Raquel A. Benavides-Torres

Factors Associated with Lifetime HIV Testing in Texas by Race/Ethnicity

Introduction: In United States, roughly 1/5 of all HIV infected persons remain undiagnosed. Because HIV testing is critical to improve prevention efforts, more research is needed to understand the characteristics of individuals who get tested for HIV. Methods: This secondary analysis of the 2010 Texas Behavioral Risk Factor Surveillance System used data from 9,744 respondents between 18-64 years of age to evaluate the relationship between demographic characteristics (gender, race/ethnicity, age, area of residence, education, marital status, employment status, and income), healthcare characteristics (insurance status, having a primary provider, and access to healthcare), and HIV risk behaviors with ever having received an HIV test. Results: Significant associations between gender, age, area of residence, marital and employment status, and HIV risk behaviors and HIV testing in a Texas population by race/ethnicity were observed. Conclusions: These findings have important implications for future research into racial/ethnic disparities between lifetime HIV testing, and can help guide practitioners who work with populations at risk for HIV/AIDS in Texas.

Developing Community-Based Rehabilitation Programs for Musculoskeletal Diseases in Low-Income Areas of Mexico: The Community-Based Rehabilitation for Low-Income Communities Living With Rheumatic Diseases (CONCORD) Protocol

Background The negative impact of musculoskeletal diseases on the physical function and quality of life of people living in developing countries is considerable. This disabling effect is even more marked in low-socioeconomic communities within developing countries. In Mexico, there is a need to create community-based rehabilitation programs for people living with musculoskeletal diseases in low-socioeconomic areas. These programs should be directed to prevent and decrease disability, accommodating the specific local culture of communities. Objective The objective of this paper is to describe a research protocol designed to develop, implement, and evaluate culturally sensitive community-based rehabilitation programs aiming to decrease disability of people living with musculoskeletal diseases in two low-income Mexican communities. Methods A community-based participatory research approach is proposed, including multi and transdisciplinary efforts among the community, medical anthropology, and the health sciences. The project is structured in 4 main stages: (1) situation analysis, (2) program development, (3) program implementation, and (4) program evaluation. Each stage includes the use of quantitative and qualitative methods (mixed method program). Results So far, we obtained resources from a Mexican federal agency and completed stage one of the project at Chankom, Yucatán. We are currently receiving funding from an international agency to complete stage two at this same location. We expect that the project at Chankom will be concluded by December of 2017. On the other hand, we just started the execution of stage one at Nuevo León with funding from a Mexican federal agency. We expect to conclude the project at this site by September of 2018. Conclusions Using a community-based participatory research approach and a mixed method program could result in the creation of culturally sensitive community-based rehabilitation programs that promote community development and decrease the disabling effects of musculoskeletal diseases within two low-income Mexican communities.

The effect of an Internet-based intervention designed to reduce HIV/AIDS sexual risk among Mexican adolescents

ABSTRACT Introduction: The purpose of the study was to evaluate the effect of an Internet-based intervention to reduce sexual risk behaviors and increase resilience to sexual risk behaviors among Mexican adolescents, a key HIV/AIDS risk group. Methodology: The study had a quasi-experimental design with single-stage cluster sampling. Participants ages 14–17 were stratified by gender and randomly assigned to either receive intervention “Connect” (which included face-to-face and Internet-based sessions designed to reduce sexual risk behaviors and increase resilience to sexual risk) or control (a general educational video on reducing health risks). A total of 9 survey instruments were administered online through SurveyMonkey pre- and post-intervention to assess changes in sexual risk and protective factors as well as two outcomes of interest: risky sexual behaviors and resilience. Pearson correlation assessed instrument reliability while multivariable linear regression models assessed two study hypotheses: (1) the effect of the intervention on sexual behavior and resilience is mediated by adolescent age, gender, and sexual experience and (2) risk and protective factors are mediators between the intervention and sexual behavior. Results: The sample was composed of 193 adolescents between 14 and 17 years old (n = 96 in the control group and n = 97 in the experimental group). Survey instruments were reliable. Age was associated with pre-to-post test changes in sexual resilience (β = −6.10, p = .019), which partially mediated the effect of the intervention on sexual resilience (β = 5.70, p = .034). Social support was associated with pre-to-post test changes in risky sexual behavior (β = −0.17, p = .039). Conclusion: Intervention “Connect” was independently associated with improved self-reported resilience to risky sexual behaviors, though not with a reduction in those behaviors in multivariate analyses. This is the first Internet-based intervention designed to reduce HIV/AIDS sexual risk among Mexican adolescents.

Self-efficacy and Coping as Correlates of Migrant Safe Sexual Behavior to Prevent HIV

&NA; Along the Mexico/United States border, migrants are at increased risk of HIV. The objective of our study was to investigate the relationship between two process indicators (self‐efficacy to prevent HIV and coping with sexual risk) and safe sexual behaviors in migrants. A correlational design was used. Migrants were recruited from two cities on the northern border of Mexico. Transition theory informed the measurement of self‐efficacy and coping process indicators. Three generalized linear models were built for each safe sexual behavior outcome: (a) partner communication, (b) use of condoms, and (c) safe sex. Of 311 migrants, indicators of self‐efficacy and coping with sexual risk were associated with all three outcome measures of safe sexual behavior (p < .05). Process indicators explained 22.5% to 30.6% of the variance in the data. Therefore, self‐efficacy to prevent HIV and coping ability are important correlates of migrant sexual risk behavior.

Factores interpersonales como predictores de la autoestima sexual en mujeres del noreste de México

OBJECTIVE Sexual self-esteem has generated results that make clear their impact on sexual health, which is forged by interactions with other people. For this reason, the goal of this study is to evaluate if the variables time spent with the partner, number of sexual partners, support of the couple, sexual assertiveness and partner violence predict sexual self-esteem in women in Northeast Mexico. MATERIAL AND METHOD Predictive and correlational study. The sample consisted of 605 women users of primary health care centers. As inclusion criteria, it was considered that participants were between 18 and 40 years of age (M=27.68; TD=6.52), who maintained a relationship of at least three months and with sexual activity within that relationship. RESULTS Couple support, partner violence and sexual assertiveness behaved as predictive factors, accounting for 32% of sexual self-esteem in women (F=52.410, p<0.001). CONCLUSIONS Interpersonal factors are key elements in the understanding and evaluation of sexual self-esteem in women. These findings will support the improvement of the sexual health of this population, who are a vulnerable group to sexual problems in Mexico.

Uso Del Condón en Adolescentes Nahuas, un Modelo Explicativo:

En México, la población indígena supera los siete millones de habitantes, en Puebla el grupo más representativo es el Náhuatl. Sin embargo, las condiciones de vida, salud, educación y transporte son precarias para esta población. En los adolescentes, las responsabilidades como el matrimonio, la familia y los compromisos ante la comunidad, favorecen conductas de riesgo sexual que dificultan su desarrollo económico, social y reproductivo. El objetivo fue proponer un modelo explicativo del uso del condón en adolescentes nahuas. Método. Bajo el marco de la teoría social cognitiva, el concepto de valores culturales de Leininger y el proceso de la sustracción teórica, se desarrolló este artículo. Se muestran las relaciones del modelo con las proposiciones y los factores que influyen en el uso del condón para este grupo específico. Finalmente, el modelo explica las variables de interés, los niveles de abstracción y las relaciones entre sí en el contexto náhuatl. El siguiente paso será implementar los indicadores empíricos para conocer el grado de influencia de los factores personales y ambientales hacia el uso del condón en adolescentes nahuas. Resultados que aportarán información para el desarrollo del conocimiento en enfermería y la reducción de riesgo sexual de esta población.

Percepciones de las Mujeres Mexicanas Sobre el Uso de Métodos Anticonceptivos: Un Estudio Cualitativo

Introducción: Más del 50% de los embarazos a nivel mundial son no planeados. El 99% de los embarazos no planeados se presentan en países en desarrollo, el 38% de estos en América Latina y el Caribe. Métodos: Se realizó un estudio cualitativo, a través un análisis de contenido congruente con la descripción cualitativa. Se realizaron entrevistas semiestructuradas a mujeres de 18 a 24 años de edad. Resultados: La angustia por un cambio de vida, el tener planes para el futuro y una relación formal mayor a un año son los principales motivos para usar un método anticonceptivo de forma correcta y consistente. Las barreras reportadas para el uso de métodos anticonceptivos fueron los efectos secundarios, las creencias de los padres acerca de la sexualidad y la reproducción y el estigma hacia las mujeres que usan métodos anticonceptivos. Conclusiones: Las principales barreras en las mujeres son las de tipo cultural. Los hallazgos muestran que la influencia de la red social es más importante que las creencias individuales. Por lo que se debe de incluir al personal de salud y la comunidad en las intervenciones de salud.

Facilitating and Inhibiting Factors of Sexual Behavior among Migrants in Transition from Mexico to the United States

Introduction Human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS) is one of the most prevalent infectious diseases in the border region of Mexico due to the flow of migrants under desperate conditions, encouraging casual and unprotected sex. Since this has become a binational public health problem, it is important to understand the factors that predict these sexual behaviors. The aim of the current study was to investigate the facilitators and inhibitors of transition in the sexual behavior of migrants from two border regions on the Mexico–United States (US) border. Methods This was a predictive and cross-sectional study. A sample of 256 migrants in shelters for migrants on the border between Mexico and US were selected through systematic random sampling. Predictor variables investigated for effect on the safe sexual behavior (SSB) of the migrant were reasons for having sex; sexual attitudes; sexual machismo; knowledge about HIV; access to health services; and social discrimination. Results The sample was predominantly male (89.5%), with 46.1% reporting being single. The average age was 33.38 years (SD = 9.73) and the average number of years of education reported was 8.05 (SD = 3.37). A permissive sexual attitude and sexual machismo both correlated with condom use (rs = 0.130, p < 0.01 and rs = −0.174, p < 0.01, respectively). Regression analysis showed that a permissive sexual attitude decreased the practice of safe sex (β = 0.17, t = 4.16, p < 0.001), as did sexual machismo (β = −0.28, t = −4.83, p < 0.001) and HIV knowledge (β = −0.11, t = −2.62, p = 0.006). Discussion It was found that access to health services did not influence the SSB of migrants, as suggested by the literature. However, a permissive sexual attitude, sexual machismo, and HIV knowledge were all variables capable of predicting SSB. It is recommended that the study is extended to study migrant populations from other parts of the border, as well undertaking as a qualitative approach to explore new variables.

Attachment and Associated Sexual Health Behaviors of Heterosexual Mexican Housewives

Sexually transmitted infections including human immunodeficiency virus are international public health concerns. Heterosexual women who are in steady relationships have been described as a particularly vulnerable population at risk for sexually transmitted infections acquired from their male partners. In this pilot study, we describe associations identified via cross-sectional survey among demographic variables, attachment style, and condom use in Mexican heterosexual women (ages 20–44 years, n = 50) who self-reported current steady partner relationships. Descriptive, bivariate, and correlation analyses were conducted. Secure attachment and condom use were positively correlated with education level. Limited sexual risk prevention knowledge and contraception use, low risk perception within male partner relationships and misconception about proper condom use were identified as sources of elevated risk for sexually transmitted infections via male partners. Implications of findings include sexual health intervention modification to include dialogue concerning the context of steady relationship and sexual risk among Mexican heterosexual women.