Sexual and reproductive health and access : Results of a rapid epidemiological assessment among migrant peoples in transit through Darién, Panamá

Background: The foot transit of migrant peoples originating from the Caribbean, South America, Asia, and Sub-Saharan Africa through the Darién Forest (DF) in Eastern Panamá towards North America has increased in recent years from approximately 30,000 people/year to >133,000 in 2021. In the DF, there is no food/housing provision nor healthcare access. Very little is known of sexual and reproductive health (SRH) among this population. This study used rapid epidemiological methods to describe the SRH situation among migrant peoples in transit through the DF. Methods: This cross-sectional study randomly selected migrant people in transit (men and women) at a Migrant Reception Station in Darién, Panamá, between January 4-11, 2022. Data collection included a self-applied questionnaire (≥18 years); clinical screening (≥12 years); and HCG, treponemal antibodies, and HIV(I/II) lateral-flow tests with blood samples (≥12 years). Descriptive analyses were used to report findings. Results: In all, 69 men and 55 women participated in the self-applied questionnaire, 70 men and 51 women in clinical screening; 78 men and 63 women in HCG, treponemal antibody and HIV testing. Overall, 26.1% (18/69) men and 36.4% (20/55) women reported sexual intercourse within the past month. The last sex partner was casual among 43.0% (21/49) of men and 27.8% (10/36) of women; of those, 42.9% (9/21) of men and 80.0% (8/10) of women reported this sex was condomless. Among women, 20.0% (11/55) tested positive for pregnancy; 5 of these pregnancies were planned. Of those screened, a reproductive tract infection symptom was reported by 5.7% (4/70) of men and 58.8% (30/51) of women. A total of 32.7% (18/55) of men and 18.2% (8/44) of women reported no prior HIV testing. Of 78 men, HIV and treponemal antibodies were found among 1.3% (n = 1) and 2.6% (n = 2), and among 63 women, 3.2% (n = 2) and 3.2% (n = 2), respectively. Conclusions: This rapid epidemiological assessment found high recent sexual activity, low condom use with casual partners, and a need for increased HIV and syphilis testing and treatment. There is a need for increased testing, condom provision, and SRH healthcare access at migrant reception stations that receive migrant peoples in transit through Panamá

Dating violence prevalence and risk factors among adolescents (14-19 years) in urban public schools in Panama.

BACKGROUND: Adolescent dating violence (ADV) can have lasting effects on youth's well-being and development. However, few studies in Latin America have described its prevalence and risk factors for having experienced ADV. METHODS: We conducted a multisite, cross-sectional study using two-stage cluster sampling among adolescents (14-19 years) attending public high schools in the urban districts of Panama, San Miguelito, Colón, and Arraiján/La Chorrera from 2015 to 2018 (N = 2469). All completed a tablet-based, self-administered questionnaire. Random effects logistic regression was used to identify risk factors for each ADV type among adolescent boys and girls separately. FINDINGS: Participants reported experiencing a range of ADV at least once (girls: emotional 61.6%, physical 7.9%, sexual 21.0%; boys: emotional 73.4%, physical 24.1%, sexual 28.9%). In adjusted models, participants with a history of sexual intercourse had greater odds of ADV than those without such history across types (boys: emotional and sexual; girls: emotional, physical, and sexual). Additionally, participants who reported three or more romantic partners in the past year had greater odds of ADV than those with one partner (boys: emotional, physical; girls: physical). Girls with an earlier sexual debut (≤14 years vs ≥15 years) had greater odds of reporting ADV (emotional and sexual violence). No associations were found between reporting dating violence survival and the sex of romantic partners in the past year or the age of the current/most recent sex partner. INTERPRETATION: This study reveals a high prevalence of ADV among adolescents in urban public schools in Panama. These findings support the need for program implementation to address ADV. FUNDING: Funding to undertake this study was acquired from Panama's Ministry of Economics and Finance, project number 009044.049

Dating violence prevalence and risk factors among adolescents (14–19 years) in urban public schools in PanamaResearch in context

Summary: Background: Adolescent dating violence (ADV) can have lasting effects on youth's well-being and development. However, few studies in Latin America have described its prevalence and risk factors for having experienced ADV. Methods: We conducted a multisite, cross-sectional study using two-stage cluster sampling among adolescents (14–19 years) attending public high schools in the urban districts of Panama, San Miguelito, Colón, and Arraiján/La Chorrera from 2015 to 2018 (N = 2469). All completed a tablet-based, self-administered questionnaire. Random effects logistic regression was used to identify risk factors for each ADV type among adolescent boys and girls separately. Findings: Participants reported experiencing a range of ADV at least once (girls: emotional 61.6%, physical 7.9%, sexual 21.0%; boys: emotional 73.4%, physical 24.1%, sexual 28.9%). In adjusted models, participants with a history of sexual intercourse had greater odds of ADV than those without such history across types (boys: emotional and sexual; girls: emotional, physical, and sexual). Additionally, participants who reported three or more romantic partners in the past year had greater odds of ADV than those with one partner (boys: emotional, physical; girls: physical). Girls with an earlier sexual debut (≤14 years vs ≥15 years) had greater odds of reporting ADV (emotional and sexual violence). No associations were found between reporting dating violence survival and the sex of romantic partners in the past year or the age of the current/most recent sex partner. Interpretation: This study reveals a high prevalence of ADV among adolescents in urban public schools in Panama. These findings support the need for program implementation to address ADV. Funding: Funding to undertake this study was acquired from Panama's Ministry of Economics and Finance, project number 009044.049

U.S. bound journey of migrant peoples InTransit across Dante's Inferno and Purgatory in the Americas

Rapid rise of population migration is a defining feature of the 21st century due to the impact of climate change, political instability, and socioeconomic downturn. Over the last decade, an increasing number of migrant peoples travel across the Americas to reach the United States seeking asylum or cross the border undocumented in search of economic opportunities. In this journey, migrant people experience violations of their human rights, hunger, illness, violence and have limited access to medical care. In the ‘Divine Comedy’, the Italian poet Dante Alighieri depicts his allegorical pilgrimage across Hell and Purgatory to reach Paradise. More than 700 years after its publication, Dante's poem speaks to the present time and the perilious journey of migrant peoples to reach safehavens. By exploring the depths and heights of the human condition, Dante's struggles resonate with the multiple barriers and the unfathomable experiences faced by migrant peoples in transit across South, Central, and North America to reach the United States. Ensuring the safety of migrant peoples across the Americas and elsewhere, and attending to their health needs during their migratory paths represent modern priorities to reduce social injustices and achieving health equity.Fund Neglected Tropical Diseases of the University of Colorado by Mr. Howard Janzen