Percepción de educación sexual en adolescentes institucionalizados con carencia de cuidado parental / Perception of Sexual Education in Institutionalized Adolescents with Lack of Parental Care

Resumen Objetivo: Conocer las percepciones sobre la educación sexual en adolescentes institucionalizados con carencia de cuidado parental. Materiales y Métodos: Estudio exploratorio cualitativo en el cual se analizaron siete entrevistas, tres dirigidas a adolescentes con carencia de cuidado parental y cuatro a cuidadores principales. Para la interpretación de datos se realizó análisis de contenido, y se utilizó el software MAXQDA Analitics Pro 2020. Resultados: Resultaron ocho subcategorías, las cuales se agruparon en tres grandes categorías, el adolescente institucionalizado, percepción desde el cuidador principal y percepción de recursos disponibles. Los resultados muestran dos posibles características de los adolescentes en esta condición, la necesidad de ser institucionalizado, debido a la carencia de cuidado parental, así como la posible experimentación de eventos traumáticos con repercusiones sobre la salud. Por otra parte, desde la percepción del cuidador se observa la construcción del concepto de sexualidad del adolescente, la cual ocurre generalmente en el entorno escolar o a través de la exposición de elementos audiovisuales fuera de este. Por otra parte, se observa la falta de reconocimiento de los derechos sexuales y reproductivos de los adolescentes, asi como de los procesos de educación sexual por cuidadores principales. Finalmente se identifican algunos recursos disponibles que pueden ser la base para el desarrollo de estrategias que promuevan la educación sexual integral. Conclusión: El análisis permitió identificar que los adolescentes en esta condición carecen de un sistema idóneo que les permita construir un concepto de sexualidad más integral, recordando que esta no se limita a su expresión a través de la genitalidad. Las instituciones ponen especial atención a los aspectos relacionados con la protección social como la alimentación, vestido, educación y atención médica, sin embargo, no se evidencian estrategias o acciones específicas que fomenten la educación sexual, ya sea por tabúes, miedo o incapacidad de proveerla.

Abstract Objective: To identify the perceptions of sexual education in institutionalized adolescents with lack of parental care. Materials and methods: Study with exploratory qualitative approach. Seven interviews were analyzed, three addressed to adolescents with lack of parental care and four to their main caregivers. The MAXQDA Analytics Pro 2020 software was used to interpret the data through content analysis method. Results: The analysis resulted in eight subcategories that were grouped into three large categories: the institutionalized adolescent, perception from the main caregiver and perception of available resources. The results show two possible characteristics of adolescents in this condition, such as the need to be institutionalized due to lack of parental care, as well as the possibility of experiencing traumatic events that have repercussions on adolescent´ health. On the other hand, from the perception of the caregiver, it is observed how the concept of sexuality is constructed, which generally occurs in the school environment or through the exposure of audiovisual elements. On the other hand, there is a lack of recognition of the sexual and reproductive rights of adolescents, as well as the processes of sexual education by main caregivers. Finally, some available resources are identified that can be the basis for strategies development that promote comprehensive sexual education. Conclusion: The analysis of the interviews allow to identify that adolescents in this condition lack an adequate system that will allow them to build a more comprehensive concept of sexuality, remembering that it is not limited to its expression through genitality. Institutions pay special attention to aspects related to social protection such as food, clothing, education, and medical care, however, there are no specific strategies or actions that promote sex education, either due to taboos, fear, or inability to provide it.

Percepciones sobre el uso del condón en migrantes haitianos en la frontera noroeste de México / Perceptions of condom use in Haitian migrants on the northwestern border of México

Resumen Objetivo: Identificar las percepciones sobre el uso de condón en migrantes haitianos en la frontera noroeste de México. Materiales y métodos: Estudio de enfoque cualitativo y diseño etnográfico, en el abordo a siete migrantes haitianos en la zona fronteriza de la ciudad de Mexicali, Baja California, México, con quienes se desarrolló una entrevista semiestructurada, la información fue analizada por el programa NVivo, para comprender frecuencia y estructura de los datos; posteriormente se realizó un proceso de categorización, interpretación y teorización del fenómeno de estudio. De un total de 281 unidades de análisis, se realizó un proceso de categorización, que permitió estructurar dos categorías, seis subcategorías y 12 códigos. Resultados: Se identifica que el uso del condón en migrantes haitianos, es interpretado como un elemento de protección a la salud sexual en la prevención de embarazos no planeados; no obstante, se identifican barreras y consecuencias del uso a nivel personal, cultural y religioso. La construcción de la idea de usarlo, recae en el tipo de relación y nivel de confianza que se tiene de la pareja sexual por lo que estar casado o vivir en concubinato, exime de la obligación o del compromiso social de usar el condón. Así mismo la idea de protección, no refleja la preocupación sobre la transmisión de las ITS. Conclusiones: El condón se percibe como un elemento de importancia para la prevención de embarazos no planeados y del VIH, sin embargo, la presencia de factores personales, sensoriales e ideológicos limitan el uso constante del condón; por lo que el desarrollo de intervenciones culturalmente adaptadas, a la población de migrantes haitianos, en el contexto de la frontera norte de México, pueden fortalecer el uso del condón y la prevención del VIH

Abstract Objective: To identify the perceptions of condom use in Haitian migrants in the northwestern border of Mexico. Materials and methods: Study with a qualitative approach and ethnographic design, on board seven Haitian migrants in the border area of the city of Mexicali, Baja California, Mexico, with whom a semi-structured interview was developed, the information was analyzed by the NVivo program, to understand the frequency and structure of the data; later a process of categorization, interpretation and theorization of the study phenomenon was carried out. Out of a total of 281 units of analysis, a categorization process was carried out, which made it possible to structure two categories, six subcategories and 12 codes. Results: It is identified that the use of condoms in Haitian migrants is interpreted as an element of protection of sexual health in the prevention of unplanned pregnancies; however, barriers and consequences of use are identified on a personal, cultural and religious level. The construction of the idea of using it relies on the type of relationship and level of trust that one has in the sexual partner, so being married or living in a common-law relationship exempts the obligation or social commitment of using the condom. Likewise, the idea of protection does not reflect the concern about the transmission of STIs. Conclusions: The condom is perceived as an important element for the prevention of unintended pregnancies and HIV, however, the presence of personal, sensory and ideological factors limit the constant use of the condom; Therefore, the development of culturally adapted interventions for the Haitian migrant population, in the context of the northern border of Mexico, can strengthen condom use and HIV prevention.

Facilitating and Inhibiting Factors of Sexual Behavior among Migrants in Transition from Mexico to the United States.

INTRODUCTION: Human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS) is one of the most prevalent infectious diseases in the border region of Mexico due to the flow of migrants under desperate conditions, encouraging casual and unprotected sex. Since this has become a binational public health problem, it is important to understand the factors that predict these sexual behaviors. The aim of the current study was to investigate the facilitators and inhibitors of transition in the sexual behavior of migrants from two border regions on the Mexico-United States (US) border. METHODS: This was a predictive and cross-sectional study. A sample of 256 migrants in shelters for migrants on the border between Mexico and US were selected through systematic random sampling. Predictor variables investigated for effect on the safe sexual behavior (SSB) of the migrant were reasons for having sex; sexual attitudes; sexual machismo; knowledge about HIV; access to health services; and social discrimination. RESULTS: The sample was predominantly male (89.5%), with 46.1% reporting being single. The average age was 33.38 years (SD = 9.73) and the average number of years of education reported was 8.05 (SD = 3.37). A permissive sexual attitude and sexual machismo both correlated with condom use (rs = 0.130, p < 0.01 and rs = -0.174, p < 0.01, respectively). Regression analysis showed that a permissive sexual attitude decreased the practice of safe sex (ß = 0.17, t = 4.16, p < 0.001), as did sexual machismo (ß = -0.28, t = -4.83, p < 0.001) and HIV knowledge (ß = -0.11, t = -2.62, p = 0.006). DISCUSSION: It was found that access to health services did not influence the SSB of migrants, as suggested by the literature. However, a permissive sexual attitude, sexual machismo, and HIV knowledge were all variables capable of predicting SSB. It is recommended that the study is extended to study migrant populations from other parts of the border, as well undertaking as a qualitative approach to explore new variables.

Self-efficacy and Coping as Correlates of Migrant Safe Sexual Behavior to Prevent HIV.

Along the Mexico/United States border, migrants are at increased risk of HIV. The objective of our study was to investigate the relationship between two process indicators (self-efficacy to prevent HIV and coping with sexual risk) and safe sexual behaviors in migrants. A correlational design was used. Migrants were recruited from two cities on the northern border of Mexico. Transition theory informed the measurement of self-efficacy and coping process indicators. Three generalized linear models were built for each safe sexual behavior outcome: (a) partner communication, (b) use of condoms, and (c) safe sex. Of 311 migrants, indicators of self-efficacy and coping with sexual risk were associated with all three outcome measures of safe sexual behavior (p < .05). Process indicators explained 22.5% to 30.6% of the variance in the data. Therefore, self-efficacy to prevent HIV and coping ability are important correlates of migrant sexual risk behavior.