Atendimento psicossocial à mulher que comete ofensa sexual / Psychosocial attention for women that commit sexual offenses / Atención psicosocial para mujeres que cometen delitos sexuales

Objetivamos apresentar uma proposta de atendimento psicossocial grupal oferecida para mulheres adultas que cometeram ofensa sexual, cuidadoras e mães. A experiência está sendo desenvolvida no Distrito Federal, Brasil, com pessoas do gênero feminino provenientes de encaminhamento judicial. Carece que os profissionais das áreas da justiça, saúde, serviço social e psicologia avancem no estudo e na compreensão desta temática, de modo a pensarem a atuação e o apoio terapêutico a essas mulheres. O modo de atendimento é focal e breve, com ênfase na criação de um ambiente lúdico como facilitador das interações grupais e da discussão sobre os temas: identidade; confiança nas relações afetivas e sociais; vivência pessoal com violência física e sexual; configuração de gênero; e expressão da sexualidade e futuro. A abordagem individual também se baseia no enfoque dos temas mencionados. O oferecimento de ajuda à mulher cuidadora ou à mãe tem participação ativa na interrupção do circuito abusivo sexual, pois essa violência é extremamente ocultada, ocasionando uma prolongada vulnerabilidade para as vítimas. Ressalta-se o valor do texto indicando a descrição de ação voltada para uma população permanentemente não estudada e evitada em seu reconhecimento. Os limites desta proposta encontram-se na falta de outras iniciativas que possibilitem uma discussão sobre essa experiência.(AU)

We aim to present a proposal of a group psychosocial intervention offered for adult female sexual offenders, caregivers, and mothers. The intervention is being developed at Federal District, Brazil, with female people coming from judicial referrals. Professionals in the areas of justice, health, social work, and psychology need to advance in the study and understanding this theme to think about action and therapeutic support for these women. The intervention is a focal and brief approach, with emphasis on the creation of a ludic environment as a facilitator of group interactions and discussion about the themes: identity; trust in affective and social relationships; personal experience with physical and sexual violence; gender configuration; and sexuality expression and future. The individual approach is also based on focusing on these themes. The offering of help to the female caregiver or the mother has an active participation in the interruption of the sexual offense circuit, since this violence is extremely hidden, bringing a prolonged condition of vulnerability to the victims. The value of this text is highlighted indicating the description of an action directed to a population that is permanently not studied and whose recognition is avoided. The limits of this proposal are found in the absence of other initiatives that would allow a discussion about this experience.(AU)

Este texto presenta una propuesta de atención psicosocial grupal destinada a mujeres adultas que han cometido delito sexual, a cuidadoras y madres. La intervención se está desarrollando en el Distrito Federal (Brasil), con personas del género femenino provenientes de remisiones judiciales. Es necesario que los profesionales de las áreas de justicia, salud, trabajo social y psicología avancen en el estudio y comprensión de esta temática para pensar en el desempeño y apoyo terapéutico de estas mujeres. El servicio es enfocado y breve, con énfasis en la creación de un ambiente lúdico como facilitador de interacciones grupales y discusión sobre los temas: identidad; confianza en las relaciones afectivas y sociales; experiencia personal con violencia física y sexual; configuración de género; y expresión de la sexualidad y el futuro. El enfoque individual también se centra en estos temas. La oferta de ayuda a la mujer cuidadora o a la madre es importante para la interrupción del circuito de abuso sexual, ya que esta violencia es extremadamente oculta y provoca una vulnerabilidad prolongada a las víctimas. Se destaca el valor del texto con la descripción de la acción dirigida a una población que no es objeto de estudios ni reconocida. Los límites de esta propuesta se encuentran en la ausencia de otras iniciativas que permitan un debate sobre esta experiencia.(AU)

Protocolo Brasileiro para Infecções Sexualmente Transmissíveis 2020: infecções que causam úlcera genital / Brazilian Protocol for Sexually Transmitted Infections 2020: infections that cause genital ulcers / Protocolo Brasileño para Infecciones de Transmisión Sexual 2020: infecciones que causan úlcera genital

As infecções que causam úlcera genital são um dos temas que compõem o Protocolo Clínico e Diretrizes Terapêuticas para Atenção Integral às Pessoas com Infecções Sexualmente Transmissíveis, publicado pelo Ministério da Saúde do Brasil em 2020. Tal documento foi elaborado com base em evidências científicas e validado em discussões com especialistas. Este artigo aborda a síndrome clínica de úlcera genital causada por infecções sexualmente transmissíveis e seus agentes etiológicos mais comuns: Treponema pallidum (sífilis), vírus herpes simples 2 (herpes genital) e vírus herpes simples 1 (herpes perioral), Haemophilus ducreyi (cancroide), Chlamydia trachomatis sorotipos L1, L2 e L3 (linfogranuloma venéreo) e Klebsiella granulomatis (donovanose). São apresentados aspectos epidemiológicos e clínicos dessas infecções, bem como orientações para seu diagnóstico e tratamento, além de estratégias para as ações de vigilância, prevenção e controle, com a finalidade de subsidiar gestores e profissionais de saúde na qualificação da assistência.

Infections that cause genital ulcers are one of the themes comprising the Clinical Protocol and Therapeutic Guidelines for Comprehensive Care for People with Sexually Transmitted Infections, published by the Brazilian Ministry of Health in 2020. The Protocol and Guidelines have been developed based on scientific evidence and validated in discussions with specialists. This article addresses clinical genital ulcer syndrome caused by sexually transmitted infections, and its most common etiological agents: Treponema pallidum (syphilis), herpes simplex virus-2 (genital herpes) and herpes simplex virus-1 (perioral herpes), Haemophilus ducreyi (chancroid), Chlamydia trachomatis serotypes L1, L2 and L3 (venereal lymphogranuloma), and Klebsiella granulomatis (donovanosis). Epidemiological and clinical aspects of these infections are presented, as well as guidelines for their diagnosis and treatment, in addition to strategies for surveillance, prevention and control actions, with the purpose of supporting health managers and professionals in the qualification of care.

El tema de las infecciones que causan úlcera genital hace parte del Protocolo Clínico y Directrices Terapéuticas para Atención Integral a las Personas con Infecciones de Transmisión Sexual, publicado por el Ministerio de Salud de Brasil en 2020. Dicho documento fue elaborado con base en evidencias científicas y validado en discusiones con especialistas. Este artículo trata del síndrome de úlcera genital clínica provocada por infecciones de transmisión sexual, con sus agentes etiológicos más comunes: Treponema pallidum (sífilis), virus del herpes simple-1 (herpes genital) y virus del herpes simple-2 (herpes perioral), Haemophilus ducreyi (chancro blando), Chlamydia trachomatis, serotipos L1, L2 y L3 (linfogranuloma venéreo), y Klebsiella granulomatis (donovanosis). Se presentan aspectos epidemiológicos y clínicos de esas infecciones, bien como pautas para su diagnóstico y tratamiento, además de estrategias para acciones de monitoreo epidemiológico, prevención y control, a fin de contribuir con gestores y personal de salud en la cualificación de la asistencia.

Transmisión sexual del virus SARS-CoV-2 y su rol en la propagación de COVID-19: protocolo de una revisión sistemática viva / Sexual transmission of SARS-CoV-2 virus and its role in the spread of COVID-19: a living systematic review protocol

Objetivo Proporcionar una revisión de la literatura sobre la presencia de SARS-CoV-2 en los fluidos sexuales de pacientes con COVID-19 y su posible transmisión sexual de manera oportuna, rigurosa y continuamente actualizada. Fuentes de datos Realizaremos búsquedas en PubMed / Medline, Embase, Registro Cochrane Central de Ensayos Controlados (CENTRAL), literatura gris y en un repositorio centralizado en L · OVE (Living OVerview of Evidence). L · OVE es una plataforma que mapea las preguntas PICO a la evidencia de la base de datos Epistemonikos. En respuesta a la emergencia de COVID-19, L · OVE se adaptó para ampliar el rango de evidencia que cubre y se personalizó para agrupar todas las pruebas de COVID-19 en un solo lugar. La búsqueda cubrirá el período hasta el día anterior al envío a una revista. Criterios de elegibilidad para la selección de estudios y métodos Adaptamos un protocolo común ya publicado para múltiples revisiones sistemáticas paralelas a las especificidades de esta pregunta. Incluiremos ensayos aleatorios que evalúen la transmisión sexual del virus SARS-CoV-2. Se buscarán ensayos aleatorizados que evalúen la transmisión sexual de otros coronavirus, como MERS-CoV y SARS-CoV, y estudios no aleatorizados en COVID-19 en caso de que no se encuentre evidencia directa de ensayos aleatorizados, o si la evidencia directa proporciona una - o certeza muy baja para resultados críticos. Dos revisores evaluarán de forma independiente la elegibilidad de cada estudio, extraerán datos y evaluarán el riesgo de sesgo. Realizaremos metanálisis de efectos aleatorios y utilizaremos GRADE para evaluar la certeza de la evidencia para cada resultado. Una versión viva basada en la web de esta revisión estará disponible abiertamente durante la pandemia de COVID-19. Lo volveremos a enviar si las conclusiones cambian o hay actualizaciones sustanciales Registro PROSPERO (CRD42020189368).

Hepatitis C prevalence among men who have sex with men in Central Brazil

Abstract To assess the prevalence of hepatitis C virus infection among men who have sex with men (MSM) in Central Brazil, a cross-sectional study was conducted in the City of Goiânia, Central Brazil, using Respondent-Driven Sampling (RDS). All serum samples were tested for anti-HCV and also for alanine aminotransferase (ALT). Anti-HCV positive samples and/or those with elevated ALT were tested for HCV RNA and genotyped. Of the 522 participants, four were found to be anti-HCV positive, and one was also HCV RNA positive (active HCV infection). Elevated ALT was found in 14 individuals. Of these, one showed evidence of acute HCV infection (HCV RNA positive and anti-HCV negative). Therefore, five MSM were positive for either anti-HCV and/or HCV RNA, giving a crude overall HCV prevalence of 1.0%; 1.3% (95% CI: 0.3-5.5) after being weighted by RDSAT. All five individuals reported high-risk sexual behaviors, including two who showed evidence of active HCV infection (genotype 1, subtypes 1a and 1b). Although the study population reported high-risk sexual practices, HCV infection was not more frequent in MSM than in the general Brazilian population.

Do AZT à PrEP e à PEP: aids, HIV, movimento LGBTI e jornalismo / From AZT to PrEP and PEP: AIDS, HIV, LGBTI movement and journalism / Del AZT a la PrEP y a la PEP: Sida, VIH, movimiento LGBTI y periodismo

O objetivo deste artigo é destacar características e atravessamentos dos movimentos LGBTI brasileiros, da aids, do HIV e de coberturas jornalísticas da síndrome que surgiu publicamente no início dos anos 1980. Resgatamos dimensões históricas e questões atuais como desafiadoras para as ciências, a medicina, governos e militantes com o intuito de refletir sobre disputas que estiveram e estão em curso, principalmente aquelas que se relacionam com a LGBTIfobia e outras opressões sociais. A pesquisa foi realizada por meio de levantamento bibliográfico acerca das políticas do movimento LGBTI, do HIV e da aids, bem como do uso de resultados de pesquisa anteriormente realizada sobre homofobia e narrativas jornalísticas. Observou-se uma conexão complexa entre as relações engendradas no surgimento da síndrome, próxima aos primeiros passos do movimento LGBTI no Brasil, como a produção ambivalente de visibilidades, assim como a manutenção de preconceitos históricos que ainda reverberam no tecido social.

The aim of this article is to highlight the characteristics and crossings of Brazilian LGBTI, AIDS, HIV movements and of journalistic coverage of the syndrome that emerged publicly in the early 1980s. We brought up historical dimensions and current issues as challenging for the sciences, medicine, governments and militants in order to reflect on ongoing disputes, especially those that are related to LGBTIphobia and others social oppressions. The research was carried out through a bibliographical survey about policies of the LGBTI, HIV and AIDS movements, as well as the use of previously conducted research results on homophobia and journalistic narratives. It was observed a complex connection between the relations generated in the beginning of the syndrome, close to the first steps of the LGBTI movement in Brazil, as the ambivalent production of visibility, as well as the maintenance of historical prejudices that still reverberate in social world.

El objetivo de este artículo es subrayar puntos y atravesamientos de los movimientos LGBTI brasileños, del Sida, del VIH y de las coberturas periodísticas del síndrome que surgió en público en el principio de los años 1980. Rescatamos dimensiones históricas y cuestiones actuales desafiantes para las ciencias, la medicina, los gobiernos y militantes con el propósito de reflexionar sobre disputas que estuvieron y están en curso, principalmente aquellas que se relacionan con la LGBTIfobia y otras opresiones sociales. La investigación fue realizada por medio de levantamiento bibliográfico acerca de las políticas del movimiento LGBTI, del VIH y del Sida, así como del uso de resultados de investigación previamente realizada sobre homofobia y narrativas periodísticas. Se observó una conexión compleja entre las relaciones engendradas en el surgimiento del síndrome, próxima a los primeros pasos del movimiento LGBTI en Brasil, como la producción ambivalente de visibilidades, así como el mantenimiento de prejuicios históricos que aún reverberan en el tejido social.

Conocimientos y prácticas sexuales asociados al VIH/SIDAen la comunidad Shuar de Uyuntza-MoronaSantiago / Knowledges and sexual practices associated with HIV/AIDS in Shuar community of Uyuntza- Morona Santiago

Introducción: en Uyuntza, una comunidad indígena shuar de Morona Santiago, se constata un alto riesgo de adquirir enfermedades de transmisión sexual y VIH/SIDA debido al escaso conocimiento sobre este tema. Objetivo: caracterizar los conocimientos y prácticas sexuales vinculadas con el VIH/SIDA, en la Comunidad Uyuntza- Morona Santiago 2018. Métodos: grupo focal, se aplicó la metodología cualitativa, la muestra fue seleccionada por conveniencia: tres hombres y tres mujeres entre los 22 y 42 años, con vida sexual aoctiva y no diagnosticada de VIH/SIDA. Resultados: la principal fuente de información son las charlas en los sub centros de salud. El conocimiento es limitado, existe confusión entre los conceptos VIH y SIDA. Las mujeres se limitan a expresar sus conocimientos y opiniones. Las prácticas sexuales de riesgo son frecuentes en el grupo masculino, entre estas está: el inicio precoz de las relaciones sexuales, frecuentar burdeles, la promiscuidad, infidelidad y el escaso uso de preservativo. Conclusión: tanto hombres como mujeres de este estudio, tienen escaso conocimiento sobre el VIH/SIDA lo que los deja como una comunidad con alto riesgo de contagio y tienen la predisposición grupal por instruirse en el tema para evitar "esta terrible enfermedad".

Introduction: in Uyuntza, a Shuar indigenous community of Morona Santiago, there is a high risk of acquiring sexually transmitted diseases and HIV / AIDS due to the scarce knowledge on this subject. Objective: to characterize the sexual knowledge and practices related to HIV / AIDS, in the Uyuntza-Morona Santiago 2018 Community. Methods: a focus group, the qualitative methodology was applied, the sample was selected for convenience: three men and three women between 22 and 42 years, with active sexual life and not diagnosed with HIV / AIDS. Results: the main source of information is the talks in the health sub-centers. Knowledge is limited, there is confusion between the concepts HIV and AIDS. Women limit themselves to expressing their knowledge and opinions. The risky sexual practices are frequent in the male group, among these are: the early onset of sexual relations, frequenting brothels, promiscuity, infidelity and the scarce use of condoms. Conclusion: both men and women in this study, have little knowledge about HIV / AIDS which leaves them as a community with high risk of infection and have the group predisposition to be educated on the subject to avoid "this terrible disease."

Zika: an ongoing threat to women and infants / Zika: uma ameaça permanente para mulheres e crianças / Zika: una amenaza permanente para mujeres y niños

Recent data from the municipality of Rio de Janeiro, Brazil, shows a sharp drop in the number of reported occurrences of Zika during the summer of 2016/2017, compared to the previous summer. There is still a much higher incidence among women than men, almost certainly due to sexual transmission. An unexpected feature of the new data is that there are proportionally far more cases affecting children under 15 months than older age classes. By comparing incidence rates in 2016/2017 and 2015/2016, we were able to deduce the proportion of reported cases affecting men and women, and verify that gender disparity is still present. Women and children are still risk groups for Zika infection, even during non-epidemic seasons.

Dados recentes do Município de Rio de Janeiro, Brasil, mostram uma queda importante na notificação de casos de Zika no verão de 2016/2017, comparado ao verão anterior. A incidência ainda é muito mais alta em mulheres do que em homens, quase certamente em função da transmissão sexual. Uma característica inesperada dos novos dados é que, proporcionalmente, há muito mais casos em crianças abaixo dos 15 meses de idade, quando comparadas àquelas das faixas mais velhas. Ao comparar as taxas de incidência em 2016/2017 e 2015/2016, conseguimos deduzir a proporção de casos notificados em homens e mulheres e confirmar que a disparidade de gênero ainda existe. As mulheres e crianças ainda são grupos de risco para a infecção pelo vírus Zika, mesmo durante períodos não epidêmicos.

Datos recientes del municipio de Río de Janeiro, Brasil, muestran un descenso importante en la notificación de casos de Zika durante el verano de 2016/2017, comparado con el verano anterior. La incidencia todavía es mucho más alta en mujeres que en hombres, casi con seguridad debido a la transmisión sexual. Una característica inesperada de los nuevos datos es que, proporcionalmente, hay muchos más casos en niños por debajo de los 15 meses de edad, cuando se comparan con aquellas franjas con edad superior. Al comparar las tasas de incidencia en 2016/2017 y 2015/2016, conseguimos deducir la proporción de casos notificados en hombres y mujeres y confirmar que la disparidad de género todavía existe. Las mujeres y niños todavía son grupos de riesgo para la infección por el virus Zika, incluso durante períodos no epidémicos.

Epidemiología de la infección oral por VPH en sujetos jóvenes sanos / Epidemiology of oral HPV infection in young healthy individuals

Resumen Introducción: La infección por VPH es la infección viral de transmisión sexual más frecuente, y se encuentra asociada a diversas neoplasias. Objetivo: Describir la epidemiología, historia natural y factores de riesgo asociados a la infección oral por VPH en adultos jóvenes asintomáticos. Métodos: Se realizó un estudio prospectivo de corte longitudinal, que incluyó sujetos sin patología oral, a los que se les tomó una muestra de la mucosa bucal. A todos los sujetos con resultados positivos se les realizó un nuevo muestreo seis meses después. Se identificó la presencia del virus por RPC; los datos demográficos y de conducta sexual fueron obtenidos con una encuesta que respondieron sin intervención del investigador. Resultados: Se recolectaron 102 muestras de sujetos de 18-26 años de edad, 60 (58,8%) correspondieron al sexo masculino. La prevalencia del virus fue de 6,9%; todos los sujetos positivos tenían vida sexual. Las relaciones sexuales entre personas del mismo sexo fue la única variable asociada a la presencia del virus (p < 0,05). A los seis meses, todos los sujetos habían eliminado al virus. Conclusión: La infección oral por VPH es transitoria y está asociada a relaciones sexuales entre personas del mismo sexo, principalmente mujeres que tienen sexo con mujeres.

Background: HPV infection is the most common sexually transmitted viral infection, and is associated with several neoplasms. Aim: To describe the epidemiology, natural history and risk factors associated with oral HPV infection in asymptomatic young adults. Methods: A prospective and longitudinal study was conducted, including subjects without oral pathology, who were sampled from the oral mucosa. All subjects with positive results were re-sampled 6 months later. The presence of HPV was identified by PCR. Demographic and sexual behavior data were obtained with a survey that was responded without the intervention of the researcher. Results: 102 samples were collected from subject of 18-26 years old, 60 (58.8%) were male. The prevalence of the virus was 6.9%; all positive subjects had active sexual life. Same-gender relationships were the only variable associated with the presence of the virus (p < 0.05). At six months all subjects had eliminated the virus. Conclusion: Oral HPV infection is transient and is associated to same-gender relationships, mainly women who have sex with women.

Perfil epidemiológico da AIDS em adultos no estado da Bahia no período de 1984 a 2013 / Epidemiological profile of AIDS in adults in the state of Bahia from 1984 to 2013

A Síndrome da Imunodeficiência Adquirida (AIDS) é uma doença infecciosa que causa danos de grande extensão na população. Objetivo: O presente estudo objetivou avaliar o perfil epidemiológico da AIDS em adultos no estado da Bahia. Métodos: Foi realizado um estudo exploratório de delineamento ecológico de série temporal com dados disponibilizados pelo Departamento de Informática do Sistema Único de Saúde (DATASUS) entre 1984 e 2013. Resultados: Foram diagnosticados 24.213 casos de AIDS em adultos com sexo informado. Desse total, 15.261 (63%) eram do sexo masculino, entretanto constatou-se tendência de crescimento da epidemia na população feminina ao longo do tempo, com diminuição da razão dos sexos. O número de casos registrados aumentou a partir do período entre 1990 e 95 para ambos os sexos. No que diz respeito à categoria de exposição, foi revelado que, ao longo dos períodos diagnósticos, houve uma mudança no perfil dos doentes, porém ocorreu a predominância da transmissão sexual, correspondendo a 53,8% (13.017) dos casos diagnosticados durante todo o período com categoria de exposição informada. Do total de casos, 8.918 (36,8%) corresponderam à via de transmissão heterossexual. Conclusão: A demonstração dos fenômenos de heterossexualização e feminização da epidemia da AIDS na Bahia evidencia a necessidade de medidas de controle como campanhas educativas abrangendo a prevenção, o diagnóstico e a assistência para deter a epidemia. Vale ressaltar a necessidade de aprimoramento das ações de vigilância epidemiológica em virtude do grande número de informações ignoradas e da qualificação da informação que possibilite a geração de dados mais precisos. No entanto, os dados obtidos permitem conhecer o perfil da epidemia e sua especificidade.

The Acquired Immunodeficiency Syndrome (AIDS) is an infectious disease that causes extensive damage to the population. Objective: To evaluate the epidemiological profile of AIDS in adults in the state of Bahia. Methods: An exploratory and ecological study of time series was conducted with data provided by the Departamento de Informática do Sistema Único de Saúde (DATASUS) from 1984 to 2013. Results: 24,213 cases of AIDS were diagnosed in adults with informed sex. Of this total, 15,261 (63%) were male, but there was a trend of epidemic growth in the female population over time, with a decrease in the sex ratio. The number of registered cases increased from 1990 to 1995 for both sexes. As for the exposure category, a change in the patient profile was revealed during the diagnostic periods. However, there was a predominance of sexual transmission, corresponding to 53.8% (13,017) of the cases diagnosed during the whole period with reported exposure category. Of the total cases, 8,918 (36.8%) corresponded to the heterosexual transmission via. Conclusion: The demonstration of the heterosexualization and feminization phenomena of the AIDS epidemic in Bahia shows the need for controlling measures such as educational campaigns including prevention, diagnosis and assistance to stop the epidemic. It is worth mentioning the need to improve epidemiological surveillance actions due to the large number of ignored information and the need for information qualification that allows the generation of more accurate data. However, the data obtained allow us to know the profile of the epidemic and its specificity.

Clinical recommendations for women exposed to Zika

Zika is an infectious disease that continues to pose an enduring threat worldwide. The disease is of particular concern to women of childbearing age, as the virus can cause devastating birth defects or fetal loss if acquired during pregnancy. Clinicians caring for women capable of becoming pregnant must inform women regarding the potential for Zika transmission via mosquito bites in affected regions as well as by sexual contact with exposed partners. Because of the global scope of the disease, clinicians caring for pregnant patients should evaluate for risk of Zika exposure to provide patients guidance in decision making related to virus prevention and testing.

Zika es una enfermedad infecciosa que aún representa una amenaza de largo plazo en todo el mundo. La enfermedad es especialmente peligrosa para las mujeres en edad fértil, ya que si se adquiere durante el embarazo, el virus puede causar defectos congénitos devastadores o pérdida del feto. Profesionales de la salud encargados del cuidado de las mujeres con planes de quedar embarazadas deberían informar a estas pacientes sobre el potencial de transmisión de Zika a través de picaduras de mosquitos en regiones afectadas, así como, por contacto sexual con parejas expuestas. Debido a los resultados de la extensión global de la enfermedad, los profesionales de salud que cuidan a las pacientes embarazadas también necesitan evaluar el riesgo de contacto con Zika para proporcionar orientación a los pacientes en la adopción de decisiones relacionadas con la prevención y las pruebas de este virus.

Perceived Risk of Human Papillomavirus Infection and Cervical Cancer among Adolescent Women in Taiwan

PURPOSE: High-risk types of human papillomavirus (HPV) are a critical etiologic factor behind cervical cancer. Adolescents are a vulnerable group for HPV infection. However, the literature on adolescent women for HPV infection and cervical cancer is limited. This study was to investigate HPV-related knowledge and perceived risk of HPV infection and cervical cancer among Taiwanese adolescent women in order to assess intervention strategies for prevention of cervical cancer and maintenance of reproductive health. METHODS: A descriptive cross-sectional study design was implemented. There were 610 adolescent women from three colleges in Southern Taiwan who participated in this study. Data were collected using an anonymous self-administered questionnaire survey. RESULTS: The results showed that the percentage of appropriate answers to HPV-related knowledge questions was only 36.8%, and smoking as the leading cause of cervical cancer received the lowest mean score for appropriate answers among the HPV-related knowledge items. The perceived risk of HPV infection and cervical cancer were moderate, with relatively lower susceptibility to infection with HPV than to cervical cancer (P < .001). Only 11.5% of the participants reported that they had received information about HPV vaccination from healthcare professionals. CONCLUSIONS: Participants lacked a comprehensive understanding of cervical cancer prevention and were not aware of their susceptibility to HPV infection. Adolescent women rarely obtained HPV-related information from healthcare professionals. Appropriate education strategies should be developed and conducted by healthcare professionals to reduce the risk of cervical cancer threat from adolescence.

Medical perspectives on the clinical value of male circumcision

Male circumcision (MC) is one of the most common surgical procedures in the world, but its medical benefits remain under debate. In the context of evidence-based medicine, MC is beneficial in reducing the risks of infantile urinary tract infection, viral-mediated sexually transmitted diseases, penile/cervical cancers, and poor hygiene. The claims of opponents against MC, such as reduced sexual performance, psychological trauma, and an excess of complications, are gradually losing credibility. Possibly influenced by US troops stationed in Korea following the Korean War, MC is highly prevalent in South Korea, though it has been losing popularity recently. The practice of MC in Korea is different from that in other countries, in that most cases of MC are performed in adolescence under local anesthesia. Although this eliminates the benefit of reducing urinary tract infection in neonates, it still offers the benefits of reducing the risk of viral sexually transmitted diseases and penile/cervical cancers. Moreover, MC can lead to improved hygiene for the majority of Koreans who are willing to undergo the procedure. The practice of MC in adolescence may reduce the risk of significant complications, though the risk of bleeding may be higher than for neonates.

Technological level and epidemiological aspects of sheep husbandry in Minas Gerais, southeastern Brazil / Nível tecnológico e aspectos epidemiológicos da ovinocultura no estado de Minas Gerais, Sudeste do Brasil

Epidemiological and health aspects of sheep husbandry were assessed on 213 sheep flocks in 142 municipalities from the state of Minas Gerais, southeastern Brazil. An updated questionnaire was filled out for each flock, requesting data on the farm, the flock and the farmer by the veterinarians of the State Government Agency for Animal Health (Instituto Mineiro de Agropecuária). Thirteen important variables were selected and scored to determine the technological level of the 117 farms; 0.9% of them was classified as high technological level, 45.3% as medium technological level and 53.0% as low technological level. Lamb production was the main objective of the farms and the main features were low-frequencies of individual identification of animals (16.9%), technical assistance (31.9%), use of quarantine for newly acquired animals (0.9%) the separation of animals by age group (3.7%) and requeste the sanitary certificate at purchasing of animals (11.7%). The main health problems reported were abortion (23.9%), keratoconjunctivitis (17.9%), contagious ecthyma (13.6%), pneumonia (10.3%), diarrhea (9.3%) and caseous lymphadenitis (6.1%). Information of the epidemiological situation and the mainly health measures used in the sheep farms are important to improve the productivity and quality of the lamb...

Os aspectos epidemiológicos e sanitários da ovinocultura foram levantados em 213 rebanhos ovinos em 142 municípios do estado de Minas Gerais, sudeste do Brasil. Um questionário atualizado foi preenchido para cada rebanho, com informações sobre a fazenda, o rebanho e do fazendeiro, por veterinários do Instituto Mineiro de Agropecuária. Treze variáveis importantes foram selecionadas e pontuadas para determinar o nível tecnológico em 117 fazendas; 0,9% foram classificadas como de alto nível tecnológico, 45,3% como de médio nível tecnológico e 53,0% como de baixo nível tecnológico. A produção de carne de cordeiro foi o principal objetivo das fazendas amostradas e as principais características foram baixa frequência de identificação individual dos animais (16,9%), assistência técnica (31,9%), uso de quarentena para os animais recém-adquiridos (0,9%), separação de animais por faixa etária (3.7%) e solicitação de certificados sanitários na compra de animais (11,7%). Os principais problemas sanitários relatados foram o aborto (23,9%), ceratoconjuntivite (17,9%), ectima contagioso (13,6%), pneumonia (10,3%), diarreia (9,3%) e linfadenite caseosa (6,1%). Informações sobre a situação epidemiológica e das principais medidas sanitárias utilizadas nas propriedades com ovinos são importantes para melhorar produtividade e a qualidade da carne ovina...

Sexual transmission of human T-cell lymphotropic virus type 1

Human T-cell lymphotropic virus type 1 (HTLV-1) is endemic in many parts of the world and is primarily transmitted through sexual intercourse or from mother to child. Sexual transmission occurs more efficiently from men to women than women to men and might be enhanced by sexually transmitted diseases that cause ulcers and result in mucosal ruptures, such as syphilis, herpes simplex type 2 (HSV-2), and chancroid. Other sexually transmitted diseases might result in the recruitment of inflammatory cells and could increase the risk of HTLV-1 acquisition and transmission. Additionally, factors that are associated with higher transmission risks include the presence of antibodies against the viral oncoprotein Tax (anti-Tax), a higher proviral load in peripheral blood lymphocytes, and increased cervicovaginal or seminal secretions. Seminal fluid has been reported to increase HTLV replication and transmission, whereas male circumcision and neutralizing antibodies might have a protective effect. Recently, free virions were discovered in plasma, which reveals a possible new mode of HTLV replication. It is unclear how this discovery might affect the routes of HTLV transmission, particularly sexual transmission, because HTLV transmission rates are significantly higher from men to women than women to men.

Detection of Leishmania infantum in the smegma of infected dogs / Detecção de Leishmania infantum no esmegma de cães infectados

Considering the venereal transmission of visceral leishmaniasis from dogs to bitches, the aim of this study was to verify if the penile surface and smegma from infected dogs can be the source of parasites in bitches. Twelve Leishmania infantum infected dogs had semen and smegma samples collected for submission to PCR identification of the DNA of the parasite. Semen (41.7 percent) and smegma (50.0 percent) have similar positive incidence (P>0.05; Fisher's exact test), with 58.3 percent of the dogs positive for semen and/or smegma samples. The proportion of positivity for both semen and smegma was 33.3 percent, but 8.3 percent was positive only for semen, and 16.7 percent only for smegma, revealing a moderate agreement between tests (K=0.5; Kappa index). It was concluded that Leishmania infantum is present in the smegma of contaminated dogs and it can be a source of parasites for the semen and the bitch...

Tendo em vista a transmissão venérea da leishmaniose visceral do cão para a cadela, o objetivo deste estudo foi verificar se a superfície peniana e o esmegma de cães infectados poderiam ser a fonte de parasitas para a fêmea. Amostras de sêmen e esmegma de 12 cães infectados com Leishmania infantum foram submetidas à identificação do DNA do parasita por PCR. As incidências de positividade no sêmen (41,7 por cento) e no esmegma (50,0 por cento) foram semelhantes (P>0,05; teste exato de Fisher), sendo 58,3 por cento dos cães positivos para sêmen e/ou esmegma. A positividade para sêmen e esmegma juntos ocorreu em 33,3 por cento, mas em 8,3 por cento dos casos apenas no sêmen, e em 16,7 por cento apenas no esmegma, o que revela uma concordância moderada entre os testes (K=0,5; índice Kappa). Conclui-se que a Leishmania infantum está presente no esmegma de cães contaminados, podendo ser a fonte de parasitas para o sêmen e a cadela...

Conhecimento de mulheres sobre alguns aspectos do papiloma vírus humano / The knowledge of women on some aspects of human papillomavirus

Verificar o conhecimento de mulheres atendidas em dois ambulatórios de Ginecologia e Obstetrícia sobre o Papiloma Vírus Humano (HPV). Metodologia:foram utilizados dados secundários de um banco de dados eletrônico em que as informações foram coletadas por meio de um questionário no período de 2007 a 2012. Resultados: foram incluídas 1.470 mulheres com média de idade de 30,7 anos. Dentre as mulheres, 51,0% já haviam ouvido falar de HPV, porém, apenas 41,6% sabiam da transmissão sexual e 33,3% da relação do patógeno com o câncer de colo uterino. Conclusão: os dados permitiram concluir que o conhecimento sobre HPV é deficiente, necessitando desenvolvimento de ações educativas voltadas para a prevenção da infecção pelo HPV e seu agravamento...

The current study aimed to assess the knowledge of women seen in two outpatient clinic of gynecology and obstetrics about the Human Papilloma Virus (HPV). Methodology: using secondary data from an electronic database that information was collected through a questionnaire during the period from 2007 to 2012. Results: were included 1470 women with average age of 30.7 years. Among women, 51.0% had heard about HPV, but only 41.6% knew of its sexual transmission and 33.3% knew about the relation of the pathogen with cervical cancer. Conclusion: data allowed to conclude that knowledge about HPV is poor, requiring improvement of educational interventions for the prevention of HPV infection and its worsening...

Molluscum contagiosum virus infection amongst PLWHA in Ibadan, Nigeria

Background: Molluscum contagiosum (MC) infection is caused by a pox virus and the virus is probably passed on by direct skin-to-skin contact which may affect any part of the body. There is anecdotal evidence associating facial lesions with HIV-related immunodeficiency. This study was aimed to determine the prevalence and associated risk factors of Molluscum contagiosum infection among PLWHAs attending ART clinic at the University College Hospital, Ibadan, Nigeria. Methods: This is a descriptive cross-sectional survey of 5,207 patients (3519 female and 1688 males) attending ART clinic between January 2006 and December 2007. Physicians performed complete physical and pelvic examinations. Diagnosis of Molluscum Contagiosum infection was based on the clinical findings of typical lesions on the external genitalia, perianal, trunk, abdominal and facial regions. Results: The mean age of the patients was 34.67 yrs. ± 9.16). About 10% (542) had various sexually transmitted infections (STIs). The male to female ratio was 1: 4.2. One hundred and twenty seven subjects (23.4%) had no formal or primary education with 247 (45.6 %) beingtreatment naïve while 295 (54.4 %) were treatment experienced. Of the 542 PLWHAs with STIs, 3.3 % had undetectable viral load (< 200 copies/ ml) while 272 (50.1 %) had low CD4 count (< 200 cells / mm3.) and The Mean log10 viral load was 5.02 + 0.94. Molluscum Contagiosum infection was diagnosed in 13 patients (0.024%; 8 females and 5 males). Vaginal Candidiasis was the commonest genital infection diagnosed in 223 (41.1%) of the patients with STIs. MC patients had higher viral load, lower CD4 count and more likely to be treatment experienced".Conclusions: Molluscum Contagiosum infection is not uncommon among the HIV-infected patients, but underreported. Awareness of this cutaneous manifestation should be known to Physicians in AIDS care