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Kalengayi F.K.N.,Umea University | Hurtig A.-K.,Umea University | Ahlm C.,Umea University | Krantz I.,Skaraborg Institute for Research and Development
Journal of Immigrant and Minority Health | Year: 2012

The increasing rates of HIV infection that are currently being reported in high-income countries can be partly explained by migration from countries with generalized epidemics. Yet, early diagnosis of HIV/AIDS in immigrants remains a challenge. This study investigated factors that might be limiting immigrants' access to HIV/ AIDS care. Data from 268 legal immigrant students of two Swedish language schools in Northern Sweden were analyzed using logistic regression. Thirty-seven percent reported reluctance to seek medical attention if they had HIV/AIDS. Fear of deportation emerged as the most important determinant of reluctance to seek care after adjusting for socio-demographic factors, knowledge level, stigmatizing attitudes and fear of disclosure. Targeted interventions should consider the heterogeneity of migrant communities and the complex interplay of various factors which may impede access to HIV-related services. The myth about deportation because of HIV/AIDS should be countered. © Springer Science+Business Media, LLC 2011.

Chikovore J.,Sexually Transmitted Infections and Tuberculosis Unit | Chikovore J.,Malawi Liverpool Wellcome Trust Research Programme | Nystrom L.,Umea University | Lindmark G.,Uppsala University Hospital | And 2 more authors.
PLoS ONE | Year: 2013

Young people face sexual and reproductive health (SRH) problems including Human immunodeficiency virus (HIV) and Acquired immunodeficiency syndrome (AIDS). It is critical to continue documenting their situation including the contexts they live in. As part of a larger study that explored perspectives of men to SRH and more specifically abortion and contraceptive use, 546 pupils (51% female; age range 9-25 years) from a rural area in Zimbabwe were invited to write anonymously questions about growing up or other questions they could not ask adults for fear or shame. The pupils were included following descriptions by adults of the violence that is unleashed on unmarried young people who engaged in sex, used contraceptives, or simply suggested doing so. The questions by the young people pointed to living in a context of prohibitive silence; their sexuality was silenced and denied. As a consequence they had poor knowledge and their fears and internal conflicts around sexuality and pregnancy were not addressed. Current action suggests concerted effort at the policy level to deal with young people's SRH in Zimbabwe. It nevertheless remains necessary, as a way to provide support to these efforts, to continue examining what lessons can be drawn from the past, and how the past continues to reflect in and shape present dynamics and relations. There is also need to look more critically at life skill education, which has previously been described as having failed to address adequately the practical needs of young people. Life skill education in Zimbabwe has rarely been systematically evaluated. A fuller understanding is also needed of the different factors co-existing in contemporary African societies and how they have been and continue to be constituted within history, and the implications to the promotion of adolescent SRH. © 2013 Chikovore et al.

Feldmeier H.,Institute of Microbiology and Hygiene | Sentongo E.,Makerere University | Krantz I.,Skaraborg Institute for Research and Development
European Journal of Clinical Microbiology and Infectious Diseases | Year: 2013

Tungiasis (sand flea disease) is caused by the penetration of females of Tunga penetrans into the skin of the feet. Within 2 weeks of penetration the burrowed flea increases its volume by a factor of 2,000. This is paralleled by intense inflammation of the surrounding tissue. Acute and chronic inflammation leads to the development of painful and debilitating clinical pathology. This results in impaired physical fitness and mobility. The social implications of tungiasis-associated morbidity are multifold. Children with tungiasis are teased and ridiculed, adults feel ashamed and stigmatized. There is anecdotal evidence that tungiasis negatively affects educational achievements. Impaired mobility and physical fitness will have a negative impact on household economics. Sand flea disease is common in resource-poor communities in South America and in sub-Saharan Africa with prevalence in the general population of up to 60%. In East Africa, it has re-emerged in epidemic dimensions in recent years. Hitherto, no effective drug treatment has been at hand. Traditional treatment, i.e., the manipulation of burrowed sand fleas with blunt and inappropriate instruments may facilitate the transmission of blood-derived pathogens. Prevention is feasible through regular application of a repellent based on coconut oil. Owing to its strong association with poverty, sand flea disease would be an excellent starting point for a community-based fight against rural poverty. © 2012 Springer-Verlag.

Puthoopparambil S.J.,Uppsala University | Ahlberg B.M.,Uppsala University | Ahlberg B.M.,Skaraborg Institute for Research and Development | Bjerneld M.,Uppsala University
International Journal of Qualitative Studies on Health and Well-being | Year: 2015

Detention of irregular migrants awaiting deportation is widely practiced in many countries and has been shown to have profound negative impact on health and well-being of detainees. Detention staff, an integral part of the detention environment, affect and are affected by detainees' health and well-being. The objective of the study was to explore experiences of staff working at Swedish immigration detention centres. Fifteen semi-structured interviews were conducted with staff in three Swedish detention centres and were analysed using thematic analysis. The results indicate that the main challenge for the staff was to manage the emotional dilemma entailed in working as migration officers and simultaneously fellow human beings whose task was to implement deportation decisions while being expected to provide humane service to detainees. They tried to manage their dilemma by balancing the two roles, but still found it challenging. Among the staff, there was a high perception of fear of physical threat from detainees that made detention a stressful environment. Limited interaction between the staff and detainees was a reason for this. There is thus a need to support detention staff to improve their interaction with detainees in order to decrease their fear, manage their emotional dilemma, and provide better service to detainees. It is important to address staff challenges in order to ensure better health and well-being for both staff and detainees. © 2015 S. J. Puthoopparambil et al.

Kubai A.,Uppsala University | Ahlberg B.M.,Uppsala University | Ahlberg B.M.,Skaraborg Institute for Research and Development
Ethnicity and Health | Year: 2013

Objectives. To examine ethnicity and gender violence in Rwanda from cultural and historical perspectives and explore the encounters between cultural beliefs and practices and the new gender equality policy and programs and the implications of the particular encounters to the health of women. Design. The study is a qualitative drawing from the growing range of interactive approaches and methods within an ethnographic framework of the research design. Twenty individual interviews, six focus group discussions and two 'community mobilization' dialogs were conducted. Results. Violence has continued and there is a conflict between cultural tradition, the de-ethnicization, and gender equality policies. Some of the gender violence preventive programs are influenced by the ethos of the traditional norms, and therefore unwittingly perpetuate gender-based violence. Conclusions. In spite of the progress that Rwanda has made in political empowerment of women, it still seems a long way before real gender equality is achieved. It seems that women's empowerment is not only just an opportunity for political participation but also this is important. It is also about the capacity to make effective choices and to translate them into desired actions and outcomes, unfettered by cultural sanctions. Universalised, top-down gender policy programs have not furnished all women with the necessary capacity to make decisions that affect their traditionally all important reproductive functions; to challenge the embedded gender imbalance; and to strive for a holistic wellbeing of their families, where they play a central role. Indeed, some of the policies could have negative implications to the health of women, in particular, with sexually transmitted infections, including HIV and AIDS. © 2013 Taylor & Francis.

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