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Sousa ÁFL, Lima SVMA, Ribeiro CJN, de Sousa AR, Camargo ELS, de Oliveira LB, Neto JC, Fronteira I, Mendes IAC. Pre-exposure prophylaxis among Brazilian men who have sex with men: a comparative study between migrants and non-migrants. Front Public Health 2023; 11:1198339. [PMID: 37663850 PMCID: PMC10469671 DOI: 10.3389/fpubh.2023.1198339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2023] [Accepted: 07/31/2023] [Indexed: 09/05/2023] Open
Abstract
Introduction Investigating the use and adherence to pre-exposure prophylaxis (PrEP) in MSM is a global health priority in the fight against HIV. Strategies must be capable of increasing usage and reaching not only the population living in the country but also those who immigrate, who face additional vulnerabilities. Based on this, in this observational, cross-sectional, and analytical study, our aim is to analyze the use of PrEP among Brazilian men who have sex with men, whether they are migrants or not. We aim to highlight preventive opportunities and strategies for the global health scenario. Methods We utilized a sample of Brazilians living in the country and Brazilian immigrants residing in Portugal, one of the main destinations for Brazilians in recent years. To estimate the prevalence ratio (PR) of PrEP use, we employed the Poisson regression model with robust variance estimation using a covariance matrix. Results A total of 1,117 Brazilian MSM PrEP users participated in this study, with 788 residing in Brazil and 328 in Portugal. Multivariate analysis was conducted in three stages: overall, and for subgroups of residents in Brazil and immigrants in Portugal. We identified four convergent factors that increased the prevalence of PrEP use in Brazilians regardless of migration status: having two or more casual sexual partners per month, engaging in challenging sexual practices as the receptive partner, disclosing serological status on apps, and being single. Among native Brazilians, four unique factors stood out: being in a polyamorous relationship, having sexual relations with unknown casual partners, and having higher levels of education. Discussion This study highlights the need to implement strategies to strengthen PrEP adherence in Brazil and create international programs that facilitate its usage among populations migrating between these two countries.
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Affiliation(s)
- Álvaro Francisco Lopes Sousa
- Hospital Sírio-Libânes, Instituto de Ensino e Pesquisa, São Paulo, Brazil
- Global Health and Tropical Medicine, Instituto de Higiene e Medicina Tropical, Universidade Nova de Lisboa, Lisbon, Portugal
| | - Shirley Verônica Melo Almeida Lima
- Collective Health Research Center, Universidade Federal de Sergipe, Lagarto, Sergipe, Brazil
- Nursing Graduate Program, Universidade Federal de Sergipe, São Cristóvão, Sergipe, Brazil
| | | | - Anderson Reis de Sousa
- Graduate Program in Nursing and Health of the Nursing School, Universidade Federal da Bahia, Salvador, Bahia, Brazil
| | | | - Layze Braz de Oliveira
- Ribeirão Preto College of Nursing, Universidade de São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - João Cruz Neto
- University for International Integration of the Afro-Brazilian Lusophony, Redenção, Ceará, Brazil
| | - Inês Fronteira
- Public Health Research Centre, Comprehensive Health Research Center, National School of Public Health, New University of Lisbon, Lisbon, Portugal
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de Sousa AFL, Lima SVMA, Ribeiro CJN, de Sousa AR, Barreto NMPV, Camargo ELS, Araújo AAC, dos Santos AD, Bezerra-Santos M, Fortunato MDR, Possani MA, dos Santos AJ, de Lima JLT, Gir E, Fronteira I, Mendes IAC. Adherence to Pre-Exposure Prophylaxis (PrEP) among Men Who Have Sex with Men (MSM) in Portuguese-Speaking Countries. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4881. [PMID: 36981792 PMCID: PMC10049571 DOI: 10.3390/ijerph20064881] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Revised: 03/07/2023] [Accepted: 03/08/2023] [Indexed: 06/18/2023]
Abstract
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.
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Affiliation(s)
- Alvaro Francisco Lopes de Sousa
- Hospital Sírio-Libânes, Instituto de Ensino e Pesquisa, São Paulo 01308-050, São Paulo, Brazil
- Global Health and Tropical Medicine, Instituto de Higiene e Medicina Tropical, Universidade Nova de Lisboa, 1349-008 Lisboa, Portugal
| | - Shirley Veronica Melo Almeida Lima
- Collective Health Research Center, Universidade Federal de Sergipe, Lagarto 49400-000, Sergipe, Brazil
- Graduate Program in Nursing, Universidade Federal de Sergipe, São Cristóvão 49100-000, Sergipe, Brazil
| | | | - Anderson Reis de Sousa
- Graduate Program in Nursing and Health of the Nursing School, Universidade Federal da Bahia, Salvador 40170-110, Bahia, Brazil
| | | | | | | | - Allan Dantas dos Santos
- Collective Health Research Center, Universidade Federal de Sergipe, Lagarto 49400-000, Sergipe, Brazil
| | - Márcio Bezerra-Santos
- Medical and Nursing Science Center, Universidade Federal de Alagoas, Arapiraca 57309-005, Alagoas, Brazil
| | | | - Matheus Arantes Possani
- Medical School, Universidade Federal do Triângulo Mineiro, Uberaba 38025-180, Minas Gerais, Brazil
| | - Adriano José dos Santos
- Collective Health Research Center, Universidade Federal de Sergipe, Lagarto 49400-000, Sergipe, Brazil
| | | | - Elucir Gir
- Ribeirão Preto College of Nursing, Universidade de São Paulo, Ribeirão Preto 14040-902, São Paulo, Brazil
| | - Inês Fronteira
- Global Health and Tropical Medicine, Instituto de Higiene e Medicina Tropical, Universidade Nova de Lisboa, 1349-008 Lisboa, Portugal
| | - Isabel Amélia Costa Mendes
- Ribeirão Preto College of Nursing, Universidade de São Paulo, Ribeirão Preto 14040-902, São Paulo, Brazil
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Romeiro V, Bullinger M, Marziale MHP, Fegadolli C, Reis RA, Silveira RCDCP, Costa-Júnior MLD, Sousa FAEF, Andrade VSD, Conacci BJ, Nascimento FK, Santos CBD. DISABKIDS® in Brazil: advances and future perspectives for the production of scientific knowledge. Rev Lat Am Enfermagem 2020; 28:e3257. [PMID: 32321044 PMCID: PMC7164929 DOI: 10.1590/1518-8345.3003.3257] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2018] [Accepted: 01/09/2019] [Indexed: 11/22/2022] Open
Abstract
Objective: to map the Brazilian scientific production related to the stages of the
methodological process for the use of DISABKIDS® instruments
and/or forms adapted to Brazil. Method: scoping review, with searches conducted on10 electronic databases, plus
Google Scholar and contacts with researchers, without restriction of period
or language. Results: the mapping identified 90 scientific studies involving 46 instruments. Of
these, 11 (23.9%) included the elaboration and/or cultural adaptation of the
DISABKIDS® instruments to measure the Quality of Life of
children or adolescents with chronic conditions and 35 (76.1%) used the
Generic Measures and/or Specific Modules for the semantic validation of
other instruments. Conclusion: this scoping review allowed a comprehensive evaluation of the use of the
DISABKIDS® instrument and forms, in relation to the
validation of the instrument adapted to Brazil, presenting a positive
advance in the scenario with the development of academic/scientific projects
in the country, incorporating the method recommended by the literature for
the elaboration, cultural adaptation and validation of instruments and for
the systematized and standardized recording of the perception and
understanding of the target population about the measure of interest, using
DISABKIDS® forms adapted for this purpose.
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Affiliation(s)
- Viviane Romeiro
- Universidade de São Paulo, Escola de Enfermagem de Ribeirão Preto, PAHO/WHO Collaborating Centre for Nursing Research Development, Ribeirão Preto, SP, Brazil
| | - Monika Bullinger
- University Medical Center Hamburg-Eppendorf, Instituto de Medicina Psicológica, Hamburgo, HB, Germany
| | - Maria Helena Palucci Marziale
- Universidade de São Paulo, Escola de Enfermagem de Ribeirão Preto, PAHO/WHO Collaborating Centre for Nursing Research Development, Ribeirão Preto, SP, Brazil
| | - Claudia Fegadolli
- Universidade Federal de São Paulo, Instituto de Ciências Ambientais, Químicas e Farmacêuticas, São Paulo, SP, Brazil
| | - Roberta Alvarenga Reis
- Universidade Federal do Rio Grande do Sul, Faculdade de Odontologia, Porto Alegre, RS, Brazil.,Scholarship holder at the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES), Brazil
| | | | - Moacyr Lobo da Costa-Júnior
- Universidade de São Paulo, Escola de Enfermagem de Ribeirão Preto, PAHO/WHO Collaborating Centre for Nursing Research Development, Ribeirão Preto, SP, Brazil
| | - Fátima Aparecida Emm Faleiros Sousa
- Universidade de São Paulo, Escola de Enfermagem de Ribeirão Preto, PAHO/WHO Collaborating Centre for Nursing Research Development, Ribeirão Preto, SP, Brazil
| | - Valéria Sousa de Andrade
- Universidade Federal do Triângulo Mineiro, Departamento de Terapia Ocupacional, Uberaba, MG, Brazil
| | - Beatriz Juliana Conacci
- Universidade de São Paulo, Escola de Enfermagem de Ribeirão Preto, PAHO/WHO Collaborating Centre for Nursing Research Development, Ribeirão Preto, SP, Brazil.,Scholarship holder at the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES), Brazil
| | - Fernanda Karla Nascimento
- Universidade de São Paulo, Escola de Enfermagem de Ribeirão Preto, PAHO/WHO Collaborating Centre for Nursing Research Development, Ribeirão Preto, SP, Brazil.,Scholarship holder at the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES), Brazil
| | - Claudia Benedita Dos Santos
- Universidade de São Paulo, Escola de Enfermagem de Ribeirão Preto, PAHO/WHO Collaborating Centre for Nursing Research Development, Ribeirão Preto, SP, Brazil.,Scholarship holder at the Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq), Grant # 311289/2017-7, Brazil
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Abstract
Background: The interest in Global Health (GH) as an academic discipline has increased in the last decade. This article reports the findings of a scoping review of studies about Global Health education in the Americas. Objective: To analyse educational programs on global health in the Americas. Method: Five electronic databases were used in a scoping review: PubMed, Scopus, Web of Knowledge, CINAHL, and Lilacs. Data collection happened in November 2017–March 2018. The following stages were rigorously observed: identification, selection, charting, and summarizing the studies that were included. To process the data, we used IRaMuTeQ software. Findings: Forty-six studies were identified and organized in categories: 1) diversity of the topics addressed in GH; 2) models of teaching; 3) emotional, cultural, and collaborative aspects in teaching GH; 4) student preparation for GH experiences; and 5) structures required for a GH course. Conclusions: The existing global health curriculum in the Americas is diffuse and limited, with a greater focus on clinical aspects. Thus, a minimum curriculum for students from different areas is needed. Results evidenced that the teaching of global health in the Americas is still incipient, although it is promising. The lack of a common curriculum for the courses in the region makes it difficult to train sensitive and capable professionals to achieve the 2030 Sustainable Development Goals.
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Queiroz AAFLN, Matos MCB, Araújo TMED, Reis RK, Sousa ÁFL. Infecções sexualmente transmissíveis e fatores associados ao uso do preservativo em usuários de aplicativos de encontro no Brasil. ACTA PAUL ENFERM 2019. [DOI: 10.1590/1982-0194201900076] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Resumo Objetivos Caracterizar os usuários brasileiros de aplicativos de encontro baseados em geolocalização, estimar a prevalência de Infecções Sexualmente Transmissíveis (ISTs) e fatores associados ao uso do preservativo. Métodos Estudo descritivo, transversal, com amostra de 2.250 homens que fazem sexo com homens (HSH) de todo o Brasil. Utilizou-se da rede social Facebook® para a coleta e divulgação da pesquisa, por meio de uma postagem impulsionada semanalmente, de novembro de 2016 a janeiro de 2017. Os dados foram analisados de forma uni e bivariada com o auxílio do software SPSS. Resultados Houve a predominância de participantes jovens (25 anos), com ensino superior completo (57,8%) e homossexuais (75,7%), que conheceram os seus parceiros através de aplicativos (64,1%), utilizando, principalmente, o Tinder ® (57,3%) e Grindr® (53,3%) para fins sexuais (69,7%). A prevalência de ISTs foi de 11,1%, sendo 7,1 de HIV. Foram fatores associados ao uso de preservativos: conhecer o parceiro pelo app (p=0,003), utilizar o Grindr ® (p=0,002), Scruff ® (p=0,027) ou Hornet ® (p<0,001), usar os apps para amizade (p<0,001), sexo (p<0,001) ou relacionamento (p<0,001), frequência de uso do aplicativo (p<0,001) e utilizar os apps durante à noite (p=0,003). Conclusão Os usuários são jovens, com alto nível educacional e que demonstram familiaridade com os apps pelo tempo de uso. A prevalência de ISTs foi elevada, sobretudo da infecção pelo HIV. Características sociodemográficas e particularidades do uso e consumo dos apps estão associadas a utilização consistente do preservativo, principalmente o motivo de uso, frequência, horário e aplicativo utilizado.
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Sousa AFL, Queiroz AAFLN, Fronteira I, Lapão L, Mendes IAC, Brignol S. HIV Testing Among Middle-Aged and Older Men Who Have Sex With Men (MSM): A Blind Spot? Am J Mens Health 2019; 13:1557988319863542. [PMID: 31288596 PMCID: PMC6620727 DOI: 10.1177/1557988319863542] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2019] [Revised: 06/09/2019] [Accepted: 06/13/2019] [Indexed: 12/30/2022] Open
Abstract
Middle-aged and older men who have sex with men (MSM) are one of the most underestimated populations with regard to HIV/AIDS infection, despite the worldwide trend of increasing prevalence in recent years. This population also has low rates of testing, although rare studies are done exclusively with middle-aged and older MSM assessing the factors associated with this prevalence. Thus, based on data from an exclusive online survey with middle-aged and older MSM who use geolocation-based dating applications, the purpose of the study was to analyze factors associated with not taking the HIV test among middle-aged (50 years old) and older MSM in Brazil. Using a modification of time-location sampling adapted to virtual reality, 412 volunteers were approached in Grindr®, Hornet®, SCRUFF®, and Daddyhunt®. The multivariate logistic regression model was adopted to produce adjusted odds ratios (ORa), considering a significance level at .05. There were factors associated with not taking the test: being in a relationship (ORa: 0.24; 95% CI [0.10, 0.53]); knowing partner through the applications (ORa: 1.84; 95% CI [1.07, 3.15]); not knowing the serological status (ORa: 5.07; 95% CI [1.88, 13.67]); ejaculating outside of anal cavity (ORa: 1.79; 95% CI [1.04, 3.05]); practicing sex without penetration (ORa: 2.30; 95% CI [1.17, 4.50]); not taking the test as a form of prevention (ORa: 2.83; 95% CI [1.05, 7.68]); and rarely using Viagra in sexual intercourse (ORa: 1.91; 95% CI [1.20, 3.65]). There is a blind spot in the prevalence of HIV testing in older MSM because this population is not being covered by services, which compromises the overall response to HIV, the goals set for universal health coverage.
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Affiliation(s)
- Alvaro Francisco Lopes Sousa
- Escola de Enfermagem de Ribeirão Preto, Universidade de São Paulo (USP), Brazil
- Global Health and Tropical Medicine, Instituto de Higiene e Medicina Tropical, Universidade NOVA de Lisboa, Portugal
| | | | - Inês Fronteira
- Global Health and Tropical Medicine, Instituto de Higiene e Medicina Tropical, Universidade NOVA de Lisboa, Portugal
| | - Luís Lapão
- Global Health and Tropical Medicine, Instituto de Higiene e Medicina Tropical, Universidade NOVA de Lisboa, Portugal
| | | | - Sandra Brignol
- Instituto de Saúde Coletiva, Universidade Federal Fluminense, Niterói, Rio de Janeiro, Brazil
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Araújo ETH, Almeida CAPL, Vaz JR, Magalhães EJL, Alcantara CHL, Lago EC. Use of Social Networks for Data Collection in Scientific Productions in the Health Area: Integrative Literature Review. AQUICHAN 2019. [DOI: 10.5294/aqui.2019.19.2.4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Objective: To investigate evidence on the use of social networks to collect data in scientific productions in the health area. Material and method: An integrative literature review from primary studies indexed in the SciELO, PubMed, LILACS, Scopus, and Web of Science platforms. Results: 16 scientific articles were selected, of which nine focused on the use of WhatsApp; five, on the use of Facebook; and two, on employing Twitter to collect data in scientific productions. Growth was noted on the number of investigations associated to the use of social networks, although an important paradigm still exists related to the use to generate scientific evidence, resulting in a still low number of investigations on this theme. Conclusions: The health area needs to approach evermore the development of research associated to social networks, given that this would enable a viable and rapid intervention in obtaining responses, besides being a low cost and very promising tool for data collection.
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