HIV prevalence among men who have sex with men in Brazil: results of the 2nd national survey using respondent-driven sampling.

This paper reports human immuno-deficiency virus (HIV) prevalence in the 2nd National Biological and Behavioral Surveillance Survey (BBSS) among men who have sex with men (MSM) in 12 cities in Brazil using respondent-driven sampling (RDS).Following formative research, RDS was applied in 12 cities in the 5 macroregions of Brazil between June and December 2016 to recruit MSM for BBSS. The target sample size was 350 per city. Five to 6 seeds were initially selected to initiate recruitment and coupons and interviews were managed online. On-site rapid testing was used for HIV screening, and confirmed by a 2nd test. Participants were weighted using Gile estimator. Data from all 12 cities were merged and analyzed with Stata 14.0 complex survey data analysis tools in which each city was treated as its own strata. Missing data for those who did not test were imputed HIV+ if they reported testing positive before and were taking antiretroviral therapy.A total of 4176 men were recruited in the 12 cities. The average time to completion was 10.2 weeks. The longest chain length varied from 8 to 21 waves. The sample size was achieved in all but 2 cities.A total of 3958 of the 4176 respondents agreed to test for HIV (90.2%). For results without imputation, 17.5% (95%CI: 14.7-20.7) of our sample was HIV positive. With imputation, 18.4% (95%CI: 15.4-21.7) were seropositive.HIV prevalence increased beyond expectations from the results of the 2009 survey (12.1%; 95%CI: 10.0-14.5) to 18.4%; CI95%: 15.4 to 21.7 in 2016. This increase accompanies Brazil's focus on the treatment to prevention strategy, and a decrease in support for community-based organizations and community prevention programs.

The influence of playing a non-reward game on motor ability and executive function in Parkinson's disease.

The aim of this study is to evaluate the acute effect of playing games on executive function and motor ability in Parkinson's disease (PD). Consecutive cases with PD were studied with the Unified Parkinson Disease Rating Scale (UPDRS), Mini-Mental State examination (MMSE), Beck Depression Inventory (BDI), Stroop test, finger tapping and 14-meter walk test. After randomization, patients performed a game of dominoes and were tested before and after experiment being further categorized as control, winners or non-winners. Forty patients, 27 male (67.5%), aged 48 to 84 years (63.2 ± 8.5), Hoehn & Yahr I to III were included. Twenty-eight (70%) presented depressive symptoms (BDI > 10). Groups (Control N = 13; Winners = 14 and Non-winners = 13) were not different regarding age, disease duration, age at onset, BMI, MMSE scores, depressive symptoms, levodopa dose, and previous practice of games. Winners presented significantly better results on executive function (Stroop test, p = 0.002) and on motor activity (Finger tapping, p = 0.01). Non-winners showed a trend of better performance in the 14-meter-walk test. This study shows that the practice of a non-reward game acutely improved memory and motor skills in PD. Our results suggest a role for the reward system in the modulation of the dopaminergic function of the basal ganglia in these patients.

Reliability of self-report of HIV status among men who have sex with men in Brazil.

INTRODUCTION: The aim of this study was to evaluate the reliability of self-reported HIV among men who have sex with men (MSM) in Brazil. METHODS: MSM 18 years of age or older were recruited to a multicenter study using respondent-driven sampling. We compared self-report of the HIV test with a rapid HIV test using the kappa coefficient. RESULTS: A total of 3859 MSM were recruited, and 39% reported ever having an HIV test; their results were reported and they agreed to a new test. Agreement between self-report and the test was very good (kappa = 0.88). CONCLUSION: Our results suggest that self-report of HIV infection is a reliable indicator among MSM.

Differences in neonatal outcome in fetuses with absent versus reverse end-diastolic flow in umbilical artery Doppler.

OBJECTIVES: It was the aim of this study to evaluate differences in the prognosis of fetuses with absent (AED) and reverse end-diastolic (RED) flow in the umbilical artery based on neonatal outcomes. METHODS: We performed a cross-sectional study based on the records of 143 patients attending at Assis Chateaubriand Teaching Maternity between 1 January 1999 and 31 December 2005. Patients were classified according to diagnosis as having either fetal centralization (FC), AED or RED. Obstetrical findings and perinatal outcomes were compared for the 3 groups and between AED and RED by Fisher's exact test. Perinatal outcomes were analyzed quantitatively with logistic or multinomial regression. Odds ratios were calculated for significant risk factors. RESULTS: There was a statistically significant difference in gestational age at diagnosis, Apgar scores at 1 and 5 min, Capurro score, use of surfactant and mechanical ventilation, admission to the neonatal intensive care unit, perinatal and neonatal death. When comparing RED with AED, the odds of neonatal intensive care unit admission, mechanical ventilation, use of surfactant, neonatal mortality and perinatal mortality were 3.2, 1.4, 1.0, 5.1 and 5.3 times higher for RED. Only perinatal mortality kept statistically significant with odds of 5.2 (p = 0.043) when adjusted by gestational age (multivariate analysis). CONCLUSION: The incidence of perinatal mortality was observed to increase with the severity of Doppler findings, with significant differences between the AED and RED groups.