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PubMed2000

Assessment of gunshot bullet injuries with the use of magnetic resonance imaging.

BACKGROUND: Magnetic resonance imaging (MRI) is rarely used for preoperative assessment of shotgun injuries because of concerns of displacing the possibly ferromagnetic foreign body within the surrounding tissue. METHODS: A total of 56 different projectiles underwent MRI testing for ferromagnetism and imaging quality in vitro and in pig carcasses with a commercially available 1.5-MRI scan. Image quality was compared with that of computed tomographic scans. RESULTS: Projectiles with ferromagnetic properties can be distinguished easily from nonferromagnetic ones by pretesting the motion of an identical projectile within the MRI coil. When ferromagnetic projectiles were excluded, MRI yielded the more precise images compared with other imaging techniques. Projectile localization and associated soft tissue injuries were visualized without artifacts in all cases. CONCLUSIONS: When ferromagnetic foreign bodies are excluded by pretesting their properties within the MRI with a comparative projectile, MRI portends an excellent imaging procedure for assessing the extent of injury and planning the removal by surgery.

Animals↗
PubMed1978

Patient outcomes in alternative long-term care settings.

The purpose of this study was to compare health status outcomes in three alternative long-term care settings in the Veterans Administration : 1) home care; 2) community-based nursing home care; and 3) hospital-based nursing home care. Patients were measured on a behavioral index of health status, at two points in time: when transferred from the acute care hospital to one of the three treatment programs (pretest and three months later (posttest). Since patients could not be randomly distributed to programs, two methods were employed to control for potential sample selection bias: the choice of a nonequivalent control group design, and multivariate analytic techniques. First, within each program type, patients were randomly selected from both a hospital that offered only that program as a long-term care alternative and from a hospital that provided all three treatment settings. Second, multiple regression analysis was used to control for pretest differences among patients. Patients placed in the home care program displayed the greatest mean improvement in functional health status, holding all other variables constant. This treatment effect was not uniform, however; patients showed differential rates of improvement across the three programs, based upon both initial health status and prognosis.

Adult↗
PubMed1983

Do category rating scales produce biased preference weights for a health index?

Category rating scales are frequently used to measure social preferences in health decision models. The use of category rating scale methods has been questioned because subjects allegedly attempt to use rating scale categories equally often. This results in scale values that are contingent upon the context in which a stimulus is presented. In Experiment 1, subjects were randomly divided into five groups that rated a series of health case descriptions using the category method. Extensive pretesting had established the scale values for the stimuli. For one group, all values of the stimuli were evenly distributed across the response scale (as determined by pretests). For a second group, only items from the top of the scale were used; for a third group, only items with low values were used; for the fourth group items with low and high values (but not middle range) were presented; and for the fifth, items with medium values were presented. The results demonstrated that the values for items remain essentially the same, regardless of the group in which they are presented. These results were confirmed and extended in a second experiment. Experiment 3 demonstrated that subjects will attempt to use categories equally often when the stimuli are not health case descriptions but only when the response continuum and end-points of the rating scale are poorly defined. It is suggested that rating scales can provide valid and reliable results if the response continuum is made clear to subjects.

Decision Theory↗
PubMed1998

Spanish language translation and initial validation of the functional assessment of cancer therapy quality-of-life instrument.

OBJECTIVES: There is a need in the United States for culture-equivalent assessment of health-related quality of life, particularly among people who speak different languages and among those with low literacy skills. This report summarizes the adaptation of the Functional Assessment of Cancer Therapy (FACT) Scales for use with Spanish-speaking cancer patients, including those with low literacy. METHODS: The Spanish language version of the general Functional Assessment of Cancer Therapy scale plus five disease-specific subscales (breast, lung, colorectal, head and neck, HIV infection) were translated, reviewed, and revised, then evaluated in interviews with Spanish-speaking patients from the mainland United States and Puerto Rico. An iterative forward-backward-forward sequence of item translation, expert bilingual/bicultural advisor review, pretesting interviews with 92 patients, and further expert advisory input were used to establish semantic, content, and partial technical equivalence. RESULTS: The Functional Assessment of Cancer Therapy-General and five disease-specific subscales were translated successfully into wording that was easily understood and answered, leading to psychometric and scoring data similar to that of the English version. All but one of the 28 Functional Assessment of Cancer Therapy-General items and all of the disease-specific items were seen as culturally relevant. The result is a document that underwent iterative forward-backward translation and evaluation and was pretested successfully with native Spanish-speaking oncology patients living in the Central United States and Puerto Rico. CONCLUSIONS: The Functional Assessment of Cancer Therapy-General and five disease-specific subscales have been translated successfully into Spanish using a thorough translation and initial validation methodology. The methods and data provide a model for preparing a health status questionnaire for cross-cultural validation. The questionnaire is available for use in clinical trials and clinical practice.

Acculturation↗
PubMed1999

Translating the CAHPS 1.0 Survey Instruments into Spanish. Consumer Assessment of Health Plans Study.

OBJECTIVES: Collecting accurate health data on the growing number of ethnic minorities in the United States has increased in policy relevance in recent years. Today, most general population sample surveys conducted in the United States, including the CAHPS 1.0 Surveys, require translation into Spanish and often other languages as well. This article discusses the process used to translate the CAHPS 1.0 survey instruments into Spanish and the techniques used to evaluate these instruments. METHODS: The CAHPS team used a technique of translation-backtranslation to translate the survey instruments into Spanish and conducted cognitive testing and pretesting of preliminary versions of the 1.0 Survey Instruments in both English and Spanish. RESULTS: The translation-backtranslation method produced Spanish-language versions of the survey instruments that were adequate for more educated respondents but were inadequate for less educated respondents and respondents who seemed to be less acculturated. CONCLUSION: Adept translation of a survey instrument is an integral part of the instrument-development process, but it alone does not ensure that a culturally appropriate survey instrument will result. Producing a survey instrument that is culturally appropriate for Latinos in the United States may require modifying the English versions of instruments as well as subjecting Spanish-language instruments to more rigorous testing that includes cognitive testing, pretesting, and an evaluation of the reading level by a literacy expert.

Adult↗
PubMed1998

Fatigue effects on the bilateral deficit are speed dependent.

PURPOSE: The bilateral deficit is characterized by a decrease in maximum voluntary contraction (MVC) force during bilateral activation of homologous muscles compared with sum of the forces produced during unilateral MVC of the muscles. A proposed relationship between the bilateral deficit and the ability to activate high threshold motor units was investigated. The effects of muscle fatigue, induced using two contraction speeds, on the size of the bilateral deficit were measured. Based on previously published findings, it was expected that fast velocity isokinetic contractions compared with slow velocity isokinetic contractions would produce a larger bilateral deficit. It was hypothesized that following a unilateral fatigue protocol, the size of the bilateral deficit at the fast and slow velocities would be comparable. METHODS: The bilateral deficit was measured for isokinetic knee extension in 20 men (age:25 +/- 3 yr) before and after a fatigue protocol performed at 30 and 150 degreesxs(-1). RESULTS: The size of the bilateral deficit was initially the same at both velocities. The fatigue protocol at each contraction speed significantly decreased the maximum voluntary knee extension moment. The size of the bilateral deficit was not influenced by the 150 degrees fatigue protocol (pretest: -14.0% post-test: -12.5%; P > 0.05). However, the size of the bilateral deficit increased following the 30 degreesxs(-1) fatigue protocol (pretest: -13.7%; post-test: -21.9%; P < 0.05). CONCLUSIONS: The failure of the size of the bilateral deficit to be comparable at 30 and 150 degreesxs(-1) following fatigue is contrary to previous published reports that suggested reduced activation of high threshold motor unit is the primary mechanism underlying the bilateral deficit.

Adult↗
PubMed1998

Exercise training induced alterations in prepubertal children's lipid-lipoprotein profile.

PURPOSE: This study examined the effect of exercise training on prepubertal children's (ET, N = 28) lipid-lipoprotein profile, relative to a maturity matched control group (CON, N = 20). METHODS: Training for ET involved stationary cycling for 30 min, 3 times.wk-1 for 12 wk, at 79.3 +/- 1.2% (mean +/- SD) peak heart rate (HR). Controls maintained their usual lifestyle pattern. Plasma concentrations of total triacylglycerol (TG), total cholesterol (TC), and high-density lipoprotein (HDL)-cholesterol (HDL-C) were determined pre- and postintervention. Low-density lipoprotein (LDL)- cholesterol (LDL-C) was subsequently estimated from these concentrations, and the ratios TC/HDL-C and LDL-C/HDL-C were also calculated. There were no pretest differences (P > 0.05) for any of these blood analytes between groups. The following, potentially, confounding variables were also measured: peak VO2, percent body fat (%BF), dietary composition, and habitual physical activity. These variables, with pretest HDL-C, were included as covariates in two-way split plot ANCOVA analyses. Dietary variables were not included as covariates as they were not related to any of the blood analytes. RESULTS: There were no differences over time or between groups for TG and TC (P > 0.05). LDL-C decreased in ET (-10.2%) but remained unchanged in CON (0.3%) over the intervention period (P < 0.05). HDL-C increased in ET (9.3%) but decreased in CON (-8.9%) (P < 0.01). A similar, but inverted, pattern of change (P < 0.01) was revealed for both ratios, TC/HDL-C (-11.6% vs 6.3%, ET and CON, respectively), and LDL-C/HDL-C (-17.2% vs 8.0%, ET and CON, respectively). The favorable alterations in the lipid-lipoprotein profile for ET were independent of alterations in peak VO2 (group x time interaction, P < 0.05), %BF (main effect time, P < 0.01), and habitual physical activity (group x time interaction, P < 0.01). CONCLUSIONS: In conclusion, the favorable alterations in the lipoprotein profile seen in this study would suggest that it is possible to influence the prepubertal lipoprotein profile independent of alterations in confounding variables such as body composition, cardiorespiratory fitness, and habitual physical activity.

Adipose Tissue↗
PubMed1999

Maximal accumulated oxygen deficit must be calculated using 10-min time periods.

PURPOSE: The accumulated O2, calculated by an extrapolation procedure from measurements of the O2 uptake at moderate powers, has been suggested as a measure of the anaerobic energy release during high intensity exercise. While some suggest that repeated 10-min bouts are required to establish the relationships in question, other use bouts of shorter durations. The purpose of this study was to examine how different exercise durations influence the calculated accumulated O2 deficit. METHODS: Eight endurance trained male cyclists with the following characteristics (Mean +/- SE): age, 25 +/- 3 yr; weight, 69.9 +/- 1.7 kg: height, 178.2 +/- 1.0 cm; and VO2max 57.5 +/- 2.4 mL x kg(-1) x min(-1) volunteered for participation in this study. The O2 uptake was measured at 2-4, 4-6, 6-8, and 8-10 min of exercise at ten different constant powers. These O2 uptakes were used to establish four relationships between the power and O2 demand for each subject. On a separate day the subjects cycled at a power of 336 +/- 42 W (corresponding to about 110% of the maximal O2 uptake) for 296 +/- 43 s to exhaustion while the O2 uptake was measured continuously. For each subject the accumulated O2 deficit was determined from the different relationships. RESULTS: The accumulated O2 deficit determined from the relationships from the 2 to 4-min exercises in the pretests were significantly less than the value calculated from the relationships obtained after the 8-10 min of exercise at constant power, the values being 39.6 +/- 11.6 mL O2 eq x kg(-1) and 53.4 +/- 14.6 mL O2 eq x kg(-1), respectively. CONCLUSIONS: This study suggests that reducing the exercise duration used in the pretests to establish the relationships between power and O2 demand from 10 min may lead to a too low accumulated O2 deficit.

Adult↗
PubMed2001

Progressive strength training in sedentary, older African American women.

PURPOSE: This study investigated effects of an 8-wk, low-frequency and low-volume, supervised, progressive strength training program emphasizing free weight, multijoint movements on the muscular power, strength, endurance, and flexibility of African American women 44 to 68 yr of age. METHODS: Nineteen sedentary African American women were randomly assigned to a strength training (ST) only group (N = 12; mean age, 51 yr) or a nonexercise control (C) group (N = 7; mean age, 52 yr). Maximal power, strength, absolute endurance, and flexibility were assessed before and after training. Subjects trained 2 d x wk(-1) using free weight (barbells and dumbbells) and machine (plate loaded) exercises for two to three sets of 8 to 10 repetitions on both primary and assistance exercises. RESULTS: Upper body power (medicine ball put distance) significantly increased statistically (P = 0.002), but gains possibly lacked practical significance because of measurement variation. Lower body power (peak watts on bicycle) experienced a small, nonsignificant increase in the ST group. Significant increases (P = 0.000) in 1RM muscle strength occurred in the ST group (leg press, +99.8%; bench press, +34.4%). Absolute endurance significantly increased (P = 0.000) in the ST group (leg press repetitions to failure at 70% pretest 1RM, +221%; bench press repetitions to failure at 50% pretest 1RM, +112%). Significant flexibility gains occurred in the ST group (sit-and-reach test, +8.2%; P = 0.017). No significant changes occurred in power, strength, absolute endurance, or flexibility in the C group. CONCLUSION: This study demonstrates that 8 wk of low-frequency, supervised, progressive strength training emphasizing free weight, multijoint movements can safely cause significant gains in muscle strength, absolute endurance, and flexibility in older African American women.

Adult↗
PubMedDate not supplied

Nursing students' opinions about acupuncture and Chinese medicine.

Eighty senior nursing students at the University of San Francisco (USF) were divided at random into four groups of 20. Two groups were pretested on their knowledge of acupuncture and Chinese medicine. One week later a 50-minute class in acupuncture and Chinese medicine was given in a community health class to one of the two pretexted groups and one of the two untested groups. Following the class, the test was given to all four groups. Using the Solomon Four-Group design to measure effects of pretesting and the class content, significant differences were found between the groups on questions seeking differences, to confirm the first hypothesis that an increase in knowledge about acupuncture and Chinese medicine will accompany an increase in its acceptance as a healing tool and the desire to learn more about it. A t-test on the results of pre- and post- tests confirmed the second hypothesis that there will be no difference between groups in history or maturation from one week to the next.

Acupuncture Therapy↗
PubMedDate not supplied

Effects of a minimal intervention to increase physical activity in women: daily activity records.

BACKGROUND: Effective interventions to increase physical activity levels are critical in a nation where inactivity is a national public health problem. OBJECTIVE: This pilot study examined whether a minimal intervention (daily records of physical activity) increased activity levels in a community sample of working women. METHODS: In a longitudinal, pretest-posttest design, 49 working women were randomly assigned at the work site level to the control (n = 25) or intervention group (n = 24). At pretest and posttest, subjects completed self-report questionnaires that measured psychological, social-environmental, physical activity, and demographic variables. Subjects in the intervention group kept daily records of their physical activities during the 12-week study, while those in the control group kept no records. In order to compare activity in the two groups, all subjects wore pedometers daily that recorded number of steps. RESULTS: There was a significant difference between groups in the pedometer values (mean number of daily steps) at the end of the study period (mean difference +/- SE 2147 +/- 636, p = .022) (2000 steps = approximately 1 mile). Multiple regression analysis showed that only the intervention (p = .003) was a significant predictor of the pedometer values. Hierarchical data analysis was used to account for the intra-class correlation of 0.48 within work site. CONCLUSION: Results from this sample of 49 women indicated that mean activity was greater in the intervention group compared to the control group. Recording daily activity is a cost-effective and acceptable intervention that may increase activity levels in women. However, more research is recommended to study the dual role of activity records as a data collection method as well as a potential intervention to increase physical activity.

Adult↗
PubMedDate not supplied

Effects of booster interventions on factory workers' use of hearing protection.

BACKGROUND: The provision of reinforcements or boosters to interventions is seen as a logical approach to enhancing or maintaining desired behavior. Empirical studies, however, have not confirmed the effectiveness of boosters nor assessed the optimum number of boosters or the timing for their delivery. OBJECTIVES: This randomized controlled trial contrasted the effect of four booster conditions (a). 30 days; (b). 90 days; (c). 30 and at 90 days; and (d). no boosters of the intervention to increase the use of hearing protection devices (HPDs). METHODS: A total of 1325 factory workers completed a computerized questionnaire and were randomly assigned to one of three computer-based (tailored, nontailored predictor-based, or control) multimedia interventions designed to increase the use of hearing protection devices. After the intervention, colorful boosters specific to the type of training received were mailed to workers' homes. Posttest measures of use were administered at the time of their next annual audiogram 6 to 18 months after the intervention. RESULTS Repeated measures of analysis of variance (ANOVA) showed a significant main effect for the booster (after 30 days) in the group that received tailored training (F[3442] = 2.722; p =.04). However, in the assessment of the interaction between time (pretest and posttest) and boosters (four groups), the ANOVA did not find significant differences in hearing protection device use for any of the training groups. To assess for significant differences between groups, post hoc comparisons were conducted at the pretest and posttest for the total sample and for the subsample of workers who reported using hearing protection devices less than 100% of the time needed. Sheffé contrasts by intervention group, gender, ethnicity, and hearing ability found no significant changes in the mean use of hearing protection devices for the booster groups. CONCLUSIONS: Although the provision of boosters represented a considerable commitment of resources, their use was not effective in this study. However, it would be premature to eliminate boosters of interventions. Further study is needed to explore the effects of different booster types for increasing the use of hearing protection devices, and to assess carefully the effects of boosters on other health behaviors in studies with controlled designs.

Adult↗
PubMedDate not supplied

Outcomes of family involvement in care intervention for caregivers of individuals with dementia.

BACKGROUND: Despite the increasing number of individuals with dementia relocated from caregiving at home to a nursing home, there is only a small body of literature examining the influence of institutional family-oriented practices on family member perceptions of care and family-staff relationships. OBJECTIVE: The study tested the effects of the Family Involvement in Care partnership intervention on family members' perceptions of their caregiving role, relationships with staff, and satisfaction with the care of relatives with dementia residing in special care units as well as the effects on staff attitudes toward families and staff satisfaction with a caregiving role. METHODS: A quasi-experimental design with nonequivalent groups and repeated pretest and posttest measures was used to examine the effects of the Family Involvement in Care intervention. The study recruited 14 Midwestern nursing home special dementia care units, matched by aegis and staff turnover, and randomized from matched pairs to experimental and control conditions. The samples included 185 family members and 895 staff. The Family Involvement in Care intervention is a protocol for family and staff negotiation of a written partnership agreement. Family caregiver outcomes were measured using instruments pretested for reliability and validity. Data were analyzed using hierarchical linear modeling. RESULTS: With adjustment for multiple tests, statistically significant beneficial intervention effects were found in three areas of family caregiver outcomes (emotional reactions to the caregiving role, perceptions of relationships with staff, and perceptions of care for relatives) and in one of three areas of staff outcomes (staff perceptions of the family caregiving role). For family members, effects were found for the measures assessing loss, captivity, staff disregard, resident activities, and physical care. Some of the intervention effects for family members were found only for caregivers of the same generation as the resident. For staff, effects were found for measures of dominion, disruption by family, and irrelevance of family. CONCLUSIONS: The results of the study indicate that the Family Involvement in Care intervention improves the caregiving experience of family members in nursing homes as well as nursing home staff attitudes toward family members. The intervention did not influence the perceived conflict with staff on the part of family caregivers or the perception of a partnership with family caregivers on the part of staff.

Adult↗
PubMedDate not supplied

Test of a nursing intervention to promote adjustment to fibromyalgia.

PURPOSE: This was a test to detect whether a 4-week cognitive behavioral nursing program was effective in increasing adjustment to fibromyalgia (FM) and if the treatment effect would last over time. DESIGN: This was a control and treatment group experimental longitudinal study with outcome measures obtained at pretest and every 3 months for 1 year. SAMPLE: A sample of 71 subjects continued their participation throughout the first year of the study. FINDINGS: Treatment subjects had improved posttreatment adjustment and symptom severity compared to control subjects. When subjects with high pretest psychosocial distress (n = 5) were removed from the analysis, these findings were statistically significant. IMPLICATIONS FOR NURSING PRACTICE: The article can provide direction for developing new comprehensive nursing intervention for patients seen with orthopaedic problems. The intervention schedule may help nurses expand their use of interventions for FM patients. Orthopaedic nurses are especially suited for this challenge.

Adaptation, Psychological↗
PubMed2001

Predictors of ventriculoperitoneal shunt pathology.

BACKGROUND: Diagnosis of ventriculoperitoneal (VP) shunt pathology remains a dilemma in patients with nonspecific constitutional signs and symptoms. Eosinophilia has been described in association with shunt infection and malfunction. Our purpose was to further define the relationship of eosinophilia and shunt pathology and to determine other predictors of VP shunt infection and malfunction. METHODS: Records of all patients admitted with a suspected VP shunt infection or malfunction were reviewed. The following data were abstracted: age; reason for and age at initial shunt placement; number of revisions; date of last revision; history of fever or vomiting; ventricular fluid cell count; differential and culture; complete blood count and differential; need for shunt revision or replacement; and use of antibiotics. After exclusion of patients admitted for initial shunt placement, the remainder were divided into three groups: those with shunt infection; those with shunt malfunction; and those without documented infection or malfunction. RESULTS: Of 12 patients with shunt infection and 69 with shunt malfunction, 2 and 11, respectively, had eosinophilia defined as > or =5%. The presence of eosinophilia had a 96% positive predictive value for shunt pathology and raised the pretest probability of pathology from 84% to a post test probability of 96%. The combination of fever history and ventricular fluid neutrophils >10% had a 99% specificity for shunt infection, had a 93 and 95% positive and negative predictive value, respectively, and raised the pretest probability of infection from 12% to a posttest probability of 92%. CONCLUSIONS: In patients suspected of having a VP shunt malfunction, the presence of > or =5% eosinophils in the ventricular fluid indicates shunt pathology. The combination of fever and ventricular fluid neutrophils > 10% is predictive of shunt infection.

Adolescent↗
PubMed2000

Minimal influence of facet joint anesthesia on isokinetic muscle performance in patients with chronic degenerative low back disorders.

STUDY DESIGN: Experimental design. OBJECTIVES: To examine the influence of pain reduction after facet joint injections on isokinetic back muscle performance. SUMMARY OF BACKGROUND DATA: Methods for evaluating the effect of facet joint injections vary. Recent studies base their results solely on the patient's subjective opinion and suggest a need for more objective, concrete, and reliable measurements. METHODS: Eighty-seven patients with a degenerative low back disorder (49 women and 38 men; mean age, 48 years; range, 22-79) who had facet joint injections as a part of preoperative evaluation participated. The mean duration of symptoms was 12.3 years (range, 1-45). The patients underwent isokinetic trunk flexor and extensor muscle strength testing at angular velocities of 60 deg/sec and 120 deg/sec. They performed two tests before the facet joint injections (to eliminate learning effect). All patients had bilateral facet joint injections at L5-S1. Those who did not report pain relief had additional injections at L4-L5. The flexion-extension test was repeated 15 minutes after each injection. Pain and fear were registered on visual analog scales. RESULTS: All 87 patients could perform the isokinetic tests. For extension at 60 deg/sec, a significant improvement was found between the two pretests (P < 0.05). Pain increased significantly from the first to the second pretest (P = 0.02), and a significant decrease in pain was found after the first injection (P = 0.0001). Fear decreased between each test, with a significant decrease after the first injection. No significant change was found for the muscle strength measurements after facet joint anesthesia. There were only weak correlations between decrease in pain and alteration in muscle performance, ranging from 0.06 to 0.37. CONCLUSION: Pain reduction after facet joint injections did not influence isokinetic muscle performance in patients with degenerative low back disorders.

Adult↗
PubMedDate not supplied

Effects of a CD-ROM educational program on sexual knowledge and attitude.

This study evaluated a CD-ROM educational program in sexual violence prevention for middle school students. A randomized control-group pretest-posttest design was used. Seventy-nine students were randomly assigned to either an experimental (n = 39) or control (n = 40) group. The experimental group watched the CD-ROM, whereas the control group did not. Both groups were pretested for the levels of knowledge and attitude about sexual violence prevention prior to intervention. A CD-ROM titled Educational Program for the Prevention of Sexual Violence was used for the intervention. The instrument contains 32 true-false items that measure knowledge level and 20 items comprising a four-point Likert-type scale that measure the attitude to sexual violence. There was a significant increase in knowledge in the experimental group, while no differences on attitude were found between the experimental and control groups. A CD-ROM-based program can be effective for delivering instructions on sexual violence prevention in the classroom.

Adolescent↗
PubMed1998

HIV counseling and testing: behavior and practices of women of childbearing age in Abidjan, Côte d'Ivoire. DYSCER-CI Group.

We assessed factors associated with women's attitudes toward HIV test results in gynecology clinics in Abidjan, Côte d'Ivoire. HIV testing was systematically offered to nonpregnant women attending two gynecology clinics in Abidjan. Individual pretest counseling was performed by trained midwives. Posttest counseling was given 2 weeks later to women who wished to know their HIV test results. HIV testing was offered to a total of 1482 women, of whom 1401 (94.5%) agreed to be screened. The prevalence of HIV infection was 21.3%. Of the women who participated, 10% failed to return. Youth, low educational level, and absence of genital infection were findings individually associated with failure by participants to return for their test results. Among the 1242 women who returned, 13.7% did not wish to know the results of their HIV test. A positive HIV test result, being native to Côte d'Ivoire, a high educational level, and knowing the existence of the asymptomatic stage of HIV infection were factors independently associated with declining to know the HIV test result. In conclusion, women who declined to know their HIV test results presented a specific profile at the time of HIV testing. This information can be used to improve pretest counseling and the efficacy of future HIV screening programs.

AIDS Serodiagnosis↗