Patterns of Chlamydia trachomatis and Neisseria gonorrhoeae in different anatomical sites among Pre-Exposure Prophylaxis (PrEP) users in Brazil

BACKGROUND

The presence of untreated sexually transmitted infections (STIs) significantly increases the chance of acquiring HIV. In Brazil, testing for Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) among Pre-Exposure Prophylaxis (PrEP) users is insufficient, and syndromic treatment is a priority in clinical practice. Multi-site testing for CT/NG improves thescreening of asymptomatic cases and ensures timely treatment. Therefore, it is essential for HIV prevention. This study aims to test the importance of two-site testing for better screening of these pathogens and to determine whether the presence of symptoms is an indicator of CT/NG infection.

METHODS

This is a cross-sectional study carried out in four public infectious diseases clinics in São Paulo State, Brazil between January of 2022 and March of 2023. All participants had an anal swab and a first-pass or mid-stream urine collected for CT/NG analysis by Polymerase chain reaction (PCR). Data about sociodemographic, sexual behavioural and clinical aspects were collected. Pathway analysis was used to examine the direct and indirect relationships between variables according to the theoretical model.

RESULTS

We screened 171 PrEP users which had two samples collected, resulting in 342 samples. Comparing the anatomic sites, the urine samples showed lower sensitivity for CT and NG than anal samples. Gonorrhoea was directly linked to lower age (β= -0.161, p = 0.001). Time of PrEP use was directly associated with CT infection (β = 0.202; p = 0.042) and inversely associated with dysuria (β= -0.121, p = 0.009). Lower occurrence of yellow-green secretion was linked to detection of CT (β= -0.089, p = 0.005) and NG (β= -0.048, p = 0.002) infections. Foul-smelling discharge was directly associated with CT (β = 0.275, p = 0.004) and NG (β = 0.295, p = 0.037) infection.

CONCLUSION

The symptoms are a bad indicator of CT and NG infection, and the screening must be done in more than one site since most of the positive results would be missed if only urines were tested. In the case of testing only one anatomical site, specifically the urethra, the CT/NG incidence and prevalence would be underestimated. The two-sites testing improves detection rates of CT/NG, and PrEP follow-up benefits people offering STI testing.

Amplified HIV Transmission Risk Among People Living With HIV in Southeast Brazil

ABSTRACT

This study investigated the factors associated with amplified HIV transmission risk among people living with HIV from a city in southeast Brazil. A cross-sectional study was conducted with 397 people living with HIV recruited in infectious diseases clinics. Data on risk of HIV transmission, sociodemographic characteristics, sexual behaviors, professional counseling, serological HIV status, HIV-related clinical data, and beliefs about risk of HIV transmission were collected through interviews and medical records. Hierarchical ordered multinomial regression analyses were performed. Amplified HIV risk transmission was associated with lower age, alcohol consumption before having sex, illicit drug use before sexual intercourse, and not receiving professional counseling about HIV transmission. The belief that HIV can be transmitted to a partner not living with HIV was associated with lower likelihood of amplified risk for HIV transmission. Our findings suggest the importance of minimizing substance use before having sex, professional counseling, and beliefs about HIV transmission on amplified HIV risk transmission.

Contribuições da arteterapia para promoção da saúde e qualidade de vida da pessoa idosa

Resumo Objetivo Analisar as contribuições da arteterapia na promoção da saúde e na qualidade de vida dos idosos. Método Trata-se de uma revisão integrativa utilizando os descritores em saúde: “health promotion”, “art therapy”, “quality of life” e “aged”. Foram selecionados artigos originais completos, nos idiomas português, inglês e espanhol. Não foi estabelecido período de publicação dos artigos para obter um maior quantitativo de artigos publicados no decorrer do tempo. A busca e a seleção dos artigos incluídos foram realizadas por dois revisores no período de novembro de 2019 a abril de 2020. Resultados Dos quatros artigos selecionados para compor a amostra, dois artigos estavam escritos em inglês e dois em português. Os artigos incluídos foram publicados no período entre 2007 e 2014. Quanto às bases de dados, dois artigos estavam indexados na Scopus, um nas bases Scopus/Pubmed/BVS e um na base CINAHL. Os recursos expressivos utilizados no processo arteterapêutico foram os mais variados: pintura, desenho, modelagem, expressão corporal entre outros Conclusão A utilização da arteterapia para promoção da saúde em idosos mostrou benefícios na redução dos fatores negativos de ordem afetiva, emocional social. Os artigos analisados sugerem o efeito positivo da arteterapia na qualidade de vida em idosos.