Factors Associated with HIV and Vulnerability Contexts for Women in Brazil.

The purpose of this study was to identify factors associated with HIV and vulnerability contexts for women in Porto Alegre, Brazil. The participants were 1326 women recruited by complex sampling design, divided into two groups: 640 women with HIV (WLH) and 686 women who did not have HIV (WNLH). Gross and weighted statistical analyses were performed. Logistic regression models were used to estimate the odds ratio (OR) for 12 variables. The main results demonstrated that WLH had lower income (p < .001) and poorer education (p = .038), and few used condoms during their first sexual intercourse (p < .001). The occurrence of HIV was higher among the black population (p < .001). Sex in exchange for money (p < .001) and sexually transmitted infections (p < .001) were more frequent among WLH than among WNLH. The age of sexual debut and age difference from the partner at first sexual intercourse (FSI) were not associated with the outcome. The high percentage of non-use of condoms during the FSI shows how vulnerable individuals are right at the beginning of their sexual lives. More effective prevention strategies can be developed by nurses in view of the contexts of vulnerability surrounding women.

Mental health assessment of the Brazilian LGBTQIAP+ population during the COVID-19 pandemic: a cross-sectional study.

OBJECTIVE: To investigate the association between the frequency and associated factors of non-psychotic mental disorders and anxiety symptoms in a Brazilian LGBTQIAP+ sample. METHOD: Cross-sectional study, conducted from September to October 2020 using an online questionnaire, with instruments for sociodemographic characterization, the Generalized Anxiety Disorder Screener and the Self-Report Questionnaire. The analysis was performed using the Chi-square and Fisher's Exact tests. Poisson regression with robust variance was performed to estimate the effect of sociodemographic variables on mental health. RESULTS: Positive screening for anxiety and non-psychotic disorders were identified in 85.2% and 60.2% of the participants, respectively. Younger age groups, who professed some religion, only had access to public health, and presented with medical conditions showed a higher risk for non-psychotic mental disorders. Individuals under 30 (1.33, 95%, CI = 1.17-1.52) presented a high risk for anxiety symptoms. CONCLUSION: The prevalence of anxiety and non-psychotic disorders during the COVID pandemic was high. Implementation of health policies and interventions targeting identified risk factors is recommended.

Prevalence, Circumstances, and Risk Factors of Falls Among Community Dwelling Members of University of the Third Age.

Introduction: The transition from adolescence to adulthood involves a variety of physical, behavioral, and social transformations, often including tobacco use. Because understanding smoking at this stage is important for tobacco control, we aimed to analyze the prevalence of cigarette smoking in the Brazilian youth population. Methods: This study included participants aged 16-25 years from all Brazilian capitals. A standardized questionnaire was administered by trained healthcare professionals to collect information about sociodemographic status, sexual behavior, and tobacco use. The samples from each capital were weighted by age range and sex. Results: Of the 8,581 participants, 15.1% were current smokers, and 20.0% were former smokers; the average age at first tobacco use was 15.5 years. The prevalence of smoking in men was higher than that in women (20.1 vs. 10.3%, p < 0.01). Education level was associated with current smoking and former smoking. Participants with an elementary education level had a higher smoking prevalence (PR: 5.84, 95%, CI: 4.29-7.95) than those with a secondary education (PR: 2.19, 95% CI: 1.63-2.93) and those with higher education. Those without current partners (PR: 1.27, 95% CI: 1.03-1.56) also had a higher prevalence of smoking than those with partners, and participants who had a previous same-sex sexual experience smoked more (PR: 2.29, 95% CI: 1.78-2.96) than those who did not. In addition, regular use of alcohol was associated with higher prevalence of cigarette smoking (PR: 5.65, 95% CI: 4.03-7.90) than a lack of alcohol consumption. Skin color and socioeconomic class did not exhibit significant relationships with tobacco use patterns. Conclusions: Smoking was associated with education level regardless of social class, and some specific behaviors associated with a same-sex sexual experience were associated with a higher prevalence of smoking. These findings are important for formulating policies and directing actions to combat and prevent smoking among young populations.

Mental health assessment of the Brazilian LGBTQIAP+ population during the COVID-19 pandemic: a cross-sectional study / Avaliação da saúde mental da população LGBTQIAP+ brasileira durante a pandemia de COVID-19: estudo transversal / Evaluación de la salud mental de la población LGBTQIAP+ brasileña durante la pandemia de COVID-19: un estudio transversal

ABSTRACT Objective: To investigate the association between the frequency and associated factors of non-psychotic mental disorders and anxiety symptoms in a Brazilian LGBTQIAP+ sample. Method: Cross-sectional study, conducted from September to October 2020 using an online questionnaire, with instruments for sociodemographic characterization, the Generalized Anxiety Disorder Screener and the Self-Report Questionnaire. The analysis was performed using the Chi-square and Fisher's Exact tests. Poisson regression with robust variance was performed to estimate the effect of sociodemographic variables on mental health. Results: Positive screening for anxiety and non-psychotic disorders were identified in 85.2% and 60.2% of the participants, respectively. Younger age groups, who professed some religion, only had access to public health, and presented with medical conditions showed a higher risk for non-psychotic mental disorders. Individuals under 30 (1.33, 95%, CI = 1.17-1.52) presented a high risk for anxiety symptoms. Conclusion: The prevalence of anxiety and non-psychotic disorders during the COVID pandemic was high. Implementation of health policies and interventions targeting identified risk factors is recommended.

RESUMO Objetivo: Investigar a associação entre a frequência e fatores associados de transtornos mentais não psicóticos e sintomas de ansiedade em uma amostra brasileira LGBTQIAP+. Método: Estudo transversal, realizado de setembro a outubro de 2020 por meio de um questionário online, incluindo instrumentos de caracterização sociodemográfica, Generalized Anxiety Disorder Screener e o Self-Report Questionnaire. A análise foi realizada utilizando-se testes Qui-quadrado e Exato de Fisher. Regressão de Poisson com variância robusta foi realizada para estimar o efeitodas variáveis sociodemográficas sobre a saúde mental. Resultados: A triagem positiva para ansiedade e transtornos não psicóticos foi identificada em 85,2% e 60,2% dos participantes, respectivamente. Faixas etárias mais jovens, que possuíam alguma religião, tinham acesso somente à saúde pública e alguma condição clínica prévia apresentaram maior risco para transtornos mentais não psicóticos. Indivíduos com menos de 30 anos (1,33, 95%, IC = 1,17-1,52) apresentaram alto risco para sintomas de ansiedade. Conclusão: A prevalência de ansiedade e transtornos não psicóticos durante a pandemia de COVID foi alta. Recomenda-se a implementação de políticas e intervenções de saúde direcionadas aos fatores de risco identificados.

RESUMEN Objetivo: Investigar la asociación entre la frecuencia y los factores asociados de trastornos mentales no psicóticos y síntomas de ansiedad en una muestra brasileña LGBTQIAP+. Método: Estudio transversal realizado de septiembre a octubre de 2020 mediante cuestionario en línea, con instrumentos de caracterización sociodemográfica, el Generalized Anxiety Disorder Screener y el Self-Report Questionnaire. El análisis se realizó mediante las pruebas Chi-cuadrado y Exacto de Fisher. Se realizó una regresión de Poisson con varianza robusta para estimar el efecto de las variables sociodemográficas sobre la salud mental. Resultados: Se observó resultado positivo para ansiedad y trastornos no psicóticos en el 85,2% y el 60,2% de los participantes, respectivamente. Los grupos de edad más jóvenes, que profesaban alguna religión, solo tenían acceso a la salud pública y tenían condiciones médicas presentaban mayor riesgo de trastornos mentales no psicóticos. Los individuos menores de 30 años (1,33, 95%, IC = 1,17-1,52) presentaron alto riesgo de síntomas de ansiedad. Conclusión: La prevalencia de ansiedad y trastornos no psicóticos durante la pandemia de COVID fue alta. Se recomienda la implementación de políticas e intervenciones de salud dirigidas a los factores de riesgo identificados.

Innovating the fight against syphilis: SIM Project / Inovando a luta contra a sífilis: Projeto SIM

Introduction: Syphilis is a major public health problem. Its incidence has increased in Brazil, particularly in the Southern Region. New tools are available, and immediate action is necessary. Objective: To describe the pilot study of an investigation aimed to assess the prevalence of syphilis, hepatitis B and C, and HIV and evaluate three strategies for adherence to syphilis treatment. Methods: A spontaneous sample of participants was evaluated with a structured questionnaire and underwent rapid tests for syphilis, HIV, and hepatitis B and C after signing an informed consent form (ICF). Rapid tests reagent for syphilis were confirmed by quantitative venereal disease research laboratory (VDRL) and Treponema pallidum hemagglutination assay (TPHA). Participants with confirmation of syphilis were randomized into three groups for follow-up: telephone calls, SIM app, and usual care at the health unit. Results: During a two-day pilot, 68 participants were included. Fourteen (20.6%) had tests reagent for syphilis, 1 (1.5%) for hepatitis B, 3 (4.4%) for hepatitis C, and 1 (1.5%) for HIV. Eight (57.1%) of the initial 14 individuals with rapid tests reagent for syphilis agreed to participate in the study. Out of the 8 rapid tests for syphilis, 2 (25%) were confirmed as active syphilis (>1/8). Conclusion: The prevalence of active syphilis estimated in this population was 3.5%. The demand for tests was high. The COVID-19 epidemic had a negative impact on the development of the study, which is ready for implementation. Discussions on the role of such a testing unit and the coverage of the research project in a context that requires increasing COVID-19-focused testing are fundamental for the future development of the project.

Introdução: A sífilis é um importante problema de saúde pública. A incidência tem aumentado no Brasil, principalmente na Região Sul. Novas ferramentas estão disponíveis e uma ação imediata é necessária. Objetivo: Descrever o estudo piloto de uma pesquisa que avalia a prevalência de sífilis, hepatites B e C e HIV e três estratégias de aderência ao seguimento do tratamento. Métodos: Uma amostra espontânea de participantes foi avaliada com um questionário estruturado e testes rápidos para sífilis, HIV e hepatites B e C foram realizados após assinatura do Termo de Consentimento Livre e Esclarecido (TCLE). Os testes rápidos reagentes para sífilis foram confirmados por VDRL (venereal disease research laboratory) quantitativo e hemaglutinação para sífilis (Treponema pallidum hemagglutination assay ­ TPHA). Os participantes com confirmação de sífilis foram randomizados em três grupos para acompanhamento: ligações telefônicas, aplicativo do SIM e cuidados habituais na unidade de saúde. Resultados: Durante um piloto de dois dias, 68 participantes foram incluídos. Quatorze (20,6%) tiveram testes reagentes para sífilis, 1 (1,5%) para hepatite B, 3 (4,4%) para hepatite C e 1 (1,5%) para HIV. Oito (57,1%) dos 14 casos iniciais com teste rápido reagente para sífilis aceitaram participar do estudo. Dos 8 testes rápidos para sífilis, 2 (25%) foram confirmados como sífilis ativa (>1/8). Conclusão: A prevalência de sífilis ativa estimada nesta população foi de 3,5%. A demanda por exames foi alta. A epidemia de COVID-19 impactou negativamente o desenvolvimento do estudo, que está pronto para implementação. A discussão sobre o papel desta espécie de unidade de teste e a abrangência do projeto de pesquisa em um contexto que pede a expansão de testes focados na COVID-19 são fundamentais para o desenvolvimento futuro do projeto.

Análise temporal das internações hospitalares e óbitos causados por doenças do aparelho respiratório em idosos, Minas Gerais / Temporal analysis of hospital admission and deaths by respiratory diseases among elderly people, Minas Gerais state, Brazil

Os distúrbios respiratórios que acometem os idosos são condições que possuem alta taxa de morbidade e mortalidade e resultam em impactos sociais, econômicos e pessoais. Objetivo: Este estudo tem por objetivos determinar e comparar o perfil das internações hospitalares e óbitos por distúrbios respiratórios em idosos na macrorregião Leste de Saúde e na região metropolitana do Vale do Aço, numa perspectiva temporal. Métodos: Analisaram-se os dados do Ministério da Saúde referentes às internações e aos óbitos por doenças respiratórias em idosos entre 1998 a 2006. Resultados: O coeficiente de internação por doenças do aparelho respiratório em idosos na Macrorregião Leste de Saúde variou entre 2,7 a 4,3 / 100 idosos, apresentando uma redução ao longo dos anos. No entanto, na região metropolitana do Vale do Aço, a taxa de internação foi maior, apresentando uma variação entre 4,3 a 5,9 / 100 idosos. As duas principais causas de internação e óbitos em ambas as regiões correspondem às doenças obstrutivas crônicas e à pneumonia, que vêm aumentado nos últimos anos. Observou-se um efeito sazonal sobre as internações que apresentaram aumentadas nos meses de maio, junho, julho e agosto. Conclusões: Os resultados sugerem que estudos devem ser realizados de forma local, identificando as particularidades das variações dos coeficientes de morbidade e mortalidade em idosos, a fim de subsidiar políticas de saúde e determinar ações preventivas adicionais.