BMC Public Health最新文献

Objective: This study was conducted to explore the human immunodeficiency virus (HIV) status of and compare HIV knowledge, HIV testing, and other healthy behaviors between men who have sex with men and women (MSMW) and men who have sex with men only (MSMO), to provide a scientific basis for targeted HIV interventions for this population.

Methods: A cross-sectional survey was conducted to collect demographic and behavioral information using questionnaires for statistical analysis.

Results: Among 1,993 participants, 772 (38.7%) reported having sexual intercourse with women. The results of the multivariate logistic regression model analysis indicated that MSMW had a lower probability than MSMO of reporting HIV knowledge 1 (adjusted odds ratio [aOR]:0.556, 95% CI: 0.409-0.756), knowledge 2 (aOR:0.626; 95% CI, 0.515-0.761), knowledge 3 (aOR:0.569; 95% CI: 0.447-0.724), informing their HIV status to the last casual sex partners offline (aOR: 0.515, 95% CI: 0.358-0.743), HIV testing more than once in the past 6 months (aOR: 0.696, 95% CI: 0.521-0.931), and HIV testing in a hospital in the past 6 months (aOR: 0.696, 95% CI: 0.521-0.931). In contrast, MSMW had a higher probability of post-exposure prophylaxis (PEP) intake in the past 6 months (aOR: 2.252, 95% CI: 1.570-3.229), pre-exposure prophylaxis (PrEP) intake in the past 6 months (aOR: 1.630, 95% CI: 1.091-2.434), and cumulative HIV testing more than twice (aOR: 1.917, 95% CI: 1.434-2.563).

Conclusion: MSMW showed significant differences with MSMO in HIV knowledge and HIV related risky reduction behaviors. It is necessary to enhance awareness and skills on HIV self-testing, PEP, and PrEP among MSM. Encouraging HIV knowledge education and HIV testing service are important for MSMW. PEP and PrEP might be enhanced among MSMO for reducing the risk of HIV transmission.

Background: The heightened HIV prevalence in Nigeria is partly associated with challenges in accessing people living with HIV in geographically isolated and unidentified regions. Spatial Data Infrastructure (SDI) is an innovation that has shown promise for HIV case-finding in unidentified settlements. This study reports the use of SDI to improve HIV case identification in Anambra North Senatorial District, Nigeria.

Methods: This study utilised a pre-post intervention study design to analyse data from the implementation of HIV testing services (HTS). Settlements for HTS were identified in the district using SDIs, such as microplans and hotspot maps. Community teams captured areas' names and geolocations using a custom application. Geographical Information Systems technology was overlayed on coordinates to generate microplans and hotspot maps, which were used for targeted tests and new case identification.

Results: Our study showed varying trends across the periods when SDIs were utilised and when they were not. The use of SDI greatly enhanced HIV case identification and provided a strategic framework for HTS implementation. Overall, the period when SDI was used recorded relatively higher new cases than before. Local Government Areas with more rural settlements that leveraged SDI significantly upscaled their case identification.

Conclusions: SDI can facilitate HIV case identification. Our study revealed twice as many cases identified across the periods compared. Our pioneering use of SDI for HIV case finding in Nigeria offers promise for efficient HTS implementation in high-burden and yet-to-be-identified locations.

Background: Breast cancer is the most common type of cancer and the leading cause of cancer death among women worldwide. In 2020, approximately 2.3 million women were newly diagnosed with breast cancer, resulting in around 685,000 deaths globally. The high incidence and prevalence of breast cancer have made it a major public health problem in both developed and developing nations, leading to overburdened health systems and increased direct medical expenditure. This research was conducted to assess the impact of breast cancer awareness programs on breast screening utilization among women in the United Arab Emirates.

Methods: A cross-sectional study using a content-validated interviewer-administered questionnaire was conducted among 959 women aged ≥ 20 years from 31st May 2023 to 31st October 2024, in the United Arab Emirates. Data on sociodemographics, awareness program participation, screening utilization, and barriers were analyzed using descriptive statistics and chi-square tests.

Results: Among the study participants,304 (31.7%) had attended awareness programs. Attendance was associated with younger age, higher education, and being single (p < 0.001). Among those who have ever attended any breast cancer awareness programs who had utilized the screening were 38.5% compared to 13.3% non-attendees (p < 0.001). The study concluded that age, education level, and marital status were significantly associated with participation in breast cancer awareness programs (p-value < 0.05). Key barriers included a lack of physician recommendations (24.3%), knowledge gaps (23%), and cost concerns (22.6%).

Conclusions: The study shows that participation in the awareness programs varied based on age, education and marital status, additionally, those with lower educational levels had a higher attendance at the awareness programs, emphasizing the significance of educational initiatives. The study showed a link between attending breast cancer awareness programs and the use of screening services, furthermore, notable gap in screening utilization such as emotional and perceived barriers were noted. Thus, its necessary to overcome these challenges for enchaning early detection and treatment outcomes. Interventions such as targeted educational campaigns, improved screening facility and better communication between physicians and patients can aid in addressing these challenges.

Background: Non-communicable diseases (NCDs) accounted for 89% of deaths in Luxembourg in 2019, aligning with Europe's figures but exceeding the global average of 74%. Behaviours play a critical role in NCD management, with unhealthy lifestyles-like poor diets, physical inactivity, tobacco use, and alcohol consumption-posing significant risks, especially when combined. The present study aims to explore sociodemographic characteristics of adolescents presenting behavioural risks for NCDs in Luxembourg.

Methods: A representative sample of 8117 adolescents (11-to-18-years-old) took part in the 2022 Health Behaviour in School-aged Children (HBSC) Luxembourg survey. We measured physical inactivity, daily sugar consumption, cigarette use and alcohol consumption, and their combination (1, 2 or 3 ≥ risks). The sociodemographic characteristics investigated were sex, age, migration background, family structure and perceived wealth. Binomial logistic regression crude and adjusted were performed with sociodemographic characteristics for each risk behaviour. In addition, multinomial logistic regression crude and adjusted were used to analyse the association between the combination of risk behaviours and the sociodemographic information of the adolescents in Luxembourg.

Results: Girls had higher odds of physical inactivity (OR = 2.06) than boys, and older age groups exhibited elevated odds of physical inactivity (OR = 2.99), cigarette smoking (OR = 25.00), and alcohol consumption (OR = 35.56). Migration background emerged as a protective factor against alcohol consumption (parents' migration OR = 0.60; self-immigrated OR = 0.45) but a risk factor for physical inactivity (parents' migration OR = 1.50; self-immigrated OR = 1.72). Adolescents who did not live with both parents were more likely to be physically inactive (OR = 1.37), consume sugar daily (OR = 1.33), smoke cigarettes (OR = 1.26) and consume alcohol (OR = 1.80). Adolescents that reported their families were not well off had higher odds to be physically inactive (OR = 2.12) and to consume sugar daily (OR = 1.39). The simultaneity of risk behaviours reveals a worrying trend of increasing risk with age, highlighting the need for preventive interventions throughout adolescence. Furthermore, the results in relation to family structure and perceived wealth highlights the complexity and interrelationship of these factors in adolescent behavioural health.  CONCLUSIONS: The study provides guidance to create more effective interventions aiming to promote healthy behaviours in adolescents.

Background: HIV infection could be regarded as a trauma that causes multidimensional distress experiences among people living with HIV. While people living with HIV may also experience positive changes which can lead to post-traumatic growth in the process of struggling with trauma. Current research has neglected the personal experience of people living with HIV, and there is a lack of qualitative research that further explores the dynamic post-traumatic growth trajectory. This study aims to explore and analyze the post-traumatic growth trajectory among people living with HIV to provide a reference for future targeted interventions.

Methods: A programmed grounded theory-based qualitative study was conducted. Data were gathered using semi-structured, in-depth interviews with 30 people living with HIV in southwest China from April 2024 to May 2024, which were then analyzed and integrated using grounded theory.

Results: 30 interviewees were between 27 and 59 years old, 18 males and 12 females, and their education levels were mainly primary school or illiterate. Trajectories of post-traumatic growth among people living with HIV are viewed as the core category and consist of four phases, which are initial (trauma and stress), support (contemplation and help-seeking), internalization (acceptance and change), and growth (hope and future).

Conclusions: The post-traumatic growth trajectory among people living with HIV is a complex and dynamic process. Medical staff should dynamically evaluate post-traumatic growth developmental phases and provide individualized psychological interventions to facilitate transitions and transformations between phases and ultimately achieving self-growth.

Background: Current evidence suggests that even in high-income countries such as Sweden, there are socioeconomic differences in children's participation in physical activity. While family-based programmes appear promising to encourage physical activity, there is a lack of knowledge on how to engage families in such programmes, particularly in socioeconomically disadvantaged areas. The Open Health-Promoting Activities programme was launched to promote physical activity outdoors and health equity for children and their families in these areas. This study aims to explore parents' experiences with the Open Health-Promoting Activities programme in socioeconomically disadvantaged areas, focusing on family engagement in physical activity and perceived changes in family dynamics.

Methods: A qualitative design with an ethnographic approach was employed. In line with an ethnographic approach, the research team conducted 15 participant observations of the programme sessions on Saturdays during Spring 2022. Field notes were compiled during the observations, which provided contextual information for individual interviews with 12 programme participants. These interviews were conducted after the researchers attended the programme. The participants were adults/parents who participated in the programme with one or more of their children. An inductive reflexive thematic analysis was used to analyse the field notes and interviews.

Results: The analysis identified three main themes: (1) prioritising children's equal engagement in physical activity, (2) helping parents promote children's healthy lifestyles, and (3) improving family dynamics through engagement in physical activity. Each theme captures an aspect of the programme that parents perceived as essential to facilitating their family's engagement in the programme. All the themes are interconnected and form the basis for improving family dynamics.

Conclusion: To develop tailored family-based programmes in socioeconomically deprived communities, it is crucial to understand parents' experiences and perceptions of aspects that facilitate their children's engagement in physical activity. The findings suggest that emphasising equal opportunities, a safe space approach and participation are essential for increasing family engagement in physical activity. These elements also supported increasing parents' awareness of their children's need to be active and have fun together.

Background: Health care professionals are in a key position to promote vaccinations. However, consulting vaccine-hesitant patients can be difficult, especially when patients bring up anti-vaccination arguments. Whereas prior research has identified essential skills for refuting anti-vaccination arguments, little is known about how to acquire these skills. Our aim was to determine if empathetic refutational interview text scenarios help health care professionals build confidence and abilities in countering anti-vaccination arguments.

Methods: We conducted an online randomized controlled experiment with UK and Finnish health care professionals in which we randomly assigned them to an empathetic refutational interview group (n = 167) or a control group (n = 180). Participants in the empathetic refutational interview group were presented with examples of the empathetic refutational interview approach, which encompasses the identification of attitude roots, affirmations, corrections of misconceptions, and provision of facts. Control group participants received a standard facts-based approach. We examined posttest use of empathetic refutational interview techniques and pre- and posttest perceived difficulty of refuting anti-vaccination arguments.

Results: Participants in the empathetic refutational interview group used more empathetic affirmations than control group participants. The empathetic refutational interview group and the control group did not differ significantly in how often they explicitly tried to identify attitude roots, correct misconceptions, and provide vaccination facts, nor in how difficult they found anti-vaccination arguments to be to refute.

Conclusions: Brief empathetic refutational interview text scenarios can increase health care professionals' use of affirmations when discussing vaccines with patients. Additional materials are needed to efficiently teach refutations of attitude roots.

Background: Perimenopausal women are a high-risk group for gynecological cancers; however, the spatiotemporal heterogeneity in prevalence and its association with socioeconomic development have not been fully explored. This study aimed to analyze the global burden of cervical, ovarian, and uterine cancers among perimenopausal women, examine health inequalities, and investigate their relationship with socioeconomic levels.

Methods: We assessed the disease burden of gynecological cancers in perimenopausal women using the 2019 Global Burden of Disease study (GBD2019) data, utilizing prevalence and Years of Life Lost (YLL) rates. Health inequality and frontier analyses were performed based on age-standardized prevalence rates for cervical, ovarian, and uterine cancers, coupled with associated socio-demographic index (SDI) data.

Results: Over the past thirty years, global prevalence rates of cervical, ovarian, and uterine cancers among perimenopausal women have risen, while the number of YLLs has declined. Correlation analysis with the SDI showed that ovarian and uterine cancer prevalence rates positively correlated with SDI, whereas cervical cancer prevalence was inversely related to it. Moreover, the burden of these cancers demonstrated marked inequalities in relation to SDI, with cervical cancer disparities intensifying-the absolute value of the inequality slope index rose from 100.98 in 1990 to 170.17 in 2019. Ovarian cancer experienced a slight decrease in inequalities, while uterine cancer saw a significant increase, with its inequality slope index jumping from 176.51 in 1990 to 226.01 in 2019. Additionally, there existed regional health disparities in the disease burden of ovarian cancer among perimenopausal women; notably, in regions where YLLs rates for ovarian cancer were increasing, economically developed areas actually exhibited a decline.

Conclusion: Globally, the prevalence of gynecological cancers in perimenopausal women showed an increasing trend. The health inequality gap for cervical and uterine cancer has widened, while disparities in ovarian cancer are particularly pronounced across regions. There remains scope for improvement in managing the prevalence of gynecological cancers among perimenopausal women across countries with varying SDI levels.

Background: Imbalanced dietary patterns, sedentary behavior, and other unhealthy lifestyle behaviors are among the potentially modifiable risk factors most consistently linked to all-cause and cardiovascular disease (CVD) mortality. This study aimed to investigate the joint association of antioxidant intakes from diet and supplements and sedentary behavior with all-cause and CVD mortality.

Methods: This retrospective cohort study included 16,019 adults from National Health and Nutrition Examination Survey (NHANES) 2007-2014. All-cause and CVD mortality was ascertained by linkage to National Death Index records through 31 December 2019. Participants were divided into four lifestyle patterns based on their intake of six antioxidants from dietary intakes and supplements and their self-reported sedentary behavior: low-antioxidant diet and prolonged sedentary behavior, low-antioxidant diet and nonprolonged sedentary behavior, high-antioxidant diet and prolonged sedentary behavior, high-antioxidant diet and nonprolonged sedentary behavior. Multivariable Cox proportional hazards models were utilized to evaluate the associations of antioxidant diet and sedentary behavior with regards to all-cause and CVD mortality.

Results: Over an average follow-up of 8.5 years, a total of 1,894 overall deaths and 482 CVD deaths were reported. Compared with the low-antioxidant diet and prolonged sedentary behavior group, participants in the high-antioxidant diet and nonprolonged sedentary behavior group had a significantly lower risk of all-cause (hazard ratio [HR], 0.60; 95% confidence interval [CI], 0.50-0.72) and CVD (0.51; 0.34-0.77) mortality. Similarly, individuals following a low-antioxidant diet and engaging in nonprolonged sedentary behavior also had a reduced risk of all-cause (0.63; 0.52-0.75) and CVD (0.54; 0.38-0.76) mortality. On the other hand, there was no significant reduction in all-cause mortality among individuals in the high-antioxidant diet and prolonged sedentary behavior group (0.83; 0.68-1.03), as well as CVD mortality (0.87; 0.62-1.21). Subgroup and sensitivity analyses yielded results that were consistent with the overall analysis.

Conclusions: Participants with both high-antioxidant diet and nonprolonged sedentary behavior had the lowest all-cause and CVD mortality. Additionally, nonprolonged sedentary behavior can help counteract the harms of low-antioxidant diet, whereas a high-antioxidant diet fails to offset the deleterious effect of prolonged sedentary behavior.

Background: Adolescence is a critical developmental period marked by significant mental and physical health changes. This longitudinal study examines the relationship between online communication and health from age 15 to 17, focusing on mental health indicators (depression, anxiety, self-esteem, and body image) and cardiorespiratory fitness (CRF). We aimed to assess whether increased time spent in online communication is associated with poorer mental health and lower CRF among adolescents, with consideration of potential moderating effects of sex and socioeconomic status (SES).

Methods: Data were collected from 315 Icelandic adolescents at age 15 (2015) and age 17 (2017; N = 236). Linear mixed-effects models were used to examine the association between online communication and health outcomes, including depression, anxiety, body image, self-esteem, and CRF. Models accounted for year, sex, and SES, with random intercepts for individual variability.

Results: More online communication was significantly associated with poorer mental health outcomes, including more symptoms of depression (p < 0.001, marginal R² = 0.14), anxiety (p = 0.032, marginal R² = 0.13), lower self-esteem (p = 0.006, marginal R² = 0.07), more negative body image (p = 0.010, marginal R² = 0.13), and lower CRF; p = 0.003, marginal R² = 0.35). These associations did not change between years and were consistent across sex and SES groups. CRF declined from age 15 to 17. Females reported generally worse mental health and lower CRF than males, while higher SES was linked to lower depression scores and higher self-esteem. However, no significant interactions were found between online communication, sex, or SES, suggesting that the impacts of online communication on health were broadly applicable across demographic groups.

Conclusions: This study underscores the potential negative effects of online communication on mental and physical health among adolescents, regardless of sex or SES. The findings highlight the importance of balancing time spent online communicating with physical activity to support overall adolescent well-being. These insights could inform public health initiatives and preventive strategies to foster healthier digital habits in an increasingly online world, especially during this sensitive developmental period.