Infecciones de transmisión sexual. Perfil de atención en zonas fronterizas de Centroamérica (2007-2010)

Abstract

Objetivo. Analizar el perfil de atención por infecciones de transmisión sexual (ITS) en centros de salud de zonas fronterizas de Centroamérica durante el periodo 2007-2010. Material y métodos. Estudio transversal en una muestra de 3 357 pacientes. Se capacitaron médicos y se suministraron medicamentos, condones y pruebas de VIH (paquete básico de atención [PBA]). Se analizaron las características sociodemográficas de los participantes y su asociación a la recepción del PBA. Resultados. De la muestra, 66.0% tuvo de 25 a 59 años, 93.2% era mujer. El síndrome más frecuente fue el flujo vaginal asociado con candidiasis, vaginosis bacteriana, trichomoniasis y gonorrea. De las prescripciones, 60% siguió recomendaciones internacionales. Sólo 10.2% recibió el PBA. La probabilidad de recibirlo fue menor en mujeres. Conclusiones. No basta con incrementar las capacidades de provisión de servicios para modificar las prácticas de atención. Éstas se encuentran enraizadas en el contexto sociocultural. Destacan prácticas médicas diferenciadas por género que influyen negativamente en la atención.

The paradox of choice in the sexual and reproductive health and rights challenges of south-south migrant girls and women in Central America and Mexico: A scoping review of the literature

“… ID Reference Method Location Population Objective 1 Acharya (2010) Qualitative Mexico 60 female internally trafficked sex workers, exact age range unspecified but below age 18 to over age 24 Extreme violence and health risks of victims of sex trafficking 2 Camarena Ojinaga et al. (2017) Qualitative Mexico northern border 60 indigenous female internal migrants aged 17–60, 4 key informants from medical staff Indigenous migrant women's experiences with health services and their understanding of their sexual and reproductive rights 3 Serván-Mori et al. (2013) Quantitative Central America and Mexico 3128 females aged 10–60+ presenting to clinics with sexually transmitted infections, includes internal and international migrants Analyze the profile of care for sexually transmitted infections (STIs) in health centers in border areas 4 Medecins Sans Frontieres (2017) Mixed methods Mexico 56 women of 467 total participants, mostly Central American migrants in migrant shelters, exact age range unspecified but less than 18 to over 35 years Measure exposure to violence and impact on health, barriers to health care, and limited access to protection of migrants 5 Goldenberg et al.…”

“…Only one paper also mentioned issues possibly indicative of psychosexual dysfunction and another mentioned cancers ( Acharya, 2010 ; Camarena Ojinaga et al., 2017 ), while 9 studies included mental and emotional health ( Medecins Sans Frontieres, 2017 ; Morris et al., 2013 ; Rodriguez-Montejano et al., 2015 ; Goldenberg et al., 2018 ; Medecins Sans Frontieres, 2020 ; Cardenas-Rodriguez and Vázquez Delgado, 2014 ; Acharya, 2019 ; Stephen, 2019 ; Wang et al., 2019 ). To be more specific, the study of risk factors, prevention interventions and detection of prevalence of sexually transmitted infections (often HIV) dominated, with only rare mention of other genitourinary problems such as urinary tract infections, abnormal vaginal discharge and other issues of gynecological illness and pain ( Acharya, 2010 ; Serván-Mori et al., 2013 ; Medecins Sans Frontieres, 2017 ). The mention of cancers was in a study of internal migrants in Mexico who confirmed that they knew about and undertook screening for cervical and breast cancer ( Camarena Ojinaga et al., 2017 ).…”

“…If taken together, 30 articles touched on issues rooted in these varied aspects of bodily integrity and sexual relations (components four through seven) ( Acharya, 2010 ; Medecins Sans Frontieres, 2017 ; Goldenberg et al., 2012 ; Gandhi et al., 2015 ; Conners et al., 2017 ; Ojeda et al., 2012 ; Morris et al., 2013 ; Goldenberg et al., 2016 ; Rocha-Jiménez et al., 2017 ; Pintin-Perez et al., 2018 ; Rocha-Jiménez et al., 2020; Rangel et al., 2012 ; Rodriguez-Montejano et al., 2015 ; Kendall and Pelcastre, 2010 ; Rocha-Jiménez et al., 2018 ; Febres-Cordero et al., 2018 ; Goldenberg et al., 2018 ; Servin et al., 2018 ; Medecins Sans Frontieres, 2020 ; Cardenas-Rodriguez and Vázquez Delgado, 2014 ; Acharya, 2019 ; Stephen, 2019 ; Wang et al., 2019 ; Zarco-Ortiz, 2018 ; Estrada-Tanck, 2017 ; Gustafsson, 2018 ; Angulo-Pasel, 2018 ; Rocha-Jimenez et al., 2016 ; Lopez et al., 2015 ). A total of 19 articles described aspects of access to sexual health services – largely for testing for sexually transmitted infections ( Acharya, 2010 ; Camarena Ojinaga et al., 2017 ; Serván-Mori et al., 2013 ; Medecins Sans Frontieres, 2017 ; Goldenberg et al., 2016 ; Rocha-Jiménez et al., 2017 ; Pintin-Perez et al., 2018 ; Rangel et al., 2012 ; Rodriguez-Montejano et al., 2015 ; Leyva-Flores et al., 2013 ; Rocha-Jiménez et al., 2018 ; Febres-Cordero et al., 2018 ; Goldenberg et al., 2018 ; Servin et al., 2018 ; Medecins Sans Frontieres, 2020 ; Cardenas-Rodriguez and Vázquez Delgado, 2014 ; Gustafsson, 2018 ;…”

“…However, the Guttmacher-Lancet framework's original focus is on whether unions are consensual and equitable, but the studies rarely discussed unions within this context. Ten papers included themes of information, or lack thereof, on sexual health ( Acharya, 2010 ; Camarena Ojinaga et al., 2017 ; Serván-Mori et al., 2013 ; Medecins Sans Frontieres, 2017 ; Pintin-Perez et al., 2018 ; Kendall and Pelcastre, 2010 ; Leyva-Flores et al., 2013 ; Rocha-Jiménez et al., 2018 ; Febres-Cordero et al., 2018 ; Goldenberg et al., 2018 ). The type of information considered was usually siloed (focusing on preventing sexually transmitted infections) with only one mention of school-based sexuality education, which internal Mexican migrants said was insufficiently informative ( Camarena Ojinaga et al., 2017 ).…”

Movilidad y turismo sexual en la ciudad de Taxco, México

“…Se han observado las experiencias y derechos sexuales de centroamericanos en tránsito a los Estados Unidos (9). Se detallan cuestiones sobre el perfil de atención por infecciones de transmisión sexual de zonas fronterizas de Centroamérica (10); o bien se esclarece el panorama sobre la tasa de uso del condón relacionado con el riesgo de adquirir infecciones de transmisión sexual en trabajadoras sexuales de ciudades del Ecuador (11).…”