Conditions associated with adherence to HIV post-sexual exposure prophylaxis.

OBJECTIVE: To analyze conditions which interfere with adherence to HIV post-sexual exposure prophylaxis. METHOD: Cross-sectional study conducted in two health care services specializing in HIV/AIDS in São Paulo city. Interviewees included men and women who were eighteen or older, sought care due to consensual sexual relation, and had a recommendation for prophylaxis. The questionnaires which compose the social reproduction index and adherence to prophylaxis were used as parameters. Non-parametric Kruskal-Wallis and Mann-Whitney tests and summation of the employed instrument through programs Excel® and Statistical Package for the Social Sciences® were performed. Ethical principles have been respected. RESULTS: Forty-nine users have been identified; their mean age was 34.7 and they were predominantly men (95.9%). Out of these, 83.6% were men who have sex with men. The conditions which correlated with adherence (p<0.05) were taking post-sexual exposure prophylaxis prior to that appointment and continuing to take the medication. CONCLUSION: Health professionals are responsible for establishing rapport with service users, especially during the first appointment, to contribute to adherence interventions plans.

Conditions associated with adherence to HIV post-sexual exposure prophylaxis / Condiciones asociadas con la adhesión a la profilaxis post-exposición al VIH / Condições associadas à adesão à profilaxia pós-exposição sexual ao HIV

ABSTRACT Objective: To analyze conditions which interfere with adherence to HIV post-sexual exposure prophylaxis. Method: Cross-sectional study conducted in two health care services specializing in HIV/AIDS in São Paulo city. Interviewees included men and women who were eighteen or older, sought care due to consensual sexual relation, and had a recommendation for prophylaxis. The questionnaires which compose the social reproduction index and adherence to prophylaxis were used as parameters. Non-parametric Kruskal-Wallis and Mann-Whitney tests and summation of the employed instrument through programs Excel® and Statistical Package for the Social Sciences® were performed. Ethical principles have been respected. Results: Forty-nine users have been identified; their mean age was 34.7 and they were predominantly men (95.9%). Out of these, 83.6% were men who have sex with men. The conditions which correlated with adherence (p<0.05) were taking post-sexual exposure prophylaxis prior to that appointment and continuing to take the medication. Conclusion: Health professionals are responsible for establishing rapport with service users, especially during the first appointment, to contribute to adherence interventions plans.

RESUMEN Objetivo: Analizar las condiciones que interfieren con la adherencia a la profilaxis post-exposición al VIH. Método: Estudio transversal, realizado en dos servicios especializados en VIH/sida en la ciudad de São Paulo. Se entrevistaron hombres y mujeres mayores de 18 años que buscaron atención por relaciones sexuales consentidas con indicación de profilaxis. Se utilizaron como parámetros los cuestionarios que conforman el índice de reproducción social y la adherencia a la profilaxis. Se realizaron pruebas no paramétricas de Kruskal-Wallis y Mann-Whitney, así como el análisis de suma del instrumento utilizado a través de Excel® y del Statistical Package for the Social Sciences®. Se respetaron los preceptos éticos. Resultados: Se detectaron 49 usuarios, con una edad media de 34,7 años y predominantemente hombres (95,9%). Del total, el 83,6% eran hombres que se relacionaban sexualmente con otros hombres. Las condiciones que se correlacionaron con la adherencia (p<0,05) fueron el uso anterior de la profilaxis post-exposición y su ingestión continua. Conclusión: Los profesionales de la salud tienen la responsabilidad de establecer el vínculo con el usuario del servicio, especialmente en la primera atención, a fin de contribuir a la planificación de las intervenciones para la adherencia.

RESUMO Objetivo: Analisar condições que interferem na adesão à profilaxia pós-exposição sexual ao HIV. Método: Estudo de corte transversal, realizado em dois serviços de assistência especializada em HIV/aids no município de São Paulo. Foram entrevistados homens e mulheres maiores de 18 anos que procuraram atendimento por motivo de relação sexual consentida com indicação de profilaxia. Foram usados como parâmetros os questionários que compõem o índice de reprodução social e a adesão à profilaxia. Realizaram-se testes não paramétricos de Kruskal-Wallis e Mann-Whitney e análises somatórias do instrumento utilizado por meio dos programas Excel® e Statistical Package for the Social Sciences®. Os preceitos éticos foram respeitados. Resultados: Foram detectados 49 usuários, com média de idade de 34,7 anos e predomínio de homens (95,9%). Do total, 83,6% eram homens que se relacionam sexualmente com homens. As condições que tiveram correlação com a adesão (p<0,05) foram uso de profilaxia pós-exposição sexual anterior a esse atendimento e prosseguimento da ingestão dos medicamentos. Conclusão: Compete aos profissionais de saúde estabelecer o vínculo com o usuário do serviço, principalmente no primeiro atendimento, de modo a contribuir para o planejamento das intervenções para a adesão.

Estratégias educativas com jovens escolares em quarenta anos da epidemia de HIV/AIDS: uma revisão integrativa / Educational strategies with young schoolchildren in forty years of HIV/AIDS epidemic: an integrative review

Introdução: Desde os primeiros casos relatados, a infecção pelo HIV é crescente entre os jovens. Pensar sobre a saúde sexual dos jovens requer a compreensão de suas implicações na vida dos indivíduos, os impactos que têm no desenvolvimento social e econômico das comunidades e dos países. A educação em saúde sexual aparece como eixo fundamental para redução da vulnerabilidade dos jovens ao HIV/aids. Objetivo: Analisar abordagens, elementos e impactos das estratégias educativas utilizadas para trabalhar a temática HIV/aids, com jovens escolares, nos quarenta anos de epidemia. Método: Trata-se de um estudo de Revisão Integrativa da Literatura. O estudo não necessita da submissão para avaliação de um Comitê de Ética em Pesquisa. As bases de dados utilizadas foram: BDENF, CINAHL, CUIDEN, EMBASE, ERIC, LILACS, MEDLINE, PSYCINFO e SCOPUS. As estratégias de busca foram adaptadas a partir da estratégia-chave: Educação em Saúde AND Jovem AND AIDS AND HIV. Foram incluídos artigos de estudos primários sobre estratégias educativas com foco em HIV/aids, sem limitação de ano, desenvolvidos no espaço escolar, destinado a jovens estudantes que estavam cursando do sexto ano do ensino fundamental ao terceiro ano do ensino médio. Resultados: Ao realizar as etapas do processo de seleção dos estudos, obteve-se 42 artigos para análise, que compuseram a amostra final. Na avaliação do rigor metodológico, todos os estudos apresentaram boa qualidade. Houve predomínio de estratégias educativas direcionadas aos jovens cursando o ensino médio e a média de idade ficou em 16,4 anos. O uso de atividades inclusivas como dramatização, discussão, espaço para perguntas e esclarecimento de dúvidas, apresentações em grupo, dentre outros recursos que envolveram a participação dos alunos, esteve presente em todos os estudos. Os professores escolares foram os principais responsáveis pelas intervenções. Somente duas pesquisas foram conduzidas integralmente por profissionais da enfermagem. O conhecimento específico sobre HIV/aids foi avaliado em todos os estudos, apresentando aumento significativo após as intervenções. Conclusão: Os achados nesta pesquisa indicam que as metodologias ativas apresentam melhores resultados no processo de ensino e aprendizagem. Porém, para que os impactos das intervenções perdurem para além de um curto período, é preciso elaborar estratégias educativas que considerem as especificidades dos jovens, reconhecendo suas vulnerabilidades e necessidades em saúde. Destaca-se que apenas dois estudos foram produzidos no Brasil, indicando a necessidade de novas pesquisas direcionadas às estratégias educativas sobre HIV/aids. Também, evidencia-se a urgência em promover a articulação entre profissionais da saúde e educação no planejamento das atividades, ressaltando o papel de professores escolares e enfermeiros neste processo.

Introduction: Since the first reported cases, HIV infection has increased among young people. Thinking about the sexual health of young people requires understanding its implications for the lives of individuals, the impacts it has on the social and economic development of communities and countries. Sexual health education appears as a fundamental axis for reducing the vulnerability of young people to HIV/AIDS. Objective: To analyze approaches, elements and impacts of educational strategies used to work on the HIV/AIDS theme, with young schoolchildren, in the forty years of the epidemic. Method: This is an Integrative Literature Review study. The study does not require submission for evaluation by a Research Ethics Committee. The databases used were: BDENF, CINAHL, CUIDEN, EMBASE, ERIC, LILACS, MEDLINE, PSYCINFO and SCOPUS. The search strategies were adapted from the key strategy: Health Education AND Youth AND AIDS AND HIV. Articles from primary studies on educational strategies focused on HIV/AIDS, without limitation of year, developed in the school environment, aimed at young students from the sixth year of elementary school to the third year of high school, were included. Results: When performing the steps of the study selection process, 42 articles were obtained for analysis, and composed the final sample. In the assessment of methodological rigor, all studies showed good quality. There was a predominance of educational strategies aimed at young people attending high school, and the average age was 16.4 years. The use of inclusive activities such as dramatization, discussion, space for questions and clarification of doubts, group presentations, among other resources that involved the participation of students, was present in all studies. School teachers were the main responsible for the interventions. Only two surveys were entirely conducted by nursing professionals. Specific knowledge about HIV/AIDS was assessed in all studies, showing a significant increase after the interventions. Conclusion: The findings in this research indicate that active methodologies present better results in the teaching and learning process, but for the impacts of interventions to last beyond a short period, it is necessary to develop educational strategies that consider the specificities of young people, recognizing their vulnerabilities and health needs. It is noteworthy that only two studies were produced in Brazil, indicating the need for further research aimed at educational strategies on HIV/AIDS. The urgency to promote the articulation between health and education professionals, in the planning of activities, is also evident, emphasizing the role of school teachers and nurses in this process.

Energy recovery from municipal solid waste of intermunicipal public consortia identified in São Paulo State.

The main reasons, which this research is based on, are evidenced by the need of technical, political, economic and socioenvironmental coordination for the municipal solid waste management in Brazil and in the State of São Paulo. Most of the counties do not have adequate size to promote the management of MSW, so it's necessary to perform a consortia to do it. Therefore, it was necessary to characterize the current State of Sao Paulo consortial arrangements considering the environment (including sanitation, waste, water resources, among others). The scale of waste generation and the total population involved in these consortia were also considered. The energy potential of municipal solid waste was evaluated considering two possible technologies: The burning of landfill biogas in engines and the incineration in plants with Rankine cycle. It was identified that the sum of consortia energy potential was 1,454,336 MWh y-1 (landfill biogas), and 2,715,925 MWh y-1 (incineration). It is intended that such results provide significant information and encourage interaction between the different agents involved in the intermunicipal arrangements. It is expected that the characterisation and calculation of energy potential will stimulate future studies about new consortia approaches that consider energy recovery in their projects.