Personal, Interpersonal, and Sociocultural Factors of Condom Use in Rural Indigenous Nahuas Adolescents in Mexico.

The goal of this research was to determine the personal, interpersonal, and sociocultural predictors of condom use among rural Indigenous adolescents. Predictor variables were selected from Bandura's Social Cognitive Theory and Leininger's Transcultural Theory. The sample consisted of 419 Nahuas adolescents randomly selected from the total number of neighborhood blocks in a rural community in Puebla, Mexico. The instruments had acceptable psychometric characteristics (Cronbach alpha and validity scores). Multiple linear regression models were used. Results: 56.8% of participants were female, and 50.40% were students. Mean age was M = 17.5 (SD = 0.97), and the majority (63%) identified as Catholic. Age at menarche/first ejaculation (ß = -1.2, p = 0.038), attitude toward condom use (ß = 0.13, p < 0.001), ethnic identity (ß = 0.21, p < 0.001), and ability to negotiate condom use (ß = 0.13, p = 0.003) predicted (R2 = 22.3) condom use. This study provided a basis for integration of the cultural values of Indigenous adolescents within interventions for sexual health promotion.

Use of Smartphones to Increase Safe Sexual Behavior in Youths at Risk for HIV.

In Mexico, young people continue to experience problems due to a lack of correct and consistent condom use during sexual intercourse. OBJECTIVE: to evaluate the effect of a randomized controlled clinical trial with the use of smartphones to increase safe sex intentions and safe sexual behavior. METHODS: experimental design with two treatment groups with 177 young people who requested the rapid HIV test in a non-governmental organization in the city of Monterrey, Mexico. The experimental group was given Respect M-Health with the use of mobile devices; the control group was given similar counseling without the use of mobile technology and 8 pencil and paper instruments were used. RESULTS: the effect of the experimental group was greater in safe sexual behavior reflected in the means at pre-test M=64.80 (SD=1.86), post-test M=85.33 (SD=1.54), and at 30 days M=87.40 (SD=1.52), and in the safe sex intentions factor at pre-test M=78.50 (SD=3.07), post-test M=94.70 (SD=2.46), and at 30 days M=95.74 (SD=2.29). CONCLUSIONS: Smartphone use was an effective tool as a support to increase safe sexual behavior in youth.

En México, los jóvenes siguen presentando problemas debido a la falta de uso correcto y consistente del preservativo durante las relaciones sexuales. OBJETIVO: evaluar el efecto de un ensayo clínico controlado y aleatorizado con el uso de teléfonos inteligentes para aumentar las intenciones de sexo seguro y la conducta sexual segura. Métodos: diseño experimental con dos grupos de tratamiento con 177 jóvenes que solicitaron la prueba rápida de VIH en una Organización no Gubernamental en la ciudad de Monterrey, México. Al grupo experimental se le brindó Respeto M-Salud para el uso de dispositivos móviles; al grupo control se le entregó una herramienta similar, pero sin el uso de tecnología móvil, y se utilizaron 8 instrumentos de lápiz y papel. RESULTADOS: el efecto del grupo experimental fue mayor en la conducta sexual segura reflejado en las medias del pre-test M=64.80 (SD=1.86), post-test M=85.33 (SD=1.54) y a los 30 días M=87.40 (SD=1.52); y en el factor de intenciones de sexo seguro, se reflejó de esta manera en el pre-test M=78.50 (SD=3.07), post-test M=94.70 (SD=2.46) y a los 30 días M=95.74 (SD=2.29). CONCLUSIONES: El uso de teléfonos inteligentes fue una herramienta eficaz como apoyo para aumentar la conducta sexual segura en los jóvenes.

Uso Del Condón en Adolescentes Nahuas, un Modelo Explicativo.

En México, la población indígena supera los siete millones de habitantes, en Puebla el grupo más representativo es el Náhuatl. Sin embargo, las condiciones de vida, salud, educación y transporte son precarias para esta población. En los adolescentes, las responsabilidades como el matrimonio, la familia y los compromisos ante la comunidad, favorecen conductas de riesgo sexual que dificultan su desarrollo económico, social y reproductivo. El objetivo fue proponer un modelo explicativo del uso del condón en adolescentes nahuas. Método. Bajo el marco de la teoría social cognitiva, el concepto de valores culturales de Leininger y el proceso de la sustracción teórica, se desarrolló este artículo. Se muestran las relaciones del modelo con las proposiciones y los factores que influyen en el uso del condón para este grupo específico. Finalmente, el modelo explica las variables de interés, los niveles de abstracción y las relaciones entre sí en el contexto náhuatl. El siguiente paso será implementar los indicadores empíricos para conocer el grado de influencia de los factores personales y ambientales hacia el uso del condón en adolescentes nahuas. Resultados que aportarán información para el desarrollo del conocimiento en enfermería y la reducción de riesgo sexual de esta población.

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.

Attachment and associated sexual health behaviors of heterosexual Mexican housewives.

Sexually transmitted infections including human immunodeficiency virus are international public health concerns. Heterosexual women who are in steady relationships have been described as a particularly vulnerable population at risk for sexually transmitted infections acquired from their male partners. In this pilot study, we describe associations identified via cross-sectional survey among demographic variables, attachment style, and condom use in Mexican heterosexual women (ages 20-44 years, n  =  50) who self-reported current steady partner relationships. Descriptive, bivariate, and correlation analyses were conducted. Secure attachment and condom use were positively correlated with education level. Limited sexual risk prevention knowledge and contraception use, low risk perception within male partner relationships and misconception about proper condom use were identified as sources of elevated risk for sexually transmitted infections via male partners. Implications of findings include sexual health intervention modification to include dialogue concerning the context of steady relationship and sexual risk among Mexican heterosexual women.

Nutritional care, time period since diagnosis, demographics and body mass index in HIV/AIDS patients.

BACKGROUND: Nutritional status and nutritional care have long been ignored among HIV/AIDS patients. Furthermore, in Mexico there is no information on potential factors favoring weight increase in such population. OBJECTIVE: To assess the association between the time period since diagnosis, demographics and BMI in different categories of patients with HIV/AIDS in Monterrey, Mexico. In addition, to provide information on overweight/obesity prevalence and nutritional care referral. MATERIAL AND METHODS: This was a cross-sectional study of HIV/AIDS positive patients receiving outpatient secondary care (n = 231). Nutritional care referral, time period since diagnosis and demographic data were obtained by interview. A standardized and registered dietitian collected anthropometrics measures. Binary multiple logistic regression was used to evaluate the association between increasing BMI categories and variables of interest. RESULTS: Mean patient age was 40.6 ± 11.2 years, 87% were male, 79.2% were economically active, 65% were single and 60% had less than a college education. The average time since diagnosis was 6.5 ± 5.4 years. Overweight and obesity prevalence were 35.8% and 12.5%, respectively. Only 18% of patients had ever been referred for nutritional care. The time period since diagnosis, the sum of skinfold measurements and the waist-to-hip ratio, were significantly predictive of the BMI category (normal/underweight vs. overweight/obese), when controlling for nutritional care referral and daily carbohydrate intake; age and marital status were not associated with BMI category. CONCLUSIONS: Identification of predisposing factors to overweight/obesity among HIV/AIDS patients constitutes a significant step for providing nutritional care, of the same importance as the load or CD4+ count, especially nowadays, with more common increased survival rates and consequently, longer lives with the disease.

Consumo de alcohol y funciones ejecutivas en adolescentes: una revisión sistemática / Alcohol Consumption and Executive Functions in Adolescents: A Systematic Review / Consumo de álcool e funções executivas em adolescentes: uma revisão sistemática

Objetivo: el consumo de alcohol es un problema de salud pública que puede implicar riesgos para la integridad del córtex prefrontal, especialmente lo relacionado al funcionamiento ejecutivo. Aunque se han estudiado los efectos negativos sobre la región prefrontal de adultos, la evidencia en la población adolescente es menor. El objetivo de este artículo es conocer el estado del arte de la relación entre el consumo de alcohol y las funciones ejecutivas de adolescentes. Materiales y métodos: se realizó una búsqueda en las bases de datos Academic OneFile, Academic Search Complete, Dialnet, DOYMA, Journal@Ovid, MedicLatina, Medline, Proquest, PsycArticles, sage y Springer para identificar artículos publicados entre enero de 2006 y noviembre de 2011. La muestra final fue de trece artículos. Resultados: los estudios mostraron divergencia de resultados en los componentes de las funciones ejecutivas; sin embargo, los componentes de inhibición de respuestas y toma de decisiones parecen ser alterados por diferentes patrones de consumo de alcohol en más del 70% de las investigaciones. Conclusiones: los hallazgos indican que la investigación de este fenómeno en población adolescente aún se encuentra en etapas de exploración; no obstante, existe evidencia de que el consumo de alcohol puede ser peligroso para el funcionamiento cognitivo adolescente.

Objective: Alcohol consumption is a public health problem that can involve risks to the integrity of the prefrontal cortex, especially with respect to executive functioning. Although the negative effects on the prefrontal region have been studied in adults, there is less evidence concerning the adolescent population. The objective of this articles it to understand the state of the art with respect to the relationship between alcohol consumption and executive functions in adolescents. Materials and methods: Academic OneFile, Academic-Search Complete, Dialnet, DOYMA, Journal@Ovid, MedicLatina, Medline, Proquest, PsycArticles, SAGE and Springer were subject to a database search for articles published between January 2006 and November 2011. The final sample was comprised of thirteen articles. Results: The studies showed inconsistent results for the components of executive functions; however, the components that deal with response inhibition and decision-making appear to be altered by different patterns of alcohol consumption in more than 70% of the studies. Conclusions: The findings indicate the research on this phenomenon in adolescents is still in the exploratory staged. Nevertheless, there is evidence that alcohol can be dangerous for adolescent cognitive functioning.

Objetivo: o consumo de álcool é um problema de saúde pública que pode implicar riscos para a integridade do córtex pré-frontal, especialmente o relacionado ao funcionamento executivo. Embora os efeitos negativos sobre a região pré-frontal de adultos tenham sido estudados, a evidência na população adolescente é menor. O objetivo deste artigo é conhecer o estado da arte da relação entre consumo de álcool e as funções executivas de adolescentes. Materiais e métodos: realizou-se uma busca nas bases de dados Academic OneFile, Academic Search Complete, Dialnet, DOYMA, Journal@Ovid, MedicLatina, Medline, Proquest, PsycArticles, sage e Springer para identificar artigos publicados entre janeiro de 2006 e novembro de 2011. A amostra final foi de treze artigos. Resultados: os estudos mostraram divergência de resultados nos componentes das funções executivas; contudo, os componentes de inibição de respostas e tomada de decisões parecem ser alterados por diferentes padrões de consumo de álcool em mais de 70% das pesquisas. Conclusões: as descobertas indicam que a pesquisa deste fenômeno em população adolescente ainda se encontra em etapas de exploração, mas existe evidência de que o consumo de álcool pode ser perigoso para o funcionamento cognitivo adolescente.

Factors Associated with Lifetime HIV Testing in Texas by Race/Ethnicity.

INTRODUCTION: In United States, roughly 1/5 of all HIV infected persons remain undiagnosed. Because HIV testing is critical to improve prevention efforts, more research is needed to understand the characteristics of individuals who get tested for HIV. METHODS: This secondary analysis of the 2010 Texas Behavioral Risk Factor Surveillance System used data from 9,744 respondents between 18-64 years of age to evaluate the relationship between demographic characteristics (gender, race/ethnicity, age, area of residence, education, marital status, employment status, and income), healthcare characteristics (insurance status, having a primary provider, and access to healthcare), and HIV risk behaviors with ever having received an HIV test. RESULTS: Significant associations between gender, age, area of residence, marital and employment status, and HIV risk behaviors and HIV testing in a Texas population by race/ethnicity were observed. CONCLUSIONS: These findings have important implications for future research into racial/ethnic disparities between lifetime HIV testing, and can help guide practitioners who work with populations at risk for HIV/AIDS in Texas.

Conducta sexual de riesgo para VIH/SIDA en jóvenes universitarios / Sexual risk behavior for HIV/AIDS in university students

Resumen

Introducción: los jóvenes son un grupo vulnerable para el VIH y otras enfermedades de transmisión sexual. Las conductas sexuales de riesgo más frecuentes para VIH/SIDA son: relaciones sexuales a temprana edad, múltiples parejas sexuales y uso de alcohol y droga durante las relaciones sexuales.

Objetivo: identificar la conducta sexual de los jóvenes entre 18 y 24 años de edad.

Metodología: se realizó un estudio transversal correlacional en 112 jóvenes (73.2 % hombres) se utilizó el instrumento Sexual Behavior aplicado por primera vez en población mexicana (Ingledew & Ferguson, 2007).

Resultados: la conducta sexual manifestada por los jóvenes fue el inicio sexual a temprana edad, múltiples parejas sexuales, relaciones sexuales sin protección bajo el efecto de drogas.

Conclusiones: los resultados del presente estudio proporcionan datos para diseñar intervenciones, en este grupo específico de la población, con eje central en la prevención de conductas sexuales.

Summary

Introduction: young adults are a vulnerable group for HIV and other sexually transmitted diseases. Frequent risky sexual behaviors for HIV/AIDS are sexual intercourse at an early age, multiple sex partners, and consumption of alcohol and drugs during intercourse.

Objective: to identify sexual behavior in individuals 18 to 24 years of age. Methodology: we carried out a cross sectional study in 112 individuals (73.2 % men) using the Sexual Behavior Instrument (Ingledew & Ferguson, 2007) applied for the first time in a Mexican population.

Results: the sexual behavior expressed by these young adults was sexual intercourse at an early age, multiple sex partners, and unprotected sex while under the influence of drugs.

Conclusions: our results provide data for designing interventions in this specific population, with a central axis of preventing risky sexual behavior.

[Benefits and barriers perceived by Mexican adolescents for consuming fruit and vegetables]. / Beneficios y barreras percibidos por adolescentes mexicanos para el consumo de frutas y verduras.

The objectives of this descriptive study were to establish the benefits and barriers perceived by adolescents for consuming fruit and vegetables, and to determine gender differences. A random sample of 829 adolescents attending public secondary schools in Matamoros, Tamaulipas was recruited (398 were males, and 431) with a mean age of 13.11 +/- 0.93 years. A scale of benefits and barriers for consuming fruit and vegetables was used. The most important perceived benefits for males were: "I'd take care of my health eating more fruit and vegetables" (4.24 +/- 0.99), "I like the taste of fruit" (4.21 +/- 1.06), and "eating fruit and vegetables would give me more vitamins and minerals (4.20 +/- 1.07). For females the perceived benefits were: "I like the taste of fruits" (4.48 +/- 0.81), and "I'd take care of my health eating more fruit and vegetables" (4.41 +/- 0.91). Adolescents of both genders, pointed out as barrier pesticides in fruit and vegetables (3.14 +/- 1.31 for males and 2.97+1.22 for females). Findings showed that perceived benefits and barriers have differences by gender. Females perceive higher benefits 24.25+9.15 (p = 0.001). Males perceived higher barriers 24.94 +/- 7.28 (p = 0.001). In conclusion, benefits and barriers are different by gender. Given the great cultural diversity in Mexico, these findings in students residing in this border city must be validated with similarly designed studies.

Beneficios y barreras percibidos por adolescentes mexicanos para el consumo de frutas y verduras / Benefits and barriers perceived by mexican adolescents for consuming fruit and vegetables

Los objetivos del presente estudio descriptivo fueron conocer los beneficios y barreras percibidos por adolescentes para el consumo de frutas y verduras y verificar si son diferentes de acuerdo al género. Fue encuestada una muestra aleatoria 829 adolescentes (398 hombres y 431 mujeres) de 16 escuelas secundarias públicas de Matamoros, ciudad fronteriza entre México y Estados Unidos. A todos los participantes con edad promedio de 13,11±0,93 años, se les aplicó un cuestionario que evalúo los beneficios y barreras para el consumo de frutas y verduras. De este cuestionario, se encontró que los beneficios más importantes para los hombres fueron: cuidaría mi salud comiendo más frutas y verduras (4,24±0,99), me gusta el sabor de las frutas (4,21±1,06) y comer más frutas y verduras me daría más vitaminas y minerales (4.20±1.07). Para las mujeres fueron: me gusta el sabor de las frutas (4,48±0,81) y cuidaría mi salud comiendo más frutas y verduras (4,41±0,94). Ambos géneros señalaron como barrera la contaminación con pesticidas, hombres (3,14±1,31) y mujeres (2,97±1,22). Las mujeres perciben mayores beneficios 50,25±9,15 (p=0,003) y los hombres perciben mayores barreras 24,94±7,28 (p=0,001), Se concluye que los beneficios y barreras percibidos son diferentes de acuerdo al género. Dada la amplia diversidad cultural que existe en México, los resultados obtenidos en estudiantes de esta ciudad fronteriza, deberán de ser validados con diseños similares de estudio.

The objectives of this descriptive study were to establish the benefits and barriers perceived by adolescents for consuming fruit and vegetables, and to determine gender differences. A random sample of 829 adolescents attending public secondary schools in Matamoros, Tamaulipas was recruited (398 were males, and 431) with a mean age of 13.11±0.93 years. A scale of benefits and barriers for consuming fruit and vegetables was used. The most important perceived benefits for males were: “I’d take care of my health eating more fruit and vegetables” (4.24±0 .99), “I like the taste of fruit” (4.21±1.06), and “eating fruit and vegetables would give me more vitamins and minerals (4.20±1.07). For females the perceived benefits were: “I like the taste of fruits” (4.48±0.81), and “I’d take care of my health eating more fruit and vegetables” (4.41±0.91). Adolescents of both genders, pointed out as barrier pesticides in fruit and vegetables (3.14±1.31 for males and 2.97±1.22 for females). Findings showed that perceived benefits and barriers have differences by gender. Females perceive higher benefits 24.25±9.15 (p= 0.001). Males perceived higher barriers 24.94±7.28 (p=0.001). In conclusions, benefits and barriers are different by gender. Given the great cultural diversity in Mexico, these findings in students residing in this border city must be validated with similarly designed studies.

La investigación en la enfermería mexicana: Análisis del contexto nacional e internacional / The research in mexican nursing: Analysis of the national and international context

La profesión de enfermería no ha sido reconocida plenamente como tal; los aspectos teóricos están en proceso de desarrollo y perfeccionamiento. La investigación es el puente que une la teoría y la práctica dentro del proceso de búsqueda del conocimiento y base para conformar el juicio y fundamento de las acciones de enfermería. Es importante que las enfermeras puedan evidenciar y describir su contribución profesional a la salud de los individuos, grupos, comunidades y población en general desarrollando investigaciones centradas en el cuidado de enfermería, con el propósito de integrar un cuerpo de conocimientos propios. La situación de la investigación de enfermería en México ha sido estudiada a través del análisis de las publicaciones hechas en revistas de enfermería donde se ha reportado que hasta ahora ha sido individualista. Para los investigadores producir resultados para la práctica, es de especial para las disciplinas, en áreas que requieren colaboración directa en actividades tanto de evaluación como de síntesis. La disciplina de enfermería no podrá llegar a ser una profesión como tal, si no fortalece la práctica con la investigación; aun cuando en las últimas décadas ha mostrado un avance notorio y su contribución en el proceso de profesionalización.

Nursing has not been recognized like a total profession, the theory is in process of being developed and being perfected. The research is the bridge that connects the theory and the practice within the search process of knowledge, this base contributes to have an own judgment and foundation of nursing. Is important that the nurses can demonstrate and describe their professional contribution to the health of the individuals, groups, communities and population in general, developing research centered mainly in the care of nursing, that contribute to the establishment of a body of own knowledge. The research of nursing in Mexico has been studied through the analysis of publications done in investigation magazines where it has been reported that until now to be individualistic. For the investigators to produce excellent practice, have an special interest in the research, since this one is an area that as much requires direct collaboration in activities of evaluation as of synthesis of investigations, since the discipline will not be able to get to be a profession like so, if the practice is not fortified. For that reason the nursing research in the last decades has shown a well-known advance which has contributed satisfactorily in the professional process.