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Biomedical subjects

E Faxelid

Publications and source records attributed to E Faxelid.

17 recordsLinked to original sources
PubMed2001

Psycho-social determinants for sexual partner referral in Uganda: quantitative results.

The purpose of this study was to investigate the factors influencing sexual partner referral using the Attitude-Social influence self-Efficacy model as a guiding theoretical framework. The data was collected in an interview survey with 236 women and 190 men attending a sexually transmitted disease clinic in Kampala, Uganda. Intention, attitude, subjective norm, self-efficacy, and past behaviour in relation to partner referral as well as partner type were collected at time 1. At time 2 (1 month later), sexual partner referral was assessed. Intention, self-efficacy, and previous behaviour predicted partner referral for women whereas intention, partner type and previous behaviour predicted partner referral for men. For the women the strongest predictors for intention were self-efficacy followed by attitude and partner type. For the men the strongest predictor was attitude followed by partner type and self-efficacy. Social influence was a better predictor of intention for women than for men. An analysis of underlying cognitive beliefs discriminating those who referred and those who did not refer the sexual partner showed that attitudinal beliefs were the most important for men whereas self-efficacy beliefs were the most important for women. The targeting of the gender-based discriminatory beliefs in intervention may improve compliance with sexual partner referral.

Attitude to Health↗
PubMed2001

Traditional healers in Zambia and their care for patients with urethral/vaginal discharge.

OBJECTIVE: The aim of this study was to describe the knowledge and practices of traditional healers in relation to the management of patients with urethral/vaginal discharge. SUBJECTS AND METHOD: Eighty (80) traditional healers, 54 from an urban and 26 from a rural setting in Zambia, who attend to patients with urethral/vaginal discharge, were interviewed using a semistructured questionnaire. RESULT: All of the traditional healers had knowledge of urethral/vaginal discharge being a symptom of a sexually transmitted disease (STD) and that individuals get the infection through sexual relations with infected persons. The healers were all able to cite other symptoms associated with urethral/vaginal discharge. The treatment the healers used was mostly herbal preparations in the form of roots or powders administered orally to induce diarrhea, vomiting, and diuresis. Patients were not allowed to combine traditional and biomedical therapies. Almost half of the healers did apply some biomedical practices in the management of patients with urethral/vaginal discharge, such as history taking and examination of patients before diagnosis and prescription. The healers also advised patients to avoid sex while on treatment and to avoid reinfection by remaining with one partner and using condoms. Some healers advised their patients to bring their sexual partners for consultation. CONCLUSION: Because traditional healers attend to patients with STDs, both in rural and urban areas, efforts should be made to promote cooperation between traditional and biomedical health care providers, so that treatment of patients and their partners could be improved. Traditional management that concurs with biomedical practices could thus be a starting point for discussion and cooperation.

Adult↗
PubMed2001

Efficacy of patient-delivered partner medication in the treatment of sexual partners in Uganda.

BACKGROUND: Patient-based partner referral (PBPR), which is the main method for treating sexual partners of patients with sexually transmitted diseases (STDs), has limited effectiveness. GOAL: The authors compared the efficacy of PBPR with patient-delivered partner medication (PDPM) among patients attending the Mulago STD clinic in Kampala, Uganda. STUDY DESIGN: A total of 383 patients (187 women, 196 men) with STDs were randomized to the PBPR or PDPM group. The proportion of sexual partners treated in either group was compared using the chi-square statistic by intention to treat for partners whose follow-up status was unknown. RESULTS: The two groups had similar background characteristics. Of the 237 partners elicited, 176 (74%) were reported treated in the PDPM group. In the PBPR group, in which 234 partners were elicited, 79 (34%) were referred to the treatment clinic. This difference was statistically significant (risk ratio [RR], 2.44; 95% CI, 1.95-3.07; P < 0.001). Furthermore, PDPM was more effective than PBPR for women and for casual partners for whom PBPR is considered difficult. For women, 86 of 103 partners in the PDPM group were reported treated, compared with 23 of 104 partners in the PBPR group (RR, 4.55; 95% CI, 2.92-7.08; P < 0.001). For casual partners, 18 of 51 (34%) were reported treated in the PDPM group, compared with only three of 45 partners (7%) who were referred in the PBPR group (RR, 1.43; 95% CI, 1.40-2.65; P < 0.01). CONCLUSION: Patient-delivered partner medication is more effective than patient-based partner referral in the treatment of sexual partners.

Adult↗
PubMed2000

"Shopping" for sexually transmitted disease treatment: focus group discussions among lay persons in rural and urban Zambia.

BACKGROUND: In Zambia, persons use different types of services when seeking treatment for sexually transmitted diseases (STDs). GOAL: To gain insight into the rationale behind the selection of treatment sources by investigating perceptions of STDs and by identifying STD treatment sources used. STUDY DESIGN: Focus group discussions were held with 57 men and 44 women in one urban and one rural area in Zambia between May 1997 and June 1997. The focus group discussions were audiotaped and analyzed qualitatively. RESULTS: Participants combined traditional and modern treatment. The main reason given was that even when biomedical medicine was effective, STDs could only be totally cured if the patient was cleansed by traditional herbs. Factors influencing health-seeking behavior were the person's perception, how the diagnosis was determined, type and cost of treatment, demand for sexual partners, and attitudes of health workers, parents, and the church. CONCLUSION: Barriers and enabling factors for the use of treatment sources were identified. Interventions to improve services and cooperation between the health sectors need to consider these factors.

Adolescent↗
PubMed2000

Psychosocial determinants for sexual partner referral in Uganda: qualitative results.

In order to understand and elicit the psychosocial factors influencing compliance with sexual partner referral, 10 focus group discussions (FGDs) and 40 individual interviews based on the attitude-social influence-self efficacy (ASE) model were held in Mbarara District of Uganda. The focus groups were derived from both rural and urban areas. Informal interviews were held with 20 men and 20 women presenting with symptoms of a sexually transmitted disease (STD) at the outpatient department of Mbarara Hospital. The emerging outcome of attitudinal beliefs regarding health consequences of partner referral were mainly positive. However, outcome beliefs relating to the relationship with the partners were mainly negative. Social influence for sexual partner referral was from health-care providers, partner(s), friends and relatives. The self-efficacy beliefs were mainly negative especially among women. Barriers hampering sexual partner referral were related to poor quality of health care, gender relations and type of sexual partners. There is a need to target these beliefs and self-efficacy expectations in health education and STD counselling and for more research to evaluate the psychosocial determinants of sexual partner referral quantitatively.

Attitude to Health↗
PubMed1999

Predictors of condom use among patients with sexually transmitted diseases in Uganda.

BACKGROUND AND OBJECTIVE: Patients with sexually transmitted diseases (STDs) are at an increased risk of HIV infection and they must be targeted for increased condom use. GOAL: To identify predictors of condom use among patients with STDs. STUDY DESIGN: In a cross-sectional survey, an interview-administered questionnaire was administered to 138 patients at the STD clinic, Mulago, and the outpatients department, Mbarara Hospital, in Uganda. Data were collected on socio-demographic situations, STD symptoms, type of sexual partners, and use of condoms. Multivariate logistic regression models were used to identify independent predictors of condom use. RESULTS: Of the 138 patients, 87 (66%) knew how to use condoms, 81 (59%) ever used a condom, 34 (25%) used a condom at least once in the previous 3 months, 20 (15%) used a condom during the last sexual intercourse, and 80 (58%) accepted a free supply of condoms. Reasons for not using condoms among the 57 who had never were: having a regular partner or spouse (28, 49%), partner does not approve (17, 30%), reduced sexual pleasure (5, 9%), and no answer (7, 12%). The independent predictors of condom use were: being a man, not having a regular partner, having had sex with a casual partner, being able to read English, having at least secondary education, and using electricity for lighting. CONCLUSION: Providing health promotion messages in local languages may improve condom use in this population. There is a need for complementary HIV prevention strategies for women and for regular sexual partnerships.

Adult↗
PubMed1999

Lay people's perceptions of sexually transmitted infections in Uganda.

In order to understand lay people's perceptions of sexually transmitted infections (STIs) focus group discussions and semi-structured interviews were held with community members and patients with STIs in Mbarara and Kampala, Uganda. Symptoms of common STIs and the modes of transmission methods were known. STIs were perceived as naturalistic diseases caused by a tiny insect called akakoko or akawutka, although female infertility, one of the common complications of STIs, was perceived as a supernatural ailment. There was no stigma towards people with AIDS, although stigma towards people with other STIs was high. There were also strong negative attitudes towards the use of condoms. More than 60% of the patients interviewed had received treatment from the informal sector which included self-treatment and traditional healers. To reduce the incidence and complications of STIs, there may be a need to collaborate with the informal sector, to further evaluate the beliefs and practices identified in this study and to target them for health education.

Adolescent↗
PubMed1998

Health-seeking behaviour of patients with sexually transmitted diseases in Zambia.

The aim of this paper is to describe health-seeking behaviour, time with symptoms and sexual activity during symptom period among patients attending the public health sector in urban and rural Zambia for treatment of an STD. The study was conducted at two urban health centres and at one rural mission hospital during four months in 1994 and 1995. Four hundred and seventy nine patients seeking health care for STD symptoms were interviewed. The patients had experienced STD symptoms for one to two weeks before they came to the clinic. During this period two thirds in the urban and one third in the rural setting had had sex. Sixty per cent of the patients in the urban and 50% in the rural setting had taken some kind of medicine before they came to the clinic. More people had used modern compared to traditional medicine, especially in the urban area. Market places, other clinics and doctors, friends, and relatives were common treatment sources. Ten per cent had received medicine from a traditional healer. Thus, a majority of the patients had received medication from other sources before they came to the clinic. Sex during periods with STD symptoms was common. This has serious implications for STD as well as HIV transmission.

Adult↗
PubMed1997

Quality of STD care in an urban Zambian setting: the providers' perspective.

The aim of this paper is to analyse obstacles to optimal STD care in an urban setting in Zambia. Eight-two health professionals answered a questionnaire with closed and open-ended questions. More than 50% were not satisfied with their working conditions, due to heavy workload, lack of equipment/drugs, poor salary, and lack of continuing education. Negative opinions about STD patients were common. Treatment and preventive activities were considered important but most respondents found patient compliance poor--especially for partner notification. To improve the quality of STD care, training in STD management should be combined with improved working conditions.

Education, Nursing, Continuing↗
PubMed1997

Quality of STD care in Zambia. Impact of training in STD management.

STUDY OBJECTIVE: To assess quality of care of sexually transmitted diseases (STDs) and evaluate interactive training methods aimed at improving providers' performance. DESIGN AND SETTING: This comparative study, with a baseline, intervention, and evaluation phases was conducted at two urban health centers in Zambia. The personnel at one health center were trained in STD management using interactive training methods. The other health center acted as a control. SUBJECTS AND METHODS: Two-hundred patients with STD were interviewed and their interaction with health care providers observed before and after the training. Another 200 interviews and observations were conducted at the control health center. RESULTS: The proportion of patients being examined, given health education and informed about partner notification increased significantly after the intervention. The proportion of patients who had complaints about the health care did not decrease. Long waiting time and lack of time to discuss the disease were the main complaints. CONCLUSION: The training solved some, but not all, problems of poor case management. This indicates the need for a more process-oriented approach for improving quality of care.

Adult↗
PubMed1995

Quality of care in sexually transmitted diseases in Zambia: patients' perspective.

The aims of this study were to describe Zambian STD patients response to treatment, compliance with partner notification, and further to measure patients' satisfaction with the health care received. The majority of 179 STD patients (92 men, 87 women) interviewed twice at an urban health centre were not satisfied with the care received. Their response to treatment and compliance with partner notification were not satisfactory. Thirteen patients had not been able to buy medicines, since they had no money. One hundred and twenty-five patients had asked 134 sexual partners to come for treatment but only 60 percent of them had received treatment. To get free medicines, to have privacy, to get injections instead of tablets, to be examined before treatment, and to be informed about the diagnosis were judged most important for good quality STD care. Health workers must improve their communication and counselling skills to understand the needs of their patients, who are the ultimate evaluators of the quality of care.

Adolescent↗
PubMed1994

Behaviour, knowledge and reactions concerning sexually transmitted diseases: implications for partner notification in Lusaka.

Available data show that STDs and their consequences are a major health problem in Zambia. This study focuses on factors which could have implications for partner notification, as a tool for prevention. Fifty women and fifty men with STD were interviewed at two outpatient clinics in Lusaka, where partner notification is not functioning optimally. A majority of the sexual partners during the last three months were known by the patients who also stated a willingness to bring more partners than they were asked to do. Women had symptoms for a longer period than men before they came for treatment. They were less aware of symptoms connected with STD and a majority of them did not know that they were receiving treatment for STD. The communication between the health care provider and the patients about disease, treatment and partner notification needs to be improved especially for women.

Adolescent↗
PubMed1993

Experiences of disease and treatment among Chlamydia patients.

Chlamydia trachomatis infection is a common sexually transmitted disease in Sweden, where counselling and partner notification are tools for prevention. Fifty infected patients (27 women, 23 men) were interviewed at an outpatient department. A majority of the patients felt that they were to blame for getting the disease and had the responsibility to inform partners. Women reacted more strongly against the disease and felt more negatively treated by the health care personnel. Chlamydia was considered a serious disease and 40% expressed fear for HIV/AIDS. Only eight per cent used condoms regularly. The concept 'causal contact' was very differently defined by the patients. Health personnel has to be more aware of the difficulties with ambiguous concepts and information need to be improved. More attention should be paid to women and their reactions.

Adolescent↗
PubMedDate not supplied

Individual counseling of patients with sexually transmitted diseases. A way to improve partner notification in a Zambian setting?

BACKGROUND: Sexually transmitted diseases (STD) are a major health problem in Zambia. Partner notification, which is a recommended strategy to decrease STD, must be improved. GOAL: To assess whether individual counseling of patients with STD, combined with contact slip(s), had any impact on the proportion of sex partners traced in an urban setting in Zambia. STUDY DESIGN: A randomized trial comprised of 94 women and 302 men with STD. RESULTS: Women and men in the intervention group informed more partners than did those in the control group. In the intervention group, 1.8 partners per man was treated compared to 1.2 in the control group (P < 0.001). There was no difference between the two groups of women. There was a gradual decline from numbers of partners informed to numbers of partners treated according to the patient to number of contact slips filed. CONCLUSIONS: Individual counseling of men with STD improved partner notification.

Adolescent↗