No abstract

Exposure to nicotine among people living with HIV (PLWH) may impact physical health as indicated by experienced symptoms. Yet, the empirical evidence documenting the relations between tobacco use and symptom experiences among PLWH remains limited. This study aims to assess the relationships between tobacco use and HIV symptoms through a cross-sectional survey conducted in Beijing and Shanghai. The WHO ASSIST screening test was used for frequency of tobacco use. Sixty-four items from the revised signs and symptoms checklist for persons with HIV disease (SSC-HIVrev) were used. "Total number of symptoms" was created by summing all the binary coded and "Maximal symptom severity" was created by taking the maximal severity level across all symptoms for each participant. After controlling for confounding variables, tobacco use was not associated with the total number of symptom, yet was associated with the maximal symptom severity. This study documents the link between tobacco use and experienced symptoms among PLWH by demonstrating that higher frequency of tobacco use is associated with greater odds of reporting more severe symptoms. Smoking cessation strategies should be integrated into symptom management interventions for PLWH to optimize their effectiveness.

Although the health care resources in Chin State are comparable to those in other regions, the indicators of maternal health status there are the poorest in Myanmar. While the Myanmar government has initiated health care system reforms, the increase in service capacity alone is a necessary but insufficient condition to improve access. Because the effectiveness of antenatal care is critical in terms of reducing maternal mortality and serious morbidity, this study determines how women's beliefs affect the utilization of antenatal services. The qualitative study analyzes in-depth interviews with 25 women who had given birth during the past year in both rural and urban areas of three townships in Chin State. The results show that women's beliefs strongly influence the utilization of antenatal services. The women did not recognize pregnancy risks or the benefits of antenatal services. They also did not trust the staff in the formal health care sector, and their trust in traditional birth attendants served as a barrier to utilization of antenatal service. To improve utilization, policymakers must understand the sociocultural context of women, as well as their beliefs and trust related to antenatal care, and should design policy to address the relevant influencing factors.

Purpose: The objective of this study was to determine women’s beliefs as influencing factors in the utilization of antenatal services. Methodology: The quantitative cross sectional survey was conducted in both rural and urban areas of three townships of Chin State. The multi-stage sampling method was used to recruit 350 women who had given birth within the past year. They were interviewed using structured questionnaires relating to their socio-demographic characteristics, beliefs about the utilization of antenatal services, and the situation of received antenatal care. The X2 values and odd ratio with a 95% of CI were calculated to find out women’s beliefs as influencing factors in the utilization of antenatal services. Findings: Among the 350 participants, the number who received antenatal care at least one time and four times were 303 (86.6%) and 222 (63.4%) respectively. There were only 98 (28.0%) who received antenatal care in first trimester. The number of women who showed awareness of life threatening risks of pregnancy was 135 (38.6%) whilst positive attitudes towards the effectiveness of antenatal care and accessibility of health care staff were 170 (48.6%) and 63 (18.0%) respectively. Women’s beliefs about the risks of pregnancy, effectiveness of antenatal care and accessibility of health care staff for antenatal care were statistically associated with the situation of receiving antenatal care at least four times and care in the first trimester but not associated with the situation of receiving at least one time. Unique contribution to theory, practice and policy: Women in Chin State received late first antenatal care and lack of regular follow-up because of their beliefs about the utilization of antenatal services. Effective health education activities are needed to raise awareness about the utilization of antenatal services.