Prepare Romania: study protocol for a randomized controlled trial of an intervention to promote pre-exposure prophylaxis adherence and persistence among gay, bisexual, and other men who have sex with men.

BACKGROUND: Gay, bisexual, and other men who have sex with men (GBMSM) represent a high-risk group for HIV transmission in Romania, yet they possess few resources for prevention. Despite having no formal access to pre-exposure prophylaxis (PrEP) through the health system, GBMSM in Romania demonstrate a high need for and interest in this medication. In anticipation of a national rollout of PrEP, this study tests the efficacy of a novel strategy, Prepare Romania, that combines two evidence-based PrEP promotion interventions for GBMSM living in Romania. METHODS: This study uses a randomized controlled trial design to examine whether GBMSM living in Romania receiving Prepare Romania, a culturally adapted counseling and mobile health intervention (expected n = 60), demonstrate greater PrEP adherence and persistence than those assigned to a PrEP education control arm (expected n = 60). Participants from two main cities in Romania are prescribed PrEP and followed-up at 3 and 6 months post-randomization. PrEP adherence data are obtained through weekly self-report surveys and dried blood spot testing at follow-up visits. Potential mediators (e.g., PrEP use motivation) of intervention efficacy are also assessed. Furthermore, Prepare Romania's implementation (e.g., proportion of enrolled participants attending medical visits, intervention experience) will be examined through interviews with participants, study implementers, and healthcare officials. DISCUSSION: The knowledge gained from this study will be utilized for further refinement and scale-up of Prepare Romania for a future multi-city effectiveness trial. By studying the efficacy of tools to support PrEP adherence and persistence, this research has the potential to lay the groundwork for PrEP rollout in Romania and similar contexts. Trial registration This study was registered on ClinicalTrials.gov, identifier NCT05323123 , on March 25, 2022.

Complicaçöes oculares da artrite reumatóide juvenil / Eye complications of the juvenile rheumatoid arthritis

Este trabalho visa relatar a incidência de iridociclite e outras alteraçöes oculares em pacientes com ARJ, no Serviço de Oftalmologia do HC-UFPR. Durante dois anos, vinte e sete pacientes com ARJ, entre 2 e 26 anos de idade, foram avaliados por meio de exame oftalmológico buscando identificar, precocemente, alteraçöes decorrentes desta doença. Para a montagem do protocolo foram levados em conta fatores como sexo, idade, tempo de início dos sintomas articulares, número de articulaçöes envolvidas, existência ou näo de sintomas articulares, número de articulaçöes envolvidas, existência ou näo de sintomas oculares, aparecimento dests sintomas em relaçäo ao início da doença articular e medicaçöes utilizadas para o tratamento da doença básica