Comparing Web-Based Venues to Recruit Gay, Bisexual, and Other Cisgender Men Who Have Sex With Men to a Large HIV Prevention Service in Brazil: Evaluation Study.

BACKGROUND: Internet and mobile phones, widely available in Brazil, could be used to disseminate information about HIV prevention and to recruit gay, bisexual, and other cisgender men who have sex with men (MSM) to HIV prevention services. Data evaluating the characteristics of MSM recruited through different web-based strategies and estimating their cost and yield in the country are not available. OBJECTIVE: We aimed to describe a web-based recruitment cascade, compare the characteristics of MSM recruited to a large HIV prevention service in Rio de Janeiro according to web-based venues, and estimate the cost per participant for each strategy. METHODS: We promoted advertisements on geosocial networking (GSN) apps (Hornet and Grindr) and social media (Facebook and Instagram) from March 2018 to October 2019. The advertisements invited viewers to contact a peer educator to schedule a visit at the HIV prevention service. Performance of web-based recruitment cascade was based on how many MSM (1) were reached by the advertisement, (2) contacted the peer educator, and (3) attended the service. We used chi-square tests to compare MSM recruited through GSN apps and social media. The estimated advertisement cost to recruit a participant was calculated by dividing total advertisement costs by number of participants who attended the service or initiated preexposure prophylaxis (PrEP). RESULTS: Advertisement reached 1,477,344 individuals; 1270 MSM contacted the peer educator (86 contacts per 100,000 views)-564 (44.4%), 401 (31.6%) and 305 (24.0%)-through social media, Grindr, and Hornet. Among the 1270 individuals who contacted the peer educator, 36.3% (n=461) attended the service with similar proportion for each web-based strategy (social media: 203/564, 36.0%; Grindr: 152/401, 37.9%; and Hornet: 107/305, 35.1%). MSM recruited through GSN apps were older (mean age 30 years vs 26 years; P<.001), more frequently self-reported as White (111/247, 44.9% vs 62/191, 32.5%; P=.03), and had higher schooling level (postsecondary: 157/254, 61.8% vs 94/194, 48.5%; P=.007) than MSM recruited through social media. GSN apps recruited MSM with higher HIV risk as measured by PrEP eligibility (207/239, 86.6% vs 133/185, 71.9%; P<.001) compared with social media, but there was no difference in PrEP uptake between the two strategies (P=.22). The estimated advertisement costs per participant attending the HIV prevention service were US $28.36 for GSN apps and US $12.17 for social media. The estimated advertisement costs per participant engaging on PrEP were US $58.77 for GSN apps and US $27.75 for social media. CONCLUSIONS: Social media and GSN app advertisements were useful to disseminate information on HIV prevention strategies and to recruit MSM to a large HIV prevention service in Brazil. Compared to GSN apps, social media advertisements were less expensive and reached more vulnerable and younger MSM. Digital marketing campaigns should use different and complementary web-based venues to reach a plurality of MSM.

Complementary Recruitment Strategies to Reach Men Who Have Sex with Men and Transgender Women: The Experience of a Large Brazilian HIV Prevention Service.

Different strategies have been used to reach men who have sex with men (MSM) and transgender women (TGW) for HIV prevention services. We described the characteristics of MSM and TGW attending a large HIV prevention service in Brazil according to different recruitment strategies or referrals. A total of 2713 individuals (2246[82.8%] MSM and 467[17.2%] TGW) attended the service. Among HIV-negative MSM and TGW, 74.6% and 82.8% were eligible for pre-exposure prophylaxis (PrEP), respectively. PrEP uptake among MSM and TGW was 56.4% and 39.1%, respectively. Participants were mostly referred by peers (43.6%), followed by web-based (24.1%) and venue-based recruitment (16.2%). More young and Black MSM were referred from venue-based recruitment, and web-based strategies more frequently referred MSM with higher education. TGW who were younger and had higher education were more frequently referred from venue-based recruitment. Web-based recruitment failed to reach TGW. Multiple strategies were complementary to reach diverse MSM and TGW populations.

RESUMEN: Diferentes estrategias se han usado para alcanzar hombres que tienen sexo con hombres (HSH) y mujeres trans (MT) en los servicios preventivos del VIH. Describimos las características de HSH y MT que acudieron a un servicio de prevención del VIH en Brasil, de acuerdo con diferentes estrategias de reclutamiento. Un total de 2713 personas (2246[82.8%] HSH y 467[17.2%] MT) asistieron al servicio y aquellos con resultado negativo al VIH (74.6% de HSH y 82.8% de MT) fueron candidatos a la profilaxis preexposición, siendo iniciada por 56.4% y 39.1%, respectivamente. Las referencias al servicio vinieron de pares (43.6%), en línea (24.1%) o por algún sitio (16.2%). Mayoritariamente los HSH jóvenes y negros, y las MT jóvenes con educación superior fueron referidos de algún sitio; mientras que los HSH con educación superior fueron en línea. Este último reclutamiento no sirvió para las MT. Múltiples estrategias fueron complementarias para alcanzar HSH y MT.

A Technology-Based Intervention Among Young Men Who Have Sex With Men and Nonbinary People (The Conectad@s Project): Protocol for A Vanguard Mixed Methods Study.

BACKGROUND: In many parts of the world, including Brazil, uptake for biomedical interventions has been insufficient to reverse the HIV epidemic among key populations at high risk for HIV, including men who have sex with men. Young MSM (YMSM), particularly Black YMSM, have high HIV incidence, low viral suppression, and low preexposure prophylaxis (PrEP) uptake and adherence. Therefore, novel approaches to increase the HIV biomedical interventions uptake by YMSM are urgently needed. OBJECTIVE: We describe the Conectad@s Project, which aims to: (1) estimate the prevalence and incidence of HIV and other sexually transmitted infections, the onset of sexual risk behavior, and barriers to biomedical interventions among YMSM aged 18 to 24 years in Rio de Janeiro, Brazil; and (2) conduct a technology-based adherence intervention study to promote a rapid linkage of YMSM to HIV care or prevention, and support and sustain adherence. METHODS: A cross-sectional survey will be conducted with 400 YMSM recruited using respondent-driven sampling (RDS) adapted for social media-based sampling, preceded by a formative phase. HIV and sexually transmitted infections testing will be conducted, including early HIV infection biomarker detection. Behavioral, partnership, network, and structural measures will be collected through structured questionnaires. All individuals recruited for the survey will have access to HIV risk assessment, antiretroviral therapy (ART), PrEP, prevention counseling, and a technology-based adherence intervention. Those who accept the adherence intervention will receive weekly text messages via a social networking app (WhatsApp) for 24 weeks, with follow-up data collected over 48 weeks. RESULTS: The Conectad@s project has been approved by our local institutional review board (#CAAE 26086719.0.0000.4262) in accordance with all applicable regulations. Questionnaires for the RDS survey and intervention were developed and tested in 2020, formative interviews were conducted in January and February 2021 to guide the development of the RDS, and enrollment is planned to begin in early 2022. CONCLUSIONS: The Conectad@s Project is a vanguard study that, for the first time, will apply digital RDS to sample and recruit YMSM in Brazil and rapidly connect them to ART, PrEP, or prevention counseling through a technology-based adherence intervention. RDS will allow us to estimate HIV prevalence among YMSM and measure HIV infection biomarkers in the context of the onset of risky behavior. The data will lay the groundwork to adapt and implement HIV prevention strategies, identify barriers to the earliest HIV infection diagnosis, immediate ART or PrEP initiation, and detect new clusters of HIV transmission. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/34885.

SARS-CoV-2 testing disparities across geographical regions from a large metropolitan area in Brazil: Results from a web-based survey among individuals interested in clinical trials for COVID-19 vaccines.

After more than a year since the novel coronavirus (SARS-CoV-2) disease 2019 or COVID-19 has reached the status of a global pandemic, the number of COVID-19 cases continues to rise in Brazil. As no effective treatment been approved yet, only mass vaccination can stop the spread of SARS-CoV-2 and end the COVID-19 pandemic. Multiple COVID-19 vaccine candidates are under development and some are currently in use. This study aims to describe the characteristics of individuals who have registered in an online platform to participate in clinical trials for COVID-19 vaccines. Additionally, participants' characteristics according to age and presence of comorbidities associated with severe COVID-19 and differences of SARS-CoV-2 testing across different geographical areas/neighborhoods are provided. This was a cross-sectional web-based study conducted between September and December/2020, aiming to reach individuals aged ≥18 years who live in Rio de Janeiro metropolitan area, Brazil. Among 21,210 individuals who completed the survey, 20,587 (97.1%) were willing to participate in clinical trials for COVID-19 vaccines. Among those willing to participate, 57.8% individuals were aged 18-59 years and had no comorbidity, 33.7% were aged 18-59 years and had at least one comorbidity, and 8.6% were aged ≥ 60 years regardless the presence of any comorbidity. Almost half (42.6%) reported ever testing for COVID-19, and this proportion was lower among those aged ≥ 60 years (p < 0.001). Prevalence of positive PCR results was 16.0%, higher among those aged 18-59 years (p < 0.009). Prevalence of positive antibody result was 10.0%, with no difference across age and comorbidity groups. Participants from areas/neighborhoods with higher Human Development Index (HDI) reported ever testing for SARS-CoV-2 more frequently than those from lower HDI areas. Interest to participate in clinical trials for COVID-19 vaccines candidates in Rio de Janeiro was significantly high. The online registry successfully reached out a large number of individuals with diverse sociodemographic, economic and clinical backgrounds.

Evidence of an untamed HIV epidemic among MSM and TGW in Rio de Janeiro, Brazil: a 2018 to 2020 cross-sectional study using recent infection testing.

INTRODUCTION: Monitoring the HIV epidemic and identifying populations among whom HIV is spreading is critical. We aimed to provide an estimate of the annualized HIV incidence rate using recency testing among cisgender men who have sex with men (MSM) and transgender women (TGW) at a reference centre in Rio de Janeiro, Brazil. METHODS: We evaluated MSM and TGW who sought HIV testing at the Evandro Chagas National Institute of Infectious Diseases-FIOCRUZ between March 2018 and January 2020. The Limiting Avidity assay (LAg) as part of a recent infection testing algorithm (RITA) was employed to identify recent infections (those with a normalized optical density ≤1.5 in the LAg that met all RITA criteria) among those who tested positive for HIV and the annualized HIV incidence was estimated. RESULTS AND DISCUSSION: Out of 3053 individuals assessed, 2591 (84.9%) were HIV negative and 462 (15.1%) were living with HIV. Among these, 302 (65.4%) with stored samples available were evaluated and 73/302 (24.2%) were classified as recent infections. The annualized incidence rate estimate using a false recency rate of zero was 7.35% (95% CI 5.76% to 9.25%). CONCLUSIONS: Our results suggest that the HIV epidemic in Rio de Janeiro, Brazil, continues to disproportionately burden vulnerable populations, including MSM and TGW despite the existence and availability of effective preventive and therapeutic interventions.

SARS-CoV-2 testing disparities across geographical regions from a large metropolitan area in Brazil: Results from a web-based survey among individuals interested in clinical trials for COVID-19 vaccines

ABSTRACT After more than a year since the novel coronavirus (SARS-CoV-2) disease 2019 or COVID-19 has reached the status of a global pandemic, the number of COVID-19 cases continues to rise in Brazil. As no effective treatment been approved yet, only mass vaccination can stop the spread of SARS-CoV-2 and end the COVID-19 pandemic. Multiple COVID-19 vaccine candidates are under development and some are currently in use. This study aims to describe the characteristics of individuals who have registered in an online platform to participate in clinical trials for COVID-19 vaccines. Additionally, participants' characteristics according to age and presence of comorbidities associated with severe COVID-19 and differences of SARS-CoV-2 testing across different geographical areas/neighborhoods are provided. This was a cross-sectional web-based study conducted between September and December/2020, aiming to reach individuals aged ≥18 years who live in Rio de Janeiro metropolitan area, Brazil. Among 21,210 individuals who completed the survey, 20,587 (97.1%) were willing to participate in clinical trials for COVID-19 vaccines. Among those willing to participate, 57.8% individuals were aged 18-59 years and had no comorbidity, 33.7% were aged 18-59 years and had at least one comorbidity, and 8.6% were aged ≥ 60 years regardless the presence of any comorbidity. Almost half (42.6%) reported ever testing for COVID-19, and this proportion was lower among those aged ≥ 60 years (p < 0.001). Prevalence of positive PCR results was 16.0%, higher among those aged 18-59 years (p < 0.009). Prevalence of positive antibody result was 10.0%, with no difference across age and comorbidity groups. Participants from areas/neighborhoods with higher Human Development Index (HDI) reported ever testing for SARS-CoV-2 more frequently than those from lower HDI areas. Interest to participate in clinical trials for COVID-19 vaccines candidates in Rio de Janeiro was significantly high. The online registry successfully reached out a large number of individuals with diverse sociodemographic, economic and clinical backgrounds.

Transição dos bacharelados interdisciplinares para a formação em psicologia / Transition from an interdisciplinary bachelor program to a psychology bachelor program / Transición entre el pregrado interdisciplinario y el pregrado en psicología

Resumo Em 2009, o Instituto de Psicologia da Universidade Federal da Bahia propõe a área de concentração Estudos da Subjetividade e do Comportamento Humano como transição dos Bacharelados Interdisciplinares (BI) para o curso de graduação em Formação de Psicólogo. São sujeitos desta investigação os 13 estudantes egressos do BI que escolheram a transição para o curso de Psicologia. O modelo teórico-metodológico é o Sistema de Signos, Significados e Práticas, que aborda o objeto nos níveis factual, narrativo e interpretativo. : não há diferença entre coeficientes de rendimento escolar dos egressos do BI e demais estudantes de Psicologia; todos ressaltam positivamente a formação interdisciplinar do BI como relevante para o curso profissionalizante de Psicologia; a maioria reconhece sua decisão de estudar Psicologia como anterior ao ingresso no BI, atribuindo a este curso o amadurecimento da decisão; a maioria tem expectativa de exercer a profissão de psicólogo, contando com a formação prévia adquirida no BI.(AU)

Abstract In 2009, the Institute of Psychology-UFBA proposed the Concentration Area of Subjectivity and Human Behavior Studies as a transition from the Interdisciplinary Bachelor (IB) to the Psychology Bachelor. 13 IB students were chosen as research subjects. The theoretical-methodological model adopted was the System of Signs, Meanings and Practices, which addresses the object from actual, narrative and interpretive levels. : there is no difference in school performance levels between IB and other Psychology students; all IB students positively emphasized interdisciplinary training as relevant to the vocational course in Psychology; most of them recognized that their desire to study Psychology existed before entering IB, attributing to IB the maturing of their decision; the majority of them expect to work as psychologists, relying on the prior training acquired in IB.(AU)

Resumen En 2009, el Instituto de Psicología-UFBA propuso el área de concentración en Estudios de la Subjetividad y de la Conducta Humana como alternativa para hacer la transición desde el pregrado Interdisciplinario (GI) hacia el pregrado en Psicología. 13 estudiantes provenientes del GI que eligieron esta alternativa fueron elegidos como sujetos de esta investigación. El modelo teórico-metodológico elegido fue el Sistema de Signos, Significados y Prácticas que aborda el objeto en sus niveles factual, narrativo e interpretativo. : no hay diferencia entre el rendimiento académico de los estudiantes provenientes de GI y los estudiantes de Psicología; todos los estudiantes de GI destacan positivamente la formación interdisciplinaria del GI como relevante para la formación profesional en psicología; la mayoría de ellos reconoce su decisión de estudiar psicología como anterior al curso GI, atribuyendo a este curso la maduración de tal decisión; la mayoría espera ejercer la profesión de psicólogo confiando en la formación previa adquirida en GI.(AU)

Transição dos Bacharelados Interdisciplinares para a Formação em Psicologia / Transition from an Interdisciplinary Bachelor Program to a Psychology Bachelor Program / Transición entre el Pregrado Interdisciplinario y el Pregrado en Psicología

Resumo Em 2009, o Instituto de Psicologia da Universidade Federal da Bahia propõe a área de concentração Estudos da Subjetividade e do Comportamento Humano como transição dos Bacharelados Interdisciplinares (BI) para o curso de graduação em Formação de Psicólogo. São sujeitos desta investigação os 13 estudantes egressos do BI que escolheram a transição para o curso de Psicologia. O modelo teórico-metodológico é o Sistema de Signos, Significados e Práticas, que aborda o objeto nos níveis factual, narrativo e interpretativo. : não há diferença entre coeficientes de rendimento escolar dos egressos do BI e demais estudantes de Psicologia; todos ressaltam positivamente a formação interdisciplinar do BI como relevante para o curso profissionalizante de Psicologia; a maioria reconhece sua decisão de estudar Psicologia como anterior ao ingresso no BI, atribuindo a este curso o amadurecimento da decisão; a maioria tem expectativa de exercer a profissão de psicólogo, contando com a formação prévia adquirida no BI....(AU)

Abstract In 2009, the Institute of Psychology-UFBA proposed the Concentration Area of Subjectivity and Human Behavior Studies as a transition from the Interdisciplinary Bachelor (IB) to the Psychology Bachelor. 13 IB students were chosen as research subjects. The theoretical-methodological model adopted was the System of Signs, Meanings and Practices, which addresses the object from actual, narrative and interpretive levels. : there is no difference in school performance levels between IB and other Psychology students; all IB students positively emphasized interdisciplinary training as relevant to the vocational course in Psychology; most of them recognized that their desire to study Psychology existed before entering IB, attributing to IB the maturing of their decision; the majority of them expect to work as psychologists, relying on the prior training acquired in IB....(AU)

Resumen En 2009, el Instituto de Psicología-UFBA propuso el área de concentración en Estudios de la Subjetividad y de la Conducta Humana como alternativa para hacer la transición desde el pregrado Interdisciplinario (GI) hacia el pregrado en Psicología. 13 estudiantes provenientes del GI que eligieron esta alternativa fueron elegidos como sujetos de esta investigación. El modelo teórico-metodológico elegido fue el Sistema de Signos, Significados y Prácticas que aborda el objeto en sus niveles factual, narrativo e interpretativo. : no hay diferencia entre el rendimiento académico de los estudiantes provenientes de GI y los estudiantes de Psicología; todos los estudiantes de GI destacan positivamente la formación interdisciplinaria del GI como relevante para la formación profesional en psicología; la mayoría de ellos reconoce su decisión de estudiar psicología como anterior al curso GI, atribuyendo a este curso la maduración de tal decisión; la mayoría espera ejercer la profesión de psicólogo confiando en la formación previa adquirida en GI....(AU)