Parental Beliefs and Perceptions of the Role of Middle Schools in Student Tobacco Use Prevention Activities in Juárez, Mexico

The purpose of this study was to examine parental beliefs and perceptions of the role that schools should play in implementing smoking prevention activities for their children in Juárez, Mexico. The parents were of sixth grade students from six randomly selected middle schools. Schools were classified by school setting and socioeconomic status. A total of 506 surveys were sent to the homes of the parents and 77% (N=390) responded. The majority of the parents (88%) were supportive of smoking prevention activities. Furthermore, mothers were significantly more likely than fathers to agree that the school had an important role to play in smoking prevention activities (p<0.01). Parents of students in the low SES category regardless of school setting were significantly more likely to support the implementation of smoking prevention activities than parents of students who attended either a middle or high SES school setting (p<0.01). However, even though 79% of parent respondents believed their child’s school should get parental input about what should be taught in tobacco prevention programs, only 62% felt that such activities should include homework and projects involving families. These results provide further evidence that if school-based adolescent tobacco prevention programs are to be successful, public health initiatives need to do a much better job not only soliciting and receiving parental input with regard to proposed anti-tobacco curricula but also in convincing parents of the importance of becoming active participants in the process

Vulnerability Factors and Pathways Leading to Underage Entry into Sex Work in two Mexican-US Border Cities

The current wave of interest in human trafficking and the commercial sexual exploitation of children has exposed a lack of knowledge about the vulnerabilities leading to underage entry into sex work. This knowledge is necessary for the development of effective prevention programs to identify girls who are most at-risk, especially in Latin America, a region that is believed to be a large source of persons moved across international borders for the purposes of sexual and labor exploitation. The objective of this study was to explore and increase understanding of the vulnerability factors and pathways leading to underage entry into sex work experienced by women currently engaging in sex work in two cities on the northern border of Mexico. From August 2013 to October 2014, 20 female sex workers (FSWs) with a history of entry into sex work prior to age 18 were recruited for in-depth interviews from a larger time-location sample of female sex workers (FSWs) participating in a quantitative survey in Tijuana and Ciudad Juarez. The median age of entry into sex work was 14 (range 10-17); 12/21 participants reported being forced into sex work and, of these, 7 were transported to another city where they began engaging in sex work. Family dysfunction (e.g., domestic violence between parents, parent drug use, neglect, etc.), sexual and physical abuse, and teen pregnancy were among the key themes that emerged as vulnerabilities to underage entry into sex work. Women’s narratives clearly illustrated that the vulnerabilities and pathways leading to underage entry are manifold, complex, and often intersect with each other. Our findings begin to lay the groundwork for understanding the potential vulnerabilities and pathways leading to underage entry into sex, and may have relevance to Latin America in general. This study also provides a foundation for further research to explore what may mitigate these vulnerabilities as well as creating evidence-based interventions to prevent commercial sexual exploitation of minors in the region

Parental Beliefs and Perceptions of the Role of Middle Schools in Student Tobacco Use Prevention Activities in Juárez, Mexico

Abstract The purpose of this study was to examine parental beliefs and perceptions of the role that schools should play in implementing smoking prevention activities for their children in Juárez, Mexico. The parents were of sixth grade students from six randomly selected middle schools. Schools were classified by school setting and socioeconomic status. A total of 506 surveys were sent to the homes of the parents and 77% (N=390) responded. The majority of the parents (88%) were supportive of smoking prevention activities. Furthermore, mothers were significantly more likely than fathers to agree that the school had an important role to play in smoking prevention activities (p<0.01). Parents of students in the low SES category regardless of school setting were significantly more likely to support the implementation of smoking prevention activities than parents of students who attended either a middle or high SES school setting (p<0.01). However, even though 79% of parent respondents believed their child's school should get parental input about what should be taught in tobacco prevention programs, only 62% felt that such activities should include homework and projects involving families. These results provide further evidence that if school-based adolescent tobacco prevention programs are to be successful, public health initiatives need to do a much better job not only soliciting and receiving parental input with regard to proposed anti-tobacco curricula but also in convincing parents of the importance of becoming active participants in the process

Chronic Expanding Hematoma Secondary to Excision of Recurrent Myxomas in a Bitch

Background: Expanding chronic hematoma is a relatively common postoperative complication in humans, not in dogs, nevertheless, is important understand this condition because it may affect the animal's health. A hematoma could be formed within hours and usually stabilizes spontaneously with the reabsorption of its content. However, occasionally the hematoma slowly expands, becomes encapsulated and forms a mass, causing a chronic expanding hematoma. Possibly skin and adipose tissue are displaced secondary to trauma, causing the formation of blood-filled cysts surrounded by a fibrous capsule. The aim of this document is to present the first report of a postsurgical chronic expanding hematoma in dog. Case: A case of chronic expanding hematoma secondary to excision of recurrent myxoma in a bitch was described. Physical examination showed a hard, firm, non-mobile mass enclosed within the deep muscular layers. This mass was between the sternum and the cranial abdomen, similar to previous lesions excised by another veterinarian. Fine needle aspiration indicated the presence of blood. Radiology demonstrated that the bone-cartilage tissue was not involved. Due to the size of the mass, a skin stretching pre-suturing technique using self-adhesive tape was applied around the mass 48 h before surgery.  The mass was removed with wide excision margins and portions of the affected muscles, but a large wound with great tension was created; consequently, a parallel to the wound incision and the thoraco-lumbar vertebrae was made.  Six months after surgery, the animal presented recurrence of the same lesion, which was also removed. The bleeding times were within the normal range, but the animal was diagnosed with hyperadrenocorticism. After both surgeries histopathological exam revealed a hematoma, that had thrombosis and granulation tissue with fibrosis and severe panniculitis, in addition of multifocal, chronic, moderate lymphohistiocytic myositis; all these changes were compatible with a chronic expanding hematoma.  Discussion: Chronic expanding hematoma is a mass that grows slowly secondary to hemorrhage and does not exhibit elements of malignancy. However, it can occasionally be confused for a soft-tissue neoplasm. It has been reported frequently in humans but not in small animals. The first case was reported in 2002: 5 puppies with a cervical hematoma classified as a chronic expanding hematoma was described. In addition, 3 cases were reported: 1 cat with perirenal chronic expanding hematoma; 1 bitch with intra-abdominal presentation, and 1 cat with this pathology on the right pelvic limb after an intramuscular injection.  The etiology of chronic expansive hematoma is unidentified in dogs, nevertheless, it is stipulated that is not an inflammatory process as previously assumed, but rather a neoplastic process. As in other cases, it was difficult to determine the origin of the chronic expanding hematoma. The coagulation times and platelets count were within ranges. Similarly, it is very complicated to relate hyperadrenocorticism with chronic expanding hematoma because dogs with Cushing’s disease generally present hypercoagulopathies. Myxomas are associated with endocrinopathies in humans and dogs, therefore, hyperadrenocorticism is possibly related with this neoplasia. Myxomas have an expansive growth pattern, contrasting with myxosarcomas, which are infiltrating; Although in the present case the skin mass appeared to be invasive, both macroscopical and histopathological appearance of it corresponded to a well-shaped capsule compatible with chronic expanding hematoma. In summary, to the best of our knowledge, this is the first report of a post-surgical chronic expanding hematoma in a dog.    Keywords: dog, canine, surgery, expanding hematoma, postoperative complications, myxomas, small animal

Actitudes sexuales y uso del condón en estudiantes universitarios de Ciudad Juárez, México

Objetivo: Describir actitudes, conductas sexuales y prevalencia de uso del condón entre los estudiantes de una universidad mexicana en la frontera de México con Estados Unidos. Material y métodos: Estudio descriptivo con una muestra de 561 estudiantes universitarios quienes dieron su consentimiento informado previo a la aplicación de un cuestionario que se depositó en una urna cerrada y sellada para garantizar confidencialidad. Se realizó análisis univariado para describir las características generales de la muestra y se compararon grupos con respecto a conductas sexuales de riesgo mediante el cálculo de la razón de momios con intervalos de confianza al 95 % y prueba de ji cuadrada de Pearson. El análisis estadístico fue realizado con el programa SPSS versión 15 para Windows. Resultados: El 69.2 % (n=379) refieren antecedentes de actividad sexual coital. En promedio el inicio de la vida sexual para los hombres fue de 16.9 años y de 18.3 años para las mujeres; el 35.9 % no utilizaron condón en su primera relación. El 76.8 % reportaron vida sexual activa en los últimos 6 meses, y solo un tercera parte de ellos (33.9 %) reportó siempre usar condón para relaciones coitales. Una proporción baja (35.3 %) reportó antecedentes de exámenes de detección de ITS, pero la mayoría (90.7 %) estaba dispuesto a practicárselos. A pesar de que la mayoría (92 %) ha recibido información sobre uso de condón y de conductas de riesgo para transmisión de VIH/SIDA e ITS, más de la mitad (55.1 %) mostraron disposición para participar en talleres educativos sobre este tema. En este artículo además se reportan los resultados de otras características, actitudes y conductas sexuales y prevalencia de comportamientos de alto riesgo para contraer VIH/SIDA e ITS de estos estudiantes. Conclusiones: Los universitarios estudiados en esta ciudad fronteriza de México forman un grupo sexualmente activo con riesgo alto para adquirir ITS por sus actitudes y características de comportamiento sexual. Es necesario desarrollar e implementar campañas de promoción de uso del condón y para detección oportuna y tratamiento de ITS en este grupo. Abstract Objective: Describe sexual attitudes and behaviors, and prevalence of condom use among students in a mexican university on the Mexico-United States border Material and methods: A descriptive study with a sample of 561 university students who gave informed consent prior to the application of a questionnaire that they deposited in a closed and sealed box to guarantee confidentiality. Univariable analysis was done to describe general characteristics of the sample, and risk sexual behaviors were compared between groups using odds ratio with confidence intervals and Pearson ́s chi square test. The statistical analysis was performed with SPSS version 15 for Windows. Results: 69.2 % (n=379) reported history of prior sexual activity. The mean age for start of sexual activity was 16.9 years for men and 18.3 years for women; 35.9 % (n=136) did not use a condom for their first life-time sexual relation. 76.8 % (n=289) had an active sex life in the past six-months, with only a third of them (n=98) reporting to always use a condom for sexual relations. A low proportion (35.3 %) reported ever having had a laboratory test to detect an STD, but most (90.7 %) stated that they would be willing to undergo a test. Although most (92 %) had received information about condom use and high-risk behaviors for HIV/AIDS and STD transmission in the past, more than half (55.1 %) showed interest to participate in educational workshops. Other results about characteristics and attitudes of sexual behaviors and prevalence of high-risk behaviors for contracting HIV/AIDS and STD’s of these students are discussed in this report. Conclusions: The University students studied in this Mexican border city represent a sexually active group at high risk for contracting HIV/AIDS or STDs given their attitudes and characteristics of sexual behaviors. It is necessary to develop and implement condom promotion campaigns and early detection and treatment of HIV/AIDS and STDs in this group. Keywords: Condom use, sexual behavior, STD’s, sexually active, university students, Mexico

Cost-Effectiveness of an Intervention to Reduce HIV/STI Incidence and Promote Condom Use among Female Sex Workers in the Mexico–US Border Region

Previous research demonstrated efficacy of a brief behavioral intervention to reduce incidence of HIV and sexually transmitted infections (STIs) among female sex workers (FSWs) in Tijuana and Ciudad Juarez, Mexico, cities on Mexico's border with the US. We assessed this intervention's cost-effectiveness.A life-time Markov model was developed to estimate HIV cases prevented, changes in quality-adjusted life expectancy (QALE), and costs per additional quality-adjusted life year gained (QALY), comparing (in US$2,009) no intervention to a once-only and annual intervention. Future costs and health benefits were discounted annually at 3$183. For FSWs receiving the intervention annually, there were 29 additional HIV cases prevented and 4.5 additional months of QALE compared to the once-only intervention. The additional cost per QALY was US$1,075. When highly active antiretroviral therapy (HAART) was included in the model, the annual intervention strategy resulted in net savings and dominated both once-only and no intervention strategies, and remained robust across extensive sensitivity analyses. Even when considering clinical benefits from HAART, ignoring added costs, the cost per QALY gained remained below three times the Mexican GDP per capita, and below established cost-effectiveness thresholds.This brief intervention was shown to be cost-effective among FSWs in two Mexico-US border cities and may have application for FSWs in other resource-limited settings.ClinicalTrials.gov NCT00338845

"Amar te Duele" ("love hurts"): sexual relationship power, intimate partner violence, depression symptoms and HIV risk among female sex workers who use drugs and their non-commercial, steady partners in Mexico.

A significant body of research among female sex workers (FSWs) has focused on individual-level HIV risk factors. Comparatively little is known about their non-commercial, steady partners who may heavily influence their behavior and HIV risk. This cross-sectional study of 214 FSWs who use drugs and their male steady partners aged ≥18 in two Mexico-U.S. border cities utilized a path-analytic model for dyadic data based upon the Actor-Partner Interdependence Model to examine relationships between sexual relationship power, intimate partner violence (IPV), depression symptoms, and unprotected sex. FSWs' relationship power, IPV perpetration and victimization were significantly associated with unprotected sex within the relationship. Male partners' depression symptoms were significantly associated with unprotected sex within the relationship. Future HIV prevention interventions for FSWs and their male partners should address issues of sexual relationship power, IPV, and mental health both individually and in the context of their relationship

Policing behaviors, safe injection self-efficacy, and intervening on injection risks: Moderated mediation results from a randomized trial.

ObjectiveWe aim to use conditional or moderated mediation to simultaneously test how and for whom an injection risk intervention was efficacious at reducing receptive needle sharing among female sex workers who inject drugs (FSWs-IDUs) in Mexico.MethodsSecondary analysis of data from a randomized trial. A total of 300 FSW-IDUs participated in Mujer Mas Segura in Ciudad Juarez, Mexico, and were randomized to an interactive injection risk intervention or a didactic injection risk intervention. We measured safe injection self-efficacy as the hypothesized mediator and policing behaviors (being arrested and syringe confiscation) as hypothesized moderators. In total, 213 women provided complete data for the current analyses.ResultsConditional (moderated) mediation showed that the intervention affected receptive needle sharing through safe injection self-efficacy among women who experienced syringe confiscation. On average, police syringe confiscation was associated with lower safe injection self-efficacy (p = .04). Among those who experienced syringe confiscation, those who received the interactive (vs. didactic) intervention reported higher self-efficacy, which in turn predicted lower receptive needle sharing (p = .04).ConclusionsWhereas syringe confiscation by the police negatively affected safe injection self-efficacy and ultimately injection risk behavior, our interactive intervention helped to "buffer" this negative impact of police behavior on risky injection practices. The theory-based, active skills building elements included in the interactive condition, which were absent from the didactic condition, helped participants' self-efficacy for safer injection in the face of syringe confiscation