Disparate rates of HIV/STIs transmission to African American women through heterosexual sex persi... more Disparate rates of HIV/STIs transmission to African American women through heterosexual sex persist. Behavioral scientists do not know how African American women perceive sexual risk; thus, efforts continue to gain better understanding. Qualitative methods were used to discern how linguistics used by African American women may indicate perceptions of minimized value of sex. Interviews with 30 eligible African American women who were 18-29 years, sexually active, and substance users took place during emergency department visits. Interviews were professionally transcribed, coded, and organized into themes. Inter-coder reliability was assessed (Cronbach’s Alpha = 0.723). The term ‘just’ was noted 89 times; 22/30 women used ‘just’ in a way that minimized the perceived value of sex when describing sexual experiences. Quotes included statements that minimized sex as a tool for physical pleasure, an adrenaline rush, a way to avoid boredom, a temporary fix, and a way of escaping stressful r...
Aids Care-psychological and Socio-medical Aspects of Aids/hiv, May 8, 2013
This study was designed to gain baseline information on the capability of the hospitals of Thaila... more This study was designed to gain baseline information on the capability of the hospitals of Thailand to provide newborn male circumcision (NC) and on the opinions of health-care personnel towards NC. Two questionnaires were sent to every hospital in Thailand that might have obstetrical services. One questionnaire requested information about the degree to which NC was provided by the hospital. The second questionnaire targeted health-care providers' opinions about NC. The response rate was 55.1% (747/1355). Of the 562 hospitals that had deliveries in 2010, 8.2% (46) provided at least one NC. Thirty-eight percent (35/92) of private hospitals and 2.3% (11/470) of government hospitals provided the service. The primary reason for performing NC was parental request (82.6%). Some providers (31.3%) said that NC was easy to perform and 39.1% thought NC was safe. Most respondents (91.8%) stated that physicians should perform the procedure instead of nurses, and choices about undergoing NC should be left to parents (55.0%). NC was rarely performed in government hospitals, and its staffs seemed to not recognize the health benefits of NC. A massive education program for health-care providers would be necessary before implementing a national program for NC. More information on the opinions of health authorities, health-care personnel and parents as well as cost-effectiveness studies are needed before a proper policy can be implemented.
This article reviews 14 recently published articles on the epidemiology of human immunodeficiency... more This article reviews 14 recently published articles on the epidemiology of human immunodeficiency virus (HIV) infection. Each article is summarized and evaluated for its usefulness in helping the practicing dentist to perform the various roles of diagnosing and treating disease, managing auxiliary staff, providing community leadership, and educating fellow professionals and patients. Each article was selected based on timeliness, accuracy, and accessibility by a panel of two dental school faculty members, a physician and HIV information specialist, and a school of public health faculty member with extensive experience in HIV and acquired immune deficiency syndrome (AIDS).
Advanced practice nurses are increasingly practicing in primary care settings where they are diag... more Advanced practice nurses are increasingly practicing in primary care settings where they are diagnosing and treating infectious diseases. Care is not complete until these conditions are reported to the local health department. Reporting is not optional--it is the law in every state. This article critiques case studies where disease reporting did not occur, reviews the evidence on noncompliance with reporting laws, discusses reasons for reporting, describes how state laws vary with respect to reporting, and presents steps to assist the advanced practice nurse in reporting infectious diseases.
Early initiation of sexual intercourse has been associated with negative consequences, such as hi... more Early initiation of sexual intercourse has been associated with negative consequences, such as higher rates of unwanted pregnancy and HIV infection. This study examined the attitudes and behavior of rural Thai adolescent students aged 16 to 20 years from northern Thailand regarding sexual intercourse. Differences between participants who previously had sexual intercourse and those who had not were explored. Those who had not previously had sexual intercourse were asked about the reasons why they had not had sex, their future plans for having sex and their dating experiences. More than 70% of participants stated they had not previously had sexual intercourse but one third of this group reported engaging in other sexual behavior. There were significant differences by gender, religion, ethnicity, and household income between those who had previously had sex and those who had not. Among those who had not previously had sexual intercourse, concern for their parents' feelings was the most common reason for delaying intercourse. About two-thirds of this group had plans not to have sexual intercourse until after marriage; nearly half of them reported currently having a boyfriend/girlfriend. Interventions aimed at delaying sexual intercourse should involve adolescents in their design and include their attitudes for delaying intercourse. Because of many gender differences seen in our study, interventions should be designed differently for males and females in rural northern Thailand.
Male circumcision (MC) has been proven to reduce the risk of HIV transmission. The WHO and UNAIDS... more Male circumcision (MC) has been proven to reduce the risk of HIV transmission. The WHO and UNAIDS jointly recommend the international community consider MC as an HIV prevention measure. MC reduces the risk of acquiring other sexually transmitted infections (STIs) among men, urinary tract infections among children and penile cancer. Lowering the prevalence of STIs in men may reduce the incidence of STIs among women. High levels of adult MC are difficult to achieve in cultures where it has not been customary. Adult MC is associated with a high prevalence of post-operative complications. Neonatal male circumcision (NC) is simpler, safer, and cheaper. Higher coverage with MC can be achieved through NC. Thailand is a good country to promoting NC for the following reasons: most HIV infections are contracted through heterosexual transmission, there is a low MC rate, most newborn deliveries occur in hospitals, there is a relatively strong health care infrastructure and Thailand has well developed HIV care services. Issues of concern regarding promoting NC include length of time before seeing benefits, cost effectiveness of the intervention, the burden to the health care delivery system and concerns about children's rights. NC is an efficacious HIV prevention strategy that should be considered by those involved in HIV/AIDS prevention planning in Thailand. Further studies are needed to determine whether NC should be promoted in Thailand.
Disparate rates of HIV/STIs transmission to African American women through heterosexual sex persi... more Disparate rates of HIV/STIs transmission to African American women through heterosexual sex persist. Behavioral scientists do not know how African American women perceive sexual risk; thus, efforts continue to gain better understanding. Qualitative methods were used to discern how linguistics used by African American women may indicate perceptions of minimized value of sex. Interviews with 30 eligible African American women who were 18-29 years, sexually active, and substance users took place during emergency department visits. Interviews were professionally transcribed, coded, and organized into themes. Inter-coder reliability was assessed (Cronbach’s Alpha = 0.723). The term ‘just’ was noted 89 times; 22/30 women used ‘just’ in a way that minimized the perceived value of sex when describing sexual experiences. Quotes included statements that minimized sex as a tool for physical pleasure, an adrenaline rush, a way to avoid boredom, a temporary fix, and a way of escaping stressful r...
Aids Care-psychological and Socio-medical Aspects of Aids/hiv, May 8, 2013
This study was designed to gain baseline information on the capability of the hospitals of Thaila... more This study was designed to gain baseline information on the capability of the hospitals of Thailand to provide newborn male circumcision (NC) and on the opinions of health-care personnel towards NC. Two questionnaires were sent to every hospital in Thailand that might have obstetrical services. One questionnaire requested information about the degree to which NC was provided by the hospital. The second questionnaire targeted health-care providers' opinions about NC. The response rate was 55.1% (747/1355). Of the 562 hospitals that had deliveries in 2010, 8.2% (46) provided at least one NC. Thirty-eight percent (35/92) of private hospitals and 2.3% (11/470) of government hospitals provided the service. The primary reason for performing NC was parental request (82.6%). Some providers (31.3%) said that NC was easy to perform and 39.1% thought NC was safe. Most respondents (91.8%) stated that physicians should perform the procedure instead of nurses, and choices about undergoing NC should be left to parents (55.0%). NC was rarely performed in government hospitals, and its staffs seemed to not recognize the health benefits of NC. A massive education program for health-care providers would be necessary before implementing a national program for NC. More information on the opinions of health authorities, health-care personnel and parents as well as cost-effectiveness studies are needed before a proper policy can be implemented.
This article reviews 14 recently published articles on the epidemiology of human immunodeficiency... more This article reviews 14 recently published articles on the epidemiology of human immunodeficiency virus (HIV) infection. Each article is summarized and evaluated for its usefulness in helping the practicing dentist to perform the various roles of diagnosing and treating disease, managing auxiliary staff, providing community leadership, and educating fellow professionals and patients. Each article was selected based on timeliness, accuracy, and accessibility by a panel of two dental school faculty members, a physician and HIV information specialist, and a school of public health faculty member with extensive experience in HIV and acquired immune deficiency syndrome (AIDS).
Advanced practice nurses are increasingly practicing in primary care settings where they are diag... more Advanced practice nurses are increasingly practicing in primary care settings where they are diagnosing and treating infectious diseases. Care is not complete until these conditions are reported to the local health department. Reporting is not optional--it is the law in every state. This article critiques case studies where disease reporting did not occur, reviews the evidence on noncompliance with reporting laws, discusses reasons for reporting, describes how state laws vary with respect to reporting, and presents steps to assist the advanced practice nurse in reporting infectious diseases.
Early initiation of sexual intercourse has been associated with negative consequences, such as hi... more Early initiation of sexual intercourse has been associated with negative consequences, such as higher rates of unwanted pregnancy and HIV infection. This study examined the attitudes and behavior of rural Thai adolescent students aged 16 to 20 years from northern Thailand regarding sexual intercourse. Differences between participants who previously had sexual intercourse and those who had not were explored. Those who had not previously had sexual intercourse were asked about the reasons why they had not had sex, their future plans for having sex and their dating experiences. More than 70% of participants stated they had not previously had sexual intercourse but one third of this group reported engaging in other sexual behavior. There were significant differences by gender, religion, ethnicity, and household income between those who had previously had sex and those who had not. Among those who had not previously had sexual intercourse, concern for their parents' feelings was the most common reason for delaying intercourse. About two-thirds of this group had plans not to have sexual intercourse until after marriage; nearly half of them reported currently having a boyfriend/girlfriend. Interventions aimed at delaying sexual intercourse should involve adolescents in their design and include their attitudes for delaying intercourse. Because of many gender differences seen in our study, interventions should be designed differently for males and females in rural northern Thailand.
Male circumcision (MC) has been proven to reduce the risk of HIV transmission. The WHO and UNAIDS... more Male circumcision (MC) has been proven to reduce the risk of HIV transmission. The WHO and UNAIDS jointly recommend the international community consider MC as an HIV prevention measure. MC reduces the risk of acquiring other sexually transmitted infections (STIs) among men, urinary tract infections among children and penile cancer. Lowering the prevalence of STIs in men may reduce the incidence of STIs among women. High levels of adult MC are difficult to achieve in cultures where it has not been customary. Adult MC is associated with a high prevalence of post-operative complications. Neonatal male circumcision (NC) is simpler, safer, and cheaper. Higher coverage with MC can be achieved through NC. Thailand is a good country to promoting NC for the following reasons: most HIV infections are contracted through heterosexual transmission, there is a low MC rate, most newborn deliveries occur in hospitals, there is a relatively strong health care infrastructure and Thailand has well developed HIV care services. Issues of concern regarding promoting NC include length of time before seeing benefits, cost effectiveness of the intervention, the burden to the health care delivery system and concerns about children's rights. NC is an efficacious HIV prevention strategy that should be considered by those involved in HIV/AIDS prevention planning in Thailand. Further studies are needed to determine whether NC should be promoted in Thailand.
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