This study examined vaginal practices and willingness to use vaginal microbicides among 23 black women in New York City. The researchers found:
1) Willingness to use a vaginal product for HIV prevention was high, especially among more educated women, though safety concerns were prominent.
2) Most women reported using douching in their lifetime for cleanliness, with vinegar and water being common ingredients.
3) Choices around vaginal practices and products were influenced by assessments of risks and efficacy, experiences, culture, and general approach to healthcare including use of complementary and alternative medicine.
4) While preferences varied, attitudes toward a vaginal microbicide were likely to be positive if side effects
This study analyzed social inequalities and inequalities in access to and utilization of prenatal and delivery health care services according to skin color using data from 9,633 postpartum women in Rio de Janeiro, Brazil from 1999-2001. The results showed two main findings:
1) Black and mulatto women consistently faced more adverse social conditions and had less access to care compared to white women, including higher rates of adolescent pregnancy, less education and paid employment, and less utilization of prenatal services.
2) These inequalities persisted even when stratified by education level, indicating discrimination occurred based on both education and skin color in the delivery of health services.
Branch vital, angela condom use among african-american women-nfmij-6-1-09William Kritsonis
Dr. William Allan Kritsonis, Editor-in-Chief, NATIONAL FORUM JOURNALS (Founded 1982). Dr. Kritsonis has served as an elementary school teacher, elementary and middle school principal, superintendent of schools, director of student teaching and field experiences, professor, author, consultant, and journal editor. Dr. Kritsonis has considerable experience in chairing PhD dissertations and master thesis and has supervised practicums for teacher candidates, curriculum supervisors, central office personnel, principals, and superintendents. He also has experience in teaching in doctoral and masters programs in elementary and secondary education as well as educational leadership and supervision. He has earned the rank as professor at three universities in two states, including successful post-tenure reviews.
Alcohol and substance use vis a vis hiv sexual risk behavioursAlexander Decker
1) The study evaluated perceptions of freshman students at a Kenyan university regarding HIV/AIDS, sexual behaviors, and drug use. It found high HIV/AIDS knowledge but behaviors did not always reflect this.
2) Over half of participants had been sexually active and nearly half did not consistently use condoms. Alcohol consumption was associated with increased risky sexual behaviors like unprotected sex.
3) While knowledge of HIV transmission and prevention was high, testing rates remained low and risk perception seemed unrealistic. There is a need for interventions to change attitudes and increase safer practices.
- Over 80% of women reported liking each of the three microbicide delivery methods tested (vaginal film, soft-gel capsule, and tablet). Over 85% said they would use the product.
- The film and soft-gel capsule were preferred by 39% and 37% of women respectively, while the tablet was preferred by 25%. Ease of use and faster dissolving time were cited as reasons for preferences.
- Product preference varied by country, with the soft-gel capsule preferred in Burkina Faso and Tanzania (42-46%) and the film preferred in Zambia (51%). Age, socioeconomic status, and marital status did not significantly impact preferences.
- Melva Covington of Sanofi discusses strategies for increasing diversity in clinical trials to better represent populations impacted by medical conditions. Currently, racial and ethnic minorities are underrepresented in trials compared to disease prevalence.
- Covington emphasizes the importance of early and sustained engagement with advocacy groups and communities to build trust and partnerships for recruitment and retention. She also stresses using diverse recruitment strategies and culturally competent materials.
- Efforts are underway across the industry and with groups like the FDA to improve representation and data collection in trials through initiatives like standardizing methods and increasing proportional representation. However, more work remains to modernize clinical trials and ensure underserved populations are meaningfully included.
The new public health and std hiv preventionSpringer
This document discusses social determinants of sexually transmitted infections. It explores how social factors like education, occupation, neighborhoods, and media can influence sexual behaviors and networks, thereby affecting STI spread. Key determinants of STI transmission include likelihood of transmission during sex, number of sexual partners, and partnership patterns. Factors like consistent condom use, access to healthcare, sex education, sexual network patterns, and timing of partnerships all influence STI rates at a population level.
Dr. William Allan Kritsonis, Editor-in-Chief, NATIONAL FORUM JOURNALS (Founded 1982). Dr. Kritsonis has served as an elementary school teacher, elementary and middle school principal, superintendent of schools, director of student teaching and field experiences, professor, author, consultant, and journal editor. Dr. Kritsonis has considerable experience in chairing PhD dissertations and master thesis and has supervised practicums for teacher candidates, curriculum supervisors, central office personnel, principals, and superintendents. He also has experience in teaching in doctoral and masters programs in elementary and secondary education as well as educational leadership and supervision. He has earned the rank as professor at three universities in two states, including successful post-tenure reviews.
Knowledge, attitude and practices of students enrolled in health related cour...Alexander Decker
This document summarizes a study that assessed the knowledge, attitudes, and practices of 432 students enrolled in health-related courses at Saint Louis University in the Philippines regarding human papillomavirus (HPV). The students demonstrated fair knowledge of HPV transmission but poor understanding of the diseases caused by HPV. Their knowledge of HPV signs and symptoms and prevention/control measures was better. Students had positive attitudes toward HPV infection and vaccination. Medical students showed higher levels of HPV knowledge than other students. While practices for reducing HPV infection were generally good, interventions are still needed to improve HPV education, especially regarding transmission and diseases caused.
This study analyzed social inequalities and inequalities in access to and utilization of prenatal and delivery health care services according to skin color using data from 9,633 postpartum women in Rio de Janeiro, Brazil from 1999-2001. The results showed two main findings:
1) Black and mulatto women consistently faced more adverse social conditions and had less access to care compared to white women, including higher rates of adolescent pregnancy, less education and paid employment, and less utilization of prenatal services.
2) These inequalities persisted even when stratified by education level, indicating discrimination occurred based on both education and skin color in the delivery of health services.
Branch vital, angela condom use among african-american women-nfmij-6-1-09William Kritsonis
Dr. William Allan Kritsonis, Editor-in-Chief, NATIONAL FORUM JOURNALS (Founded 1982). Dr. Kritsonis has served as an elementary school teacher, elementary and middle school principal, superintendent of schools, director of student teaching and field experiences, professor, author, consultant, and journal editor. Dr. Kritsonis has considerable experience in chairing PhD dissertations and master thesis and has supervised practicums for teacher candidates, curriculum supervisors, central office personnel, principals, and superintendents. He also has experience in teaching in doctoral and masters programs in elementary and secondary education as well as educational leadership and supervision. He has earned the rank as professor at three universities in two states, including successful post-tenure reviews.
Alcohol and substance use vis a vis hiv sexual risk behavioursAlexander Decker
1) The study evaluated perceptions of freshman students at a Kenyan university regarding HIV/AIDS, sexual behaviors, and drug use. It found high HIV/AIDS knowledge but behaviors did not always reflect this.
2) Over half of participants had been sexually active and nearly half did not consistently use condoms. Alcohol consumption was associated with increased risky sexual behaviors like unprotected sex.
3) While knowledge of HIV transmission and prevention was high, testing rates remained low and risk perception seemed unrealistic. There is a need for interventions to change attitudes and increase safer practices.
- Over 80% of women reported liking each of the three microbicide delivery methods tested (vaginal film, soft-gel capsule, and tablet). Over 85% said they would use the product.
- The film and soft-gel capsule were preferred by 39% and 37% of women respectively, while the tablet was preferred by 25%. Ease of use and faster dissolving time were cited as reasons for preferences.
- Product preference varied by country, with the soft-gel capsule preferred in Burkina Faso and Tanzania (42-46%) and the film preferred in Zambia (51%). Age, socioeconomic status, and marital status did not significantly impact preferences.
- Melva Covington of Sanofi discusses strategies for increasing diversity in clinical trials to better represent populations impacted by medical conditions. Currently, racial and ethnic minorities are underrepresented in trials compared to disease prevalence.
- Covington emphasizes the importance of early and sustained engagement with advocacy groups and communities to build trust and partnerships for recruitment and retention. She also stresses using diverse recruitment strategies and culturally competent materials.
- Efforts are underway across the industry and with groups like the FDA to improve representation and data collection in trials through initiatives like standardizing methods and increasing proportional representation. However, more work remains to modernize clinical trials and ensure underserved populations are meaningfully included.
The new public health and std hiv preventionSpringer
This document discusses social determinants of sexually transmitted infections. It explores how social factors like education, occupation, neighborhoods, and media can influence sexual behaviors and networks, thereby affecting STI spread. Key determinants of STI transmission include likelihood of transmission during sex, number of sexual partners, and partnership patterns. Factors like consistent condom use, access to healthcare, sex education, sexual network patterns, and timing of partnerships all influence STI rates at a population level.
Dr. William Allan Kritsonis, Editor-in-Chief, NATIONAL FORUM JOURNALS (Founded 1982). Dr. Kritsonis has served as an elementary school teacher, elementary and middle school principal, superintendent of schools, director of student teaching and field experiences, professor, author, consultant, and journal editor. Dr. Kritsonis has considerable experience in chairing PhD dissertations and master thesis and has supervised practicums for teacher candidates, curriculum supervisors, central office personnel, principals, and superintendents. He also has experience in teaching in doctoral and masters programs in elementary and secondary education as well as educational leadership and supervision. He has earned the rank as professor at three universities in two states, including successful post-tenure reviews.
Knowledge, attitude and practices of students enrolled in health related cour...Alexander Decker
This document summarizes a study that assessed the knowledge, attitudes, and practices of 432 students enrolled in health-related courses at Saint Louis University in the Philippines regarding human papillomavirus (HPV). The students demonstrated fair knowledge of HPV transmission but poor understanding of the diseases caused by HPV. Their knowledge of HPV signs and symptoms and prevention/control measures was better. Students had positive attitudes toward HPV infection and vaccination. Medical students showed higher levels of HPV knowledge than other students. While practices for reducing HPV infection were generally good, interventions are still needed to improve HPV education, especially regarding transmission and diseases caused.
Using Everett Rogers' Diffusion of Innovations Theory an intervention for automatic STI screening for adolescents is applied to primary care settings in Baltimore, Maryland.
International Journal of Humanities and Social Science Invention (IJHSSI)inventionjournals
International Journal of Humanities and Social Science Invention (IJHSSI) is an international journal intended for professionals and researchers in all fields of Humanities and Social Science. IJHSSI publishes research articles and reviews within the whole field Humanities and Social Science, new teaching methods, assessment, validation and the impact of new technologies and it will continue to provide information on the latest trends and developments in this ever-expanding subject. The publications of papers are selected through double peer reviewed to ensure originality, relevance, and readability. The articles published in our journal can be accessed online
This document provides a grant proposal for a program to address sexually transmitted infections (STIs) among students at The College at Brockport. It includes an epidemiological assessment noting high STI rates locally and among young people. Factors contributing to STIs include lack of condom use and testing. The program aims to increase condom use and testing by 10% through a theoretical framework of the Health Belief Model. It will provide STI education and resources in freshman residence halls and the student union.
This study evaluated the knowledge, attitudes and practices of 30 traditional birth attendants in Cameroon regarding danger signs in pregnancy and infection prevention. The average age of attendants was 49.6 years. Most had no formal education beyond primary school. While all attendants reported referring women in difficult deliveries, only 40% did so regularly. Common reasons for referral included convulsions, heavy bleeding, and large stomach size. Over 70% reported regularly washing hands, but few used other infection prevention measures consistently. The study found traditional birth attendants play an important role but could benefit from additional training to improve safety.
Healthcare seeking and sexual behaviour of clients attending the suntreso sti...Alexander Decker
A study of 185 clients with sexually transmitted infections (STIs) attending an STI clinic in Kumasi, Ghana found that 64% delayed seeking treatment for more than 4 weeks after symptoms appeared. 61% had previously sought treatment elsewhere before coming to the clinic. 80% had unprotected sex while symptomatic. The document discusses factors that influence healthcare seeking behaviors for STIs, including long wait times, stigma, lack of privacy, and attitudes of healthcare providers. It also examines sexual behaviors among STI patients, noting that most engage in unprotected sex during symptomatic periods. Understanding these healthcare seeking patterns and behaviors can help develop more effective STI prevention and control programs.
Awarenes of aids amongst hs students in bonaire with amended list of authorsAleksandar Dusic, MD, MSc
- The document discusses a study that assessed awareness of AIDS among high school students in Bonaire before and after a workshop on AIDS.
- Fifty-two students completed a survey before and after the workshop to test their knowledge of AIDS transmission and prevention.
- The results found that the students' knowledge of AIDS significantly increased after the workshop for several key questions regarding transmission and prevention. There was a decrease in the number of students reporting discomfort discussing AIDS with others after the workshop.
This document presents a final report on a multi-pronged public health intervention to raise HIV/AIDS awareness and encourage testing in Florida on World AIDS Day 2014. Three approaches were evaluated: 1) An art installation and candlelight vigil honoring those with HIV/AIDS. 2) A health fair with HIV/STD testing at a university in an African American neighborhood with high HIV rates. 3) A panel discussion and testing at a predominantly African American church in the same neighborhood. The goal was to increase awareness and testing among at-risk groups like African Americans in Florida, who have disproportionately high HIV rates. Evaluation methods included event attendance, media coverage, testing rates, and interviews. The results showed the events raised awareness and some
Development of a Color-Coded Bilingual Food Label for Low-Literacy Latino Car...Aida Md Saad
This study developed a color-coded bilingual food label for low-literacy Latino caretakers. Researchers conducted a needs assessment involving a survey of 150 low-income Latino caretakers and 3 focus groups to understand current food label use and barriers. They then developed a user-friendly food label (UFFL) based on this input. The UFFL included color coding, bilingual text, and a shaded Food Guide Pyramid. An evaluation with 8 participants found the UFFL was easy to understand. The methodology can help improve the nutrition education value of food labels for low-literacy audiences.
Condoms as a harm reduction approach in prisonsErin Bortel
Keeping High-Impact Prevention at the forefront of our attention will guide administrators and policy-makers implementing harm reduction strategies in incarcerated settings to End AIDS in NYS by 2020.
This study examined factors that influence pregnant women's decisions to get the seasonal influenza vaccine. The authors conducted a randomized controlled study with pregnant women in Atlanta, Georgia to test the effects of immunization history, exposure to vaccine messages, and sociodemographic characteristics. The key findings were:
1) Women who had received the influenza vaccine in the past 5 years were over twice as likely to intend to get vaccinated during their current pregnancy compared to those without prior vaccination.
2) Perceiving the influenza vaccine as highly effective (over 80% effective) increased women's intent to vaccinate by over 10 times compared to those who saw it as less effective. Similarly, perceiving high susceptibility to influenza during pregnancy increased
McMillan Worth The impact ofsocio-cultural context on young people's condom useKaren McMillan
This article discusses factors that influence young people's condom use in Tonga and Vanuatu based on interviews with 62 people aged 18-25. It finds a disconnect between positive attitudes towards condoms and low actual usage. Social and cultural influences play a strong role in condom decisions by shaping identity, norms, and traditions. Effective HIV prevention requires understanding these contextual factors rather than just focusing on individual knowledge and attitudes. Country-specific approaches are also needed given cultural differences between Pacific nations.
1) A study assessed the prevalence of diagnosed diabetes and diabetes mortality rate in a large Puerto Rican community in Chicago. 2) The prevalence of diabetes was found to be 20.8%, the highest reported for Puerto Ricans and twice as high as rates for Puerto Ricans in New York and Puerto Rico. 3) The diabetes mortality rate of 67.6 per 100,000 population was more than twice the rates for all of Chicago and the US.
This document provides updated guidelines from the World Health Organization (WHO) on the management of severe acute malnutrition in infants and children. It summarizes the evidence and recommendations on key interventions. The guideline was developed using the GRADE methodology and input from experts in nutrition and child health. It focuses on admission and discharge criteria, treatment settings, use of antibiotics, vitamin A supplementation, therapeutic feeding approaches, fluid management, treatment of HIV-infected children, and management of infants under 6 months. The recommendations are meant to inform revisions to WHO's 1999 manual on managing severe malnutrition and to guide clinical practice.
This presentation provides an overview of the role that policy advocacy has played in activating greater visibility for the female condom and increased procurement in the developing world. It highlights the important role that third-party partnerships play in mobilizing evidence of need and demand for health products in the developing world. The presentation identifies policy advocacy and social marketing as essential complements to a comprehensive marketing and promotion strategy.
Global Medical Cures™ | HIV Among Women
DISCLAIMER-
Global Medical Cures™ does not offer any medical advice, diagnosis, treatment or recommendations. Only your healthcare provider/physician can offer you information and recommendations for you to decide about your healthcare choices.
Richard Garfein, Ph.D., M.P.H., of UC San Diego Department of Medicine, presents "HIV, HCV, and TB Infection among Injection Drug Users in San Diego" at AIDS Clinical Rounds
Nutrition and Secondary Prevention: A public health projectdebbiewalkerr
Nutrition and Secondary Prevention: A public health project
University of Florida
Amarillys Alvarado-Sojo, Christie Champaign,
Kristin Miller, Debbie Walker, Chris Weiss
The FDA plans to prioritize improvements in the quality of demographic subgroup data collection, reporting and analysis, encourages greater participation of diverse patients, and supports the transparency of subgroup data. To this end, ways to recruit, engage, educate, and study those of diverse backgrounds to alopecia areata trials will be discussed.
This study used mixed quantitative and qualitative methods to assess the acceptability of tenofovir gel, an experimental vaginal microbicide, among women participating in an early phase clinical trial. While 94% of women stated they would likely use the gel based on quantitative surveys, qualitative group discussions revealed a more complex picture of acceptability, with factors like lubrication, leakage during sex, impact on pleasure, and potential for covert use emerging as important. The authors conclude that future microbicide trials should include strategic mixed-methods data collection to better understand acceptability from multiple perspectives.
This study assessed the acceptability of tenofovir gel as a potential vaginal microbicide among women participating in a phase I clinical trial through a mixed-methods approach. Quantitative data indicated that 94% of participants stated they would probably or definitely use the gel. However, qualitative group discussions revealed a more complex picture of acceptability, with women raising concerns about lubrication, leakage, effects on sexual pleasure, and the possibility of covert use. The authors conclude that while participants were generally accepting of the gel based on quantitative responses, qualitative findings show acceptability is shaped by multiple contextual factors important for product development and optimization of use. Future microbicide trials should include strategic mixed-methods acceptability assessments.
This study used mixed quantitative and qualitative methods to assess the acceptability of tenofovir gel, an experimental vaginal microbicide, among women participating in an early phase clinical trial. While 94% of women stated they would likely use the gel based on quantitative surveys, qualitative group discussions revealed a more complex picture of acceptability, with concerns around lubrication, leakage during sex, impact on pleasure, and potential for covert use. The authors conclude that future microbicide trials should include strategic mixed-methods data collection to better understand acceptability from multiple perspectives.
Smoking Cessation and Relapse Among PregnantAfrican-American.docxrosemariebrayshaw
Smoking Cessation and Relapse Among Pregnant
African-American Smokers in Washington, DC
Ayman A. E. El-Mohandes • M. Nabil El-Khorazaty •
Michele Kiely • Marie G. Gantz
Published online: 8 June 2011
� Springer Science+Business Media, LLC (outside the USA) 2011
Abstract Smoking is the single most preventable cause
of perinatal morbidity. This study examines smoking
behaviors during pregnancy in a high risk population of
African Americans. The study also examines risk factors
associated with smoking behaviors and cessation in
response to a cognitive behavioral therapy (CBT) inter-
vention. This study is a secondary analysis of data from a
randomized controlled trial addressing multiple risks dur-
ing pregnancy. Five hundred African-American Washing-
ton, DC residents who reported smoking in the 6 months
preceding pregnancy were randomized to a CBT inter-
vention. Psycho-social and behavioral data were collected.
Self-reported smoking and salivary cotinine levels were
measured prenatally and postpartum to assess changes in
smoking behavior. Comparisons were made between active
smokers and those abstaining at baseline and follow-up in
pregnancy and postpartum. Sixty percent of participants
reported quitting spontaneously during pregnancy. In
regression models, smoking at baseline was associated with
older age,\a high school education and illicit drug use. At
follow-up closest to delivery, smoking was associated with
lower education, smoking and cotinine level at baseline
and depression. At postpartum, there was a relapse of 34%.
Smokers postpartum were significantly more likely to
smoke at baseline and use illicit drugs in pregnancy.
Mothers in the CBT intervention were less likely to
relapse. African-American women had a high spontaneous
quit rate and no response to a CBT intervention during
pregnancy. Postpartum mothers’ resolve to maintain a quit
status seems to wane despite their prolonged period of
cessation. CBT reduced postpartum relapse rates.
Keywords Smoking � Pregnancy � African-Americans �
Washington, DC
Introduction
Smoking during pregnancy is associated with problems of
placentation [1], low birthweight [2–8], prematurity [3, 9,
10], sudden infant death [10–12], infant mortality [12],
and later physical [13], developmental [13] and behav-
ioral [10, 14, 15] problems. A significant percentage of
smokers continue to smoke during pregnancy and are
unable to quit on their own despite their knowledge of the
risks involved. Existing behavioral interventions are only
modestly successful, having an attributable benefit of no
more than 10% above spontaneous quit rates among
pregnant women [16].
M. Nabil El-Khorazaty: Deceased.
Clinical trial registration: ClinicalTrials.gov, www.clinicaltrials.gov,
NCT00381823.
A. A. E. El-Mohandes
College of Public Health, University of Nebraska Medical
Center, Omaha, NE, USA
M. N. El-Khorazaty � M. G. Gantz
RTI International (RTI International is a trad.
Using Everett Rogers' Diffusion of Innovations Theory an intervention for automatic STI screening for adolescents is applied to primary care settings in Baltimore, Maryland.
International Journal of Humanities and Social Science Invention (IJHSSI)inventionjournals
International Journal of Humanities and Social Science Invention (IJHSSI) is an international journal intended for professionals and researchers in all fields of Humanities and Social Science. IJHSSI publishes research articles and reviews within the whole field Humanities and Social Science, new teaching methods, assessment, validation and the impact of new technologies and it will continue to provide information on the latest trends and developments in this ever-expanding subject. The publications of papers are selected through double peer reviewed to ensure originality, relevance, and readability. The articles published in our journal can be accessed online
This document provides a grant proposal for a program to address sexually transmitted infections (STIs) among students at The College at Brockport. It includes an epidemiological assessment noting high STI rates locally and among young people. Factors contributing to STIs include lack of condom use and testing. The program aims to increase condom use and testing by 10% through a theoretical framework of the Health Belief Model. It will provide STI education and resources in freshman residence halls and the student union.
This study evaluated the knowledge, attitudes and practices of 30 traditional birth attendants in Cameroon regarding danger signs in pregnancy and infection prevention. The average age of attendants was 49.6 years. Most had no formal education beyond primary school. While all attendants reported referring women in difficult deliveries, only 40% did so regularly. Common reasons for referral included convulsions, heavy bleeding, and large stomach size. Over 70% reported regularly washing hands, but few used other infection prevention measures consistently. The study found traditional birth attendants play an important role but could benefit from additional training to improve safety.
Healthcare seeking and sexual behaviour of clients attending the suntreso sti...Alexander Decker
A study of 185 clients with sexually transmitted infections (STIs) attending an STI clinic in Kumasi, Ghana found that 64% delayed seeking treatment for more than 4 weeks after symptoms appeared. 61% had previously sought treatment elsewhere before coming to the clinic. 80% had unprotected sex while symptomatic. The document discusses factors that influence healthcare seeking behaviors for STIs, including long wait times, stigma, lack of privacy, and attitudes of healthcare providers. It also examines sexual behaviors among STI patients, noting that most engage in unprotected sex during symptomatic periods. Understanding these healthcare seeking patterns and behaviors can help develop more effective STI prevention and control programs.
Awarenes of aids amongst hs students in bonaire with amended list of authorsAleksandar Dusic, MD, MSc
- The document discusses a study that assessed awareness of AIDS among high school students in Bonaire before and after a workshop on AIDS.
- Fifty-two students completed a survey before and after the workshop to test their knowledge of AIDS transmission and prevention.
- The results found that the students' knowledge of AIDS significantly increased after the workshop for several key questions regarding transmission and prevention. There was a decrease in the number of students reporting discomfort discussing AIDS with others after the workshop.
This document presents a final report on a multi-pronged public health intervention to raise HIV/AIDS awareness and encourage testing in Florida on World AIDS Day 2014. Three approaches were evaluated: 1) An art installation and candlelight vigil honoring those with HIV/AIDS. 2) A health fair with HIV/STD testing at a university in an African American neighborhood with high HIV rates. 3) A panel discussion and testing at a predominantly African American church in the same neighborhood. The goal was to increase awareness and testing among at-risk groups like African Americans in Florida, who have disproportionately high HIV rates. Evaluation methods included event attendance, media coverage, testing rates, and interviews. The results showed the events raised awareness and some
Development of a Color-Coded Bilingual Food Label for Low-Literacy Latino Car...Aida Md Saad
This study developed a color-coded bilingual food label for low-literacy Latino caretakers. Researchers conducted a needs assessment involving a survey of 150 low-income Latino caretakers and 3 focus groups to understand current food label use and barriers. They then developed a user-friendly food label (UFFL) based on this input. The UFFL included color coding, bilingual text, and a shaded Food Guide Pyramid. An evaluation with 8 participants found the UFFL was easy to understand. The methodology can help improve the nutrition education value of food labels for low-literacy audiences.
Condoms as a harm reduction approach in prisonsErin Bortel
Keeping High-Impact Prevention at the forefront of our attention will guide administrators and policy-makers implementing harm reduction strategies in incarcerated settings to End AIDS in NYS by 2020.
This study examined factors that influence pregnant women's decisions to get the seasonal influenza vaccine. The authors conducted a randomized controlled study with pregnant women in Atlanta, Georgia to test the effects of immunization history, exposure to vaccine messages, and sociodemographic characteristics. The key findings were:
1) Women who had received the influenza vaccine in the past 5 years were over twice as likely to intend to get vaccinated during their current pregnancy compared to those without prior vaccination.
2) Perceiving the influenza vaccine as highly effective (over 80% effective) increased women's intent to vaccinate by over 10 times compared to those who saw it as less effective. Similarly, perceiving high susceptibility to influenza during pregnancy increased
McMillan Worth The impact ofsocio-cultural context on young people's condom useKaren McMillan
This article discusses factors that influence young people's condom use in Tonga and Vanuatu based on interviews with 62 people aged 18-25. It finds a disconnect between positive attitudes towards condoms and low actual usage. Social and cultural influences play a strong role in condom decisions by shaping identity, norms, and traditions. Effective HIV prevention requires understanding these contextual factors rather than just focusing on individual knowledge and attitudes. Country-specific approaches are also needed given cultural differences between Pacific nations.
1) A study assessed the prevalence of diagnosed diabetes and diabetes mortality rate in a large Puerto Rican community in Chicago. 2) The prevalence of diabetes was found to be 20.8%, the highest reported for Puerto Ricans and twice as high as rates for Puerto Ricans in New York and Puerto Rico. 3) The diabetes mortality rate of 67.6 per 100,000 population was more than twice the rates for all of Chicago and the US.
This document provides updated guidelines from the World Health Organization (WHO) on the management of severe acute malnutrition in infants and children. It summarizes the evidence and recommendations on key interventions. The guideline was developed using the GRADE methodology and input from experts in nutrition and child health. It focuses on admission and discharge criteria, treatment settings, use of antibiotics, vitamin A supplementation, therapeutic feeding approaches, fluid management, treatment of HIV-infected children, and management of infants under 6 months. The recommendations are meant to inform revisions to WHO's 1999 manual on managing severe malnutrition and to guide clinical practice.
This presentation provides an overview of the role that policy advocacy has played in activating greater visibility for the female condom and increased procurement in the developing world. It highlights the important role that third-party partnerships play in mobilizing evidence of need and demand for health products in the developing world. The presentation identifies policy advocacy and social marketing as essential complements to a comprehensive marketing and promotion strategy.
Global Medical Cures™ | HIV Among Women
DISCLAIMER-
Global Medical Cures™ does not offer any medical advice, diagnosis, treatment or recommendations. Only your healthcare provider/physician can offer you information and recommendations for you to decide about your healthcare choices.
Richard Garfein, Ph.D., M.P.H., of UC San Diego Department of Medicine, presents "HIV, HCV, and TB Infection among Injection Drug Users in San Diego" at AIDS Clinical Rounds
Nutrition and Secondary Prevention: A public health projectdebbiewalkerr
Nutrition and Secondary Prevention: A public health project
University of Florida
Amarillys Alvarado-Sojo, Christie Champaign,
Kristin Miller, Debbie Walker, Chris Weiss
The FDA plans to prioritize improvements in the quality of demographic subgroup data collection, reporting and analysis, encourages greater participation of diverse patients, and supports the transparency of subgroup data. To this end, ways to recruit, engage, educate, and study those of diverse backgrounds to alopecia areata trials will be discussed.
This study used mixed quantitative and qualitative methods to assess the acceptability of tenofovir gel, an experimental vaginal microbicide, among women participating in an early phase clinical trial. While 94% of women stated they would likely use the gel based on quantitative surveys, qualitative group discussions revealed a more complex picture of acceptability, with factors like lubrication, leakage during sex, impact on pleasure, and potential for covert use emerging as important. The authors conclude that future microbicide trials should include strategic mixed-methods data collection to better understand acceptability from multiple perspectives.
This study assessed the acceptability of tenofovir gel as a potential vaginal microbicide among women participating in a phase I clinical trial through a mixed-methods approach. Quantitative data indicated that 94% of participants stated they would probably or definitely use the gel. However, qualitative group discussions revealed a more complex picture of acceptability, with women raising concerns about lubrication, leakage, effects on sexual pleasure, and the possibility of covert use. The authors conclude that while participants were generally accepting of the gel based on quantitative responses, qualitative findings show acceptability is shaped by multiple contextual factors important for product development and optimization of use. Future microbicide trials should include strategic mixed-methods acceptability assessments.
This study used mixed quantitative and qualitative methods to assess the acceptability of tenofovir gel, an experimental vaginal microbicide, among women participating in an early phase clinical trial. While 94% of women stated they would likely use the gel based on quantitative surveys, qualitative group discussions revealed a more complex picture of acceptability, with concerns around lubrication, leakage during sex, impact on pleasure, and potential for covert use. The authors conclude that future microbicide trials should include strategic mixed-methods data collection to better understand acceptability from multiple perspectives.
Smoking Cessation and Relapse Among PregnantAfrican-American.docxrosemariebrayshaw
Smoking Cessation and Relapse Among Pregnant
African-American Smokers in Washington, DC
Ayman A. E. El-Mohandes • M. Nabil El-Khorazaty •
Michele Kiely • Marie G. Gantz
Published online: 8 June 2011
� Springer Science+Business Media, LLC (outside the USA) 2011
Abstract Smoking is the single most preventable cause
of perinatal morbidity. This study examines smoking
behaviors during pregnancy in a high risk population of
African Americans. The study also examines risk factors
associated with smoking behaviors and cessation in
response to a cognitive behavioral therapy (CBT) inter-
vention. This study is a secondary analysis of data from a
randomized controlled trial addressing multiple risks dur-
ing pregnancy. Five hundred African-American Washing-
ton, DC residents who reported smoking in the 6 months
preceding pregnancy were randomized to a CBT inter-
vention. Psycho-social and behavioral data were collected.
Self-reported smoking and salivary cotinine levels were
measured prenatally and postpartum to assess changes in
smoking behavior. Comparisons were made between active
smokers and those abstaining at baseline and follow-up in
pregnancy and postpartum. Sixty percent of participants
reported quitting spontaneously during pregnancy. In
regression models, smoking at baseline was associated with
older age,\a high school education and illicit drug use. At
follow-up closest to delivery, smoking was associated with
lower education, smoking and cotinine level at baseline
and depression. At postpartum, there was a relapse of 34%.
Smokers postpartum were significantly more likely to
smoke at baseline and use illicit drugs in pregnancy.
Mothers in the CBT intervention were less likely to
relapse. African-American women had a high spontaneous
quit rate and no response to a CBT intervention during
pregnancy. Postpartum mothers’ resolve to maintain a quit
status seems to wane despite their prolonged period of
cessation. CBT reduced postpartum relapse rates.
Keywords Smoking � Pregnancy � African-Americans �
Washington, DC
Introduction
Smoking during pregnancy is associated with problems of
placentation [1], low birthweight [2–8], prematurity [3, 9,
10], sudden infant death [10–12], infant mortality [12],
and later physical [13], developmental [13] and behav-
ioral [10, 14, 15] problems. A significant percentage of
smokers continue to smoke during pregnancy and are
unable to quit on their own despite their knowledge of the
risks involved. Existing behavioral interventions are only
modestly successful, having an attributable benefit of no
more than 10% above spontaneous quit rates among
pregnant women [16].
M. Nabil El-Khorazaty: Deceased.
Clinical trial registration: ClinicalTrials.gov, www.clinicaltrials.gov,
NCT00381823.
A. A. E. El-Mohandes
College of Public Health, University of Nebraska Medical
Center, Omaha, NE, USA
M. N. El-Khorazaty � M. G. Gantz
RTI International (RTI International is a trad.
This document summarizes a study on the acceptability of tenofovir gel as a potential vaginal microbicide for preventing HIV transmission.
1) Quantitative data found that 94% of women said they would probably or definitely use the gel, indicating high acceptability. However, qualitative discussions revealed a more complex picture, with women having varying opinions on factors like lubrication and leakage.
2) While most women liked the gel's color, smell, and consistency, qualitative findings showed opinions varied on issues like the thickness and application process requiring privacy.
3) The study demonstrated the value of mixed quantitative and qualitative methods to provide a fuller understanding of microbicide acceptability, as qualitative data provided important contextual factors and
This study assessed the acceptability of tenofovir gel as a potential vaginal microbicide among women participants in a phase I clinical trial through a mixed-methods approach. Quantitative data found that 94% of participants stated they would probably or definitely use the gel. However, qualitative group discussions revealed a more complex picture of acceptability, with women expressing a range of views on factors like lubrication, leakage, and effects on sexual pleasure. The authors conclude that while most women found the gel acceptable according to the quantitative data, qualitative research provided important contextual factors around acceptability that manufacturers should consider to optimize future microbicide products. Using mixed methods to collect both types of acceptability data in clinical trials was deemed useful by the
This study assessed the acceptability of tenofovir gel as a potential vaginal microbicide among women participants in a phase I clinical trial through a mixed-methods approach. Quantitative data found that 94% of participants stated they would probably or definitely use the gel. However, qualitative group discussions revealed a more complex picture of acceptability, with women expressing a range of views on factors like lubrication, leakage, and effects on sexual pleasure. The authors conclude that while most women found the gel acceptable according to the quantitative data, qualitative research provided important contextual factors around acceptability that manufacturers should consider to optimize future microbicide products. Using mixed methods to collect both types of acceptability data in clinical trials was deemed useful.
This study used mixed-methods to assess acceptability of tenofovir gel as a potential vaginal microbicide for HIV prevention. Quantitative data from interviews found 94% of participants stated they would likely use the gel. However, qualitative group discussions revealed a more complex picture, with women expressing a range of opinions about factors like lubrication, leakage during sex, and effects on sexual pleasure. The authors conclude that while participants were generally open to using the gel, acceptability is shaped by individual contexts and experiences. They argue future microbicide trials should include strategic mixed-methods data collection to better understand acceptability.
The Impact of Genital Hygiene Practices on the Occurrence of Vaginal Infectio...iosrjce
IOSR Journal of Nursing and health Science is ambitious to disseminate information and experience in education, practice and investigation between medicine, nursing and all the sciences involved in health care.
Nursing & Health Sciences focuses on the international exchange of knowledge in nursing and health sciences. The journal publishes peer-reviewed papers on original research, education and clinical practice.
By encouraging scholars from around the world to share their knowledge and expertise, the journal aims to provide the reader with a deeper understanding of the lived experience of nursing and health sciences and the opportunity to enrich their own area of practice
HEALTH POLICY AND ETHICSFacilitating HIV DisclosureFac.docxpooleavelina
The document reviews literature on HIV status disclosure across diverse settings. Some key findings from the literature include:
- The majority of people disclosed their HIV status to someone, though disclosure rates varied from about 2/3 to 3/4 of respondents. Disclosure was generally higher in high-income countries.
- Gender shaped disclosure motivations and reactions, with women more likely to disclose to other women like mothers and sisters. Disclosure rates to partners varied between studies and by gender.
- Involuntary disclosure and low levels of disclosure to partners highlight the difficulties faced by health workers in facilitating disclosure while protecting privacy.
- Stigmatization increased fears of disclosure. The meaning and process of disclosure differed across settings.
The document summarizes a report on a project conducted by the International HIV/AIDS Alliance to address the feminization of HIV/AIDS in India. The project worked with 16 partner organizations across 5 Indian states to empower vulnerable women through community-driven approaches. Activities included forming support groups, conducting trainings and workshops, and raising awareness of HIV/AIDS, sexual and reproductive health, and legal rights. An evaluation found that the project increased women's knowledge, access to services, and the capacity of partner organizations to address the issue in a sustainable manner through community participation.
The document summarizes a study examining HIV stigma among opioid-dependent individuals under community supervision. It describes high HIV rates in Washington D.C. and the criminal justice system. The study used a stigma scale to assess stigma in 16 participants. Females and homosexuals reported higher levels of stigma than males and heterosexuals, particularly around disclosure concerns. The study aims to reduce stigma and HIV risk through counseling in Project STRIDE, which provides medication-assisted treatment for opioid dependence and HIV.
1) The study examined factors related to contraceptive use among Latina women in Los Angeles, including cultural expectations, attitudes, and perceived barriers.
2) Surveys were administered to 291 Latina women ages 15-50 at four clinics, in English or Spanish, to assess contraceptive use practices and perceptions of various social and cultural influences.
3) Key factors examined included cultural norms about the value of motherhood, perceived reliability and side effects of contraceptives, embarrassment about obtaining or discussing contraceptives, and perceived barriers to use. Understanding these factors could provide insight into the high birth rate among Latinas in the United States.
1) The document discusses gaps in post-sexual assault healthcare among homeless young adults. It reports on a study of 1,405 young adults aged 18-26 across 7 US cities.
2) The study found high rates of sexual assault (22%) and forced sex (24%) among participants. However, only 29% of those forced to have sex received post-assault medical care.
3) Latinx young adults were more likely than other groups to receive post-assault care. Participants frequently did not seek care because they did not want to involve the legal system and did not think it was important.
This document summarizes a study examining non-adherence to contraceptive vaginal ring (CVR) use among women in Kisumu, Kenya from 2014-2015. Non-adherence was assessed through self-report, pharmacy records, and residual hormone levels in returned rings. Non-adherence was 14.0% by self-report and 54.5% by pharmacy records. Women with salary-based income had lower non-adherence. Participants dissatisfied with 4 or more aspects of the ring were more likely to report non-adherence. Over time, residual hormone levels showed increasing non-adherence in 46.5% of participants. Economic empowerment and education on CVR features may help reduce non
This document summarizes a study examining non-adherence to contraceptive vaginal ring (CVR) use among women in Kisumu, Kenya from 2014-2015. Non-adherence was assessed through self-report, pharmacy records, and residual hormone levels in returned rings. Non-adherence was 14.0% by self-report and 54.5% by pharmacy records. Women with salary-based income had lower non-adherence. Participants dissatisfied with 4 or more aspects of the ring were more likely to report non-adherence. Over time, residual hormone levels showed increasing non-adherence in 46.5% of participants. Economic empowerment and education on CVR features may help reduce non
EXPLORING U.S. MINORITY ATTITUDES TOWARDS CLINICAL TRIALSCOUCH Health
Patient diversity is still a huge issue in clinical trials. And like us, you might be wondering why this is still an ongoing challenge, and how can it be improved?
This report summarises research from ethnic minority groups in the US to find the answers to those very questions.
RESEARCH ARTICLEWill Combined Prevention Eliminate Racia.docxronak56
RESEARCH ARTICLE
Will "Combined Prevention" Eliminate Racial/
Ethnic Disparities in HIV Infection among
Persons Who Inject Drugs in New York City?
Don Des Jarlais1*, Kamyar Arasteh1, Courtney McKnight1, Jonathan Feelemyer1,
Holly Hagan2, Hannah Cooper3, Aimee Campbell4, Susan Tross4, David Perlman1
1 The Baron Edmond de Rothschild Chemical Dependency Institute, Mount Sinai Beth Israel, New York,
New York, United States of America, 2 College of Nursing, New York University, New York, New York,
United States of America, 3 Rollins School of Public Health at Emory University, Atlanta, Georgia, United
States of America, 4 Department of Psychiatry, Columbia University, New York, New York, United States of
America
* [email protected]
Abstract
It has not been determined whether implementation of combined prevention programming
for persons who inject drugs reduce racial/ethnic disparities in HIV infection. We examine
racial/ethnic disparities in New York City among persons who inject drugs after implementa-
tion of the New York City Condom Social Marketing Program in 2007. Quantitative inter-
views and HIV testing were conducted among persons who inject drugs entering Mount
Sinai Beth Israel drug treatment (2007–2014). 703 persons who inject drugs who began in-
jecting after implementation of large-scale syringe exchange were included in the analyses.
Factors independently associated with being HIV seropositive were identified and a pub-
lished model was used to estimate HIV infections due to sexual transmission. Overall HIV
prevalence was 4%; Whites 1%, African-Americans 17%, and Hispanics 4%. Adjusted
odds ratios were 21.0 (95% CI 5.7, 77.5) for African-Americans to Whites and 4.5 (95% CI
1.3, 16.3) for Hispanics to Whites. There was an overall significant trend towards reduced
HIV prevalence over time (adjusted odd ratio = 0.7 per year, 95% confidence interval (0.6–
0.8). An estimated 75% or more of the HIV infections were due to sexual transmission. Ra-
cial/ethnic disparities among persons who inject drugs were not significantly different from
previous disparities. Reducing these persistent disparities may require new interventions
(treatment as prevention, pre-exposure prophylaxis) for all racial/ethnic groups.
Introduction
Significant racial/ethnic disparities in HIV infection among persons who inject drugs (PWID)
have been observed in many countries, with ethnic minority group members [1] and females
[2] typically having higher HIV prevalence. There are effective interventions to reduce HIV
transmission among PWID, and the logic of “combined” prevention programming is that
PLOS ONE | DOI:10.1371/journal.pone.0126180 May 12, 2015 1 / 11
OPEN ACCESS
Citation: Des Jarlais D, Arasteh K, McKnight C,
Feelemyer J, Hagan H, Cooper H, et al. (2015) Will
"Combined Prevention" Eliminate Racial/Ethnic
Disparities in HIV Infection among Persons Who
Inject Drugs in New York City? PLoS ONE 10(5):
e0126180. doi:10.1371/journal.pone.0126 ...
This document summarizes qualitative formative research using focus groups and interviews with African American girls ages 11-18 and their mothers to inform the development of a social marketing campaign to promote HPV vaccination among those who are undecided. Key findings were that the HPV vaccine should be presented as a routine cancer prevention vaccine. Two subgroups of the undecided were identified that would require different messaging - those ready if offered basic info, and those needing more extensive safety info. Campaigns should target both girls and boys and tailor messaging for pre-teens vs teens. Findings will help normalize HPV vaccine perception and design culturally appropriate interventions.
Technical brief decision making for condom use and hiv testing among fisherf...Jane Alaii
A research brief assessing motivators and decision-making factors among fisherfolk who take up condom use and HIV testing services in a selected hot spot in Uganda.
This document provides an overview of various techniques used in biotechnology and molecular biology to study DNA, including X-ray crystallography, chromatography, electrophoresis, ultracentrifugation, UV spectroscopy, restriction enzymes, DNA cloning, sequencing, probes, Southern blotting, and polymerase chain reaction. These techniques have contributed to understanding the structure of DNA and sequencing the human genome, enabling research on genetic diseases.
Radiopharmacy involves the compounding and dispensing of radioactive materials for use in nuclear medicine procedures. Radiopharmaceuticals are radioactive drugs used for diagnostic or therapeutic purposes. They consist of radioactive isotopes attached to other molecules to allow for localization within the body. Radiopharmaceuticals are prepared following stringent quality control procedures to ensure safety, purity and sterility prior to administration. Effective shielding is also required to protect personnel from radiation exposure during preparation and handling.
The document provides an outline for lectures on pharmaceutical dosage form processing. It will cover general introduction to manufacturing processes, formulation assessment, analytical method development, formulation development, good manufacturing practices, and drug product stability. Key aspects of preformulation are also summarized, including characterizing organoleptic properties, purity, particle size and shape, solubilization using surfactants, and preformulation stability studies. Manufacturing processes involve transforming raw materials into finished products through various treatment, machining, and reshaping steps while ensuring quality.
Colloids have many important applications in pharmaceuticals, food, and industry. Pharmaceutical applications include using colloids for drug delivery and therapy, as well as coating tablets for protection and controlled release. Colloids are also important in food products like milk, butter, and ice cream. Industrial uses involve non-drip paints, sewage treatment, clarifying water, and in artificial kidney machines.
This document discusses polymers and their applications in drug delivery. It begins by defining polymers as large molecules composed of repeating monomer units. The document then covers different types of polymers based on their structure and properties, including thermoplastics, thermosets, and elastomers. It also addresses various polymerization methods and classifications. The document discusses mechanisms of drug release from polymers, including diffusion, degradation, and swelling. It provides examples of controlled drug delivery applications using polymers, such as transdermal patches, implants, and biodegradable systems. In closing, it emphasizes the benefits of biodegradable polymers for localized, sustained drug delivery with reduced side effects.
This document discusses different types and design considerations for sedimentation processes used in water and wastewater treatment to remove solids via gravity settling. It describes four types of settling (discrete, flocculent, zone, and compression) and compares design parameters for discrete and flocculent settling. The document outlines batch settling tests and analyses, including determining zone settling velocity and its relationship to solids concentration. It provides details on designing zone settling tanks, including mass balances and limiting flux analyses to size tanks and select operating parameters like underflow rate.
Lyophilization, also known as freeze drying, is a process used to remove water from materials while preserving their structure. It involves freezing the material and then reducing pressure to allow the frozen water to sublimate from the solid to gas phase. The process is carried out below the triple point of water to enable sublimation of ice. Freeze drying has applications in the food and pharmaceutical industries as it can preserve thermolabile compounds and materials by removing water while retaining quality.
This document provides an overview of heat transfer and related topics. It discusses the three methods of heat transfer: convection, conduction, and radiation. It also covers factors that affect heat transfer like temperature and thermal resistance. The document outlines course contents on heat transfer equipment, fired process equipment, and combustion of fuels. It provides details on topics like heat exchangers, boilers, burners, and methods of heat exchange.
Extraction theory involves removing soluble materials from insolids using liquid solvents. Liquid-liquid extraction is a useful method to separate components of a mixture based on differences in solubility between solvents. For example, sugar can be extracted from vegetable oil by shaking the mixture with water, as sugar is more soluble in water than oil. The partition coefficient K quantifies differences in solubility, with some compounds made more water-soluble by conversion to ionic salt forms using acid or base treatment. This allows separation of organic acid/base mixtures based on differing solubility properties.
This document discusses various processes by which water changes phase from liquid to gas, including evaporation, transpiration, and sublimation. It provides details on the factors that control evaporation rates, such as energy inputs, temperature, humidity, wind, and water availability. It explains the differences between potential evapotranspiration (PET) and actual evapotranspiration (AET). Transpiration from plants and how it is affected by various environmental factors is also covered. Common methods for measuring and estimating evaporation and evapotranspiration are presented.
Distillation is a process used to separate mixtures based on differences in their boiling points. It involves heating the mixture until it vaporizes, then cooling the vapors until they condense. There are several types of distillation processes. Simple distillation is used to purify liquids. Fractional distillation separates mixtures with components of different boiling points. Steam distillation is used for mixtures containing water. Vacuum distillation allows distillation of substances that decompose at their normal boiling points. Destructive distillation involves decomposition during heating.
This document provides an overview of crystallization as a separation and purification technique. It discusses key concepts such as crystallization, nucleation, crystal growth, and factors that affect crystallization. Specifically, it describes three steps of crystallization from solution: induction of supersaturation through methods like cooling, solvent evaporation, or adiabatic evaporation; nucleation through Miers' theory; and crystal growth which depends on concentration, temperature, and velocity gradients. It also discusses methods of controlling crystal size and factors that influence the crystallization process like temperature, impurities, and agitation.
This document discusses coagulation and flocculation processes. It defines key terms like coagulation and flocculation. It also poses questions to prompt a detailed explanation of the processes, examples of their applications, and potential topics for group discussion including further explaining the processes with examples and applications.
This document discusses the importance and process of mixing in pharmaceutical manufacturing. It makes several key points:
1) Mixing is required in most pharmaceutical products to ensure uniform distribution of active ingredients and proper functioning of the dosage form.
2) The type of mixing needed (positive, negative, neutral) depends on the product components and how they interact.
3) Achieving a perfectly mixed state is impossible, so the goal is a random mixture with minimal variation between doses.
4) Both the number of particles in a dose and the proportion of active ingredient impact mixing quality and uniformity. More of each improves consistency.
This document provides an overview of filtration theory and processes. It defines filtration as the removal of solids suspended in a liquid by passing the liquid through a porous medium that retains the solids. Various filter types and operating mechanisms are described, including depth filtration, cake filtration, and clarification. Key factors that affect filtration rates such as pressure, viscosity, permeability, and particle size are also discussed. Dimensionless parameters important to modeling filtration like the Reynolds number are introduced.
This document provides an overview of drying in the pharmaceutical industry. It discusses the importance of drying as the last stage of manufacturing before packaging. The key types of drying covered are convective, conductive, and radiative drying. Convective drying can be static bed or dynamic fluidized bed. Conductive drying uses vacuum ovens or tumblers. Radiative drying includes infrared and microwave radiation. Factors that influence drying like moisture content, bound vs unbound water, and equilibrium moisture content are also explained.
This document discusses size reduction and comminution. It outlines the objectives of size reduction such as improving flow properties and increasing surface area. It examines how material properties like brittleness, toughness, and hardness influence size reduction. Different size reduction methods are described, including cutting, compression, impact, attrition, and combined impact/attrition. Specific equipment like ball mills, hammer mills, and fluidized mills are discussed in terms of how they achieve size reduction through impacts and attrition. Factors that influence particle size distribution changes during milling are also covered.
Adsorption is the adhesion of atoms, ions or molecules from a gas, liquid or dissolved solid onto a surface. There are two types of adsorption - physical adsorption, which involves relatively weak van der Waals forces, and chemisorption, which involves stronger chemical bonding. Physical adsorption is rapid, reversible and allows for multilayers, while chemisorption is specific, may require activation energy, and allows only for monolayers. Factors like solute concentration, temperature, pH, and surface area affect adsorption from solutions. Pharmaceutical applications of adsorption include chromatography, removal of toxins, taste masking, and haemoperfusion. Adsorption can also cause issues like loss of pot
This document provides an overview of rheology concepts including:
1. It defines rheology as the science concerned with the deformation of matter under stress.
2. It describes Newtonian and non-Newtonian fluids, explaining that Newtonian fluids have a constant viscosity while non-Newtonian fluids have variable viscosity.
3. It discusses the different types of non-Newtonian flow - plastic, pseudoplastic, and dilatant - and provides examples of materials that exhibit each type of flow.
This document discusses polymers and their applications in drug delivery. It begins with an introduction to polymers, including their classification and molecular structure. It then covers general mechanisms of drug release from polymers, including diffusion, degradation and swelling. Applications of polymers in conventional dosage forms and controlled drug delivery are presented. The document also discusses biodegradable polymers and natural polymers. It provides details on the classification, characteristics and selection of polymers for drug delivery.
More from University of Zambia, School of Pharmacy, Lusaka, Zambia (20)
The best massage spa Ajman is Chandrima Spa Ajman, which was founded in 2023 and is exclusively for men 24 hours a day. As of right now, our parent firm has been providing massage services to over 50,000+ clients in Ajman for the past 10 years. It has about 8+ branches. This demonstrates that Chandrima Spa Ajman is among the most reasonably priced spas in Ajman and the ideal place to unwind and rejuvenate. We provide a wide range of Spa massage treatments, including Indian, Pakistani, Kerala, Malayali, and body-to-body massages. Numerous massage techniques are available, including deep tissue, Swedish, Thai, Russian, and hot stone massages. Our massage therapists produce genuinely unique treatments that generate a revitalized sense of inner serenely by fusing modern techniques, the cleanest natural substances, and traditional holistic therapists.
Comprehensive Rainy Season Advisory: Safety and Preparedness Tips.pdfDr Rachana Gujar
The "Comprehensive Rainy Season Advisory: Safety and Preparedness Tips" offers essential guidance for navigating rainy weather conditions. It covers strategies for staying safe during storms, flood prevention measures, and advice on preparing for inclement weather. This advisory aims to ensure individuals are equipped with the knowledge and resources to handle the challenges of the rainy season effectively, emphasizing safety, preparedness, and resilience.
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Michigan HealthTech Market Map 2024. Includes 7 categories: Policy Makers, Academic Innovation Centers, Digital Health Providers, Healthcare Providers, Payers / Insurance, Device Companies, Life Science Companies, Innovation Accelerators. Developed by the Michigan-Israel Business Accelerator
Gemma Wean- Nutritional solution for Artemiasmuskaan0008
GEMMA Wean is a high end larval co-feeding and weaning diet aimed at Artemia optimisation and is fortified with a high level of proteins and phospholipids. GEMMA Wean provides the early weaned juveniles with dedicated fish nutrition and is an ideal follow on from GEMMA Micro or Artemia.
GEMMA Wean has an optimised nutritional balance and physical quality so that it flows more freely and spreads readily on the water surface. The balance of phospholipid classes to- gether with the production technology based on a low temperature extrusion process improve the physical aspect of the pellets while still retaining the high phospholipid content.
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DECODING THE RISKS - ALCOHOL, TOBACCO & DRUGS.pdfDr Rachana Gujar
Introduction: Substance use education is crucial due to its prevalence and societal impact.
Alcohol Use: Immediate and long-term risks include impaired judgment, health issues, and social consequences.
Tobacco Use: Immediate effects include increased heart rate, while long-term risks encompass cancer and heart disease.
Drug Use: Risks vary depending on the drug type, including health and psychological implications.
Prevention Strategies: Education, healthy coping mechanisms, community support, and policies are vital in preventing substance use.
Harm Reduction Strategies: Safe use practices, medication-assisted treatment, and naloxone availability aim to reduce harm.
Seeking Help for Addiction: Recognizing signs, available treatments, support systems, and resources are essential for recovery.
Personal Stories: Real stories of recovery emphasize hope and resilience.
Interactive Q&A: Engage the audience and encourage discussion.
Conclusion: Recap key points and emphasize the importance of awareness, prevention, and seeking help.
Resources: Provide contact information and links for further support.
TEST BANK For Accounting Information Systems, 3rd Edition by Vernon Richardso...rightmanforbloodline
TEST BANK For Accounting Information Systems, 3rd Edition by Vernon Richardson, Verified Chapters 1 - 18, Complete Newest Version
TEST BANK For Accounting Information Systems, 3rd Edition by Vernon Richardson, Verified Chapters 1 - 18, Complete Newest Version
TEST BANK For Accounting Information Systems, 3rd Edition by Vernon Richardson, Verified Chapters 1 - 18, Complete Newest Version
Exploring the Benefits of Binaural Hearing: Why Two Hearing Aids Are Better T...Ear Solutions (ESPL)
Binaural hearing using two hearing aids instead of one offers numerous advantages, including improved sound localization, enhanced sound quality, better speech understanding in noise, reduced listening effort, and greater overall satisfaction. By leveraging the brain’s natural ability to process sound from both ears, binaural hearing aids provide a more balanced, clear, and comfortable hearing experience. If you or a loved one is considering hearing aids, consult with a hearing care professional at Ear Solutions hearing aid clinic in Mumbai to explore the benefits of binaural hearing and determine the best solution for your hearing needs. Embracing binaural hearing can lead to a richer, more engaging auditory experience and significantly improve your quality of life.
R3 Stem Cell Therapy: A New Hope for Women with Ovarian FailureR3 Stem Cell
Discover the groundbreaking advancements in stem cell therapy by R3 Stem Cell, offering new hope for women with ovarian failure. This innovative treatment aims to restore ovarian function, improve fertility, and enhance overall well-being, revolutionizing reproductive health for women worldwide.
Healthy Eating Habits:
Understanding Nutrition Labels: Teaches how to read and interpret food labels, focusing on serving sizes, calorie intake, and nutrients to limit or include.
Tips for Healthy Eating: Offers practical advice such as incorporating a variety of foods, practicing moderation, staying hydrated, and eating mindfully.
Benefits of Regular Exercise:
Physical Benefits: Discusses how exercise aids in weight management, muscle and bone health, cardiovascular health, and flexibility.
Mental Benefits: Explains the psychological advantages, including stress reduction, improved mood, and better sleep.
Tips for Staying Active:
Encourages consistency, variety in exercises, setting realistic goals, and finding enjoyable activities to maintain motivation.
Maintaining a Balanced Lifestyle:
Integrating Nutrition and Exercise: Suggests meal planning and incorporating physical activity into daily routines.
Monitoring Progress: Recommends tracking food intake and exercise, regular health check-ups, and provides tips for achieving balance, such as getting sufficient sleep, managing stress, and staying socially active.
2. fected by social and cultural norms.10,11 Vaginal practices,
such as cleansing the vagina and genital area with commer-
cial and noncommercial products, wiping inside the vagina,
or inserting substances inside the vagina, are commonly em-
ployed by women.10,12,13 Reasons for vaginal practices in-
clude hygiene (removing menstrual blood, vaginal dis-
charge, and odors), sexual pleasure, pregnancy prevention,
fertility, and prevention and treatment of vaginal infec-
tions.10 Vaginal practice norms have been found to be linked
to ideas about sexuality and the body, gender roles, age, ed-
ucation, geographic area, ethnicity, marital status, and ritu-
als.10 For example, douching (intravaginal cleansing with a
liquid solution) is a common practice among African Amer-
ican women in the United States.14,15 Other vaginal practices,
including type of protection used during menstruation16 and
insertion of vaginal products,17 also vary geographically and
cross-culturally.
Knowledge about women’s decision making and man-
agement of their health is relevant to understanding how to
develop healthcare products that effectively promote health-
ier practices.18,19 Medical pluralism among American
women is common.20,21 The use of complementary and al-
ternative medicine (CAM), referring to practices and prod-
ucts not usually prescribed by doctors or taught in medical
schools,22 has been documented among African-American
women.23–29 Educational level, age, personal beliefs, and so-
cial factors, such as family members and the media, influ-
ence choice of treatments by African American women.30,31
It is not known if these factors also predict vaginal practices.
Research is needed on attitudes toward and use of a range
of vaginal practices in the context of pluralistic healthcare
and cultural influences.
This paper describes vaginal practices and preferences
among black women in New York City, explores how choices
in vaginal care may relate to an overall approach to health,
and examines the implications for microbicide acceptability.
Materials and Methods
Data were collected as part of a follow-up study to a cross-
sectional telephone survey of women aged Ն18 living in the
United States. The survey was conducted in 2001 to provide
nationally representative data on women’s use of CAM dur-
ing the past year20 as well as estimates of use among women
in four racial/ethnic groups: white, African American, Mex-
ican American, and Chinese American.23 In 2004, follow-up
data were collected to examine culture-related beliefs and
sensitive topics. A new sample was recruited by the survey
research firm that conducted the original telephone survey.
Participants completed the same telephone interview used
in the national study23 and were interviewed in person. The
study was approved by Columbia University Medical Cen-
ter’s Institutional Review Board.
Households were telephoned using random digit dialing
within geographic areas of New York City known to have a
high proportion of African Americans. Respondents were
screened for gender (female), age (Ͼ18), ethnicity/race (self-
identification as African American or black), and CAM use.
CAM users were overrecruited for the follow-up study. Of
those who qualified, 36% refused to participate; the final
sample consisted of 23 women, 16 CAM users and 7
nonusers.
In-person interviews were conducted by a trained African
American female interviewer. The interviewer and respon-
dents were matched for gender and ethnicity in order to fa-
cilitate cooperation and maximize communication and un-
derstanding. The interviews lasted between 1 and 2 hours
and took place in respondents’ homes or public spaces, and
those who participated received compensation. The inter-
views were audiotaped and transcribed.
A semistructured questionnaire was used to elicit experi-
ences and opinions relevant to healthcare practices and treat-
ment choices, focusing on the use of CAM and feminine
hygiene practices. The interview included open-ended ques-
tions and probes to explore the decision-making processes
involved in healthcare choices and to identify and under-
stand the factors affecting these choices. For example, ques-
tions about treatment, such as, What were the main reasons
you chose to use that treatment? were followed by probes
about how treatments were used and how they were com-
bined with other health practices. Questions about vaginal
practices focused on the use and reasons for use of products,
including commercial and home-made, synthetic and nat-
ural, and methods of application, such as douches and
creams. Additionally, open-ended questions were asked
about ethnic identity and cultural background (e.g., How
would you define your own culture? What ethnicity do you
identify with?) and use of remedies or practices associated
with the respondents’ cultural background and upbringing.
Following the interview, participants completed a self-ad-
ministered questionnaire about specific practices relating to
feminine hygiene, contraception, treatment of vaginal infec-
tions, and use of a variety of vaginal products.
Willingness to use vaginal products was measured using
a 4-point scale (1, very unwilling; 2, somewhat unwilling; 3,
somewhat willing; 4, very willing), in response to the five
following questions: Would you be willing to use a product
in the vagina for any of the following reasons: (1) to reduce
the chance of getting pregnant, (2) to reduce the chance of
getting an infection;, (3) to reduce the chance of getting HIV
or AIDS, (4) to make sex more pleasurable, (5) to treat a
health problem or infection? The five items concerning will-
ingness to use a vaginal product were combined to form a
willingness scale (standardized Cronbach’s alpha reliability
of 0.74).
CAM users were defined as those who used at least one
of the following CAM domains for a health problem in the
past year: vitamins and nutritional supplements, a special
diet (such as whole foods, macrobiotic or other vegetarian
diet), medicinal herbs or teas, remedies or practices associ-
ated with a particular culture (e.g., Chinese healing,
Ayurveda, Native American healing, Curanderismo), home-
opathic remedies, yoga/meditation/tai chi, manual thera-
pies (such as massage or acupressure), energy therapies
(such as Reiki or therapeutic touch), or any other remedy or
treatment not typically prescribed by a medical doctor. Use
of prayer for health reasons was assessed but not included
as a CAM domain, consistent with inclusion criteria used in
previous research.23,24
This report uses quantitative and qualitative analytical
methods. Quantitative analyses (using SPSS for Windows
15.0, Chicago, IL) focus on vaginal practices used by the
women in the sample; willingness to use vaginal products;
and relationships between past practices and willingness to
REIFF ET AL.1346
3. use a vaginal product for HIV/AIDS prevention. Statistically
significant differences were tested using analysis of variance
(ANOVA). Because of small sample size, estimates and as-
sociations were not expected to be stable or generalizable to
a larger population but do provide an overview of the prac-
tices and preferences of the women in the sample. The open-
ended responses were analyzed using Atlas-ti, a qualitative
software program,32 to explore the reasoning underlying the
respondents’ choices and preferences regarding their vagi-
nal practices. Relevant domains in the transcripts were iden-
tified, coded, and thematically organized. Themes explored
included attitudes toward using vaginal products, reasons
underlying these attitudes; and approaches to healthcare in
general.
Results
Characteristics of the sample
Respondents were women between the ages of 25 and 64,
the majority (70%, n ϭ 16) over the age of 45. Most respon-
dents (85%, n ϭ 15) had completed at least 2 years of college.
Most women were born in the United States (78%, n ϭ 18).
Other birthplaces were St. Vincent (2), Haiti (1), Jamaica (1),
and Belize (1). Self-reported cultural backgrounds included
Southern black (8), African American (4), Caribbean (6), Be-
lizean (1), Haitian (1), mixed African American and Ameri-
can Indian (2), mixed African American and Caribbean (1).
Willingness to use vaginal products
Table 1 shows the mean scores for willingness to use a hy-
pothetical vaginal product for various reasons (prevention
of pregnancy, prevention of infection or HIV, pleasure, and
treatment), by education, age, and CAM use. Women were
more willing to use a vaginal product to reduce the chance
of getting HIV or AIDS than for other reasons (e.g., to re-
duce risk of pregnancy and make sex more pleasurable).
Women with more than 2 years of college education were
more willing to use a vaginal product to reduce the chance
of getting HIV/AIDS than were those with less education.
Age did not affect willingness to use a microbicide, but re-
sults should be interpreted with caution because of the small
number of women (n ϭ 7) in the younger age group (18–44).
Vaginal practices
Table 2 shows the vaginal practices and products used in
the past by women in the sample. More than 90% of the sam-
ple (91%, n ϭ 21) used a douche in their lifetime. Open-
ended responses indicated that almost all douches (home-
made and store-bought) consisted of vinegar and water.
Douching was reported by 94% (n ϭ 15) of CAM users and
86% (n ϭ 6) of nonusers of CAM (results not shown).
Regardless of women’s past use of general vaginal prod-
ucts, women indicated a high degree of willingness to use a
hypothetical vaginal product to prevent HIV/AIDS. Women
who had not used birth control methods had slightly lower
willingness scores, and this was statistically significant for
condom use (Table 2).
Reasons for vaginal practices
The most common reason for using vaginal practices other
than birth control methods was “cleanliness.” This was true
for douching (n ϭ 17) and for other practices (n ϭ 12). Other
reasons were discharge (n ϭ 8), odor (n ϭ 9), bloody spot-
ting (n ϭ 5), itching/irritation (n ϭ 4), and pain (n ϭ 1).
Douching was also used as a birth control method (n ϭ 3).
The mean willingness score for using a hypothetical vaginal
product for HIV prevention was consistently high for
women regardless of the reasons for use of a vaginal prac-
tice. Attitudes and knowledge underlying women’s reasons
for employing vaginal practices were explored in depth us-
ing the qualitative data. Findings were organized into three
major themes, which overlap and inform each other: atti-
tudes toward natural and synthetic products, issues of safety
and efficacy, and the consistency of vaginal practices with
general approaches to healthcare, such as CAM use.
VAGINAL MICROBICIDE ACCEPTABILITY 1347
TABLE 1. WILLINGNESS TO USE VAGINAL PRODUCT, BY EDUCATION, AGE, AND CAM USE
Willingness to use vaginal product to
reduce reduce
chance of chance of reduce chance make sex treat health
getting getting an of getting HIV more problem or Willingness
pregnant infection or AIDS pleasurable infection scale mean
Mean (na) 2.68 (19) 3.55 (22) 3.73 (22) 3.45 (20) 3.59 (22) 3.39 (22)
Education
8th grade–some 2.75 (4) 3.14 (7) 3.14 (7) 3.20 (5) 3.57 (7) 3.13 (7)
college (n ϭ 8)
Ն2-year college (n ϭ 15) 2.67 (15) 3.73 (15) 4.00 (15)* 3.53 (15) 3.60 (15) 3.51 (15)
Age
25–44 (n ϭ 7) 2.29 (7) 3.57 (7) 4.00 (7) 3.29 (7) 3.14 (7) 3.26 (7)
45–64 (n ϭ 16) 2.92 (12) 3.53 (15) 3.60 (15) 3.54 (13) 3.80 (15) 3.45 (15)
CAM use
Nonuser (n ϭ 7) 2.40 (5) 3.50 (6) 3.50 (6) 3.60 (5) 3.50 (6) 3.17 (6)
CAM user (n ϭ 16) 2.79 (14) 3.56 (16) 3.81 (16) 3.40 (15) 3.63 (16) 3.47 (16)
an, reported for the number of responses to each item.
*p Ͻ 0.05 (ANOVA).
4. Attitudes toward natural and synthetic vaginal products.
The open-ended interviews explored respondents’ concepts
of naturalness and their attitudes toward using natural and
synthetic vaginal products. In defining what “natural” meant
to them, respondents referred to products that originate from
nature, and that were used by former generations, for ex-
ample:
Real, not synthetic; something that is organically
based that I don’t require a prescription for.
No chemicals, and things that come from the earth.
Home grown . . . Mother nature.
Noninvasive and less side effects.
Herbal rather than chemical.
Using things from the earth that our grandparents
used.
Respondents were asked about their propensity to use nat-
ural and synthetic vaginal products, and to explain the rea-
sons for their preferences. Of 21 available responses, 14
(66.7%) reported that they preferred to use natural rather
than synthetic vaginal products, 2 respondents reported a
preference for synthetic products, 3 preferred to use both
natural and synthetic, and 2 preferred neither (i.e., using
nothing). It is worth noting that of 5 Caribbean-born women,
4 preferred natural, and 1 preferred to combine both natural
and synthetic vaginal products. Enduring cultural influence
is illustrated by the use of steam from boiled leaves for post-
partum healing reported by 2 women, both with Haitian
backgrounds (1 born in Haiti, the other born in the United
States, with a Haitian grandmother), who were Ͻ45 years of
age and had at least 2 years of college education. They de-
scribed the practice as follows:
Well, after I had my son, there is something that we use
to heal inside after you’ve had a baby, stitches, after
you’ve had all that done, it’s sort of like a cleansing and
a healing. For healing especially if you are having epi-
siotomy . . . a soothing feeling because you’re very un-
comfortable after the childbirth. I feel like the doctors
don’t give you anything really because when I came
home from the doctor they didn’t give me anything for
that. And I was like I know I have to go to the bathroom
but it really, really hurts. So that was very helpful.
There is something you use after you have a baby to
clean out your system; you use a leaf. You boil the leaves
and put it in a bucket and you sit over the bucket and
let the hot steam just go right inside of you.
Reasons reported for preferring natural products included
perceived safety (less risk of side effects), low cost, and ef-
fectiveness. Reasons for preferring synthetic products in-
cluded perceived safety (tested or prescribed or both), ef-
fectiveness, tendency to be fast acting, and lack of knowledge
about natural products for vaginal use.
Safety and efficacy. Safety and, to some extent, efficacy
were the predominant reasons cited by women for their
choices in vaginal healthcare regardless of whether respon-
REIFF ET AL.1348
TABLE 2. VAGINAL PRACTICES AND WILLINGNESS TO USE VAGINAL PRODUCT TO PREVENT HIV/AIDS
Willingness to use vaginal product to
reduce chances of getting HIV/AIDSa
Used product
Mean (n)
% (n) Product users Product nonusers
General products (past year)
Talcum powder 17.4 (4) 3.25 (4) 3.83 (18)
Towelettes/wipes 65.2 (15) 3.60 (15) 4.00 (7)
Feminine spray 26.1 (6) 4.00 (6) 3.63 (16)
Vaginal suppositories 13.0 (3) 4.00 (3) 3.68 (19)
Douche
Douche (past year) 68.4 (13) 4.00 (12) 4.00 (6)
Douche (lifetime use) 91.3 (21) 3.70 (20) 4.00 (2)
Birth control method (lifetime use)
Condom 65.2 (15) 4.00 (15) 3.14 (7)*
Diaphragm 30.4 (7) 4.00 (7) 3.60 (15)
Sponge 33.3 (3) 4.00 (3) 3.68 (19)
Spermicide 44.4 (6) 4.00 (6) 3.63 (16)
Douche 13.0 (3) 4.00 (3) 3.68 (19)
Birth control pills 56.5 (13) 4.00 (13) 3.33 (9)
IUD 17.4 (4) 4.00 (4) 3.67 (18)
Implants –– –– 3.73 (22)
Rhythm/natural family planning 21.7 (5) 4.00 (5) 3.65 (17)
Other (tubal ligation) 4.3 (1) 4.00 (1) 3.71 (21)
Menstrual productsb (past year)
Pads 92.3 (12) 3.75 (12) 1.00 (1)*
Tampons 30.8 (4) 4.00 (4) 3.33 (9)
aBased on n ϭ 22 because 1 respondent did not answer this item.
bBased on respondents who menstruated in the past year (n ϭ 13).
*p Ͻ 0.05 (ANOVA).
5. dents preferred natural or synthetic products, home reme-
dies or prescriptions. An American-born woman from South
Carolina, in her early 40s, with less than 2 years of college
education, explained why she had used yogurt for vaginal
infections:
. . . it was sloppy, messy. But I’d rather that than over
the counter . . . [because] I don’t know what’s in it.
An American-born woman in her late 40s, with 2 years of
college education, explained her preference for synthetic
vaginal products as follows:
That’s a part of your body you have to take care of it
and to use something that’s not prescribed, I don’t think
that’s healthy.
A similar concern for safety with an additional stated pref-
erence for the perceived fast effects of pharmaceuticals was
expressed by a woman born in St. Vincent, in her early 50s,
with 4 years of college education, who reported using pre-
scription medication first and then natural products.
Because that’s scary stuff. You want it fixed right away
with no jokes about it. . . . I know that most medicines
are tried and true and I kind of don’t want to fool
around. I want to make sure that, you know, that what-
ever is cleared up and I think antibiotics and things like
that I really don’t think you can beat them. In terms of
speed, anyway.
General approach to health care. We explored whether
women’s decision-making processes about vaginal practices
seemed consistent with their approaches to healthcare in
general, including their choices to use conventional and non-
conventional medicine. Several respondents who used CAM
reported a preference for conventional medicine for vaginal
problems. An American-born woman in her early 50s, with
a college education, explained why she would use prescrip-
tion medication in the vaginal area, although she generally
preferred natural products.
I feel that some things that are technologically produced
could have more hazardous effects, and I also find that
with a lot of medications, sometimes the side effects are
worse than what you actually started out with. You
know, so which is worse? You know, I have one prob-
lem. I go to a doctor. He gives me a prescription that
now gives me four additional problems that I never had.
So I’m better off a lot of times with something more nat-
ural because I don’t face having these side effects.
However, she adds:
That’s one area of my body that I’m very, very cautious
with. . . . That is the one area that I feel . . . on that I go
to my doctor regularly.
An American-born woman in her early 60s, with 2 years
of college education, explained that her preference for nat-
ural vaginal products was consistent with her reason for
avoiding conventional medicine in general: adverse side ef-
fects and ineffective treatments.
they gave me antibiotics and I caught a urinary tract in-
fection. . . . I think medicine is killing people. I think the
drug companies are using people as guinea pigs. I tried
drugs; and my conditions were still the same.
An American-born woman in her late 60s with 2 years of col-
lege education, who used CAM stated:
I don’t know any products for that. I don’t think women
think of natural products for the vagina . . . that part of
the body.
In general, women did not tell their health providers about
their use of nonconventional vaginal products, including
douching. Only 1 respondent reported disclosing this kind
of information to a health provider: she discussed her use of
a douche with her gynecologist.
Overall, the qualitative data indicate that one of the main
factors guiding respondents’ choices of vaginal practices was
their concern about safety and side effects. Synthetic prod-
ucts had the advantage of being tested for safety and effec-
tiveness, but their side effects were considered potentially
harmful; natural products may have less harmful side effects
but have the disadvantage of being untested and not rec-
ommended by doctors. Many women reported a need for ex-
tra caution using any product in this sensitive area of the
body, regardless of whether they expressed a preference for
natural or synthetic products. In addition, beliefs about
safety were not always consistent with the respondents’ ap-
proach to treatments for other health conditions.
Discussion
A key finding of our study is that the women in this sam-
ple reported willingness to protect themselves from serious
health risks, such as HIV/AIDS, through a vaginal method,
with the caveat that caution is paramount because the vagina
is a sensitive part of the body. Our data suggest that educa-
tion levels and past condom use may affect willingness to
some degree. More educated women may be more aware of
the risks of HIV. Women who have used condoms, the most
effective known method for HIV prevention, may feel the
need to protect themselves from HIV and, therefore, be more
willing to use a vaginal method.
Women’s assessment of risk is an important factor in their
decision to use or avoid a product. Concern about safety un-
derlies women’s choices whether they prefer natural or syn-
thetic products. Those who preferred natural products per-
ceived them to be less risky in terms of side effects. This
observation confirms findings from another study of CAM
use among those with HIV, which reported that safety was
a concern in regard to prescription medications because of
iatrogenic consequences and side effects.33 Those who pre-
ferred synthetic products perceived them as safer because
they are tested by health authorities and approved by physi-
cians.
Previous research has found that black American women
commonly seek natural approaches to healthcare.30,31 It is
possible that microbicide acceptability can be enhanced and
satisfaction with medical care can be improved by herbal
products that are well tested for safety and efficacy. Several
natural products (e.g., seaweed and Azadirachta indica, a
common Indian medicinal plant known as neem) have been
VAGINAL MICROBICIDE ACCEPTABILITY 1349
6. tested as microbicides and spermicides.34–36 Naturalness, fa-
miliarity, and tradition seemed to influence acceptability for
Indian women in the study of neem.34
Douching was the most common vaginal practice of
women in this sample. It is noteworthy that women catego-
rized as non-CAM users (because they did not report using
any CAM domains for health reasons) reported using a
douche. In addition, most women who reported using a
douche also reported never having used “any herbal reme-
dies or other substance not prescribed by a physician in the
vagina.” This suggests that respondents do not think of
douching as CAM, even though vinegar is a plant extract
and douching is a practice not typically recommended by
medical doctors. Most women probably consider douching
to be in the realm of hygiene, and normative hygiene prac-
tices may not come to mind when reporting health-related
behavior. Douching is a common practice among African
American women and has been found to be associated with
health risks, including adverse reproductive health out-
comes.14 Douching or otherwise cleansing the vagina around
the time of sex may unintentionally dilute, remove, or in-
teract with a microbicide product, having potentially harm-
ful effects.12 Including questions about specific vaginal prac-
tices, such as douching, would be beneficial in microbicide
studies, as well as in health behavior research and in clini-
cal settings.
Based on a review of microbicide studies, Mantell et al.3
highlighted the importance of addressing the diversity of
study populations and how cultural norms affect sexual
practices, sexual satisfaction, product use during menstrua-
tion, perceptions about effects of product use on fertility, and
vaginal insertion of a foreign substance. Prevention of HIV
sexual transmission does not occur in a vacuum. Product ac-
ceptability has been found to differ among racial/ethnic
groups (African American, Caucasian, Hispanic, Haitian)
along several dimensions, including delivery systems and
product characteristics.37 Results of this study suggest that
cultural influences from the Caribbean may differ from those
operating among American-born black women, illustrating
the diversity that exists within the sample of black Ameri-
can women and the wide range of factors that affect vaginal
practices and healthcare in general. Certain vaginal practices
that vary cross-culturally involve a level of comfort with
touching the genitalia,3,17 which is likely to affect accept-
ability of intravaginal microbicides. As douching is common
among the women in this sample, there may be a relatively
high level of comfort with self-touching, which may posi-
tively influence willingness to use a vaginal substance for
HIV prevention. The relationship between self-touching and
microbicide acceptability requires further investigation in di-
verse study populations.
Factors predicting behavior regarding vaginal practices
may not be the same as those predicting general healthcare
behavior. Our results suggest that perceived sensitivity of
the vaginal area leads some women to follow medical ad-
vice concerning vaginal treatment, despite a general prefer-
ence for natural treatments, but also leads others who gen-
erally do not use CAM to prefer natural vaginal products
because of possible adverse side effects from synthetic prod-
ucts. Heightened physical and cultural sensitivity of the
vagina is likely to influence women’s decision making. In-
formation about vaginal practices garnered through social
networking may be limited because of social taboos, and
women may choose products without adequate information
or be less confident about making a choice to self-treat.
This study is limited by the constraints of the data, which
were collected primarily to follow up a larger study on the
use of CAM by women. Because of the sample selection and
small sample size, results are not generalizable to other
groups, particularly those most at risk for HIV/AIDS. Most
women in the sample were over the age of 45 and may have
different attitudes and needs than a younger age group re-
garding vaginal practices and microbicide use. Small sam-
ple size limited our ability to detect statistically significant
differences and may have produced unstable estimates.
Findings from the qualitative analyses have been empha-
sized in this paper, and statistical analyses provide an
overview of the study sample. Another limitation is that
women were asked to report willingness to use a hypothet-
ical product, and this may not be an accurate indicator of ac-
tual use.5,38
Despite these limitations, the findings have important im-
plications for the design and promotion of intravaginal prod-
ucts for the prevention of HIV/AIDS and other STIs.
Women’s choices regarding vaginal practices and their will-
ingness to use vaginal products to prevent HIV/AIDS are
likely to be related to perceptions of risk and decision-mak-
ing processes about healthcare in general as well as to de-
mographic factors. Health approaches and practices differ
depending on varying cultural influences, even within
racial/ethnic groups. These are important factors to explore
further with larger sample sizes.
Conclusions
Women in the sample reported more willingness to use
vaginal products for the prevention of HIV or AIDS than for
any other reason. This was especially true for women with
higher educational levels. Decision-making processes in-
clude assessing risk and effectiveness and choosing health
products that are likely to be effective and not harmful. Risk
assessments vary according to prior experience, cultural in-
fluences, and attitudes about general health and self-care.
Perceptions differ as to the risks of synthetic and natural
products: some view synthetic products as having poten-
tially harmful side effects; others perceive natural products
as potentially harmful because they may not be adequately
tested for safety. If women are well informed about health
products and if side effects are minimal, women’s willing-
ness to use a vaginal product is likely to increase.
Acknowledgments
We thank the interviewer Faith Miller-Sethi, Nina Shilling,
Whitney Dessio, and Cathy Butler of Audits and Surveys
Worldwide and the women who took the time from their
busy lives to answer our questions. We are grateful to the
four anonymous reviewers for their careful reading and
thoughtful comments, which greatly improved the paper.
Disclosure Statement
No competing financial interests exist.
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