Knowledge of HIV transmission, prevention strategies and U = U among adult sexual and gender minorities in Brazil.

INTRODUCTION: Although strong scientific evidence of the efficacy and effectiveness of treatment-as-prevention (TasP) is available, full endorsement of the "Undetectable = Untransmittable" (U = U) and "zero-risk" messages could be improved. Increasing knowledge about HIV transmission, prevention and treatment is a critical component of care efforts. The study assessed knowledge of HIV transmission and prevention strategies, and the perceived accuracy of the slogan U = U among sexual and gender minorities (SGM) in Brazil. METHODS: Cross-sectional web-based survey targeting adult SGM living in Brazil (2021-2022) recruited on social media and dating apps. We used the 12-item HIV Knowledge Assessment (HIV-KA) questionnaire to assess HIV knowledge, three items of which address pre-exposure prophylaxis (PrEP), post-exposure prophylaxis and TasP. Perceived accuracy of the U = U slogan was assessed with the question: "With regards to HIV-positive individuals transmitting HIV through sexual contact, how accurate do you believe the slogan U = U is?". We a priori grouped the study population into three mutually exclusive groups: people living with HIV (PLHIV), HIV negative and HIV unknown. We used logistic regression models to assess factors associated with high HIV knowledge and perception of the U = U as completely accurate. RESULTS: Of 50,222 individuals accessing the questionnaire, 23,981 were included: 5071 (21.0%) PLHIV, 17,257 (71.5%) HIV negative and 1653 (6.9%) HIV unknown. The proportion of participants with high knowledge was significantly higher for PLHIV and HIV negative (48.1% and 45.5%, respectively) compared to 26.1% of HIV unknown. More PLHIV perceived U = U as completely accurate (80.4%), compared to 60.0% of HIV negative and 42.9% of HIV unknown. HIV knowledge correlates with perceived accuracy of the U = U slogan across all groups. Higher HIV knowledge was associated with higher income and education regardless of HIV status. Among HIV-negative participants, PrEP awareness and use were associated with higher knowledge and accurate perception of the U = U slogan. CONCLUSIONS: Our findings show that HIV knowledge and perceived accuracy of U = U are strongly correlated, that knowledge differs according to HIV status, and that poor socio-economic is linked to poor knowledge among SGM from Brazil. Educational strategies regarding TasP, U = U and zero risk targeting socio-economically vulnerable populations are urgent in Brazil.

O padrão etário na dinâmica temporal da dengue no Brasil

Dengue é uma doença viral provocada por quatro sorotipos de arbovírus e transmitida aos seres humanos por mosquitos do gênero Aedes. A dispersão geográfica dos vetores e dos vírus levou a uma reemergência global deste agravo, com destaque para as epidemias e o aparecimento de formas graves nosúltimos anos. Se, por um lado, as recentes publicações revelam baixo impacto nas estratégias de controle vetorial para dengue, por outro lado, houve grande expectativa com o lançamento de vacinas para a prevenção da doença. Em vários países onde a ocorrência de dengue é relevante, a distribuição dos casos por faixa etária não é homogênea, levantando dúvidas sobre quais os fatores interferem na dinâmica da incidência de dengue segundo a idade. Objetivo: Caracterizar o padrão de incidência de dengue e dengue grave ao longo do tempo segundo a faixa etária no período de 2007 a 2012 nas capitais estaduais brasileira.Métodos: Foi realizada a seleção das capitais com maior taxa de incidência entre as séries de dengue edengue grave por faixa etária em cada região do país para prosseguimento da pesquisa, totalizando a análise estatística de 4 capitais, referentes a suas respectivas regiões: Rio Branco (Região Norte), Aracaju(Região Nordeste), Cuiabá (Região Centro-Oeste) e Vitória (Região Sudeste). Seguiu-se a regressão das curvas de incidência de dengue e dengue grave, segundo faixa etária ao longo do tempo, utilizando Modelos Lineares Generalizados com distribuição de probabilidade de Poisson. Resultados e Discussão:Em função da análise exploratória das séries, foram construídos dois modelos de Poisson que incluíram como variáveis dependentes um termo autorregressivo, o grupo etário (<15 e ≥15 anos) e o tempo; no segundo modelo de Poisson, incluiu-se ainda um termo de interação entre o grupo etário e o tempo...

Dengue is a viral disease caused by 4 serotypes of arbovirus and transmitted to humans byAedes mosquitoes. The geographical dispersion of these vectors and viruses has led to a globalresurgence of this disease, with the occurrence of epidemics and the appearance of severe forms in thelast years. Prior studies have shown that vector control can have only limited impact on dengueincidence. We currently have 2 vaccines available to prevent dengue and there is great expectationwith the application of these vaccines on a large scale. In several countries where the incidence ofdengue is relevant, the distribution of cases by age group is not homogeneous, raising questions aboutwhich factors influence the dynamics of dengue incidence according to age. Objective: To characterizethe pattern of the incidence of dengue and severe dengue over time according to age group from 2007to 2012 in the Brazilian state capitals. Methods: Brazilian capitals with highest incidence rate ofdengue and severe dengue by age group in each region of the country were selected for furtherresearch, totaling the statistical analysis of 4 capitals, referring to their respective regions: Rio Branco(North Region), Aracaju (Northeast), Cuiabá (Midwest Region) and Vitória (Southeast). The incidencerate of dengue and severe dengue, according to age over time, were modeled using Generalized LinearModels with Poisson probability distribution. Results and Discussion: Descriptive statistics guided thecreation of two models that included an autoregressive term, age group and time as explanatoryvariables. The second model included also an interaction term of age group and time. In cases ofdengue in Rio Branco, Aracaju and Vitoria, the age group ≥15 years had a incidence rate that wassignificantly higher than that observed among those who were <15 years...