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1.
AIDS Care ; : 1-9, 2020 Feb 03.
Artigo em Inglês | MEDLINE | ID: mdl-32008356

RESUMO

China's HIV/AIDS epidemic continues to grow in rural and less developed areas. This consecutive cross-sectional study examines demographic and behavioral factors associated with HIV/STI infection, Hepatitis C (HCV) and other sexually transmitted infections (STIs) among Vietnamese female sex workers (FSW), a vulnerable population who cross into Guangxi, China. This study is a secondary data analysis of 303 Vietnamese and 4,348 Chinese FSWs recruited over seven years from two Chinese counties that border Vietnam. Logistic regression models compared demographics, HIV/STI status, HIV/AIDS-related knowledge, attitudes, and risk behaviors between Vietnamese FSWs and Chinese FSWs. Compared with Chinese FSWs, Vietnamese FSWs were younger, had attained lower education levels, were highly mobile, more likely to report using drugs, and were more vulnerable to HIV/STIs. Younger age, less educational attainment, shorter time in their current working location, no voluntary HIV testing in the last year, greater drug use, and not using condoms for all commercial sex in the last month were associated with higher HIV/STIs. In conclusion, several factors were associated with HIV/STI risk in Vietnamese cross-border FSWs. There is a pressing need to improve support systems for Vietnamese cross-border FSW and health system cooperation across the Chinese/Vietnamese border.

2.
Emerg Microbes Infect ; 8(1): 367-376, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31851879

RESUMO

The dimorphic fungus Talaromyces marneffei (TM) is a common cause of HIV-associated opportunistic infections in Southeast Asia. Cotrimoxazole (CTX) inhibits folic acid synthesis which is important for the survival of many bacteria, protozoa, and fungi and has been used to prevent several opportunistic infections among HIV/AIDS patients. We question whether CTX is effective in preventing TM infection. To investigate this question, we conducted an 11-year (2005-2016) retrospective observational cohort study of all patients on the Chinese national antiretroviral therapy (ART) programme in Guangxi, a province with high HIV and TM burden in China. Survival analysis was conducted to investigate TM cumulative incidence, and Cox regression and propensity score matching (PSM) were used to evaluate the effect of CTX on TM incidence. Of the 3359 eligible individuals contributing 10,504.66 person-years of follow-up, 81.81% received CTX within 6 months after ART initiation, and 4.73% developed TM infection, contributing 15.14/1,000 person-year TM incidence rate. CTX patients had a significantly lower incidence of TM infection than non-CTX patients (4.11% vs. 7.53%; adjusted hazard ratio (aHR) = 0.50, 95% CI 0.35-0.73). CTX reduced TM incidence in all CD4+ cell subgroups (<50 cells/µL, 50-99 cells/µL, 100-199 cells/µL), with the highest reduction observed in patients with a baseline CD4+ cell count <50 cells/µL in both Cox regression and the PSM analyses. In conclusion, in addition to preventing other HIV-associated opportunistic infections, CTX prophylaxis has the potential to prevent TM infection in HIV/AIDS patients receiving ART.

3.
Eval Health Prof ; : 163278719839435, 2019 Mar 27.
Artigo em Inglês | MEDLINE | ID: mdl-30917690

RESUMO

The Clinical and Translational Science Awards (CTSA) program sponsors an array of innovative, collaborative research. This study uses complementary bibliometric approaches to assess the scope, influence, and interdisciplinary collaboration of publications supported by single CTSA hubs and those supported by multiple hubs. Authors identified articles acknowledging CTSA support and assessed the disciplinary scope of research areas represented in that publication portfolio, their citation influence, interdisciplinary overlap among research categories, and characteristics of publications supported by multihub collaborations. Since 2006, CTSA hubs supported 69,436 articles published in 4,927 journals and 189 research areas. The portfolio is well distributed across diverse research areas with above-average citation influence. Most supported publications involved clinical/health sciences, for example, neurology and pediatrics; life sciences, for example, neuroscience and immunology; or a combination of the two. Publications supported by multihub collaborations had distinct content emphasis, stronger citation influence, and greater interdisciplinary overlap. This study characterizes the CTSA consortium's contributions to clinical and translational science, identifies content areas of strength, and provides evidence for the success of multihub collaborations. These methods lay the foundation for future investigation of the best policies and priorities for fostering translational science and allow hubs to understand their progress benchmarked against the larger consortium.

4.
Medicine (Baltimore) ; 97(36): e12077, 2018 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-30200087

RESUMO

We evaluated the risk of human immunodeficiency virus (HIV) transmission among serodiscordant couples with low adherence to antiretroviral therapy (ART).Data of heterosexual couples/partners in 2010 were extracted from an Internet-based system. Participants were then followed over the course of a year with 6- and 12-month assessments. Prevalence and density of HIV seroconversion were calculated for spouses/partners who did not have a positive HIV test results at baseline. We calculated the transmission odds ratio (OR) value stratified by personal characteristics and behavioral correlates at 6- and 12-month follow-up, as well as seroconversion in spouses/partners over the year.A total of 5544 HIV/AIDS patients and their spouses/partners were recruited in this cohort. Incidence of HIV seroconversion among HIV-negative spouse/partner was 63.7/100 person years (PYs) (430/674.9) at the 6-month follow-up and 33.2/100PYs (567/1707.1PYs) at 12 months. The OR value of transmission from female to male was 2.1 times higher than from male to females at 6 months and 2.3 times higher at 12 months (P < .001). The 55- to 64-year age group was most likely to transmit HIV to their spouses/partners, 2.2 times greater than the participants who were 65 years and older. Married participants were 2.4 times higher at 6 months and 2.5 times higher at 12 months to transmit HIV than divorced/widowed participants. Lastly, transmission among illiterate participants was 6.7 times higher at 6 months and 2.3 times higher at 12 months than those with an educational attainment of community college or above.High HIV seroconversion was observed in this cohort. Spouses/partners who were male had the highest risk of HIV acquisition; those aged 55 to 64 years, having married status, and are HIV-positive with less education were more likely to transmit HIV.


Assuntos
Infecções por HIV/transmissão , Heterossexualidade , Parceiros Sexuais , Adolescente , Adulto , Fatores Etários , Idoso , Antirretrovirais/uso terapêutico , China/epidemiologia , Escolaridade , Feminino , Seguimentos , Infecções por HIV/tratamento farmacológico , Humanos , Incidência , Masculino , Adesão à Medicação , Pessoa de Meia-Idade , Fatores Sexuais , Cônjuges , Fatores de Tempo , Adulto Jovem
5.
BMC Public Health ; 18(1): 450, 2018 04 04.
Artigo em Inglês | MEDLINE | ID: mdl-29618343

RESUMO

BACKGROUND: Female sex workers (FSW) are a population that are at high risk for HIV infection, and their HIV/AIDS knowledge levels and sexual behaviors are of concern. This study describes changes in HIV prevalence and factors associated among female sex workers in Guigang City, Guangxi, one of the highest HIV prevalence areas in China. METHODS: Data were derived from an annual cross-sectional venue-based survey, 2008 to 2015, in the form of sentinel surveillance. The participants were recruited using cluster sampling. FSW aged 16 years and above who completed a questionnaire and HIV testing. Both descriptive and multi-level analyses were used to explore factors associated with changes in HIV prevalence. RESULTS: Seven thousand four hundred ninety-six FSW were recruited in this study. HIV prevalence among FSW in Guigang City fell into two periods, one with an increasing trend (2008-2011) and one with a decline (2012-2015). Differences between these time periods included age, relationship status, HIV knowledge, consistent condom use, lifetime illicit drug use, history of sexually transmitted infection in the past year, HIV testing, receipt of a condom distribution and education program or HIV counseling and testing, and peer education services. CONCLUSIONS: Since 2012, a reduction in HIV prevalence among FSW in Guigang City has been observed. The decline of HIV prevalence was associated with coinciding changes in demographic characteristics of FSW, improvement of HIV knowledge and safer sexual behaviors, and a program that promotes condom use, HIV counseling & testing, and peer education.


Assuntos
Infecções por HIV/epidemiologia , Vigilância de Evento Sentinela , Profissionais do Sexo/estatística & dados numéricos , Adolescente , Adulto , China/epidemiologia , Estudos Transversais , Feminino , Humanos , Pessoa de Meia-Idade , Prevalência , Fatores de Risco , Inquéritos e Questionários , Adulto Jovem
6.
Acad Med ; 93(8): 1162-1170, 2018 08.
Artigo em Inglês | MEDLINE | ID: mdl-29298181

RESUMO

PURPOSE: The authors evaluated publication and citation patterns for articles supported by Clinical and Translational Science Awards (CTSA) hub investment over the first decade of the CTSA program. The aim was to elucidate a pivotal step in the translational process by providing an account of how time, hub maturity, and hub attributes were related to productivity and influence in the academic literature. METHOD: In 2017, the authors collected bibliometric data from PubMed, Web of Science InCites, and National Institutes of Health (NIH) iCite for articles citing any CTSA hub grants published from hub inception through 2016. They compiled data on publication and citation rates and indices of relative citation impact aggregated by hub funding year cohort. They compared hub-level bibliometric activity by multi- versus single-institution structure and total monetary award sums, compiled from NIH RePORTER. RESULTS: From 2006-2016, CTSA hubs supported over 66,000 publications, with publication rates accelerating as hubs matured. These publications accumulated over 1.2 million citations, with some articles cited over 1,000 times. Indices of relative citation impact indicated CTSA-supported publications were cited more than twice as often as expected for articles of their publication years and disciplines. Multi-institutional hubs and those awarded higher grant sums exhibited significantly higher publication and citation activity. CONCLUSIONS: The CTSA program is yielding a robust and growing body of influential research findings with consistently high indices of relative citation impact. Preliminary evidence suggests multi-institutional collaborations and more monetary resources are associated with elevated bibliometric activity and, therefore, may be worth their investment.


Assuntos
Bibliometria , National Institutes of Health (U.S.)/tendências , Publicações/normas , Pesquisa Médica Translacional/normas , Distinções e Prêmios , Comportamento Cooperativo , Humanos , National Institutes of Health (U.S.)/organização & administração , Publicações/tendências , Projetos de Pesquisa/tendências , Pesquisa Médica Translacional/tendências , Estados Unidos
7.
AIDS Care ; 29(1): 125-131, 2017 01.
Artigo em Inglês | MEDLINE | ID: mdl-27367038

RESUMO

Men who have sex with men (MSM) are the group at highest risk for HIV in China. Researchers have used various recruitment methods to reach this population hidden from the hetero-normative culture. To inform future recruitment strategies, we compared estimates of socio-demographic characteristics, HIV risk behaviors, depression, and intimate partner violence (IPV) across three samples of MSM and money boys in Shanghai, China. Data were collected from three community-based samples of MSM and money boys (n = 1352) recruited via respondent-driven sampling (RDS) (n = 404), community popular opinion leaders (CPOL) (n = 385), and Internet and venue-based sampling (VBS) (n = 546). Different recruitment methods generated samples with statistically significant differences among a number of socio-demographic characteristics, sexual behaviors, drug use, depression scores, and exposure to IPV. Specifically, RDS participants had lower education (p = .002), income levels (p < .001), and were more likely to report condomless sex with a woman (p < .001). CPOL participants were younger (p < .001), more likely to report lifetime condomless anal sex (p = .009), more than 10 male partners in the past 30 days (p < .001), and were less likely to experience violence by a male intimate partner (p = .001). VBS participants had lowest depression score (p = .005) and were more likely to report lifetime drug use (p = .003). Our findings reinforce that each recruitment method may reach a sub-group of MSM with a specific risk profile, so multiple methods may be needed to obtain a representative sample of MSM. Interventions may use specific recruitment methods to target certain segments of the MSM population.


Assuntos
Infecções por HIV , Homossexualidade Masculina/estatística & dados numéricos , Seleção de Pacientes , Profissionais do Sexo/estatística & dados numéricos , Adulto , China/epidemiologia , Depressão/epidemiologia , Infecções por HIV/epidemiologia , Infecções por HIV/prevenção & controle , Humanos , Internet , Violência por Parceiro Íntimo , Masculino , Projetos de Pesquisa , Assunção de Riscos , Autorrelato , Comportamento Sexual/estatística & dados numéricos , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Inquéritos e Questionários , Adulto Jovem
9.
AIDS Educ Prev ; 28(3): 272-6, 2016 06.
Artigo em Inglês | MEDLINE | ID: mdl-27244194

RESUMO

This commentary considers the AIDS Education and Prevention special issue (volume 28, number 3) entitled "Behavioral HIV Prevention Interventions for Diverse Young Men Who Have Sex with Men (MSM)." The research presented in this special issue highlights the importance of addressing sub-populations of young MSM in order to better understand the unique realities and risk-factors affecting HIV epidemics and intervention needs. Here, we focus on several broad topics raised in this special issue and comment on their implications for HIV research and practice targeting young MSM in low- and middle-income countries. We consider issues relevant to reaching hidden populations, tailoring interventions, and integrating new communications and bio-medical technologies in research and practice in low-resource settings.


Assuntos
Infecções por HIV/epidemiologia , Infecções por HIV/prevenção & controle , Homossexualidade Masculina , Síndrome de Imunodeficiência Adquirida/epidemiologia , Adolescente , Adulto , Pesquisa Biomédica , Epidemias/prevenção & controle , Saúde Global , Educação em Saúde , Humanos , Masculino , Fatores de Risco , Adulto Jovem
10.
Drug Alcohol Depend ; 160: 151-6, 2016 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-26850511

RESUMO

BACKGROUND: Detection of heavy drinking among men who have sex with men (MSM) is crucial for both intervention and treatment. The CAGE questionnaire is a popular screening instrument for alcohol use problems. However, the validity of CAGE for Chinese MSM is unknown. METHOD: Data were from three waves of cross-sectional assessments among general MSM (n=523) and men who sell sex to other men ("money boys" or MBs, n=486) in Shanghai, China. Specifically, participants were recruited using respondent-driven, community popular opinion leader, and venue-based sampling methods. The validity of the CAGE was examined for different cutoff scores and individual CAGE items using self-reported heavy drinking (≥14 drinks in the past week) as a criterion. RESULTS: In the full sample, 75 (7.4%) of participants were classified as heavy drinkers. 32 (6.1%) of general MSM and 43 (8.9%) of MBs were heavy drinkers. The area under curve statistics for overall sample was 0.7 (95% CI: 0.36-0.77). Overall, the sensitivities (ranging from 18.7 to 66.7%), specificities (ranging from 67.5 to 95.8%), and positive predictive values (ranging from 14.1 to 26.4%) for different cutoff scores were inadequate using past week heavy drinking as the criterion. The ability of CAGE to discriminate heavy drinkers from non-heavy drinkers was limited. CONCLUSIONS: Our findings showed the inadequate validity of CAGE as a screening instrument for current heavy drinking in Chinese MSM. Further research using a combination of validity criteria is needed to determine the applicability of CAGE for this population.


Assuntos
Alcoolismo/diagnóstico , Homossexualidade Masculina/estatística & dados numéricos , Inquéritos e Questionários/normas , Adulto , Alcoolismo/psicologia , China , Estudos Transversais , Homossexualidade Masculina/psicologia , Humanos , Masculino , Valor Preditivo dos Testes , Sensibilidade e Especificidade
11.
AIDS Behav ; 20(2): 449-60, 2016 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-26188618

RESUMO

The focus of this paper is on HIV sexual risk taking among a community-based sample of disadvantaged African American adults. The objective is to examine multiple factors associated with sexual HIV risk behaviors within a syndemic conceptual framework. Face-to-face, computer-assisted, structured interviews were conducted with 1535 individuals in Atlanta, Georgia. Bivariate analyses indicated a high level of relationships among the HIV sexual risks and other factors. Results from multivariate models indicated that gender, sexual orientation, relationship status, self-esteem, condom use self-efficacy, sex while the respondent was high, and sex while the partner was high were significant predictors of condomless sex. Additionally, a multivariate additive model of risk behaviors indicated that the number of health risks significantly increased the risk of condomless sex. This intersection of HIV sexual risk behaviors and their associations with various other behavioral, socio-demographic, and psychological functioning factors help explain HIV risk-taking among this sample of African American adults and highlights the need for research and practice that accounts for multiple health behaviors and problems.


Assuntos
Afro-Americanos/psicologia , Preservativos/estatística & dados numéricos , Infecções por HIV/prevenção & controle , Assunção de Riscos , Comportamento Sexual/psicologia , Sexo sem Proteção/etnologia , Adulto , Sobreviventes Adultos de Maus-Tratos Infantis , Afro-Americanos/estatística & dados numéricos , Estudos Transversais , Depressão , Feminino , Georgia/epidemiologia , Infecções por HIV/etnologia , Infecções por HIV/transmissão , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Entrevistas como Assunto , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Autoimagem , Comportamento Sexual/etnologia , Fatores Socioeconômicos , Transtornos Relacionados ao Uso de Substâncias , Sexo sem Proteção/estatística & dados numéricos , População Urbana , Populações Vulneráveis/etnologia , Populações Vulneráveis/estatística & dados numéricos
12.
Glob Public Health ; 11(9): 1135-47, 2016 10.
Artigo em Inglês | MEDLINE | ID: mdl-26400191

RESUMO

Guangzhou is China's third most populous city, and the region's burgeoning manufacturing economy has attracted many young African businessmen and entrepreneurs to the city. The aims of this study were to examine strategies that African migrants in Guangzhou have adopted in response to health-care barriers, and explore their perceptions of how to address their needs. Twenty-five semi-structured interviews and two focus groups were conducted among African migrants residing in Guangzhou, China. Facing multiple barriers to care, African migrants have adopted a number of suboptimal and unsustainable approaches to access health care. These included: using their Chinese friends or partners as interpreters, self-medicating, using personal connections to medical doctors, and travelling to home countries or countries that offer English-speaking doctors for health care. Health-care providers and health organisations in Guangzhou have not yet acquired sufficient cultural competence to address the needs of African migrants residing in the city. Introducing linguistically and culturally competent health-care services in communities concentrated with African migrants may better serve the population. With the growing international migration to China, it is essential to develop sustainable approaches to improving health-care access for international migrants, particularly those who are marginalised.


Assuntos
Barreiras de Comunicação , Confidencialidade/psicologia , Assistência à Saúde Culturalmente Competente/normas , Acesso aos Serviços de Saúde , Turismo Médico/psicologia , Programas Nacionais de Saúde/normas , Migrantes/psicologia , Adulto , África/etnologia , China/epidemiologia , Assistência à Saúde Culturalmente Competente/economia , Assistência à Saúde Culturalmente Competente/tendências , Feminino , Grupos Focais , Acesso aos Serviços de Saúde/economia , Humanos , Entrevistas como Assunto , Linguagem , Masculino , Turismo Médico/economia , Turismo Médico/tendências , Programas Nacionais de Saúde/economia , Pesquisa Qualitativa , Migrantes/estatística & dados numéricos
13.
J Sex Res ; 53(7): 805-15, 2016 09.
Artigo em Inglês | MEDLINE | ID: mdl-26580813

RESUMO

Gender inequalities in sexual behavior are explored from the perspective of the theory of gender and power. This study focused on the effect of sex partner type (steady versus casual), drug use, and condom use self-efficacy regarding consistent condom use (CCU) among a community-based sample of adults. The sample included 1,357 African American men and women (M age 37.0, SD 13.1 years; 44% women, 66% men) from 61 disadvantaged census block groups in Atlanta, GA as part of a study of individual and neighborhood characteristics and HIV risk-taking. Having a steady partner decreased the odds of CCU, while higher condom use self-efficacy increased the odds of CCU. Among non-drug users, having a drug-using partner was associated with decreased odds of condom use for women only. Women with drug-using partners, especially a steady partner, were least likely to report CCU. Therefore, interventions intended to empower CCU among women need to expand beyond acknowledging the reduced control that women who use drugs demonstrate to also consider those who have drug-using sexual partners.


Assuntos
Afro-Americanos/etnologia , Sexo Seguro/etnologia , Autoeficácia , Parceiros Sexuais/psicologia , Populações Vulneráveis/psicologia , Adulto , Preservativos/estatística & dados numéricos , Feminino , Humanos , Masculino , Fatores Sexuais , Adulto Jovem
14.
J Psychoactive Drugs ; 47(1): 51-9, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-25715072

RESUMO

The objectives of this study were to describe drug use among Asian/Pacific Islander (API) men who have sex with men (MSM) and to examine how nativity (and acculturation as a secondary correlate) predicted such use. A total of 445 self-identified API MSM from seven metropolitan cities participated in a national HIV serological testing and psychosocial and behavioral assessment study. Results indicate clubbing was significantly associated with higher levels of substance use. Additionally, participants who were U.S.-born were more likely to have reported marijuana use and those with higher levels of acculturation reported less marijuana use. Our bivariate findings suggest that foreign-born status and acculturation experience may provide a protective effect against marijuana use among API MSM. These associations largely did not hold in our multivariate models. Future research should more fully examine the role of acculturation and nativity in substance use behaviors.


Assuntos
Americanos Asiáticos/psicologia , Comportamento Aditivo/etnologia , Infecções por HIV , Homossexualidade Masculina , Grupo com Ancestrais Oceânicos/psicologia , Transtornos Relacionados ao Uso de Substâncias , Aculturação , Adulto , Pesquisa Participativa Baseada na Comunidade , Infecções por HIV/diagnóstico , Infecções por HIV/epidemiologia , Infecções por HIV/psicologia , Homossexualidade Masculina/psicologia , Homossexualidade Masculina/estatística & dados numéricos , Humanos , Masculino , Programas de Rastreamento/métodos , Assunção de Riscos , Transtornos Relacionados ao Uso de Substâncias/etnologia , Transtornos Relacionados ao Uso de Substâncias/psicologia , Estados Unidos/epidemiologia
15.
Infect Genet Evol ; 31: 135-41, 2015 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-25653132

RESUMO

To examine and compare the epidemiological and molecular characteristics of HIV infection between money boys (MBs) and general men who have sex with men (MSM) in Shanghai, China. Using a venue-based sampling strategy, a total of 535 MSM including 226 MBs and 309 general MSM were recruited to participate in a cross-sectional survey including a face-to-face questionnaire interview and HIV testing. Genotyping of HIV-1 pol gene was performed for HIV-positive participants. Compared with general MSM, MBs reported more sexual partners, more alcohol and drug use and more sex after alcohol or drug use. HIV prevalence was 10.7% overall, 14.6% for MBs and 7.8% for general MSM (p=0.011). Two independent multiple logistic regression analyses indicated that HIV infection was positively associated with non-Han ethnicity (Odds Ratio [OR]=4.79, 95% Confidence Interval [CI]: 1.08-21.28) and sex after drug use in the past 6months (OR=3.59, 95% CI: 1.50-8.61) among MBs, and with sex after drug use in the past 6months (OR=3.38, 95% CI: 1.10-10.34) among general MSM as well. HIV-1 pol gene was successfully amplified and sequenced for 52 (91.2%) of HIV-positive participants. Of them, 53.8% were genotyped as CRF01_AE, 36.5% as CRF07_BC and 9.6% as subtype B. Two CRF01_AE subtype-infected participants (3.8%), a 50years old MB and a 24years old general MSM, harbored viruses with a M46L mutation conferring resistance to protease inhibitors (PI). MSM particularly MBs in Shanghai, China were at high risk of HIV infection, underscoring an urgent need for joint intervention efforts for drug use and sexual behaviors. HIV drug resistance surveillance is also warranted although the relatively low prevalence of HIV drug resistance implies the effectiveness of current antiretroviral treatment regimen.


Assuntos
Infecções por HIV/epidemiologia , Infecções por HIV/virologia , HIV-1/genética , Homossexualidade Masculina , Comportamento Sexual , Adolescente , Adulto , Idoso , China/epidemiologia , Estudos Transversais , Genótipo , Infecções por HIV/diagnóstico , HIV-1/classificação , Humanos , Masculino , Pessoa de Meia-Idade , Mutação , Razão de Chances , Filogenia , Prevalência , Vigilância em Saúde Pública , RNA Viral , Fatores de Risco , Adulto Jovem
16.
Am J Public Health ; 105(7): 1415-23, 2015 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-25521872

RESUMO

OBJECTIVES: We compared 2 strategies for disseminating an evidence-based skin cancer prevention program. METHODS: We evaluated the effects of 2 strategies (basic vs enhanced) for dissemination of the Pool Cool skin cancer prevention program in outdoor swimming pools on (1) program implementation, maintenance, and sustainability and (2) improvements in organizational and environmental supports for sun protection. The trial used a cluster-randomized design with pools as the unit of intervention and outcome. The enhanced group received extra incentives, reinforcement, feedback, and skill-building guidance. Surveys were collected in successive years (2003-2006) from managers of 435 pools in 33 metropolitan areas across the United States participating in the Pool Cool Diffusion Trial. RESULTS: Both treatment groups improved their implementation of the program, but pools in the enhanced condition had significantly greater overall maintenance of the program over 3 summers of participation. Furthermore, pools in the enhanced condition established and maintained significantly greater sun-safety policies and supportive environments over time. CONCLUSIONS: This study found that more intensive, theory-driven dissemination strategies can significantly enhance program implementation and maintenance of health-promoting environmental and policy changes. Future research is warranted through longitudinal follow-up to examine sustainability.


Assuntos
Promoção da Saúde/métodos , Neoplasias Cutâneas/prevenção & controle , Piscinas , Adulto , Feminino , Educação em Saúde/métodos , Política de Saúde , Humanos , Masculino , Avaliação de Programas e Projetos de Saúde , Piscinas/estatística & dados numéricos , Estados Unidos/epidemiologia , Adulto Jovem
17.
J Immigr Minor Health ; 17(5): 1509-17, 2015 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-25294415

RESUMO

Guangzhou, one of China's largest cities and a main trading port in South China, has attracted many African businessmen and traders migrating to the city for financial gains. Previous research has explored the cultural and economic roles of this newly emerging population; however, little is known about their health care experiences while in China. Semi-structured interviews and focus groups were used to assess health care experiences and perceived barriers to health care access among African migrants in Guangzhou, China. Overall, African migrants experienced various barriers to accessing health care and were dissatisfied with local health services. The principal barriers to care reported included affordability, legal issues, language barriers, and cultural differences. Facing multiple barriers, African migrants have limited access to care in Guangzhou. Local health settings are not accustomed to the African migrant population, suggesting that providing linguistically and culturally appropriate services may improve access to care for the migrants.


Assuntos
Grupo com Ancestrais do Continente Africano/psicologia , Barreiras de Comunicação , Acesso aos Serviços de Saúde/organização & administração , Satisfação do Paciente/etnologia , Percepção , Adulto , China , Confidencialidade , Cultura , Feminino , Financiamento Pessoal , Grupos Focais , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Masculino , Pesquisa Qualitativa , Racismo , Fatores Socioeconômicos
18.
Subst Use Misuse ; 50(1): 123-36, 2015 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-25321154

RESUMO

BACKGROUND: This study explores patterns of drug use and related correlates among a sample of men who have sex with men (MSM) and men who sell sex to other men (aka "money boys") in China. OBJECTIVES: Data were collected from MSM and money boys (MBs) in Shanghai, China using a Community Popular Opinion Leader (CPOL) research design with a self-administered cross-sectional survey to: (1) describe drug use and drug use correlates and (2) examine relationships between drug use and sexual behaviors in general MSM and MBs. METHODS: The sample consisted of 402 MSM (203 MBs) who live in Shanghai, China. Descriptive statistics and regression analyses were used to explore associations between drug use and sexual behaviors and make comparisons between MBs and general MSM. RESULTS: MBs reported using more drugs in the last week, 3 months and ever; sex after using drugs, and unprotected sex after using drugs more frequently than general MSM. Additionally, many MBs reported receiving free drugs from their clients and those who did receive free drugs were very likely to report having unprotected sex. CONCLUSIONS: It is crucial to increase research and include Chinese MSM and their drug use in the Chinese policy conversation. These data suggest that drug use and sexual behaviors after drug use among Chinese MSM differ widely based upon selling sex and separate intervention strategies may be appropriate.


Assuntos
Homossexualidade Masculina/psicologia , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Adulto , Atitude Frente a Saúde , China/epidemiologia , Estudos Transversais , Depressão/epidemiologia , Depressão/psicologia , Homossexualidade Masculina/estatística & dados numéricos , Humanos , Masculino , Profissionais do Sexo/psicologia , Profissionais do Sexo/estatística & dados numéricos , Transtornos Relacionados ao Uso de Substâncias/psicologia , Sexo sem Proteção/psicologia , Sexo sem Proteção/estatística & dados numéricos , Adulto Jovem
19.
Open J Prev Med ; 4(4): 216-221, 2014 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-24999445

RESUMO

Given that alcohol use is highly prevalent at US colleges, we explored factors related to problem drinking behaviors (PDB; binge drinking, driving after drinking, sexual intercourse after drinking) among 4098 Black and White students from two- and four-year colleges who completed an online survey. We found an interaction between race and sex such that, among Whites, females had less PDB than males (B = 0.09, CI: 0.05; 0.40, p = 0.01). An interaction between race and school type also existed, such that White students from four-year schools had greater PDB (B = 0.11, CI: 0.20; 0.54, p < 0.001). An interaction between race and stress suggested that Black students were more negatively affected by stress in terms of PBD (B = 0.12, CI: 0.01; 0.07, p = 0.01).

20.
Sex Health ; 11(3): 285-7, 2014 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-24919661

RESUMO

The primary objective was to examine prevalence and correlates of social support and depressive symptoms among male sex workers (known as 'money boys' (MBs)) and general men who have sex with men (MSM) in Shanghai. The Social Provision Scale (SPS), which consists of 24 items, scored out of 4 for social provision, was used to evaluate the functions of social relationships. The score for each item ranges from 1 to 4, with a higher score indicating more social provision. The overall mean SPS score was 68.1 (s.d.=6.53) for MBs and 69.3 (s.d.=6.99) for general MSM. Depression was measured with a 12-item version of the Center for Epidemiological Studies Depression Scale (CES-D), where a score of 9 has been recommended as the cutoff score to indicate possible depressive symptoms. The prevalence of depressive symptoms was 57.9%, with MBs having a higher level of depressive symptoms than general MSM (70.0% v. 46.1%) (odds ratio=1.86, 95% confidence interval=1.07-3.24). Social support was a protective factor for depressive symptoms (odds ratio=0.92, 95% confidence interval=0.89-0.96). MSM in China, particularly MBs, are vulnerable to low social support and high depressive symptoms, highlighting the need for tailored psychological programs targeting this population.

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