22 results on '"Dourado, Inês"'
Search Results
2. Evaluating social protection mitigation effects on HIV/AIDS and Tuberculosis through a mathematical modelling study.
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Rubio, Felipe Alves, Amad, Alan Alves Santana, Aransiola, Temidayo James, de Oliveira, Robson Bruniera, Naidoo, Megan, Moya, Erick Manuel Delgado, Anderle, Rodrigo Volmir, Sironi, Alberto Pietro, Ordoñez, José Alejandro, Sanchez, Mauro Niskier, de Oliveira, Juliane Fonseca, de Souza, Luis Eugenio, Dourado, Inês, Macinko, James, and Rasella, Davide
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TUBERCULOSIS ,AIDS ,RUSSIAN invasion of Ukraine, 2022- ,HIV ,ECONOMIC forecasting ,COMMUNICABLE diseases - Abstract
The global economic downturn due to the COVID-19 pandemic, war in Ukraine, and worldwide inflation surge may have a profound impact on poverty-related infectious diseases, especially in low-and middle-income countries (LMICs). In this work, we developed mathematical models for HIV/AIDS and Tuberculosis (TB) in Brazil, one of the largest and most unequal LMICs, incorporating poverty rates and temporal dynamics to evaluate and forecast the impact of the increase in poverty due to the economic crisis, and estimate the mitigation effects of alternative poverty-reduction policies on the incidence and mortality from AIDS and TB up to 2030. Three main intervention scenarios were simulated—an economic crisis followed by the implementation of social protection policies with none, moderate, or strong coverage—evaluating the incidence and mortality from AIDS and TB. Without social protection policies to mitigate the impact of the economic crisis, the burden of HIV/AIDS and TB would be significantly larger over the next decade, being responsible in 2030 for an incidence 13% (95% CI 4–31%) and mortality 21% (95% CI 12–34%) higher for HIV/AIDS, and an incidence 16% (95% CI 10–25%) and mortality 22% (95% CI 15–31%) higher for TB, if compared with a scenario of moderate social protection. These differences would be significantly larger if compared with a scenario of strong social protection, resulting in more than 230,000 cases and 34,000 deaths from AIDS and TB averted over the next decade in Brazil. Using a comprehensive approach, that integrated economic forecasting with mathematical and epidemiological models, we were able to show the importance of implementing robust social protection policies to avert a significant increase in incidence and mortality from AIDS and TB during the current global economic downturn. [ABSTRACT FROM AUTHOR]
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- 2024
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3. Income determines the impact of cash transfers on HIV/AIDS: cohort study of 22.7 million Brazilians.
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Silva, Andréa F., Dourado, Inês, Lua, Iracema, Jesus, Gabriela S., Guimarães, Nathalia S., Morais, Gabriel A. S., Anderle, Rodrigo V. R., Pescarini, Julia M., Machado, Daiane B., Santos, Carlos A. S. T., Ichihara, Maria Y., Barreto, Mauricio L., Magno, Laio, Souza, Luis E., Macinko, James, and Rasella, Davide
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AIDS ,CONDITIONAL cash transfer programs ,HIV ,COHORT analysis ,DEATH rate - Abstract
Living with extremely low-income is an important risk factor for HIV/AIDS and can be mitigated by conditional cash transfers. Using a cohort of 22.7 million low-income individuals during 9 years, we evaluated the effects of the world's largest conditional cash transfer, the Programa Bolsa Família, on HIV/AIDS-related outcomes. Exposure to Programa Bolsa Família was associated with reduced AIDS incidence by 41% (RR:0.59; 95%CI:0.57-0.61), mortality by 39% (RR:0.61; 95%CI:0.57-0.64), and case fatality rates by 25% (RR:0.75; 95%CI:0.66-0.85) in the cohort, and Programa Bolsa Família effects were considerably stronger among individuals of extremely low-income [reduction of 55% for incidence (RR:0.45, 95% CI:0.42-0.47), 54% mortality (RR:0.46, 95% CI:0.42-0.49), and 37% case-fatality (RR:0.63, 95% CI:0.51 −0.76)], decreasing gradually until having no effect in individuals with higher incomes. Similar effects were observed on HIV notification. Programa Bolsa Família impact was also stronger among women and adolescents. Several sensitivity and triangulation analyses demonstrated the robustness of the results. Conditional cash transfers can significantly reduce AIDS morbidity and mortality in extremely vulnerable populations and should be considered an essential intervention to achieve AIDS-related sustainable development goals by 2030. Brazil has operated a conditional cash transfer program to support families living in precarious conditions since 2004. Here, the authors use linked administrative and health data to investigate the impacts of the program on HIV/AIDS-related outcomes, demonstrating strong positive associations. [ABSTRACT FROM AUTHOR]
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- 2024
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4. Mapping evidence on health promotion in HIV testing among men who have sex with men and transgender women using the social-ecological model and the vulnerability theoretical framework: a scoping review.
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Freitas, Camila Amaral Moreno, Rossi, Thais Aranha, Dourado, Inês, Castellanos, Marcelo Eduardo Pfeiffer, Guimarães, Nathalia Sernizon, and Magno, Laio
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DIAGNOSIS of HIV infections ,TRANSGENDER people ,HEALTH promotion ,SOCIAL support ,DISCRIMINATION in medical care ,HIV - Abstract
This study aimed to map the scientific evidence on health promotion in human immunodeficiency virus) HIV testing among men who have sex with men (MSM) and transgender women (TGW) based on the social-ecological model (i.e., individual, organizational and social levels) and the theoretical framework of vulnerability (i.e., individual, social, and programmatic levels). The reviewed studies indicated several barriers to accessing HIV testing (e.g., economic, structural, and bureaucratic) and demonstrated the potential for community approaches to promote greater access to HIV testing and minimize the stigma and discrimination associated with HIV testing, primarily through community leadership and social support networks. The socio-ecological model of health promotion and the vulnerability approach have the potential to contribute to improving HIV testing services by balancing the technical and political power of health services and providers with community participation while considering the social contexts. Therefore, there is a need for reflection on health promotion policies and programs aimed at expanding access to HIV testing among MSM and TGW through interventions that consider the social contexts and cultural perspectives. Moreover, inter-sectoral strategies aimed at improving living conditions and access to fundamental resources for maintaining health and well-being should be considered. [ABSTRACT FROM AUTHOR]
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- 2023
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5. Prevalence of Mollicutes among men who have sex with men and transgender women aged 15 to 19 years in Salvador, North-eastern Brazil.
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de Jesus Salgado, Valdiele, de Abreu Oliveira, Caio Marcellus Pereira, da Silva, Ágatha Morgana Bertoti, de Brito, Henrique Inácio Lima, de Medeiros, Danielle Souto, Soares, Fabiane, Magno, Laio, Dourado, Inês, Campos, Guilherme Barreto, and Marques, Lucas Miranda
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TRANSGENDER people ,MYCOPLASMATALES ,SEXUALLY transmitted diseases ,ANAL sex ,HIV - Abstract
Background: Some species of Mollicutes have been associated with different pathologies of the urogenital tract in humans, with a high prevalence among adult men who have sex with men (MSM) and transgender women (TGW). However, few studies have been performed to investigate its prevalence among adolescents. In this study, we estimated the initial prevalence of Mycoplasma genitalium (MG), Mycoplasma hominis (MH), Ureaplasma urealyticum (UU), and Ureaplasma parvum (UP); the rate of misdiagnosis at different anatomical sites; and the associated factors with positive tests for Mollicutes among MSM and TGW aged 15 to 19 years enrolled in the PrEP1519 study. Methods: PrEP-1519 is the first study to investigate the effectiveness of pre-exposure prophylaxis for human immunodeficiency virus among adolescent MSM and TGW aged 15 to 19 in Latin America. Oral, anal, and urethral swabs were taken from 246 adolescents upon enrolment in the study to detect MG, MH, UU, and UP by quantitative polymerase chain reaction (qPCR). Bivariate and multivariate analyses were conducted by Poisson regression and 95% confidence intervals (95% CI) were estimated. Results: The prevalence of Mollicutes was 32.1%. UU was the most prevalent species (20.7%), followed by MH (13.4%), MG (5.7%), and UP (3.2%); 67.3% of the positive samples would have been missed if only urethral samples had been taken. Receptive anal sex (prevalence ratio [PR] = 1.79; 95% CI = 1.07–3.01) and clinical suspicion of sexually transmitted infection (PR = 1.62; 95% CI = 1.01–2.61) were factors associated with the detection of Mollicutes in general. Group sex (PR = 1.98; 95% CI = 1.12–3.50) and receptive anal sex (PR = 2.36; 95% CI = 0.95–5.86) were associated with the detection of Mycoplasma spp. No sociodemographic, clinical, or behavioural variable was significantly associated with the detection of Ureaplasma spp. Conclusions: A high prevalence of Mollicutes was observed among adolescent MSM and TGW, especially at extragenital sites. Further research is required to understand the epidemiological profile of high-risk adolescents in different regions and contexts, and to investigate the pathogenesis of Mollicutes in the oral and anal mucosa before routine screening can be recommended in clinical practice. [ABSTRACT FROM AUTHOR]
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- 2023
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6. Factors Associated with the Use of Industrial Liquid Silicone among Travesti and Transgender Women in Salvador, Northeast Brazil.
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da Silva, Ricardo Araújo, da Silva, Luís Augusto Vasconcelos, Soares, Fabiane, and Dourado, Inês
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SILICONES ,TRANSGENDER identity ,BIVARIATE analysis ,MULTIVARIATE analysis ,HIV - Abstract
Background: The illicit use of industrial liquid silicone (ILS) is a common practice among travesti and transgender Women (TrTW) in the process of bodily change. The "pumped ladies" apply the ILS without any preparation regarding biosafety, and this practice poses serious risks to the health of TrTW, including death. This study aims to describe the prevalence of ILS use and estimate the associated factors among TrTW in a Brazilian city. Methods: This behavioral and serological survey employed the Respondent-Driven Sampling (RDS) recruitment technique. Participants who declared themselves to be travesti or transgender women over 15 years were considered eligible. The sample consisted of 127 TrTW. The bivariate analysis estimated the prevalence of ILS use by sociodemographic, cultural, and behavioral variables. Multivariate analysis used Poisson regression for adjusted estimates with respective 95% confidence intervals. Results: Approximately 31.6% of the TrTW (n = 44) used ILS and 57.2% (n = 67) were under 25 years old. Most (73.2%, n = 79) had access to more than eight years of schooling. Nine percent (n = 15) tested positive for HIV, and 31.6% (n = 48) tested positive for syphilis. The TrTW who felt more comfortable with their body image had a threefold higher prevalence of ILS use and those who performed an HIV test before the study had a 4.5 times higher prevalence of ILS. Conclusion: ILS is widely used by TrTW in Brazil. Although public policies for the transgenderizing process exist, this process still occurs illicitly. [ABSTRACT FROM AUTHOR]
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- 2022
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7. Evaluating the impact of social determinants, conditional cash transfers and primary health care on HIV/AIDS: Study protocol of a retrospective and forecasting approach based on the data integration with a cohort of 100 million Brazilians.
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Rasella, Davide, Morais, Gabriel Alves de Sampaio, Anderle, Rodrigo Volmir, Silva, Andréa Ferreira da, Lua, Iracema, Coelho, Ronaldo, Rubio, Felipe Alves, Magno, Laio, Machado, Daiane, Pescarini, Julia, Souza, Luis Eugênio, Macinko, James, and Dourado, Inês
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CONDITIONAL cash transfer programs ,PANDEMICS ,AIDS ,PRIMARY health care ,DATA integration ,REGRESSION discontinuity design ,HIV - Abstract
Background: Despite the great progress made over the last decades, stronger structural interventions are needed to end the HIV/AIDS pandemic in Low and Middle-Income Countries (LMIC). Brazil is one of the largest and data-richest LMIC, with rapidly changing socioeconomic characteristics and an important HIV/AIDS burden. Over the last two decades Brazil has also implemented the world's largest Conditional Cash Transfer programs, the Bolsa Familia Program (BFP), and one of the most consolidated Primary Health Care (PHC) interventions, the Family Health Strategy (FHS). Objective: We will evaluate the effects of socioeconomic determinants, BFP exposure and FHS coverage on HIV/AIDS incidence, treatment adherence, hospitalizations, case fatality, and mortality using unprecedently large aggregate and individual-level longitudinal data. Moreover, we will integrate the retrospective datasets and estimated parameters with comprehensive forecasting models to project HIV/AIDS incidence, prevalence and mortality scenarios up to 2030 according to future socioeconomic conditions and alternative policy implementations. Methods and analysis: We will combine individual-level data from all national HIV/AIDS registries with large-scale databases, including the "100 Million Brazilian Cohort", over a 19-year period (2000–2018). Several approaches will be used for the retrospective quasi-experimental impact evaluations, such as Regression Discontinuity Design (RDD), Random Administrative Delays (RAD) and Propensity Score Matching (PSM), combined with multivariable Poisson regressions for cohort analyses. Moreover, we will explore in depth lagged and long-term effects of changes in living conditions and in exposures to BFP and FHS. We will also investigate the effects of the interventions in a wide range of subpopulations. Finally, we will integrate such retrospective analyses with microsimulation, compartmental and agent-based models to forecast future HIV/AIDS scenarios. Conclusion: The unprecedented datasets, analyzed through state-of-the-art quasi-experimental methods and innovative mathematical models will provide essential evidences to the understanding and control of HIV/AIDS epidemic in LMICs such as Brazil. [ABSTRACT FROM AUTHOR]
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- 2022
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8. 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
9. 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
10. Rev. Bras. Epidemiol
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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
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- 2017
11. Cad. Saúde Pública
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MacCarthy, Sarah, Reisner, Sari, Hoffmann, Michael, Perez-Brumer, Amaya, Silva-Santisteban, Alfonso, Nunn, Amy, Bastos, Leonardo, Vasconcellos, Mauricio Teixeira Leite de, Kerr, Ligia, Bastos, Francisco Inácio, and Dourado, Inês
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Acquired Immunodeficiency Syndrome ,HIV ,Sampling Studies - Abstract
Submitted by Maria Creuza Silva (mariakreuza@yahoo.com.br) on 2017-05-26T18:56:32Z No. of bitstreams: 1 Ines Dourado 5. 2016.pdf: 76222 bytes, checksum: 5f2edc948cc28b0c8bf900f033da812c (MD5) Made available in DSpace on 2017-05-26T18:56:32Z (GMT). No. of bitstreams: 1 Ines Dourado 5. 2016.pdf: 76222 bytes, checksum: 5f2edc948cc28b0c8bf900f033da812c (MD5) Sampling strategies such as respondent-driven sampling (RDS) and time-location sampling (TLS) offer unique opportunities to access key populations such as men who have sex with men (MSM) and transgender women. Limited work has assessed implementation challenges of these methods. Overcoming implementation challenges can improve research quality and increase uptake of HIV services among key populations. Drawing from studies using RDS in Brazil and TLS in Peru, we summarize challenges encountered in the field and potential strategies to address them. In Brazil, study site selection, cash incentives, and seed selection challenged RDS implementation with MSM. In Peru, expansive geography, safety concerns, and time required for study participation complicated TLS implementation with MSM and transgender women. Formative research, meaningful participation of key populations across stages of research, and transparency in study design are needed to link HIV/AIDS research and practice. Addressing implementation challenges can close gaps in accessing services among those most burdened by the epidemic. Francisco Inácio Bastos Inês Dourado10
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- 2017
12. Cad. Saúde Pública
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Gonçalves, Valéria Freire, Kerr, Ligia Regina Franco Sansigolo, Mota, Rosa Salani, Macena, Raimunda Hermelinda Maia, Almeida, Rosa Lívia de, Freire, Deborah Gurgel, Brito, Ana Maria de, and Dourado, Inês, et al.
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Sexual Behavior ,Male Homosexuality ,HIV ,Anonymous Testing - Abstract
Submitted by Maria Creuza Silva (mariakreuza@yahoo.com.br) on 2017-05-02T20:16:35Z No. of bitstreams: 1 artigo 26. 2016.pdf: 151225 bytes, checksum: d9a98b86d845ce6c087b08e1d2023164 (MD5) Made available in DSpace on 2017-05-02T20:16:35Z (GMT). No. of bitstreams: 1 artigo 26. 2016.pdf: 151225 bytes, checksum: d9a98b86d845ce6c087b08e1d2023164 (MD5) This study aimed to identify incentives and barriers to HIV testing in men who have sex with men (MSM). This was a cross-sectional study of MSM who had lived at least three months in greater metropolitan Fortaleza, Ceará State, Brazil, 2010. The study recruited 391 men ≥ 18 years of age who reported sexual relations with men in the previous six months, using Respondent Driven Sampling. Personal network and socio-demographic data were collected and HIV testing was offered, analyzed with RDSAT 6.0 and Stata 11.0. The majority were young (40.3%), had 5 to 11 years of schooling (57.3%), were single (85.1%), had low income (37.6%), and 58.1% had tested for HIV some time in life. Incentive to test: certainty of not being infected (34.1%) and the exposure to national campaign Fique Sabendo [Know your Status] (34%). Barriers: trust in partner(s) (21%) and fear of discrimination if tested positive (20.3%). Policies should be developed to ensure test confidentiality and communication campaigns focusing on information gaps and encouragement for testing. Rio de Janeiro
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- 2017
13. Gender-based discrimination and unprotected receptive anal intercourse among transgender women in Brazil: A mixed methods study.
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Magno, Laio, Dourado, Inês, Silva, Luís Augusto V. da, Brignol, Sandra, Amorim, Leila, and MacCarthy, Sarah
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ANAL sex , *UNSAFE sex , *SEX discrimination , *WOMEN , *FICTION , *TRANSGENDER people , *MIXED methods research , *HEALTH - Abstract
Introduction: Discrimination related to gender identity may directly influence vulnerability to HIV through increased exposure to unprotected receptive anal intercourse (URAI). Little is known about the relationship between gender-based discrimination (GBD) and URAI with stable partners among transgender women. Methods: This mixed-methods research began with a cross-sectional survey conducted between 2014 and 2016 with transgender women in Salvador, the capital city in one of the poorest regions in Brazil. Respondent-driven sampling was used to recruit the study population. GBD was defined through Latent Class Analysis. Additionally, 19 semi-structured interviews with participants were transcribed and analyzed through thematic content analysis. Results: URAI with stable partners was commonly reported (37.3%). GDB was positively associated with URAI among stable partners (OR = 6.47; IC 95%: 1.67–25.02). The analysis of the interviews illustrated how GBD impacted transgender women in diverse ways. Experiences with GBD perpetrated by the family often initiated a trajectory of economic vulnerability that led many to engage in survival sex work. The constant experience with GBD contributed to participants feeling an immense sense of trust with their stable partners, ultimately diminished their desire to use condoms. Further, the high frequency of GBD contributed to poor mental health overall, though some participants said engagement in transgender advocacy efforts provided a vital source of resilience and support. Conclusion: Our mixed-method study capitalizes upon the strengths of diverse data sets to produce a holistic understanding of GBD and URAI with stable partners. Furthermore, by confirming the association between greater GBD and URAI, we have demonstrated how GBD can impact condom negotiation in diverse relationships. [ABSTRACT FROM AUTHOR]
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- 2018
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14. Prevention of HIV vertical transmission: obstetricians'atitude in Salvador, Brasil
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Farias,João Paulo Queiroz, Franco,Anamélia, Santos,Kleber Pimentel, Dourado,Inês, and Galvão-Castro,Bernardo
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Transmissão vertical de doença/prevenção & controle ,HIV/prevenção & controle ,Health knowledge, attitudes, practice ,Transmissão vertical de doença ,HIV ,Antiretroviral therapy, highly active ,Conhecimentos, atitudes e prática em saúde ,Terapia anti-retroviral de alta atividade ,Disease transmission, vertical - Abstract
OBJETIVO: avaliar as atitudes e conhecimento dos obstetras das maternidades públicas da cidade de Salvador (MPS) sobre as recomendações do Ministério da Saúde para a profilaxia da transmissão vertical do vírus humano da imunodeficiência (HIV) e terapia antiretroviral em gestantes. Avaliou-se também a influência das condições de trabalho, disponibilidade da testagem rápida e da terapia antiretroviral em relação à aplicação destas recomendações. MÉTODOS: realizou-se um estudo de corte transversal entre agosto e novembro de 2005, envolvendo 129/152 (85%) dos obstetras de todas as MPS. Utilizou-se como instrumento um questionário anônimo, estruturado e auto-explicativo, com questões sobre as características da população, condições de trabalho e disponibilidade de insumos, conhecimento e atitudes relacionadas ao aconselhamento e testagem para o HIV e condutas com as pacientes (uso da zidovudina (AZT), reconhecimento de fatores de risco, escolha e manejo da via de parto e cuidados no puerpério). RESULTADOS: dos obstetras, 69% referiram conhecer integralmente as recomendações do Ministério da Saúde; 90,7% concordaram com a solicitação compulsória da testagem rápida para o HIV; 63,6% escolheram a cesariana para via de parto; 38% contra-indicaram o parto por via vaginal; 37,5% recomendaram isolamento das pacientes soropositivas e 58,1% indicaram laqueadura tubária. A maioria (90%) dos sujeitos referiram a existência de fatores prejudiciais à aplicabilidade das recomendações, sendo que os mais apontados foram a realização inadequada e a indisponibilidade das informações do pré-natal na admissão. Embora a testagem rápida estivesse disponível, apenas um terço dos entrevistados afirmou que o resultado estava sempre disponível em tempo hábil. CONCLUSÕES: algumas atitudes relacionadas à assistência à gestante com HIV foram discordantes das recomendações do Ministério da Saúde. Na opinião dos entrevistados a inadequação do pré-natal e a indisponibilidade do resultado da testagem rápida influenciam negativamente na aplicação das recomendações para profilaxia da transmissão vertical do HIV. PURPOSE: to evaluate the attitudes and knowledge of obstetricians from public maternities in Salvador city (PMS) about the recommendations from the Health Ministry (HM) for the prophylaxis of vertical transmission of HIV (VTH) and antiretroviral therapy in pregnant women. The influence of working conditions, availability for quick testing and antiretroviral therapy has also been evaluated concerning the application of these recommendations. METHODOLOGY: a transversal study from August to November 2005, involving 129/152 (85%) of the obstetricians from all the PMS. The instrument used was a structured and self-explanatory anonymous questionnaire, with questions on the population characteristics, working conditions and availability of material, knowledge and attitudes related to HIV counseling and testing, and proceedings with the patients (use of AZT, recognition of risk factors, choice and management of type of delivery and puerperal care). RESULTS: 69% of the obstetricians stated they knew integrally the HM recommendations, 90.7% agreed with the compulsory request of quick testing for HIV; 63.6% chose the caesarean section as the type of delivery; 38% were against normal delivery; 37.5% recommended isolation of positive serum patients and 58.1% indicated tubal ligation. Most of them (90%) mentioned the existence of factors unfavorable to the recommendations applicability, and among those factors, the most pointed were the inadequate way the pre-natal admission was done and the lack of information at that occasion. Even though the quick testing was available, only one third of the interviewees stated that the result was always available in due time. CONCLUSIONS: some attitudes related to the assistance to the pregnant women with HIV were incompatible with the HM recommendations. According to the interviewees, the inadequacy of the pre-natal plus the non-availability of quick testing, influence negatively the applicability of VTH prophylaxis recommendations.
- Published
- 2008
15. HTLV-1 is predominantly sexually transmitted in Salvador, the city with the highest HTLV-1 prevalence in Brazil.
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Nunes, David, Boa-Sorte, Ney, Grassi, Maria Fernanda Rios, Taylor, Graham P., Teixeira, Maria Gloria, Barreto, Mauricio L., Dourado, Inês, and Galvão-Castro, Bernardo
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SEXUALLY transmitted diseases ,TREPONEMA pallidum ,AGE factors in disease ,DATA analysis ,INFECTIOUS disease transmission - Abstract
Background: Salvador is the city with the highest number of HTLV-1 infected individuals in Brazil, yet the main route of HTLV-1 transmission is unknown. Objective: To investigate the association of syphilis infection as a proxy for sexual transmission of HTLV-1 infection in the general population of this city. Methods: A cross sectional population-based study was conducted with 3,451 serum samples obtained by a representative simple random sampling. Data on gender, age, income, and years of education were collected by questionnaire and the presence of HTLV, HIV and Treponema pallidum infection was determined by serology. Logistic regression analysis was used to evaluate the independent effect of the potential explanatory variables to HTLV-1 infection and Odds Ratios (OR) and 95% CI were calculated. Results: The majority of studied individuals were female (56.4%), had less than 7 years of education (55.3%) and earned two or less minimum wages (52.0%). The overall prevalence of HTLV-1 was 1.48% (51/3,451; 95% CI: 1.10%– 1.94%), which increased with age. Only three persons younger than 17 (3/958; 0.31%; CI 95% 0.06–0.91) years were infected by HTLV-1. Among the 45 syphilis positives, 12 (26.7%) were HTLV positive, while among 21 HIV positives, only one (4.8%) was HTLV positive. HTLV-1 infection was found to be associated with syphilis infection (OR
ADJUSTED 36.77; 95% CI 14.96–90.41). Conclusion: The data presented herein indicate that horizontal transmission between adults is the main route of HTLV-1 infection in the general population of Salvador and that this is likely to occur through sexual contact. [ABSTRACT FROM AUTHOR]- Published
- 2017
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16. Mind the gap: implementation challenges break the link between HIV/AIDS research and practice.
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MacCarthy, Sarah, Reisner, Sari, Hoffmann, Michael, Perez-Brumer, Amaya, Silva-Santisteban, Alfonso, Nunn, Amy, Bastos, Leonardo, de Vasconcellos, Mauricio Teixeira Leite, Kerr, Ligia, Bastos, Francisco Inácio, and Dourado, Inês
- Abstract
Copyright of Cadernos de Saude Publica is the property of Escola Nacional de Saude Publica Sergio Arouca 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.)
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- 2016
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17. 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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Silva Brignol, Sandra Mara, Dourado, Inês, Amorim, Leila Denise, Garcia Vivas Miranda, José, and Kerr, Lígia R. F. S.
- Abstract
Copyright of Cadernos de Saude Publica is the property of Escola Nacional de Saude Publica Sergio Arouca 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.)
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- 2015
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18. Factors Associated with Low Levels of HIV Testing among Men Who Have Sex with Men (MSM) in Brazil.
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Brito, Ana Maria, Kendall, Carl, Kerr, Ligia, Mota, Rosa Maria Salani, Guimarães, Mark Drew Crosland, Dourado, Inês, Pinho, Adriana A., Benzaken, Adele Schwartz, Brignol, Sandra, and Reingold, Arthur L.
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AIDS diagnosis ,HIV ,MEN who have sex with men ,MEDICAL care use - Abstract
The aim of this study was to assess risk factors associated with low levels of HIV testing among MSM recruited through respondent driven sampling (RDS) in Brazil. Of 3,617 participants, 48.4% had never tested previously for HIV. A logistic model indicated that younger age, lower socioeconomic class, education, poor HIV/AIDS knowledge, no history of cruising, and having been tested during the study were characteristics independently associated with low levels of previous HIV testing. The HIV testing rate among MSM in Brazil is still low in spite of the availability of a large number services providing universal and free access to HIV/AIDS diagnosis and treatment. To respond to low utilization, the authors propose a higher priority for testing for key populations such as MSM, expanded education, expanding testing sites and a welcoming and nonjudgmental environment in health services. [ABSTRACT FROM AUTHOR]
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- 2015
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19. 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.
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Brignol, Sandra, Dourado, Inês, Amorim, Leila D., and Sansigolo Kerr, Lígia Regina Franco
- Abstract
Copyright of Cadernos de Saude Publica is the property of Escola Nacional de Saude Publica Sergio Arouca 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
20. Trends in maternal-infant transmission of AIDS after antiretroviral therapy in Brazil.
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De Brito, Ana Maria, De Sousa, Jailson Lopes, Luna, Carlos Feitosa, and Dourado, Inês
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Copyright of Revista de Saúde Pública is the property of Faculdade de Educacao da Universidade de Sao Paulo 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
- 2006
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21. 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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22. Prevalence of the CCR5Δ32 mutation in Brazilian populations and cell susceptibility to HIV-1 infection.
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Grimaldi, Rogério, Shindo, Nice, Acosta, Angelina, Dourado, Inês, Brites, Carlos, de Melo Carvalho, Ozenilda, Brito, Ivo, Bou-Habib, Dumith Chequer, and Galvão-Castro, Bernardo
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HIV infections ,HIV ,BRAZILIANS ,GENETIC mutation ,GENETICS ,HUMAN genetics - Abstract
We investigated the occurrence of the CCR5Δ32 mutation in various regional ethnic groups in Brazil and tested the resistance of mutant peripheral blood mononuclear cells (PBMCs) to infection by HIV-1 in vitro. The heterozygous prevalence was 5.3% in uninfected African descendents and 8.8% in HIV-1-positive individuals (neither population had Δ32/Δ32). German descendents were 11% heterozygous and l% Δ32/Δ32. Amerindians were exclusively CCR5/CCR5. Heterozygous uninfected PBMCs showed partial resistance to R5-HIV-1 strains in vitro, but no resistance to X4 virus. HIV-1-positive CCR5/CCR5 had higher viral loads than did heterozygous cells. [ABSTRACT FROM AUTHOR]
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- 2002
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