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Schwarz K, Villas-Bôas AP, Cielo CA, da Silva DC, da Silva ED, Fighera TM, Costa AB, Lobato MIR, Spritzer PM. Application of the transgender male voice questionnaire in a Brazilian population sample. Front Public Health 2024; 12:1480423. [PMID: 39737453 PMCID: PMC11683065 DOI: 10.3389/fpubh.2024.1480423] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2024] [Accepted: 11/29/2024] [Indexed: 01/01/2025] Open
Abstract
Objectives The aim of this study was to adapt and apply the Portuguese version of the Transgender Man Voice Questionnaire in a sample of Brazilian transgender men and to investigate the relationship between voice satisfaction and hormone therapy duration. In addition, we suggest reducing and reformulating the questionnaire for screening. Methods We conducted a cross-sectional study of 31 transgender men aged 18-50 years undergoing hormone therapy who answered a questionnaire adapted from the Transgender Woman Voice Questionnaire, validated in Portuguese. Sociodemographic and clinical data were collected from the individuals' electronic medical records: age, smoking status, and type and duration of hormone therapy. The questionnaire, consisting of 30 questions rated on a Likert scale, was answered individually during a psychotherapy session. In each question, the gender-specific words were modified. Furthermore, we added a question: 31 (After GAHT, my voice became completely male), with the response options yes or no. In questions 32 and 33, asking participants to provide an overall rating of their voice. Total score ranged from 0 to 120, with higher scores indicating greater dissatisfaction with voice. Results Mean patient age was 30.13 ± 7.6 years, and 19.4% were smokers. The mean duration of hormone therapy was 29.7 ± 24.9 months, and 95% received intramuscular testosterone cypionate, maintaining serum testosterone levels within the male reference range. The questionnaire mean total score was 51 ± 17.72. There was a significant negative correlation between the questionnaire total score and duration of hormone therapy (r = -0.484, p = 0.006). The questionnaire had a high level of internal consistency/reliability, with a Cronbach's alpha coefficient of 0.95 for all items and a split-half Spearman-Brown coefficient of 0.96. For the elaboration of a screening tool, it is suggested to remove questions 8, 10, 12, 13, 14, 17, 19, 23, 27, and 29 and modify question 1. Conclusion Longer hormone therapy favors voice deepening and satisfaction with voice. The psychometric properties of the Transgender Man Voice Questionnaire are reliable, supporting its use as a screening tool in clinical practice and as an adjunct to the planning of vocal and communication support for transgender individuals.
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Brandelli Costa A, Martins da Silva M, Wiehe Chaves L, Gelain M, Graeff Bins-Ely I, Alckmin-Carvalho F, Wendt GW. General and healthcare-related HIV stigma among cisgender Brazilian women: the role of socioeconomic vulnerability. HIV Res Clin Pract 2024; 25:2361179. [PMID: 38884378 DOI: 10.1080/25787489.2024.2361179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2024] [Accepted: 05/24/2024] [Indexed: 06/18/2024]
Abstract
BACKGROUND HIV-related stigma is associated with worse health outcomes and lower adherence to antiretroviral therapy. There is limited data on the stigma faced by Latin American cisgender women, although they are among the populations most affected by HIV. This study aims to provide insight into the Stigma Index Brazil, with the objective of estimating the prevalence of HIV-related stigma among cisgender women in Brazil and to investigate the role of low socioeconomic status in stigma experience. METHODS This is a cross-sectional community-based study. A total of 30 people with HIV were trained to recruit participants from their peer networks; 1,768 people with HIV from all regions of Brazil participated in the study, of which 566 participants were cisgender women. We used the Stigma Index, an instrument that assesses global trends in HIV-related stigma from the perspective of people with HIV. RESULTS Approximately 70% of participants reported some form of HIV-related stigma. The most prevalent forms were discriminatory comments or gossiping (51.26%) and verbal harassment (30.99%). More than 20% experienced any health care related HIV-stigma in the last 12 months, the most frequent being the avoidance of physical contact (10.02%). Women in social vulnerability faced more stigma compared to the group without social vulnerability, both in general contexts (75.79% vs 64.32%; χ2 = 8.67, p < 0.05) and in healthcare contexts (24.12% vs 16.02%; χ2 = 4.06, p < 0.05). CONCLUSION We found a high prevalence of stigma associated with HIV faced by Brazilian women from all regions of the country, both in everyday life and in healthcare contexts. Evidence-based interventions to reduce stigma in the general population, and specific mental health care aimed at women with HIV in Brazil, especially among those with greater socioeconomic vulnerability, are urgent.
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Skura S, Fontanari AMV, de Azevedo LBH, Bagatini RM, Júnior VS, Benvegnú DM, Fortes PCN, Costa AB, Wendt GW, Ferreto LED. Erectile dysfunction in men with human immunodeficiency virus: prevalence and associated factors. Transl Androl Urol 2024; 13:2396-2407. [PMID: 39698577 PMCID: PMC11650357 DOI: 10.21037/tau-24-234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2024] [Accepted: 11/03/2024] [Indexed: 12/20/2024] Open
Abstract
Background Male sexuality plays a crucial role in determining the overall quality of life, and it involves complex interactions between physical systems and psychosocial dimensions. Erectile dysfunction (ED) has a particularly notable impact on men's well-being, especially among those living with human immunodeficiency virus (HIV). This study's aim was to explore the prevalence of ED and its associated factors in men with HIV. Methods Cross-sectional research was conducted in a specialized care unit in Paraná, involving 120 adult men living with HIV. Data collection occurred from March 2021 to December 2023, and ED was assessed using the 6-item version of International Index of Erectile Function (IIEF-6) questionnaire. Psychological factors were assessed using the Depression, Anxiety and Stress Scales-21 (DASS-21). The primary outcome was ED. Results The prevalence of ED was 37.5% [95% confidence interval (CI): 28.8% to 46.2%]. A significant association was observed between advanced age and ED. Regarding the type of antiretroviral therapy (ART), the data revealed a significant association with ED, the differences were particularly notable when comparing the therapeutic regimens of nucleoside reverse transcriptase inhibitor (NRTI) + Integrase inhibitor (INI) vs. NRTI + protease inhibitor (PI) and NRTI + NRTI. Furthermore, mental health factors were analyzed, with anxiety demonstrating a significant association with ED [odds ratio (OR) =2.35; 95% CI: 1.02 to 5.43; P=0.046]. Conclusions The findings highlight the urgent need for an integrated approach to clinical management that considers both medical and emotional aspects in men living with HIV. It has also a potential to subside further investigations, particularly those adopting a longitudinal design to capture casual mechanisms of ED in men with HIV.
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Brandelli Costa A, Boeira LDS, de Almeida-Segundo DS, Chaves LW, Sainz L, Silva L, Garcia Dos Santos LM, Reis N, Pasqualotto AC, Sued O, Perez F. Experiences and perspectives on rapid-test diagnosis of tuberculosis, histoplasmosis and cryptococcosis in people with advanced HIV/AIDS disease in Porto Alegre, Brazil. PLoS One 2024; 19:e0312204. [PMID: 39602400 PMCID: PMC11602015 DOI: 10.1371/journal.pone.0312204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2024] [Accepted: 09/20/2024] [Indexed: 11/29/2024] Open
Abstract
The rapid diagnosis of opportunistic infections (OIs) is critical for improving the health outcomes of people living with HIV/AIDS (PLWHA). This study aimed to describe the feasibility of implementing a package for the rapid diagnosis of tuberculosis, histoplasmosis, and cryptococcosis in patients with advanced HIV/AIDS disease in Porto Alegre, Brazil. The research involved two focus groups with health professionals, four in-depth interviews with healthcare managers, and twelve interviews with PLWHA. The corpus was analyzed using Descending Hierarchical Classification (DHC). The study found that the rapid test diagnosis intervention was generally well-received by patients and health professionals, improving diagnosis and treatment outcomes. However, it also identified several areas for improvement, including the need for expanded psychosocial support and enhanced coordination between health services. The findings have important implications for the development and implementation of policies and programs aimed at enhancing the diagnosis and treatment of OIs among PLWHA with advanced diseases. Further research should explore social determinants of HIV/AIDS mortality to offer valuable insights into improving prevention and treatment strategies. By prioritizing patient-centered care and improving coordination between health services, policymakers and health professionals can improve the health outcomes of PLWHA with advanced disease in Porto Alegre and other similar settings.
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Chinazzo ÍR, Vaitses Fontanari AM, Riva A, de Brito Silva B, Rodrigues LP, Trajano AC, Feijó M, Brandelli Costa A, Lobato MIR. Coping strategies employed by transgender youth with higher and lower quality of life. BRITISH JOURNAL OF DEVELOPMENTAL PSYCHOLOGY 2024. [PMID: 39380415 DOI: 10.1111/bjdp.12524] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2023] [Accepted: 09/17/2024] [Indexed: 10/10/2024]
Abstract
Understanding transgender youth coping mechanisms may help create strategies that reduce the influence of stress on quality of life. Our study aims to measure the quality of life of Brazilian transgender youth and analyse the association with their coping strategies used for dealing with general and gender-related stress. The sample consisted of 185 participants (μ = 18.49 years; SD 2.42); of which 95 (46.34%) transgender boys, 45 (21.95%) transgender girls, 65 (31.71%) non-binary. Better quality of life was related to social support, whereas lower quality of life was related to the use of avoidance coping style in the context of general stress. The study found no association between coping strategies for gender-related stress and quality of life. Thus, the increase in quality of life in the context of gender distress among transgender youth should involve other mechanisms than promoting coping skills.
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Viscardi LH, Kleber FD, Custódio H, Costa AB, Brollo J. Akinetopsia (visual motion blindness) associated with brain metastases: a case report. Neurol Sci 2024; 45:4621-4623. [PMID: 38691276 DOI: 10.1007/s10072-024-07565-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2024] [Accepted: 04/28/2024] [Indexed: 05/03/2024]
Abstract
Akinetopsia is a rare neurological syndrome characterized by an impaired perception of movement, often resulting from brain damage due to ischemia, epilepsy, or medication. It is also known as visual motion blindness, and patients with this condition are unable to perceive motion normally even with perfect visual acuity. This report aims to present a case of a patient in their late 40 s who developed akinetopsia and also an impairment in movement perception of objects without emitting sounds, after experiencing a late relapse of breast cancer with the occurrence of multiple brain metastases. The patient also experienced visual hallucinations, night terrors, and difficulty forming anterograde memory. Neuroimaging with MRI revealed severe brain damage, especially in the middle temporal area of the visual cortex. Akinetopsia is a rare phenomenon, and this is the first known case of its association with brain metastases.
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Abubakar A, Brandelli Costa A, Cui L, Koller SH, Nwafor CE, Raval VV. Towards a decolonial developmental science: Adolescent development in the Majority World taking center stage. JOURNAL OF RESEARCH ON ADOLESCENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR RESEARCH ON ADOLESCENCE 2024; 34:246-256. [PMID: 38773708 DOI: 10.1111/jora.12956] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/15/2024] [Accepted: 04/16/2024] [Indexed: 05/24/2024]
Abstract
While aspiring to be a diverse and global science, developmental science continues to be dominated by EuroAmerican epistemologies, researchers, and communities in its published scholarship. Adolescents in communities across Africa, Asia, the Middle East, and Latin America comprise 85% of the world's adolescent population, and yet their experiences and perspectives are marginalized in our science. Adolescents in the Majority World live in highly diverse social, cultural, political, economic, educational and healthcare contexts that contribute to their development, and we have much to learn from their experiences. This article situates the marginalization of the global majority within coloniality embedded in developmental science. The article describes the impetus for this special issue Towards a decolonial developmental science and the process of putting it together, along with providing an overview of the 18 articles in this collection that push us towards decoloniality. The special issue serves as a call to transform developmental science to be decolonial by empowering adolescent development in Majority World communities to take center stage. Adolescent development research from Majority World communities has the potential to challenge the knowledge base generated from Minority World samples, contributing to a science that is comprehensive, inclusive, and can inform prevention and intervention efforts to support the well-being of adolescents globally.
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Esposito G, Marschik PB, Nordahl-Hansen A, Costa AB. Developmental disabilities in low resource contexts. RESEARCH IN DEVELOPMENTAL DISABILITIES 2023; 140:104589. [PMID: 37634265 DOI: 10.1016/j.ridd.2023.104589] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/29/2023]
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Schwarz K, Cielo CA, Spritzer PM, Villas-Boas AP, Costa AB, Fontanari AMV, Costa Gomes B, da Silva DC, Schneider MA, Lobato MIR. A speech therapy for transgender women: an updated systematic review and meta-analysis. Syst Rev 2023; 12:128. [PMID: 37481572 PMCID: PMC10363306 DOI: 10.1186/s13643-023-02267-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Accepted: 06/04/2023] [Indexed: 07/24/2023] Open
Abstract
BACKGROUND We systematically reviewed the literature and performed a meta-analysis on the effects of speech therapy and phonosurgery, for transgender women, in relation to the fundamental frequency gain of the voice, regarding the type of vocal sample collected, and we compared the effectiveness of the treatments. In addition, the study design, year, country, types of techniques used, total therapy time, and vocal assessment protocols were analyzed. METHODS We searched the PubMed, Lilacs, and SciELO databases for observational studies and clinical trials, published in English, Portuguese, or Spanish, between January 2010 and January 2023. The selection of studies was carried out according to Prisma 2020. The quality of selected studies was assessed using the Newcastle-Ottawa scale. RESULTS Of 493 studies, 31 were deemed potentially eligible and retrieved for full-text review and 16 were included in the systematic review and meta-analysis. Six studies performed speech therapy and ten studies phonosurgery. The speech therapy time did not influence the post-treatment gain in voice fundamental frequency (p = 0.6254). The type of sample collected significantly influenced the post-treatment voice frequency gain (p < 0.01). When the vocal sample was collected through vowel (p < 0.01) and reading (p < 0.01), the gain was significantly more heterogeneous between the different types of treatment. Phonosurgery is significantly more effective in terms of fundamental frequency gain compared to speech therapy alone, regardless of the type of sample collected (p < 0.01). The average gain of fundamental frequency after speech therapy, in the /a/ vowel sample, was 27 Hz, 39.05 Hz in reading, and 25.42 Hz in spontaneous speech. In phonosurgery, there was a gain of 71.68 Hz for the vowel /a/, 41.07 Hz in reading, and 39.09 Hz in spontaneous speech. The study with the highest gain (110 Hz) collected vowels, and the study with the lowest gain (15 Hz), spontaneous speech. The major of the included studies received a score between 4 and 8 on the Newcastle-Ottawa Scale. CONCLUSION The type of vocal sample collected influences the gain result of the fundamental frequency after treatment. Speech therapy and phonosurgery increased the fundamental frequency and improved female voice perception and vocal satisfaction. However, phonosurgery yielded a greater fundamental frequency gain in the different samples collected. The study protocol was registered at Prospero (CRD42017078446).
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Vilanova F, Milfont TL, Costa AB. Short version of the right-wing authoritarianism scale for the Brazilian context. PSICOLOGIA-REFLEXAO E CRITICA 2023; 36:17. [PMID: 37470848 PMCID: PMC10359236 DOI: 10.1186/s41155-023-00260-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Accepted: 07/07/2023] [Indexed: 07/21/2023] Open
Abstract
Right-Wing Authoritarianism (RWA) is a central predictor of distinct phenomena such as prejudice, voting behavior, corruption, conspiratory beliefs and dietary habits. Given its theoretical and practical relevance, researchers have incorporated RWA measures in large-scale surveys but their length can be an impediment. Although short RWA scales exist, none consider the cultural variability of the RWA structure in non-WEIRD contexts such as Brazil. Here, we report data from five cross-sectional and longitudinal Brazilian samples (Ntotal = 2,493) used to develop a short RWA version that considers cross-cultural specificities of the Brazilian context, where an alternative four-factor model was observed. Exploratory and confirmatory factor analyses confirmed a four-factor structure comprising Authoritarianism, Traditionalism, Submission to Authority and Contestation to Authority dimensions. Six-month longitudinal results indicated that Authoritarianism and Traditionalism are more stable than both Submission and Contestation to Authority. Correlations between these dimensions and right-wing political self-categorization were statistically equivalent for the full 34-item RWA scale version and the new 12-item version. Results confirm the psychometric properties of the four-factor, 12-item RWA scale in this cultural context.
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Vaitses Fontanari AM, Bauer GR, Churchill SM, Brandelli Costa A. Gynecological Care Among Brazilian Women Who Have Sex with Women: A Respondent-Driven Sampling Study. LGBT Health 2023; 10:287-295. [PMID: 37022728 DOI: 10.1089/lgbt.2021.0384] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/07/2023] Open
Abstract
Purpose: This study aimed to describe the gynecological care provided to Brazilian women who have sex with women (WSW). Methods: Respondent-driven sampling was used to recruit Brazilian WSW. The survey questions, concerning gynecological care, were designed in Portuguese by medical professionals, medical students, and LGBTQIA+ community members, including the authors. The statistical analyses were weighted to account for the likelihood of recruitment. Results: From January to August of 2018, 299 participants were recruited in 14 recruitment waves. The mean age of the WSW was 25.3 years. Most (54.9%) identified as lesbian and had been involved in past-year sexual intercourse mainly with cisgender women (86.1%). The WSW also reported having sex with cisgender men (22.2%), transgender men (5.3%), nonbinary people (2.3%), and transgender women (5.3%) in the last year. More than a quarter of the WSW did not have regular appointments with a gynecologist: 8.0% (95% confidence interval [CI] = 4.2-11.6) and 19% (95% CI = 12.8-25.2) stated that they had never gone to the gynecologist or they had only gone for emergencies, respectively. Almost one-third had never had cervical cancer screening (cervical cytology, Pap test or Pap smear). Most women justified avoiding the test because they felt healthy, thought it would hurt, or feared a health professional might mistreat them. Conclusion: Gynecologists should avoid heteronormative assumptions, inquire about sexual practices, orientation, and identity separately, and provide Pap tests as advised to WSW.
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Chinazzo ÍR, Fontanari AMV, Costa AB, Lobato MIR. Factors Associated with Suicidal Ideation and Suicide Attempt in Brazilian Transgender Youth. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3215. [PMID: 36833910 PMCID: PMC9960929 DOI: 10.3390/ijerph20043215] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Revised: 01/24/2023] [Accepted: 02/09/2023] [Indexed: 06/18/2023]
Abstract
The rates of suicidal ideation and suicide attempts among transgender youths are high. However, in Brazil, there are no studies about these outcomes in this population. The present study aims to investigate the prevalence of suicidal ideation and suicide attempts in Brazilian transgender youths (binary and non-binary), in association with predictor variables, following the Minority Stress Theory. The predictor variables analyzed were depressive symptoms, discrimination, gender distress, deprivation, social support, and gender identity support from parents and friends. Participants were recruited through an online survey. The final sample consisted of 213 participants, aged 13 to 25 years old. Two equal regression analyses were performed, one for each outcome. Out of the total, 103 (48.6%) identified as transgender boys, 44 (20.8%) as transgender girls, and 65 (30.7%) as non-binary. The mean age was 18.53 years (SD 2.50). The study found that 57.6% of the sample had depressive symptoms, 72.3% experienced suicidal ideation, and 42.7% had attempted suicide. In the final model, the variables that were associated with suicidal ideation were deprivation, gender distress, and depressive symptoms. As for suicide attempts, the variables deprivation and depressive symptoms were correlated. Further studies on this population should be conducted to analyze protective factors for these outcomes.
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Brasil MV, Cúnico SD, Guilherme AA, Costa AB. What Is Citizenship and How Is It Practiced: The Views from Students in Porto Alegre. HUMAN ARENAS 2023. [DOI: 10.1007/s42087-022-00325-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
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Costa AB, Viscardi LH, Feijo M, Fontanari AMV. HIV Voluntary Counseling and Testing (VCT-HIV) effectiveness for sexual risk-reduction among key populations: A systematic review and meta-analysis. EClinicalMedicine 2022; 52:101612. [PMID: 36034408 PMCID: PMC9399159 DOI: 10.1016/j.eclinm.2022.101612] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Revised: 07/21/2022] [Accepted: 07/21/2022] [Indexed: 11/20/2022] Open
Abstract
Background HIV disproportionately affects people who inject drugs, transgender people, sex workers, men who have sex with men, and incarcerated people. Recognized as key populations (KP), these groups face increased impact of HIV infection and reduced access to health assistance. In 1990, the Center for Disease Control and Prevention organized technical guidance on HIV Voluntary Counseling and Testing (VCT-HIV), with subsequent trials comparing intervention methodologies, no longer recommending this strategy. However, KP needs have not been explicitly considered. Methods We assessed VCT-HIV effectiveness for sexual risk-reduction among KP (PROSPERO 2020 CRD42020088816). We searched Pubmed, EMBASE, Global Health, Scopus, PsycINFO, and Web of Science for peer-reviewed, controlled trials from February, 2020, to April, 2022. We screened the references list and contacted the main authors, extracted data through Covidence, applied the Cochrane Risk-of-Bias tool, and performed the meta-analysis using Review Manager. Findings We identified 17 eligible trials, including 10,916 participants and evaluated HIV risk behaviors. When compared to baseline, VCT-HIV reduced unsafe sex frequency (Z=5.40; p<0.00001, I²=0%). Interpretation While our meta-analysis identified VCT-HIV as protective for sexual risk behaviors for among KP, the results are limited to MSM and PWID, demonstrating the paucity of data on the other KP. Also, it highlights the importance of applying a clear VCT-HIV guideline as well as properly training the counselors. Funding Research funded by Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPQ/MS-DIAHV N° 24/2019), and Coordenação de Aperfeiçoamento de Pessoal de Nível Superior.
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Almeida-Segundo DSD, Stucky JL, Bercht AM, Vilanova F, Pizzinato A, Costa AB. Trajetórias de Pesquisa do Programa de Pós-Graduação em Psicologia da PUCRS (1972-2020). PSICOLOGIA EM PESQUISA 2022. [DOI: 10.34019/1982-1247.2022.v16.32993] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Este estudo analisa a trajetória temática e histórica do PPGP da PUCRS. Compuseram o banco os títulos de teses e dissertações defendidas de 1972 até 2020. Foi realizada uma Classificação Hierárquica Descendente por meio do IRAMUTEQ e análises descritivas com o SPSS. Analisaram-se 1012 segmentos de texto em que reteve 82,21% do total (832 unidades), que se organizaram em quatro classes: Cognição Humana e Neuropsicologia, Psicologia Clínica e Saúde Mental, Psicologia Social e Processos Psicossociais e Produção de Subjetividades e Políticas Sociais. Discute-se a história do Programa, destacando sua pluralidade de abordagens, e impacto na Psicologia brasileira.
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Martínez C, Costa AB, Tomicic A. Development of a Collaborative Network: Latin-American Network for Research in Psychotherapy and Mental Health in Sexual and Gender Diversity. TRENDS IN PSYCHOLOGY 2022. [PMCID: PMC9263037 DOI: 10.1007/s43076-022-00204-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
The main goal of this article is to describe the formation and development of a Latin-American network for research in psychotherapy and mental health in sexual and gender diversity. Research has shown that psychological well-being and mental health problems of sexual minority individuals are strongly influenced by the particular social and cultural contexts in which people develop and live. Therefore, the development of effective psychological and mental health interventions that meet the specific needs of people of sexual and gender diversity is necessary to deepen the knowledge of the psychosocial and specific contextual-related aspects of mental health of these populations. The Latin-American network for research in psychotherapy and mental health in sexual and gender diversity seeks to reinforce the contextualized study of these topics. This is an ongoing project that has generated collaborative work among researchers from centers in Chile, Brazil, Colombia, Ecuador, and Argentina. The diverse modalities of collaboration that have been developed so far between the centers are described, as well as the specific products that have emerged from these efforts. Finally, there is a discussion of the value of regional collaborative work in the global south that, while emphasizing differences, allows the comparison of different contexts, their histories, and influences on the object of study, as well as the shared cultural similarities derived from a common geographic space and history.
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Valentim Brasil M, Cúnico SD, Brandelli Costa A. Gênero sob ataque: atravessamentos da suposta neutralidade política na pauta educacional brasileira. REVISTA POLIS E PSIQUE 2022. [DOI: 10.22456/2238-152x.110786] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
O presente artigo se propõe a discutir teoricamente de que forma os discursos relativos ao conceito de gênero e de sexualidade atravessam e são reproduzidos no que tange à pauta da educação no Brasil. Este trabalho parte da posição que a escola possui uma função política fundamental – a formação de cidadãos – embora também enfrente um momento de tentativa de controle de professores/as e currículos por parte de organizações político-partidárias conservadoras. A partir da literatura de gênero, argumentamos neste artigo teórico, que a escola deva ser um espaço em que temáticas como gênero, sexualidade, diversidade sexual, dentre outras, possam ser debatidas e problematizadas, uma vez que tais discussões contribuem para uma formação que estimula o pensamento crítico e a valorização da diversidade. Conclui-se que estimular o pensamento plural não é uma armadilha para desmantelar os lares e as famílias, como a realidade conservadora brasileira busca supor. Ao contrário, é contribuir para a formação de cidadãos/ãs comprometidos/as com um país menos desigual.
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Catelan RF, Saadeh A, Lobato MIR, Gagliotti DAM, Nardi HC, Costa AB. Depression, Self-Esteem, and Resilience and its Relationship with Psychological Features of Sexuality among Transgender Men and Women from Brazil. ARCHIVES OF SEXUAL BEHAVIOR 2022; 51:1993-2002. [PMID: 35414149 DOI: 10.1007/s10508-021-02189-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/09/2019] [Revised: 10/09/2021] [Accepted: 10/11/2021] [Indexed: 05/23/2023]
Abstract
This cross-sectional study investigated whether depression, self-esteem, and resilience (mental health indicators) are associated with some psychological features of sexuality (sexual fear, sexual anxiety, sexual dissatisfaction, and sexual body image worries) in a sample of 462 transgender men and women from Brazil. Pearson's correlations were performed between all continuous variables in the study. Those that were significantly associated with the psychological features of sexuality in previous analyses were tested as independent variables in multiple linear regression models. Sexual fear, sexual anxiety, sexual dissatisfaction, and sexual body image worries were negatively related to self-esteem and resilience, while positively related to depression. Higher levels of depression were associated with sexual fear, while higher levels of depression and lower self-esteem were associated with sexual anxiety. In addition, higher levels of depression and lower levels of resilience were associated with sexual dissatisfaction. Depression and resilience were associated with the composite score of sexual dissatisfaction and sexual anxiety. Our results suggest that negative mental health indicators may impair the sexual life of transgender individuals. Clinical interventions should be developed and tested to address the psychological features of sexuality.
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Figueiredo Catelan R, Azevedo FMD, Sbicigo JB, Vilanova F, da Silva LP, Zanella GI, Ramos ML, Costa AB, Nardi HC. Anticipated HIV stigma and delays in HIV testing among Brazilian heterosexual male soldiers. PSYCHOLOGY & SEXUALITY 2022. [DOI: 10.1080/19419899.2020.1773909] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Vilanova F, Milfont TL, Costa AB. A dual process social psychological model of corrupt intention and attitudes toward corrupt people. J Pers Soc Psychol 2022; 123:854-883. [PMID: 35311335 DOI: 10.1037/pspp0000414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Preliminary studies indicate that ideologies and worldviews are key in understanding the motivation behind corruption. Yet, there is no model seeking to explain corrupt intention that incorporates ideology and worldviews as predictors. Our objective was to propose a model integrating ideological factors (social dominance orientation [SDO] and right-wing authoritarianism [RWA]) and their underlying worldviews (competitive worldview beliefs [CWB] and dangerous worldview beliefs [DWB]) as predictors of corrupt intention and attitudes toward corrupt people and examine the model in the high corruption context of Brazil. For that purpose, preregistered hypotheses were tested across six studies. Results confirmed that corrupt intention is predicted by SDO but not RWA, while attitudes toward corrupt people are predicted by RWA but not SDO (Studies 1, 2, and 4). Replicating these findings cross-culturally, World Values Survey data (Study 3) indicated that corrupt intention is predicted by a proxy SDO index but not by a proxy RWA index. Experimentally increasing DWB amplified corrupt intention, but attitudes toward corrupt people remained unaffected (Study 5). Study 6 further confirmed the independence of corrupt intention and attitudes toward corrupt people, with corrupt intention primarily predicted by CWB and attitudes toward corrupt people primarily predicted by RWA. Hence, the first social psychological model that seeks to explain corruption integrating ideologies and worldviews was successfully proposed with implications for future research. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
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Terra T, Schafer JL, Pan PM, Costa AB, Caye A, Gadelha A, Miguel EC, Bressan RA, Rohde LA, Salum GA. Mental health conditions in Lesbian, Gay, Bisexual, Transgender, Queer and Asexual youth in Brazil: A call for action. J Affect Disord 2022; 298:190-193. [PMID: 34715179 DOI: 10.1016/j.jad.2021.10.108] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Revised: 10/07/2021] [Accepted: 10/23/2021] [Indexed: 11/16/2022]
Abstract
BACKGROUND Lesbian, Gay, Bisexual, Transgender, Queer, and Asexual (LGBTQA+) youth have a greater chance of experiencing stressful life events when compared to cisgender heterosexual peers, which can lead to mental health problems. We aimed to estimate the prevalence of mental disorders among LGBTQA+ youths from two large cities in Brazil. METHODS Participants were 13-22 years old youths from the 3rd wave of the Brazilian High-Risk Cohort for Psychiatric Disorders (n = 1475). Mental disorders were assessed using the Development and Well-Being Behavior Assessment. Sexual orientation and gender identity were assessed using a self-report confidential questionnaire. Data were analyzed through logistic regressions (adjusting for sociodemographic) using sampling weights to account for attrition and our oversampling high-risk design. RESULTS 15.18% of the sample described themselves as LGBTQA+. The LGBTQA+ group presented higher rates of anxiety disorders (30.14% vs. 13.37%; OR = 3.37; 95%CI:2.51-4.50), depressive disorders (27.75% vs. 15.34%; OR = 2.17; 95%CI:1.60-2.93) and post-traumatic stress disorder (4.98% vs. 2.25%; OR = 4.20; 95%CI:2.24-7.82), if compared with the cisgender heterosexual group. No difference was found for conduct disorders (2.97% vs. 5.21%; OR = 0.82; 95%CI:0.35-1.65) or attention deficit hyperactivity disorder (5.92% vs. 3.28%; OR = 1.56; 95%CI:0.83-2.79). LIMITATIONS Although recruitment was performed at 57 schools in the two cities, sampling was non-probabilistic and included only urban areas, which might bias prevalence estimates and group comparisons. CONCLUSIONS Our results elucidate the mental health disparities between LGBTQA+ people and cisgender heterosexuals in Brazil. It highlights the need to promote the inclusion of this population in policy formulation and support actions to mitigate the suffering related to sexual orientation and gender identity.
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Costa AB, Rosa LDO, Fontanari AMV. Sampling bias in Brazilian studies on transgender and gender diverse populations: the two-step measure for assessing gender identity in surveys. CAD SAUDE PUBLICA 2022; 38:e00180420. [DOI: 10.1590/0102-311x00180420] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Accepted: 07/29/2021] [Indexed: 11/22/2022] Open
Abstract
Abstract: Correctly recognizing gender identity in population-based surveys is essential to develop effective public health strategies to improve the living conditions of transgender and gender-diverse populations, as well as to adequately collect data on cisgender individuals. This study aims to present the two-step measure as the best strategy for assessing gender identity in Brazilian surveys, thus we performed two separate analyses. Firstly, we conducted a systematic review concerning HIV-related care among Brazilian transgender and gender-diverse populations to assess the strategy used to identify participants’ gender identity. Secondly, we re-analyzed data from a recent survey that included Brazilian transgender populations, comparing characteristics and health outcomes from the sample identified by single-item and by the two-step measure. Concerning the systematic review, from 6,585 references, Brazilian research teams published seven articles, and only one study used the two-step measure. Regarding this survey, the two-step measure recognized 567 cisgender and 773 transgender and gender diverse participants among the 1,340 participants who answered the questionnaire, whereas the single-item measure was able to recognize only 540 transgender and gender diverse people. Furthermore, 31 transgender women self-identified as “transgender men” on the single-item measure. Therefore, although scarcely used in Brazil, the two-step measure is a more accurate strategy to recognize gender identity.
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Fontanari AMV, Churchill S, Schneider MA, Soll B, Costa AB, Lobato MIR. Tobacco use among transgender and gender non-binary youth in Brazil. CIENCIA & SAUDE COLETIVA 2021; 26:5281-5292. [PMID: 34787219 DOI: 10.1590/1413-812320212611.3.35272019] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2019] [Accepted: 12/20/2019] [Indexed: 11/22/2022] Open
Abstract
Transgender and gender non-binary youth are particularly vulnerable to tobacco smoking and susceptible to smoking adverse health outcomes. That is, they are in special risk to start smoking and, after starting, they may face worse outcomes when comparing to their cisgender peers. Therefore, the present study aims to evaluate factors associated with tobacco use among transgender and gender non-binary youth. Brazilian youth aged 16 to 25 who identify as transgender or gender non-binary answered an online questionnaire. Poisson regression with robust variance was run to predict smoking cigarettes based on individual and environmental factors. 14.1% of 206 youth reported smoking cigarettes daily, whereas 9.3% of participants reported smoking e-cigarettes occasionally. Drug use, lack of social support, deprivation, discrimination, the wait for medical gender-affirming procedures and being outside school were associated with smoking cigarettes. Contextual and individual factors should be further explored in causal analysis and taken into consideration when planning smoking prevention and cessation interventions for transgender and gender non-binary youth.
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Chinazzo ÍR, Lobato MIR, Nardi HC, Koller SH, Saadeh A, Costa AB. Impact of minority stress in depressive symptoms, suicide idea and try suicide in trans. CIENCIA & SAUDE COLETIVA 2021; 26:5045-5056. [PMID: 34787197 DOI: 10.1590/1413-812320212611.3.28532019] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2019] [Accepted: 11/18/2019] [Indexed: 11/22/2022] Open
Abstract
Minority stress comprehends the relationship between prejudice (perceived, anticipated and internalized) and mental health in people belonging to minority groups, as well as protective factors for stressors. This study evaluated the prevalence of depressive symptoms, suicidal ideation and attempted suicide in Brazilian trans people, and it`s relationship with minority stress, passability, social support and trans identity support. 378 people participated through a questionnaire answered online and in the hospital services they attended. Of these, 67.20% had depressive symptoms, 67.72% suicidal ideation and 43.12% attempted suicide. Three Poisson regression analyzes were performed in two steps, according to the outcomes. In the three outcomes there was a positive association with internalized prejudice and a negative association with social support, which were the only associations in the suicide attempt. Depressive symptoms and suicidal ideation were also positively associated with anticipated prejudice and negatively passability and support for trans identity. The vulnerability of transgender people to negative mental health outcomes and the importance of addressing prejudice on an individual and social level, as well as promoting social support and transgender identity support are perceived.
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Silva DC, Salati LR, Fontanari AMV, Schwarz K, Schneider MA, Soll BBM, Costa AB, Guadagnin F, Hirakata VN, Lobato MIR. Prevalence of Gender Dysphoria in Southern Brazil: A Retrospective Study. ARCHIVES OF SEXUAL BEHAVIOR 2021; 50:3517-3526. [PMID: 34697689 DOI: 10.1007/s10508-021-02036-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/31/2019] [Revised: 05/01/2021] [Accepted: 05/04/2021] [Indexed: 06/13/2023]
Abstract
To ensure that public health services provide comprehensive and inclusive health care to the general population, it is important for countries to estimate how many of their citizens experience gender dysphoria and wish to receive specialized hormone treatment or gender-affirming surgery. The aim of this study was to estimate the prevalence of individuals with gender dysphoria seeking transgender health care in a public teaching hospital in southern Brazil. In this retrospective follow-up study, we analyzed the medical records and sociodemographic data of individuals aged > 15 years living in Rio Grande do Sul, Brazil, that enrolled in a specialized program to receive hormone therapy and gender-affirming surgery between 2000 and 2018. This study is the first to attempt estimating the prevalence of gender dysphoria in Rio Grande do Sul; it describes novel data on the clinical profile of individuals with gender dysphoria treated in a public hospital specialized in providing transgender health care. Prevalence estimates were calculated based on statewide annual population data in the study period. Of 934 identified individuals, 776 (601 trans women and 175 trans men) were included in this study. The overall prevalence of individuals with gender dysphoria was 9.3 per 100,000 individuals (95% CI: 8.6 to 9.8). Meanwhile, there were 15 trans women per 100,000 people (95% CI: 14 to 16) and 4.1 trans men per 100,000 people (95% CI: 3.5 to 4.8). There was a progressive increase in the number of people seeking hormone therapy and gender-affirming surgery during the study period. Future research is needed to determine the size of the trans population in other regions of Brazil and to expand the knowledge regarding gender dysphoria to allow for the development of effective public policies for people with gender dysphoria.
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