[Mortality and disability-adjusted life years in motorcyclists in Latin America and the Caribbean during the first decade of action for road safetyMortalidad y años de vida ajustados por discapacidad de los motociclistas en América Latina y el Caribe en la primera década de seguridad vial]. / Mortalidade e anos de vida ajustados por incapacidade de motociclistas na América Latina e Caribe na primeira década de segurança viária.

Objective: To identify the temporal trend in mortality and years of life lost to death or disability (DALY) due to motorcycle accidents in males from Latin America and the Caribbean from 2010 to 2019, using estimates produced by the Global Burden of Disease (GBD) study. Method: In this ecological study, the time series was analyzed using a piecewise linear regression model (joinpoint) to estimate and test the annual percent change and the average annual percent change with a 95% confidence interval. Results: The super-region defined by GBD 2019 as Latin America and the Caribbean ranked first globally in mortality and DALY for male motorcyclists aged 15-49 in 2019. Rates increased significantly from 2010 to 2013, with a significant reduction in both after this period. During the analyzed decade, the Tropical Latin America sub-region (Brazil and Paraguay) had the highest mortality and DALY rates in the population of interest; nevertheless, this was the only sub-region achieving a significant reduction in these rates. The Caribbean sub-region (Bermuda, Dominica, Suriname, Guyana, Belize, Bahamas, Puerto Rico, Saint Lucia, Dominican Republic, Haiti, Saint Kitts and Nevis, U.S. Virgin Islands, Grenada, Trinidad and Tobago, Barbados, Saint Vincent and the Grenadines, Antigua and Barbuda, Cuba e Jamaica) showed a significant increase in both rates over the same period, while Andean Latin America (Ecuador, Bolivia and Peru) and Central Latin America (Colombia, Costa Rica, El Salvador, Guatemala, Mexico, Nicaragua, Panama, Honduras, and Venezuela) remained stable. Conclusions: The data underscore the importance of developing surveillance actions aimed at preventing motorcycle accidents, since the observed declining rates are still insufficient to address the morbidity and mortality associated with road accidents as a public health problem.

Objetivo: Determinar la tendencia temporal de la mortalidad y los años de vida perdidos por muerte o ajustados por discapacidad (AVAD) de hombres por accidentes de motocicleta en América Latina y el Caribe en el período 2010-2019, a partir de las estimaciones del estudio de la carga mundial de enfermedades (CME). Métodos: En este estudio ecológico se analizaron las series temporales mediante el modelo de regresión lineal segmentada (joinpoint), con cálculo y comprobación del cambio porcentual anual y del cambio porcentual anual promedio, con un intervalo de confianza del 95%. Resultados: La región de América Latina y el Caribe definida por el estudio de la CME ocupó el primer lugar a nivel mundial en mortalidad y AVAD de motociclistas varones de 15 a 49 años en el 2019. Las tasas tuvieron un notable aumento del 2010 al 2013, y ambas registraron una reducción importante después de ese período. En la década analizada, la subregión de América Latina Tropical (Brasil y Paraguay) presentó las mayores tasas de mortalidad y de AVAD en la población de estudio, pero fue la única con una reducción importante de las mismas. La subregión del Caribe (Antigua y Barbuda, Bahamas, Barbados, Belice, Bermudas, Cuba, Dominica, Granada, Guyana, Haití, Islas Vírgenes de Estados Unidos, Jamaica, Puerto Rico, República Dominicana, Saint Kits y Nevis, San Vicente y las Granadinas, Santa Lucía, Suriname, y Trinidad y Tabago) mostró un aumento importante de ambas tasas, mientras que América Latina Andina (Bolivia, Ecuador y Perú) y América Latina Central (Colombia, Costa Rica, El Salvador, Guatemala, Honduras, México, Nicaragua, Panamá y Venezuela) se mantuvieron estables. Conclusiones: Los datos refuerzan la importancia de las actividades de vigilancia destinadas a prevenir los accidentes de motocicleta, puesto que la reducción observada de las tasas aún es insuficiente para abordar la morbimortalidad por accidentes de tráfico como problema de salud pública.

[Hypertension in female prisoners in Brazil: far beyond the biological aspects]. / Hipertensão em mulheres presas no Brasil: muito além do biológico.

The scope was to estimate the prevalence of arterial hypertension (AHT) and associated risk factors among female prisoners. Data from the National Health Survey of the Female Prison Population and Prison Guards were used, investigating sociodemographic variables, prison characteristics, health behaviors and conditions. Information was collected through a self-administered questionnaire, and the magnitude of the association was estimated by the odds ratio and 95% confidence interval. Of the 1,327 prisoner participants, 24.4% were hypertensive, the majority were 31 years of age or older (54.6%), and 51.5% self-reported mixed race. After adjustment for associated risk factors in the bivariate analysis, a direct relationship between age and AHT was observed, in which age equal to/over 41 years was independently associated with a 7-fold greater chance of having AHT, compared to those under 25 years of age. Those who self-reported mixed race, had high cholesterol, were obese and were also independently associated with a higher prevalence of AHT. The greater the number of people with whom the inmate shares a cell was associated with a higher prevalence of AHT, but without a dose-response relationship. The conclusion drawn is that age, race, obesity, physical inactivity and stress are risk factors for AHT in female prisoners.

Objetivou-se estimar a prevalência de hipertensão arterial (HA) e os fatores de risco associados em mulheres presas. Utilizou-se dados do Inquérito Nacional de Saúde na População Penitenciária Feminina e em Servidoras Prisionais, investigando-se características sociodemográficas, fatores das prisões, comportamentos e condições de saúde. As informações foram coletadas por meio de questionário autoaplicado, sendo a magnitude da associação estimada por odds ratio e intervalo de confiança de 95%. Das 1.327 participantes, 24,4% eram hipertensas, a maioria tinha 31 anos ou mais (54,6%), 51,5% autorreferiram etnia/cor parda. Após mutual ajustamento pelos fatores de risco associados na análise bivariada, observou-se relação direta e com gradiente entre idade e HA, em que idade igual/maior a 41 anos foi associada independentemente com uma chance sete vezes maior de ter HA, se comparado a quem tem menos de 25 anos. Aquelas que autorreferiram etnia/cor negra apresentaram colesterol alto e estavam obesas, também foram associadas de forma independente com maior prevalência de HA. O maior número de pessoas com que a presa divide cela esteve associado à maior prevalência de há, sem uma relação dose-resposta. Conclui-se que idade, etnia/cor, obesidade, inatividade física e estresse são fatores de risco para HA em mulheres presas.

Hipertensão em mulheres presas no Brasil: muito além do biológico / Hypertension in female prisoners in Brazil: far beyond the biological aspects

Resumo Objetivou-se estimar a prevalência de hipertensão arterial (HA) e os fatores de risco associados em mulheres presas. Utilizou-se dados do Inquérito Nacional de Saúde na População Penitenciária Feminina e em Servidoras Prisionais, investigando-se características sociodemográficas, fatores das prisões, comportamentos e condições de saúde. As informações foram coletadas por meio de questionário autoaplicado, sendo a magnitude da associação estimada por odds ratio e intervalo de confiança de 95%. Das 1.327 participantes, 24,4% eram hipertensas, a maioria tinha 31 anos ou mais (54,6%), 51,5% autorreferiram etnia/cor parda. Após mutual ajustamento pelos fatores de risco associados na análise bivariada, observou-se relação direta e com gradiente entre idade e HA, em que idade igual/maior a 41 anos foi associada independentemente com uma chance sete vezes maior de ter HA, se comparado a quem tem menos de 25 anos. Aquelas que autorreferiram etnia/cor negra apresentaram colesterol alto e estavam obesas, também foram associadas de forma independente com maior prevalência de HA. O maior número de pessoas com que a presa divide cela esteve associado à maior prevalência de há, sem uma relação dose-resposta. Conclui-se que idade, etnia/cor, obesidade, inatividade física e estresse são fatores de risco para HA em mulheres presas.

Abstract The scope was to estimate the prevalence of arterial hypertension (AHT) and associated risk factors among female prisoners. Data from the National Health Survey of the Female Prison Population and Prison Guards were used, investigating sociodemographic variables, prison characteristics, health behaviors and conditions. Information was collected through a self-administered questionnaire, and the magnitude of the association was estimated by the odds ratio and 95% confidence interval. Of the 1,327 prisoner participants, 24.4% were hypertensive, the majority were 31 years of age or older (54.6%), and 51.5% self-reported mixed race. After adjustment for associated risk factors in the bivariate analysis, a direct relationship between age and AHT was observed, in which age equal to/over 41 years was independently associated with a 7-fold greater chance of having AHT, compared to those under 25 years of age. Those who self-reported mixed race, had high cholesterol, were obese and were also independently associated with a higher prevalence of AHT. The greater the number of people with whom the inmate shares a cell was associated with a higher prevalence of AHT, but without a dose-response relationship. The conclusion drawn is that age, race, obesity, physical inactivity and stress are risk factors for AHT in female prisoners.

Mortalidade e anos de vida ajustados por incapacidade de motociclistas na América Latina e Caribe na primeira década de segurança viária / Mortality and disability-adjusted life years in motorcyclists in Latin America and the Caribbean during the first decade of action for road safety / Mortalidad y años de vida ajustados por discapacidad de los motociclistas en América Latina y el Caribe en la primera década de seguridad vial

RESUMO Objetivo. Identificar a tendência temporal da mortalidade e dos anos de vida perdidos por morte ou incapacidade (DALY) de homens por acidente motociclístico na América Latina e Caribe no período de 2010 a 2019, utilizando estimativas do estudo Global Burden of Disease (GBD). Métodos. Este estudo ecológico analisou a série temporal pelo modelo de regressão linear segmentada (joinpoint), estimando-se e testando-se a variação percentual anual e a variação percentual anual média, com intervalo de confiança de 95%. Resultados. A grande região da América Latina e Caribe definida pelo GBD ocupou o primeiro lugar global em mortalidade e DALY de motociclistas homens de 15 a 49 anos em 2019. As taxas aumentaram significativamente de 2010 a 2013, havendo redução significativa de ambas após esse período. Durante a década analisada, a sub-região da América Latina Tropical (Brasil e Paraguai) apresentou as maiores taxas de mortalidade e DALY na população em estudo, porém foi a única com redução significativa das mesmas; a sub-região do Caribe (Bermudas, Dominica, Suriname, Guiana, Belize, Bahamas, Porto Rico, Santa Lúcia, República Dominicana, Haiti, São Cristóvão e Névis, Ilhas Virgens/EUA, Granada, Trinidad e Tobago, Barbados, São Vicente e Granadinas, Antígua e Barbuda, Cuba e Jamaica) apresentou aumento significativo de ambas as taxas, enquanto América Latina Andina (Equador, Bolívia e Peru) e América Latina Central (Colômbia, Costa Rica, El Salvador, Guatemala, México, Nicarágua, Panamá, Honduras e Venezuela) permaneceram estáveis. Conclusões. Os dados reforçam a importância das ações de vigilância destinadas à prevenção de acidentes motociclísticos, uma vez que os resultados de queda nas taxas ainda são insuficientes frente à morbimortalidade no trânsito como problema de saúde pública.

ABSTRACT Objective. To identify the temporal trend in mortality and years of life lost to death or disability (DALY) due to motorcycle accidents in males from Latin America and the Caribbean from 2010 to 2019, using estimates produced by the Global Burden of Disease (GBD) study. Method. In this ecological study, the time series was analyzed using a piecewise linear regression model (joinpoint) to estimate and test the annual percent change and the average annual percent change with a 95% confidence interval. Results. The super-region defined by GBD 2019 as Latin America and the Caribbean ranked first globally in mortality and DALY for male motorcyclists aged 15-49 in 2019. Rates increased significantly from 2010 to 2013, with a significant reduction in both after this period. During the analyzed decade, the Tropical Latin America sub-region (Brazil and Paraguay) had the highest mortality and DALY rates in the population of interest; nevertheless, this was the only sub-region achieving a significant reduction in these rates. The Caribbean sub-region (Bermuda, Dominica, Suriname, Guyana, Belize, Bahamas, Puerto Rico, Saint Lucia, Dominican Republic, Haiti, Saint Kitts and Nevis, U.S. Virgin Islands, Grenada, Trinidad and Tobago, Barbados, Saint Vincent and the Grenadines, Antigua and Barbuda, Cuba e Jamaica) showed a significant increase in both rates over the same period, while Andean Latin America (Ecuador, Bolivia and Peru) and Central Latin America (Colombia, Costa Rica, El Salvador, Guatemala, Mexico, Nicaragua, Panama, Honduras, and Venezuela) remained stable. Conclusions. The data underscore the importance of developing surveillance actions aimed at preventing motorcycle accidents, since the observed declining rates are still insufficient to address the morbidity and mortality associated with road accidents as a public health problem.

RESUMEN Objetivo. Determinar la tendencia temporal de la mortalidad y los años de vida perdidos por muerte o ajustados por discapacidad (AVAD) de hombres por accidentes de motocicleta en América Latina y el Caribe en el período 2010-2019, a partir de las estimaciones del estudio de la carga mundial de enfermedades (CME). Métodos. En este estudio ecológico se analizaron las series temporales mediante el modelo de regresión lineal segmentada (joinpoint), con cálculo y comprobación del cambio porcentual anual y del cambio porcentual anual promedio, con un intervalo de confianza del 95%. Resultados. La región de América Latina y el Caribe definida por el estudio de la CME ocupó el primer lugar a nivel mundial en mortalidad y AVAD de motociclistas varones de 15 a 49 años en el 2019. Las tasas tuvieron un notable aumento del 2010 al 2013, y ambas registraron una reducción importante después de ese período. En la década analizada, la subregión de América Latina Tropical (Brasil y Paraguay) presentó las mayores tasas de mortalidad y de AVAD en la población de estudio, pero fue la única con una reducción importante de las mismas. La subregión del Caribe (Antigua y Barbuda, Bahamas, Barbados, Belice, Bermudas, Cuba, Dominica, Granada, Guyana, Haití, Islas Vírgenes de Estados Unidos, Jamaica, Puerto Rico, República Dominicana, Saint Kits y Nevis, San Vicente y las Granadinas, Santa Lucía, Suriname, y Trinidad y Tabago) mostró un aumento importante de ambas tasas, mientras que América Latina Andina (Bolivia, Ecuador y Perú) y América Latina Central (Colombia, Costa Rica, El Salvador, Guatemala, Honduras, México, Nicaragua, Panamá y Venezuela) se mantuvieron estables. Conclusiones. Los datos refuerzan la importancia de las actividades de vigilancia destinadas a prevenir los accidentes de motocicleta, puesto que la reducción observada de las tasas aún es insuficiente para abordar la morbimortalidad por accidentes de tráfico como problema de salud pública.

Análise ergonômica do trabalho de policiais civis da polícia especializada do Ceará: um estudo de caso / Ergonomic analysis of the work of civilian policemen of the specialized police of Ceará: a case study / Análisis ergonómico del trabajo de los policías civiles de la policía especializada de Ceará: un estudio de caso

Introdução: a dinâmica laboral, os fatores ambientais e a individualidade de enfrentamento nos postos de trabalho podem influenciar o surgimento de alterações físicas e psicológicas nos indivíduos. Objetivo: identificar os riscos ergonômicos de policiais de uma Unidade Especializada da Polícia Civil do Estado do Ceará. Métodos: trata de um estudo de caso no qual foi realizada uma Análise Ergonômica do Trabalho, de forma qualitativa e multidisciplinar, de três policiais civis, considerando quatro posições diferentes: posição ortostática com seu equipamento de proteção individual e de exercício laboral; posição de prontidão de tiro; posição de descanso, alerta em operação e fora da operação; e posição ortostática em operação. A análise foi realizada por meio de cinco etapas: análise da demanda; análise da tarefa; análise da atividade; diagnóstico; e recomendações, sendo avaliados o peso dos equipamentos, sobrecargas musculares e articulares e compensações posturais oriundas do exercício das atividades laborais. Resultados: foi detectada elevada carga de peso dos equipamentos, levando a desvios posturais. Os policiais também apresentaram condutas posturais viciosas na execução das atividades. Conclusão: alterações e vícios posturais precisam ser solucionadas visando o cuidado com a saúde dos policiais, de modo a evitar afastamentos para tratamento de saúde. Recomendações foram propostas.

Introduction: the labor dynamics, the environmental factors and the individuality of confrontation at workstations may influence the emergence of physical and psychological alterations in individuals. Objective: to identify the ergonomic risks of policemen of a Specialized Unit of the Civil Police of the State of Ceará. Methods: this is a case study in which a qualitative and multidisciplinary Ergonomic Analysis of Work was carried out on three civilian policemen, considering four different positions: orthostatic position with their individual protection equipment and work exercise; shooting readiness position; resting position, alert in operation and out of operation; and orthostatic position in operation. The analysis was conducted through five stages: demand analysis; task analysis; activity analysis; diagnosis; and recommendations, evaluating the weight of the equipment, muscle and joint overloads and postural compensations arising from the exercise of labor activities. Results: a high weight load of the equipment was detected, leading to postural deviations. The policemen also presented vicious postural behaviors in the execution of their activities. Conclusion: postural alterations and addictions need to be solved in order to take care of the policemen's health, so as to avoid absence for health treatment. Recommendations were proposed.

Introducción: la dinámica laboral, los factores ambientales y la individualidad del enfrentamiento en los puestos de trabajo pueden influir en la aparición de alteraciones físicas y psicológicas en los individuos. Objetivo: identificar los riesgos ergonómicos de los policías de una Unidad Especializada de la Policía Civil del Estado de Ceará. Método: se trata de un estudio de caso en el que se realizó un Análisis Ergonómico del Trabajo cualitativo y multidisciplinar a tres policías civiles, considerando cuatro posiciones diferentes: posición ortostática con su equipo de protección individual y ejercicio de trabajo; posición de preparación para el tiro; posición de descanso, alerta en operación y fuera de operación; y posición ortostática en operación. El análisis se realizó a través de cinco etapas: análisis de la demanda; análisis de la tarea; análisis de la actividad; diagnóstico; y recomendaciones, evaluando el peso del equipo, las sobrecargas musculares y articulares y las compensaciones posturales derivadas del ejercicio de las actividades laborales. Resultados: se detectó una elevada carga de peso del equipo, lo que provocó desviaciones posturales. Los policías también presentaron comportamientos posturales viciosos en la ejecución de sus actividades. Conclusión: las alteraciones posturales y las adicciones necesitan ser solucionadas para cuidar de la salud de los policías, de forma a evitar ausencias para tratamiento sanitario. Se propusieron recomendaciones.

Leprosy among female prisoners in Brazil / Hanseníase entre mulheres privadas de liberdade no Brasil

Abstract To estimate the prevalence of leprosy among Brazilian female prisoners and identify factors associated with the disease. Cross-sectional study conducted between 2014 and 2015 in 15 Brazilian female prisons. The data of 1,327 women were collected using Audio Computer-Assisted Self-Interviewing and dermatological and neurological examination to identify suspicious lesions of leprosy. The average age was 33.4 years. Suspicion of leprosy was identified in 5.1% of women in prison, and lifetime self-reported prevalence was 7.5%. The variables that were associated with lifetime self-reported leprosy were: women in prison once being twice as likely to have leprosy; white women were 1.4 time more likely to have leprosy than non-white women; women who knew someone with leprosy was 1.9 time more likely to have leprosy; and women who shared a cell with 11 or more women were 2.5 times more likely to have leprosy than women who shared a cell with two or fewer people. The leprosy prevalence among female prisoners in Brazil were greater than that found in a Brazilian woman of the general population and show the extremely high vulnerability of this population generated through pre-incarceration poverty, as well as potential transmission in prison.

Resumo Objetivou-se estimar a prevalência de hanseníase entre presidiárias brasileiras e identificar fatores associados à doença. Estudo transversal realizado entre 2014 e 2015 em 15 presídios femininos brasileiros. Os dados de 1.327 mulheres foram coletados por meio de autoentrevista assistida por computador e exame dermatológico e neurológico para identificar lesões suspeitas de hanseníase. A idade média foi de 33,4 anos. A suspeita de hanseníase foi identificada em 5,1% das mulheres na prisão, e a prevalência autorreferida ao longo da vida foi de 7,5%. As variáveis que se associaram à hanseníase autorrelatada ao longo da vida foram: mulheres presas uma vez com duas vezes mais chance de ter hanseníase; mulheres brancas tinham 1,4 vez mais chance de ter hanseníase do que mulheres não brancas; mulheres que conheciam alguém com hanseníase tinham 1,9 vez mais chance de ter hanseníase; e mulheres que compartilhavam uma cela com 11 ou mais mulheres tinham 2,5 vezes mais chance de ter hanseníase do que mulheres que compartilhavam uma cela com duas ou menos pessoas. A prevalencia de hanseníase entre presidiárias no Brasil foi maior do que a encontrada entre mulheres da população geral e evidencia a vulnerabilidade dessa população gerada pela pobreza pré-reclusão, bem como o potencial de transmissão na prisão.

Leprosy among female prisoners in Brazil.

To estimate the prevalence of leprosy among Brazilian female prisoners and identify factors associated with the disease. Cross-sectional study conducted between 2014 and 2015 in 15 Brazilian female prisons. The data of 1,327 women were collected using Audio Computer-Assisted Self-Interviewing and dermatological and neurological examination to identify suspicious lesions of leprosy. The average age was 33.4 years. Suspicion of leprosy was identified in 5.1% of women in prison, and lifetime self-reported prevalence was 7.5%. The variables that were associated with lifetime self-reported leprosy were: women in prison once being twice as likely to have leprosy; white women were 1.4 time more likely to have leprosy than non-white women; women who knew someone with leprosy was 1.9 time more likely to have leprosy; and women who shared a cell with 11 or more women were 2.5 times more likely to have leprosy than women who shared a cell with two or fewer people. The leprosy prevalence among female prisoners in Brazil were greater than that found in a Brazilian woman of the general population and show the extremely high vulnerability of this population generated through pre-incarceration poverty, as well as potential transmission in prison.

My Exposure to Violence: translation and cultural adaptation to the BR Portuguese.

OBJECTIVE: To translate and adapt the My Exposure to Violence instrument for measuring exposure to community violence into Brazilian Portuguese. METHODS: Psychometric study of translation and cross-cultural adaptation in seven stages: (I) initial translations, (II) synthesis of translations, (III) back-translations, (IV) cross-cultural pre-adaptation, (V) evaluation by committee of judges, (VI) pre-test, and (VII) submission to the original author. In step V eight judges evaluated the instrument's equivalence of content, and the content validity index was calculated for each item (CVI-I) and for the average of the instrument (CVI-M), considering a CVI-I ≥ 0.78 as excellent and a CVI-M ≥ 0.80 as acceptable and ≥ 0.90 as excellent. The pre-test was conducted with 39 adolescents enrolled in an educational institution in Fortaleza, state of Ceará. The understandability of the items was evaluated. RESULTS: In step I, two translations were produced with few differences between them. These were resolved in step II, by generating the synthesis version (T12). In step III, the back-translated items reflected the same content as the items in the original version. In step IV, T12 was revised by the authors, who made specific linguistic changes in order to facilitate understanding. In step V, one item (22) presented CVI < 0.78. Due to the relevance of the suggestions, 19 of the 23 items (82.60%) were modified. The CVI-M of the instrument was 0.92. In stage VI, the mean age of the participants was 17.48 years (SD = 1.27). The pre-final version had 21 out of 23 items (91.30%) fully understood by more than 90% of the participants. No changes were made to the final version. CONCLUSIONS: My Exposure to Violence was cross-culturally adapted into Brazilian Portuguese, and was well understood by the target population. Other psychometric properties, such as reliability and validity, should be evaluated in further studies to strengthen the evidence of the translated and adapted version.

Mortalidade por violência contra mulheres antes e durante a pandemia de Covid-19. Ceará, 2014 a 2020 / Mortality from violence against women before and during the Covid-19 pandemic. Ceará, 2014 to 2020

RESUMO Compreendendo a importância do monitoramento da violência contra mulheres, este estudo teve como objetivo analisar o comportamento da curva de crimes violentos, letais e intencionais contra mulheres, no estado do Ceará, nos últimos anos e discutir acerca dos aspectos que envolvem a curva epidemiológica dos crimes letais contra a mulher, principalmente com o início da pandemia de Covid-19. Trata-se de uma pesquisa ecológica, utilizando os dados secundários disponíveis na plataforma da Secretaria de Segurança Pública e Defesa Social do estado do Ceará entre os anos de 2014 a 2020. A coleta foi realizada no mês de janeiro de 2021, os dados foram analisados com auxílio do programa Excel. Constatou-se que a violência contra a mulher no estado do Ceará encontra-se em ascensão e que anos com eventos sanitários atípicos, como a pandemia da Covid-19, tendem a impactar negativamente a vida em sociedade e mais diretamente a vida das mulheres. Torna-se essencial que as autoridades, as instituições, organizações sociais, comunidade acadêmica, profissionais de todos os setores e serviços públicos e privados estejam sensibilizados e empenhados em cobrar a efetivação das políticas de enfrentamento alinhadas a rede de serviços, principalmente no momento de maior vulnerabilidade da pandemia.

ABSTRACT Understanding the importance of monitoring in confront violence against women, this study aimed to analyze the behavior of the curve of violent, lethal and intentional crimes against women in the state of Ceará in recent years and discuss aspects that involve the epidemiological curve of lethal crimes against women, especially with the beginning of the Covid-19 pandemic. This is an ecological survey, using the secondary data available on the platform of the Secretariat of Public Security and Social Defense of the state of Ceará between the years 2014 to 2020. The collection was carried out in January 2021, the data were purchased with the aid of the Excel program. It was found that violence against women in the state of Ceará is on the rise and that years with atypical health events, such as the Covid-19 pandemic, tend to have a negative impact on life in society and more directly on women lives. It is essential that authorities, institutions, social associations, the academic community, professionals from all sectors in public and private services are sensitized and committed to demanding the implementation of confrontation policies aligned with the service network, especially at the moment of greatest vulnerability of the pandemic.

My Exposure to Violence: translation and cultural adaptation to the BR Portuguese / My Exposure to Violence: tradução e adaptação transcultural para o português brasileiro

ABSTRACT OBJECTIVE To translate and adapt the My Exposure to Violence instrument for measuring exposure to community violence into Brazilian Portuguese. METHODS Psychometric study of translation and cross-cultural adaptation in seven stages: (I) initial translations, (II) synthesis of translations, (III) back-translations, (IV) cross-cultural pre-adaptation, (V) evaluation by committee of judges, (VI) pre-test, and (VII) submission to the original author. In step V eight judges evaluated the instrument's equivalence of content, and the content validity index was calculated for each item (CVI-I) and for the average of the instrument (CVI-M), considering a CVI-I ≥ 0.78 as excellent and a CVI-M ≥ 0.80 as acceptable and ≥ 0.90 as excellent. The pre-test was conducted with 39 adolescents enrolled in an educational institution in Fortaleza, state of Ceará. The understandability of the items was evaluated. RESULTS In step I, two translations were produced with few differences between them. These were resolved in step II, by generating the synthesis version (T12). In step III, the back-translated items reflected the same content as the items in the original version. In step IV, T12 was revised by the authors, who made specific linguistic changes in order to facilitate understanding. In step V, one item (22) presented CVI < 0.78. Due to the relevance of the suggestions, 19 of the 23 items (82.60%) were modified. The CVI-M of the instrument was 0.92. In stage VI, the mean age of the participants was 17.48 years (SD = 1.27). The pre-final version had 21 out of 23 items (91.30%) fully understood by more than 90% of the participants. No changes were made to the final version. CONCLUSIONS My Exposure to Violence was cross-culturally adapted into Brazilian Portuguese, and was well understood by the target population. Other psychometric properties, such as reliability and validity, should be evaluated in further studies to strengthen the evidence of the translated and adapted version.

RESUMO OBJETIVO Traduzir e adaptar para português brasileiro o instrumento de aferição de exposição à violência comunitária, My Exposure to Violence. MÉTODOS Estudo psicométrico de tradução e adaptação transcultural em sete etapas: (I) traduções iniciais, (II) síntese das traduções, (III) retrotraduções, (IV) pré-adaptação transcultural, (V) avaliação por comitê de juízes, (VI) pré-teste e (VII) submissão ao autor original. Na etapa V oito juízes avaliaram a equivalência de conteúdo do instrumento, sendo calculado o índice de validade de conteúdo para cada item (IVC-I) e para a média do instrumento (IVC-M), considerando-se um IVC-I ≥ 0,78 como excelente e um IVC-M ≥ 0,80 como aceitável e ≥ 0,90 como excelente. O pré-teste foi realizado com 39 adolescentes matriculados em uma instituição de ensino em Fortaleza, no Ceará, sendo avaliada a compreensibilidade dos itens. RESULTADOS Na etapa I, duas traduções foram produzidas, com poucas diferenças entre si. Estas foram dirimidas na etapa II, gerando a versão síntese (T12). Na etapa III, os itens retrotraduzidos refletiram o mesmo conteúdo dos itens da versão original. Na etapa IV, ocorreu a revisão de T12 pelos autores, que realizaram modificações linguísticas específicas, de modo a facilitar o entendimento. Na etapa V, um item (22) apresentou IVC < 0,78. Devido a pertinência das sugestões, 19 dos 23 itens (82,60%) sofreram modificações. O IVC-M do instrumento foi 0,92. Na etapa VI, a média de idade dos participantes foi de 17,48 anos (DP = 1,27). A versão pré-final teve 21 dos 23 itens (91,30%) totalmente compreendidos por mais de 90% dos participantes. Não foram realizadas alterações na versão final. CONCLUSÕES O My Exposure to Violence foi adaptado transculturalmente para o português brasileiro, tendo sido bem compreendido pela população alvo. Outras propriedades psicométricas, como confiabilidade e validade, devem ser avaliadas em estudos posteriores para fortalecer as evidências da versão traduzida e adaptada.

Complementary and Integrative Medicine in academic health education.

OBJECTIVE: To analyze academic education in Complementary and Integrative Medicine (CIM) according to university students from the health area. METHODS: Cross-sectional study with 1399 students from six public and private Brazilian universities, with online and in-person collection of socioeconomic, demographic, educational and academic data, carried out in 2019. The bivariate analysis was applied for the outcome "presence of CIM in academic health education", using the SPSS Statistic program, version 23.0™. RESULTS: The prevalence of the presence of CIM in academic health education was 52.3%, being 31.1% in the compulsory and 8% in the non-compulsory curricular education, 2.0% in scientific research and 4.7% in university extension activities. There was an association of the outcome with knowledge of the national CIM policy (OR = 5.258; p = 0.000), of which knowledge can be indicated and used in one's professional area (OR = 4.836; p = 0.000), interest and/or use of CIM by the teachers/tutors of the course (OR = 3.955; p = 0.000), stimulus by the university to carry out scientific research (OR = 3.277; p = 0.000) and university extension projects with CIM (OR = 3.686; p = 0.000). CONCLUSION: Academic education using CIM in health area courses is not very prevalent in teaching, research and university extension in Brazil, but when present in the curricular and non-curricular educational processes, it shows a significant association with knowledge, skills and their use by university students. The creation of a National Educational Planning in CIM is a vital imperative.

Tendência temporal dos homicídios no Brasil no período de 2000-2019 / Temporal trend of homicides in Brazil in the period 2000-2019

Objetivo: descrever a tendência temporal da mortalidade por homicídios no Brasil e Regiões de 2000 a 2019. Métodos: trata-se de estudo ecológico de análise de série temporal por meio de dados extraídos do Sistema de Informações de Mortalidade correspondentes às mortes provocadas por agressões (CID X85-Y09), intervenções legais (CID Y35-Y36) e óbitos por eventos de intenção não determinada, (CID Y10-Y34) ocorridas em BR e regiões Norte, Nordeste, Sudeste, Sul e Centro-Oeste, no período de 2000 a 2019. A tendência temporal foi calculada utilizando o Joinpoint Regression Program versão 4.9.0.0, obtendo-se as variações percentuais anuais e variações percentuais anuais médias, com intervalo de confiança de 95%. Resultados: houve redução significativa dos óbitos por homicídios após 2017, além de aumento significativo das mortes por intervenção legal de 2000 a 2019, em todas as unidades territoriais estudadas, acompanhado de redução daquelas por agressões no Brasil e Sudeste e aumento nas regiões Norte e Nordeste, ambos significativos estatisticamente. Houve aumento substancial dos óbitos por eventos de intenção não determinada a partir de 2017, em todas as regiões, significativos para Brasil, Norte e Sudeste. Observou-se inexistência de ponto de inflexão em 2017 no Sudeste relativo aos homicídios estimados, evidenciando o elevado ocultamento dos homicídios no período por falhas nas notificações. Conclusões: torna-se essencial, para a integridade e correção dos dados contidos nos sistemas de informações, o compartilhamento destas entre os atores envolvidos na produção daqueles.

Objective to describe the temporal trend of homicide mortality in Brazil and the Regions from 2000 to 2019. Methods: this is an ecological study of time series analysis based on data extracted from the Mortality Information System corresponding to deaths caused by aggression (CID X85-Y09), legal interventions (CID Y35-Y36), and deaths due to undetermined intentions (CID Y10-Y34) occurring in BR and the North, Northeast, Southeast, South, and Center-West regions, in the period from 2000 to 2019. The temporal trend was calculated using Joinpoint Regression Program version 4.9.0.0, obtaining the annual percentage changes and mean annual percentage changes, with a 95% confidence interval. Results: there was a significant reduction in deaths from homicide after 2017, in addition to a significant increase in deaths from legal intervention from 2000 to 2019 in all territorial units studied, accompanied by a reduction in those from aggression in Brazil and the Southeast and an increase in the North and Northeast regions, both statistically significant. There was a substantial increase in deaths from events of undetermined intention as of 2017 onwards in all regions, significant for Brazil, North, and Southeast. There was no inflection point in 2017 in the Southeast regarding estimated homicides, evidencing the high concealment of homicides in the period due to failures in notifications. Conclusions: it is essential for the integrity and correction of the data contained in the information systems that these are shared among the actors involved in their production.

Prevalence of hypertension and associated factors in female prison correctional officers in a national sample in Brazil.

OBJECTIVES: To estimate hypertension prevalence and associated factors among female correctional officers (FCO) in female Brazilian prisons. METHODS: Cross-sectional, analytical study conducted in 15 female prisons in all five Brazilian regions between January 2014 and December 2015. The study population consisted of correctional officers with at least 6 months in the position. The sampling included 40% of FCO present in the prison during data collection, yielding 295 FCOs. Data were collected via Audio Computer-Assisted Self-Interview. A physical examination of participants was conducted including blood pressure, weight, and waist and hip circumference. The Odds Ratio and confidence intervals for independent factors were estimated. RESULTS: Hypertension prevalence in correctional officers was 37.9%, (95% CI 32.1-44.0). Hypertension was associated with obesity (95% CI = 1.884-9.947), cardiovascular disease (95% CI = 3.348-16.724), and participation in the specific training course for the relevant position (95% CI = 1.413-9.564). CONCLUSIONS: While findings, except for the last factor, are not novel, this is the first such study conducted in Brazil. Hypertension prevalence among this pool of all female correctional officers is higher than in the average population, and FCOs associate this with the prison environment. Current training does not appear to address this problem. Especially since prison populations are growing in Brazil, this problem needs to be addressed for the health of the FCOs and the prisoners in their care.

Physical violence inside female prisons in Brazil: prevalence and related factors.

The present study aims to identify the prevalence of physical violence against female prisoners in Brazil, as well as related factors. This is a cross-sectional national survey conducted in 15 female prisons in five regions of Brazil selected in multiple stages. The following types of analysis were performed: univariate analysis; stratified analysis relating the outcome (suffer physical violence inside prison) to predictor variables, using the Pearson chi-square test; calculation of the Odds Ratio (O.R.); and multiple logistic regression. The Hosmer-Lemeshow test was used for analysis of goodness of fit and adequacy of the model. The prevalence of physical violence inside female prisons was 37.4%. There was a correlation between physical violence victimization in prison and the following variables: physical victimization prior to arrest (p = 0.013), solitary confinement (p = 0.000), mental suffering (p = 0.003), current or previous abusive intake of alcohol (p = 0.011), current or previous injection of cocaine (p = 0.002) and not performing prison labor (p = 0.003). Physical violence has become inherent in the Brazilian female prison system. Continued studies are needed to monitor the situation and to develop  interventions to prevent physical violence inside the facilities.

Physical violence inside female prisons in Brazil: prevalence and related factors / Violência física dentro das prisões femininas no Brasil: prevalência e fatores relacionados

Abstract The present study aims to identify the prevalence of physical violence against female prisoners in Brazil, as well as related factors. This is a cross-sectional national survey conducted in 15 female prisons in five regions of Brazil selected in multiple stages. The following types of analysis were performed: univariate analysis; stratified analysis relating the outcome (suffer physical violence inside prison) to predictor variables, using the Pearson chi-square test; calculation of the Odds Ratio (O.R.); and multiple logistic regression. The Hosmer-Lemeshow test was used for analysis of goodness of fit and adequacy of the model. The prevalence of physical violence inside female prisons was 37.4%. There was a correlation between physical violence victimization in prison and the following variables: physical victimization prior to arrest (p = 0.013), solitary confinement (p = 0.000), mental suffering (p = 0.003), current or previous abusive intake of alcohol (p = 0.011), current or previous injection of cocaine (p = 0.002) and not performing prison labor (p = 0.003). Physical violence has become inherent in the Brazilian female prison system. Continued studies are needed to monitor the situation and to develop interventions to prevent physical violence inside the facilities.

Resumo O presente artigo objetiva identificar a prevalência de violência física no interior das prisões femininas brasileiras, bem como fatores associados. Estudo transversal de abrangência nacional, realizado em 15 unidades prisionais femininas nas cinco regiões do Brasil em amostra selecionada por múltiplos estágios. Realizou-se análise univariada; análise estratificada em relação ao desfecho (sofrer violência física dentro da prisão) e as variáveis preditoras através do teste de Chi-quadrado de Pearson; cálculo da Odds Ratio; e regressão logística múltipla. Utilizou-se o teste Hosmer-Lemeshow para análise de qualidade de ajuste e adequação do modelo. A prevalência de violência física dentro das prisões femininas brasileiras foi de 37.4%. Houve correlação entre a vitimização da violência física na prisão e as seguintes variáveis: vitimização física prévia (p = 0.013), isolamento (p = 0.000), sofrimento mental (p = 0.003), ingestão abusiva e/ou dependência alcoólica (p = 0.011), uso atual ou prévio de cocaína injetável (p = 0.002) e ócio prisional (p = 0.003). A violência física tornou-se inerente ao sistema prisional feminino brasileiro. Estudos futuros são necessários no intuito de fornecer propostas para intervenções efetivas de modo a prevenir a violência física dentro das instalações prisionais.

Implantação e implementação do Núcleo de Apoio à Saúde da Família: residência multiprofissional em Saúde da Família como estratégia de efetivação das políticas públicas do SUS / Implantation and implementation of Family Health Support Centers: multiprofessional residence in Family Health as a strategy for the effectiveness of SUS public policies / Implantación e implementación del Núcleo de Apoyo a la Salud de la Familia: residencia multiprofesional en Salud de la Familia como estrategia tan eficaz para políticas públicas de SUS

A Estratégia Saúde da Família (ESF) foi ampliada com os Núcleos de apoio à Saúde da Família (NASF). Devido ao ineditismo dos NASF, sua implantação representa um desafio. Diante disso, objetivou-se relatar a experiência de implantação e implementação do NASF, no município de Arneiroz/CE, a partir da experiência da Residência Multiprofissional em Saúde da Família e Comunidade da Escola de Saúde Pública do Ceará (RMSFC-ESP-CE). Trata-se de relato de experiência oriundo da prática gerencial e assistencial, entre julho/2013 e maio/2016, em Arneiroz/CE. As informações emergentes da prática profissional foram registradas em diário de campo e analisadas na perspectiva hermenêutico dialética com base no referencial teórico e nos dados dos sistemas de informação. A implantação dos NASF exige reformulações no processo de trabalho da ESF capazes de promover a interprofissionalidade e intersetorialidade na perspectiva do apoio matricial. Em Arneiroz/CE, esse desafiador processo aconteceu concomitantemente à implantação da RMSFC-ESP-CE, cujas atividades foram essenciais no suporte técnico-pedagógico aos gestores e profissionais do município, facilitando a incorporação e efetivação do preconizado pelo Ministério da Saúde. Quanto às ações educativas em saúde e aos atendimentos de profissionais de nível superior na ESF, houve um aumento importante depois da implantação do NASF, indicando melhoria no acesso e nos indicadores de saúde. Aponta-se ainda o impacto das Residências Multiprofissional em Saúde enquanto estratégia de Educação Permanente em Saúde e subsídio aos processos de gestão municipal em saúde, especialmente em municípios de pequeno porte, de modo a também subsidiar a implementação das políticas públicas de saúde. (AU)

The Family Health Strategy (ESF) has been expanded with the Family Health Support Centers (NASF). In face of NASF's novelty, its implementation represents a challenge. This study aimed to report NASFs implantation and implementation experience in Arneiroz/CE municipality from Multiprofessional Residency Program in Family and Community Health of the School of Public Health of Ceará (RMSFC-ESP-CE) experience. This is an experience report from management and assistance practice between July/2013 and May/2016 in Arneiroz/CE. The information emerged from professional practice was recorded in a field diary and analyzed in dialectical hermeneutic perspective based on theoretical reference and data of information systems. The NASF's implementation requires reformulations in ESF's work process capable to promote interprofessionality and intersectoriality in matrix support perspective. In Arneiroz/CE, this challenging process happened concurrently with RMSFC-ESP-CE implementation, whose activities were essential in the technical-pedagogical support to managers and professionals of the municipality, facilitating incorporation and effectiveness of the recommended by Health Ministry. Regarding health educational actions and attendances of higher level professionals in ESF, there were a significant increased after NASF implementation, indicating improved access and health indicators. It also pointed out the impact of the Multiprofessional Residency in Health as a strategy of Continuing Education in Health and subsidy to municipal health management processes, especially in small municipalities, in order to also subsidize public health policies implementation. (AU)

The Family Health Strategy (ESF) has been expanded with the Family Health Support Centers (NASF). In face of NASF's novelty, its implementation represents a challenge. This study aimed to report NASFs implantation and implementation experience in Arneiroz/CE municipality from Multiprofessional Residency Program in Family and Community Health of the School of Public Health of Ceará (RMSFC-ESP-CE) experience. This is an experience report from management and assistance practice between July/2013 and May/2016 in Arneiroz/CE. The information emerged from professional practice was recorded in a field diary and analyzed in dialectical hermeneutic perspective based on theoretical reference and data of information systems. The NASF's implementation requires reformulations in ESF's work process capable to promote interprofessionality and intersectoriality in matrix support perspective. In Arneiroz/CE, this challenging process happened concurrently with RMSFC-ESP-CE implementation, whose activities were essential in the technical-pedagogical support to managers and professionals of the municipality, facilitating incorporation and effectiveness of the recommended by Health Ministry. Regarding health educational actions and attendances of higher level professionals in ESF, there were a significant increased after NASF implementation, indicating improved access and health indicators. It also pointed out the impact of the Multiprofessional Residency in Health as a strategy of Continuing Education in Health and subsidy to municipal health management processes, especially in small municipalities, in order to also subsidize public health policies implementation. de trabajo de ESF capaces de promocionar interprofissionalidade y el enfoque intersectorial en perspectiva de soporte de la matriz. En Arneiroz/CE, este proceso desafiante ocurrió al mismo tiempo que ha pasado a la aplicación de la RMSFC-ESP-CE, cuyas actividades eran esenciales en apoyo técnico y pedagógico a los directivos y profesionales municipales, facilitando el desarrollo y realización de la recomendada por el Ministerio de Salud. En cuanto a las acciones de educación en salud y la atención de los profesionales de alto nivel en el ESF, hubo un aumento significativo después de la aplicación de NASF, lo que indica mejoría en los indicadores de acceso y de salud. También destacó el impacto de la Multidisciplinar Residencia en Salud como una estrategia de Educación Continua en Salud y subsidio a los procesos de gestión municipal en materia de salud, especialmente en los municipios pequeños, con el fin de subsidiar la implementación de políticas de salud pública. (AU)

Acidentes Automobilísticos no Brasil em 2017: estudo ecológico dos anos de vida perdidos por incapacidade / Automobile Accidents in Brazil in 2017: ecological study of the disability-adjusted life years

RESUMO Este estudo se propõe a descrever o impacto dos Acidentes Automobilísticos no Brasil, no ano de 2017, sobre os anos de vida perdidos ajustados por incapacidade. Estudo ecológico, com dados secundários da Global Health Data Exchange (Global Burden of Disease 2017) disponibilizados pelo Institute for Health Metricsand Evaluation. Os dados foram obtidos utilizando filtros de causa (ferimentos na estrada por veículo automotor), localização (global, Brasil e sul da América Latina) e indivíduos de ambos os sexos, com idades entre 15 e 49 anos. Foram considerados os anos de vida perdidos por incapacidade e a taxa de mortes por 100 mil habitantes. Os dados foram exportados para o Excel® for Windows 2010 e analisados conforme a literatura. Observa-se, no Brasil, um decréscimo nas taxas de óbitos (19,68%) e de anos de vida perdidos por incapacidade (22,10%) por acidente automobilístico entre indivíduos de ambos os sexos, com idades entre 15 e 49 anos, porém mostram-se superiores as taxas globais e do sul da América Latina. Estudos como este são importantes para o aperfeiçoamento e o direcionamento de politicas públicas específicas, para formular e implementar estratégias de promoção e prevenção da saúde de segurança no trânsito.

ABSTRACT This study aims to describe the impact of Automobile Accidents in Brazil, in the year 2017, on the years of life lost adjusted for disability. Ecological study, with secondary data from the Global Health Data Exchange (Global Burden of Disease 2017) provided by the Institute for Health Metrics and Evaluation (IHME). The data were obtained using cause filters (road injuries by motor vehicle), location (Global, Brazil and Southern Latin America) and individuals of both sexes, aged 15 to 49 years. Rates of death and Disability-Adjusted Life Years per 100 thousand inhabitants were considered. The data were exported to Excel® for Windows 2010 and analyzed according to the literature. It is observed, in Brazil, a decrease in death rates (19.68%) and Disability-Adjusted Life Years (22.10%) per automobile accident among individuals of both sexes, between 15 and 49 years, but they are higher than the Global and Southern rates of Latin America. Studies such as this are important for the improvement and targeting of specific public policies, to formulate and implement strategies for health promotion and prevention of traffic safety.

Fatores associados ao uso do álcool entre homens autores de violência por parceiro íntimo no Ceará / Factors associated to the use of alcohol and the perpetration of physical violence between men authors of violence of intimate partner in the state of Ceará

Objetivo: analisar os fatores associados ao uso de álcool entre homens autores de violência por parceiro íntimo (VPI) no estado do Ceará. Métodos: estudo transversal-exploratório, com 152 homens em privação de liberdade por prática de VPI, sob custódia do Estado na Casa de Privação Provisória de Liberdade II. Dados coletados por questionário com quatro blocos: sócio demográfico, impulsividade (Barratt Impulsiveness Scale), uso abusivo de álcool e outras drogas (Alcohol, Smoking and Substance Involvement Screening Test) e histórico de violência. Os participantes foram categorizados em 0-10 para baixo risco; 11- 26 para risco moderado e > 27 para alto risco. Para análise, foi feita a correção de população finita. As associações em tabelas de contingência foram realizadas por meio do qui-quadrado de Pearson, cálculo da odds ratio e regressão logística com múltiplas variáveis independentes pelo IBM SPSS STATISTICS® 23.1. Resultados: a prevalência do uso de risco de álcool foi de XX%. Os fatores associados ao consumo de risco de álcool foram zona de nascimento (OR=6,52, P<0,001), uso de risco de tabaco (OR=7,94, P<0,001), autoafirmação de ciúmes (OR=2,66, P=0,017) e já ter sido casado/amasiado (OR=2,64, P<0,001). Conclusões: há elevada prevalência do uso de álcool entre os homens que perpetram VPI, tornando-se necessário o desenvolvimento de novos estudos e a criação de políticas públicas que influenciem na redução do consumo de álcool.

Análise do atendimento nos serviços de saúde entre pessoas vivendo com HIV/AIDS / Analysis of the care of health services between people living with HIV/AIDS

Objetivo: analisar o atendimento dos serviços de saúde prestados às pessoas que vivem com HIV/AIDS, buscando identificar atitudes de discriminação e preconceito vivenciadas na perspectiva dos usuários no município de Fortaleza/CE. Método: estudo seccional e exploratório, com abordagem quantitativa, realizada no período de março a junho/2018, com 65 indivíduos que frequentam a unidade da Rede Nacional de pessoas que vivem com HIV/AIDS (RNP) na cidade de Fortaleza-CE. As atitudes de discriminação foram mensuradas por meio da escala de Allport. Os dados foram digitados pelo software Excel for Windows® 2010 e, a seguir, exportados e analisados pelo programa STATA/SE® 11.2. Resultados: 20% dos indivíduos afirmaram sofrer algum tipo de discriminação em locais de saúde por viverem com HIV/AIDS. Entretanto, 67,7% informaram já terem sido vitimas de algum tipo de preconceito por causa da doença, desses 50% foram vítimas de piadas e apenas 6% de ataques físicos. Conclusão: ainda há muito a melhorar para uma efetiva garantia do acesso e humanização do atendimento às pessoas vivendo com HIV/AIDS.

Objective: to analyze the care provided to people living with HIV/AIDS, seeking to identify discrimination and prejudicial attitudes experienced by the users' perspective, in the city of Fortaleza. Method: this is a cross-sectional and exploratory field survey, with a quantitative approach, which was carried out between March and June 2018, with 65 individuals who attending the unit of the National Network of People Living with HIV/AIDS (RNP), located in the municipality of Fortaleza-Ceará. Discriminative attitudes were measured by the Allport Scale. The data was entered by the software Excel for Windows® 2010 and then was exported and analyzed by the STATA/SE® 11.2 program. Results: 20% of individuals reported having suffered some kind type of discrimination in health places due to the fact that they have HIV/AIDS. However, 67.7% reported that they had already suffered some kind of prejudice because of the disease, and that 50% were victims of jokes and only 6% of physical attacks. Conclusion: there is still much to improve for an effective guarantee of access and humanization of care for people living with HIV/AIDS.

The 12 city HIV Surveillance Survey among MSM in Brazil 2016 using respondent-driven sampling: a description of methods and RDS diagnostics.

INTRODUCTION: This paper details the methods used in the second national Biological and Behavioral Surveillance Survey (BBSS) of HIV, syphilis, and hepatitis B and C among men who have sex with men in Brazil. METHODS: Respondent-driven sampling (RDS) was used in 12 cities in 2016. The targeted sample size was initiated with five to six seeds in each city. HIV, syphilis, and Hepatitis B and C rapid tests were offered to participants. RDS Analyst with Gile's successive sampling (SS) estimator was used to adjust results as recommended and a weight for each individual was generated for further analysis. Data for the 12 cities were merged and analyzed using Stata 14.0 complex survey data tools with each city treated as its own stratum. RESULTS: Duration of data collection varied from 5.9 to 17.6 weeks. 4,176 men were recruited in the 12 cities. Two sites failed to achieve targeted sample size due to a six-month delay in local IRB approval. No city failed to reach convergence in our major outcome variable (HIV). CONCLUSION: The comprehensive BBSS was completed as planned and on budget. The description of methods here is more detailed than usual, due to new diagnostic tools and requirements of the new STROBE-RDS guidelines.