Kate S. Wilson

Public opinion about abortion-related stigma among Mexican Catholics and implications for unsafe abortion

A nationally representative survey was conducted among 3000 Catholics in Mexico during 2009 and 2010. Respondents were presented with a hypothetical situation about a young woman who decided to have an abortion and were asked their personal opinion of her. On the basis of a stigma index, it was found that the majority (61%) had stigmatizing attitudes about abortion; however, 81% believed that abortion should be legal in at least some circumstances. Respondents were significantly more likely to stigmatize abortion if they disagreed with the Mexico City law legalizing the procedure (odds ratio 1.66; 95% CI, 1.30–2.11) and believed that abortion should be prohibited in all cases (odds ratio 3.13; 95% CI, 2.28–4.30). Such stigma can lead women to seek unsafe abortions to avoid judgment by society.

Abortion and women's roles in society: opinions from Tlaxcala, Mexico

OBJECTIVE We aim to assess the opinions of Mexicans in the state of Tlaxcala on abortion and other topics concerning womens reproductive health and status in society. MATERIAL AND METHODS We summarize opinions on abortion and womens roles in society and perform logit regressions to assess characteristics correlated with support for abortion rights. RESULTS A majority of respondents were against a womans right to abortion when asked generally, but when asked about specific circumstances, a majority supported the right to abortion in five of the nine hypothetical circumstances proposed. In multivariate analysis, age, education, religion, religious service attendance, and views regarding womens roles in society had significant effects on support for the right to abortion. CONCLUSIONS Our results demonstrate that residents of Tlaxcala view abortion as a personal decision and support a womans right to abortion in more circumstances than currently allowed under state law.

The co-occurrence of intimate partner violence and syphilis among pregnant women in Bolivia.

BACKGROUND Intimate partner violence (IPV) and sexually transmitted infections (STI) are epidemics that disproportionately affect women. This study determined IPV prevalence and the association between IPV and positive syphilis tests among pregnant women attending antenatal clinics in three provinces in Bolivia. METHODS We administered structured questionnaires to women after syphilis testing. The questionnaire included sociodemographic variables and four questions form the modified version of the Abuse Assessment Screen (AAS) to assess physical and sexual violence. RESULTS Of 6002 women who completed the violence questionnaire and had a syphilis test, 20.4% (n=1227) reported physical or sexual abuse or both committed by their partner in the past year. Prevalence of positive syphilis tests was twice as high among women who reported IPV (8%) than among women who did not (4%) (p<0.01). Womens age (younger), education level (lower), occupation as homemaker, being in a consensual union, more previous pregnancies, lower economic status, and language spoken at home (Spanish and an indigenous language), as well as history of IPV in the past 12 months, were significantly associated with positive syphilis tests in bivariate analysis. History of IPV remained significantly associated with positive syphilis tests in multivariate analysis (OR 1.59, 95% CI 1.23-2.07). In addition, low education among womens partners and having at least one previous pregnancy were positively associated with IPV in multivariate analysis. CONCLUSIONS There is a significant association between history of partner violence and a positive syphilis test among pregnant women, suggesting that syphilis can be an important negative health consequence of IPV. Bolivias new maternal and infant health program in antenatal clinics, which includes universal syphilis screening, should also provide screening and follow-up care for IPV.

HIV/STI risk among male Mexican immigrants in Dallas, Texas: findings from a pilot study.

Rates of HIV and STIs are higher among Latinos than the general U.S. population. A number of factors place Latino immigrants at particularly high risk. 128 male Mexican immigrants in Dallas, Texas completed personal interviews. We measured the prevalence of HIV/STI risk factors and identified sociodemographic and behavioral characteristics associated with higher risk. 9% of the total sample had 3 or more sexual partners in the past year. 5% had sex with a commercial sex worker (CSW). 11% had sex with another man. 11% had a previous STI diagnosis. Risk behaviors and STI history were more prevalent among men who had used illegal drugs or frequently consumed alcohol (18% of the sample) than among others. The overall prevalence of HIV/STI risk factors in this population was moderate. However, men who drank alcohol frequently and used illegal drugs were more likely than others to report engaging in behaviors that put them at risk for acquiring HIV/STI.

Health Care Experiences of HIV-Infected Women With Fertility Desires in Mexico: A Qualitative Study

&NA; Increased access to antiretroviral therapy has enabled Mexican HIV‐infected women to resume healthy sexual and reproductive lives and reduce the risk of mother‐to‐child transmission of HIV infection. However, little information is available on the experiences of HIV‐infected women desiring children. In this qualitative study, we conducted in‐depth interviews with 31 HIV‐infected women in four Mexican cities. The findings indicated that most of the women were given limited information on their pregnancy options. With some exceptions, the women felt they were denied the option to have (or to have more) children and advised to undergo tubal ligations or abortions. The findings of this study indicate that ongoing efforts are needed to promote the reproductive rights of HIV‐infected women in Mexico and to ensure that they receive options aligned with their fertility desires.

Exploring intergenerational changes in perceptions of gender roles and sexuality among Indigenous women in Oaxaca

Abstract The south of Mexico has traditionally faced disproportionate social, health and economic disadvantage relative to the rest of the country, due in part to lower levels of economic and human development, and barriers faced by Indigenous populations. The state of Oaxaca, in particular, has one of the highest proportions of Indigenous people and consistently displays high rates of maternal mortality, sexually transmitted infections and teenage pregnancy. This study examines how social values and norms surrounding sexuality have changed between two generations of women living in Indigenous communities in Oaxaca. We conducted semi-structured in-depth interviews with 19 women from two generational cohorts in 12 communities. Comparison views of these two cohorts suggest that cultural gender norms continue to govern how women express and experience their sexuality. In particular, feelings of shame and fear permeate the expression of sexuality, virginity continues be a determinant of a woman’s worth and motherhood remains the key attribute to womanhood. Evidence points to a transformation of norms, and access to information and services related to sexual health is increasing. Nonetheless, there is still a need for culturally appropriate sex education programmes focused on female empowerment, increased access to sexual health services, and a reduction in the stigma surrounding women’s expressions of sexuality.

Exploring Abortion Knowledge and Opinion Among Lawyers, an Important yet Overlooked Stakeholder Group in Mexico

Lawyers are important actors shaping the abortion debate in Mexico. Of 250 private and public sector criminal lawyers surveyed from four regions, the majority knew about abortion laws in their states. At least 80% agreed with abortion in cases of rape, risk to a womans life or health, and fetal malformations. Overall, 61% agreed with the Mexico City law and 84% would defend a woman denied a legal abortion. In multivariate analysis, being very knowledgeable of abortion laws was a significant predictor of more “progressive” abortion opinions, support for the Mexico City law, and support for the health indication.

O332 Sexual and reproductive health needs of pregnant and recently pregnant women living with HIV in Mexico

visual dipsticks compared to a 24 hour urine protein collection (gold standard) to detect significant proteinuria in hypertensive pregnant women. Methods: 163 women presenting with hypertension during pregnancy after 20 weeks of gestation were recruited from antenatal clinics at hospitals serving the Durban Metropolitan region in South Africa. On admission each participant had a spot urine sample that was tested by trained midwives for proteinuria using a semi-quantitative visual dipstick (Makromed). Participants were admitted to the ward where a spot midstream urine sample was collected and analysed using the semi-quantitative urinary microalbumin to creatinine ratio dipsticks (CLINITEK Microalbumin, Bayer Healthcare LLC, USA) read instrumentally on the Clinitek 50 urine chemistry analyser. A 24 hour urine collection was then commenced and a quantitative measurement of protein in the urine measured. The results of the spot urinary microalbumin to creatinine ratio dipsticks and conventional visual dipsticks was compared to the 24 hour urine protein collection (gold standard) to detect significant proteinuria. A negative result was considered to be a spot urinary albumin to creatinine ratio of <300mg/g (nil and trace on urine dipsticks). A positive result was a spot urinary albumin to creatinine ratio of 300mg/g (1+ to 4+ on urine dipsticks). 0.3 g/24 hrs was considered significant proteinuria on the 24 hr total urinary protein measurement. Results: The visual dipstick had a sensitivity of 51% (95% CI [0.41–0.61]) and specificity of 91% (95% CI [0.81–0.96]). The PPV and NPV was 89% (95% CI [0.77–0.95]) and 58% (95% CI [0.48–0.67]) respectively. The spot urinary albumin to creatinine ratio dipsticks had a sensitivity of 63% (95% CI [0.52–0.72]) and specificity of 81% (95% CI [0.70–0.89]). The PPV was 82% (95% CI [0.71–0.90]) and NPV was 62% (95% CI [0.51–0.71]). Conclusion: Both the visual dipstick (Makromed) and the spot urinary microalbumin to creatinine ratio dipstick read on the Clinitek 50 system are not accurate when compared to the total 24 hour urinary protein. Differences between the spot urinary microalbumin to creatinine ratio and 24 hour total urinary protein may be due to the variation in the albumin fraction of the total urinary protein of pre-eclampsia, technical problems with imprecision of the assay technique and clinical causes of false positives and negatives. The improved sensitivity of the automated urinary microalbumin to creatinine ratio dipstick over the visual dipstick suggests it may be a suitable substitute for the visual dipstick in clinical practice. Whether the spot urinary microalbumin to creatinine ratio correlates better to other clinical measurements of disease severity or clinical outcomes need to be investigated further.