experienced violence from a partner. Increased odds of having a past STI were also found among long-term migrants and those who reported sexual risk behaviors. In total, 4.1% of participants had TB in the past; these were more likely male and HIV positive. Unawareness of HIV-positive status was notably high (35%). Half of the participants had never been tested for HIV before, including over a third of those who had STI or TB in the past. Efforts are needed to reduce missed opportunities for HIV/STIs prevention and uptake of HIV testing among SSAMs through more integrated care, while addressing social determinants of infectious diseases.
Collapse
|
2
|
Musyoki H, Bhattacharjee P, Blanchard AK, Kioko J, Kaosa S, Anthony J, Javalkar P, Musimbi J, Malaba SJ, Olwande C, Blanchard JF, Sirengo M, Isac S, Moses S. Changes in HIV prevention programme outcomes among key populations in Kenya: Data from periodic surveys. PLoS One 2018; 13:e0203784. [PMID: 30231072 PMCID: PMC6145580 DOI: 10.1371/journal.pone.0203784] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2018] [Accepted: 08/27/2018] [Indexed: 11/28/2022] Open
Abstract
The Kenya National AIDS and STI Control Programme (NASCOP) conducted annual polling booth surveys (PBS) in 2014 and 2015 to measure outcomes from the national HIV prevention programme for key populations (KPs), comprising behavioural, biomedical and structural interventions. KPs included female sex workers (FSWs), men who have sex with men (MSM) and people who inject drugs (PWID). We compared survey results from the first and second rounds. Comparing the second to the first round, significantly more FSWs (93% vs. 88%, p<0.001) and MSM (77% vs. 58%, p<0.001) reported condom use at last sex with a paying client, and at last anal sex among MSM (80% vs. 77%, p<0.05) and PWID (48% vs. 27%, p<0.01). However, condom use with regular partners remained low, at less than 53% for FSWs and 69% for MSM. Among PWID, there was a significant increase in use of new needles and syringes at last injection (93% vs. 88%, p<0.001), and a significant decrease in reported non-availability of clean needles (23% vs. 36%, p<0.001). The number of overdoses in the past six months reduced significantly but remained high (40% vs. 51%, p<0.001). FSWs and MSM reported significantly higher HIV testing, and in all KP groups, over 93% reported ever having been tested for HIV. Among the respondents self-reporting to have tested HIV positive (24% of FSW, 22% of MSM and 19% of PWID), 80% of FSWs, 70% of MSM, and 73% of PWID reported currently taking antiretroviral therapy (ART). While the experience of forced intercourse by partners declined among FSWs (18% vs. 22%, p<0.01) and MSM (13% vs. 17%, p<0.01), more FSWs reported violence by law enforcement personnel (49% vs. 44%, p<0.001). These findings provide valuable information on the programme's progress, and a signpost for the integrated behavioural, biomedical and structural interventions to achieve their HIV prevention targets.
Collapse
Affiliation(s)
- Helgar Musyoki
- National AIDS and STI Control Programme, Ministry of Health, Government of Kenya, Nairobi, Kenya
| | - Parinita Bhattacharjee
- Centre for Global Public Health, Department of Community Health Sciences, University of Manitoba, Winnipeg, Canada
| | - Andrea K. Blanchard
- Centre for Global Public Health, Department of Community Health Sciences, University of Manitoba, Winnipeg, Canada
| | - Japheth Kioko
- Partners for Health and Development in Africa, Nairobi, Kenya
| | - Shem Kaosa
- Partners for Health and Development in Africa, Nairobi, Kenya
| | - John Anthony
- Centre for Global Public Health, Department of Community Health Sciences, University of Manitoba, Winnipeg, Canada
| | | | - Janet Musimbi
- Partners for Health and Development in Africa, Nairobi, Kenya
| | | | - Carol Olwande
- National AIDS and STI Control Programme, Ministry of Health, Government of Kenya, Nairobi, Kenya
| | - James F. Blanchard
- Centre for Global Public Health, Department of Community Health Sciences, University of Manitoba, Winnipeg, Canada
| | - Martin Sirengo
- National AIDS and STI Control Programme, Ministry of Health, Government of Kenya, Nairobi, Kenya
| | - Shajy Isac
- Centre for Global Public Health, Department of Community Health Sciences, University of Manitoba, Winnipeg, Canada
| | - Stephen Moses
- Centre for Global Public Health, Department of Community Health Sciences, University of Manitoba, Winnipeg, Canada
| |
Collapse
|
3
|
Cianelli R, Villegas N, McCabe BE, de Tantillo L, Peragallo N. Self-efficacy for HIV Prevention Among Refugee Hispanic Women in South Florida. J Immigr Minor Health 2018; 19:905-912. [PMID: 27470226 DOI: 10.1007/s10903-016-0462-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
The number of refugees increased in recent years due to factors worldwide, including violence, wars, political strife, and natural disasters. Refugees who are Hispanic women (RHW) in South Florida are a vulnerable population at risk of acquiring HIV infection. Although studies have shown a relationship between self-efficacy for HIV prevention and behavior changes, none have studied RHW. The purpose of this study was to assess whether predictors suggested by the literature were related to self-efficacy for HIV prevention in a sample of RHW. The study is a secondary analysis that uses baseline data from a randomized controlled experimental study, SEPA. A total of 99 refugee Hispanic women from South Florida, 18-50 years of age, participated in the study. There were two predictors of self-efficacy. HIV knowledge was positively related to self-efficacy, and living with a partner was inversely related to self-efficacy for HIV prevention. Culturally competent sexual health education interventions in this population may impact self-efficacy for HIV prevention.
Collapse
Affiliation(s)
- Rosina Cianelli
- School of Nursing and Health Studies, University of Miami, 5030 Brunson Dr., Miami, FL, 33146, USA. .,Escuela de Enfermeria, Pontificia Universidad Catolica de Chile, Santiago, Chile.
| | - Natalia Villegas
- School of Nursing and Health Studies, University of Miami, 5030 Brunson Dr., Miami, FL, 33146, USA
| | - Brian E McCabe
- School of Nursing and Health Studies, University of Miami, 5030 Brunson Dr., Miami, FL, 33146, USA
| | - Lila de Tantillo
- School of Nursing and Health Studies, University of Miami, 5030 Brunson Dr., Miami, FL, 33146, USA
| | - Nilda Peragallo
- School of Nursing and Health Studies, University of Miami, 5030 Brunson Dr., Miami, FL, 33146, USA
| |
Collapse
|
4
|
Zoboli F, Martinelli D, Di Stefano M, Fasano M, Prato R, Santantonio TA, Fiore JR. Correlation between knowledge on transmission and prevention of HIV/STI and proficiency in condom use among male migrants from Africa and Middle East evaluated by a Condom Use Skills score using a wooden penile model. BMC Res Notes 2017. [PMID: 28629409 PMCID: PMC5477424 DOI: 10.1186/s13104-017-2520-1] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Migrants in Italy are prevalently young adults, with a higher risk of sexual transmitted infections (STI) and HIV infection. Promoting consistent as well as correct use of condoms could reduce failure rate due to their improper use. The aim of our study was to evaluate Condom Use Skills among a migrant population recently landed in Italy, hosted in a government center for asylum seekers. METHODS The study sample was composed of 80 male migrants. Sanitary trained interviewers submitted a questionnaire to participants to investigate age, provenience, marital status, educational level and knowledge about transmission and prevention of HIV/STI. Then, we assessed participants' level of condom use skill with the Condom Use Skills (CUS) measure by using a wooden penile model. The interviewer filled in a checklist and assigned 1 point for correct demonstration of each behavior that may prevent condom failure during sex. RESULTS Participants' median age was 26 years and the sample was composed of 54 migrants from sub-Saharan Africa and 26 from Middle East. Most of them were married, with a lower middle level of education, up to 8 or 5 years. Half of the sample achieved the highest score in the questionnaire and our CUS showed a large number of people with middle high score classes. The Spearman's rho was 0.30, therefore answers to the questionnaire and CUS score appeared correlated (p < 0.05). In the multivariate model, to have a higher CUS score resulted to be associated to be older than 26 years (p < 0.05), with a higher level of education (p = 0.001), and a higher score in the questionnaire (p < 0.05). There were no significant differences in the level of CUS between single or married men and between African and Middle Asian migrants of the sample. CONCLUSIONS Our study shows that educational level influences the quality of knowledge and awareness about STI/AIDS and contribute to correct condom use. Since the half of participants had a low educational level and linguistic problems, the risk of missing campaigns messages or misunderstanding informative materials increases. Direct observation of condom-application on penile model may offer realistic assessment of application skills in these individuals.
Collapse
Affiliation(s)
- Fabio Zoboli
- Clinic of Infectious Diseases, Department of Clinical and Experimental Medicine, University of Foggia, Viale Pinto 5, 71100, Foggia, Italy
| | - Domenico Martinelli
- Sector of Hygiene, Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
| | - Mariantonietta Di Stefano
- Clinic of Infectious Diseases, Department of Clinical and Experimental Medicine, University of Foggia, Viale Pinto 5, 71100, Foggia, Italy
| | - Massimo Fasano
- Clinic of Infectious Diseases, Department of Clinical and Experimental Medicine, University of Foggia, Viale Pinto 5, 71100, Foggia, Italy
| | - Rosa Prato
- Sector of Hygiene, Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
| | - Teresa Antonia Santantonio
- Clinic of Infectious Diseases, Department of Clinical and Experimental Medicine, University of Foggia, Viale Pinto 5, 71100, Foggia, Italy
| | - Jose' Ramòn Fiore
- Clinic of Infectious Diseases, Department of Clinical and Experimental Medicine, University of Foggia, Viale Pinto 5, 71100, Foggia, Italy.
| |
Collapse
|
5
|
Andrade SSDC, Zaccara AAL, Leite KNS, Brito KKGD, Soares MJGO, Costa MML, Pinheiro AKB, Oliveira SHDS. Knowledge, attitude and practice of condom use by women of an impoverished urban area. Rev Esc Enferm USP 2015; 49:364-72. [DOI: 10.1590/s0080-623420150000300002] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2014] [Accepted: 02/03/2015] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE Assessing the adequacy of knowledge, attitude and practice of women regarding male and female condoms as STI/HIV preventive measures. METHOD An evaluative Knowledge, Attitude and Practice (KAP) household survey with a quantitative approach, involving 300 women. Data collection took place between June and August 2013, in an informal urban settlement within the municipality of João Pessoa, Paraiba, Northeast Brazil. RESULTS Regarding the male condom, most women showed inadequate knowledge and practice, and an adequate attitude. Regarding the female condom, knowledge, attitude and practice variables were unsatisfactory. Significant associations between knowledge/religious orientation and attitude/education regarding the male condom were observed. CONCLUSION A multidisciplinary team should be committed to the development of educational practices as care promotion tools in order to improve adherence of condom use.
Collapse
|