Prevalence and Determinants of Underweight, Overweight, and Obesity: A Cross-Sectional Study of Sociodemographic, Dietary, and Lifestyle Factors Among Adolescent Girls in Jutiapa, Guatemala.

BACKGROUND: As the incidence of overweight continues to increase among children and adolescents in Guatemala, underweight remains a prominent health problem. However, the prevalence of overweight or underweight and associated risk factors has not been investigated among adolescent girls. OBJECTIVE: To determine the prevalence of underweight and overweight/obesity and associated sociodemographic, dietary, and lifestyle factors among adolescent girls in Jutiapa, Guatemala. METHODS: A cross-sectional study of a subsample of 392 girls aged 12 to 17 years from an agriculture-nutrition trial was conducted. Anthropometric data were obtained using standard methods. Sociodemographic, dietary, and lifestyle data were collected using a structured questionnaire. Multivariable logistic regression was conducted using underweight (body mass index [BMI] for age < 5th percentile) and overweight/obesity (BMI for age ≥ 85th percentile) as outcome variables. RESULTS: The prevalence of underweight and overweight/obesity was 9.9% and 15.6%, respectively. Age (15-17 years), high waist circumference, high blood pressure, father being a farmer, large family (> 5 persons), hours spent watching TV, and high red meat consumption were significantly associated with underweight. Whereas being in school, high waist circumference, high blood pressure, overweight/obese mother, unemployed father, watching TV for more than 2 hours, having soft drinks at home, and meeting fruit recommendations were significantly associated with overweight/obesity. CONCLUSIONS: Our findings highlight the importance of concurrently addressing underweight and overweight/obesity among adolescent girls in rural Guatemala. Studies in various parts of the country are needed to confirm the results of the present study and for appropriate strategies to be implemented to reduce both underweight and overweight.

Factors associated with the acceptability of male circumcision among men in Jamaica.

OBJECTIVES: To determine the prevalence of male circumcision (MC) among men in the western region of Jamaica, and to identify factors associated with acceptability of MC for self, infants (<1 year) and older sons (1-17 years). METHODS: A cross-sectional, interviewer-administered questionnaire survey of 549 men aged 19-54 years was conducted in the western region of Jamaica. The survey included questions about the acceptance of MC for self, infants, and sons before and after an information session about the benefits of MC in preventing HIV/STI transmission. Logistic regression models were used to identify factors that were associated with acceptability of MC. Adjusted odds ratios (AOR) and 95% confidence intervals (CI) were calculated from the models. RESULTS: Fourteen percent of the men reported that they were circumcised. In the multivariable model, which adjusted for age, education, religion and income, there were increased odds of accepting MC for infants/sons among uncircumcised men who accepted MC for self (AOR=8.1; 95% CI = 4.1-15.9), believed they would experience more pleasure during sex if circumcised (AOR=4.0; 95% CI = 2.0-8.2), and reported having no concerns regarding MC (AOR=3.0; 95% CI = 1.8-4.8). Similarly, uncircumcised men who reported no concerns about MC or who believed that they would experience more pleasure during sex if circumcised were more likely to accept MC for self. CONCLUSION: Providing men with information about MC increased acceptance of MC for self, infants (<17 years) and sons (1-17 years). Since targeted education on the benefits of male circumcision for prevention of HIV/STI can be effective in increasing acceptability of MC, health professionals should be trained, and willing to discuss MC with men in healthcare facilities and in the community.

Prevalence and correlates of depressive symptoms among high school students in Hanover, Jamaica.

The objective of this study was to determine the prevalence of depressive symptoms in Jamaican adolescents and examine its association with individual and family factors. We used an abbreviated form of the Beck's Depression Inventory II (BDI-II) to assess depressive symptoms among 748 students, attending public high schools in the parish of Hanover Jamaica. In the analysis, we classified adolescents with scores in the upper quartile of the depressive symptom score as having depressive symptoms. Multivariate logistic regression was used to determine the predictors of depressive symptoms. 14.2% of participants reported depressive symptoms. There was association between engagement in sexual activity [Odds Ratio (OR) = 1.61, 95% Confidence Interval (CI) = 1.02-2.51], parental monitoring of adolescent activity (OR=2.04, 95%CI=1.33 -3.12), maternal affection and support (OR= 4.07, 95%CI= 2.62-6.33), and paternal affection and support (OR= 1.58, 95%CI= 1.05-2.39) with self reported depressive symptoms at the bivariate level. In the final model, depressive symptoms was associated with perceived lack of maternal affection and support (OR= 4.06, 95%CI= 2.61-6.32) and showed marginal association with being sexually experienced (OR= 1.59, 95%CI= 1.00-2.52). As most homes are female-headed, establishing support systems for the mother to take care of their adolescent children may decrease the odds of depressive symptoms. Sexually experienced adolescents may require screening for depression. Further research is required to fully explore all factors that could predispose Jamaican adolescents to depression.

Sociocultural correlates of HIV/AIDS-related stigma in rural Jamaica.

UNLABELLED: BACKGROUND; AIDS-related stigma is one of the biggest obstacles in the fight to prevent HIV transmission. Since stigma deters people from seeking treatment or getting tested for HIV, determining the factors that underpin AIDS-related stigmatization may be key to finding new ways to improve care and support for people living with HIV/AIDS (PLWHA) and to reduce new infections. SETTING: The town of Lucea and surrounding communities in the parish of Hanover, Jamaica. METHOD: Cross-sectional questionnaire survey of 195 individuals from health centers and households in Hanover. RESULTS: Of the 195 respondents, 28 percent felt the names of HIV-positive people should be public information. We found three constructs (avoidant behavior, social contact stigma, and blame stigma) that underpin stigmatization of PLWHA. The factors that influence avoidance behavior were education and being married. The factors associated with social contact stigma were being married and having no acquaintance with PLWHA. The factor that influenced blame stigma was not owning a home. CONCLUSION: Public health campaigns to reduce stigmatization must address individuals on the basis of their socio-demographic characteristics. A critical appraisal of current anti-stigma measures is warranted, and appropriate anti-stigma interventions are needed. Interventions with community members should address the social context of stigma, particularly the arenas of community norms, through education, information, and legislative measures to promote interaction with, and positive attitudes toward, PLWHA.

Predictors of sexual involvement among adolescents in rural Jamaica.

Early sexual activity of adolescents is associated with increased risk of teenage pregnancy, sexually transmitted infections including HIV, and higher maternal/perinatal morbidity and mortality. HIV and adolescent pregnancy are among the most serious public health problems in Jamaica. The objective of this study was to identify the potential predictors of adolescent sexual activity in Jamaica. A cross-sectional survey was conducted among 788 students 13-19 years of age in Jamaica. A questionnaire containing items on socio-demographic characteristics such as age and gender, and scales on adolescent values about sexual activity, self-efficacy for abstinence, parental love, and depression were administered to adolescents at secondary schools in the parish of Hanover. Reliability analysis of the scales, descriptive statistics, and logistic regression to determine predictors of sexual activity were conducted. Approximately 62% of adolescents who responded reported previous sexual intercourse and 38% reported never having had sex. The mean age for sexual debut was 13.6 years. Logistic regression revealed delay values (values towards delaying sexual activity) as protective (OR=0.16, CI=0.09-0.26) against involvement in sexual activity. Risk factors for sexual activity included being older (OR=1.9, CI=1.50-2.50), being male (OR=2.26, CI=1.39-3.68) and having grown-up values (OR=1.49, CI=1.05-2.12). Contrary to expectations, having higher self-efficacy skills was predictive (OR=1.47, CI=1.05-2.05) of adolescent sexual involvement. Analyses by gender revealed that delay and grownup values predicted male sexual activity, while self-efficacy, paternal love and delay values predicted female behavior. These findings show the importance of age, gender, self-efficacy, delay and grown-up values in predicting sexual activity in adolescents and indicate the need for gender-specific interventions for Jamaican adolescents.