Knowledge and views regarding condom use among female garment factory workers in Cambodia.

Cambodia is experiencing a generalized HIV epidemic; there is evidence some populations within Cambodia are particularly vulnerable to infection. A mixed methods study was conducted in 2006 on the vulnerability to contract HIV of rural-to-urban migrant Cambodian garment factory workers. This paper reports the views of these female migrant workers regarding the use of condoms in their sexual relationships. Semi-structured interviews were conducted among 20 workers about their knowledge and experiences regarding condom use. Both married and single women were knowledgeable about HIV transmission, but there was a spectrum of perspectives about condom use with their current or future partners. Some women insisted partners use condoms, while others did not expect partner compliance, and a third group avoided discussing condom use with their partners. HIV prevention programs should include male partners. For many of these migrant women, interventions focussing on education about HIV transmission and condom negotiation skills are insufficient since implementation requires male cooperation.

Evaluation of the impact of overseas pre-departure treatment for infection with intestinal parasites among Montagnard refugees migrating from Cambodia to North Carolina.

We evaluated the effectiveness of an overseas pre-departure regimen of five days of albendazole for presumptive treatment of intestinal parasites by examining stool specimens in treated and untreated Montagnard refugees after arrival in the United States. Among 815 refugees evaluated, fully treated refugees had a significantly lower prevalence of helminths (11 [1.4%] of 777), specifically hookworm and Ascaris lumbricoides, than untreated pregnant women (3 [20%] of 15) (P < 0.001). Multivariate analysis showed that treatment was associated with significantly lower rates of infection with helminths but not protozoa. Post-arrival gastrointestinal symptoms were not associated with findings on stool examination. Our evaluation suggests that although additional studies are needed to determine optimal treatment regimens for intestinal parasites, especially among young children and pregnant women, a five-day course of pre-departure albendazole was effective in reducing helminthic infection in treated refugees.

Rapid malaria screening and targeted treatment of United States-bound Montagnard refugees from Cambodia in 2002.

In 2002, a group of Montagnard refugees living in Cambodia was accepted for resettlement in the United States. Pre-departure malaria screening and targeted treatment was conducted to prevent morbidity, and minimize the potential for local malaria transmission post-arrival. We screened 902 of 906 refugees using rapid diagnostic tests (RDTs), microscopy, and polymerase chain reaction (PCR) analysis. Twelve (1.3%) RDT results were positive and 28 (3.1%) were indeterminate. Microscopy confirmed Plasmodium species in two of the positive RDT and one of the indeterminate results. Among a random 10% sample of negative RDT results (n = 86), none were positive by microscopy. The PCR confirmed the two microscopically (and RDT) positive specimens. The PCR result was negative for all other specimens tested. Eighteen (2.0%) refugees were treated with antimalarials. The RDTs were useful in this setting, facilitating timely, sensitive diagnosis and targeted treatment. Evaluations to determine the most appropriate interventions in other refugee settings should include cost-effectiveness analyses of alternative strategies.

Quantitative evaluation of counseling associated with HIV testing.

The purpose of the study was to demonstrate a quantitative evaluation of the educational impact of HIV pretest counseling. Two cohorts of clients exposed to different counseling methodologies were evaluated. The clients completed questionnaires before and after counseling. Responses were scored and compared, and a quantitative measure of educational impact reached. Quantitative educational change following counseling was demonstrated. The change was significantly greater in the more interactive and culturally sensitive counseling format. Quantitative measurement of educational change on focused HIV/AIDS counseling can be easily undertaken. Given that an ill informed population is unlikely to appropriately modify behavior, such educational evaluation should be considered as integral to national HIV/AIDS programs.