19 results on '"Grangeiro, Alexandre"'
Search Results
2. “It was unusual but amazing”: demand creation for PrEP among adolescents’ men who have sex with men (MSM) and transgender women (TGW) in Brazil.
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Reis de Sousa, Anderson, Vasconcelos da Silva, Luis Augusto, Assis Brasil, Sandra, Miura Zucchi, Eliana, de Souza Ferraz, Dulce Aurélia, Magno, Laio, Grangeiro, Alexandre, and Dourado, Ines
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- 2024
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3. Same-Day Initiation of Oral Pre-Exposure Prophylaxis is High Among Adolescent Men Who Have Sex With Men and Transgender Women in Brazil.
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Soares, Fabiane, Magno, Laio, Pinto, Jony Arrais, Grangeiro, Alexandre, Bruxvoort, Katia, Greco, Dirceu, and Dourado, Inês
- Abstract
This study analyzed the sociodemographic and behavioral characteristics of adolescent men who have sex with men (aMSM) and transgender women (aTGW) initiating oral pre-exposure prophylaxis (PrEP) in human immunodeficiency virus (HIV) prevention clinics. PrEP1519 is a prospective, multicenter, open-label PrEP demonstration cohort study of aMSM and aTGW aged 15–19 years living in three large Brazilian capital cities. For this analysis, we included adolescents who enrolled in PrEP1519 from February 2019 to August 2021. Adolescents who visited PrEP clinics were classified into four groups based on PrEP eligibility and on their decision to use PrEP: (1) ineligible for same-day PrEP initiation; (2) eligible for same-day PrEP initiation, initiated PrEP at first visit; (3) eligible for PrEP initiation, initiated PrEP after the first visit; and (4) eligible for same-day PrEP initiation but declined. The groups that were eligible for same-day PrEP initiation were compared using the Chi-square and Fisher's exact tests. Of the 1,254 adolescents enrolled in the PrEP1519 study, 61 (4.9%) were considered ineligible for same-day PrEP initiation. Of the 1,193 eligible for same-day PrEP initiation, 1,113 (93.3%) initiated PrEP [1,054 initiated PrEP in the first visit (88.3%) and 59 in subsequent visits (4.9%)] and 80 (6.7%) did not. Despite 90% of the PrEP decliners reporting a low risk of HIV infection, most reported condomless anal sex in the past six months (70%). Same-day PrEP initiation among aMSM and aTGW was high, highlighting that this strategy was important to promote PrEP initiation among adolescents with increased vulnerability to HIV in Brazil. [ABSTRACT FROM AUTHOR]
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- 2023
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4. Methodological issues in qualitative research on HIV prevention: an integrative review.
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Spadacio, Cristiane, Alves dos Santos, Lorruan, da Silva Sorrentino, Isa, Gomes, Romeu, Pfeiffer Castellanos, Marcelo Eduardo, Miura Zucchi, Eliana, Grangeiro, Alexandre, and Thereza Couto, Marcia
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- 2023
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5. Factors associated to HIV prevalence among adolescent men who have sex with men in Salvador, Bahia State, Brazil: baseline data from the PrEP1519 cohort.
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Magno, Laio, Souto de Medeiros, Danielle, Soares, Fabiane, Grangeiro, Alexandre, Caires, Priscila, Fonseca, Thaís, Westin, Mateus Rodrigues, and Dourado, Ines
- 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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- 2023
- Full Text
- View/download PDF
6. Interdisciplinarity in HIV prevention research: the experience of the PrEP1519 study protocol among adolescent MSM and TGW in Brazil.
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Dourado, Ines, Magno, Laio, Bartolomeu Greco, Dirceu, Zucchi, Eliana Miura, Ferraz, Dulce, Westin, Mateus Rodrigues, and Grangeiro, Alexandre
- 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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- 2023
- Full Text
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7. Reaching Out to Adolescents at High Risk of HIV Infection in Brazil: Demand Creation Strategies for PrEP and Other HIV Combination Prevention Methods.
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Magno, Laio, Soares, Fabiane, Zucchi, Eliana Miura, Eustórgio, Marcos, Grangeiro, Alexandre, Ferraz, Dulce, Greco, Dirceu, Escuder, Maria Mercedes, and Dourado, Ines
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HIV ,PRE-exposure prophylaxis ,MEN who have sex with men ,TRANSGENDER people - Abstract
Using baseline data from the PrEP1519 cohort, in this article we aimed to analyze: (i) the effectiveness of demand creation strategies (DCS) to enroll adolescent men who have sex with men (AMSM) and adolescent transgender women (ATGW) into an HIV combination prevention study in Brazil; (ii) the predictors of DCS for adolescents' enrollment; and (iii) the factors associated with DCS by comparing online and face-to-face strategies for enrollment. The DCS included peer recruitment (i.e., online and face-to-face) and referrals from health services and non-governmental organizations (NGOs). AMSM and ATGW who agreed to participate in the study could opt to enroll in either PrEP (PrEP arm) or to use other prevention methods (non-PrEP arm). Bivariate and multivariate analyses were conducted and logistic regression odds ratios were estimated. The DCS reached 4529 AMSM and ATGW, the majority of which were derived online (73.8%). Of this total, 935 (20.6%) enrolled to participate (76.6% in PrEP arm and 23.4% in non-PrEP arm). The effectiveness of enrolling adolescents into both arms was greater via direct referrals (235/382 and 84/382, respectively) and face-to-face peer recruitment (139/670 and 35/670, respectively) than online (328/3342). We found that a combination under DCS was required for successful enrollment in PrEP, with online strategies majorly tending to enroll adolescents of a higher socioeconomic status. Our findings reinforce the need for DCS that actively reaches out to all adolescents at the greatest risk for HIV infection, irrespective of their socioeconomic status. [ABSTRACT FROM AUTHOR]
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- 2023
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8. HIV Pre-Exposure Prophylaxis (PrEP) among men who have sex with men: peer communication, engagement and social networks.
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Alves dos Santos, Lorruan, Grangeiro, Alexandre, and Thereza Couto, Marcia
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PRE-exposure prophylaxis ,MEN who have sex with men ,PEER communication ,SOCIAL networks ,HIV ,SEXUAL minorities ,ONLINE social networks ,DIGITAL media - Abstract
HIV Pre-Exposure Prophylaxis (PrEP) has renewed optimism in controlling the HIV epidemic, despite its continued growth among men who have sex with men (MSM). The popularity of dating-sexual dating apps and digital media platforms in exchanging information and experiences about PrEP on peer social networks is recognized. However, studies on contexts, motivations, and scope in HIV prevention are scarce. The article aims to understand the dynamics of virtual and face-to-face peer networks among MSM for the decision to use PrEP, its disclosure, and publicity. Qualitative study using semi-structured interviews with 48 PrEP users from five Brazilian cities. Most interviewees share information and experiences about PrEP in peer social networks. However, its publication reveals tensions arising from the permanence of stigmas associated with homosexuality and HIV. The protagonism in exposing the use of PrEP expresses commitment to attracting new users. The relevance of peer social networks in sharing experiences and information about PrEP has the potential to diversify the target audience and expand and democratize PrEP coverage in the country. [ABSTRACT FROM AUTHOR]
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- 2022
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9. Reincidentes en el cuidado, pero sin derecho a la prevención: un análisis de la oferta de la profilaxis posexposición sexual al VIH en Porto Alegre, Brasil
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Kauss, Bruno, Leal, Andréa Fachel, Grangeiro, Alexandre, and Couto, Marcia Thereza
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Brasil ,Sexually Transmitted Diseases ,VIH ,HIV ,Profilaxis Posexposición ,Post-Exposure Prophylaxis ,Infecciones de Transmisión Sexual ,Brazil - Abstract
RESUMEN Buscamos identificar los desafíos para la implementación de la profilaxis posexposición sexual al VIH, a partir de analizar el accionar de las y los profesionales de la salud en un servicio de salud pública en Porto Alegre, Rio Grande do Sul, Brasil. Desde un enfoque cualitativo, con técnicas de observación etnográfica y entrevistas en profundidad, se encontró que los factores contextuales, organizacionales e individuales eran desafíos para implementar la profilaxis posexposición sexual al VIH. Las barreras para su implementación incluyeron el contexto histórico de la estructuración y la actuación del servicio, la falta de capacitación y/o educación continua en salud, y las concepciones de las y los profesionales de la salud (ideas sobre la estrategia en sí, y sobre las personas que buscan PEP). Se concluye que existe la necesidad de mayor atención al universo de servicios especializados en ITS/VIH/sida y a las y los profesionales que componen estos servicios, a fin de garantizar una mayor efectividad en el acceso a la estrategia a nivel local. ABSTRACT This study seeks to identify challenges in the implementation of post-exposure prophylaxis for HIV, based on an analysis of actions taken by healthcare professionals in the state-run health sector in Porto Alegre, Brazil. Based on a qualitative approach that included ethnographic observations and in-depth interviews, we found that contextual, institutional, and individual factors represented challenges to the implementation of post-exposure prophylaxis for HIV. Barriers to implementation included the historical context structuring healthcare services and practices, the lack of training and/or continued education in health, and certain attitudes on the part of healthcare professionals (ideas regarding both the strategy itself as well as the individuals that seek PEP). We conclude that there is a need for greater attention to specialized services for STI/HIV/AIDS as well as the professionals that provide these services, in order to guarantee greater effective access to this strategy at the local level.
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- 2020
10. HIV risk perceptions and post-exposure prophylaxis among men who have sex with men in five Brazilian cities.
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Mathias, Augusto, Alves dos Santos, Lorruan, Grangeiro, Alexandre, and Thereza Couto, Marcia
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RISK perception ,MEN who have sex with men ,SENSORY perception ,HIV infections ,HIV prevention ,HIV ,PREVENTIVE medicine - Abstract
In the current context of the HIV epidemic, multiple prevention strategies including biomedical interventions have been presented as alternatives for vulnerable groups. This study investigated homosexuals’ and bisexuals’ perceptions of the risk of HIV infection and their experiences of using HIV post-exposure prophylaxis (PEP). We conducted a qualitative study with 25 men who have sex with men (MSM) in five Brazilian cities using semi-structured interviews. The results showed that the use of condoms was the main HIV prevention strategy employed by the respondents. In addition, condom failure, inconsistent condom use and intentional non-use are the main prompters of risk perception and the consequent decision to seek PEP. The respondent’s perceptions and meanings of the use of PEP were mediated by prior knowledge of PEP. This work broadens the debate on the more subjective aspects of HIV prevention among MSM, especially those related to risk perception and the decision to use PEP in the context of combined prevention. [ABSTRACT FROM AUTHOR]
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- 2021
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11. Profissionais de saúde frente a homens jovens que buscam profilaxia pós-exposição sexual ao HIV (PEPSexual): desafios para o cuidado.
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Coutinho Massa, Viviane, Grangeiro, Alexandre, and Thereza Couto, Marcia
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YOUNG adults ,MEDICAL personnel ,PATIENT-professional relations ,HUMAN sexuality ,AT-risk behavior - Abstract
Copyright of Interface - Comunicação, Saúde, Educação is the property of Fundacao UNI 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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- 2021
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12. Cardiovascular disease among people living with HIV in Brazil.
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Boettiger, David C., Escuder, Maria Mercedes, Law, Matthew G., Veloso, Valdiléa, Souza, Rosa A., Ikeda, Maria L. R., Alencastro, Paulo R., Tupinambás, Unai, Brites, Carlos, Grinsztejn, Beatriz, Ggomes, Jackeline O., Ribeiro, Sayonara, McGowan, Catherine C., Jayathilake, Karu, Castilho, Jessica L., Grangeiro, Alexandre, and de Alencastro, Paulo R
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CARDIOVASCULAR diseases ,CD4 lymphocyte count ,CAUCASIAN race ,ANTIRETROVIRAL agents ,HIGH-income countries - Abstract
Copyright of Tropical Medicine & International Health is the property of Wiley-Blackwell 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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- 2020
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13. Thematic synthesis HIV prevention qualitative studies in men who have sex with men (MSM).
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Mathias, Augusto, dos Santos, Lorruan Alves, Grangeiro, Alexandre, and Thereza Couto, Marcia
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HIV prevention ,HEALTH behavior ,MEDICAL information storage & retrieval systems ,MEDLINE ,PREVENTIVE health services ,SOCIAL stigma ,QUALITATIVE research ,SOCIAL support ,MEN who have sex with men ,META-synthesis - Abstract
Copyright of Colombia Medica is the property of Universidad del Valle 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
- 2019
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14. The effect of prevention methods on reducing sexual risk for HIV and their potential impact on a large-scale: a literature review
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Grangeiro, Alexandre, Ferraz, Dulce, Calazans, Gabriela, Zucchi, Eliana Miura, and Díaz-Bermúdez, Ximena Pamela
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Prevenção & controle ,Prevention & control ,Sorologia ,Sexo seguro para prevenção da AIDS ,HIV ,Pre-exposure prophylaxis ,Profilaxia pós-exposição ,HIV Serosorting ,Post-exposure prophylaxis ,Profilaxia pré-exposição ,Condom ,Seleção por Sorologia para HIV ,Preservativo ,HIV (Vírus) - Abstract
A spectrum of diverse prevention methods that offer high protection against HIV has posed the following challenge: how can national AIDS policies with high coverage for prevention and treatment make the best use of new methods so as to reverse the current high, and even rising, incidence rates among specific social groups? We conducted a narrative review of the literature to examine the prevention methods and the structural interventions that can have a higher impact on incidence rates in the context of socially and geographically concentrated epidemics. Evidence on the protective effect of the methods against sexual exposure to HIV, as well as their limits and potential, is discussed. The availability and effectiveness of prevention methods have been hindered by structural and psychosocial barriers such as obstacles to adherence, inconsistent use over time, or only when individuals perceive themselves at higher risk. The most affected individuals and social groups have presented limited or absence of use of methods as this is moderated by values, prevention needs, and life circumstances. As a result, a substantial impact on the epidemic cannot be achieved by one method alone. Programs based on the complementarity of methods, the psychosocial aspects affecting their use and the mitigation of structural barriers may have the highest impact on incidence rates, especially if participation and community mobilization are part of their planning and implementation. RESUMOA existência de diferentes métodos preventivos que oferecem elevado grau de proteção contra o HIV tem trazido à luz um desafio: como países que proporcionaram ampla cobertura de prevenção e tratamento poderão utilizar novos métodos preventivos para reverter taxas de incidência que permanecem elevadas, até mesmo crescentes, em grupos sociais específicos? Realizamos uma revisão narrativa da literatura com a finalidade de examinar os métodos preventivos e as intervenções estruturais que, no contexto de epidemias concentradas populacional e geograficamente, podem ter maior impacto nas taxas de incidência. Com isso, analisamos o conhecimento acerca do grau de proteção dos diferentes métodos, seus limites e suas potencialidades. O alcance e a efetividade dos métodos têm sido minimizados, notadamente, por barreiras estruturais e psicossociais, como falhas de adesão, uso inconsistente ao longo do tempo ou apenas em situações em que as pessoas se percebem em maior risco. Indivíduos e grupos sociais mais atingidos pela epidemia têm limitado o uso e o não uso de métodos de acordo com seus valores, necessidades identificadas de prevenção e condições de vida. Isso impede que um método isoladamente venha a promover um forte impacto de redução na epidemia. Políticas baseadas na oferta conjunta e na complementaridade entre os métodos, na atenção aos aspectos psicossociais que interferem no seu uso e na redução das barreiras estruturais de acesso poderão ter maior impacto na incidência, especialmente se forem planejadas e implantadas com participação e mobilização social.
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- 2015
15. Hombres heterosexualmente activos, masculinidades, prevención de infección por VIH y búsqueda de profilaxis posexposición sexual consentida.
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Alves dos Santos, Lorruan, Thereza Couto, Marcia, Mathias, Augusto, and Grangeiro, Alexandre
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HIV infections ,MEDICAL care ,RISK perception ,CONDOM use ,MASCULINITY - Abstract
Copyright of Salud Colectiva is the property of Instituto de Salud Colectiva Universidad Nacional de Lanus 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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- 2019
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16. Da evidência à ação: desafios do Sistema Único de Saúde para ofertar a profilaxia pré-exposição sexual (PrEP) ao HIV às pessoas em maior vulnerabilidade.
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Miura Zucchi, Eliana, Grangeiro, Alexandre, Ferraz, Dulce, Félix Pinheiro, Thiago, Alencar, Tatianna, Ferguson, Laura, Lotufo Estevam, Denize, Munhoz, Rosemeire, and do Estudo Combina, Equipe
- 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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- 2018
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17. The HIV-Brazil Cohort Study: Design, Methods and Participant Characteristics.
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Grangeiro, Alexandre, Escuder, Maria Mercedes, Cassanote, Alex Jones Flores, Souza, Rosa Alencar, Kalichman, Artur O., Veloso, Valdiléa, Ikeda, Maria Letícia Rodrigues, Barcellos, Nêmora Tregnago, Brites, Carlos, Tupinanbás, Unai, Lucena, Noaldo O., da Silva, Carlos Lima, Lacerda, Heloisa Ramos, Grinsztejn, Beatriz, and Castilho, Euclides Ayres
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ANTIRETROVIRAL agents , *HIV infections , *QUALITY of life , *PUBLIC health , *MORTALITY , *FOLLOW-up studies (Medicine) - Abstract
Background: The HIV-Brazil Cohort Study was established to analyze the effectiveness of combination antiretroviral therapy (cART) and the impact of this treatment on morbidity, quality of life (QOL) and mortality. The study design, patients’ profiles and characteristics of cART initiation between 2003 and 2010 were described. Methodology/Principal Findings: Since 2003, the HIV-Brazil Cohort has been following HIV-infected adults receiving cART at 26 public health care facilities, using routine clinical care data and self-reported QOL questionnaires. When not otherwise available, data are obtained from national information systems. The main outcomes of interest are diseases related or unrelated to HIV; suppression of viral replication; adverse events; virological, clinical and immunological failures; changes in the cART; and mortality. For the 5,061 patients who started cART between 2003 and 2010, the median follow-up time was 4.1 years (IQR 2.2–5.9 years) with an 83.4% retention rate. Patient profiles were characterized by a predominance of men (male/female ratio 1.7∶1), with a mean age of 36.9 years (SD 9.9 years); 55.2% had been infected with HIV via heterosexual contact. The majority of patients (53.4%) initiated cART with a CD4+ T-cell count ≤200 cells/mm3. The medications most often used in the various treatment regimens were efavirenz (59.7%) and lopinavir/ritonavir (18.2%). The proportion of individuals achieving viral suppression within the first 12 months of cART use was 77.4% (95% CI 76.1–78.6). Nearly half (45.4%) of the patients presented HIV-related clinical manifestations after starting cART, and the AIDS mortality rate was 13.9 per 1,000 person-years. Conclusions/Significance: Results from cART use in the daily practice of health services remain relatively unknown in low- and middle-income countries, and studies with the characteristics of the HIV-Brazil Cohort contribute to minimizing these shortcomings, given its scope and patient profile, which is similar to that of the AIDS epidemic in the country. [ABSTRACT FROM AUTHOR]
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- 2014
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18. Trends and predictors of non‐communicable disease multimorbidity among adults living with HIV and receiving antiretroviral therapy in Brazil.
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Castilho, Jessica L, Escuder, Maria M, Veloso, Valdiléa, Gomes, Jackeline O, Jayathilake, Karu, Ribeiro, Sayonara, Souza, Rosa A, Ikeda, Maria L, Alencastro, Paulo R, Tupinanbas, Unai, Brites, Carlos, McGowan, Catherine C, Grangeiro, Alexandre, and Grinsztejn, Beatriz
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NON-communicable diseases ,COMORBIDITY ,TRENDS ,PROPORTIONAL hazards models ,POISSON regression - Abstract
Introduction: People living with HIV (PLHIV) on antiretroviral therapy (ART) experience high rates of non‐communicable diseases (NCDs). These co‐morbidities often accumulate and older adults may suffer from multimorbidity. Multimorbidity has been associated with loss of quality of life, polypharmacy, and increased risk of frailty and mortality. Little is known of the trends or predictors NCD multimorbidity in PLHIV in low‐ and middle‐income countries. Methods: We examined NCD multimorbidity in adult PLHIV initiating ART between 2003 and 2014 using a multi‐site, observational cohort in Brazil. NCDs included cardiovascular artery disease, hyperlipidemia (HLD), diabetes, chronic kidney disease, cirrhosis, osteoporosis, osteonecrosis, venous thromboembolism and non‐AIDS‐defining cancers. Multimorbidity was defined as the incident accumulation of two or more unique NCDs. We used Poisson regression to examine trends and Cox proportional hazard models to examine predictors of multimorbidity. Results: Of the 6206 adults, 332 (5%) developed multimorbidity during the study period. Parallel to the ageing of the cohort, the prevalence of multimorbidity rose from 3% to 11% during the study period. Older age, female sex (adjusted hazard ratio (aHR) = 1.30 (95% confidence interval (CI) 1.03 to 1.65)) and low CD4 nadir (<100 vs. ≥200 cells/mm3 aHR = 1.52 (95% CI: 1.15 to 2.01)) at cohort entry were significantly associated with increased risk of multimorbidity. Among patients with incident multimorbidity, the most common NCDs were HLD and diabetes; however, osteoporosis was also frequent in women (16 vs. 35% of men and women with multimorbidity respectively). Conclusions: Among adult PLHIV in Brazil, NCD multimorbidity increased from 2003 to 2014. Females and adults with low CD4 nadir were at increased risk in adjusted analyses. Further studies examining prevention, screening and management of NCDs in PLHIV in low‐ and middle‐income countries are needed. [ABSTRACT FROM AUTHOR]
- Published
- 2019
- Full Text
- View/download PDF
19. AIDS- and sexuality-related stigmas underlying the use of post-exposure prophylaxis for HIV in Brazil: findings from a multicentric study.
- Author
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Ferraz, Dulce, Couto, Marcia Thereza, Zucchi, Eliana Miura, Calazans, Gabriela Junqueira, dos Santos, Lorruan Alves, Mathias, Augusto, and Grangeiro, Alexandre
- Subjects
- *
HIV prevention , *AIDS , *HEALTH attitudes , *HEALTH services accessibility , *INTERVIEWING , *RESEARCH methodology , *MEDICAL cooperation , *PREVENTIVE medicine , *PUBLIC hospitals , *QUALITY of life , *RESEARCH , *RESEARCH funding , *SOCIAL stigma , *QUALITATIVE research , *THEMATIC analysis , *HEALTH equity , *HEALTH literacy , *DATA analysis software , *ATTITUDES toward sex , *DESCRIPTIVE statistics , *ATTITUDES toward illness - Abstract
AIDS-related stigma is a major hurdle to care and it hinders people from accessing HIV prevention methods, such as post-exposure prophylaxis. This study was designed to explore how AIDS-related stigma impacts the experience of using non-occupational post-exposure prophylaxis (nPEP) for HIV after sexual contact. Data were gathered in in-depth interviews with 59 people who voluntarily sought out nPEP in five public healthcare facilities in Brazil between 2015 and 2016. Data were analysed into three thematic categories: fear of being mistaken for a person living with HIV and AIDS (PLWHA); desire to hide particular features of one's sexual life; and experiences of stigmatising behaviour due to nPEP use. Based on the Health Stigma and Discrimination Framework, predominant manifestations of AIDS-related stigma in each category were analysed, as well as their intersections with gender- and sexuality-related stigmas. Results show that experiences of using nPEP are permeated by AIDS-related stigma, intersecting with sexuality- and gender-related stigmas. Stigma experiences are mainly perceived, anticipated and internalised; stigma practices include prejudice and stigmatising behaviours. Taking antiretrovirals (ARVs) led participants to the fear of being discriminated against as a PLWHA and having particular features of their sexual identities disclosed. Thus, hiding nPEP was strategic to protect from stigmatising behaviour. As ARV-based prevention technologies are scaled-up, interventions designed to tackle AIDS- and sexuality-related stigmas must be expanded in Brazil. Required interventions include public campaigns about nPEP, educational programmes in healthcare settings to offer adequate support to nPEP users and investments in stigma research and monitoring. [ABSTRACT FROM AUTHOR]
- Published
- 2019
- Full Text
- View/download PDF
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