Anti-PF4 immunothrombosis without proximate heparin or adenovirus vector vaccine exposure.

ABSTRACT: Platelet-activating anti-platelet factor 4 (PF4)/heparin antibodies and anti-PF4 antibodies cause heparin-induced thrombocytopenia (HIT) and vaccine-induced immune thrombocytopenia and thrombosis (VITT), respectively. Diagnostic and treatment considerations differ somewhat between HIT and VITT. We identified patients with thrombocytopenia and thrombosis without proximate heparin exposure or adenovirus-based vaccination who tested strongly positive by PF4/polyanion enzyme-immunoassays and negative/weakly positive by heparin-induced platelet activation (HIPA) test but strongly positive by PF4-induced platelet activation (PIPA) test (ie, VITT-like profile). We tested these patients by a standard chemiluminescence assay that detects anti-PF4/heparin antibodies found in HIT (HemosIL AcuStar HIT-IgG(PF4-H)) as well as a novel chemiluminescence assay for anti-PF4 antibodies found in VITT. Representative control sera included an exploratory anti-PF4 antibody-positive but HIPA-negative/weak cohort obtained before 2020 (n = 188). We identified 9 patients with a clinical-pathological profile of a VITT-like disorder in the absence of proximate heparin or vaccination, with a high frequency of stroke (arterial, n = 3; cerebral venous sinus thrombosis, n = 4), thrombocytopenia (median platelet count nadir, 49 × 109/L), and hypercoagulability (greatly elevated D-dimer levels). VITT-like serological features included strong reactivity by PIPA (aggregation <10 minutes in 9/9 sera) and positive testing in the novel anti-PF4 chemiluminescence assay (3/9 also tested positive in the anti-PF4/heparin chemiluminescence assay). Our exploratory cohort identified 13 additional patient sera obtained before 2020 with VITT-like anti-PF4 antibodies. Platelet-activating VITT-like anti-PF4 antibodies should be considered in patients with thrombocytopenia, thrombosis, and very high D-dimer levels, even without a proximate exposure to heparin or adenovirus vector vaccines.

Personal, Interpersonal, and Sociocultural Factors of Condom Use in Rural Indigenous Nahuas Adolescents in Mexico.

The goal of this research was to determine the personal, interpersonal, and sociocultural predictors of condom use among rural Indigenous adolescents. Predictor variables were selected from Bandura's Social Cognitive Theory and Leininger's Transcultural Theory. The sample consisted of 419 Nahuas adolescents randomly selected from the total number of neighborhood blocks in a rural community in Puebla, Mexico. The instruments had acceptable psychometric characteristics (Cronbach alpha and validity scores). Multiple linear regression models were used. Results: 56.8% of participants were female, and 50.40% were students. Mean age was M = 17.5 (SD = 0.97), and the majority (63%) identified as Catholic. Age at menarche/first ejaculation (ß = -1.2, p = 0.038), attitude toward condom use (ß = 0.13, p < 0.001), ethnic identity (ß = 0.21, p < 0.001), and ability to negotiate condom use (ß = 0.13, p = 0.003) predicted (R2 = 22.3) condom use. This study provided a basis for integration of the cultural values of Indigenous adolescents within interventions for sexual health promotion.

Mental health throughout the medical career: A comparison of depression, anxiety, and stress levels among medical students, residents, and physicians.

BACKGROUND: Different stages of a physician's career may be associated with different types of mental health impairment. AIMS: This study aimed to compare symptoms of anxiety, depression, and stress and their associated factors among medical students, medical residents, and physicians. METHODS: A cross-sectional study was conducted. Data collection included sociodemographic data, religiosity (Duke University Religion Index), and mental health (21-item Depression, Anxiety and Stress Scale - DASS-21) data. The comparison between the groups was performed using ANOVA, and the associated factors were evaluated via linear regression models. RESULTS: The sample consisted of 1,417 participants: 778 medical students, 190 medical residents, and 468 established physicians. Medical students had significantly higher depression, anxiety, and stress scores as compared to medical residents and established physicians. However, regarding DASS 21 scores, no significant differences were found between established physicians and medical residents. The factors associated with mental health in the different groups showed that being married and male were associated with better mental health among physicians and medical residents, while the factors of male gender, being in later years of the course, and lower religious attendance were associated with better mental health in students. CONCLUSION: Medical students had worse mental health outcomes when compared to residents and established physicians. Interventions are needed to minimize suffering during medical education and career.

The Importance of Graduate Education for Nursing Care / La Importancia de Educación del Postgrado en el Cuidado de Enfermería / A importância da educação da pós-graduação no cuidado de enfermagem

Graduate nursing education faces various challenges linked to research products that must be innovative and have an impact on social well-being. Knowledge transfer is a complex multidimensional process requiring multiple mechanisms, methods, and measurements to be considered in graduate training. Educational institutions must have a support infrastructure and be responsible for preparing interdisciplinary syllabi, coordinating management strategies to address student learning, and providing an environment for harmonized communication among those interested in problem-solving.

La educación del Postgrado en enfermería se enfrenta a diversos desafíos ligados a los productos de la investigación que deben ser innovadores con impacto a nivel de bienestar social. La transferencia del conocimiento se refiere a un proceso complejo y multidimensional que requiere de diversos mecanismos, métodos y mediciones que deben de ser considerados en a la formación del postgrado. Las instituciones educativas deben de contar con infraestructura de apoyo y considerar como su responsabilidad desarrollar planes de estudio interdisciplinarios, coordinación de estrategias de gestión que aborden el aprendizaje de los estudiantes y la provisión de un entorno que desarrolle comunicación coordinada entre los interesados en la solución de los problemas.

A educação da pós-graduação em enfermagem enfrenta diversos desafios relacionados aos produtos da pesquisa que devem ser inovadores e com impacto no bem-estar social. A transferência do conhecimento se refere a um processo complexo e multidimensional que requer diversos mecanismos, métodos e avaliações que devem ser considerados na formação em pós-graduação. As instituições educacionais devem contar com infraestrutura de apoio e considerar, como sua responsabilidade, o desenvolvimento de planos de estudo interdisciplinares, a coordenação de estratégias de gestão que abordem a aprendizagem dos estudantes e a provisão de um ambiente que desenvolva comunicação coordenada entre os interessados na solução dos problemas.

Ultrasound-Guided Percutaneous Cryoanalgesia for Pectus Excavatum: When Should It be Applied?

INTRODUCTION: The addition of ultrasound-guided percutaneous cryoanalgesia (PCr) for pain management after pectus excavatum (PE) surgery offers a new and advantageous approach. Our aim is to describe our experience with PCr applied on the same day, 24 hours, and 48 hours prior to PE surgery. MATERIAL AND METHODS: Prospective pilot study in patients undergoing ultrasound-guided PCr (2019-2022) was divided into three groups: PCr on the same day of surgery (PCrSD), PCr 24 hours before (PCr24), and PCr 48 hours before (PCr48). We describe the application of technique and data obtained by comparing the three groups. RESULTS: We present 42 patients (25 PCrSD, 11 PCr24, 6 PCr48). PCr24 had a shorter procedure duration than PCrSD (65.8 vs. 91.2 minute; p = 0.048). Related to analgesia, PCr24 and PCr48 showed lower opioid consumption than PCrSD in PCA volume (48.5 and 49.6 vs. 75.1 mL; p = 0.015) and PCA time (23.3 and 23.8 vs. 34.3 hours; p = 0.01). Degree of pain (VAS scale) on the day of surgery and on the second postoperative day was lower in PCr24 and PCr48 than in PCrSD (4 and 2 vs. 5; p = 0.012; 0 and 1 vs. 2; p = 0.01, respectively) as well as shorter hospital stay (3 and 3.5 vs. 5 days; p = 0.021). In addition, PCr24 showed lower opioid consumption and hospital stay than PCr48 (p > 0.05). The greatest savings in hospital costs were obtained in the PCr24 group. CONCLUSION: PCr48 and PCr24 prior to PE surgery offers lower opioid consumption, less pain and shorter hospital stay than PCrSD. PCr24 is comparable to PCr48, but seems to show advantages and simpler logistics for the patient and the hospital.

Crystal structure of active CDK4-cyclin D and mechanistic basis for abemaciclib efficacy.

Despite the biological and therapeutic relevance of CDK4/6 for the treatment of HR+, HER2- advanced breast cancer, the detailed mode of action of CDK4/6 inhibitors is not completely understood. Of particular interest, phosphorylation of CDK4 at T172 (pT172) is critical for generating the active conformation, yet no such crystal structure has been reported to date. We describe here the x-ray structure of active CDK4-cyclin D3 bound to the CDK4/6 inhibitor abemaciclib and discuss the key aspects of the catalytically-competent complex. Furthermore, the effect of CDK4/6 inhibitors on CDK4 T172 phosphorylation has not been explored, despite its role as a potential biomarker of CDK4/6 inhibitor response. We show mechanistically that CDK4/6i stabilize primed (pT172) CDK4-cyclin D complex and selectively displace p21 in responsive tumor cells. Stabilization of active CDK4-cyclin D1 complex can lead to pathway reactivation following alternate dosing regimen. Consequently, sustained binding of abemaciclib to CDK4 leads to potent cell cycle inhibition in breast cancer cell lines and prevents rebound activation of downstream signaling. Overall, our study provides key insights demonstrating that prolonged treatment with CDK4/6 inhibitors and composition of the CDK4/6-cyclin D complex are both critical determinants of abemaciclib efficacy, with implications for this class of anticancer therapy.

Feasibility of a Physical Training Intervention With Music in Community-Dwelling Older Women: A Quasi-Experimental Study.

Physical activity performed with music activates important brain areas associated with cognition, emotions, and motor skills. Limited information is available on the feasibility and acceptability of physical activity and music interventions. The current study aimed to (a) determine the feasibility of a physical training intervention with music in older women, and (b) describe the differences between pretest and posttest variables (i.e., cognitive state, immediate memory, executive function, gait parameters [cadence and gait speed], muscle strength, flexibility, and symptoms of depression). Results suggest that the intervention with physical training and music was feasible, given the high acceptability and retention rates, high level of attendance at the sessions, and absence of adverse events. Significant improvements were observed in immediate memory (p ≤ 0.01), executive function (p ≤ 0.05), cadence (p ≤ 0.01), leg strength (p ≤ 0.01), right arm strength (p ≤ 0.01), left arm strength (p ≤ 0.05), symptoms of depression (p ≤ 0.01), and left lower body flexibility (p ≤ 0.05). Therefore, a randomized clinical trial with a larger sample could confirm the effects of this intervention on memory, executive function, cadence, leg strength, arm strength, symptoms of depression, and left lower body flexibility. [Journal of Gerontological Nursing, 48(11), 37-43.].

Use of Smartphones to Increase Safe Sexual Behavior in Youths at Risk for HIV.

In Mexico, young people continue to experience problems due to a lack of correct and consistent condom use during sexual intercourse. OBJECTIVE: to evaluate the effect of a randomized controlled clinical trial with the use of smartphones to increase safe sex intentions and safe sexual behavior. METHODS: experimental design with two treatment groups with 177 young people who requested the rapid HIV test in a non-governmental organization in the city of Monterrey, Mexico. The experimental group was given Respect M-Health with the use of mobile devices; the control group was given similar counseling without the use of mobile technology and 8 pencil and paper instruments were used. RESULTS: the effect of the experimental group was greater in safe sexual behavior reflected in the means at pre-test M=64.80 (SD=1.86), post-test M=85.33 (SD=1.54), and at 30 days M=87.40 (SD=1.52), and in the safe sex intentions factor at pre-test M=78.50 (SD=3.07), post-test M=94.70 (SD=2.46), and at 30 days M=95.74 (SD=2.29). CONCLUSIONS: Smartphone use was an effective tool as a support to increase safe sexual behavior in youth.

En México, los jóvenes siguen presentando problemas debido a la falta de uso correcto y consistente del preservativo durante las relaciones sexuales. OBJETIVO: evaluar el efecto de un ensayo clínico controlado y aleatorizado con el uso de teléfonos inteligentes para aumentar las intenciones de sexo seguro y la conducta sexual segura. Métodos: diseño experimental con dos grupos de tratamiento con 177 jóvenes que solicitaron la prueba rápida de VIH en una Organización no Gubernamental en la ciudad de Monterrey, México. Al grupo experimental se le brindó Respeto M-Salud para el uso de dispositivos móviles; al grupo control se le entregó una herramienta similar, pero sin el uso de tecnología móvil, y se utilizaron 8 instrumentos de lápiz y papel. RESULTADOS: el efecto del grupo experimental fue mayor en la conducta sexual segura reflejado en las medias del pre-test M=64.80 (SD=1.86), post-test M=85.33 (SD=1.54) y a los 30 días M=87.40 (SD=1.52); y en el factor de intenciones de sexo seguro, se reflejó de esta manera en el pre-test M=78.50 (SD=3.07), post-test M=94.70 (SD=2.46) y a los 30 días M=95.74 (SD=2.29). CONCLUSIONES: El uso de teléfonos inteligentes fue una herramienta eficaz como apoyo para aumentar la conducta sexual segura en los jóvenes.

Preliminary Study of the Fresh and Hard Properties of UHPC That Is Used to Produce 3D Printed Mortar.

Three-dimensional printed concrete (3DPC) is a relatively recent technology that may be very important in changing the traditional construction industry. The principal advantages of its use are more rapid construction, lower production costs, and less residues, among others. The choice of raw materials to obtain adequate behavior is more critical than for traditional concrete. In the present paper a mixture of cement, silica fume, superplasticizer, setting accelerator, filler materials, and aggregates was studied to obtain a 3DPC with high resistance at short curing times. When the optimal mixture was found, metallic fibers were introduced to enhance the mechanical properties. The fresh and hard properties of the concrete were analyzed, measuring the setting time, workability, and flexural and compressive strength. The results obtained demonstrated that the incorporation of fibers (2% in volume) enhanced the flexural and compressive strength by around 163 and 142%, respectively, compared with the mixture without fibers, at 9 h of curing. At 28 days of curing, the improvement was 79.2 and 34.7% for flexural and compressive strength, respectively.

Percepción de riesgo para VIH y sexo seguro en migrantes de la frontera norte de México / HIV risk perception and safe sex in migrants from the northern border of Mexico

Introducción: En el año 2019 se detectaron 9.828 nuevos casos de VIH y 5.825 de sida en México, la población migrante es considerada de alta vulnerabilidad, lo cual se presume se debe a las condiciones desfavorables en su tránsito por el país. Una variable de importancia en el contexto de la salud sexual es la percepción que puedan llegar a tener sobre estar o no en riesgo, un estudio de percepción de contraer el VIH puede tener implicaciones importantes para la salud.Objetivo: Describir la asociación entre la percepción de riesgo para VIH y el sexo seguro en migrantes de la frontera norte de México.Métodos: El diseño fue correlacional predictivo y transversal, muestra de 302 migrantes de dos ciudades de fronterizas de Tamaulipas, muestreo probabilístico aleatorio sistemático.Resultados: Se encontró que cerca del 90% fueron varones con una media de edad de (M = 33,25, DE = 9,62) años, en general los migrantes tienen baja percepción de riesgo para VIH y esta se correlacionó con el sexo seguro (rs = -0,134, p = 0,020), además, un análisis de regresión demostró que la percepción de riesgo para VIH tiene un efecto predictivo sobre el sexo seguro (β = -0,143, F = 6,27 [gl =1, 300], p = 0,013)Conclusión: Los migrantes son un grupo que requiere de interés en el ámbito de la investigación relacionada con la sexualidad, a pesar de ser un grupo vulnerable e identificado como de riesgo. Es poca su percepción acerca de adquirir VIH, esta variable debe ser considerada de importancia en futuras investigaciones en el ámbito sexual de los migrantes, debido a que puede ser utilizada en conjunto con otras, a manera de modelo o bien como mediadora. (AU)

Introduction: In 2019, 9,828 new cases of HIV and 5,825 of AIDS were detected in Mexico, the migrant population is considered highly vulnerable, which is presumed to be due to unfavorable conditions in their transit through the country, an important variable in the context of sexual health is the perception that they may have about being or not at risk. A study of perception of contracting HIV can have important implications for health.Objective: To determine the association between the perception of risk for HIV and safe sex in migrants from the northern border of Mexico.Methods: The design was predictive correlational and cross-sectional, sample of 302 migrants from two border cities of Tamaulipas, systematic random probability sampling.Results: It was found that about 90% were men with a mean age of (M = 33,25, SD = 9,62) years, in general, migrants have a low perception of risk for HIV and this was correlated with safe sex (rs = -,134, p =,020), furthermore, a regression analysis showed that the perception of risk for HIV has a predictive effect on safe sex (β = -, 143, F = 6,27 [gl=1,300], p = 0,013),Conclusion: Migrants are a group that requires interest in the field of research related to sexuality, despite being a vulnerable group and identified as at risk, their perception of acquiring HIV is low, this variable should be considered of importance in future research in the sexual field of migrants, because it can be used in conjunction with others as a model or as a mediator. (AU)

[HIV risk perception and safe sex in migrants from the northern border of Mexico]. / Percepción de riesgo para VIH y sexo seguro en migrantes de la frontera norte de México.

INTRODUCTION: In 2019, 9,828 new cases of HIV and 5,825 of AIDS were detected in Mexico, the migrant population is considered highly vulnerable, which is presumed to be due to unfavorable conditions in their transit through the country, an important variable in the context of sexual health is the perception that they may have about being or not at risk. A study of perception of contracting HIV can have important implications for health. OBJECTIVE: To determine the association between the perception of risk for HIV and safe sex in migrants from the northern border of Mexico. METHODS: The design was predictive correlational and cross-sectional, sample of 302 migrants from two border cities of Tamaulipas, systematic random probability sampling. RESULTS: It was found that about 90% were men with a mean age of (M = 33,25, SD = 9,62) years, in general, migrants have a low perception of risk for HIV and this was correlated with safe sex (rs = -,134, p =,020), furthermore, a regression analysis showed that the perception of risk for HIV has a predictive effect on safe sex (ß = -, 143, F = 6,27 [gl=1,300], p = 0,013), CONCLUSION: Migrants are a group that requires interest in the field of research related to sexuality, despite being a vulnerable group and identified as at risk, their perception of acquiring HIV is low, this variable should be considered of importance in future research in the sexual field of migrants, because it can be used in conjunction with others as a model or as a mediator.

Risk assessment for HIV infection in men who have sex with men and the contribution of sexual partner networks. / Avaliação de risco para infecção HIV em homens que fazem sexo com homens e a contribuição das redes de parceiros sexuais.

This study aimed to evaluate the risk of HIV infection in men who have sex with men (MSM) by developing an index that considers sex partner networks. The index variables were age, ethnicity/skin color, schooling, relationship type, condom use in receptive and insertive relationships, self-perception of the possibility of HIV infection, sexually transmitted infections, and rapid HIV testing results. We used data from a cross-sectional MSM egocentric network survey conducted in Rio de Janeiro between 2014 and 2015. The initial research volunteer is called ego, each partner is called alter, and each pair of people in a relationship is called the dyad. Multiple logistic regression was used to define the coefficients of the equations for the elaboration of the indices. The index ranged from 0 to 1; the closer to 1, the higher the risk of HIV infection. HIV prevalence was 13.9% among egos. The mean egos index with an HIV-reactive test was 57% higher than non-reactive, and the same profile was observed in the index values of dyads. The index allowed the incorporation of network data through the dyads and contributed to the identification of individuals with a higher likelihood of acquiring HIV.

O objetivo do estudo foi avaliar o risco de infecção por HIV em homens que fazem sexo com homens (HSH) a partir do desenvolvimento de um índice que considere as redes de parceiros sexuais. As variáveis do índice foram faixa etária, raça/cor, escolaridade, tipo de relacionamento, uso de preservativo em relações receptivas e insertivas, autopercepção da chance de se infectar pelo HIV, história de infecções sexualmente transmissíveis, além dos resultados dos testes rápidos para HIV. Foram utilizados dados de uma pesquisa de rede egocêntricas HSH, com desenho transversal, realizada no Rio de Janeiro entre 2014 e 2015. O voluntário inicial da pesquisa é denominado ego, cada parceiro é alter, e cada par de pessoas em um relacionamento é a díade. Utilizou-se regressão logística múltipla para definição dos coeficientes das equações para elaboração dos índices. O índice variou de 0 a 1, quanto mais próximo de 1, maior o risco de infecção por HIV. A prevalência de HIV dos egos foi de 13,9%. A média do índice dos egos com teste HIV reagente foi 57% maior do que aqueles não reagentes, o mesmo perfil foi observado nos valores dos índices das díades. O índice permitiu incorporar os dados das redes por meio das díades e contribuiu para a identificação de indivíduos com maior chance de aquisição do HIV.

Multilevel elements associated with HIV serosorting for sexual encounters: a scoping literature review.

A scoping literature review to identify the multilevel HIV serosorting related elements was developed. Articles from EBSCO, PubMed, PsyNET and Science Direct with serosort* or serosorting at the tittle or abstract, written in English or Spanish were included. No restriction in type of population or design were applied. 239 records were retrieved after duplicates removed, but 181 references were extracted for full-text review. Individual level: HIV knowledge, serostatus, risk perceptions, abilities to disclose and for condom use negotiation, motivations, use of drugs, stigma, attitudes toward condom use, and perceptions/beliefs about the HIV and related treatments, HIV infection rates/testing and behavioral factors. Interpersonal level: social networks, abilities (sexual behavior negotiation, and communication). Community level: stigma, social norms, access to HIV related services. Structural level: political context, HIV related funding and public policies. HIV Serosorting is not solely an interpersonal behavior it involves multilevel elements that must be acknowledged by professionals and stakeholders.

Multilevel elements associated with HIV serosorting for sexual encounters: a scoping literature review / Elementos multinivel asociados a seroclasificación por VIH en encuentros sexuales: revisión de alcance de la literatura

Abstract A scoping literature review to identify the multilevel HIV serosorting related elements was developed. Articles from EBSCO, PubMed, PsyNET and Science Direct with serosort* or serosorting at the tittle or abstract, written in English or Spanish were included. No restriction in type of population or design were applied. 239 records were retrieved after duplicates removed, but 181 references were extracted for full-text review. Individual level: HIV knowledge, serostatus, risk perceptions, abilities to disclose and for condom use negotiation, motivations, use of drugs, stigma, attitudes toward condom use, and perceptions/beliefs about the HIV and related treatments, HIV infection rates/testing and behavioral factors. Interpersonal level: social networks, abilities (sexual behavior negotiation, and communication). Community level: stigma, social norms, access to HIV related services. Structural level: political context, HIV related funding and public policies. HIV Serosorting is not solely an interpersonal behavior it involves multilevel elements that must be acknowledged by professionals and stakeholders.

Resumen Se desarrolló una revisión de alcance de la literatura para identificar elementos multinivel relacionados a la seroclasificación de VIH. Se incluyeron artículos de EBSCO, PubMed y Science Direct con serosort* o serosorting en título o resumen, escritos en Inglés o Español. No se aplicaron restricciones por tipo de población y diseño. Después de remover duplicados, se recuperaron 239 records, solo 181 referencias se extrajeron para revisión a texto completo. Nivel individual: Conocimiento del VIH, seroestado, percepciones de riesgo, habilidades para develar el seroestado y negociar el condón, motivaciones, uso de drogas, estigma, actitudes sobre uso del condón, y percepciones/ creencias acerca del VIH y tratamientos, tasas de infección y tamizaje de VIH, factores conductuales. Nivel interpersonal: redes sociales, habilidades (negociación de la conducta sexual, y comunicación). Nivel comunitario: Estigma, normas sociales, acceso a servicios de VIH. Nivel estructural: contexto político, políticas públicas y financiamiento relacionado al VIH. La seroclasificación de VIH no es solamente una conducta interpersonal, incluye elementos multinivel que deben ser reconocidos por los profesionales de salud y tomadores de decisiones.

Comprehensive approach to HIV/AIDS testing and linkage to treatment among men who have sex with men in Curitiba, Brazil.

INTRODUCTION: The Curitiba (Brazil)-based Project, A Hora é Agora (AHA), evaluated a comprehensive HIV control strategy among men who have sex with men (MSM) aimed at expanding access to HIV rapid testing and linking HIV-positive MSM to health services and treatment. AHA's approach included rapid HIV Testing Services (HTC) in one mobile testing unit (MTU); a local, gay-led, non-governmental organization (NGO); an existing government-run health facility (COA); and Internet-based HIV self-testing. The objectives of the paper were to compare a) number of MSM tested in each strategy, its positivity and linkage; b) social, demographic and behavioral characteristics of MSM accessing the different HTC and linkage services; and c) the costs of the individual strategies to diagnose and link MSM to services. METHODS: We used data for 2,681 MSM tested at COA, MTU and NGO from March 2015 to March 2017. This is a cross sectional comparison of the demographics and behavioral factors (age group, race/ethnicity, education, sexually transmitted diseases, knowledge of AHA services and previous HIV test). Absolute frequencies, percentage distributions and confidence intervals for the percentages were used, as well as unilateral statistical tests. RESULTS AND DISCUSSION: AHA performed 2,681 HIV tests among MSM across three in-person strategies: MTU, NGO, and COA; and distributed 4,752 HIV oral fluid tests through the self-testing platform. MTU, NGO and COA reported 365 (13.6%) HIV positive diagnoses among MSM, including 28 users with previous HIV diagnosis or on antiretroviral treatment for HIV. Of these, 89% of MSM were eligible for linkage-to-care services. Linkage support was accepted by 86% of positive MSM, of which 66.7% were linked to services in less than 90 days. The MTU resulted in the lowest cost per MSM tested ($137 per test), followed by self-testing ($247). CONCLUSIONS: AHA offered MSM access to HTC through innovative strategies operating in alternative sites and schedules. It presented the Curitiba HIV/AIDS community the opportunity to monitor HIV-positive MSM from diagnosis to treatment uptake. Self-testing emerged as a feasible strategy to increase MSM access to HIV-testing through virtual tools and anonymous test kit delivery and pick-up. Cost per test findings in both the MTU and self-testing support expansion to other regions with similar epidemiological contexts.

Factors Associated With the Role of Parents for the Prevention of Human Papillomavirus in Mexican Adolescents.

BACKGROUND: The parental role is key for the prevention of human papillomavirus (HPV) in adolescents; however, there are factors that can facilitate or inhibit its performance. For this reason, the purpose of this study was to determine the factors that influence the role of parents for prevention of HPV in their adolescent children. METHOD: A descriptive correlational study design included a convenience sample of 582 Mexican parents, whose son or daughter, 13 to 15 years of age, was in either the second or third year of high school. Data analyses included multiple linear regression. RESULTS: Factors related to the role of parents included knowledge about HPV (rs = 0.180, p < .01), perceived risk to contract HPV (rs = 0.148, p < .01), self-efficacy for sexual communication with adolescents (rs = 0.507, p < .01), and attitude toward prevention of HPV (rs = 0.272, p < .01). Self-efficacy for sexual communication with adolescents and attitude toward prevention of HPV positively influenced the parental role, explaining 28.8% of the variance, F(4, 577) = 59.80, p < .001. CONCLUSIONS: Parents with positive attitudes regarding prevention of HPV and who perceive self-efficacy in communicating sexuality issues with their adolescent children, develop a preventative role.