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Introduction: Sexualized drug use (SDU) to enhance and extend sexual relations may involve risks of substances abuse (intoxication, interactions and overdose) and higher exposure to HIV and other sexually transmitted infections. There are inconsistencies in the methodology and findings of previous research on SDU in Latin America (LA), and more studies are required. The purpose of this research was to characterize SDU in gay men and other men who have sex with men from 18 LA countries, and describe the aspects by comparing people who practice and do not practice SDU, at the general and country levels., Material and Methods: Cross-sectional study based on the data collected by LAMIS-2018. Dependent variable was SDU (last 12 months), and the independent variables were: drug use (in any context/in sexual context), sociodemographic, socioepidemiological, and psychosocial aspects. A descriptive analysis was carried out, comparing those who practiced and did not practice SDU., Results: LAMIS-2018 included 64,655 participants, averaging 30 years of age. 13.6% declared having practiced SDU (6.6% with multiple partners). In the last sexual encounter the most commonly used drugs were cannabis (9.3%), poppers (6%), and Viagra (5.4%), and in the last encounter with multiple partners, poppers (19.7%), cannabis (17%), and Viagra (13.2%). HIV diagnosis was reported by 27% of people practicing SDU, vs. 14.3% in the other group. Severe anxiety-depression symptoms were more common among people practicing SDU (9.2% vs. 7%), as were the episodes of homophobic intimidation (52.6% vs. 48.2%), insults (34.4% vs. 28.6%), and aggression (4.1% vs. 3.0%)., Conclusions: SDU was reported by a high percentage of people, with a predominance of the use of drugs related to sexual practice, and others for recreational use. Aspects described as the higher proportion of self-reported HIV diagnosis and severe symptoms of anxiety-depression among those who practiced SDU, show that is necessary to implement preventive strategies to reduce the harmful impacts that can sometimes result from this practice, including harm reduction policies, promote access to mental health services and support in situations of homophobia and stigma., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2023 Lisboa et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Despite men-who-have-sex-with-men (MSM) from Latin America (LA) are still a vulnerable population for known health-related conditions and social problems, availability of comparable data across LA countries for assessment and monitoring purposes is limited. The objective of this article is to present the study design and the questionnaire of LAMIS-2018 (Latin America MSM Internet Survey), its recruitment strategy, rates and sources by country, and the lessons learned from its implementation. LAMIS-2018 was a cross-sectional, internet-based survey targeting MSM living in 18 LA countries (Argentina, Bolivia, Brazil, Chile, Colombia, Costa Rica, Ecuador, El Salvador, Guatemala, Honduras, Mexico, Nicaragua, Panama, Paraguay, Peru, Suriname, Uruguay, and Venezuela) that gathered data about sexual behaviors, HIV/STI and viral hepatitis knowledge, prophylactic use of antiretrovirals, psychosocial health, and access to sexual health services. The survey went online for four months and was available in three languages (Spanish, Portuguese, and Dutch). Promotion was carried out using dating apps, websites, social networks, and by community-based and academic organizations of each participating country directly in gay venues and in their own premises. Overall, 64,655 MSM participated in LAMIS-2018. Dating apps and websites were the most important recruitment source in most countries, except for Honduras, Nicaragua, and Suriname, where community-based organizations recruited most of the participants. Beyond the LAMIS-2018 implementation description, we highlight the feasibility of such a study in this context, based on the collaboration between community-based and academic organizations to obtain a large sample of MSM in the region. LAMIS-2018 data will contribute to identify determinants of risk behaviors and prevention needs of vulnerable MSM populations in each country of the region., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2022 Reyes-Díaz et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Background: Poor living conditions promote the spread of communicable diseases. It happened with Tuberculosis (TB) and is happening with COVID-19. Due to its dynamic nature, this group of diseases must be studied in the context of the social determinants of health., Aim: To describe the epidemiological behavior of COVID-19 in response to the control strategies implemented by the Chilean Ministry of Health and its similarities with the socio-economic distribution of TB in the Metropolitan Region (MR) of Chile., Material and Methods: The 2018 Tuberculosis rates and average income of districts belonging to the MR were described, as well as the incidence rates of COVID-19. A Pearson correlation analysis was applied between the rates of both diseases, to assess similarities in the epidemiological distribution patterns., Results: The RM accounts for over 50% of the total national cases of COVID-19. After the implementation of selective quarantines, only four districts in the RM managed to control the outbreak (those with the highest incomes). In the rest, a clear increase in cases was observed. The districts with the highest increase in cases were the most disadvantaged, and those with the highest TB rates during 2018, with a correlation coefficient of 0.6., Conclusions: Control policies cannot deepen health inequalities. If vulnerable groups, as well as the factors that determine their health, are not properly identified, the consequences of the current pandemic could be even more devastating.

Background: The Chilean Program for the Control and Elimination of Tuberculosis (PROCET) has reduced mortality from this disease by 78% between 2004 and 2013. However, after decades of successful results, starting in 2000 there was a slowdown in the reduction of incidence and since 2014, an increase in it., Aim: To describe the socio-epidemiological evolution of tuberculosis (TB) cases treated at health clinics in the Metropolitan Region (MR) of Chile from 2005 to 2018, stratifying by country of origin., Methods: Cross-sectional study with ecological components, including analyses of age, sex, TB localization, bacteriological confirmation of diagnosis, co-infection with HIV, incarceration, country of origin, and effectiveness of tuberculosis treatment., Results: A total of 7,507 TB cases were recorded during the study period; 75.1% of cases were pulmonary tuberculosis, and 65.4% were bacteriologically confirmed. Overall, 19.0% of cases involved persons born outside of Chile, with the proportion of cases in foreign-born persons increasing over the past 6 years. Incidence decreased during the first half of the study period but then began to increase after 2012, moving the country away from the threshold of elimination. A total of 74.3% of cases were treated successfully, and 13.4% expired., Conclusion: In recent years, TB incidence has increased in the MR of Chile, possibly attributable to growing populations of vulnerable groups such as immigrants. This finding suggests an urgent need to implement and reinforce strategies such as education, an active screening model and more efficient contact tracing to prevent the spread of TB.

Background: Tuberculosis (TB)/HIV coinfection has a high mortality rate., Aim: To describe socio-epidemiological characteristics of tuberculosis (TB)-HIV coinfection, and aspects associated with its prevalence, from 2005 to 2018., Material and Methods: Analysis of the registry of the tuberculosis control and elimination program of three public health services of metropolitan Santiago. The variables considered were: TB/HIV coinfection, age, sex, location of tuberculosis, bacteriological confirmation, incarceration, commune of residence, country of origin and effectiveness of the tuberculosis therapy., Results: We analyzed 7507 TB cases, of whom 12% corresponded to cases of coinfection. The number of coinfections doubled in the last 6 years. In 2018, 45% of coinfection cases occurred in migrants. Of the total cases evaluated, 53% were successfully treated and 28% died., Conclusions: The remarkable increase in TB/HIV coinfection, urgently demands new prevention and control strategies, aimed at the most vulnerable groups.

In Chile, sex work takes place covertly in a variety of venues and locations. Formative research using time-location sampling methods is important in order to understand the nature of this diversity. This study used qualitative methods to develop a typology of female sex work in the Metropolitan Region of Santiago, Chile, using semi-structured interviews, focus groups and ethnographic fieldwork during visits to sex work venues. The study identified seven types of venue, which reflect the context and regulatory framework of the country and the structural vulnerabilities that affect female sex workers in Chile. These venues and locations include: cafés con piernas (coffee with legs); nightclubs, topless bars and cabarets; brothels; hotels; street and highway soliciting; massage parlours; and private residences. Formative research methods were helpful in identifying and characterising the venues and locations in which sex work occurred. Barriers to accessing and mapping specific locations were also identified. Recommendations for addressing these barriers include working with non-governmental organisations to map venues and initiate contact with the populations of interest. A comprehensive typology of sex work in the Metropolitan Region of Santiago, Chile, is an essential element for future time-location sampling and bio-behavioural research in the context of second-generation surveillance for HIV and sexually transmitted infections in Chile.

Objective: To adapt a behavioural questionnaire for second-generation HIV/AIDS surveillance in female sex workers (FSWs) in the Metropolitan Region, Chile., Methods: Qualitative study of instruments validation. A Spanish instrument adapted in Catalonia was validated through a translation and back-translation of the original version. The content validity was determined through a modified Delphi method, via FSW and HIV experts representing community, political and institutional levels. Applicability aspects were determined by the application of the questionnaire to FSW in the Metropolitan Region., Results: The questionnaire, drafted in Spain, was successfully adapted to Chilean Spanish. The content validity process enabled sections to be created that address HIV in FSWs. The adapted questionnaire takes less than 15minutes to complete, which makes it usable in fieldwork. The 61 women surveyed came from different countries (all were Latin Americans) and had different educational levels; all this enabled potential applicability problems to be detected., Discussion: The adapted questionnaire for Chile contains all the UNAIDS indicators for FSWs, as well as the recommended indicators of Family Health International for bio-behavioural surveillance. Said questionnaire serves as a tool for second-generation HIV/other STD surveillance and further contributes to preventive policies in Chilean FSWs., (Copyright © 2016 SESPAS. Publicado por Elsevier España, S.L.U. All rights reserved.)

Background: Adequate adherence to HAART has a high impact on survival of AIDA patients. There is little consensus on the causes of low adherence to treatment in women, who are in a situation of inequality in terms of prevention and related care., Objectives: To explore and describe the socio-cultural aspects related to the adherence of women to antiretroviral treatment for HIV / AIDS., Material and Methods: Qualitative, exploratory-descriptive study. The study population was focused on Chilean women, who are 18 years of age or older, living with HIV/AIDS. The sample size was defined by information saturation. In-depth interviews were conducted with 16 women contacted in seven public care centers for people living with HIV (PLHIV) in 4 regions of the country, and it was take into account the saturation of the information., Results: There are several sociocultural factors that determine the level of adherence that women adopt in relation to HAART. The most relevant ones are the vital satisfaction, the imaginary about HIV, the availability of their networks in front of diagnosis and the availability of information are fundamental., Discussion: It is necessary to enter into specific interventions considering the sociocultural aspects and satisfying the psychosocial needs of women. It is imperative that public policies and health teams consider these aspects to improve adherence to HAART.

Introduction: Meningococcal disease (MD) is a public health problem worldwide, due to its high morbidity and mortality. Most cases occur in sub-Saharan Africa, where there is a marked seasonal pattern with predominance during the dry season., Objectives: To describe the morbidity of MD in the Metropolitan Region (MR) of Chile and explore whether there is a correlation between the number of cases with the levels of atmospheric particulate matter PM 10 and PM 2.5, relative humidity (RH), temperature and total environmental pollen., Materials and Methods: Ecological time series study, statistical analysis with R 3.0.1, graphics with Excel 2013., Results: Between 2010 and 2013, 234 MD cases were reported in the MR with an increasing trend. There is a seasonal pattern with an increase of cases from August to October, and a decrease from March to April. There is no correlation with the levels of PM10 and PM2.5. There is a slight positive correlation with RH and a slight negative correlation with temperature. There is a moderate positive correlation with the levels of total environmental pollens., Discussion: Overcrowding and the winter viral infections could explain the increased incidence of MD and the slight correlation with RH and temperature. The moderate correlation with the pollens could be explained by an effect of irritation of the upper airway., Conclusions: More epidemiological studies whose designs allow a greater causal inference are required.

Background: High-risk human Papillomavirus infection is a necessary factor for cervical squamous intraepithelial lesions and invasive cervical cancer. In HIV-1-infected women, HPV infection is more prevalent and a higher risk of cervical cancer has been identified. We aimed to calculate the prevalence of infection by HR-HPV, determine the factors associated with this infection and abnormal cytology findings and to describe the history of cervical cancer screening in HIV-1-infected women., Methods: We enrolled 479 HIV-1-infected women from the PISCIS cohort. Each patient underwent a gynecological check-up, PAP smear, HPV AND Hybrid capture, HPV genotyping, and colposcopy and biopsy, if necessary. We applied questionnaires to obtain information on sociodemographic, behavioral, clinical, and cervical screening variables. We present a cross-sectional analysis., Results: Median age was 42 years. The prevalence of HR-HPV infection was 33.2% and that of high-grade squamous intraepithelial lesions (HSIL) was 3.8%. The most common genotypes were 16(23%), 53(20.3%), and 52(16.2%). The factor associated with HR-HPV infection was age <30 years (odds ratio[OR],2.5; 95%confidence interval[CI],1.1-5.6). The factors associated with the presence of HSIL or low-grade squamous intraepithelial lesions (LSIL) were CD4T-lymphocyte count <200 cells/mm(3) versus >500 cells/mm(3) (OR,8.4; 95%CI,3.7-19.2), HIV-1 viral load >10,000 copies/mL versus <400 copies/mL (OR,2.1; 95%CI,1.0-4.4), and use of oral contraceptives (OR,2.0; 95%CI,1.0-3.9). Sixty percent of HIV-1-infected women had had one Pap smear within the last 2 years., Conclusions: The high prevalence of HPV infection and cervical lesions in the HIV-1-infected population in Catalonia, as well as the low coverage and frequency of screening in this group, means that better preventive efforts are necessary and should include vaccination against HPV, better accessibility to screening programs, training of health care professionals, and specific health education for HIV-1-infected women.