Current Issue : April - June Volume : 2014 Issue Number : 2 Articles : 5 Articles
Street children worldwide do not have the information, skills, health services, and support they need to go through sexual\r\ndevelopment during adolescence.This study is undertaken to systematically investigate the fit between street childrenââ?¬â?¢s sexual and\r\nreproductive health needs and the existing services. A cross-sectional study was conducted among 422 street children and four\r\nservice providers. About 72.5% of the respondents were sexually active during data collection and 84.3% of males and 85.7% of\r\nfemales tended to have multiple sexual partners. More than two-thirds (67.3%) of the participants had used at least one type of\r\nsubstance. History of substance use (OR = 2.5; 95% CI = 1.42ââ?¬â??4.56) and being on the street for the first one to three years (OR =\r\n5.9; 95% CI = 1.41ââ?¬â??7.22) increased the likelihood of having sexual activity. More than half (64.9%) of the street children did not\r\nattend any kind of sexual or reproductive health education programs. Lack of information on available services (26.5%) was the\r\nbiggest barrier for utilization of local sexual and reproductive health services. From the individual interview with coordinator, the\r\nfinancial and networking problems were hindering the service delivery for street children. In conclusion, street children who are\r\nspecial high risk group have not been targeted and hence continue to remain vulnerable and lacking in sexual and reproductive\r\nhealth services and sexual health services are poorly advertised and delivered to them....
Background: Sexual coercion is prevalent in sub-Saharan Africa and is a risk factor for unintended pregnancies,\r\nsexually transmitted infections and mental health problems. Alcohol consumption patterns have been suggested to\r\nbe an important factor behind the experience of sexual coercion among university students.\r\nObjective: To study the association between alcohol consumption and the experience of sexual coercion among\r\nUgandan university students.\r\nMethod: In 2010, 1954 Ugandan students participated in a cross sectional survey, conducted in Mbarara University\r\nof Science and Technology (72% response rate). A self-administered questionnaire assessed socio-demographic\r\nfactors, alcohol consumption, mental health, and sexual behavior. Multivariable logistic regression analysis was used\r\nto examine the various predictors of recent experience of sexual coercion. The data were stratified by sex.\r\nResults: Of the 1954 students, 27.6% reported having experienced sexual coercion and 16.4% stated that they had such\r\nan experience recently. Individuals who reported frequent consumption of alcohol, or having consumed alcohol often on\r\nthe occasion of sexual intercourse, were found to have a higher probability of recent experiences of sexual coercion (OR\r\nadjusted 2.29, 95% CI 1.40ââ?¬â??3.72, and OR adjusted 2.78, 95% CI 1.56ââ?¬â??4.97, respectively). These associations were significant\r\neven after adjusting for potential confounders. A synergistic effect was found between poor mental health and frequent\r\nconsumption of alcohol in conjunction with having sex with regard to its impact on recent experiences of sexual coercion.\r\nConclusion: We found an association between alcohol consumption and experiences of sexual coercion among Ugandan\r\nuniversity students. Therefore, universities may want to consider alcohol prevention under their policy framework, as it\r\ncould reduce the potential risk of sexual coercion....
Background. Despite the availability of rapid diagnostic tests and inexpensive treatment for pregnant women, maternal-child\r\nsyphilis transmission remains a leading cause of perinatal morbidity and mortality in developing countries. In Haiti, more than\r\n3000 babies are born with congenital syphilis annually. Methods and Findings. From 2007 to 2011, we used a sequential time\r\nseries,multi-intervention study design in fourteen clinics throughout Haiti to improve syphilis testing and treatment in pregnancy.\r\nThe two primary interventions were the introduction of a rapid point-of-care syphilis test and systems strengthening based on\r\nquality improvement (QI) methods. Syphilis testing increased from 91.5% prediagnostic test to 95.9% after (?? < 0.001) and further\r\nincreased to 96.8% (?? < 0.001) after the QI intervention. Despite high rates of testing across all time periods, syphilis treatment\r\nlagged behind and only increased from70.3% to 74.7% after the introduction of rapid tests (?? = 0.27), but it improved significantly\r\nfrom 70.2% to 84.3% (?? < 0.001) after the systems strengthening QI intervention. Conclusion. Both point-of-care diagnostic\r\ntesting and health systems-based quality improvement interventions can improve the delivery of specific evidence-based healthcare\r\ninterventions to prevent congenital syphilis at scale in Haiti. Improved treatment rates for syphilis were seen only after the use of\r\nsystems-based quality improvement approaches....
Background. Sexually transmitted infections (STIs) continue to be a significant public health problem especially among women of\r\nreproductive age in Africa. Methods. A total of 2236 women that had enrolled in theMDP301 vaginal microbicide trial were tested\r\nfor the presence of Chlamydia trachomatis (CT), Neisseria gonorrhea (NG), Treponema pallidum, and Trichomonas vaginalis (TV).\r\nResults. CT was identified as the most prevalent STI (11%) followed by TV (10%), NG, and Syphilis (3%). The highest prevalence\r\nof coinfection was reported between T. pallidum and TV (19.67%, ?? = 0.004), followed by CT and TV (13.52%, ?? = 0.001). Risk\r\nfactors that were significantly associated with STI acquisition were women of 23 years of age or younger (HR: 1.50, 95% CI 1.17, 1.93),\r\nbaseline STI with CT (HR: 1.77, 95% CI 1.32, 2.35), TV (HR: 1.58, 95% CI, 1.20, 2.10), and T. pallidum (HR: 5.13, 95% CI 3.65, 7.22),\r\nand a low education level (HR: 1.30, 95% CI 1.02, 1.66). Conclusion. Young women with lower education and a history of STIs are\r\nat high risk of multiple STIs. Prevention programs should consider target approach to STI prevention among young women. This\r\ntrial is registered with ISRCTN64716212....
We evaluated the integration of rapid syphilis tests (RSTs) and penicillin treatment kits into routine antenatal clinic (ANC)\r\nservices in two rural districts in Nyanza Province, Kenya. In February 2011, nurses from 25 clinics were trained in using RSTs\r\nand documenting test results and treatment. During March 2011ââ?¬â??February 2012, free RSTs and treatment kits were provided to\r\nclinics for use during ANC visits.We analyzed ANC registry data fromeight clinics during the 12-month periods before and during\r\nRST program implementation and compared syphilis testing, diagnosis, and treatment during the two periods. Syphilis testing at\r\nfirst ANC visit increased from 18% (279 of 1,586 attendees) before the intervention to 70% (1,123 of 1,614 attendees) during the\r\nintervention (?? < 0.001); 35 women (3%) tested positive during the intervention period compared with 1 (<1%) before (?? < 0.001).\r\nSyphilis treatment was not recorded according to training recommendations; seven clinics identified 28 RST-positive women and\r\nrecorded 34 treatment kits as used. Individual-level data from three high-volume clinics supported that the intervention did not\r\nnegatively affect HIV test uptake. Integrating RSTs into rural ANC services increased syphilis testing and detection. Record keeping\r\non treatment of syphilis in RST-positive women remains challenging....
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