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Ransome Y, Martinez-Brockman JL, Galusha D, Thompson TA, Adams OP, Nazario CM, Nunez M, Nunez-Smith M, Maharaj RG. Prevalence and correlates of alcohol use among the elderly in the Eastern Caribbean Health Outcomes Research Network (ECHORN) cohort study. Addict Behav 2024; 153:108001. [PMID: 38447411 DOI: 10.1016/j.addbeh.2024.108001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Revised: 02/17/2024] [Accepted: 02/25/2024] [Indexed: 03/08/2024]
Abstract
BACKGROUND Alcohol use is pervasive in the Caribbean; however, the prevalence and correlates of alcohol use and drinking problems in the elderly have not been extensively studied. METHODS Data were obtained from the Eastern Caribbean Health Outcomes Research Network (ECHORN) Cohort Study, a cohort study of Caribbean people from Puerto Rico, Barbados, Trinidad, and Tobago, and the U.S. Virgin Islands, collected between 2013 and 2018 (baseline study sample, ages 60+, n = 811). Descriptive statistics were used to compare the differences in drinking status (current vs. former vs. never), alcohol problems (Cut-down, Annoyed, Guilty, and Eye-opener (CAGE) scale score ≥2 vs. <2), and binge drinking days (0 days vs. 1-2 days vs. ≥3 days) across sample characteristics. Logistic regression analyses estimated the association of these alcohol measures with sociodemographic (e.g., sex), psychological (depression), and cultural (e.g., religion) correlates. RESULTS Thirty-six percent were 70 + years of age, 64 % were female, and 41 % had less than a high school education. Alcohol problems (≥2 CAGE score) was 21 %. Binge drinking ≥3 days was 30.6 %. Never attending religious services (vs. attending once a week or more) was associated with almost three times higher odds of alcohol problems (adjusted Odds Ratio: OR = 2.88, 95 % CI = 1.02, 8.15) four times higher odds of increasing binge drinking days (aOR = 4.04, 95 % CI = 1.11, 14.96). College education was protective against both the outcomes. CONCLUSION We provide current estimates of alcohol problems among elderly Eastern Caribbean people. Among the sociodemographic, psychological, and cultural correlates examined, religious attendance was significant. Replicate longitudinal studies using DSM-5 alcohol dependence are recommended.
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Affiliation(s)
- Yusuf Ransome
- Department of Social and Behavioral Sciences, Yale School of Public Health, New Haven, CT 06510, USA.
| | - Josefa L Martinez-Brockman
- Equity Research and Innovation Center, Yale School of Medicine, New Haven, CT 06510, USA; Department of Internal Medicine, Yale School of Medicine, New Haven, CT 06510, USA.
| | - Deron Galusha
- Department of Internal Medicine, Yale School of Medicine, New Haven, CT 06510, USA.
| | | | - Oswald P Adams
- Department of Family Medicine, Faculty of Medical Sciences, University of the West Indies, Cave Hill BB11000, Barbados.
| | - Cruz M Nazario
- Department of Biostatistics and Epidemiology, Graduate School of Public Health, University of Puerto Rico at Medical Sciences Campus, San Juan 00936, PR, USA.
| | - Maxine Nunez
- School of Nursing, University of the Virgin Islands, St. Thomas, VI 00802, USA.
| | - Marcella Nunez-Smith
- Equity Research and Innovation Center, Yale School of Medicine, New Haven, CT 06510, USA; Department of Internal Medicine, Yale School of Medicine, New Haven, CT 06510, USA.
| | - Rohan G Maharaj
- Department of Paraclinical Sciences, University of the West Indies, Saint Augustine, Trinidad and Tobago.
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Fischer B, Jaoko W, Kirui E, Muture B, Madegwa I, Kageni L. Dyspareunia, signs of epithelial disruption, sexual abstinence, and HIV status in female sex workers in Nairobi: a cross-sectional study. BMC Infect Dis 2023; 23:569. [PMID: 37658320 PMCID: PMC10472738 DOI: 10.1186/s12879-023-08572-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Accepted: 08/28/2023] [Indexed: 09/03/2023] Open
Abstract
BACKGROUND Epithelial trauma is a risk factor of HIV infection in men who have sex with men (MSM) and female sex workers (FSWs). Painful intercourse may be indicative of epithelial tissue disruption. Previous studies on a cohort of Kenyan FSWs established an association between prolonged sexual abstinence and late HIV seroconversion. Our research objective was to establish whether there is a relationship between HIV serostatus and signs of epithelial disruption and between HIV serostatus and sexual abstinence behaviour. METHODS Participants were selected from a Nairobi health facility. A structured questionnaire was administered to 322 FSWs, who provided data on HIV status, sexual behaviour, abstinence intervals and the level of sexual dysfunction. Sexual dysfunction scores were created using parts of the Female Sexual Function Index (FSFI-19). Additional questions addressed epithelial trauma signs. Descriptive data analysis, bivariate and multivariate logistic regression were used to describe the study population and determine factors associated with living with HIV. Potential factors influencing sexual dysfunction were assessed by FSWs via self-rating. RESULTS 36% of FSWs reported discomfort or pain during vaginal penetration half the time. 44% noticed genital bleeding half the time. Vaginal tenderness was experienced by 70.6% half the time during or after intercourse. Variables predictive of living with HIV on multivariate analysis included a medium and high score of discomfort or pain during and following vaginal penetration (medium: AOR 2.288, p-value 0.032, 95% CI 1.075-4.871; high: AOR 3.044, p-value 0.031, 95% CI 1.110-8.348). No significant association of HIV status with past abstinence durations as reported by participants could be established in the multivariate analysis. A majority of FSWs agreed that steady partnerships (81% agreement), regularity of intercourse (74%), foreplay (72%) and lubricants (65%) alleviated dyspareunia. CONCLUSIONS Recurrent exposure to blood during sex was highly prevalent in FSWs, as was sexual dysfunction. Complaint levels were associated with living with HIV, providing evidence that reducing sexual dysfunctions may prevent HIV transmission. Preventive initiatives may be created that address sexual dysfunction in key populations and general populations with a high HIV prevalence. Subjective assessments indicate that prevention may include the promotion of sexual intercourse regularity, foreplay, and lubricant use.
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Affiliation(s)
- Bastian Fischer
- Department of Psychiatry and Psychotherapy, Hubertusburg Hospital Wermsdorf, Husarenpark 5, 04860, Torgau, Germany.
| | - Walter Jaoko
- KAVI-Institute of Clinical Research College of Health Sciences, University of Nairobi, 3rd Floor Wing B, P.O. Box 19676 - 00202, Nairobi, Kenya
| | - Elvis Kirui
- Independent scholar, P.O. Box 30197-00100, Nairobi, Kenya
| | - Bernard Muture
- Independent scholar, P.O. Box 30197-00100, Nairobi, Kenya
| | - Isaac Madegwa
- KAVI-Institute of Clinical Research College of Health Sciences, University of Nairobi, 3rd Floor Wing B, P.O. Box 19676 - 00202, Nairobi, Kenya
| | - Lisbeth Kageni
- KAVI-Institute of Clinical Research College of Health Sciences, University of Nairobi, 3rd Floor Wing B, P.O. Box 19676 - 00202, Nairobi, Kenya
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Escoffery C, Lebow-Skelley E, Haardoerfer R, Boing E, Udelson H, Wood R, Hartman M, Fernandez ME, Mullen PD. A systematic review of adaptations of evidence-based public health interventions globally. Implement Sci 2018; 13:125. [PMID: 30257683 PMCID: PMC6158804 DOI: 10.1186/s13012-018-0815-9] [Citation(s) in RCA: 173] [Impact Index Per Article: 28.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2018] [Accepted: 09/10/2018] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Adaptations of evidence-based interventions (EBIs) often occur. However, little is known about the reasons for adaptation, the adaptation process, and outcomes of adapted EBIs. To address this gap, we conducted a systematic review to answer the following questions: (1) What are the reasons for and common types of adaptations being made to EBIs in community settings as reported in the published literature? (2) What steps are described in making adaptations to EBIs? and (3) What outcomes are assessed in evaluations of adapted EBIs? METHODS We conducted a systematic review of English language publications that described adaptations of public health EBIs. We searched Ovid PubMed, PsycINFO, PsycNET, and CINAHL and citations of included studies for adapted public health EBIs. We abstracted characteristics of the original and adapted populations and settings, reasons for adaptation, types of modifications, use of an adaptation framework, adaptation steps, and evaluation outcomes. RESULTS Forty-two distinct EBIs were found focusing on HIV/AIDS, mental health, substance abuse, and chronic illnesses. More than half (62%) reported on adaptations in the USA. Frequent reasons for adaptation included the need for cultural appropriateness (64.3%), focusing on a new target population (59.5%), and implementing in a new setting (57.1%). Common adaptations were content (100%), context (95.2%), cultural modifications (73.8%), and delivery (61.9%). Most study authors conducted a community assessment, prepared new materials, implemented the adapted intervention, evaluated or planned to evaluate the intervention, determined needed changes, trained staff members, and consulted experts/stakeholders. Most studies that reported an evaluation (k = 36) included behavioral outcomes (71.4%), acceptability (66.7%), fidelity (52.4%), and feasibility (52.4%). Fewer measured adoption (47.6%) and changes in practice (21.4%). CONCLUSIONS These findings advance our understanding of the patterns and effects of modifications of EBIs that are reported in published studies and suggest areas of further research to understand and guide the adaptation process. Furthermore, findings can inform better reporting of adapted EBIs and inform capacity building efforts to assist health professionals in adapting EBIs.
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Affiliation(s)
- Cam Escoffery
- Rollins School of Public Health, Emory University, 1518 Clifton Road, Atlanta, GA 30322 USA
| | - E. Lebow-Skelley
- Rollins School of Public Health, Emory University, 1518 Clifton Road, Atlanta, GA 30322 USA
| | - R. Haardoerfer
- Rollins School of Public Health, Emory University, 1518 Clifton Road, Atlanta, GA 30322 USA
| | - E. Boing
- Rollins School of Public Health, Emory University, 1518 Clifton Road, Atlanta, GA 30322 USA
| | - H. Udelson
- Rollins School of Public Health, Emory University, 1518 Clifton Road, Atlanta, GA 30322 USA
| | - R. Wood
- University of Texas School of Public Health, 7000 Fannin, Ste 2522, Houston, TX 77030 USA
| | - M. Hartman
- University of Texas School of Public Health, 7000 Fannin, Ste 2522, Houston, TX 77030 USA
| | - M. E. Fernandez
- University of Texas School of Public Health, 7000 Fannin, Ste 2522, Houston, TX 77030 USA
| | - P. D. Mullen
- University of Texas School of Public Health, 7000 Fannin, Ste 2522, Houston, TX 77030 USA
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Jarlais DCD, Arasteh K, McKnight C, Feelemyer J, Campbell ANC, Tross S, Cooper HLF, Hagan H, Perlman DC. What happened to the HIV epidemic among non-injecting drug users in New York City? Addiction 2017; 112:290-298. [PMID: 27613968 PMCID: PMC5233554 DOI: 10.1111/add.13601] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2016] [Revised: 08/23/2016] [Accepted: 09/08/2016] [Indexed: 11/28/2022]
Abstract
BACKGROUND AND AIMS HIV has reached high prevalence in many non-injecting drug user (NIDU) populations. The aims of this study were to (1) examine the trend in HIV prevalence among non-injecting cocaine and heroin NIDUs in New York City, (2) identify factors potentially associated with the trend and (3) estimate HIV incidence among NIDUs. DESIGN Serial-cross sectional surveys of people entering drug treatment programs. People were permitted to participate only once per year, but could participate in multiple years. SETTING Mount Sinai Beth Israel drug treatment programs in New York City, USA. PARTICIPANTS We recruited 3298 non-injecting cocaine and heroin users from 2005 to 2014. Participants were 78.7% male, 6.1% white, 25.7% Hispanic and 65.8% African American. Smoking crack cocaine was the most common non-injecting drug practice. MEASURES Trend tests were used to examine HIV prevalence, demographics, drug use, sexual behavior and use of antiretroviral treatment (ART) by calendar year; χ2 and multivariable logistic regression were used to compare 2005-10 versus 2011-14. FINDINGS HIV prevalence declined approximately 1% per year (P < 0.001), with a decline from 16% in 2005-10 to 8% in 2011-14 (P < 0.001). The percentages of participants smoking crack and having multiple sexual partners declined and the percentage of HIV-positive people on ART increased. HIV incidence among repeat participants was 1.2 per 1000 person-years (95% confidence interval = 0.03/1000-7/1000). CONCLUSIONS HIV prevalence has declined and a high percentage of HIV-positive non-injecting drug users (NIDUs) are receiving antiretroviral treatment, suggesting an end to the HIV epidemic among NIDUs in New York City. These results can be considered a proof of concept that it is possible to control non-injecting drug use related sexual transmission HIV epidemics.
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Affiliation(s)
| | | | | | | | - Aimee N. C. Campbell
- New York State Psychiatric Institute, Department of Psychiatry, Columbia University Medical Center, New York, NY
| | - Susan Tross
- New York State Psychiatric Institute, Department of Psychiatry, Columbia University Medical Center, New York, NY
| | - Hannah LF Cooper
- Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, Atlanta Georgia
| | - Holly Hagan
- College of Nursing, New York University, New York NY
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Gendered sexual uses of alcohol and associated risks: a qualitative study of Nigerian University students. BMC Public Health 2016; 16:474. [PMID: 27267273 PMCID: PMC4895988 DOI: 10.1186/s12889-016-3163-1] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2015] [Accepted: 05/18/2016] [Indexed: 11/10/2022] Open
Abstract
Background Alcohol misuse among young people is a global phenomenon. In many countries, young people engage in heavy drinking and this exacerbates risky sexual behaviour. In Nigeria, alcohol held multiple roles in the traditional era but was mainly consumed by adult males for pleasure. Adult females and young people were culturally constrained from drinking in most communities. In contemporary Nigeria, young people’s drinking is increasing, and many engage in sexual intercourse under the influence of alcohol. Methods This study draws on the traditional gender and social sexual scripts to explore the factors that motivate young people to use alcohol for sexual purposes. In-depth interviews were conducted with 19 to 23-year old male and female undergraduate students from a Nigerian university. Thematic analysis was conducted with the aid of NVivo 10 software. Results Men drink to become confident to initiate sexual relationships, stimulate sexual urges, prolong erection, increase sexual satisfaction and become more aggressive during sexual intercourse. Women also drink to be bold in initiating sexual relationships, for sexual arousal and to increase satisfaction. Relatedly, not every brand of alcohol is used for sexual purposes. For example, while men use ‘herbal’ alcoholic beverages and a mixture of locally-produced gin and marijuana, women use champagne and other flavoured alcoholic beverages. The results also revealed that young people use alcohol or salt in a bid to prevent conception after sexual intercourse. Conclusions Adherence to the traditional gender (masculinity) and social sexual scripts amongst men and the enactment of what appears to be a new form of femininity script amongst women contribute to a culturally specific understanding of the motivations to use alcohol for sexual purposes. Evidence-based strategies should be employed to distribute information about the consequences of sexual intercourse under the influence of alcohol.
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Kaljee L, Wang B, Deveaux L, Lunn S, Rolle G, Villar ME, Stanton B. Cross-sectional data on alcohol and marijuana use and sexual behavior among male and female secondary school students in New Providence, The Bahamas. Int J Adolesc Med Health 2016; 28:133-40. [PMID: 25781669 DOI: 10.1515/ijamh-2014-0079] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2014] [Accepted: 01/17/2015] [Indexed: 11/15/2022]
Abstract
BACKGROUND While The Bahamas have significantly reduced poor reproductive health outcomes among adolescents and emerging adults, data indicate that youth are engaged in sexual risk behaviors. Substance use has been linked to increased risk for HIV and sexually transmitted infections in other contexts. There are limited data on Bahamian youth in relation to consumption of alcohol and marijuana use and engagement in sexual behaviors. OBJECTIVE This study aimed to assess potential relationships between alcohol and marijuana use and engagement in sexual behavior among government secondary school students in New Providence, The Bahamas. MATERIALS AND METHODS Total sample size was 2572, and about 56% of respondents were female. Mean age was 14.2 (SD 2.7 years). Cross-sectional data came from a baseline survey conducted as part of a longitudinal randomized controlled evaluation of a school-based HIV prevention and reproductive health program in New Providence. RESULTS Overall, 46.5% (519) males and 44.8% (652) females reported alcohol consumption; 7.3% (82) males and 1.7% (25) females reported use of marijuana in the last 6 months. About 43% (477) male respondents and 16% (231) female respondents reported ever having vaginal sex. Logistic regression analysis indicates that increased likelihood of engaging in sex during the past 6 months is associated with being older, male, and consuming alcohol and marijuana. CONCLUSION These data provide a 'global correlation' between substance use and engagement in sexual behaviors among Bahamian adolescents. Longitudinal research is needed to assess event specific risks and identify mediating and moderating factors. These findings indicate the importance of integrating reproductive health and substance use education.
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Reid SD, Downes E, Khenti A. Participants' perception of a unique community of practice for substance abuse education in the Caribbean. Subst Abus 2015; 37:427-434. [PMID: 26713402 DOI: 10.1080/08897077.2015.1134753] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
BACKGROUND Substance abuse is a significant public health challenge in the Caribbean. It is important that health and allied professionals be adequately trained in this field. The Caribbean Institute on Alcoholism and other Drug Problems (CARIAD) was established to provide new knowledge and share successful best practices in substance abuse in the Caribbean. CARIAD brings together diverse participants from throughout the region in a structured community of practice and emphasizes local knowledge formation. This paper evaluates the acceptability and perceived impact of CARIAD to/on participants. METHODS The authors analyzed anonymous written evaluations of 458 CARIAD participants completed immediately after the program in 2003-2012. Questionnaires collected quantitative data on the acceptability of the program in meeting the learning needs of participants. Perception of program acceptability and impact on the participant were also obtained from descriptive content analysis of qualitative data obtained through open-ended questions. A 2013 online follow-up survey collected data about the utilization and dissemination of knowledge acquired at CARIAD from 141 graduates of the same period. Data analysis employed basic descriptive statistics and qualitative content analysis. RESULTS Participant evaluation immediately following CARIAD showed a high level of satisfaction with the organization, structure, content, and usefulness of the program. Participants valued the program's cultural relevance and the opportunity for networking and collaboration. They expressed a collective solidarity, and empowerment to address substance abuse problems. Participants reported that CARIAD had impacted positively on their professional practice and facilitated knowledge transfer to colleagues and communities. CONCLUSION CARIAD is perceived as an effective community of practice, producing a network of graduates who use the acquired knowledge, skills, and motivation to lead in the field of substance abuse in the Caribbean. This process of learning can be recommended to countries where research is not prioritized and evidence-driven interventions are not always available.
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Affiliation(s)
- Sandra D Reid
- a Psychiatry Unit, Faculty of Medical Sciences, The University of the West Indies , St. Augustine , Trinidad
| | - Erica Downes
- b Centre for Addiction and Mental Health , Toronto , Canada
| | - Akwatu Khenti
- b Centre for Addiction and Mental Health , Toronto , Canada
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Time for a regional alcohol policy – A literature review of the burden of normative alcohol use in the Caribbean. J Public Health Policy 2015; 36:469-83. [DOI: 10.1057/jphp.2015.27] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
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Fleming PJ, Agnew-Brune C. Current Trends in the study of Gender Norms and Health Behaviors. Curr Opin Psychol 2015; 5:72-77. [PMID: 26075291 DOI: 10.1016/j.copsyc.2015.05.001] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
Gender norms are recognized as one of the major social determinants of health and gender norms can have implications for an individual's health behaviors. This paper reviews the recent advances in research on the role of gender norms on health behaviors most associated with morbidity and mortality. We find that (1) the study of gender norms and health behaviors is varied across different types of health behaviors, (2) research on masculinity and masculine norms appears to have taken on an increasing proportion of studies on the relationship between gender norms and health, and (3) we are seeing new and varied populations integrated into the study of gender norms and health behaviors.
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Affiliation(s)
- Paul J Fleming
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, 302 Rosenau Hall, Chapel Hill, NC 27599-7440, (tel) 630-777-0160, (fax) 919-966-2921
| | - Christine Agnew-Brune
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, 302 Rosenau Hall, Chapel Hill, NC 27599-7440
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Youssef FF, Bachew R, Bodie D, Leach R, Morris K, Sherma G. Knowledge and attitudes towards mental illness among college students: insights into the wider English-speaking Caribbean population. Int J Soc Psychiatry 2014; 60:47-54. [PMID: 23070999 DOI: 10.1177/0020764012461236] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Mental illness is a significant contributor to global disease burden and this is expected to increase over the coming decades. Traditionally mental illness has not been well understood by the general public, resulting in poor attitudes towards persons with mental illness and stigmatization. Such conditions are common in the Caribbean where less than 5% of the health budget is allocated to mental illness. AIMS To assess knowledge and attitudes towards mental illness among college students within the English-speaking Caribbean. METHODS A self-report questionnaire was adapted from previous studies designed to measure knowledge and attitudes of mental illness. Students were sampled from the University of the West Indies campuses in Jamaica, Barbados and Trinidad & Tobago. RESULTS Responses were collected from 673 persons with a response rate of 84%. While participants were agreed that particular diseases were mental illnesses, overall knowledge scores were low. Knowledge was higher among those persons who knew someone with a mental illness. Attitude scores were suggestive of stigmatization, with drug abuse and schizophrenia seen in a particularly poor light. CONCLUSIONS These results suggest that widespread educational campaigns need to be implemented across the region, designed to both increase knowledge about mental illness and reduce discrimination towards persons suffering with mental illness.
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Affiliation(s)
- Farid F Youssef
- The University of the West Indies, St Augustine Campus, Trinidad & Tobago
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Colón-López V, Soto-Salgado M, Rodríguez-Díaz C, Suárez EL, Pérez CM. Addressing Health Disparities among Men: Demographic, Behavioral and Clinical Characteristics of Men who have Sex with Men Living in Puerto Rico. SEXUALITY RESEARCH & SOCIAL POLICY : JOURNAL OF NSRC : SR & SP 2013; 10:10.1007/s13178-013-0130-9. [PMID: 24288521 PMCID: PMC3839854 DOI: 10.1007/s13178-013-0130-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/20/2023]
Abstract
The objective of this study was to compare sociodemographic, behavioral and clinical characteristics associated with HIV among Men who have sex with Men (MSM) and men who have sex with women (MSW) in Puerto Rico. Data from a population-based cross-sectional study in PR (2005-2008) was analyzed. Descriptive statistics were used to describe the study sample and bivariate analyses were performed to identify differences of sociodemographic, behavioral and clinical characteristics between MSM and MSW. Exact logistic regression models adjusting for age were constructed for each risk behavior associated to MSM in bivariate analysis. Of the 674 men interviewed, 6.1% (n=41) reported ever having sex with men. Age-adjusted logistic regression models indicated that MSM were significantly more likely than MSW to have first sexual intercourse before the age of 15 (POR=2.6; 95%CI= 1.3, 5.3) and have at least 10 lifetime sex partners (POR=2.8; 95%CI= 1.4,5.9). Also, MSM were significantly more likely to report lifetime use of marihuana (POR=2.7; 95%CI= 1.3,5.8), cocaine (POR=2.5; 95%CI= 1.2,5.0), amphetamines (POR=3.8; 95%CI= 1.4,9.2) and sedatives or tranquilizers (POR=3.3; 95%CI= 1.4,7.2). Also, MSM were 13 times more likely to be HIV seropositive as compared to MSW (POR=13.3; 95%CI=1.7,102.0). In this population-based sample of men living in Puerto Rico, self-reported same-sex behavior is strongly associated with HIV, and other behavioral factors associated with HIV. Future targeted research is still necessary for the development of intervention programs among MSM in Puerto Rico.
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Affiliation(s)
- Vivian Colón-López
- Cancer Control and Population Sciences Program, University of Puerto Rico Comprehensive Cancer Center, San Juan, PR
- Department of Health Services Administration, Graduate School of Public Health
| | - Marievelisse Soto-Salgado
- UPR/MDACC Partnership in Excellence in Cancer Research Program, School of Medicine, Medical Sciences Campus, University of Puerto Rico, San Juan, PR
- Department of Social Sciences, Graduate School of Public Health, Medical Sciences Campus, University of Puerto Rico
| | - Carlos Rodríguez-Díaz
- Department of Social Sciences, Graduate School of Public Health, Medical Sciences Campus, University of Puerto Rico
| | - Erick L. Suárez
- Department of Biostatistics and Epidemiology, Graduate School of Public Health, Medical Sciences Campus, University of Puerto Rico, San Juan, PR
| | - Cynthia M. Pérez
- Department of Biostatistics and Epidemiology, Graduate School of Public Health, Medical Sciences Campus, University of Puerto Rico, San Juan, PR
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