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1.
RECIIS (Online) ; 16(2): 332-346, abr.-jun. 2022. ilus
Article in Portuguese | LILACS | ID: biblio-1378392

ABSTRACT

Barebacking sex é o engajamento intencional de homens que fazem sexo com homens na relação anal sem camisinha. Para além de abordagens moralistas, relacionadas à possibilidade de infecção pelo HIV, analisamos como narrativas barebacking classificam os corpos em desejáveis e indesejáveis, a partir da maneira como são apresentados em cartazes de divulgação de orgias brasileiras disponíveis para visualização na internet. Neste artigo, almejamos uma discussão interseccional sobre desejo sexual, gênero, raça e classe, partindo das imagens em circulação nos contextos brasileiros do bareback.


Barebacking sex is the intentional engagement of men who have sex with other men in anal intercourse without a condom. Beyond moralistic approaches, related to the possibility of HIV infection, we analyse how barebacking narratives classify bodies into the desirable and the undesirable, through the way they are shown in posters publicizing Brazilian orgies available for viewing on the internet. In this article, we aim to develop an intersectional discussion about sexual desire, gender, race and class, starting from the images circulating in Brazilian bareback contexts.


Barebacking sex es el compromiso intencional de hombres que tienen sexo con hombres en el coito anal sin condón. Además de los enfoques moralistas relacionados con la posibilidad de infección por el VIH, analizamos cómo las narrativas barebacking clasifican los cuerpos en deseables e indeseables, en función de la forma en que se presentan en carteles para la difusión de orgías brasileñas disponibles para su visualización en Internet. En este artículo,apuntamos a una discusión interseccional del deseo sexual, género, raza y clase, a partir de las imágenes en circulación en contextos de bareback brasileños.


Subject(s)
Humans , HIV , Masculinity , Racism , Sexual and Gender Minorities , Health Risk Behaviors , Sexual Behavior , Unsafe Sex , Gender Identity
2.
Nursing (Säo Paulo) ; 25(290): 8137-8150, julho.2022.
Article in English, Portuguese | LILACS, BDENF | ID: biblio-1379898

ABSTRACT

Objetivo: analisar as percepções de mães adolescentes com HIV/Aids sobre a gestação e a transmissão vertical. Método: Estudo de revisão integrativa de literatura. As bases de informação utilizadas foram: Biblioteca Virtual de Saúde (BVS), Web of Science, PubMed e Science Direct, reunindo artigos do recorte temporal de 2012 a 2020. O período de coleta de dados se deu entre outubro de 2021 a dezembro de 2021. Resultados: Elencaram-se dois artigos que relataram a condição biopsicossocial da gestante adolescente, associada ao medo, insegurança, incapacidade e culpabilização. Os resultados foram agrupados em categorias, a saber: a maternidade sob ótica da adolescente soropositiva e a transmissão vertical do HIV durante a gestação na adolescência. Conclusão: Espera-se que a temática possa ser explorada a fim de contribuir para a assistência voltada para o público estudado e minimizar os riscos da transmissão vertical.(AU)


Objective: to analyze the perceptions of adolescent mothers with HIV/AIDS about pregnancy and vertical transmission. Method: Study of integrative literature review. The information bases used were: Virtual Health Library (VHL), Web of Science, PubMed and Science Direct, gathering articles from the time frame from 2012 to 2020. The data collection period took place between October 2021 and December 2021. Results: Two articles were reported on the biopsychosocial condition of pregnant adolescents, associated with fear, insecurity, disability and guilt. The results were grouped into categories, that is: maternity from the perspective of hiv-positive adolescents and vertical transmission of HIV during pregnancy in adolescence. Conclusion: It is expected that the theme can be explored in order to contribute to the assistance aimed at the studied public and minimize the risks of vertical transmission.(AU)


Objetivo: analizar las percepciones de las madres adolescentes con VIH/SIDA sobre el embarazo y la transmisión vertical. Método: Estudio de la revisión integradora de la literatura. Las bases de información utilizadas fueron: Biblioteca Virtual en Salud (BVS), Web of Science, PubMed y Science Direct, recopilando artículos del marco de tiempo de 2012 a 2020. El período de recolección de datos tuvo lugar entre octubre de 2021 y diciembre de 2021. Resultados: Se reportaron dos artículos sobre la condición biopsicosocial de adolescentes embarazadas, asociada con miedo, inseguridad, discapacidad y culpa. Los resultados se agruparon en categorías, es decir: maternidad desde la perspectiva de las adolescentes seropositivas y transmisión vertical del VIH durante el embarazo en la adolescencia. Conclusión: Se espera que el tema pueda ser explorado con el fin de contribuir a la asistencia dirigida al público estudiado y minimizar los riesgos de transmisión vertical.(AU)


Subject(s)
Pregnancy in Adolescence , HIV , Infectious Disease Transmission, Vertical
3.
Arq. ciências saúde UNIPAR ; 26(2): 187-192, maio-ago. 2022.
Article in Portuguese | LILACS | ID: biblio-1372977

ABSTRACT

O vírus da imunodeficiência humana é o agente etiológico da AIDS, doença crônica que destrói o sistema imunológico e é caracterizada pela baixa contagem de células TCD4, alta contagem de partículas virais no sangue e manifestações clínicas da doença. O diagnóstico se dá com o aparecimento de infecções oportunistas, que levam a contagem de TCD4 a níveis menores que 200 céls/mm³. Os exames laboratoriais para o diagnóstico do HIV foram os principais avanços para o início do tratamento, reduzindo a transmissão. Detecção de anticorpos, detecção de antígenos e amplificação do genoma do vírus são alguns dos exames laboratoriais utilizados para diagnóstico. Os dois principais biomarcadores são os exames de contagem de células TCD4, que verifica o sistema imune, e a quantificação de carga viral, que informa a quantidade de partículas virais, mostrando a progressão da infecção. Quanto maior a carga viral, maior o dano ao sistema imune. Uma carga viral indetectável é inferior a 50 cópias/mL, mas valores menores ou iguais a 200 cópias/mL também impedem a transmissão. Uma declaração de consenso afirma que Indetectável é igual a Intransmissível. Portanto, quando indetectável, a transmissão inexiste. O presente estudo relata e discute o caso clínico de uma paciente diagnosticada com HIV/AIDS aos 28 anos, que sobreviveu, apesar do diagnóstico tardio, e sob presença de doença oportunista com um grave grau de diminuição de células TCD4 (22 cél/mm³). Por meio do diagnóstico, introdução e adesão correta da terapia antirretroviral e monitorização de exames laboratoriais, conseguiu evitar a morte e ter uma vida semelhante à de um HIV negativo. Ultrapassou a expectativa de vida que na descoberta era de 10 anos, com uma qualidade de vida considerável, não sendo transmissora do vírus, diminuindo assim o estigma e preconceito. O biomédico é peça fundamental nesse contexto, considerando que deve fornecer informações precisas e fidedignas, tão necessárias ao acompanhamento de pessoas vivendo com HIV, para que autoridades e profissionais de saúde adotem medidas adequadas, tanto na prevenção, quanto no diagnóstico e monitoramento da doença.


The human immunodeficiency virus is the etiological agent of AIDS, a chronic disease that destroys the immune system and is characterized by low TCD4 cell count, high viral particle count in blood and clinical manifestations of the disease. The diagnosis is due to the appearance of opportunistic infections, which lead to TCD4 counts below 200 cells / mm³. Laboratory tests for the diagnosis of HIV were the main advances in starting treatment, reducing transmission. Antibody detection, antigen detection and virus genome amplification are some of the laboratory tests used for diagnosis. The two main biomarkers are the TCD4 cell count tests, which checks the immune system, and viral load quantification, which reports the number of viral particles, showing the progression of infection. The higher the viral load, the greater the damage to the immune system. An undetectable viral load is less than 50 copies / mL, but values less than or equal to 200 copies / mL also prevent transmission. A consensus statement states that Undetectable equals Non-Transmissible. Therefore, when undetectable, transmission does not exist. The present study reports and discusses the clinical case of a patient diagnosed with HIV / AIDS at age 28, who survived despite late diagnosis and under the presence of opportunistic disease with a severe degree of TCD4 cell reduction (22 cells / mm³). Through the diagnosis, introduction and correct adherence of antiretroviral therapy and monitoring of laboratory tests, she was able to avoid death and have a life similar to that of an HIV negative. Exceeded the life expectancy that in the discovery was 10 years, with a considerable quality of life, not transmitting the virus, thus reducing the stigma and prejudice. The biomedical is a key player in this context, considering that he must provide accurate and reliable information, which is so necessary for the monitoring of people living with HIV, so that authorities and health professionals adopt appropriate measures, both in prevention, diagnosis and monitoring of the disease.


Subject(s)
Humans , Female , Adult , HIV Infections/drug therapy , HIV , Toxoplasmosis/virology , AIDS-Associated Nephropathy/virology , Acquired Immunodeficiency Syndrome , AIDS-Related Opportunistic Infections , Viral Load , Cryptococcosis/drug therapy , Antiretroviral Therapy, Highly Active , Fever/virology , Headache/virology , Anemia/virology , Meningitis/virology
4.
Espaç. saúde (Online) ; 23: 1-10, maio 2022. ilus
Article in Portuguese | LILACS | ID: biblio-1369151

ABSTRACT

Este estudo pretende conhecer, com base na revisão integrativa da literatura, os fatores associados à vulnerabilidade de idosos ao HIV/Aids. Para tal, foi realizada uma busca de artigos nas bases de dados SciELO, LILACS e Medline via PubMed, utilizando-se os descritores controlados "HIV" (HIV); "Idoso" (Aged); e "Vulnerabilidade em Saúde" (Vulnerable Populations). Foram selecionados ao final 14 artigos, cuja análise evidenciou a conformidade do conhecimento dividido em três categorias temáticas principais. O estudo da literatura evidenciou que os principais fatores associados à vulnerabilidade de idosos ao HIV/Aids foram a não utilização do preservativo, a falta de conhecimento da doença e a invisibilidade da sexualidade do idoso perante a sociedade, influenciando na abordagem dos profissionais de saúde e no contexto das ações de saúde em geral.


Based on an integrative literature review, this study intends to know the factors associated with the vulnerability of elderly people to HIV/Aids. Thus, a search for articles was performed in the SciELO, LILACS and Medline databases via PubMed, using the controlled descriptors "HIV"; "Aged" and "Vulnerable Populations". At the end, 14 articles were selected, whose analysis showed the conformity of knowledge divided into three main thematic categories. The study of the literature showed that the main factors associated with the vulnerability of the elderly to HIV/AIDS were the non-use of condoms, the lack of knowledge about the disease, and the invisibility of the elderly's sexuality in society, influencing the approach of health professionals and the context of health actions in general.


partir de una revisión integradora de la literatura, este estudio pretende conocer los factores asociados a la vulnerabilidad de los ancianos al VIH / SIDA. Se realizó una búsqueda de artículos en las bases de datos SciELO, LILACS y Medline vía PubMed, utilizando los descriptores controlados "HIV" (HIV); "Anciano" (Anciano); y "Vulnerabilidad en salud" (Poblaciones vulnerables). Al final, se seleccionaron 14 artículos, cuyo análisis mostró la conformidad de conocimientos divididos en tres categorías temáticas principales. La literatura mostró que los principales factores asociados a la vulnerabilidad de las personas mayores al VIH / SIDA fueron la falta de uso de condones, el desconocimiento de la enfermedad y la invisibilidad de la sexualidad de las personas mayores en la sociedad, influyendo en el abordaje de las personas mayores por profesionales de la salud y en el contexto de las acciones de salud en general.


Subject(s)
Aged , HIV , Health Vulnerability
5.
Rev. Ciênc. Plur ; 8(2): e24290, mar. 2022. ilus, tab
Article in Portuguese | LILACS, BBO | ID: biblio-1367904

ABSTRACT

Introdução:O Serviço de Assistência Especializada é um serviço responsável pela assistência ambulatorial às pessoas vivendo com HIV/AIDSe Hepatites Virais. Em meio à importância desses serviços, é primordial instituir estratégias de avaliação do seu desempenho.Objetivo:Assim, objetivou-se construir e validar um modelo lógico para o Serviço de Atenção Especializada do município de Natal.Metodologia:Para tanto, desenvolveu-se um estudo metodológico para validação de um modelo lógicoconstruído com técnicas de abordagem qualitativa. Os profissionais participaram da fase de construção e validação do modelo. Para construção do modelo lógico foram realizadas duas técnicas; revisão de literatura para uma construção prévia ao grupo focal eo grupo focal para viabilizar a construção participativa do modelo e posterior validação de conteúdo. Os dados colhidos foram analisados de forma qualitativa, buscando identificar nos discursos, a pertinência dos elementos do modelo, bem como a possível inserção de outros elementos. Resultados:O modelo construído com base na Revisão de literatura foi aprovado por consenso dos participantes, não sendo sugeridas modificações. No caso, a missão, recursos, processos, resultados, contexto foram considerados adequados e o modelo ilustrativo do funcionamento esperado. Conclusões:O modelo lógico pretende viabilizar uma auto avaliação do serviço, auxiliando a administração e os profissionais a identificarem problemas, buscando estratégias de melhoria. Espera-se que a reflexão propiciada no grupo focal possa sensibilizar os profissionais para buscar estratégias de enfrentamento das dificuldades elencadas e aprimoramento dos pontos positivos (AU).


Introduction:The Specialized Care Service is a service responsible for outpatient care for people living with HIV/AIDSand Viral Hepatitis. In the midst of the importance of these services, it is essential to institute performance evaluation strategies.Objective:Thus, the objective was to build and validate a logical model for the Specialized Care Service of the municipality of Natal.Methodology:Therefore, a methodological study was developed to validate a logical model built with qualitative approach techniques. Theprofessionals participated in the model construction and validation phase. To build the logical model, two techniques were performed; literature review for prior construction of the focus group and focus group to enable participatory model construction and subsequent content validation. The collected data were analyzed qualitatively, seeking to identify in the speeches, the pertinence of the model elements, as well as the possible insertion of other elements.Results:The model constructed based on the literature review was approved by consensus of the participants, and no modifications were suggested. In this case, the mission, resources, processes, results, context were considered adequate and the illustrative model of the expected functioning. Conclusions:The logical model aims to enable a self-assessment of the service, helping management and professionals to identify problems, seeking improvement strategies. It is hoped that the reflection provided in the focus group can sensitize professionals to seek strategies to cope with the difficulties listed and improvement of positive points (AU).


Introducción: El Servicio de Asistencia Especializada es un servicio responsable de la atención ambulatoria para personas que viven con VIH / SIDA y Hepatitis Virales. En medio de la importancia de estos servicios, es fundamental establecer estrategias para evaluar su desempeño. Objetivo: Así, el objetivo fue construir y validar un modelo lógico para el Servicio de AtenciónEspecializada del municipio de Natal. Metodología: Para ello se desarrolló un estudio metodológico para validar un modelo lógico construido con técnicas de enfoque cualitativo. Profesionales participaron en la fase de construcción y validación del modelo. Se utilizaron dos técnicas para construir el modelo lógico; revisión de la literatura para una construcción previa al focus group y al focus group que posibilite la construcción participativa del modelo y posterior validación de contenido. Los datos recolectados fueron analizados de manera cualitativa, buscando identificar en los discursos, la pertinencia de los elementos del modelo, así como la posible inserción de otros elementos.Resultados: El modelo construido a partir de la revisión de la literatura fue aprobado por consenso de los participantes, sin que se sugirieran modificaciones. En este caso se consideró adecuado la misión, recursos, procesos, resultados, contexto y el modelo ilustrando el funcionamiento esperado. Conclusiones: El modelo lógico pretende posibilitar una autoevaluación del servicio, ayudando a la dirección y profesionales a identificar problemas, buscando estrategias de mejora. Se espera que la reflexión brindada en el grupo focal pueda sensibilizar a los profesionales para buscar estrategias para enfrentar las dificultades enumeradas y mejorar los puntos positivos (AU).


Subject(s)
Humans , Male , Female , Health Evaluation , HIV , Health Strategies , Basic Health Services , Hepatitis , Organization and Administration , Brazil , Focus Groups , Qualitative Research , Ambulatory Care , Persons
6.
J. coloproctol. (Rio J., Impr.) ; 42(1): 63-67, Jan.-Mar. 2022. tab, ilus
Article in English | LILACS | ID: biblio-1375759

ABSTRACT

Objectives: To compare morphological abnormalities on anal colposcopy against histology to determine anal high-grade squamous intraepithelial lesions (HSILs). Methods: This is a retrospective data assessment of HIV-negative and HIV-positive patients undergoing outpatient follow-up. The sample comprised 54 patients presenting acetowhite lesions on anal colposcopy. Acetowhite lesions were classified according to their morphology into punctation, verrucous, mosaic, ulcerated, or hypervascularized, and biopsies of these specimens were classified as anal HSIL, low-grade squamous intraepithelial lesion (LSIL), or normal. The data were analyzed using SPSS forWindows version 13.0 (SPSS Inc., Chicago, IL, USA). The results were analyzed using the nonparametric Mann-Whitney test, the Fisher exact test and the chi-squared parametric test. A 95% confidence interval (CI) was used and a level of significance <5% was adopted for all statistical tests. Results Fifty-four patients (50 males, 80% HIV+) with biopsied acetowhite lesions were assessed. There were 31 punctation lesions, 1 classified as HSIL (3.2%; 95%CI: 0- 40.0), 17 verrucous lesions, 3 HSIL (17.7%; 95%CI: 0-10.7), and 1 ulcerated, classified as HSIL (100%), and 4 mosaic and 1 atypical vessel lesion, all classified as LSIL. The results showed no association of presence of anal HSIL with positivity for HIV infection or with counts above or below 500/µl in HIV+patients. Statistical analysis was performed using the Mann-Whitney nonparametric test, the Fisher exact test, and the chi-squared parametric test. Conclusion: The comparison of morphological findings on anal colposcopy against histology revealed no morphological pattern suggesting anal HSIL. (AU)


Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Anal Canal , Carcinoma in Situ/ultrastructure , Condylomata Acuminata , Papillomaviridae , Colonoscopy , HIV , CD4 Lymphocyte Count
7.
RECIIS (Online) ; 16(1): 104-119, jan.-mar. 2022. ilus
Article in Portuguese | LILACS | ID: biblio-1366548

ABSTRACT

O presente artigo busca analisar postagens na rede social digital Twitter que contêm os termos 'HIV/aids' e 'covid-19' publicadas em abril de 2021, quando o Ministério da Saúde amplia a vacinação contra a covid-19 para pessoas com HIV/aids. Nosso objetivo foi o de comparar os dois acontecimentos epidemiológicos do país, evidenciar paralelos, subjetividades e lições a partir do corpus. Para tanto, optamos por um método quantiqualitativo de análise de redes semânticas baseada na coleta de conteúdos digitais, identificandose os pares ou o conjunto de palavras que mais se conectam, formando redes de significações análogas, denominadas clusters. Como resultado, identificamos a polarização político-partidária dos comentários sobre covid-19 e HIV/aids no Twitter, a reemergência dos estigmas associados a grupos específicos, como de homossexuais e asiáticos, o espalhamento em larga escala de desinformação sobre as duas doenças, revelando um campo de tensões e de disputas narrativas e midiáticas como ferramenta 'necropolítica'.


This article seeks to analyze posts on the digital social network Twitter containing the terms 'HIV/aids' and 'covid-19' published in April 2021, when the Ministry of Health expands vaccination against covid-19 for people with HIV/aids. Our objective was to compare the two epidemiological events in the country, highlighting parallels, subjectivities and lessons from the corpus. In order to do that, we chose a quanti-qualitative method of analysis of semantic networks based on the collection of digital content, identifying the pairs or sets of words that most connect, forming networks of analogous meanings, called clusters. As a result, we identified the political-partisan polarization of comments on covid-19 and HIV/aids on Twitter, the re-emergence of stigmas associated with specific groups, such as homosexuals and Asians, the largescale spread of misinformation about the two diseases, revealing a field of tensions and narrative and media disputes as a 'necropolitical' tool.


Este artículo busca analizar publicaciones em la red social digital Twitter que contienen los términos 'VIH/sida' y 'covid-19' publicados en abril de 2021, cuando el Ministerio de Salud amplía la vacunación contra covid-19 para personas con VIH/sida. Nuestro objetivo fue comparar los dos eventos epidemiológicos en el país, destacando paralelos, subjetividades y lecciones del corpus. Por ello, optamos por un método cuanticualitativo de análisis de redes semánticas basado en la recolección de contenido digital, identificando los pares o conjuntos de palabras que más conectan, formando redes de significados análogos, llamados clusters. Como resultado, identificamos la polarización político-partidista de los comentarios sobre el covid-19 y el VIH/sida en Twitter, el resurgimiento de estigmas asociados con grupos específicos, como los homosexuales y los asiáticos, la difusión a gran escala de información errónea sobre las dos enfermedades, revelando un campo de tensiones y disputas narrativas y mediáticas como herramienta 'necropolítica'.


Subject(s)
Humans , HIV , Communication , Social Media , Semantic Web , COVID-19/immunology , Vaccination , Access to Information , Social Discrimination
8.
Nursing (Säo Paulo) ; 25(285): 7134-7150, fev.2022.
Article in English, Portuguese | LILACS, BDENF | ID: biblio-1371971

ABSTRACT

Objetivo: analisar as evidências na literatura nacional e internacional acerca das barreiras de acesso à saúde de adolescentes que vivem com o vírus da imunodeficiência humana e/ou Síndrome da Imunodeficiência Adquirida. Método: revisão integrativa sem restrição de anos de publicações, conduzida nas bases Science Direct, Web of Science, CINAHL, Scopus, PubMed, LILACS, Biblioteca Virtual em Saúde, EMBASE e MEDLINE. Utilizou-se duas estratégias de busca com os descritores: Adolescent, Health Services Accessibility, Acquired Immunodeficiency Syndrome e HIV. Resultados: identificaram-se 7.371 estudos, destes selecionaram-se 92 para leitura na íntegra, e quatro artigos compuseram a amostra final. As principais barreiras de acesso foram, medo do reconhecimento, falta de empatia no atendimento e pouca flexibilidade de horários dos serviços. Conclusão: o medo, estigma e a discriminação interferem no acesso aos serviços de saúde de adolescentes negativamente na vida dos jovens em questão, prejudicando-os na sua proteção e na possibilidade de se manterem saudáveis.(AU)


Objective: to analyze the evidence in the national and international literature about barriers to accessing health care for adolescents living with the human immunodeficiency virus and/or Acquired Immunodeficiency Syndrome. Methods: integrative review without restriction of years of publications, conducted in Science Direct, Web of Science, CINAHL, Scopus, PubMed, LILACS, Virtual Health Library, EMBASE and MEDLINE databases. Two search strategies were used with the descriptors: Adolescent, Health Services Accessibility, Acquired Immunodeficiency Syndrome and HIV. Results: 7371 studies were identified, 92 were selected for full reading, and four articles made up the final sample. The main barriers to access were fear of recognition, lack of empathy in care and little flexibility in service hours. Conclusion: fear, stigma and discrimination interfere with access to health services for adolescents negatively in the lives of the young people in question harming them in their protection and in the possibility of staying healthy.(AU)


Objetivo: analizar la evidencia en la literatura nacional e internacional sobre las barreras de acceso a la atención de salud de los adolescentes que viven con el virus de la inmunodeficiencia humana y / o el síndrome de inmunodeficiencia adquirida. Métodos: revisión integradora sin restricción de años de publicaciones, realizada en las bases de datos Science Direct, Web of Science, CINAHL, Scopus, PubMed, LILACS, Virtual Health Library, EMBASE y MEDLINE. Se utilizaron dos estrategias de búsqueda con los descriptores: Adolescente, Accesibilidad a los Servicios de Salud, Síndrome de Inmunodeficiencia Adquirida y HIV. Resultados: Se identificaron 7371 estudios, se seleccionaron 92 para lectura completa y cuatro artículos conformaron la muestra final. Las principales barreras de acceso fueron el miedo al reconocimiento, la falta de empatía en la atención y la poca flexibilidad en los horarios de atención. Conclusión: el miedo, el estigma y la discriminación interfieren negativamente en el acceso a los servicios de salud de los adolescentes en la vida de los jóvenes en cuestión, perjudicando su protección y la posibilidad de mantenerse saludables(AU)


Subject(s)
Adolescent , Acquired Immunodeficiency Syndrome , HIV , Health Services Accessibility
9.
Säo Paulo med. j ; 140(1): 94-100, Jan.-Feb. 2022. tab
Article in English | LILACS | ID: biblio-1357456

ABSTRACT

ABSTRACT BACKGROUND: Studies that test associations between anthropometric indicators and insulin resistance (IR) need to provide better evidence in the context of the pediatric population (children and adolescents) with human immunodeficiency virus (HIV), as anthropometric indicators present a better explanation of the distribution of body fat. OBJECTIVE: To test the associations between anthropometric indicators and insulin resistance (IR) among children and adolescents diagnosed with HIV. DESIGN AND SETTING: Cross-sectional study on 65 children and adolescents (8-15 years) infected with HIV through vertical transmission conducted at the Joana de Gusmão Children's Hospital, Florianópolis, Brazil. METHODS: The anthropometric indicators measured were the abdominal (ASF), triceps (TSF), subscapular (SSF) and calf (CSF) skinfolds. The relaxed arm (RAC), waist (WC) and neck (NC) circumferences were also measured. Body mass index (BMI) was calculated from the relationship between body mass and height. IR was calculated through the Homeostasis Model Assessment for Insulin Resistance (HOMA-IR). Simple and multiple linear regression analyses were used. RESULTS: After adjustment for covariates (sex, bone age, CD4+ T lymphocytes, CD8+ T lymphocytes, viral load, and physical activity), associations between IR and models with SSF and CSF remained. Each of these explained 20% of IR variability. For females, in the adjusted analyses, direct associations between IR and models with ASF (R² = 0.26) and TSF (R² = 0.31) were observed. CONCLUSIONS: SSF and CSF in males and ASF and TSF in females were associated with IR in HIV-infected children and adolescents.


Subject(s)
Humans , Male , Female , Child , Adolescent , Insulin Resistance , HIV Infections , Body Mass Index , Anthropometry , Cross-Sectional Studies , HIV , Waist Circumference
11.
San Salvador; MINSAL; ene. 06, 2022. 37 p. ilus, graf.
Non-conventional in Spanish | LILACS, BISSAL | ID: biblio-1359275

ABSTRACT

La presente guía clínica para la atención de las personas con coinfección TB/VIH, es el resultado de un esfuerzo multidisciplinario, en el que se aborda un problema de salud pública tan importante como es la coinfección TB/VIH. La intersección y la interacción entre las epidemias del virus de inmunodeficiencia humana (VIH) y tuberculosis (TB) han tenido consecuencias mortales en todo el mundo. Sin un control adecuado de la TB/VIH, no se alcanzará el objetivo de eliminación de la tuberculosis a largo plazo. Existe una necesidad urgente de recursos adicionales y enfoques novedosos para el diagnóstico, el tratamiento y la prevención tanto del VIH como de la tuberculosis. Además, serán necesarios enfoques multidisciplinarios que consideren el VIH y la tuberculosis juntos, en lugar de como problemas y enfermedades separados, para prevenir un mayor empeoramiento de la sindemia del VIH-TB


This clinical guideline for the care of people with TB/HIV coinfection is the result of a multidisciplinary effort, in which a public health problem as important as TB/HIV coinfection is addressed. The intersection and interaction between the human immunodeficiency virus (HIV) and tuberculosis (TB) epidemics have had deadly consequences around the world. Without adequate TB/HIV control, the long-term goal of tuberculosis elimination will not be achieved. There is an urgent need for additional resources and novel approaches for the diagnosis, treatment and prevention of both HIV and tuberculosis. In addition, multidisciplinary approaches that consider HIV and TB together, rather than as separate problems and diseases, will be necessary to prevent further worsening of the HIV-TB syndemic.


Subject(s)
Tuberculosis , HIV , Guideline , Coinfection , Viruses , Disease , Epidemics
13.
Rev. Eugenio Espejo ; 16(1): 71-80, 20220111.
Article in Spanish | LILACS | ID: biblio-1353012

ABSTRACT

La tuberculosis continúa siendo un problema de salud pública. Al respecto, se realizó un estudio no experimental de corte transversal, con el objetivo de caracterizar clínica y epidemiológica-mente el estado de la TB resistente a medicamentos de primera línea en la ciudad de Durán, desde enero 2015 hasta diciembre 2019. Los datos incluidos en los documentos de la matriz del programa de tuberculosis resistente. De 1111 casos nuevos de tuberculosis reportados en el cantón Durán durante el período estudiado, 45 de estos presentaron resistencia a medicamentos de primera línea. El 88,89% tuvo resistencia a rifampicina, el 33,33% de los pacientes se dispen-sarizaron en 2019. Los valores de chi cuadrado de Pearson no mostraron asociación estadística-mente significativa entre las variables investigadas (p>0,05). Entre los involucrados predominó el grupo de edades de 20 a 39 años, el sexo masculino, la tuberculosis pulmonar, infectados con VIH/sida, resistencia clasificada como primaria, los que abandonaron el seguimiento al trata-miento y la no manifestación de reacciones adversas a los medicamentos. No se observó mortali-dad entre los casos nuevos, predominando entre aquellos con recaída, el género masculino y los que tuvieron tuberculosis extrapulmonar.


Tuberculosis is a disease that continues to be a public health problem. In this regard, a non-expe-rimental cross-sectional study was carried out to characterize clinically and epidemiologically the status of TB resistant to first-line drugs in the city of Durán, from January 2015 to December 2019. The data included in the resistant tuberculosis program matrix documents. 1111 new cases of tuberculosis were reported in the Duran canton during the study period, 45 of these ones presented resistance to first-line drugs. 88.89% had rifampicin resistance, 33.33% of the patients were dispensed in 2019. Pearson's chi-square values did not show a statistically significant asso-ciation between the investigated variables (p> 0.05). Among the study population, it was predo-minated the age group between 20 and 39, male sex, pulmonary tuberculosis, infected with HIV / AIDS, resistance classified as primary, those who abandoned the follow-up to treatment and the non-manifestation of adverse drug reactions. No mortality was observed among new cases, predominantly among those ones with relapse, the male gender and those ones who had extra-pulmonary tuberculosis


Subject(s)
Humans , Male , Female , Adult , Patients , Tuberculosis , Drug Resistance , Therapeutics , Epidemiologic Factors , HIV
14.
Psico USF ; 27(1): 45-60, jan.-mar. 2022. tab, graf
Article in Portuguese | LILACS, INDEXPSI | ID: biblio-1376048

ABSTRACT

Dentre os fatores associados à adesão à Terapia Antirretroviral (TARV) em pessoas vivendo com HIV, destaca-se a religiosidade/espiritualidade (R/E). O objetivo deste estudo foi apresentar as evidências disponíveis sobre a relação entre a dimensão da R/E e a adesão aos antirretrovirais. Realizou-se uma revisão integrativa de literatura com buscas nas bases/bibliotecas CINAHL, LILACS, PePSIC, PsycINFO, PubMed, SciELO, Scopus e Web of Science. Foram selecionados artigos empíricos publicados entre janeiro de 2008 e junho de 2019, sendo recuperados 49 estudos após a aplicação dos critérios de inclusão/exclusão. Encontraram-se associações positivas, negativas e neutras entre R/E e adesão à TARV, evidenciando que a R/E é uma dimensão psicossocial que pode ser preditora da adesão aos antirretrovirais. O sentido dessa influência, no entanto, ainda não é um consenso na literatura científica. Recomenda-se que essas influências sejam compreendidas a partir de elementos contextuais dessa população e não apenas de marcadores pessoais (AU).


Religiosity and spirituality (R/S) have stood out among factors associated with adherence to antiretroviral therapy (ART) in people living with HIV. This study aimed to identify evidence on the relationship between R/S and adherence to ART. An integrative literature review was conducted within the CINAHL, LILACS, PePSIC, PsycINFO, PubMed, SciELO, Scopus, and Web of Science databases. Empirical articles published between January 2008 and June 2019 were selected, and 49 studies were retrieved after applying the inclusion/exclusion criteria. Positive, negative, and neutral associations were found between R/S and adherence to ART, showing that R/S is a psychosocial dimension that can be a predictor of adherence to antiretrovirals. The meaning of this influence, however, is not yet a consensus in the scientific literature. It is recommended that these influences be understood from the contextual elements of this population and not just from personal markers (AU).


Entre los factores asociados a la adherencia a la Terapia Antirretroviral (TARV) en personas diagnosticadas con VIH, destaca la religiosidad/espiritualidad (R/E). El objetivo de este estudio fue presentar las evidencias disponibles sobre la relación entre la dimensión de la R/E y la adherencia a los antirretrovirales. Se realizó una revisión integradora de la literatura con búsquedas en las bases de datos/bibliotecas CINAHL, LILACS, PePSIC, PsycINFO, PubMed, SciELO, Scopus y Web of Science. Se seleccionaron artículos empíricos publicados entre enero de 2008 y junio de 2019, y se recuperaron 49 estudios tras aplicar los criterios de inclusión/exclusión. Fueron encontradas asociaciones positivas, negativas y neutras entre la R/E y la adherencia al TARV, lo que demuestra que la R/E es una dimensión psicosocial que puede ser un predictor de la adherencia a los medicamentos antirretrovirales. Sin embargo, el significado de esta influencia aún no está consensuado en la literatura científica. Se recomienda que estas influencias se entiendan a partir de los elementos contextuales de esta población y no solo de los marcadores personales (AU).


Subject(s)
HIV , Antiretroviral Therapy, Highly Active , Anti-Retroviral Agents , Medication Adherence , Religion , Religion and Medicine , Spirituality
15.
Acta sci., Health sci ; 44: e56764, Jan. 14, 2022.
Article in English | LILACS | ID: biblio-1367790

ABSTRACT

The aim of this study was to investigate possible factors related to antiretroviral therapy (ART) that contribute to the understanding of the highest rate of Aids detection on the coast of the state of Paraná, a port region identified administratively as the 1stRegional Health Division (1stHD) in the state of Paraná. Data on the sociodemographic profile of the population undergoing antiretroviral treatment (ART), medication changes, dropout of therapy, proportion of the population undergoing treatment and viral load were obtained through computerized systems. Between July 1, 2018 and June 31, 2019, 1,393 people were on ART in the 1stRS. Of these, 57.6% were male. During this period, 110 people started ART with a predominance of the age group between 30 and 39 years old. ART was switched for169 people and 211 patient dropouts were detected. The proportion of people diagnosed with HIV without treatment (gap) is still high, however 92.7% people on ART have suppressed viral load. It can be concluded that the lower educational level of the population undergoing treatment, the late diagnosis of those infected and the treatment gapprobably contribute to the highest rate of Aids detection in the 1stRS.


Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Acquired Immunodeficiency Syndrome/epidemiology , Pharmacoepidemiology/methods , Anti-Retroviral Agents/therapeutic use , Sociodemographic Factors , Population , Acquired Immunodeficiency Syndrome/diagnosis , Acquired Immunodeficiency Syndrome/therapy , HIV/pathogenicity , Viral Load , Delivery of Health Care
16.
Acta sci., Health sci ; 44: e53630, Jan. 14, 2022.
Article in English | LILACS | ID: biblio-1367783

ABSTRACT

The aim of this study was to investigate adverse reactions to Dolutegravir, a drug recently made available by the Unified Health System (SUS) for treating HIV infections. The frequency, severity and sex distribution of adverse reactions to Dolutegravir were identified over the first 18 months of its availability in users in the state of Paraná. Information was obtained through the pharmacovigilance questionnaire prepared by the Ministry of Health, accessed through the Logistics Control System for Medicines(SICLOM). During the study period, dolutegravirwas dispensed to 9,865 patients in the state. However, 9,207 users (93.3%) answered the pharmacovigilance questionnaire. Among them, 1.75% reported 279 adverse reactions. This population was composed mainly of male people (69.57%), in the ratio of 2.29 men for each woman, white (67.08%), aged between 20 and 29 years (26.71%), single (45.34%) and with education between 8 and 11 years of study (41.61%). Gastrointestinal (36.92%) and nervous system (14.34%) disorders were the most prevalent. 77.78% adverse reactions were considered non-serious by users. It can be concluded that dolutegravirhad a low prevalence of adverse reactions in users in the state of Paraná, demonstrating to be safe for use by the population in therapy against HIV, in accordance with clinical trials.


Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Anti-Retroviral Agents/adverse effects , Anti-Retroviral Agents/toxicity , Anti-Retroviral Agents/therapeutic use , Anti-Retroviral Agents/pharmacology , Pharmacovigilance , Unified Health System , Pharmaceutical Preparations , HIV Infections/drug therapy , HIV/drug effects , Gastrointestinal Tract/drug effects , Nervous System/drug effects
17.
Rev. bras. promoç. saúde (Impr.) ; 35(1): 1-9, 20220125.
Article in English, Portuguese | LILACS | ID: biblio-1377782

ABSTRACT

Objetivo: Analisar as repercussões do diagnóstico do Vírus da Imunodeficiência Humana (HIV) e as perspectivas acerca do tratamento em pessoas atendidas em um centro de testagem e aconselhamento. Métodos: Realizou-se uma pesquisa qualitativa, por meio da análise de narrativas de 28 pessoas que vivem com HIV atendidas em um centro de testagem e aconselhamento de Pinheiro, Maranhão, Brasil. Durante o período de fevereiro a junho de 2019, aplicaram-se entrevistas semiestruturadas contendo questões sociodemográficas, sobre o diagnóstico e o tratamento. Resultados: Os impactos pós-diagnóstico e as pespectivas sobre o tratamento apresentaram-se como as categorias emergentes das análises. As narrativas demonstraram as formas como o diagnóstico do HIV pode refletir na vida do indivíduo, principalmente quanto às questões social e econômica e quanto ao enfrentamento de estigmas e preconceitos relativos à infecção. A terapia antirretroviral, ainda que importante para a manutenção da saúde, pode sofrer empecilhos devido aos desafios que acometem os participantes da pesquisa. Conclusão: O afastamento de familiares e amigos, o sentimento de exclusão, a maior preocupação com a saúde e a dificuldade de obter renda representam as maiores repercussões no pós-diagnóstico. assim, o tratamento é considerado uma medida de promoção à saúde e impedimento de avanço da infecção, podendo ser afetado por diversas questões, dentre elas a financeira.


Objective: To analyze the repercussions of Human Immunodeficiency Virus (HIV) diagnosis and the perspectives on the treatment in people attending a testing and counseling center. Methods: A qualitative research was carried out using analysis of narratives of 28 people living with HIV treated at a testing and counseling center in Pinheiro, Maranhão, Brazil. From February to June 2019, semi-structured interviews were carried out using sociodemographic questions about diagnosis and treatment. Results:Post-diagnosis impact and treatment perspectives were categories that emerged from the analyses. The narratives showed the ways in which the HIV diagnosis can reflect on the individual's life, especially regarding social and economic issues and the confrontation of stigma and prejudice related to the infection. Although important for the maintenance of health, antiretroviral therapy can face obstacles due to the challenges that affect the research participants. Conclusion: Distancing from family and friends, the feeling of exclusion, the greater concern with health and the difficulty in earning an income represent the greatest repercussions after diagnosis. Thus, treatment is considered a measure to promote health and prevent the progress of infection, but it can be affected by several issues, including financial ones.


Objetivo: Analizar las repercusiones del diagnóstico del Virus de la Inmunodeficiencia Humana (VIH) y las perspectivas del tratamiento de personas asistidas en un centro de pruebas para el diagnóstico y consejería. Métodos: Se realizó una investigación cualitativa a través del análisis de narrativas de 28 personas que tienen el VIH y que son asistidas en un centro de pruebas de diagnóstico y consejería de Pinheiro, Maranhão, Brasil. Se aplicaron entrevistas semiestructuradas con preguntas sociodemográficas, el diagnóstico y el tratamiento durante el período entre febrero y junio de 2019. Resultados: Los impactos posdiagnóstico y las perspectivas sobre el tratamiento se presentaron como las categorías emergentes de los análisis. Las narrativas demostraron las formas como el diagnóstico de VIH puede influenciar en la vida del individuo, en especial sobre los aspectos social y económico y sobre el enfrentamiento de los estigmas y perjuicios de la infección. La terapia antirretroviral, aunque sea importante para la manutención de la salud, puede tener objeciones debido a los desafíos que acometen los participantes de la investigación. Conclusión: El alejamiento de los familiares y los amigos, el sentimiento de exclusión, mayor preocupación con la salud y la dificultad de una renta representan las mayores repercusiones del pos diagnóstico. De esa manera, se considera el tratamiento como una medida de promoción de la salud y barrera para el avanzo de la infección que puede ser afectado por distintos aspectos, entre ellos, el financiero.


Subject(s)
Acquired Immunodeficiency Syndrome , HIV , Psychosocial Impact , Qualitative Research , Diagnosis
18.
Afr. j. lab. med. (Print) ; 11(1): 1-8, 2022.
Article in English | AIM | ID: biblio-1378699

ABSTRACT

Background: Pancytopenia is a manifestation of numerous disease entities. The causes of pancytopenia differ with geographic region, socio-economic factors and HIV prevalence. Awareness of the common causes of pancytopenia may aid timely diagnosis. Objective: This study aimed to determine the aetiology of pancytopenia in a South African population.Methods: A retrospective observational study of adult patients presenting with pancytopenia at Tygerberg Academic Hospital, South Africa, from January 2016 to December 2017 was performed. Data on pancytopenia cases were obtained from the laboratory information system and utilised to determine the causes of pancytopenia. Results: A total of 673 cases of pancytopenia were identified. The most common causes of pancytopenia were chemoradiation therapy (25%), sepsis (18%), haematological malignancy (9%), advanced HIV (7%), and megaloblastic anaemia (6%). The diagnostic yield of bone marrow examinations (BME) was 57% (n = 52/91). The aetiology of pancytopenia differed according to age, with malignancy being a more common cause of pancytopenia among the elderly. Conclusion: Several easily recognisable and treatable conditions can manifest as pancytopenia. Prompt management of such conditions, notably sepsis and megaloblastic anaemia, can result in the resolution of the cytopenias and negate the need for a BME. However, haematological malignancy and unexplained pancytopenia strongly rely on a BME to establish a diagnosis. Pancytopenia investigations, when guided by appropriate clinic-laboratory findings, can promptly identify the underlying aetiology, while also identifying cases where an expedited BME is required. This is valuable in resource-conscious medicine


Subject(s)
Humans , Male , Female , Pancytopenia , Anemia, Megaloblastic , Aging , HIV , Sepsis , Afibrinogenemia , Malnutrition , Neoplasms
19.
Afr. j. lab. med. (Print) ; 11(1): 1-7, 2022. tables, figures
Article in English | AIM | ID: biblio-1378853

ABSTRACT

Background: Early diagnosis and confirmation of HIV infection in newborns is crucial for expedited initiation of antiretroviral therapy. Confirmatory testing must be done for all children with a reactive HIV PCR result. There is no comprehensive data on confirmatory testing and HIV PCR test request rejections at National Health Laboratory Service laboratories in South Africa.Objective: This study assessed the metrics of routine infant HIV PCR testing at the Tygerberg Hospital Virology Laboratory, Cape Town, Western Cape, South Africa, including the proportion of rejected test requests, turn-around time (TAT), and rate of confirmatory testing.Methods: We retrospectively reviewed laboratory-based data on all HIV PCR tests performed on children ≤ 24 months old (n = 43346) and data on rejected HIV PCR requests (n = 1479) at the Tygerberg virology laboratory over two years (2017­2019). Data from sample collection to release of results were analysed to assess the TAT and follow-up patterns.Results: The proportion of rejected HIV PCR requests was 3.3%; 83.9% of these were rejected for various pre-analytical reasons. Most of the test results (89.2%) met the required 96-h TAT. Of the reactive initial test results, 53.5% had a follow-up sample tested, of which 93.1% were positive. Of the initial indeterminate results, 74.7% were negative on follow-up testing.Conclusion: A high proportion of HIV PCR requests were rejected for pre-analytical reasons. The high number of initial reactive tests without evidence of follow-up suggests that a shorter TAT is required to allow confirmatory testing before children are discharged.


Subject(s)
Early Diagnosis , Infant , Polymerase Chain Reaction , HIV , Aftercare , Clinical Laboratory Techniques , Diagnostic Techniques and Procedures , Antiretroviral Therapy, Highly Active
20.
Afr. j. lab. med. (Print) ; 11(1): 1-9, 2022. tables, figures
Article in English | AIM | ID: biblio-1379112

ABSTRACT

Background: The Northern Cape is South Africa's largest province with an HIV prevalence of 7.1% versus a 13.5% national prevalence. CD4 testing is provided at three of five National Health Laboratory Service district laboratories, each covering a 250 km precinct radius. Districts without a local service report prolonged CD4 turn-around times (TAT).Objective: This study documented the impact of a new CD4 laboratory in Tshwaragano in the remote John Taolo Gaetsewe district of the Northern Cape, South Africa.Methods: CD4 test volumes and TAT (total, pre-analytical, analytical, and post-analytical) data for the Northern Cape province were extracted for June 2018 to October 2019. The percentage of CD4 results within the stipulated 40-h TAT cut-off and the median and 75th percentiles of all TAT parameters were calculated. Pre-implementation, samples collected at Tshwaragano were referred to Kimberley or Upington, Northern Cape, South Africa.Results: Pre-implementation, 95.4% of samples at Tshwaragano were referred to Kimberley for CD4 testing (36.3% of Kimberley's test volumes). Only 7.5% of Tshwaragano's total samples were referred post-implementation. The Tshwaragano laboratory's CD4 median total TAT decreased from 24.7 h pre-implementation to 12 h post-implementation (p = 0.003), with >95.0% of results reported within 40 h. The Kimberley laboratory workload decreased by 29.0%, and testing time significantly decreased from 10 h to 4.3 h.Conclusion: The new Tshwaragano CD4 service significantly decreased local TAT. Upgrading existing community laboratories to include CD4 testing can alleviate provincial service load and improve local access, TAT and efficiency in the centralised reference laboratory


Subject(s)
Humans , Male , Female , HIV , Hospitals, District , Operations Research , CD4 Antigens , Allergy and Immunology , Exercise Test , Laboratories
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