Peruvian Women Research Articles

Cultural adaptation to Spanish and psychometric analysis of the Woman Abuse Screening Tool (WAST) in Peruvian adult women

BACKGROUND: Partner violence is a public health problem. In Peru, women with spouses are vulnerable to suffering it. The Woman Abuse Screening Tool (WAST) is a widely recommended instrument for the early identification of these cases. Therefore, our objective was to adapt and analyse the psychometric properties of the WAST scale in adult Peruvian women. METHODOLOGY: This was an instrumental study, with a sample of 628 women who were in a marital condition of cohabitation or married at the time of the study. The mean age was 35 years (M = 35.58; SD = 10.92) and on average they were living with their partner for 9 years (M = 9.93; SD = 8.41). This sample was selected by non-probabilistic snowball sampling. The Woman Abuse Screening Tool (WAST), Generalized Anxiety Disorder-7 (GAD-7) and Patient Health Questionnaire (PHQ-9) were used. The validity of the internal structure was verified with confirmatory factor analysis (CFA), convergent validity by correlation coefficients between the WAST, GAD-7 and PHQ-9, while reliability was verified using Cronbach’s alpha and McDonald’s Omega coefficient. RESULTS: Factorial analysis indicated that the one-dimensional model showed adequate goodness-of-fit indices (CFI = 0.998; TLI=0.991; RMSEA=0.103; SRMR=0.075), and reliability coefficients (α = 0.899 and ω = 0.916) were optimal. Additionally, the WAST showed strong external validity based on the relationship with the PHQ-9 and GAD-7 scores (Rho > 0.50). CONCLUSIONS: The Woman Abuse Screening Tool (WAST) scale demonstrated solid evidence of internal and external validity and optimal reliability in adult Peruvian women. Its use will benefit the early identification of victims of intimate partner violence in primary health care and further research.

Comprehensive Health Insurance and access to maternal healthcare services among Peruvian women: a cross-sectional study using the 2021 national demographic survey

BackgroundThe government-subsidized health insurance scheme Seguro Integral de Salud (“SIS”) was introduced in Peru initially to provide coverage to uninsured and poor pregnant women and children under five years old and was later extended to cover all uninsured members of the population following the Peruvian Plan Esencial de Aseguramiento Universal – “PEAS” (Essential UHC Package). Our study aimed to analyze the extent to which the introduction of SIS has increased equity in access and quality by comparing the utilization of maternal healthcare services among women with different insurance coverages.MethodsRelying on the 2021 round of the nationally-representative survey “ENDES” (Encuesta Nacional Demográfica y de Salud Familiar), we analyzed data for 19,181 women aged 15–49 with a history of pregnancy in the five years preceding the survey date. We used a series of logistic regressions to explore the association between health insurance coverage (defined as No Insurance, SIS, or Standard Insurance) and a series of outcome variables measuring access to and quality of all services along the available maternal healthcare continuum.ResultsOnly 46.5% of women across all insurance schemes reported having accessed effective ANC prevention. Findings from the adjusted logistic regression confirmed that insured women were more likely to have accessed ANC services compared with uninsured women. Our findings indicate that women in the “SIS” group were more likely to have accessed six ANC visits (aOR = 1.40; 95% CI 1.14–1.73) as well as effective ANC prevention (aOR = 1.32; 95% CI 1.17–1.48), ANC education (aOR = 1.59; 95% CI 1.41–1.80) and ANC screening (aOR = 1.46; 95% CI 1.27–1.69) during pregnancy, compared with women in the “Standard Insurance” group [aOR = 1.35 (95% CI 1.13–1.62), 1.22 (95% CI 1.04–1.42), 1.34 (95% CI 1.18–1.51) and 1.31(95% CI 1.15–1.49)] respectively. In addition, women in the “Standard Insurance” group were more likely to have received skilled attendance at birth (aOR = 2.17, 95% CI 1.33–3.55) compared with the women in the “SIS” insurance group (aOR = 2.12; 95% CI 1.41–3.17).ConclusionsOur findings indicate the persistence of inequities in access to maternal healthcare services that manifest themselves not only in the reduced utilization among the uninsured, but also in the lower quality of service coverage that uninsured women received compared with women insured under “Standard Insurance” or “SIS”. Further policy reforms are needed both to expand insurance coverage and to ensure that all women receive the same access to care irrespective of their specific insurance coverage.

Interruption of the Use of Contraceptive Methods During the Quarantine By COVID-19 in Peruvian Women

Background: The covid-19 pandemic affected family planning management and the sexual and reproductive rights of couples. Objective: To determine the factors associated with the interruption of the use of contraceptive methods during the quarantine by COVID-19 in Peruvian women. Methods: Analytical and cross-sectional study, which included 342 women who used a contraceptive method before the COVID-19 quarantine, to whom a virtual questionnaire disseminated on social networks was applied. Pearson's chi-square evaluated associations between method discontinuation and the factors studied. Results: Of the total number of women, 45% discontinued the use of contraceptive methods during the COVID-19 quarantine. The predominant age range was from 18 to 34 years (93.9%). The factors associated with this interruption were age (p = 0.044), marital status (p < 0.001), parity (p < 0.001), sexual relations (p < 0.001), and searching for information by digital means (p = 0.044). The main reason for stopping use was fear of contagion by COVID-19 (42.8%). Conclusion: About half of contraceptive method users interrupted their use during the COVID-19 quarantine, and the factors associated with said interruption were personal, reproductive, and informational. Therefore, health personnel must provide comprehensive care for women, especially in health emergencies.

Association between receiving information on obstetric complications and institutional delivery: An analysis of the demographic and health survey of Peru, 2019

ObjectiveTo evaluate the association between receiving information on obstetric complications and institutional delivery in Peruvian women in 2019. MethodsWe conducted a secondary analysis of the 2019 Peruvian Demographic and Family Health Survey (ENDES) database. The dependent variable was the type of delivery (institutional or non-institutional). The exposure variable was self-reporting of having received information on obstetric complications during prenatal care. The association of interest was evaluated using binary logistic regression models, obtaining crude odds ratios (cOR) and adjusted odds ratios (aOR) with their respective 95 % confidence intervals (95%CI). Values of p < 0.05 were considered statistically significant. ResultsWe included a total of 14,835 women in the analysis. Of the total, 14,088 (94.1 %) reported having received information on pregnancy complications. Also, 13,883 (92.5 %) had an institutional delivery in their last pregnancy. The adjusted model showed that women who reported knowing the complications that can occur in pregnancy had a higher probability of presenting an institutional delivery (aOR = 1.47; 95%CI: 1.04–2.08). ConclusionsReceiving information about pregnancy complications was found to be associated with a higher probability of institutional delivery. Ensuring the provision of information to the pregnant woman about pregnancy complications can be a useful strategy to increase institutional delivery.

Association between early sexual initiation and sexually transmitted infections among Peruvian reproductive-age women.

Sexually transmitted infections (STIs) are a serious public health problem worldwide, especially among reproductive-age women. The early sexual onset of sexual intercourse (EOSI) has been suggested as a risk factor, although there is no data at the national level. To evaluate the association between EOSI and STIs in Peruvian women of childbearing age. Analytical cross-sectional study with secondary data analyzes of the Peruvian Demographic and Family Health Survey 2018. The outcome was the presence of STIs in the last 12 months and the exposure variable was EOSI (age < 15 years at the time of their first sexual experience). To evaluate the association of interest, crude and adjusted prevalence ratios (aPRs) were calculated using generalized linear models with Poisson family and logarithmic link function. We analyzed data from 31,028 women of childbearing age. The 11.3% reported having STIs in the last 12 months and 20.2% of the participants had an EOSI. After adjusting for potential confounders, we found that EOSI was associated with STIs (aPR: 1.27; 95% CI: 1.08-1.50; p = 0.005). When conducting stratified analysis by area of residence and number of sexual partners, this association was maintained in women living in urban areas (aPR: 1.36; 95% CI: 1.11-1.66; p = 0.003) those who did not report having a history of multiple sexual partners (aPR: 1.27; 95% CI: 1.08-1.51; p = 0.005), and those in the middle (aPR: 1.42; 95% CI: 1.03-1.97; p = 0.034) and highest (aPR: 2.12; 95% CI: 1.33-3.39; p = 0.002) wealth quintiles. Among reproductive-age women from Peru, EOSI was associated with STIs, especially in women living in urban areas, with no history of multiple sexual partners, and belonging to the middle to higher wealth index. The implementation of measures to prevent EOSI and fostering appropriate sexual health counseling for women with EOSI is advised.

What it means to live with fibromyalgia for Peruvian women: A phenomenological study

IntroductionPatients with fibromyalgia experience pain at a constant and incapacitating pace. It is still a complex entity yet to be fully understood but meanwhile affects patients in every aspect of their lives. ObjectiveThe purpose of this study is to describe what living with fibromyalgia means for Peruvian women and how it affects their family, work, and social lives in 2021. Materials and methodsThe study has a qualitative design with a phenomenological approach; snowball sampling and theoretical saturation sample size; 10 patients were interviewed through semi-structured in-depth interviews. An ideographic and a nomothetic analysis were conducted, divergences and convergences in the statements were sought and units of analysis were obtained. ResultsThere were 12 categories: meaning of fibromyalgia, clinical picture, complications and sequelae, diagnostic process, impact on work, impact on family life, impact on social life, experience with health personnel, lessons learned from fibromyalgia, ecclesiastical support, and myths, misinformation, and prejudices about fibromyalgia. ConclusionThe experiences and the clinical picture are diverse, the family remains an active and reliable support network for patients, unlike social and work lives, where there is a lack of initiative or empathy towards patients. In light of our findings, we expect healthcare workers and the public in general to learn and see beyond “just histrionics” or “attention seekers” and thus improve the patient's quality of life.

The Entrepreneurship of Peruvian Women: Analysis of Some Cases on The Production of Pisco and The Installation of Family Organic Gardens

The objective of this article is to analyze entrepreneurship in Peruvian women, specifically in the production of pisco and in the creation of organic gardens that have been developed in recent years in order to support the family economy. A study was carried out based on the discourse of the experiences of the main protagonists.

Assessment of regional body composition, physical function and sarcopenia among peruvian women aging with HIV: A cross-sectional study.

Management of chronic conditions and optimization of overall health has become a primary global health concern in the care of people living with HIV in the era of highly active antiretroviral therapy (ART), particularly in lower-and-middle income countries where infrastructure for chronic disease management may be fragmented. Alterations in body composition can reflect important changes in musculoskeletal health, particularly among populations at risk for developing fat and muscle redistribution syndromes, such as women with HIV on ART. Given the lack of data on this topic in Latin America and the Caribbean, we designed an exploratory study to measure these outcomes in a population of women aging with HIV in Peru. We conducted a cross-sectional study among Peruvian women with and without HIV aged ≥40 years. Dual X-ray absorptiometry was used to measure trunk and limb lean mass (LM) and fat mass (FM). Physical performance was assessed with the Short Physical Performance Battery (SPPB) and physical strength with a dynamometer. Sarcopenia was assessed based upon EWGSOP criteria. We used linear regression to model associations between body composition, sarcopenia and physical performance scores. 104 women with HIV and 212 women without HIV were enrolled (mean age 52.4±8.2 vs. 56.4±8.8 years, p≤0.001). Among women with HIV, mean years since diagnosis was 11.8±6 and all were on ART. Mean SPPB score was 9.9 vs 10.8 (p<0.001) between both groups. Sarcopenia spectrum was found in 25.9% and 23.1%, respectively. In the multivariable regression analysis, trunk FM and older age were negatively correlated with physical performance among women with HIV. Severe sarcopenia was found among a greater proportion of those with HIV (3.8% vs. 0.9%, p = 0.84), however this finding was not statistically significant. Women with HIV had significantly lower SPPB scores compared to women without HIV, and trunk FM and upper limb LM were independent predictors for the SPPB and Grip Strength tests, respectively. Larger, prospective studies are needed in Latin America & the Caribbean to identify individuals at high risk for sarcopenia and declines in physical function, and to inform prevention guidelines.

Promoter hypermethylation of RARB and GSTP1 genes in plasma cell-free DNA as breast cancer biomarkers in Peruvian women.

Promoter hypermethylation is one of the enabling mechanisms of hallmarks of cancer. Tumor suppressor genes like RARB and GSTP1 have been reported as hypermethylated in breast cancer tumors compared with normal tissues in several populations. This case-control study aimed to determine the association between the promoter methylation ratio (PMR) of RARB and GSTP1 genes (separately and as a group) with breast cancer and its clinical-pathological variables in Peruvian patients, using a liquid biopsy approach. A total of 58 breast cancer patients and 58 healthy controls, matched by age, participated in the study. We exacted cell-free DNA (cfDNA) from blood plasma and converted it by bisulfite salts. Methylight PCR was performed to obtain the PMR value of the studied genes. We determined the association between PMR and breast cancer, in addition to other clinicopathological variables. The sensitivity and specificity of the PMR of these genes were obtained. A significant association was not found between breast cancer and the RARB PMR (OR = 1.90; 95% CI [0.62-6.18]; p = 0.210) or the GSTP1 PMR (OR = 6.57; 95% CI [0.75-307.66]; p = 0.114). The combination of the RARB + GSTP1 PMR was associated with breast cancer (OR = 2.81; 95% CI [1.02-8.22]; p = 0.026), controls under 50 years old (p = 0.048), patients older than 50 (p = 0.007), and postmenopausal (p = 0.034). The PMR of both genes showed a specificity of 86.21% and a sensitivity of 31.03%. Promoter hypermethylation of RARB + GSTP1 genes is associated with breast cancer, older age, and postmenopausal Peruvian patients. The methylated promoter of the RARB + GSTP1 genes needs further validation to be used as a biomarker for liquid biopsy and as a recommendation criterion for additional tests in asymptomatic women younger than 50 years.

Exploring the prevalence of abortion and its characteristics in Perú

ObjectivesOur paper presents the analysis of a nationwide survey that explored induced abortion among women using a ballot-box technique. Our objective was to determine the prevalence of abortion and the main characteristics of the procedure. Study designWe conducted surveys in households with 2400 women aged 18–49 from urban areas nationwide, between October 15 and 29, 2018. Data collection was overseen by the Instituto de Opinión Pública de la Universidad Católica del Perú. We performed a probabilistic, multistage, and socioeconomic level-stratified sampling. Our study used the “ballot-box technique” to ensure anonymity and reduce the risk of social desirability. ResultsWe visited 15,433 houses nationwide. Among those households where surveys could not be conducted, it was due to abandoned or inaccessible property, unwilling to participate, absent members, out of quota, or inconclusive survey. On average, 19.0% of Peruvian women at all socioeconomic levels reported having had at least one abortion in their lifetime. Induced abortion is reported at all socioeconomic levels and reported age of the abortion is concentrated between 19 and 29 years old. In 57.7% of cases, women sought healthcare personnel for their last induced abortion. Among them, procedure abortion (45.3%) stands out over medical abortions (34.0%). Thirty-three percent of women who reported having had at least one induced abortion in their lifetime were admitted to a hospital after their last abortion. ConclusionsThe illegality of abortion has not prevented its occurrence in Peru. Our results suggest that, in Peru, legal restrictions on induced abortion create an unfavorable context for women's health, exposing them to services whose safety is not guaranteed. Efforts should be made to increase awareness and education about contraception and family planning methods to prevent unwanted pregnancies and reduce the need for abortion. ImplicationsThese findings should be considered in public policy discussions regarding abortion, since they might have a great impact for better decision making. They demonstrate that legal restrictions have not prevented the occurrence of abortion but has only created unsafe conditions around it.

Association Between Intimate Partner Violence and Depression in Peruvian Pregnant Women: A Secondary Analysis of the ENDES 2013–2019

Background: Intimate partner violence (IPV) against women is common during pregnancy and can have adverse mental health outcomes in women. Our objective was to evaluate the association between IPV and symptoms of depression in Peruvian pregnant women.Methods: In this study, we performed a secondary analysis of the Demographic and Family Health Survey, ENDES 2013–2019. The study population consisted of a subsample of married or cohabiting Peruvian pregnant women. IPV was defined as any reported violence (psychological, physical, or sexual) committed by the last partner of women. The symptoms of depression were measured using the Patient Health Questionnaire-9. Poisson regression-generalized linear models were used to calculate adjusted prevalence ratios (aPR) with their respective 95% confidence intervals (95% CI).Results: Overall IPV was 11.64%. The prevalence of psychological, physical, and sexual IPV was 6.92%, 8.56%, and 1.12%, respectively. After adjusting for confounding variables, IPV was associated with the symptoms of depression (aPR: 2.26, 95% CI: 1.88–2.73;p&lt; 0.001). Likewise, psychological, physical, and sexual violence were also associated with the symptoms of depression (aPR: 2.01, 95% CI: 1.65–2.50;p&lt; 0.001, aPR: 2.34, 95% CI: 1.91–2.86;p&lt; 0.001, aPR: 2.31, 95% CI: 1.45–3.68;p&lt;0.001).Conclusion: One in 10 pregnant women experienced IPV, the most frequent type being physical violence. One in four pregnant women experiences depressive disorders. Furthermore, the presence of psychological, physical, or sexual violence independently doubles the probability of the occurrence of depression in Peruvian pregnant women.

Association Between the Autonomy of Peruvian Women and the Choice of the Place of Delivery: Analysis of a National Survey, 2019.

To determine the association between Peruvian women's autonomy and place of delivery. An analytical cross-sectional study of secondary data from the Demographic and Family Health Survey 2019 was carried out. The dependent variable was institutionalized childbirth, and the independent variable was women's autonomy. Likewise, the association between women's autonomy and institutionalized childbirth was evaluated using Poisson family generalized linear models with logarithmic link function, and crude (PR) and adjusted prevalence ratios (aPR) with their respective 95% confidence interval (CI) were estimated. The analysis included 15,334 women aged 15-49 years. It was found that a high proportion of women had a low level of autonomy (42.6%; 95% CI: 41.5-43.7), while 92.1% (95% CI: 91.3-92.9) had institutionalized childbirth. Moderate (PR: 1.10; 95% CI: 1.08-1.12) and high (PR: 1.13; 95% CI: 1.12-1.15) levels of women's autonomy were found to be associated with institutionalized childbirth, and the same association was found in the adjusted analysis. Being a woman with a higher level of autonomy was related to a higher prevalence of institutionalized childbirth. Therefore, as decision-making is a multifactorial characteristic, it is necessary to study in depth the determinants of non-institutionalized childbirth in women with less autonomy.

Perinatal Health in Amazon Triple Border Region: Cross-Sectional Analysis Comparing Outcomes in the Brazilian, Peruvian and Colombian Population.

To investigate the perinatal outcomes in Brazilian, Peruvian, and Colombian women in a Brazilian reference maternity hospital based at Amazon triple border region. A cross-sectional case study of data from 3242 live birth certificates issued at the Tabatinga public maternity hospital, in the countryside of Amazonas, in the period between January 2015 and December 2017. Maternal and perinatal independent variables were analysed based on central tendency and variability, and frequency distribution for categorical variables. The Pearson's Chi-Square test and univariate analyses were performed to estimate probability ratios (Odds Ratio-OR). Significant differences were found in the education level in the three population groups, as well as in the number of previous pregnancies, antenatal consultations, month of initial prenatal care, and type of delivery. Brazilian pregnant women had more prenatal consultations, caesarean sections, and premature births. Peruvian and Colombian women started antenatal care later, and those with high-risk pregnancies tended to deliver in their home country. Our findings show some singularities in the care of women and infants in the Amazonian triple border region. The Brazilian Unified Health Care System performs an important role in the guarantee of free access to health services, and ensures comprehensive care for women and infants, promoting human rights in border regions regardless of nationality.

Prevalence of and risk factors for vertebral fracture and low bone mineral density among Peruvian women aging with HIV.

Studies have shown that patients with HIV are at increased risk for bone loss and fracture due to a combination of host, viral, and antiretroviral therapy (ART)-related factors. We aimed to explore the prevalence of vertebral fracture (VF) and low bone mineral density (BMD) among women aging with HIV in Peru and identify risk factors for osteoporosis and fracture in this population. We enrolled women living with and without HIV aged ≥40 years between 2019 and 2020. Participants completed a survey and obtained dual X-ray absorptiometry (DXA) test to assess BMD at the lumbar spine (LS), femoral neck (FN), and total hip (TH). A subset of patients also obtained lateral thoracolumbar X-rays. Presence of VF was determined using the Genant semiquantitative method. Regression analyses were used to model associations between key risk factors and BMD. 104 women living with HIV and 212 women living without HIV were enrolled with a mean age of 52.4±8.2 and 56.4±8.8 years (p < 0.001). Among postmenopausal women (257/316, 81.3%), 26.3% of women living with HIV and 25.9% of those without HIV had osteoporosis. Among the 88 women living with HIV and 178 women living without HIV who obtained thoracolumbar X-rays, 12.5% and 6.2%, respectively, had at least one VF. Based on DXA and the FRAX score, 22/104 women living with HIV met criteria for osteoporosis treatment according to national guidelines; however, none were on treatment. Propensity score matching revealed that women living with HIV had 0.032 g/cm2 lower FN BMD (p = 0.012) and 0.034 g/cm2 lower TH BMD (p = 0.041) compared to women without HIV. In this study, women living with HIV on long-standing ART had increased VF prevalence compared to the slightly older group of women without HIV. Age and BMI were independent predictors for BMD at the lumbar spine, hip, and femoral neck among women living with HIV, and there was a treatment gap among women who met criteria for osteoporosis treatment. Larger studies are needed in this region to identify individuals at risk for fracture and to inform prevention guidelines.

El conocimiento sobre la no adherencia de métodos anticonceptivos ¿Podría disminuir la mortalidad?

ntroduction: In Peru, 78.1% of women between the ages of 15 and 49 use a contraceptive method, which is diminished by various factors associated with non-adherence to the contraceptive method, thus producing unwanted pregnancies and the spread of sexually transmitted diseases. Objective: To determine the factors associated with non-adherence to contraceptive methods in women of childbearing age in Peru according to ENDES 2021. Methods: Observational, analytical and cross-sectional study. The information used is found in the ENDES 2021 public database. The population of this research is made up of Peruvian women between the ages of 15 and 49. Statistical analysis was performed with the statistical program SPSS version 26.0. The qualitative variables were represented in a univariate table with frequencies and coefficients of variation. The approved statistical significance value was p &lt;0.05 with 95% confidence intervals. Results: 43.7% of women did not adhere to the contraceptive method. There was a significant association for the variables: area of rural residence (Rpa 1.05 IC 1 – 1.1), separated marital status (Rpa 1.1, IC 1 – 1.1), widow marital status (Rpa 1.3, IC 1.1 – 1.5), cohabiting marital status ( Rpa 1.1, IC 1.1 – 1.2) , poor wealth index (Rpa 1.03, IC 0.9 – 1.0) Conclusions: The factors associated with non-adherence to contraceptive methods in women of childbearing age in Peru, which are significantly associated are: Rural area of residence, separate marital status, widow and cohabitant and have a poor wealth index.

Abstract 5235: Transcriptome-wide study of tumor samples from Peruvian women identifies dysregulated pathways in luminal tumors typically associated with more aggressive disease

Abstract Purpose: Breast cancer incidence and outcomes differ by US census racial/ethnic category. Since large-scale genetic studies of human disease are predominately focused on populations of European ancestry, little is known about breast cancer molecular biology in Hispanic/Latinos which can widen cancer health disparities due to suboptimal translation of discoveries into clinical practice or public health policy. We aim to describe relevant pathways in breast cancer subtype differentiation in breast cancer patients from Peru. Patients and Methods: Formalin fixed paraffin embedded tumor tissues samples were whole exome sequenced for a total of 271 patients, recruited by the Peruvian Breast Cancer Genomics Study (PEGEN-BC) from the Instituto Nacional de Enfermedades Neoplásicas (INEN) in Lima, Peru. Quality control was conducted to remove genes with low counts. Intrinsic tumor subtypes were classified using the PAM50 method using genefu package in R. Differential gene expression between subtypes was performed by DEseq2 R package and statistical significance was determined using FDR&amp;lt;0.05 for samples with at least log2 1.5-fold change. Pathway analyses were performed to explore differences among the subtypes using GSEA with fgsea package in R. Indigenous American ancestry proportions for participants were estimated using germline genome-wide genotypes and the program Admixture. Results: The mean age of patients was 50 and the median Indigenous American ancestry was 79%. PAM50 classification of the sequenced samples defined 20.2% of tumors as LumA, 27.9% as LumB, 27.1% as HER2, 22.5% as Basal and 2.3% as Normal. Transcriptomic pathway analysis showed that most of the significantly changed pathways were similar to those previously described such as upregulation of high proliferation pathways in LumB, HER2E and Basal tumors, and a strong dependency on the estrogen pathway for LumA. Top 10 significantly changed pathways show some unique findings: the epithelial-mesenchymal-transition (EMT) pathway is downregulated in Basal, comparing to LumA and HER2 tumors, which is unexpected given that the EMT is associated with stem cell features and poor outcomes. The E2F-targets pathway is upregulated in LumA when comparing to HER2 tumors, but downregulated when compared to Basal tumors. Conclusions: We identified novel pathways associated with breast cancer subtypes in individuals with high Indigenous American ancestry from Peru and are working on testing the robustness of these findings. If our findings are confirmed, results would suggest a more aggressive profile of Luminal subtypes in the studied samples from Peru, with implications for treatment and survival. Citation Format: Chenghuiyun Xu, Valentina A. Zavala-Cordero, Xiaosong Huang, David M. Rocke, Sandro Casavilca-Zambrano, Jeannie M. Navarro-Vásquez, Carlos A. Castañeda, Guillermo Valencia, Zaida Morante, Monica Calderón, Julio E. Abugattas, Henry Gómez, Hugo A. Fuentes, Ruddy Liendo-Picoaga, Jose M. Cotrina, Silvia P. Neciosup, Katia Roque, Jule Vásquez, Luis Mas, Marco Gálvez-Nino, Jovanny Zabaleta, Tatiana Vidaurre, Laura Fejerman. Transcriptome-wide study of tumor samples from Peruvian women identifies dysregulated pathways in luminal tumors typically associated with more aggressive disease. [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2023; Part 1 (Regular and Invited Abstracts); 2023 Apr 14-19; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2023;83(7_Suppl):Abstract nr 5235.

Food as a social weapon: Peruvian immigrant entrepreneurs claiming home, belonging, and distinction in Southern California

ABSTRACT Peruvian immigrants in Southern California encounter a complex context of reception in which xenophobic portrayals of Latinxs exist alongside positive discourses on immigration. Simultaneously, the Peruvian gastronomic boom has reached the Golden State, where foodies’ celebration of Peruvian cuisine creates a favourable opportunity structure for Peruvian immigrant entrepreneurs. Drawing on ethnographic fieldwork and life history interviews with 35 Peruvian women culinary entrepreneurs in and around Los Angeles, the article argues that these entrepreneurs capitalize on the positive food discourses surrounding Peruvian gastronomy to contest stigmas of an ascribed Latinx identity. Food becomes a powerful weapon to negotiate a position within racial/ethnic hierarchies. By showing that culinary businesses constitute a unique space where these complex processes play out, the paper expands the economic focus in the ethnic entrepreneurship literature and provides knowledge on how immigrants’ economic agency is embedded in broader social processes, such as their search for home and belonging.

Altitude and Its Association with Low Birth Weight among Children of 151,873 Peruvian Women: A Pooled Analysis of a Nationally Representative Survey.

The aim of this study was to determine the relationship between the altitude of residence and the low birth weight (LBW) of the children of pregnant Peruvian women using a nationally representative database. An analysis of individual-level data from the last 13 years (from 2009 to 2021) of the Demographic and Family Health Survey was performed. The outcome variable was LBW, defined as birth weight less than 2500 g, while the independent variable was the altitude of residence in meters above sea level (masl). To estimate the association between the two variables, the crude and adjusted generalized linear model of the Poisson family with a log link was used along with crude and adjusted prevalence ratios, which were estimated with their respective 95% confidence interval. A total of 151,873 women aged 15-49 years were included between 2009 and 2021. The pooled proportion of LBW was 7.0%. As the main finding, the children of mothers residing at an altitude from 2500 to 3499 masl and ≥3500 masl had a higher probability of LBW. It was found that the children of mothers residing at an altitude above 2500 masl were more likely to have LBW. Our results will help to strengthen the cultural practice of maternal health care and increase its coverage in women residing in high-altitude regions.

Physical Violence during Pregnancy and Its Implications at Birth: Analysis of a Population Survey, 2019.

Physical partner violence is widely recognized as a global health problem, especially in pregnant women. This study determines the association between physical violence during pregnancy in Peruvian women aged 15 to 49 years with low birth weight and abortion according to the Demographic and Family Health Survey (ENDES) 2019. An analytical cross-sectional observational study was carried out based on the data from the ENDES 2019. Two dependent variables referring to birth outcomes were included: abortion and low birth weight. The independent variable was physical violence during pregnancy by her current or former husband/partner. A total of 15,305 women were included in the study. The prevalence of physical violence during pregnancy was 6.43%. Regarding the adverse outcomes of pregnancy, the prevalences of abortion and low birth weight were 20.84% and 6.01%, respectively. Women suffering physical violence during pregnancy were more likely to have an abortion but not low birth weight. In conclusion, it was found that 6 in 100 Peruvian women of childbearing age were victims of violence during pregnancy. Likewise, it was observed that women who were victims of violence during pregnancy had a higher probability of having an abortion but not low birth weight.

Associated factors, inequalities, and spatial distribution of the use of modern contraceptive methods among women of reproductive age in Peru: a population-based cross-sectional study

BackgroundThe use of contraceptive methods in Peru has remarkably increased in recent decades. Nevertheless, despite the completeness and accessibility of family planning methods, modern contraceptive methods utilization in Peru remains below the South American average. Thus, this study aimed to elucidate the factors associated with modern contraceptive use, as well as the presence of inequalities and the spatial distribution in Peruvian women aged 15–49 years in 2019.MethodsA secondary data analysis was conducted using information from the 2019 Peruvian Demographic and Health Survey. We performed descriptive statistics, bivariate analysis, and Poisson multiple regression. Inequalities were estimated through concentration curves and Erreygers’ normalized concentration index. Spatial analysis included choropleth map, Global Moran’s I, Kriging interpolation and Getis-Ord-Gi* statistic.ResultsThe prevalence of modern contraceptive use was 39.3% among Peruvian women of reproductive age. Modern contraceptive use was directly associated with youth (aPR 1.39), women having their first sexual intercourse before the age of 18 (aPR 1.41), and being married but not together (aPR 1.87). In addition, speaking Quechua or Aymara (aPR 0.87) and having no children (aPR 0.59) were inversely associated with utilization of modern contraceptives. We found the presence of inequalities in the use of contraceptive methods (pro-rich distribution), although the magnitude was low. Spatial analysis unveiled the presence of a clustered distribution pattern (Moran’s Index = 0,009); however, there was inter-departmental and intra-departmental heterogeneity in the predicted prevalence of the use of modern contraceptives. In addition, significant hot and cold spots were found in Peru.ConclusionTwo out of five Peruvian women of reproductive age used modern contraceptives. It was associated with younger women’s age, younger age at first sexual intercourse, being married or cohabitant, among others. No substantial inequality was found in modern contraceptive use. The prevalence was heterogeneous at the intra- and inter-departmental level. Those departments located in the south, south-east, and north-east had the lowest prevalence. Therefore, nonfinancial barriers must be tackled through multi- and cross-sectoral efforts and continue to universally provide modern contraceptives.