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Peer Reviewed

Title: Preventing transfusion-transmitted HIV infection in Latin America and the Caribbean: issues associated with blood donor interviews and sex between men.
Author: Alonso M; Mazin R; Md RM; Cruz JR
Source: Journal of Acquired Immune Deficiency Syndromes. 2009 May 1;51 Suppl 1:S67-72.
Abstract: BACKGROUND: Blood-borne transmission is the most efficient route for acquiring HIV infection, particularly through transfusion. Availability of noninfectious blood units for hemotherapy is a necessary condition for efficient functioning of health services. They have the obligation to ensure that the blood supply is safe, which includes interviewing potential donors to ascertain whether they might be at risk of being HIV infected. The interview procedures demand that blood services staff inquire potential blood donors about sexual practices associated to HIV transmission. Assumptions and misconceptions may unnecessary exclude adequate donors. METHODS: Review of published and unpublished country reports in Latin America regarding blood safety and deferral criteria related to same sexual behavior among males. RESULTS: An analysis of criteria for deferral of potential blood donors shows inconsistencies that may impact the necessary safe blood supply. CONCLUSIONS: The blood donor deferral criteria should be revised according to relevant epidemiological evidence and social legitimacy. Personnel in blood banks and hemotherapy services should be educated to conduct appropriate interviews for accepting or deferring potential donors. Potential donors and the public should be knowledgeable for them to understand the reasons why some individuals may be deferred. Health authorities should work to reduce the stigma associated with HIV, prioritize building strong and meaningful partnerships with civil society, and engage diverse sectors in the national AIDS response.
Language: English
Keywords:
LATIN AMERICA | CARIBBEAN | RESEARCH REPORT | MEN HAVING SEX WITH MEN | HIV INFECTIONS | HIV TRANSMISSION | BLOOD DONORS | SAFETY | STIGMA | HOMOSEXUALS | BLOOD TRANSFUSION | Americas | Developing Countries | Sex Behavior | Behavior | Viral Diseases | Diseases | Blood Supply | Equipment and Supplies | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Public Health | Social Problems | Sociocultural Factors | Treatment
Document Number: 341318

Peer Reviewed

Title: A cluster randomized controlled trial of an adolescent HIV prevention program among Bahamian youth: effect at 12 months post-intervention.
Author: Chen X; Lunn S; Deveaux L; Li X; Brathwaite N; Cottrell L; Stanton B
Source: AIDS and Behavior. 2009 Jun;13(3):499-508.
Abstract: Behavioral interventions based on the Protection Motivation Theory (PMT) have been demonstrated to reduce HIV risk behavior among mid- and older adolescents in different settings across the globe but have not been evaluated among Caribbean nations and have received limited evaluation among pre-adolescents. To determine (1) the effectiveness among pre-adolescents in The Bahamas of a PMT-based HIV prevention program "Focus on Youth in the Caribbean" (FOYC) and (2) the role of the targeted PMT constructs in intervention effect. 1,360 sixth grade youth (10-11 years of age) from 15 urban schools in New Providence, The Bahamas were randomized by school to receive either FOYC or a control condition. Data collected at baseline, 6 and 12 months post intervention were analyzed. A five-step scheme was used to assess sexual behavior progression, ranging from "1" = "a virgin without intention to have sex" to "5" = "having sex without a condom". Group-based trajectory analysis was utilized in assessing the program effect. Two sexual behavior progression patterns were detected: slow progressors and quick progressors. Receiving FOYC reduced the likelihood for adolescents to become quick progressors (adjusted OR = 0.77, 95% CI: 0.64-1.00). The observed effectiveness was especially impacted by a subset of the targeted PMT constructs. FOYC effectively delays sexual risk among Bahamian pre-adolescents. The group-based trajectory analysis provides an analytical approach for assessing interventions among adolescents with low rates and diverse progression patterns of sexual activity.
Language: English
Keywords:
CARIBBEAN | RESEARCH REPORT | PRE-POST TESTS | ADOLESCENTS | YOUTH | HIV PREVENTION | AIDS PREVENTION | RISK BEHAVIOR | SEX BEHAVIOR | INTERVENTIONS | PROGRAM EFFECTIVENESS | Developing Countries | Americas | Program Evaluation | Programs | Organization and Administration | Age Factors | Population Characteristics | Demographic Factors | Population | HIV Infections | Viral Diseases | Diseases | AIDS | Behavior
Document Number: 342104

Title: Gender and migration: West Indians in comparative perspective.
Author: Foner N
Source: International Migration. 2009 Jun;47(1):3-29.
Abstract: This article explores gender issues in West Indian migration by taking a comparative -cross-national -perspective. The focus is on the three major West Indian migration movements of the mid- and late-twentieth and early twenty-first centuries -to the United States, Britain, and Canada. A comparative approach has a number of benefits for the study of West Indian migration. It not only points to similarities and contrasts in gender-related patterns among West Indian migrants in the United States, Britain, and Canada but also forces us to try to account for them. It brings out, in an especially dramatic way, the role of the context of reception and the receiving country's immigration policies in shaping male-female differences in West Indian migration flows as well as immigrant adaptation. The comparative analysis of the three migrations in this article explores the reasons for and patterns of West Indian migration as they relate to gender, including the practice of leaving children behind in the Caribbean, as well as aspects of the labour market incorporation of West Indian men and women when they have arrived and settled in the migrant destination. More specifically, the comparisons raise some intriguing questions. Why, for example, did West Indian women comprise a greater proportion of the migrations to the United States and Canada than to Britain? Why were West Indian women more likely to work in caregiving jobs in private homes in the United States and Canada than in Britain? And have the dynamics of transnational motherhood differed in the North American and British contexts?
Language: English
Keywords:
CARIBBEAN | CANADA | UNITED KINGDOM | UNITED STATES OF AMERICA | HISTORICAL REVIEW | COMPARATIVE STUDIES | DOMESTIC WORKERS | MIGRATION | GENDER ISSUES | MIGRATION POLICY | FAMILY RELATIONSHIPS | Developing Countries | Americas | Developed Countries | North America, Northern | Europe, Western | Europe | North America | Studies | Research Methodology | Labor Force | Human Resources | Economic Factors | Population Dynamics | Demographic Factors | Population | Sociocultural Factors | Population Policy | Social Policy | Policy | Political Factors | Family Characteristics | Family and Household
Document Number: 341298

Peer Reviewed

Title: Effects through 24 months of an HIV/AIDS prevention intervention program based on protection motivation theory among preadolescents in the Bahamas.
Author: Gong J; Stanton B; Lunn S; Deveaux L; Li X; Marshall S; Brathwaite NV; Cottrell L; Harris C; Chen X
Source: Pediatrics. 2009 May;123(5):e917-28.
Abstract: OBJECTIVES: The purpose of this work was to report the intervention effects of Focus on Youth in the Caribbean (youth HIV intervention), an HIV prevention intervention based on protection motivation theory, through 24 months of follow-up on sexual risk and protection knowledge, perceptions, intentions, and behavior among Bahamian sixth-grade youth. METHODS: We randomly assigned 1360 sixth-grade youth (and their parents) attending 15 government elementary schools in the Bahamas to 1 of 3 conditions: (1) youth HIV intervention plus a parental monitoring/communication/HIV education intervention; (2) youth HIV intervention plus a parental goal-setting intervention; or (3) an environmental protection intervention plus the parental goal-setting intervention. Baseline and 4 follow-up surveys at 6-month intervals were conducted. Intervention effects were assessed using the mixed model for continuous outcome variables and the generalized linear mixed model for dichotomous outcome variables. RESULTS: Through 24 months of follow-up, youth HIV intervention, in combination with the parent interventions, significantly increased youths' HIV/AIDS knowledge, perceptions of their ability to use condoms, perception of the effectiveness of condoms and abstinence, and condom use intention and significantly lowered perceived costs to remaining abstinent. There was a trend for higher condom use among youth in the Focus on Youth in the Caribbean groups at each follow-up interval. CONCLUSIONS: Focus on Youth in the Caribbean, in combination with 1 of 2 parent interventions administered to preadolescents and their parents in the Bahamas, resulted in and sustained protective changes on HIV/AIDS knowledge, sexual perceptions, and condom use intention. Although rates of sexual experience remained low, the consistent trend at all of the follow-up periods for higher condom use among youth who received youth intervention reached marginal significance at 24 months. Additional follow-up is necessary to determine whether the apparent protective effect is statistically significant as more youth initiate sex and whether it endures over time.
Language: English
Keywords:
CARIBBEAN | RESEARCH REPORT | ADOLESCENTS | PARENTAL INVOLVEMENT | SEX BEHAVIOR | KNOWLEDGE | CONDOM USE | HIV PREVENTION | AIDS PREVENTION | INTERVENTIONS | YOUTH PROGRAMS | Developing Countries | Americas | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Child Rearing | Behavior | Sociocultural Factors | Risk Reduction Behavior | HIV Infections | Viral Diseases | Diseases | AIDS | Programs | Organization and Administration
Document Number: 341344

Peer Reviewed

Title: Understanding the HIV epidemic in the Dominican Republic: a prevention success story in the Caribbean?
Author: Halperin DT; de Moya EA; Perez-Then E; Pappas G; Garcia Calleja JM
Source: Journal of Acquired Immune Deficiency Syndromes. 2009 May 1;51 Suppl 1:S52-9.
Abstract: OBJECTIVE: To analyze the general dynamics and trends of the HIV epidemic in the Dominican Republic (DR). METHODS: Thorough review of available HIV seroprevalence and sexual behavioral data from the DR. RESULTS: Multiple sources of data suggest that the DR's HIV epidemic has generally declined. Between the mid-1990s and about 2002, HIV-1 prevalence fell among pregnant women in the capital, Santo Domingo, particularly among young women. Declines in prevalence were also observed over the same period among sexually transmitted infection clinic patients, blood bank donors, US entry visa applicants, and female sex workers. National household surveys found 1.0% (confidence interval: 0.9% to 1.1%) adult prevalence in 2002 and 0.8% (0.6% to 0.9%) in 2007. Among largely Haitian immigrant residents of the impoverished former "sugarcane plantations," prevalence was much higher but declined from 5.0% to 3.2% between 2002 and 2007. The DR's heterogeneous epidemic includes an important men-having-sex-with-men (MSM) and bisexual component. The proportion of reported AIDS cases among men remained constant from 1989 to 2006, accounting for about two thirds of both total cumulative and year 2006 cases. Some survey and qualitative data also suggest a considerable occurrence of MSM-related risk behaviors. HIV prevalence remains relatively high in MSM, with no evidence of significant decrease. CONCLUSIONS: As in several other developing countries that have succeeded in slowing HIV transmission, HIV reductions in the DR seem mainly due to changes in sexual behavior, particularly increased condom use, especially for sex work, and partner reduction in men. Similarly favorable HIV declines and reported behavior change have occurred in some other Caribbean countries, including neighboring Haiti. However, of concern is that anal sex, both male-male and heterosexual, remains a taboo yet apparently common practice largely ignored by existing prevention campaigns. And although the DR epidemic has generally stabilized, there is a danger of complacency, and some recent data suggest that HIV prevalence is no longer declining (and may even be increasing) in some populations.
Language: English
Keywords:
DOMINICAN REPUBLIC | CARIBBEAN | RESEARCH REPORT | MEN HAVING SEX WITH MEN | HETEROSEXUALS | HIV PREVENTION | HIV TRANSMISSION | ANAL SEX | Developing Countries | Americas | Sex Behavior | Behavior | HIV Infections | Viral Diseases | Diseases
Document Number: 341320

8.
Title: The contributing role of tourism in the HIV/AIDS epidemic in the Caribbean.
Author: Orisatoki RO; Oguntibeju OO; Truter EJ
Source: Nigerian Journal of Medicine. 2009 Apr-Jun;18(2):143-8.
Abstract: The first confirmed case of HIV/AIDS in the Caribbean was reported in 1982, however a recent report by UNAIDS shows that the epidemic has risen to over 250,000 persons living with the virus with the highest prevalence rates shown to be in the Dominican Republic and Haiti. Various factors ranging from commercial sex trading to unsafe injection employed for drug abuse have been identified to play a contributing role in this increase. Also, the role and impact of tourism on the spread of HIV infection has been reported. Due to concerns shown by countries and territories who are dependent on tourism and that they rank amongst the most highly affected by HIV/AIDS in the region, this paper endeavours to examine the impact of HIV/AIDS and the contributing role of tourism to HIV/AIDS epidemic in the Caribbean.
Language: English
Keywords:
CARIBBEAN | CRITIQUE | SEX WORKERS | HIV INFECTIONS | AIDS | EPIDEMICS | TRAVEL AND TOURISM | PREVALENCE | HIV TRANSMISSION | SEX BEHAVIOR | ECONOMIC FACTORS | Developing Countries | Americas | Behavior | Viral Diseases | Diseases | Measurement | Research Methodology
Document Number: 342685

Title: AIDS stigma in health services in the Eastern Caribbean.
Author: Rutledge SE; Abell N; Padmore J; McCann TJ
Source: Sociology of Health and Illness. 2009 Jan;31(1):17-34.
Abstract: Stigma obstructs HIV/AIDS prevention and care worldwide, including in the Caribbean, where the prevalence of AIDS is second only to sub-Saharan Africa. To contextualise the experience of AIDS stigma in health services in Grenada and Trinidad and Tobago, we conducted eight focus groups with 51 people living with HIV/AIDS (PLHA), families, and service providers. Quasi-deductive content analysis revealed consonance with Western and Northern conceptualisations of AIDS stigma wherein stigma is enacted upon marginalized populations and reinforced through psycho-sociological processes comparing 'in' and 'out' groups. Socially constructed to be physically contagious and socially deviant, PLHA are scorned by some service providers, especially when they are perceived to be gay or bisexual. PLHA and providers identified passive neglect and active refusal by hospital and clinic staff to provide care to PLHA. Institutional practices for safeguarding patient confidentiality are perceived as marginally enforced. Interventions are needed to reduce provider stigma so the public will access HIV testing and PLHA will seek treatment.
Language: English
Keywords:
GRENADA | TRINIDAD AND TOBAGO | CARIBBEAN | RESEARCH REPORT | PERSONS LIVING WITH HIV/AIDS | HIV INFECTIONS | AIDS | STIGMA | DELIVERY OF HEALTH CARE | HEALTH SERVICES | Americas | Developing Countries | Viral Diseases | Diseases | Social Problems | Sociocultural Factors | Health
Document Number: 330865

10.

Title: Life expectancy and welfare in Latin America and the Caribbean.
Author: Soares RR
Source: Health Economics. 2009 Apr;18 Suppl 1:S37-54.
Abstract: This paper analyses the recent evolution of life expectancy in Latin American and Caribbean countries, and evaluates how much it has contributed to the overall improvements in welfare. We argue that increases in life expectancy between 1960 and 2000, which were largely independent of income, represented gains in welfare comparable to the ones derived from income growth. For countries in the region, estimates of welfare improvements accounting for health increase the numbers obtained from income alone by 40% on average. The available evidence suggests that improvements in public health infrastructure - such as provision of treated water and sewerage services - and large-scale immunization programs may have been the key factors behind the mortality reductions observed in the period.
Language: English
Keywords:
CARIBBEAN | LATIN AMERICA | CRITIQUE | LIFE EXPECTANCY | SOCIAL WELFARE | PUBLIC HEALTH | IMMUNIZATION | WATER QUALITY | SANITATION | INCOME | INEQUALITIES | MORTALITY DECLINE | Developing Countries | Americas | Length of Life | Mortality | Population Dynamics | Demographic Factors | Population | Economic Factors | Health | Primary Health Care | Health Services | Delivery of Health Care | Water | Natural Resources | Environment | Socioeconomic Factors
Document Number: 341985

11.

Peer Reviewed

Title: HIV/AIDS in Latin America and the Caribbean [editorial]
Source: Lancet. 2008 Jul 26;372(9635):263.
Abstract: The amalgam of cultures and populations, socioeconomic disparities, languages, and sexual proprieties means the HIV epidemic is not homogeneous and it is hard to make generalisations from one country to the next. In this region the subject of HIV/AIDS is often swept under the carpet. Some of the common factors that characterise this region and prohibit an effective response include: generalised poverty, homophobia, gender inequality, lack of access to health-care and educational services, immigration and emigration, the absence of leadership in some countries, the lack of research into patterns of transmission, pressure from the Catholic Church that hinders prevention efforts, and laws that are inadequate in the context of the epidemic. One of the major themes at the 2008 Mexico City conference will be tackling stigma and discrimination, which is particularly pervasive in the region but also happens elsewhere. For too long the needs of vulnerable populations have been neglected. In Mexico the adoption of a rights-based perspective to address the challenge of HIV/AIDS globally needs to reaffirm that universal access to prevention, treatment, and care is a human right and that no form of stigma and discrimination will be tolerated. There is still an enormous amount to do to bring about the large reductions in HIV prevalence in the high-risk groups. The global-health architecture needs to put Latin America in their plans. Not to do so is unfair and shortsighted, because there are likely to be good returns on investment. At the meeting, people from Latin America and the Caribbean will have the chance to show the world the reality of the different epidemics the region is confronting, the responses in place, and the obstacles to overcome. Garnering the world's attention for 5 days must have a lasting impact and re-energise the HIV community in the region. (excerpt)
Language: English
Keywords:
LATIN AMERICA | CARIBBEAN | SUMMARY REPORT | CONFERENCES AND CONGRESSES | PREVALENCE | SEX WORKERS | IV DRUG USERS | HETEROSEXUALS | MEN HAVING SEX WITH MEN | HIV INFECTIONS | AIDS | STIGMA | ANTIRETROVIRAL DRUGS | PROGRAM ACCESSIBILITY | Americas | Developing Countries | Measurement | Research Methodology | Sex Behavior | Behavior | Drug Use and Abuse | Viral Diseases | Diseases | Social Problems | Sociocultural Factors | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Program Evaluation | Programs | Organization and Administration
Document Number: 328462

12.

Title: Socio-demographic analysis of youth in the Caribbean: a three country case study.
Author: Economic Commission for Latin America and the Caribbean [ECLAC]
Source: Port-of-Spain, Trinidad and Tobago, Economic Commission for Latin America and the Caribbean [ECLAC], 2008 Nov. 20 p.
Abstract: The study provides an analysis of 2000 census data from Antigua and Barbuda, Grenada, and Saint Lucia, with a focus on children, youth, and young families. Special attention is given to the description of their living arrangements and household composition, religion, health, well-being, migration, education and profession, economic activities, civil status, and reproductive patterns.
Language: English
Keywords:
CARIBBEAN | SUMMARY REPORT | CASE STUDIES | YOUTH | LIVING ARRANGEMENTS | MIGRATION | HEALTH | EDUCATION | MARRIAGE PATTERNS | REPRODUCTIVE BEHAVIOR | YOUTH PROGRAMS | Developing Countries | Americas | Studies | Research Methodology | Age Factors | Population Characteristics | Demographic Factors | Population | Residence Characteristics | Population Distribution | Geographic Factors | Population Dynamics | Marriage | Nuptiality | Fertility | Programs | Organization and Administration
Document Number: 339991

13.

Title: Rapid youth assessment in the Eastern Caribbean.
Author: Educational Development Center [EDC]
Source: Newton, Massachusetts, EDC, 2008 Aug. [84] p.
Abstract: The Education Development Center conducted a rapid youth assessment to glean information and strategic ideas from a diverse range of stakeholders about the lives of 15- to 20-year-olds in Antigua, Grenada, St. Kitts, and St. Lucia in July 2008. Across the four islands, researchers interviewed 211 key informants from the private sector, government, nongovernmental organizations, community colleges, and international donor organizations. This report describes regional and country-specific youth programs, and it organizes the assessment's findings into three major sections: (1) a multisectoral analysis of key issues surrounding young people; (2) a supply (youth assets) and demand (key industries and emerging markets) analysis across the four countries; and (3) recommendations for youth strategy development.
Language: English
Keywords:
CARIBBEAN | SUMMARY REPORT | YOUTH | EDUCATION | HEALTH | POPULATION GROWTH | POVERTY | ECONOMIC DEVELOPMENT | Developing Countries | Americas | Age Factors | Population Characteristics | Demographic Factors | Population | Population Dynamics | Socioeconomic Factors | Economic Factors
Document Number: 342034

14.

Title: Improving youth education and services.
Author: Family Health International [FHI]
Source: Research Triangle Park, North Carolina, FHI, 2008. [2] p. (FHI Briefs: Menu of PracticesUSAID Cooperative Agreement No. GPO-A-00-05-00022-0)
Abstract: Young people are a critically important population group to address when considering education and services for better reproductive health options. Youth are at significant risk of unintended pregnancy and exposure to sexually transmitted infections (STIs). Inside or outside of marriage, more than half of young women in sub-Saharan Africa and a third in Latin America and the Caribbean deliver their first child before age 20. Every day, 5,000 young people ages 15 to 24 become infected with HIV, representing almost two million new infections each year. Strategies to improve reproductive health and family planning services for young people can address these growing problems and improve their sexual and reproductive health. These supportive strategies should also segment educational activities to the appropriate age group, ensure that program activities address desired outcomes, reduce gender inequities, and reinforce protective factors such as parental involvement and education.
Language: English
Keywords:
LATIN AMERICA | CARIBBEAN | AFRICA, SUB SAHARAN | RECOMMENDATIONS | YOUTH | PARTICIPATION | REPRODUCTIVE HEALTH | HIV PREVENTION | MASS MEDIA | COMMUNICATION STRATEGY | PROMOTION | PEER EDUCATORS | Americas | Developing Countries | Africa | Age Factors | Population Characteristics | Demographic Factors | Population | Social Behavior | Behavior | Health | HIV Infections | Viral Diseases | Diseases | Communication | Marketing | Economic Factors | Education
Document Number: 331522

15.

16.

Title: [Safeguarding contraceptive security in Latin America and the Caribbean] Salvaguardando la disponibilidad asegurada de insumos anticonceptivos en America Latina y El Caribe.
Author: Futures Group International. Health Policy Initiative
Source: Washington, D.C., Futures Group International, Health Policy Initiative, 2008 Sep. 4 p. (USAID Contract No. GPO-I-01-05-00040-00) This brief is also available in English: Safeguarding contraceptive security in Latin America and the Caribbean at: http://www.healthpolicyinitiative.com/index.cfm?ID=publications&get=pubID&pubID=604
Abstract: This is the Spanish version of "Safeguarding Contraceptive Security in Latin America and the Caribbean," a brief that describes HPI's contributions to the work of USAID's Regional Initiative on Contraceptive Security in Latin America and the Caribbean. It highlights key approaches and activities, outcomes to date, and provides an extensive list of resources. A CD-ROM companion to this brief is available. It contains all the resources, as well as supplemental materials.
Language: Spanish
Keywords:
LATIN AMERICA | CARIBBEAN | SUMMARY REPORT | CONTRACEPTIVE SECURITY | EDUCATIONAL METHODS | Americas | Developing Countries | Contraceptive Availability | Contraception | Family Planning | Educational Activities | Education
Document Number: 308949

17.

Title: Semi-annual report, Task Order 1, April 1, 2008-September 30, 2008. Contract No. GPO-I-01-05-00040-00.
Author: Futures Group International. Health Policy Initiative
Source: Washington, D.C., Futures Group International, Health Policy Initiative, 2008 Sep. 170 p. (USAID Contract No. GPO-I-01-05-00040-00)
Abstract: The purpose of this task order is to exercise global leadership and provide field-level programming in policy development and implementation. The assistance provided under this procurement is expected to improve the enabling environment for health, making it possible for men and women around the world to obtain and use information and services they need for better health, especially in the areas of family planning and reproductive health, HIV/AIDS, and maternal health. Task Order 1 implements a comprehensive and challenging set of corefunded activities with funding from the Office of Population and Reproductive Health, Office of HIV/AIDS, and the Office of Health, Infectious Diseases, and Nutrition. To date, the project has received field support funds from 36 country or regional programs. The bureaus for Africa, Asia and the Near East, Eastern Europe and Central Asia, and Latin America and the Caribbean also provide funds for HPI to support their regional activities in health, HIV/AIDS, family planning, and contraceptive security. For the period from April 1, 2008 to September 30, 2008, we report 72 results in 16 country and regional programs. (Excerpt)
Language: English
Keywords:
AFRICA | ASIA | EUROPE | LATIN AMERICA | CARIBBEAN | SUMMARY REPORT | MATERNAL HEALTH | HIV INFECTIONS | AIDS | HEALTH POLICY | FAMILY PLANNING | REPRODUCTIVE HEALTH | Developing Countries | Developed Countries | Americas | Health | Viral Diseases | Diseases | Policy | Political Factors | Sociocultural Factors
Document Number: 331368

18.

Title: Using geographic information system tools to address disparities in access to family planning services and commodities in Latin America and the Caribbean. Technical brief.
Author: John Snow [JSI]. DELIVER
Source: Arlington, Virginia, JSI, DELIVER, 2008 Dec. [8] p. (Technical Brief)
Abstract: This analysis shows that the Guatemalan departments with the greatest disparities in access to FP are Alta Verapaz, Quetzaltenango, Totonicap�n, and Solol�. To reduce unmet need for target populations in these departments, as well as to increase overall access to FP services and commodities, various approaches may be taken simultaneously. Some approaches and interventions may involve service delivery providers, particularly the MOH and community-based NGOs. Other strategies may be taken by advocacy and interest / community groups and local religious leaders who can explain the benefits of FP in improving family well-being and prosperity. Such strategies might include working on advocacy and community engagement; information, education, and communication; quality of service delivery; and organizational strengthening. Using GIS as a planning tool for policymakers demonstrates how existing data sources can be leveraged to gain new information about the complex issue surrounding health inequities and poverty. Approaching the problem from an inherently geographic perspective allows detailed variations in health and demographic data to be examined for spatial trends, and using GIS tools facilitates an integrated analysis of multiple variables to identify priority areas for future targeted initiatives to reduce inequity in access to FP.(Excerpts)
Language: English
Keywords:
LATIN AMERICA | CARIBBEAN | SUMMARY REPORT | USAID | INFORMATION PROCESSING | GEOGRAPHIC FACTORS | FAMILY PLANNING PROGRAMS | INEQUALITIES | CULTURE | PROGRAM ACCESSIBILITY | Americas | Developing Countries | Government Agencies | Organizations | Political Factors | Sociocultural Factors | Information | Population | Family Planning | Socioeconomic Factors | Economic Factors | Program Evaluation | Programs | Organization and Administration
Document Number: 331437

19.

20.

21.

22.

Title: HIV risk behaviors of Latin American and Caribbean men who have sex with men in Miami, Florida, USA.
Author: Akin M; Fernandez MI; Bowen GS; Warren JC
Source: Revista Panamericana de Salud P�blica / Pan American Journal of Public Health. 2008 May 20;23(5):341-348.
Abstract: The goal of this study is to describe the sexual practices, drug use behaviors, psychosocial factors, and predictors of unprotected anal intercourse (UAI) in a sample of Hispanic men who have sex with men (MSM) born in Latin American and Caribbean (LAC) countries who currently reside in Miami-Dade County, Florida. Hispanic MSM (N = 566) recruited from community and Internet venues completed a computer-assisted self-interview assessing sociodemographic factors, drug use, sexual behaviors, and psychosocial factors. We focused on the 470 men who were born in LAC countries, including Puerto Rico. We first examined separately, by country of origin, the sexual practices, drug use behaviors, and psychosocial factors of the sample. We then collapsed the groups and examined the factors associated with UAI in the previous 6 months for the entire sample of Hispanic MSM from LAC countries. In the previous 6 months, 44% of the sample engaged in UAI, and 41% used club drugs. At the multivariate level, psychological distress, higher number of sexual partners, club drug use, HIV-positive status at the time of immigration, and greater orientation to American culture were significantly associated with UAI in the previous 6 months. Many MSM born in LAC countries engage in HIV-related risk behaviors in the AIDS epicenter of Miami-Dade County, Florida. Culturally appropriate interventions should address these risk behaviors in this underserved population. (author's)
Language: English
Keywords:
FLORIDA | CARIBBEAN | RESEARCH REPORT | KAP SURVEYS | MEN HAVING SEX WITH MEN | HISPANICS | IMMIGRANTS | MULTIPLE PARTNERS | URBAN POPULATION | PSYCHOSOCIAL FACTORS | SEX BEHAVIOR | RISK BEHAVIOR | DRUG USE AND ABUSE | STRESS | CULTURAL BACKGROUND | Developed Countries | United States of America | North America | Americas | Developing Countries | Surveys | Sampling Studies | Studies | Research Methodology | Behavior | Ethnic Groups | Population Characteristics | Demographic Factors | Population | Migrants | Migration | Population Dynamics | Sexual Partners | Psychological Factors
Document Number: 326968

23.

Peer Reviewed

Title: HIV/AIDS-related stigma and discrimination: accounts of HIV-positive Caribbean people in the United Kingdom.
Author: Anderson M; Elam G; Gerver S; Solarin I; Fenton K; Easterbrook P
Source: Social Science and Medicine. 2008 Sep;67(5):790-8.
Abstract: This paper explores the effects of HIV/AIDS-related stigma and discrimination (HASD) on HIV-positive Caribbean people in the Caribbean and the UK. In-depth, semi-structured interviews were held with a purposively selected group of 25 HIV-positive people of Caribbean origin, using primary selection criteria of sex, age, sexuality and country of birth. Interviews with respondents revealed that they are keenly aware of the stigma surrounding HIV/AIDS, which some attribute to a particularly Caribbean combination of fear of contamination, homophobia, and ignorance, reinforced by religious beliefs. In fact, religion serves a double role: underpinning stigma and assisting in coping with HIV. HASD has usually occurred where respondents have lost or do not have control over disclosure. Compared to UK-born respondents, the accounts of Caribbean-born respondents, most of whom were born in Jamaica, include more reports of severe HASD, particularly violence and employment discrimination. All respondents mobilise a variety of strategies in order to avoid HASD, which have implications for their social interactions and emotional well being. While some manage to avoid the "spoiled identity" of the stigmatised, thereby creating their own understandings of HIV infection, these may remain individual-level negotiations. HASD affects HIV-positive Caribbean people at home and in the diaspora in a variety of ways: emotionally, mentally, financially, socially and physically. Interventions specifically addressing stigma and discrimination must be formulated for the UK's Caribbean population. Tackling stigma and discrimination requires more than education; it requires "cultural work" to address deeply entrenched notions of sexuality.
Language: English
Keywords:
UNITED KINGDOM | CARIBBEAN | RESEARCH REPORT | INTERVIEWS | BLACKS | PERSONS LIVING WITH HIV/AIDS | STIGMA | SOCIAL DISCRIMINATION | HIV INFECTIONS | Developed Countries | Europe, Western | Europe | Developing Countries | Americas | Data Collection | Research Methodology | Ethnic Groups | Cultural Background | Population Characteristics | Demographic Factors | Population | Viral Diseases | Diseases | Social Problems | Sociocultural Factors
Document Number: 330566

24.

Title: Step by Step: a guide to HIV and AIDS policy development for the education sector. Caribbean Education Sector HIV and AIDS Capacity Building Programme.
Author: Clarke D; Constantine C; Oommen M; Ross V; Whitman CV
Source: Newton, Massachusetts, Education Development Center, [2008]. 58 p.
Abstract: Caribbean and UNESCO's 2006 series, Good Policy and Practice in HIV and AIDS Education. Further, the Mobile Task Team on the Impact of HIV/AIDS on Education (MTT) in South Africa had developed the rapid policy development process. Used in a number of African countries, this approach involves bringing together a multi-sectoral group to develop an initial draft policy. This process reverses the traditional approach, in which a first draft may only emerge after long consultation, review, and deliberation. This interactive, consensus-building process concentrates on getting 80% of the drafting accomplished during a four-day workshop. EDC partnered with MTT in piloting this approach in the Caribbean and based these tools on that Caribbean experience. The division of Health and Human Development Programs at EDC designed this toolkit as part of the CARICOM-funded project Caribbean Education Sector HIV/AIDS Capacity Building Programme. This toolkit was developed to guide Ministries of Education, particularly in the Caribbean region, through the rapid policy development process towards a specific outcome: an effective HIV and AIDS policy for the education sector that is linked with an achievable implementation plan. Ten tools are provided to assist education sector leaders and staff in the policy cycle process, from planning to evaluation. (excerpt)
Language: English
Keywords:
CARIBBEAN | MANUAL | HIV | AIDS | HEALTH EDUCATION | HEALTH POLICY | POLICY DEVELOPMENT | IMPLEMENTATION | MONITORING | EVALUATION | Americas | Developing Countries | HIV Infections | Viral Diseases | Diseases | Education | Policy | Political Factors | Sociocultural Factors | Planning | Organization and Administration | Programs
Document Number: 308674

25.
Title: AIDS stigma combinations in a sample of Puerto Rican health professionals: qualitative and quantitative evidence.
Author: Diaz NV; Rivera SM; Bou FC
Source: Puerto Rico Health Sciences Journal. 2008 Jun;27(2):147-57.
Abstract: The HIV/AIDS epidemic continues to impact Puerto Rico and the Caribbean region with growing numbers of cases each year. The stigma that surrounds the epidemic has harmful implications on the health of people living with the disease and public health in general, fostering health deterioration and new infections. When this stigma emanates from health professionals it can severely hinder access to health services, which are crucial for those living with the virus. Still, AIDS stigma has been previously explored among this population as a separate phenomenon from other pre-existing stigmas. This has yielded a limited perspective on the complexity of how AIDS stigma is manifested. In light of this limitation, the main objectives of this study were: 1) to document AIDS stigma among a sample of Puerto Rican health professionals and health professionals in training and 2) to explore the combination of other stigmas (sexism, homophobia, and negative attitudes towards drug users) with that associated to HIV/AIDS. Through an exploratory design, using a mixed method approach (qualitative in-depth interviews and quantitative questionnaires), we explored the objectives in a sample of 501 health professionals and health professionals in training. The results evidenced the combinations of other stigmas with that of HIV/AIDS. Homophobia yielded the strongest correlation and was the best predictor of AIDS stigma. These results evidence the need to develop interventions to reduce AIDS stigma and its combinations among this population.
Language: English
Keywords:
PUERTO RICO | CARIBBEAN | RESEARCH REPORT | QUANTITATIVE RESEARCH | INTERVENTIONS | PERSONS LIVING WITH HIV/AIDS | AIDS | HIV INFECTIONS | STIGMA | SOCIAL DISCRIMINATION | Americas | Developed Countries | Developing Countries | Research Methodology | Programs | Organization and Administration | Viral Diseases | Diseases | Social Problems | Sociocultural Factors
Document Number: 328982

26.
Peer Reviewed

Title: Use of Q methodology to analyze divergent perspectives on participatory action research as a strategy for HIV / AIDS prevention among Caribbean youth.
Author: Goto K; Tiffany J; Pelto G; Pelletier D
Source: AIDS Education and Prevention. 2008 Aug;20(4):301-311.
Abstract: This study used Q methodology to examine perspectives regarding participatory action research (PAR) among participants in a UNICEF initiative aimed at enhancing HIV/AIDS prevention among youth in the Caribbean. We interviewed 20 youth PAR researchers and 12 project managers from youth organizations about their attitudes and experiences. Statements from the interviews were used in a structured ranking task. Q factor analysis of the rankings identified three clusters of respondents with differing viewpoints on PAR. The clusters respectively saw PAR as an effective peer education tool, an empowering process for youth, and a tool for gathering information on the gap between knowledge and behavior. We identified divergent perspectives on the purpose and utility of PAR among participants who received the same orientation, training, and support and who worked in the context of a single initiative. These multiple perspectives present both challenges and resources for health projects. (author's)
Language: English
Keywords:
CARIBBEAN | RESEARCH REPORT | HIV INFECTIONS | HIV PREVENTION | YOUTH | ADOLESCENTS | UNICEF | Americas | Developing Countries | Viral Diseases | Diseases | Age Factors | Population Characteristics | Demographic Factors | Population | UN | International Agencies | Organizations | Political Factors | Sociocultural Factors
Document Number: 327955

27.

Peer Reviewed

Title: Comparison of adult HIV prevalence from national population-based surveys and antenatal clinic surveillance in countries with generalised epidemics: implications for calibrating surveillance data.
Author: Gouws E; Mishra V; Fowler TB
Source: Sexually Transmitted Infections. 2008 Aug;84 Suppl 1:i17-i23.
Abstract: BACKGROUND: Estimates of the impact of HIV in countries with generalised epidemics are generally based on antenatal clinic surveillance data collected over time. In an attempt to obtain geographically more representative estimates of HIV prevalence, many countries are now also conducting national population-based surveys in which HIV testing is included. We compare adult HIV prevalence estimates from antenatal clinic surveillance to those from national population-based surveys to assess the implications for calibrating surveillance data. METHODS: HIV prevalence estimates derived from fitting prevalence curves to antenatal clinic surveillance data are statistically compared to prevalence from national population-based surveys using data from 26 countries with generalised epidemics for the year in which the survey was conducted. Appropriate transformations are applied to inform the correction factors needed to adjust prevalence in countries where population-based surveys have not been conducted. RESULTS: HIV prevalence derived from antenatal clinic surveillance data generally overestimate population-based survey prevalence by about 20% (95% confidence interval: 10% to 30%) in both urban and rural areas. CONCLUSIONS: In countries where national population-based HIV surveys have been conducted, survey estimates of HIV prevalence (adjusted for potential survey biases as appropriate) can be used directly to calibrate antenatal clinic surveillance data. In countries where national HIV surveys have not been conducted, HIV prevalence derived from antenatal clinic surveillance data should be multiplied by about 0.8 to adjust for overestimation.
Language: English
Keywords:
AFRICA, SUB SAHARAN | CARIBBEAN | RESEARCH REPORT | DEMOGRAPHIC SURVEYS | HEALTH SURVEYS | HIV INFECTIONS | PREVALENCE | EPIDEMIOLOGY | DATA COLLECTION | ESTIMATION TECHNIQUES | STATISTICS | Africa | Developing Countries | Americas | Population Dynamics | Demographic Factors | Population | Health | Viral Diseases | Diseases | Measurement | Research Methodology | Public Health
Document Number: 328284

28.

29.

Title: You, your life, your dreams: a book for Caribbean adolescents.
Author: Poy PL; Montero MF; Murdock M
Source: [New York, New York], Family Care International, 2008. [11], 178 p. First published in 2000 as You, Your Life, Your Dreams: A Book for Adolescents. Based on the original version by Ellen Brazier (Family Care International) and Catharine Watson (Straight Talk Foundation).
Abstract: You, Your Life, Your Dreams is a book that helps young people make informed decisions about their sexual lives. It provides accessible, objective, and urgently-needed information on a broad range of sexual and reproductive health issues. Designed for young people and for educators who work with them, the manual was originally conceived for use in English-speaking Africa, and is now being distributed in three languages and four different versions reflecting the regional contexts and the unique challenges facing adolescents in Sub-Saharan Africa, Latin America and the Caribbean.
Language: English
Keywords:
CARIBBEAN | RECOMMENDATIONS | EVALUATION | ADOLESCENTS | VALUE ORIENTATION | ADOLESCENT HEALTH | CHILD DEVELOPMENT | GROWTH | PUBERTY | HORMONES | SEX FACTORS | MENSTRUATION | SELF CARE | SELF ESTEEM | FAMILY RELATIONSHIPS | Americas | Developing Countries | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Psychological Factors | Behavior | Health | Biology | Reproduction | Endocrine System | Physiology | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Family Characteristics | Family and Household | Sociocultural Factors
Document Number: 308940

30.

Peer Reviewed

Title: Health insurance and cervical cancer screening among older women in Latin American and Caribbean cities.
Author: Reyes-Ortiz CA; Velez LF; Camacho ME; Ottenbacher KJ; Markides KS
Source: International Journal of Epidemiology. 2008 Aug;37(4):870-878.
Abstract: The purpose of this study is to describe the prevalence of Papanicolaou (Pap) smear use for cervical cancer screening and to estimate A cross-sectional study using data from the Health, Well-Being and Aging in Latin America and the Caribbean Study (SABE). The sample includes 6357 women aged 60 and older from seven cities. The outcome was reporting a Pap smear for cervical cancer screening during the previous 2 years. Main independent variable was health care insurance. Covariates were demographic or socioeconomic variables, medical conditions and functional status. Prevalence of Pap smear use across the seven cities ranged from 21% in Bridgetown to 45% in Mexico City. In a multivariate analysis of the combined sample, without Havana that has universal health care insurance, women with public insurance (OR 0.55, 95% CI 0.43-0.71) or with no insurance (OR 0.23, 95% CI 0.15-0.34) were less likely to have a Pap smear compared with women with private insurance. Also, women with no insurance were less likely to have a Pap smear (OR 0.40, 95% CI 0.30-0.54) compared with women with any health insurance. In general, the prevalence of Pap smear use was lower than that reported for Hispanic populations in the United States. Overall, lack of health insurance or having public health insurance determined lower odds for having a Pap smear for cervical cancer screening. (author's)
Language: English
Keywords:
LATIN AMERICA | CARIBBEAN | RESEARCH REPORT | CROSS SECTIONAL ANALYSIS | CANCER | SCREENING | HEALTH INSURANCE | PAP SMEAR | WOMEN | MIDDLE AGED ADULTS | OLDER ADULTS | Americas | Developing Countries | Research Methodology | Neoplasms | Diseases | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Financial Activities | Economic Factors | Laboratory Examinations and Diagnoses | Demographic Factors | Population | Adults | Age Factors | Population Characteristics
Document Number: 327853


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