27 results on '"Leal, Andrea Fachel"'
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2. Acceptability and Usability of Self-Sampling for the Detection of Sexually Transmitted Infections Among Transgender Women: The TransOdara Multicentric Study in Brazil
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McCartney, Daniel Jason, Bassichetto, Katia Cristina, Leal, Andrea Fachel, Knauth, Daniela, Dourado, Inês, Magno, Laio, Carvalho da Silva, Roberto José, Mayaud, Philippe, and Veras, Maria Amélia
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- 2024
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3. Perceived Risk of HIV Infection and Acceptability of PrEP among Men Who Have Sex with Men in Brazil
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Soares, Fabiane, Magno, Laio, da Silva, Luís Augusto V., Guimarães, Mark Drew Crosland, Leal, Andrea Fachel, Knauth, Daniela, Veras, Maria Amélia, de Brito, Ana Maria, Kendall, Carl, Kerr, Ligia Regina Franco Sansigolo, and Dourado, Inês
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- 2023
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4. Factors associated with loss to follow up among HIV-exposed children: a historical cohort study from 2000 to 2017, in Porto Alegre, Brazil
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da Silva Calvo, Karen, Knauth, Daniela Riva, Hentges, Bruna, Leal, Andrea Fachel, da Silva, Mariana Alberto, Silva, Danielle Lodi, Vasques, Samantha Correa, Hamester, Letícia, da Silva, Daila Alena Raenck, Dorneles, Fernanda Vaz, Fraga, Fernando Santana, Bobek, Paulo Ricardo, and Teixeira, Luciana Barcellos
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- 2022
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5. Motherhood in early adolescence: a case-control study in Southern Brazil/Maternidade na adolescencia inicial: estudo caso-controle no sul do Brasil
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Beria, Jorge Umberto, Schermann, Ligia Braun, Leal, Andrea Fachel, Hilgert, Juliana Balbinot, Stein, Airton Tetelbom, Alves, Gehysa Guimaraes, Camara, Sheila, and Palazzo, Lilian
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- 2020
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6. Perceived Risk of HIV Infection and Acceptability of PrEP among Men Who Have Sex with Men in Brazil
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Soares, Fabiane, primary, Magno, Laio, additional, da Silva, Luís Augusto V., additional, Guimarães, Mark Drew Crosland, additional, Leal, Andrea Fachel, additional, Knauth, Daniela, additional, Veras, Maria Amélia, additional, de Brito, Ana Maria, additional, Kendall, Carl, additional, Kerr, Ligia Regina Franco Sansigolo, additional, and Dourado, Inês, additional
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- 2022
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7. A scoping review of how exposure to urban violence impacts youth access to sexual, reproductive and trauma health care in LMICs
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Green, Gill, primary, Swartz, Alison, additional, Tembo, Doreen, additional, Cooper, Diane, additional, George, Asha, additional, Matzopoulos, Richard, additional, Leal, Andrea Fachel, additional, Cabral, Cristiane, additional, Barbosa, Regina, additional, and Knauth, Daniela, additional
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- 2022
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8. A scoping review of how exposure to urban violence impacts youth access to sexual, reproductive and trauma health care in LMICs.
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Green, Gill, Swartz, Alison, Tembo, Doreen, Cooper, Diane, George, Asha, Matzopoulos, Richard, Leal, Andrea Fachel, Cabral, Cristiane, Barbosa, Regina, and Knauth, Daniela
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ONLINE information services ,PSYCHOLOGY information storage & retrieval systems ,CINAHL database ,HEALTH services accessibility ,MIDDLE-income countries ,TRAUMA centers ,SYSTEMATIC reviews ,VIOLENCE ,SOCIAL stigma ,HELP-seeking behavior ,LOW-income countries ,INTERPERSONAL relations ,SEX crimes ,HEALTH attitudes ,RESEARCH funding ,METROPOLITAN areas ,MEDLINE ,SEXUAL health ,REPRODUCTIVE health ,ERIC (Information retrieval system) - Abstract
Violence in the community can impact access to health care. This scoping review examines the impact of urban violence upon youth (aged 15–24) access to sexual and reproductive health and trauma care in Low and Middle Income Countries (LMICs). We searched key electronic health and other databases for primary peer-reviewed studies from 2010 through June 2020. Thirty five of 6712 studies extracted met criteria for inclusion. They were diverse in terms of study objective and design but clear themes emerged. First, youth experience the environment and interpersonal relationships to be violent which impacts their access to health care. Second, sexual assault care is often inadequate, and stigma and abuse are sometimes reported in treatment settings. Third is the low rate of health seeking among youth living in a violent environment. Fourth is the paucity of literature focusing on interventions to address these issues. The scoping review suggests urban violence is a structural and systemic issue that, particularly in low-income areas in LMICs, contributes to framing the conditions for accessing health care. There is a gap in evidence about interventions that will support youth to access good quality health care in complex scenarios where violence is endemic. [ABSTRACT FROM AUTHOR]
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- 2023
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9. Survival and predictors of death in tuberculosis/HIV coinfection cases in Porto Alegre, Brazil: A historical cohort from 2009 to 2013
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Brand, Évelin Maria, primary, Rossetto, Maíra, additional, Hentges, Bruna, additional, Winkler, Gerson Barreto, additional, Duarte, Erica Rosalba Mallmann, additional, Silva, Lucas Cardoso da, additional, Leal, Andrea Fachel, additional, Knauth, Daniela Riva, additional, Silva, Danielle Lodi, additional, Mantese, George Henrique Aliatti, additional, Volpato, Tiane Farias, additional, Bobek, Paulo Ricardo, additional, Dellanhese, Amanda Pereira Ferreira, additional, and Teixeira, Luciana Barcellos, additional
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- 2021
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10. Factors Associated with Follow-Up of Children Exposed to Mother-to-Child Transmission of HIV: A Historical Cohort Study Form 2000 to 2017, in Porto Alegre, Brazil.
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Calvo, Karen da Silva, primary, Knauth, Daniela Riva, additional, Hentges, Bruna, additional, Leal, Andrea Fachel, additional, Silva, Mariana Alberto da, additional, Silva, Danielle Lodi, additional, Vasques, Samantha Correa, additional, Hamester, Letícia, additional, Silva, Daila Alena Raenck da, additional, Dorneles, Fernanda Vaz, additional, Fraga, Fernando Santana, additional, Bobek, Paulo Ricardo, additional, and Teixeira, Luciana Barcellos, additional
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- 2021
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11. Legibilidade e gestão da saúde: notas etnográficas sobre o comitê municipal de mortalidade por AIDS de Porto Alegre
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Lui, Lizandro and Leal, Andrea Fachel
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comitê de mortalidade por aids ,legibilidade ,Legibility ,Public policies ,Legibilidade ,lcsh:Social Sciences ,lcsh:H ,políticas públicas ,Legibilidad ,Comité de mortalidad por SIDA ,Políticas públicas ,lcsh:H1-99 ,AIDS mortality committee ,lcsh:Social sciences (General) ,Comitê de mortalidade por AIDS - Abstract
We discuss how the first AIDS Mortality Committee created at Brazil works based on the theoretical framework provided by Scott’s concept of legibility. Based on ethnographic observations and in-depth interviews, from fieldwork carried out in 2014-2015, we analyze both the process of governance and of policy creation within this newly create institutional space. The Committee members, through collaborative relations and sometimes disagreements, use different tools to map and document those processes that resulted in a premature and avoidable AIDS death in Porto Alegre (RS). The Committee formulates recommendations and suggestions based on those patients’ itineraries who have become legible – despite being patients who are at State margins. Those recommendations center on how the health services could improve, but fall short of discussing direct and immediate actions that could change those social conditions that have put these subjects who have died at the margins. Este artículo tiene como objetivo discutir el funcionamiento del primer Comité de Mortalidad por SIDA de Brasil con base principalmente en el concepto de legibilidad de Scott. A partir de observaciones de cuño etnográfico y entrevistas en profundidad con los miembros del Comité, realizadas en 2014-15, se discute los procesos de gobernanza y de formulación de políticas públicas en el espacio institucional recién creado del Comité. Los miembros del Comité, en relaciones que pueden ser de colaboración o de divergencia, echan mano de diferentes herramientas para mapear y documentar los procesos que resultaron en un óbito considerado por todos evitable y precoz de personas que viven con SIDA en Porto Alegre (RS). La trayectoria, hecha legible, de los pacientes que están a orillas del Estado permite la formulación de recomendaciones del Comité sobre el funcionamiento de los servicios de salud, pero no aseguran sugerencias de acciones más inmediatas y directas sobre las condiciones sociales que engendran la situación marginal de aquellos que murieron. Este artigo tem como objetivo discutir o funcionamento do primeiro Comitê de Mortalidade por AIDS do Brasil com base principalmente no conceito de legibilidade de Scott. A partir de observações de cunho etnográfico e entrevistas em profundidade com os membros do Comitê, realizadas em 2014-15, discutese os processos de governança e de formulação de políticas públicas no espaço institucional recém-criado do Comitê. Os membros do Comitê, em relações que podem ser de colaboração ou de divergência, lançam mão de diferentes ferramentas para mapear e documentar os processos que resultaram num óbito considerado por todos evitável e precoce de pessoas que vivem com AIDS em Porto Alegre (RS). A trajetória, tornada legível, dos pacientes que estão às margens do Estado permite a formulação de recomendações do Comitê sobre o funcionamento dos serviços de saúde, mas não asseguram sugestões de ações mais imediatas e diretas sobre as condições sociais que engendram a situação marginal daqueles que morreram.
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- 2018
12. Discrimination Due to Sexual Orientation and Associated Factors Among Men Who have Sex with Men in 12 Brazilian Cities: A Respondent-Driven Sampling Survey
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Magno, Laio, primary, Dourado, Inês, additional, Leal, Andrea Fachel, additional, Knauth, Daniela, additional, Guimarães, Mark Drew Crosland, additional, Bermúdez, Ximena Pamela Díaz, additional, Rocha, Gustavo Machado, additional, Veras, Maria Amélia, additional, Kendall, Carl, additional, de Brito, Ana Maria, additional, and Kerr, Lígia, additional
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- 2020
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13. Acceptability of HIV self-testing is low among men who have sex with men who have not tested for HIV: a study with respondent-driven sampling in Brazil
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Magno, Laio, primary, Leal, Andrea Fachel, additional, Knauth, Daniela, additional, Dourado, Ines, additional, Guimarães, Mark Guimarães Drew Crosland, additional, Santana, Elis Passos, additional, Jordão, Tiago, additional, Rocha, Gustavo Machado, additional, Veras, Maria Amélia, additional, Kendall, Carl, additional, Pontes, Alexandre Kerr, additional, Brito, Ana Maria, additional, Kerr, Ligia, additional, and Group, The Brazilian HIV/MSM Surveillance, additional
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- 2020
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14. Acceptability of HIV self-testing is low among MSM who have not tested: a study with respondent-driven sampling in Brazil
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Magno, Laio, primary, Leal, Andrea Fachel, additional, Knauth, Daniela, additional, Dourado, Ines, additional, Guimarães, Mark Guimarães Drew Crosland, additional, Santana, Elis Santana Passos, additional, Jordão, Tiago Jordão, additional, Rocha, Gustavo Rocha Machado, additional, Veras, Maria Amélia Amélia, additional, Kendall, Carl Kendall, additional, Pontes, Alexandre Pontes Kerr, additional, Brito, Ana Maria, additional, and Kerr, Ligia Kerr, additional
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- 2020
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15. High Rates of Unprotected Receptive Anal Intercourse and Their Correlates Among Young and Older MSM in Brazil
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Rocha, Gustavo Machado, Guimar?es, Mark Drew Crosland, Brito, Ana Maria de, Dourado, Ines, Veras, Maria Am?lia, Magno, Laio, Kendall, Carl, Kerr, Ligia Regina Franco Sansigolo, Pontes, Alexandre Kerr, Camillo, Ana Claudia, Magalh?es, Ageu, Motta-Castro, Ana Rita Coimbra, Knauth, Daniela Riva, Leal, Andrea Fachel, Merchan-Hermann, Edgar, Diaz, Ximena Pamela, Lima, Luana Nepomuceno Costa, Dourado, Maria Ines, Oliveira, Lisangela Cristina de, Macena, Raimunda Hermelinda Maia, Mota, Rosa Salani, Cavalcante, Maria do Socorro, Rutherford, George, McFarland, Will, Pimenta, Cristina, Benzaken, Adele Schwartz, and Pereira, Gerson
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Adult ,Male ,medicine.medical_specialty ,Health Knowledge, Attitudes, Practice ,Multivariate analysis ,Social Psychology ,Adolescent ,Preval?ncia ,Sexual Behavior ,Comportamento Sexual / classifica??o ,HIV Infections ,Condoms ,Sexual and Gender Minorities ,Young Adult ,Risk-Taking ,Acquired immunodeficiency syndrome (AIDS) ,Risk Factors ,Surveys and Questionnaires ,medicine ,Prevalence ,Estudos Transversais ,Humans ,Homosexuality, Male ,Heterosexuality ,Sexual identity ,Sexual violence ,Marital Status ,Unsafe Sex ,business.industry ,S?ndrome de Imunodefici?ncia Adquirida ,Public health ,Sex Offenses ,Public Health, Environmental and Occupational Health ,Age Factors ,HIV ,Middle Aged ,medicine.disease ,Sex Work ,Doen?as Virais Sexualmente Transmiss?veis / transmiss?o ,Risk perception ,Health psychology ,Infectious Diseases ,Sexual Partners ,Marital status ,Bisexuality ,business ,Brazil ,Demography - Abstract
Department of Surveillance, Prevention and Control of Sexually Transmitted Infections, HIV/AIDS and Viral Hepatitis, of the Secretariat for Health Surveillance of the Brazilian Ministry of Health Universidade Federal de S?o Jo?o del-Rei. Divinopolis, MG, Brazil. Universidade Federal de Minas Gerais. Departamento de Medicina Preventiva e Social. Belo Horizonte, MG, Brazil. Fundacao Oswaldo Cruz. Instituto Aggeu Magalhaes. Recife, PE, Brazil. Universidade Federal da Bahia. Instituto de Sa?de Coletiva. Salvador, BA, Brasil. Faculdade de Ci?ncias Medicas Santa Casa de S?o Paulo. S?o Paulo, SP, Brazil. Tulane University. School of Public Health and Tropical Medicine. New Orleans, LA, USA / Universidade Federal do Ceara. Dept Community Hlth. Fortaleza, CE, Brazil. Universidade Federal do Ceara. Dept Community Hlth. Fortaleza, CE, Brazil. Universidade Federal do Rio de Janeiro. Rio de Janeiro, RJ, Brasil. Funda??o Alfredo Mata. Manaus, AM, Brazil. Funda??o Oswaldo Cruz. Recife, PE, Brazil. Funda??o Oswaldo Cruz. Recife, PE, Brazil. Funda??o Oswaldo Cruz. Campo Grande, MS, Brazil / Universidade Federal de Mato Grosso do Sul. Campo Grande, MS, Brazil. Universidade Federal do Rio Grande do Sul. Porto Alegre, RS, Brazil. Universidade Federal do Rio Grande do Sul. Porto Alegre, RS, Brazil. Universidade de Brasilia. Brasilia, DF, Brazil. Universidade de Brasilia. Brasilia, DF, Brazil. Faculdade de Ci?ncias Medicas Santa Casa de S?o Paulo. S?o Paulo, SP, Brazil. Universidade Federal da Bahia. Salvador, BA, Brasil. Universidade Federal do Ceara. Project PI. Fortaleza, CE, Brazil. Centro Universit?rio Aut?nomo do Brasil. Curitiba, PR, Brazil. Universidade Federal de Minas Gerais. Belo Horizonte, MG, Brazil. Universidade Federal do Ceara. Fortaleza, CE, Brazil. Universidade Federal do Ceara. Fortaleza, CE, Brazil. Secretaria Sa?de Cear?. Fortaleza, CE, Brazil. Tulane University. New Orleans, LA, USA / Universidade Federal do Ceara. Fortaleza, CE, Brazil. University of California San Francisco. San Francisco, CA, USA. University of California San Francisco. San Francisco, CA, USA. Minist?rio da Sa?de. Departamento de Vigil?ncia, Preven??o e Controle das IST, do HIV/Aids e das Hepatites Virais. Brasilia, DF, Brazil. Minist?rio da Sa?de. Departamento de Vigil?ncia, Preven??o e Controle das IST, do HIV/Aids e das Hepatites Virais. Brasilia, DF, Brazil. Minist?rio da Sa?de. Departamento de Vigil?ncia, Preven??o e Controle das IST, do HIV/Aids e das Hepatites Virais. Brasilia, DF, Brazil. Universidade do Estado Bahia. Departamento de Ci?ncias da Vida. Salvador, BA, Brazil. 16IEC The aim of this study was to estimate the prevalence and factors associated with unprotected receptive anal intercourse (URAI), stratified by age (18-24 or 25 + years old), in a sample of 4,129 MSM recruited by respondent driven sampling in 12 Brazilian cities in 2016. The prevalence of URAI was higher among younger MSM (41.9% vs 29.7%) (p < 0.01). Multivariate analysis indicated that perception of risk, sexual identity, self-rated health status, and having commercial sex were associated with URAI among younger MSM. History of sexual violence, sex with younger partners, having 6 + partners and unprotected sexual debut were associated with URAI among older MSM. Marital status, having stable partner, and reporting sex with men only were associated with URAI in both groups. Despite access to condoms and lubricants, preventive efforts may not be reaching MSM effectively. Age specific intervention approaches, including stigma, discrimination, and perception of risk must be considered.
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- 2019
16. 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
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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.
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- 2019
17. Discrimination based on sexual orientation against MSM in Brazil : a latent class analysis
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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
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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.
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- 2019
18. Inquérito sobre o HIV entre HSH no Brasil em 2016 usando respondent-driven sampling (RDS) : descrição dos métodos e dos diagnósticos do RDS
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Kendall, Carl, Kerr, Ligia Regina Franco Sansigolo, Leal, Andrea Fachel, Knauth, Daniela Riva, and Johnston, Lisa G.
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AIDS ,Brasil [Saúde] ,Statistics ,Methods ,HIV ,Minorias sexuais e de gênero ,Sexual and gender minorities ,Método ,HIV antibodies ,Brazil - Abstract
Introduction: This paper details the methods used in the second national Biological and Behavioral Surveillance Survey (BBSS) of HIV, syphilis, and hepatitis B and C among men who have sex with men in Brazil. Methods: Respondent-driven sampling (RDS) was used in 12 cities in 2016. The targeted sample size was initiated with five to six seeds in each city. HIV, syphilis, and Hepatitis B and C rapid tests were offered to participants. RDS Analyst with Gile’s successive sampling (SS) estimator was used to adjust results as recommended and a weight for each individual was generated for further analysis. Data for the 12 cities were merged and analyzed using Stata 14.0 complex survey data tools with each city treated as its own stratum. Results: Duration of data collection varied from 5.9 to 17.6 weeks. 4,176 men were recruited in the 12 cities. Two sites failed to achieve targeted sample size due to a six-month delay in local IRB approval. No city failed to reach convergence in our major outcome variable (HIV). Conclusion: The comprehensive BBSS was completed as planned and on budget. The description of methods here is more detailed than usual, due to new diagnostic tools and requirements of the new STROBE-RDS guidelines.
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- 2019
19. Discrimination based on sexual orientation against MSM in Brazil: a latent class analysis
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Magno, Laio, primary, Silva, Luís Augusto V. da, additional, Guimarães, Mark Drew Crosland, additional, Veras, Maria Amélia de Sousa Mascena, additional, Deus, Luiz Fábio Alves de, additional, Leal, Andrea Fachel, additional, Knauth, Daniela Riva, additional, Brito, Ana Maria de, additional, Rocha, Gustavo Machado, additional, Lima, Luana Nepomuceno Gondim Costa, additional, Kendall, Carl, additional, Motta-Castro, Ana Rita Coimbra, additional, Kerr, Ligia Regina Franco Sansigolo, additional, Mota, Rosa Maria Salani, additional, Merchan-Hamann, Edgar, additional, and Dourado, Inês Costa, additional
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- 2019
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20. HIV/AIDS knowledge among MSM in Brazil: a challenge for public policies
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Guimarães, Mark Drew Crosland, primary, Magno, Laio, additional, Ceccato, Maria das Graças Braga, additional, Gomes, Raquel Regina de Freitas Magalhães, additional, Leal, Andrea Fachel, additional, Knauth, Daniela Riva, additional, Veras, Maria Amélia de Sousa Mascena, additional, Dourado, Inês, additional, Brito, Ana Maria de, additional, Kendall, Carl, additional, and Kerr, Ligia Regina Franco Sansigolo, additional
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- 2019
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21. The 12 city HIV Surveillance Survey among MSM in Brazil 2016 using respondent-driven sampling: a description of methods and RDS diagnostics
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Kendall, Carl, primary, Kerr, Ligia, additional, Mota, Rosa Salani, additional, Guimarães, Mark Drew Crosland, additional, Leal, Andrea Fachel, additional, Merchan-Hamann, Edgar, additional, Dourado, Inês, additional, Veras, Maria Amélia, additional, Brito, Ana Maria de, additional, Pontes, Alexandre Kerr, additional, Motta-Castro, Ana Rita Coimbra, additional, Macena, Raimunda Hermelinda Maia, additional, Knauth, Daniela, additional, Lima, Luana Nepomuceno Gondim Costa, additional, Oliveira, Lisangela Cristina, additional, Cavalcante, Socorro, additional, Camillo, Ana Cláudia, additional, Bermudez, Ximena Pamela Diaz, additional, Moreira, Regina Célia, additional, Benzaken, Adele Schwartz, additional, Pereira, Gerson, additional, Pascom, Ana Roberta Pati, additional, Pimenta, Cristina, additional, and Grazina Johnston, Lisa, additional
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- 2019
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22. Comparing HIV risk-related behaviors between 2 RDS national samples of MSM in Brazil, 2009 and 2016
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Guimarães, Mark Drew Crosland, primary, Kendall, Carl, additional, Magno, Laio, additional, Rocha, Gustavo Machado, additional, Knauth, Daniela Riva, additional, Leal, Andrea Fachel, additional, Dourado, Ines, additional, Veras, Maria Amélia, additional, Brito, Ana Maria de, additional, and Kerr, Ligia Regina Franco Sansigolo, additional
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- 2018
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23. Legibilidade e gestão da saúde: notas etnográficas sobre o Comitê Municipal de Mortalidade por AIDS de Porto Alegre
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Lui, Lizandro, primary and Leal, Andrea Fachel, additional
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- 2017
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24. Acceptability of HIV self-testing is low among men who have sex with men who have not tested for HIV: a study with respondent-driven sampling in Brazil.
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Magno, Laio, Leal, Andrea Fachel, Knauth, Daniela, Dourado, Inês, Guimarães, Mark Drew Crosland, Santana, Elis Passos, Jordão, Tiago, Rocha, Gustavo Machado, Veras, Maria Amélia, Kendall, Carl, Pontes, Alexandre Kerr, de Brito, Ana Maria, Kerr, Ligia, The Brazilian HIV/MSM Surveillance Group, Pontes, Alexandre K., Camillo, Ana C., Brito, Ana M., Magalhães, Ageu, Motta-Castro, Ana R. C., and Knauthe Andréa F Leal, Daniela R.
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MEN who have sex with men , *HIV , *HIV infection epidemiology , *DIAGNOSIS of HIV infections , *HOMOSEXUALITY , *AIDS serodiagnosis , *PATIENTS' attitudes , *INTELLECT , *CONDOMS , *HEALTH self-care , *EDUCATIONAL attainment - Abstract
Background: Brazil has many people living with HIV (PLWH) who are unaware of their serostatus. The public health system has recently added HIV self-testing (HIVST) for key populations such as men who have sex with men (MSM). This study estimates HIVST acceptability among Brazilian MSM and explores factors associated with acceptability among MSM who have never tested for HIV or who had a previous negative result.Methods: Respondent-driven sampling (RDS) was used to recruit 4176 MSM in 12 Brazilian cities in 2016 to this biological and behavioral surveillance study. We excluded from this analysis all MSM who were aware of their positive HIV serostatus. Descriptive, bivariate and multivariate analyses were conducted. Overall proportions were weighted with Gile's estimator in RDS Analyst software and 95% confidence intervals were calculated. The analyses of HIVST acceptability were stratified by prior HIV testing (never or one or more times).Results: For this analysis, 3605 MSM were included. The acceptability of HIVST was 49.1%, lower among those who had never tested for HIV (42.7%) compared to those who had a previous HIV negative test (50.1%). In the subgroup of MSM who had never tested for HIV, those who reported discrimination or who had a medical appointment in the last 12 months reported higher HIVST acceptability. Among MSM who had a previous negative HIV test, only those reporting condomless receptive anal sex reported higher HIVST acceptability. In addition, we observed that high levels of knowledge of HIV/AIDS, taking part in lesbian, gay, bisexual, and transgender nongovernmental organizations (LGBT-NGO), or complete secondary or incomplete higher undergraduate education reported higher acceptability.Conclusions: The acceptability of HIVST was low among MSM, especially among those who never tested for HIV. Given access to HIVST in Brazil, we point to the need for programs that enhance promotion of testing addressed to MSM. [ABSTRACT FROM AUTHOR]- Published
- 2020
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25. Os juizados de violência doméstica e familiar contra a mulher no Rio Grande do Sul : articulações em rede
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Conteratto, Deisi and Leal, Andrea Fachel
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Violência contra a mulher ,Street level bureaucracy ,Políticas públicas ,Network of Specialized Assistance to Women in situation of domestic violence ,Lei Maria da Penha ,Violência doméstica ,Domestic and Family Violence against women - Abstract
Os Juizados de Violência Doméstica e Familiar contra a Mulher – JVDFM são instituições especializadas, criadas pela Lei Federal Maria da Penha (nº 11.340/2006), com competências cível e criminal para conhecer e julgar as causas decorrentes da prática de violência doméstica e familiar contra a mulher. O principal diferencial das referidas varas especializadas diz respeito à perspectiva multidisciplinar, em consonância às prerrogativas nacionais e internacionais sobre a atuação governamental no enfrentamento à violência contra as mulheres. Tal perspectiva também é ressaltada pelos documentos da Rede de Enfrentamento às violências contra as mulheres (2011) e do Manual de Rotinas e Estruturação dos JVDFM (CNJ, 2011). O Rio Grande do Sul, por meio do Tribunal da Justiça Estadual, criou nove Varas Especializadas e as distribuiu em oito comarcas: Rio Grande, Pelotas, Porto Alegre (2), Canoas, São Leopoldo, Novo Hamburgo, Caxias do Sul e Santa Maria. A partir dessa realidade das varas especializadas do Rio Grande do Sul, o desafio proposto por essa pesquisa foi a investigação de quais as formas de articulações que os JVDFM têm se utilizado para que as mulheres em situação de violência doméstica e familiar, assim como os autores da referida violência, fossem encaminhados para atendimento psicossocial, jurídico e de saúde. Conferiu-se que os serviços articulados com os JVDFM para os atendimentos são diversos e se apresentam como inovações institucionais no combate à violência doméstica. Também se averiguou que não somente as articulações são influenciadas pelas percepções e visões de mundo dos atores implementadores, vistos aqui como burocratas de rua (Lipsky, 1980), mas também a construção social de quem é a clientela atendida pelos JVDFM. The Juizados de Violência Doméstica e Familiar contra a Mulher (Domestic and Family Violence against Women Courts) – JVDFM are specialized institutions, created by the Federal Law Maria da Penha (nº 11.340 / 2006), with civil and criminal jurisdiction to hear and judge causes arising from the practice of domestic and family violence against the woman. These specialized institutions are different from other courts specially because of their multidisciplinary perspective, in line with the national and international prerogatives on the governmental action regarding violence against women. Rio Grande do Sul, through the Supreme State Court of Justice, created nine Specialized District Courts and distributed them in eight districts: Rio Grande, Pelotas, Porto Alegre (2), Canoas, São Leopoldo, Novo Hamburgo, Caxias do Sul and Santa Maria. We investigate how the JVDMF articulate and offer services to the women victims of domestic and familiar violence, as well as the authors of such violence, focusing on psychosocial, legal and health care. We observed that those services articulated with the JVDFM are multiple and represent an innovative element within the institutional and structural net of services. Not only articulations are influenced by the perceptions and worldviews of the implementing actors, seen here as street-level bureaucrats (Lipsky, 1980), but also the social construction of who is the clientele served by the JVDFM.
- Published
- 2018
26. Novas tecnologias, sexualidade e direitos em tempos de risco : um estudo sobre a implementação da profilaxia pós-exposição ao HIV/AIDS pelos trabalhadores da linha de frente das políticas públicas
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Kauss, Bruno Silva and Leal, Andrea Fachel
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AIDS ,Qualitative Approach ,Public policy ,Frontline Health Workers ,Direitos sexuais ,Profilaxia ,Políticas públicas ,HIV ,Trabalhadores [Saude] ,Sexual Rights ,Post-Exposure Prophylaxis - Abstract
Novas tecnologias biomédicas de prevenção à infecção por HIV têm sido incorporadas às políticas públicas de HIV e Aids no Brasil. A Profilaxia Pós-Exposição ao HIV ou simplesmente PEP consiste num método de prevenção antirretroviral, que implica no uso de medicamentos antirretrovirais, após uma situação de exposição de risco para o HIV e Aids. O objetivo do presente trabalho é investigar como a PEP, nos casos de exposição sexual consensual, é implementada pelos profissionais de saúde, no cotidiano de um Serviço de Assistência Especializada em IST/HIV/Aids de Porto Alegre, estado do Rio Grande do Sul, Brasil. Trata-se de uma análise de implementação de políticas públicas, a qual possui como parâmetro a atuação de profissionais de saúde na implementação da PEP. Com base numa abordagem qualitativa, o estudo privilegiou as técnicas da observação de cunho etnográfico e de entrevistas em profundidade. No referencial teórico, estabeleceu-se um diálogo entre os campos das Políticas Públicas, da Sexualidade, dos Direitos Sexuais e da Biopolítica. Na análise de dados, observaram-se quatro fatores do processo de implementação: a) o contexto no qual os profissionais estão inseridos; b) os fatores institucionais e organizacionais; c) fatores individuais e relacionais; e, por fim, d) a discricionariedade administrativa. A partir da análise realizada, apontaram-se elementos que provocam dificuldades e elementos facilitadores da implementação da PEP no serviço estudado. Entre os elementos que causam dificuldades estão: (a) concentração de atividades em poucos profissionais no SAE; (b) o baixo conhecimento sobre o Protocolo de PEP; (c) o não alinhamento institucional entre os serviços SAE e CTA; (d) as percepções negativas sobre PEP e, também, sobre o comportamento dos sujeitos que acessam a PEP; e (e) não implementação da estratégia, com base no atributo da discricionariedade. Entre os elementos facilitadores, destacaram-se: (a) a percepção da importância da PEP pela maioria dos profissionais; (b) o atendimento de PEP como uma emergência médica no SAE; (c) o aconselhamento realizado pelos profissionais de Enfermagem no SAE; (d) o reconhecimento da coordenação do serviço sobre a necessidade de mudanças para a efetividade da PEP. Os elementos negativos podem trazer consequências no acesso à estratégia, trazendo prejuízos ao cuidado de si, à preservação da autonomia do sujeito e ao exercício de direitos sexuais. Não obstante a presença de elementos facilitadores, estes devem ser aprimorados no contexto de implementação, por meio de mecanismos de gestão e planejamento dos recursos disponíveis, para fins de alcançar a efetividade da estratégia. Concluiu-se que, para além de uma execução técnica, os profissionais de saúde na “linha de frente das políticas públicas” exercem uma execução simbólica, informados pelo contexto em que estão inseridos, pelas percepções, pela cultura organizacional e pelas interações cotidianas com os demais colegas e usuários. Nesse sentido, há de se fomentar os estudos qualitativos sobre o cotidiano dos profissionais de saúde, na busca de maior efetividade das estratégias de prevenção antirretrovirais, e, de modo geral, no aprimoramento das políticas públicas de HIV e Aids, do cuidado de si e do exercício de direitos sexuais. New biomedical technologies for HIV infection prevention have been incorporated into public HIV/AIDS policies in Brazil. Post-Exposure Prophylaxis to HIV or PEP is a method of antiretroviral prevention, which involves the use of antiretroviral drugs after a situation of exposure to HIV. The objective of this study is to investigate how PEP, in cases of consensual sexual exposure, is implemented by health professionals, in the daily routine of a health specialized service for HIV/AIDS in Porto Alegre, state of Rio Grande do Sul, Brazil. This is an analysis of the implementation of public policies, which has as a parameter the performance of health professionals in the implementation of the PEP. Based on a qualitative approach, the study focused on techniques of ethnographic observation and in-depth interviews. In the theoretical framework, a dialogue was established between the fields of Public Policies, Sexuality, Sexual Rights and Biopolitics. In the analysis of data, four factors of the implementation process were observed: a) the context in which the professionals are inserted; b) institutional and organizational factors; c) individual and relational factors; and, finally, (d) administrative discretion. Based on the analysis carried out, it was pointed out elements that cause difficulties and facilitating elements of the PEP implementation in the service studied. Among the elements that cause difficulties are: (a) concentration of activities in a few professionals in the SAE; (b) low knowledge of the PEP Protocol; (c) the lack of institutional alignment between SAE and CTA services; (d) the negative perceptions about PEP and also about the behavior of the subjects that access the PEP; and (e) non-implementation of the strategy, based on the discretionary attribute. Among the facilitators, the following stand out: (a) the perception of the importance of PEP by most professionals; (b) PEP care as a medical emergency in the SAE; (c) counseling by Nursing professionals in the SAE; (d) recognition of the coordination of the service on the need for changes to the effectiveness of the PEP. The negative elements can have consequences in the access to the strategy, bringing damages to the care of oneself, the preservation of the autonomy of the subject and the exercise of sexual rights. Despite the presence of facilitating elements, these should be improved in the context of implementation, through mechanisms of management and planning of available resources, in order to achieve the effectiveness of the strategy. It was concluded that, in addition to a technical execution, health professionals in the "front line of public policies" exercise a symbolic execution, informed by the context in which they are inserted, by perceptions, organizational culture and daily interactions with other colleagues and users. In this sense, qualitative studies on the daily life of health professionals should be encouraged, in the search for greater effectiveness of antiretroviral prevention strategies, and, in general, in the improvement of HIV/AIDS policies, self care and of the exercise of sexual rights.
- Published
- 2017
27. O Comitê Municipal de Mortalidade por AIDS de Porto Alegre : uma abordagem sociológica
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Lui, Lizandro and Leal, Andrea Fachel
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AIDS ,Participatory institutions ,Políticas públicas de saúde ,Mortality Committee for AIDS ,Instituições participativas ,Porto Alegre (RS) ,Political sociology - Abstract
Esta dissertação tem como objetivo investigar o processo de criação e os modos de funcionamento do Comitê Municipal de Mortalidade por AIDS de Porto Alegre. Por se tratar do primeiro comitê desse tipo a ser criado no Brasil e de estar situado na cidade que apresenta as maiores taxas de incidência, prevalência e mortalidade por AIDS no país, o mesmo apresenta-se como uma importante iniciativa na resposta à epidemia em âmbito local. O Comitê objetiva, a partir da análise dos óbitos por AIDS, pensar em medidas que possam impactar na melhoria da qualidade do atendimento dos serviços de saúde que atendem as pessoas que vivem com HIV/AIDS. Dessa forma, o estudo aqui empreendido, dentro do campo da Sociologia, preocupou-se em pensar esse universo empírico a partir de discussões já consolidadas nas Ciências Sociais sobre produção de Legibilidade, Permeabilidade do Estado, Políticas Públicas e Instituições Participativas. Os resultados deste trabalho mostram que um grupo de pessoas que possuíam expertises muito específicas foi responsável pela criação do Comitê na cidade; com apoio político, foi possível recrutar representantes dos serviços de saúde da cidade que atendem a população que vive com HIV/AIDS. Em relação à dinâmica das reuniões, há inúmeros conflitos, no que concerne à discussão dos casos de óbito por AIDS. Há diferentes entendimentos por parte dos membros do Comitê em relação à linha de cuidado que deveria ser adotada no tratamento dos pacientes. O Comitê é capaz de diagnosticar inúmeros problemas no sistema de saúde da cidade e apontar as fragilidades dos serviços de atendimento. Todavia, ainda não consegue garantir que as propostas por ele sugeridas sejam implementadas nos serviços a fim de resolver os problemas identificados e, por conseguinte, melhorar a qualidade dos serviços de atendimento às pessoas que vivem com HIV/AIDS. The dissertation aims to investigate the process of creating and operationalizing the AIDS Mortality Committee in Porto Alegre. Being the first committee of its kind in Brazil, and being located in the city that possess the highest incidence, prevalence and mortality rates by AIDS in the country, the Committee presents itself as an important initiative in response to the epidemic at local level. The Committee aims, based on analysis of reported deaths from AIDS, to investigate these deaths and improve care services. This study is developed in sociology field, seek to think the empirical universe of discussions already consolidated in the Social Sciences, on production Legibility, Permeability of State, Public Policy and Participatory Institutions. The results show that a group of people who had very specific expertise was responsible for the creation of the Committee, with political support, has been possible to recruit representatives of health services responsible by people living with HIV / AIDS care system of the city. Regarding the dynamics of meetings, there are numerous conflicts, mostly on discussion of death by AIDS cases, there are different understandings by committee members in relation to the kind of care that should be adopted to patients treatment. The Committee is able to diagnose many problems and failures on the city care services. However, still cannot develop, in a systematic way, suggestions to solve the identified problems and improve the quality of care services for people living with HIV/AIDS.
- Published
- 2016
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