Poverty and survival from COVID-19 in Mexico.

BACKGROUND: Recent evidence points to the relevance of poverty and inequality as factors affecting the spread and mortality of the COVID-19 pandemic in Latin America. This study aimed to determine whether COVID-19 patients living in Mexican municipalities with high levels of poverty have a lower survival compared with those living in municipalities with low levels. METHODS: Retrospective cohort study. Secondary data was used to define the exposure (multidimensional poverty level) and outcome (survival time) among patients diagnosed with COVID-19 between 27 February and 1 July 2020. Crude and adjusted hazard ratios (HR) from Cox regression were computed. RESULTS: Nearly 250 000 COVID-19 patients were included. Mortality was 12.3% reaching 59.3% in patients with ≥1 comorbidities. Multivariate survival analyses revealed that individuals living in municipalities with extreme poverty had 9% higher risk of dying at any given time proportionally to those living in municipalities classified as not poor (HR 1.09; 95% CI 1.06-1.12). The survival gap widened with the follow-up time up to the third to fourth weeks after diagnosis. CONCLUSION: Evidence suggests that the poorest population groups have a lower survival from COVID-19. Thus, combating extreme poverty should be a central preventive strategy.

Sexual risk behavior and type of sexual partners in transnational indigenous migrant workers.

Indigenous migrant workers (IMWs) have a high vulnerability to HIV and STDs due to poverty and marginalization. This study examined factors associated with sexual risk behavior (SRB) according to type of partner in transnational young male IMWs at a sugar cane agro-industrial complex in western Mexico. A total of 192 sexually active IMWs were recruited from four laborer shelters to participate in a sexual partner survey. The IMWs were interviewed about their sexual partners and practices over the last 12 months during which it emerged that they had had a total of 360 sexual partners. Multiple linear regression analyses were performed to identify factors related to SRB in 222 main (spouse, mistress and girlfriend) and 138 casual partners (colleague, friend, casual encounter and sex worker). Results showed a significantly higher SRB score with casual partners. For the main partner regression model, prior exposure to HIV- and STD-preventive information and sexual intercourse with higher employment status partners (formal workers vs. self-employed in informal activities and unemployed) were associated with lower SRB scores, but if the sexual relations occurred in Mexico (vs. the U.S.), the SRB scores increased. For the casual partner model, the practice of survival sex (sex in exchange for basic needs), sexual relations in Mexico (vs. the U.S.), and being a circular migrant (person traveling for temporary work to return home when the contract is over) were related to higher SRB scores. Findings support the implementation of preventive interventions using different messages depending on the type of partners, main or casual, within the labor migrant context.

The effects of social networks on tobacco use among high-school adolescents in Mexico.

OBJECTIVE: To identify the effect of centrality in social network positions on tobacco-use among high-school adolescents in Tonala, Jalisco, Mexico. MATERIALS AND METHODS: Longitudinal sociometric social network data were collected among 486 high-school adolescents in 2003 and 399 in 2004. The survey included: social network components, smoking and sociodemographic characteristics. Social network measures of centrality were calculated and multivariate logistic regression was used. RESULTS: Ever used tobacco (OR= 44.98), marginalized-low stratum (OR= 2.16) and in-degree (OR=1.10) predicted tobacco use. Out-degree (OR= 0 .89) and out-in-degree (OR= 0.90) protected against tobacco use. CONCLUSION: Nominating more friends rather than receiving such nominations was protective for tobacco use. Popular students, those receiving many nominations, were at higher risk for tobacco use. Involvement of leaders with capacity to influence might be an efficient strategy for dissemination of preventive messages.

Factors Associated with Unprotected Anal Sex among Men Who Have Sex with Men in Mexico.

The global prevalence of HIV is notably higher in men who have sex with men (MSM) compared with other male populations. Unprotected anal intercourse is the riskiest sexual behavior for HIV acquisition and/or transmission among this minority population. The purpose of the study was to identify if the syndemic of psychosocial stressors and experienced stigma are predictors of unprotected anal sex in Mexican MSM. A cross-sectional analytic study was carried out. It included adults residing in Manzanillo, Mexico, with oral/anal sex practices within the last year. Informed consent was given by 142 participants selected using snowball sampling. Collected data included sociodemographic characteristics, psychosocial stressors, experienced stigma, HIV knowledge, knowing a friend/acquaintance living with HIV/AIDS, and sexual risk behaviors. Adjusted logistic regression was used to identify predictors of unprotected anal sex within the last six months. Presence of syndemic of psychosocial stressors, drug use during sex, having friends/acquaintances with HIV/AIDS, and experiencing high stigma were positively associated; high level of HIV knowledge was negatively linked. Reducing psychosocial stressors and integrating stigma-mitigation strategies are key elements to reduce HIV transmission.

Intervention to prevent intestinal parasitic reinfections among Tarahumara indigenous schoolchildren in northern Mexico.

OBJECTIVE: To assess the effectiveness of a 20-week, broad intervention to prevent reinfection by Ascaris lumbricoides (AL) and Giardia lamblia (GL) among indigenous schoolchildren in northern Mexico. METHODS: A prospective, comparative, ecological study. Two isolated boarding schools, each hosting 100-120 children, 4-15 years of age, were selected based on physical infrastructure: intervention school (IS), modern; control school (CS), deprived. After initial diagnosis, children with positive stool samples received supervised treatment with oral nitazoxanide. Diagnoses were made with at least one positive microscopic result from two serial samples using the Faust technique, as reported by the independent observations of two trained, laboratory technicians. Post-treatment samples were taken, and only those with negative results were followed-up. The intervention included infrastructure improvements/maintenance and an educational preventive program for children, parents, and school personnel; no activities were undertaken in the CS. RESULTS: Baseline prevalence for AL was 37.5% at the IS versus 16.6% at the CS (P < 0.01); and for GL, 51.7% versus 37.8%, respectively. At the IS, 35.7% did not speak Spanish, compared to 6.7% in the CS (P < 0.01). Cure rates were similar in both schools for AL (~ 98%) and GL (~ 80%). Final prevalence and reinfection rates for GL were 10.4% versus 10.8%, and 17.2% versus 21% at the IS and CS, respectively. No children were infected/reinfected with AL in either school. Follow-up rates were 80%-83% at the CS and 90%-95% at the IS. CONCLUSIONS: Infection/reinfection rates were similar at the schools after 20 weeks. Supervised treatment alone every semester could effectively control AL/GL infections in this indigenous setting.

[Association between neuropathy and peripheral vascular insufficiency in patients with diabetes mellitus type 2]. / Asociación entre la presencia de enfermedad vascular periférica y neuropatía en pacientes con diabetes mellitus tipo 2.

INTRODUCTION: Diabetes mellitus (DM) can present complications of neuropathy and peripheral arterial disease with high risk for developing foot ulcers and consequent amputations. OBJECTIVE: To identify the association between peripheral vascular disease, and neuropathy in type 2 Diabetes mellitus patients from the Hospital General de Zona No. 1 IMSS in Colima, Mexico. MATERIAL AND METHODS: Cross-sectional study of 80 patients with diabetes mellitus evaluated by means of the Edinburgh Claudication Questionnaire, Michigan Neuropathy Screening Instrument, ankle-arm index, Motor Nerve Conduction Velocity and H-reflex. RESULTS: 51 women and 29 men were studied. Mean age was 53.9 +/- 9.6 years, mean diabetes mellitus progression was 8 +/- 6.6 years and mean glucose level was 283 +/- 110 mg/mL. Neuropathy presented in 65 patients (81.2%). Ankle/arm index revealed 19% of patients presented with moderate peripheral vascular insufficiency. Motor Nerve Conduction Velocity was abnormal in 40% of patients and H-reflex was absent in 70%. DISCUSSION: Grade 2 motor-sensitive polyneuropathy was found in 70-80% of patients and moderate peripheral vascular insufficiency in 19%. It can thus be inferred that the complication of diabetic neuropathy appears before that of peripheral vessel damage.

[Cultural conceptions on dengue in urban contexts in Mexico]. / Concepciones culturales sobre el dengue en contextos urbanos de México.

OBJECTIVE: To explore the conceptual dimensions of dengue in the urban context, aiming at creating hypotheses about community attitudes toward prevention campaigns. METHODS: An exploratory cross-sectional study was carried out between March and April 2003 comprising 130 people selected by proposition sampling in three municipalities with different dengue prevalences in Mexico. Semi-structured interviews were applied using free lists, pile sorts and triads. Dengue-related terms and groups of conceptual dimensions were investigated. A consensual analysis was performed by factorizing the major components as well as a dimensional analysis with hierarchical clustering and multidimensional scales. RESULTS: The consensual model showed high homogeneity in dengue conceptions (values of 14.5 and 13.5 in the most prevalent contexts, and 5.4 in the least prevalent one). The common dimensions of conceptions were: preventive measures, symptoms, causes and reservoirs of Aedes aegypti (goodness of fit test values: <0.28). In the three contexts studied, a conception of basic prevention based on public actions by health officials predominated while individual and community actions were almost never mentioned. A moral dimension also appeared in the conception based on a notion of hygiene as a differentiating mechanism between the nearby community (clean) and outside people and communities (dirty and sick). CONCLUSIONS: The cultural conceptions of dengue do not favor self-managed community involvement in vertical prevention campaigns, and create obstacles to modifying community and individual prevention and control practices.

[Vaccination messages foster mobilization and high coverage in Mexico]. / Los mensajes de vacunación favorecen la movilización y altas coberturas en México.

OBJECTIVE: To understand the perceptions of the effect of vaccination messages aired during the Second National Health Week in 1996 on the predisposition to vaccinate children among mothers from a lower class neighbourhood in Mexico City. METHODS: 120 mothers of children between the ages of 0 and 7 years who were exposed to the campaign messages participated. They were divided into 8 focus groups based on the age of the children and level of schooling attained by the mothers. A content analysis was conducted using open-ended coding and categorization based on shared concepts. RESULTS: The mothers had a positive image of vaccines for the health of their children. They perceived that the messages reminded them that they needed to vaccinate their children and contributed to the mobilization of their social network in support of vaccination. The authors inferred of mother 5 narratives that some components of messages generated inaccurate interpretations and knowledge and reinforced negative attitudes and cultural and organizational barriers to vaccination in some mothers. CONCLUSIONS: The messages prompted the use of vaccination services during the health campaign. In the production, the form and content should be modified to overcome misunderstandings and barriers to vaccination.

[Respiratory tract infections in indigenous migrant Mexican day-laboring families' children]. / Infecciones respiratorias en niños migrantes indígenas de familias jornaleras mexicanas.

OBJECTIVE: Identifying factors associated with respiratory tract infection in indigenous migrant day-laborer families'children living in the sugarcane sector in Colima, Mexico. METHODS: This was a cross-sectional study. Having given their informed consent, 71 mothers were interviewed for compiling pertinent sociodemographic data and a history of respiratory tract infection in their children during the harvest period 2010-2011. Anthropometry for 176 children aged 0-14 years was recorded and they were clinically examined for upper and lower respiratory tract infection. Frequencies, percentages, Chi-square, odds ratio (crude and adjusted) and 95 % confidence intervals were calculated for the resulting data. RESULTS: 52.3 % of the children in the sample had a history of respiratory infection occurring during the last six months. Respiratory infection rates were statistically significant regarding temporary residence in shelters/hostels. The factors associated with a background of infection were being aged less than four years (AOR 4.06 (2.03-8.09) 95 % CI) and having been involved in temporary residence in a shelter,thereby leading to more overcrowding and an increased use of wood stoves for cooking (AOR 1.92 (1.01-3.63) 95 % CI). CONCLUSION: Indigenous migrant day-laboring families'children are vulnerable to respiratory infection. Prevention programs should target their activities by age-group, emphasizing younger children, and promote improved sanitary conditions in the shelters.

Factors associated with HIV transmission risk in people with a severe mental illness. A narrative review / Factores asociados con el riesgo de transmisión de VIH en personas con un trastorno mental grave. Una revisión narrativa

Abstract Background. People with a severe mental illness (SMI) are a highly vulnerable group for the transmission risk of the human immunodeficiency virus (HIV). They have a higher seroprevalence compared with the general population and their life expectancy is shorter than those of people without the disease. This narrative review describes individual factors or those inherent to a person’s characteristics and the sociocultural factors conditioning sexual behaviour and prevention norms. Objective. The purpose of this narrative review is to describe individual and sociocultural factors associated with the risk of HIV in people with a severe mental illness. Method. 82 empirical studies published between 1981 and 2015, addressing HIV transmission risk factors and sociocultural dimensions related to vulnerability were selected. Four indexes were used for this purpose: ISI Web of Knowledge, Redalyc, SciELO, and PUBMED; and four multidisciplinary electronic databases: Ebscohost Web, ProQuest, Sage Publications and ScienceDirect. Results. The analysis based on coding and systematic categorization shows that people with SMI are more vulnerable to risk than the general population, with differentials based on the severity of the disease symptomatology and economic and sociocultural characteristics associated with HIV-related risk practices. Discussion and conclusion. The need to design longitudinal studies with mixed methodology is proposed to attain a deeper understanding of the interaction of factors associated and processes conditioning risk. In this population group, structural preventive programs that take into account social and gender inequality must be implemented.

Resumen Antecedentes. Las personas con trastornos mentales graves (TMG) constituyen un grupo de alta vulnerabilidad al riesgo de transmisión del virus de inmunodeficiencia humana (VIH). Asimismo, presentan una mayor seroprevalencia en comparación con la población en general y su esperanza de vida es más corta que la de personas sin TMS. La presente revisión narrativa describe los factores individuales e inherentes a las características de estas personas y los factores socioculturales que condicionan los comportamientos sexuales y las normas de prevención. Objetivo. Describir los factores individuales y socioculturales asociados con el riesgo de infección del VIH en personas con trastornos mentales graves. Método. Se seleccionaron 82 estudios empíricos publicados entre 1981 y 2015 sobre los factores asociados al riesgo de transmisión del VIH y dimensiones socioculturales relacionadas con la vulnerabilidad. Se utilizaron cuatro índices: ISI Web of Knowledge, Redalyc, SciELO y PUBMED; y cuatro bases de datos electrónicas multidisciplinarias: Ebscohost Web, ProQuest, Sage Publications y ScienceDirect. Resultados. Un análisis basado en la codificación y categorización sistemática muestra que las personas con TMG son más vulnerables al riesgo que la población general, con diferenciales basados en la gravedad sintomatológica de la enfermedad y en las características económicas y socioculturales que se asocian con prácticas de riesgo. Discusión y conclusión. Se propone desarrollar estudios con un diseño longitudinal y metodología mixta para alcanzar una comprensión más profunda de la interacción de factores asociados y procesos que condicionan el riesgo. Los programas preventivos estructurales realizados con este grupo de personas deben considerar las desigualdades sociales y la inequidad de género.

A280V polymorphism in the histamine H3 receptor as a risk factor for migraine.

BACKGROUND AND AIMS: Activation of histamine H3 receptors blocks the release of peptides responsible for headache. Our objective was to investigate the association between the genotypes of A280V polymorphism in the H3 receptor and migraine risk. METHODS: We evaluated the frequency of the genotypes of A280V, polymorphism A280V and allelic variants of H3 receptor in 147 migraine patients and 186 healthy controls using a PCR-RLFP method. RESULTS: V allele frequency was 6.46% and 2.68% for the cases and controls, respectively (p = 0.02) (OR 2.67; 95% CI 1.20-5.93). The frequency of V/V + V/A genotypes was 12.92% in migraine patients, significantly higher when compared to the 3.22% frequency in the control group (p = 0.001) (OR 4.45; 95% CI 1.7-11.46). CONCLUSIONS: The results of this study suggest that V-allele genotypes in the H3 receptor gene are related to migraine risk in the Mexican population. We propose the hypothesis that the V-allele genotypes in the H3 receptor gene increase the population of inactive receptors, enhancing the inhibition of the negative feedback mechanism on the H3 receptor and increasing histamine release, which correlates with migraine attacks in susceptible patients. The case-control study reinforces the role of histamine in migraine pathogenesis.

Between tradition and change: condom use with primary sexual partners among Mexican migrants.

The frequency of male Mexico-US migration has been associated with increased HIV risk for sexual partners awaiting their return in Mexico. This study examined the association between sexual partner characteristics and condom use among a sample of 354 male migrants from two Mexican municipalities. Migrants were interviewed about their past year's sex practices. Results indicated that migrants were more likely to use condoms with their non-spousal partners, partners with less education than the migrant, and partners with higher employment status. Condom use was greater among younger migrants and residents of the more densely populated municipality. Findings suggest the coexistence of a traditional cultural orientation that does not support condom use and another one that does provided the sex partner is formally employed. Prevention programs must strengthen the structural conditions fostering greater equality between the sexes and adapt their approaches for different population density, age and partner types.

Infecciones respiratorias en niños migrantes indígenas de familias jornaleras mexicanas / Respiratory tract infections in indigenous migrant Mexican day-laboring families' children

Objetivo Identificar factores asociados a infecciones de vías respiratorias en niños migrantes indígenas de familias jornaleras del sector cañero en Colima, México. Métodos Estudio transversal descriptivo. Previo consentimiento informado, se entrevistaron 71 madres sobre aspectos sociodemográficos y antecedentes de infecciones de vías respiratorias en sus niños, durante el período decosecha 2010-2011. Se realizó antropometría a 176 niños de 0-14 años y se revisaron clínicamente en busca de infecciones de vías respiratorias superiores e inferiores. Se calcularon frecuencias, porcentajes, Ji cuadrado,razones de momios (cruda y ajustada) e intervalos de confianza del 95 %. Resultados El 52,3 % de los niños tuvieron antecedentes de infecciones respi-ratorias en los últimos seis meses. Los porcentajes de infecciones respiratorias tuvieron diferencias significativas por albergues de residencia. Los factores asociados al antecedente de infección fueronla edad menor a cuatro años (RMA=4,06, IC 95 % (2,03-8,09)) y la residencia temporal en un albergue conmayor hacinamiento en sus cuartos y mayor uso de fogones de leña para cocinar (RMA=1,92, IC95 % (1,01-3,63)). Conclusión Los niños migrantes indígenas de familias jornaleras son vulnerables a las infecciones de vías respiratorias. Los programas preventivos deben segmentar sus acciones por grupos de edad, con énfasis en los niños menores, y favorecer la mejora en las condiciones de salubridad en los albergues.(AU)

Objective Identifying factors associated with respiratory tract infection in indigenous migrant day-laborer families'children living inthe sugarcane sector in Colima, Mexico. Methods This was a cross-sectional study. Having given theirinformed consent, 71 mothers were interviewed for compiling pertinentsociodemographic data and a history of respiratory tract infection in their children during the harvest period 2010-2011. Anthropometry for 176 children aged 0-14 years was recorded and they were clinically examinedfor upper and lower respiratory tract infection. Frequencies, percentages, Chi-square, odds ratio (crude and adjusted) and 95 % confidence intervals were calculated for the resulting data. Results 52.3 % of the children in the sample had a history of respiratory infection occurring during the last six months. Respiratory infectionrates were statistically significant regarding temporary residence in shelters/hostels. The factors associated with a background of infection were being aged less than four years (AOR 4.06 (2.03-8.09) 95 % CI) and having been involved in temporary residence in a shelter,thereby leading tomore overcrowding and an increased use of wood stoves for cooking (AOR 1.92 (1.01-3.63) 95 % CI). ConclusionIndigenous migrant day-laboring families'children are vulnerable to respiratory infection. Prevention programs should target their activities by age-group, emphasizing younger children, and promote improved sanitary conditions in the shelters.(AU)

Significados sobre la prevención del riesgo de VIH en cibernautas con trastorno bipolar / The meaning of the prevention of HIV among internet users with bipolar disorder

Introduction The persons with affective bipolar disorder (ABD) constitute a vulnerable group to the infection of HIV; in spite of that, there has been little investigation about the preventive culture in this population. Objective To identify the meanings and practices about the prevention of the risk of HIV infection with persons having bipolar disorders, active members of the weblog "Foro Bipolarmexico". Methodology A quality ethnographic type study was carried out on the Mexican weblog, directed by and for persons with ABD. The sampling of forums of expression published from 2007 to 2010 were positive. An analysis of the contained inductive thematic was conducted and the ATLAS.ti was utilized for the process of the information. Results The meanings and the conditions implied in the construction of the practices on the prevention of the risk of transmission of HIV cover three levels: a) physic-biologic, where the symptomatology associated with the disorder is identified, and the use of medications are implicated in the altercation of desires and sexual practices; before this, the bloggers propose the execution of activities which would permit the canalization of sexual impulse, the change of medication and use of preservatives; b) the micro-social, in which enhanced conditions like communication deficiency with their psychiatrists and similarities on the disorders and their effects on sexuality, for which they promote open discussion on the changes experienced; and c) the macro-social, where the stigma of the disease is expressed in solitude and the difficulty of stable couples to relate, conditions that could counteract, so they suggested, with the social recognition of their potentials. The emphasis on the recuperation of significance constructed socially clearly showed that it is urgent to consider directed towards not only preventive interventions, but also to micro and macro social conditions which have a part in the vulnerability and infection of HIV.

Introducción Las personas con trastorno afectivo bipolar (TAB) constituyen un grupo vulnerable al contagio del VIH; a pesar de ello, poco se ha investigado sobre la cultura preventiva en esta población. Objetivo Identificar los significados y prácticas sobre la prevención del riesgo de transmisión de VIH en personas con trastorno bipolar, miembros activos del weblog "Foro Bipolarmexico". Metodología Se realizó un estudio cualitativo de tipo etnográfico en una weblog mexicana, dirigida por y para personas con TAB. El muestreo de foros de expresión publicados de 2007 a 2010 fue propositivo. Se realizó un análisis de contenido temático inductivo y para el procesamiento de la información se utilizó el software ATLAS.ti. Resultados Los significados y las condiciones implicadas en la construcción de prácticas sobre la prevención del riesgo de transmisión de VIH abarcan tres niveles: a) el psicobiológico, donde se identifica que la sintomatología asociada al trastorno y el uso de medicamentos están implicados en la alteración de deseos y prácticas sexuales; ante esto los blogueros proponen realizar actividades que permitan la canalización del impulso sexual, el cambio de medicamentos y utilizar preservativos; b) el microsocial, en el cual destacaron condiciones como la deficiente comunicación con sus psiquiatras y parejas sobre el trastorno y su efecto en la sexualidad, por lo que ellos promueven la discusión abierta sobre los cambios experimentados y c) el macrosocial, donde el estigma de la enfermedad se expresa en el aislamiento y dificultad para relacionarse con parejas estables, condiciones que podrían contrarrestarse, según sugieren, con el reconocimiento social de sus potencialidades. El énfasis en la recuperación de significados construidos socialmente evidenció que es apremiante considerar intervenciones preventivas dirigidas tanto a las prácticas de riesgo individuales como hacia las condiciones microsociales y macrosociales que participan en la vulnerabilidad al contagio de VIH.

The effects of social networks on tobacco use among high-school adolescents in Mexico / Efectos de redes sociales sobre el uso de tabaco en adolescentes de preparatoria en México

OBJECTIVE: To identify the effect of centrality in social network positions on tobacco-use among high-school adolescents in Tonala, Jalisco, Mexico. MATERIALS AND METHODS: Longitudinal sociometric social network data were collected among 486 high-school adolescents in 2003 and 399 in 2004. The survey included: social network components, smoking and sociodemographic characteristics. Social network measures of centrality were calculated and multivariate logistic regression was used. RESULTS: Ever used tobacco (OR= 44.98), marginalized-low stratum (OR= 2.16) and in-degree (OR=1.10) predicted tobacco use. Out-degree (OR= 0 .89) and out-in-degree (OR= 0.90) protected against tobacco use. CONCLUSION: Nominating more friends rather than receiving such nominations was protective for tobacco use. Popular students, those receiving many nominations, were at higher risk for tobacco use. Involvement of leaders with capacity to influence might be an efficient strategy for dissemination of preventive messages.

OBJETIVO: Identificar el efecto de posiciones de centralidad de la red social sobre el uso de tabaco en adolescentes de preparatoria en Tonalá, Jalisco. MATERIAL Y MÉTODOS: Estudio longitudinal de redes sociales sociométricas. Participaron 486 bachilleres (2003) y 399 (2004). La encuesta incluyó: componentes de redes sociales, tabaquismo y características sociodemográficas. Se calcularon medidas de centralidad de redes sociales y utilizó regresión logística multivariada. RESULTADOS: El consumo alguna vez de tabaco (RM= 44.98), estrato socioeconómico marginado-bajo (RM= 2.16) y vínculos recibidos (RM=1.10) predijeron el tabaquismo; mientras que los vínculos enviados (RM= 0.89) y la diferencia entre vínculos enviados y recibidos (RM= 0.90) protegieron contra el tabaquismo. CONCLUSIÓN: Nombrar más amigos que ser nombrado por otros protegió contra el tabaquismo. Los estudiantes populares, aquellos con muchos nombramientos, tuvieron mayor riesgo de ser consumidores. La inclusión de líderes con influencia podría ser una estrategia eficiente en la diseminación de mensajes preventivos.

Condom use and migration in a sample of Mexican migrants: potential for HIV/STI transmission.

OBJECTIVE: To analyze the association between condom use and migration to the United States (US) in two Mexican municipalities. MATERIAL AND METHODS: A cross-sectional, non-probabilistic study of egocentric social networks was conducted in Cuauhtémoc, Colima and Tonalá, Jalisco during the months of December 2003 and January 2004, in 354 migrant subjects. Migration, sexual network, history and risk for sexually transmitted infections (STIs) characteristics were surveyed. Statistical analyses was conducted using logistic regression. RESULTS: Increased migration travel to the US was significantly associated with consistent condom use for Cuauhtémoc (OR: 3.87; p< 0.05) and Tonalá (OR: 4.12; p< 0.05) municipalities. Other significant predictors included: age, type of sex partner, and perceived monogamy. CONCLUSIONS: Our data support the hypothesis that migration to the US is associated with condom use.

Intervention to prevent intestinal parasitic reinfections among Tarahumara indigenous schoolchildren in northern Mexico / Intervención para prevenir las reinfecciones parasitarias intestinales en niños indígenas tarahumara en edad escolar en el norte de México

OBJECTIVE: To assess the effectiveness of a 20-week, broad intervention to prevent reinfection by Ascaris lumbricoides (AL) and Giardia lamblia (GL) among indigenous schoolchildren in northern Mexico. METHODS: A prospective, comparative, ecological study. Two isolated boarding schools, each hosting 100-120 children, 4-15 years of age, were selected based on physical infrastructure: intervention school (IS), modern; control school (CS), deprived. After initial diagnosis, children with positive stool samples received supervised treatment with oral nitazoxanide. Diagnoses were made with at least one positive microscopic result from two serial samples using the Faust technique, as reported by the independent observations of two trained, laboratory technicians. Post-treatment samples were taken, and only those with negative results were followed-up. The intervention included infrastructure improvements/maintenance and an educational preventive program for children, parents, and school personnel; no activities were undertaken in the CS. RESULTS: Baseline prevalence for AL was 37.5 percent at the IS versus 16.6 percent at the CS (P < 0.01); and for GL, 51.7 percent versus 37.8 percent, respectively. At the IS, 35.7 percent did not speak Spanish, compared to 6.7 percent in the CS (P < 0.01). Cure rates were similar in both schools for AL (~ 98 percent) and GL (~ 80 percent). Final prevalence and reinfection rates for GL were 10.4 percent versus 10.8 percent, and 17.2 percent versus 21 percent at the IS and CS, respectively. No children were infected/reinfected with AL in either school. Follow-up rates were 80 percent-83 percent at the CS and 90 percent-95 percent at the IS. CONCLUSIONS: Infection/reinfection rates were similar at the schools after 20 weeks. Supervised treatment alone every semester could effectively control AL/GL infections in this indigenous setting.

OBJETIVO: Evaluar la eficacia de una intervención amplia de 20 semanas de duración para prevenir la reinfección por Ascaris lumbricoides y Giardia lamblia en niños indígenas en edad escolar del norte de México. MÉTODOS: Estudio prospectivo, de comparación y ecológico. Se seleccionaron dos internados geográficamente aislados, cada uno de los cuales alberga entre 100 y 120 niños de 4 a 15 años de edad, según su infraestructura física: una escuela moderna en la que se llevó a cabo la intervención y otra, precaria, que se empleó como control. Tras el diagnóstico inicial, los niños con resultados positivos en los análisis de las muestras de heces recibieron tratamiento supervisado con nitazoxanida oral. El diagnóstico se hizo con al menos un resultado microscópico positivo en dos muestras sucesivas con la técnica de Faust, según lo informado por las observaciones independientes efectuadas por dos técnicos de laboratorio capacitados. Se tomaron muestras postratamiento y solo se hizo el seguimiento de los niños con resultados negativos. La intervención incluyó mejoras y mantenimiento de la infraestructura y un programa educativo de prevención para los niños, los padres y el personal de la escuela; en la escuela de control no se llevó a cabo ninguna actividad. RESULTADOS: La prevalencia inicial de la infección por A. lumbricoides fue de 37,5 por cento en la escuela de la intervención frente a 16,6 por cento en la escuela de control (P < 0,01); la de G. lamblia, de 51,7 por cento frente a 37,8 por cento, respectivamente. En la escuela de la intervención 35,7 por cento no hablaba español, en comparación con 6,7 por cento en la escuela de control (P < 0,01). Las tasas de curación fueron similares en ambas escuelas para A. lumbricoides (aproximadamente 98 por cento) y para G. lamblia (aproximadamente 80 por cento). La prevalencia final y las tasas de reinfección para G. lamblia fueron de 10,4 por cento frente a 10,8 por cento en la escuela de la intervención y de 17,2 por cento frente a 21 por cento en la escuela de control. No hubo nuevas infecciones o reinfecciones con A. lumbricoides en ninguna de las escuelas. Las tasas de seguimiento fueron de 80 por cento a 83 por cento en la escuela de control y de 90 por cento a 95 por cento en la escuela de la intervención. CONCLUSIONES: Las tasas de infección o reinfección fueron similares en las dos escuelas después de 20 semanas. El tratamiento supervisado cada semestre como única medida controló eficazmente las infecciones con A. lumbricoides o G. lamblia en este entorno indígena.

[Knowledge about HIV/AIDS in young people from indigenous migrant day laborer families in Colima and Nayarit]. / Conocimientos sobre el VIH/sida en jóvenes de familias jornaleras migrantes indígenas en Colima y Nayarit.

Objective: to explore the pattern of knowledge about HIV/AIDS among young native migrant farm workers. Methods: analytical crosscut study. Sample: 135 young people selected by propositive sampling. A questionnaire about knowledge of HIV/AIDS and socio-demographics was applied. A descriptive analysis was made and a knowledge pattern was estimated by means of factorial analysis. Results: average age 19.9 ± 5.8, men 54.8 %, bilingual 79.4 %, elementary or no education, 78.7 %, single 60.4 %, Catholic 67.6 %, two or more work trips 61.8 %; 80.7 % had heard about HIV/AIDS, especially from informal information sources (72 %). Knowledge pattern was homogenous (greater consensus in Nayarit than in Colima: 6.2 versus 3.8) and directed towards building risk identities based on personage (prostitutes 88.1%, men having sex with other men 45 %) and urban setting (78 %). It includes uncertainty about the effectiveness of condoms, the mosquito as a vector, and dentists as transmitters. The pattern showed significant differences according to sex, education and migrant experience. Conclusions: the knowledge of young people does not favor safe sex practices, and the low risk perception could favor their vulnerability to HIV/AIDS.

Objetivo: explorar el patrón de conocimientos sobre VIH/sida en jóvenes indígenas jornaleros migrantes. Métodos: : estudio transversal analítico de 135 jóvenes seleccionados por muestreo propositivo. Se aplicó cuestionario sociodemográfico y de conocimientos de VIH/sida. Se realizó análisis descriptivo y se estimó un patrón de conocimientos mediante análisis factorial. Resultados: : edad 19.9 ± 5.8 años, hombres 54.8 %, bilingües 79.4 %, escolaridad primaria o ninguna 78.7 %, solteros 60.4 %, católicos 67.6 %, dos o más viajes laborales 61.8 %. El 80.7 % escuchó hablar de VIH/sida. El patrón de conocimientos fue homogéneo (consenso mayor en Nayarit que en Colima: 6.2 versus 3.8) y orientado a construir identidades de riesgo basadas en personajes (trabajadoras sexuales 88.1 %, hombres que tienen sexo con hombres 45 %) y contexto urbano (78 %). Incluye incertidumbre sobre la eficacia del condón al mosquito como vector (45 %) y a los dentistas como transmisores. Patrón con diferencias significativas por sexo, escolaridad y experiencia migratoria. Conclusiones: el conocimiento de los jóvenes desfavorece el uso de protección y una baja percepción del riesgo, que podrían propiciar la vulnerabilidad al riesgo de transmisión del VIH/sida.

[Knowledge of HIV/AIDS among urban adolescents: cultural consensus of doubts and uncertainties]. / Conocimientos sobre VIH/SIDA en adolescentes urbanos: consenso cultural de dudas e incertidumbres.

OBJECTIVE: To describe the knowledge of HIV/AIDS among adolescents from different socioeconomic strata (SS), using cultural consensus analysis. MATERIAL AND METHODS: A cross-sectional descriptive and analytic study was conducted from July 1995 to March 1996, among 758 adolescents from Guadalajara, México. Data were collected using a questionnaire, and analyzed by means of: a) consensus by SS and gender using factorial analysis; and b) identification of the cultural pattern of correct answers, and concordance of individual/group answers using Pearson's r correlation coefficients. RESULTS: There was a high degree of consensus across SS. The individual/group knowledge concordance was greater in higher SS. The pattern of correct responses showed: a) similar knowledge on casual transmission, AIDS characteristics, and higher risk in sex workers; and b) discrepancies regarding doubts and uncertainties about condom protection, distinction between HIV and AIDS, and HIV transmission in health clinics. CONCLUSIONS: Knowledge was homogeneous and mainly medically oriented across all SS. Nevertheless, there were elements of doubt and uncertainty that require differentiated informative interventions.