Developing a Motion Comic for HIV/STD Prevention for Young People Ages 15–24, Part 2: Evaluation of a Pilot Intervention

In the United States, young people (ages 15–24 years) are disproportionately affected by human immunodeficiency virus (HIV) and other sexually transmitted diseases (STDs), due at least in part to inadequate or incorrect HIV/STD-related knowledge, attitudes, beliefs, and behavioral intentions (KABI). Comic book narratives are a proven method of HIV/STD prevention communication to strengthen KABI for HIV/STD prevention. Motion comics, a new type of comic media, are an engaging and low-cost means of narrative storytelling. The objective of this study was to quantitatively evaluate the effectiveness of a pilot six-episode HIV/STD-focused motion comic series to improve HIV/STD-related KABI among young people. We assessed change in HIV/STD knowledge, HIV stigma, condom attitudes, HIV/STD testing attitudes, and behavioral intentions among 138 participants in 15 focus groups immediately before and after viewing the motion comic series. We used paired t-tests and indicators of overall improvement to assess differences between surveys. We found a significant decrease in HIV stigma (p < .001) and increases in both HIV knowledge (p = .002) and behavioral intentions to engage in safe sex (p < .001). In summary, this motion comic intervention improved HIV/STD-related KABI of young adult viewers by reducing HIV stigma and increasing behavioral intentions to engage in safer sex. Our results demonstrate the promise of this novel intervention and support its use to deliver health messages to young people.     

参与式方法在学校艾滋病健康教育中的效果评估

目的评价参与式方法在学校艾滋病防治健康教育中的效果。方法在参与式教学前后采用相同问卷对昆明市一所中等医学专科学校267名二年级学生进行性病/艾滋病相关知识、态度对比调查。结果参与式教学前后:①艾滋病相关知识认知有变化,且差别有统计学意义(χ2=9.53,P<0.01);②性病知识认知变化大,差别有统计学意义(χ2=83.09,P<0.01);③艾滋相关态度有不同程度地改变,且差别有统计学意义(P<0.01)。结论参与式方法应用于课堂对学生的性病/艾滋病相关知识、相关态度作用明显,有利于学校更好地开展艾滋病健康教育。     

RURAL YOUTH: HIV/STD KNOWLEDGE LEVELS AND SOURCES OF INFORMATION

ABSTRACT: Though it is recognised that a sound knowledge of HIV/STD transmission is insufficient on its own to ensure that young people practise safer sex, knowledge of this sort is a necessary prerequisite to safe sex behaviours. Research on the HIV/STD knowledge levels of young people has shown that, while they have high levels of HIV knowledge, they generally have little idea about the transmission of other STDs. Moreover, most of this research has been conducted with more accessible youth in large urban centres. The research reported in this paper focused on HIV/STD knowledge levels, awareness of safe and unsafe sexual practices, and the information sources accessed by 1168 young people living in small rural towns in Queensland, Tasmania and Victoria. As with mainstream youth, the participants in this study had high levels of HIV knowledge and very low levels of knowledge about the transmission of other STDs, their names and symptoms. Practical knowledge of the safety of sexual practices was good, although a number of students confused high risk practices with high risk groups. Students mainly accessed informal information sources such as parents, peers and magazines and took little advantage of more formal sources even when they were available in their towns. There were few gender differences in levels of knowledge; however, girls accessed more information sources and knew more names of STDs. The implications of these findings are discussed in relation to young people developing critical attitudes towards more informal sources, and the better use of more formal sources.     

上海市流动人口性病/艾滋病知识状况及影响因素分析

目的:了解上海市流动人口性病/艾滋病相关知识,探讨其影响因素,掌握人群对性病/艾滋病健康教育的需求,为流动人口艾滋病预防及健康教育工作提供科学依据。方法:按照拟定的筛选表,采用多级抽样的方法及知情同意的原则,选取上海市闵行区外来流动人口1000人,通过结构式问卷调查其性病/艾滋病相关知识并进行量化评分,采用方差分析和多元线性回归分析综合知识得分的可能影响因素。结果:流动人口性病/艾滋病综合知识得分仅为50.67±25.40分,在各项知识回答中,关于性病症状和艾滋病症状的得分最低。学历、婚姻状况及月收入是知识得分的主要影响因素。性病/艾滋病知识的主要来源为影视广播、书报杂志、宣传板报和网络。结论:流动人口性病/艾滋病知识水平有待提高,应针对流动人口相关知识的薄弱环节如性病/艾滋病症状等方面开展宣传,加强学历水平较低的未婚人群的健康教育工作。     

Health Education at Family Planning Clinics: Strategies for Improving Information About Contraception and Sexually Transmitted Diseases for Low-Income Women

Female clients from three family planning clinics were surveyed for their sources of health information and knowledge regarding contraception and sexually transmitted diseases (STDs). Clinics, doctors, pamphletdbrochures, and nurses frequently were used as sources of contraceptive information. Television was used most frequently for STD information by the group with higher reading skills, whereas clinic and pamphlet/brochures were used most frequently by the group with lower reading skills. Some significant correlations among contraceptive and STD knowledge and the number of sources of health information and perceived amount learned also were found in the study. These findings can be helpful in developing health information and education programs at family planning clinics.     

Contact tracing and sexually transmitted disease among Aboriginal men on the Anangu Pitjantjatjara lands

Sexually transmitted diseases (STDs) are a major health problem for Pitjantjatjara Aboriginal people, causing considerable morbidity and being implicated in the potential rapid transmission of human immunodeficiency virus (HIV) infection. This paper presents data in relation to STD contact tracing on the Anangu Pitjantjatjara lands. In-depth interviews were conducted with Aboriginal men and non-Aboriginal clinic staff to ascertain their attitudes to and perceptions of contact tracing. The interviews with Aboriginal men also sought more general information in relation to health-seeking behaviour and knowledge of STDs. While contact tracing has proven an effective method of case detection on the Anangu Pitjantjatjara lands (most named contacts are able to be located and a high proportion are found to be infected), the data suggest that important constraining issues are the reluctance of Aboriginal men to consult with particular health workers because of moiety group considerations, concerns about confidentiality, and the low level of knowledge of STDs, particularly of largely asymptomatic infections such as chlamydia, syphilis and HIV.     

Evaluation of the effect of a health education campaign of HIV by using an analytical hierarchy process method

This study was designed to understand the status of HIV/AIDS knowledge, attitude and practice (KAP) among different populations and to provide scientific evidences for further health education. Three rounds of questionnaires were administered among service industry workers who were selected through stratified cluster sampling. Study subjects included hotel attendants, employees of beauty parlors and service workers of transportation industry. Data were analyzed using the analytical hierarchy process. All demonstrated high KAP overall. Synthetic scoring indexes of the three surveys were above 75%. However, the correct response rate on questions whether mosquito bite can transmit HIV/AIDS and what is the relationship between STD with HIV was unsatisfactory (lower than expected); and their attitudes towards people living with HIV and AIDS need to be improved. Moreover, the effect of health education on these groups was unclear. In conclusion, analytical hierarchy process is a valid method in estimating overall effect of HIV/AIDS health education. Although the present status of HIV/AIDS KAP among the service industry workers was relatively good, greater efforts should be made to improve their HIV transmission knowledge, attitude and understanding of the relationship between STDs and HIV.     

Preparing Long-Term Care Staff to Meet the Needs of Aging Persons With Serious Mental Illness

ObjectivesIndividuals with serious mental illness (SMI; schizophrenia spectrum disorders and affective psychoses) are increasingly aging into older adulthood and are overrepresented in residential long-term care settings. The present study aimed to examine the preparedness of staff in these settings to care for individuals with SMI.DesignA multidisciplinary US Department of Veterans Affairs (VA) workgroup of professionals with expertise in geriatric mental health collected voluntary feedback via online questionnaire as part of a quality improvement project.Setting and ParticipantsRespondents were mental health providers (N=51) embedded in VA nursing homes called Community Living Centers (CLCs).MeasuresThe questionnaire contained multiple-choice, Likert-type scale, and open-ended questions regarding the opportunities and challenges associated with caring for Veterans with SMI in CLCs.ResultsRespondents identified a lack of training of front-line staff as a key challenge in providing high-quality care to residents with SMI. Specifically, respondents indicated a need to increase staff knowledge about SMI symptoms and diagnoses, to improve staff communication and interactions with residents with SMI, and to decrease mental illness stigma among staff.Conclusions/ImplicationsThe present study revealed significant areas of training need for front-line staff in nursing homes. Many perceived staff training needs overlap with the knowledge and skill set required to provide high-quality dementia care. Integrating training regarding the care of residents with SMI into dementia care training efforts may be a fruitful future direction. Strategies for this and a suggested curriculum are provided.     

Traditional women's associations as channels for HIV / AIDS / STD prevention

Women of the Laobe ethnic group and the Dimba, a traditional women's association, provide advice about sexuality and reproductive health in southern Senegal. Research was initiated in October 1992 by the Cheikh Anta Diop University to determine whether these women could also help in HIV/AIDS and STD prevention activities. The study investigated men's and women's knowledge, attitudes, beliefs, and practices (KABP) related to sexuality and HIV/AIDS/STDs in the community of Kolda; practices potentially increasing women's risk of HIV/STD infection; and possibilities for integrating HIV/STD prevention messages into the interactions which take place between the Laobe and Dimba groups and the Kolda community. The KABP study was a questionnaire administered to 250 men and 250 women of reproductive age representing five ethnic groups residing in Kolda. 11 men and 14 women older than age 40 participated in in-depth sexual life history interviews. The survey and interviews indicate that people in Kolda do not generally see a link between sexual relations and STD transmission. Instead, STDs are attributed to behaviors such as urinating, walking barefoot on the urine of an already-infected person, encountering a "bad wind", and being cursed. Women may be at increased risk of HIV infection through practices designed to enhance sexual pleasure, including the insertion of organic and mineral product into the vagina, and the cutting of bumps and warts in and around the vagina. Sexual practices, knowledge, prevention through the Laobe and Dimba, and outcome and follow-up are discussed.     

深圳市社区居民艾滋病/性病预防干预效果评价

目的了解深圳市社区居民艾滋病/性病知识、态度和行为状况,评价近年来社区居民艾滋病、性病健康教育远期效果。方法采用整群抽样方法,对深圳市社区的18～69岁居民608人进行健康教育干预前后的2次相同的问卷调查。结果居民相关知识普遍来源于大众传媒;居民对艾滋病/性病知识知晓率随着健康教育次数越多,正确率越高;受教育程度越高,正确率越高。传播途径和预防措施知晓率分别达97.8%和99.1%,艾滋病的损害系统、传播途径、潜伏期和感染者危险行为、诊断方法、安全套的作用、对待艾滋病感染者的态度正确回答率上升具有统计学意义(P<0.05)。结论通过开展有针对性的多种形式的健康教育,有助于提高社区人群对艾滋病的认知水平,艾滋病/性病相关知识得到普及,健康教育能收到良好效果,但一次教育不足以改变人们的固有观念,应常抓不懈。应把对艾滋病的健康教育和性病及其他疾病的健康教育结合起来;有针对性地和社区卫生服务、学校卫生服务结合起来,把专业知识和大众传媒结合起来,会取得更好的效果。     

Prevalence and risk factors associated with syphilis in women]

INTRODUCTION: Although the incidence of syphilis is generally low, it remains an important global public health problem, given its interaction with other sexually transmitted diseases (STDs). It has been shown that syphilis, due to the genital ulcers it produces, is a co-factor for acquiring other STDs, principally those of viral origin such as herpes simples type 2, hepatitis B and HIV. Many female commercial sex workers (FCSW) in Mexico have been found to have acquired good levels of knowledge about STD prevention. Nevertheless, they constitute a heterogeneous group in terms of socio-economic level, health status and type of work site; these factors in turn appear to determine their attitudes, knowledge and behavior related to acquiring and transmitting STDs, including syphilis. This study, therefore, focused on the factors associated with Treponema pallidum infection in this group of women. METHOD: Based on a sample frame of sites where female commercial sex work takes place within Mexico City, a sample of 807 FCSWs was selected; after providing informed consent, they completed a structured questionnaire. A blood sample for identifying serologic markers for STDs was collected and analyzed according to a procedure manual for STD diagnosis. Treponema pallidum was diagnosed using the RPR (Bigaux Diagnostica) screening test, and FTA-ABS (Pasteur Diagnostics) for confirmation. RESULTS: The prevalence of syphilis in this sample of FCSWs was 6.4% (52/807), and was higher among women who worked at street sites than among those who worked in massage parlors. The age of the women interviewed ranged from 17 to 58 years, with a mean of 29.2 years (SD 7.3 years); syphilis was more prevalent among women over 30 years of age. Age at first sexual intercourse ranged from 11 to 30 years, with a mean of 16 years (SD 3.1 years), which is similar to that of the general female population in Mexico. Predictive factors for T. pallidum infection, determined adjusted logistic regression, included: tupe of by work site (bar and street sites); socio-economic level (middle and low); age (over 30 years); duration of involvement in sex work (> 5 years) and number of clients per week (> 10). CONCLUSION: In spite of some limitations regarding statistical precision, this study shows that FCSWs are heterogeneous in terms of risk of acquiring STDs, including syphilis; the principal differentiating factor was shown to be the type of work site. Given that it is not belonging to a risk group but rather participating in risky practices that leads to acquiring STDs, situations that facilitate riskier or safer practices (such as type of sex work site, for sex workers) should be taken into account when studying people's risk level. STD prevention campaigns must also consider these factors, in addition to focusing on FCSWs and their clients and personal partners, so that all involved assume their responsibility for safer sex.     

青春期学生的家长性知识及对性教育态度的调查研究

目的：了解青春期学生的家长性知识及对性教育的态度，探讨青春期性教育在我国的必要性、可行性。方法：采用自行设计的家长用有关学生青春期性教育问卷，对368名青春期学生的家长进行了调查。结果：有相当一部分的家长缺少基本的生殖健康知识及预防性病／艾滋病知识。具有大专以上文化程度的家长性知识得分明显高于其他文化程度的家长。84．5％的家长认为有必要向青少年开展性教育；但仍有30．2％的家长认为对青少年进行性教育可能会诱导过早的性行为。结论：青春期性教育在我国是可行的；在对青春期学生进行性教育时要注意适时、适量和适度原则；应重视对学生家长普及基本的性生理卫生知识和预防性病／艾滋病知识教育。     

Prevalence of mental disorders and torture among Tibetan refugees: A systematic review

Background  

Rural Indian tribes are anthropologically distinct with unique cultures, traditions and practices. Over the years, displacement and rapid acculturation of this population has led to dramatic changes in their socio-cultural and value systems. Due to a poor health infrastructure, high levels of poverty and ignorance, these communities are highly vulnerable to various health problems, especially, communicable diseases including HIV/AIDS. Our study sought to assess knowledge, attitudes and practices regarding sexuality, and the risk factors associated with the spread of HIV/AIDS and STDs among these communities.     

Preventing HIV Among U.S. Women of Color With Severe Mental Illness: Perceptions of Mental Health Care Providers Working in Urban Community Clinics

Given their knowledge of the behavioral issues related to psychiatric illness, mental health care providers are in a unique position to help prevent HIV among women with severe mental illness (SMI). We conducted in-depth interviews with providers at two New York City community clinics. We identified three major, interrelated themes pertaining to HIV prevention among women of color with SMI. Interventions that address the barriers that clinicians face in discussing sex, sexuality, and HIV with patients and train providers in the cultural considerations of cross-cultural mental health care are needed to help prevent HIV among women of color with SMI.     

初中生艾滋病／性病健康教育近期效果评价

目的了解浙江省初中生对艾滋病/性病相关知识的知晓情况、相关态度及行为状况,初步评价在初中生中开展艾滋病/性病健康教育的近期效果。方法采用整群抽样方法,对2385名初中生在健康教育前和健康教育后1个月分别下发同一调查问卷进行相关问题调查。结果被调查对象健康教育后比健康教育前艾滋病/性病知识知晓率有明显提高;可以接受和艾滋病病毒感染者或病人一起学习、生活的学生由健康教育前的46.62%上升到健康教育后的62.09%(P<0.01)。结论通过专题讲座、小册子、VCD等多种形式,在初中生中开展艾滋病/性病健康教育能收到良好效果。     

Changes in HIV/AIDS education, knowledge and attitudes among Scottish 15-16 year olds, 1990-1994: findings from the WHO: Health Behaviour in School-aged Children Study (HBSC).

There is concern about the high prevalence of adolescent sexual health problems, such as sexually transmitted diseases (STDs) and unwanted pregnancies, that currently exist in the UK. If young people are to reduce their risk from HIV/AIDS and other STDs it is imperative, in the first instance, they know what the risks are and how they can avoid them. However, effective school-based sex education can only be delivered if there are accurate data on young people's current levels of knowledge and existing sex education needs. This paper details findings from the WHO: Health Behaviours of School-aged Children Study on the changes that have occurred between 1990 and 1994 in Scottish school-children's knowledge, attitudes and perceived educational needs in relation to HIV/AIDS. There have been significant changes in knowledge and attitudes that may affect their sexual behaviour, e.g. in their attitudes to condom use, risk of HIV/AIDS and other STDs, and also other sexual health problems, such as the risk of unwanted pregnancies and abortions. Finally, areas that require future research and recommendations for future sexual health education interventions are highlighted.     

Barriers to asymptomatic screening and other STD services for adolescents and young adults: focus group discussions

Background  

Sexually transmitted diseases (STDs) are a major public health problem among young people and can lead to the spread of HIV. Previous studies have primarily addressed barriers to STD care for symptomatic patients. The purpose of our study was to identify perceptions about existing barriers to and ideal services for STDs, especially asymptomatic screening, among young people in a southeastern community.     

The knowledge,education and behaviour of young people with regard to Chlamydia trachomatis in Aarhus,Denmark and Bonn,Germany: Do prevention concepts matter?

Young people are at high risk of sexually transmitted infections, especially Chlamydia trachomatis, the most prevalent bacterial sexually transmitted disease in the developed world. Young people lack knowledge about sexually transmitted diseases (STDs) and are more aware of the risks of unwanted pregnancy than their risk of acquiring a STD. Different STD prevention concepts in different countries focus on different STDs. Based on explorative data analysis (Categorical Principal Component Analysis, CatPCA) this study, conducted in 2005, investigates the associations between self-estimation of sexual knowledge, active knowledge of chlamydia and HIV/AIDS, differing sex education and the sexual behaviour of 15–19 year old pupils from Aarhus, Denmark (N = 97), and Bonn, Germany (N = 93). A constructed knowledge, education and behaviour space model shows interesting associations between active STD knowledge and the sex education provided by both media and professionals. Sexual behaviour depends especially on sex education acquired through TV, Internet and print media. The young people from Aarhus and Bonn have significantly differing knowledge levels of chlamydia and HIV/AIDS. This is understood to be an effect of the different STD prevention concepts in Denmark and Germany.     

Break the Silence: HIV/AIDS Knowledge, Attitudes, and Educational Needs among Arab University Students in United Arab Emirates

PurposeIn light of increasing spread of human immunodeficiency virus (HIV) in the Middle East, we assessed knowledge, attitudes, and educational needs of young people in United Arab Emirates (UAE), a modern and moderately conservative Islamic country.MethodsA cross-sectional survey among randomly selected first-year, gender-segregated Arab students at the national university in Al Ain in 2005 was conducted using an adaptation of an anonymous self-administered World Health Organization questionnaire. Knowledge and attitudes were scored.ResultsResponse was 89%; 119 males and 148 females. Knowledge scores about HIV/AIDS were low for 75%, moderate for 24%, high for <1%. Although 90% knew main routes of infection, there were misconceptions about transmission, and only 31% knew there is no vaccine and 34% no cure. Religion was stated as a reason to avoid extramarital relationships by 91% and sexually transmitted diseases (STDs) by 38%; 94% favored premarital testing. Attitudes toward people living with HIV (PLH) were neither friendly nor tolerant, including 97% who felt all people entering UAE should be tested, 53% that PLH should be forced to live apart, and only 27% who felt children with HIV should be allowed to attend school. Ninety-six percent stated that young people should be taught how to protect themselves and 57% that teaching at school was insufficient. Main information sources were books/media; preferred sources were media, schools, and health professionals. Males scored higher on knowledge and were more susceptible to fear of STDs, society, and family; females showed greater compassion and interest in premarital testing and education to protect themselves.ConclusionsAlarming gaps in knowledge about transmission and curability put young Arabs at risk of contracting HIV. Fear and intolerant attitudes toward PLH were prevalent. HIV/AIDS education designed to raise knowledge and change attitudes, and respectful of community values, is urgently needed from media, schools, and health professionals.     

Developing a Motion Comic for HIV/STD Prevention for Young People Ages 15–24, Part 1: Listening to Your Target Audience

Young people (15–24 years) in the United States are disproportionately affected by infection with human immunodeficiency virus (HIV) and sexually transmitted diseases (STD). Shortfalls in HIV/STD-related knowledge, attitudes, beliefs, and behavioral intentions (KABI) likely contribute to this discrepancy. In this report we describe our experience developing a novel means of health communication combining entertainment-education theory and recent technological advances to create a HIV/STD-focused “motion comic.” We also report the audience satisfaction and acceptance of the intervention. We used the Health Belief Model (HBM), entertainment-education (EE) principles, and the Sabido Method (SM) and conducted three rounds of focus groups to develop a 38-minute HIV/STD focused motion comic for young people between the ages 15 and 24 years. Participants indicated that motion comics were an acceptable method of delivering HIV/STD prevention messages. They also expressed satisfaction with motion comics plot, story settings, the tone of humor, and drama. Our results suggest that motion comics are a viable new method of delivering health communication messages about HIV/STD and other public health issues, and warrant further development and broader evaluation.