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      Características sociodemográficas, indicadores de riesgo y atención sanitaria en relación a infecciones de transmisión sexual en población inmigrante de Granada Translated title: Socio-demographic characteristics, indicators of risk and health care in relation to sexual transmission infections in migrant population of Granada

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          Abstract

          RESUMEN Fundamentos: El objetivo de este estudio fue describir el perfil sociodemográfico, las características de la atención clínica recibida, los indicadores de riesgo y la prevalencia de Infecciones de Transmisión Sexual (ITS) en la población inmigrante que acude a un centro especializado en ITS de la provincia de Granada, así como analizar la asociación entre la presencia o no de ITS con variables sociodemográficas e indicadores de riesgo. Métodos: Se realizó un estudio observacional, transversal y analítico, elaborado en el Centro de Orientación y Enfermedades de Transmisión Sexual de Granada. Se revisaron las historias clínicas de 374 inmigrantes, extraídas de una muestra de 1.455 historias de sujetos con sospecha de padecer una ITS, correspondientes al periodo 2000-2014. Se realizó análisis univariante, bivariante mediante U de Mann-Whitney y test de chi cuadrado, además de regresión logística múltiple. Resultados: La edad media de los sujetos fue de 28,28 años (Dt=7,54). El 69,3% eran mujeres y el 30,7% hombres, procedentes del Mercado Común del Sur (39%) y Unión Europea (35,6%), fundamentalmente. Un 36,1% eran profesionales o ex profesionales del sexo, un 34,5% tenía estudios superiores y un 79,9% eran solteros. Un 70% de los casos tuvo un diagnóstico positivo de ITS, siendo la más prevalente el Virus del Papiloma Humano. El número de parejas en el último año (OR=1,39; IC 95%=1,12-1,74; p=0,002) se asoció significativamente a la presencia de ITS. Conclusiones: En la muestra, que es principalmente de mujeres, profesionales o ex profesionales del sexo, jóvenes, procedentes de Sudamérica y Europa, hay una prevalencia alta de ITS y un mayor riesgo a medida que aumenta el número de parejas en el último año.

          Translated abstract

          ABSTRACT Background: The objective of this paper was to describe the sociodemographic profile, the characteristics of clinical care received, the risk indicators and the prevalence of Sexually Transmitted Infections (STI) in an immigrant population attending a specialized center in Granada, as well as to analyse the association between the presence or absence of STI with the sociodemographic variables and risk indicators. Methods: A cross-sectional observational and analytical study was conducted at the at the Center for Sexually Transmitted Diseases and Sexual Orientation in Granada, by reviewing the clinical records of 374 immigrants extracted from a sample of 1.455 records of subjects with a suspected of STI, corresponding to the period 2000-2014. Univariate analyses was conducted, bivariate analyses was conducted by using Mann-Whitney U and chi-square test, in addition to multiple logistic regression. Results: The mean age of individuals was 28,28 years (Dt=7,54). 69,3% were women and 30,7% were men, mainly from the Southern Common Market (39%) and the European Union (35.6%). 36.1% were professionals or former sex professionals, 34,5% had higher education and 79,9% were single. 70% of the cases had a positive diagnosis of STI, Human Papilloma Virus was the most prevalent infection. The number of partners in the last year (OR = 1,39; IC 95% = 1,12 - 1,74; p = 0,002) was significantly associated with the presence of STI. Conclusions: The sample, mainly women, sex workers or former sex workers, young people, from South America and Europe, has a high prevalence of infections and an increased risk as the number of partners increases in the last year.

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          HIV, Other Blood-Borne Viruses and Sexually Transmitted Infections amongst Expatriates and Travellers to Low- and Middle-Income Countries: A Systematic Review

          In some high-income countries, a proportion of human immunodeficiency virus (HIV), other blood-borne virus (BBV) or sexually transmitted infection (STI) diagnoses have been reported as acquired overseas in low- and middle-income countries. A review was conducted to explore HIV, other BBV or STI related knowledge, risk behavior and acquisition amongst expatriates and travelers, particularly males, travelling from high to low- and middle-income countries. Seven academic databases were searched for 26 peer reviewed articles that met inclusion criteria. Significant variability in the studies was noted, in age, travel duration and frequency and outcomes/risk factors measured and reported on. Risk factors described included longer duration of stay; being single; travel for romance or sex; alcohol and other drug use; lack of travel advice; being male; higher number of sexual partners; and inconsistent condom use. Vaccination, pre-travel health advice, and having fewer sexual partners were described as protective. Studies are needed focusing on the social context in which risk-taking occurs. Better collaboration is essential to deliver comprehensive health promotion interventions alongside more consistent pre- and post- travel testing and advice. Policy measures are crucial, including consistent evaluation indicators to assess impacts of HIV, other BBVs or STIs in the context of mobility. Risks and responses for these epidemics are shared globally.
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            Screening for Infectious Diseases among Newly Arrived Migrants: Experiences and Practices in Non-EU Countries of the Mediterranean Basin and Black Sea

            Changing migration dynamics in the Mediterranean Sea and differences in infectious diseases (ID) burden between the countries of origin have raised questions whether public health actions are needed to avoid the transmission of ID. Screening newly arrived migrants for ID is one health monitoring option, offering opportunities for prevention, early detection and treatment. The authors conducted a survey among country experts in non-European Union countries of the Mediterranean and Black Sea, in order to explore current ID screening practices and policies for newly arrived migrants. The association between the existence of guidelines and the proportion of refugees in the population was also estimated. Eighteen country experts responded (90%) out of the 20 invited. Eleven countries (61%) implemented screening programmes and six (38%) had national guidelines. Screening was performed most often for tuberculosis at the holding level. A higher proportion of refugees in the population was associated with the existence of guidelines for screening (p = 0.05). Fourteen experts (88%) considered screening among migrants useful. The results show that screening for ID in newly arrived migrants is relevant for non-EU countries of the Mediterranean and Black Sea. Common guidelines could be promoted focusing on both individual and public health benefits of screening programmes.
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              Acculturation and HIV-related sexual behaviours among international migrants: a systematic review and meta-analysis.

              This review examines the global literature regarding the relationship between acculturation and HIV-related sexual behaviours among international migrants. Seventy-nine articles published in English-language journals prior to July 2012 met the criteria for inclusion. We conducted a systematic review and subset meta-analysis of correlations between acculturation and five types of sexual behaviours including condom use, multiple partnerships, early sexual initiation, sexually transmitted diseases (STDs) and other unsafe sexual practices. Immigrants high in mainstream acculturation were more likely to have multiple partnerships, early sexual initiation, STDs and unsafe sex (rs ranged from 0.10 to 0.16), but acculturation was not associated with condom use (r = 0.02). Gender moderated the relationships between acculturation and multiple partnerships, STDs and unsafe sex. The relationship between acculturation and unsafe sex also varied across ethnicity. These findings suggest that acculturation may serve as a risk factor towards immigrants' HIV-related sexual health. We offered a theoretical framework and suggested applying cross-cultural and longitudinal designs in future research on acculturation and health behaviours.
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                Author and article information

                Journal
                resp
                Revista Española de Salud Pública
                Rev. Esp. Salud Publica
                Ministerio de Sanidad, Consumo y Bienestar social (Madrid, Madrid, Spain )
                1135-5727
                2173-9110
                2019
                : 93
                : e201912102
                Affiliations
                [3] Granada orgnameComplejo Hospitalario Virgen de las Nieves España
                [1] Jaén Andalucía orgnameUniversidad de Jaén orgdiv1Facultad de Ciencias de la Salud Spain
                [4] Granada Andalucía orgnameUniversidad de Granada orgdiv1Facultad de Ciencias de la Salud Spain
                [2] Granada orgnameHospital de Guadix España
                Article
                S1135-57272019000100451 S1135-5727(19)09300000451
                b901f5b9-bf18-4338-82d9-acee3de2b53e

                This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 International License.

                History
                : 07 June 2019
                : 02 October 2019
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 41, Pages: 0
                Product

                SciELO Public Health

                Categories
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                Dinámica poblacional,Factores de riesgo,Emigration and immigration,Population dynamics,Sexually transmitted diseases,Emigración e inmigración,Risk factors,Enfermedades de transmisión sexual

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