RESUMEN
To determine effectiveness of alternate venue testing (AVT), social network strategy (SNS) and provider referral (PR) for identifying previously undiagnosed HIV-infected 18-64-year-old African American men who have sex with men (AA MSM) by a health department. For AVT, staff used a mobile clinic to conduct HIV testing. For PR, staff solicited contact information from HIV-infected AA MSM, located contacts and offered HIV testing. For SNS, HIV-positive AA MSM recruited network associates for HIV testing. Two hundred and eighteen self-identified AA MSM were tested through AVT (25.2% HIV positivity) of whom 20 were newly identified HIV-positive. Fourteen HIV-positive men participated in SNS; 22 AA MSM contacts were recruited through SNS, eight (36.4%) were HIV positive and none were new positives. Two HIV-infected men participated in the PR strategy, yielding two AA MSM sex partners (one previously positive). The results suggest the need for health departments to consider using several complimentary strategies for identifying previously undiagnosed HIV infections in AA MSM in urban environments such as Baltimore.
Asunto(s)
Negro o Afroamericano/etnología , Negro o Afroamericano/psicología , Seropositividad para VIH/diagnóstico , Homosexualidad Masculina/psicología , Tamizaje Masivo/métodos , Serodiagnóstico del SIDA , Adolescente , Adulto , Negro o Afroamericano/estadística & datos numéricos , Baltimore/epidemiología , Servicios de Salud Comunitaria , Trazado de Contacto , Infecciones por VIH/diagnóstico , Infecciones por VIH/etnología , Seropositividad para VIH/etnología , Homosexualidad Masculina/etnología , Homosexualidad Masculina/estadística & datos numéricos , Humanos , Masculino , Persona de Mediana Edad , Unidades Móviles de Salud , Factores de Riesgo , Asunción de Riesgos , Parejas Sexuales , Apoyo Social , Factores Socioeconómicos , Adulto JovenRESUMEN
OBJECTIVES: Little is known about the post-STD diagnosis management practices of community based doctors. The purpose of this study was to describe the reported actions that doctors take after diagnosing gonorrhoea, chlamydia, or syphilis and to determine if these actions differ across the three STDs. METHODS: A random national sample of 7300 doctors (70% response rate) practising in five medical specialties responded to 13 questions related to STD management. Mean differences across STDs were examined using the General Linear Model function of SPSS. RESULTS: Most doctors reported instructing patients to abstain from sex during treatment, to use condoms, and to inform their sexual partners of their exposure after diagnosing gonorrhoea, chlamydia, or syphilis. For syphilis, however, doctors were less likely to treat the patients presumptively and to give them drugs for their partners; and more likely to collect partner information, to follow up with the patient to see if the partner was referred for treatment and to send patient information to the health department. CONCLUSIONS: Doctors' post-STD diagnosis actions were similar for gonorrhoea and chlamydia compared to syphilis. Study findings suggest low levels of STD case reporting and partner follow up by doctors in the sample. Interventions are needed to educate community based doctors about the importance of partner follow up and case reporting in the management of STDs.
Asunto(s)
Encuestas de Atención de la Salud , Pautas de la Práctica en Medicina , Enfermedades Bacterianas de Transmisión Sexual/diagnóstico , Adulto , Anciano , Anciano de 80 o más Años , Análisis de Varianza , Infecciones por Chlamydia/diagnóstico , Femenino , Gonorrea/diagnóstico , Humanos , Masculino , Persona de Mediana Edad , Derivación y Consulta , Especialización , Sífilis/diagnósticoRESUMEN
OBJECTIVE: This study examines the association between having a history of dating violence and the sexual health of adolescent females. METHODS: Black adolescent females (n = 522) completed a survey that assessed dating violence, defined as ever having a physically abusive boyfriend, and an interview that assessed sexual behaviors. RESULTS: Dating violence was reported by 18.4% of adolescents (n = 96). Adolescents with a history of dating violence were, in the past 6 months, 2.8 times more likely to have a sexually transmitted disease, 2.8 times more likely to have nonmonogamous male partners, and half as likely to use condoms consistently. Furthermore, adolescents with a history of dating violence were significantly more likely to fear the perceived consequences of negotiating condom use (odds ratio [OR] = 2.8); fear talking with their partner about pregnancy prevention (OR = 2.6); have a higher perceived risk of acquiring a sexually transmitted disease (OR = 2.1); perceive less control over their sexuality (OR = 2.4); have peer norms nonsupportive of using condoms (OR = 3.1); and have norms nonsupportive of having a healthy relationship (OR = 2.1). CONCLUSIONS: Adolescents who have experienced dating violence are more likely to exhibit a spectrum of unhealthy sexual behaviors, attitudes, beliefs, and norms.