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1.
Nurs Inq ; : e12635, 2024 Apr 01.
Article in English | MEDLINE | ID: mdl-38558441

ABSTRACT

Our goal was to explore self-care practices among men who have sex with men in the context of Mpox in Brazil. This study used qualitative research methods, including interviews and thematic analysis, to collect and analyze data from male participants across the Brazilian territory. The narratives unveil men's perspectives on self-care, risk reduction, and health beliefs during the Mpox pandemic. Our findings highlight a multifaceted approach to self-care among men, encompassing hygiene, physical contact management, mask usage, skin lesion vigilance, and adherence to official guidelines. Men's attitudes toward sexual behaviors emphasize the importance of reducing sexual partners, practicing safe sex, and combating misinformation through accurate information dissemination. The development of these behaviors and self-care practices can be facilitated by nurses guided by Dorothea Orem's Self-Care Theory, supported by patient-centered care, with strategies to address and confront the stigma associated with the disease and provide emotional support. Thus, the study underscores the pivotal role of self-care in mitigating infection risks, especially in the context of emerging infectious diseases. It acknowledges the impact of socio-cultural factors and healthcare policies on men's preventive measures. However, it also recognizes limitations, such as potential bias due to stigma concerns and a nonrepresentative sample. Ultimately, the research advocates for tailored education, promotion of gender equity, and healthcare empowerment to effectively manage health risks in such contexts.

2.
Belitung Nurs J ; 10(1): 96-104, 2024.
Article in English | MEDLINE | ID: mdl-38425679

ABSTRACT

Background: Men's health is influenced by a complex interplay of social, economic, and cultural determinants. Understanding how these aspects affect the health of adult cisgender men in medium and high-complexity healthcare settings is essential for improving healthcare services and promoting better health outcomes. Objective: This study aimed to analyze the health status of adult cisgender men in medium and high-complexity healthcare settings based on social determinants and conditioners. Methods: This study employed a qualitative design involving 45 adult cisgender men receiving care in medium/high complexity services in Bahia, Brazil. Semi-structured interviews were conducted from July 2019 to February 2020, and data were interpreted based on Dahlgren and Whitehead's Model of Social Determinants of Health using deductive thematic analysis. Results: Proximal determinants included biological aspects, preventive behaviors, lifestyle/social life, and aging processes. Intermediate factors included work conditions, access/utilization of healthcare services/medications, and psychosocial factors. Macro determinants involved income distribution, power dynamics, resource allocation, health inequalities/iniquities, morbidity, culture, political decisions, environmental factors, and structural elements. Conclusion: The health status of men in medium/high complexity care was profoundly influenced by structural social determinants. These determinants impacted healthcare attention, service organization, cultural influences, the reproduction of hegemonic masculinity patterns, lifestyle, social support, and socioeconomic conditions necessary to realize the right to health. Nursing practices should conduct comprehensive assessments that extend beyond physical health indicators.

3.
Public Health Nurs ; 41(3): 589-601, 2024.
Article in English | MEDLINE | ID: mdl-38528749

ABSTRACT

OBJECTIVE: To understand the factors associated with the practice of chemsex among MSM in Brazil, especially during the Mpox health crisis, and to design effective prevention and intervention strategies specifically for this population. DESIGN: A cross-sectional and analytical study using an electronic survey, conducted from September to December 2022, during the peak of the Mpox outbreak in Brazil. SAMPLE: A total of 1452 MSM aged 18 and older. MEASUREMENTS: Data were collected via the REDCap platform through a survey with 46 questions. These addressed demographic data, sexual affiliations, practices, experiences with Mpox, healthcare service usage, and stigma or fear related to Mpox. RESULTS: The prevalence of chemsex was 19.42% (n = 282). Multivariate Poisson modeling indicated a high incidence of chemsex among those diagnosed with Mpox and those involved in high-risk behaviors. The practice of chemsex was six times higher among those diagnosed with Mpox (95% CI: 4.73-9.10). MSM who engage in bugchasing had a prevalence twice that of the main outcome (95% CI: 1.31-3.16). CONCLUSION: There is a significant need for targeted interventions for MSM in Brazil, especially given the Mpox outbreak. This study highlights the strong relationships between chemsex, experiences with Mpox, and various sexual behaviors, underscoring the importance of effective public health initiatives.


Subject(s)
HIV Infections , Mpox (monkeypox) , Sexual and Gender Minorities , Substance-Related Disorders , Male , Humans , Homosexuality, Male , Brazil/epidemiology , Cross-Sectional Studies , Substance-Related Disorders/epidemiology , Sexual Behavior , HIV Infections/epidemiology
4.
Rev Bras Enferm ; 77(1): e20230356, 2024.
Article in English, Portuguese | MEDLINE | ID: mdl-38511790

ABSTRACT

OBJECTIVES: to carry out the cultural adaptation and evaluation of validity evidence of the Student Nurse Stressor-15 (SNS-15) Scale for use in Brazil. METHODS: psychometric study, conducted from the stages of translation, synthesis, back-translation, review by a committee of seven experts, pre-test and evaluation of measurement properties with 32 and 238 nursing students, respectively. Descriptive statistics, Exploratory Factor Analysis (EFA), and Confirmatory Factor Analysis (CFA) were performed. The reliability of the instrument was estimated using McDonald's Omega (ω). RESULTS: EFA subsidized the distribution of the fifteen SNS-15 items into four factors. Using AFC, satisfactory fit indices were achieved (Comparative Fit Index = 0.94; Tucker-Lewis Index = 0.93; Root Mean Square Error of Approximation = 0.06; Standardized Root Mean Square Residual = 0.16) and ω = 0.86. CONCLUSIONS: the Brazilian version of the SNS-15 presents evidence that confirms its validity and reliability.


Subject(s)
Students, Nursing , Humans , Brazil , Reproducibility of Results , Surveys and Questionnaires , Factor Analysis, Statistical , Psychometrics
5.
Article in English | MEDLINE | ID: mdl-38511807

ABSTRACT

Trimethoprim-sulfamethoxazole (TMP-SMX) is the primary therapeutic option for Pneumocystis jirovecii pneumonia (PCP). Gastrointestinal symptoms and cutaneous rash are common side effects, with hyperkalemia being uncommon in patients without kidney dysfunction, and myelotoxicity being even rarer. We present the case of a male patient with hypertension and a recent diagnosis of non-Hodgkin lymphoma, undergoing rituximab treatment for two months. He was admitted to the intensive care unit due to dyspnea, tachypnea, and pleuritic pain, requiring mechanical ventilation. Chest computed tomography showed bilateral and multilobed ground-glass opacities, compromising more than 80% of the lung parenchyma. Pulmonary tuberculosis and COVID-19 were ruled out. An angiotomography and Doppler ultrasound revealed an extensive pulmonary thrombus and deep venous thrombosis. Empiric treatment with TMP-SMX for PCP was initiated, but within four days, the patient experienced metabolic acidosis and severe hyperkalemia, necessitating hemodialysis. He also presented with progressive pancytopenia and critical levels of leukopenia and thrombocytopenia. The hypothesis of TMP-SMX-induced myelotoxicity was suspected. Considering the unavailability of an alternative treatment, it was opted to continue TMP-SMX and initiate a granulocyte-colony-stimulating factor. However, the patient maintained medullary deterioration, becoming refractory to the transfusion of blood derivates. On the 17th day of treatment, a clinical decision was made to suspend TMP-SMX, leading to improvements within 48 hours in marrow and kidney functions, metabolic acidosis, and hyperkalemia. Despite all efforts, the patient died after 35 days of hospitalization due to hospital-acquired infections. This case highlights the importance of clinicians recognizing potential myelotoxicity with TMP-SMX and promptly discontinuing the drug if necessary.


Subject(s)
Acidosis , Hyperkalemia , Pneumocystis carinii , Pneumonia, Pneumocystis , Humans , Male , Trimethoprim, Sulfamethoxazole Drug Combination/therapeutic use , Pneumonia, Pneumocystis/drug therapy , Pneumonia, Pneumocystis/chemically induced , Hyperkalemia/chemically induced , Hyperkalemia/complications , Hyperkalemia/drug therapy , Acidosis/chemically induced , Acidosis/complications , Acidosis/drug therapy , Kidney , Retrospective Studies
6.
Infect Dis Rep ; 16(1): 116-127, 2024 Feb 09.
Article in English | MEDLINE | ID: mdl-38391587

ABSTRACT

The aim of the study was to assess the impact of the COVID-19 pandemic on the notification of new VL cases in Brazil in 2020. It is an ecological and time-series study (2015-2020) with spatial analysis techniques, whose units of analysis were the 5570 Brazilian municipalities. The study population consisted of all new cases of VL recorded between 2015 and 2020. The P-score was calculated to estimate the percentage variation in new VL cases. Global and local univariate Moran's Indices and retrospective space-time scan statistics were used in spatial and space-time analyses, respectively. It was expected that there would be 3627 new cases of VL in Brazil in 2020, but 1932 cases were reported (-46.73%). All Brazilian regions presented a negative percentage variation in the registration of new VL cases, with the Southeast (-54.70%), North (-49.97%), and Northeast (-44.22%) standing out. There was spatial dependence of the disease nationwide in both periods, before and during the first year of the COVID-19 pandemic. There was a significant reduction in the incidence of new VL cases in Brazil during the first year of the COVID-19 pandemic. These findings reinforce the need for better preparedness of the health system, especially in situations of new epidemics.

7.
Article in English | MEDLINE | ID: mdl-38248571

ABSTRACT

This study aims to analyze the repercussions of the ongoing COVID-19 pandemic on the health of male immigrants, refugees, and asylum seekers in Brazil. A qualitative study involving 307 adult men living in Brazil during the COVID-19 pandemic was conducted. Data were collected between August 2021 and March 2022 and interpreted based on the Transcultural Nursing Theory. Cultural care repercussions were identified in various dimensions: technological: changes in daily life and disruptions in routine; religious, philosophical, social, and cultural values: changes stemming from disrupted social bonds, religious practices, and sociocultural isolation; political: experiences of political partisanship, conflicts, government mismanagement, a lack of immigration policies, human rights violations, and xenophobia; educational/economic: challenges arising from economic impoverishment, economic insecurity, unemployment, language difficulties, and challenges in academic and literacy development during the pandemic. The persistence of the COVID-19 pandemic in Brazil had significant repercussions for the health of migrant men, resulting in a transcultural phenomenon that requires sensitive nursing care. Implications for nursing: the uniqueness of cultural care in nursing and health, as most of the repercussions found were mostly negative, contributed to the increase in social and health vulnerabilities.


Subject(s)
COVID-19 , Pandemics , Adult , Humans , Male , Brazil/epidemiology , Qualitative Research , COVID-19/epidemiology , Culturally Competent Care
8.
Article in English | LILACS-Express | LILACS | ID: biblio-1550674

ABSTRACT

ABSTRACT Trimethoprim-sulfamethoxazole (TMP-SMX) is the primary therapeutic option for Pneumocystis jirovecii pneumonia (PCP). Gastrointestinal symptoms and cutaneous rash are common side effects, with hyperkalemia being uncommon in patients without kidney dysfunction, and myelotoxicity being even rarer. We present the case of a male patient with hypertension and a recent diagnosis of non-Hodgkin lymphoma, undergoing rituximab treatment for two months. He was admitted to the intensive care unit due to dyspnea, tachypnea, and pleuritic pain, requiring mechanical ventilation. Chest computed tomography showed bilateral and multilobed ground-glass opacities, compromising more than 80% of the lung parenchyma. Pulmonary tuberculosis and COVID-19 were ruled out. An angiotomography and Doppler ultrasound revealed an extensive pulmonary thrombus and deep venous thrombosis. Empiric treatment with TMP-SMX for PCP was initiated, but within four days, the patient experienced metabolic acidosis and severe hyperkalemia, necessitating hemodialysis. He also presented with progressive pancytopenia and critical levels of leukopenia and thrombocytopenia. The hypothesis of TMP-SMX-induced myelotoxicity was suspected. Considering the unavailability of an alternative treatment, it was opted to continue TMP-SMX and initiate a granulocyte-colony-stimulating factor. However, the patient maintained medullary deterioration, becoming refractory to the transfusion of blood derivates. On the 17th day of treatment, a clinical decision was made to suspend TMP-SMX, leading to improvements within 48 hours in marrow and kidney functions, metabolic acidosis, and hyperkalemia. Despite all efforts, the patient died after 35 days of hospitalization due to hospital-acquired infections. This case highlights the importance of clinicians recognizing potential myelotoxicity with TMP-SMX and promptly discontinuing the drug if necessary.

9.
Rev. bras. enferm ; 77(1): e20230356, 2024. tab
Article in English | LILACS-Express | LILACS, BDENF - Nursing | ID: biblio-1550754

ABSTRACT

ABSTRACT Objectives: to carry out the cultural adaptation and evaluation of validity evidence of the Student Nurse Stressor-15 (SNS-15) Scale for use in Brazil. Methods: psychometric study, conducted from the stages of translation, synthesis, back-translation, review by a committee of seven experts, pre-test and evaluation of measurement properties with 32 and 238 nursing students, respectively. Descriptive statistics, Exploratory Factor Analysis (EFA), and Confirmatory Factor Analysis (CFA) were performed. The reliability of the instrument was estimated using McDonald's Omega (ω). Results: EFA subsidized the distribution of the fifteen SNS-15 items into four factors. Using AFC, satisfactory fit indices were achieved (Comparative Fit Index = 0.94; Tucker-Lewis Index = 0.93; Root Mean Square Error of Approximation = 0.06; Standardized Root Mean Square Residual = 0.16) and ω = 0.86. Conclusions: the Brazilian version of the SNS-15 presents evidence that confirms its validity and reliability.


RESUMEN Objetivos: realizar adaptación cultural y evaluación de evidencia de validez de la Student Nurse Stressor-15 (SNS-15) Scale para su uso en Brasil. Métodos: estudio psicométrico, realizado desde las etapas de traducción, síntesis, retrotraducción, revisión por un comité de siete expertos, pretest y evaluación de propiedades de medición con 32 y 238 estudiantes de enfermería, respectivamente. Se realizó estadística descriptiva, Análisis Factorial Exploratorio (AFE), Análisis Factorial Confirmatorio (AFC). La confiabilidad del instrumento se estimó mediante el Omega de McDonald (ω). Resultados: AFE subvencionó la distribución de los quince ítems del SNS-15 en cuatro factores. A través de la AFC se lograron índices de ajuste satisfactorios (Comparative Fit Index = 0,94; Tucker-Lewis Index = 0,93; Root Mean Square Error of Approximation = 0,06; Standardized Root Mean Square Residual = 0,16) y ω = 0,86. Conclusiones: la versión brasileña del SNS-15 presenta evidencias que confirman su validez y confiabilidad.


RESUMO Objetivos: realizar a adaptação cultural e a avaliação das evidências de validade da Student Nurse Stressor-15 (SNS-15) Scale para uso no Brasil. Métodos: estudo psicométrico, conduzido a partir das etapas de tradução, síntese, retrotradução, revisão por um comitê de sete especialistas, pré-teste e avaliação das propriedades de medida com 32 e 238 estudantes de enfermagem, respectivamente. Realizou-se estatística descritiva, Análise Fatorial Exploratória (AFE), Análise Fatorial Confirmatória (AFC). Estimou-se a confiabilidade do instrumento através do Ômega de McDonald's (ω). Resultados: a AFE subsidiou a distribuição dos quinze itens da SNS-15 em quatro fatores. Mediante AFC, alcançou-se índices satisfatórios de ajuste (Comparative Fit Index = 0,94; Tucker-Lewis Index = 0,93; Root Mean Square Error of Approximation = 0,06; Standardized Root Mean Square Residual = 0,16) e ω = 0,86. Conclusões: a versão brasileira da SNS-15 apresenta evidências que confirmam sua validade e confiabilidade.

10.
PLoS One ; 18(12): e0295444, 2023.
Article in English | MEDLINE | ID: mdl-38096234

ABSTRACT

BACKGROUND: SARS-CoV-2 infection is associated with worse maternal and fetal outcomes. This study aims to describe the characteristics of pregnant and postpartum women with severe Covid-19 admitted to ICU. METHODS AND FINDINGS: It's a retrospective cohort study evaluating pregnant and postpartum women referenced to a specialized ICU between May 2020 and June 2022. Covid-19 was confirmed with RT-PCR or rapid antigen test on a nasopharyngeal swab. Variables were described by median and IQR when numerical, and by frequency and percentage when categorical. OR with 95% CI were calculated for the evaluation of factors related to death. P-values were calculated using Pearson's ꭓ2-test, Fisher's exact test, Wilcoxon rank sum test, and Kruskall-Wallis test, and statistical significance was established as < 0·05. Missing data were excluded. All statistical analysis were performed using R software version 4.2.2. Of the 101 admissions, 85 (84·2%) were of pregnant women. Obesity (23·0%) and systemic arterial hypertension (13·0%) were the most prevalent medical conditions. Sixty-six (65·3%) were admitted using some type of oxygen support. Forty-seven (46·5%) evolved to mechanical ventilation. There were 61 events considered obstetric complications, with 8 stillbirths/fetal losses. The overall lethality was 15·8%. Pregnancy interruption, need for non-invasive mechanical ventilation, level of oxygen support at admission, prone maneuver, hemodialysis, and healthcare-related infections were factors associated with death. Evaluating the WHO 7-category ordinary scale, there was a trend of increase in the risk of death with higher punctuation, with a statistically significant difference of women with 5 (OR = 7·27; 95% IC = 1·17-194; p = 0·031) or 6 points (OR = 12·0; 95% IC = 1·15-391; p = 0·038) when compared to the ones with 3 points, i.e., of women admitted with a high-flow non-rebreathing mask or invasive mechanical ventilation, compared with the ones admitted at room air, respectively. The main limitations of this study are the relatively small number of participants, and the use of data derived of medical records-which are susceptible to misclassification and variable amounts of missing data. CONCLUSIONS: Pregnant and postpartum women with severe Covid-19 have high lethality and a high incidence of clinical and obstetric complications. These findings support that this population should be prioritized in public health strategies that address Covid-19.


Subject(s)
COVID-19 , Humans , Female , Pregnancy , COVID-19/epidemiology , SARS-CoV-2 , Retrospective Studies , Pregnant Women , Intensive Care Units , Postpartum Period , Oxygen
12.
Sci Rep ; 13(1): 23003, 2023 12 27.
Article in English | MEDLINE | ID: mdl-38155227

ABSTRACT

The COVID-19 pandemic has severely affected global health, leading to the suspension of numerous routine healthcare services and posing challenges in efforts to control other diseases, such as HIV/AIDS. This study aimed to assess the impact of the COVID-19 pandemic on HIV/AIDS diagnoses and mortality rates in Brazil during 2020 and 2021. The percentage change was calculated to determine whether there was an increase or decrease in HIV/AIDS diagnoses and mortality, considering the average numbers from the last 5 years. Additionally, a Joinpoint regression model and an interrupted time series analysis were applied to assess time trends before and after the onset of the pandemic. Lastly, choropleth maps were prepared. We observed a reduction of 22.4% (2020) and 9.8% (2021) in the diagnosis of HIV/AIDS in Brazil. Conversely, there was a significant increase in the percentage change of late diagnosis of AIDS deaths in 2020 (6.9%) and 2021 (13.9%), with some states showing an increase of over 87%. Decreasing time trends in the diagnosis of HIV/AIDS were identified before the pandemic in Brazil, especially in the Southeast and South regions, and then time trends stabilized after including the pandemic years. Along with the dissemination of COVID-19, there was a reduction in the diagnosis of HIV/AIDS and an increase in late diagnosis AIDS deaths, signaling a serious impact of the pandemic on HIV/AIDS control strategies in Brazil. Therefore, we highlight the need for continuous efforts to control both diseases, that is, maintaining regular health services even in crisis situations.


Subject(s)
Acquired Immunodeficiency Syndrome , COVID-19 , HIV Infections , Humans , Acquired Immunodeficiency Syndrome/diagnosis , Acquired Immunodeficiency Syndrome/epidemiology , Pandemics , Delayed Diagnosis , Brazil/epidemiology , COVID-19/diagnosis , COVID-19/epidemiology , HIV Infections/diagnosis , HIV Infections/epidemiology , COVID-19 Testing
13.
Psychol Res Behav Manag ; 16: 4665-4676, 2023.
Article in English | MEDLINE | ID: mdl-38024653

ABSTRACT

Objective: The aim of the study was to assess the levels of fear and anxiety in the particularly vulnerable population group of women during pregnancy. Methods: Cross-sectional study between March 2022 and July 2022 involving 978 pregnant women aged 16 to 50 years. It was carried out based on the scale for the assessment of fear and anxiety in pregnant women (AMICO_Pregnant) and the collection of sociodemographic data. Normality analysis was performed prior to univariate and bivariate statistical analysis. Results: The sample was composed of a total of 978 pregnant women. The mean of the AMICO_Pregnant scale was intermediate (5.04 points; SD=2.36). The bivariate analysis showed a statistically significant relationship between the AMICO_Pregnant scale and the following variables: vaccination schedule status, contact with the disease, weeks of gestation, altered delivery or birth plan. Conclusion: Women with pregnancies closer to term, with no contact with the disease, without a complete vaccination schedule, or who had undergone changes in their delivery or birth plans, showed higher levels of fear and anxiety.

14.
J Assoc Nurses AIDS Care ; 34(6): 548-565, 2023.
Article in English | MEDLINE | ID: mdl-37815844

ABSTRACT

ABSTRACT: This study aimed to evaluate the sexual practices of men ages 50 years or older who have sex with men (MSM) and factors influencing their predisposition to use preexposure prophylaxis (PrEP). An analytical cross-sectional study was conducted in Brazil and Portugal with 718 MSM. Of these, 278 (38.7%) were categorized as being at high risk for HIV based on the HIV Incidence Risk Index (HIRI), and 418 (58.2%) expressed a predisposition to use PrEP. Overall, sociodemographic factors and specific sexual practices increased the likelihood of being classified as high risk for HIV, particularly sexual position and sexual activity. However, factors that influenced the predisposition to use PrEP included age group, receptive anal sex, knowledge of postexposure prophylaxis, high HIRI score, and a history of syphilis. These findings underscore the urgent need for health services to provide comprehensive and adequate attention to the realities of this population, considering its complexities and specificities.


Subject(s)
Anti-HIV Agents , HIV Infections , Pre-Exposure Prophylaxis , Sexual and Gender Minorities , Male , Humans , Homosexuality, Male , HIV Infections/drug therapy , Cross-Sectional Studies , Anti-HIV Agents/therapeutic use , Sexual Behavior
15.
Ther Adv Infect Dis ; 10: 20499361231206918, 2023.
Article in English | MEDLINE | ID: mdl-37900982

ABSTRACT

Background: Pre-exposure prophylaxis (PrEP) is a valuable tool in the response to the HIV epidemic, recommended for groups with a higher risk of HIV infection, such as men who have sex with men (MSM), particularly in the context of high-risk sexual behavior such as chemsex. Purpose: This study aimed to analyze the prevalence and factors associated with the intention to use PrEP among MSM who engage in chemsex in Brazil and Portugal. Methods: This was a cross-sectional study of a secondary dataset from a larger study conducted between January 2020 and May 2021 throughout Brazil and Portugal involving 1852 MSM who engage in chemsex. An initial descriptive analysis was performed to calculate the absolute and relative frequencies of independent variables related to the intention to use PrEP among MSM. A multivariate regression model was developed to identify factors independently associated with the intention to use PrEP. Results: Although a high level of PrEP knowledge (85.75%) was observed among MSM who engage in chemsex, the prevalence of intention to use PrEP was only 59.07%. Five variables were associated with a higher prevalence of intention to use PrEP [engaging in double penetration - adjusted prevalence ratio (aPR): 1.56, 95% CI: 1.44-1.69; being assigned female sex at birth - aPR: 1.34, 95% CI: 1.12-1.61; cruising - aPR: 1.21, 95% CI: 1.06-1.38; not using condoms - aPR: 1.20, 95% CI: 1.05-1.36; and being an immigrant - aPR: 1.16; 95% CI: 1.07-1.25], while having knowledge of postexposure prophylaxis (aPR: 0.91; 95% CI: 0.84-0.98), having a casual sexual partner (aPR: 0.86 and 0.85; 95% CI: 0.74-0.99 and 0.74-0.98), and engaging in group sex (aPR: 0.81; 95% CI: 0.73-0.90) were associated with a lower intention to use PrEP. Conclusion: The intention to use PrEP among MSM who engage in chemsex was high, and several factors were associated with this intention. Understanding the factors associated with the intention to use PrEP among MSM practicing chemsex is crucial for developing targeted interventions to increase PrEP uptake in this population. The results of this study suggest that tailored approaches are necessary to promote PrEP use in this population.

16.
Front Public Health ; 11: 1198339, 2023.
Article in English | MEDLINE | ID: mdl-37663850

ABSTRACT

Introduction: Investigating the use and adherence to pre-exposure prophylaxis (PrEP) in MSM is a global health priority in the fight against HIV. Strategies must be capable of increasing usage and reaching not only the population living in the country but also those who immigrate, who face additional vulnerabilities. Based on this, in this observational, cross-sectional, and analytical study, our aim is to analyze the use of PrEP among Brazilian men who have sex with men, whether they are migrants or not. We aim to highlight preventive opportunities and strategies for the global health scenario. Methods: We utilized a sample of Brazilians living in the country and Brazilian immigrants residing in Portugal, one of the main destinations for Brazilians in recent years. To estimate the prevalence ratio (PR) of PrEP use, we employed the Poisson regression model with robust variance estimation using a covariance matrix. Results: A total of 1,117 Brazilian MSM PrEP users participated in this study, with 788 residing in Brazil and 328 in Portugal. Multivariate analysis was conducted in three stages: overall, and for subgroups of residents in Brazil and immigrants in Portugal. We identified four convergent factors that increased the prevalence of PrEP use in Brazilians regardless of migration status: having two or more casual sexual partners per month, engaging in challenging sexual practices as the receptive partner, disclosing serological status on apps, and being single. Among native Brazilians, four unique factors stood out: being in a polyamorous relationship, having sexual relations with unknown casual partners, and having higher levels of education. Discussion: This study highlights the need to implement strategies to strengthen PrEP adherence in Brazil and create international programs that facilitate its usage among populations migrating between these two countries.


Subject(s)
Pre-Exposure Prophylaxis , Sexual and Gender Minorities , Male , Humans , Brazil/epidemiology , Homosexuality, Male , Cross-Sectional Studies
17.
Public Health Nurs ; 40(6): 826-835, 2023.
Article in English | MEDLINE | ID: mdl-37526386

ABSTRACT

OBJECTIVE: To evaluate the prevalence of non-testing for HIV among immigrant men who have sex with men (MSM) residing in Brazil and identify associated factors. DESIGN: An analytical web-survey study was conducted across all Brazilian states from January 2020 to May 2021. SAMPLE: The study included 804 MSM immigrants from Portuguese-speaking countries. MEASUREMENTS: Odds ratio (OR) and adjusted Odds Ratio (AOR) were utilized to determine the strength of the association between non-HIV testing and associated factors. RESULTS: Among the participants, 63.7% had never undergone HIV testing. Multivariate analysis revealed several factors associated with a higher likelihood of not being tested for HIV: having a steady/monogamus partner (AOR: 1.5; 95%CI: 1.1-2.3) or both casual and steady partners (AOR: 1.8; 95%CI: 1.2-3.4), not engaging in bareback sex (AOR: 1.91; 95%CI: 3-3.5), being an immigrant in the country for less than 12 months (AOR: 3.7; 95%CI: 2.5-9.7), and having a preference for insertive (AOR: 1.5; 95%CI: 1.1-2.5) or receptive (AOR: 2.9; 95%CI: 1.4-5.7) roles. However, practicing chemsex was found to be a protective factor for testing (AOR: 4). CONCLUSION: To enhance HIV prevention strategies, it is crucial to implement specific measures that ensure accessibility, confidentiality, and a reduction in stigma associated with HIV testing.


Subject(s)
HIV Infections , Sexual and Gender Minorities , Male , Humans , Homosexuality, Male , Sexual Behavior , HIV Infections/diagnosis , HIV Infections/epidemiology , HIV Infections/prevention & control , Brazil/epidemiology , HIV Testing
18.
Rev Esc Enferm USP ; 57(spe): e20220401, 2023.
Article in English, Portuguese | MEDLINE | ID: mdl-37603876

ABSTRACT

OBJECTIVE: The aim of this study was to assess the prevalence of COVID-19 misinformation among migrants aged 50 or older residing in Brazil and Portugal. METHOD: This was a cross-sectional analytical study conducted among migrants from Portuguese-speaking countries living in Brazil and Portugal, who were 50 years of age or older. The prevalence ratios (PR) were estimated using the Poisson regression model. RESULTS: Out of the 304 participants included in the study, 188 (61.8%) agreed with at least one piece of misinformation. Factors such as having a religious affiliation (aPR: 1.24), higher educational attainment (aPR: 1.17), knowing someone who died from COVID-19 (aPR: 1.78), and having no intention to get vaccinated (aPR: 1.36) were associated with a higher likelihood of agreeing with COVID-19 misinformation. CONCLUSION: The findings suggest that access to misinformation was influenced by social, economic, and religious factors among elderly migrants with low digital literacy, thus contributing to the dissemination of false content within this population.


Subject(s)
COVID-19 , Transients and Migrants , Aged , Middle Aged , Humans , Brazil/epidemiology , Portugal/epidemiology , Cross-Sectional Studies , Communication
19.
Rev Bras Enferm ; 76Suppl 1(Suppl 1): e20230091, 2023.
Article in English, Portuguese | MEDLINE | ID: mdl-37585924

ABSTRACT

OBJECTIVES: to assess agreement with COVID-19 disinformation among Portuguese-speaking individuals aged 50 years or older. METHODS: a descriptive and analytical study involving 1,214 older adults born in Portuguese-speaking countries. Data collection occurred through online information mining to recognize COVID-19 and disinformation content, and the application of a structured questionnaire. RESULTS: agreement with disinformation content was 65.2%. Residing outside Brazil is a protective factor for agreement with disinformation content, and those who believe in the truthfulness of the information sources they receive were 31% more likely to agree with disinformation content. CONCLUSIONS: there is a high prevalence of disinformation among the older population in two Portuguese-speaking countries, which should raise the attention of healthcare professionals and guide coping strategies.


Subject(s)
COVID-19 , Humans , Aged , Disinformation , Portugal/epidemiology , Surveys and Questionnaires , Ethnicity
20.
Rev Bras Enferm ; 76(3): e20230004, 2023.
Article in English, Portuguese | MEDLINE | ID: mdl-37556700

ABSTRACT

OBJECTIVES: to discuss the repercussions of chemsex on the health of men who have sex with men (MSM), contextualizing it in a global health scenario and pointing out the implications for nursing care. METHODS: theoretical-reflexive study based on scientific literature and concepts related to global health. RESULTS: we present the epidemiology of the chemsex phenomenon, the main demands of the field, the reasons why it has become a global public health problem, and the implications for nursing practice. FINAL CONSIDERATIONS: chemsex is growing in all age groups of MSM and is globally benefiting from location-based applications to gain magnitude, finding an important potential audience in the migrant population. Nursing structures can help accelerate the proposal and implementation of biomedical and behavioral measures to address chemsex in its entirety, qualifying care and inducing teamwork with interprofessional collaboration.


Subject(s)
HIV Infections , Sexual and Gender Minorities , Substance-Related Disorders , Male , Humans , Homosexuality, Male , Sexual Behavior , Substance-Related Disorders/complications , Substance-Related Disorders/epidemiology , Global Health , HIV Infections/complications , HIV Infections/epidemiology
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