[COVID-19 on migrants and ethnic minorities]. / COVID-19 en migrantes y minorías étnicas.

There are still few publications that analyse the effects on migrants or ethnic minorities of COVID-19 or of measures taken to curb this pandemic, although early studies point to a greater impact on black, asian and ethnic minority populations in the UK or on migrants in Mexico. In addition to barriers to access to information and health services, we consider it a priority to focus on their living conditions, particularly those in situations of vulnerability or social exclusion. People who are unemployed or with precarious jobs, without social benefits, in overcrowded conditions, may be more at risk of infection and not receiving adequate treatment. Confinement has predictably more negative impact on migrants in irregular administrative situations, victims of gender-based violence and those unable to comply with physical estrangement measures, such as refugees in camps or migrants under-living and settlements, without adequate hygienic conditions. Recommendations such as suspending deportations, extending or facilitating residence and work permits, closing detention centres for foreign persons, evacuating those in prisons and refugee camps or settlements have been applied unequally in different countries. Only a strong political commitment to global health equity can ensure the health of migrant populations and ethnic minorities, as well as their access to protection measures, information, medical testing and health services.Keywords: Migrants, COVID-19, Minority Groups, Vulnerable Populations, Social Determinants of Health.

Reticencia vacunal: análisis del discurso de madres y padres con rechazo total o parcial a las vacunas / Vaccine hesitancy: discourse analysis of parents who have not fully or partially vaccinated their children

Objetivo: Analizar y comprender los discursos reticentes a la vacunación, particularmente los de las personas que han decidido no vacunar a sus hijos/as. Métodos: Estudio cualitativo con cinco entrevistas individuales y dos grupos focales con personas que optaron por no vacunar a su hijos/as en la provincia de Granada. Resultados: Padres y madres manifiestan un sistema de creencias en salud diferente al paradigma biomédico. Desde el punto de vista ético, justifican su posición a partir del derecho a la autonomía y la responsabilidad de sus decisiones. Como argumentos concretos, dudan de la administración de varias vacunas simultáneamente en edades muy tempranas de manera sistemática y sin individualizar cada caso, temen efectos adversos y no entienden la variabilidad en el calendario vacunal. Conclusiones: Los discursos reticentes responden al conflicto de individualidad vs. colectividad: padres y madres, en defensa de su derecho a una crianza sin interferencias del Estado, centran su responsabilidad en el bienestar individual de sus hijos/as independientemente de las consecuencias que su acción u omisión conlleve a la colectividad. En su gestión de los riesgos, elevan los derivados de vacunar por encima de las consecuencias individuales y colectivas de no hacerlo. Las vacunas que más dudas generan son aquellas con mayor controversia en el ámbito científico. La transparencia en la comunicación de efectos adversos, el respeto de las autoridades a otros conceptos de salud/enfermedad, el destierro del término «antivacunas» del lenguaje mediático y científico, y el desarrollo de espacios de diálogo son puentes por construir

Objective: To analyse and understand vaccination hesitancy discourses, particularly those of people who have decided not to vaccinate their sons and daughters. Methods: Qualitative study of five individual interviews and two focus groups with people who chose not to vaccinate their children in the province of Granada (Spain). Results: Mothers and fathers manifest a system of health beliefs different to the biomedical paradigm. From an ethical point of view, they justify their position based on the right to autonomy and responsibility for their decisions. Alleged specific reasons: they doubt administration of several vaccines simultaneously at an early age in a systematic way and without individualising each case; they fear adverse effects and do not understand the variations of the vaccination schedule. Conclusions: These vaccination hesitancy discourses respond to the individual vs collective conflict; parents defend their right to bring up their children without any interference from the state and focus their responsibility on the individual welfare of their sons and daughters, regardless of the consequences that their actions might have on the collective. In their management of risks, they consider those derived from vaccination more relevant than the individual or collective consequences of not doing so. The vaccines generating most doubts are the more controversial ones within the scientific world. Transparency in communication of adverse effects; authorities respect for other health/disease concepts; banishment of the term "anti-vaccines" from the media and scientific vocabulary, and developing spaces for dialogue are bridges to be built

[Vaccine hesitancy: discourse analysis of parents who have not fully or partially vaccinated their children]. / Reticencia vacunal: análisis del discurso de madres y padres con rechazo total o parcial a las vacunas.

OBJECTIVE: To analyse and understand vaccination hesitancy discourses, particularly those of people who have decided not to vaccinate their sons and daughters. METHODS: Qualitative study of five individual interviews and two focus groups with people who chose not to vaccinate their children in the province of Granada (Spain). RESULTS: Mothers and fathers manifest a system of health beliefs different to the biomedical paradigm. From an ethical point of view, they justify their position based on the right to autonomy and responsibility for their decisions. Alleged specific reasons: they doubt administration of several vaccines simultaneously at an early age in a systematic way and without individualising each case; they fear adverse effects and do not understand the variations of the vaccination schedule. CONCLUSIONS: These vaccination hesitancy discourses respond to the individual vs collective conflict; parents defend their right to bring up their children without any interference from the state and focus their responsibility on the individual welfare of their sons and daughters, regardless of the consequences that their actions might have on the collective. In their management of risks, they consider those derived from vaccination more relevant than the individual or collective consequences of not doing so. The vaccines generating most doubts are the more controversial ones within the scientific world. Transparency in communication of adverse effects; authorities respect for other health/disease concepts; banishment of the term "anti-vaccines" from the media and scientific vocabulary, and developing spaces for dialogue are bridges to be built.

Salud Pública (también) para las personas migrantes y refugiadas en Europa / Public Health for migrants and refugees in Europe (as well)

No disponible

Hospital admissions due to alcohol related disorders among young adult refugees who arrived in Sweden as teenagers - a national cohort study.

BACKGROUND: Psychological distress and lack of family support may explain the mental health problems that are consistently found in young unaccompanied refugees in Western countries. Given the strong relationship between poor mental health and alcohol misuse, this study investigated hospital admissions due to alcohol related disorders among accompanied and unaccompanied young refugees who settled in Sweden as teenagers. METHODS: The dataset used in this study was derived from a combination of different registers. Cox regression models were used to estimate the risks of hospital care due to alcohol related disorders in 15,834 accompanied and 4376 unaccompanied young refugees (2005-2012), aged 13 to 19 years old when settling in Sweden and 19 to 32 years old in December 2004. These young refugees were divided into regions with largely similar attitudes toward alcohol: the former Yugoslavian republics, Somalia, and the Middle East. The findings were compared with one million peers in the native Swedish population. RESULTS: Compared to native Swedes, hospital admissions due to alcohol related disorders were less common in young refugees, with a hazard ratio (HR) of 0.65 and 95% confidence interval (CI) between 0.56 and 0.77. These risks were particularly lower among young female refugees. However, there were some differences across the refugee population. For example, the risks were higher in unaccompanied (male) refugees than accompanied ones (HR = 1.49, 95% CI = 1.00-2.19), also when adjusted for age, domicile and income. While the risks were lower in young refugees from Former Yugoslavia and the Middle East relative to native Swedes, independent of their length of residence in Sweden, refugees from Somalia who had lived in Sweden for more than ten years showed increased risks (HR = 2.54, 95% CI = 1.71-3.76), after adjustments of age and domicile. These risks decreased considerably when income was adjusted for. CONCLUSION: Young refugees have lower risks of alcohol disorders compared with native Swedes. The risks were higher in unaccompanied young (male) refugees compared to the accompanied ones. Moreover, Somalian refugees who had lived in Sweden for more than ten years seems to be particularly vulnerable to alcohol related disorders.

[What do adolescents and young people think about recreational drug use and sexual risks?]. / Qué opinan adolescentes y jóvenes sobre el consumo de drogas recreativas y las conductas sexuales de riesgo?

The objective of this article is to analyse the opinions of adolescents and young people, from gypsy and non-gypsy populations, on the relationship between recreational drug use and sexual practices that increase the risk of HIV infection. A descriptive qualitative research was undertaken. 14 focus groups were conducted with 98 adolescents and young people, and 7 semi-structured interviews with young recreational drug users. Both sort of results were triangulated. Two major discursive lines emerge in the analysis. The first one defends the notion that moderate consumption of alcohol facilitates the sexual encounter, but it does not imply risky behaviours. However, polydrug use or an elevated use of recreational drugs is related to a lack of concern for sexual risks, and in men with the loss of sexual sensitivity that sometimes justifies not using a condom. The second line argues other reasons for the non-use of condoms, such as their lack of availability, confidence in one's sexual partner, a concept of desire as something uncontrollable, infatuation and the state of mind or self-esteem. Some recommendations to prevent sexual transmission of HIV are derived from the results, such as the distribution of condoms in places where alcohol and other drugs are consumed, publicising the use of condoms and other latex barriers for oral genital sexual practices, working with young males on the optimisation of pleasure, designing preventive interventions targeting stable partners, and training adolescent girls in the social skills needed to negotiate the use of condoms.

¿Qué opinan adolescentes y jóvenes sobre el consumo de drogas recreativas y las conductas sexuales de riesgo? / What do adolescents and young people think about recreational drug use and sexual risks?

El objetivo de este artículo es analizar las opiniones de adolescentes y jóvenes, de población gitana y no gitana, sobre la relación entre el consumo de drogas recreativas y las prácticas sexuales que incrementan el riesgo de infección por VIH. Para ello se ha desarrollado un estudio transversal descriptivo que emplea una metodología cualitativa. Se realizaron 14 grupos focales en los que participaron 98 adolescentes y jóvenes y 7 entrevistas semiestructuradas a jóvenes usuarios de drogas recreativas. Los resultados fueron triangulados. En el análisis aparecen dos grandes líneas discursivas. La primera defiende que el consumo moderado de alcohol facilita el encuentro sexual, pero no implica la asunción de riesgos. Sin embargo, el policonsumo o consumo elevado de drogas recreativas se relaciona con la despreocupación por los riesgos sexuales, y en varones con pérdida de sensibilidad sexual que justifica el no uso de preservativos. La segunda argumenta otros motivos para no utilizar preservativos, entre ellos la falta de disponibilidad de los mismos, la confianza en la pareja sexual, una concepción del deseo como algo incontrolable, el enamoramiento, el estado de ánimo o la autoestima. De los resultados se derivan recomendaciones para prevenir la transmisión sexual del VIH, como distribuir preservativos en espacios donde se consume alcohol y otras drogas, publicitar su uso y el de otras barreras en prácticas bucogenitales, trabajar en la optimización del placer con varones, convertir en objeto de campañas a las parejas estables y formar a mujeres adolescentes en habilidades sociales para negociar el uso del preservativo

The objective of this article is to analyse the opinions of adolescents and young people, from gypsy and non-gypsy populations, on the relationship between recreational drug use and sexual practices that increase the risk of HIV infection. A descriptive qualitative research was undertaken. 14 focus groups were conducted with 98 adolescents and young people, and 7 semi-structured interviews with young recreational drug users. Both sort of results were triangulated.Two major discursive lines emerge in the analysis. The first one defends the notion that moderate consumption of alcohol facilitates the sexual encounter, but it does not imply risky behaviours. However, polydrug use or an elevated use of recreational drugs is related to a lack of concern for sexual risks, and in men with the loss of sexual sensitivity that sometimes justifies not using a condom. The second line argues other reasons for the non-use of condoms, such as their lack of availability, confidence in one’s sexual partner, a concept of desire as something uncontrollable, infatuation and the state of mind or self-esteem. Some recommendations to prevent sexual transmission of HIV are derived from the results, such as the distribution of condoms in places where alcohol and other drugs are consumed, publicising the use of condoms and other latex barriers for oral genital sexual practices, working with young males on the optimisation of pleasure, designing preventive intervention stargeting stable partners, and training adolescent girls in the social skills needed to negotiate the use of condoms

¿Tienen adolescentes y jóvenes que consumen drogas no inyectadas mayor probabilidad de transmisión sexual del VIH? / Have adolescents and young people who take non-injected drugs a greater probability of HIV sexual transmission?

El objetivo de este artículo es analizar la relación entre el consumo de drogas no inyectadas y las conductas sexuales que incrementan el riesgo de infección por VIH u otras Enfermedades de Transmisión Sexual en adolescentes y jóvenes. Para ello se ha realizado una revisión bibliográfica de investigaciones publicadas en revistas científicas entre 1998 y 2003. Éstas han sido descritas considerando el tipo de droga consumida, el tipo de población, la posición social y el sexo/género de las personas participantes. Algo más de la mitad de los artículos analizados asocian el consumo de alcohol o marihuana con prácticas sexuales de riesgo. Sobre el consumo de otras drogas no inyectadas como cocaína, anfetaminas, etc. y su mezcla con alcohol no hay acuerdo. No aparecen grandes diferencias entre varones y mujeres, según pertenencia poblacional o por posición social. La mayoría de los trabajos analizados encuentran relación entre el consumo de algunas drogas y las prácticas sexuales que incrementan el riesgo de infección por VIH. No obstante, la escasa comparabilidad y otros problemas metodológicos dan pie a la controversia. Se identificaron limitaciones en los artículos revisados y recomendaciones para futuras investigaciones

The objective of this article is to analyse the relationship between the use of non-injected drugs and the sexual risks of HIV infection or another STD in adolescents and young people. A bibliographical review was made of articles published in scientific journals between 1998 and 2003. These studies were described considering type of drug, type of population (population minorities), social position and sex/gender of the participants. Slightly more than a half of the articles analysed associate the use of alcohol or marijuana with risky sexual behaviour. There is no agreement on the use of other non-injected drugs such as cocaine, amphetamines, etc. or their combination with alcohol. No major differences were found between men and women, by population group or by social position. Most of the studies find some relationship between the use of certain drugs and sexual behaviours that increase the risk of HIV infection. However, the lack of comparability and other methodological problems are conducive to controversy. Limitations in reviewed articles were identified and recommendations made for future research