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Knowledge on, and attitude toward, HIV/AIDS among staff of an international organization in Bangladesh.

Two hundred and ninety-three randomly-selected members of the staff of ICDDR,B: Centre for Health and Population Research were surveyed anonymously in June 1998, using a pre-tested and self-administered questionnaire, to assess their knowledge on, and attitude toward, human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS). All except 4 (1.4%) heard of AIDS. Main sources of information were radio and television (93%), newspapers and magazines (84.8%), posters and leaflets (70.2%), and friends (59.2%). About 94% of the respondents believed that HIV might spread in Bangladesh. Only 61.6% knew about the causative agent for AIDS. More than 96% had knowledge that HIV could be detected through blood test. The respondents were aware that unprotected sexual intercourse (92%), transfusion of blood and blood components (93.8%), sharing unsterile needles for injections (94.1%), and delivery of babies by infected mothers (82.7%) could transmit HIV. Similarly, the respondents had the knowledge that HIV infection could be prevented by using condom during sexual intercourse (85.5%), having sex only with an HIV-negative faithful partner (87.2%), avoiding transfusion of blood not screened for HIV (88.9%), and taking injections with sterile needles (86.5%). However, only 33.0% had the knowledge that HIV-infected persons can look healthy, and 56.4% were unaware of transmission through breastmilk. Most members of the staff, particularly at lower level, had misconceptions about transmission and prevention of HIV/AIDS. More than 40% of the respondents had the attitude that HIV-infected persons should not be allowed to work, while another 10% did not have any idea about it. The findings of the study suggest that the members of the Centre's staff have a satisfactory level of essential knowledge on HIV/AIDS, although half of them have poor attitudes toward persons with HIV/AIDS. Therefore, preventive strategy for the staff should be directed toward behaviour change communication.

Acquired Immunodeficiency Syndrome↗

Knowledge and attitude of undergraduate students towards sexually transmitted infections in Tirana, Albania.

AIM: To assess the knowledge and attitude of undergraduate students in Tirana, Albania, towards sexually transmitted infections (STI). METHODS: A sample of 729 students (76% women) at the University of Tirana were surveyed by the use of an anonymous questionnaire with 10 multiple-choice questions testing their knowledge and 27 statements testing their attitude towards STI (adapted to a 1-5 Likert scale, with a low score indicating poor attitude). Socio-demographic data were also collected. The survey was carried out in October and November 2002. Multiple regression analysis was used to assess the associations between socio-demographic factors on the one hand and attitude towards and knowledge about sexually transmitted infections, on the other. RESULTS: Men had poorer knowledge and attitude toward STI than women (beta= -4.59, p<0.001 for attitude, and beta= -0.38, p=0.006 for knowledge). Higher parental education and urban origin were strongly associated with better STI knowledge. After adjustment for age, sex, marital status, religion, income, and number of siblings, students whose parents had low and middle education level had a mean STI knowledge score of <1.16 (95% confidence interval [CI], 0.85-1.47) and <0.98 (95% CI, 0.74-1.23), respectively, which was significantly lower than the score of students with highly educated parents (p<0.001 for linear trend). Also, students born in rural areas had significantly lower mean STI knowledge score (<0.70, p=0.003) than students born in urban areas. CONCLUSION: Parental education and origin are strongly associated with knowledge and attitude of undergraduate students in Tirana towards sexually transmitted infections.

Adolescent↗

The relationship of religious involvement to a variety of indicators of cognitive ability and achievement in college students.

A total of 635 undergraduates at a small, competitive, secular, liberal arts university in the Northeast were administered a brief questionnaire in which they reported anonymously their degree of religiousness, their Scholastic Aptitude Test (SAT) scores, and their grade point average (GPA). Religiousness was negatively related to ability as measured by SAT, and not related to achievement, as measured by GPA. The students' capacity to maximize their potential was measured by the difference (in standard score) between GPA and SAT, and revealed a strong, positive connection with degree of religiousness. A conceptual rationale for the diverse findings is presented by the author.

Achievement↗

Feasibility of northern Thai factory workers as participants in HIV vaccine trials.

To determine the feasibility of establishing a cohort of HIV-1 seronegative factory workers for potential HIV vaccine trials, and other HIV preventive interventions, we enroled and followed 499 male and female industrial workers in Lamphun Province, northern Thailand. A baseline demographic and HIV seroprevalence survey was conducted by a mobile team at worker's housing units in Lamphun Province in 1994. Follow-up HIV and syphilis incidence rates were measured 6 months later. The study was voluntary, anonymous, and included HIV pre- and post-test counseling, HIV and syphilis serology, and a self-administered fact sheet. A total of 106 men and 393 women were recruited. The median age was 22 years, and the mean 23.4 years. Educational levels were moderate; 41.9% had some secondary school and 23.6% had completed secondary school. HIV prevalence was 2.4% overall but differed by sex; among men it was 7/106, 6.6%, among women 5/393, 1.3%, OR = 5.49 (95% CI = 1.52, 20.39). Low educational levels were associated with HIV infection, OR = 7.2 (95% CI = 2.2, 23.4). Syphilis prevalence was 3.8%. Follow-up at 6 months was successful for 420/499 subjects, 84.2%, and varied by sex: 73/106 men, 68.9%, returned while 347/393 women, 88.3%, did so, RR = 1.21 (95% CI = 1.07, 1.37). There were 5 incident HIV-1 infections, a rate of 2.1/100 person years. The HIV seroconversion rate differed by sex, but not significantly; it was 4.1/100 person years for men and 1.5/100 person years for women. This population is largely young, female, and at considerable HIV risk. If follow-up could be improved, factory workers in northern Thailand could be an appropriate population in which to mount HIV preventive efficacy studies, including vaccine trials.

AIDS Vaccines↗

Patient knowledge about human papillomavirus and relationship to history of abnormal Papanicolaou test results.

OBJECTIVE: To assess patient knowledge about human papillomavirus (HPV) and determine if self-report of a previous abnormal Papanicolaou test result improves knowledge. MATERIALS AND METHODS: A survey was designed and administered to patients at three obstetrics and gynecology clinics in Milwaukee, WI. The anonymous surveys assessed demographics, history of sexually transmitted infections or abnormal Papanicolaou test results, and knowledge about HPV and cervical cancer. The chi and Wilcoxon tests were used for statistical comparisons. RESULTS: Three hundred sixty-three surveys were collected, representing a diverse patient population. Forty-two percent of patients had heard of HPV. Women who reported a history of abnormal Papanicolaou test results were not more likely to have heard of HPV or to know that it causes cervical cancer than those who did not report abnormal Papanicolaou test results. CONCLUSIONS: There is no significant difference in knowledge about HPV between patients who reported a history of abnormal Papanicolaou tests and those who did not.

Adolescent↗

Prevalence of HIV, hepatitis B and associated risk behaviours in clients of a needle-exchange in central London.

In order to determine the prevalence of risk behaviour for, and antibodies to HIV and hepatitis B in clients of a needle-exchange scheme in central London we employed an anonymous, self-administered questionnaire along with salivary antibody testing by immunoglobulin (Ig) G antibody capture immunoassay. Two hundred and thirty-two subjects (193 men, 39 women; median age 32) participated; a response rate of 89%. Clients were long-term, frequent injectors. Lending used equipment at any time was reported by 55%, and borrowing by 52%. Of those who had shared needles and syringes during the last year, the majority had lent to, or borrowed from, one person only (53 and 55%, respectively). Younger clients (less than 29 years of age) reported more recent sharing than older clients (greater than 30 years of age). Five out of 211 (2.4%) samples tested for anti-HIV were positive. One hundred and eleven out of 199 (56%) samples were positive for anti-hepatitis B core (HBc). In this population of needle-exchange attenders there is no evidence of further spread of HIV, and a low prevalence of HIV infection appears to have been sustained. However, the high prevalence of anti-HBc provides evidence of previous risk behaviour and so constant vigilance is necessary if further viral spread is to be avoided. This study has established an acceptable method for the anonymous surveillance of current risk behaviour and salivary antibodies to HIV and hepatitis B virus (HBV) in a drug-using population.

Adolescent↗

[Systematic screening of deafness at a maternity ward using evoked otoacoustic emissions: practical aspects and parental attitudes].

OBJECTIVE: Evaluation of the feasibility and parental attitudes towards a hearing screening programme using evoked otoacoustic emissions, implemented in a maternity ward in France. METHODS: A hearing screening test using transiently evoked otoacoustic emissions (TEOAE) was proposed to each baby, and an anonymous questionnaire was given to parents to assess their attitudes towards the screening procedure. RESULTS: Although the refusal of the test reached 16% (mainly during the first two weeks of the program), more than 92% of parents judged the test as being useful, and 65% wished it to be systematically done. However, nearly 35% of parents admitted to have a low level anxiety about being unnecessarily worried by the test results. One hundred and twenty-four babies were screened. Fifty three per cent of the tests have been performed in less than ten minutes, with an average of 12.2 minutes. This duration does not include delays due to programme and babies management. False positive rate (uni or bilateral fail) was 10.5% at the first stage. Repeating the test before discharge decreased the false positive rate to 6.5%. CONCLUSION: Although limited in time, this study shows that a systematic hearing screening programme using TEOAE is possible and should be done in France. False positive rate was below 7%, and the test was considered as useful by more than 90% of parents, although knowledge about deafness in childhood and its consequences were clearly insufficient.

Evoked Potentials, Auditory↗

Differentiation of normal and disturbed sleep by automatic analysis.

The main purpose of the present study was to develop an automatic hybrid system and evaluate its performance in the differentiation of normal and disturbed sleep. The study was carried out in roughly the following steps: At the beginning the quantity of five EEG waveforms, delta, theta, alpha, sigma and beta were examined with respect to sleep stages and their temporal distributions and inter-relationships throughout the nights in young 20-22 year-old, healthy individuals. These data were used as a basis for the choice of parameters for a sleep stage scoring program. Secondly, the sleep stage scoring software was developed using as test material three subject groups: about 10 years older controls, anonymous alcoholics and chronic alcoholics in the withdrawal phase. The last group was examined on two occasions, first in the initial withdrawal and then after two weeks' abstinence between the recordings. The sleep stage scoring program was evaluated in comparison with a visual sleep stage determination and its performance was also tested on the young normals. Attention was paid to three main points: First, how well does an automatic system imitate the visual classification of a human subject, when both the human and the computer classifications are compared side by side at a 20 s epoch level? Second, even if this comparison did not show a satisfactory agreement, could the computer classification still replace the visual sleep stage scoring when the objective is to describe the neurophysiological characteristics of the human whole-night sleep process or differentiate between normal and disturbed sleep. For this purpose it was examined, whether the values for the sleep stage parameters obtained by visual classification corresponded to those obtained by computer scoring and whether the differences found between the groups by manual methods could also be obtained by computer classification. The third goal was to see whether other measures than parameters received by sleep stage classification could be used for the differentiation between normal and disturbed sleep. In the present work only EEG waveform parameters and body movement activity were studied with this in mind. It was found that sleep can satisfactorily be classified in stages by automatic analysis if it is not markedly disturbed. The percentage agreement obtained for the three groups having practically normal sleep (young normals appr. 80%, older normals 77% and anonymous alcoholics 75%) was satisfactory and sufficient for clinical and experimental work.(ABSTRACT TRUNCATED AT 400 WORDS)

Adult↗

[Relationship between ethanol patch test and problem drinkers among dental students].

In 2000 and 2001, we carried out a drinking habit survey and the Ethanol Patch Test on 232 fourth-year dental students (128 males, 104 females). The results were statistically analyzed. For the survey, the students were asked to fill out, anonymously, the forms of the Tokyo-University ALDH2-Phenotype Screening Test (TAST), the Kurihama Alcoholism Screening Test (KAST), and the Adolescent Alcohol Involvement Scale (AAIS). The results of the subsequent Ethanol Patch test were evaluated by the students themselves. The Patch test demonstrated that 44.5% of males and 49.0% of females were positive to the test or ALDH2 deficient, the rest having the marker substance. According to the TAST results, ALDH2-deficient or TAST-positive (alcohol-intolerant) subjects accounted for 48.4% of males and 51.9% of females, the rest being ALDH2-present or TAST-negative students. Among the Patch test-positive group, the ratio of problem drinkers according to the KAST was 8.8% in males and 2.0% in females. The corresponding figures for the test-negatives group were; 22.5% in males; 7.5% in females, being higher than those for the test-positive group. Among the test-positive group, the ratio of problem drinkers scoring at least 42 points on the AAIS stood at 19.3% in males, 7.8% in females and among the test-negative group, the corresponding figures were; 21.1% in males; 13.2% in females, the difference from those for the other group being relatively small. The results of the Ethanol Patch test were related to those of the TAST and KAST, but not to the AAIS. The correlation between the Patch test and KAST indicates that the test-negatives are prone to become alcohol-dependant. Though the results of the Patch test and those of the AAIS were not related, the findings show that some alcohol-intolerant university students are drinking excessively.

Adult↗

Korsakoff and alcoholic subjects are severely impaired in animal tasks of associative memory.

Korsakoff subjects, members of the Alcoholics Anonymous, and alcoholics with 1 week or 5-6 months of abstinence were tested in a concurrent object discrimination task with 10 and 20 pairs of objects and compared to control subjects matched for age and education. The anonymous alcoholics were moderately Korsakoff subjects strongly impaired, whereas alcoholics with 1 week or 5-6 months abstinence performed similar to control subjects. The results are discussed with respect to current research on human amnesia and comparative neuropsychological topics.

Adult↗

Random mandatory drugs testing of prisoners: a biassed means of gathering information.

BACKGROUND: Our objective was to develop and test a methodology for inferring the percentage of prisoners currently using opiates from the percentage of prisoners testing positive for opiates in random mandatory drugs testing (rMDT). METHODS: The study used results from Willing Anonymous Salivary HIV (WASH) studies (1994-6) in six adult Scottish prisons, and surveys (1994-5 and 1997) in 14 prisons in England and Wales. For Scottish prisons, the percentage of prisoners currently using opiates was determined by assuming, with varying empirical support, that: current users of opiates in prison were 1.5 times as many as current inside-injectors; and current inside-injectors were 0.75 times as many as ever injectors in prison. We also assumed that current inside-users' frequency of use of opiates (by any route) was equal to the frequency of inside-injecting by current inside-injectors in Aberdeen and Lowmoss Prisons in 1996, namely six times in 4 weeks. We assumed that some scheduling of heroin-use prior to weekends takes place, so that only 50% of current inside-users of opiates would test positive for opiates in rMDT: these assumptions allow us to arrive at WASH-based expectations for the total percentage of prisoners testing positive for opiates in rMDT. For England and Wales, a multiplier of 118/68 was applied which was derived from prisoners' interviews, to convert the results from ever inside-injectors, as determined by WASH studies, to the percentage of current inside users of opiates. We made the same assumptions on frequency of inside-use of opiates as in dealing with the Scottish results. RESULTS: We expected 202.7 opiate positive results in April to September 1997 in rMDTs at six adult prisons in Scotland, 226 were observed. We expected 227.0 at a set of 13 adult prisons and one other in England and Wales; 211 were observed. CONCLUSIONS: Further testing of the methodology for prisons in England and Wales will be possible when 1997 WASH data are released. So far, the methodology has performed well. From it, we infer that 24% of inmates at the six adult prisons in Scotland were current inside-users of opiates, compared to 11% at the 14 adult prisons where survey data were available in England and Wales. The corresponding April to September 1997 percentage of opiate positives in rMDT were: 13% (results from the six Scottish prisons) and 5.4% (results from 14 prisons in England and Wales), a two-fold under-estimate of % current users of opiates in prison (24% and 11%). Planning of drug rehabilitation places for prisoners should thus be based on twice the percentage of prisoners testing opiate positive in rMDT. This correction factor of two should be kept under review.

Adult↗

Determinants of HIV antibody testing among selected groups of Chinese residents in Hong Kong.

HIV testing is promoted to the public as a tool for HIV prevention in many countries. However, the patterns and determinants of HIV antibody testing among the Chinese people are unknown. To describe the prevalence and determinants of HIV antibody testing amongst the Hong Kong Chinese a cross-sectional anonymous survey was carried out among 1,027 subjects from different population groups (airport travellers, business sector workers, service sector workers, university staff, and STD clinic attendees). Subjects were categorized into either 'STD population' (respondents from STD clinics) versus 'all others' (respondents from other settings) groups. Forty-five percent of the respondents reported ever having had a test for HIV antibody. 'STD population' group members were almost three times more likely to have had an HIV test than were 'all others' group members (77% vs 20%). After adjustments, 'STD population' group members who reported having tested for HIV were more often aged 45 years or older, alcohol drinkers, with high self-efficacy scores, and inconsistent condom users; members in the 'all others' group, more often had had sex with strangers, drank alcohol, and favoured having multiple sex partners. Awareness among the public about the risk behaviours for HIV should be enhanced and efforts should be made to reduce high-risk behaviours among those tested by emphasizing the importance of maintaining safer sex behaviour and having follow-up tests during post-test counselling.

Adult↗

Receiving a positive HIV test result: the experience of patients in Europe.

OBJECTIVE: To describe HIV-infected people's experience of the HIV test procedure in Europe. METHODS: Between August 1996 and September 1997, anonymous self-administered questionnaires were distributed to HIV-infected people in 11 European countries. RESULTS: A total of 1366 people completed the questionnaire (50% response rate). Of these, 194 (16%) had more than five negative HIV tests before being diagnosed as HIV positive, 179 (14%) were tested without consent and 192 (15%) were informed about the HIV positive test result by mail or by telephone. Of the 963 people who received a positive test result during a consultation, 247 (26%) reported that this visit lasted less than 10 min, 336 (35%) between 10 and 20 min, and 289 (30%) more than 20 min. Over half the total respondents (591, 54%) felt they did not receive adequate support when they were informed about being HIV positive, with 249 (19%) experiencing feelings of rejection. People who were diagnosed as HIV positive after 1994 reported more frequently receiving adequate support, information and understanding when the positive test result was revealed compared with those diagnosed before 1990. CONCLUSION: A large number of our study participants did not endorse the way HIV tests were conducted and positive test results revealed. Although there was an improvement over time in the way HIV tests were conducted, they often did not conform to international guidelines.

AIDS Serodiagnosis↗

To test or not to test, could you repeat the question?

We aimed to investigate clinical practice in the offering of HIV tests and subsequent uptake in a central London genitourinary medicine (GUM) clinic. A random sample (n = 330) of attenders at 3 inner-London GUM departments was surveyed. Reasons for and rates of offering of HIV tests were recorded and analysed in relation to demographic, risk group information and uptake. The results were integrated with the latest unlinked, anonymous seroprevalence data for the clinic. After exclusion of patients known to be HIV-positive or to have recently undergone HIV testing, HIV tests were offered to 96% of homo/bisexual men, 55% of heterosexual men and 60% of heterosexual women. Comparison with anonymous HIV seroprevalence data showed an inverse relationship between seroprevalence rates for heterosexual men/women (2.5% vs 1%) and rates of HIV test offering. A lack of research into the policy of offering HIV tests may have resulted in inconsistencies in practice. An evidence based policy should offer HIV tests in line with seroprevalence.

Adult↗

[The extent of HIV testing in the Norwegian population seen in relation to sex behavior].

To estimate the incidence of clinical HIV-testing and the association between testing and sexual habits, data from a 1992 population-based, anonymous survey of sexual behaviour were analysed. The sample size was 10,000 subjects between 18 and 60 years of age and the response rate was 48%. 15% of the males and 13% of the females reported having been HIV-tested at least once during the period 1985-92, and 1% of the sample four times or more. The incidence of testing has increased. However, a decrease in first time testing was observed after 1990. The best predictors of HIV-testing are the partner's test behaviour and the number of sexual partners during a lifetime.

AIDS Serodiagnosis↗

To test or not to test: are Hispanic men at highest risk for HIV getting tested?

This study examined how HIV testing history and future testing intentions were related to sexual risk and perceptions of risk in a community sample of 1,052 Hispanic men. This sample is noteworthy in its diverse representation of Hispanics, its high ratio of participants born outside the USA, and its inclusion of heterosexuals and men who have sex with men (MSM). We used area-based sampling to recruit participants at public venues. Data were collected via anonymous, structured interviews from December 1999 to February 2001. Lifetime testing rates were high (76%), but only 45% had been tested in the last 12 months. Results indicate that men at highest risk-those who were MSM, had more partners and had STDs-were more likely to have been tested, and to have been tested recently, than men with lower risk. Being MSM and having been previously tested predicted future testing intentions. Inconsistent condom users with more than five partners were less likely to intend to be tested than men with more than five partners who used condoms consistently. Studying men who have successfully routinized HIV prevention practices (including testing) will assist in the development of interventions for those who remain at risk.

Adolescent↗

[Adolescents and young subjects facing contraception, pregnancy and abortion].

The objective aimed was to obtain information about the sexual behavior of adolescents and youths attending university as regards contraception, pregnancy and abortion and the knowledge of the Papanicolau test as a preventive, method for malignant diseases. An anonymous survey which was especially designed for this investigation was implemented with 438 students - 123 women and 315 men - divided into three groups according to age; between 17 - 20, 21 - 24 and more than 25 years-old. Taking into account the sexually active population. 70% of the men between 17-20 use contraceptive methods (condoms 98,6%) and so do 100% of the women of the same age (menstrual cycle control method 71,4%, contraceptive pills 14,2%, or her partner uses condom 21,4%). In the group of youths between 21-24 years old, 76,8% of the men and 82,7% of the women use contraceptive methods: 70% of the men use condoms and 30% contraceptive methods used by their patner, whereas 58,3% of the women use the menstrual cycle control method, 25% take pills and 8,3% use DIU. In the group of older youths 71,4% of the men use contraception methods (66,6% condoms) and 51,14% of the women (100% the menstrual cycle control method) and 25% add other methods to this one. Only 20,68% of the women stated having had pregnancies (all of the between 21 - 24). As there is the same porcentage of abortion in this age groups, it can be presumed that all the pregnancies ended in abortion. This contradicts the position stated regarding abortion due to the fact that 66% of the population questioned in the survey was against abortion and defended the right to live, whereas 23% was for abortion mainly in the case of rapes and/or maternal diseases. A small porcentage was for abortion in the case of pregnancies which may disturb their life projects. As regards the Papanicolau test, all the groups have a good knowledge about it, but only women over 25 years old practice it responsably.

Abortion, Spontaneous↗

Informed lay preferences for delivery of racially varied pharmacogenomics.

OBJECTIVES: To understand public perceptions and opinions of three options for prescribing medicine: individualized genetic testing, race-based prescription, and traditional prescription. METHODS: Focus groups in urban, suburban, and rural communities over-sampled for minority groups conducted from February through April, 2001 in Georgia. RESULTS: Group members (N = 102) identified individualized genetic testing as providing the best quality of care (60% of talk turns; 75% in postdiscussion anonymous survey), but stipulated the need for protection from the invasion of privacy, discrimination, and prohibitive cost. Most individuals chose genetic testing because it provided individualized attention, and African-Americans indicated they would choose genetic testing even if the costs were high. Overall, individuals were suspicious of race-based prescription. Analyses for degree of suspicion revealed a main effect for race and an interaction effect for race and gender. CONCLUSIONS: If issues of cost, discrimination, and privacy are addressed, lay individuals prefer genetic testing as the basis for prescription of medicines that exhibit racially patterned response variation.

Attitude to Health↗