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2.
Rev Peru Med Exp Salud Publica ; 38(2): 240-247, 2021.
Artigo em Espanhol, Inglês | MEDLINE | ID: mdl-34468570

RESUMO

OBJECTIVE: To determine the factors associated with the non-use of health services in a sample of the lesbian, gay, bisexual, transgender, and intersex population of Peru. MATERIALS AND METHODS: Analytical cross-sectional study, analysis of secondary data from the First LGBTI Survey of Peru. Those who suffered from a medical condition during the last twelve months and had to receive medical attention were considered a variable of interest. Crude prevalence ratios (PRc) and adjusted (PRa), with 95% confidence intervals (95% CI) were calculated using Poisson regressions with robust variance. Three models were developed, adjusted to variables grouped according to sexual orientation, gender identity, and intersexuality. RESULTS: 55.4% were male at birth, the median age was 25 years (IR: 21-30). 16% stated that they had not sought medical attention. The three models presented a negative association in having suffered a chronic disease, infectious, contagious diseases, and mental illness and those who expressed their orientation openly. Not being respected for the gender they identified with was related to not using the services in model 3. Models 1 and 3 included a positive association with not being respected with the gender identified. CONCLUSION: Suffering from a mental illness, an infectious contagious disease, a chronic disease, and not being treated with respect according to their gender identity are factors associated with the non-use of health services.


Assuntos
Identidade de Gênero , Minorias Sexuais e de Gênero , Adulto , Estudos Transversais , Feminino , Serviços de Saúde , Humanos , Recém-Nascido , Masculino , Peru/epidemiologia
3.
Cien Saude Colet ; 26(suppl 2): 3543-3554, 2021.
Artigo em Português, Inglês | MEDLINE | ID: mdl-34468650

RESUMO

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.


Assuntos
Infecções por HIV , Minorias Sexuais e de Gênero , Brasil/epidemiologia , Estudos Transversais , Infecções por HIV/epidemiologia , Homossexualidade Masculina , Humanos , Masculino , Medição de Risco , Comportamento Sexual , Parceiros Sexuais
4.
J Pak Med Assoc ; 71(Suppl 4)(8): S26-S29, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-34469425

RESUMO

OBJECTIVE: To estimate the probability of human immunodeficiency virus (HIV)-1 transmission from different key HIV population groups using probabilistic modelling. Methods: This study was conducted in December 2020. A probabilistic model was used to estimate the probability of HIV-1 transmission from different key HIV population groups in Larkana. Our model was run on three probabilistic assumptions: 1) each replication gave two conceivable results: 'true' or 'false'; 2) the chance of giving a 'true' result is the same for each replication; and 3) the replications are independent - 'true' in one will not impact the likelihood of 'true' in another. RESULTS: The results estimated the probability of HIV transmission in key HIV population groups in Larkana to range between 0.42-0.54 per trial, where the highest probability of transmission was predicted for men who have sex with men (MSM; 0.54 per trial), followed by transgender (TG; 0.46 per trial) and people who inject drugs (PWID; 0.457 per trial). CONCLUSIONS: Our results suggest that there is a high likelihood of HIV transmission by key population groups in Larkana, such as MSM, TG, and PWID. Mathematic models, such as one proposed in our study can aid the HIV and acquired immunodeficiency syndrome (AIDS) control programmes in evaluating and optimising the strategies in controlling transmission of HIV from the key population groups.


Assuntos
Infecções por HIV , HIV-1 , Minorias Sexuais e de Gênero , Abuso de Substâncias por Via Intravenosa , Infecções por HIV/epidemiologia , Homossexualidade Masculina , Humanos , Masculino , Paquistão/epidemiologia , Grupos Populacionais
5.
Cad Saude Publica ; 37(8): e00263720, 2021.
Artigo em Português | MEDLINE | ID: mdl-34495096

RESUMO

The objective was to characterize sociodemographic, behavioral, and clinical aspects in young Brazilian military recruits according to prevalence of syphilis. This was a descriptive study based on a nationwide population-based survey in 2016 with a probabilistic sample of military recruits 17 to 22 years of age. A confidential self-applied questionnaire was used. Blood samples were drawn from participants for treponemal and non-treponemal syphilis tests. Descriptive statistical techniques were used to estimate syphilis prevalence rates and distribution of frequencies between the target variables, considering 95% confidence intervals (95%CI), after weighting the data. Of the total of 37,282 participants, 73.7% were sexually initiated. Prevalence rates for lifetime and confirmed syphilis were 1.6% and 1.1%, respectively. The following population variables showed higher prevalence of syphilis: lack of Internet access at home; initiation of sexual activity before 14 years of age; men who have sex with men; more than five sexual partners; having received presents, drugs, or other incentives in exchange for sex; and prior history of symptoms of sexually transmissible infections. An increase was observed in syphilis in Brazilian military recruits when compared to previous surveys. This increase emphasizes the importance of this sentinel population for performing active surveillance in order to support healthcare strategies for youth, including in the school system.


Assuntos
Infecções por HIV , Militares , Minorias Sexuais e de Gênero , Sífilis , Adolescente , Brasil/epidemiologia , Estudos Transversais , Homossexualidade Masculina , Humanos , Masculino , Prevalência , Fatores de Risco , Comportamento Sexual , Sífilis/epidemiologia
6.
Rev Lat Am Enfermagem ; 29: e3470, 2021.
Artigo em Inglês, Português, Espanhol | MEDLINE | ID: mdl-34468626

RESUMO

OBJECTIVE: to develop and implement an online education resources to address a gap in nursing education regarding the concept of cultural humility and its application to healthcare encounters with persons who identify as lesbian, gay, bisexual, transgender, queer, intersex (LGBTQI) or Two-Spirit. Improved understanding of LGBTQI and Two-Spirit community health issues is essential to reducing the healthcare access barriers they currently face. METHOD: an online educational toolkit was developed that included virtual simulation games and curated resources. The development process included community involvement, a team-building meeting, development of learning outcomes, decision-point maps and scriptwriting for filming. A website and learning management system was designed to present learning objectives, curated resources, and the virtual games. RESULTS: the Sexual Orientation and Gender Identity Nursing Toolkit was created to advance cultural humility in nursing practice. The learning toolkit focuses on encounters using cultural humility to meet the unique needs of LGBTQI and Two-Spirit communities. CONCLUSION: our innovative online educational toolkit can be used to provide professional development of nurses and other healthcare practitioners to care for LGBTQI and Two-Spirit individuals.


Assuntos
Educação à Distância , Cuidados de Enfermagem , Minorias Sexuais e de Gênero , Feminino , Identidade de Gênero , Humanos , Masculino , Comportamento Sexual
7.
Rev Lat Am Enfermagem ; 29: e3474, 2021.
Artigo em Inglês, Português, Espanhol | MEDLINE | ID: mdl-34468628

RESUMO

OBJECTIVE: to investigate the factors associated with the practice of sex under the influence of drugs (chemsex) among Portuguese men who have sex with men during the period of social distancing to prevent the COVID-19. METHOD: online survey applied in May 2020 to a sample of 1,301 participants living in Portugal, recruited according to Respondent Driven Sampling and via social media Facebook®. Descriptive and bivariate analyses were performed along with logistic regression to calculate adjusted Odds Ratio (ORa). RESULTS: the prevalence of chemsex was 20.2%. The likelihood of practicing chemsex increased with group sex (ORa: 28.4, 95%CI 16.93-47.49); unprotected sex (ORa: 7.1 95%CI 4.57-10.99); the use of pre-exposure prophylaxis (PrEP) to prevent COVID-19 (ORa: 4.2, 95%CI 2.71-6.39) and COVID-19 testing (ORa: 1.9, 95%CI 1.15-3.10). CONCLUSION: the practice of chemsex among men who have sex with men during the COVID-19 pandemic in Portugal was very frequent and may support greater understanding of the role and impact of sexual behavior on the COVID-19 transmission rates and the current pandemic situation in Portugal.


Assuntos
COVID-19 , Infecções por HIV , Minorias Sexuais e de Gênero , Teste para COVID-19 , Estudos Transversais , Infecções por HIV/epidemiologia , Homossexualidade Masculina , Humanos , Masculino , Pandemias , Portugal/epidemiologia , SARS-CoV-2 , Comportamento Sexual
8.
BMJ Open ; 11(9): e047856, 2021 09 02.
Artigo em Inglês | MEDLINE | ID: mdl-34475162

RESUMO

OBJECTIVES: To critically appraise and synthesise the evidence in relation to both the receipt and delivery of LGBTI+ (Lesbian, Gay, Bisexual, Transgender, Intersex) inclusive sexual health education. DESIGN: A systematic review and narrative synthesis. DATA SOURCES: A systematic search of three online databases (EMBASE, PsychINFO and SocINDEX) from January 1990 to May 2021 was conducted. ELIGIBILITY CRITERIA: Studies included were (1) peer-reviewed; (2) English; (3) quantitative, qualitative and mixed methods; that evaluated (4) inclusive sexual health in an educational or online setting and (5) focused on training or educating. Studies were excluded if (1) the population was not LGBTI+ inclusive; (2) the studies did not focus on original data or (3) the study was not available in full text. DATA EXTRACTION AND SYNTHESIS: The studies that met the inclusion criteria were assessed using the Critical Appraisal Skills Programme tool. A narrative synthesis was then completed employing content analysis focusing on the results section of each article. RESULTS: Of the 5656 records retrieved, 24 studies met the inclusion criteria. The majority of studies noted that both LGBTI+ youth and those who facilitate sexual health education are turning to online sources of information. Current sexual health education programmes operate mainly from a heterosexual perspective, creating a sense of exclusion for LGBTI+ youth. This is compounded by a lack of training, or provision of an inclusive curricula, resulting in facilitators feeling ill equipped or inhibited by their personal biases. CONCLUSIONS: LGBTI+ youth are not experiencing inclusive and comprehensive sexual health education. In parallel, educators report poor access to information, training and resources remain the primary reasons. There is a need to standardise sexual health curricula, making them LGBTI+ inclusive and incorporate holistic aspects of health such as pleasure and healthy relationships. Online approaches should be considered in the future, as they represent equality of access for both sexual health education professionals and LGBTI+ youth alike.


Assuntos
Homossexualidade Feminina , Minorias Sexuais e de Gênero , Pessoas Transgênero , Adolescente , Bissexualidade , Feminino , Humanos , Educação Sexual
9.
J Headache Pain ; 22(1): 110, 2021 Sep 18.
Artigo em Inglês | MEDLINE | ID: mdl-34537006

RESUMO

BACKGROUND: These subgroup analyses of a Phase 3, randomized, double-blind, placebo-controlled study evaluated the efficacy and safety of erenumab 70 mg in Japanese migraine patients with/without prior preventive treatment failure(s) ("failed-yes" and "failed-no" subgroups) and with/without concomitant preventive treatment ("concomitant preventive-yes" and "concomitant preventive-no" subgroups). METHODS: Overall, 261 patients were randomized; 130 and 131 patients to erenumab 70 mg and placebo, respectively. Subgroup analyses evaluated the change from baseline to Months 4-6 in mean monthly migraine days (MMD) (primary endpoint), achievement of a ≥50% reduction in mean MMD, and change from baseline in mean monthly acute migraine-specific medication (MSM) treatment days. Treatment-emergent adverse events were also evaluated. RESULTS: Of the 261 patients randomized, 117 (44.8%) and 92 (35.3%) patients were in the failed-yes and concomitant preventive-yes subgroups, respectively. Erenumab 70 mg demonstrated consistent efficacy across all subgroups, with greater reductions from baseline in mean MMD versus placebo at Months 4-6 (treatment difference versus placebo [95% CI], failed-yes: - 1.9 [- 3.3, - 0.4]; failed-no: - 1.4 [- 2.6, - 0.3]; concomitant preventive-yes: - 1.7 [- 3.3, 0.0]; concomitant preventive-no: - 1.6 [- 2.6, - 0.5]). Similar results were seen for achievement of ≥50% reduction in mean MMD and change from baseline in mean monthly acute MSM treatment days. The safety profile of erenumab 70 mg was similar across subgroups, and similar to placebo in each subgroup. CONCLUSION: Erenumab was associated with clinically relevant improvements in all efficacy endpoints and was well tolerated across all subgroups of Japanese migraine patients with/without prior preventive treatment failure(s) and with/without concomitant preventive treatment. TRIAL REGISTRATION: Clinicaltrials.gov . NCT03812224. Registered January 23, 2019.


Assuntos
Transtornos de Enxaqueca , Minorias Sexuais e de Gênero , Anticorpos Monoclonais Humanizados , Antagonistas do Receptor do Peptídeo Relacionado ao Gene de Calcitonina , Método Duplo-Cego , Homossexualidade Masculina , Humanos , Japão , Masculino , Transtornos de Enxaqueca/tratamento farmacológico , Transtornos de Enxaqueca/prevenção & controle , Falha de Tratamento , Resultado do Tratamento
10.
Int J Med Inform ; 153: 104529, 2021 09.
Artigo em Inglês | MEDLINE | ID: mdl-34385097

RESUMO

OBJECTIVE: The widespread and frequent use of mobile technology among adolescents, including sexual minority adolescents, presents an opportunity for the development of mobile health (mHealth) technology to combat the continuing HIV epidemic among young men who have sex with men (YMSM). We analyzed perceptions of the quality and impact of an HIV prevention mobile app on sexual risk reduction among YMSM. METHODS: Participants were recruited from a larger randomized controlled trial of the MyPEEPS Mobile app among YMSM aged 13-18 years. Data were collected via semi-structured interviews to assess quality and user satisfaction with MyPEEPS Mobile app using analysis informed by the Information Systems Success framework. Interview data were transcribed verbatim and analyzed using six themes: information quality, net benefit, user satisfaction, product quality, service quality, and health care barriers. RESULTS: Interviews were conducted with 40 YMSM (45% Hispanic; 80% non-White; 88% non-rural resident; 28% aged 17 years). Participants' responses indicated that information quality was high, reporting that the app information was concise, easy to understand, useful, and relevant to their life. The net benefits were stated as improvements in their decision-making skills, health behaviors, communication skills with partner(s), and increased knowledge of HIV risk. There was general user satisfaction and enjoyment when using the app, although most of the participants did not intend to reuse the app unless new activities were added. Participants expressed that the product quality of the app was good due to its personalization, representation of the LGBTQIA + community, and user-friendly interface. Although no major technical issues were reported, participants suggested that adaption to a native app, rather than a web app, would improve service quality through faster loading speed. Participants also identified some health care barriers that were minimized by app use. CONCLUSIONS: The MyPEEPS Mobile app is a well received, functional, and entertaining mHealth HIV prevention tool that may improve HIV prevention skills and reduce HIV risk among YMSM.


Assuntos
Infecções por HIV , Aplicativos Móveis , Saúde Sexual , Minorias Sexuais e de Gênero , Adolescente , Infecções por HIV/prevenção & controle , Homossexualidade Masculina , Humanos , Sistemas de Informação , Masculino
11.
F1000Res ; 10: 222, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33968367

RESUMO

BACKGROUND: Voluntary therapeutic interventions to reduce unwanted same-sex sexuality are collectively known as sexual orientation change efforts (SOCE).  To date almost all evidence addressing the contested question whether SOCE is effective or safe has consisted of anecdotes or very small sample qualitative studies of persons who currently identify as sexual minority and thus by definition failed to change.  We conducted this study to examine the efficacy and risk outcomes for a group of SOCE participants unbiased by current sexual orientation.       Methods: We examined a convenience sample of 125 men who had undergone SOCE for homosexual-to-heterosexual change in sexual attraction, identity and behavior, and for positive and negative changes in psychosocial problem domains (depression, suicidality, self-harm, self-esteem, social function, and alcohol or substance abuse).  Mean change was assessed by parametric (t-test) and nonparametric (Wilcoxon sign rank test) significance tests.   Results: Exposure to SOCE was associated with significant declines in same-sex attraction (from 5.7 to 4.1 on the Kinsey scale, p <.000), identification (4.8 to 3.6, p < .000), and sexual activity (2.4 to 1.5 on a 4-point scale of frequency, p < .000).  Over 42.7% of SOCE participants achieved at least partial remission of unwanted same-sex sexuality; full remission was achieved by 14% for sexual attraction and identification, and 26% for sexual behavior.  Rates were higher among married men, but 4-10% of participants experienced increased same-sex orientation after SOCE.  From 0.8% to 4.8% of participants reported marked or severe negative psychosocial change following SOCE, but 12.1% to 61.3% reported marked or severe positive psychosocial change.  Net change was significantly positive for all problem domains.   Conclusion: SOCE was perceived as an effective and safe therapeutic practice by this sample of participants.  We close by offering a unifying understanding of discrepant findings within this literature and caution against broad generalizations of our results.


Assuntos
Comportamento Sexual , Minorias Sexuais e de Gênero , Feminino , Humanos , Masculino , Casamento , Estudos Retrospectivos , Autoimagem
12.
AIDS Res Ther ; 18(1): 52, 2021 08 16.
Artigo em Inglês | MEDLINE | ID: mdl-34399787

RESUMO

BACKGROUND: HIV and hepatitis C virus (HCV) have shared routes of transmission among men who have sex with men (MSM). Routine testing facilitates early diagnosis and treatment, thereby preventing morbidity and onward transmission. We evaluated factors associated with HIV and HCV testing in a behaviorally vulnerable cohort of predominantly MSM. METHODS: From June 2018 through June 2019, the BRAHMS study enrolled adults at ten German outpatient clinics that serve gender and sexual minority populations. Participants completed behavioral questionnaires that captured prior experience with HIV and HCV testing. Multivariable robust Poisson regression was used to evaluate factors potentially associated with testing in the previous 6 months. RESULTS: Among 1017 participants with median age 33 (interquartile range 28-39) years, 1001 (98.4%) reported any lifetime history of HIV testing and 787 (77.4%) reported any HCV testing, including 16 (1.6%) known to be living with HCV. Testing within the last 6 months was reported by 921 (90.6%) and 513 (50.4%) for HIV and HCV, respectively. Recent HIV testing was more common among participants with higher education level and recent HCV testing. Recent HCV testing was more common among participants with non-cisgender identity, lifetime history of illicit drug use, hepatitis B immunity or infection, and recent HIV testing. CONCLUSION: Prior testing for HIV was common in this cohort, but interventions are needed to improve HCV risk stratification and access to testing. HIV testing infrastructure can be successfully leveraged to support HCV testing, but differentiated preventive care delivery is needed for some vulnerable populations.


Assuntos
Infecções por HIV , Hepatite C , Minorias Sexuais e de Gênero , Adulto , Estudos de Coortes , Estudos Transversais , Alemanha/epidemiologia , Infecções por HIV/diagnóstico , Infecções por HIV/epidemiologia , Hepacivirus , Hepatite C/diagnóstico , Hepatite C/epidemiologia , Homossexualidade Masculina , Humanos , Masculino , Fatores de Risco
13.
Front Public Health ; 9: 653565, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34354973

RESUMO

Background: The ATLAS program promotes and implements HIVST in Côte d'Ivoire, Mali, and Senegal. Priority groups include members of key populations-female sex workers (FSW), men having sex with men (MSM), and people who use drugs (PWUD)-and their partners and relatives. HIVST distribution activities, which began in mid-2019, were impacted in early 2020 by the COVID-19 pandemic. Methods: This article, focusing only on outreach activities among key populations, analyzes quantitative, and qualitative program data collected during implementation to examine temporal trends in HIVST distribution and their evolution in the context of the COVID-19 health crisis. Specifically, we investigated the impact on, the adaptation of and the disruption of field activities. Results: In all three countries, the pre-COVID-19 period was marked by a gradual increase in HIVST distribution. The period corresponding to the initial emergency response (March-May 2020) witnessed an important disruption of activities: a total suspension in Senegal, a significant decline in Côte d'Ivoire, and a less pronounced decrease in Mali. Secondary distribution was also negatively impacted. Peer educators showed resilience and adapted by relocating from public to private areas, reducing group sizes, moving night activities to the daytime, increasing the use of social networks, integrating hygiene measures, and promoting assisted HIVST as an alternative to conventional rapid testing. From June 2020 onward, with the routine management of the COVID-19 pandemic, a catch-up phenomenon was observed with the resumption of activities in Senegal, the opening of new distribution sites, a rebound in the number of distributed HIVST kits, a resurgence in larger group activities, and a rebound in the average number of distributed HIVST kits per primary contact. Conclusions: Although imperfect, the program data provide useful information to describe changes in the implementation of HIVST outreach activities over time. The impact of the COVID-19 pandemic on HIVST distribution among key populations was visible in the monthly activity reports. Focus groups and individual interviews allowed us to document the adaptations made by peer educators, with variations across countries and populations. These adaptations demonstrate the resilience and learning capacities of peer educators and key populations.


Assuntos
COVID-19 , Infecções por HIV , Profissionais do Sexo , Minorias Sexuais e de Gênero , Costa do Marfim/epidemiologia , Feminino , Infecções por HIV/diagnóstico , Homossexualidade Masculina , Humanos , Masculino , Mali/epidemiologia , Pandemias , SARS-CoV-2 , Autoteste , Senegal/epidemiologia
14.
Front Public Health ; 9: 673959, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34368050

RESUMO

Background: Pre-exposure prophylaxis (PrEP) and post-exposure prophylaxis (PEP) have been increasingly available in Europe. Due to the high burden of HIV in key populations, these could benefit from their use. In 2016, in Portugal, an open, non-interval, prospective cohort study was established in a network of 26 community-based voluntary HIV/STI counseling and testing centers. Data collected included questions on PEP and PrEP knowledge and use. We aimed to estimate the proportion of PEP and PrEP knowledge and its use among key populations, visiting the centers between 2016 and 2019. Method and results: Individuals who self-identify as being among at least one key population for HIV, men who have sex with men (MSM), people who inject drugs (PWID), sex workers (SW), migrants, and male-to-female transgender individuals (MTF), responded to questions on PEP and PrEP knowledge and use while waiting for their test results between 2016 and 2019 (n = 12,893 for PEP; n = 10,973 for PrEP). Reported knowledge was low in all key populations for both tools: 15.7% of respondents reported knowing about PEP and 10.9% about PrEP over the course of 4 years. PEP was used by 1.8% and PrEP by 0.4% of the respondents, MSM being 88.9% of PrEP users, and 52.8% of PEP users. Multivariate logistic regression showed multiple factors associated with knowing the tools, including age, education, country of birth, gender, year of test, having a reactive HIV test in the same visit, reporting an STI or condomless sex in the last 12 months, and identifying with being MSM or SW. Conclusions: Knowledge and use of PEP and PrEP remain low among key populations in Portugal. The need remains to increase knowledge and use among those at risk for HIV infection.


Assuntos
Infecções por HIV , Minorias Sexuais e de Gênero , Doenças Sexualmente Transmissíveis , Feminino , Infecções por HIV/epidemiologia , Homossexualidade Masculina , Humanos , Masculino , Portugal/epidemiologia , Estudos Prospectivos
15.
Orv Hetil ; 162(32): 1267-1274, 2021 08 08.
Artigo em Húngaro | MEDLINE | ID: mdl-34370688

RESUMO

Összefoglaló. Az elmúlt 40 évben a nemi kisebbségek speciális orvosi ellátásához szükséges kutatások elterjedése és a publikációk folyamatos növekedése figyelheto meg a külföldi orvosi adatbázisokban. A nemi vonzalom és identitás sajátosságai nagyban befolyásolják a helyes diagnózis felállítását, a szükséges kezelések és szurések meghatározását, valamint a magas öngyilkossági veszélyeztetettség miatt a prevenciós beavatkozási pontok körét is. Az orvosi adatbázisokon kívül orvosszakmai szervezetek és oktatási-kutatási hátteru klinikai intézmények is számos bevált gyakorlatról és irányelvrol adnak tájékoztatást. A szükséges ismeretek bovítésén túl eloremutató lehet a nem tudatos eloítéletek csökkentése és az orvos-beteg kommunikáció elmélyítése. Orv Hetil. 2021; 162(32): 1267-1274. Summary. In the past 40 years, research studies related to the special healthcare for sexual and gender minorities have become widely known and the number of publications has increased in international medical databases. The characteristics of gender attraction and identity have an impact on developing a successful diagnosis, on determining the necessary screenings and treatments, and on performing preventive intervention since the sexual and gender minorities are at elevated risk for suicide. Apart from medical databases, best practices and guidelines are also provided by healthcare professional organizations and clinics committed to education and research as well. In addition to broadening knowledge, reducing unconscious prejudices and improving the doctor-patient communication would lead to a veritable leap forward in meeting the healthcare needs of sexual and gender minorities. Orv Hetil. 2021; 162(32): 1267-1274.


Assuntos
Comunicação , Minorias Sexuais e de Gênero , Atenção à Saúde , Humanos , Comportamento Sexual
16.
BMJ Open ; 11(8): e047280, 2021 08 06.
Artigo em Inglês | MEDLINE | ID: mdl-34362801

RESUMO

INTRODUCTION: Research has established that various forms of stigma (HIV stigma, gender non-conforming stigma and same-gender sex stigma) exist across Sub-Saharan Africa and have consequences for the utilisation of HIV prevention and care services. Stigmas are typically investigated in HIV literature individually or through investigating individual populations and the various stigmas they may face. The concept of intersectionality highlights the interconnected nature of social categorisations and their ability to create interdependent systems of discrimination based on gender, race, sexuality and so on. Drawing from perspectives on intersectionality, intersectional stigma denotes the convergence of multiple marginalised identities within an individual or a group, the experiences of stigma associated with these identities as well as the synergistic impact of these experiences on health and well-being. With respect to HIV, public health scholars can examine the impacts of intersectional stigmas on HIV prevention and care utilisation. METHODS AND ANALYSIS: Reviewers will search systematically through MEDLINE, Global Health, Embase, Scopus, Web of Science Core Collection and Africa Index Medicus and citations for quantitative studies, qualitative studies and grey literature that include data on stigma and HIV among men who have sex with men and women who have sex with women in Sub-Saharan Africa. Eligible studies will include primary or secondary data on stigma related to HIV risk factors experienced by this population. Studies will be written in French or English and be published between January 1991 and November 2020. All screening and data extraction will be performed in duplicate, and if discrepancies arise, they will be settled by GM'RA, LEN, DD or AO. Findings from this study will be reported according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews. ETHICS AND DISSEMINATION: Ethics approval is not required as there will be no human participants and no protected data will be used in this study. We will disseminate findings through peer-reviewed manuscripts, conferences and webinars.


Assuntos
Infecções por HIV , Minorias Sexuais e de Gênero , África ao Sul do Saara , Feminino , Infecções por HIV/prevenção & controle , Homossexualidade Masculina , Humanos , Masculino , Literatura de Revisão como Assunto , Estigma Social , Revisões Sistemáticas como Assunto
17.
AIDS Educ Prev ; 33(4): 276-289, 2021 08.
Artigo em Inglês | MEDLINE | ID: mdl-34370568

RESUMO

In the United States, Hispanic/Latino men who have sex with men (HLMSM) are disproportionally affected by HIV. We conducted a rapid review of national surveillance data to examine disparities in HIV prevention and care outcomes among HLMSM. Thirteen reports provided relevant data from 2011 to 2018. Compared to White MSM, a higher percentage of HIV-negative HLMSM reported not taking PrEP and engaging in condomless sex; a lower percentage of HIV-negative HLMSM at risk for HIV reported PrEP awareness and use; and a lower percentage of HIV-positive HLMSM were aware of their status, linked to HIV care, and virally suppressed. Viral suppression rates in HLMSM were better among Ryan White clients than the national rates, suggesting that access to comprehensive care/services reduces disparities. Findings also call for identifying individual, social, and structural factors contributing to condomless sex without PrEP use and HIV status unawareness and identifying best approaches for scaling up comprehensive care/services.


Assuntos
Infecções por HIV , Profilaxia Pré-Exposição , Minorias Sexuais e de Gênero , Afro-Americanos , Infecções por HIV/prevenção & controle , Hispano-Americanos , Homossexualidade Masculina , Humanos , Masculino , Estados Unidos/epidemiologia
18.
Addict Behav ; 123: 107053, 2021 12.
Artigo em Inglês | MEDLINE | ID: mdl-34416533

RESUMO

INTRODUCTION: Heavy episodic drinking poses a risk for HIV-infection, particularly among men who have sex with men (MSM). Previous research suggests implicit associations may play a role in heavy episodic drinking and that various executive functions (EF) may moderate the relation between implicit associations and heavy episodic drinking. This study investigated the role of two EF - working memory (maintaining and updating information) and response inhibition (inhibiting prepotent responses) - as moderators of the relation between implicit alcohol approach associations and heavy episodic drinking among moderate-to-heavy drinking MSM. METHODS: Two-hundred and fifty-one participants completed measures of implicit alcohol associations (the implicit alcohol approach association test - IAT), working memory, and response inhibition, as well as a self-report questionnaire assessing heavy episodic drinking. Regression analyses were conducted to examine whether the association between the IAT and heavy episodic drinking was moderated by working memory and response inhibition. RESULTS: Results showed that working memory moderated the relation between the alcohol IAT and heavy episodic drinking such that IAT alcohol approach scores were positively associated with heavy episodic drinking among those low in working memory but not those high in working memory. Response inhibition did not moderate the association between IAT scores and heavy episodic drinking. CONCLUSIONS: Results suggest that the relation between implicit alcohol approach associations and heavy episodic drinking is stronger among moderate-to-heavy drinking MSM with lower working memory capacity compared to those with higher working memory capacity, and these individuals may particularly benefit from alcohol intervention approaches that target automatic alcohol responses.


Assuntos
Homossexualidade Masculina , Minorias Sexuais e de Gênero , Consumo de Bebidas Alcoólicas/epidemiologia , Etanol , Humanos , Masculino , Memória de Curto Prazo
19.
Artigo em Inglês | MEDLINE | ID: mdl-34444038

RESUMO

This study describes the prevalence of anabolic-androgenic steroid (AAS) injection, their main correlates, and the prevalence of specific AAS injection risk behaviours among men who have sex with men (MSM), an area insufficiently addressed in scientific research. Participants were HIV-negative MSM attending four HIV/STI diagnosis services: two clinics and two community programmes in Madrid and Barcelona. Participants answered an online self-administered questionnaire. Crude and adjusted lifetime prevalence and prevalence ratios (PRs) were calculated by different factors and using Poisson regression models with robust variance. Of the 3510 participants, 6.1% (95% CI: 5.3-6.9) had injected AAS before and 3.5% (95% CI: 2.9-4.2) had done so in the last 12 months. In the multivariate analysis, AAS injection was independently associated with being over 40 years old (aPR = 3.6; 95% CI: 2.0-6.5) and being born in Latin America (aPR = 2.5; 95% CI:1.9-3.4), and was less strongly associated (aPRs of around two) with having been recruited into STI clinics, having ever been paid for sex before, injected drugs, used drugs for sex, having been diagnosed with an STI before, and having been diagnosed with HIV at the recruitment consultation. Only three participants, 1.4%, of those who had injected AAS before had shared AAS or equipment for preparation or injecting before. Conclusions: In contrast to drugs, AAS injecting behaviours do not play a relevant, direct role in the transmission of blood-borne infections among MSM. However, AAS injectors have a higher prevalence of sexual risk behaviours. These findings should be confirmed using new studies that employ other sampling procedures.


Assuntos
Infecções por HIV , Minorias Sexuais e de Gênero , Doenças Sexualmente Transmissíveis , Adulto , Infecções por HIV/epidemiologia , Homossexualidade Masculina , Humanos , Masculino , Prevalência , Fatores de Risco , Parceiros Sexuais , Doenças Sexualmente Transmissíveis/epidemiologia , Congêneres da Testosterona
20.
Am J Case Rep ; 22: e931595, 2021 Aug 09.
Artigo em Inglês | MEDLINE | ID: mdl-34370719

RESUMO

BACKGROUND Mycobacterium avium intracellulare complex (MAI) is a member of the non-tuberculous mycobacteria family, which can cause both pulmonary and non-pulmonary disease. In patients with advanced HIV, it is known to cause disseminated disease. We present a case of a 65-year-old man who has sex with men (MSM) with AIDS, found to have spondylodiscitis and an epidural abscess, who had recently completed treatment for disseminated MAI. CASE REPORT The patient was a 65-year-old with AIDS secondary to HIV and a prior history of disseminated MAI, who presented with severe back pain. Upon presentation to the hospital, an MRI was performed, which was suggestive of spondylodiscitis and an epidural abscess. He was taken to surgery for a minimally invasive T12-L1 laminectomy and evacuation of the epidural abscess. Both traditional cultures and acid-fast bacillus (AFB) cultures were negative. Due to worsening pain, he was taken back to surgery for a repeat debridement and biopsy. Repeat cultures were positive for MAI. He was started on rifabutin, ethambutol, azithromycin, and moxifloxacin. Moxifloxacin was subsequently discontinued. He has had problems tolerating the treatment regimen, but is planned to complete an 18-24-month course. CONCLUSIONS For patients with AIDS who have a diagnosis of spondylodiscitis and an epidural abscess, an opportunistic infection such as MAI should be considered. A repeat biopsy should be considered if suspicion is still high, even despite initially negative cultures. Treatment regimens should be prolonged, despite difficulty with medication compliance.


Assuntos
Síndrome de Imunodeficiência Adquirida , Discite , Abscesso Epidural , Infecção por Mycobacterium avium-intracellulare , Minorias Sexuais e de Gênero , Idoso , Discite/diagnóstico , Abscesso Epidural/complicações , Abscesso Epidural/diagnóstico , Homossexualidade Masculina , Humanos , Masculino , Complexo Mycobacterium avium , Infecção por Mycobacterium avium-intracellulare/complicações , Infecção por Mycobacterium avium-intracellulare/diagnóstico , Recidiva Local de Neoplasia
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