Transactional sex and risky sexual practices in Jamaica.

BACKGROUND: Transactional sex relationships (TSRs) create financial and emotional support for men and women, as well as an increased sexual risk. Studies have reported high HIV and STI transmission rates among young women in transactional sex relationships. However, little is known about TSR prevalence in Jamaica and risky sexual practices among participants. This study investigates the sexual behaviour of Jamaicans in TSR. METHODS: Secondary data analysis of a national survey revealed that 586 participants (38%) self-reported being in at least one TSR in the last 12 months. We also identified a third category called "Benefluids", who play both roles of benefactor and beneficiary in transactional sex relationships. RESULTS: 59 percent of male Benefluids had two to five transactional sex relationship partners in the last 12 months, compared to 40% of female Benefluids. Twenty-eight percent of female Benefluids reported sexually transmitted infection symptoms in the last 12 months compared to 13.5% of male Benefluids. While females reported more sexually transmitted infection symptoms, young men had the highest sexual risk precursors. CONCLUSIONS: People in transactional sex relationships often play the role of beneficiaries and benefactors to meet material and sexual needs but this increases the risk of STI symptoms.

Trajectories of adolescents living with vertical transmission-HIV virus. / Trajetórias de adolescentes que vivem com o vírus HIV por transmissão vertical.

This study analyzes the life stories of eight young people living with vertically transmitted HIV in order to understand their perceptions marked by secrecy and silence regarding their experiences with the virus. Conducted at a specialized outpatient clinic in Rio de Janeiro, the study adopted circle dance, a Complementary and Integrative Health Practice, as a care tool. Using a qualitative approach and Life History as a data collection method, the focus was to understand the youth's experiences related to the disease and the crucial aspects of their lives. Three girls and five boys participated in the study, all aware of their diagnosis. The principal emerging themes included family dynamics, school environment connection, challenges in treatment adherence, age at the time of diagnosis disclosure, and time elapsed since then. Analyzing these young people's narratives allowed us to explore individual and social aspects of their experiences, revealing their similarities and differences. The circle dance workshops provided a playful space for expressing emotions and feelings through body movements, expanding young people's perspectives on the future.

Este estudo analisa as histórias de vida de oito jovens vivendo com HIV por transmissão vertical, visando compreender suas percepções marcadas pelo segredo e silêncio sobre suas vivências com o vírus. Realizado em ambulatório especializado no Rio de Janeiro, o estudo adotou como ferramenta de cuidado a dança circular, considerada uma Prática Integrativa e Complementar em Saúde. Utilizando abordagem qualitativa e a História de Vida como método de coleta, o foco foi compreender as experiências dos jovens, não apenas relacionadas à doença, mas também a aspectos cruciais de suas vidas. Participaram do estudo três meninas e cinco meninos, todos cientes de seu diagnóstico. Os principais temas emergentes incluíram dinâmica familiar, conexão com o ambiente escolar, desafios na adesão ao tratamento, idade no momento da revelação do diagnóstico e tempo decorrido desde então. A análise das narrativas desses jovens, permitiu explorar aspectos individuais e sociais da experiência, revelando similaridades e diferenças entre eles. As oficinas de dança circular ofereceram um espaço lúdico para a expressão de emoções e sentimentos por meio dos movimentos corporais, ampliando as perspectivas dos jovens em relação ao futuro.

Interventions to prevent mother-to-child transmission in breastfeeding mothers with HIV: a systematic review and meta-analysis of randomized controlled trials.

This study aimed to systematically review interventions to prevent mother-to-child transmission of HIV during breastfeeding. We conducted a systematic review and meta-analysis using specific criteria to identify randomized controlled trials that focused on pregnant and breastfeeding women living with HIV and their children from birth to 2 years of age. We extensively searched electronic databases, including Web of Science, Scopus, PubMed, MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, and Google Scholar up to October 24, 2023. After screening 3,110 titles and abstracts, we reviewed 306 full texts. Of these, we assessed the quality and risk of bias of fifty-five articles, ultimately identifying seven studies. Four of these studies, which focused on antiretroviral therapy (ART), were included in the meta-analysis. There was little heterogeneity in study methodology and pooled estimates. The postnatal HIV transmission rate was found to be 0.01 (95%CI: 0.00 - 0.02). Therefore, the risk of mother-to-child transmission among breastfeeding mothers with HIV was significantly lower in the intervention groups than in the placebo groups. Analysis of funnel plots and Egger's test (p = 0.589) showed no evidence of publication bias. In addition to the four articles, two studies compared different ART regimens and one study compared the administration of high-dose vitamin A to the mother or the child. The results suggest that the use of ART significantly reduces the risk of postnatal HIV transmission compared with placebo. However, the effectiveness of different ART regimens or other therapies, including high-dose vitamin A, is unclear.

HIV acute infection and long-term undisclosed HIV status among blood donors from the highly endemic Amazonas state, located in the Brazilian Amazon.

BACKGROUND: The Amazonas state/AM and Manaus rank among the highest AIDS detection rates in Brazil. High proportion of HIV infected blood donors and transmission clusters of multidrug antiretroviral/ARV resistant viruses were described in HEMOAM blood donors, a main Amazonas public blood bank. Recent and long-term infections among previously genotyped donors are reported. METHODS/MATERIALS: The recency immunoassay Lag Avidity EIA (Maxim, USA) was employed. Clinical/CD4/viral load medical file data of the main local HIV management center (FMT-HVD) and ARV treatment/ART data were reviewed. RESULTS: Among 142 HIV-blood donors, chronic infection predominated (n = 87; 61.3 %), 79 based on LAg EIA and 8 undisclosed HIV identified in FMT-HVD records, mostly young adult, single males, 4 repeat donors, all ART-naive. Recent infections represented 30.3 % (n = 43), 39 identified by LAg EIA and 4 immunologic windows (antibody negative/NAT/RNA positive). The overall profile of recent and long-term infections was similar, including moderate rate of transmitted drug resistance/TDR, however with multiple resistance mutations to more than one ARV-class, suggesting ART/failure. DISCUSSION: Recent/acute and undisclosed/long-term HIV infections represent blood safety alerts suggesting test-seeking behavior of at-risk populations. Early ART use in Brazil, can turn HIV diagnosis more challenging representing a blood transfusion risk in the highly endemic Brazilian Amazon.

HIV in pregnant woman and children: Mother-to-child transmission of HIV in the Brazilian land border from 2010 to 2021.

OBJECTIVE: The aim of the present study was to analyze the profile and trends of HIV mother-to-child transmission (MTCT) in the Brazilian land border strip (LBS). METHODS: This was a quantitative, ecological, and cross-sectional study using secondary data available in the information systems of the Brazilian Ministry of Health. All cases reported in the Notifiable Diseases Information System between 2010 and 2021 were studied. RESULTS: Between 2010 and 2021, 275 children were born infected through MTCT, and 6076 pregnant women were living with HIV in the Brazilian LBS. HIV detection rates in pregnant women increased in all border arcs. The northern arc experienced the highest increase (19.6%), followed by the central arc (11.4%), and the southern arc (6.1%). Despite historically high detection rates, the southern arc exhibited the smallest increase. While MTCT rate decreased by 37.7% in the border area, the central arc showed no statistically significant reduction. In 2021, the average age of pregnant women was 26.2 years, 25.7% had up to 8 years of schooling, and 55.8% identified as non-white. The majority (92.8%) received antenatal care, and 59.7% were diagnosed with HIV before prenatal care. The use of prophylactic antiretroviral therapy during prenatal care occurred in 69.6% of pregnant women, and infant prophylaxis was provided within first 24 h to 43.6% of live births. CONCLUSION: The results indicate progress in reducing MTCT cases in Brazilian LBS. Disparities in HIV detection rates may be influenced by differences in testing uptake, despite mandatory testing for all babies. It is crucial to continue implementing strategies to reach these women and ensure equitable access to healthcare services for MTCT prevention.

Perceived risk for HIV acquisition and sexual HIV exposure among sexual and gender minorities: a systematic review.

We conducted a systematic review to explore the relationship between perceived risk for HIV acquisition and sexual HIV exposure among sexual and gender minorities. We included 39 studies divided into (i) correlations or associations, (ii) models using sexual HIV exposure as the outcome, and (iii) models using perceived risk for HIV acquisition as the outcome. The sample size range was from 55 to 16,667 participants, primarily cisgender men who have sex with men (73.3%) and White (51.3%). Sexual HIV exposure and perceived risk for HIV acquisition assessments and recall time frames across studies differed markedly. Most of studies (84.6%) found significant correlations, comparisons, or associations between different levels of perceived risk for HIV acquisition and high sexual HIV exposure. In addition, 51.3% of studies reported other variables associated with high sexual HIV exposure (i.e., misuse of substances or alcohol) or with high perceived risk for HIV acquisition (i.e., younger age). In conclusion, the association between perceived risk for HIV acquisition and sexual HIV exposure has shown to be consistent. However, the assessment for perceived risk for HIV acquisition should include more components of perception (i.e., an affective component), or for sexual HIV exposure should consider the different estimated sexual per-acts probability of acquiring HIV.

Dynamics and features of transmission clusters of HIV-1 subtypes in the state of São Paulo, Brazil.

Background: Molecular epidemiology techniques allow us to track the HIV-1 transmission dynamics. Herein, we combined genetic, clinical and epidemiological data collected during routine clinical treatment to evaluate the dynamics and characteristics of transmission clusters of the most prevalent HIV-1 subtypes in the state of São Paulo, Brazil. Methods: This was a cross-sectional study conducted with 2,518 persons living with HIV (PLWH) from 53 cities in São Paulo state between Jan 2004 to Feb 2015. The phylogenetic tree of protease/reverse transcriptase (PR/RT) regions was reconstructed by PhyML and ClusterPicker used to infer the transmission clusters based on Shimodaira-Hasegawa (SH) greater than 90% (phylogenetic support) and genetic distance less than 6%. Results: Of a total of 2,518 sequences, 2,260 were pure subtypes at the PR/RT region, being B (88%), F1 (8.1%), and C (4%). About 21.2% were naïve with a transmitted drug resistance (TDR) rate of 11.8%. A total of 414 (18.3%) of the sequences clustered. These clusters were less evident in subtype B (17.7%) and F1 (15.1%) than in subtype C (40.2%). Clustered sequences were from PLWH at least 5 years younger than non-clustered among subtypes B (p < 0.001) and C (p = 0.037). Men who have sex with men (MSM) predominated the cluster in subtype B (51%), C (85.7%), and F1 (63.6%; p < 0.05). The TDR rate in clustered patients was 15.4, 13.6, and 3.1% for subtypes B, F1, and C, respectively. Most of the infections in subtypes B (80%), C (64%), and F1 (59%) occurred within the state of São Paulo. The metropolitan area of São Paulo presented a high level of endogenous clustering for subtypes B and C. The São Paulo city had 46% endogenous clusters of subtype C. Conclusion: Our findings showed that MSM, antiretroviral therapy in Treatment-Naive (ART-naïve) patients, and HIV1-C, played an important role in the HIV epidemic in the São Paulo state. Further studies in transmission clusters are needed to guide the prevention intervention.

Situación epidemiológica de VIH a nivel global y nacional: Puesta al día / Epidemiological situation of HIV at global and national level: update

INTRODUCCIÓN: En las cuatro décadas de la epidemia por VIH, se han observado avances notables que han contribuido a una disminución progresiva en la incidencia de nuevas infecciones y en la mortalidad a nivel mundial. Sin embargo, no ha ocurrido lo mismo en Latinoamérica y en Chile. OBJETIVO: Esta revisión tiene como objetivo conocer la epidemiología actual a nivel global, latinoamericano y chileno. METODOLOGÍA: Se analizaron los informes epidemiológicos oficiales de infección por VIH emitidos por organismos nacionales e internacionales, más los estudios epidemiológicos nacionales. RESULTADOS: Se estima que 39 millones de personas viven con VIH en el mundo; no obstante, la mortalidad y la incidencia de nuevos casos han disminuido de forma notoria durante las últimas dos décadas, asociado a una expansión en al acceso a terapia antirretroviral en forma global. A diferencia del resto del mundo, América Latina presenta una tendencia de alza en las nuevas infecciones y Chile registra un aumento de 35% en nuevos casos durante los últimos 10 años, coincidiendo con un aumento en los flujos de migrantes que ha afectado a la región. Algunas estrategias preventivas como la profilaxis pre exposición se han implementa-do a un ritmo lento, tanto a nivel mundial, como latinoamericano. CONCLUSIONES: La epidemiología del VIH presenta características propias regionales y nacionales. En particular en Chile, diversos factores incluyendo déficit en políticas públicas de prevención y los recientes flujos migratorios han modelado nuestra actual epidemia. El desafío presente debe contemplar los esfuerzos multisectoriales para lograr los objetivos de ONUSIDA en esta década.

BACKGROUND: Over the course of the last four decades of global HIV epidemic, significant improvements have contributed to gradually reduce the frequency of new infections and global mortality rates. However, in Latin America particularly in Chile, new infections continue increasing. AIM: This review aims to comprehend the_epidemiology today on a worldwide, Latin American, and Chilean scale. METHODS: National epidemiology studies and official HIV reports from international and national organizations were reviewed. RESULTS: It is estimated that 39 million people live with HIV worldwide; however, mortality and the incidence of new cases have decreased markedly over the last two decades, associated with an expansion in access to antiretroviral therapy globally. In contrast to the rest of the world, Latin America shows an upward trend in new infections, with Chile registering a 35% increase in new cases over the last 10 years, coinciding with an increase in migratory flows that has occurred throughout the region. Some preventive strategies, such as pre-exposure prophylaxis, have been implemented at a slow pace, both globally and in Latin America. CONCLUSIONS: The epidemiology of HIV has regional and national characteristics. Specifically in Chile, several factors, including deficits in public prevention policies and recent migratory flows, have shaped our current epidemic. The present challenge must contemplate multisectoral efforts to achieve the UNAIDS objectives during this decade.

Investigation of Presumptive HIV Transmission Associated with Receipt of Platelet-Rich Plasma Microneedling Facials at a Spa Among Former Spa Clients - New Mexico, 2018-2023.

HIV transmitted through cosmetic injection services via contaminated blood has not been previously documented. During summer 2018, the New Mexico Department of Health (NMDOH) was notified of a diagnosis of HIV infection in a woman with no known HIV risk factors who reported exposure to needles from cosmetic platelet-rich plasma microneedling facials (vampire facials) received at a spa in spring 2018. An investigation of the spa's services began in summer 2018, and NMDOH and CDC identified four former spa clients, and one sexual partner of a spa client, all of whom received HIV infection diagnoses during 2018-2023, despite low reported behavioral risks associated with HIV acquisition. Nucleotide sequence analysis revealed highly similar HIV strains among all cases. Although transmission of HIV via unsterile injection practices is a known risk, determining novel routes of HIV transmission among persons with no known HIV risk factors is important. This investigation identified an HIV cluster associated with receipt of cosmetic injection services at an unlicensed facility that did not follow recommended infection control procedures or maintain client records. Requiring adequate infection control practices and maintenance of client records at spa facilities offering cosmetic injection services can help prevent the transmission of HIV and other bloodborne pathogens and ensure adequate traceback and notification in the event of adverse clinical outcomes, respectively.

Raltegravir 100 mg granulado para profilaxia da transmissão vertical do HIV em crianças com alto risco de exposição ao HIV / Raltegravir 100 mg granules for transmission prophylaxis vertical of HIV in children at high risk of exposure to HIV

INTRODUÇÃO: A transmissão materna ou transmissão vertical do HIV é um importante fator contribuinte para a pandemia do HIV. O vírus do HIV pode ser transmitido de uma mulher vivendo com HIV para seu bebê durante a gravidez, trabalho de parto ou parto, ou após o parto através da amamentação. Sem tratamento, a infecção pelo HIV em lactentes e crianças pequenas resulta em mortalidade precoce ou cria uma condição crônica vitalícia que aumenta muito a morbidade, reduz a expectativa de vida, impõe um grande fardo à criança e à família e contribui para perdas humanas, sociais e econômicas. PERGUNTA: O uso do medicamento raltegravir 100 mg granulado é eficaz e seguro para a profilaxia da transmissão vertical do HIV em crianças com alto risco de exposição ao HIV? EVIDÊNCIAS CLÍNICAS: Das 417 referências identificadas nas quatro bases científicas consultadas, apenas um estudo contribuiu para a análise do uso de raltegravir 100 mg granulado em crianças expostas ao HIV por transmissão vertical. Este estudo não foi realizado para mensurar a eficácia, contudo nenhum dos neonatos incluídos em qualquer uma das duas coortes foi diagnosticado com HIV. O raltegravir granulado foi bem tolerado e apenas um evento adverso encontrado foi possivelmente associado a ele. O estudo demonstrou que foi possível formular um regime de raltegravir granulado que pode ser administrado de maneira segura em neonatos expostos ao HIV: 1,5 mg/kg diariamente até o sétimo dia de vida; 3 mg/kg duas vezes ao dia de oito a 28 dias de vida; e 6 mg/kg duas vezes ao dia de quatro a seis semanas de vida. No entanto, considerando as características dos participantes incluídos no estudo, o raltegravir granulado não é recomendado para prematuros ou para recém-nascidos com menos de 2 kg. De acordo com o sistema GRADE, a qualidade da evidência foi considerada muito baixa para os desfechos segurança e tolerabilidade. AVALIAÇÃO ECONÔMICA: Foi construído um modelo de árvore de decisão do raltegravir 100 mg granulado (RAL) comparado à nevirapina (NVP), para profilaxia da transmissão vertical do HIV em recém-nascidos de alto risco, com idade gestacional igual ou maior a 37 semanas. A perspectiva adotada foi a do SUS e o horizonte temporal foi de quatro semanas (tempo de duração da profilaxia). O custo incremental da profilaxia com raltegravir foi de R$ 1.088,62. Considerando os parâmetros utilizados, principalmente a maior resistência encontrada à nevirapina, a profilaxia com raltegravir se apresentou como mais efetiva e a razão de custo-efetividade incremental (ICER) resultou em R$ 6.538,26 por caso evitado de infecção pelo HIV em neonato no cenário base. Os resultados de benefício monetário líquido (NMB) encontrados foram de R$ 32.824,68 para raltegravir e R$ 27.930,00 para a nevirapina. ANÁLISE DE IMPACTO ORÇAMENTÁRIO: Foi realizada análise do impacto orçamentário com a simulação da incorporação do esquema contendo raltegravir 100 mg granulado, na perspectiva do SUS, considerado um horizonte temporal de 5 anos, comparado ao esquema contendo nevirapina 10 mg/ml para a profilaxia da transmissão vertical do HIV em crianças com alto risco de exposição ao HIV. Considerando um market share de 100% logo no primeiro ano de incorporação, o gasto total estimado para a compra do medicamento raltegravir 100 mg granulado em um horizonte temporal de 5 anos seria de R$ 6.028.223,73. Foi estimado que o uso do novo esquema de profilaxia contendo raltegravir 100 mg granulado em substituição ao esquema anterior contendo nevirapina, resultará em um impacto orçamentário incremental total de R$ 6.098.699,79 em 5 anos. RECOMENDAÇÕES INTERNACIONAIS: Foram consultadas as agências internacionais de ATS National Institute for Health and Care Excellence (NICE), Canadian Agency for Drugs and Technologies in Health (CADTH), Pharmaceutical Benefits Advisory Committee (PBAC) e Scottish Medicines Consortium (SMC) sobre o raltegravir granulado de 100 mg. Contudo, não foram encontrados documentos para a apresentação de interesse. MONITORAMENTO DO HORIZONTE TECNOLÓGICO: No horizonte considerado nesta análise, não foram detectadas tecnologias potenciais para profilaxia da transmissão vertical do HIV em crianças com alto risco de exposição ao vírus. CONSIDERAÇÕES FINAIS: Os dados disponíveis até o momento sobre o uso de raltegravir 100 mg granulado na profilaxia da transmissão vertical do HIV em crianças expostas de alto risco são provenientes de ensaio clínico de fase 1, não comparativo, sem grupo controle, que demonstrou que o raltegravir granulado foi bem tolerado e que pode ser administrado de maneira segura em neonatos expostos ao HIV. Por outro lado, este estudo não foi realizado para mensurar a eficácia. Na avaliação econômica, a profilaxia com raltegravir se apresentou mais efetiva e a ICER resultou em R$ 6.538,26 por caso evitado de infecção pelo HIV em neonato no cenário base. Os resultados de benefício monetário líquido encontrados foram de R$ 32.824,68 para raltegravir e R$ 27.930,00 para a nevirapina. Já a análise do impacto orçamentário, considerando um market share de 100% no primeiro ano de incorporação, apontou que o gasto total estimado para a compra do medicamento raltegravir 100 mg granulado em um horizonte temporal de 5 anos seria de R$ 6.028.223,73. Foi estimado que o uso do novo esquema de profilaxia contendo raltegravir 100 mg granulado, em substituição ao esquema anterior contendo nevirapina, resultará em um impacto orçamentário incremental total de R$ 6.098.699,79 em 5 anos. PERSPECTIVA DO PACIENTE: Foi aberta chamada pública nº 06/2023, no período entre 13/02/2023 e 26/02/2023, para interessados em participar da Perspectiva do Paciente para este tema. Entretanto, não houve inscrições. RECOMENDAÇÃO PRELIMINAR DA CONITEC: O Plenário da Conitec, em sua 116ª Reunião Ordinária, no dia 15 de março de 2023, deliberou que a matéria fosse disponibilizada em Consulta Pública com recomendação preliminar favorável à incorporação de raltegravir 100 mg granulado para profilaxia da transmissão vertical do HIV em crianças com alto risco de exposição ao HIV no SUS. Os membros da Conitec consideraram que apesar da escassez de evidências disponíveis no momento, trata-se de uma população pouco estudada em ensaios clínicos e com uma necessidade de saúde relacionada à alta resistência que atualmente se tem com o uso da alternativa disponível no SUS, a nevirapina. Dessa forma, entendeuse que a incorporação da apresentação farmacêutica granulada do raltegravir seria apropriada para essa faixa etária dos pacientes atendidos no SUS. CONSULTA PÚBLICA: Foi realizada entre 19/04/2023 e 08/05/2023 a Consulta Pública nº 12/2023. Foram recebidas três contribuições, todas concordantes com a recomendação preliminar, sendo uma técnico-científica e duas sobre experiência ou opinião. A única contribuição técnico-científica foi enviada por pessoa física e profissional de saúde. Foi anexado um documento elaborado pela Comissão de Farmácia e Terapêutica da Secretaria Estadual de Saúde de Minas Gerais, que sugeriu um período mais longo para implementação do protocolo de HIV nos estados e municípios, considerando a logística da distribuição e dispensação do novo medicamento. Não foram recebidas informações adicionais sobre evidências clínicas, avaliação econômica e impacto orçamentário. As duas contribuições de experiência e opinião foram enviadas por pessoas físicas, sendo uma de familiar, amigo ou cuidador de paciente e a outra de profissional de saúde, sem nenhum documento anexado. Citou-se os seguintes potenciais benefícios com raltegravir granulado: melhor profilaxia para recém-nascidos de alto risco; maior facilidade de administração; maior barreira genética; apresentação farmacêutica que melhora a adesão ao tratamento. Por fim, considerou-se que as contribuições recebidas na CP estiveram alinhadas com a recomendação preliminar da Conitec, não justificando mudança de entendimento sobre o tema. RECOMENDAÇÃO FINAL DA CONITEC: Os membros do Comitê de Medicamentos presentes na 119ª Reunião Ordinária da Conitec, realizada no dia 31 de maio de 2023, deliberaram por unanimidade, recomendar a incorporação do raltegravir 100 mg granulado para profilaxia da transmissão vertical do HIV em crianças com alto risco de exposição ao HIV no SUS. Os membros mantiveram o entendimento que culminou na recomendação inicial sobre o tema. Assim, foi assinado o Registro de Deliberação nº 828/2023. DECISÃO: Incorporar, no âmbito do Sistema Único de Saúde - SUS, o raltegravir 100 mg granulado para profilaxia da transmissão vertical do HIV em crianças com alto risco de exposição ao HIV, publicada no Diário Oficial da União nº 126, seção 1, página 118, em 5 de julho de 2023.

Vulnerability of the young university population to HIV/AIDS and other sexually transmitted infections

Introduction: Brazilian universities receive annually thousands of young people who experience situations of vulnerability to the human immunodeficiency virus, sexually transmitted infections, and viral hepatitis. Objective: The aim of the present study was to analyze the secondary data obtained from the attendance record of the rapid testing campaign for these health problems at a federal university in the state of Minas Gerais, Brazil, in 2019. Methods: A cross-sectional study was conducted with secondary data of students (n=1,113) obtained from the standard attendance form by the Ministry of Health during the campaigns Fique Sabendo (Be Aware) in the period between November 25 and 29, 2019. Analyses were performed with the support of the Statistical Package for Social Sciences program, with the calculation of absolute and relative frequencies. Pearson's chi-square test (5%) was used for comparison. Results: The results revealed a young, heterosexual, white profile. More than half reported having consumed alcohol and drugs in their lives. Other findings were the non-use of condoms with steady partners (18.1%) and occasional partners (21.3%), oral sex (86.8%), and unprotected sex in the last intercourse (45.6%). Most declared never being tested for human immunodeficiency virus (74.5%), syphilis (67.4%), hepatitis B (76.1%), or hepatitis C (77.0%). Conclusion: The university population is vulnerable to human immunodeficiency virus and other sexually transmitted infections due to the number of sexual partners and discontinued use of condoms with occasional partners. Such vulnerability is increased by the use of alcohol and other drugs

Phylodynamics of HIV in the Mexico City Metropolitan Region.

Evolutionary analyses of viral sequences can provide insights into transmission dynamics, which in turn can optimize prevention interventions. Here, we characterized the dynamics of HIV transmission within the Mexico City metropolitan area. HIV pol sequences from persons recently diagnosed at the largest HIV clinic in Mexico City (between 2016 and 2021) were annotated with demographic/geographic metadata. A multistep phylogenetic approach was applied to identify putative transmission clades. A data set of publicly available sequences was used to assess international introductions. Clades were analyzed with a discrete phylogeographic model to evaluate the timing and intensity of HIV introductions and transmission dynamics among municipalities in the region. A total of 6,802 sequences across 96 municipalities (5,192 from Mexico City and 1,610 from the neighboring State of Mexico) were included (93.6% cisgender men, 5.0% cisgender women, and 1.3% transgender women); 3,971 of these sequences formed 1,206 clusters, involving 78 municipalities, including 89 clusters of ≥10 sequences. Discrete phylogeographic analysis revealed (i) 1,032 viral introductions into the region, over one-half of which were from the United States, and (ii) 354 migration events between municipalities with high support (adjusted Bayes factor of ≥3). The most frequent viral migrations occurred between northern municipalities within Mexico City, i.e., Cuauhtémoc to Iztapalapa (5.2% of events), Iztapalapa to Gustavo A. Madero (5.4%), and Gustavo A. Madero to Cuauhtémoc (6.5%). Our analysis illustrates the complexity of HIV transmission within the Mexico City metropolitan area but also identifies a spatially active transmission area involving a few municipalities in the north of the city, where targeted interventions could have a more pronounced effect on the entire regional epidemic. IMPORTANCE Phylogeographic investigation of the Mexico City HIV epidemic illustrates the complexity of HIV transmission in the region. An active transmission area involving a few municipalities in the north of the city, with transmission links throughout the region, is identified and could be a location where targeted interventions could have a more pronounced effect on the entire regional epidemic, compared with those dispersed in other manners.

HIV knowledge and its correlation with the Undetectable = Untransmittable slogan in Brazil

ABSTRACT Knowledge about HIV transmission and prevention is a necessary step for adopting preventive behaviors. We assessed HIV knowledge and its correlation with the perceived accuracy of the "Undetectable = Untransmittable" (U=U) slogan in an online sample with 401 adult Brazilians. Overall, 28% of participants showed high HIV knowledge level. The perceived accuracy of the U=U slogan significantly correlated with HIV knowledge. Younger participants, those reporting lower income or lower education, or who had never tested for HIV showed poorer HIV knowledge. Filling gaps of knowledge among specific populations is urgent in order to increase preventive behaviors and decrease HIV stigma.

Tendência temporal e distribuição espacial dos casos de transmissão vertical do HIV em Santa Catarina, 2007-2017: um estudo ecológico / Tendencia temporal y distribución espacial de los casos de transmisión vertical del VIH en el estado de Santa Catarina, Brasil, 2007-2017: un estudio ecológico / Temporal trend and spatial distribution of cases of mother-to-child transmission of HIV in the state of Santa Catarina, Brazil, 2007-2017: an ecological study

Objetivo: Analisar a tendência temporal e a distribuição espacial dos casos de transmissão vertical do HIV, Santa Catarina, 2007-2017. Métodos: Estudo ecológico misto, com dados do Sistema de Informação de Agravos de Notificação. Realizou-se regressão linear para análise de série temporal; calcularam-se as taxas médias no período e variações percentuais médias anuais das taxas de gestantes infectadas pelo HIV, de crianças expostas ao HIV na gestação e de soroconversão das crianças expostas ao HIV/aids na gestação, além do geoprocessamento dos dados. Resultados: Foram registradas 5.554 gestantes infectadas pelo HIV, com taxa de 5,6 gestantes/1 mil nascidos vivos. A taxa média de soroconversão foi de 13,5/100 mil nascidos vivos (IC95% 6,8;20,1) e apresentou tendência decrescente (APC = -99,4%; IC95% -99,9;-93,1). A taxa de soroconversão foi mais elevada em municípios de pequeno porte. Conclusão: A taxa de gestantes infectadas pelo HIV foi estável; houve diminuição de crianças infectadas com HIV por via vertical.

Objetivo: Estimar la tendencia temporal y la distribución de casos de VIH por transmisión vertical en Santa Catarina, 2007-2017. Métodos: Estudio ecológico mixto con datos del Sistema de Información de Enfermedades de Declaración Obligatoria. Se utilizó la regresión lineal para análisis de series temporales y se calcularon las tasas medias en el período y los cambios porcentuales medios anuales en las tasas de mujeres embarazadas infectadas por el VIH; de niños expuestos al VIH; y seroconversión de niños expuestos al VIH/SIDA durante el embarazo, además del geoprocesamiento de datos Resultados: Había 5.554 gestantes infectadas por el VIH, con tasa de 5,6 gestantes/1.000 nacidos vivos. La tasa media de seroconversión fue 13,5/100.000 de nacidos vivos (IC95% 6,8;20,1) y mostró tendencia decreciente (APC = -99,4%; IC95%-99,9;-93,1). La tasa de seroconversión fue más expresiva en los municipios pequeños. Conclusão: Hubo una tasa estable de mujeres embarazadas infectadas por el VIH, mientras que el número de niños infectados por el VIH disminuyó.

Objective: To analyze the temporal trend and spatial distribution of mother-to-child HIV transmission in Santa Catarina between 2007 and 2017. Methods: This was a mixed ecological study with data from the Notifiable Health Conditions Information System. Linear regression was performed for time series analysis and the mean rates in the period and mean annual percentage changes in the rates of HIV-infected pregnant women were calculated, children exposed to HIV during pregnancy, and seroconversion of children exposed to HIV/AIDS during pregnancy, in addition to data geoprocessing. Results: There were 5,554 records of HIV-infected pregnant women, with a rate of 5.6 pregnant women per 1,000 live births. The mean seroconversion rate was 13.5/100,000 live births (95%CI 6.8;20.1) and it showed a falling trend (APC = -99.4%; 95%CI -99.9;-93.1). The seroconversion rate was more expressive in small towns. Conclusion: The rate of HIV-infected pregnant women was stable in the period, whereas the number of children infected with HIV through mother-to-child transmission decreased.

Representações sociais de adolescentes sobre a transmissão do HIV/AIDS nas relações sexuais: vulnerabilidades e riscos / Representaciones sociales de adolescentes sobre la transmisión del VIH/AIDS en relaciones sexuales: vulnerabilidades y riesgos / Social representations of adolescents about HIV/AIDS transmission in sexual relations: vulnerabilities and risks

RESUMO Objetivo compreender as representações sociais de adolescentes sobre vulnerabilidades e riscos para contrair o HIV/Aids nas relações sexuais. Método estudo de representações sociais, realizado a partir de entrevistas individuais com 15 adolescentes e grupo focal com oito adolescentes de uma escola pública do Recife, Pernambuco, Brasil. Os dados foram coletados no período de maio a outubro de 2016. Para tratamento dos dados, empregou-se a técnica de análise de conteúdo temática-categorial com o auxílio do Software QSR Nvivo11. Resultados as categorias: riscos de contrair HIV/Aids nas relações sexuais; e dos riscos de contrair HIV/Aids nas relações sexuais às vulnerabilidades abrigam os temas não usar preservativo, ter usado álcool e/ou drogas, ter vários parceiros, ter dificuldades de acesso aos serviços de saúde e de educação sexual nas escolas; e não ter conversas com os pais ou familiares. Conclusão e implicações para a prática compreendeu-se que as representações sociais circulam no imaginário e no ambiente escolar, interferindo na realidade dos adolescentes. Propõe-se priorizar políticas públicas focadas nas dimensões emocionais, afetivas e sociais.

RESUMEN Objetivo comprender las representaciones sociales de adolescentes acerca de las vulnerabilidades y riesgos de contraer el VIH/SIDA en relaciones sexuales. Método estudio de representaciones sociales realizado a partir de entrevistas individuales con 15 adolescentes y un grupo focal con ocho adolescentes de una escuela pública en Recife, Pernambuco, Brasil. Los datos se recolectaron entre mayo y octubre de 2016. Para el tratamiento de los datos, se utilizó la técnica de análisis de contenido temático-categórico, con la ayuda del software QSR Nvivo11. Resultados las categorías riesgos de contraer el VIH/SIDA en las relaciones sexuales; y de los riesgos de contraer el VIH/SIDA en las relaciones sexuales a las vulnerabilidades que cubren los temas de no usar condón, haber consumido alcohol y/o drogas, tener varios pares, tener dificultades para acceder a los servicios de salud y de educación sexual en las escuelas; y no tener conversaciones con los padres o miembros de la familia. Conclusión e implicaciones para la práctica se entendió que las representaciones sociales circulan en el imaginario y en el ámbito escolar, interfiriendo en la realidad de los adolescentes. Se propone priorizar políticas públicas enfocadas en las dimensiones emocionales, afectivas y sociales.

ABSTRACT Objective To understand social representations of adolescents about vulnerabilities and risks of contracting HIV/AIDS in sexual relations. Method Study of social representations, based on individual interviews with 15 adolescents and a focus group with eight adolescents from a public school in Recife, Pernambuco, Brazil. Data were collected from May to October 2016. For the processing of data, the thematic-categorial content analysis technique was used with the aid of the QSR Nvivo11 Software. Results The categories: risks of contracting HIV/AIDS in sexual relations; and from the risks of contracting HIV/AIDS in sexual relations to the vulnerabilities cover the themes of not using condoms, having used alcohol and/or drugs, having several partners, having difficulties in accessing health and sex education services in schools; and not having conversations with parents or family members. Conclusion and implications for practice it was understood that social representations circulate in the imaginary and in the school environment, interfering in the reality of adolescents. It is proposed to prioritize public policies focused on the emotional, affective and social dimensions.

Prevalence and risk factor analysis for HIV/HTLV 1/2 coinfection in Paraíba state, Brazil.

INTRODUCTION: Human T-lymphotropic virus (HTLV) 1 and 2 infections can lead to neurological diseases, mainly in HIV/HTLV 1 coinfected. Furthermore, HTLV 1 infection in HIV/AIDS patients has also been associated with AIDS progression. Despite this, HTLV 1/2 infections are not of mandatory notification in Brazil. Here, we describe the prevalence of HTLV 1/2 in HIV/AIDS patients from Paraíba state, Brazil, as well as the sociodemographic characteristics of the coinfected individuals. METHODOLOGY: Information about HIV viral load and TCD4 lymphocyte count were obtained from patients' records. Data on the patients' sociodemographic characteristics were obtained by interview conducted after signing the informed consent form. The serological diagnosis for HTLV 1/2 was performed by Enzyme-Linked Immunosorbent Assay (ELISA) and Western Blot (WB). RESULTS: A total of 401 HIV/AIDS patients participated in the study, of whom about 1.5% (6/401) were positive for antibodies against HTLV, specifically for HTLV 1, evaluated by both ELISA and WB. No risk factors were found associated with HIV/HTLV 1/2 coinfection. CONCLUSIONS: We report a 1.5% prevalence of HTLV 1 infection in HIV/AIDS patients from Paraíba state. Although we have not identified risk factors associated with HTLV 1, we describe the most observed sociodemographic characteristics in HIV/HTLV 1 coinfection.