RESUMO
In this study, the RESPECT-2, an HIV risk reduction intervention developed by the Centers for Disease Control and Prevention, was translated into Spanish and culturally adapted to the Puerto Rican population. A new intervention emerged called the RReduC-PR (Risk Reduction Counseling-Puerto Rico). This instrument allows the assessment of sexual behaviors and development of risk reduction plans. Women from three distinct risk behavior groups participated: women recruited from a community-based organization (CBO), which includes street sex workers, crack users, and sexual partners of intravenous drug users; participants from a sexually transmitted infection (STI) clinic; and participants from a family planning clinic (FPC) in Puerto Rico. As part of the RReduC-PR, participants were provided counseling before and after a rapid HIV test to explore their attitudes about sexual behaviors. At baseline, all participants from the FPC reported having monogamous relationships (100%), as compared with the participants from the STI clinic (70%) and those from the CBO (20%). STI risk-reduction behaviors varied by site. Most of the participants acknowledged risk behaviors that may have exposed them to HIV. They did not use condoms, or used them inconsistently, even though acquiring HIV was a great concern for them. Most regarded a positive HIV diagnosis as a negative event. Their attitudes toward an HIV diagnosis varied by site. The groups varied in the perception of risk behaviors, knowledge, and concerns. These findings provide useful information for future risk-reduction interventions with these women.
Assuntos
Atitude Frente a Saúde , Infecções por HIV/psicologia , Infecções Sexualmente Transmissíveis/psicologia , Adulto , Feminino , Infecções por HIV/epidemiologia , Infecções por HIV/prevenção & controle , Humanos , Estudos Longitudinais , Pessoa de Meia-Idade , Porto Rico/epidemiologia , Medição de Risco , Comportamento de Redução do Risco , Comportamento Sexual , Infecções Sexualmente Transmissíveis/epidemiologia , Infecções Sexualmente Transmissíveis/prevenção & controleRESUMO
OBJECTIVES: Posttraumatic stress disorder (PTSD) is an anxiety disorder associated with serious traumatic events. People with PTSD tend to perceive medical interventions as intrusive. Factors such as dose complexity, number of pills, food requirements, patient-health provider relationship, and individual factors influence adherence. This study intends to examine if traumatic experiences affect the way women living with HIV adhere to their medical treatment. METHODS: Adherence to HIV medications was examined with a self-report scale that was administered to a group of women that attend the Maternal Infant Studies Center. Trauma symptoms were measured by using the Trauma Symptom Inventory. RESULTS: A total of 15 women were studied. Of these, 86.6% were found adherent and 13.4% nonadherent. Both the adherent and nonadherent activated the anger/irritability (7.7% vs 50%), sexual concerns (7.7% vs 50%), and tension-reduction clinical (TRB) scales (15.4% vs 100%). The adherent women also activated the anxious arousal, depression, defensive avoidance, and dissociation scales. CONCLUSIONS: This study reveals differences in trauma-related symptoms among adherent and nonadherent patients. Increases in the TRB index of 100% among the nonadherent may reflect a need for psychological treatment. By lowering this index, they might improve their desire to live and adhere better to their treatment. Because of the limited sample size, we cannot generalize these findings. We will continue to collect data on a desired sample size of 85 women.