26 results on '"Dourado, Inês"'
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2. Desafios e propostas para ampliação da testagem e diagnóstico para COVID-19 no Brasil
- Author
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Magno, Laio, Rossi, Thais Aranha, Santos, Carina Carvalho dos, Pereira, Marcos, Prado, Nilia Maria de Brito Lima, and Dourado, Inês, et al.
- Subjects
Vigilância Epidemiológica ,Diagnóstico ,Brasil ,COVID-19 ,Testagem - Abstract
Submitted by Maria Creuza Silva (mariakreuza@yahoo.com.br) on 2021-10-21T18:10:44Z No. of bitstreams: 1 Desafios e propostas para ampliação da testagem e diagnóstico.pdf: 126908 bytes, checksum: 099e5e32d345026a3621e0cfc7a5051d (MD5) Approved for entry into archive by Maria Creuza Silva (mariakreuza@yahoo.com.br) on 2021-10-21T19:27:07Z (GMT) No. of bitstreams: 1 Desafios e propostas para ampliação da testagem e diagnóstico.pdf: 126908 bytes, checksum: 099e5e32d345026a3621e0cfc7a5051d (MD5) Made available in DSpace on 2021-10-21T19:27:07Z (GMT). No. of bitstreams: 1 Desafios e propostas para ampliação da testagem e diagnóstico.pdf: 126908 bytes, checksum: 099e5e32d345026a3621e0cfc7a5051d (MD5) Previous issue date: 2020-09 O contexto brasileiro de desigualdades sociais e barreiras no acesso aos serviços de saúde pode agravar a situação da pandemia de COVID-19, que já afeta todos os estados da federação, com a curva crescente de aumento de casos confirmados e mortes. O governo dos países e os agentes do campo científico têm buscado evidências para as melhores práticas de prevenção e controle da transmissão, e cuidado da infecção e doença, incluindo medidas de diagnóstico, tratamento e de atenção à saúde. A estratégia de testagem em larga escala, visando o diagnóstico precoce, quarentena dos casos leves identificados, bem como dos contactantes, e cuidado adequado dos casos graves, tem sido revisada e indicada como uma das medidas eficientes para o controle da pandemia em vários países do mundo. O artigo tem como objetivo discutir os desafios da testagem e do diagnóstico de COVID-19 no Brasil. Rio de Janeiro
- Published
- 2020
3. Uso de hormônios não prescritos na modificação corporal de travestis e mulheres transexuais de Salvador/Bahia, Brasil.
- Author
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Araújo da Silva, Ricardo, Vasconcelos da Silva, Luís Augusto, Soares, Fabiane, and Dourado, Inês
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TRANS women ,PUBLIC health ,PENIS ,CROSS-sectional method ,SELF-perception - Abstract
Copyright of Revista Ciência & Saúde Coletiva is the property of Associacao Brasileira de Pos-Graduacao em Saude Coletiva and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
- Published
- 2022
- Full Text
- View/download PDF
4. HIV/AIDS knowledge among MSM in Brazil: a challenge for public policies
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Guimarães, Mark Drew Crosland, Magno, Laio, Ceccato, Maria das Graças Braga, Gomes, Raquel Regina de Freitas Magalhães, Leal, Andrea Fachel, Knauth, Daniela Riva, Veras, Maria Amélia de Sousa Mascena, Dourado, Inês, Brito, Ana Maria de, Kendal, Carl, and Kerr, Ligia Regina Franco Sansigolo
- Subjects
AIDS ,Acquired Immunodeficiency Syndrome ,Knowledge ,Brasil [Saúde] ,Conhecimento ,Políticas públicas ,HIV ,MSM ,Síndrome da Imunodeficiência ,RDS ,Item response theory ,Brazil - Abstract
Introduction: High level of HIV/AIDS knowledge is required for an effective adoption of preventive strategies. Objective: To assess HIV/AIDS knowledge among men who have sex with men (MSM) in 12 Brazilian cities. Methods: Respondent-Driven Sampling method was used for recruitment. HIV/AIDS knowledge was assessed by Item Response Theory. Difficulty and discrimination parameters were estimated, and the knowledge score was categorized in three levels: high, medium, and low. Logistic regression was used for analysis. Results: Among 4,176 MSM, the proportion of high level of knowledge was 23.7%. The following variables were positively associated with high knowledge (p < 0.05): age 25+ years old, 12+ years of schooling, white skin color, having health insurance, having suffered discrimination due to sexual orientation, having had a syphilis test, and having received educational material in the previous 12 months. Exchanging sex for money was negatively associated. Conclusions: The proportion of only 23.7% of high HIV/AIDS knowledge was low. We should note that the only potential source of knowledge acquisition associated with high level of knowledge was receiving educational materials. Our study indicates the need for expansion of public prevention policies focused on MSM and with more effective communication strategies, including the development of knowledge that involves motivation and abilities for a safer behavior. Introdução: Alto nível de conhecimento sobre HIV/aids é necessário para uma efetiva adoção de estratégias preventivas. Objetivo: Avaliar o nível de conhecimento sobre HIV/aids entre homens que fazem sexo com homens (HSH) de 12 cidades brasileiras. Metodologia: O método Respondent-Driven Sampling foi utilizado para recrutamento. O conhecimento sobre HIV/aids foi avaliado por meio de 12 perguntas e analisados pela Teoria de Resposta ao Item. Foram estimados os parâmetros de dificuldade e discriminação e o escore de conhecimento categorizado em três níveis: alto, médio e baixo. Regressão logística foi utilizada para a análise. Resultados: Do total de 4.176 HSH, a proporção de alto nível de conhecimento foi de 23,7%. Estiveram associados positivamente (p < 0,05) com o alto conhecimento: idade 25+ anos, escolaridade 12+ anos, cor da pele branca, ter plano de saúde, ter sofrido discriminação devido à orientação sexual, ter realizado teste para sífilis e recebido material educativo nos últimos 12 meses. Ter recebido dinheiro por sexo esteve negativamente associado. Conclusões: A proporção de apenas 23,7% de alto nível de conhecimento sobre HIV/ aids foi baixa. Destaca-se que a única potencial fonte formal de aquisição de conhecimento associada com alto nível de conhecimento foi receber material educativo. Este estudo aponta a necessidade de expandir as políticas públicas de prevenção focadas no segmento HSH e com estratégias de comunicação mais eficazes, incluindo o desenvolvimento de conhecimento que envolva motivação e habilidade para um comportamento mais seguro.
- Published
- 2019
5. Discrimination based on sexual orientation against MSM in Brazil : a latent class analysis
- Author
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Magno, Laio, Silva, Luis Augusto Vasconcelos da, Guimarães, Mark Drew Crosland, Veras, Maria Amélia, Deus, Luiz Fábio Alves de, Leal, Andrea Fachel, Knauth, Daniela Riva, Brito, Ana Maria de, Rocha, Gustavo Machado, Lima, Luana Nepomuceno Gondim Costa, Kendall, Carl, Castro, Ana Rita Coimbra Motta, Kerr, Ligia Regina Franco Sansigolo, Mota, Rosa Maria Salani, Merchán-Hamann, Edgar, and Dourado, Inês
- Subjects
AIDS ,Brasil [Saúde] ,Social discrimination ,Latent class analysis ,HIV ,Sexual orientation ,MSM ,Discriminação ,Orientação sexual ,Brazil - Abstract
Introdução: A discriminação por orientação sexual (DPOS) pode influenciar a vulnerabilidade ao HIV aumentando a exposição a comportamentos sexuais de risco entre homens que fazem sexo com homens (HSH). Objetivos: Examinar dados utilizando a análise de classes latentes (ACL) para identificar grupos de indivíduos com padrões específicos de DPOS. Métodos: Estudo transversal com entrevistados recrutados pelo processo amostral respondent driven sampling em 12 cidades brasileiras em 2016. A ACL foi usada para caracterizar o DPOS entre HSH com base em 13 variáveis do bloco de discriminação do questionário da pesquisa. As proporções de DPOS e das variáveis de interesse, bem como seus intervalos de confiança (95%) foram ponderados usando o estimador de Gile. Resultados: A maioria era de jovens, solteiros, com alguma religião, escolaridade média ou superior, cor da pele preta ou parda e com nível socioeconômico médio. Mais da metade referiu ter sido discriminado nos últimos 12 meses por sua orientação sexual (65%), mais de um terço referiu ter tido medo de andar em lugares públicos nos últimos 12 meses e em torno de um quinto dos participantes reportaram ter sofrido agressão física ou sexual na vida. A DPOS foi classificada em 4 classes latentes, “muito alta”, “alta”, “média” e “baixa”, com estimativas de 2,2%, 16,4%, 35,1% e 46,19%, respectivamente. Conclusão: Observou-se alta proporção de discriminação entre os HSH participantes deste estudo. A utilização da ACL discriminou de maneira parcimoniosa as classes de DPOS. Introduction: Discrimination based on sexual orientation can influence vulnerability to HIV, increasing exposure to risky sexual behavior among men who have sex with men (MSM). Objectives: To analyze data using latent class analysis (LCA) to identify groups of individuals with specific patterns of discrimination based on sexual orientation (DSO). Methods: Cross-sectional study using respondent-driven sampling in 12 Brazilian cities in 2016. LCA was used to characterize discrimination among MSM based on 13 variables in the survey questionnaire. The proportions of men reporting DSO and other variables of interest were estimated using Gile’s Successive Sampling estimator. Results: Most MSM were young, single, had a religion, had a high school or college degree, black or brown skin color, and socioeconomic status classified as average. More than half of the participants reported that they had been discriminated against during the last 12 months due to their sexual orientation (65%), more than a third said they had felt afraid of walking in public places during the past 12 months, and about one-fifth of participants reported having been victims of physical or sexual assault due to DSO. DSO was classified into four latent classes: “very high”, “high”, “moderate” and “low”, with estimates of 2.2%, 16.4%, 35.1%, and 46.19%, respectively. Conclusion: We observed a high proportion of discrimination against MSM in this study. The use of LCA differentiated parsimoniously classes of discrimination.
- Published
- 2019
6. Rev. Bras. Epidemiol
- Author
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Brignol, Sandra, Kerr, Ligia, Amorim, Leila Denise, and Dourado, Inês
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Sífilis ,Fatores de risco ,Homossexualidade masculina ,HIV ,Populações vulneráveis ,Modelos logísticos - Abstract
Submitted by Maria Creuza Silva (mariakreuza@yahoo.com.br) on 2017-05-26T17:49:04Z No. of bitstreams: 1 Ines Dourado 3. 2016.pdf: 277312 bytes, checksum: ea4d3b8eab90f5797178f0722643e857 (MD5) Made available in DSpace on 2017-05-26T17:49:04Z (GMT). No. of bitstreams: 1 Ines Dourado 3. 2016.pdf: 277312 bytes, checksum: ea4d3b8eab90f5797178f0722643e857 (MD5) Diante das evidências de que os homens que fazem sexo com homens são afetados de forma desproporcional pelas infecções por HIV, investigamos os fatores de risco sociodemográficos, biológicos e de comportamentos sexuais associados à infecção por HIV, na cidade de Salvador, Bahia. Este trabalho é um recorte da pesquisa nacional "Comportamento, atitudes, práticas e prevalência de HIV e Sífilis entre homens que fazem sexo com homens em 10 cidades brasileiras", que foi do tipo corte transversal e selecionou participantes via técnica Respondent Driven Sampling . Devido à prevalência do HIV ser menor do que 10% e ao reduzido tamanho da amostra (383), utilizamos regressão logística exata nas análises para medir associação entre os fatores de risco e a infecção por HIV. A prevalência do HIV foi de 6,3% (IC95% 3,9 - 8,8), e após o ajuste do modelo final, os fatores de vulnerabilidade que se associaram à infecção por HIV foram: não fez teste de sífilis na vida (OR = 3,1: IC95% 1,3 - 7,3), ter mais de 8 parceiros sexuais (OR = 3,3; IC95% 1,4 - 8,1). Este estudo mostrou a alta prevalência do HIV na amostra, em comparação a população geral, bem como confirmou a importância da realização do teste de sífilis na vida no contexto da epidemia do HIV, sendo que essa detecção precoce permite uma aproximação das ações de prevenção para DST. São Paulo
- Published
- 2017
7. Internações por condições sensíveis à Atenção Primária à Saúde em crianças menores de 1 ano no Brasil.
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Pereira Pinto Junior, Elzo, Aquino, Rosana, Dourado, Inês, de Queiroz Costa, Líllian, and Carlos da Silva, Marcelo Gurgel
- Subjects
PRIMARY care ,LINEAR statistical models ,HEALTH status indicators ,MEDICAL care ,SYPHILIS - Abstract
Primary care-sensitive condition hospitalizations (PCSCH) are an essential health care indicator. This ecological, time-series study aimed to analyze the time trend of PCSCH in children under the age of 1 in Brazil, considering the age subcomponents of newborns and post-newborns. The PCSCH rates were calculated for infants under the age of 1 and in the neonatal and postneonatal subgroups. The Prais-Winsten generalized linear analysis model and the Annual Percent Change (APC) calculation were used to evaluate the time trend. The results showed that infectious gastroenteritis represented the most important cause of hospitalizations due PCSCH in children under the age of 1. Congenital syphilis and other congenital infections accounted for the highest proportion of hospitalizations in newborns, whereas gastroenteritis prevailed in post-newborns. An increase in newborn hospitalization rates and a decrease in hospitalization rates in both the postneonatal group and the group of children under the age of 1. Differences in trends in these hospitalization rates may reflect the influence of specific determinants on the risk of hospitalization in each age subcomponent. [ABSTRACT FROM AUTHOR]
- Published
- 2020
- Full Text
- View/download PDF
8. Entre idas e vindas: histórias de homens sobre seus itinerários ao serviço de saúde para diagnóstico e tratamento de HIV/Aids
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Silva, Luis Augusto V. da, Santos, Melquisedec, and Dourado, Inês
- Subjects
itinerários terapêuticos ,apresentação tardia ,homens ,cuidado à saúde ,HIV/Aids ,men ,therapeutic itineraries ,late presentation ,health care - Abstract
Resumo A partir de um estudo epidemiológico sobre apresentação tardia ao serviço de saúde para diagnóstico e tratamento de HIV/Aids, este artigo busca aprofundar a discussão sobre alguns aspectos envolvidos nesse processo. Buscou-se registrar narrativas de homens sobre suas trajetórias ou itinerários no processo de diagnóstico e tratamento de HIV/Aids, descrevendo os acontecimentos e atores presentes nas práticas cotidianas em que ocorrem os deslocamentos até o serviço de saúde. Foram realizadas 25 entrevistas semiestruturadas com homens com sorologia positiva para HIV, em um centro de referência para diagnóstico e tratamento em HIV/Aids, na cidade de Salvador, Bahia. Algumas dessas histórias estão presentes no decorrer deste artigo. Para além de um momento específico de apresentação tardia ao serviço de saúde, destaca-se a existência de uma série de ações/acontecimentos que se estende no tempo, ora dificultando, ora facilitando a continuidade do tratamento. Nessa direção, reconhecemos também a existência de barreiras, conflitos e tensões que ocorrem no interior das práticas do cuidado à saúde. Entretanto, essas mesmas tensões podem mobilizar formas e estratégias diversas de ação para que ocorra um acolhimento melhor e um cuidado à saúde de forma contínua e mais integral. Abstract As part of an epidemiologic study on late presentation (LP) to HIV/Aids health services, this study intends to analyze men´s narratives on trajectories or itineraries in seeking for HIV/Aids services and further describe the events and actors present on daily practices in which occurs the displacement of the patients to the health service. The study was conducted at the only State Reference Center for HIV/Aids in Salvador, Bahia. Twenty five semi-structured interviews with men - with positive HIV serology - were realized at the reference center. Some of those narratives are presented throughout this article. This article considers LP to health services not as an specific moment. Beyond that, it analyses the existence of a network of actions/events which prolongs the LP on time, sometimes hindering and sometimes facilitating the ongoing treatment. In this direction we also recognize the existence of barriers, conflicts and tensions in which occurs the practices of health care. Nonetheless, these same conflicts enable the creation of several actions and strategies to a better reception and a more continuous and fulfilled way of health care.
- Published
- 2015
9. Factores asociados a la no adherencia a la terapia antirretroviral en adultos con SIDA en los primeros seis meses de tratamiento en Salvador, Bahia, Brasil
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Silva, José Adriano Góes, Dourado, Inês, Brito, Ana Maria de, and Silva, Carlos Alberto Lima da
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Acquired Immunodeficiency Syndrome ,Cumplimiento de la Medicación ,Anti-Retroviral Agents ,Antirretrovirales ,Antirretrovirais ,Síndrome de Imunodeficiência Adquirida ,Síndrome de Inmunodeficiencia Adquirida ,Adesão à Medicação ,Medication Adherence - Abstract
O controle da replicação viral é essencial na terapia antirretroviral altamente potente (TARV) e a adesão ao tratamento é o fundamento para esse controle. Fatores individuais e externos influenciam a adesão aos antirretrovirais (ARV). Estudo transversal para investigar fatores associados à não adesão à TARV, em indivíduos com AIDS em Salvador, Bahia, Brasil, com idade ≥ 13 anos e primeira prescrição em 2009. Dados coletados em prontuários e registros da farmácia. Dos 216 pacientes, 65,3% eram homens; idade média 37,8 ± 9,5 anos, solteiros 67,9%; heterossexuais 64%; > 8 anos de estudo 65,3%, etilistas 61,5% e não relatou tabagismo 75,1% ou uso de drogas 93,7%. Iniciaram a TARV com TCD4+ < 350 células/mm3 94%, 61,8% sintomáticos e 68,4% apresentaram reação adversa ao medicamento. Prevalência de não adesão 25%. Variáveis associadas: maior tempo entre o diagnóstico de infecção pelo HIV e a AIDS (aOR = 3,9), reação adversa ao medicamento (aOR = 2,4), idade menor que 34 anos (aOR = 2,2), menos que 8 anos de estudo (aOR = 2,2) e uso de drogas (aOR = 2,6). A alta taxa de não adesão é um problema importante nos seis primeiros meses da TARV. El objetivo de este estudio fue investigar factores asociados a la no adherencia a terapia antirretroviral altamente potente (TARV) en los primeros seis meses de tratamiento. Estudio transversal en individuos con SIDA de Salvador, Bahia, Brasil, de edad ≥ 13 anos, cuya primera prescripción a antirretroviral (ARV) fue en 2009. Se utilizaron historias clínicas y registros de farmacia. De 216 pacientes, 65,3% fueron hombres de 37,8 ± 9,5 años en promedio. La mayoría informó ser soltero 67,9%, heterosexual 64%, 8 años de estudio o más 65,3%, consumir alcohol 61,5%, y negó tabaquismo 75,1% y uso de drogas ilícitas 93.7%. El 94% inició TARV con TCD4+ < 350 células/mm3; 61,8% estaba sintomático, 68,4% presentó reacciones adversas a ARV. La prevalencia de no adherencia fue 25%. Variables asociadas fueron: mayor tiempo entre infección por HIV y SIDA (aOR = 3,9), reacción adversa al medicamento (aOR = 2,4), edad menor a 34 años (aOR = 2,2), escolaridad menor a 8 años (aOR = 2,2) y uso de drogas ilícitas (aOR = 2,6). La alta tasa de no adherencia es un problema importante en los primeros seis meses de tratamiento antirretroviral. The control of viral replication is essential in the highly active antiretroviral therapy (HAART), and adherence to therapy is instrumental for such control. Individual and external factors influence adhesion to the use of antiretroviral (ARV) drugs. This is a cross-sectional study to investigate factors associated with non-adherence to HAART in AIDS patients in Salvador, Bahia State, Brazil, with age ≥ 13 years and first prescription in 2009. Data was collected from patient charts and pharmacy records. From a total of 216 patients, 65.3% were males; mean age 37.8 ± 9.5 years; single, 67.9%; heterosexual, 64%; more than 8 years of school education, 65.3%; alcohol users, 61.5%; non-smokers, 75,1% or non-illicit drug users, 93.7%. A proportion of 94% started ARV therapy with TCD4+ < 350 cells/mm3; 61.8% were symptomatic; and 68.4% had an adverse drug reaction. The prevalence of non-adherence was 25%. The variables associated were: longer time between HIV infection and AIDS (aOR = 3.9), adverse drug reaction (aOR = 2.4), under 34 years of age (aOR = 2.2), less than 8 years of school education (aOR = 2.2) and illicit drugs use (aOR = 2.6). A high-non-adherence rate is an important problem within the first six months of HAART.
- Published
- 2015
10. Entre idas e vindas: histórias de homens sobre seus itinerários ao serviço de saúde para diagnóstico e tratamento de HIV/Aids.
- Author
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da Silva, Luis Augusto V., Santos, Melquisedec, and Dourado, Inês
- Abstract
Copyright of Physis: Revista de Saúde Coletiva is the property of CEPESC and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
- Published
- 2015
- Full Text
- View/download PDF
11. Use of unprescribed hormones in the body modification of travestis and transsexual women in Salvador/Bahia, Brazil.
- Author
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Silva RAD, Silva LAVD, Soares F, and Dourado I
- Subjects
- Brazil, Cross-Sectional Studies, Female, Hormones, Humans, Male, HIV Infections, Transgender Persons
- Abstract
This article aims to analyze the use of non-prescribed hormones among travestis and transgender women (TrTGW) in Salvador, Bahia, Brazil. This cross-sectional study used the Respondent Driven Sampling (RDS) methodology to recruit TrTGW from 2014 to 2016 in Salvador and the Metropolitan Region. A comparative analysis was carried out between sociodemographic, behavioral, and gender declaration conditions using hormones. The RDS-II estimator weighted the data. Stata version 14 was used for statistical analyses. One hundred twenty-seven TrTGW were recruited. From the studied sample, 69.1% of participants used non-prescribed hormones, which was associated with industrial liquid silicone use and body satisfaction. The TrTGW who were comfortable with the penis and felt pleasure with the penis used hormone less. The seropositive participants reported a higher proportion of hormone use. The non-prescribed use of hormones was used by most TrTGW. This use is likely associated with better satisfaction with self-image and body among TrTGW. Elevated and exacerbated use of these hormones was identified, probably due to the rare access to public health services.
- Published
- 2022
- Full Text
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12. Usual source of healthcare and use of sexual and reproductive health services by female sex workers in Brazil.
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Matteoni TCG, Magno L, Luppi CG, Grangeiro A, Szwarcwald CL, and Dourado I
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- Brazil epidemiology, Female, Humans, Patient Acceptance of Health Care, Pregnancy, Sexual Behavior, HIV Infections prevention & control, Reproductive Health Services, Sex Workers, Sexually Transmitted Diseases epidemiology, Sexually Transmitted Diseases prevention & control
- Abstract
The fact of having a usual source of care can improve access to health services and preventive activities. The article aimed to estimate the proportion of factors associated with usual source of care among female sex workers. This was a socio-behavioral survey with 4,328 female sex workers, ≥ 18 years, in 12 Brazilian cities. Female sex workers were recruited by the respondent-driven sampling method (RDS). A descriptive profile was performed of the female sex workers who had usual source of care and the association was analyzed between usual source of care and indicators of access to HIV prevention and reproductive health. As effect measure, the study used adjusted odds ratio (OR) in a logistic regression model. The data were weighted by the RDS-II estimator. 71.5% of the female sex workers reported having a usual source of care, and of these, 54.3% cited primary healthcare (PHC) as their main usual source of care. Among female sex workers 18-24 years of age, there was an association between usual source of care and having a Pap smear test (OR = 2.27; 95%CI: 1.66-3.12), seven or more prenatal visits (OR = 2.56; 95%CI: 1.30-5.03), and the use of a contraceptive method (OR = 1.64; 95%CI: 1.09-2.46). Among female sex workers ≥ 25 years, there was an association between usual source of care and attending talks on sexually transmitted infections (STIs) (OR = 1.45; 95%CI: 1.12-1.89), prior knowledge of post-exposure prophylaxis (OR = 1.32; 95%CI: 1.02-1.71), and history of Pap smear test (OR = 1.92; 95%CI: 1.54-2.40). The study's results showed that female sex workers have PHC as their main usual source of care. usual source of care can also positively impact care and activities in reproductive health and prevention of HIV and STIs in this population group.
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- 2021
- Full Text
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13. Challenges and proposals for scaling up COVID-19 testing and diagnosis in Brazil.
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Magno L, Rossi TA, Mendonça-Lima FW, Santos CCD, Campos GB, Marques LM, Pereira M, Prado NMBL, and Dourado I
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- Brazil, COVID-19, COVID-19 Testing, Coronavirus Infections epidemiology, Healthcare Disparities, Humans, Pandemics, Pneumonia, Viral epidemiology, Clinical Laboratory Techniques, Coronavirus Infections diagnosis, Health Services Accessibility, Pneumonia, Viral diagnosis
- Abstract
The Brazilian context of social inequalities and barriers in accessing health services may deteriorate the situation of the COVID-19 pandemic, which already affects all Brazilian federative states, with the growing curve of increasing confirmed cases and deaths. National governments and scientific field agents have been looking for evidence for the best practices of prevention and control of transmission, and care of infection and disease, including diagnosis, treatment, and health care measures. The large-scale testing strategy, aimed at early diagnosis, quarantine of the mild cases identified, as well as those of the contacts, and adequate care of severe cases, has been revised and indicated as one of the efficient pandemic control measures in several countries in the world. This paper aims to discuss the challenges of COVID-19 testing and diagnosis in Brazil.
- Published
- 2020
- Full Text
- View/download PDF
14. Primary care-sensitive hospitalization conditions in children under the age of 1 in Brazil.
- Author
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Pinto Junior EP, Aquino R, Dourado I, Costa LQ, and Silva MGCD
- Subjects
- Brazil epidemiology, Child, Delivery of Health Care, Humans, Infant, Infant, Newborn, Primary Health Care, Gastroenteritis, Hospitalization
- Abstract
Primary care-sensitive condition hospitalizations (PCSCH) are an essential health care indicator. This ecological, time-series study aimed to analyze the time trend of PCSCH in children under the age of 1 in Brazil, considering the age subcomponents of newborns and post-newborns. The PCSCH rates were calculated for infants under the age of 1 and in the neonatal and postneonatal subgroups. The Prais-Winsten generalized linear analysis model and the Annual Percent Change (APC) calculation were used to evaluate the time trend. The results showed that infectious gastroenteritis represented the most important cause of hospitalizations due PCSCH in children under the age of 1. Congenital syphilis and other congenital infections accounted for the highest proportion of hospitalizations in newborns, whereas gastroenteritis prevailed in post-newborns. An increase in newborn hospitalization rates and a decrease in hospitalization rates in both the postneonatal group and the group of children under the age of 1. Differences in trends in these hospitalization rates may reflect the influence of specific determinants on the risk of hospitalization in each age subcomponent.
- Published
- 2020
- Full Text
- View/download PDF
15. Factors associated with exchanging sex for money in men who have sex with men in Brazil.
- Author
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Alecrim DJD, Ceccato MDGB, Dourado I, Kerr L, Brito AM, and Guimarães MDC
- Subjects
- Adult, Brazil, Cross-Sectional Studies, Humans, Male, Socioeconomic Factors, Urban Population, Young Adult, Homosexuality, Male statistics & numerical data, Sex Work statistics & numerical data
- Abstract
This study aimed to analyze the association between sociodemographic, programmatic and contextual factors and the receipt of money in exchange for sex among men who have sex with men (MSM). This is a multicenter, cross-sectional study conducted in ten Brazilian cities between 2008 and 2009. Adult MSM recruited through the Respondent Driven Sampling (RDS) were interviewed. Weighted Odds Ratio (ORw) was obtained through logistic regression, retaining the variables associated with the event (p < 0.05) in the final model. Of the total sample, 33.3% reported receiving money in exchange for sex in the last 12 months before the interview. The variables that were independently associated with the event were age less than or equal to 25 years, lower education, lower social classes, previous history of syphilis, using sites or services to find sexual partners in the previous month, very high risk behavior, using illicit drugs in the previous six months, self-identifying as heterosexual or bisexual, having suffered physical violence due to sexual orientation and having suicidal thoughts always or most of the time. It was observed that MSM who received money in exchange for sex had greater socioeconomic, programmatic and contextual vulnerability, potentially increasing the risk of HIV infection than the other MSM in the sample.
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- 2020
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16. Discrimination based on sexual orientation against MSM in Brazil: a latent class analysis.
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Magno L, Silva LAVD, Guimarães MDC, Veras MASM, Deus LFA, Leal AF, Knauth DR, Brito AM, Rocha GM, Lima LNGC, Kendall C, Motta-Castro ARC, Kerr LRFS, Mota RMS, Merchan-Hamann E, and Dourado IC
- Subjects
- Adult, Brazil epidemiology, Cross-Sectional Studies, Discrimination, Psychological, Homosexuality, Male ethnology, Humans, Latent Class Analysis, Male, Self Report, Sexism ethnology, Socioeconomic Factors, Homosexuality, Male statistics & numerical data, Sexism statistics & numerical data
- Abstract
Introduction: Discrimination based on sexual orientation can influence vulnerability to HIV, increasing exposure to risky sexual behavior among men who have sex with men (MSM)., Objectives: To analyze data using latent class analysis (LCA) to identify groups of individuals with specific patterns of discrimination based on sexual orientation (DSO)., Methods: Cross-sectional study using respondent-driven sampling in 12 Brazilian cities in 2016. LCA was used to characterize discrimination among MSM based on 13 variables in the survey questionnaire. The proportions of men reporting DSO and other variables of interest were estimated using Gile's Successive Sampling estimator., Results: Most MSM were young, single, had a religion, had a high school or college degree, black or brown skin color, and socioeconomic status classified as average. More than half of the participants reported that they had been discriminated against during the last 12 months due to their sexual orientation (65%), more than a third said they had felt afraid of walking in public places during the past 12 months, and about one-fifth of participants reported having been victims of physical or sexual assault due to DSO. DSO was classified into four latent classes: "very high", "high", "moderate" and "low", with estimates of 2.2%, 16.4%, 35.1%, and 46.19%, respectively., Conclusion: We observed a high proportion of discrimination against MSM in this study. The use of LCA differentiated parsimoniously classes of discrimination.
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- 2019
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17. HIV/AIDS knowledge among MSM in Brazil: a challenge for public policies.
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Guimarães MDC, Magno L, Ceccato MDGB, Gomes RRFM, Leal AF, Knauth DR, Veras MASM, Dourado I, Brito AM, Kendall C, and Kerr LRFS
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- Adult, Brazil, Cross-Sectional Studies, Health Risk Behaviors, Humans, Logistic Models, Male, Multivariate Analysis, Socioeconomic Factors, Surveys and Questionnaires, HIV Infections prevention & control, Health Knowledge, Attitudes, Practice, Homosexuality, Male statistics & numerical data
- Abstract
Introduction: High level of HIV/AIDS knowledge is required for an effective adoption of preventive strategies., Objective: To assess HIV/AIDS knowledge among men who have sex with men (MSM) in 12 Brazilian cities., Methods: Respondent-Driven Sampling method was used for recruitment. HIV/AIDS knowledge was assessed by Item Response Theory. Difficulty and discrimination parameters were estimated, and the knowledge score was categorized in three levels: high, medium, and low. Logistic regression was used for analysis., Results: Among 4,176 MSM, the proportion of high level of knowledge was 23.7%. The following variables were positively associated with high knowledge (p < 0.05): age 25+ years old, 12+ years of schooling, white skin color, having health insurance, having suffered discrimination due to sexual orientation, having had a syphilis test, and having received educational material in the previous 12 months. Exchanging sex for money was negatively associated., Conclusions: The proportion of only 23.7% of high HIV/AIDS knowledge was low. We should note that the only potential source of knowledge acquisition associated with high level of knowledge was receiving educational materials. Our study indicates the need for expansion of public prevention policies focused on MSM and with more effective communication strategies, including the development of knowledge that involves motivation and abilities for a safer behavior.
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- 2019
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18. HIV testing coverage among female sex workers, Brazil, 2016.
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Brito AM, Szwarcwald CL, Damacena GN, and Dourado IC
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- Adolescent, Adult, Brazil, Condoms statistics & numerical data, Educational Status, Female, Health Services statistics & numerical data, Humans, Income statistics & numerical data, Multivariate Analysis, Sexual Behavior, Young Adult, AIDS Serodiagnosis statistics & numerical data, HIV Infections diagnosis, Sex Workers statistics & numerical data
- Abstract
Introduction: Knowing the factors associated with periodic HIV testing among female sex workers (FSW) is essential to expand testing coverage and to broaden programs of treatment as prevention., Methods: We used data from 4,328 FSWs recruited by the respondent-driven sampling (RDS) method in 12 Brazilian cities in 2016. Data analysis considered the complex sampling design. The prevalence of HIV testing in the last year and periodic HIV test were estimated. Factors associated with regular HIV testing were identified through logistic regression models., Results: The testing coverage in the last year was 39.3%. Only 13.5% of FSW reported having performed a periodic HIV test in the last year. Among the factors associated with the higher probability of HIV testing in the last year were a better level of education, living with a partner, working indoors, consistent use of condoms, and regular use of public and private health services stood out., Discussion: Periodic HIV testing allows early diagnosis and immediate treatment of cases, reducing the chances of spreading the infection to the population. However, factors such as stigma and discrimination hinder the use of regular health services., Conclusion: It is necessary to expand awareness campaigns, especially among FSWs with low educational level and greater vulnerability, in order to broaden the perception of risk and the importance of periodic testing, in addition to encouraging regular health care.
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- 2019
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19. Incentives and barriers to HIV testing among female sex workers in Ceará.
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Martins TA, Kerr L, Macena RHM, Mota RS, Dourado I, Brito AM, Atlani Dualt L, Vidal L, and Kendall C
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- Adolescent, Adult, Aged, Brazil epidemiology, Cross-Sectional Studies, Female, HIV Infections epidemiology, HIV Infections psychology, Health Services Accessibility, Humans, Mass Screening, Middle Aged, Prevalence, Sex Workers psychology, Socioeconomic Factors, Young Adult, HIV Infections diagnosis, Health Knowledge, Attitudes, Practice, Sex Workers statistics & numerical data
- Abstract
Objective: Estimating HIV prevalence and describing the incentives and barriers for HIV testing among female sex workers., Methods: This cross-sectional study recruited 402 women aged 18 years or older, residing in Fortaleza, state of Ceará, Brazil, who reported having had sexual intercourse in exchange for money in last four months. The sample was recruited using Respondent Driven Sampling, between August and November 2010., Results: The 84.1% of the sample tested and the estimated prevalence of HIV infection was 3.8%. The sample was young (25 to 39 years ), single (80.0%), with one to three children (83.6%), had eight or more years of schooling (65.7%), and belonged to social classes D/E (53.1%). The majority worked in fixed locations (bars, motels, hotels, sauna - 88.9%), and prostitution was their only source of income (54.1%). About 25% of the sample did not know where to test in the public health sector and 51.8% either never tested or hadn't tested for over a year or more. The main reported barriers to testing were the perceptions that there was no risk of becoming infected (24.1%), and, alternatively, fear of discrimination if the test was positive (20.5%). Incentives for testing were the greater availability of testing sites (57.0%) and health facilities with alternative schedules (44.2%)., Conclusions: Prevalence for HIV was similar to that found in other Brazilian cities in different regions of the country, although higher than the general female population. Non-traditional venues not associated with the health system and availability of testing in health units during non-commercial hours are factors that encourage testing. Not considering oneself to be at risk, fear of being discriminated against and not knowing testing locations are barriers.
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- 2018
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20. [Stigma and resistance among travestis and transsexual women in Salvador, Bahia State, Brazil].
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Magno L, Dourado I, and Silva LAVD
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- Adult, Brazil, Exposure to Violence psychology, Female, Gender Identity, Humans, Interpersonal Relations, Male, Middle Aged, Qualitative Research, Young Adult, Social Stigma, Transgender Persons psychology, Transvestism psychology
- Abstract
This was a qualitative study based on an analysis of narratives produced by travestis and transsexual women in Salvador, Bahia State, Brazil, with the aim of analyzing their experiences with stigmatization by describing events, actors, and contexts that have marked their life stories, as well as elucidating the relationship between stigma and their female performances. The narratives came from 19 in-depth interviews during an epidemiological survey, based on a prior script that explored the production of narratives on lifestyles and experiences of travestis and transsexual women in the city of Salvador. The life stories that emerged in the field were transcribed and analyzed from a theoretical and narrative perspective. The narratives of many travestis and transsexual women described an "effeminate" gender performance that had been identified since their childhood by family and community members. This performance was presented as insubordination to the power established by heteronormative society's legal system. The process of stigmatization begins to operate when social expectations concerning the coherence between "biological sex" and "gender performance" are frustrated in social interactions, submitting the individuals to discrimination and violence. Thus, stigmatization is operated through the power exercised over bodies by the laws of compulsory heterosexuality. However, during the life stories of travestis and transsexual women, strategies of resistance to stigma are produced, with the potential to transform this situation.
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- 2018
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21. Factors associated with HIV infection among a respondent-driven sample of men who have sex with men in Salvador, Brazil.
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Brignol S, Kerr L, Amorim LD, and Dourado I
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- Adult, Brazil epidemiology, Cross-Sectional Studies, Humans, Male, Middle Aged, Prevalence, Risk Factors, Risk-Taking, Self Report, Urban Health, HIV Infections epidemiology, Homosexuality, Male statistics & numerical data
- Abstract
Human immunodeficiency virus (HIV) continues to disproportionately affect men who have sex with men (MSM); therefore, we investigated the sociodemographic, biological, and sexual behavioral risk factors associated with HIV infection in the city of Salvador, Bahia. This study is part of the national survey Behavior, Attitudes, Practices and Prevalence of HIV and Syphilis among men who have sex with men in 10 Brazilian Cities, which is a cross-sectional survey whose participants were selected by means of the respondent-driven sampling. Exact logistic regression analysis was used to measure the association of potential risk factors with HIV infection due to an HIV prevalence lower than 10% and a small sample size (383). The prevalence of HIV was 6.3% (95%CI 3.9-8.8) and the risk factors associated with HIV infection in our adjusted final model included having never been tested for syphilis (OR = 3.1; 95%CI 1.3 - 7.3) and having more than eight sexual partners (OR = 3.3; 95%CI 1.4 - 8.1). This study highlights the high prevalence of HIV among MSM in the sample compared with the general population and confirms the importance of testing for syphilis in the context of the HIV epidemic as early detection may provide opportunities to prevent sexually transmitted diseases.
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- 2016
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22. Social networks of men who have sex with men: a study of recruitment chains using Respondent Driven Sampling in Salvador, Bahia State, Brazil.
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Brignol SM, Dourado I, Amorim LD, Miranda JG, and Kerr LR
- Subjects
- Adolescent, Adult, Brazil, Female, HIV Infections prevention & control, HIV Infections transmission, Health Knowledge, Attitudes, Practice, Humans, Male, Risk Factors, Risk-Taking, Sexual Partners, Sexually Transmitted Diseases prevention & control, Homosexuality, Male statistics & numerical data, Sexually Transmitted Diseases transmission, Social Networking
- Abstract
Social and sexual contact networks between men who have sex with men (MSM) play an important role in understanding the transmission of HIV and other sexually transmitted infections (STIs). In Salvador (Bahia State, Brazil), one of the cities in the survey Behavior, Attitudes, Practices, and Prevalence of HIV and Syphilis among Men Who Have Sex with Men in 10 Brazilian Cities, data were collected in 2008/2009 from a sample of 383 MSM using Respondent Driven Sampling (RDS). Network analysis was used to study friendship networks and sexual partner networks. The study also focused on the association between the number of links (degree) and the number of sexual partners, in addition to socio-demographic characteristics. The networks' structure potentially facilitates HIV transmission. However, the same networks can also be used to spread messages on STI/HIV prevention, since the proximity and similarity of MSM in these networks can encourage behavior change and positive attitudes towards prevention.
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- 2015
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23. Revisiting the use of condoms in Brazil.
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Dourado I, MacCarthy S, Reddy M, Calazans G, and Gruskin S
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- Adolescent, Adult, Aged, Brazil, Female, HIV Infections prevention & control, Health Knowledge, Attitudes, Practice, Humans, Male, Middle Aged, Sexual Behavior, Young Adult, Condoms
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Introduction: It is known that a single prevention strategy is not enough to control multiple HIV epidemics around the world and in Brazil. However, it is not only necessary to recognize the importance of condoms as part of the policy of HIV/AIDS prevention but also discuss its limits. In this article, we aim to investigate the use of condoms in Brazil, draw critical reflections, and understand how they can once again be highlighted in Brazil's prevention strategy going forward., Methods: A narrative review of literature was conducted using keywords in PubMed. Reports from national surveys that guide the epidemiological and behavioral surveillance of the Brazilian Ministry of Health were also included., Results: A total of 40 articles and 3 reports were included in the review and 11 intervention studies to promote the condom use; the main findings were as follows: 1) Despite the increase in national studies on sexual behavior, little attention is given to the role of condom use; 2) There are few studies examining the factors associated with condom use among key populations such as men who have sex with men (MSM), female sex workers (FSW), drug users (DU), and transvestites and transexuals (TT), while substantial studies focus on adolescents and women; 3) Evidence suggests that a combination of interventions is more effective., Discussion: new prevention technologies must not lose sight of the critical importance of condoms, and efforts to reintroduce them should focus on the role of pleasure in addition to their potential to minimize the risk of HIV.
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- 2015
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24. Factors associated with non-adherence to antiretroviral therapy in adults with AIDS in the first six months of treatment in Salvador, Bahia State, Brazil.
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Silva JA, Dourado I, Brito AM, and Silva CA
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- Adolescent, Adult, Age Factors, Brazil, Cross-Sectional Studies, Female, HIV Infections drug therapy, Humans, Male, Patient Compliance, Sex Factors, Socioeconomic Factors, Acquired Immunodeficiency Syndrome drug therapy, Anti-HIV Agents therapeutic use, Antiretroviral Therapy, Highly Active, Medication Adherence statistics & numerical data
- Abstract
The control of viral replication is essential in the highly active antiretroviral therapy (HAART), and adherence to therapy is instrumental for such control. Individual and external factors influence adhesion to the use of antiretroviral (ARV) drugs. This is a cross-sectional study to investigate factors associated with non-adherence to HAART in AIDS patients in Salvador, Bahia State, Brazil, with age ≥ 13 years and first prescription in 2009. Data was collected from patient charts and pharmacy records. From a total of 216 patients, 65.3% were males; mean age 37.8 ± 9.5 years; single, 67.9%; heterosexual, 64%; more than 8 years of school education, 65.3%; alcohol users, 61.5%; non-smokers, 75,1% or non-illicit drug users, 93.7%. A proportion of 94% started ARV therapy with TCD4+ < 350 cells/mm3; 61.8% were symptomatic; and 68.4% had an adverse drug reaction. The prevalence of non-adherence was 25%. The variables associated were: longer time between HIV infection and AIDS (aOR = 3.9), adverse drug reaction (aOR = 2.4), under 34 years of age (aOR = 2.2), less than 8 years of school education (aOR = 2.2) and illicit drugs use (aOR = 2.6). A high-non-adherence rate is an important problem within the first six months of HAART.
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- 2015
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25. Vulnerability in the context of HIV and syphilis infection in a population of men who have sex with men (MSM) in Salvador, Bahia State, Brazil.
- Author
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Brignol S, Dourado I, Amorim LD, and Kerr LR
- Subjects
- Adolescent, Adult, Brazil epidemiology, Condoms statistics & numerical data, Cross-Sectional Studies, HIV Infections prevention & control, Health Knowledge, Attitudes, Practice, Humans, Male, Middle Aged, Prevalence, Risk Factors, Sexual Behavior, Socioeconomic Factors, Syphilis prevention & control, Young Adult, HIV Infections epidemiology, Homosexuality, Male statistics & numerical data, Syphilis epidemiology
- Abstract
Social, individual, and programmatic vulnerability of men who have sex with men (MSM) in the context of the HIV epidemic and other sexually transmitted infections (STI) is a reality in many countries. The survey Behavior, Attitudes, Practices, and Prevalence of HIV and Syphilis in Men Who Have Sex with Men in 10 Brazilian Cities selected 383 MSM in the city of Salvador, Bahia State, Brazil, using the respondent driven sampling (RDS) technique. Individual vulnerability early sexual initiation (51%), average of eight sex partners, and unprotected receptive anal sex with casual (32%) and steady partners (45%) and positive rapid tests HIV (6.5%) and syphilis (9%). Social vulnerability young adults (80%), black race/skin color (91%), mean monthly family income of BRL 1,000.00, and personal history of discrimination (57%). Programmatic factors no previous HIV test (63%) and no access to lubricant gel (88%). The study showed a profile of vulnerability and the urgent need for interventions and STI prevention in the MSM population in Salvador, in addition to high prevalence rates for HIV and syphilis.
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- 2015
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26. Translation, adaptation and validation of "Community Integration Questionnaire".
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Fraga-Maia HM, Werneck G, Dourado I, Fernandes Rde C, and Brito LL
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- Adolescent, Adult, Aged, Cultural Characteristics, Humans, Male, Middle Aged, Young Adult, Brain Injuries rehabilitation, Community Integration, Surveys and Questionnaires, Translations
- Abstract
Objective: To translate, adapt, and validate the "Community Integration Questionnaire (CIQ)," a tool that evaluates community integration after traumatic brain injury (TBI)., Methods: A study of 61 TBI survivors was carried out. The appraisal of the measurement equivalence was based on a reliability assessment by estimating inter-rater agreement, item-scale correlation and internal consistency of CIQ scales, concurrent validity, and construct validity., Results: Inter-rater agreement ranged from substantial to almost perfect. The item-scale correlations were generally higher between the items and their respective domains, whereas the intra-class correlation coefficients were high for both the overall scale and the CIQ domains. The correlation between the CIQ and Disability Rating Scale (DRS), the Extended Glasgow Outcome Scale (GOSE), and the Rancho Los Amigos Level of Cognitive Functioning Scale (RLA) reached values considered satisfactory. However, the factor analysis generated four factors (dimensions) that did not correspond with the dimensional structure of the original tool., Conclusion: The resulting tool herein may be useful in globally assessing community integration after TBI in the Brazilian context, at least until new CIQ psychometric assessment studies are developed with larger samples.
- Published
- 2015
- Full Text
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