Fisherfolk

渔夫
  • 文章类型: Journal Article
    渔民等流动人口显示出很高的艾滋病毒发病率和患病率。我们对实施策略进行了试点测试,以在维多利亚湖的两个大陆渔民社区的医疗外展活动中增强暴露前预防(PrEP)的吸收和依从性,乌干达从2021年9月到2022年2月。实施策略包括PrEP坚持支持者(从PrEP用户的社交网络中选择),社区研讨会(解决误解和污名,并授权PrEP倡导),和签入电话(包括续杯提醒)。从干预前6个月到干预后6个月收集PrEP病历数据。对20名PrEP用户进行定性采访(10人继续,10谁停产了),9个坚持的支持者,和7个主要合作伙伴(提供商,社区领导人)探讨了可接受性。PrEP发起者的百分比(在符合条件的人中)在干预期间(96.5%)明显高于干预前6个月(84.5%)。p<0.0001;坚持的PrEP用户的百分比(即,拥有续杯)启动后6个月(47.9%vs.6.7%),并且从开始日期到6个月后至少有80%的PrEP覆盖率(基于他们的药物持有率)(35.9%vs.0%)高于干预前,p<0.0001。具有更好医疗保健服务的渔民社区在6个月时的摄取率(78.3%;p<0.0001)和持久性(34.0%;p<0.001)较低,但干预期间的覆盖率更高(70.4%;p<0.0001)。定性数据表明,这些策略通过减少污名和误解来促进PrEP的使用。每个额外的PrEP启动人员的干预费用为223.95美元,172.98美元和94.66美元,持久性,和覆盖范围,分别。加强基于社区的PrEP实施,促进支持性社区环境,可以改善流动人口的PrEP使用,而无需轻松获得医疗保健。(NCT05084716)。
    Mobile populations such as fisherfolk show high HIV incidence and prevalence. We pilot-tested implementation strategies to enhance pre-exposure prophylaxis (PrEP) uptake and adherence in the context of healthcare outreach events in two mainland fisherfolk communities on Lake Victoria, Uganda from September 2021 to February 2022. The implementation strategies included PrEP adherence supporters (selected from PrEP users\' social networks), community workshops (to address misconceptions and stigma, and empower PrEP advocacy), and check-in calls (including refill reminders). PrEP medical records data were collected from 6-months pre-intervention to 6-months post-intervention. Qualitative interviews with 20 PrEP users (10 who continued, 10 who discontinued), 9 adherence supporters, and 7 key partners (providers, community leaders) explored acceptability. Percentages of PrEP initiators (of those eligible) were significantly higher during the intervention (96.5%) than 6-months before the intervention (84.5%), p < 0.0001; percentages of PrEP users who persisted (i.e., possessed a refill) 6-months post-initiation (47.9% vs. 6.7%) and had at least 80% PrEP coverage (based on their medication possession ratio) from the initiation date to 6-months later (35.9% vs. 0%) were higher during versus pre-intervention, p < 0.0001. A comparison fisherfolk community with better healthcare access had lower uptake (78.3%; p < 0.0001) and persistence at 6-months (34.0%; p < 0.001), but higher coverage during the intervention period (70.4%; p < 0.0001). Qualitative data suggested the strategies promoted PrEP use through reduced stigma and misconceptions. The intervention bundle cost was $223.95, $172.98, and $94.66 for each additional person for PrEP initiation, persistence, and coverage, respectively. Enhanced community-based PrEP implementation that fosters a supportive community environment can improve PrEP use in mobile populations without easy access to healthcare. (NCT05084716).
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  • 文章类型: Journal Article
    人类与尼罗河鳄鱼之间的冲突普遍存在,鳄鱼对整个撒哈拉非洲的渔民和河流社区构成了重大威胁。每年发生数百起致命袭击,死亡率可能在50%到100%之间。使用结构化问卷对尼罗河沿岸和南苏丹Sudd湿地的渔民进行了研究,研究了他们对鳄鱼的态度和看法。当地社区使用鳄鱼进行肉类和皮肤/皮革交易。肉被认为可以延长寿命,性能力,以及对巫术的保护.鳄鱼被认为是对生命和生计的主要威胁,因为它们限制了人们沿着水体的行动自由,攻击牲畜和人类,和毁灭性的捕鱼设备。为了评估反应是否受到鳄鱼威胁强度的影响,使用广义线性模型(GLMs)分析了有关鳄鱼对人类和牲畜的致命攻击的公开数据。这项分析表明,鳄鱼袭击的数量与人类态度之间存在直接联系。人们普遍害怕和憎恨鳄鱼,并同意有必要摧毁繁殖栖息地。然而,一些态度是复杂和微妙的,正如当地社区关于一方面需要摧毁尼罗河鳄鱼繁殖栖息地,另一方面需要建立鳄鱼保护区作为减轻风险和冲突的首选策略所强调的那样。有必要在Sudd湿地建立一个鳄鱼保护区,以最大程度地减少非法狩猎的风险,并缓冲内战后由于人口增长和经济好转而对鳄鱼造成的越来越大的压力。
    Conflicts between human populations and Nile crocodiles are widespread with crocodiles posing significant threats to fisherfolk and riverine communities across r-Saharan Africa. Hundreds of deadly attacks take place annually, and mortality rates may range from 50% to 100%. Attitudes and perceptions towards crocodiles were studied using structured questionnaires among fisherfolk along the River Nile and the Sudd wetlands in South Sudan. Local communities used crocodiles for their meat and skin/leather trades. The meat is regarded to enhance longevity, sexual potency, and protection against witchcraft. Crocodiles are perceived as a main threat to lives and livelihoods as they restrict people\'s freedom of movement along water bodies, attack livestock and humans, and devastate fishing equipment. To assess whether responses were influenced by the intensity of crocodile threats, published data on fatal crocodile attacks on humans and livestock were analysed using Generalised Linear Models (GLMs). This analysis indicated a direct link between the number of crocodile attacks and human attitudes. Crocodiles were generally feared and hated, and there was the agreement of the need to destroy breeding habitats. However, some attitudes were complex and nuanced as highlighted by the agreement of local communities on the need to destroy Nile Crocodile breeding habitats on the one hand and the need to establish crocodile sanctuaries as the the preferred strategy to mitigate risks and conflict on the other hand. There is a need for the creation of a crocodile sanctuary in the Sudd wetlands to minimise the risks of illegal hunting and to buffer the increasing pressure on crocodiles due to human population growth and economic upturn after the civil war.
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  • 文章类型: Journal Article
    背景:关于植物在渔业中的作用的民族植物学知识提供了对当地资源的可持续管理至关重要的宝贵生态信息;然而,它在全球范围内被稀释和研究不足。这篇文献综述旨在绘制传统渔业社区内植物使用的知识。
    方法:通过PRISMA方法,我们确定并选择了34篇报告在渔业中使用植物的文章,包括344个植物和藻类类群。植物和藻类的用途分为不同的类别。
    结果:在我们提出的渔业相关用途的新分类中,提到最多的是捕鱼和建造/修复捕鱼文物和与栖息地相关的用途,虽然与纤维使用有关的植物记录,在捕鱼管理和造成问题的物种方面提供援助,是被提及最少的。半结构化访谈最常用于本地资源用户,尤其是渔业专家,探索传统渔业社区对植物使用的看法。所有有记录的家庭的多样性都很高,但大多数是在当地报道的。
    结论:关于渔民的民族植物学研究在文献中并不常见,但它们提供了大量的使用报告。在此回顾的基础上,在世界大部分地区,这些信息是随意和零星的。渔民可以提供有关水生植物和藻类的信息,这些水生植物和藻类会造成问题,并有助于捕鱼管理,这对于理解经历环境挑战的地区的生态系统至关重要。这种知识在全球范围内被大大低估,并且正在迅速下降,正如几篇评论文章所强调的那样。因此,考虑到渔业对渔业资源可持续管理的潜在贡献,需要对渔民与渔业相关的植物使用进行进一步的系统研究。
    BACKGROUND: Ethnobotanical knowledge about the role of plants in fisheries provides valuable ecological information vital for sustainable management of local resources; however, it is diluted and understudied globally. This literature review aims to map the knowledge of plant use within traditional fishing communities.
    METHODS: Through the PRISMA method, we identified and selected 34 articles reporting the use of plants in fisheries, and including 344 taxa of plants and algae. Uses of plants and algae were grouped into different categories.
    RESULTS: In the novel categorization of fishery-related uses we proposed, the most mentioned were for fishing and building/repair of fishing artifacts and habitat-related uses, while the records of plants related to fiber uses, providing aid in fishing management and species causing problems, were among the least mentioned. Semi-structured interview is most commonly used with local resource users, especially fishery experts, in exploring perceptions on plant use within traditional fishing communities. Diversity was high in all the recorded families, but most were reported locally.
    CONCLUSIONS: Ethnobotanical studies with fishers are not common in the documented literature but they provide a large number of use reports. On the basis this review, in most of the world, the information is of a casual and sporadic nature. Fishers can provide information on aquatic plants and algae that create problems and aid in fishing management, which are crucial in understanding the ecosystem of a region experiencing environmental challenges. This knowledge is greatly understudied globally and undergoing a rapid decline, as highlighted in several of the reviewed articles. Thus, further systematic research on fishery-related uses of plants by fisherfolk is needed considering its potential contribution to the sustainable management of fishery resources.
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  • 文章类型: Journal Article
    背景:东非的捕鱼社区经历了两个相互关联且经常共同发生的健康问题的沉重负担:艾滋病毒和有害酒精使用。近三分之二的乌干达渔民符合有害酒精使用标准。我们开发了一种多层次的干预措施,以减少有害酒精的使用,并改善Wakiso地区感染艾滋病毒的渔民(LWHIV)的艾滋病毒护理参与,乌干达。
    方法:这是对利益相关者关于适当性的观点的定性研究,可接受性,以及对渔民LWHIV进行多层次干预的可行性。拟议的干预措施,Kisoboka(“这是可能的!”),将结构成分[将工作支付方式从现金更改为移动货币]与行为成分[基于动机性访谈的咨询与使用行为经济学原理促进行为改变的内容相结合]相结合。我们进行了一个焦点小组(n=7)和八个对渔民LWHIV的深入访谈,以及对卫生工作者的19个关键线人(KI)访谈,雇主,和社区领袖。这些探索了适当性,可接受性,以及具体关键干预组件的可行性。
    结果:总体而言,利益相关者的观点支持高干预可接受性和对拟议干预措施的适当性。人们认为这是可行的,并提出了一些建议,以克服已确定的潜在实施挑战(例如,如果一个人无法自己写的话,请有一个朋友协助记录储蓄和酒精使用情况)。
    结论:这项工作突出了Kisoboka干预的潜力以及关键利益相关者早期参与干预制定过程以确保适当性的重要性,可接受性,可行性,和社会文化契合。
    BACKGROUND: East Africa\'s fishing communities experience a high burden of two interrelated and frequently co-occurring health issues: HIV and hazardous alcohol use. Nearly two-thirds of Ugandan fisherfolk men meet the criteria for harmful alcohol use. We developed a multilevel intervention to reduce hazardous alcohol use and improve HIV care engagement among fisherfolk men living with HIV (LWHIV) in Wakiso district, Uganda.
    METHODS: This is a qualitative study of stakeholder perspectives on the appropriateness, acceptability, and feasibility of a multilevel intervention for fisherfolk men LWHIV. The proposed intervention, Kisoboka (\"It is possible!\"), combines a structural component [changing the mode of work payments from cash to mobile money] with a behavioral component [motivational interviewing-based counseling combined with content using behavioral economic principles to promote behavior change]. We conducted one focus group (n=7) and eight in-depth interviews with fisherfolk men LWHIV and 19 key informant (KI) interviews with health workers, employers, and community leaders. These explored the appropriateness, acceptability, and feasibility of specific key intervention components.
    RESULTS: Overall, stakeholders\' perspectives supported high intervention acceptability and perceived appropriateness of the proposed intervention. It was perceived to be feasible with some caveats of recommendations for overcoming potential implementation challenges identified (e.g., having a friend assist with documenting savings and alcohol use if an individual was unable to write themselves) which are discussed.
    CONCLUSIONS: This work highlights the potential of the Kisoboka intervention and the importance of early engagement of key stakeholders in the intervention development process to ensure appropriateness, acceptability, feasibility, and socio-cultural fit.
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  • 文章类型: Journal Article
    背景:艾滋病毒在撒哈拉以南非洲的渔民中流行得很高,尤其是维多利亚湖周围,乌干达。目的/研究设计:我们对35名乌干达渔民(15名妇女,20名男性)和10名主要利益相关者(医疗保健提供者,政策制定者,社区领导人)。我们使用了基于实施科学和社会营销框架的定向内容分析方法。结果:参与者对PrEP表现出很高的可接受性。渔民之间的预期障碍包括污名(由于与艾滋病毒治疗类似的药物/包装);误解;流动性,相互竞争的需求,贫穷,和伙伴冲突。预期的提供者障碍包括人员配备和旅行支持不足。建议包括:更改PrEP包装;将PrEP与其他服务整合;减少PrEP补充频率;向提供者提供运输资源;培训更多的医护人员向渔民提供PrEP;并使用积极的框架信息来推广PrEP。结论:结果可以为政策制定者和医疗保健组织提供有关如何克服在大多数医疗保健条件较差的风险人群中扩大PrEP的障碍。
    Background: HIV is hyperendemic among fisherfolk in Sub-Saharan Africa, especially around Lake Victoria, Uganda. Purpose/Research Design: We conducted cross-sectional semi-structured interviews about oral pre-exposure prophylaxis (PrEP) implementation with 35 Ugandan fisherfolk (15 women, 20 men) and 10 key stakeholders (healthcare providers, policymakers, community leaders). We used a directed content analysis approach based on implementation science and social marketing frameworks. Results: Participants showed high acceptability for PrEP. Anticipated barriers among fisherfolk included stigma (due to similar medications/packaging as HIV treatment); misconceptions; mobility, competing needs, poverty, and partner conflict. Anticipated provider barriers included insufficient staffing and travel support. Recommendations included: change PrEP packaging; integrate PrEP with other services; decrease PrEP refill frequency; give transportation resources to providers; train more healthcare workers to provide PrEP to fisherfolk; and use positively framed messages to promote PrEP. Conclusions: Results can inform policymakers and healthcare organizations on how to overcome barriers to PrEP scale-up in most at-risk populations with poor healthcare access.
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  • 文章类型: Journal Article
    联合国评估:渔民在加纳等新兴经济体中发挥着重要作用。虽然许多捕鱼社区被认为不发达,渔民被认为忽视了他们的口腔卫生,同时由于特殊的风险而容易出现某些情况。这项研究的目的是确定加纳选定的捕鱼社区中成年人的牙周健康状况。
    UNASSIGNED:进行了一项描述性横断面研究,以评估詹姆斯敦成年人的牙周状况,加纳的一个城市周边地区。数据采集是通过结构化问卷和牙周检查进行的。获得的信息包括人口统计数据(年龄,性别,教育和职业类别)口腔卫生实践(牙齿清洁材料的类型,牙齿清洁的方法,牙科就诊频率和就诊原因)和牙周临床参数(菌斑指数,和社区牙周指数的治疗需求)。
    UNASSIGNED:总共276名参与者被纳入研究,年龄从21岁到70岁不等。参与者由138名渔民和138名非渔民组成。与女性相比,男性的牙周病得分更差。斑块评分在各年龄组之间没有差异,但在教育水平和职业类别之间发生了显著变化。CPITN在教育水平之间差异很大,年龄类别和职业类别。
    UNASSIGNED:该研究发现,詹姆斯敦捕鱼社区的居民牙周状况普遍不理想,但对社区的渔民来说更糟。
    UNASSIGNED: fisherfolk play a major role in emerging economies such as Ghana. While many fishing communities are noted to be underdeveloped, fisherfolk are considered to neglect their oral hygiene, while being prone to certain conditions due to peculiar risks. The purpose of this study was to determine the periodontal health status of adults in a selected fishing community in Ghana.
    UNASSIGNED: a descriptive cross-sectional study was carried out to assess the periodontal status of adults in Jamestown, a peri-urban area in Ghana. Data acquisition was by means of a structured questionnaire and periodontal examination. Information obtained consisted of demographic data (age, sex, education and occupation category) oral hygiene practices (type of teeth cleaning materials, methods of tooth cleansing, frequency of dental visits and reasons for the visit) and periodontal clinical parameters (plaque index, and community periodontal index of treatment needs).
    UNASSIGNED: a total of 276 participants were included in the study, with ages ranging from 21 to 70 years. The participants were made up of 138 fisherfolk and 138 non-fisherfolk. Males had worse scores for periodontal disease compared to females. Plaque score did not vary among age groups, but changed significantly between educational level and occupational categories. CPITN varied significantly between educational levels, age categories and occupational categories.
    UNASSIGNED: the study found inhabitants of the fishing community of Jamestown to have a generally unsatisfactory periodontal status, but worse for the fisherfolk in the community.
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  • 文章类型: Journal Article
    南苏丹的Sudd,由白尼罗河的巴·阿尔·贾巴尔部分组成,是世界上最大和最重要的湿地之一。该地区的社区几乎完全依靠渔业来获取食物和生计。尽管受到过度开发和栖息地变化的威胁,鱼类种群也受到气候变化的影响。使用半结构化问卷,我们评估了渔民对近期气候变化如何影响其生计和环境的看法。渔民认为气候在过去十年中发生了变化,并受到了负面影响。受访者报告平均气温较高,洪水和干旱的频率更高,季节不可预测的时机,和不稳定的降雨。破坏渔村/营地,捕鱼设备的损失和损坏,钓鱼日历的变化,减少鱼类贸易,渔获量下降以及心理社会问题被认为是气候变化的主要后果。人们认为气候变化和多变性的原因与森林资源的无节制采伐有关,上帝和祖先的愤怒,和气候的自然变化。大多数受访者表示希望采取更负责任的行为,例如植树和建立社区苗圃,接受气候变化风险的教育,可持续渔业管理。我们的结果表明,Sudd的渔民受到气候变化对其生计和鱼类种群的影响的困扰。在南苏丹,根据水文气候数据报告了气候变化,但由于最近的战争和经济不景气,对人们的具体影响在很大程度上仍然未知,也很少受到关注。我们的研究提供了一个例子,说明渔民如何将当地生态知识(LEK)用作对生计和鱼类种群的负面影响的预警系统,并支持适应不断变化的气候。
    在线版本包含补充材料,可在10.1007/s10113-022-01928-w获得。
    The Sudd in South Sudan, formed by the White Nile\'s Baḥr al-Jabal section, is one of the largest and most important wetlands in the world. Communities in the region almost exclusively depend on fisheries for food and livelihoods. Although threatened by over-exploitation and habitat changes, fish populations are also affected by climate change. Using semi-structured questionnaires, we assessed fisherfolk\'s opinions of how recent variation in climate affected their livelihoods and the environment. Fisherfolk perceived that climate had changed in the past decade and were negatively impacted by this. Interviewees reported average higher temperatures, a greater frequency of floods and droughts, unpredictable timing of seasons, and erratic rainfall. Destruction of fishing villages/camps, loss and damage of fishing equipment, shifts in the fishing calendar, reduction of fish trade, and fish catch declines as well as psycho-social problems were given as the major consequences of climate change. Causes of climate change and variability were perceived to be linked to uncontrolled harvest of forest resources, anger of God and ancestors, and natural variability in climate. Most respondents expressed a desire to adopt more responsible behavior such as planting trees and establishing community nurseries, being educated on climate change risks, and sustainable fisheries management. Our results show that fisherfolk in the Sudd are troubled by climate change impacts on their livelihoods and on fish populations. In South Sudan, climate change has been reported from hydroclimatological data but concrete impacts on people remain largely unknown and of little concern because of recent wars and the poor economy. Our study provides an example of how fisherfolks\' local ecological knowledge (LEK) can be used as an early warning system of the negative impacts on livelihoods and fish populations and support adaptation to the changing climate.
    UNASSIGNED: The online version contains supplementary material available at 10.1007/s10113-022-01928-w.
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  • 文章类型: Journal Article
    世界卫生组织(WHO)建议在暴露于艾滋病毒风险较高的关键人群中使用暴露前预防(PrEP)。如果使用有效,PrEP可以将每年的HIV发病率降低到0.05%以下。然而,PrEP在所有可能从中受益的社区中是不可接受的。有,因此,需要了解对PrEP的看法以及与在有艾滋病毒风险的关键人群中使用PrEP的意愿相关的因素,例如艾滋病毒感染率极高的社区成员。
    为了研究乌干达渔业社区成员中与使用口头PrEP的意愿相关的看法和因素,有感染艾滋病毒风险的关键人群。
    我们于2019年2月至6月在Ggaba捕鱼社区进行了解释性序贯混合方法研究。调查数据是从283个社区成员的系统随机样本中收集的,在我们进行研究时,PrEP尚未推出。我们对使用PrEP的意愿与人口统计特征的关联进行了双变量测试,艾滋病毒风险感知,HIV检测史我们估计了使用PrEP的意愿的患病率比率。我们使用后向消除法建立多变量修正的Poisson回归模型来描述与使用PrEP的意愿相关的因素。我们有目的地选择了16名参与者进行焦点小组讨论,以了解调查结果的背景,归纳分析数据并确定与PrEP感知相关的紧急主题。
    我们招募了283名参与者,平均年龄为31±8岁。大多数(80.9%)为男性。大多数参与者在他们的一生中都进行了艾滋病毒检测,但64%的人在过去6个月没有进行过测试.自我报告的艾滋病毒感染率为6.4%。大多数(80.6,95CI75.5-85.0)原则上愿意使用PrEP。使用PrEP的意愿与认为自己处于HIV的高风险相关(aPR1.99,95CI1.31-3.02,P=0.001),在过去的6个月中进行了HIV检测(APR1.13,95CI1.03-1.24,P=0.007),并完成高等教育(APR1.97,95CI1.39-2.81,P<0.001)。在焦点小组讨论中,参与者描述了药丸负担,副作用和药物安全性是使用PrEP的潜在障碍。
    在坎帕拉市郊的捕鱼社区成员中,OralPrEP被广泛接受。为渔民扩大PrEP的计划应将HIV检测服务与对PrEP的敏感性结合起来,并提高对PrEP作为HIV预防策略的认识。
    The World Health Organization (WHO) recommends the use of pre-exposure prophylaxis (PrEP) in key populations at elevated risk for exposure to HIV. If used effectively, PrEP can reduce annual HIV incidence to below 0.05%. However, PrEP is not acceptable among all communities that might benefit from it. There is, therefore, a need to understand perceptions of PrEP and factors associated with willingness to use PrEP among key populations at risk of HIV, such as members of communities with exceptionally high HIV prevalence.
    To examine the perceptions and factors associated with willingness to use oral PrEP among members of fishing communities in Uganda, a key population at risk of HIV.
    We conducted an explanatory sequential mixed-methods study at Ggaba fishing community from February to June 2019. Survey data were collected from a systematic random sample of 283 community members in which PrEP had not been rolled out yet by the time of we conducted the study. We carried out bivariate tests of association of willingness to use PrEP with demographic characteristics, HIV risk perception, HIV testing history. We estimated prevalence ratios for willingness to use PrEP. We used backward elimination to build a multivariable modified Poisson regression model to describe factors associated with willingness to use PrEP. We purposively selected 16 participants for focus group discussions to contextualize survey findings, analysing data inductively and identifying emergent themes related to perceptions of PrEP.
    We enrolled 283 participants with a mean age of 31 ± 8 years. Most (80.9%) were male. The majority of participants had tested for HIV in their lifetime, but 64% had not tested in the past 6 months. Self-reported HIV prevalence was 6.4%. Most (80.6, 95%CI 75.5-85.0) were willing in principle to use PrEP. Willingness to use PrEP was associated with perceiving oneself to be at high risk of HIV (aPR 1.99, 95%CI 1.31-3.02, P = 0.001), having tested for HIV in the past 6-months (aPR 1.13, 95%CI 1.03-1.24, P = 0.007), and completion of tertiary education (aPR 1.97, 95%CI 1.39-2.81, P < 0.001). In focus group discussions, participants described pill burden, side-effects and drug safety as potential barriers to PrEP use.
    Oral PrEP was widely acceptable among members of fishing communities in peri-urban Kampala. Programs for scaling-up PrEP for fisherfolk should merge HIV testing services with sensitization about PrEP and also increase means of awareness of PrEP as an HIV preventive strategy .
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  • 文章类型: Journal Article
    背景:由于艾滋病毒流行率高和对艾滋病毒服务的参与度低,渔民已被确定为乌干达艾滋病毒应对的关键人群。虽然研究已经检查了生活方式和风险,关于帮助和寻求健康的经历还有很多有待理解,包括生物医学和传统医疗保健的结合使用。
    目的:在乌干达维多利亚湖附近的两个捕鱼社区中,研究生物医学和传统医疗保健的使用。
    方法:探索性,深入的定性研究,涉及对42名HIV阳性渔民的半结构化访谈。
    结果:在HIV诊断之前,描述患病的参与者寻求不同形式的帮助,包括由卫生工作者开处方或自行开处方的生物医学治疗;生物医学和草药一起使用;仅草药;或没有任何形式的治疗。HIV诊断后,大多数参与者只使用ART,虽然少数人同时使用ART和传统护理策略,或报告他们使用替代疗法代替ART的次数。在HIV诊断之前,渔民寻求医疗保健的做法抑制了参与艾滋病毒检测和获得生物医学艾滋病毒治疗和护理。HIV诊断后,大多数人只是使用艺术。
    结论:研究结果提供了关于渔民在诊断前使用生物医学和传统护理如何影响随后参与HIV治疗的见解。需要努力通过日常健康寻求网络接触渔民,以确保尽早诊断和治疗艾滋病毒。
    BACKGROUND: Fisherfolk have been identified as a key population in the HIV response in Uganda due to high HIV prevalence and low engagement in HIV services. While studies have examined lifestyles and risk, much remains to be understood about help and health seeking experiences, including the combined use of biomedical and traditional health care.
    OBJECTIVE: To examine the use of biomedical and traditional health care in two fishing communities around Lake Victoria in Uganda.
    METHODS: Exploratory, in-depth qualitative study involving semi-structured interviews with 42 HIV positive fisherfolk.
    RESULTS: Prior to HIV diagnosis, participants who described becoming ill sought different forms of help including biomedical treatment prescribed by health workers or self-prescribed; biomedical and herbal medicines together; herbal medicines only; or no form of treatment. Following HIV diagnosis, the majority of participants used ART exclusively, while a smaller number used both ART and traditional care strategies, or reported times when they used alternative therapies instead of ART. Prior to HIV diagnosis, fisherfolk\'s health care seeking practices inhibited engagement with HIV testing and access to biomedical HIV treatment and care. After HIV diagnosis, most resorted only to using ART.
    CONCLUSIONS: Study findings provide insight into how fisherfolk\'s use of biomedical and traditional care prior to diagnosis influences subsequent engagement with HIV treatment. Efforts are needed to reach fisherfolk through everyday health seeking networks to ensure HIV is diagnosed and treated as early as possible.
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  • 文章类型: Journal Article
    捕鱼社区是人类免疫缺陷病毒(HIV)负担的亚种群,主要是由于他们的流动性和现金收入。减轻艾滋病毒在捕鱼社区传播的战略有不同的结果。我们进行了一项研究,以确定艾滋病毒的流行程度,坦桑尼亚维多利亚湖捕鱼社区最近的感染和相关因素。
    我们在2019年第一季度进行了一项横断面研究。参与者的信息是使用结构化问卷收集的。对血液样本进行HIV感染筛查;对阳性样本进行亲合力和病毒载量测试,以确定最近的感染。采用Logistic回归分析确定与HIV感染相关的因素。
    共纳入1048名个体,平均年龄34岁(SD±11.5)。艾滋病毒的总体患病率为9.1%,而7.4%的人最近有感染。缺乏正规教育,分居/离婚/丧偶,交易性,性传播感染史,在过去的12个月中,未进行HIV检测的感染HIV的几率增加了1.7至3倍。
    渔民中最近感染艾滋病毒的比例相对较高,标志着持续的传播,这是由一些人口统计学和行为特征决定的。
    Fishing communities are a subpopulation burdened by human immunodeficiency virus (HIV), mainly due to their mobility and cash income access. Strategies to mitigate the spread of HIV in fishing communities have varying outcomes. We conducted a study to determine the prevalence of HIV, recent infection and associated factors among fishing communities at Lake Victoria in Tanzania.
    We conducted a cross-sectional study in the first quarter of 2019. The participants\' information was collected using a structured questionnaire. Blood samples were screened for HIV infection; the positive samples were tested for avidity and viral load to determine the recent infection. Logistic regression analysis was used to determine the factors associated with HIV infection.
    A total of 1048 individuals were included with a mean age of 34 years (SD ± 11.5). The overall prevalence of HIV was 9.1%, while 7.4% had a recent infection. Lack of formal education, being separated/divorced/widowed, transactional sex, history of sexually transmitted infections, not tested for HIV in the last 12 months had 1.7 to three times more odds of contracting HIV.
    A proportion of HIV recent infection among the fisherfolks was relatively high, signifying the continuous spread, which is predisposed by some demographic and behavioural characteristics.
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