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1.
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
2.
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
3.
Ciênc. Saúde Colet ; 26(8): 3053-3064, ago. 2021. tab
Article in English, Portuguese | LILACS | ID: biblio-1285949

ABSTRACT

Resumo O objetivo deste artigo é identificar fatores associados ao conhecimento e utilização de estratégias de prevenção combinada do HIV entre mulheres trabalhadoras do sexo (MTS). Estudo epidemiológico transversal, utilizando o método Respondent Driven Sampling (RDS). Foram realizadas análises descritivas após ajustes requeridos pelo método RDS. Para investigar fatores associados ao conhecimento de PEP e PrEP e utilização do preservativo feminino foi usada a regressão de Poisson, utilizando como medida de associação o Odds Ratio. MTS sem vínculo com ONGs, que não receberam material informativo sobre prevenção e/ou participaram de palestras nos últimos seis meses e que não se identificam como MTS nos serviços de saúde têm menos conhecimento sobre PEP e PrEP e utilizam com menor frequência o preservativo feminino. De maneira geral, as MTS não têm conhecimento e acesso suficiente às tecnologias de prevenção combinada do HIV a ponto de usufruir de seus benefícios. Consideramos que a adoção de modelos diferenciados de cuidados voltados para MTS em parceria com ONGs pode ser uma estratégia efetiva para ampliação do conhecimento e utilização das tecnologias de prevenção do HIV no Brasil.


Abstract This article aims to Identify factors associated with knowledge and use of combined HIV prevention strategies among female sex workers (FSW). Cross-sectional epidemiological study, using the Respondent Driven Sampling (RDS) method. Descriptive analyzes were performed after adjustments required by the RDS method. To investigate factors associated with knowledge of PEP and PrEP and use of the female condom, Poisson regression was applied, using odds ratio as an association measure. FSW not affiliated with NGOs, who did not receive informational material on prevention and / or participated in lectures in the last six months and who do not identify themselves as FSW in healthcare service facilities have less knowledge about PEP and PrEP and use the female condom less frequently. In general, FSW do not have sufficient knowledge and access to combined HIV prevention methods to take advantage of their benefits. We believe that the adoption of different models of care for FSW in partnership with NGOs can be an effective strategy for expanding knowledge and use of HIV prevention methods in Brazil.


Subject(s)
Humans , Female , HIV Infections/prevention & control , HIV Infections/epidemiology , Sex Workers , Brazil , Cross-Sectional Studies , Cities
4.
Rev. Bras. Saúde Mater. Infant. (Online) ; 21(3): 945-953, July-Sept. 2021. tab, graf
Article in English | LILACS | ID: biblio-1346996

ABSTRACT

Abstract Objectives: to calculate the prevalence and rate per 1,000 live births of sexually transmitted infections (STI) in pregnant women at a public maternity hospital in Salvador. Methods: this descriptive, cross-sectional study retrospectively collected data from compulsory notifications and medical records of pregnant women with STI seen at a maternity hospital in northeastern Brazil between 2014 and 2017 (n = 520). Prevalence and rate per 1,000 live births were estimated for hepatitis B, hepatitis C, HIV, and syphilis. Associations between STI and other clinical and sociodemographic variables were investigated. Results: most pregnant women were born and resided in Salvador, presented a mean age of 26.4 years, self-reported mixed-race and had unplanned pregnancies. Prevalence and rates per 1,000 live births were, respectively: 0.26% and 3.39 for hepatitis B, 0.06% and 0.79 for hepatitis C, 0.47% and 6.23 for HIV, and 2.46% and 32.2 for syphilis. Conclusion: higher prevalence and rates of infection per 1,000 live births were seen at the maternity hospital in northeastern Brazil compared to official data provided by the Brazilian government, notably with regard to HIV and syphilis. The appropriate epidemiological notification of STI, especially in pregnant women, enables the elaboration of effective preventive strategies incorporating specific sociodemographic and clinical characteristics.


Resumo Objetivos: calcular a prevalência e as taxas por 1000 nascidos vivos de infecções sexualmente transmissíveis (IST) em gestantes de uma maternidade pública de Salvador. Métodos: estudo transversal, descritivo, com dados coletados retrospectivamente a partir das fichas de notificação dos agravos e dos prontuários de todas as gestantes com IST atendidas na maternidade, entre os anos de 2014 e 2017 (n=520). Foram calculadas as prevalências e as taxas por 1000 nascidos vivos de hepatite B, hepatite C, HIV e sífilis para a população de gestantes da maternidade. Associações entre as IST e demais variáveis clínicas e sociodemográficas também foram investigadas. Resultados: a maioria das gestantes era natural e residente de Salvador, pardas, com idade média de 26,4 anos e que não planejaram a gravidez. As prevalências e as taxas por 1000 nascidos vivos foram respectivamente: 0,26% e 3,39 para hepatite B, 0,06% e 0,79 para hepatite C, 0,47% e 6,23 para HIV e 2,46% e 32,2 para sífilis. Conclusão: a maternidade apresenta prevalências e taxas por 1000 nascidos vivos superiores aos dados oficiais do governo brasileiro, especialmente para HIV e sífilis. A correta notificação epidemiológica desses agravos, especialmente em gestantes, permite o desenvolvimento de estratégias preventivas mais eficientes e com enfoque nas características sociodemográficas e clínicas das pacientes.


Subject(s)
Humans , Female , Pregnancy , Infant, Newborn , Syphilis/transmission , Syphilis/epidemiology , HIV Infections/transmission , HIV Infections/epidemiology , Hepatitis C/transmission , Hepatitis C/epidemiology , Pregnant Women , Hepatitis B/transmission , Hepatitis B/epidemiology , Socioeconomic Factors , Brazil/epidemiology , Sexually Transmitted Diseases/epidemiology , Cross-Sectional Studies , Live Birth , Health Information Systems
5.
Ciênc. Saúde Colet ; 26(7): 2653-2662, jul. 2021. tab
Article in English, Portuguese | LILACS | ID: biblio-1278781

ABSTRACT

Resumo Neste estudo investigamos como vivências de estigma do HIV se expressam entre jovens soropositivos, em transição para a clínica de adultos, no serviço de saúde, na família e nas interações afetivos-sexuais e sua relação com as desigualdades e hierarquias sociais. O estudo envolveu 31 jovens (idade mediana 21) em transição para a clínica de adultos (G1) e 12 jovens (idade mediana 30) que já fizeram essa transição (G2), ambos atendidos num serviço de saúde do Rio de Janeiro. Dentre os 43 jovens, 70% eram mulheres e 65% foi infectado por transmissão vertical. Os jovens responderam a questionários e participaram de grupos focais sobre estigma da aids e passagem para a vida adulta. A maioria relatou situações de discriminação associadas ao estigma do HIV na vida cotidiana e no cuidado em saúde. Os jovens do G1 revelaram maior preocupação com as consequências da revelação do HIV e dificuldades com o tratamento. Os relatos do G2 sugerem que a constituição de relações conjugais, incluindo parceiro/a e filhos soronegativos e o acesso ao tratamento, possibilitaram resignificar o receio da estigmatização. Os achados visam orientar a formação e ação de profissionais envolvidos na prevenção e cuidado de jovens vivendo com HIV.


Abstract This study analyzes how experiences of HIV-related stigma are expressed among HIV-positive young people transitioning to an adult clinic, the health service, the family, the affective-sexual interactions, and their relationship with inequalities and social hierarchies. This research included 31 young people (median age 21) transitioning to an adult clinic (G1) and 12 young people (median age 30) who had already made this transition (G2), both monitored at a health service in Rio de Janeiro. Seventy percent of the 43 young people were women and 65% were infected by mother-to-child transmission. Young people answered questionnaires and participated in focus groups on AIDS stigma and transition to adulthood. Most reported discrimination associated with HIV stigma in daily life and health care. G1 young people showed more significant concern about the consequences of HIV disclosure and difficulties with treatment. The G2 accounts suggest that establishing marital relationships, including HIV-negative partners and children, linked to treatment access allowed resignifying the fear of stigmatization. The findings aim to guide the training and action of professionals involved in the prevention and care of young people living with HIV.


Subject(s)
Humans , Female , Adolescent , Adult , Young Adult , HIV Infections/epidemiology , Infectious Disease Transmission, Vertical , Brazil , Social Stigma , Hospitals, Public
6.
Medicina (B.Aires) ; 81(2): 149-153, June 2021. graf
Article in Spanish | LILACS | ID: biblio-1287264

ABSTRACT

Resumen Una diferencia de edad > 5 años en la elección de la pareja sexual puede constituir un factor de riesgo de infecciones de trasmisión sexual (ITS), incluida la infección por HIV. Se realizó una encuesta de salud sexual y reproductiva a personas que consultaron por ITS o serología para HIV en dos centros de salud del conurbano bonaerense, con el objetivo de brindar información para el diseño de medidas de prevención y conocer si en nuestra área existe asociación entre la máxima diferencia de edad (MDE) en la elección de la pareja sexual y la adquisición de HIV y/o ITS. Se incluyeron 120 consultantes. En 108 (90%) se investigó sero logía, resultando 15 (13.9%) positivos para HIV y 46 (42.6%) para sífilis. La MDE con la pareja fue ≤ 5 años en 65 (54.6%) y > 5 años en 54 (45.4%) de 119 que respondieron la encuesta. Los hombres que tenían sexo con hombres refirieron una MDE > 5 años con mayor frecuencia (p = 0.022, OR: 3.59). El riesgo de HIV aumentó 9% por cada año de diferencia de edad con la pareja sexual (OR: 1.093). El porcentaje de casos de uretritis fue significativamente menor en el grupo de edad ≥ 25 años. Ninguna de las personas con uretritis tenía infección HIV. En conclusión: en esta población los hombres que tenían sexo con hombres tendieron a elegir sus parejas sexuales con una MDE mayor, y una MDE mayor fue un factor de riesgo de infección HIV.


Abstract An age difference > 5 years in the choice of sexual partner may constitute a risk factor for sexually transmitted infections (STIs), including HIV infection. A sexual and reproductive health survey was carried out on people who consulted for STIs or HIV serology in two health centers in Buenos Aires suburbs, with the aim of providing information for the design of prevention measures and to know if in this area there is an association between the maximum age difference (MAD) in the choice of sexual partner and the acquisition of HIV and/or STIs. A total of 120 patients consulted, 90% (108) performed serology, resulting 15 of them (13.9%) infected with HIV and 46 (42.6%) with syphilis. The MAD with the partner was ≤ 5 years in 65 (54.6%) and > 5 years in 54 (45.4%) of 119 who answered the survey. Men who have sex with men reported a MAD > 5 years more frequently (p = 0.022 OR: 3.59). The risk for HIV increased 9% for each year of age difference with the sexual partner (OR: 1.093). The percentage of urethritis cases was significantly lower in the age group ≥ 25 years. None of the people with urethritis had HIV infection. In conclusion: Men who have sex with men tended to choose their sexual partners with a higher MAD, and a higher MAD was a risk factors for HIV infection.


Subject(s)
Humans , Male , Child, Preschool , Adult , Sexually Transmitted Diseases/prevention & control , Sexually Transmitted Diseases/epidemiology , HIV Infections/prevention & control , HIV Infections/epidemiology , Sexual and Gender Minorities , Sexual Behavior , Sexual Partners , Risk Factors , Homosexuality, Male
7.
Medicina (B.Aires) ; 81(2): 143-148, June 2021. graf
Article in Spanish | LILACS | ID: biblio-1287263

ABSTRACT

Resumen Para hacer frente a la pandemia causada por el SARS CoV-2, en la Ciudad Autónoma de Buenos Aires se establecieron Unidades Febriles de Urgencias anexas a los hospitales de alta compleji dad. Se realizó un estudio observacional y retrospectivo con el objeto de evaluar el perfil de las personas que consultaron durante el período comprendido entre las semanas epidemiológicas 28 y 42, 2020. Se recibieron 12 571 consultas, el promedio de edad fue 38.2 años y 6801 (54.1%) pacientes eran varones. Se realizaron 9501 hisopados (RT-PCR para SARS-CoV-2) y 2499 (26.3%) fueron confirmados positivos. La edad media de los confirmados para COVID-19 fue 37.9 años, 1367 (54.7%) eran varones y 143 (5.7%) requirieron internación en la primera consulta. Tantos como 6097 (48.5%) participantes contaban con obra social o medicina prepaga. Consultaron solo 160 pacientes con HIV, se diagnosticó coinfección HIV/COVID-19 en 39/160 (24.4%) infectados con HIV y requirieron internación 9/39 (23.1%) coinfectados. Consultaron 128 pacientes con tuberculosis (TB), se diagnosticó coinfección TB/COVID-19 en 31/128 (24.2%) y requirieron internación 8/31 (25.8%) coinfectados. La triple asociación HIV/TB/COVID-19 fue constatada en 2 pacientes. Contrariamente a lo esperado, las dos principales enfermedades atendidas en el hospital, TB y HIV, estuvieron poco representadas en la consulta, pero el requerimiento de internación para los coinfectados fue elevado. Esto puede deberse a consulta tardía por restricciones de movilidad y asistencia durante la cuarentena. Nuestros datos también indican que el sector público de la ciudad debió absorber demanda insatisfecha del sector privado.


Abstract Febrile Emergency Units were annexed to tertiary hospitals to face the pandemic caused by SARS CoV-2 in Buenos Aires City. We performed a retrospective observational study in order to evaluate the profile of people consulting the Unit annexed to the Muñiz Hospital, during the period comprising epidemiological weeks 28 to 42, 2020. The total number of consultations was 12 571; 6801 (54.1%) patients were male, and the average age was 38 years. A total of 2499 (26.3 %) of 9501 swabs resulted positive for SARS-CoV-2 when analyzed by RT-PCR. The average age of confirmed COVID-19 patients was 37.9 years; 1367 (54.7%) were male and 143 (5.7%) required hospitalization at the first consultation. As many as 6097 (48.5%) participants were beneficiaries of social security or prepaid medicine. Only 160 (1.3%) were HIV positive, with COVID-19 coinfection diagnosed in 39/160 (24.4%), of which 9 (23.1%) required hospitalization. Only 128 (1%) had tuberculosis (TB); TB/CO VID-19 coinfection was diagnosed in 31 of them (24.2%), and 8/31 (25.8%) required hospitalization. The triple association HIV/TB /COVID-19 was reported in only 2 patients. Contrary to expectations, TB and HIV, the two main diseases treated in our hospital, were under-represented in this Emergency Unit, but the requirement of hospitalization for coinfected patients was quite frequent. This may be due to late consultation caused by mobility and assistance restrictions during quarantine. Interestingly, our data also indicate that the city's public sector had to absorb unsatisfied demand from the private sector and suburban population.


Subject(s)
Humans , Male , Female , Adult , Tuberculosis/diagnosis , Tuberculosis/epidemiology , HIV Infections/complications , HIV Infections/epidemiology , COVID-19 , Emergency Service, Hospital , SARS-CoV-2 , Hospitals
8.
Ciênc. Saúde Colet ; 26(6): 2183-2194, jun. 2021. graf
Article in English | LILACS | ID: biblio-1278688

ABSTRACT

Abstract A scoping literature review to identify the multilevel HIV serosorting related elements was developed. Articles from EBSCO, PubMed, PsyNET and Science Direct with serosort* or serosorting at the tittle or abstract, written in English or Spanish were included. No restriction in type of population or design were applied. 239 records were retrieved after duplicates removed, but 181 references were extracted for full-text review. Individual level: HIV knowledge, serostatus, risk perceptions, abilities to disclose and for condom use negotiation, motivations, use of drugs, stigma, attitudes toward condom use, and perceptions/beliefs about the HIV and related treatments, HIV infection rates/testing and behavioral factors. Interpersonal level: social networks, abilities (sexual behavior negotiation, and communication). Community level: stigma, social norms, access to HIV related services. Structural level: political context, HIV related funding and public policies. HIV Serosorting is not solely an interpersonal behavior it involves multilevel elements that must be acknowledged by professionals and stakeholders.


Resumen Se desarrolló una revisión de alcance de la literatura para identificar elementos multinivel relacionados a la seroclasificación de VIH. Se incluyeron artículos de EBSCO, PubMed y Science Direct con serosort* o serosorting en título o resumen, escritos en Inglés o Español. No se aplicaron restricciones por tipo de población y diseño. Después de remover duplicados, se recuperaron 239 records, solo 181 referencias se extrajeron para revisión a texto completo. Nivel individual: Conocimiento del VIH, seroestado, percepciones de riesgo, habilidades para develar el seroestado y negociar el condón, motivaciones, uso de drogas, estigma, actitudes sobre uso del condón, y percepciones/ creencias acerca del VIH y tratamientos, tasas de infección y tamizaje de VIH, factores conductuales. Nivel interpersonal: redes sociales, habilidades (negociación de la conducta sexual, y comunicación). Nivel comunitario: Estigma, normas sociales, acceso a servicios de VIH. Nivel estructural: contexto político, políticas públicas y financiamiento relacionado al VIH. La seroclasificación de VIH no es solamente una conducta interpersonal, incluye elementos multinivel que deben ser reconocidos por los profesionales de salud y tomadores de decisiones.


Subject(s)
Humans , Male , HIV Infections/epidemiology , Sexual Behavior , Sexual Partners , Condoms , Homosexuality, Male , Safe Sex , HIV Serosorting
9.
Ciênc. Saúde Colet ; 26(5): 1923-1930, maio 2021. tab
Article in English | LILACS | ID: biblio-1249505

ABSTRACT

Abstract This study aimed to assess the association between tobacco smoking and body composition in patients with HIV/AIDS in combination antiretroviral therapy (cART). This is a cross-sectional study with people of HIV followed in specialized care service for HIV patients located in the South of Brazil. The Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) was used to assess smoking and other psychoactive substance use. Body mass index (BMI) was calculated as the ratio of body weight (in kilograms) to squared height (in meters). Patients also had their body composition evaluated with a multi-frequency bioelectrical impedance (Bodystat® Quadscan 4000, RU) to estimate skeletal muscle index (SMI). In total, 320 subjects were included in the study. The prevalence of smoking was 54.7%. Tobacco smoking was associated with malnutrition, lower body mass index scores, and lower skeletal muscle mass index. It is concluded that there is a high prevalence of smoking among patients with HIV/AIDS and that this behavior is associated with worse body composition. Thus, it is suggested to implement strategies to support smoking cessation among people with HIV/AIDS.


Resumo O objetivo deste estudo foi avaliar a relação entre tabagismo e composição corporal em pacientes com HIV/AIDS em terapia antirretroviral combinada (TARVc). Trata-se de um estudo transversal com portadores de HIV acompanhados em um serviço de atendimento especializado localizado no Sul do Brasil. O instrumento Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) foi utilizado para avaliar o uso de tabaco e outras substâncias psicoativas. O índice de massa corporal (IMC) foi calculado como a razão do peso corporal (em quilogramas) pela altura ao quadrado (em metros). Os pacientes também tiveram sua composição corporal avaliada com uma impedância bioelétrica de múltiplas frequências (Bodystat® Quadscan 4000, RU) a fim de estimar o índice de massa muscular esquelética. No total, 320 sujeitos foram incluídos no estudo. A prevalência de tabagismo foi de 54,7%. O tabagismo foi associado à desnutrição, menores escores do índice de massa corporal e menor índice de massa muscular esquelética. Conclui-se que há uma alta prevalência de tabagismo entre pacientes com HIV/AIDS e que esse comportamento está associado a pior composição corporal. Assim, sugere-se a implementação de estratégias de apoio à cessação do tabagismo entre pessoas com HIV/AIDS.


Subject(s)
Humans , HIV Infections/epidemiology , Body Composition , Brazil/epidemiology , Cross-Sectional Studies , Tobacco Smoking
10.
Ciênc. Saúde Colet ; 26(5): 1853-1862, maio 2021. tab, graf
Article in English, Portuguese | LILACS | ID: biblio-1249506

ABSTRACT

Resumo Este ensaio reflete sobre práticas sexuais e prevenção nos contextos das pandemias de AIDS e da COVID-19. Analisa dados coletados entre julho e outubro de 2020, por meio de observação participante, no âmbito de uma pesquisa etnográfica sobre vulnerabilidade e prevenção ao HIV entre homens que fazem sexo com homens da Região Metropolitana do Recife. Os resultados apontam para a relevância da aparência corporal e da vinculação afetiva entre os parceiros no engendramento de emoções que medeiam a lida com risco de infecção em ambas as pandemias. Sinaliza para a necessidade de incorporar essas dimensões comunicacionais em materiais informativos, de modo a torná-los mais eficazes.


Abstract This essay reflects on sexual practices and prevention in the contexts of the AIDS and COVID-19 pandemics. It analyses data collected between July and October 2020 through participant observation, as part of an ethnographic research project on HIV vulnerability and prevention among men who have sex with men in the Metropolitan Region of Recife, state of Pernambuco (PE), Brazil. The results point to the relevance of physical appearance and the affective bond between partners in engendering emotions that mediate coping with the risk of infection during both pandemics. It indicates the need to incorporate those communicational dimensions into informational materials to make them more effective.


Subject(s)
Humans , Male , HIV Infections/prevention & control , HIV Infections/epidemiology , Acquired Immunodeficiency Syndrome/prevention & control , Acquired Immunodeficiency Syndrome/epidemiology , Sexual and Gender Minorities , COVID-19 , Sexual Behavior , Brazil/epidemiology , Sexual Partners , Homosexuality, Male , Sexuality , Pandemics/prevention & control , SARS-CoV-2
11.
Säo Paulo med. j ; 139(2): 99-106, Mar.-Apr. 2021. tab, graf
Article in English | LILACS | ID: biblio-1290233

ABSTRACT

ABSTRACT BACKGROUND: High prevalence of human immunodeficiency virus (HIV) infection and occurrence of drug-resistant strains have been recorded in northern Brazil. Abandonment of treatment and insufficient and inadequate adherence to antiretroviral therapy (ART) among people living with HIV/AIDS (PLWHA) have been recorded in the metropolitan area of Belém, the capital of the state of Pará. OBJECTIVES: To identify the sociodemographic profile and level of adherence to ART among women seen at a referral unit in the interior of Pará, northern Brazil. DESIGN AND SETTING: Cross-sectional study at a referral unit for care for PLWHA. METHODS: We included 86 women living with HIV/AIDS (WLWHA) in the Rio Caeté integrated region, northeastern Pará. Social, demographic and behavioral information, as well as the ART level, were obtained using forms that have been described in the scientific literature. Logistic regression models were used to assess associations of variables with ART. RESULTS: Most WLWHA were single (52.4%), young (47.7%) and heterosexual (97.7%), had low levels of education (63.0%), were unemployed (69.8%), had one sexual partner (75.7%), used condoms (46.7%) and were not using either licit drugs (68.7%) or illicit drugs (89.6%). Their adherence level was classified as insufficient , and only their viral load showed an association with ART. CONCLUSIONS: The participants' low level of education and poor socioeconomic conditions may have been interfering with their adherence to ART. Such influences can be minimized through multiprofessional interventions that take the individuality of women served by the healthcare service into consideration.


Subject(s)
Humans , Female , HIV Infections/drug therapy , HIV Infections/epidemiology , Medication Adherence , Brazil/epidemiology , Cross-Sectional Studies , Viral Load
12.
Rev. bras. neurol ; 57(1): 6-12, jan.-mar. 2021. tab, graf
Article in English | LILACS | ID: biblio-1177663

ABSTRACT

INTRODUCTION: HIV-associated neurocognitive disorders (HAND) are the subject of many studies, some of them reporting a prevalence of up to 50 percent. OBJECTIVES: To determine the prevalence and factors associated with HIV neurocognitive disorders (HAND) in a cohort of HIV-1-infected patients in São Paulo city, Brazil. METHODOLOGY: Descriptive cross-sectional study including 106 HIV-1-infected patients, employing direct interview and neuropsychological tests, applied by trained neuro-psychologists with expertise in the tests. Other, similar assessment tools we used were Brief Neurocognitive Questionnaire, International HIV Dementia Scale, Lawton Instrumental Activities of Daily Living, Hospital Anxiety and Depression Scale, Social Support Scale for People with HIV/Aids, Assessment of Adherence to Antiretroviral Therapy Questionnaire, and a complex neuropsychological assessment. RESULTS: We included 106 patients from May 2015 to April 2018. We found a high prevalence of HAND in our patients (45%), with 27.5% presenting asymptomatic neurological impairment (ANI) and 17.5% mild neurological dysfunction (MND); only one patient presented HIV-associated dementia (HAD) (0.9%). Women were more likely to have MND (52.9%) and the only case of HAD was also female. The high prevalence of neurocognitive disorders was independent of the immunological status, use of efavirenz, or virological control. CONCLUSIONS: This study may mirror the national and international scenarios, showing a high prevalence of HAND (45%) and the prevalence of some risk factors, in special among women


INTRODUÇÃO: As doenças neurocognitivas associadas ao HIV (HAND), são o assunto de muitos estudos, alguns deles relatando uma prevalência de até 50 por cento. OBJETIVOS: Determinar a prevalência e os fatores associados aos distúrbios neurocognitivos do HIV (HAND) em uma coorte de pacientes infectados pelo HIV-1 na cidade de São Paulo, Brasil. METODOLOGIA: Estudo transversal descritivo incluindo 106 pacientes infectados pelo HIV-1, utilizando entrevista direta e testes neuropsicológicos, aplicados por neuropsicólogos treinados com experiência nos testes. Foram utilizados também: Questionário Neurocognitivo Breve, Escala Internacional de Demência do HIV, Atividades Instrumentais de Vida Diária de Lawton, Escala Hospitalar de Ansiedade e Depressão, Escala de Apoio Social para Pessoas com HIV / Aids, Avaliação da Adesão à Terapia Antiretroviral Questionário e uma bateria de avaliação neuropsicológica complexa. RESULTADOS: Foram avalaidos 106 pacientes de maio de 2015 a abril de 2018. Foi observado uma alta prevalência de HAND em nossos pacientes (45%), com 27,5% apresentando comprometimento neurológico assintomático (ANI) e 17,5% comprometimento cognitive leve (MND); apenas um paciente apresentou demência associada ao HIV (DAH) (0,9%). As mulheres eram mais propensas a ter MND (52,9%) e o único caso de HAD também era do sexo feminino. A alta prevalência de distúrbios neurocognitivos foi independente do estado imunológico, uso de efavirenz ou controle virológico. CONCLUSÕES: Este estudo pode espelhar o cenário nacional e internacional, mostrando uma alta prevalência de HAND (45%) e a prevalência de alguns fatores de risco, em especial entre as mulheres


Subject(s)
Humans , Male , Female , Middle Aged , HIV Infections/complications , HIV Infections/epidemiology , Neurocognitive Disorders/etiology , Neurocognitive Disorders/epidemiology , Brazil/epidemiology , Prevalence , Cross-Sectional Studies , Risk Factors , Neuropsychological Tests
13.
Rev. Bras. Saúde Mater. Infant. (Online) ; 21(1): 207-215, Jan.-Mar. 2021. tab
Article in English | LILACS | ID: biblio-1250688

ABSTRACT

Abstract Objectives: to present an analysis of the follow-up of exposed children and pregnant women living with HIV who are assisted in a reference public healthcare service of a Brazilian capital. Methods: this is a cross-sectional study with sociodemographic and clinical data obtainedfrom physical and electronic medical records of women living with HIV and exposed children, treated between 2000 and 2018, in a secondary healthcare service. For associations, the chi-square test at 5% significance was used. Results: the data about 183 pregnancies and 214 children from the capital or other municipalities in the state were analyzed. The women have low schooling, are brown or black, single, multiparous, diagnosed with HIV during prenatal care, with the start of follow-up from the third trimester of pregnancy and the use of prophylaxis during childbirth. As for children, the associations were significant for notification on SINAN, admission to the health service, use of prophylaxis indicating better monitoring for those who live in the state capital. Conclusions: the prevention measures recommended by the Ministry of Health, in general, were followed, but children and pregnant women who live in other cities were worse off than those ones in the capital. Unnotified cases were identified on SINAN. These issues may contribute to new cases of vertical transmission of HIV.


Resumo Objetivos: apresentar uma análise do acompanhamento de crianças expostas e gestantes vivendo com HIV atendidas em um serviço público de referência de uma capital brasileira. Métodos: trata-se de estudo transversal, com dados sociodemográficos e clínicos obtidos em prontuários físicos e eletrônicos mulheres vivendo com HIV e crianças expostas, atendidas entre 2000 a 2018 em um serviço de atenção secundária à saúde. Para as associações foi utilizado o teste qui-quadrado, com significância de 5%. Resultados: foram analisados dados de 183 gestações de 150 mulheres e 214 crianças expostas a infecção pelo HIV As mulheres possuíam baixa escolaridade, eram pardas ou pretas, solteiras, multíparas, com diagnóstico de HIV durante o pré-natal, com início do acompanhamento a partir do terceiro trimestre de gestação e uso de profilaxia durante o parto. Quanto às crianças, as associações foram significativas para notificação no SINAN, admissão no serviço de saúde, uso de profilaxia indicando melhor acompanhamento para aquelas que moravam na capital do estado. Conclusões: as medidas de prevenção recomendadas pelo Ministério da Saúde, em geral, foram seguidas, porém apresentaram pior cenário as crianças e gestantes que residiam em outros munícipios quando comparadas as da capital. Foram identificados casos não notificados no SINAN. Essas questões podem contribuir para novos casos de transmissão vertical do HIV.


Subject(s)
Humans , Female , Pregnancy , Infant, Newborn , Infant , Child, Preschool , Child , Socioeconomic Factors , Secondary Care , HIV Infections/prevention & control , HIV Infections/epidemiology , Infectious Disease Transmission, Vertical/prevention & control , Epidemiological Monitoring , Underregistration , Brazil/epidemiology , Chi-Square Distribution , Cross-Sectional Studies , Pregnant Women , Maternal-Child Health Services
15.
Ciênc. Saúde Colet ; 26(1): 297-307, jan. 2021. tab, graf
Article in English, Portuguese | LILACS | ID: biblio-1153768

ABSTRACT

Resumo O estudo teve por objetivo analisar a tendência temporal dos coeficientes de incidência da infecção por HIV-aids por meio de estudo ecológico retrospectivo e regressão segmentada em maiores de 13 anos notificados no SINAN entre os anos de 1980 e 2016. Dos 14.204 casos notificados, 70,9% eram do sexo masculino e 39,5% brancos. Nota-se aumento da incidência do critério aids de 1986 a 1996 com variação anual percentual (APC) de 108,5% ao ano entre 1983 a 1989 (IC: 90,3 - 128,4), entre os anos de 1989 e 1998 a APC foi de 13,2% (IC: 8,2 - 18,3) e redução da APC no período de 1998 a 2016, -6,2% (IC: -7,4 - -4,9). Altos coeficientes do critério óbito entre os anos 1988 a 2002 (4,7/100.00 hab.) com queda acentuada após 1995. Observa-se crescimento do critério HIV+ a partir do ano 2000, chegando a 30,2 por 100 mil habitantes em 2016. Embora as taxas de incidência ainda permaneçam altas no município, estas tendências são compatíveis com o impacto positivo das políticas de detecção precoce e acesso ao seguimento clínico e terapêutico dos indivíduos com HIV e aids na cidade.


Abstract The objective of this study was to analyze the temporal trend of the incidence coefficients of HIV-AIDS infection via a retrospective ecological study and segmented regression in individuals older than 13 year reported at SINAN between 1980 and 2016. Of the 14,204 reported cases, 70.9% were male and 39.5% were white. The AIDS criterion presented growing incidence from 1986 to 1996 with Annual Percentual Change (APC) of 108.5% per year between 1983 and 1989 (CI: 90.3 - 128.4), between 1989 and 1998 the APC was 13.2% (CI: 8.2 - 18.3) and APC reduction in the period from 1998 to 2016, -6.2% (CI: -7.4 - -4.9). High coefficients of the death criteria between 1988 and 2002 (4.7/100,000 inhabitants), with a noticeable decrease after 1995. The growth of the HIV+ criteria from 2000 onward was observed, reaching 30.2 cases per 100,000 inhabitants in 2016. Although incidence rates still remain high in the municipality, these trends are consistent with the positive impact of early detection policies and access to clinical and therapeutic follow-up of individuals with HIV and AIDS in Campinas.


Subject(s)
Humans , Male , Female , HIV Infections/diagnosis , HIV Infections/epidemiology , Acquired Immunodeficiency Syndrome/diagnosis , Acquired Immunodeficiency Syndrome/epidemiology , Brazil/epidemiology , Incidence , Retrospective Studies , Cities
16.
Article in Portuguese | ColecionaSUS, LILACS, ColecionaSUS, CONASS, SES-GO | ID: biblio-1292642

ABSTRACT

Objetivo: Descrever o perfil epidemiológico dos casos de Vírus da Imunodeficiência Humana (HIV) notificados no estado de Goiás, por meio de dados do Sistema de Informação de Agravos e Notificação (SINAN). Metodologia: Foi realizado um estudo observacional, descritivo, de corte transversal, com dados secundários. A população alvo foi constituída de indivíduos diagnosticados com HIV notificados pelo SINAN no estado de Goiás, no período de 2015 a 2019. Resultados: Foram registradas 7.575 notificações para HIV; destas, 79,2% eram homens, 71,1% tinham entre 20 e 39 anos de idade e 42% eram naturais da grande Goiânia. Este estudo demonstrou que entre os anos de 2015 e 2019 ocorreu aumento nas taxas de incidência de HIV. A modalidade de transmissão mais prevalente foi a homossexual. Dos casos analisados, 34% (n=2.598) apresentaram algum sintoma ou doença definidora da Síndrome da Imunodeficiência Humana (AIDS). Cerca de 60 pessoas (0,9%) foram registradas com o status de teste não realizado, inferindo que esses indivíduos foram casos descartados, ou seja, não se tratava de uma infecção por HIV. Considerações finais: É preciso que se desenvolvam políticas públicas de saúde voltadas para essa população, sendo considerados seus fatores sociodemográficos e determinantes sociais, para que medidas apropriadas e efetivas de promoção, prevenção e recuperação da saúde sejam implementadas


Objective: To describe the epidemiological profile of Human immunodeficiency vírus (HIV) cases, notified in the State of Goiás using data from the Diseases Information and Notification System (SINAN). Methodology: An observational, descriptive, cross-sectional study was carried out with secondary data. The target population consisted of individuals diagnosed with HIV notified by SINAN in the State of Goiás, in the period from 2015 to 2019. Results: Were registered 7.575 notifications for HIV, were registered, of these 79.2% were men, 71.1% were between 20 and 39 years old and 42% born in Greater Goiânia. This study demonstrated that between the years 2015 to 2019 there was an increase in HIV incidence rates. The most prevalent mode of transmission was homosexual. Of the cases, 34% (n = 2.598) of the symptoms, some symptom or disease defining AIDS (Human Immunodeficiency Syndrome). About 60 people (0.9%) were registered with the status of a test not performed, inferring that these individuals were discarded cases, that is, it was not an HIV infection. Final considerations: It is necessary to develop public health policies aimed at this population, considering their sociodemographic factors and social determinants, in order to implement appropriate and effective measures for the promotion, prevention and recovery of health


Subject(s)
Humans , Male , Female , Adolescent , Adult , HIV Infections/epidemiology , Acquired Immunodeficiency Syndrome , Health Information Systems , Health Profile , HIV Infections/diagnosis , HIV Infections/mortality , AIDS-Related Opportunistic Infections , Disease Notification
17.
Article in Chinese | WPRIM | ID: wpr-880167

ABSTRACT

OBJECTIVE@#To investigate the recent HIV-1 infections of the blood donors in Fuzhou zone.@*METHODS@#The positive HIV antibody confirmatory samples in Fuzhou zone from 2012 to 2016 were collected and tested by LAg-Avidity EIA, and HIV long-term infections or recent infections were determined.@*RESULTS@#405 371 cases of blood donors were tested in the period from 2012 to 2016, and 94 HIV confirmatory positive samples were collected. 35 cases were recent infections determined by LAg-Avidity EIA, the annual HIV-1 incidences were 1.326‰, 0.845‰, 0.694‰, 1.148‰ and 0.364‰, the average incidences were 0.863‰. Among 94 cases of HIV confirmatory positive donors,58 cases were first donors and 36 cases were repeated donors, 17(29.3%) and 18 (50.0%) cases were recent infections respectively, which showed statistical significance(χ@*CONCLUSION@#The HIV-1 incidences were stable among blood donors in Fuzhou zone. The percentage of HIV-1 recent infections in repeated donors were more higher than that in first donors.


Subject(s)
Blood Donors , HIV Infections/epidemiology , HIV-1 , Humans , Incidence
18.
Chinese Medical Journal ; (24): 1175-1180, 2021.
Article in English | WPRIM | ID: wpr-878151

ABSTRACT

BACKGROUND@#Despite almost two decades of well-funded and comprehensive response efforts by the Chinese Government, human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) remains a major problem in China. Yet, few studies have recently examined long-term trends in HIV/AIDS prevalence, incidence, and mortality at the national level. This study aimed to determine the prevalence, incidence, and mortality trends for HIV/AIDS over the past 28 years in China.@*METHODS@#We conducted a descriptive, epidemiological, secondary analysis of the Global Burden of Diseases, Injuries, and Risk Factors Study 2017 data. To evaluate trends in prevalence, incidence, and mortality over the study period from 1990 to 2017, we calculated values for annual percentage change (APC) and corresponding 95% confidence intervals (CIs) using joinpoint regression analysis.@*RESULTS@#A significant increase in HIV/AIDS prevalence was observed for 1990 to 2009 (APC: 10.7; 95% CI: 10.4, 11.0; P < 0.001), and then remained stable for 2009 to 2017 (APC: 0.7; 95% CI: -0.3, 1.7; P = 0.1). A significant increase in HIV incidence was also observed for 1990 to 2005 (APC: 13.0; 95% CI: 12.6, 13.4; P < 0.001), and then a significant decrease was detected for 2005 to 2017 (APC: -6.5; 95% CI: -7.0, -6.1; P < 0.001). A significant increase in AIDS-related mortality rate was detected for 1990 to 2004 (APC: 10.3; 95% CI: 9.3, 11.3; P < 0.001), followed by a period of stability for 2004 to 2013 (APC: 1.3; 95% CI: -0.7, 3.3; P = 0.2), and then another significant increase for 2013 to 2017 (APC: 15.3; 95% CI: 8.7, 22.2; P < 0.001).@*CONCLUSIONS@#Although prevalence has stabilized and incidence has declined, AIDS-related mortality has risen sharply in recent years. These findings suggest more must be done to bring people into treatment earlier, retain them in treatment more effectively, actively seek to reenter them in treatment if they dropout, and improve the quality of treatment and care regimens.


Subject(s)
Acquired Immunodeficiency Syndrome/epidemiology , China/epidemiology , Global Burden of Disease , HIV , HIV Infections/epidemiology , Humans , Incidence , Prevalence
19.
Cad. Saúde Pública (Online) ; 37(5): e00078820, 2021. tab, graf
Article in English | LILACS | ID: biblio-1249447

ABSTRACT

Abstract: Historically, human migrations have determined the spread of many infectious diseases by promoting the emergence of temporal outbreaks between populations. We aimed to analyze health indicators, expenditure, and disability caused by tuberculosis (TB) and HIV/AIDS burden under the Colombian-Venezuelan migration flow focusing on the Northeastern border. A retrospective study was conducted using TB and HIV/AIDS data since 2009. We consolidated a database using official reports from the Colombian Surveillance System, World Health Organization, Indexmundi, the Global Health Observatory, IHME HIV atlas, and Joint United Nations Programme on HIV/AIDS (UNAIDS). Disability metrics regarding DALYs (disability adjusted life years) and YLDs (years lived with disability), were compared between countries. Mapping was performed on ArcGIS using official migration data of Venezuelan citizens. Our results indicate that TB profiles from Colombia and Venezuela are identical in terms of disease burden, except for an increase in TB incidence in the Colombian-Venezuelan border departments in recent years, concomitantly with the massive Venezuelan immigration since 2005. We identified a four-fold underfunding for the TB program in Venezuela, which might explain the low-testing rates for cases of multidrug-resistant TB (67%) and HIV/AIDS (60%), as well as extended hospital stays (150 days). We found a significant increase in DALYs of HIV/AIDS patients in Venezuela, specifically, 362.35 compared to 265.37 observed in Colombia during 2017. This study suggests that the Venezuelan massive migration and program underfunding might exacerbate the dual burden of TB and HIV in Colombia, especially towards the Colombian‐Venezuelan border.


Resumen: Históricamente, las migraciones humanas han determinado la expansión de muchas enfermedades infecciosas, promoviendo el surgimiento de brotes temporales en la población. Nuestro objetivo fue analizar indicadores de salud, gastos, así como la discapacidad causada por la tuberculosis (TB) y la carga del VIH/SIDA ante el flujo migratorio entre Colombia-Venezuela, centrándose en los departamentos fronterizos del nordeste. Se realizó un estudio retrospectivo usando datos sobre TB y VIH/SIDA desde 2009. Consolidamos una base de datos usando informes oficiales del Sistema de Vigilancia Colombiano, Organización Mundial de la Salud, Indexmundi, Observatorio Global de la Salud, IHME HIV atlas, y Programa Conjunto de las Naciones Unidas sobre el VIH/SIDA (ONUSIDA). Se midió la discapacidad en términos del DALYs (incapacidad ajustada por años de vida) y YLDs (años vividos con discapacidad) y se compararon entre ambos países. El mapeo se realizó en ArcGIS, usando datos oficiales de migración de ciudadanos venezolanos. Nuestros resultados indican que los perfiles de TB de Colombia y Venezuela son idénticos, en lo que se refiere a la carga de la enfermedad, excepto por el incremento en la incidencia de TB en los departamentos fronterizos de la frontera entre Colombia y Venezuela en años recientes, concomitantemente con la inmigración masiva venezolana desde 2005. Identificamos una cuadruplicación de la subfinanciación para el programa de TB en Venezuela, que podría explicar las bajas tasas de test para los casos multirresistentes a medicamentos contra la TB (67%) y VIH/SIDA (60%), al igual que las estancias prolongadas en el hospital (150 días). Hallamos un incremento significativo en DALYs de pacientes con VIH/SIDA en Venezuela, específicamente, 362,35 comparados con los 265,37 observados en Colombia durante 2017. Este estudio sugiere que la migración venezolana masiva y la subfinanciación del programa podrían haber exacerbado la doble carga de la TB y el VIH en Colombia, especialmente a través de la frontera entre Colombia y Venezuela.


Resumo: Historicamente, as migrações humanas determinaram a propagação de muitas doenças infecciosas ao facilitar surtos temporais entre populações. O estudo buscou analisar os indicadores sanitários e os gastos e taxas de incapacidade relacionados à tuberculose (TB) e à carga de HIV/aids no fluxo migratório entre Colômbia e Venezuela, com destaque para os departamentos (estados) da fronteira nordeste. Foi realizado um estudo retrospectivo de dados sobre TB e HIV/aids desde 2009. Consolidamos uma base de dados a partir de relatórios do Sistema de Vigilância da Colômbia, Organização Mundial da Saúde, Indexmundi, Observatório de Saúde Global, IHME HIV Atlas e Programa Conjunto das Nações Unidas sobre HIV/AIDS (UNAIDS). As métricas de incapacidade em termos de AVAIs (anos de vida ajustados para incapacidade) e AVIs (anos vividos com incapacidade) foram comparadas entre os dois países. O mapeamento foi realizado no ArcGIS, com dados oficiais sobre migração de cidadãos venezuelanos. Nossos resultados indicam que os perfis de TB da Colômbia e da Venezuela são idênticos em termos de carga de doença, exceto por um aumento da incidência de TB nos departamentos na fronteira entre os dois países em anos recentes, concomitantemente com a imigração venezuelana maciça desde 2005. Identificamos um subfinanciamento (por um fator de quatro) no programa de tuberculose da Venezuela, o que pode explicar as baixas taxas de testagem para casos de TB multirresistente (67%) e HIV/aids (60%), além das internações hospitalares prolongadas (150 dias). Encontramos um aumento significativo de AVAIs em pacientes de HIV/aids na Venezuela, especificamente 362,35 comparado com 265,37 na Colômbia em 2017. O estudo sugere que a migração maciça venezuelana e o subfinanciamento podem exacerbar a carga dupla de TB e HIV na Colômbia, principalmente na fronteira com a Venezuela.


Subject(s)
Humans , Tuberculosis/epidemiology , HIV Infections/epidemiology , Venezuela/epidemiology , Brazil , Retrospective Studies , Colombia/epidemiology , Emigration and Immigration
20.
Cad. Saúde Pública (Online) ; 37(3): e00069820, 2021. tab, graf
Article in Portuguese | LILACS | ID: biblio-1285811

ABSTRACT

Resumo: A transmissão vertical do HIV ainda representa um importante problema de saúde pública no mundo. O objetivo deste estudo foi verificar a transmissão vertical do HIV em Rio Branco, Acre, Brasil, e avaliar a possibilidade de eliminação. Foi realizado estudo transversal dos casos de HIV em gestante e longitudinal sobre a incidência da transmissão vertical do HIV na base populacional de gestantes residentes no Município de Rio Branco, no período de 2007-2015. As coortes de gestantes foram formadas por mulheres que tiveram filhos nascidos vivos, mortos ou abortos. Os dados foram obtidos do Sistema de Informação de Agravos de Notificação (SINAN), Sistema de Informações sobre Nascidos Vivos (SINASC), Sistema de Informação sobre Mortalidade (SIM) e Sistema de Informações Hospitalares (SIH). Foi realizado o relacionamento entre as bases de dados utilizando o software OpenRecLink. Foram calculadas as prevalências de HIV em gestante, a taxa de transmissão vertical e os principais fatores associados. A prevalência de HIV em gestante apresentou tendência de aumento, e a prevalência média foi de 0,18%, as variáveis estatisticamente associadas à ocorrência de HIV em gestantes foram idade materna ≥ 20 anos (p = 0,007), menor escolaridade (p = 0,054) e não ter companheiro (p = 0,001). A transmissão vertical foi de 6,9%. O uso de terapia antirretroviral (TARV) no pré-natal, mesmo entre as gestantes que já sabiam ser portadoras do vírus, foi menor que 90%. A realização de cesáreas eletivas ficou abaixo de 60%, e o uso de TARV no parto e pelo recém nascido nas primeiras 24 horas apresentou variações, dependendo do período em que o diagnóstico materno foi realizado. Embora as estratégias de eliminação da transmissão vertical do HIV estejam bem estabelecidas, os resultados deste estudo ainda apontam falhas importantes na cascata de cuidados das gestantes infectadas em Rio Branco.


Abstract: Vertical HIV transmission is still an important global public health problem. This study aimed to verify vertical HIV transmission in Rio Branco, Acre, Brazil, and to assess the possibility of its elimination. A cross-sectional study was conducted of HIV in pregnant women and a longitudinal study on the incidence of vertical HIV transmission in pregnant women living in the municipality (county) of Rio Branco in 2007-2015. The cohorts of pregnant women consisted of women who had liveborn children, stillbirths, or abortions. The data were obtained from the Brazilian Information System for Notificable Diseases (SINAN), Brazilian Information System on Live Births (SINASC), Brazilian Mortality Information System (SIM), and Brazilian Hospital Information Systems (SIH). Databases. Probabilistic database linkage was performed with the OpenRecLink software. The authors calculated the HIV prevalence rate in pregnant women, the vertical transmission rate, and the principal associated factors. HIV prevalence in pregnant women showed an upward trend, and the mean prevalence was 0.18%. Variables statistically associated with the occurrence of HIV in pregnant women were maternal age ≥ 20 years (p = 0.007), lower schooling (p = 0.054), and unmarried conjugal status/without partner (p = 0.001). Vertical HIV transmission was 6.9%. Use of antiretroviral therapy (ART) during prenatal care, even among pregnant women that already knew they were HIV-positive, was less than 90%. The elective cesarean rate was less than 60%, and the use of ART during delivery and by the newborn in the first 24 hours showed variations, depending on the period in which the maternal diagnosis was made. Although the strategies for the elimination of vertical HIV transmission are well established, this study's results point to important flaws in the cascade of care for HIV-infected pregnant women in Rio Branco.


Resumen: La transmisión vertical del VIH todavía representa un importante problema de salud pública en el mundo. El objetivo de este estudio fue verificar la transmisión vertical del VIH en Río Branco-Acre y evaluar la posibilidad de su eliminación. Se realizó un estudio transversal de los casos de VIH en gestantes y longitudinal sobre la incidencia de la transmisión vertical del VIH en la base poblacional de gestantes residentes en el municipio de Río Branco, durante el período de 2007-2015. Las cohortes de gestantes estuvieron formadas por mujeres que tuvieron hijos nacidos vivos, muertos o abortos. Los datos se obtuvieron del Sistema Brasileño de Información de Enfermedades de Notificación (SINAN), Sistema de Información sobre Nacidos Vivos (SINASC), Sistema de Información sobre Mortalidad (SIM) y Sistema de Informaciones Hospitalarias (SIH). Se realizó la relación entre las bases de datos, utilizando el software OpenRecLink. Se calcularon las prevalencias de VIH en gestantes, la tasa de transmisión vertical y sus principales factores asociados. La prevalencia de VIH en gestantes presentó una tendencia de aumento y la prevalencia media fue de 0,18%, las variables estadísticamente asociadas a la ocurrencia de VIH en gestantes fueron: edad materna ≥ 20 años (p = 0,007), menor escolaridad (p = 0,054) y no contar con compañero (p = 0,001). La transmisión vertical fue de un 6,9%. El uso de terapia antirretroviral viral (TARV) durante el período prenatal, incluso entre las gestantes que ya se sabían portadoras del virus, fue menor de un 90%. La realización de cesáreas electivas quedó por debajo de un 60% y el uso de TARV en el parto y por el recién nacido en las primeras 24 horas presentó variaciones, dependiendo del período en que el diagnóstico materno fue realizado. A pesar de que las estrategias de eliminación de la transmisión vertical del HIV estén bien establecidas, los resultados de este estudio todavía apuntan fallos importantes en la cascada de cuidados de las gestantes infectadas en Río Branco.


Subject(s)
Humans , Female , Pregnancy , Infant, Newborn , Child , Adult , Young Adult , Pregnancy Complications, Infectious/prevention & control , Pregnancy Complications, Infectious/epidemiology , HIV Infections/prevention & control , HIV Infections/epidemiology , Brazil/epidemiology , Cross-Sectional Studies , Longitudinal Studies , Infectious Disease Transmission, Vertical/prevention & control
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