Shigellosis Among Gay and Bisexual Men: A Qualitative Assessment to Examine Knowledge, Attitudes, and Practices.

BACKGROUND: Shigellosis is a highly contagious enteric bacterial disease transmitted through the fecal-oral route. It is primarily transmitted through person-to-person contact and via contaminated food and water. Outbreaks of shigellosis among men who have sex with men (MSM) attributed to sexual person-to-person contact have been reported. These outbreaks are of concern because they are often caused by multidrug-resistant strains of Shigella. Little is known about shigellosis-related knowledge, attitudes, and practices among gay, bisexual, and other MSM. METHODS: Six focus groups were conducted among self-identified gay or bisexual men in Atlanta, GA, in Fall 2017. Participants were asked about shigellosis-related knowledge, attitudes, and practices. Focus groups were audio recorded, and the transcribed audio was analyzed using inductive and deductive thematic coding. RESULTS: Among the 24 focus group participants, most perceived that diarrheal illness was caused by contaminated food. Knowledge of shigellosis and Shigella was low, with most never having heard of the disease or bacteria. Participants did not perceive shigellosis to be a serious health concern, especially when compared with HIV; however, they did perceive gay and bisexual men to be at risk of Shigella infection. Participants reported mixed intentions to change sexual behaviors to prevent shigellosis or talk with sexual partners about diarrhea. CONCLUSIONS: Health communication and education efforts could be used to increase knowledge about shigellosis and shift perceptions about the severity of shigellosis among gay, bisexual, and other MSM. Additional work is needed to identify effective ways to promote shigellosis-related prevention behaviors among gay, bisexual, and other MSM.

A Cross-Sectional Study of Antenatal Care Attendance among Pregnant Women in Western Jamaica.

BACKGROUND: Pregnancy complications are preventable with appropriate antenatal care (ANC). However, ANC attendance recommendations vary. OBJECTIVE: This study investigated ANC practices and predictors of ANC visits among pregnant women in western Jamaica during 2010. METHODS: A cross-sectional study was conducted among 356 pregnant women. ANC visits were categorized as not meeting recommendations (<4 ANC visits), meeting WHO and the Jamaican Ministry of Health recommendations of a minimum of 4 ANC visits (4-6 ANC visits) or meeting previously standard recommendation of ≥7 visits. Differences in demographic factors, health status, ANC services received and ANC knowledge by ANC attendance were assessed and a multinomial forward-selection stepwise logistic regression model was used to identify predictors of ANC attendance. RESULTS: Most women had an adequate number of ANC visits with 53.4% attending ≥ 7 ANC visits and 27.2% attending 4-6 visits. Despite this, 19.4% of the women had inadequate ANC care and a large portion did not receive key ANC services such as folic acid supplementation (48%), information on breastfeeding (32%) and nutrition (13%). Employment status, number of live births, distance from clinic, history of diabetes or hypertension, possession of ANC card at delivery, receiving iron supplementation and HIV counseling and testing and antenatal care knowledge were predictors of ANC visits. CONCLUSION: Although most women met the WHO or Jamaican ANC recommendations, many women still did not receive key ANC services. Further investigation of ANC practices and a standardized ANC curriculum may improve provision of adequate ANC services.