Children's Knowledge of Sexual Abuse Prevention in El Salvador

BACKGROUND:

Child sexual abuse (CSA) remains a global health problem that must be addressed. In a country with limited resources such as El Salvador, we sought an alternative way to disseminate CSA prevention information to elementary school children.

OBJECTIVE:

The aim of this study was to evaluate the effectiveness of a child sexual abuse (CSA) prevention exhibit at a children's museum.

METHODS:

We asked 189 children to answer a questionnaire about CSA prevention before entering a museum exhibit on the subject and then asked 59 different children to answer the questionnaire after visiting the exhibit.

FINDINGS:

Children's knowledge scores on CSA prevention significantly improved after visiting the exhibit (P < .012).

CONCLUSIONS:

A museum exhibit that addresses CSA prevention is an effective way of communicating CSA prevention to children.

Children's Answers to Knowledge Questionnaire Pre– and Post–Museum Visit (all ages) and P Values for Correct Answers

Question	Pre-visit	Post-visit (P-value)
Q1. “My body belongs to me”
Yes (%)	89.9	98.3 (.038)
No (%)	10.1	1.7
Q2. “What should you do if someone tries to touch you or looks at you in a manner that scares or makes you feel bad?”
I would scream NO and get away (%)	73.4	88.1 (.018)
I would tell someone until later (%)	11.6	11.9
I would say nothing (%)	15	2.4
Q3. “Why is it important to tell if someone tries to touch you or looks at you in a manner that scares or makes you feel bad?”
Because I have not done anything wrong and I have the right to ask for help (%)	86.7	96.1 (.033)
It is not important to tell or I do not know (%)	13.3	3.4
Q4. What are a girl's private parts?
vulva, vagina, buttocks and breast (%)	93.6	100 (.045)
face, arms (%)	4	0
Q5. What are a boy's private parts?
penis, testicles, buttocks (%)	95.2	100 (.086)
knees, teeth (%)	4.8	0

Full article at:   http://goo.gl/2BV0qY

By:  Hurtado A, Katz CL, Ciro D, Guttfreund D, Nosike D.

¹Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY

²Department of Preventive Medicine, Icahn School of Medicine at Mount Sinai, New York, NY

³Global Health Center, Icahn School of Medicine at Mount Sinai, New York, NY

⁴Department of Medical Education, Icahn School of Medicine at Mount Sinai, New York, NY

Ann Glob Health. 2014 Mar-Apr;80(2):103-7. doi: 10.1016/j.aogh.2014.04.004.

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Is Violence Associated with Increased Risk Behavior among MSM? Evidence from A Population-Based Survey Conducted Across Nine Cities in Central America

There is a dearth of research examining the linkages between violence and HIV risk behavior among men who have sex with men (MSM), including those who identify as transgender women (TW), particularly in Central America where violence is widespread. In this paper, we use population-based survey results to independently examine the correlations between physical, emotional and sexual violence and HIV risk behavior among MSM populations in five countries in Central America.

As part of USAID's Combination Prevention for HIV program in Central America, PASMO conducted population based surveys using respondent-driven sampling (RDS) in nine cities in Guatemala, El Salvador, Nicaragua, Costa Rica, and Panama. Initial seeds were recruited using the following criteria: individuals who represented subgroups of MSM by self-identification (homosexual vs. heterosexual or bisexual vs. transgender), social economic strata, and by sex work practices. This study examines the association between violence and 

1. HIV risk behaviors relevant to the study populations; 
2. protective behaviors; and 
3. reported STIs. Individualized RDS estimator weights for each outcome variable were calculated using RDSAT software, and logistic regression analysis was used to determine associations between different forms of violence and the outcome variables.

MSM who experienced physical violence were more likely to be engaged in transactional sex, have multiple partners in the past 30 days, and have engaged in sex under the influence of alcohol or drugs. 

Both physical violence and psychological/verbal violence were also associated with reporting STI symptoms or diagnosis within the past 12 months. The effects of violence on the outcomes were observed after controlling for other risk factors. Transgender women were 3.9 times more likely to report engaging in transactional sex. 

Respondents who were heterosexual, bisexual, or transgender were also more likely to both report multiple partnerships and more likely to report engaging in sex under the influence of alcohol or drugs, as compared to those identifying as homosexual.

Violence experienced by MSM and TW is widespread in Central America. The experience of violence is shown in this study to be independently associated with risk behaviors for HIV infections. Further research and studies are needed to identify the effects violence has on HIV risk behavior among this under-researched population to improve targeted HIV prevention interventions.

Full article at: http://goo.gl/NX73bR

By: Wheeler J1, Anfinson K2, Valvert D3, Lungo S3.

• 1Population Services International, Washington, DC, USA
• 2Population Services International, Washington, DC, USA.
• 3Association PASMO, Guatemala City, Central America.

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HIV Treatment for Alcohol and Non-Injection Drug Users in El Salvador

Since the mid-1990s, many developing countries have introduced and expanded the availability of combination antiretroviral therapy (cART) to persons living with HIV (PLH). However, AIDS-related mortality continues to be high particularly among drug users. 

In this article, we present results from in-depth interviews with 13 HIV medical providers and 29 crack cocaine and alcohol using PLH in El Salvador. 

• Providers endorsed negative attitudes toward substance using PLH 
• and warned PLH that combining cART with drugs and alcohol would damage their livers and kidneys resulting in death. 

Upon diagnosis, PLH 

• received little information about HIV treatment 
• and many suffered depression and escalated their drug use. 
• PLH reported suspending cART when they drank or used drugs because of providers' warnings. 
• Substance using PLH were given few strategies and resources to quit using drugs. 

Messages from medical providers discourage drug users from initiating or adhering to antiretroviral therapy (ART) and may contribute to treatment abandonment.

Via:  http://ht.ly/SIPaf  Purchase full article at: http://goo.gl/werBiQ

By: Dickson-Gomez J1, Bodnar G2, Petroll A3, Johnson K3, Glasman L3.

• 1Medical College of Wisconsin, Milwaukee, Wisconsin, USA
• 2Fundación Antidrogas de El Salvador, Santa Tecla, El Salvador.
• 3Medical College of Wisconsin, Milwaukee, Wisconsin, USA.

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