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HIV self-testing uptake and associated factors among adolescent girls and young women in certificate and diploma colleges, Dodoma, Tanzania: a cross-sectional study

Por: Osima · D. J. · Hussein · A. K. · Anasel · M. G. · Ngasala · B.
Objectives

To determine the prevalence and factors associated with the uptake of HIV self-testing (HIVST) among adolescent girls and young women (AGYW) attending middle learning institutions in Dodoma City, Tanzania, in 2024.

Design: A cross-sectional study design was employed.

Setting

The study was conducted in five randomly selected colleges in Dodoma City, Tanzania.

Participants

A total of 771 female students aged 15–24 years who provided informed consent were enrolled. Students who declined participation or were reported by the college matron as medically unfit were excluded. In this study, ‘sick’ referred to participants with a clinically diagnosed illness rendering them unable to participate.

Primary outcome

The primary outcome was the uptake of HIVST among participants.

Results

The mean age of participants was 20.78 years (SD=1.85). Overall, 360 participants (46.7% (95% CI 43.2% to 50.2%) reported having used HIVST. Among those who had not tested, the most commonly reported barriers included cultural resistance 392 (95.4%), fear of judgement from healthcare providers, 372 (90.5%); legal restrictions on kit provision, 360 (87.6%); fear of testing procedures, 291 (70.8%); concerns about test reliability, 286 (69.6%); fear of test results, 283 (68.9%); limited accessibility to HIVST kits, 280 (68.1%); fear of others discovering they had tested, 273 (66.4%); low awareness of HIVST, 193 (47.0%); and a perceived low risk of HIV infection, 73 (17.8%).

Factors significantly associated with HIVST uptake included having multiple sexual partners adjusted prevalence ratio (aPR 1.23, 95% CI 1.05 to 1.45), studying health-related courses (aPR 1.14, 95% CI 1.04 to 1.27), availability of kits (aPR 2.83, 95% CI 2.21 to 3.62), previous HIV testing experience (aPR 2.65, 95% CI 2.05 to 3.43) and perceiving oneself at risk of HIV infection (aPR 1.29, 95% CI 1.11 to 1.50).

Conclusion

The uptake of HIVST among AGYW in Dodoma City remains below the national target of 95% HIV awareness among people living with HIV. Uptake was influenced by factors such as multiple sexual partnerships, study discipline, kit availability, prior testing experience and perceived risk of infection. Addressing the identified barriers and improving awareness and accessibility of HIVST could enhance testing rates among AGYW.

Association of part-time clinical work of hospitalists with efficiency and quality of care on medical wards: a retrospective study

Por: Bretagne · L. · Roten · C. · Mosimann · S. · Blum · M. R. · Debieux · M. · Martin · A. · Kraege · V. · Beck · T. · Aujesky · D. · Mancinetti · M. · Mean · M. · Baumgartner · C.
Background

Physicians are increasingly interested in part-time employment. However, the impact of part-time work on efficiency and quality of care of inpatients is unknown.

Objectives

To investigate the association between part-time clinical work of hospitalists in General Internal Medicine (GIM) and resource utilisation and short-term patient outcomes.

Design

Retrospective study.

Setting

GIM wards of 3 Swiss teaching hospitals.

Participants

Each inpatient was categorised as having received care mainly (>50%) by part-time or full-time hospitalists. Part-time clinical work was defined as employment of

Primary and secondary outcome measures

Primary outcome was length of hospital stay, secondary outcomes included 30-day readmission, in-hospital mortality, hospitalisation cost and time to completion of the discharge letter. We assessed the association between both groups and outcomes using generalised estimating equations, clustering for individual patients and adjusting for patient and hospitalist characteristics.

Results

There was no statistically relevant difference in length of stay in cases cared for mainly by part-time (mean 7.3 days, 95% CI 7.1 to 7.6) compared with full-time hospitalists (mean 7.6 days, 95% CI 7.3 to 7.8; p=0.18). Time to completion of the discharge letter was longer in the part-time (mean 11.4 days, 95% CI 11.0 to 11.8) versus full-time group (mean 10.9 days, 95% CI 10.6 to 11.2, p=0.049). There was no statistically significant difference between groups for the other outcomes.

Conclusion

We found no evidence that part-time clinical work of hospitalists negatively affects resource utilisation and short-term patient outcomes compared with full-time work.

Percepción del proceso de trabajo de los técnicos de enfermería titulados

Objetive: analizar las percepciones, motivaciones y dificultades de los técnicos de enfermería titulados en enfermería. Metodología: Me-todología: Se trata de una investigación cualitativa, exploratoria descriptiva, la recolección de datos se realizó en un Hospital Municipal del Noroeste de Paraná, durante el primer semestre de 2020, mediante la aplicación de un guión semiestructurado con preguntas orien-tadoras y un cuestionario sociodemográfico. Resultados: El conocimiento adquirido en la graduación de enfermería fue uno de los facto-res facilitadores que contribuyó a una mejor ejecución de la atención brindada, y la mayor dificultad está relacionada con la aceptación de los colegas y supervisores, en relación a las opiniones y sugerencias sobre los procedimientos u organización de la Servicio. Las razones que llevaron a los técnicos de enfermería a cursar una carrera en el área en la que trabajan se deben a la necesidad de cono-cimientos y la búsqueda de un mejor futuro financiero. Conclusión: cuando el profesional tiene un título, se desarrolla con mayor destreza y eficacia en la asistencia proporcionada.

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