Human Papillomavirus (HPV) Vaccination and Adolescent Girls' Knowledge and Sexuality in Western Uganda: A Comparative Cross-Sectional Study.

The purpose of the study was to investigate the influence of human papillomavirus (HPV) vaccination on adolescent girls' knowledge of HPV and HPV vaccine, perception of sexual risk and intentions for sexual debut. This cross-sectional comparative study was conducted in Ibanda and Mbarara districts. Data was collected using a standardized self-administered questionnaire and analyzed using the Statistical Package for the Social Sciences computer software. Univariate, bivariate, and logistic regression analyses were conducted with significance level set at p < .05. Results showed that HPV vaccination was associated with being knowledgeable (Crude OR: 5.26, CI: 2.32-11.93; p = 0.000). Vaccination against HPV did not predict perception of sexual risk. Knowledge was low (only 87/385 or 22.6% of vaccinated girls were knowledgeable), but predicted perception of a high sexual risk (Adjusted OR: 3.12, CI: 1.37-3.63; p = 0.008). HPV vaccination, knowledge and perceived sexual risk did not predict sexual behaviour intentions. High parental communication was associated with adolescent attitudes that support postponement of sexual debut in both bivariate and multiple regression analyses. In conclusion, findings of this study suggest that HPV vaccination is not likely to encourage adolescent sexual activity. Influence of knowledge on sexual behaviour intentions was not definitively explained. Prospective cohort studies were proposed to address the emerging questions

Prevalence and risk factors of attempted suicide in adult war-affected population of eastern Uganda.

BACKGROUND: There is conflicting evidence on the relationship between war trauma and suicidal behavior. Some studies point to an increased risk of suicidal behavior while others do not, with a paucity of such data from sub-Saharan Africa. AIMS: To investigate the prevalence and risk factors of attempted suicide in war-affected Eastern Uganda. METHOD: A cross-sectional survey was carried out in two districts of Eastern Uganda where 1,560 respondents (15 years and older) were interviewed. Multivariable logistic regression was used to assess risk factors of attempted suicide in this population. RESULTS: Lifetime attempted suicide was 9.2% (n = 142; 95% CI, 7.8%-10.8%), and 12-month attempted suicide was 2.6% (n = 41; 95% CI, 1.9-3.5%). Lifetime attempted suicide was significantly higher among females 101 (11.1%) than among males 43 (6.5%; OR = 1.80, 95% CI 1.21-2.65). Factors independently associated with lifetime rate of attempted suicide among females were subcounty, being a victim of intimate partner violence, having reproductive health complaints, and having major depressive disorder. Among males these were belonging to a war-vulnerable group, having a surgical complaint, and having a major depressive disorder. CONCLUSIONS: In both sexes, the lifetime rate of attempted suicide was not independently directly related to experiences of war trauma. It was, however, indirectly related to war trauma through its association with psychological, somatic, and psychosocial sequelae of war

Background characteristics of respondents by level of perceived sexual risk.

<p><b>Notes</b>:</p><p>¹ Vaccinated represents the sample from Ibanda; unvaccinated represents the Mbarara sample.</p><p>Background characteristics are the predictors while perceived risk for HIV and other STIs infection is the outcome.</p><p>For all background or predictor variables, high risk odds are divided by low risk odds.</p><p>Significance is at <i>p</i> ≤ 0.05.</p><p>Background characteristics of respondents by level of perceived sexual risk.</p

Predictors of perceived sexual risk derived by logistic regression analysis.

<p><b>Note</b>:</p><p>** Significant at <i>p</i> ≤ 0.01</p><p>Predictors of perceived sexual risk derived by logistic regression analysis.</p

Predictors of attitudes towards postponement of sexual debut (PSD) derived by logistic regression analysis.

<p><b>Notes:</b> Number of observations = 645.</p><p>*Significant at <i>p</i> ≤ 0.05.</p><p>Predictors of attitudes towards postponement of sexual debut (PSD) derived by logistic regression analysis.</p

Background characteristics of respondents by attitudes towards postponement of sexual debut (PSD).

<p><b>Notes</b>:</p><p>¹ Vaccinated represents the sample from Ibanda; unvaccinated represents the Mbarara sample.</p><p>⁺Figures do not add up to 357 due to a missing case.</p><p>Background characteristics are the predictors while attitude towards postponement of sexual debut is the outcome.</p><p>For all background or predictor variables, 2^nd column odds are divided by 3^rd column odds.</p><p>Significance is at <i>p</i> ≤ 0.05.</p><p>Background characteristics of respondents by attitudes towards postponement of sexual debut (PSD).</p

“Thinking too much”: A systematic review of a common idiom of distress

Idioms of distress communicate suffering via reference to shared ethnopsychologies, and better understanding of idioms of distress can contribute to effective clinical and public health communication. This systematic review is a qualitative synthesis of “thinking too much” idioms globally, to determine their applicability and variability across cultures. We searched eight databases and retained publications if they included empirical quantitative, qualitative, or mixed-methods research regarding a “thinking too much” idiom and were in English. In total, 138 publications from 1979–2014 met inclusion criteria. We examined the descriptive epidemiology, phenomenology, etiology, and course of “thinking too much” idioms and compared them to psychiatric constructs. “Thinking too much” idioms typically reference ruminative, intrusive, and anxious thoughts and result in a range of perceived complications, physical and mental illnesses, or even death. These idioms appear to have variable overlap with common psychiatric constructs, including depression, anxiety, and PTSD. However, “thinking too much” idioms reflect aspects of experience, distress, and social positioning not captured by psychiatric diagnoses and often show wide within-cultural variation, in addition to between-cultural differences. Taken together, these findings suggest that “thinking too much” should not be interpreted as a gloss for psychiatric disorder nor assumed to be a unitary symptom or syndrome within a culture. We suggest five key ways in which engagement with “thinking too much” idioms can improve global mental health research and interventions: it (1) incorporates a key idiom of distress into measurement and screening to improve validity of efforts at identifying those in need of services and tracking treatment outcomes; (2) facilitates exploration of ethnopsychology in order to bolster cultural appropriateness of interventions; (3) strengthens public health communication to encourage engagement in treatment; (4) reduces stigma by enhancing understanding, promoting treatment-seeking, and avoiding unintentionally contributing to stigmatization; and (5) identifies a key locally salient treatment target