Silvia Susana Robles Montijo

The Information and Motivation and Behavioral Skills Model of ART Adherence among HIV-Positive Adults in Mexico

Introduction: Middle-income countries are in need of research that uses theoretical-based models to assess factors that predict adherence to antiretroviral therapy (ART) and help in the design, implementation, and evaluation of interventions for nonadherent populations. In Mexico, the Information and Motivation and Behavioral Skills (IMB) Model of ART Adherence constructs is useful in describing and predicting adherence behaviors in various samples but has not been articulated to people living with HIV (PLWH) on ART. The aim of this was to characterize the IMB core constructs and identify correlates of ART adherence in an HIV-positive clinic sample in Mexico. Methods: A convenience sample of 109 HIV-positive patients attending their monthly visits at a local public hospital were interviewed with the Spanish version of the LifeWindows IMB ART Adherence Questionnaire (LW-IMB-AAQ) as well as a sociodemographic questionnaire. All participants were recruited from a hospital-based outpatient clinical care site. Results: Partial confirmation of the relationships proposed by the IMB Model of ART Adherence was found. As predicted by the model, only behavioral skills had direct association with all measures of self-reported adherence, and motivation was associated with behavioral skills. Information did not demonstrate significant relations to either motivation or behavioral skills, nor did it directly associate with adherence. Self-reported adherence did not associate with CD4 counts, nor did any of the IMB model core constructs. Conclusion: Applicability of the IMB Model of ART Adherence in this setting is discussed. The IMB Model of ART Adherence offered promise in this population and could help tailor population-specific interventions to promote high rates of ART adherence.Introduction:Middle-income countries are in need of research that uses theoretical-based models to assess factors that predict adherence to antiretroviral therapy (ART) and help in the design, impl...

Comunicación con padres, comportamiento sexual e indicadores de abuso sexual en jóvenes mexicanos con discapacidad visual

La investigacion tuvo dos objetivos: 1) describir el patron de conducta sexual, indicadores de abuso y nivel de comunicacion con padres y con madres, en una muestra de jovenes mexicanos con discapacidad visual, realizando comparaciones por sexo y debut sexual, y 2) analizar la relacion entre la comunicacion con padres, el uso del preservativo y la presencia de relaciones sexuales forzadas. Se utilizo un diseno transversaldescriptivo-correlacional-observacional. Participaron voluntariamente 64 jovenes entre 12 y 26 anos de edad. Se aplicaron individualmente cinco instrumentos: 1) Perfil sociodemografico, 2) Datos familiares y antecedentes de la discapacidad, 3) Patron de conducta sexual, 4) Escala de comunicacion sexual con padres y 5) Escala de comunicacion sexual con madres. 70% de los participantes habian tenido relaciones sexuales, 50% tuvo su primera relacion antes de los 18 anos, 70% no utilizo algun metodo anticonceptivo. El 41.5% reporto haber tenido tres o mas parejas sexuales, 28% un embarazo, 14.6% un aborto, 4.9% una infeccion de transmision sexual, 22% indico haber sufrido abuso sexual en su primera relacion y el 14% en subsecuentes. La mayoria contesto que nunca o casi nunca han conversado con sus padres sobre los temas evaluados, y con sus madres lo han hecho con poca frecuencia. Se discute la necesidad de desarrollar mas investigaciones y programas preventivos para disminuir situaciones de riesgo en jovenes con discapacidad.

Comportamientos de riesgo y abuso sexual en varones y mujeres con discapacidad visual o auditiva

The present study proposed a descriptive analysis of sociodemographic and family variables, as well as risky sexual behaviors and sexual abuse in a sample of young Mexicans with hearing or visual impairments, examining differences based on gender and type of disability of the participants. 128 young persons (64 hearing impaired and 64 visually impaired) of whom, 53.2% were male and 86.6% were single, were included in the study. The instruments used were adapted linguistically to be answered by young people with hearing disabilities, and translated into Braille for visually impaired young people. The results show that participants maintain an active sex life with a risk profile that is characterized by the early onset of sexual intercourse, lack of planning their first sexual encounter, underuse of condoms and victimization of some form of sexual abuse. The risk was higher in women and among those with visual disabilities.

EVALUATION OF AN INTERVENTION PROGRAM TO PROMOTE SEXUAL HEALTH AMONG MEXICAN ADOLESCENTS IN CONFLICT WITH THE LAW

The purpose of this research was to evaluate the effectiveness of an intervention program to promote sexual health of adolescents in conflict with the law. The study was carried out with 118 adolescents belonging to a diagnosis community. A quasi-experimental design was used with an intervention group and one control group, consisting of three phases: preevaluation, intervention and post-evaluation. The intervention, which consisted of five sessions of two hours each one, comprised the elements that respond to the ecological model in its three levels: micro-system (knowledge, believes, attitudes, intentions and self-efficacy to use condoms, self-esteem, communication with partner, negotiating styles, etc.); meso-system (support, supervision and communication with parent, etc.) and macro-system (gender stereotypes). An analysis of repeated measures was performed. Results showed changes between control and experimental groups, in favor of the latter in all the variables of the model, except for partner communication and self-esteem. The findings are discussed in terms of the importance of designing programs based on the ecological model aimed at people who are deprived of freedom.El proposito de la presente investigacion fue evaluar la efectividad de un programa de intervencion para promover la salud sexual de adolescentes que se encuentran en conflicto con la ley. Se trabajo con 118 adolescentes pertenecientes a una comunidad de diagnostico. Se utilizo un diseno cuasiexperimental con un grupo de intervencion y uno control, conformado por tres fases: preevaluacion, intervencion y postevaluacion. La intervencion consistio en cinco sesiones de dos horas cada una, y estuvo conformada por los elementos que responden al modelo ecologico en sus tres niveles: microsistema (conocimientos, creencias, actitudes, intencion y autoeficacia para usar condon, autoestima, comunicacion con pareja, estilos de negociacion para usar condon, entre otras); mesosistema (apoyo, supervision y comunicacion con padre y madre, entre otras), y macrosistema (estereotipos de genero). Se realizo un analisis de medidas repetidas. Los resultados mostraron cambios entre el grupo control y el experimental, a favor de este ultimo en todas las variables del modelo, excepto en comunicacion con la pareja y autoestima. Los hallazgos se discuten en terminos de la importancia de disenar programas con base en el modelo ecologico dirigidos a poblacion que se encuentran en un ambiente privado de la libertad. Abstract The purpose of this research was to evaluate the effectiveness of an intervention program to promote sexual health of adolescents in conflict with the law. The study was carried out with 118 adolescents belonging to a diagnosis community. A quasi-experimental design was used with an intervention group and one control group, consisting of three phases: preevaluation, intervention and post-evaluation. The intervention, which consisted of five sessions of two hours each one, comprised the elements that respond to the ecological model in its three levels: micro-system (knowledge, believes, attitudes, intentions and self-efficacy to use condoms, self-esteem, communication with partner, negotiating styles, etc.); meso-system (support, supervision and communication with parent, etc.) and macro-system (gender stereotypes). An analysis of repeated measures was performed. Results showed changes between control and experimental groups, in favor of the latter in all the variables of the model, except for partner communication and self-esteem. The findings are discussed in terms of the importance of designing programs based on the ecological model aimed at people who are deprived of freedom. Resumo O proposito desta pesquisa foi avaliar a efetividade de um programa de intervencao para promover a saude sexual de adolescentes que se encontram em conflito com a lei. Trabalhou-se com 118 adolescentes pertencentes a uma comunidade de diagnostico. Foi utilizado um desenho quase-experimental com um grupo de intervencao e um de controle, conformado por tres fases: pre-avaliacao, intervencao e pos-avaliacao. A intervencao consistiu em cinco sessoes de duas horas cada uma e foi formada pelos elementos que respondem ao modelo ecologico em seus tres niveis: microssistema (conhecimentos, crencas, atitudes, intencao e autoeficacia para usar preservativo, autoestima, comunicacao com o parceiro, estilos de negociacao para usar preservativo, entre outros); mesossistema (apoio, supervisao e comunicacao com os pais, entre outros) e macrossistema (estereotipos de genero). Foi realizada uma analise de medidas repetidas. Os resultados mostraram mudancas entre o grupo controle e o experimental a favor deste ultimo em todas as variaveis do modelo, exceto em comunicacao com o parceiro e autoestima. Os achados sao discutidos quanto a importância de desenhar programas com base no modelo ecologico dirigidos a populacao que se encontra num ambiente privado de liberdade.

AVALIAÇÃO DE UM PROGRAMA DE INTERVENÇÃO PARA PROMOVER A SAÚDE SEXUAL DE ADOLESCENTES MEXICANOS EM CONFLITO COM A LEI

The purpose of this research was to evaluate the effectiveness of an intervention program to promote sexual health of adolescents in conflict with the law. The study was carried out with 118 adolescents belonging to a diagnosis community. A quasi-experimental design was used with an intervention group and one control group, consisting of three phases: preevaluation, intervention and post-evaluation. The intervention, which consisted of five sessions of two hours each one, comprised the elements that respond to the ecological model in its three levels: micro-system (knowledge, believes, attitudes, intentions and self-efficacy to use condoms, self-esteem, communication with partner, negotiating styles, etc.); meso-system (support, supervision and communication with parent, etc.) and macro-system (gender stereotypes). An analysis of repeated measures was performed. Results showed changes between control and experimental groups, in favor of the latter in all the variables of the model, except for partner communication and self-esteem. The findings are discussed in terms of the importance of designing programs based on the ecological model aimed at people who are deprived of freedom.El proposito de la presente investigacion fue evaluar la efectividad de un programa de intervencion para promover la salud sexual de adolescentes que se encuentran en conflicto con la ley. Se trabajo con 118 adolescentes pertenecientes a una comunidad de diagnostico. Se utilizo un diseno cuasiexperimental con un grupo de intervencion y uno control, conformado por tres fases: preevaluacion, intervencion y postevaluacion. La intervencion consistio en cinco sesiones de dos horas cada una, y estuvo conformada por los elementos que responden al modelo ecologico en sus tres niveles: microsistema (conocimientos, creencias, actitudes, intencion y autoeficacia para usar condon, autoestima, comunicacion con pareja, estilos de negociacion para usar condon, entre otras); mesosistema (apoyo, supervision y comunicacion con padre y madre, entre otras), y macrosistema (estereotipos de genero). Se realizo un analisis de medidas repetidas. Los resultados mostraron cambios entre el grupo control y el experimental, a favor de este ultimo en todas las variables del modelo, excepto en comunicacion con la pareja y autoestima. Los hallazgos se discuten en terminos de la importancia de disenar programas con base en el modelo ecologico dirigidos a poblacion que se encuentran en un ambiente privado de la libertad. Abstract The purpose of this research was to evaluate the effectiveness of an intervention program to promote sexual health of adolescents in conflict with the law. The study was carried out with 118 adolescents belonging to a diagnosis community. A quasi-experimental design was used with an intervention group and one control group, consisting of three phases: preevaluation, intervention and post-evaluation. The intervention, which consisted of five sessions of two hours each one, comprised the elements that respond to the ecological model in its three levels: micro-system (knowledge, believes, attitudes, intentions and self-efficacy to use condoms, self-esteem, communication with partner, negotiating styles, etc.); meso-system (support, supervision and communication with parent, etc.) and macro-system (gender stereotypes). An analysis of repeated measures was performed. Results showed changes between control and experimental groups, in favor of the latter in all the variables of the model, except for partner communication and self-esteem. The findings are discussed in terms of the importance of designing programs based on the ecological model aimed at people who are deprived of freedom. Resumo O proposito desta pesquisa foi avaliar a efetividade de um programa de intervencao para promover a saude sexual de adolescentes que se encontram em conflito com a lei. Trabalhou-se com 118 adolescentes pertencentes a uma comunidade de diagnostico. Foi utilizado um desenho quase-experimental com um grupo de intervencao e um de controle, conformado por tres fases: pre-avaliacao, intervencao e pos-avaliacao. A intervencao consistiu em cinco sessoes de duas horas cada uma e foi formada pelos elementos que respondem ao modelo ecologico em seus tres niveis: microssistema (conhecimentos, crencas, atitudes, intencao e autoeficacia para usar preservativo, autoestima, comunicacao com o parceiro, estilos de negociacao para usar preservativo, entre outros); mesossistema (apoio, supervisao e comunicacao com os pais, entre outros) e macrossistema (estereotipos de genero). Foi realizada uma analise de medidas repetidas. Os resultados mostraram mudancas entre o grupo controle e o experimental a favor deste ultimo em todas as variaveis do modelo, exceto em comunicacao com o parceiro e autoestima. Os achados sao discutidos quanto a importância de desenhar programas com base no modelo ecologico dirigidos a populacao que se encontra num ambiente privado de liberdade.

Evaluación de un programa de intervención para promover la salud sexual en adolescentes mexicanos en conflicto con la ley

The purpose of this research was to evaluate the effectiveness of an intervention program to promote sexual health of adolescents in conflict with the law. The study was carried out with 118 adolescents belonging to a diagnosis community. A quasi-experimental design was used with an intervention group and one control group, consisting of three phases: preevaluation, intervention and post-evaluation. The intervention, which consisted of five sessions of two hours each one, comprised the elements that respond to the ecological model in its three levels: micro-system (knowledge, believes, attitudes, intentions and self-efficacy to use condoms, self-esteem, communication with partner, negotiating styles, etc.); meso-system (support, supervision and communication with parent, etc.) and macro-system (gender stereotypes). An analysis of repeated measures was performed. Results showed changes between control and experimental groups, in favor of the latter in all the variables of the model, except for partner communication and self-esteem. The findings are discussed in terms of the importance of designing programs based on the ecological model aimed at people who are deprived of freedom.El proposito de la presente investigacion fue evaluar la efectividad de un programa de intervencion para promover la salud sexual de adolescentes que se encuentran en conflicto con la ley. Se trabajo con 118 adolescentes pertenecientes a una comunidad de diagnostico. Se utilizo un diseno cuasiexperimental con un grupo de intervencion y uno control, conformado por tres fases: preevaluacion, intervencion y postevaluacion. La intervencion consistio en cinco sesiones de dos horas cada una, y estuvo conformada por los elementos que responden al modelo ecologico en sus tres niveles: microsistema (conocimientos, creencias, actitudes, intencion y autoeficacia para usar condon, autoestima, comunicacion con pareja, estilos de negociacion para usar condon, entre otras); mesosistema (apoyo, supervision y comunicacion con padre y madre, entre otras), y macrosistema (estereotipos de genero). Se realizo un analisis de medidas repetidas. Los resultados mostraron cambios entre el grupo control y el experimental, a favor de este ultimo en todas las variables del modelo, excepto en comunicacion con la pareja y autoestima. Los hallazgos se discuten en terminos de la importancia de disenar programas con base en el modelo ecologico dirigidos a poblacion que se encuentran en un ambiente privado de la libertad. Abstract The purpose of this research was to evaluate the effectiveness of an intervention program to promote sexual health of adolescents in conflict with the law. The study was carried out with 118 adolescents belonging to a diagnosis community. A quasi-experimental design was used with an intervention group and one control group, consisting of three phases: preevaluation, intervention and post-evaluation. The intervention, which consisted of five sessions of two hours each one, comprised the elements that respond to the ecological model in its three levels: micro-system (knowledge, believes, attitudes, intentions and self-efficacy to use condoms, self-esteem, communication with partner, negotiating styles, etc.); meso-system (support, supervision and communication with parent, etc.) and macro-system (gender stereotypes). An analysis of repeated measures was performed. Results showed changes between control and experimental groups, in favor of the latter in all the variables of the model, except for partner communication and self-esteem. The findings are discussed in terms of the importance of designing programs based on the ecological model aimed at people who are deprived of freedom. Resumo O proposito desta pesquisa foi avaliar a efetividade de um programa de intervencao para promover a saude sexual de adolescentes que se encontram em conflito com a lei. Trabalhou-se com 118 adolescentes pertencentes a uma comunidade de diagnostico. Foi utilizado um desenho quase-experimental com um grupo de intervencao e um de controle, conformado por tres fases: pre-avaliacao, intervencao e pos-avaliacao. A intervencao consistiu em cinco sessoes de duas horas cada uma e foi formada pelos elementos que respondem ao modelo ecologico em seus tres niveis: microssistema (conhecimentos, crencas, atitudes, intencao e autoeficacia para usar preservativo, autoestima, comunicacao com o parceiro, estilos de negociacao para usar preservativo, entre outros); mesossistema (apoio, supervisao e comunicacao com os pais, entre outros) e macrossistema (estereotipos de genero). Foi realizada uma analise de medidas repetidas. Os resultados mostraram mudancas entre o grupo controle e o experimental a favor deste ultimo em todas as variaveis do modelo, exceto em comunicacao com o parceiro e autoestima. Os achados sao discutidos quanto a importância de desenhar programas com base no modelo ecologico dirigidos a populacao que se encontra num ambiente privado de liberdade.