Investigating the Chemical Profile of Underexplored Parts of Dipteryx alata (Baru) Using the PS-MS Technique.

The baru (Dipteryx alata Vog.), a fruit native to the Cerrado biome, is well-known for its almonds, which are extensively exploited and exported. Unfortunately, the remaining parts of this fruit are often discarded. This study investigates the fixed chemical constituents of the baru, including the bark, pulp, endocarp, and almonds, using the PS-MS technique in positive and negative ionization modes. Notably, this research presents the first chemical profile of baru almonds in both their raw and roasted states. The analysis identified 57 compounds reported for the first time in a baru and 24 common compounds. The majority of these compounds are classified as flavonoids. In both ionization modes, the peel exhibited a higher proportion of phenolic compounds, although the chemical compounds varied among the peel, pulp, almond, and endocarp. These findings highlight the perspective of bioeconomy and biotechnology. By staggering baru fruit production alongside extractivists, we can optimize the utilization of all parts of the fruit. Furthermore, given the knowledge of the biological properties of flavonoids and the baru composition, we recommend additional studies to analyze their potential in preventing chronic non-communicable diseases.

Instrumento sobre conhecimento, atitudes e práticas da automedicação em estudantes universitários

Objetivo: construir e validar instrumento para investigar os conhecimentos, atitudes e práticas de estudantes universitários brasileiros sobre a automedicação. Método: estudo metodológico realizado em universidade pública do centro oeste mineiro, Brasil. Um comitê de juízes avaliou clareza, pertinência e abrangência e o pré-teste realizado com público alvo para avaliar compreensão e aceitabilidade. O índice de validade de conteúdo (IVC) foi utilizado para avaliar a proporção de concordância e o coeficiente alfa de Cronbach (a) para mensurar a confiabilidade. Resultados: o instrumento foi composto por 38 itens divididos em três seções: caracterização dos participantes (13 itens); conhecimentos e práticas da automedicação (3 itens); e crenças e atitudes (22 itens). A média do IVC de todas as seções do instrumento foi de 0,97 e o coeficiente alfa de Cronbach da seção crenças e atitudes >0,70. Conclusão: o instrumento foi considerado válido para avaliar conhecimento, prática, crenças e atitudes sobre automedicação em estudantes universitários.

SUMMARY Objective: To build and validate an instrument to investigate the knowledge, attitudes and practices of Brazilian university students about self-medication. Method: Methodological study carried out at a public university in the center of western Minas Gerais, Brazil. A committee of judges assessed clarity, relevance and comprehensiveness and the pre-test carried out with a target audience to assess understanding and acceptability. The content validity index (CVI) was used to assess the proportion of agreement and Cronbach's alpha coefficient (a) to measure reliability. Results: The instrument consisted of 38 items divided into three sections: characterization of participants (13 items); knowledge and practices of self-medication (3 items); and beliefs and attitudes (22 items). The mean CVI for all sections of the instrument was 0.97 and the Cronbach's alpha coefficient for the beliefs and attitudes section >0.70. Conclusion: The instrument was considered valid to assess knowledge, practice, beliefs and attitudes about self-medication in university students.

Objetivo: construir y validar un instrumento para investigar los conocimientos, actitudes y prácticas de estudiantes universitarios brasileños sobre la automedicación. Método: estudio metodológico realizado en una universidad pública del centro del occidente de Minas Gerais, Brasil. Un comité de jueces evaluó la claridad, la relevancia y la exhaustividad y la prueba previa se llevó a cabo con un público objetivo para evaluar la comprensión y la aceptabilidad. El índice de validez de contenido (IVC) se utilizó para evaluar la proporción de acuerdo y el coeficiente alfa de Cronbach (a) para medir la confiabilidad. Resultados: el instrumento constaba de 38 ítems divididos en tres apartados: caracterización de los participantes (13 ítems); conocimientos y prácticas de automedicación (3 ítems); y creencias y actitudes (22 ítems). El CVI medio para todas las secciones del instrumento fue 0,97 y el coeficiente alfa de Cronbach para la sección de creencias y actitudes> 0,70. Conclusión: el instrumento se consideró válido para evaluar conocimientos, prácticas, creencias y actitudes sobre la automedicación en estudiantes universitarios.

Chemical Approach to the Optimization of Conditions Using HS-SPME/GC-MS for Characterization of Volatile Compounds in Eugenia brasiliensis Fruit.

Grumixama (Eugenia brasiliensis Lam.) is a native fruit of the Brazilian Atlantic Forest, belonging to the Myrtaceae family, which designatesthe most significant number of species with food potential. It stands out due to its phytochemical characteristics because of the presence of polyphenols and volatile organic compounds. Volatile compounds are substances released by foods that give off an aroma and influence flavor. Solid-phase microextraction is a technique that allows for low-cost, fast, and solvent-free extraction, has an affinity for numerous analytes, and is easily coupled to gas chromatography. The objectives of this work were to evaluate the efficiency of different fibers of SPME (solid-phase microextraction) in the extraction of volatile organic compounds from grumixama pulp; optimize a method for extraction time, temperature, and sample weight; and to determine the characteristic volatile profile of this fruit. For the extraction of volatile compounds, three fibers of different polarities were used: polar polyacrylate (PA) fibers, divinylbenzene/carboxyne/polydimethylsiloxane (DVB/CAR/PDMS) semipolar fibers, and polydimethylsiloxane/divinylbenzene (PDMS/DVB). Fourteen volatile organic compounds (VOCs) were identified by DVB/CAR/PDMS, six by PA, and seven by PDMS/DVB through solid-phase microextraction in the headspace mode (SPME-HS). Considering the total number of compounds identified, regardless of the fiber used, and the optimization of the method, Eugenia brasiliensis presented sesquiterpene fractions (85.7%, 83.3%, and 85.7% of total VOCs) higher than the monoterpene fractions (14.3%, 16.7%, and 14.3%) for DVB/CAR/PDMS, PA, and PDMS/DVB, respectively in its composition. In addition, it was possible to verify that the fiber DVB/CAR/PDMS presented a better efficiency due to the larger chromatographic area observed when the grumixama pulp was subjected to conditions of 75 °C, 2.0 g, and an adsorption time of 20 min.

Physicochemical Characterization and Paper Spray Mass Spectrometry Analysis of Myrciaria Floribunda (H. West ex Willd.) O. Berg Accessions.

Myrciaria floribunda, also known as rumberry, is a tree native to the Brazilian Atlantic Forest, where its fruits have the potential for commercial use. This study evaluates the antioxidant potential, determines the phytochemical profile, and chemically characterizes the rumberry fruit. Accessions were sampled from the Rumberry Active Germplasm Bank of the Federal University of Alagoas, Brazil. Physical characteristics, chemical characteristics, and phenolic compound content were analyzed. Chemical profile characterization was carried out using PSMS. Accessions had an average weight of 0.86 g. Accession AC137 presented a higher pulp yield (1.12 g). AC132 and AC156 had larger fruits, AC137 showed greater firmness (5.93 N), and AC160 had a higher and total phenolic content ratio (279.01 ± 11.11). Orange-colored accessions scored higher in evaluated parameters, except for AC160 for phenolic content. Thirty-two compounds were identified on positive ionization mode and 42 compounds on negative ionization mode using PSMS. Flavonoids, followed by the derivatives of benzoic acid, sugars, and phenylpropanoids, were the most prominent. Myricitrin, quercitrin, and catechin stand out as flavonoids that have been reported in previous studies with antioxidant and antimicrobial properties, in addition to health and therapeutical benefits, demonstrating the potential of the rumberry fruit.

Tuberculosis in Brazil: one country, multiple realities.

OBJECTIVE: To identify the determinants of tuberculosis-related variables in the various regions of Brazil and evaluate trends in those variables over the ten-year period preceding the end of the timeframe defined for the United Nations Millennium Development Goals (MDGs). METHODS: This was an ecological analytical study in which we utilized eight national public databases to investigate the 716,971 new tuberculosis cases reported between 2006 and 2015. RESULTS: Over the study period, there were slight reductions in the prevalence, incidence, and mortality associated with tuberculosis. Brazil did not reach the MDG for tuberculosis-related mortality. Among the performance indicators of tuberculosis control, there were improvements only in those related to treatment and treatment abandonment. In terms of the magnitude of tuberculosis, substantial regional differences were observed. The tuberculosis incidence rate was highest in the northern region, as were the annual mean temperature and relative air humidity. That region also had the second lowest human development index, primary health care (PHC) coverage, and number of hospitalizations for tuberculosis. The northeastern region had the highest PHC coverage, number of hospitalizations for primary care-sensitive conditions, and tuberculosis-related mortality rate. The southern region showed the smallest reductions in epidemiological indicators, together with the greatest increases in the frequency of treatment abandonment and retreatment. The central-west region showed the lowest overall magnitude of tuberculosis and better monitoring indicators. CONCLUSIONS: The situation related to tuberculosis differs among the five regions of Brazil. Those differences can make it difficult to control the disease in the country and could explain the fact that Brazil failed to reach the MDG for tuberculosis-related mortality. Tuberculosis control measures should be adapted to account for regional differences.

Training and standardization of simulated patients for multicentre studies in clinical pharmacy education

OBJECTIVE: To evaluate the training and standardization methods of multiple simulated patients (SPs) performing a single scenario in a multicenter study. METHODS: A prospective quasi-experimental study, using a multicenter approach, evaluated the performance of five different individuals with the same biotype during a simulation session in a high-fidelity environment. The SPs training and standardization process consisted of four steps and six web or face-to-face mediated: Step 1: simulation scenario design and pilot test. Step 2: SPs selection, recruitment and beginning training (Session 1: performance instructions and memorization request.) Session 2: check the SPs' performances and adjustments). Step 3 and session 3: training role-play and performance's evaluation. Step 4: SPs' standardization and performances' evaluation (Sessions 4 and 5: first and second rounds of SPs' standardization assessment. Session 6: Global training and standardization evaluation. SPs performance consistency was estimated using Cronbach's alpha and ICC. RESULTS: In the evaluation of training results, the Maastricht Simulated Patient Assessment dimensions of SPs performances "It seems authentic", "Can be a real patient" and "Answered questions naturally", presented "moderate or complete agreement" of all evaluators. The dimensions "Seems to retain information unnecessarily", "Remains in his/her role all the time", "Challenges/tests the student", and "Simulates physical complaints in an unrealistic way" presented "moderate or complete disagreement" in all evaluations. The SPs "Appearance fits the role" showed "moderate or complete agreement" in most evaluations. In the second round of evaluations, the SPs had better performance than the first ones. This could indicate the training process's had good influence on SPs performances. The Cronbach's alpha in the second assessment was better than the first (varied from 0.699 to 0.978). The same improvement occurred in the second round of intraclass correlation coefficient that was between 0.424 and 0.978. The SPs were satisfied with the training method and standardization process. They could perceive improvement on their role-play authenticity. CONCLUSIONS: The SPs training and standardization process revealed good SPs reliability and simulation reproducibility, demonstrating to be a feasible method for SPs standardization in multicenter studies. The Maastricht Simulated Patient Assessment was regarded as missing the assessment of the information consistency between the simulation script and the SPs provision

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Uso de medicamentos em crianças de zero a cinco anos de idade residentes no município de tubarão, santa catarina / Use of drugs in children aged zero to five years old in tubarão, santa catarina, brazil

RESUMO Objetivo: Analisar o perfil de utilização de medicamentos em crianças de zero a cinco anos de idade. Métodos: Estudo transversal baseado em entrevistas realizadas em domicílio com cuidadores (pais, tios ou avós) das crianças cadastradas em dez unidades de Estratégia Saúde da Família (ESF), distribuídas em diferentes pontos geográficos do município de Tubarão, Santa Catarina. Resultados: Foram entrevistados 350 cuidadores, cujas crianças sorteadas possuíam, em média, 2,6 anos de idade. Destas, 56,9% utilizaram, pelo menos, um medicamento nos 15 dias anteriores à entrevista, sendo que 31,1% foram expostas à automedicação e 35,7% utilizaram, pelo menos, um medicamento obtido por prescrição atual. O uso de medicamentos foi associado à faixa etária de até 24 meses, consulta periódica com pediatra e diagnóstico de doenças agudas e doenças crônicas. Entre as crianças medicadas, 19,1% foram expostas a pelo menos um medicamento de forma inadequada (considerando dose, intervalo entre doses ou período de tratamento). Quanto ao armazenamento, 55,2% dos medicamentos estavam guardados em lugar inseguro, ou seja, ao acesso das crianças, e 32,0% em locais inadequados, por estarem expostos a luz, calor ou umidade. Ainda, 45,2% estavam sem bula, 38,9% sem embalagem secundária e 1,6% fora do prazo de validade. Conclusões: As crianças estudadas apresentam uma frequência elevada de uso de medicamentos, devendo ser incentivadas ações que visem ao uso seguro e racional de fármacos nessa população.

ABSTRACT Objective: To analyze the context of drug use in children aged zero to five years old. Methods: Cross-sectional study based on interviews conducted at home with caregivers (parents, uncles or grandparents) of the children enrolled in ten Family Health Strategy units across different geographical points of the city of Tubarão, Santa Catarina, Brazil. Results: A total of 350 caregivers were interviewed, whose children's mean age was 2.6 years. Of these, 56.9% had used at least one drug in the 15 days prior to the interview, 31.1% had been exposed to self-medication and 35.7% had used at least one medication obtained by current prescription. The use of medication was associated with the age range up to 24 months, periodic consultation with pediatricians and diagnosis of chronic and acute diseases. Among medicated children, 19.1% inappropriately had been exposed to at least one medication (considering dose, dose interval or period of treatment). Regarding medication storage, 55.2% of interviewees stored them in unsafe places that could be accessed by children and 32.0% in inappropriate places, with exposure to light, heat or humidity. Moreover, 45.2% of the interviewees stored drugs out of their packages, 38.9% without secondary packaging, and 1.6% of drugs had expired date. Conclusions: Drug use is high among children in this age range, and actions aimed at the safe and rational use of these substances in this population should be encouraged.

USE OF DRUGS IN CHILDREN AGED ZERO TO FIVE YEARS OLD IN TUBARÃO, SANTA CATARINA, BRAZIL. / USO DE MEDICAMENTOS EM CRIANÇAS DE ZERO A CINCO ANOS DE IDADE RESIDENTES NO MUNICÍPIO DE TUBARÃO, SANTA CATARINA.

OBJECTIVE: To analyze the context of drug use in children aged zero to five years old. METHODS: Cross-sectional study based on interviews conducted at home with caregivers (parents, uncles or grandparents) of the children enrolled in ten Family Health Strategy units across different geographical points of the city of Tubarão, Santa Catarina, Brazil. RESULTS: A total of 350 caregivers were interviewed, whose children's mean age was 2.6 years. Of these, 56.9% had used at least one drug in the 15 days prior to the interview, 31.1% had been exposed to self-medication and 35.7% had used at least one medication obtained by current prescription. The use of medication was associated with the age range up to 24 months, periodic consultation with pediatricians and diagnosis of chronic and acute diseases. Among medicated children, 19.1% inappropriately had been exposed to at least one medication (considering dose, dose interval or period of treatment). Regarding medication storage, 55.2% of interviewees stored them in unsafe places that could be accessed by children and 32.0% in inappropriate places, with exposure to light, heat or humidity. Moreover, 45.2% of the interviewees stored drugs out of their packages, 38.9% without secondary packaging, and 1.6% of drugs had expired date. CONCLUSIONS: Drug use is high among children in this age range, and actions aimed at the safe and rational use of these substances in this population should be encouraged.

OBJETIVO: Analisar o perfil de utilização de medicamentos em crianças de zero a cinco anos de idade. MÉTODOS: Estudo transversal baseado em entrevistas realizadas em domicílio com cuidadores (pais, tios ou avós) das crianças cadastradas em dez unidades de Estratégia Saúde da Família (ESF), distribuídas em diferentes pontos geográficos do município de Tubarão, Santa Catarina. RESULTADOS: Foram entrevistados 350 cuidadores, cujas crianças sorteadas possuíam, em média, 2,6 anos de idade. Destas, 56,9% utilizaram, pelo menos, um medicamento nos 15 dias anteriores à entrevista, sendo que 31,1% foram expostas à automedicação e 35,7% utilizaram, pelo menos, um medicamento obtido por prescrição atual. O uso de medicamentos foi associado à faixa etária de até 24 meses, consulta periódica com pediatra e diagnóstico de doenças agudas e doenças crônicas. Entre as crianças medicadas, 19,1% foram expostas a pelo menos um medicamento de forma inadequada (considerando dose, intervalo entre doses ou período de tratamento). Quanto ao armazenamento, 55,2% dos medicamentos estavam guardados em lugar inseguro, ou seja, ao acesso das crianças, e 32,0% em locais inadequados, por estarem expostos a luz, calor ou umidade. Ainda, 45,2% estavam sem bula, 38,9% sem embalagem secundária e 1,6% fora do prazo de validade. CONCLUSÕES: As crianças estudadas apresentam uma frequência elevada de uso de medicamentos, devendo ser incentivadas ações que visem ao uso seguro e racional de fármacos nessa população.

Effect of allopurinol and uric acid normalization on serum lipids hyperuricemic subjects: A systematic review with meta-analysis.

Although uric acid is not part of any definition of metabolic syndrome, a number of studies have shown strong associations between the concentration of uric acid and metabolic syndrome or its components. The purpose of this systematic review with meta-analysis was to evaluate, using prospective interventional studies, the effects of allopurinol therapy and uric acid normalization on serum concentrations of triacylglycerol, total-cholesterol, LDL-cholesterol and HDL-cholesterol in hyperuricemic subjects. A systematic search of the PubMed and Scopus databases was performed following the guidelines described in the PRISMA statement. Seven studies were included in the meta-analysis, including six randomized controlled trials and one controlled before-and-after study. Despite differences in the follow-up periods (4, 12 and 24weeks) and allopurinol dose (100-300mg/day), all the studies showed decreases in the mean serum uric acid level (95% confidence interval: -2.61 to -1.55 (4weeks), -2.94 to -1.09 (12weeks) and -2.59 to -1.22 (24weeks); p<0.05). However, no effect was observed based on differences in mean serum triacylglycerol and total- and LDL-cholesterol concentrations, independent of the follow-up period. Allopurinol therapy during weeks 4 and 12 induced a decrease in the mean HDL-cholesterol level (95% confidence interval: -7.22 to -0.47 (4weeks) and -7.18 to -0.32 (12weeks); p<0.05). This review suggests that allopurinol and uric acid normalization does not improve serum lipid levels, although larger and longer trials of higher quality are needed to confirm this.

Clinical outcomes of medication therapy management services in primary health care

ABSTRACT This study evaluates whether the integration of pharmacists into health-care teams through the delivery of pharmaceutical care-based medication therapy management (MTM) services can improve the clinical outcomes of patients with chronic health conditions in the primary health-care setting. A retrospective descriptive study of 92 outpatients assisted by MTM pharmacists in primary health-care units was carried out over 28 months (median follow-up: 05 months). Patients were followed up by MTM pharmacists, with a total of 359 encounters and a ratio of 3.9 encounters per patient. The prevalence of hypertension, diabetes mellitus and dyslipidaemia was 29.5%, 22.0% and 19.4%, respectively. There was a high prevalence of drug-related problems with a ratio of 3.4 per patient. Pharmacists performed a total of 307 interventions to prevent or resolve drug-related problems. With regard to control of the most prevalent chronic medical conditions, a high percentage of patients reached their therapy goals by the last encounter with the pharmacist: 90.0% for hypertension, 72.3% for diabetes mellitus and 90.3% for dyslipidaemia. MTM services provided by pharmacists resolved drug therapy problems and improved patients' clinical outcomes. This study provides evidence for health-care managers of the need to expand the clinical role of pharmacists within the Brazilian public health-care system.

Control measures to trace ≤ 15-year-old contacts of index cases of active pulmonary tuberculosis.

This was descriptive study carried out in a medium-sized Brazilian city. In ≤ 15-year-old contacts of index cases of active pulmonary tuberculosis, we assessed compliance with the Brazilian national guidelines for tuberculosis control. We interviewed 43 contacts and their legal guardians. Approximately 80% of the contacts were not assessed by the municipal public health care system, and only 21% underwent tuberculin skin testing. The results obtained with the Chi-square Automatic Interaction Detector method suggest that health care teams have a biased attitude toward assessing such contacts and underscore the need for training health professionals regarding tuberculosis control programs.

Homeopatia: percepção da população sobre significado, acesso, utilização e implantação no sus / Homeopathy: Population Perceptions on its Meanings, Access, Use and Implementation on SUS

Em 1980, a homeopatia foi reconhecida como especialidade médica pelo Conselho Federal de Medicina, e, em 1986, após a 8ª Conferência Nacional de Saúde (CSN), foi introduzida como prática alternativa de assistência à saúde no âmbito dos serviços de saúde. Em 2004, foi criada a Política Nacional de Medicina Natural e Práticas Complementares (PNMNPC), publicação do Ministério da Saúde, que estabelece pontos importantes para a inserção destas práticas no sistema público desaúde. Objetivos: verificar o conhecimento dos usuários do SUS sobre a homeopatia e o seu interesse pela implantação da prática em Divinópolis, MG. Método: Estudo qualitativo do tipo estudo de caso por meio de entrevista semi-estruturada. Resultados: Prevalece na população pouco ou nenhum conhecimento sobre a homeopatia. No imaginário dos entrevistados constatou-se a confusãode homeopatia e tratamentos fitoterápicos caseiros; identificação de homeopatia como doença; a crença de inocuidade ao organismo dos medicamentos homeopáticos ou fitoterápicos e a relação de fé ou misticismo com os homeopáticos ou fitoterápicos. Apesar do pouco conhecimento, a maioria dosentrevistados considera importante a implantação do tratamento homeopático no SUS Divinópolis como uma alternativa de assistência. Conclusões: existe interesse na implantação da homeopatia no SUS Divinópolis. Recomenda-se aqui a realização de novos estudos que busquem maior amplitude de resultados.

In 1980, homeopathy had been recognized as a medical speciality by the Federal Council of Medicine, and, in 1896, after the 8th National Conference on Health (CSN), it was introduced as an alternative practice of health assistance in the scope of health services. In 2004, it was created the National Policy of Natural Medicine and Complementary Practices (PNMNPC), a publication of the Health Ministry,which establishes important points for the insertion of these practices in the public health system. Objectives: to verify the information that SUS users have on homeopathy and their interest on the implementation of this practice in Divinópolis, MG. Method: Qualitative research of the type “case study” was developed through semi-structured interviews. Results: Prevails among the population, little or no information on homeopathy. In the imaginary of the interviewed participants, it was observed a confusion between homeopathy and homemade herbal treatments; the identification of homeopathy as a disease; the belief in the innocuously nature of homeopathic and phytotherapy to the organismand the relation of faith and mysticism with homeopathic and phytotherapy. In spite of the poor information, most part of the interviewed considers important to implement the homeopathic treatment on SUS Divinópolis as an alternative method of assistance. Conclusions: there is interest in theimplementation of homeopathy on SUS Divinópolis. It is recommended here for further studies that seek greater range of results.

Utilization of HIV/AIDS treatment services: comparing injecting drug users and other clients.

This study compared healthcare utilization by injection drug users (IDUs) and non-IDUs. Data were abstracted from patients' medical records, admitted on HIV/AIDS treatment centers, between 1986 and 2002, forming a non-concurrent cohort study. Variables included: sociodemographics, HIV/AIDS exposure group, healthcare utilization (consultations, procedures, and prescriptions). Descriptive analyses included age-period and cohort effects. Out of 170 patients, with an average age of 30 years, 39.4% were IDUs, 71.8% were males and had low levels of education. At the first consultation, 86.5% neither received an ARV prescription nor had a request for CD4 or viral load. Injection drug users, as compared to non-IDUs, were less likely to receive ARV prescriptions and requests for CD4 lymphocyte and viral load counts, even though the number of consultations did not differ between the two groups. Healthcare utilization increased in calendar-year in the non-IDUs group, parallel to the implementation of the Brazilian health policy of universal care. However, this favorable trend was not observed among IDUs. Differential outcomes for HIV/AIDS among IDUs, towards worse prognosis, suggest difficulties in terms of adherence and follow-up of ARV therapy in this population.

Utilization of HIV/AIDS treatment services: comparing injecting drug users and other clients

Objetivou-se descrever a utilizacão de servicos, comparando usuários de drogas injetáveis (UDIs) e não-UDIs. Informacões coletadas nos prontuários de pacientes em atendimento para HIV/AIDS, de 1986 a 2002, estabeleceram uma coorte não concorrente. As variáveis incluíam: dados sócio-demográficos, exposicão ao HIV/AIDS e utilizacão de servico (consultas, prescricões e solicitacões de exames). Análises descritivas e verificacão dos efeitos calendário e de coorte foram realizadas. Dos 170 pacientes, com trinta anos na mediana idade, 39,4 por cento eram UDIs, 71,8 por cento homens e com baixa escolaridade; 86,5 por cento não receberam, na primeira consulta, prescricão ARV, solicitacão de CD4 ou carga viral. Usuários de drogas injetáveis tiveram menor chance de receber prescricão de ARV, solicitacão de CD4/carga viral, seja na primeira consulta, seja nas demais, apesar de o número de consultas não diferir em virtude de ser ou não UDIs. Observou-se incremento na utilizacão dos servicos para pacientes não-UDIs ao longo do tempo, coincidindo com a implementacão de políticas públicas visando à ampliacão do acesso; porém, tal impacto não foi observado entre UDIs. Evolucão diferencial da infeccão pelo HIV, com piores prognósticos entre os UDIs, sugere deficiências na adesão e manutencão do tratamento ARV.