Critical Literature review
A: Data Collection
1 What was the context of the study? What motivated the researchers to conduct the study?
This study talks about the spread of HIV AIDS to African American women mostly in the rural areas of the United States of America. More African American women as compared to White and Hispanic women are disproportionately identified with this disease. Most of the people who are infected with HIV AIDS are those that reside in urban and suburban areas as well as the surrounding communities. In the current situation, this disease is increasingly diffusing into the rural areas and has become an issue of concern. Young African American rural women are increasingly infected with HIV AIDS as they are less prepared to meet the prevention and treatment measures of this disease (Crosby, 2002).
2 What were the study objectives?
The main objective of the study was to compare HIV related sexual health history, sexual conducts of low income rural and urban African American women, and risk attitudes. Low income population is at greater risk of contracting HIV AIDS and hence the researcher chose to study them (Crosby, 2002).
3 What was the primary exposure of interest? Was it accurately measured?
The primary exposure of interest was to collect data a statewide survey of women who attend federally financed Special Supplemental Nutrition Program that is planned for children, infants, and women in Missouri. About 90% of the Missouri counties are rural and hence rural women were studied in this area. There were twenty three counties that were selected with 29 women, infants, and children clinics. This method would reach many women in the area as many of them visit these clinics. The stratified random sampling method used helped in controlling the selection of urban and rural counties. The statewide survey was aimed at collecting information on why low income women do not use condoms in prevention of HIV infection (Crosby, 2002).
4 What was the primary outcome of interest? Was it accurately measured?
The participation rate of the WIC was very high (93%) showing that there was accurate measurement. The study protocol was approved by the relevant authorities. Approximately 90% of the women requested to take part in the study agreed indicating that the study provided accurate information. About 58% of the women who were given questionnaires returned them by mail. The findings indicated that the level of acceptability of the study by women was relatively high (Crosby, 2002).
5 What type of study was conducted?
Survey method was used in the study where data was collected through questionnaires and interview.
6 Describe the source of the study population, process of subject selection, and sample size.
Data was collected from WIC clinics which are located in the 23 counties of Missouri. 17 out of 23 counties of this area were rural, 4 were suburban, and 2 were urban. Out of the 29 clinics, 27 were eligible to participate in the study. The study was conducted for a period of two months since every two months women who received WIC benefits went to pick their vouchers hence all women had a chance to be studied. About 4117 of women agreed to participate in the study which was a good population size (Crosby, 2002).
7 Could there have been bias in the selection of the study subjects?
There could have been a bias in selecting study subjects since a woman may be residing in the urban area but visit the rural clinic to get the WIC benefits.
8 Could there have been bias in the collection of information? How likely was this bias?
In the process of data collection, some of the questions such as HIV status were very sensitive and hence one could give false information (Crosby, 2002).
9 What provisions were made to minimize the influence of confounding factors prior to the analysis of the data?
In order to avoid confusing information, demographic variables were studied and tested before conducting data analysis. Pregnancy status and regularity of sexual intercourse were assessed in order to avoid confusion on regularity of condom use (Crosby, 2002).
B: Analysis of the data
1 What measures of association were reported in this study?
In this study, measures of risk perception, sexual risk conducts, and health history were reported. These measures were significantly tested in the presence of observed covariates. For each result measure attaining bivariate significance, a detached logistic regression scrutiny was conducted. 95% confidence intervals and adjusted odds ratios were the results of this process (Crosby, 2002).
C: Interpretation of data
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What were the major results of this study?
The major results of the study are; more urban than rural women have ever been tested with HIV, a higher per cent of rural women indicated that their partners have not being tested with HIV, and HIV prevention measures are used more in urban than in rural areas. More people in urban areas use condoms as compared to those in rural areas. There is much counseling on HIV in urban areas than in rural areas (Crosby, 2002).
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What were the study's strengths?
One of the strengths of this study is the use of controlled analysis in supporting study hypothesis. All women in WIC had an equal chance of being studied hence reducing cases of biases. A large population size (2391) was used in order to get accurate data. The data collected answered the hypothesis adequately. The results of this study can be used in giving directions in other rural states in USA (Crosby, 2002).
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