The impact of sexually transmitted diseases on minority populations

Sexually transmitted diseases (STD) are more prevalent among some minority populations in the United States than they are among the white majority. Primary and secondary syphilis occurs 45 times as often among non-Hispanic blacks as among non-Hispanic whites and 13 times as often among Hispanics as among non-Hispanic whites, according to morbidity reports received in 1988 by the Centers for Disease Control. Gonorrhea is reported more commonly among some minorities, with 1988 rates per 100,000 population being 54 for whites, 1,801 for blacks, and 201 for Hispanics. The reasons for the higher incidence of STD among some minorities are unknown. Data on racial differences in behavior and disease susceptibility are meager and do not account for the observed differences. Poverty, which is more common among some minorities than among the white majority, is closely associated with the prevalence of STD and may be a link between membership in a minority population and an increased risk.     

2010—2019年贵州省汉族与少数民族学生肺结核流行现况

目的 了解2010—2019年贵州省学生肺结核流行特征,为制定学生结核病防控策略提供依据。方法 对2010—2019年贵州省“结核病管理信息系统”中学生肺结核资料进行描述流行病学分析。结果 2010—2019年贵州省报告学生肺结核32448例（年均发病率36.21/10 万）,其中汉族21331例,少数民族11117例。学生肺结核年均发病率汉族（40.65/10 万）高于少数民族（29.93/10 万）,均呈逐年上升趋势。汉族与少数民族学生肺结核初治涂阳构成比均呈逐年降低趋势。汉族学生肺结核累计发病数,毕节市8884例(41.65%) 、遵义市3705例(17.37%) 、贵阳市2141例(10.04%)位列前三。少数民族学生肺结核累计发病数,黔东南州2688例(24.18%) 、毕节市2283例(20.54%) 、铜仁市2154例(19.38%)位列前三。2010—2019年汉族学生肺结核20～24 岁构成比呈下降趋势,少数民族却呈上升趋势。2010—2019年汉族与少数民族累计报告学生肺结核均为男性大于女性（男女比分别为1∶1.15;1∶1.27）。2010—2019年贵州省学生肺结核主动发现率少数民族（13.43%）高于汉族（12.70%）,均呈逐年上升趋势。2010—2019年学生肺结核就诊延迟率汉族（52.87%）小于少数民族（57.73%）,均呈逐年递减趋势。结论 2010—2019年贵州省汉族与少数民族学生肺结核疫情在发病率、主动发现率和就诊延迟率趋势上存在一致性,但在地区分布、年龄分布上存在差异。建议相关部门根据本地情况,加强重点年龄段、重点民族及重点地区的防控监测;加大对少数民族学生的健康宣教,降低其就诊延迟率。     

云南省农村三个民族慢性阻塞性肺疾病的患病、知晓、治疗率和疾病负担

目的 分析云南省农村汉族、纳西族和白族慢性阻塞性肺疾病(chronic obstructive pul-monary disease,COPD)患病、知晓和治疗情况以及疾病负担现状.方法 采用多阶段分层随机抽样方法抽取云南省3个县≥35岁的农村常住居民共7 534名进行现场问卷调查及肺功能检查.结果 云南省汉族、纳西族...     

1999、2000年大连市性病流行病学分析

目的 了解1999年和2000年大连市性病的发病趋势和流行特点，为政府部门制定控制对策提供科学依据。方法 用全市性病疫情报告系统上报的年度报表资料并利用SPSS软件、EXCEL分析。结果 2000年大连市共报告常见7种性病6619例，较1999年降低16、13％，大连市性病总报告发病率为121．07／10万，在大连市尖锐湿疣较1999年增长了1．56％，而梅毒和淋病则出现了下降的趋势，降幅分别是51．57％和33．50％；大连市仍以城镇为高发地区.结论 2000年大连市性病发病有下降的趋势，性病流行病谱在发生改变，提示防治措施和资源分配应作相应调整。     

Modeling a syphilis outbreak through space and time using the Bayesian maximum entropy approach

PURPOSE: The aim of the study is to describe changes in the spatial distribution of syphilis before, during, and after an outbreak in Baltimore, MD, by using Bayesian maximum entropy (BME), a modern geostatistical technique for space-time analysis and mapping. METHODS: BME was used to conduct simple and composite space-time analyses of the density of syphilis infection based on primary, secondary and early latent syphilis cases reported to the Baltimore City Health Department between January 1, 1994, and December 31, 2002. RESULTS: Spatiotemporal covariance plots indicated that the distribution of the density of syphilis cases showed both spatial and temporal dependence. Temporally dependent disease maps suggested that syphilis increased within two geographic core areas of infection and spread outward. A new core area of infection was established to the northwest. As the outbreak waned, density diminished and receded in all core areas. Morbidity remained elevated in the two original central and new northwestern core areas after the outbreak. CONCLUSIONS: Density of syphilis infection was a simple informative measure easily compared across years. The BME approach was useful for quantitatively and qualitatively describing the spatial development and spread of syphilis. Our results are specific to Baltimore; however, the BME approach is generalizable to other settings and diseases.     

Person and place: the compounding effects of race/ethnicity and rurality on health

Rural racial/ethnic minorities constitute a forgotten population. The limited research addressing rural Black, Hispanic, and American Indian/Alaska Native populations suggests that disparities in health and in health care access found among rural racial/ethnic minority populations are generally more severe than those among urban racial/ethnic minorities. We suggest that disparities must be understood as both collective and contextual phenomena. Rural racial/ethnic minority disparities in part stem from the aggregation of disadvantaged individuals in rural areas. Disparities also emerge from a context of limited educational and economic opportunity. Linking public health planning to the education and economic development sectors will reduce racial/ethnic minority disparities while increasing overall well-being in rural communities.     

2004—2011年上海口岸国际旅行者性传播疾病分析

目的评估上海口岸出入境旅行者中性传播疾病的流行趋势及危险因素。方法回顾性分析2004—2011年上海口岸国际旅行者中性传播疾病(艾滋病和梅毒)监测结果,对感染者进行流行病学调查,分析人群特征及危险因素。结果共调查国际旅行者523 731人次,检出性传播疾病感染者613例。艾滋病病毒(HIV)感染平均检出率为27.30/10万,大部分为境外输入性病例。梅毒平均检出率为93.94/10万,超过半数为本地出境人员。检出率呈上升趋势。感染者中以男性20至49岁性活跃人群为主,≤19岁女性和≥50岁男性所占比例近年有所增加,平均年龄有增高趋势。性接触尤其是与商业性工作者及男性同性接触仍是主要传播途径。共发现22例HIV/梅毒双重感染病例。结论上海口岸出入境国际旅行者中性传播疾病感染率有所上升,在旅行医学工作中应该重视采取提倡安全性行为,筛查高危人群及宣传教育等干预措施。     

北京市密云县2005—2009年性传播疾病流行形势

目的分析北京市密云县2005—2009年性传播疾病(STD)的流行特征,为制定有效的预防控制策略提供科学依据。方法分析密云县2005—2009年性传播疾病(STD)的流行特征,为制定有效的预防控制策略提供科学依据。结果 5年累计报告STD 931例,其中男性522例(56.07%),女性409例(43.93%);男女比例为1.28:1。年龄主要集中在20～40岁年龄组(62.41%);职业主要为农民(36.84%)、家务及待业(18.69%)及其他(10.31%)。年平均发病率为39.02/10万,各种STD发病率依次为:尖锐湿疣(17.77/10万)、淋病(8.80/10万))、梅毒(7.33/10万))、非淋菌性尿道炎(非淋)(3.86/10万))、艾滋病病毒(H IV)感染者(0.80/10万)、生殖器疱疹(0.46/10万)。结论 2005—2009年,密云县性病平均报告发病率虽然呈逐年下降趋势,尤以非淋菌性尿道炎、淋病下降趋势明显,但H IV感染者、梅毒报告发病率升高明显。建议根据STD发病趋势制定密云县性病防治措施,合理分配资源,积极开展健康教育工作。     

Knowledge and attitudes in multicultural health care

Health professionals' knowledge of ethnic minority cultures and lifestyles was assessed to determine whether the respondents' cultural background and experience of working with ethnic minorities affected the health care delivered by them and to assess the need for training. Improving access to health services for ethnic minorities requires continuing education and training of all health professionals.     

Hypertension and the Hmong community: using the health belief model for health promotion

Hmong Americans are a minority population with a hypertensive health problem that is often undiagnosed and not medically managed. Vulnerable populations, such as ethnic minorities, are susceptible to poor health because of their unique perception of disease and treatment. Healthy People 2010 has goals that include promoting quality of life and eliminating health disparities. The Health Belief Model recognizes an individual's perceived susceptibility to disease, perceived severity of disease, perceived benefits of certain behaviors in reducing disease, and perceived barriers, such as cost, to preventive action. Nurses and other health care professionals are in a unique position to promote health in these vulnerable populations by using the Health Belief Model. Health promotion includes identifying barriers, empowering individuals through knowledge, as well as encouraging and educating positive health behaviors.     

Ethnic Disparities in Self-Reported Oral Health Status and Access to Care among Older Adults in NYC

There is a growing burden of oral disease among older adults that is most significantly borne by minorities, the poor, and immigrants. Yet, national attention to oral heath disparities has focused almost exclusively on children, resulting in large gaps in our knowledge about the oral health risks of older adults and their access to care. The projected growth of the minority and immigrant elderly population as a proportion of older adults heightens the urgency of exploring and addressing factors associated with oral health-related disparities. In 2008, the New York City Health Indicators Project (HIP) conducted a survey of a representative sample of 1,870 adults over the age of 60 who attended a random selection of 56 senior centers in New York City. The survey included questions related to oral health status. This study used the HIP database to examine differences in self-reported dental status, dental care utilization, and dental insurance, by race/ethnicity, among community-dwelling older adults. Non-Hispanic White respondents reported better dental health, higher dental care utilization, and higher satisfaction with dental care compared to all other racial/ethnic groups. Among minority older adults, Chinese immigrants were more likely to report poor dental health, were less likely to report dental care utilization and dental insurance, and were less satisfied with their dental care compared to all other racial/ethnic groups. Language fluency was significantly related to access to dental care among Chinese immigrants. Among a diverse community-dwelling population of older adults in New York City, we found significant differences by race/ethnicity in factors related to oral health. Greater attention is needed in enhancing the cultural competency of providers, addressing gaps in oral health literacy, and reducing language barriers that impede access to care.     

南通市三类人群梅毒感染状况调查及影响因素分析

目的了解南通市人群梅毒感染现状及影响因素。方法对南通市性病门诊男性就诊者和暗娼、外来务工人员及健康体检人员等三类人群进行梅毒检测,并对其中性病门诊男性就诊者和暗娼等性病高危人群进行问卷调查。结果性病门诊男性就诊者和暗娼梅毒感染率分别为8.29%和6.02%,外来务工人员为1.58%,健康体检人员为0.49%,差异有统计学意义。婚烟状况、最近1年与暗娼是否发生过性行为、最近3个月与临时性伴是否发生过性行为、最近3个月发生性行为的临时性伴数等,均与性病门诊男性就诊者梅毒感染率存在统计学关联,文化程度、在本地工作时间、安全套使用情况均与暗娼人群梅毒感染率存在统计学关联。结论应采取相应措施,加强性病高危人群的行为干预,开展人群梅毒主动检测工作。     

深圳市1994～2003年性传播疾病流行病学分析

目的了解深圳市1994~2003年性病艾滋病流行动态特征,为政府制订预防控制措施提供科学依据。方法采用描述性流行病学方法对深圳市1994~2003年性病年报资料进行统计分析。结果深圳市1994~2003年共报告性病104963例,性病报告年发病率为196·74/10万~327.76/10万。发病构成位于前3位的依次为淋病(占30.71%)、尖锐湿疣(占29.11%)、非淋菌性尿道炎(占20.86%)。1994~2001年性病报告发病率均为男性高于女性,但自2002年起,女性发病率高于男性;年龄别发病率以20~39岁性活跃年龄段最高,其发病数占总病例数的80.74%;婚姻状况以已婚为主(占56.18%);文化程度以中学文化程度居多(占72.81%);职业构成以工人、无业、干部职工、饮食服务业、个体列前五位;传播方式以非婚性接触占大多数(占67.21%)。2001年起,HIV/AIDS报告病例数大幅上升;梅毒发病率从1996年开始呈上升趋势,1999年达到高峰,然后维持在一个较高的水平;淋病发病率呈逐年下降趋势,但病例绝对数依然很高;尖锐湿疣发病率1998年以前呈逐年上升趋势,1999年起呈下降趋势;非淋菌性尿道炎和生殖器疱疹发病率呈波动式上升趋势。结论深圳市性病总的上升势头得到控制,但梅毒、艾滋病流行仍呈上升趋势,预防和控制工作力度仍应加强。     

HOSPITAL ADMISSION AND MORTALITY DIFFERENTIALS OF ASTHMA BETWEEN URBAN AND RURAL POPULATIONS IN NEW SOUTH WALES

It remains unclear whether there are any differentials in hospital admission and mortality rates of asthma between urban and rural populations. An observational study was conducted, based on patient hospital records, to examine the distribution of asthma admissions and mortality in New South Wales. Data on all reported cases of asthma were obtained from New South Wales hospitals between 1989 and 1994. Information on deaths of asthma was collected between 1983 and 1992. The hospital admission rates of asthma varied from 4.8 per 1000 in 1990 to 5.4 per 1000 in 1992 for rural population, and from 3.0 per 1000 in 1991 to 3.4 per 1000 in 1992 for urban population. The hospital admission rates were 51.2–69.1% higher for rural residents than urban dwellers. The mortality rates of asthma ranged from 4.8 per 100 000 in 1983 to 8.0 per 100 000 in 1985 for rural population, and from 3.8 per 100 000 in 1983 to 6.0 per 100 000 in 1989 for urban population. The mortality rates of asthma were 3.62–42.85% higher for rural residents than urban dwellers. These results indicate that the non-age-adjusted hospital admission and mortality rates of asthma were considerably higher in rural populations than in urban populations in New South Wales.     

Trends in Birth Rates: New York City 1970–1995

Traditional means of assessing the problem of teen pregnancy have relied on national or state statistics. By using large geographic areas, usually comprised of a heterogeneous population, it is impossible to tell which subareas have more of a problem than others. This study focused on trends in teen birth rates at the health district level in New York City over a 25-year period to illustrate variations among ethnic groups. Teen birth rates were calculated based on vital statistics published by the New York City Department of Health. They were calculated as the number of births per 1,000 females in each of three age groups: under age 15, 15–17, and 18–19. Rates were calculated for the entire City, for four boroughs, and for selected health center districts. The decline in the birth rate among New York City teens is most significant in health districts populated by blacks. An exception is the noted increases in birth rates in districts populated predominantly by Hispanics. Data show substantial decreases among older teens compared to younger teens. Birth trends in small areas of New York City mirror trends seen nationwide. As migration changes the ethnic composition of small areas, it is important to monitor trends so that policies and programs can be targeted to those in need.     

少数民族流动人口艾滋病防治教育现状及影响因素分析

目的 了解少数民族流动人口艾滋病防治教育接受现状及其影响因素。方法 以2017年全国流动人口卫生计生动态监测调查中14226名少数民族流动人口为研究对象,利用SPSS 25.0进行数据分析,x2检验比较不同特征接受艾滋病防治教育的差异,logistic回归分析防治教育的影响因素。结果 14226名少数民族流动人口,艾滋病防治教育接受率为47.9%,传统线下宣传方式仍是其接受防治教育的主要途径。多因素分析显示,年龄为55~64岁（OR=0.786,95%CI:0.633~0.976）、≥65岁（OR=0.708,95%CI:0.528~0.949）、非经济型原因流动（OR=0.805,95%CI:0.727~0.892）、无工作单位（OR=0.684,95%CI:0.545~0.858）、很少与人交往（OR=0.865,95%CI:0.786~0.953）是少数民族流动人口接受艾滋病防治教育的危险因素。结论 少数民族流动人口艾滋病防治教育接受率较低,在兼顾不同的社会文化背景下,促进防治教育内容、方式与少数民族本土文化资源结合,增强少数民族流动人口防艾意识。     

路边店服务小姐艾滋病/性传播疾病健康教育与行为干预研究

目的　了解 3 2 0国道沿线路边店服务小姐艾滋病 /性病预防知识、态度、行为状况 ,并对开展健康教育与行为干预实施效果及可行性进行评价。方法　采用定性和定量研究相结合的方法 ,以行为干预前、后调查问卷进行评价。结果　在干预前目标人群对艾滋病 /性病预防知识仍缺乏必要的认识 ,对婚外性行为的态度又比较开放 ,大多数人对艾滋病病毒感染有恐惧心理 ,害怕和担心 ,不愿意与艾滋病感染者一起工作 ,安全套使用频率极低 ,通过行为干预 ,艾滋病 /性病知识正确掌握率显著上升 ,态度及高危行为明显改善 ,在发生性行为时安全套使用频率有所提高。结论　项目实施方法可行、效果良好 ,但态度和危险行为的改善不是一朝一夕的 ,应深入持久地开展艾滋病的行为干预 ,同时针对其他人群 (嫖客 )开展广泛的行为干预工作。     

STD and HIV risk factors among U.S. young adults: variations by gender, race, ethnicity and sexual orientation

CONTEXT: STDs, including HIV, disproportionately affect individuals who have multiple minority identities. Understanding differences in STD risk factors across racial, ethnic and sexual minority groups, as well as genders, is important for tailoring public health interventions. METHODS: Data from Waves 3 (2001–2002) and 4 (2007–2008) of the National Longitudinal Study of Adolescent Health were used to develop population‐based estimates of STD and HIV risk factors among 11,045 young adults (mean age, 29 at Wave 4), by gender, race and ethnicity, and sexual orientation (heterosexual, mixed‐oriented, gay). Regression analyses were conducted to examine associations between risk factors and young adults’ characteristics. RESULTS: Overall, sexual‐minority women in each racial or ethnic group had a higher prevalence of sexual risk behaviors—including a history of multiple partners, forced sex and incarceration—than their heterosexual counterparts. Mixed‐oriented women in each racial or ethnic group were more likely than heterosexual white women to have received an STD diagnosis (odds ratios, 1.8–6.4). Black men and sexual‐minority men also appeared to be at heightened risk. Gay men in all racial and ethnic groups were significantly more likely than heterosexual white men to report having received an STD diagnosis (2.3–8.3); compared with heterosexual white men, mixed‐oriented black men had the highest odds of having received such a diagnosis (15.2). CONCLUSIONS: Taking account of multiple minority identities should be an important part of future research and intervention efforts for STD and HIV prevention.