Knowledge and practice of family planning and HIV-prevention behaviour among just delivered adolescents in Ecuador: the problem of adolescent pregnancies

HIV/AIDS-related Knowledge and Behavior among School-attending Afro-Descendant Youths in Ecuador

BACKGROUND OR OBJECTIVES

HIV/AIDS transmission in Ecuador is considered a concentrated epidemic; therefore, there are some studies on high risk groups but there is limited published data regarding the HIV/AIDS risk factors among adolescents of African descent. In this study, we sought to explore the determinants of HIV/AIDS-related knowledge and behavior among afro-descendant youths attending schools in the city of Esmeraldas, Ecuador.

METHODS

A cross-sectional survey among school-attending youths was conducted in Esmeraldas, Ecuador in 2010. Our target population was afro-descendant youths attending the last two years of high school. Thirty public high schools enrolling students in junior and senior years were identified. Outcome data were analyzed in the form of three composite variables. A multivariate linear regression model was built for each outcome.

RESULTS

A total of 213 school-attending afro-descendant youths aged 14 to 21 years old were enrolled in this study. Gender distribution was almost equal with a 1:1.17 male to female ratio. Overall, students in this population scored well in comprehensive knowledge of HIV with 88% having medium or higher knowledge.

CONCLUSION AND GLOBAL HEALTH IMPLICATIONS

Knowledge of HIV and its determinants was medium to high, but knowledge of sexually transmitted diseases was low among afro-descendant Ecuadorian adolescents in our study. Results of this study might be instrumental in facilitating decision-making processes related to the planning, implementation, and evaluation of HIV/AIDS prevention and control strategies in this specific population.

A qualitative view of the HIV epidemic in coastal Ecuador

In 2013 approximately 37,000 people were living with HIV in Ecuador (prevalence 0.4%), representing a generalized epidemic where most new infections arise from sexual interactions in the general population. Studies that examine attitudes towards people living with HIV (PLWH), individual risk perception of acquiring HIV amongst Ecuadorians, and the ways in which levels of risk perception may affect risk behaviors are lacking. This qualitative study aimed to fill this gap in the literature by investigating these issues in the rural, coastal community of Manglaralto, Ecuador, which has among the highest incidence of HIV in Ecuador. We conducted interviews with 15 patients at Manglaralto Hospital. Analysis of interview transcripts revealed widespread negative attitudes towards PLWH, prevalent risk behaviors such as multiple sex partners and lack of condom use, and low individual risk-perception of contracting HIV. These findings underscore the need for increased efforts to prevent further growth of the HIV epidemic in Ecuador.

Adolescent pregnancies in the Amazon Basin of Ecuador: a rights and gender approach to adolescents' sexual and reproductive health

In the Andean region of Latin America over one million adolescent girls get pregnant every year. Adolescent pregnancy (AP) has been associated with adverse health and social outcomes, but it has also been favorably viewed as a pathway to adulthood. AP can also be conceptualized as a marker of inequity, since it disproportionately affects girls from the poorest households and those who have not been able to attend school.

Using results from a study carried out in the Amazon Basin of Ecuador, this paper explores APs and adolescents' sexual and reproductive health from a rights and gender approach. The paper points out the main features of a rights and gender approach, and how it can be applied to explore APs. Afterward it describes the methodologies (quantitative and qualitative) and main results of the study, framing the findings within the rights and gender approach. Finally, some implications that could be generalizable to global reserach on APs are highlighted.

The application of the rights and gender framework to explore APs contributes to a more integral view of the issue. The rights and gender framework stresses the importance of the interaction between rights-holders and duty-bearers on the realization of sexual and reproductive rights, and acknowledges the importance of gender–power relations on sexual and reproductive decisions. A rights and gender approach could lead to more integral and constructive interventions, and it could also be useful when exploring other sexual and reproductive health matters.

Giving birth: the voices of Ecuadorian women

PURPOSE

The purpose of this ethnographic study was to describe the perceptions of Ecuadorian childbearing women

BACKGROUND

No studies published in English could be found documenting the perspectives of Ecuadorian childbearing women about their birth experiences.

METHOD

Thirty-two women who had recently given birth in Guayaquil, Ecuador participated in audiotaped interviews, which were analyzed as appropriate for ethnographic inquiry.

RESULTS

"Enduring birth to obtain the gift" was the overarching theme. Supporting themes included caring for self and accessing prenatal care to have a healthy newborn; relying on God to ensure positive maternal/newborn outcomes; submission of self to healthcare providers because of fear, pain, and lack of education; and valuing motherhood. The focus was on the well-being of the child rather than the quality of the birth experience.

IMPLICATIONS FOR CLINICAL PRACTICE

With a growing population of women of childbearing age immigrating into the United States from Central and South America, the need for culturally competent care is increasing. Sensitivity to the cultural beliefs and practices of Hispanic and other culturally diverse childbearing women is critical. Women's reliance on God to ensure positive outcomes should be respected. The provision of education and supportive care will help ensure positive outcomes in culturally diverse women.

Pregnancy among young adolescents: trends, risk factors and maternal-perinatal outcome

Adolescent pregnancies have increased over the past years and are considered a significant social and reproductive concern. This document will briefly describe trends, risk factors and maternal-perinatal outcome associated to pregnancies among young adolescents. Prevalence and trends vary from one population to another with main risk factors being low family income, poor education, lack of knowledge of reproductive health, and poor psychological family support. Maternal and perinatal outcomes also vary according to the country and the methodological design. Regardless, adverse outcomes were identified in the mother (high cesarean section rates, puerperal infections, intrapartum complications) and in the fetus (preterm birth, low birth weight and small for gestational age).