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Worldwide, the number of children 15 years and under living with HIV has increased from 1.6 million in 2001 to 2 million in 2007. The care of these children is demanding. The challenges related to this care are even more when it is delivered in homes where not the workers have training in the area. The was conducted to understand the level of knowledge and self-efficacy related to HIV communication among the workers in a home for children and families living with HIV. A cross sectional, descriptive study was conducted. The average age of participants was 39.37(±11.97) years, close to 50% had low levels of general HIV knowledge and HIV prevention knowledge. In relation to self-efficacy, the majority (61.9%) did not feel confident speaking about this topic with the children. These results demonstrate the need for training for people working with children who live with HIV, both in terms of content and communication abilities and the need to generate a continuous training program that assures the delivery of quality care.

Purpose Health and social care professionals are ideally placed to identify and address gender-based violence (GBV), yet research continues to demonstrate that the subject is being poorly covered at undergraduate level. This qualitative study explored health and social care students’ and educators’ views on GBV education, with a view to identifying ‘best practice’. We aimed to capture students’ and educators’ experiences and perceptions of GBV education across participating countries; how participants thought GBV should be taught/learned within their curricula; and their views on how GBV education might be ‘optimized’. Methods We conducted nine focus group discussions and one semi-structured interview with 23 students and 21 academic staff across the UK, Australia and Chile. Results Thematic analysis yielded three themes: (1) GBV addressed in all but name, (2) Introduce sooner, explore later and (3) A qualitative approach to learning. Educators and students indicated that GBV is largely being overlooked or incompletely addressed within curricula. Many participants expressed a wish for the subject to be introduced early and revisited throughout their study, with content evolving as cohorts mature. Lastly, our findings indicate that GBV education could benefit from adopting a ‘qualitative’ approach, prioritizing survivor narratives and incorporating dialogue to facilitate student engagement. Conclusion Though time constraints and competing demands within undergraduate curricula are frequently cited as barriers to moving away from traditional didactic methods, our findings suggest that teacher-centered strategies are insufficient and, in some regards, inappropriate for GBV education. The need for a paradigm shift in GBV education is discussed.

Objective: To understand the perspectives of pregnant and postpartum women living with HIV in Sofala, Mozambique, regarding barriers and facilitators to following Prevention of Mother-to-Child Transmission (PMTCT) recommendations. Method: Qualitative study conducted in three health centers and with a peer support group of women living with HIV, between October 2020 and March 2021. We applied purposeful sampling, semi-structured interviews, and content analysis. Results: Among the barriers that emerged were the social stigma associated with HIV-positive status and fear of discrimination, side effects of medications, economic barriers, and denial of diagnosis/treatment. As facilitating factors: peer support networks and inspiration, innate concern for health and family. Finally, they recommend that the community should become more educated about HIV. Conclusion: The results of this study give a broad understanding of the experience of women living with HIV in this province, making it possible to focus strategies in improving the care of women in PMTCT programs in Mozambique. RESUMO Objetivo: Compreender as perspectivas das mulheres grávidas ou puérperas vivendo com HIV em Sofala, Moçambique, sobre as barreiras e facilidades para seguir as recomendações para a Prevenção da Transmissão Materno-Infantil (PMTCT). Método: estudo qualitativo realizado em três centros de saúde e com um grupo de apoio de pares de mulheres vivendo com HIV, entre outubro de 2020 e março de 2021. Aplicou-se amostra intencional, entrevistas semiestruturadas e análise de conteúdo. Resultados: O estigma social associado a ser HIV positivo e o medo da discriminação, efeitos colaterais dos medicamentos, barreiras econômicas e negação do diagnóstico/tratamento surgiram como barreiras. Como fatores facilitadores: redes de apoio e inspiração dos pares, preocupação inata com a saúde e a família. Finalmente, eles recomendam que a comunidade se eduque mais sobre o HIV. Conclusão: Os resultados deste estudo proporcionam uma compreensão ampla da experiência das mulheres que vivem com o HIV nesta província, possibilitando centrarse em estratégias para melhorar o atendimento às mulheres nos programas de PTMI em Moçambique. RESUMEN Objetivo: Comprender las perspectivas de las mujeres embarazadas o en posparto viviendo con VIH en Sofala, Mozambique, respecto a las barreras y facilitadores para seguir las recomendaciones para la Prevención de Transmisión Materno Infantil (PTMI). Método: estudio cualitativo realizado en tres centros de salud y con un grupo de apoyo entre pares de mujeres viviendo con VIH, entre octubre de 2020 y marzo de 2021. Aplicamos muestreo intencional, entrevistas semiestructuradas y análisis de contenido. Resultados: Surgieron como barreras el estigma social que conlleva la condición de ser VIH positivo y el miedo a la discriminación, los efectos secundarios de los medicamentos, barreras económicas y la negación al diagnóstico/tratamiento. Como factores facilitadores: redes de apoyo e inspiración de pares, innata preocupación por la salud y la familia. Finalmente, ellas recomiendan que la comunidad se eduque más en materia de VIH. Conclusión: Los resultados de este estudio dan una comprensión amplia acerca de la experiencia de mujeres viviendo con VIH en esta provincia, posibilitando focalizar estrategias para mejorar la atención de las mujeres en los programas de PTMI en Mozambique.

Introduction: To address the phenomenon of gender-based violence in Latin America and the Caribbean is an issue of epic proportion that reflects the unequal power dynamics created within the binary gender system and is often perpetrated by those with more physical, cultural, or social power and inflicted upon those without. Method: Each database was comprehensively searched for MeSH keyword combinations of gender violence (violence against women) or (gender-based violence) with the region of interest (Latin America and the Caribbean) in addition to a third word or phrase regarding health care (health care training, training, health care curricula, curricula, health care professionals). Results: After completing this scope review, we have found a widespread call for more comprehensive preparation for health care professionals involved in identifying and addressing gender-based violence. Conclusions: Though some research has been conducted documenting the ways in which gender-based violence is managed or not managed by health care providers, Latin America and the Caribbean in particular represent a gap in research on health care tools and their effectiveness in these situations. There is a distinct need for the creation of context-specific protocols for vulnerable and underrepresented groups.

PURPOSE: The purpose of this study was to examine the influence of selected facilitators, barriers, beliefs, and knowledge suggested by the literature to be associated with human immunodeficiency virus (HIV) testing among heterosexual Hispanic women. DESIGN: This study utilizes a cross-sectional design to analyze secondary data from SEPA III: The Effectiveness Trial. SEPA stands for Salud, Educacion, Prevencion y Autocuidado, which translates to Health, Education, Prevention, and Self-Care. The Social Cognitive Model (SCM) guided this study. METHODS: Three hundred twenty heterosexual Hispanic women 18 to 50 years of age participated in this study. Data were analyzed using descriptive statistics and logistic regression. FINDINGS: The most common facilitators for HIV testing were receiving recommendations from a healthcare provider (HCP) and the test is offered by an HCP rather than women asking for it. The most common barrier to testing was having no reason to believe they were infected. Most women believed a positive test result would encourage them to take better care of themselves. However, as much as 15% of women reported desires to kill or hurt themselves if they test positive. On the other hand, a negative result would make them assume their partners are negative and thus do not need to be tested. Significantly, explanatory variables related to HIV testing were knowledge and the HIV test is offered by an HCP instead of women asking for it. CONCLUSIONS: Strengthening HIV knowledge and offering HIV tests are significant contributions that nurses make to the health of Hispanic women. The SCM can be used to design programs to increase HIV testing among Hispanic women. CLINICAL RELEVANCE: Nurses are encouraged to offer testing and provide culturally competent HIV prevention education to increase HIV testing among Hispanic women.

Introduction: HIV transmission presents an ongoing risk to Hispanic women, and prevention efforts remain a priority. The use of technology to prevent HIV transmission among Hispanic women and those of lower socioeconomic status underscore the need for effective implementation of technology. The purpose of this study is to describe technology preferences and predictors of the use of the internet for HIV prevention among low-income Hispanic women. Method: A secondary analysis was conducted using baseline data from an intervention to prevent HIV among 320 Hispanic women. The parent study was SEPA, Salud (health), Educación (education), Promoción (promotion), y [and] Autocuidado (self-care). Results: Most participants reported using personal technology, such as smartphones (90.6%), the internet (78.1%), and personal email (67.5%), every day. Most (71.3%) participants were open to learning about HIV education via the internet. In the logistic regression analysis, education and time since the last visit to the health care provider were significant predictors of the use of the internet to learn about HIV prevention, after controlling for age, living with the partner, and years living in the United States. Conclusion: Hispanic women demonstrated high levels of comfort with different forms of technology. These results indicated the potential to expand future HIV intervention efforts by implementing electronic dissemination of bilingual and culturally appropriate information for Hispanic women of diverse ages.

Indexación Scopus El objetivo fue explorar la influencia del nivel socioeconómico (NSE), como determinante estructural de la salud, sobre la construcción de significados y valor atribuidos a la obesidad. Se realizaron entrevistas semiestructuradas a usuarios de programas de obesidad de dos centros de salud, procurando diferencias en el NSE del público objetivo. A partir del análisis de contenido temático, los resultados se organizaron en cuatro categorías construidas inductivamente: 1) significado atribuido de vivir con obesidad, 2) conciencia manifiesta del impacto de la obesidad sobre la propia salud, 3) búsqueda vivida de alternativas ante la obesidad y 4) origen atribuido de la obesidad. Se observó que la obesidad, entendida como categoría médica, varió según NSE tanto en significado como en la forma en que es problematizada, tomando sentidos incluso contradictorios. El salutismo se incorporó de manera heterogénea entre distintos grupos socioeconómicos, reproduciéndose como estilo de vida. Así, el NSE, entrelazado con otros determinantes sociales estructurales de la salud, pudo influir no sólo en los resultados de salud de manera ‘causal’, sino también -a través de mecanismos donde participaron contextualmente- en la definición del estado de salud y en el valor atribuido a la salud. Considerar este efecto diferencial de los determinantes sociales de la salud en la obesidad, sería importante para el logro de intervenciones efectivas en salud. The objective of the study was to explore the influence of socio-economic status (SES), as a structural social determinant of health, in the construction of the meaning and value attached to obesity. To do so, we conducted semi-structured interviews with obesity care users from two health centres, targeting socio-economic differences amongst participants. Using thematic content analysis, the findings were organised into four inductively constructed categories, labelled as: 1) the meaning attached to suffering from obesity; 2) awareness of the impact of obesity on one’s health; 3) the search for alternatives while being obese; 4) attributed origin of obesity. Obesity was understood as a medical category, varied in meaning as well as in the way it was problematized depending on SES, acquiring contradictory meanings. Healthism is incorporated in a heterogeneous way among different socioeconomic groups, reproduced via specific lifestyles. Thus, SES, intertwined with other structural social determinants of health, was not only a ‘cause’ of the outcome but also contextually in the mechanisms through which health status and the value of health were defined. Considering this differential effect of social determinants of health would be important in designing appropriate health interventions. https://www-scielo-cl.recursosbiblioteca.unab.cl/scielo.php?script=sci_arttext&pid=S0717-75182020000600983&lng=en&nrm=iso&tlng=en

Latin America and Asia have been tied for hundreds of years through a transcontinental trade network, which has culminated in their current economic interdependence. This interdependence necessitates cooperation, which can be bolstered through cultural understanding between the two continents. International student mobility is one way to foster intercultural relations, which are currently quite low between these regions. Canada has faced a similar struggle as Latin America to attract students in the Americas when faced with competition from US universities, but has had some successes which Latin American countries could learn from. This study therefore completes a scoping review of the literature to categorize barriers and enablers to academic mobility between higher education institutions (HEIs) in Asia, Canada, and Latin America and synthesizes relevant suggestions. An integrative literature search of qualitative and quantitative studies was conducted using six different databases. After considering inclusion and exclusion criteria, 33 studies were selected and analyzed. The results were categorized into six themes: Cultural, Academic and Professional, Linguistic, Economic, Program Structure, and Political Climate. Each theme included factors which enabled or hindered student mobility between Asia and the Americas. The findings highlight the need for Latinamerican HEIs to emphasize relevant initiatives and qualities that go beyond rankings, boost the use of English among academics and staff, actively reach out to Asian partners, and collaborate to develop credit transfer policies compatible with Asian institutions. These considerations could be all the more timely considering students are currently more open to virtual international opportunities in the midst of the COVID-19 pandemic, generating possibilities of greater collaboration between these regions of the world.

Haiti, located on the western portion of the Caribbean island Hispaniola, faces many geopolitical and healthcare issues. Haiti carries the highest maternal mortality rate in the Western Hemisphere, and many women and children lack access to healthcare (WHO, 2015b). Various obstacles to access exist, including economics, transportation, and low ratios of healthcare providers to citizens. Haiti is one of the poorest countries in the world, with an annual gross national income per capita of $820 in 2014 (The World Bank, 2015b), making economics a barrier to accessing health care (The World Bank, 2015a). According to the International Monetary Fund (2015), Haiti lacks infrastructure and an appropriate number of health professionals for each inhabitant. Data available from the World Health Organization (WHO, 2015c) show that in 1998 there were 0.25 physicians per 1,000 inhabitants and 0.107 nurses and midwifery personnel per 1,000 inhabitants, making it difficult for Haitians to find a healthcare provider.The maternal mortality rate in Haiti is 380 deaths per 100,000 live births, compared to 85 deaths per 100,000 live births in the Latin American and Caribbean region (Pan American Health Organization, 2014). The adolescent fertility rate per 1,000 women was 65, based on the latest data available from 2009 (WHO, 2015a). In addition, no formal reports on abortion and its occurrence are available for the country. In particular, data about beliefs and practices as they relate to abortion in a country where it is an illegal practice could help illuminate some of the needs of the Haitian people (Martin, 2013). Because of the social stigma, unsafe abortions disproportionately affect developing nations, with more than 55% of abortions being performed in unsafe environments, compared to 92% of abortions in developed countries being performed in safe environments (Sedgh, Henshaw, Singh, Ahman, & Shah, 2007).Haitian women state that abortion stigma prevents access to care, and following abortion women often present with symptoms for more than a week before pursuing necessary postabortion care (Berry-Bibee et al., 2014). Generally, Haitian women do not have access to contraception, abortion is illegal, and women who seek an abortion endure a social stigma both culturally and religiously (Maternowska, 2006).Abortions in Haiti are governed by provisions of the Haitian Penal Code. The law regulating abortion is based on Article 317 of the French Penal Code of 1810. Under this law, any person performing an abortion is subject to imprisonment, and a medical professional who performs abortions is subject to forced labor (United Nations, 2011).With the cultural beliefs and judicial rulings in Haiti making abortion both illegal and illicit, many women seek clandestine abortions. International studies have revealed unsafe conditions for women seeking abortions, with many women acquiring severe infections postabortion and needing to go to tertiary care facilities when possible, potentially increasing women's mortality (Berry-Bibee et al., 2014; Martin, 2013; Maternowska, 2006; Sundaram, Juarez, Bankole, & Singh, 2012).In underdeveloped nations, such as Haiti, with strict abortion laws, women are susceptible to unsafe conditions for abortions. Often in these countries, women receive abortion services from people lacking the necessary skills and in environments deemed below the minimum medical standards. The legality of abortion plays a role in the safety of abortion procedures performed yet shows no correlation with the number of abortions performed (Sedgh et al., 2007).Women feeling the burden of childrearing often resort to herbal remedies and other concoctions to terminate pregnancy (Editorial, 2009; Maternowska, 2006). Often, women with available funds go to a private hospital or clinic and receive an abortion with anesthesia. However, women without monetary resources resort to herbal potions and unsafe abortion practices. …

Hospitalization is a good opportunity to offer smoking cessation programs to smokers. Healthcare providers′ (HCP) tobacco consumption and cessation attitudes are known to affect the provision of cessation interventions. Lesser known are Latino HCP’s tobacco intervention attitudes. This study aimed to examine the associations between tobacco cessation attitudes (TCA), levels of consumption, and demographics among Latino HCP’s. A quantitative, correlational, cross-sectional design was used. 66 HCP’s working in a public hospital in Santiago, Chile self-reported demographics (age, gender, profession), tobacco consumption, and TCA. TCA’s include questions regarding Acceptability of Brief Counseling (ABC), belief whether smoking is harmful for patients, and duty to aid patients quit smoking. Majority of HCP’s (34 years old, 83% female, 58.5% technical nurses, 38.5% nurses, 3.1% Kinesiologists) did not consume tobacco (67%). Pearson’s correlation revealed that greater HCP age was significantly associated with less belief that smoking is harmful for their patients (r = -.36, p. = .004). ABC (M = 22, SD = 5.5) was positively associated with the belief that smoking is harmful for patients (r = .306, p = .016) and duty to help patients quit smoking (r = .574, p = .000). Findings provide evidence that HCP’s TCA’s are important factors to consider during implementation of a brief counseling for tobacco cessation. Further research should focus on increasing HCP’s acceptability of providing cessation care to their patients. Specifically, tailoring education and interventions by age might serve useful to address the differences in TCA’s which may subsequently influence their tobacco cessation practices.

Objectives Despite research documenting significant health disparities among sexual minority women (lesbian, bisexual, and other non-heterosexual women) in high-income countries, few studies of sexual minority women’s health have been conducted in low- and middle-income countries. The purpose of this scoping review was to examine the empirical literature related to the health disparities and health needs of sexual minority women in Latin America and the Caribbean (LAC), and to identify research gaps and priorities. Design A scoping review methodology was used. Data sources We conducted a comprehensive search of seven electronic databases. The search strategy combined keywords in three areas: sexual minority women, health, and LAC. English, Spanish, and Portuguese language studies published through 2017 in peer-reviewed journals were included. Review methods A total 1471 articles were retrieved. An additional 5 articles were identified following descendancy search; 3 of these met inclusion criteria. After removal of duplicates and title and abstract screening, we screened the full text of 37 articles, of which 22 (representing 18 distinct studies) met inclusion criteria. At least two authors independently reviewed and abstracted data from all articles. Results More than half of the studies were conducted in Brazil (n = 9) and Mexico (n = 5). Sexual health was the most studied health issue (n = 11). Sexual minority women were at elevated risk for sexually transmitted infections related to low use of barrier contraceptive methods during sexual encounters with men. Findings suggest that sexual minority women are generally distrustful of healthcare providers and view the healthcare system as heteronormative. Providers are believed to lack the knowledge and skills to provide culturally competent care to sexual minority women. Sexual minority women generally reported low levels of sexual health education and reluctance in seeking preventive screenings due to fear of mistreatment from healthcare providers. Sexual minority women also reported higher rates of poor mental health, disordered eating, and substance use (current tobacco and alcohol use) than heterosexual women. Gender-based violence was identified as a significant concern for sexual minority women in LAC. Conclusions Significant knowledge gaps regarding sexual minority women’s health in LAC were identified. Additional investigation of understudied areas where health disparities have been observed in other global regions is needed. Future research should explore how the unique social stressors sexual minority women experience impact their health. Nurses and other healthcare providers in the region need training in providing culturally appropriate care for this population.

Introduction: Women represent 15% of the people living with HIV in Chile. Risk behaviors for HIV are: multiple partners, unsafe sex, and exchange of sex for drugs/money. Methodology: A correlational design was used. A sample of 203 women who were sexually active and consumed substances within the last 3-months were selected for this study. Results: The average age of the participants was 32.4 years (SD = 9.2) and 68.1% were housewives. The substance most commonly used was alcohol (95.1%) and marijuana (49.8%); 23.7% of the women were drunk or drugged before having sex; 74.4% had multiple sexual partners and 95.6% had unprotected sex. There is a significant correlation ( p < 0.05) between substance abuse and HIV risk behaviors. Conclusion: It is necessary to develop more research to understand in depth the relationship between substance use and HIV risk among Chilean women. It is important to consider the use of substances to develop and implement HIV prevention programs in the Chilean community.

Se propone una reflexion sobre el desafio que representa el cuidado de personas con condiciones cronicas de salud (CC) en la atencion de salud y la incorporacion del constructo "Apoyo al Automanejo" como parte de la formacion profesional y a su vez, como este desafio ha sido asumido por la Escuela de Enfermeria UC. Se apoya esta propuesta, en el escenario epidemiologico actual de las condiciones cronicas de salud, especialmente de las enfermedades no transmisibles y los limitados resultados alcanzados con el modelo actual de atencion, con los consecuentes efectos en las personas y familias. Se discute sobre el deficit de preparacion en el equipo de salud para afrontar la complejidad de la situacion. Se revisa la trayectoria de la Escuela de Enfermeria en el ambito de formacion e investigacion en autocuidado de la salud y su relacion y evolucion hacia el apoyo al automanejo como parte integral del Modelo de Cuidados Cronicos que es la estrategia definida por el Ministerio de Salud para enfrentar esta situacion y se releva el rol de la Escuela al ser reconocida como Centro Colaborador OMS-OPS para el Desarrollo de Servicios de Salud y Enfermeria para el Cuidado en Enfermedades No Transmisibles

Aims and objectives: To investigate if socio-demographic factors religiosity HIV-related knowledge Marianismo history of having been tested for HIV knowing someone who died of AIDS and HIV risk perception were predictive factors to HIV enacted stigma predictors among Chilean women. Background: HIV infection is the number one cause of death among women during their reproductive years. In Chile studies with people living with HIV demonstrate the existence of HIV-related stigma. However limited evidence is available about the underlying causes of HIV enacted stigma that results in stigmatisation and discrimination. Design: The current cross-sectional study is a secondary analysis of data collected to assess the impact of an HIV prevention intervention (Mano a Mano-Mujer) designed for Chilean women. A quasi-experimental design was used in the original study. Methods: This study was conducted in two communities in Santiago Chile. The sample for this study consisted of 496 Chileans between ages 18-49. Descriptive statistics and multiple regression were used for the analysis. Results: Participants in the study reported high levels (77.8%) of HIV enacted stigma. Higher levels of HIV-related knowledge were associated with lower levels of HIV enacted stigma. Women with higher education had lower levels of HIV enacted stigma than women with elementary education. In addition greater levels of marianismo (cultural belief that women should be passive faithful and devoted to family) were associated with higher HIV enacted stigma scores. Conclusions: The findings reflected the presence of HIV enacted stigma among Chilean women. Identifying the significant predictors of HIV enacted stigma can help the nursing community to design HIV prevention interventions that include the reduction in HIV enacted stigma. HIV evidence-based prevention interventions should incorporate contents related to stigma to contribute to prevent HIV enacted stigma at individual and community levels in accordance with the bioecological model. Relevance to clinical practice: The results of this study could serve to develop HIV prevention interventions that target the reduction in HIV enacted stigma.

Training strategies are highly used in the health media, since these have a beneficial effect on health personnel and care that they provide users of the health center. In Chile it is alegalized and required at different levels of health care tool. A literature review performed between March and April 2014, was used to answer the question what ar which allow training strategies with better outcomes in health personnel? 35 articles in this review, of which it was concluded that good training for these authors, assembled a staff willing to be trained and actual training needs were obtained. An expert trainer on the subject , the local situation and in educational strategy. And a combination of training techniques , including traditional, modern and playful techniques improve the results of these training objectives closer to the results to be obtained. Finally, the trainings have a positive benefit on health personnel, and in the institutions in which they work.

The World Health Organization (WHO, 2012) reported an annual incidence of 499 million new infections of curable sexually transmitted infections (STIs), and it is estimated that globally 35.3 million people live with human immunodeficiency virus (HIV). In developing countries, STIs are an enormous burden of morbidity and mortality through their impact on reproductive and child health and through their role in the spread of HIV (WHO, 2007, 2012). In Chile, there has been an increase in the number of STI and HIV cases, especially among women between 18 and 24 years of age (Chilean Ministry of Health [MINSAL], 2013), which is similar to trends seen worldwide. Chilean women younger than 25 years have been found to have the highest prevalence of syphilis, gonorrhea, chlamydia, and papillomavirus (MINSAL, 2014; Peredo, 2007; Santander et al., 2009), and a high percentage (45%) of STI-related medical visits (Santander et al., 2009). There are several unique and interrelated risk factors in Chilean young women, such as liberalization of sexual behaviors, multiple partners, drug and alcohol consumption, stigma, intimate partner violence (IPV), and cultural factors, including machismo and marianismo. Machismo is defined as the construction of masculinity and the profile of a man as a provider who is independent, strong, willing to face danger, dominant, heterosexual, virile, knowledgeable, aggressive, and in control of his environment, including women. Meanwhile marianismo derives from the Virgin Mary or “Maria” and denotes the submission of women to men, with the ideal of women defined as being pure, dependent, vulnerable, abstinent until marriage, innocent, silent, and self-sacrificing (Cianelli, Ferrer, & McElmurry, 2008). Culture-related values and patterns such as these may increase Chilean women’s risk for acquiring STIs and HIV by contributing to a lack of condom use, acceptance of infidelity by the male, domestic violence, and the absence of sexual communication and negotiation with their partners (Cianelli et al., 2008; Gonzalez, Molina, Montero, Martinez, & Leyton, 2007). In addition to the unique set of risk factors, there are also barriers to prevention, such as lack of health education, lack of STI and HIV prevention efforts in the educational institutions, long wait times for medical care, and practitioner attitudes and behaviors that may lead to discriminatory practices (e.g., personal fear that they will contract the infection, judgmental attitudes, exaggerated precautions taken when treating a person living with HIV) and that interfere with high-quality prevention, treatment, and care (Chilean Ministry of Education, 2005; Cianelli et al., 2011; Dides, Benavente, & Moran, 2009). Internet-based interventions have the potential to increase interest and participation in STI and HIV prevention programs (Bull, Pratte, Whitesell, Rietmeijer, & McFarlane, 2009; Noar, Black, & Pierce, 2009) and have shown favorable preventive behavior outcomes (Ritterband & Tate, 2009; Swendeman & Rotheram-Borus, 2010). Some of the major advantages provided by Internet interventions include standardization of the content, privacy and anonymity, and easy access to appropriate information from any place and at any time that is convenient. Internet interventions can also reduce obstacles experienced in face-to-face interventions, such as transportation, the cost of a place to meet, and the fear of embarrassment to discuss sensitive topics in front of other people (Ritterband, Thorndike, Cox, Kovatchev, & Gonder-Frederick, 2009; Tate, Finkelstein, Khavjou, & Gustafson, 2009). Based on the promise of a culturally informed STI and HIV prevention intervention for young Chilean women that can address barriers to services, an Internet-based STI and HIV prevention intervention (I-STIPI) was developed and was shown to be highly feasible and acceptable in a sample of young Chilean women (Villegas et al., 2014). This intervention was culturally adapted for Chilean women and represented an innovation in the method of delivering STI and HIV prevention. This is the first intervention delivered online in Chile, to prevent STIs and HIV, that was designed to reduce barriers and to increase participation in prevention programs. The implementation of the intervention was feasible because of the high accessibility of the Internet and broadband connections in Chile, and the regularity in the use of the Internet (86%) among Chileans between 18 and 24 years of age (Godoy, 2011; Internet World Stats, 2013). This article reports on Chilean women’s risk factors and the preliminary efficacy of the I-STIPI as it concerns prevention-related STI- and HIV-related information, motivation, behavioral skills, and preventive behaviors. The findings regarding STI and HIV prevention-related outcomes can be used as a source of information for nurses working in STI and HIV prevention with women or young populations.

Background Young Chilean women between 18 and 24 years of age are at high risk of contracting sexually transmitted infection (STI) and human immunodeficiency virus (HIV). The literature shows a shortage of STI–HIV prevention interventions focused on this specific high-risk population and a unique set of barriers to receiving prevention messages. Internet-based interventions are promising for delivering STI–HIV prevention interventions and avoiding barriers to services. Aims The study aimed to develop a culturally informed Internet-based STI–HIV prevention intervention for Chilean women between 18 and 24 years of age, to investigate its feasibility and acceptability, and to compile recommendations on what would make the intervention more acceptable and feasible for these women. Methods The development of the Internet intervention was facilitated by a process that featured consultation with content and technology experts. A pre-post test design was used to test the acceptability and feasibility of the intervention with 40 young Chilean women between 18 and 24 years of age. Results The intervention website consisted of four modules of content and activities that support learning. The intervention was feasible and acceptable for young Chilean women between 18 and 24 years of age. Discussion and conclusion This study demonstrated the value of engaging multiple expert panels to develop culturally informed and technology-based interventions. The results of this study support the feasibility and acceptability of conducting an Internet-based intervention with multiple sessions, yielding high participation rates in a population in which there are barriers to discussion of STI–HIV prevention and sex-related content. Implications for nursing and health policy The outcomes have implications for nursing education and clinical practice and they can be used for the legal and judicial systems to promote or reinforce policies that encourage STI–HIV prevention strategies among women.

Simulated patients (SPs) have participated successfully in nursing and medical education. The SPs portraying stressful situations may have psychological or physiological effects for several days after their performance; however, long-term effects have not been well documented in the literature. The purpose of this study is to investigate the impact of interpreting roles related to HIV among SPs. A qualitative descriptive approach was used for this study. Questionnaires with open-ended questions were conducted immediately after the interpretation of HIV-related roles and a year later by 10 SPs. In addition, a focus group was run a year later using a preestablished interview guide. As a result of direct content analysis, 2 major themes emerged: effects of interpreting roles relating to HIV and complexity of the roles. The findings of this study stress that interpreting an HIV-related role produces emotional, behavioral, and physical effects in SPs, at any stage during the training or performance, and has a long-term impact on their perception of their personal health and risk. Los pacientes simulados (PS) han participado exitosamente en la educación de enfermeras y médicos. Simular situaciones complejas puede producir efectos sicológicos o fisiológicos incluso varios días después de la interpretación, sin embargo, efectos a largo plazo no han sido bien documentados en la literatura. El propósito del estudio es investigar el impacto de la interpretación de roles relacionados con VIH en PS. La metodología usada fue cualitativa descriptiva. Los 10 PS respondieron a cuestionarios con preguntas abiertas inmediatamente y un año después de la interpretación de los roles en escenarios relacionados con VIH. Además se realizó un grupo focal usando un guión preestablecido. Como resultado del análisis de contenido emergieron dos grandes temas: efectos de la interpretación y complejidad de los roles. Los hallazgos de este estudio informan sobre los efectos emocionales, conductuales y físicos que se producen en los PS, durante el entrenamiento y la interpretación, y también a largo plazo sobre su percepción de salud y riesgo personal.

El avance tecnologico de los ultimos anos ha permitido la creacion de equipos que facilitan prolongar la vida de los seres humanos. Sin embargo, hoy los profesionales comprenden que hay circunstancias en las que mantener con vida a un paciente no necesariamente significa un beneficio para el y su familia. En este contexto aparece la limitacion del esfuerzo terapeutico (LET), frente a la cual el rol de los profesionales, incluido el profesional de enfermeria, no se encuentra descrito. Objetivo: Analizar la bibliografia existente en relacion al rol de enfermeria en el proceso de la toma de decision y aplicacion del LET. Material y metodo: Se realizo una revision bibliografica en distintas bases de datos, utilizando las palabras claves: withholding treatment, withdrawal treatment, nursing care, role nursing, life-sustaining y su traduccion en espanol. Se obtuvieron en total 18 articulos, relacionados con la descripcion del rol de la enfermera(o) en la LET. Resultados: los principales hallazgos de la revision son: primero el modelo de Gardaz desarrollado en el 2011, donde propone una guia de las funciones que debe desempenar cada uno de los profesionales y segundo, los roles de abogacia, soporte y agentes de informacion que debe desempenar la enfermera(o) en el contexto de LET. Conclusiones: Fue escasa la literatura encontrada donde se clarifique el rol de la enfermera(o). Se hace necesario la elaboracion de guias sobre LET en las instituciones de salud, que permitan clarificar los roles de los profesionales.

In Chile, it is estimated that over 38,000 people live with Human Immunodeficiency Virus [HIV]. In 2001, there were 1092 Chilean women living with HIV, and in 2006 there were 7,600, further affecting low income populations. These findings reveal the necessity to create prevention strategies directed towards Chilean women.the purpose of this revision is to analyze studies of prevention programs in HIV in order to determine what aspects should be included in successful HIV prevention programs with women.a literature review was carried out using searches done in the databases Proquest and CINAHL, Pubmed and Scielo. The search was limited by the criteria of full text only, within the last ten years and free access, written in Spanish or English. Fifteen articles were selected for the following revision.all of the selected articles measured the effect of an intervention on knowledge and behaviours related to HIV/AIDS. Fourteen articles produced significant changes in positive behaviours or knowledge related to the prevention of HIV.prevention programs in HIV with socially disadvantaged women can be effective in provoking changes in behaviours and knowledge associated with HIV. Successful interventions were those based on prevention theories or models of behavior change and adapted to the culture of the sample.

Worldwide, and in Chile, the number of women living with HIV is increasing. Depression is considered a factor that interferes with HIV prevention. Depression may reach 41% among low-income Chilean women. Depressed people are less willing to participate in behaviours that protect them against HIV. The aim of this study is to analyze the impact of Mano a Mano-Mujer (MM-M), and HIV prevention intervention, on depressive symptoms among Chilean women. A quasi-experimental design was used for this study. The research was conducted in Santiago, Chile; a total of 400 women participated in the study (intervention group, n=182; control group, n=218). The intervention was guided by the social-cognitive model and the primary health care model. The intervention consists of six 2-h sessions delivered in small groups. Sessions covered: HIV prevention, depression, partner's communication, and substance abuse. Face-to-face interviews were conducted at baseline and at 3-month follow-up. Chilean women who participated in MM-M significantly decreased, at 3 months follow up, their reported depressive symptoms. MM-M provided significant benefits for women's depression symptoms. In this study nurses participated as leaders for the screening of depressive symptoms and as facilitators of community interventions.

Las mujeres Hispanas de 50 anos y mas (MHC) son una minoria en Estados Unidos, presentan un elevado riesgo de adquirir VIH y son el grupo menos estudiado en lo que respecta a salud, caracteristicas sociales y de comportamiento sexual. Objetivo: Investigar los factores que incrementan el riesgo de VIH en las MHC con el proposito de desarrollar o adaptar una intervencion apropiada para la edad y la cultura de este grupo de mujeres. Metodologia: Estudio descriptivo de corte transversal con una muestra de 50 MHC, sexual- mente activas y que residian en Miami, Florida, Estados Unidos. Se utilizo un cuestionario estructurado administrado por entrevistadores entrenados y bilingues (ingles/espanol). Las participantes fueron reclutadas en diferentes lugares en el sur de Florida. Para el analisis de los datos se utilizo estadistica descriptiva, tanto medidas de tendencia central como medidas de dispersion. Resultados: La edad promedio de las MHC fue de 55,7 ± 6 anos (rango 5-76 anos). Todas las MHC estaban en la menopausia. Prevencion del VIH: Las MHC reportaron niveles medios de conocimientos sobre VIH y comunicacion con la pareja. En la muestra se reporto la presencia de sintomas depresivos, violencia en la pareja, actitudes negativas hacia las personas viviendo con VIH y baja percepcion de riesgo de adquirir VIH. Las MHC mencionaron necesidades de aprendizaje en topicos relacionados con prevencion de VIH y cambios de la edad. Conclusion: Las MHC estan a riesgo de adquirir VIH y tienen necesidades especiales en terminos de educacion sobre prevencion de VIH.

VIH y SIDA es una preocupacion permanente en todo el mundo, a pesar de ello, solo 3 millones de personas tuvieron acceso al tratamiento antirretroviral durante el ano 2007 y se estima que solo 11.6 millones de personas tendran acceso este en el ano 2015. El proposito de esta revision de literatura es identificar el uso de medicinas y terapias complementarias y alternativas (CAM) que utilizan las personas que viven con VIH o SIDA. Esto permitira evaluar la factibilidad de sugerir la incorporacion de estas terapias en los planes de tratamiento. La busqueda se realizo entre el 1 de junio y 3 de junio de 2011, utilizando como criterio de seleccion ser un articulo de los ultimos 5 anos. Esta revision permitio identificar que CAM se usa hoy manejar y tratar varios problemas relacionados a vivir con VIH, tanto a nivel biologico, social y psicologico, logrando buenos resultados de acuerdo a la percepcion de quienes lo utilizan. Es relevante considerar que CAM potencialmente podria servir como metodo de potenciar un tratamiento mas integral y centrado en el paciente, para quienes estas terapias parecen ser formas de manejar los aspectos incontrolables de vivir con VIH.

PURPOSE: This study aims to describe human immunodeficiency virus (HIV)-related knowledge and beliefs, as well as understanding attitudes towards masculinity in the context of HIV prevention, held among Chilean men. DESIGN: This study reports the qualitative findings of a sequential qualitative-quantitative mixed methodology study: Bringing men into HIV Prevention in Chile, NIH R01 TW007674-03. METHODS: Twenty in-depth interviews using a qualitative, descriptive approach to elicit information for the study were conducted among men residing in two communities of low socio-economic status in Santiago, Chile. FINDINGS: Content analysis of interviews revealed three main themes regarding machismo and how it relates to HIV: sexuality and machismo, the changing nature of machismo, and violence against women. CONCLUSIONS: Addressing HIV and intimate partner violence through developing education programs tailored to meet the needs of Chilean men are needed to include men in HIV prevention efforts. CLINICAL RELEVANCE: Specifically, incorporating ideas of what men consider healthy masculinity and working to destigmatize men who have sex with men are important steps in addressing the negative aspects of machismo.

Background: In Chile, members of the civil society and government achieved the passing of the HIV/AIDS Law (19.779). The level of knowledge of the law held by healthcare workers in Chile is not well known. Aim: To analyze the effect of an intervention on knowledge of the existence of the law and its application in clinical practice amongprimary healthcare workers in southeastern Santiago. Material and Methods: Healthcare workers of primary care centers were invited to participate in the study. One group received an educational intervention lasting a total of 16 hours, about AIDS physiopathology, sexually transmitted diseases, communication with patients and current legislation. A control group did not receive the educational intervention. Both groups answered a self-administered questionnaire about the HIV/AIDS law at baseline and three months after the intervention. Results: The intervention was carried out in 262 workers and 293 participated as controls. The initial evaluation revealed that only 16.3% (n = 89) had heard of the law, without any significant difference between intervention and control groups. The knowledge about the law improved by 65% in the intervention group and did not change in controls. At the end of the education period, the intervention and control groups improved their global knowledge by 29 and 3%, respectively (p < 0.05). Conclusions: The educational intervention was effective in improving knowledge of the HIV/AIDS Law among Chilean healthcare workers.

In Chile, it is estimated that over 38,000 people live with Human Immunodeficiency Virus [HIV]. In 2001, there were 1092 Chilean women living with HIV, and in 2006 there were 7,600, further affecting low income populations. These findings reveal the necessity to create prevention strategies directed towards Chilean women. OBJECTIVE the purpose of this revision is to analyze studies of prevention programs in HIV in order to determine what aspects should be included in successful HIV prevention programs with women. DESIGN AND METHOD a literature review was carried out using searches done in the databases Proquest and CINAHL, Pubmed and Scielo. The search was limited by the criteria of full text only, within the last ten years and free access, written in Spanish or English. Fifteen articles were selected for the following revision. RESULTS all of the selected articles measured the effect of an intervention on knowledge and behaviours related to HIV/AIDS. Fourteen articles produced significant changes in positive behaviours or knowledge related to the prevention of HIV. CONCLUSIONS prevention programs in HIV with socially disadvantaged women can be effective in provoking changes in behaviours and knowledge associated with HIV. Successful interventions were those based on prevention theories or models of behavior change and adapted to the culture of the sample.

HIV/AIDS continues to expand throughout the world, and in recent times has had a severe impact on the number of women living with HIV. Access to methods of prevention for HIV/AIDS around the world is limited and for many women may not be feasible. Examples of such methods are sexual abstinence, which though recognized as an effective method of prevention is difficult for many women to achieve. Mutual fidelity is another option, but many women cannot control the sexual behavior of their partners. Finally, the male condom continues to be an available method of HIV prevention for sexually active people. However, in many places, gender inequality, social norms, and economic disparities severely limit women's capacity to negotiate the use of a condom with their partner. For this reason, an urgent need exists to develop a product for the prevention of HIV/AIDS that can be handled by women. Microbicides, products that can reduce HIV risk when applied intravaginally, hold promise for stopping the advance of HIV/AIDS, especially when considering that women can make their own decisions about whether to use them when other methods of prevention are not available. The objective of the current literature review was to understand the scientific advances related to microbicides in the prevention of HIV/AIDS in women through the analysis of available literature in this area. Interest in this topic emerged from the need to contribute to women's health and HIV/AIDS prevention. To achieve this review's objective, a search was carried out in multiple databases, including OVID, PUBMED, PROQUEST, and CINAHL, as well as published materials from organizations related to this area such as UNAIDS and CONASIDA, and literature available from the Internet. Upon completion of the literature review, it was concluded that microbicides are an effective method for preventing HIV/AIDS for women as well as their partners. Although they have a high level of acceptance among the female population, the majority of microbicides are still in clinical studies, requiring further evaluation for their safe use in humans. There are 3 microbicides in the final phases of clinical studies that will soon be available on the market. One of these was found to be 60% effective in protecting against the transmission of HIV and was used by women in 50% of their sexual activity, which resulted in avoiding approximately 2.5 million new HIV infections in men, women, and children over a 3-year period.El VIH/SIDA sigue expandiéndose a nivel mundial y en el último tiempo ha tenido un impacto severo en el número de mujeres que viven con VIH. El acceso a métodos de prevención para VIH/SIDA alrededor del mundo son limitados y no factibles de acceder para muchas mujeres. Dentro de estos métodos se encuentran: la abstinencia sexual que es reconocida como un efectivo método de prevención para VIH, pero es considerada por las mujeres como difícil de realizar, en segundo lugar esta la fidelidad mutua en la relación de pareja, donde muchas mujeres no pueden asegurar el comportamiento sexual de sus parejas, y por ultimo el preservativo masculino que continua siendo el método de elección disponible para la prevención de VIH/SIDA en personas sexualmente activas, sin embargo, en muchos lugares, las desigualdades de género, normas sociales y disparidades económicas, limitan severamente la capacidad de las mujeres a negociar el uso del preservativo con sus parejas. Es por esta razón, que existe la urgente necesidad de desarrollar un producto para la prevención de VIH/SIDA que sea manejado por mujeres. Los Microbicidas, productos que pueden reducir el riesgo de VIH, cuando son aplicados en forma intravaginal, representan una promesa para frenar el avance del VIH/SIDA, sobretodo considerando que las mujeres podrán tomar sus propias desiciones para utilizarlos o no cuando todas las otras medidas de prevención no sean posibles de utilizar. Es por este motivo, que la presente revisión bibliográfica tiene como propósito conocer el avance científico sobre el desarrollo de los microbicidas en la prevención de VIH/SIDA en mujeres, a través del análisis de la literatura disponible respecto al tema. El interés en este tema surge a partir de la necesidad de contribuir a la salud de las mujeres y a la prevención del VIH/SIDA. Para responder este propósito se realizó una búsqueda de información a través de distintas bases de datos, entre ellas OVID, PUBMED, PROQUEST y CINAHL, además de material publicado en organizaciones relacionadas con el tema ONUSIDA, CONASIDA y literatura accesible en Internet. Al finalizar esta revisión bibliográfica, se concluye que los microbicidas se presentan como un método efectivo para prevenir el VIH/SIDA, tanto en mujeres como en sus parejas. Presentan una alta aceptabilidad en la población femenina, sin embargo la mayoría de los candidatos a microbicidas aún se encuentran en estudios clínicos, necesitando una mayor evaluación para que su uso en humanos sea seguro. Tres son los microbicidas que están prontamente a finalizar las fases de estudio y estar disponibles en el mercado. Un microbicida que fuese 60% efectivo para proteger contra el VIH y fuese utilizado por las mujeres en un 50% de su actividad sexual, se evitarían en 3 años 2.5 millones de infecciones por VIH (en mujeres, hombres y niños).

Chile is a country with an incipient HIV epidemic. Just as in other countries, disadvantaged groups in Chile are contributing to the increased incidence of the disease. The Mapuche indigenous population is one such group that has been affected by the spread of HIV. However, no prevention programs are tailored to the culturally specific needs of this community. In recognition of this discrepancy, an academic-community partnership was formed to develop an HIV educational module for a Mapuche community. The module was developed for use as part of an already established health-related program. The aims of the module were to identify perceptions about HIV among Mapuches and present information specific to HIV and its prevention. Focus was placed on cultural sensitivity. A total of 16 Mapuches participated voluntarily and showed some knowledge regarding HIV, but they lacked an overall understanding as to how it is transmitted and why prevention strategies are effective. Continued collaboration between academia and affected communities as well as incorporating HIV information into established programs are effective strategies for delivering prevention information to disadvantaged populations and for further understanding their perceptions and health care needs.

VIH/SIDA es una pandemia que afecta a hombres, mujeres y niños, pero que presenta una tendencia hacia la feminización, afectando especialmente a mujeres jóvenes. Su consecuencia es el aumento de la transmisión vertical, durante el embarazo, parto o lactancia materna. Este estudio bibliográfico describe la relación entre VIH/SIDA y lactancia materna, explicitando factores que influyen en la elección de la modalidad de alimentación de madres viviendo con VIH/SIDA. Se describen causas de morbimortalidad infantil asociada y recomendaciones internacionales de lactancia en mujeres con VIH/SIDA. En un mundo globalizado con constantes migraciones poblacionales, estos resultados representan un llamado de atención para profesionales de salud quienes deben considerar factores sociales que influenciarán la toma de decisión de madres viviendo con VIH/SIDA al escoger la modalidad de lactancia. No sólo basta conocer el riesgo de transmisión vertical, sino que se debe tomar conciencia de aquellos factores dinámicos y específicos de cada comunidad

Si consideramos que todo proceso de salud-enfermedad, sus actores y determinantes, son manifestados por las estructuras y dinamicas sociales, no es extrano pensar que dicho proceso esta marcado por la globalizacion reinante en el mundo contemporaneo. Globalizacion es un concepto complejo y multifactorial que involucra procesos de participacion colectiva a nivel mundial

The incidence of sexually transmitted infections (STIs) and human immunodeficiency virus (HIV) is high among young Chilean women, and there are no STI or HIV prevention interventions available to them that incorporate technology. The purpose of this study was to investigate the preliminary efficacy of an Internet-based STI and HIV prevention intervention (I-STIPI) for Chilean young women on measures of STI- and HIV-related information, motivation, behavioral skills, and preventive behaviors.This is a pretest-posttest study. Forty young Chilean women between 18 and 24 years of age participated in an investigation of the I-STIPI's preliminary efficacy on STI and HIV prevention-related outcomes between baseline and a postintervention assessment. The intervention consisted of four online modules. Data collection was conducted in Santiago, Chile. Paired-samples t test analysis was used to determine whether there were significant differences in each of the outcome variables.After receiving I-STIPI, women reported a significant increase in levels of STI- and HIV-related knowledge, attitudes toward the use of condoms and perceived self-efficacy, and a reduction of risky sexual behaviors with uncommitted partners.The I-STIPI showed promise as an Internet-based intervention that can reduce barriers to accessing preventive interventions and increase STI and HIV preventive behaviors in young Chilean women.The study provided important information about the ability of an Internet-based intervention to reduce young women's risk factors and to provide positive preliminary efficacy on STI- and HIV-related outcomes. Internet-based interventions can eliminate many barriers to receiving prevention interventions and may prove to be cost effective.