Objective. To assess the satisfaction level attained by pre- natal care users in primary health s... more Objective. To assess the satisfaction level attained by pre- natal care users in primary health services in Mexico, and to compare the level of satisfaction according to character- istics of the provider and the service. Material and Meth- ods. A cross-sectional survey was conducted to analyze data from 217 care provider-user pairs. Interviews were carried out in 95 primary care
To assess the satisfaction level attained by prenatal care users in primary health services in Me... more To assess the satisfaction level attained by prenatal care users in primary health services in Mexico, and to compare the level of satisfaction according to characteristics of the provider and the service. A cross-sectional survey was conducted to analyze data from 217 care provider-user pairs. Interviews were carried out in 95 primary care units in eight Mexican states. The information was collected through a) direct observation of the medical encounter, b) interviews with providers and users, and c) a questionnaire and knowledge examination to providers. Users' satisfaction was analyzed according to providers' clinical ability and the treatment received during the visit. Summary and dispersion measures of the main issues were calculated, as well as bivariate and trends analysis. User satisfaction in prenatal care is associated with the treatment received during the visit and to the waiting time before being attended, but not with the provider's clinical ability, nor wi...
Objective. To document the association between supplyside determinants and AIDS mortality in Mexi... more Objective. To document the association between supplyside determinants and AIDS mortality in Mexico between2008 and 2013. Materials and methods. We analyzedthe SALVAR database (system for antiretroviral management, logistics and surveillance) as well as data collected through a nationally representative survey in health facilities. We used multivariate logit regression models to estimate the association between supply-side characteristics, namely management, training and experience of health care providers, and AIDS mortality, distinguishing early and non-early mortality and controlling for clinical indicators of the patients. Results. Clinic status of the patients (initial CD4 and viral load) explain 44.4% of the variability of early mortality across clinics and 13.8% of the variability in non-early mortality. Supply-side characteristics increase explanatory power of the models by 16% in the case of early mortality, and 96% in the case of non-early mortality. Conclusions. Aspects of management and implementation of services contribute significantly to explain AIDS mortality in Mexico. Improving these aspects of the national program, can similarly improve its results.
To describe the prevalence of specific HPV types among HIV-positive men who have sex with men (MS... more To describe the prevalence of specific HPV types among HIV-positive men who have sex with men (MSM), particularly the presence of HPV-16 and/or -18, and to determine the factors associated with anal HPV-16/18 infections. This is a cross-sectional study from a baseline cohort of 525 HIV-positive MSM, who attended an HIV Clinic in Mexico City. Socio-demographic characteristics, sexual behaviors and HIV-related parameters were assessed. Anal samples were tested for HPV DNA using the Linear Array HPV genotyping assay. The overall prevalence of any HPV type in the anal canal among 446 participants was 93.1%. At least one oncogenic HPV type was detected in 72.2% of the subjects and HPV-16 and/or18 were detected in 30.7%. Additionally, 76.9% of patients were infected with multiple HPV types. Having more than 10 receptive sexual partners in the last 6months (OR=2.30; 95% CI 1.12-4.74) and a CD4 cell count ≤350cells/μL (OR=1.97; 95% CI 1.26-3.09) were factors positively associated with HPV-16/18 infection in the anal canal. Co-infection with HPV-16/18 and other oncogenic types are predominant in this group of HIV-positive MSM. The recognition of infection with specific oncogenic types will be of aid in designing future preventive strategies that target this high-risk population.
PURPOSE: Human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome surveillance data ... more PURPOSE: Human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome surveillance data are critical for monitoring epidemic trends, but they can mask dynamic subepidemics, especially in vulnerable populations that underuse HIV testing. In this case study, we describe community-based epidemiologic data among injection drug users (IDUs) and female sex workers (FSWs) in two northern Mexico-U.S. border states that identified an emerging HIV epidemic and generated a policy response. METHODS: We draw from quantitative and qualitative cross-sectional and prospective epidemiologic studies and behavioral intervention studies among IDUs and FSWs in Tijuana, Baja California, and Ciudad Juarez, Chihuahua. RESULTS: The recognition that the HIV epidemic on Mexico's northern border was already well established in subgroups in whom it had been presumed to be insignificant was met with calls for action and enhanced prevention efforts from researchers, nongovernmental organizations, and policy makers. CONCLUSIONS: Successful policies and program outcomes included expansion of needle-exchange programs, a nationwide mobile HIV prevention program targeting marginalized populations, a successful funding bid from the Global Fund for HIV, TB, and Malaria to scale up targeted HIV-prevention programs, and the establishment of bi-national training programs on prevention of HIV and substance use. We discuss how epidemiologic data informed HIV prevention policies and suggest how other countries may learn from Mexico's experience.
In a cross-sectional study 241 patients with HIV positive status, were asked for their informed c... more In a cross-sectional study 241 patients with HIV positive status, were asked for their informed consent and completed the BDI. The analysis of the psychometric properties was made using standard procedures: frequency analysis to distinguish whether all response options were attractive, Student t-test comparison between extreme quartiles, internal consistency analysis and the intercorrelations between questions to determine the rotation method for the factor analysis. The lower limit load to the item to be included in the factor was 0.40 6-9. The statistical analysis was performed in SPSS v. 16. A p< 0.01 was considered to be significant.
Sexuality Research and Social Policy: Journal of Nsrc, 2007
In this study, the authors explored the construction of embodiment among Mexican men who had expe... more In this study, the authors explored the construction of embodiment among Mexican men who had experienced migration between Mexico and the United States—and between Mexico and California in particular. The body emerged as a basic, fundamental underpinning of the migratory experience and as a space in which relations of gender and power, identities, sexualities, and desire converged. The migrant men constructed the body in specific ways depending on the different contexts they inhabited. Based on these findings, the authors have detected 2 paradoxes that are essential to understanding the relationships among body, power, and sexuality in the context of gender relations for these men: a paradox manifesting as an estrangement from the body in relation to the migratory trajectory, and a paradox of identity resulting from the collapse of the gender and sexual orders in which the men had been educated.
34 AIDS: ethical issues in the developing world UDO SCHUKLENK, VICHAI CHOKEVIVAT, CARLOS DEL RIO,... more 34 AIDS: ethical issues in the developing world UDO SCHUKLENK, VICHAI CHOKEVIVAT, CARLOS DEL RIO, SEGUN GBADEGESIN AND CARLOS MAGIS Ethical issues of AIDS in developing countries are to some degree similar to those in Western countries, but the problems are ...
To investigate the current sexual behavior and condom use during the first sexual intercourse amo... more To investigate the current sexual behavior and condom use during the first sexual intercourse among adolescents, as well as variations and factors influencing condom use at first sexual intercourse. The data source for this study was Mexico's National Health Survey 2000. Study subjects were male and female adolescents aged 12 to 19 years (n = 16,258). Statistical analysis consisted of descriptive statistics and multivariate logistic regression, to assess the association of four types of factors (demographic, socioeconomic, cultural, and cognitive) with condom use during the first sexual intercourse. Males and residents of urban areas reported greater sexual activity and condom use. Typically, adolescents who used condoms during the first sexual intercourse were male, older, resided in urban areas, non-speakers of an indigenous language, and with higher schooling. New policies should be framed to prevent sexually transmitted infections to span the gap between knowledge and practi...
Key words: STI;sexual behavior; adolescence; condom use; Mexico ... Gayet C, Juárez F, Pedrosa LA... more Key words: STI;sexual behavior; adolescence; condom use; Mexico ... Gayet C, Juárez F, Pedrosa LA, Magis C. Uso del condón entre adolescentes mexicanos para la prevención de las infecciones de transmisión sexual. Salud Publica Mex 2003;45 supl 5:S632-S640. El texto completo ...
Objective. To assess the satisfaction level attained by pre- natal care users in primary health s... more Objective. To assess the satisfaction level attained by pre- natal care users in primary health services in Mexico, and to compare the level of satisfaction according to character- istics of the provider and the service. Material and Meth- ods. A cross-sectional survey was conducted to analyze data from 217 care provider-user pairs. Interviews were carried out in 95 primary care
To assess the satisfaction level attained by prenatal care users in primary health services in Me... more To assess the satisfaction level attained by prenatal care users in primary health services in Mexico, and to compare the level of satisfaction according to characteristics of the provider and the service. A cross-sectional survey was conducted to analyze data from 217 care provider-user pairs. Interviews were carried out in 95 primary care units in eight Mexican states. The information was collected through a) direct observation of the medical encounter, b) interviews with providers and users, and c) a questionnaire and knowledge examination to providers. Users' satisfaction was analyzed according to providers' clinical ability and the treatment received during the visit. Summary and dispersion measures of the main issues were calculated, as well as bivariate and trends analysis. User satisfaction in prenatal care is associated with the treatment received during the visit and to the waiting time before being attended, but not with the provider's clinical ability, nor wi...
Objective. To document the association between supplyside determinants and AIDS mortality in Mexi... more Objective. To document the association between supplyside determinants and AIDS mortality in Mexico between2008 and 2013. Materials and methods. We analyzedthe SALVAR database (system for antiretroviral management, logistics and surveillance) as well as data collected through a nationally representative survey in health facilities. We used multivariate logit regression models to estimate the association between supply-side characteristics, namely management, training and experience of health care providers, and AIDS mortality, distinguishing early and non-early mortality and controlling for clinical indicators of the patients. Results. Clinic status of the patients (initial CD4 and viral load) explain 44.4% of the variability of early mortality across clinics and 13.8% of the variability in non-early mortality. Supply-side characteristics increase explanatory power of the models by 16% in the case of early mortality, and 96% in the case of non-early mortality. Conclusions. Aspects of management and implementation of services contribute significantly to explain AIDS mortality in Mexico. Improving these aspects of the national program, can similarly improve its results.
To describe the prevalence of specific HPV types among HIV-positive men who have sex with men (MS... more To describe the prevalence of specific HPV types among HIV-positive men who have sex with men (MSM), particularly the presence of HPV-16 and/or -18, and to determine the factors associated with anal HPV-16/18 infections. This is a cross-sectional study from a baseline cohort of 525 HIV-positive MSM, who attended an HIV Clinic in Mexico City. Socio-demographic characteristics, sexual behaviors and HIV-related parameters were assessed. Anal samples were tested for HPV DNA using the Linear Array HPV genotyping assay. The overall prevalence of any HPV type in the anal canal among 446 participants was 93.1%. At least one oncogenic HPV type was detected in 72.2% of the subjects and HPV-16 and/or18 were detected in 30.7%. Additionally, 76.9% of patients were infected with multiple HPV types. Having more than 10 receptive sexual partners in the last 6months (OR=2.30; 95% CI 1.12-4.74) and a CD4 cell count ≤350cells/μL (OR=1.97; 95% CI 1.26-3.09) were factors positively associated with HPV-16/18 infection in the anal canal. Co-infection with HPV-16/18 and other oncogenic types are predominant in this group of HIV-positive MSM. The recognition of infection with specific oncogenic types will be of aid in designing future preventive strategies that target this high-risk population.
PURPOSE: Human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome surveillance data ... more PURPOSE: Human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome surveillance data are critical for monitoring epidemic trends, but they can mask dynamic subepidemics, especially in vulnerable populations that underuse HIV testing. In this case study, we describe community-based epidemiologic data among injection drug users (IDUs) and female sex workers (FSWs) in two northern Mexico-U.S. border states that identified an emerging HIV epidemic and generated a policy response. METHODS: We draw from quantitative and qualitative cross-sectional and prospective epidemiologic studies and behavioral intervention studies among IDUs and FSWs in Tijuana, Baja California, and Ciudad Juarez, Chihuahua. RESULTS: The recognition that the HIV epidemic on Mexico's northern border was already well established in subgroups in whom it had been presumed to be insignificant was met with calls for action and enhanced prevention efforts from researchers, nongovernmental organizations, and policy makers. CONCLUSIONS: Successful policies and program outcomes included expansion of needle-exchange programs, a nationwide mobile HIV prevention program targeting marginalized populations, a successful funding bid from the Global Fund for HIV, TB, and Malaria to scale up targeted HIV-prevention programs, and the establishment of bi-national training programs on prevention of HIV and substance use. We discuss how epidemiologic data informed HIV prevention policies and suggest how other countries may learn from Mexico's experience.
In a cross-sectional study 241 patients with HIV positive status, were asked for their informed c... more In a cross-sectional study 241 patients with HIV positive status, were asked for their informed consent and completed the BDI. The analysis of the psychometric properties was made using standard procedures: frequency analysis to distinguish whether all response options were attractive, Student t-test comparison between extreme quartiles, internal consistency analysis and the intercorrelations between questions to determine the rotation method for the factor analysis. The lower limit load to the item to be included in the factor was 0.40 6-9. The statistical analysis was performed in SPSS v. 16. A p< 0.01 was considered to be significant.
Sexuality Research and Social Policy: Journal of Nsrc, 2007
In this study, the authors explored the construction of embodiment among Mexican men who had expe... more In this study, the authors explored the construction of embodiment among Mexican men who had experienced migration between Mexico and the United States—and between Mexico and California in particular. The body emerged as a basic, fundamental underpinning of the migratory experience and as a space in which relations of gender and power, identities, sexualities, and desire converged. The migrant men constructed the body in specific ways depending on the different contexts they inhabited. Based on these findings, the authors have detected 2 paradoxes that are essential to understanding the relationships among body, power, and sexuality in the context of gender relations for these men: a paradox manifesting as an estrangement from the body in relation to the migratory trajectory, and a paradox of identity resulting from the collapse of the gender and sexual orders in which the men had been educated.
34 AIDS: ethical issues in the developing world UDO SCHUKLENK, VICHAI CHOKEVIVAT, CARLOS DEL RIO,... more 34 AIDS: ethical issues in the developing world UDO SCHUKLENK, VICHAI CHOKEVIVAT, CARLOS DEL RIO, SEGUN GBADEGESIN AND CARLOS MAGIS Ethical issues of AIDS in developing countries are to some degree similar to those in Western countries, but the problems are ...
To investigate the current sexual behavior and condom use during the first sexual intercourse amo... more To investigate the current sexual behavior and condom use during the first sexual intercourse among adolescents, as well as variations and factors influencing condom use at first sexual intercourse. The data source for this study was Mexico's National Health Survey 2000. Study subjects were male and female adolescents aged 12 to 19 years (n = 16,258). Statistical analysis consisted of descriptive statistics and multivariate logistic regression, to assess the association of four types of factors (demographic, socioeconomic, cultural, and cognitive) with condom use during the first sexual intercourse. Males and residents of urban areas reported greater sexual activity and condom use. Typically, adolescents who used condoms during the first sexual intercourse were male, older, resided in urban areas, non-speakers of an indigenous language, and with higher schooling. New policies should be framed to prevent sexually transmitted infections to span the gap between knowledge and practi...
Key words: STI;sexual behavior; adolescence; condom use; Mexico ... Gayet C, Juárez F, Pedrosa LA... more Key words: STI;sexual behavior; adolescence; condom use; Mexico ... Gayet C, Juárez F, Pedrosa LA, Magis C. Uso del condón entre adolescentes mexicanos para la prevención de las infecciones de transmisión sexual. Salud Publica Mex 2003;45 supl 5:S632-S640. El texto completo ...
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Papers by Carlos Magis
controlling for clinical indicators of the patients. Results. Clinic status of the patients (initial CD4 and viral load) explain 44.4% of the variability of early mortality across clinics and 13.8% of the variability in non-early mortality. Supply-side characteristics increase explanatory power of the models by 16% in the case of early mortality, and 96% in the case of non-early mortality. Conclusions. Aspects of management and implementation of services contribute significantly to explain AIDS mortality in Mexico. Improving these aspects of the national program, can similarly improve its results.
controlling for clinical indicators of the patients. Results. Clinic status of the patients (initial CD4 and viral load) explain 44.4% of the variability of early mortality across clinics and 13.8% of the variability in non-early mortality. Supply-side characteristics increase explanatory power of the models by 16% in the case of early mortality, and 96% in the case of non-early mortality. Conclusions. Aspects of management and implementation of services contribute significantly to explain AIDS mortality in Mexico. Improving these aspects of the national program, can similarly improve its results.