Your browser doesn't support javascript.
loading
Show: 20 | 50 | 100
Results 1 - 20 de 7.769
Filter
1.
Ciênc. Saúde Colet ; 27(2): 503-514, Fev. 2022. tab, graf
Article in Portuguese | LILACS | ID: biblio-1356071

ABSTRACT

Resumo O objetivo deste artigo é analisar o uso de hormônios não prescritos entre travestis e mulheres transexuais (TrMT) na cidade de Salvador, Bahia, Brasil. Trata-se de um estudo de corte transversal onde se utilizou a metodologia RDS (respondent driven sampling) para recrutar TrMT entre 2014 e 2016, em Salvador e sua Região Metropolitana. Foi realizada uma análise comparativa entre condições sociodemográficas, comportamentais e de afirmação de gênero com o uso de hormônios. Os dados ponderados pelo estimador RDS-II. Utilizou-se o programa Stata, versão 14, para análises estatísticas. Foram recrutadas 127 TrMT. Da amostra estudada, 69,1% das participantes fizeram uso de hormônios não prescritos, o que esteve associado ao uso de silicone líquido industrial e ao relato de satisfação corporal. As TrMT que estavam confortáveis com o pênis e que sentiam prazer com o mesmo apresentaram menor probabilidade de uso de hormônio. As participantes soropositivas para HIV reportaram maior proporção de uso de hormônio. O uso não prescrito de hormônios foi utilizado pela maioria das TrMT. É provável que esse uso esteja associado a uma melhor satisfação com a autoimagem e com o corpo entre as TrMT. Verificou-se o uso em elevadas quantidades desses medicamentos e de maneira exacerbada, provavelmente devido ao pouco acesso aos serviços de saúde pública.


Abstract This article aims to analyze the use of non-prescribed hormones among travestis and transgender women (TrTGW) in Salvador, Bahia, Brazil. This cross-sectional study used the Respondent Driven Sampling (RDS) methodology to recruit TrTGW from 2014 to 2016 in Salvador and the Metropolitan Region. A comparative analysis was carried out between sociodemographic, behavioral, and gender declaration conditions using hormones. The RDS-II estimator weighted the data. Stata version 14 was used for statistical analyses. One hundred twenty-seven TrTGW were recruited. From the studied sample, 69.1% of participants used non-prescribed hormones, which was associated with industrial liquid silicone use and body satisfaction. The TrTGW who were comfortable with the penis and felt pleasure with the penis used hormone less. The seropositive participants reported a higher proportion of hormone use. The non-prescribed use of hormones was used by most TrTGW. This use is likely associated with better satisfaction with self-image and body among TrTGW. Elevated and exacerbated use of these hormones was identified, probably due to the rare access to public health services.


Subject(s)
Humans , Male , Female , HIV Infections , Brazil , Cross-Sectional Studies , Transgender Persons , Hormones
2.
Acta Paul. Enferm. (Online) ; 35: eAPE03661, 2022. tab
Article in Portuguese | LILACS, BDENF | ID: biblio-1364242

ABSTRACT

Resumo Objetivo Analisar aspectos relacionados à adesão ao tratamento da tuberculose em pessoas que vivem com coinfecção tuberculose/vírus da imunodeficiência humana. Métodos Trata-se de um estudo exploratório, do tipo descritivo, com abordagem qualitativa sobre a adesão ao tratamento da tuberculose entre pessoas que apresentam a coinfecção tuberculose/vírus da imunodeficiência humana. O cenário do estudo foi um centro de referência para vírus da imunodeficiência humana/síndrome da imunodeficiência adquirida do estado de São Paulo, localizado na capital. O instrumento de coleta de dados continha questões relacionadas ao perfil sóciodemográfico e de saúde. Para a análise do material empírico foi utilizado o método de análise de discurso que permitiu a depreensão de frases temáticas. Resultados Foram entrevistadas 16 pessoas, sendo a maioria do sexo masculino, da cor parda, na faixa etária entre 30 a 39 anos, com 9 a 12 anos de estudo, que moravam sozinhos, solteiros e que se declararam homossexuais. Da análise dos depoimentos emergiram três categorias de análise: Processo saúde doença: o impacto do diagnóstico e os significados de viver a coinfecção; Tratamento medicamentoso: motivos para o seguimento, facilidades e dificuldades envolvidas; e Cuidado no serviço de saúde: acolhimento e redes de apoio que favorecem a adesão ao tratamento. Conclusão A adesão ao tratamento na coinfecção tuberculose/vírus da imunodeficiência humana mostrou-se relacionada à forma como a pessoa está inserida na sociedade, suas condições de vida e trabalho. Ressalta-se também que o cuidado nos serviços de saúde interfere na adesão, dada a importância do vínculo entre o profissional de saúde e o usuário.


Resumen Objetivo Analizar los aspectos relacionados con la adherencia al tratamiento de tuberculosis en personas que viven con la coinfección tuberculosis/virus de la inmunodeficiencia humana. Métodos Se trata de un estudio exploratorio, tipo descriptivo, con enfoque cualitativo, sobre la adherencia al tratamiento de tuberculosis en personas que presentan la coinfección tuberculosis/virus de la inmunodeficiencia humana. El escenario de estudio fue un centro de referencia del virus de la inmunodeficiencia humana/síndrome de inmunodeficiencia adquirida del estado de São Paulo, ubicado en la capital. El instrumento de recopilación de datos contenía preguntas relacionadas con el perfil sociodemográfico y de salud. Para analizar el material empírico se utilizó el método de análisis de discurso que permitió extraer frases temáticas. Resultados Se entrevistaron 16 personas, de las cuales la mayoría era de sexo masculino, de color pardo, del grupo de edad entre 30 y 39 años, con 9 a 12 años de estudios, que vivían solos, solteros y que se declararon homosexuales. Del análisis de los relatos surgieron tres categorías de análisis: Proceso de salud y enfermedad: el impacto del diagnóstico y los significados de vivir la coinfección; Tratamiento farmacológico: motivos para el acompañamiento, facilidades y dificultades relacionadas, y Cuidado en el servicio sanitario: contención y redes de apoyo que favorecen la adherencia al tratamiento. Conclusión La adherencia al tratamiento de la coinfección tuberculosis/virus de la inmunodeficiencia humana demostró estar relacionada con la forma como la persona está insertada en la sociedad, su condición de vida y trabajo. También se observó que el cuidado en los servicios de salud interfiere en la adherencia, debido a la importancia del vínculo entre los profesionales de la salud y los usuarios.


Abstract Objective To analyze aspects related to adherence to tuberculosis treatment in people living with tuberculosis/human immunodeficiency virus coinfection. Methods This is an exploratory, descriptive, qualitative study on adherence to tuberculosis treatment among people with tuberculosis/human immunodeficiency virus coinfection. The study setting was a reference center for human immunodeficiency virus/acquired immunodeficiency syndrome located in the capital of the state of São Paulo. The data collection instrument contained socio-demographic and health profile related questions. The discourse analysis method was used for the analysis of the empirical material, which allowed the comprehension of thematic phrases. Results Sixteen people were interviewed. Most were male, mixed race, in the age group of 30-39 years, with 9-12 years of study, living alone, single and declared themselves homosexuals. Three categories of analysis emerged from the analysis of testimonies: Health-disease process: the impact of the diagnosis and the meanings of living with coinfection; Drug treatment: reasons for follow-up, facilities and difficulties involved; and Care in the health service: embracement and support networks that favor treatment adherence. Conclusion Adherence to treatment in the tuberculosis/human immunodeficiency virus coinfection has shown a relation to the way people are inserted in society, their living and working conditions. The fact that care in health services interferes with adherence is also noteworthy, given the importance of the bond between the health professional and the user.


Subject(s)
Humans , Male , Female , Adult , Perception , Tuberculosis/drug therapy , HIV Infections/drug therapy , Antiretroviral Therapy, Highly Active , Coinfection , Treatment Adherence and Compliance , Quality of Life , Health-Disease Process , Epidemiology, Descriptive , Interviews as Topic , Evaluation Studies as Topic
3.
Rev. latinoam. enferm. (Online) ; 30: e3512, 2022. tab, graf
Article in Portuguese | LILACS, BDENF | ID: biblio-1365888

ABSTRACT

Resumo Objetivo Validar um material educativo digital interativo no formato de livro eletrônico sobre prevenção e redução do risco cardiovascular na perspectiva das pessoas vivendo com vírus da imunodeficiência humana. Método Trata-se de um estudo metodológico baseado na teoria de pesquisa de avaliação, do tipo análise de resultados, que envolve produção tecnológica. Os dados foram coletados em todo o Brasil por meio de um questionário virtual composto por itens para avaliação geral, visual, linguagem, usabilidade, conteúdo e aparência do material educativo. Para atestar a validade, adotou-se o Índice de Concordância mínimo de 80%. Resultados Participaram do estudo 309 pessoas vivendo com vírus da imunodeficiência humana, a maioria (84,3%) do sexo masculino, com idade entre 19 e 65 anos e ensino superior completo (29,3%). Mais de 90% dos participantes avaliaram o livro como adequado para tirar dúvidas e realizar cuidados preventivos à saúde cardiovascular. Todos os itens avaliados alcançaram índice acima de 0,80. A avaliação geral de todos os itens alcançou média de 0,92, sendo a avaliação geral (0,97) e o conteúdo (0,94). Conclusão O material educativo mostrou-se válido, adequado e pertinente para promover a alfabetização em saúde, e poderá contribuir com a promoção da saúde e prevenção de doenças cardiovasculares.


Abstract Objective To validate interactive digital educational material in the form of an electronic book about the prevention and reduction of cardiovascular risk from the perspective of people living with the Human Immunodeficiency Virus. Method This is a methodological study based on the theory of evaluation research, of the results analysis type, which involves technological production. The data were collected throughout Brazil by means of a virtual questionnaire consisting of items for general, visual, language, usability, content and appearance assessment of the educational material. A minimum Agreement Index of 80% was adopted in order to certify validity. Results 309 individuals living with the Human Immunodeficiency Virus participated in the study, the majority (84.3%) being male, aged between 19 and 65 years old and with complete higher education (29.3%). More than 90% of the participants assessed the book as suitable for solving doubts and providing preventive care for cardiovascular health. All the items evaluated reached an index above 0.80. The general evaluation of all the items reached a mean of 0.92, with general assessment (0.97) and content assessment (0.94). Conclusion The educational material proved to be valid, adequate and relevant to promote literacy in health, and could contribute to health promotion and to the prevention of cardiovascular diseases.


Resumen Objetivo Validar un material educativo digital interactivo en forma de libro electrónico sobre prevención y reducción del riesgo cardiovascular desde la perspectiva de las personas que viven con el virus de la inmunodeficiencia humana. Método Se trata de un estudio metodológico basado en la teoría de la investigación evaluativa, del tipo análisis de resultados, que incluye producción tecnológica. Los datos fueron recolectados en todo Brasil a través de un cuestionario virtual compuesto por ítems de evaluación general e ítems que evalúan el aspecto visual, el lenguaje, la usabilidad, el contenido y la apariencia del material educativo. Para comprobar la validez se adoptó un Índice de Concordancia mínimo del 80%. Resultados Participaron en el estudio 309 personas que viven con el virus de la inmunodeficiencia humana, la mayoría (84,3%) era del sexo masculino, tenía entre 19 y 65 años y estudios superiores completos (29,3%). Más del 90% de los participantes calificaron el libro como adecuado para aclarar dudas y realizar cuidados preventivos para la salud cardiovascular. Todos los ítems evaluados alcanzaron un índice superior a 0,80. La evaluación general de todos los ítems alcanzó una media de 0,92, la evaluación general fue 0,97 y la de contenido 0,94. Conclusión El material educativo demostró ser válido, adecuado y relevante para promover la alfabetización en salud y puede contribuir a la promoción de la salud y a la prevención de enfermedades cardiovasculares.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Cardiovascular Diseases/prevention & control , HIV Infections , Health Education , Acquired Immunodeficiency Syndrome , Educational Technology , Validation Study , Health Literacy
4.
Cad. Saúde Pública (Online) ; 38(1): e00081821, 2022. tab
Article in English | LILACS | ID: biblio-1355995

ABSTRACT

Abstract: We assessed the proportions and causes of the underreporting of deaths among people living with HIV (PLHIV) in Rio de Janeiro, Brazil, from 2014 to 2019. Demographic variables, mention of tuberculosis (TB), and CD4 cell counts closest to death were used to compare those who had HIV/AIDS mentioned on their death certificate (HMDC) to those who did not. Out of 10,698 deaths, 2,863 (26.8%) had no HMDC, from which 412 (14.4%) had external underlying cause. After excluding deaths from external causes, we found that 24% still had no HMDC. Age ≥ 40 years (OR = 1.75; 95%CI: 1.52-2.01), non-white race/ethnicity (OR = 1.16; 95%CI: 1.02-1.31), the male gender (OR = 1.25; 95%CI: 1.11-1.42), higher CD4 cell counts closest to death (OR = 1.14; 95%CI: 1.12-1.16), absence of TB (OR = 4.86; 95%CI: 3.76-6.29) and not dying within a hospital (OR = 2.61; 95%CI: 2.31-2.95) were associated with increased probabilities of not having HMDC. The proportion of deaths with no HMDC increased from 18.7% to 35.1% between 2014 and 2019. The high proportion of underreported deaths in Rio de Janeiro indicates that HIV/AIDS mortality coefficients in the state may be underestimated. With the changing patterns of mortality of PLHIV, physicians are advised to consider the broader clinical spectrum of HIV infection, and surveillance officers should improve death monitoring.


Resumo: Os autores avaliaram as proporções de subnotificação de óbitos e fatores associados em pessoas vivendo com HIV (PVHIV) no Rio de Janeiro, Brasil, entre 2014 e 2019. Variáveis demográficas, menção de tuberculose (TB) e contagem de células CD4 mais próxima ao óbito foram utilizadas para comparar indivíduos que tiveram códigos para HIV/aids mencionados na declaração de óbito (HMDO) àqueles que não apresentaram tal menção. Entre 10.698 certidões de óbito, 2.863 (26.8%) não citaram HIV/aids. Entre estes, 412 (14,4%) apresentaram causas externas como a causa subjacente. Depois de excluir as causas externas, 24% das certidões não mencionaram HIV/aids. Idade acima de 40 anos (OR = 1,75; IC95%: 1,52-2,01), raça/etnicidade não branca (OR = 1,16; IC95%: 1,02-1,31), sexo masculino (OR = 1,25; IC95%: 1,11-1,42), contagem de CD4 mais alta próximo ao óbito (OR = 1,14; IC95%: 1,12-1,16), não ter TB (OR = 4,86; IC95%: 3,76-6,29) e morte extra-hospitalar (OR = 2,61; IC95%: 2,31-2,95) mostraram associação com aumento de probabilidade de não apresentar HMDO. A proporção de certidões de óbito que não citavam HIV/aids aumentou de 18,7% para 35,1% entre 2014 e 2019. A alta proporção de óbitos subnotificados no Rio de Janeiro indica a possível subestimação dos coeficientes de mortalidade por HIV/aids no estado. A mudança nos padrões de mortalidade em PVHIV desafia tanto os médicos, no sentido de considerar o espectro clínico mais amplo na infecção pelo HIV, quanto os especialistas em vigilância, no sentido de aprimorar o monitoramento da mortalidade.


Resumen: Evaluamos los porcentajes y factores asociados con el subregistro de muertes entre personas afectadas por VIH (PLHIV) en Río de Janeiro, Brasil, desde 2014 a 2019. Se utilizaron variables demográficas, mención de tuberculosis (TB) y recuentos de células CD4 más cercanos al fallecimiento, para comparar a quienes tenían VIH/SIDA reflejado en el certificado de defunción (HMDC), con quienes no lo tenían. De las 10.698 muertes, 2.863 (26,8%) no tuvieron HMDC. De entre ellos, 412 (14,4%) tenían causas externas como causa subyacente. Tras excluir las causas externas, un 24% no tuvieron HMDC. Edad ≥ 40 años (OR = 1,75; IC95%: 1,52-2,01), raza no blanca raza/etnicidad (OR = 1,16; IC95%: 1,02-1,31), género masculino (OR = 1,25; IC95%: 1,11-1,42), recuentos de células CD4 más altos más cercanos a la muerte (OR = 1,14; IC95%: 1,12-1,16), que no tenían TB (OR = 4,86; IC95%: 3,76-6,29), y que no murieron en un hospital (OR = 2,61; IC95%: 2,31-2,95), estuvieron asociados con probabilidades crecientes de no tener HMDC. La proporción de muertes que no tenían HMDC aumentó de un 18,7% a un 35,1% entre 2014 y 2019. La alta proporción de muertes subregistradas en Río de Janeiro indican que los coeficientes de mortalidad VIH/SIDA en el estado quizás estaban subestimados. Los patrones cambiantes de mortalidad suponen un desafío para las PLHIV, así como para los médicos, a la hora de considerar infección por VIH dentro de un espectro clínico más amplio, al igual que para los agentes de supervisión, con el fin de mejorar el monitoreo de muertes.


Subject(s)
Humans , Male , Adult , Tuberculosis/epidemiology , HIV Infections/epidemiology , Acquired Immunodeficiency Syndrome/epidemiology , Brazil/epidemiology , CD4 Lymphocyte Count
5.
Cad. Saúde Pública (Online) ; 38(1): e00290620, 2022. tab
Article in Portuguese | LILACS | ID: biblio-1355979

ABSTRACT

Resumo: A profilaxia pré-exposição ao HIV (PrEP) tem sido considerada uma estratégia fundamental para o controle da epidemia de HIV/aids, e desde 2018 tem sido objeto de estudo de implementação (Estudo ImPrEP Stakeholders), realizado no Brasil, no México e no Peru. Um componente qualitativo desse estudo foi desenvolvido com o objetivo de identificar os contextos sociais e estruturais que envolvem e organizam a oferta de serviços de PrEP no Brasil, as subjetividades dos atores envolvidos e as diferentes percepções que podem impactar a efetivação dessa estratégia. O presente artigo teve como foco de análise o acesso das populações vulneráveis aos serviços de PrEP, na perspectiva de gestores, profissionais de saúde, lideranças ou ativistas e usuários de PrEP. É um estudo qualitativo com o uso de metodologia compreensiva, realizado em seis capitais brasileiras, em que foram entrevistados 71 atores-chave no período de novembro de 2018 a maio de 2019. A análise foi pautada pelos modelos analíticos sobre acesso propostos por Giovanella & Fleury, McIntyre et al. e Penchansky & Thomas. Os resultados são apresentados com base em três eixos: "percepções sobre prevenção combinada e PrEP"; "disponibilidade e adequação: perfil e estrutura dos serviços no contexto do ImPrEP"; e "aceitabilidade: atitudes e práticas dos profissionais de saúde e usuários".


Abstract: HIV preexposure prophylaxis (PrEP) has been considered a fundamental strategy for controlling the HIV/AIDS epidemic, and since 2018 it has been the object of an implementation study (ImPrEP Stakeholders Study), conducted in Brazil, México, and Peru. A qualitative component of this study was developed with the objective of identifying the social and structural contexts that involve and organize the supply of PrEP services in Brazil, the stakeholders' subjectivities, and the different perceptions that can impact the strategy's implementation. The current article's focus was to analyze access by vulnerable populations to PrEP services from the perspective of managers, health professionals, leaders or activists, and users of PrEP. This was a qualitative study using a comprehensive methodology, conducted in six Brazilian state capitals, interviewing 71 key actors from November 2018 to May 2019. The analysis was based on access analysis models as proposed by Giovanella & Fleury, McIntyre et al. and Penchansky & Thomas. The results are presented along three lines: "perceptions of combined prevention and PrEP", "availability and adequacy: profile and structure of services in the context of ImPrEP", and "acceptability: attitudes and practices of health professionals and users".


Resumen: La profilaxis preexposición al VIH (PrEP) ha sido considerada una estrategia fundamental para el control de la epidemia de VIH/sida y desde 2018 ha sido objeto de estudio de implementación (Estudio ImPrEP Stakeholders), realizado en Brasil, México y Perú. Un componente cualitativo de este estudio se desarrolló con el objetivo de identificar los contextos sociales y estructurales que engloban y organizan la oferta de servicios de PrEP en Brasil, las subjetividades de los actores implicados y las diferentes percepciones que pueden impactar en hacer efectiva esa estrategia. El objetivo de este artículo es el análisis del acceso de las poblaciones vulnerables a los servicios de PrEP, desde la perspectiva de los gestores, profesionales de salud, líderes o activistas y usuarios de la PrEP. Se trata de un estudio cualitativo con uso de metodología comprensiva, realizado en seis capitales brasileñas, en las que fueron entrevistados 71 actores-clave, durante el período de noviembre de 2018 a mayo de 2019. El análisis se pautó mediante modelos analíticos sobre acceso, propuestos por Giovanella & Fleury, McIntyre et al. y Penchansky & Thomas. Los resultados se presentan a partir de tres ejes: "percepciones sobre prevención combinada y PrEP", "disponibilidad y adecuación: perfil y estructura de los servicios en el contexto de la ImPrEP" y "aceptabilidad: actitudes y prácticas de los profesionales de salud y usuarios".


Subject(s)
Humans , HIV Infections/prevention & control , HIV Infections/drug therapy , Anti-HIV Agents/therapeutic use , Pre-Exposure Prophylaxis/methods , Brazil , Health Personnel , Vulnerable Populations
6.
S. Afr. j. child health (Online) ; 16(1): 1-5, 2022. figures, tables
Article in English | AIM, AIM | ID: biblio-1359340

ABSTRACT

Background. Mother-to-child transmissions (MTCT) accounts for 90% of the 370 000 new HIV-positive children, globally. Despite progress in the prevention of mother-to-child transmission (PMTCT) of HIV, children still acquire HIV infection. Objective. To identify and describe the prevalence of maternal, infant and/or health system-related risk factors gleaned from the literature for HIV transmission in HIV-positive children admitted to the paediatric intensive care unit (PICU) at Inkosi Albert Luthuli Central Hospital (IALCH), Durban, South Africa. Method. A retrospective electronic chart review identifying all HIV-positive children under 2 years admitted to the PICU at IALCH between January 2017 and December 2019 was undertaken. Individual patient records were analysed using a standardised template. Results. Of the 80 mothers and children with HIV enrolled in the present study, 38.8% (n=31/80) of mothers were diagnosed prior to pregnancy, 42.5% (n=34/80) were diagnosed during pregnancy (unsure when exactly transmission occurred), and 18.8% (n=15/80) of mothers were diagnosed after delivery. The median (range) time of antiretroviral treatment (ART) was 225 (30 - 365) days for mothers. More than half of mothers (56.3%, n=45/80) whose babies became HIV-positive had poor adherence to antiretroviral drugs (HIV viral load >1 000 copies/mL). An HIV-positive diagnosis in the children of these mothers occurred throughout infancy and early childhood, especially in the first 6 months (87.5%, n=70/80). A third of mothers practised mixed feeding. Health system deficiency, mainly via cancellation of tests without notifying healthcare workers, was typical in infants (33%; n=26/80) and mothers (68.8%, n=55/80). All others (100%) were not counselled about the importance of PMTCT and 93.8% of mothers were not counselled about the importance of follow-up. Almost all HIV-positive infants (95%, n=76) presented with severe respiratory illness, mainly severe acute respiratory distress syndrome (62.5%, n=50/80) and pneumonia with hypoxic respiratory failure (32.5%, n=26/80). The overall mortality of the cohort was 22.5% (n=18/80), and most deaths were associated with cytomegalovirus (CMV), Pneumocystis jirovecii pneumonia (PJP) or both (61.1%, n=11/18). Conclusion. This present study confirmed that a new diagnosis of HIV positivity occurs throughout pregnancy and early childhood in infants. Poor adherence to ART in mothers and their infants, poor counselling, failure to attend antenatal and postnatal care, mixed feeding, and challenged laboratory services were common modifiable factors that need addressing.


Subject(s)
Humans , Male , Female , Child, Preschool , HIV Infections , Child, Hospitalized , HIV Seropositivity , Infectious Disease Transmission, Vertical , Intensive Care Units , Postpartum Period
7.
S. Afr. med. j ; 112(2): 96-101, 2022.
Article in English | AIM, AIM | ID: biblio-1358378

ABSTRACT

Background. Better integration of HIV and sexually transmitted infection (STI) prevention and treatment services is needed to accelerate progress towards the goal of zero new HIV infections. Objectives. To describe HIV positivity, antiretroviral therapy (ART) use, viral suppression and recency of HIV infection among symptomatic STI service attendees at two primary care clinics in South Africa. Methods. In a cross-sectional study, male and female STI service attendees presenting with symptoms consistent with STI syndromes were enrolled following informed consent. An interviewer-administered questionnaire was completed and appropriate genital and blood specimens were collected for STI testing and HIV biomarker measurements including recency of infection and antiretroviral (ARV) drug levels. Descriptive statistics were used to describe enrolled attendees, and to determine the proportion of attendees who were HIV-positive, recently infected, taking ART and virally suppressed. HIV-positive attendees with detectable ARVs were considered to be on ART, while those with viral loads (VLs) ≤200 copies/mL were considered virally suppressed. Results. Of 451 symptomatic attendees whose data were analysed, 93 (20.6%) were HIV-positive, with 15/93 (16.1%) being recently infected. Recent infection was independently associated with genital ulcer disease at presentation, especially ulcers with no detectable STI pathogens. Among the 78 (83.9%) with long-term infection, only 30 (38.5%) were on ART, with 23/30 (76.7%) virally suppressed. Conclusions. In a population at risk of HIV transmission, there was a high burden of recent infection and unsuppressed VLs. Incorporating pre-exposure prophylaxis, ART initiation and adherence support into STI services will be necessary for progress towards eliminating HIV transmission


Subject(s)
HIV Infections , Viral Load , Sexually Transmitted Diseases , HIV Seropositivity
8.
Esc. Anna Nery Rev. Enferm ; 26: e20210083, 2022. graf
Article in Portuguese | LILACS, BDENF | ID: biblio-1346056

ABSTRACT

RESUMO Objetivo compreender as representações sociais de adolescentes sobre vulnerabilidades e riscos para contrair o HIV/Aids nas relações sexuais. Método estudo de representações sociais, realizado a partir de entrevistas individuais com 15 adolescentes e grupo focal com oito adolescentes de uma escola pública do Recife, Pernambuco, Brasil. Os dados foram coletados no período de maio a outubro de 2016. Para tratamento dos dados, empregou-se a técnica de análise de conteúdo temática-categorial com o auxílio do Software QSR Nvivo11. Resultados as categorias: riscos de contrair HIV/Aids nas relações sexuais; e dos riscos de contrair HIV/Aids nas relações sexuais às vulnerabilidades abrigam os temas não usar preservativo, ter usado álcool e/ou drogas, ter vários parceiros, ter dificuldades de acesso aos serviços de saúde e de educação sexual nas escolas; e não ter conversas com os pais ou familiares. Conclusão e implicações para a prática compreendeu-se que as representações sociais circulam no imaginário e no ambiente escolar, interferindo na realidade dos adolescentes. Propõe-se priorizar políticas públicas focadas nas dimensões emocionais, afetivas e sociais.


RESUMEN Objetivo comprender las representaciones sociales de adolescentes acerca de las vulnerabilidades y riesgos de contraer el VIH/SIDA en relaciones sexuales. Método estudio de representaciones sociales realizado a partir de entrevistas individuales con 15 adolescentes y un grupo focal con ocho adolescentes de una escuela pública en Recife, Pernambuco, Brasil. Los datos se recolectaron entre mayo y octubre de 2016. Para el tratamiento de los datos, se utilizó la técnica de análisis de contenido temático-categórico, con la ayuda del software QSR Nvivo11. Resultados las categorías riesgos de contraer el VIH/SIDA en las relaciones sexuales; y de los riesgos de contraer el VIH/SIDA en las relaciones sexuales a las vulnerabilidades que cubren los temas de no usar condón, haber consumido alcohol y/o drogas, tener varios pares, tener dificultades para acceder a los servicios de salud y de educación sexual en las escuelas; y no tener conversaciones con los padres o miembros de la familia. Conclusión e implicaciones para la práctica se entendió que las representaciones sociales circulan en el imaginario y en el ámbito escolar, interfiriendo en la realidad de los adolescentes. Se propone priorizar políticas públicas enfocadas en las dimensiones emocionales, afectivas y sociales.


ABSTRACT Objective To understand social representations of adolescents about vulnerabilities and risks of contracting HIV/AIDS in sexual relations. Method Study of social representations, based on individual interviews with 15 adolescents and a focus group with eight adolescents from a public school in Recife, Pernambuco, Brazil. Data were collected from May to October 2016. For the processing of data, the thematic-categorial content analysis technique was used with the aid of the QSR Nvivo11 Software. Results The categories: risks of contracting HIV/AIDS in sexual relations; and from the risks of contracting HIV/AIDS in sexual relations to the vulnerabilities cover the themes of not using condoms, having used alcohol and/or drugs, having several partners, having difficulties in accessing health and sex education services in schools; and not having conversations with parents or family members. Conclusion and implications for practice it was understood that social representations circulate in the imaginary and in the school environment, interfering in the reality of adolescents. It is proposed to prioritize public policies focused on the emotional, affective and social dimensions.


Subject(s)
Humans , Male , Female , Adolescent , Social Perception , HIV Infections/transmission , Coitus , Adolescent Health , Health Vulnerability , Poverty , Sex Education , Alcohol Drinking , Sexual Partners , Condoms , Substance-Related Disorders , Qualitative Research , Unsafe Sex , Family Relations , Health Services Accessibility
9.
Niger. j. clin. pract. (Online) ; 25(1): 49-54, 2022. Tableaux
Article in English | AIM, AIM | ID: biblio-1357859

ABSTRACT

Background: As the SARS-CoV-2 pandemic continues to ravage the world, its impact on the health systems and survival of people with chronic diseases especially People living with HIV [PLWH] could be undermined. It becomes relevant to assess the challenges PLWH face during this period to institute measures towards combating the negative effects of the pandemic. Aims: This study aims to investigate the challenges faced by PLWH in accessing care during the lockdown period in Lagos, Nigeria. The study was a cross-sectional one involving PLWH aged 18 years and above who presented for care. An interviewer-administered questionnaire was used to obtain information on demographic characteristics, their knowledge about COVID-19 disease, and challenges experienced in accessing care during the COVID-19-induced lockdown. Ethical approval was obtained from the Institution Research Ethics Board (IRB) of NIMR. Patients and Methods: Data generated from the survey was exported to Excel and analyzed using SPSS version 23.0. Results: The mean age of PLWH who participated in the study was 42.2 (±12.2) years. The majority were female (74.3%), married (66.3%), employed (58.9%), and on less than $100 monthly income (80.5%). The commonest challenges experienced were psychological (78.5%), financial (68%) and food (40.7%). There were significant association among the income status, lack of food (OR: 2.5, CI: 1.4-4.5, P = 0.002), financial challenges (OR: 1.7, CI: 1.0­3.0, P = 0.048) and psychological challenges (OR; 1.8, CI: 1.0-3.5, P = 0.05). Ninety­five percent of participants believed SARS-COV-2 infection is a viral infection. Conclusions: PLWH faces a myriad of challenges that would have a significant impact on their overall well-being and the gains of HIV care.


Subject(s)
Humans , Male , Female , Middle Aged , HIV Infections , Ambulatory Care Facilities , SARS-CoV-2 , COVID-19 , Antiretroviral Therapy, Highly Active
10.
Rev. bioét. (Impr.) ; 29(4): 867-879, out.-dez. 2021. tab
Article in Portuguese | LILACS | ID: biblio-1365511

ABSTRACT

Resumo Esta pesquisa qualitativa foi conduzida com dez participantes da região Sul do Brasil com idade entre 15 e 24 anos e visou identificar os elementos do processo comunicativo do diagnóstico de infecção pelo HIV em sua experiência, por meio de análise de conteúdo a partir das categorias teóricas do modelo lasswelliano. O canal foi a consulta médica; o contexto foi determinado pelo tipo de exposição (vertical ou horizontal); os ruídos apresentaram questões veladas e incertezas; as falhas implicaram as situações que levavam o jovem a suspeitar do diagnóstico; e os efeitos envolveram reações emocionais imediatas que se dissipam com o tempo. A comunicação na adolescência foi pontual, indicando a necessidade de qualificar o processo comunicativo, e desencadeada por familiares com apoio de profissionais. A comunicação do diagnóstico de HIV geralmente é postergada pelos familiares quando se trata de criança ou adolescente, o que fere o princípio da autonomia, por desconsiderar o direito de saber.


Abstract This qualitative research aimed at identifying the elements of the communication process of HIV infection diagnosis in the experience of ten participants from Southern Brazil aged between 15 and 24 years old that was conducted via content analysis based on the theoretical categories of Lasswell's model. The channel was the medical consultation; the context was determined by the type of exposure (vertical or horizontal); the noises presented veiled issues and uncertainties; the failures involved situations that led the young person to suspect the diagnosis; and the effects involved immediate emotional reactions that dissipated over time. Communication in adolescence was punctual and triggered by family members with support from professionals, indicating the need to improve the communicative process. The communication of the HIV diagnosis is usually postponed by family members when it comes to children or adolescents, which violates the principle of autonomy by disregarding the right to know.


Resumen Esta investigación cualitativa fue realizada con diez participantes de la región sur de Brasil con edades entre 15 y 24 años y tuvo como objetivo identificar los elementos del proceso comunicativo del diagnóstico de infección por VIH en su experiencia; a través del análisis de contenido a partir de las categorías teóricas del modelo lasswelliano. El canal fue la consulta médica, el contexto fue determinado por el tipo de exposición (vertical u horizontal); los ruidos presentaron preguntas veladas e incertidumbres, los fracasos implicaron las situaciones que llevaron al joven a sospechar el diagnóstico, y los efectos implicaron reacciones emocionales inmediatas que se disipan con el tiempo. La comunicación en la adolescencia fue puntual, indicando la necesidad de calificar el proceso comunicativo, y desencadenada por familiares con apoyo profesional. La comunicación del diagnóstico del VIH suele ser postergada por los familiares cuando se trata de niños o adolescentes, lo que perjudica el principio de autonomía, porque ignora el derecho a saber.


Subject(s)
HIV Infections , Adolescent , Acquired Immunodeficiency Syndrome , Qualitative Research , Young Adult , Health Communication
11.
Biomédica (Bogotá) ; 41(4): 734-744, oct.-dic. 2021. tab
Article in English | LILACS | ID: biblio-1355746

ABSTRACT

Abstract | Introduction: Intestinal apicomplexa protozoa are a recognized cause of gastroenteritis. They are endemic in Honduras and their epidemiology varies in different population groups. Objective: To identify risk factors for cyclosporiasis, cryptosporidiosis, and cystoisosporiasis. Materials and methods: We conducted a case-control study in a hospital-based population. We performed the diagnosis using the modifed Ziehl-Neelsen staining technique and collected the information from laboratory records and clinical charts. Results: Cyclosporiasis was associated with diarrhea (OR=2.28; 95%CI: 1.10-4.89), weight loss (OR=12.7; 95%CI: 2.49-122.00), watery stools (OR=2.42; 95%CI: 1.26-4.65), and infection with another protozoan (OR=3.13; 95%CI: 1.66-5.95). Cryptosporidiosis was associated with HIV infection (OR=15.43; 95%CI: 3.34-71.22), diarrhea (OR=3.52; 95%CI: 1.40-9.40), lymphopenia (OR=6.16; 95%CI: 1.99-18.98), and green color stools (OR=3.00; 95%CI: 1.23-7.30). Cystoisosporiasis was associated with HIV infection (OR=11.20; 95%CI: 3.53-35.44), diarrhea (OR=7.30; 95%CI: 1.89-28.52), leukopenia (OR=4.28; 95%CI: 1.33-13.75), green color stools (OR=11.59; 95%CI: 1.16-558.60), and Charcot-Leyden crystals (OR=11.59; 95%CI: 1.16-558.60). Conclusions: In this hospital-based population from Honduras, HIV infection was a risk factor for cryptosporidiosis and cystoisosporiasis, but not for cyclosporiasis.


Resumen | Introducción. Los protozoos Apicomplexa intestinales son causa reconocida de gastroenteritis. Estas parasitosis son endémicas en Honduras y su epidemiologia varia según los grupos poblacionales. Objetivo. Identifcar los factores de riesgo para ciclosporiasis, criptosporidiosis y cistoisosporiasis. Materiales y métodos. Se hizo un estudio de casos y controles en población hospitalaria. El diagnóstico se hizo utilizando la coloración modifcada de Ziehl-Neelsen. La información se obtuvo del registro de laboratorio y las historias clínicas. Resultados. La ciclosporiasis se asoció con diarrea (OR=2,28; IC95% 1,10-4.89), pérdida de peso (OR=12,7; IC95% 2,49-122), heces líquidas (OR=2,42; IC95% 1,26-4,65), infección con otros protozoos (OR=3,13; IC95% 1,66-5,95). La criptosporidiosis se asoció con el HIV (OR=15,43; IC95% 3,34-71,22), la diarrea (OR=3,52; IC95% 1,40-9,40), la linfopenia (OR=6,16; IC 95% 1,99-18,98), las heces de color verde (OR=3,00; IC95% 1,23-7,30). La cistoisosporiasis se asoció con el HIV (OR=11,20; IC95% 3,53-35,44), la diarrea (OR=7,30; IC95% 1,89-28,52), la leucopenia (OR=4,28; IC95% 1,33-13,75), las heces de color verde (OR=11,59; IC95% 1,16- 558,60), y los cristales de Charcot-Leyden (OR=11,59; IC95% 1,16-558,60). Conclusiones. En este estudio de base hospitalaria en Honduras, el HIV fue un factor de riesgo para la criptosporidiosis y la cistoisosporiasis, pero no así para la ciclosporiasis.


Subject(s)
Honduras , Intestinal Diseases, Parasitic , Parasitic Diseases , Case-Control Studies , HIV Infections , Cryptosporidiosis , Cyclosporiasis
12.
Infectio ; 25(4): 250-255, oct.-dic. 2021. tab
Article in Spanish | LILACS, COLNAL | ID: biblio-1286718

ABSTRACT

Resumen Introducción: Las alteraciones de la bioquímica hepática son frecuentes en los pacientes con infección por VIH, la etiología es variada, la esteatosis hepática es frecuente con una prevalencia estimada del 60% Objetivos: Caracterizar las alteraciones hepáticas en una serie de pacientes con infección por VIH en un centro de investigación de Bogotá Colombia durante el periodo 2009 - 2019. Materiales y Métodos: Estudio descriptivo, retrospectivo, observacional de pacientes con infección por VIH que asistieron a un centro de investigación durante los años 2009-2019. Resultados: 94% fueron hombres y 6% mujeres con edad promedio de 44 años, 92,5% de los pacientes presentaba uso de terapia antiretroviral. Las principales hepatopatías fueron la coinfección VIH-Hepatitis C y el hígado graso en iguales porcentajes, 31,3%. El promedio del indice HOMA fue de 2,58. Discusión: Las enfermedades hepáticas son una causa importante de morbimortalidad en pacientes con infección por VIH, las coinfecciones virales y el hígado graso pueden ser muy frecuentes en nuestro medio a diferencia de otros estudios Conclusiones: Este es el primer estudio a nivel local en describir las alteraciones hepáticas en pacientes con VIH, las comorbilidades no SIDA, juegan un papel importante dentro de la enfermedad. La hepatitis C continúa siendo una coinfección frecuente en la población VIH.


Abstract Introduction: Alterations in liver biochemistry are frequent in patients with HIV infection, the etiology is varied and includes multiple causes, liver steatosis is one of the most frequent with an estimated prevalence of 60% after the appearance of antiretroviral treatment Objectives: To characterize liver disorders in a series of patients with HIV infection at a research center in Bogotá Colombia during the period 2009-2019. Materials and Methods: Descriptive, retrospective, observational study of patients with HIV infection who attended a disease research center during the years 2009-2019. Results: 67 clinical histories were reviewed, 94% were men and 6% women with an average age of 44 years, 92.5% of the patients had use of anti-retroviral therapy and the diagnosis of HIV was known 11.7 years ago on average. The main liver diseases were HIV-Hepatitis C coinfection and fatty liver in equal percentages, 31.3%. The average HOMA index was 2.58. Discussion: Liver diseases are an important cause of morbidity and mortality in patients with HIV infection. Viral coinfections and fatty liver can be very frequent in our setting, unlike other studies. Conclusions: This is the first study locally to describe the liver disorders in patients with HIV, non-AIDS comorbidities, including fatty liver, play an important role in the disease and could behave like the general population. Hepatitis C continues to be a frequent coinfection in the HIV population.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , HIV Infections , Liver Diseases , Therapeutics , Prevalence , Acquired Immunodeficiency Syndrome , Hepatitis C , Colombia , Fatty Liver , Liver
13.
Infectio ; 25(4): 207-211, oct.-dic. 2021. tab, graf
Article in Spanish | LILACS, COLNAL | ID: biblio-1286715

ABSTRACT

Resumen Objetivo: Describir la proporción, características clínicas, demográficas y programáticas de casos fatales de coinfección TB/VIH de Cali-Colombia, en 2017. Material y Método: Estudio de corte transversal, con información de las bases de datos del programa de tuberculosis, las historias clínicas y unidades de análisis de mortalidad disponibles. Resultados: Se depuraron 257 casos fatales por TB, el 24,5% (63/257) falleció con coinfección TB/VIH. La mediana de edad fue 43 años (Rango Intercuartílico: 30-52), 73% (46/63) eran hombres, 76,2% (48/63) no pertenecían al régimen contributivo, 28,6% eran habitantes de calle. 81,2% (39/48) eran casos nuevos de TB, 76,6% (37/47), inició tratamiento; al 74,6% (47/63) se les realizó unidad de análisis de mortalidad. La presentación pulmonar fue frecuente (75,9%-44/58), en 60% de los registros se observó desnutrición (Índice de Masa Corporal <20), en 39,7% (25/63) dependencia al alcohol, tabaco o farmacodependencia. Conclusiones: La mortalidad asociada a TB/VIH es prevenible, pero en 2017 representó la cuarta parte de la mortalidad por TB en Cali. Hombres adultos con condiciones de vulnerabilidad social, diagnosticados en estados avanzados de enfermedad, fueron blanco de fatalidad. Mejorar los sistemas de información e integrar los programas de TB/VIH, deben ser estrategias prioritarias para la salud pública en Colombia.


Abstract Objective: To describe the proportion, clinical, demographic and programmatic characteristics of fatal cases of TB/HIV coinfection from Cali-Colombia, in 2017. Material and Method: Cross-sectional study, with information from the TB program databases, clinical records and mortality analysis units available. Results: 257 TB fatal cases were cleared in Cali in 2017, 24.5% (63/257) of these died with TB/HIV coinfection. The median age was 43 years (Interquartile Range: 30-52), 73% (46/63) were men, 76.2% (48/63) did not belong to the contributory health regimen, 28.6% were homeless. 81.2% (39/48) were new TB cases, 76.6% (37/47) started treatment; 74.6% (47/63) had mortality analysis register. Pulmonary presentation was frequent (75.9% -44 / 58), in 60% of the registries malnutrition was observed (Body Mass Index <20), in 39.7% (25/63), dependence on alcohol, tobacco or drug dependence was registered. Conclusions: Mortality associated with TB/HIV is preventable, but in 2017 it represented a quarter of the TB mortality in Cali. Adult men with conditions of social vulnerability, diagnosed in advanced stages of disease, were fatally targeted. Improving information systems and integrating TB/HIV programs should be priority strategies for public health in Colombia.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Tuberculosis , HIV , Body Mass Index , HIV Infections , Public Health , Cross-Sectional Studies , Mortality , Health Strategies , Colombia , Social Vulnerability , Malnutrition
14.
San Salvador; MINSAL; dic . 10, 2021. 66 p. ilus, tab.
Non-conventional in Spanish | LILACS, BISSAL | ID: biblio-1352917

ABSTRACT

Estos Lineamientos Técnicos se enmarcan en un esfuerzo por poner en práctica la «Prevención Combinada¼, un conjunto de programas comunitarios fundamentados en derechos y la evidencia que combina elementos biomédicos, estructurales y comportamentales para frenar las infecciones del VIH. Como parte del elemento biomédico se encuentra la PrEP


These Technical Guidelines are framed in an effort to put into practice the «Combined Prevention¼, a set of community programs based on rights and the evidence that combines biomedical, structural and behavioral measures to curb HIV infections. As part of the element biomedical is PrEP


Subject(s)
HIV , Pre-Exposure Prophylaxis , HIV Infections
15.
Prensa méd. argent ; 107(8): 406-411, 20210000. fig
Article in Spanish | LILACS, BINACIS | ID: biblio-1358658

ABSTRACT

Objetivo: Los pacientes con enfermedad por el virus de la inmunodeficiencia humana suelen presentar lesiones orales, hasta en un 50% de los casos con diagnóstico de sida. La displasia fibrosa es una lesión intra-ósea caracterizada por una alteración del crecimiento y diferenciación de los osteoblastos debida a una mutación genética. Clínicamente se caracteriza por presentar una tumoración de lento crecimiento con dolor, deformidad ósea y, en ocasiones, fracturas ante traumas mínimos. Caso clínico: Se presenta una paciente con sida y tuberculosis diseminada que desarrolló una lesión ósea tumoral , con compromiso de paladar y encía superior derecha, cuyo diagnóstico histopatológico fue de displasia fibrosa de paladar óseo y maxilar superior. Conclusión: La displasia fibrosa debe incluirse en el diagnóstico diferencial de las lesiones tumorales orales de los pacientes con enfermedad VIH/sida.


Aim: Patients with human immunodeficiency virus infection usually have oral lesions, including up to 50% of patients diagnosed with AIDS. Fibrous dysplasia is an intra-bone lesion, characterized by an alteration of the growth and differentiation of osteoblastes produced by a genetic mutation. Clinically it is characterized by presenting a tumor of slow growth with pain, bone deformity and sometimes fractures to minimal trauma. Clinical case: Here we describe a patient with AIDS and disseminated tuberculosis who developed a large tumor lesion that involve the hard palate and the maxilla. Final histopathological diagnosis was of fibrous dysplasia involving the hard palate and the upper maxilla. Conclusion: fibrous dysplasia should be included in the differential diagnosis of intraoral tumor lesions in HIV/AIDS patients.


Subject(s)
Humans , Female , Adult , Mouth Neoplasms/etiology , Mouth Neoplasms/therapy , HIV Infections/therapy , Early Diagnosis , Diagnosis, Differential , Fibrous Dysplasia, Monostotic/therapy
16.
Ciênc. Saúde Colet ; 26(11): 5841-5849, nov. 2021. tab
Article in English, Portuguese | LILACS | ID: biblio-1350453

ABSTRACT

Resumo O objetivo deste estudo foi avaliar a influência do consumo de mídia sexualmente explícita (MSE) de modalidade bareback na prática de sexo anal sem preservativo por homens que fazem sexo com homens (HSH). Para tanto, foi criada uma página na rede social Facebook® com um link que direcionava os interessados para um questionário. Foram incluídos homens cisgênero, com 18 anos ou mais e que praticaram sexo com outro(s) homem(ns) nos últimos 12 meses. Os dados foram coletados em 2017 e analisados por meio de estatística inferencial (uni)bivariada e regressão logística multivariada. Participaram da pesquisa 2.248 HSH, com média de idade de 24,4 anos e média de 3,9 parceiros nos últimos 30 dias. Possuir múltiplos parceiros sexuais (ORa:9,4; IC95% 3,9-22,4), preferir filmes com cenas bareback (ORa:2,6; IC95% 1,5-4,6), julgar essa prática um fetiche e realizá-lo (ORa:3,52; IC95% 2,3-5,4), ter parceria casual (ORa:1,8; IC95% 1,5-1,9) e ciência do status sorológico negativo do parceiro para o HIV (ORa:1,4; IC95% 1,1-2,3) foram fatores que aumentaram as chances de envolvimento em sexo anal sem preservativo. Dessa forma, verificamos associação entre o consumo de MSE bareback e a prática de sexo sem preservativo entre HSH.


Abstract This study aimed to evaluate the influence of bareback sexually explicit media (SEM) consumption on anal sex without a condom by men who have sex with men (MSM). To this end, a page was created on the Facebook® social network with a link that directed interested parties to a questionnaire. Cisgender men, aged 18 years and over, who had sex with other men in the last 12 months, were included. Data were collected in 2017 and analyzed using univariate and bivariate inferential statistics and multivariate logistic regression. A total of 2,248 MSM participated in the research, with a mean age of 24.4 years and a mean number of 3.9 partners in the last 30 days. Having multiple sexual partners (ORa: 9.4; 95% CI 3.9-22.4), preferring movies with bareback scenes (ORa: 2.6; 95% CI 1.5-4.6), considering this practice a fetish and realizing it (ORa: 3.52; 95% CI 2.3-5.4), having casual partnerships (ORa: 1.8; 95% CI 1.5-1.9) and being aware of the partner's negative serological status for HIV (ORa: 1.4; 95% CI 1.1-2.3) were factors that increased the likelihood of engaging in anal sex without a condom. Thus, we found an association between the consumption of bareback SEM and sex without a condom among MSM.


Subject(s)
Humans , Male , Adolescent , Adult , Young Adult , HIV Infections/prevention & control , HIV Infections/epidemiology , Sexual and Gender Minorities , Risk-Taking , Sexual Behavior , Sexual Partners , Condoms , Homosexuality, Male , Unsafe Sex
17.
Ciênc. Saúde Colet ; 26(11): 5739-5749, nov. 2021. tab
Article in English, Portuguese | LILACS | ID: biblio-1350444

ABSTRACT

Resumo No atual contexto da epidemia de HIV múltiplas estratégias de prevenção vêm se apresentando como alternativas para populações mais suscetíveis, incluindo as biomédicas. Este trabalho buscou compreender as percepções de risco ao HIV de homossexuais e bissexuais e a experiência de uso da Profilaxia Pós-Exposição sexual ao HIV (PEP Sexual). Trata-se de estudo de abordagem qualitativa com uso de entrevistas semiestruturadas com 25 participantes em cinco cidades brasileiras. Os resultados apontam que dada a proeminência do preservativo como estratégia de prevenção ao HIV/Aids, a falha do método, o uso não consistente e o não uso intencional constituem as referências centrais da percepção de risco e a consequente tomada de decisão de busca por PEP. Quanto às percepções e os significados do uso da PEP, estes são modulados pelo conhecimento prévio sobre o método. O trabalho amplia o debate sobre aspectos subjetivos envolvendo a prevenção do HIV entre HSH, especialmente no que concerne a percepção de risco e tomada de decisão para o uso da PEP no atual cenário da epidemia e no contexto da prevenção combinada.


Abstract In the current context of the HIV epidemic, multiple prevention strategies including biomedical interventions have been presented as alternatives for vulnerable groups. This study investigated homosexuals' and bisexuals' perceptions of the risk of HIV infection and their experiences of using HIV post-exposure prophylaxis (PEP). We conducted a qualitative study with 25 men who have sex with men (MSM) in five Brazilian cities using semi-structured interviews. The results showed that the use of condoms was the main HIV prevention strategy employed by the respondents. In addition, condom failure, inconsistent condom use and intentional non-use are the main prompters of risk perception and the consequent decision to seek PEP. The respondent's perceptions and meanings of the use of PEP were mediated by prior knowledge of PEP. This work broadens the debate on the more subjective aspects of HIV prevention among MSM, especially those related to risk perception and the decision to use PEP in the context of combined prevention.


Subject(s)
Humans , Male , HIV Infections/prevention & control , Sexual and Gender Minorities , Cities , Condoms , Homosexuality, Male , Post-Exposure Prophylaxis
18.
Ciênc. Saúde Colet ; 26(supl.3): 5361-5370, Oct. 2021.
Article in English, Portuguese | LILACS | ID: biblio-1345762

ABSTRACT

Resumo O artigo intenta levantar reflexões sobre a necropolítica direcionada ao HIV/Aids no Brasil a partir de um conjunto de racionalidades que perpassam os processos de configuração da agenda governamental, tratamento da doença e as políticas e tecnologias envolvidas. Para tanto, foi realizada uma revisão teórica não-sistemática a partir de um tríplice aspecto: o do estigma da aids, o da necropolítica e o da política da vida. Concluiu-se que a política da vida como contraposição à necropolítica contribui para a defesa dos direitos humanos e da saúde, sobretudo para a desmistificação do estigma e da política de inimizade historicizada na Aids.


Abstract The article aims to raise reflections about the necropolitics directed to HIV/AIDS in Brazil from a set of rationalities that permeate the processes of configuration of the governmental agenda, treatment of the disease, and the policies and technologies involved. For this purpose, a non-systematic theoretical review was carried out from a threefold aspect: the stigma of AIDS, necropolitics, and life politics. We concluded that life politics, as opposed to necropolitics, contributes to the defense of human rights and health, above all, to the demystification of stigma and the politics of enmity historicized in AIDS.


Subject(s)
Humans , HIV Infections , Acquired Immunodeficiency Syndrome , Politics , Brazil , Social Stigma , Human Rights
19.
Arq. bras. cardiol ; 117(2): 365-375, ago. 2021. tab, graf
Article in English, Portuguese | LILACS | ID: biblio-1339149

ABSTRACT

Resumo Fundamento Pacientes com HIV têm maior probabilidade de apresentar doenças cardiovasculares quando comparados à população em geral. Objetivo Este foi um estudo de caso-controle que teve como objetivo avaliar quais fatores estavam associados a uma redução na espessura médio-intimal da carótida (IMT) da carótida e ao aumento na dilatação mediada por fluxo (DMF) da artéria braquial em pacientes com HIV que receberam atorvastatina + aspirina por um período de 6 meses. Métodos Foi realizada uma análise secundária de um ensaio clínico, que incluiu pessoas vivendo com HIV e baixo risco cardiovascular. Um total de 38 pacientes alocados para o braço de intervenção e tratados por 6 meses com uma combinação de atorvastatina + aspirina foram incluídos. Todos os participantes foram submetidos a ultrassonografia da carótida e da artéria braquial, tanto no início quanto no final do estudo. Os casos que responderam com aumento >10% da dilatação braquial (DMF) e redução da espessura médio-intimal da carótida (IMT) foram considerados casos, e aqueles que não responderam foram considerados controles. Avaliamos os fatores associados às respostas positivas obtidas através da IMT e DMF. Resultados A redução do IMT não se associou significativamente a nenhum dos fatores de risco avaliados: idade (p = 0,211), sexo (p = 0,260), tabagismo (p = 0,131) ou tempo de diagnóstico do HIV (p = 0,836). Um aumento na DMF foi significativamente associado com a idade entre aqueles na faixa etária de 40-59 anos, p = 0,015 (OR = 4,37; IC 95%: 1,07-17,79). Conclusões Os indivíduos mais velhos foram mais propensos a apresentar um aumento na DMF após 6 meses de tratamento com atorvastatina + aspirina.


Abstract Background Patients with HIV are more likely to present with cardiovascular disease when compared to the general population. Objective This was a case-control study that aimed to assess which factors were associated with a reduction in the carotid intima-media thickness (IMT) and an increase in the brachial artery flow-mediated dilation (FMD) in HIV patients who received atorvastatin + aspirin during a period of 6 months. Methods A secondary analysis of a clinical trial was conducted, which included people living with HIV infection and low cardiovascular risk. A total of 38 patients allocated to the intervention arm and treated for 6 months with a combination of atorvastatin + aspirin were included. All participants underwent a carotid and brachial artery ultrasound, both at the beginning and the end of the study. Cases that responded with an increase of >10% of the brachial dilatation (FMD) and reduction of the carotid intima-media thickness (IMT) were considered cases, and those who did not respond were considered controls. We assessed the factors associated with the positive responses obtained through IMT and FMD. Results A reduction in the IMT was not significantly associated with any of the evaluated risk factors: age (p=0.211), gender (p=0.260), smoking (p=0.131) or time since HIV diagnosis (p=0.836). An increase in the FMD was significantly associated with age amongst those in the 40-59 age group, p = 0.015 (OR = 4.37; 95% CI: 1.07-17.79). Conclusions Older individuals were more likely to present with an increased FMD after 6 months of treatment with atorvastatin + aspirin.


Subject(s)
Humans , HIV Infections/complications , HIV Infections/drug therapy , Vasodilation , Brachial Artery/diagnostic imaging , Endothelium, Vascular/diagnostic imaging , Carotid Arteries/diagnostic imaging , Case-Control Studies , Aspirin/therapeutic use , Risk Factors , Ultrasonography , Carotid Intima-Media Thickness , Atorvastatin/therapeutic use
SELECTION OF CITATIONS
SEARCH DETAIL