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Biomedical subjects

S Bagshaw

Publications and source records attributed to S Bagshaw.

10 recordsLinked to original sources
PubMed2001

Women's acceptability of screening for HIV in pregnancy.

AIMS: To elicit acceptability of HIV screening during pregnancy in women of reproductive age in Christchurch. METHODS: In-depth face-to-face interviews were conducted with women of reproductive age recruited from seven different service sites in Christchurch. RESULTS: Women wanted to know about treatment that significantly reduces the risk of mother-to-child transmission. They wanted to know about other antenatal screening and were prepared to provide general consent, rather than specific consent for HIV testing. All study participants favoured routine offer of HIV testing during pregnancy for all women and most would agree to be tested, if the test was offered and recommended. CONCLUSIONS: The results of this study indicate the need to develop and test a user-friendly approach for offering routine HIV testing during standard antenatal care in New Zealand.

AIDS Serodiagnosis↗
PubMed2001

Maternity care providers' attitudes and practices concerning HIV testing during pregnancy; results of a survey of the Canterbury and upper South Island region.

AIMS: To assess current attitudes and practice toward antenatal human immunodeficiency virus (HIV) risk assessment, HIV testing and barriers towards implementation of these among midwives, general practitioners (GPs) and obstetricians in the upper South Island METHODS: A survey was conducted among maternity care providers by anonymous self-administered questionnaire. Most questions were dichotomous, forced choice or Likert scale format but there were four open- ended questions asking for a written response. RESULTS: The response rate was 57% overall. The main finding was that 275 (66%) of respondents assessed risk of HIV in less than 10% of patients, and 328 (midwives 93, 85%; GP's 226,77%; obstetricians 9,64%) respondents had performed less than three HIV tests in the past twelve months. Most respondents strongly agreed that detection of HIV during pregnancy is beneficial to mother 318 (83%) and to baby 367 (96%) and to mother prior to pregnancy 353 (92%). 202 (52%) supported and 44 (11%) were opposed to an antenatal screening programme in New Zealand. Most knew how to assess risk for HIV saw themselves as having an important role in antenatal HIV testing, and were comfortable performing risk assessment. Multiple reasons for current practices were offered, including perceived reluctance by women to be tested, lack of time, skills, knowledge and support services, and low rates of HIV in the community. CONCLUSIONS: The current policy of routine HIV risk assessment is not working among respondents. A systematic reassessment and implementation of a workable strategy needs to be undertaken in New Zealand.

AIDS Serodiagnosis↗
PubMed1999

Knowledge, attitudes and behaviour towards HIV infection among family planning clinic attendees: changes between 1991 and 1997.

AIM: To detect changes in knowledge, attitudes and behaviour towards HIV infection amongst Family Planning Clinic attendees in Christchurch, New Zealand, between 1991 and 1997. METHODS: A voluntary, anonymous, self-administered questionnaire was applied to consecutive subjects attending the Montreal Centre of the Family Planning Association in Christchurch, in 1991 and repeated in 1997. Results were compared to assess changes in demographic features, knowledge, attitudes and behaviour pertaining to HIV infection between these times. RESULTS: A 99% response rate was obtained in 1991 and 98% in 1997. Two hundred people in 1991 and 353 people in 1997 responded. These predominantly female heterosexual groups were demographically similar. Levels of knowledge pertaining to HIV infection were high and did not change significantly between 1991 and 1997, except for a rise in the proportion who felt donating blood was a high risk behaviour from 12.0% to 25.7% (p<0.001). HIV testing and discussion about HIV testing amongst couples was more common in 1997. However, the use of recreational intravenous drugs rose from 5.0% to 10.6% (p=0.025), condom use with every new partner fell from 65.1% to 42.1% (p=0.001) and the perceived risk of acquiring HIV in New Zealand and several Western Hemisphere countries fell, with 40.0% perceiving the South Island as a high-risk place in 1991 to 24.1% in 1997(p<0.001). This was paralleled by an apparent rise in known HIV testing. CONCLUSIONS: This predominantly heterosexual population appears to have maintained good levels of knowledge about HIV infection. However, this does not seem to be being translated into safer behaviour. This study detects alarming changes in behaviour in the face of adequate knowledge levels and increased testing for HIV which may provide pathways for entry of HIV into, and transmission within, the heterosexual population of New Zealand. Several aims of the New Zealand Strategy on HIV/AIDS 1990 need to be revisited in light of the evidence and resources directed appropriately.

Adolescent↗
PubMed1995

Improved detection of Chlamydia trachomatis in endocervical samples by using a new polymerase chain reaction assay.

AIM: To compare the performance of a commercially developed polymerase chain reaction (PCR) assay, Amplicor Chlamydia trachomatis from Roche Molecular Systems, with that of a standard enzyme immunoassay (EIA) system, Chlamydiazyme from Abbott Laboratories, which is currently used throughout New Zealand. METHODS: Cervical swabs were collected from 819 female patients attending the family planning clinic in Christchurch. These swabs were then analysed using the Amplicor and Chlamydiazyme assays. RESULTS: The prevalence of chlamydia infection was 4.2% by the Chlamydiazyme EIA method and 5.3% with the Amplicor PCR assay. In 20 cases, where the results from the two assays were discordant, the conflict was 'resolved' by using a third assay which detects a separate region of the chlamydia genome. This gave an overall prevalence of 5.8% of confirmed infections in this group. The Amplicor PCR assay detected 29.4% more cases than the usual EIA method. CONCLUSIONS: This study demonstrates that Amplicor PCR assay allows improved identification of C trachomatis infections in a population with a relatively low prevalence of infection. The Amplicor PCR assay detects a significant number of additional infections and should be considered for routine use. As the PCR assay is more expensive a shift in the price/payment structure may be required before this assay comes into widespread use. However, the reduced morbidity resulting from the detection and treatment of otherwise unrecognised cases should also be considered in any cost benefit analysis.

Adult↗
PubMed1995

The combined oral contraceptive. Risks and adverse effects in perspective.

The risks and adverse effects of the low dose, new generation progestogen combined oral contraceptives (COCs) are much lower than original studies involving pills containing 50 micrograms estrogen. The main effects are those on the cardiovascular system, lipid and glucose metabolism and cancer. Any effect of the COC on myocardial infarction is probably minimal if the woman has no other risk factors especially smoking. The third generation progestogen, low dose COCs have very little effect on lipid or glucose metabolism. There may be a slight increase in breast cancer if COCs are used under the age of 25 years and for more than 4 to 8 years, and in the risk of cervical cancer. It is too early to estimate long term cancer effects of the newer COCs. Adverse effects such as nausea and breast tenderness can be managed by changing the estrogen dose or the type of progestogen. Overall, the clinical benefits of the COC probably outweight the risks and adverse effects.

Breast Neoplasms↗
PubMed1991

1991 cervical screening recommendations: a working group report.

The Department of Health and the Cancer Society invited a working group to review the 1985 recommendations on cervical screening. Minor modifications have been made to the earlier recommendations in the light of more information about the effectiveness of different screening policies, and in the expectation that comprehensive cytology registers to ensure recall and follow up of abnormalities will be in place shortly. All women from the age of 20 up to 70 years should be offered cervical screening every three years. Any woman who has never had sexual intercourse or who has had a hysterectomy with complete removal of the cervical epithelium for a benign condition need not be screened. Women should have a second smear within one year if they have never had a smear before or if more than five years have passed since their last smear. But recall through the register should not be more frequently than three yearly for women with a history of normal smears.

Adult↗