scholarly journals Brief intervention to prevent HIV, STI and unintended pregnancies: preliminary results of a feasibility study from the perspective of healthcare providers in Peru

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Jean Pierre Jiron ◽  
Clara Sandoval ◽  
Juan Carlos Enciso ◽  
Ana Sofía De Vasconcelos ◽  
Karel Blondeel ◽  
...  

Abstract Background Brief interventions have proven to be valuable instruments for the treatment and care of clients with diverse health needs, due to their potential to impact both the individual and the population. In this regard, the Brief Sexuality-Related Communication (BSC) is presented as a viable and effective alternative for addressing sexual and reproductive health problems, assessing risk behaviors and motivating clients to generate behavioral change. Since health providers are key actors in treatment and prevention, it is essential to know their perceptions about the BSC intervention, as well as its acceptability in different contexts, with diverse client populations. Thus, the following paper reflects the findings of the perceptions and experiences of health providers in Peru from the first phase of the Feasibility study of a BSC intervention to prevent STIs and unintended pregnancies. Methods This is the first phase of a multisite and multiphase study of the feasibility of a BSC intervention. We conducted twenty in-depth interviews (IDI) with health care providers (physicians, obstetricians, psychologists, nurses and peer counselors) recruited from three health care institutions in Peru: The Tahuantinsuyo Bajo Maternal and Child Center (CMI) and the San José Maternal and Child Center, both located in the capital city, Lima; and La Caleta Hospital located in Chimbote, northern coast of Peru. Participating health providers included those working at the HIV/STI Reference service and the family planning/reproductive health service. The IDI addressed three domains: 1) Acceptability of the BSC intervention; 2) Perceived willingness to implement the BSC intervention; and 3) Considerations for the Implementation of the BSC intervention. Results Health providers expressed high acceptance of the BSC intervention, considering it as a useful and effective instrument to address sexual and reproductive health problems with all clients; however, some providers had some concerns about the real impact of the intervention to achieve significant behavior change. On the other hand, health providers showed high willingness to learn and implement the BSC intervention, affirming their commitment to learn new techniques and strategies that could allow them to improve their knowledge and the quality of their care. Health care providers consider it necessary to take into account the barriers that arise in the implementation of the BSC intervention, such as the structural limitations to access, the providers’ abilities to deliver the intervention effectively, and the participants’ reception of the intervention. Finally, providers consider it essential to establish the BSC intervention in a normative framework that allows it to receive the support of the health departments and eventually enforces implementation. Conclusions Health providers consider the BSC intervention as an interesting and exciting behavioral intervention to deal with the sexual and reproductive health issues existing in different populations, and seemed highly willing to adapt and implement it, hoping that it become beneficial to all client populations to prevent HIV/STIs and unintended pregnancies.

2021 ◽  
Author(s):  
Jean Pierre Jiron ◽  
Clara Sandoval ◽  
Juan Carlos Enciso ◽  
Ana Sofía Vasconcelos ◽  
Karel Blondeel ◽  
...  

Abstract Background Brief interventions have proven to be valuable instruments for the treatment and care of clients with diverse health needs, due to their potential to impact both the individual and the population. In this regard, the Brief Sexuality-Related Communication (BSC) is presented as a viable and effective alternative for addressing sexual and reproductive health problems, assessing risk behaviors and motivating clients to generate behavioral change. Since health providers are key actors in treatment and prevention, it is essential to know their perceptions about the BSC intervention, as well as its acceptability in different contexts, with diverse client populations. Thus, the following paper reflects the findings of the perceptions and experiences of health providers in Peru from the first phase of the Feasibility study of a BSC intervention to prevent STIs and unintended pregnancies. Methods This is the first phase of a multisite and multiphase study of the feasibility of a BSC intervention. We conducted twenty in-depth interviews (IDI) with health care providers (physicians, obstetricians, psychologists, nurses and peer counselors) recruited from three health care institutions in Peru: The Tahuantinsuyo Bajo Maternal and Child Center (CMI) and the San José Maternal and Child Center, both located in the capital city, Lima; and La Caleta Hospital located in Chimbote, northern coast of Peru. Participating health providers included those working at the HIV/STI Reference service and the family planning/reproductive health service. The IDI addressed three domains: 1) Acceptability of the BSC intervention; 2) Perceived willingness to implement the BSC intervention; and 3) Considerations for the Implementation of the BSC intervention. Results Health providers expressed high acceptance of the BSC intervention, considering it as a useful and effective instrument to address sexual and reproductive health problems with all clients; however, some providers had some concerns about the real impact of the intervention to achieve significant behavior change. On the other hand, health providers showed high willingness to learn and implement the BSC intervention, affirming their commitment to learn new techniques and strategies that could allow them to improve their knowledge and the quality of their care. Health care providers consider it necessary to take into account the barriers that arise in the implementation of the BSC intervention, such as the structural limitations to access, the providers’ abilities to deliver the intervention effectively, and the participants’ reception of the intervention. Finally, providers consider it essential to establish the BSC intervention in a normative framework that allows it to receive the support of the health departments and eventually enforces implementation. Conclusions Health providers consider the BSC intervention as an interesting and exciting behavioral intervention to deal with the sexual and reproductive health issues existing in different populations, and seemed highly willing to adapt and implement it, hoping that it become beneficial to all client populations to prevent HIV/STIs and unintended pregnancies.


2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Maria Grandahl ◽  
Maja Bodin ◽  
Jenny Stern

Abstract Background Sexual and reproductive health and rights (SRHR) have historically been regarded as a woman’s issue. It is likely that these gender norms also hinder health care providers from perceiving boys and men as health care recipients, especially within the area of SRHR. The aim of this study was to explore midwives’ thoughts and experiences regarding preventive work for men’s sexual and reproductive health and rights in the primary care setting. Methods An exploratory qualitative study. Five focus group interviews, including 4–5 participants in each group, were conducted with 22 midwives aged 31–64, who worked with reproductive, perinatal and sexual health within primary care. Data were analysed by latent content analysis. Results One overall theme emerged, in everybody’s interest, but no one’s assigned responsibility, and three sub-themes: (i) organisational aspects create obstacles, (ii) mixed views on the midwife’s role and responsibility, and (iii) beliefs about men and women: same, but different. Conclusions Midwives believed that preventive work for men’s sexual and reproductive health and rights was in everybody’s interest, but no one’s assigned responsibility. To improve men’s access to sexual and reproductive health care, actions are needed from the state, the health care system and health care providers.


2020 ◽  
Vol 47 (5) ◽  
pp. 728-739
Author(s):  
Margaret M. Paschen-Wolff ◽  
Madelyne Z. Greene ◽  
Tonda L. Hughes

Although sexual minority women (SMW) are at risk for cervical cancer and sexually transmitted infections (STIs), they may not seek preventative sexual and reproductive health care at the same rates as their heterosexual peers. We conducted a qualitative descriptive study of 22 adult SMW, a subsample of participants enrolled in the Chicago Health and Life Experiences of Women study. The aim was to describe the sexual and reproductive health literacy of this community sample based on qualitative themes, using an integrated model of health literacy. This model considers not only access to information but also understanding, appraisal, and application of information. We found that family of origin, health care providers, and school-based sexual education were the most important sources of sexual and reproductive health information. Participants described their understanding, appraisal, and application of sexual and reproductive health information as interdependent concepts. Pap test literacy and decision making were strongly independent, with SMW seeking various sources of information, or were driven by health care providers, with SMW following instructions and trusting provider advice. STI-related literacy hinged on whether the participant perceived SMW as at risk for STIs. Our findings reinforce that simply having access to information is insufficient to enact health behaviors that reflect full literacy. Findings have implications for health care providers, who should provide evidence-based recommendations for their SMW clients, and for public health practitioners and educators, who could make sexual health education more inclusive of and specific to the needs of SMW.


2021 ◽  
Author(s):  
Olufemi Adetutu ◽  
Sola Asa ◽  
Bola Solanke ◽  
AbdulRahman Azeez Aroke ◽  
David Okunlola

Abstract Background Socio-cultural and gender-based issues influence sexuality of emerging adults. These gender-based issues worsen sexual health outcomes of emerging adults in studies outside Nigeria. Some of these issues are male dominance in sexual relationships, health care providers’ bias in attending to sexual health needs of emerging adults and age disparate sexual relationships. Studies have reported that males dominate females in sexual relationship largely in part owing to masculinity tendencies. Also, health care providers view emerging adults as randy when seeking information on sexual and reproductive health care services. Added to these is age disparate sexual relationships. Older men engage in exchanged sex while younger females are unable to negotiate condom. All these speak to gender and social inequality in sexual relationships are largely undocumented in Nigeria. Method This study collected information purposively using a qualitative inquiry. Thirty (30) in-depth interviews (IDIs), six (6) Focus Group Discussions (FGDs) and Eighteen (18) Key Informant Interviews (KIIs) were conducted across the three main ethnic groups in Nigeria. Result Narratives and interviews showed nuanced discourses of all these gendered issues. Males dominated females in sexual relationships through suppression to negotiate condom, diminished females’ individual agency, and engagement in multiple sexual partnerships. Females endured domination of males in sexual relationships to sustain relationships. Also, health providers were biased and indifferent in providing sexual and reproductive health services to emerging adults. This study showed poor socio-economic status makes older men to exploit and take advantage of younger females in sexual relationships. Wide age difference and the notion of fulfilling their side in a paid sexual intercourse made younger females unable to negotiate condom. Conclusion Gender-based issues and socio-cultural norms diminished individual agency of emerging adults, especially females, achieving positive sexuality. Policies that dispel socio-cultural and gendered norms in sexual relationships should be encouraged, including increased awareness on sex education to parents and children, skill acquisitions and empowerment programmes for emerging adults and capacity building of health providers to improve provision of SRH needs of emerging adults.


Author(s):  
M. P. Dapar ◽  
B. N. Joseph ◽  
A. P. Damun ◽  
R. C. Okunlola ◽  
H. A. Ibrahim ◽  
...  

Background: Community pharmacies are located close to the people, open long hours and weekends, making them ideal for provision of sexual and reproductive health (SRH) services, as a means of enhancing access and achieving universal coverage. However, structures (encompassing facilities and resources such as funds, private counselling space, number and qualification of staff) and processes (denoting actual activities undertaken such as: client screening, counselling, mechanisms for referral and collaboration with other healthcare professional) determine the suitability and capacity of community pharmacies to deliver quality SRH services.  Objective: To assess the structures and processes of SRH services in community pharmacies in Jos, Nigeria. Methods: A cross-sectional questionnaire survey of staff in 63 community pharmacies of Jos metropolis, Plateau state, Nigeria. Three hundred and ten copies of the questionnaire were distributed to consenting participants.  Statistical Package for Social Sciences (SPSS) ® version 21 was used to manage data. Results were presented as descriptive statistics for structures and processes of SRH in the study population.         Results: A total of 296 completed questionnaires were retrieved. Eighty-two percent of respondents reported providing SRH services, which was mainly the sale of family planning (FP) products and counselling. Majority of these services 75%, were only offered on clients’ demand. SRH products sold were mainly oral contraceptive pills and the male condom. In terms of processes, about half (49.7%) of the respondents reported offering SRH services in collaboration with other health care providers, mainly in primary health care centres and private clinics. However, only a small proportion of the staff had any formal SRH specific training.      Conclusion: The composition and qualification of mix of staff in community pharmacies presented some inherent weaknesses in their capacity to deliver quality and effective SRH services. This may impede the desired goal of promoting wider access and achieving universal coverage of SRH services.


2021 ◽  
pp. 104973232110500
Author(s):  
Madina Agénor ◽  
Dougie Zubizarreta ◽  
Sophia Geffen ◽  
Natasha Ramanayake ◽  
Shane Giraldo ◽  
...  

Research focusing on the specific and unique sexual and reproductive health care experiences of transmasculine young adults of color are extremely scarce. We conducted five focus group discussions with 19 Black, Latinx, Asian, Native, and other transmasculine individuals of color aged 18–25 years in the greater Boston area. Using thematic analysis, we found that transmasculine young adults of color experienced cissexism, heterosexism, and racism in accessing and utilizing sexual and reproductive health services. These multiple forms of discrimination undermined participants’ receipt of high-quality sexual and reproductive health information and care from competent health care providers who shared their lived experiences. Participants relied on support from their lesbian, gay, bisexual, transgender, and queer peers to obtain needed sexual and reproductive health resources and minimize harm during clinical encounters. Multilevel interventions are needed to promote access to person-centered and structurally competent sexual and reproductive health care among transmasculine young adults of color.


2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
S Villadsen ◽  
S Dias

Abstract For complex public health interventions to be effective their implementation needs to adapt to the situation of those implementing and those receiving the intervention. While context matter for intervention implementation and effect, we still insist on learning from cross-country comparison of implementation. Next methodological challenges include how to increase learning from implementation of complex public health interventions from various context. The interventions presented in this workshop all aims to improve quality of reproductive health care for immigrants, however with different focus: contraceptive care in Sweden, group based antenatal care in France, and management of pregnancy complications in Denmark. What does these interventions have in common and are there cross cutting themes that help us to identify the larger challenges of reproductive health care for immigrant women in Europe? Issues shared across the interventions relate to improved interactional dynamics between women and the health care system, and theory around a woman-centered approach and cultural competence of health care providers and systems might enlighten shared learnings across the different interventions and context. Could the mechanisms of change be understood using theoretical underpinnings that allow us to better generalize the finding across context? What adaption would for example be needed, if the Swedish contraceptive intervention should work in a different European setting? Should we distinguish between adaption of function and form, where the latter might be less important for intervention fidelity? These issues will shortly be introduced during this presentation using insights from the three intervention presentations and thereafter we will open up for discussion with the audience.


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