HIV testing among immigrant men who have sex with men in Brazil.

OBJECTIVE: To evaluate the prevalence of non-testing for HIV among immigrant men who have sex with men (MSM) residing in Brazil and identify associated factors. DESIGN: An analytical web-survey study was conducted across all Brazilian states from January 2020 to May 2021. SAMPLE: The study included 804 MSM immigrants from Portuguese-speaking countries. MEASUREMENTS: Odds ratio (OR) and adjusted Odds Ratio (AOR) were utilized to determine the strength of the association between non-HIV testing and associated factors. RESULTS: Among the participants, 63.7% had never undergone HIV testing. Multivariate analysis revealed several factors associated with a higher likelihood of not being tested for HIV: having a steady/monogamus partner (AOR: 1.5; 95%CI: 1.1-2.3) or both casual and steady partners (AOR: 1.8; 95%CI: 1.2-3.4), not engaging in bareback sex (AOR: 1.91; 95%CI: 3-3.5), being an immigrant in the country for less than 12 months (AOR: 3.7; 95%CI: 2.5-9.7), and having a preference for insertive (AOR: 1.5; 95%CI: 1.1-2.5) or receptive (AOR: 2.9; 95%CI: 1.4-5.7) roles. However, practicing chemsex was found to be a protective factor for testing (AOR: 4). CONCLUSION: To enhance HIV prevention strategies, it is crucial to implement specific measures that ensure accessibility, confidentiality, and a reduction in stigma associated with HIV testing.

Hospital infection control programs: assessment of process and structure indicators. / Programas de Controle de Infecção Hospitalar: avaliação de indicadores de estrutura e processo.

OBJECTIVE: To assess hospital infection control committees in relation to structure and process indicators of hospital infection control programs. METHOD: Descriptive, cross-sectional study conducted with hospital committees registered in the National Registry of Healthcare Facilities. Primary and secondary data collection was conducted through structured interview using validated instruments and verification of documents, respectively. RESULTS: Fourteen committees participated in the research. Mean values of conformity of 80.58% were evidenced for the technical-operational structure assessment indicator, 60.77% for the infection control and prevention operational guidelines indicator, 81.59% for the epidemiological surveillance system assessment indicator, and 63.44% for hospital infection control and prevention activities assessment indicator. CONCLUSION: Among the four instruments applied to assess hospital infection control programs, only two presented results with more than 80.0% of conformity: those related to the epidemiological surveillance and technical-operational structure assessments.

Serophobia related to HIV and AIDS: what is debated in digital social networks in Brazil? / Sorofobia relacionada ao HIV e à Aids: o que se debate nas redes sociais digitais no Brasil?

The aim of this article is to analyze the serophobic content explicit in the publications published in Digital Social Networks in the context of HIV and AIDS in Brazil. This is a qualitative study of the descriptive exploratory type, based on documents. The data obtained were evaluated using the methodology of documentary analysis through Thematic Content Analysis with the aid of NVivo®12 Plus (Windows). A total of 187 codes were generated, subsequently grouped according to the semantics of the words, originating five thematic categories: #LivingWithHIV, #WeNeedtoTalkAboutIt, #WhatISSEROPHOBIA, #SerophobiaIsACrime, and #NoSerophobia. The results showed the main manifestations of HIV and AIDS-related serophobia on social networks. The shared content discussed the difficulties of living with a disease that has social dimensions; the relevance of talking and disseminating content about HIV and AIDS; the elements that make up the stigmatization process and, consequently, structure serophobia in society; the social and civil rights of people living with HIV; measures to combat serophobia in health institutions; and the implications of serophobia in the field of public health.

O objetivo do artigo é analisar o conteúdo sorofóbico explicitado nas publicações veiculadas nas redes sociais digitais no contexto do HIV e da Aids no Brasil. Trata-se de um estudo qualitativo do tipo exploratório descritivo, de base documental. Os dados obtidos foram avaliados utilizando a metodologia de análise documental por meio da análise de conteúdo temático com auxílio do software NVivo®12 Plus (Windows). Foram gerados 187 códigos, posteriormente agrupados conforme a semântica das palavras, originando cinco categorias temáticas: #VivendoComHIV, #PrecisamosFalarSobreIsso, #OQueÉSOROFOBIA, #SorofobiaéCrime e #SorofobiaNÃO. Os resultados evidenciaram as principais manifestações acerca da sorofobia relacionada ao HIV e à Aids nas redes sociais. O conteúdo compartilhado debateu as dificuldades de viver com uma doença que apresenta dimensões sociais; a relevância de falar e difundir conteúdo sobre o HIV e a Aids; os elementos que compõem o processo de estigmatização e, consequentemente, estruturam a sorofobia na sociedade; os direitos sociais e civis das pessoas vivendo com HIV; as medidas de combate à sorofobia nas instituições de saúde; e as implicações da sorofobia no âmbito da saúde pública.

Impact of the COVID-19 Pandemic Surveillance of Visceral Leishmaniasis in Brazil: An Ecological Study.

The aim of the study was to assess the impact of the COVID-19 pandemic on the notification of new VL cases in Brazil in 2020. It is an ecological and time-series study (2015-2020) with spatial analysis techniques, whose units of analysis were the 5570 Brazilian municipalities. The study population consisted of all new cases of VL recorded between 2015 and 2020. The P-score was calculated to estimate the percentage variation in new VL cases. Global and local univariate Moran's Indices and retrospective space-time scan statistics were used in spatial and space-time analyses, respectively. It was expected that there would be 3627 new cases of VL in Brazil in 2020, but 1932 cases were reported (-46.73%). All Brazilian regions presented a negative percentage variation in the registration of new VL cases, with the Southeast (-54.70%), North (-49.97%), and Northeast (-44.22%) standing out. There was spatial dependence of the disease nationwide in both periods, before and during the first year of the COVID-19 pandemic. There was a significant reduction in the incidence of new VL cases in Brazil during the first year of the COVID-19 pandemic. These findings reinforce the need for better preparedness of the health system, especially in situations of new epidemics.

Surveillance of TB-HIV coinfection in Brazil: a space-time approach.

OBJECTIVE: To identify the epidemiological, spatial, and temporal pattern of TB-HIV coinfection in Brazil during the period from 2001 to 2020. METHODS: Ecological study using space-time analysis techniques. It included cases of TB-HIV coinfection registered in Brazil from 2001 to 2020. The temporal trend analysis was performed using segmented regression by Joinpoint regression. For spatial analysis, Moran indices were calculated and choropleth maps were produced using TerraView and QGIS software. RESULTS: A stable temporal trend was observed in the incidence rates of TB-HIV coinfection in Brazil during the analyzed period. In addition, high-risk areas for coinfection located in states in the North, Southeast, South, and Midwest regions were identified. CONCLUSION: There was stability in the incidence of TB-HIV coinfection in Brazil over the last 20 years and heterogeneous geographic distribution of risk areas for the condition.

Contamination of equipment and surfaces in the operating room anesthesia workspace: a cross-sectional study.

BACKGROUND: Contamination of the breathing circuit and medication preparation surface of an anesthesia machine can increase the risk of cross-infection. OBJECTIVE: To evaluate the contamination of the anesthetic medication preparation surface, respiratory circuits, and devices used in general anesthesia with assisted mechanical ventilation. DESIGN AND SETTING: Cross-sectional, quantitative study conducted at the surgical center of a philanthropic hospital, of medium complexity located in the municipality of Três Lagoas, in the eastern region of the State of Mato Grosso do Sul. METHODS: Eighty-two microbiological samples were collected from the breathing circuits. After repeating the samples in different culture media, 328 analyses were performed. RESULTS: A higher occurrence of E. coli, Enterobacter spp., Pseudomonas spp., Staphylococcus aureus, and Streptococcus pneumoniae (P < 0.001) were observed. Variations were observed depending on the culture medium and sample collection site. CONCLUSION: The study findings underscore the inadequate disinfection of the inspiratory and expiratory branches, highlighting the importance of stringent cleaning and disinfection of high-touch surfaces.

Spatial and Temporal Dynamics of Chikungunya Incidence in Brazil and the Impact of Social Vulnerability: A Population-Based and Ecological Study.

To assess the temporal and spatial dynamics of chikungunya incidence and its association with social vulnerability indicators in Brazil, an ecological and population-based study was conducted herein, with confirmed cases of chikungunya and based on clinical and clinical-epidemiological criteria from 2017 to 2023. Data were obtained from the Notifiable Diseases Information System and social vulnerability indicators were extracted from the official platform of the United Nations Development Program and the Social Vulnerability Atlas. Temporal, spatial, and global spatial regression models were employed. The temporal trend showed that in 2017, the incidence increased by 1.9%, and this trend decreased from 2020 to 2021 (-0.93%). The spatial distribution showed heterogeneity and positive spatial autocorrelation (I: 0.71; p < 0.001) in chikungunya cases in Brazil. Also, the high-risk areas for the disease were concentrated in the northeast and north regions. The social vulnerability indicators associated with the outcome were those related to income, education, and housing conditions. Our analyses demonstrate that chikungunya continues to be a serious health concern in Brazil, but specially in the northeast and north regions. Lastly, mapping risk areas can provide evidence for the development of public health strategies and disease control in endemic regions.

Clinical outcomes in newborns of pregnant women with COVID-19: integrative review.

OBJECTIVES: to analyze clinical outcomes in newborns of pregnant women with COVID-19. METHODS: integrative review conducted in PubMed, Web of Knowledge, SCOPUS, CINHAL; 2,111 studies were obtained, and 8 articles comprised the final sample. RESULTS: clinical outcomes in neonates of pregnant women positive for COVID-19 were classified according to the following categories: a) contamination by COVID-19, reported in 62.5% of the studies; b) hospital discharge due to improvement, mentioned in 37.5% of the articles; c) death, representing rare cases in 25% of the sample. The most prevalent gestational complication was prematurity, mentioned in 75% of the studies. This complication has been observed due to cases of premature rupture of membranes and placental abruption. CONCLUSIONS: despite the knowledge of asymptomatic and mildly symptomatic behavior in neonates, it is important to continue the search for new clinical data, as this public has uncertain reactions to SARS-CoV-2 infection.

Migrant Men Living in Brazil during the Pandemic: A Qualitative Study.

This study aims to analyze the repercussions of the ongoing COVID-19 pandemic on the health of male immigrants, refugees, and asylum seekers in Brazil. A qualitative study involving 307 adult men living in Brazil during the COVID-19 pandemic was conducted. Data were collected between August 2021 and March 2022 and interpreted based on the Transcultural Nursing Theory. Cultural care repercussions were identified in various dimensions: technological: changes in daily life and disruptions in routine; religious, philosophical, social, and cultural values: changes stemming from disrupted social bonds, religious practices, and sociocultural isolation; political: experiences of political partisanship, conflicts, government mismanagement, a lack of immigration policies, human rights violations, and xenophobia; educational/economic: challenges arising from economic impoverishment, economic insecurity, unemployment, language difficulties, and challenges in academic and literacy development during the pandemic. The persistence of the COVID-19 pandemic in Brazil had significant repercussions for the health of migrant men, resulting in a transcultural phenomenon that requires sensitive nursing care. Implications for nursing: the uniqueness of cultural care in nursing and health, as most of the repercussions found were mostly negative, contributed to the increase in social and health vulnerabilities.

Chemsex and its repercussions on the health of men who have sex with men (MSM): a global health perspective.

OBJECTIVES: to discuss the repercussions of chemsex on the health of men who have sex with men (MSM), contextualizing it in a global health scenario and pointing out the implications for nursing care. METHODS: theoretical-reflexive study based on scientific literature and concepts related to global health. RESULTS: we present the epidemiology of the chemsex phenomenon, the main demands of the field, the reasons why it has become a global public health problem, and the implications for nursing practice. FINAL CONSIDERATIONS: chemsex is growing in all age groups of MSM and is globally benefiting from location-based applications to gain magnitude, finding an important potential audience in the migrant population. Nursing structures can help accelerate the proposal and implementation of biomedical and behavioral measures to address chemsex in its entirety, qualifying care and inducing teamwork with interprofessional collaboration.

Spatial modeling of homicide mortality in the Northeast region of Brazil.

OBJECTIVE: To analyze the spatiotemporal distribution of homicide mortality and association with social determinants of health in the Northeast Region of Brazil. METHODS: Ecological study with spatiotemporal modeling of homicide deaths between 2000 and 2019. Temporal trends were analyzed by segmented linear regression. Crude mortality was calculated and adjusted by smoothing the local empirical Bayesian method and analyzed by the Global/Local Moran Index and spatiotemporal scan statistics. The association between social determinants of health and homicide mortality was performed using multiple linear regression and autoregressive spatial models. RESULTS: 353,089 deaths were recorded. Mortality increased from 2000 to 2019, with an annual increase of 4.37 in males and 3.57 in females. High risk spatial and spatiotemporal clusters were identified in the coastal region of the states. The spatial regression model showed an association with socioeconomic inequalities. CONCLUSIONS: High risk areas for homicides associated with socioeconomic inequality, which should be considered as a priority for designing and investing in public health policies were investigated.

Misinformation about COVID-19 among middle-aged and older migrants residing in Brazil and Portugal.

OBJECTIVE: The aim of this study was to assess the prevalence of COVID-19 misinformation among migrants aged 50 or older residing in Brazil and Portugal. METHOD: This was a cross-sectional analytical study conducted among migrants from Portuguese-speaking countries living in Brazil and Portugal, who were 50 years of age or older. The prevalence ratios (PR) were estimated using the Poisson regression model. RESULTS: Out of the 304 participants included in the study, 188 (61.8%) agreed with at least one piece of misinformation. Factors such as having a religious affiliation (aPR: 1.24), higher educational attainment (aPR: 1.17), knowing someone who died from COVID-19 (aPR: 1.78), and having no intention to get vaccinated (aPR: 1.36) were associated with a higher likelihood of agreeing with COVID-19 misinformation. CONCLUSION: The findings suggest that access to misinformation was influenced by social, economic, and religious factors among elderly migrants with low digital literacy, thus contributing to the dissemination of false content within this population.

Agreement with COVID-19 disinformation among Portuguese-speaking older adults: an international study.

OBJECTIVES: to assess agreement with COVID-19 disinformation among Portuguese-speaking individuals aged 50 years or older. METHODS: a descriptive and analytical study involving 1,214 older adults born in Portuguese-speaking countries. Data collection occurred through online information mining to recognize COVID-19 and disinformation content, and the application of a structured questionnaire. RESULTS: agreement with disinformation content was 65.2%. Residing outside Brazil is a protective factor for agreement with disinformation content, and those who believe in the truthfulness of the information sources they receive were 31% more likely to agree with disinformation content. CONCLUSIONS: there is a high prevalence of disinformation among the older population in two Portuguese-speaking countries, which should raise the attention of healthcare professionals and guide coping strategies.

Positive and negative aspects of psychological stress in clinical education in nursing: A scoping review.

BACKGROUND: Even though clinical practice is crucial for nursing students' personal and professional development, it is recurrently associated with stress. However, stressful situations may not only elicit negative responses, but positive responses as well, and such aspects should be further investigated. AIM: To explore the literature addressing the positive and negative aspects of stress experienced by nursing students during clinical practicum. DESIGN: This scoping review followed the Joanna Briggs Institute (JBI) and PRISMA-ScR guidelines. DATA SOURCES: CINAHL, MEDLINE/PubMed, PsycINFO, Web of Science, IBECS, LILACS, BDENF and two theses and dissertations repositories. REVIEW METHODS: Searches were conducted from June to August 2022. Studies addressing the positive and negative aspects of stress experienced by nursing students during clinical practice were included regardless of the method adopted. RESULTS: This review included 32 studies published between 1999 and 2022 in 25 countries across four continents: Africa, America, Asia, and Europe. Stress can positively influence academic performance, especially in mobilizing a search for learning and professional development and in integrating theoretical knowledge and improving clinical skills and competencies. Negatively, stress can cause biopsychosocial symptoms that compromise a student's academic performance and can cause doubts and uncertainties about the construction of their professional identity. CONCLUSIONS: Although the negative aspects stand out over the positive ones, it is evident that both are present in the clinical practice environment. When considering stress of nursing students, educators should conduct the teaching-learning process in order to reduce the negative impact and promote the positive side of stressful situations.

Sexual exposure to HIV in Angolan men who have sex with men immigrants: A cross-sectional study in Portugal and Brazil.

BACKGROUND: In different contexts, international migrants are vulnerable to health disparities that increase the risk of HIV/AIDS exposure and continue to bear a significant burden of new virus infections in developed and developing countries. In this study, we sought to examine sexual practices and factors linked to HIV exposure among a sample of Angolan men who have sex with men (MSM) immigrants. METHODS: The study was conducted in two Portuguese-speaking countries, Brazil and Portugal, and involved 250 Angolan MSM immigrants between September 2020 and February 2021, using sampling methods to constitute the sample and the HIV Incidence Risk Index (HIRI) to define virus exposure risk. Odds ratio (OR) and adjusted odds ratio (aOR) were used to calculate the chances of higher HIRI index in the sample. RESULTS: Our results showed that 76.8% of participants presented a high HIRI index, influenced by the practice of chemsex (aOR: 4.26), having a known/repeated partner (aOR: 4.59), and engaging in passive sex without a condom in the last 30 days (aOR: 1.29) or 6 months (aOR: 1.98). CONCLUSIONS: It is crucial to focus on this vulnerable population and implement sexual health policies that integrate combined HIV prevention measures aimed at immigrant MSM.

Knowledge, Attitude and Practices towards the Prevention of Schistosomiasis Mansoni in an Endemic Area of Alagoas, Northeast Brazil.

We analyzed the knowledge, attitudes and practices (KAP) of schistosomiasis mansoni prevention in an endemic area of Brazil. This cross-sectional study was conducted between March and May 2021, with 412 participants living in the municipality of Feira Grande, Alagoas, Brazil. Data collection occurred through visits to the Health Center Urbano II and Massapê, through an interview with a structured questionnaire to identify the levels of KAP regarding schistosomiasis prevention. Of all respondents, 70.87% lived in rural areas, 22.66% reported a history of past schistosomiasis and 52.71% never participated in schistosomiasis control program actions. Factors associated with better KAP scores were being part of an older age group, not using rainwater and having no history of past schistosomiasis. Specifically, among the domains, attitude was the highest score and knowledge was the lowest. Participation in a health intervention program, knowing someone who had schistosomiasis and having been informed through a public health program seemed to have an important impact on the population's KAP. Our results contributed to broadening perceptions about schistosomiasis prevention, highlighting the positive impacts that health programs and interventions have on disease control.

Adherence to Pre-Exposure Prophylaxis (PrEP) among Men Who Have Sex with Men (MSM) in Portuguese-Speaking Countries.

Strengthening strategies to improve adherence to the use of pre-exposure prophylaxis (PrEP) in key populations constitutes a global health priority to be achieved across countries, especially in countries that share a high flow of people such as Brazil and Portugal. This study aimed to analyze the factors associated with adherence to PrEP among MSM from two Portuguese-speaking countries, highlighting the opportunities and preventive strategies for the global health scenario. This was a cross-sectional analytical online survey conducted from January 2020 to May 2021 with MSM in Brazil and Portugal. For analysis of the data, the Poisson regression model was used to estimate the prevalence ratio (PR) for developing a model to evaluate the associated factors in both countries in a comparative and isolated way. Adherence to PrEP use corresponded to 19.5% (n = 1682) of the overall sample: 18.3% (n = 970) for Brazil and 21.5% (n = 712) for Portugal. Having more than two sex partners in the last 30 days (aPR: 30.87) and routinely undergoing HIV tests (aPR: 26.21) increased the use of this medication. Being an immigrant (PR: 1.36) and knowing the partner's serological status (PR: 1.28) increased adherence to PrEP in Portugal, whereas, in Brazil, it was being an immigrant (PR: 0.83) and not knowing the serological status (PR: 2.24) that promoted the use of this medication. Our findings reinforce the need to invest in programs and strategies to improve access and adherence to PrEP, especially in key populations.

Determinants of sexual exposure to HIV in Portuguese and Brazilian adolescents: a path analysis. / Fatores determinantes da exposição sexual ao HIV em adolescentes luso-brasileiros: uma análise de caminhos.

OBJECTIVE: to analyze the direct and indirect effects of determinants of sexual exposure to the human immunodeficiency virus among male adolescents who have sex with men and the implications for nursing care. METHOD: cross-sectional study carried out with 578 Portuguese and Brazilian adolescents aged 18 and 19. Interrelationships of conjugal status, use of dating apps, practice of chemsex, unawareness, partner credibility, challenging sexual practices and ineffective forms of protection against sexual exposure to the human immunodeficiency virus were evaluated using the Path Analysis technique. RESULTS: significant direct effect on sexual exposure to the human immunodeficiency virus: conjugal status (ß=-0.16), use of apps (ß=-0.30), challenging sexual practices (ß=0.48) and ineffective forms of protection (ß=0.35). Indirect paths: partner credibility influenced ineffective forms of protection (ß=0.77); having a steady/polyamorous relationship influenced the use of dating apps (ß=-0.46); chemsex, mediated by challenging sexual practices (ß=0.67), determined greater sexual exposure. CONCLUSION: adolescent sexual behaviors and forms of amorous/sexual relationship must be considered in nursing care planning to reduce sexual exposure to the human immunodeficiency virus.(1) Adolescents present high prevalence (81.0%) of sexual exposure to HIV. (2) Specificities of sexual practices are determinant factors of sexual exposure. (3) The higher the credibility given to a partner, the higher the sexual exposure to HIV. (4) Challenging sexual practices (such as fisting) determine sexual exposure. (5) Nursing care must focus on lowering exposure to HIV.

Clinical and epidemiological characteristics and individual experiences of illness in men with COVID-19: mixed method study.

BACKGROUND: Since the beginning of the coronavirus disease 2019 (COVID-19) pandemic, studies have shown that this disease has affected the male population on a significant scale in various parts of the world, making men one of the main risk groups. OBJECTIVE: To analyze the clinical and epidemiological characteristics and experiences of illness in men with COVID-19. DESIGN AND SETTING: A mixed sequential-explanatory study with cross-sectional and exploratory-descriptive approaches. METHOD: Data was collected from a small municipality located in the central-north region of the state of Bahia, Brazil. Primary quantitative data was extracted from compulsory notification forms from 598 men. Qualitative data from individual interviews of 30 men was analyzed by the Discourse of the Collective Subject method. RESULTS: The findings identified the characterization of reports of suspected and confirmed cases of COVID-19 in men, the organization of the healthcare system, and strategies for the control and combat of COVID-19 directed towards the men of the investigated municipality. They revealed the clinical characteristics based on the collective discourse of men with COVID-19. CONCLUSION: In men, the individual experience of disease explicitly explains the clinical markers of COVID-19 expressed by the self-reported syndromic approach. Additionally, this understanding also explains the behaviors observed in their search for health care, as well as the adoption of prevention and control measures and therapies recommended by health professionals.

Factors Associated with Emotion Regulation in Men with Internet Access Living in Brazil during the COVID-19 Pandemic.

Objective: to evaluate the factors associated with emotion regulation in men with internet access living in Brazil during the COVID-19 pandemic. Method: an epidemiological survey, conducted with 1015 men. An electronic form was applied containing sociodemographic and occupational characteristics, support and coping strategies, as well as emotional and behavioral aspects. Emotion regulation was assessed using the Emotion Regulation Questionnaire. Results: The prevalence values observed were 44.6% for Low Cognitive Reappraisal and of 47.1% for High Emotional Suppression. The following factors were identified as associated: (a) with Low Cognitive Reappraisal: being aged 30 years old or more, practicing physical activity, worrying about social distancing and having positive emotions and feelings; and (b) with High Emotional Suppression: being heterosexual, non-white race/skin color, having security support or public administration, not sanitizing food, worrying about lack of physical activity and not having negative emotions. Conclusion: the adoption of emotion regulation strategies was associated with individual, contextual and emotional/behavioral characteristics. Masculinity ideals seem to exert an influence on these relationships.