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Prevalence and correlates of current cigarette smoking among transgender women in Argentina
No full textFil: Cartujano-Barrera, F. Department of Public Health Sciences, University of Rochester Medical Center; Rochester, NY. United StatesFil: Mejia, RM. Division of Implementation Research, Fundación Huésped; Buenos Aires. ArgentinaFil: Mejia, RM. Department of Ambulatory Care, Universidad de Buenos Aires; Buenos Aires. ArgentinaFil: Mejia, RM. CEDES. Centro de Estudios de Estado y Sociedad. Área de Salud, Economía y Sociedad; Buenos Aires. ArgentinaFil: Radusky, PD. Division of Implementation Research, Fundación Huésped; Buenos Aires. ArgentinaFil: Cardozo, Nadir. Division of Implementation Research, Fundación Huésped; Buenos Aires. ArgentinaFil: Cardozo, Nadir. Asociación de Travestis, Transexuales y Transgéneros de Argentina; Buenos Aires. ArgentinaFil: Duarte, M. Division of Implementation Research, Fundación Huésped; Buenos Aires. ArgentinaFil: Duarte, M. Casa Trans; Buenos Aires. ArgentinaFil: Fabian, S. Division of Implementation Research, Fundación Huésped; Buenos Aires. ArgentinaFil: Fabian, S. Hotel Gondolín; Buenos Aires. ArgentinaFil: Caballero, R. Division of Implementation Research, Fundación Huésped; Buenos Aires. ArgentinaFil: Zalazar, V. Division of Implementation Research, Fundación Huésped; Buenos Aires. ArgentinaFil: Ramos-Pibernus, A. School of Behavioral and Brain Sciences, Ponce Health Sciences University; Ponce, PR. United StatesFil: Alpert, AB. Department of Public Health Sciences, University of Rochester Medical Center; Rochester, NY. United StatesFil: Alpert, AB. Division of Hematology, Department of Medicine, Yale School of Medicine; New Haven, CT. United StatesFil: Cupertino, AP. Department of Public Health Sciences, University of Rochester Medical Center; Rochester, NY. United StatesFil: Cupertino, AP. Department of Surgery, University of Rochester Medical Center; Rochester, NY. United StatesFil: Frola, C. Division of Implementation Research, Fundación Huésped; Buenos Aires. ArgentinaFil: Aristegui, I. Division of Implementation Research, Fundación Huésped; Buenos Aires. ArgentinaObjective: To assess the prevalence of current cigarette smoking among transgender women in Argentina, and to examine the unique associations of current cigarette smoking with demographic and psychosocial factors.
Methods: This study is a secondary data analysis of the TransCITAR – a prospective cohort study of transgender individuals living in Buenos Aires, Argentina – baseline data. The baseline survey collected information on sociodemographic characteristics, perceived health status, depressive symptoms, suicide attempts, current cigarette smoking, alcohol use disorder, and substance use. Participants were also asked about lifetime experiences of physical and sexual violence perpetrated by partners, clients and/or the police, and experiences of gender identity stigma in the past year from healthcare workers and the police. Lastly, participants were asked if they had ever been arrested. Fisher’s exact test was used to compare proportions in categorical variables and student t-test was used for continuous variables. Significant associations with current cigarette smoking were tested in a logistic regression model adjusted for all significant associations.
Results: A total of 41.7% of participants (n = 393) reported current cigarette smoking. Compared to their non-smoking counterparts, participants who reported current cigarette smoking (1) had completed less education, (2) were more likely to be born in Argentina, (3) more likely to had migrated to Buenos Aires from other parts of the country, (4) more likely to report a history of sex work, (5) more likely to perceive their health as excellent, (6) more likely to screen positive for hazardous alcohol drinking, (7) more likely to report any substance and cocaine use in the past year, (8) more likely to experience gender identity stigma from the police in the past year, and (9) more likely to being arrested in their lifetime (all p’s < 0.05). After controlling for all significant associations, education level of less than high school (AOR = 1.79, 95% CI 1.02–2.12), hazardous drinking (AOR = 2.65, 95% CI 1.30–5.37), and any substance use in the last year (AOR = 2.14, 95% CI 1.16–3.94) were positively and independently associated with current cigarette smoking.
Conclusion: Among transgender women in Argentina, current cigarette smoking was more than double the rate for cisgender women. Current cigarette smoking was associated with education, hazardous drinking, and any drug use. These results will inform future smoking cessation interventions among transgender women in Argentina
Forty years in sexual and (non) reproductive health
No full textFil: Tiseyra, MV. CEDES. Centro de Estudios de Estado y Sociedad. Área de Salud, Economía y Sociedad; Argentina.Fil: Tiseyra, MV. Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET); ArgentinaFil: Tiseyra, MV. Instituto de Investigaciones Gino Germani (IIGG); ArgentinaFil: Pecheny, MM. Instituto de Investigaciones Gino Germani (IIGG); ArgentinaFil: Pecheny, MM. Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET); ArgentinaFil: Sciurano, GA. Centro de Investigaciones Sociales, Consejo Nacional de Investigaciones Científicas y Técnicas, Instituto de Desarrollo Económico y Social (CIS-CONICET/IDES); ArgentinaEste artículo describe y analiza algunos logros relevantes y deudas pendientes en materia de salud sexual y (no) reproductiva (SSR) en la Argentina a partir del retorno democrático. Se referirán en el texto distintas dimensiones de desigualdad en el acceso a derechos de SSR, con especial énfasis en la discapacidad. Asimismo, se mencionarán políticas actuales y potenciales que podrían contribuir a combatir estas desigualdades. Con tal fin, se trabajará a partir de fuentes secundarias, que incluyen documentos científicos-técnicos y entrevistas a expertas/os. El análisis indica que, si bien en los últimos cuarenta años asistimos a avances considerables en materia de derechos y al reconocimiento de demandas en estos planos, persisten aún deudas pendientes y desigualdades que atraviesan a distintos grupos
Acceptability and continuation of use of the subdermal contraceptive implant among adolescents and young women in Argentina: a retrospective cohort study
No full textFil: Maceira, Daniel. CEDES. Centro de Estudio de Estado y Sociedad. Área de Economía; Argentina.Fil: Oizerovich, Silvia. Universidad Favaloro; Argentina.Fil: Perrotta, Gabriela. Universidad de Buenos Aires. Facultad de Psicología; Argentina.Fil: Gómez Ponce de León, Rodolfo. World Health Organization. Pan-American Health Organization. Latin-American Center of Perinatology and Women’s Health; Uruguay.Fil: Karolinski, Ariel. World Health Organization. Pan-American Health Organization. Family, Gender and Life Course; Brasil.Fil: Suárez, Natalia. CONICET. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina.Fil: Espinola, Natalia. Universidad de Buenos Aires. Departamento de Economía; Argentina.Fil: Caffe, Sonja. World Health Organization. Pan-American Health Organization. Adolescent Health, Healthy Life Course Family, Health Promotion and Life Course; Estados Unidos.Fil: Chandra-Moulio, Venkatraman. World Health Organization. Department of Sexual and ReproductiveHealth and Research; Suiza.A new public policy was instituted in Argentina for free distribution of subdermal contraceptiveimplants to women aged 15–24 years old in the public healthcare system. The objective of this study is todetermine the extent to which this population adhered to the implant, as well as predictors of continuation.The retrospective cohort study was based on a telephone survey of a random sample of 1101 Ministry ofHealth-registered implant users concerning the continuation of use, satisfaction with the method and side-effects, and reasons for removal. Descriptive statistics and multivariate regression analysis were used toexplore the association between adherence and having received contraceptive counselling, satisfaction, andside effects. We found high levels of adherence (87%) and satisfaction (94%). Common reported side effectswere amenorrhoea or infrequent bleeding, perceived weight gain, increased menstrual bleeding andheadaches. Multivariate regression analysis indicates that, among adolescents, having receivedcontraceptive counselling increased comfort, while frequent bleeding at six months hindered trust.Participants who had a history of a prior delivery or who had themselves primarily chosen the method wereless likely to request the removal of the implant. Our results support the public policy of free implant distribution in the public health sector. This is a sustainable public policy that contributes to equity andaccess to effective contraception. It is appropriate for adolescents and young women and will also reduceunintended pregnancies. Our results suggest that counselling patients is key prior to insertion of the implant,as it improves acceptability and continuation
Perspectivas del Estado abierto en la era exponencial, a la luz de la experiencia latinoamericana
No full textComo en el resto del mundo, los Estados de América Latina están impulsando
desde hace una década, diversas iniciativas en materia de “gobierno abierto”
que, más recientemente, alcanzaron a parlamentos y cortes de justicia en
una transición hacia un “Estado abierto”. Este trabajo reflexiona sobre las
perspectivas de que el Estado abierto llegue a ser el paradigma dominante
de la gobernanza pública en los países de la región, en una época en que el
cambio exponencial que caracteriza a las tecnologías de la 4.ª Revolución
Industrial, plantea novedosos y complejos desafíos a la gestión estatal. Para
ello, se ubica el surgimiento del gobierno abierto en la secuencia histórica
de los sucesivos paradigmas que han dominado el campo de la gestión
pública, a fin de establecer cuánto de continuidad o de ruptura supuso
su aparición con respecto a sus predecesores. Luego, se examinan los
supuestos y desafíos que implica la adopción de sus principios, así como
las modalidades que asume su aplicación. Finalmente, se especula sobre las
perspectivas de que el gobierno o Estado abierto se convierta en la antesal
Agentes Sanitarios y mSalud: Adopción de estrategias para la prevención del cáncer cervicouterino en Argentina
No full textFil: Sánchez Antelo, V. CEDES. Centro de Estudios de Estado y Sociedad. Área de Salud, Economía y Sociedad; ArgentinaFil: Paolino, M. CEDES. Centro de Estudios de Estado y Sociedad. Área de Salud, Economía y Sociedad; ArgentinaFil: Arrossi, S. CEDES. Centro de Estudios de Estado y Sociedad. Área de Salud, Economía y Sociedad; ArgentinaIntroducción: la estrategia ATICA es una intervención multicomponente basada en el envío de mensajes SMS a las mujeres VPH+ para promover la realización de la citología de triaje. Pasados 60 días, se envió además un correo electrónico y un mensaje al Agente Sanitario (AS) para que visitara a las mujeres que no habían acudido al triaje.
Objetivo: analizar las percepciones y experiencias de AS sobre barreras y facilitadores de la implementación de la intervención multicomponente y su intención de adoptarla en la rutina de trabajo.
Métodos: se utilizaron modelos teóricos de las ciencias de la implementación para diseñar una encuesta para los AS participantes del estudio ATICA. Se midió la asociación entre características de AS y factores que facilitaron u obstaculizaron la implementación y la intención de adoptar ATICA. Se utilizó el software IBM SPSS para calcular el chi-cuadrado y evaluar asociaciones.
Resultados: de 221 participantes en ATICA, 197 AS completaron la encuesta. 78,3 % adoptaría la estrategia en su rutina de trabajo sin diferencias entre perfiles sociodemográficos o según la familiaridad en el uso del teléfono. La intención de adoptar ATICA fue mayor entre quienes la perciben como una ventaja relativa (81 %vs. 62,5 %; p=0,04) y entre quienes fue fácil registrar el teléfono de la mujer (81,8 % vs. 64,3 %; p=0,04). 98,3 % afirmó que se requieren estrategias para ampliar la cobertura de triaje en la provincia (hay tensión al cambio).
Conclusión: la alta intención de adoptar la estrategia ATICA entre los AS contribuirá al futuro escalamiento de la intervención
Es mucho más que un aborto
No full textFil: Ramón Michel, A. CEDES. Centro de Estudios de Estado y Sociedad. Área de Salud, Economía y Sociedad; ArgentinaFil: Krause, M. CEDES. Centro de Estudios de Estado y Sociedad. Área Salud, Economía y Sociedad; ArgentinaFil: Molina, S. CEDES. Centro de Estudios de Estado y Sociedad. Área Salud, Economía y Sociedad; ArgentinaFil: Ramos, S. CEDES. Centro de Estudios de Estado y Sociedad. Área Salud, Economía y Sociedad; ArgentinaFil: Romero, M. CEDES. Centro de Estudios de Estado y Sociedad. Área de Salud, Economía y Sociedad; ArgentinaFil: Romero, M. Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET); ArgentinaA tres años de la sanción de la Ley de Interrupción Voluntaria del Embarazo y Atención Posaborto, el proyecto mirar recalca la importancia del aborto legal y voluntario en la vida de las mujeres y otras personas con capacidad de gestar, en los servicios de salud, en la vida democrática y en la sociedad toda. Por eso, refuerza que “es mucho más que un aborto”
Quantification of impact of COVID-19 pandemic on cancer screening programmes - a case study from Argentina, Bangladesh, Colombia, Morocco, Sri Lanka, and Thailand
No full textFil: Lucas, Eric. International Agency for Research on Cancer; Francia.Fil: Murillo, Raúl. Hospital Universitario San Ignacio; Colombia.Fil: Arrossi, Silvina. CEDES. Centro de Estudios de Estado y Sociedad. Área de Salud, Economía y Sociedad; Argentina.Fil: Arrossi, Silvina. Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET); Argentina.Fil: Bárcena, Martín. Instituto Provincial del Cáncer (Jujuy); Argentina.Fil: Chami, Youssef. Foundation Lalla Salma Cancer Prevention and Treatment; Marruecos.Fil: Nessa, Ashrafun. Bangabandhu Sheikh Mujib Medical University; Bangladesh.Fil: Perera, Suraj. Ministry of Health; Sri Lanka.Fil: Silva, Padmaka. Ministry of Health; Sri Lanka.Fil: Sangrajrang, Suleeporn. National Cancer Institute of Thailand; Tailandia.Fil: Muwonge, Richard. Hospital Universitario San Ignacio; Colombia.Fil: Basu, Partha. Hospital Universitario San Ignacio; Colombia.It is quite well documented that the COVID-19 pandemic disrupted cancer screening services in all countries, irrespective of their resources and healthcare settings. While quantitative estimates on reduction in volume of screening tests or diagnostic evaluation are readily available from the high-income countries, very little data are available from the low- and middle-income countries LMICs). From the CanScreen5 global cancer screening data repository we identified six LMICs through purposive sampling based on the availability of cancer screening data at least for the years 2019 and 2020.
These countries represented those in high human development index (HDI) categories (Argentina, Colombia, Sri Lanka, and Thailand) and medium HDI categories (Bangladesh and Morocco). No data were available from low HDI countries to perform similar analysis. The reduction in the volume of tests in 2020 compared to the previous year ranged from 14.1% in Bangladesh to 72.9% in Argentina (regional programme) for cervical screening, from 14.2% in Bangladesh to 49.4% in Morocco for breast cancer screening and 30.7% in Thailand for colorectal cancer screening. Number of colposcopies was reduced in 2020 compared to previous year by 88.9% in Argentina, 38.2% in Colombia, 27.4% in Bangladesh, and 52.2% in Morocco. The reduction in detection rates of CIN 2 or worse lesions ranged from 20.7% in Morocco to 45.4% in Argentina. Reduction of breast cancer detection by 19.1% was reported from Morocco. No association of the impact of
pandemic could be seen with HDI categories. Quantifying the impact of service disruptions in screening and diagnostic tests will allow the programmes to strategize how to ramp up services to clear the backlogs in screening and more crucially in further evaluation of screen positives. The data can be used to estimate the impact on stage distribution and avoidable mortality from these common cancers
Decídetexto México: Recruitment and baseline characteristics of Mexican individuals who smoke in a cessation study
No full textThe objective of this study was to evaluate the effectiveness of digital and traditional methods and strategies in the recruitment of Mexican individuals who smoke into a cessation study. Recruitment method refers in general to either digital or traditional recruitment. Recruitment strategies refer to the particular recruitment type utilized within each recruitment method. Traditional recruitment strategies included radio interviews, word of mouth, newspaper advertisement, posters/banners placed in primary healthcare clinics, and medical referrals. Digital recruitment strategies involved emails and study advertisements through social media (i.e., Facebook, Instagram and Twitter) and website. In a 4-month period, 100 Mexican individuals who smoke were successfully enrolled into a smoking cessation study. The majority of participants were enrolled via traditional recruitment strategies (86%) compared to the digital recruitment strategies (14%). Individuals screened in the digital method were more likely to be eligible to participate in the study, compared to the traditional method. Similarly, in comparison to the traditional method, individuals in the digital method were more likely to enroll in the study. However, these differences were not statistically significant. Both traditional and digital strategies made important contributions to the overall recruitment effort
Implementación de una intervención de mHealth para aumentar la adherencia al triaje entre mujeres VPH positivas con auto-recolección de VPH (estudio ATICA): evaluación posterior a la implementación desde la perspectiva de las mujeres
No full textFil: Kohler, Racquel E. Cancer Health Equity, Cancer Institute of New Jersey, Rutgers, The State University of New Jersey; Estados Unidos.Fil: Arrossi, Silvina. CEDES. Centro de Estudio de Estado y Sociedad. Área de Salud, Economía y Sociedad; Argentina.Fil: Viswanath, Kasisomayajula. Harvard University. Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health; Estados Unidos.Fil: Paolino, Melisa. CEDES. Centro de Estudio de Estado y Sociedad. Área de Salud, Economía y Sociedad; Argentina.Fil: Sánchez Antelo, Victoria. CEDES. Centro de Estudios de Estado y Sociedad. Área de Salud, Economía y Sociedad; Argentina.Background: Low adherence to triage after positive screening is a widespread problem for cervical cancer screening programs in Low- and Middle-income Countries. Adherence to cytology-based triage can be challenging, especially among women with self-collected tests. SMS-based interventions are accepted by women and can increase screening uptake. The ATICA study was an effectiveness-implementation hybrid type I trial, combining a cluster randomized controlled trial (RCT) with a mixed-methods implementation evaluation involving quantitative and qualitative methods. Although the RCT provided evidence regarding the effectiveness of the SMS-based intervention, less is known about its acceptability, relevance, and usefulness from the women´s perspective.
Methods: We carried out a cross-sectional study based on a structured questionnaire among HPV-positive women who were enrolled in ATICA's intervention group. We measured acceptability, appropriateness, and message content comprehension. Also, we evaluated if the SMS message was considered a cue to encourage women to pick up their HPV test results and promote the triage.
Results: We interviewed 370 HPV-positive women. Acceptability of SMS messages among women who had received at least one message was high (97%). We found high levels of agreement in all appropriateness dimensions. More than 77% of women showed high comprehension of the content. Among women who received at least one SMS message, 76% went to the health center to pick up their results. Among those who got their results, 90% reported that the SMS message had influenced them to go. We found no significant differences in acceptability, appropriateness or message comprehension between women who adhered to triage and those who did not adhere after receiving the SMS messages.
Conclusion: The intervention was highly acceptable, and women reported SMS was an appropriate channel to be informed about HPV test results availability. SMS was also a useful cue to go to the health center to pick up results. The implementation did not encounter barriers associated with the SMS message itself, suggesting the existence of other obstacles to triage adherence. Our results support the RCT findings that scaling up SMS is a highly acceptable intervention to promote cervical screening triage adherence
Vademecum obstétrico : un instrumento para mejorar el acceso y la calidad de la atención de la salud sexual y reproductiva y la salud perinatal
No full textEste instrumento técnico tiene la finalidad de indicar los medicamentos que quienes ejercen la obstetricia pueden prescribir y utilizar. Sin embargo, su revisión a la luz de la normativa en salud sexual y reproductiva, los avances clínicos y de atención y de la tecnología farmacológica ha mostrado que todos re- quieren una actualización para que incluyan los medicamentos e insumos que garantizan una atención con los más altos estándares de calidad.4 Es necesario resaltar que la existencia de un vademécum pretende brindar mayor seguridad jurídica a las profesionales y no limitar o impedir el ejercicio profesional de acuerdo con altos estándares clínicos de calidad basados en la evidencia actualizada disponible. Los vademe- cums son herramientas técnicas que requieren actualización periódica por parte de la autori- dad sanitaria. Asimismo, si la evidencia actualizada recomienda el uso de otro tipo de medi- cación, desaconseja el uso de una medicación incluida en un vademecum vigente, o existe cualquier otra consideración que modifique lo prescrito en un vademécum, se deberá usar el criterio profesional para la asistencia, siempre basada en evidencia validada y recomendaciones