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Public Health Rep ; 135(1_suppl): 65S-74S, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32735198


In 2014, New York State became the first jurisdiction to launch a statewide initiative to end AIDS by reducing the number of persons living with HIV for the first time since effective HIV treatment became available. The Ending the Epidemic (ETE) initiative encompasses (1) identifying and linking undiagnosed persons with HIV to care, (2) retaining persons with HIV in care, and (3) facilitating access to preexposure prophylaxis for persons at risk for acquiring HIV. We used a framework for public health program implementation to describe key characteristics of the ETE initiative, present progress toward 13 ETE target metrics, and identify areas in need of increased programming. We provide evidence suggesting that New York State is on track to end AIDS as an epidemic by the end of 2020. As of 2017, 76% of progress toward our primary ETE target had been achieved. Substantial progress on several additional metrics critical to decreasing HIV prevalence and to improving the health of persons living with HIV had also been achieved. Lessons learned included the following: (1) ETE-based programming should be tailored to each jurisdiction's unique political and social climate, HIV epidemiology, fiscal resources, and network of HIV service providers; (2) key stakeholders should be involved in developing ETE metrics and setting targets; (3) performance-based measurement and timely communication to key stakeholders in real time are essential; and (4) examining trends in HIV prevention and care metrics is important for developing realistic ETE timelines.

Epidemias/prevenção & controle , Infecções por HIV/epidemiologia , Infecções por HIV/prevenção & controle , Síndrome de Imunodeficiência Adquirida/epidemiologia , Síndrome de Imunodeficiência Adquirida/prevenção & controle , Comunicação , Infecções por HIV/diagnóstico , Infecções por HIV/terapia , Acesso aos Serviços de Saúde/organização & administração , Humanos , Relações Interinstitucionais , New York , Cooperação do Paciente , Política , Profilaxia Pré-Exposição , Prevalência , Avaliação de Programas e Projetos de Saúde , Características de Residência , Fatores Socioeconômicos
Public Health Rep ; 135(1_suppl): 158S-171S, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32735199


OBJECTIVES: In 2014, the governor of New York announced the Ending the Epidemic (ETE) plan to reduce annual new HIV infections from 3000 to 750, achieve a first-ever decrease in HIV prevalence, and reduce AIDS progression by the end of 2020. The state health department undertook participatory simulation modeling to develop a baseline for comparing epidemic trends and feedback on ETE strategies. METHODS: A dynamic compartmental model projected the individual and combined effects of 3 ETE initiatives: enhanced linkage to and retention in HIV treatment, increased preexposure prophylaxis (PrEP) among men who have sex with men, and expanded housing assistance. Data inputs for model calibration and low-, medium-, and high-implementation scenarios (stakeholders' rollout predictions, and lower and upper bounds) came from surveillance and program data through 2014, the literature, and expert judgment. RESULTS: Without ETE (baseline scenario), new HIV infections would decline but remain >750, and HIV prevalence would continue to increase by 2020. Concurrently implementing the 3 programs would lower annual new HIV infections by 16.0%, 28.1%, and 45.7% compared with baseline in the low-, medium-, and high-implementation scenarios, respectively. In all concurrent implementation scenarios, although annual new HIV infections would remain >750, there would be fewer new HIV infections than deaths, yielding the first-ever decrease in HIV prevalence. PrEP and enhanced linkage and retention would confer the largest population-level changes. CONCLUSIONS: New York State will achieve 1 ETE benchmark under the most realistic (medium) implementation scenario. Findings facilitated framing of ETE goals and underscored the need to prioritize men who have sex with men and maintain ETE's multipronged approach, including other programs not modeled here.

Fármacos Anti-HIV/uso terapêutico , Epidemias/prevenção & controle , Infecções por HIV/tratamento farmacológico , Infecções por HIV/prevenção & controle , Homossexualidade Masculina , Síndrome de Imunodeficiência Adquirida/epidemiologia , Síndrome de Imunodeficiência Adquirida/prevenção & controle , Simulação por Computador , Infecções por HIV/diagnóstico , Infecções por HIV/epidemiologia , Acesso aos Serviços de Saúde/organização & administração , Humanos , Masculino , Modelos Teóricos , New York , Cooperação do Paciente , Profilaxia Pré-Exposição/métodos , Prevalência , Avaliação de Programas e Projetos de Saúde
Zhonghua Liu Xing Bing Xue Za Zhi ; 41(7): 1081-1085, 2020 Jul 10.
Artigo em Chinês | MEDLINE | ID: mdl-32741175


Objective: To analyze the prevalence of anal sex and related factors in low-tier female sex workers (FSWs) in the demonstration areas of comprehensive AIDS responses (DACAR) in Zhejiang province. Method: In 2013, a survey on low-tier FSWs was carried out in 21 Demonstration Areas of AIDS Responses in Zhejiang. Experience of having anal sex with clients in the last month was taken as dependent variable while independent variables would include perception and characteristics related to behavior of the FSWs. The multivariate logistic regression analyses were conducted to identify the factors related to anal sex in low-tier FSWs. Results: A total of 2 645 low-tier FSWs were interviewed. Among these FSWs, 67.9% (1 796/2 645) were over 26 years old, 89.9% (2 378/2 645) were with education level of junior high school or below, 58.4% (1 546/2 645) were married, 78.2% (2 068/2 645) were from other provinces, 68.6% (1 814/2 645) had income level less than 4 000 Yuan, and rates of anal sex with client in the last month were 5.03% (133/2 645). Results from the multivariate logistic regression analysis of related factors of anal sex with client in the last month showed that among the low-tier FSWs, the venues of having commercial sex were in hair salons/massage parlors (OR=7.31, 95%CI: 2.27-23.59), roadside shops (OR=7.89, 95%CI: 2.27- 27.40) or other places (OR=4.65, 95%CI: 1.23-17.53), when compared with the street-women service. FSWs often engaged in commercial sex business in three or more counties (OR=1.68, 95%CI: 1.01-2.81), when compared with FSWs often engaged in commercial sex business just one county. FSWs had sex with only middle-aged and the elderly clients (OR=0.45, 95%CI: 0.30-0.66), when compared with FSWs had sex with young or middle-aged and the elderly clients. FSWs had risk perception for sexually transmitted disease (STD) (OR=2.00, 95%CI: 1.20-3.32), when compared with FSWs with no risk perception. FSWs had oral sex experience with their clients in the last month (OR=7.29, 95%CI: 4.78-11.12), when compared with the ones without oral sex. The above said factors were all related to the incidence of anal sex. Conclusions: Certain numbers of low-tier FSWs had anal sex experiences with their clients, especially those who had oral sex were more likely to have anal sex in DACAR in Zhejiang province. Attention should be paid to anal sex behavior when conducting behavior-related intervention programs, targeting on the low-tier FSWs.

Síndrome de Imunodeficiência Adquirida/prevenção & controle , Profissionais do Sexo/psicologia , Comportamento Sexual/estatística & dados numéricos , Síndrome de Imunodeficiência Adquirida/epidemiologia , Adulto , China/epidemiologia , Feminino , Humanos , Prevalência , Fatores de Risco , Profissionais do Sexo/estatística & dados numéricos , Fatores Socioeconômicos
Rev Med Liege ; 75(5-6): 356-361, 2020 May.
Artigo em Francês | MEDLINE | ID: mdl-32496679


In order to end the AIDS pandemic, new infections must be avoided. This prevention can be divided into four axes depending on the risk of exposure to the HIV virus. Over the past decade, new prevention strategies supported by various studies have emerged. These are effective when they are used in combination. Some are not without risk or even controversial according to some authors.

Síndrome de Imunodeficiência Adquirida , Infecções por HIV , Síndrome de Imunodeficiência Adquirida/prevenção & controle , Síndrome de Imunodeficiência Adquirida/transmissão , Infecções por HIV/prevenção & controle , Infecções por HIV/transmissão , Humanos
BMC Infect Dis ; 20(1): 338, 2020 May 12.
Artigo em Inglês | MEDLINE | ID: mdl-32398032


BACKGROUND: Peer education has become a strategy for health promotion among high-risk groups for HIV infection worldwide. However, the extent to which peer education could have an impact on HIV prevention or the long-term effect of this impact is still unknown. This study thus quantifies the impact of peer education over time among high-risk HIV groups globally. METHOD: Following the PRISMA guidelines, a systematic review and meta-analysis was used to assess the effects and duration of peer education. A thorough literature search of PubMed, Web of Science, Embase and Cochrane Library was performed, and studies about peer education on high-risk HIV groups were reviewed. Pooled effects were calculated and the sources of heterogeneity were explored using meta-regression and subgroup analysis. RESULTS: A total of 60 articles with 96,484 subjects were identified, and peer education was associated with 36% decreased rates of HIV infection among overall high risk groups (OR: 0.64; 95%CI: 0.47-0.87). Peer education can promote HIV testing (OR = 3.19; 95%CI:2.13,4.79) and condom use (OR = 2.66, 95% CI: 2.11-3.36) while reduce equipment sharing (OR = 0.50; 95%CI:0.33,0.75) and unprotected sex (OR = 0.82; 95%CI: 0.72-0.94). Time trend analysis revealed that peer education had a consistent effect on behavior change for over 24 months and the different follow-up times were a source of heterogeneity. CONCLUSION: Our study shows that peer education is an effective tool with long-term impact for behavior change among high-risk HIV groups worldwide. Low and middle-income countries are encouraged to conduct large-scale peer education.

Síndrome de Imunodeficiência Adquirida/prevenção & controle , Síndrome de Imunodeficiência Adquirida/psicologia , Promoção da Saúde/métodos , Grupo Associado , Adolescente , Adulto , Preservativos , Feminino , Humanos , Masculino , Programas de Rastreamento/tendências , Assunção de Riscos , Sexo sem Proteção/prevenção & controle , Adulto Jovem
Rev Med Suisse ; 16(690): 744-748, 2020 Apr 15.
Artigo em Francês | MEDLINE | ID: mdl-32301309


Medical advances in the treatment of HIV over the last 35 years mean that people living with HIV (PLHIV) now have a life expectancy close to that of the general population. Further, when successfully treated, PLHIV cannot transmit the virus. Despite this, HIV-related stigma remains widespread, including within healthcare settings. Stigma is not a vague sociological notion but represents a real threat to public health, with repercussions for both PLHIV and HIV-negative individuals. Stigma has been shown to have a negative impact on HIV prevention, testing, access to health services, and on the healthcare management of PLHIV. Taking stigma into consideration is essential, both in meeting the medical and psycho-social needs of PLHIV and in order to effectively combat HIV/AIDS.

Infecções por HIV/psicologia , Saúde Pública , Estigma Social , Síndrome de Imunodeficiência Adquirida/diagnóstico , Síndrome de Imunodeficiência Adquirida/prevenção & controle , Síndrome de Imunodeficiência Adquirida/psicologia , Síndrome de Imunodeficiência Adquirida/transmissão , Infecções por HIV/diagnóstico , Infecções por HIV/prevenção & controle , Infecções por HIV/transmissão , Soronegatividade para HIV , Soropositividade para HIV/diagnóstico , Soropositividade para HIV/psicologia , Soropositividade para HIV/transmissão , Humanos
MMWR Morb Mortal Wkly Rep ; 69(12): 329-334, 2020 Mar 27.
Artigo em Inglês | MEDLINE | ID: mdl-32214084


Tuberculosis (TB) is the leading cause of death among persons living with human immunodeficiency virus (HIV) infection. In 2018, an estimated 251,000 persons living with HIV infection died from TB, accounting for one third of all HIV-related deaths and one sixth of all TB deaths (1). TB preventive treatment (TPT) is recommended by the World Health Organization (WHO) for persons living with HIV infection without active TB disease (i.e., adults with a negative clinical symptom screen for cough, fever, night sweats, or weight loss; and children with a negative clinical screen for cough, fever, contact with a person with TB, or poor weight gain) and either without* a tuberculin skin test result or with a known positive result (2). TPT decreases morbidity and mortality among persons living with HIV infection, independent of antiretroviral therapy (ART) (3); however, in 2017, fewer than 1 million of the estimated 21.3 million ART patients started TPT worldwide. Most patients receiving TPT were treated with 6 months of daily isoniazid (1,4). This report summarizes data on TB symptom screening and TPT initiation and completion among ART patients in 16 countries supported by the U.S. President's Emergency Plan for AIDS† Relief (PEPFAR) during April 1, 2017-March 31, 2019. During this period, these 16 countries accounted for approximately 90% of PEPFAR-supported ART patients. During April 1, 2017-September 30, 2018, TB symptom screening increased from 54% to 84%. Overall, nearly 2 million ART patients initiated TPT, and 60% completed treatment during October 1, 2017-March 31, 2019. Although TPT initiations increased substantially, completion among those who initiated TPT increased only from 55% to 66%. In addition to continuing gains in initiation, improving retention after initiation and identifying barriers to TPT completion are important to increase TPT scale-up and reduce global TB mortality.

Síndrome de Imunodeficiência Adquirida/prevenção & controle , Antirretrovirais/uso terapêutico , Cooperação Internacional , Tuberculose/prevenção & controle , Síndrome de Imunodeficiência Adquirida/epidemiologia , África/epidemiologia , Humanos , Tuberculose/epidemiologia , Estados Unidos
BMC Public Health ; 20(1): 169, 2020 Feb 04.
Artigo em Inglês | MEDLINE | ID: mdl-32019506


BACKGROUND: The problem of AIDS response has not only involved public health, but also had a great impact on the family burden.The objective of this study was to estimate the preventive and curative care expenditure(PCE)for AIDS of Hunan Province in 2017 based on System of Health Accounts 2011(SHA2011)by quantity,financing scheme,health provider,health function,and to analyses the factors affecting patients' medical burden. METHODS: Through stratified multi-stage sampling method, 1336 institutions were surveyed to obtain AIDS prevention and control data, and the official data collected from Health Statistical Yearbook, Health Financial Annual Reports and Government Input Monitoring System were used to estimate the AIDS PCE based on SHA2011. Univariate analyses and ordered logistic regression were used to evaluate the factors affecting the medical burden of AIDS patients. RESULTS: The AIDS PCE of Hunan Province in 2017 was 266.67 million, mainly flowed to hospitals and disease prevention and control institutions. The proportions of curative care expenditure(CCE) and prevention expenditure were 51.39 and 48.61% respectively. Prevention expenditure were mainly used for traditional prevention methods. All prevention expenditure and 88.52% of CCE were borne by public financing scheme. Family health expenditure accounted for 11.12% of CCE, but there were still some people with heavy burden of treatment. Non insurance, co-infection and length of stay are risk factors to the total hospitalization expenses(Totalexp)and the out-of-pocket payments(OOPs)(all p < 0.05,OR > 1). Taking the age group under 30 as the reference, the partial regression coefficient of the age group over 60 was statistically significant (OR (Totalexp) = 1.809, OR (OOPs) = 0.30). CONCLUSION: The financing structure of the PCE for AIDS in Hunan Province was relatively stable and the flow of institutions was reasonable. The functional flow of expenditure embodied the principle of "prevention first". China should incorporate oral PrEP into the national guidelines as soon as possible to improve the allocation efficiency of AIDS prevention resources. Meantime, several measures should be taken to reduce the medical burden of AIDS patients, including expanding the scope of government assistance, adjusting insurance compensation measures, increasing the rate of patients participating in insurance,encouraging commercial insurance to join the AIDS insurance system,and controlling length of stay in hospital.

Síndrome de Imunodeficiência Adquirida/economia , Síndrome de Imunodeficiência Adquirida/prevenção & controle , Efeitos Psicossociais da Doença , Gastos em Saúde/estatística & dados numéricos , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , China , Feminino , Financiamento Governamental/economia , Hospitalização/economia , Humanos , Lactente , Recém-Nascido , Masculino , Pessoa de Meia-Idade , Inquéritos e Questionários , Adulto Jovem
Artigo em Inglês | MEDLINE | ID: mdl-31936190


African American young adults continue to be disproportionately affected by HIV/AIDS. The Southern United States has been particularly affected by HIV/AIDS, accounting for 52% of the new HIV diagnoses. Efforts to reduce the burden of HIV among young African Americans are still needed. Project HAPPY (HIV/AIDS Prevention Project for Youth) was developed and implemented using a community-based participatory research (CBPR) model. There were several challenges that arose during implementation of Project HAPPY that included recruitment, partner engagement, and retention. The realities of implementing an HIV prevention project with urban adolescents is discussed in detail and strategies to overcome these challenges, using a CBPR approach are described. The lessons learned from CBPR implementation of Project HAPPY include: (1) Create a feedback loop to receive community input and guidance throughout the life of the project; (2) Periodic community inventory to determine who is providing similar services to avoid saturation; (3) Prepare for Alternative Partner Engagement; (4) Consult (formally and informally) with the Institutional Review Board prior to submitting proposed changes to avoid unnecessary delays in implementation; (5) Select meaningful incentives for your priority population; and (6) Maintain multiple points of contact with community partners to mitigate the effects of staff turnover.

Síndrome de Imunodeficiência Adquirida/prevenção & controle , Terapia Comportamental/métodos , Pesquisa Participativa Baseada na Comunidade/normas , Comportamentos Relacionados com a Saúde , Adolescente , Afro-Americanos/psicologia , Terapia Comportamental/organização & administração , Pesquisa Participativa Baseada na Comunidade/tendências , Feminino , Humanos , Estados Unidos , Adulto Jovem
AIDS Behav ; 24(1): 1-4, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30903450


On January 2019, Brazil's new far-right president Jair Bolsonaro was sworn into office. Bolsonaro's administration supports downsizing the Brazilian Unified Health System (SUS), while increasing the size of the private health sector. The new administration might leave millions of Brazilians without medical care, including hundreds of thousands of people living with HIV/AIDS. Bolsonaro's administration, allied with a highly conservative Congress and sharp decreases in federal funding for public health, education and research, could jeopardize key health and human rights strategies focused on women, LGBTQ + individuals, Indigenous populations, and people living with HIV/AIDS.

Democracia , Infecções por HIV/prevenção & controle , Infecções por HIV/terapia , Direitos Humanos , Saúde Pública , Síndrome de Imunodeficiência Adquirida/prevenção & controle , Brasil , Programas Governamentais , Humanos , Política
AIDS Behav ; 24(1): 5-7, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30953302


Cities worldwide are striving to get to zero HIV stigma as a condition to get to zero new infections. We tracked an indicator of perceived HIV stigma across surveys of men who have sex with men (MSM) in San Francisco from 2011 to 2017. Little improvement in perceived HIV stigma was observed, from 22.3% (95% CI 18.7-26.3) of MSM agreeing with the statement "Most people would discriminate against someone with HIV" in 2011 to 21.0% (95% CI 17.5-24.9) in 2017 (χ2 test for trend 0.252, p = 0.616). Success in ending the epidemic may flag without addressing the causes of HIV stigma.

Síndrome de Imunodeficiência Adquirida/epidemiologia , Infecções por HIV/psicologia , Homossexualidade Masculina/estatística & dados numéricos , Preconceito , Estigma Social , Síndrome de Imunodeficiência Adquirida/prevenção & controle , Adulto , Epidemias , Infecções por HIV/epidemiologia , Infecções por HIV/prevenção & controle , Homossexualidade Masculina/psicologia , Humanos , Masculino , Prevalência , São Francisco/epidemiologia , Inquéritos e Questionários
Interface (Botucatu, Online) ; 24: e180626, 2020. tab, ilus
Artigo em Português | LILACS | ID: biblio-1040199


Buscou-se analisar as representações da sexualidade e prevenção em cartazes produzidos pelo Departamento de Doenças de Condições Crônicas e Infecções Sexualmente Transmissíveis (DCCI) a partir da diretriz da prevenção combinada (PC), adotada em 2013. Realizou-se análise de conteúdo, de caráter descritivo e documental, dos cartazes de campanhas do dia 1º de dezembro (2013-2017). Resultados apontam que aspectos relacionais do uso do preservativo teriam menos relevância, ao passo que a individualização do cuidado vem se acirrando sob a lógica de "testar para se conhecer". Nota-se a oferta de alternativas de prevenção, por meio do símbolo do tripé "preservativo, teste e comprimido", ou de novas tecnologias como a profilaxia pré-exposição (PrEP) e Profilaxia Pós Exposição (PEP). Isso sugere que, desde seu lançamento, a PC passou a orientar as campanhas do DCCI, em oposição a campanhas anteriores que privilegiavam populações-alvo e o preservativo masculino.(AU)

El objetivo fue analizar las representaciones de la sexualidad y prevención en carteles producidos por el Departamento de Enfermedades de Condiciones Crónicas e Infecciones de Transmisión Sexual (DCCI, por sus siglas en portugués), a partir de la directriz de prevención combinada (PC), adoptada en 2013. Se realizó el análisis de contenido, de carácter descriptivo y documental de los carteles de campañas del día 1º de diciembre (2013-2017). Los resultados señalan que aspectos relacionales del uso del preservativo tendrían menos relevancia, mientras que la individualización del cuidado se recrudece bajo la lógica de "hacer test para conocerse". Se observa la oferta de alternativas de prevención a través del símbolo del trípode: "preservativo, test y comprimido" o de nuevas tecnologías como PrEP y PEP. Eso sugiere que, desde su lanzamiento, la PC pasó a orientar las campañas del DCCI, en oposición a campañas anteriores que privilegiaban a poblaciones-objetivo y el preservativo masculino.(AU)

The article sought to analyze representations of sexuality and prevention on posters produced by the Department of Chronic Conditions Diseases and Sexually Transmitted Infections (DCCI) stemming from the combination prevention (CP) guidelines adopted in 2013. A descriptive and documental content analysis of posters relative to the World Aids Day (December 1st) was carried out (2013-2017). Results indicate that relational aspects of condom use appear to be less relevant, and increments of the individualization of care under the logic of "know your status" are becoming stronger. It is also possible to notice preventive alternatives, by way of the tripod symbol: "condom, test and pill", or new technologies such as PrEP and PEP. This suggests that the CP has been guiding the DCCI campaigns since its launch, as opposed to previous campaigns focusing on target populations and male condoms.(AU)

Síndrome de Imunodeficiência Adquirida/prevenção & controle , Sexualidade , Pôsteres como Assunto , Promoção da Saúde/provisão & distribução , Brasil , Estudos Epidemiológicos , Armazenamento e Recuperação da Informação/estatística & dados numéricos
Am J Public Health ; 110(1): 22-24, 2020 01.
Artigo em Inglês | MEDLINE | ID: mdl-31725312


In his State of the Union Address on February 5, 2019, President Donald J. Trump announced his administration's goal to end the domestic HIV epidemic. Following the announcement of the Ending the HIV Epidemic: A Plan for America initiative, the president proposed $291 million in new funding for the fiscal year 2020 Department of Health and Human Services (HHS) budget to implement a new initiative to reduce the number of new HIV infections by 75% in the next five years (2025) and by 90% in the next 10 years (2030). This is in addition to the $20 billion the US government already spends each year, domestically, for HIV prevention and care.With this initiative, HHS recognizes that the time to end the HIV epidemic is now: we have the right data, the right biomedical and behavioral tools, and the right leadership. With the new resources, the goal is achievable.This article outlines how this initiative will be accomplished through the implementation of four fundamental strategies that will be tailored by local communities on the basis of their own needs and strengths.

Epidemias/prevenção & controle , Epidemias/estatística & dados numéricos , Infecções por HIV/epidemiologia , Infecções por HIV/prevenção & controle , United States Dept. of Health and Human Services/organização & administração , Vacinas contra a AIDS/administração & dosagem , Síndrome de Imunodeficiência Adquirida/prevenção & controle , Antirretrovirais/uso terapêutico , Administração de Caso/organização & administração , Técnicas e Procedimentos Diagnósticos , Financiamento Governamental , Infecções por HIV/diagnóstico , Infecções por HIV/tratamento farmacológico , Humanos , Liderança , Programas de Troca de Agulhas/organização & administração , Objetivos Organizacionais , Profilaxia Pré-Exposição/métodos , Estados Unidos/epidemiologia , United States Dept. of Health and Human Services/economia
Interface (Botucatu, Online) ; 24: e180625, 2020. tab
Artigo em Português | LILACS | ID: biblio-1056562


Esse artigo discute os desafios da prevenção em tempos de crescimento de casos de Aids entre jovens. Opiniões e práticas de estudantes no ensino médio, coletadas em pesquisa realizada de 2013-2017, indicaram que estavam incorporando o discurso preventivo e que a religiosidade tem efeito em crenças e valores antes da iniciação sexual, mas pode interferir negativamente no uso de preservativo desde a primeira relação. Sustentar o direito à prevenção dependerá de ampliarmos a compreensão pública sobre como a religiosidade vivida difere da política-religiosa. Sugere-se monitorar o efeito da retomada de discursos morais que remontam à ditadura civil-militar e da possível descontinuidade de programas de prevenção bem-sucedidos junto aos jovens desde os anos 1990. É urgente compreender a dinâmica entre velhos e novos discursos que estruturam a sexualização (frequentemente via redes sociais) assim como o acesso à recomendada "prevenção combinada" das Infecções Sexualmente Transmissíveis (IST/Aids).(AU)

Este artículo discute los desafíos de la prevención en tiempos de aumento de casos de Sida entre jóvenes. Opiniones y prácticas de estudiantes en la enseñanza media, recolectadas en un estudio realizado entre 2013-2017, indicaron que incorporaron el discurso preventivo y que la religiosidad tiene efecto en creencias y valores antes de la iniciación sexual, pero que puede interferir negativamente en el uso del preservativo desde la primera relación. Mantener el derecho a la prevención dependerá de que ampliemos la comprensión pública sobre cómo la religiosidad vivida difiere de la política-religiosa. Se sugiere el monitoreo del efecto de la reanudación de discursos morales que remiten a la dictadura civil-militar y de la posible discontinuidad de programas de prevención exitosos con los jóvenes desde la década de 1990. Es urgente comprender la dinámica entre viejos y nuevos discursos que estructuran la sexualización (frecuentemente vía redes sociales) así como el acceso a la recomendada "prevención combinada" de las Infecciones de Transmisión Sexual (ITS)/Sida.(AU)

This article discusses Aids prevention in Brazil in the midst of growing numbers of cases of the disease among young people. A study was conducted between 2013 and 2017 to explore the sexual behavior of high school students and their opinions regarding sexuality. The findings show that students have adopted the prevention discourse and that religiosity influences beliefs and values relating to sexual initiation, negatively affecting condom use from the onset of sexual activity. To ensure the right to prevention is upheld, it will be necessary to broaden public understanding about how religion as it is actually lived differs from religious politics. The effects of the reversion to moral discourses reminiscent of the military dictatorship and possible discontinuity of successful longstanding prevention programs targeting young people should be monitored. There is an urgent need to understand the dynamic between the old and new discourses that shape sexualization (often via social media) and access to "combination prevention" of Sexually Transmitted Infections (STI)/Aids.(AU)

Humanos , Adolescente , Adulto Jovem , Religião , Instituições Acadêmicas , Síndrome de Imunodeficiência Adquirida/prevenção & controle , Sexualidade , Educação Sexual/tendências , Direitos Humanos