Routine Opt-Out HIV Testing Strategies in a Female Jail Setting: A Prospective Controlled Trial

Background: Ten million Americans enter jails annually. The objective was to evaluate new CDC guidelines for routine optout HIV testing and examine the optimal time to implement routine opt-out HIV testing among newly incarcerated jail detainees. Methods: This prospective, controlled trial of routine opt-out HIV testing was conducted among 323 newly incarcerated female inmates in Connecticut’s only women’s jail. 323 sequential entrants to the women’s jail over a five week period in August and September 2007 were assigned to be offered routine opt-out HIV testing at one of three points after incarceration: immediate (same day, n = 108), early (next day, n = 108), or delayed (7 days, n = 107). The primary outcome was the proportion of women in each group consenting to testing. Results: Routine opt-out HIV testing was significantly highest (73%) among the early testing group compared to 55 % for immediate and 50 % for 7 days post-entry groups. Other factors significantly (p = 0.01) associated with being HIV tested were younger age and low likelihood of early release from jail based on bond value or type of charge for which women were arrested. Conclusions: In this correctional facility, routine opt-out HIV testing in a jail setting was feasible, with highest rates of testing if performed the day after incarceration. Lower testing rates were seen with immediate testing, where there is a high prevalence of inability or unwillingness to test, and with delayed testing, where attrition from jail increases with each passing day

Mapping patterns of complementary and alternative medicine use in cancer: An explorative cross-sectional study of individuals with reported positive "exceptional" experiences

<p>Abstract</p> <p>Background</p> <p>While the use of complementary and alternative medicine (CAM) among cancer patients is common and widespread, levels of commitment to CAM vary. "Committed" CAM use is important to investigate, as it may be associated with elevated risks and benefits, and may affect use of biomedically-oriented health care (BHC). Multiple methodological approaches were used to explore and map patterns of CAM use among individuals postulated to be committed users, voluntarily reporting exceptional experiences associated with CAM use after cancer diagnosis.</p> <p>Method</p> <p>The verbatim transcripts of thirty-eight unstructured interviews were analyzed in two steps. First, manifest content analysis was used to elucidate and map participants' use of CAM, based on the National Center for Complementary Medicine (NCCAM)'s classification system. Second, patterns of CAM use were explored statistically using principal component analysis.</p> <p>Findings</p> <p>The 38 participants reported using a total of 274 specific CAM (median = 4) consisting of 148 different therapeutic modalities. Most reported therapies could be categorized using the NCCAM taxonomy (n = 224). However, a significant number of CAM therapies were not consistent with this categorization (n = 50); consequently, we introduced two additional categories: <it>Spiritual/health literature </it>and <it>Treatment centers</it>. The two factors explaining the largest proportion of variation in CAM usage patterns were a) number of CAM modalities used and b) a category preference for <it>Energy therapies </it>over the categories <it>Alternative Medical Systems </it>and <it>Treatment centers </it>or vice versa.</p> <p>Discussion</p> <p>We found considerable heterogeneity in patterns of CAM use. By analyzing users' own descriptions of CAM in relation to the most commonly used predefined professional taxonomy, this study highlights discrepancies between user and professional conceptualizations of CAM not previously addressed. Beyond variations in users' reports of CAM, our findings indicate some patterns in CAM usage related to number of therapies used and preference for different CAM categories.</p

A violência de gênero e o processo saúde-doença das mulheres La violencia de género y el proceso salud-enfermedad de las mujeres The violence of gender and health-disease process of women

Trata-se de um estudo que teve como objetivo compreender e analisar as repercussões da violência conjugal no processo saúde-doença das mulheres. È resultado da reanálise do material obtido em uma investigação por meio de entrevistas com mulheres em situação de violência e de denúncia, na Delegacia da Mulher no Município de João Pessoa - PB. A análise dos discursos evidenciou que a violência conjugal é um fenômeno social recorrente e multifacetado que influencia significativamente a saúde das mulheres que a vivenciam. Seu enfrentamento exige dos profissionais de saúde o reconhecimento de que a violência é um problema de saúde coletiva que perpassa todas as dimensões das relações sociais, cujas raízes encontram-se nas desigualdades de gênero. Tal fenômeno necessita de ser captado, compreendido e combatido em todas as dimensões da realidade social.<br>Tratase de un estudio cuyo objetivo fue analizar y comprender el impacto de la violencia conyugal en el proceso salud-enfermedad de las mujeres. Es resultado de la revisión del material obtenido en una investigación a través de entrevistas con mujeres en situación de violencia y abuso, en la Comisaría de Policía de la Mujer en la ciudad de João Pessoa PB (Brasil). El análisis de los testimonios evidenció que la violencia conyugal es un fenómeno social multifacético recurrente y que influye en forma significativa en la salud de las mujeres que vivencian esta experiencia. Confrontar esta problemática exige que los profesionales de la salud reconozcan que la violencia es un problema de salud colectiva que sobrepasa todas las dimensiones de las relaciones sociales, cuyas raíces están en la desigualdad de género. Este fenómeno debe ser comprendido y combatido en todas las dimensiones de la realidad social.<br>It is about a study that had as objective to understand and to analyze the repercussions of the conjugal violence in the process health-illness of the women. It's a result of analyses of the material gotten in an inquiry by means of interviews with women in situation of violence and denunciation, in the Police station of the Woman in the City of João Pessoa PB (Brazil). The analysis of the speeches evidenced that the conjugal violence is a recurrent and multifaceted social phenomenon that significantly influences the health of the women who lived it. Its confrontation demands from the health professionals, the recognition of this violence as a problem of collective health that crosses all the dimensions of the social relations, whose roots meet in the inequalities of gender. Such phenomenon needs to be caught, understood and fought in all the dimensions of the social realit