[Sources of information and their relationship to the degree of knowledge about AIDS in Mexican adolescents]

Risk for HIV Infection Among Adolescents in the Border City of Tijuana, Mexico

Previous studies have suggested high rates of HIV infection and other sexually transmitted infections in theU.S.–Mexico border region. However, no information is available on the risk for HIV infection among Mexican adolescents living in this geographic area. This study examines the prevalence of HIV risk practices and psychosocial correlates among 370 high school students in the border city of Tijuana, Mexico, by gender and age group. The results indicate substantial risk for HIV infection among Tijuana youth due to unprotected sexual practices, lifetime rates of pregnancy and sexually transmitted infections, and needle-sharing practices, mostly related to tattooing and body piercing. These findings suggest the need for HIV prevention programs for Tijuana adolescents. These programs must be culturally sensitive and tailored to meet the needs of the different age and gender groups in this region.

Reducing harm from HIV/AIDS misconceptions among female sex workers in Tijuana and Ciudad Juarez, Mexico: A cross sectional analysis

Background

HIV prevalence is increasing among female sex workers (FSWs) in Mexico’s Northern border region, who experience multiple occupational risks. Improving vulnerable populations’ education, empowerment, and access to preventive services are important components of harm reduction strategies. Given the increasing interest in adapting harm reduction principles from drug use to sex work and other public health responses to the HIV epidemic, we used a sex work harm reduction framework to guide our investigation of FSWs’ HIV knowledge.

Methods

From 2004–2006, FSWs aged ≥18 years in Tijuana and Ciudad Juarez participated in a behavioral intervention study and completed structured interviews. Measures included HIV knowledge assessment and factors within each domain of our theoretical framework for sex work harms: (1) socio-demographic factors that may lead to sex work, (2) sex work characteristics and behaviors that may lead to harm, and (3) mutually reinforcing harms that lead to sex work and result from it (e.g., drug abuse). Negative binomial regression identified factors independently associated with suboptimal HIV knowledge (i.e., incorrect responses during the HIV knowledge assessment).

Results

Among 924 FSWs, the median proportion of incorrect responses was nearly one third (28% incorrect). Examination of item responses revealed misconceptions regarding specific transmission and prevention mechanisms, including prevention of mother to child transmission. Suboptimal HIV knowledge was independently associated with older age, lower education, living in Tijuana (vs. Ciudad Juarez), inconsistent condom use for vaginal sex with male clients, and lacking prior HIV testing.

Conclusions

Our application of a sex work harm reduction framework to the study of FSWs’ HIV knowledge is an important first step in enhancing HIV prevention efforts in Northern Mexican border cities. Our findings imply that interventions should identify and discredit local HIV misconceptions to improve knowledge of specific HIV transmission routes and self-protective strategies (e.g., condom negotiation). Interventions will require materials appropriate for women from diverse socio-economic backgrounds and may benefit from innovative harm reduction approaches such as peer education and outreach.

Fighting AIDS among adolescent women: effects of a public communication campaign in Brazil

In 2003, Brazil's Ministry of Health launched a national campaign aimed at promoting the use of condoms by adolescent women. The Carnival Campaign was broadcast on television and radio between February 16 and March 3 and targeted young women, between 13 and 19 years of age, a social group that previously had registered a growth in the number of cases of AIDS and other sexually transmitted diseases (STDs). The Ministry hired Kelly Key, a Brazilian pop singer, to deliver the campaign messages. One of the objectives was to empower the girls and encourage them not to be ashamed to buy condoms and to demand that their partners use them. The article presents the results of a national survey conducted with 1,006 adolescent women, which was sponsored by the Ministry of Health. The results show that campaign materials reached the main target public and that they were very positively received. Moreover, the survey data show that the Carnival Campaign had important effects, generating discussions in the adolescents' social environments and reinforcing a social norm that favors the participation of women in the purchase and use of condoms.

Lutando contra a AIDS entre meninas adolescentes: os efeitos da Campanha de Carnaval de 2003 do Ministério da Saúde do Brasil

Em 2003, o Ministério da Saúde do Brasil (MS) lançou uma campanha nacional para promover o uso de preservativos entre meninas adolescentes. A Campanha de Carnaval 2003 foi transmitida por emissoras de rádio e televisão entre 16 de fevereiro e 3 de março, tendo como público-alvo adolescentes do sexo feminino entre 13 e 19 anos, um grupo social que havia registrado crescimento no número de casos de AIDS e outras doenças sexualmente transmissíveis. O MS contratou a artista Kelly Key para estrelar os anúncios de rádio e TV. Um dos objetivos foi o de estimular as adolescentes a não sentirem vergonha de adquirir preservativos e de exigir que seus parceiros os utilizassem. O artigo apresenta os resultados de um survey nacional encomendado pelo MS, que contou com a participação de 1.006 jovens adolescentes em 86 municípios. Os resultados demonstram que os materiais de campanha alcançaram o público-alvo, e que eles foram muito bem avaliados pelas entrevistadas. Finalmente, os resultados mostram, ainda, que a campanha teve efeitos importantes, como o desencadeamento de discussões no ambiente social das jovens e o reforço de atitudes relacionadas ao uso de preservativos.

Associations among condom use, sexual behavior, and knowledge about HIV/AIDS. A study of 13,293 public school students

BACKGROUND

This school-based study explored associations between Mexican young people's condom use, other sexual behaviors, and HIV/AIDS knowledge.

METHODS

Students (n=13,293, 11-24 years of age) from a random sample of public schools in the central Mexican state of Morelos completed a self-administered questionnaire. We performed logistic regression analysis of condom use and sexual behavior variables and a knowledge-based index on HIV/AIDS prevention and transmission.

RESULTS

Average age at sexual debut was 13.6 +/- 1.9 years among young men and 14.2 +/- 2.2 years among young women; 34.5% of sample participants reported using condoms during their first sexual intercourse. More students had intermediate HIV/AIDS knowledge levels (46%, 95% confidence interval [95% CI], 45.2-46.9) than high levels (37%, 95% CI 36.2-37.8, p <0.01). Students knew more concerning HIV transmission than about prevention of HIV infection. Among young men, high levels of HIV/AIDS knowledge increased likelihood of condom use (odds ratio [OR] 1.4, 95% CI, 1.1-1.7), while among young women high levels of knowledge decreased likelihood of using condoms (OR 0.7, 95% CI, 0.5-1.0). Young men with high levels of HIV/AIDS knowledge were more likely to have had three or more sexual partners (OR 1.7, 95% CI, 1.3-2.2), but young women with high knowledge levels were more likely to have only one lifetime sexual partner (OR 0.6, 95% CI, 0.4-0.9).

CONCLUSIONS

As in previous studies in smaller samples, levels of knowledge with regard to HIV/AIDS were low in Mexican youth. HIV/AIDS education programs for Mexican students should focus on conveying knowledge on HIV prevention. Because apparently knowledge is not directly correlated with condom use among young women, prevention strategies that deal with social acceptability of condoms and social skills related with condom negotiation are also needed.