Menarche and reproductive health in Spanish Roma women from a reproductive justice perspective: a qualitative study.

OBJECTIVES: This study aimed to explore the perceptions of Roma women about their experience of menarche and reproductive health considering the principles of reproductive justice. DESIGN: Qualitative study based on semi-structured interviews with Roma women ages 18 through 67 in different neighborhoods in the southeast of Spain. Using a thematic analysis, we analyzed experiences related to menarche and menstruation and their significance for reproductive health, the preparation for the phase of menarche and intergenerational support. RESULTS: The Roma women interviewed shared their approach to the experiences of menarche and menstruation as children in their family environments with a focus on access to information provided by other women in the family and community for reproductive health management. In their discourses we observed that the onset of menstruation supposes a rupture in the public and private spaces of girls and women. CONCLUSIONS: The results of this study suggest that women and girls do not gain access to information that contributes to their reproductive wellbeing through their experience of menarche. Access to resources and skills to manage biological changes in adolescents could contribute to reducing the impact of cultural myths, false ideas and taboos that prevent advocacy and empowerment on issues of reproductive justice.

This study shows that the public spaces surrounding Roma women do not provide the tools and resources to promote and maintain their wellbeing and reproductive health after the onset of this important time. Sexual and reproductive health is not addressed during the time of childhood nor adolescence. Roma women lack a framework with an established discourse on reproductive justice, along with the necessary institutional resources. Preparation for and follow-up of the onset of menstruation among Roma women could be a key for their health. These results coincide with qualitative studies carried out in women from different cultural origins, in which menarche and menstruation are experienced as a transcendental fact. In other contexts, similar to Roma women, this stage in women's health lacks resources and information and an adequate approach from the perspective of reproductive health, which conditions the menstrual, sexual and reproductive health of women across their lifespan. Roma women experience menarche as a significant change in the life of a woman. They describe having lived the process as an abandonment of childhood and the beginning of an adult life, one that is implicitly linked to maternity and couple relationships. The results show that they defend the continuity of childhood among the new generation. Roma women express that they experienced menarche as an event that was traumatic, embarrassing and confusing. Menarche and menstruation are attended to in private and among the family, and masculine figures do not participate. The mother is the only transmitter of information and support during the process.

'Who is telling the truth?' Migrants' experiences with COVID-19 related information in Norway: a qualitative study.

AIMS: The over-representation of migrants among those infected by COVID-19 in high-income countries has spurred questions about insufficient distribution of health information to society's subgroups. Our study aimed to shed light on migrants' experiences with information relating to COVID-19 in Norway. METHODS: We conducted 55 semi-structured interviews with migrants from five different countries living in Norway: Somalia (10), Syria (15), Sri Lanka (10), Chile (10), and Poland (10). The interviews were performed by bilingual researchers with a migrant background, audio-recorded, transcribed and thematically analysed. RESULTS: We identified the four key themes of multiple and contradictory information sources, language barriers, conspiracy theories/speculations, strategies for information provision and ways ahead. Participants accessed and combined several often transnational sources of information. Information was perceived as confusing and contradictory and there was a wish for more translated information. CONCLUSIONS: It is important to recognise the specific factors affecting migrants' ability to receive, trust and use health-related information during pandemics and other health crises.

The evolvement of trust in response to the COVID-19 pandemic among migrants in Norway.

BACKGROUND: The COVID-19 pandemic has had profound consequences for the world's population, particularly for vulnerable groups like migrants who face barriers to healthcare access. Trust in authorities is crucial to any crisis management strategy implemented by a government. However, trust in authorities is linked to trust in other areas of life and it evolves during a crisis. This study explores migrants' trust in the Norwegian government's response to the COVID-19 pandemic. METHODS: We conducted semi-structured interviews from April to May 2020 with migrants from Somalia (10), Syria (15), Sri Lanka (10), Chile (10) and Poland (10) who were living in Norway. Interviews were conducted via telephone and in participants' mother tongue. Data were analysed thematically using the systematic text condensation method. RESULTS: Trust was established at four levels: (i) in the personal sphere, (ii) in Norwegian society in general, (iii) in the Norwegian authorities' management of the pandemic, and (iv) in the transnational sphere. Trust was deeply rooted in relationships with individuals, groups and entities, across countries. High trust in authorities emerged in the accounts of participants who felt they were taken care of in the diverse relationships they established in Norway, particularly during the crisis. CONCLUSION: Pandemics create more vulnerability but also opportunities for trust-building. Trust-building can be fostered through relationships in the host country that provide the foundation for migrants to feel included. Healthcare providers are in a position from which they can nurture trust as they can build relationships with migrants over time.

Interventions to improve immigrant health. A scoping review.

Background: : Disparities in health between immigrants and their host populations have been described across countries and continents. Hence, interventions for improving health targeting general populations are not necessarily effective for immigrants. To conduct a systematic search of the literature evaluating health interventions for immigrants; to map the characteristics of identified studies including range of interventions, immigrant populations and their host countries, clinical areas targeted and reported evaluations, challenges and limitations of the interventions identified. Following the results, to develop recommendations for research in the field. A scoping review approach was chosen to provide an overview of the type, extent and quantity of research available. Studies were included if they empirically evaluated health interventions targeting immigrants and/or their descendants, included a control group, and were published in English (PubMed and Embase from 1990 to 2015). Most of the 83 studies included were conducted in the USA, encompassed few immigrant groups and used a randomized controlled trial (RCT) or cluster RCT design. Most interventions addressed chronic and non-communicable diseases and attendance at cancer screening services, used individual targeted approaches, targeted adult women and recruited participants from health centres. Outcome measures were often subjective, with the exception of interventions for cardiovascular risk and diabetes. Generally, authors claimed that interventions were beneficial, despite a number of reported limitations. Recommendations for enhancing interventions to improve immigrant health are provided to help researchers, funders and health care commissioners when deciding upon the scope, nature and design of future research in this area.

Legislation on violence against women: overview of key components.

This study aimed to determine if legislation on violence against women (VAW) worldwide contains key components recommended by the Pan American Health Organization (PAHO) and the United Nations (UN) to help strengthen VAW prevention and provide better integrated victim protection, support, and care. A systematic search for VAW legislation using international legal databases and other electronic sources plus data from previous research identified 124 countries/territories with some type of VAW legislation. Full legal texts were found for legislation from 104 countries/territories. Those available in English, Portuguese, and Spanish were downloaded and compiled and the selection criteria applied (use of any of the common terms related to VAW, including intimate partner violence (IPV), and reference to at least two of six sectors (education, health, judicial system, mass media, police, and social services) with regard to VAW interventions (protection, support, and care). A final sample from 80 countries/territories was selected and analyzed for the presence of key components recommended by PAHO and the UN (reference to the term "violence against women" in the title; definitions of different types of VAW; identification of women as beneficiaries; and promotion of (reference to) the participation of multiple sectors in VAW interventions). Few countries/territories specifically identified women as the beneficiaries of their VAW legislation, including those that labeled their legislation "domestic violence" law ( n = 51), of which only two explicitly mentioned women as complainants/survivors. Only 28 countries/territories defined the main forms of VAW (economic, physical, psychological, and sexual) in their VAW legislation. Most highlighted the role of the judicial system, followed by that of social services and the police. Only 28 mentioned the health sector. Despite considerable efforts worldwide to strengthen VAW legislation, most VAW laws do not incorporate the key recommended components. Significant limitations were found in the legislative content, its application, and the extent to which it provided women with integrated protection, support, and care. In developing new VAW legislation, policymakers should consider the vital role of health services.

Maternity care through the eyes of Southern European immigrant parents in Norway.

OBJECTIVE: To explore Southern European immigrant mothers and fathers' experiences of reproductive health services in Norway, and their perceptions of health providers' beliefs and attitudes regarding pregnancy and childbirth. METHOD: We employed a qualitative research methodology with two focus group discussions and 11 in-depth interviews with 4 fathers and 11 mothers from Italy, Spain, Portugal, and Greece, whose children were born in Norway. Thematic Analysis was conducted to identify and analyze patterns across the data. RESULTS: We identified three themes as key elements in parents' experiences: experiences with the coverage and organization of the Reproductive Health Services; relational experiences with health providers; and pregnancy and delivery as a culturally-shaped event. The immigrant parents experienced a clash between their expectations and the procedures and health facility environment encountered in Norway regarding check-ups, diagnosis tests, childbirth preparation courses, and health facilities. Informants perceived that the maternity care practices of the host country were underpinned by the health care providers' cultural understandings of labor and pregnancy. Particularly, they experienced a less interventionist approach towards pregnancy and childbirth. CONCLUSIONS: The experiences of immigrant parents provide relevant information to improve reproductive health services in a cross-cultural context. Inmigration brings new challenges that must be addressed from a perspective of cultural competence. These services should acknowledge diversity in cultural beliefs around childrearing and involve both fathers and mothers in decision-making.

COVID-19: information access, trust and adherence to health advice among migrants in Norway.

BACKGROUND: Migrants in Norway bear a higher burden of COVID-19 infections and hospitalization as compared to non-migrants. The aim of our study was to understand how migrants perceive their own health risk, how they access information regarding the preventive measures, the degree of trust in this information, in the Norwegian authorities and the news media, and migrants' adherence to authorities' recommendations regarding the pandemic. METHODS: An online survey was performed between May and July 2020 among 529 Polish, Arabic, Somali, Tamil, and Spanish-speaking migrants in Norway. For each outcome presented in the aims, unweighted and weighted descriptive analyses were performed for all migrants together and for each language group. RESULTS: Sixty-one percent of migrants perceived their health as excellent or very good, with the lowest value (42%) in the Tamil group and the highest among Somalians (85%). The majority of respondents (82%) felt they had received sufficient information. Press conferences from the government, health authorities' websites, and Norwegian news media were the preferred channels of information for all groups. Most migrants reported a high level of adherence to preventive measures (88%) and trust in Norwegian authorities (79%). However, there were variations among groups regarding the importance of sources of information and level of trust, which was lowest for the Polish group. CONCLUSION: Migrants in Norway reported receiving sufficient information about COVID-19 and high adherence to preventive measures. However, the levels of trust in the information sources, the services and the authorities varied among the groups. Understanding how migrants are dealing with this pandemic is crucial to improve the dissemination of information and trust in the health authorities for the different groups.

Are the voices of parents heard? A scoping review of satisfaction in parenting programs.

Parenting programs are an effective approach to promote positive parenting. In evidence-based practice, client's values and preferences contribute to promoting quality, and are a crucial component of service evaluation. The current scoping review summarizes quantitative research that examines parental satisfaction with parent training for families with child conduct problems. We aimed to know how much research had been undertaken; what measures have been used; and what were the findings related to parental satisfaction. A scoping review was conducted to retrieve peer-reviewed original articles. Out of 420 papers 5.5 % obtained data on parental satisfaction. Seven different measures were used, mainly Therapy Attitude Inventory and Client Satisfaction Questionnaire. Out of 23 papers, ten studies reported Cronbach's alpha coefficients on the assessment that was used to evaluate parental satisfaction. All of the 23 included studies found that parents are very satisfied with the parenting program they have received. The findings indicate that only a few studies included parents' values and preferences in quantitative evaluation studies on parental programs. In addition, there is a limited arsenal of assessment tools to measure what matters to parents. There is a need to develop measures with high psychometric quality, which will promote more quality in service evaluation.

The Position of the Child in the Life Experiences of Immigrant Survivors of Intimate Partner Violence: A Study of Service Providers' Perspectives in Spain.

Intimate partner violence (IPV) is a global public health concern that has serious effects on the well-being of women and their children. Being a mother and an immigrant are critical factors that prevent women from seeking to end an abusive relationship. Evidence suggests that immigrant women see their children's well-being and future as paramount while managing an abusive relationship. However, less is known about how women negotiate their children's needs and interests when deciding whether to stay with or leave an abusive partner. Drawing on interviews with IPV service providers in Spain, this study aims to explore providers' understandings of the position of the child in mothers' reflections regarding whether to end an abusive relationship and of the implications of such positioning for mothers' decision-making. The findings indicate that children hold two main positions in this process. In one, children are positioned as a trigger for mothers to stay with abusers. This occurs when women are economically dependent on their partner, when they think that their children need a father figure, or when the abuser plays a role in women's migratory status within Spain. Second, children are positioned as a trigger for mothers to leave abusers when mothers see children as victims of violence or children in need of a mother figure. Framed by positioning theory, we discuss how we can understand the consequences of such positioning for immigrant women who are survivors of IPV and for service provision in this context. The implications of the findings for research, policy making, and professional decision-making are discussed.

Keeping silent or running away. The voices of Vietnamese women survivors of Intimate Partner Violence.

Background: Legislative initiatives have been implemented to fight against Intimate Partner Violence (IPV) and offer protection to its survivors in Vietnam. However, this type of violence is relatively common in the country, where broader structural inequalities, like poverty and the system of male dominance, increase women's vulnerability to IPV. Objective: This study aimed to explore the strategies that Vietnamese IPV survivors take to cope with the abuse from their partners and maximize their safety and wellbeing. Methods: Qualitative in-depth interviews were conducted with eight women survivors of IPV who lived in one of the Peace House Shelter in Hanoi. Participants were recruited through the shelter. Data were collected using semi-structured interviews and analyzed using qualitative content framed by the theoretical concept of the patriarchal bargain. Results: The IPV survivors in our study took two main strategies to cope with IPV: keeping silent and/or leaving the abuser. Leaving was a challenging strategy because it required support from others, something that was difficult to find due to the social stigma associated with divorce and the normalization of violence in intimate relationships. This was specially the case for participants coming from rural areas who did not count on a social network in the city where the shelter is located. The women strategized within a complex set of structural constrains like poverty, cultures of honor, social stigma, and traditional gender roles. As active agents, they decided whether challenging the patriarchal system would optimize their life options. Motherhood also played a crucial role in women's decisions regarding IPV. Conclusion: A strategy of conformity like silence can be a tactic for women to cope with a system of male dominance while navigating complex structural inequalities. To better address IPV in Vietnam, interventions should be sensitive to the structural gender inequalities within family and societal contexts.

Lean on Me: A Scoping Review of the Essence of Workplace Support Among Child Welfare Workers.

Child welfare workers (CWWs) often work under conditions similar in nature to workers within safety critical organizations (SCOs). This is because most of their work surrounds child neglect, securing homes for foster children, haphazard, and intricate cases, among other things, and where making wrong decisions, inattention to details, and the likes could lead to adverse consequences especially for the kids within their care. Research has shown that employees who experience support at work often report less stress symptoms, burnout, and a host of other negative workplace experiences. Experience of support at work has also been found to boost employees' retention, job satisfaction, and productivity. Despite this development, research exploring the essence of workplace support among CWW is very scarce in the literature, and we know very little about the type of workplace support and their influence on a host of workplace outcomes, especially the negative ones like secondary traumatic stress, aggression, and violence toward CWWs. The purpose of the current scoping review was to uncover what is known about workplace support and their relationship with workplace outcomes among CWWs. The authors explored four databases and identified 55 primary studies investigating workplace support and workplace outcomes among CWWs in the review. Studies mostly framed support under three main support types of coworker/peer support, social/organizational/management support, and supervisor/leadership support. Findings showed that workplace support has a positive impact on workplace variables like job satisfaction, engagement, commitment, and reduces the risk of turnover, burnout, and other negative workplace variables. The review highlights possible directions for future research.

Maternity care through the eyes of Southern European immigrant parents in Norway / Experiencias de padres y madres inmigrantes del sur de Europa con los servicios noruegos de salud reproductiva

Objective: To explore Southern European immigrant mothers and fathers' experiences of reproductive health services in Norway, and their perceptions of health providers' beliefs and attitudes regarding pregnancy and childbirth. Method: We employed a qualitative research methodology with two focus group discussions and 11 in-depth interviews with 4 fathers and 11 mothers from Italy, Spain, Portugal, and Greece, whose children were born in Norway. Thematic Analysis was conducted to identify and analyze patterns across the data. Results: We identified three themes as key elements in parents' experiences: experiences with the coverage and organization of the Reproductive Health Services; relational experiences with health providers; and pregnancy and delivery as a culturally-shaped event. The immigrant parents experienced a clash between their expectations and the procedures and health facility environment encountered in Norway regarding check-ups, diagnosis tests, childbirth preparation courses, and health facilities. Informants perceived that the maternity care practices of the host country were underpinned by the health care providers' cultural understandings of labor and pregnancy. Particularly, they experienced a less interventionist approach towards pregnancy and childbirth. Conclusions: The experiences of immigrant parents provide relevant information to improve reproductive health services in a cross-cultural context. Inmigration brings new challenges that must be addressed from a perspective of cultural competence. These services should acknowledge diversity in cultural beliefs around childrearing and involve both fathers and mothers in decision-making. (AU)

Objetivo: Explorar cómo fueron las experiencias de padres y madres inmigrantes procedentes del sur de Europa al utilizar los servicios de salud reproductiva en Noruega, así como sus percepciones sobre las actitudes y las creencias del personal de salud con respecto al embarazo y el parto. Método: Estudio cualitativo, basado en dos grupos focales y 11 entrevistas en profundidad con 4 padres y 11 madres italianos, españoles, portugueses y griegos, quienes habían tenido algún/a hijo/a en Noruega. Los datos se analizaron usando análisis temático. Resultados: Emergieron tres temas: experiencias con la cobertura y la organización de los servicios de salud reproductiva; experiencias con profesionales de salud; y embarazo y parto como eventos culturales. Los padres y las madres inmigrantes experimentaron un choque entre sus expectativas y las prácticas de los servicios de salud reproductiva noruegos, especialmente en cuanto a consultas, procedimientos, pruebas diagnósticas, preparación para el parto e infraestructura sanitaria. Los informantes percibieron que las prácticas de los/las profesionales de los servicios de salud reproductiva están influenciadas por creencias culturales relacionadas con el embarazo y el parto en Noruega. En concreto, los informantes experimentaron un enfoque menos intervencionista al recibir los cuidados perinatales del personal de salud en Noruega. Conclusiones: Las experiencias de los padres y las madres inmigrantes ofrecen información relevante para contribuir a mejorar los servicios de salud reproductiva en un contexto intercultural. La inmigración supone nuevos retos que deben afrontarse desde una perspectiva de competencia cultural. Los servicios de salud reproductiva deben reconocer la diversidad cultural en el embarazo y el parto, e involucrar a ambos progenitores. (AU)

Revisiting the Healthy Migrant Paradox in Perinatal Health Outcomes Through a Scoping Review in a Recent Host Country.

Ample evidence shows that, in many developed countries, immigrants have similar or better perinatal health outcomes than natives despite facing socioeconomic disadvantages in the host country ("healthy migrant paradox" -HMP). This scoping review aims to: (1) summarize the literature on perinatal health among immigrants and natives in Spain and (2) examine whether there is evidence of the HMP in a context of recent migration. A total of 25 articles published between 1998 and 2014 were reviewed. Overall, we found evidence of the HMP in low birthweight and to a lesser extent in preterm, though the patterns vary by origin, but not in macrosomia and post-term. The results are consistent across settings, levels of adjustment, and birth year. Policies should be oriented towards identifying the modifiable risk factors leading to a higher risk of macrosomia and post-term among immigrants.

[Health inequalities in immigrant populations in Spain: a scoping review]. / Desigualdades sociales en salud en poblaciones inmigradas en España: revisión de la literatura.

BACKGROUND: Health differences between immigrants and natives should be analyzed from an equity perspective due to socioeconomic inequality between them. The aim of this study is to Know the influence of social determinants of health in the immigrant population in Spain and/or inequalities compared with the Spanish population. METHODS: SA scoping review of the literature published in the period 1998-2012 was performed. The literature search was conducted on Medline and MEDES-MEDicina databases. All studies that include the participation of immigrant population from areas such as Latin America, Africa, Asia and Eastern Europe and performed in Spain were selected. RESULTS: A 27 articles were included. Most of the studies were published in the year 2009 (n=11). Twelve used population health surveys at national (n=6) and autonomous (n = 6) level. A total of 23 studies focused on adult population over 15 years. The most frequently studied indicators were self-rated health (n=9) and mental health (n=7). CONCLUSION: The immigrant population is exposed to lower socioeconomic status than natives and, despite a lower prevalence of chronic diseases, it appears to experience more mental health problems and worse self-rated health, especially in women and with longer stay.

[Scoping review on cancer prevention in immigrants living in Spain]. / Revisión bibliográfica sobre la prevención del cáncer en personas inmigrantes residentes en España.

BACKGROUND: Secondary prevention of breast cancer, cervix and colon is performed by screening. Spain in the last decade has presented a major wave of migration; it is known that immigrants have more inequalities in access to health services compared to the native population. The objective is to review the published studies and identify gaps in research on cancer prevention among immigrants living in Spain. METHODS: We have conducted a scoping review. The sources of information were the databases Medline (Pubmed) and MEDES - medicine in Spanish (1998-2012). We used three thematic filters: concerning to Cancer, immigration and geographic. Inclusion criteria were studies of cancer prevention and health of immigrants from Latin America, Africa, Asia and Eastern Europe and developed in Spain. We developed an ad hoc data collection protocol. RESULTS: We included five studies of 237 reviewed. The included studies are written in English and published in journals with impact factor. Most studies have used country of origin as the immigration variable 80 % of the studies conducted cross-sectional surveys. Immigrant population had a lower participation of early detection of breast and cervical cancer. Women reported to be sex workers were more likely to be human papillomavirus positive for high risk types. CONCLUSION: There is little information on cancer prevention through screening programs in the immigrant population. It is important to evaluate and improve the screening circuits and registries to implement programs to better identify the most vulnerable population groups.

[Diet, physical activity and other cardiometabolic risk factors in the immigrant population in Spain: a review]. / Alimentación, actividad física y otros factores de riesgo cardiometabólico en la población inmigrante en España: revisión bibliográfica.

BACKGROUND: The "epidemiological transition" of the immigrant population in the world, and particularly in Spain, is insufficiently understood, due to the multi-causality of the morbi-mortality and the limitations of the information about the lifestyles of immigrants. Thus, the objective of this work was to know behavioural and biological risk factors of cardiometabolic disease in the immigrant population in Spain. METHODS: Scoping review of the literature published in the period 1998-2012. We selected articles in Spanish or English, with study participants from Latin-America, Africa, Asia and Eastern Europe or who comply with the immigrant definition from the International Organization for Migration. Bibliographic search was performed in Medline and MEDES. RESULTS: We identified 117 articles, and 16 were included in this review. Thirteen studies were published since 2009. In total, 15 articles corresponded to cross-sectional studies and one to a non-randomized trial; five were population-based, seven were conducted within a clinical setting, and four in mixed settings (population and clinic). In nine studies the sample was less than 500 participants, and 15 studies were conducted at the local or regional level. Thirteen articles focused on food habits and nutritional status, but showed substantial heterogeneity in objectives and results. Some studies found that the frequency of obesity was higher in the immigrant than in the Spanish native population, that the length of residence in Spain was not associated with obesity, and that the immigrants consumed less tobacco and alcohol but did less physical activity than the people born in Spain. CONCLUSION: The scientific production on the lifestyle and cardiometabolic risk factors among the immigrants in Spain is quite recent and scarce. Thus, it does not allow for characterizing the risk profile of this population.

[General characteristics of the original articles included in the scoping review on health and immigration in Spain]. / Características generales de los artículos originales incluidos en las revisiones bibliográficas sobre salud e inmigración en España.

BACKGROUND: The new socio-demographic reality that came about with the incorporation of the immigrant population in Spain requires an analysis of the needs and priorities generated by this situation in all areas, including research in health. The objective of this study is to determine the general characteristics of a group of articles included in a literature review on the subject, carried out within the framework of the CIBERSP Subprogram on Migration and Health. METHODS: Scoping Review of the literature published in the period 1998-2012. Articles in Spanish or English developed in Spain and that fulfil the definition of immigrant from the International Organization for Migration were selected. The literature search was performed in Medline and MEDES. The temporal distribution of the production and main characteristics of the articles are described trough absolute and relative frequencies. RESULTS: The initial search identified 2.625 articles (Medline 2434; 191 Medes-MEDicina) 311 were including finally. Most epidemiological studies are cross-sectional design with primary data. 69% compared with native population. The main theme has been associated with infectious diseases (n=217, 70%). The period of maximum production is between 2004 and 2011(n=256, 82%). The country of origin is the most common way of classifying immigrants (n=220, 71%). CONCLUSIONS: The epidemiology of infectious prevails as the main theme of the studies performed in Spain about the health of the immigrant population. Most of the studies include native population as a comparison group.

[HIV and other sexually transmitted infections among migrant population in Spain: a scoping review]. / Infección VIH/Sida y otras infecciones de transmisión sexual en la población inmigrante en España: revisión bibliográfica.

BACKGROUND: Migration flows have the ability to disperse infectious agents and alter local epidemiologies. The aim of the study is to describe the socio-epidemiological, clinical and microbiology / molecular epidemiology of HIV / AIDS infection in the immigrant population. METHODS: Review of the literature following the methodology Scoping review. A literature search in Medline and MEDES, original items made in Spain, published between 1998-2012, with people from Latin America, sub-Saharan Africa, North Africa, Asia and / or Eastern Europe was conducted. RESULTS: 41 articles were selected. The most studied population was from Latin America (48.8%). Higher HIV prevalence than in native was observed in men who have sex with men from Latin America (18.1%), transvestite and transsexual sex workers from Latin America (23.3%), pregnant women (0.9%) and men and women from sub-Saharan Africa (9.1% and 7.5%). Risk behaviors were different depending on the country of origin and sex. The diagnostic delay of HIV infections reached 43%, with higher prevalence in immigrants from sub-Saharan Africa, which showed delayed diagnosis in 41% and resistance to anti-retroviral treatment in 13%. Immigrant women had more losses to follow up, worse immunological response to antiretroviral treatment and shorter time treatment failure. CONCLUSION: Higher prevalence of HIV is presented by subjects from sub-Saharan Africa, men who have sex with men and transgender and transvestite sex workers from Latin America. Also pregnant women. Delayed diagnosis and resistance to treatment are more common in individuals from sub-Saharan Africa. Immigrant women presented poorer response to antiretroviral treatment.

Professionals' perceptions of support resources for battered immigrant women: chronicle of an anticipated failure.

The aim of this study was to explore the experience of service providers in Spain regarding their daily professional encounters with battered immigrant women and their perception of this group's help-seeking process and the eventual abandonment of the same. Twenty-nine in-depth interviews and four focus group discussions were conducted with a total of 43 professionals involved in providing support to battered immigrant women. We interviewed social workers, psychologists, intercultural mediators, judges, lawyers, and public health professionals from Spain. Through qualitative content analysis, four categories emerged: (a) frustration with the victim's decision to abandon the help-seeking process, (b) ambivalent positions regarding differences between immigrant and Spanish women, (c) difficulties in the migratory process that may hinder the help-seeking process, and (d) criticisms regarding the inefficiency of existing resources. The four categories were cross-cut by an overarching theme: helping immigrant women not to abandon the help-seeking process as a chronicle of anticipated failure. The main reasons that emerged for abandoning the help-seeking process involved structural factors such as economic dependence, loss of social support after leaving their country of origin, and limited knowledge about available resources. The professionals perceived their encounters with battered immigrant women to be frustrating and unproductive because they felt that they had few resources to back them up. They felt that despite the existence of public policies targeting intimate partner violence (IPV) and immigration in Spain, the resources dedicated to tackling gender-based violence were insufficient to meet battered immigrant women's needs. Professionals should be trained both in the problem of IPV and in providing support to the immigrant population.

[Imported parasitic diseases in the immigrant population in Spain]. / Parasitosis importadas en la población inmigrante en España.

BACKGROUND: Migration has contributed to the emergence of certain infectious diseases in host countries. In Spain the number of immigrants has increased exponentially in recent decades. The aim of this review is to identify and analyze the available information on imported parasitic diseases in immigrant population in our country. METHODS: A scope review of original articles published on imported parasitic diseases between 1998 and 2012. Study populations from Latin America, Africa, Asia, Eastern Europe and individuals who are under the definition of an immigrant from International Organization for Migration were included. The literature search was performed in the Medline and MEDES-MEDicina databases. RESULTS: A total of 51 descriptive studies were included in the analysis. Most immigrants attended at referral health facilities were originally from sub-Saharan Africa (between 16%-87%), followed by Latin America (13%-37%), while Asia was the region less represented (0.2%-8.8%). A considerable proportion (6.5-31%) of immigrants that attended to referral units of tropical medicine or inmigrant health, and that were originally from Latin America, particularly those from Bolivia, are affected by the Chagas disease, and several cases of mother-to-child transmission have been registered in our country. CONCLUSION: Imported parasitosis is a frequent diagnosis among migrant population. This review highlight the impact that migration has had on the emergence of certain imported parasitic diseases, being Chagas disease the most paradigmatic example.