Prevalence and incidence of SIL in HIV-positive women were associated with severity of HIV disease. Interventions to increase access to Pap smears and further diagnostic tests should be implemented and targeted to HIV-positive women.

Objetivo: verificar a prevalência de sífilis em mulheres que realizaram o teste rápido em um serviço de referência de Porto Alegre/RS. Metodologia: estudo quantitativo, descritivo, transversal, realizado com 1300 prontuários de mulheres que realizaram o teste rápido no período de julho de 2012 a abril de 2014. Os dados foram analisados a partir de estatística descritiva.As variáveis categóricas foram expressas em número absoluto e percentual e aquelas com distribuição normal expressas como média ± desvio padrão. Resultados: 103 (7,9%) THE PREVALENCE OF SYPHILIS IN WOMENObjective: To verify the prevalence of syphilis in women who performed the rapid check up at a referral service in Porto Alegre.Methodology: A quantitative, descriptive, cross-sectional study of 103 records of women who performed the rapid check up from July 2012 to April 2014. Data were analyzed using descriptive statistics, categorical variables were expressed in absolute number and Percentage and those with normal distribution expressed as average ± standard deviation. Results: 103 (35.6%) had syphilis. The age ranged from 16 to 76 years, the average was 38.9 ± 12,8 years, 46 (45.1%) had completed secondary education, 31 (30,4%) had a fixed partnership, 35 (34.3 %) already had some type of STD. Conclusions: It is understood that for the control of the disease, the early diagnosis is fundamental and the assistance should be performed immediately in the primary care, aiming at a greater integration and bond with the unit /community/health/team. Descriptors:Sexually Transmitted Diseases, Syphilis, Women's Health. PREDOMINIO DE SÍFILIS EN MUJERESObjetivo: Determinar el predominio de sífilis en mujeres que se sometieron a la prueba rápida en un servicio de referencia en Porto Alegre. Metodología: cuantitativa, estudio descriptivo transversal realizado con 103 registros de mujeres que se sometieron a la prueba rápida de julio de 2012 hasta abril de 2014. Los datos fueron analizados utilizando estadística descriptiva, las variables categóricas se expresan en números absolutos y porcentaje y los que tienen distribución normal expresaron como media ± desviación estándar. Resultados: 103 (35,6%) presentaron sífilis. La edad varió de 16 a 76 años, el promedio fue de 38,9± 12,8 años, 46 (45,1%) habían completado la escuela secundaria, 31 (30,4%) tenían pareja estable, 35 (34,3 %) ya tenía algún tipo de enfermedad de transmisión sexual. Conclusiones: Se entiende que para controlar la enfermedad, el diagnóstico precoz es importante y el servicio debe realizarse inmediatamente en la atención primaria, con el objetivo de una mayor integración y vínculo con el servicio de salud/comunidad/equipo de salud.Descriptores: Enfermedades de Transmisión Sexual, Sífilis, Salud de la Mujer.

IntroductionPre-exposure prophylaxis (PrEP) is an important and well-established prevention strategy for sexual acquisition of HIV. In Brazil, transgender women (TGW) and men who have sex with men (MSM) bear the largest burden among key populations. Little is known about preferences for PrEP characteristics in these vulnerable populations in Latin America. The goal of this study is to investigate preferences of TGW and MSM with respect to PrEP characteristics, whether current user or not, and to assess any attributes and levels that may improve the decision to start using PrEP (uptake) and optimal continuity of use (adherence), which are important dimensions for PrEP success.Methods and analysisWe hereby outline the protocol of a discrete choice experiment (DCE) to be conducted among TGW and MSM in Brazil. The study will be carried out in two phases. The first phase involves literature review and qualitative approaches including in-depth interviews to inform the development of the DCE (attributes and levels). The second phase entails the DCE survey and supporting questions pertaining to sociodemographic and risk behaviour information. The survey is aimed at current PrEP users and non-users, consisting of two modes of administration: face to face in five Brazilian capitals (Rio de Janeiro, Brasília, Manaus, Porto Alegre and Salvador) and online targeting the entire country. A D-efficient zero-prior blocked experimental design will be used to select 60 paired-profile DCE choice tasks, in which participants will be randomly assigned to one of four groups and presented with a set of 15 choice tasks. The planned sample size is 1000 volunteers.Ethics, timeline and disseminationThe study was approved by Comitê de Ética em Pesquisa—Instituto Nacional de Infectologia Evandro Chagas—INI/FIOCRUZ, CEP/INI, CAAE 28416220.2.1001.5262, approval number 3.979.759 in accordance with the Comissão Nacional de Ética em Pesquisa (CONEP—Brazilian National Board of Research Ethics). The study will be conducted between 2020 and 2021. The results will be disseminated to the scientific community and to the public in general through publications in published in peer-reviewed journals and in scientific conferences.

Objectives: to reflect on the implementation of an integrated strategy to eradicate the Acquired Immunodeficiency Syndrome (AIDS) epidemic in Guinea-Bissau by 2030. Methods: a reflective study. Reflection: Guinea-Bissau is a Portuguese-speaking country located in Sub-Saharan Africa, in constant political and economic instability. Among its characteristics are sociocultural diversity and high rates of morbidity and mortality from causes related to infection by the Human Immunodeficiency Virus. In the quest to eradicate the AIDS epidemic by 2030, instituted especially by the United Nations, it is noted that political and socio-cultural factors transformed eradication of the AIDS epidemic by 2030 into a utopia. Final Considerations: international strategies, although ambitious, are considered opportunities for countries to propose and build public policies capable of changing the existing reality.

ResumoO objetivo deste trabalho é oferecer subsídios teóricos para entender o processo do luto, a fim de contribuir na compreensão da subjetividade observada na dor de amar. Como ponto de partida para o desenvolvimento deste texto, busca-se o entendimento na formação dos primeiros vínculos afetivos e do estabelecimento dos padrões de apego iniciais desenvolvidos na vida dos seres humanos. Esses dois pressupostos são levantados para análise, visto que estes padrões são responsáveis pelos dispositivos utilizados por cada indivíduo para enfrentar os processos de luto ao longo da vida. As bases teóricas utilizadas para debater tal temática foram autores consagrados como Bowlby (1990), Nasio (2007) e Worden (1998; 2013). Acredita-se que a partir deste estudo será possível oferecer contribuições aos psicoterapeutas que trabalham com esta temática, auxiliando-os no manejo dos pacientes que apresentam essa condição. Essa discussão aponta para a necessidade de trabalhar com o indivíduo a adaptação de uma nova vida, desenvolvida sem a presença física do amado, sendo elaborado um reposicionamento emocional no encontro de um novo sentido para a vida. Palavras-chave: apego, dor de amar, luto.

BackgroundTB/HIV coinfection is a serious public health issue in Brazil, and patients with coinfection have difficulty adhering to treatments. Directly observed treatment (DOT) has been recommended by the World Health Organization, considering the vulnerability of those affected. The purpose is to investigate the occurrence of DOT and associated factors compared to conventional treatment in Porto Alegre, Brazil.MethodsA retrospective cohort study was carried out with all patients with coinfection from 2009 to 2013 in the city of Porto Alegre, Brazil, the state capital with the highest rate of coinfection in Brazil. The data came from national health information systems. The dependent variable was the performance of DOT. Bivariate and multivariable models were used to determine factors associated with DOT. The percentage of cure and death was verified in a period of two years, comparing patients who received and did not receive DOT.Results2,400 cases of coinfection were reported, with 1,574 males and 826 females and a mean age of 38 years ± 9.91 years. The occurrence of DOT was 16.9%. In the multivariable analysis, factors independently associated to DOT were the year (with greater chances of being received in 2012 and 2013), place of origin, non-white race (OR = 1.29, 95% CI = 1.08–1.54), cases of relapse (OR = 1.33; 95% CI = 1.03–1.73), readmission after abandonment (OR = 1.48, 95% CI = 1.20–1.83), transfer (OR = 2.04; 95% CI = 1.40–2.98), acid-fast bacilli (AFB) test with positive result in first sample (OR = 1.73, 95% CI = 1.24–2.42), alcohol abuse (OR = 1.39; 95% CI = 1.16–1.67), and mental disorders (OR = 1.83; 95% CI = 1.38–2.44.) Of the 532 cases of death, occurring in two years, 10.2% were in patients who underwent DOT and 89.8% in patients who did not undergo DOT (p<0.001). O percentual de óbitos em pessoas que receberam DOT foi de 13% e o percentual de óbitos para pessoas que receberam tratamento convencional foi de 24%.ConclusionsThere was an increase in the percentage of DOT over the years in the scenario studied, and the predictors for DOT were related to social vulnerability. In relation to death within two years, a lower proportion was found in patients who underwent DOT, suggesting a protective effect of the strategy.

Background There are many inequalities in terms of prevention and treatment for pregnant women with HIV and exposed children in low and middle-income countries. The Brazilian protocol for prenatal care includes rapid diagnostic testing for HIV, compulsory notification, and monitoring by the epidemiological surveillance of children exposed to HIV until 18 months after delivery. The case is closed after HIV serology results are obtained. Lost to follow-up is defined as a child who was not located at the end of the case, and, therefore, did not have a laboratory diagnosis. Lost to follow-up is a current problem and has been documented in other countries. This study analyzed factors associated with loss to follow-up among HIV-exposed children, including sociodemographic, behavioral, and health variables of mothers of children lost to follow-up. Methods This historical cohort study included information on mothers of children exposed to HIV, born in Porto Alegre, from 2000 to 2017. The research outcome was the classification at the end of the child's follow-up (lost to follow-up or not). Factors associated with loss to follow-up were investigated using the Poisson regression model. Relative Risk calculations were performed. The significance level of 5% was adopted for variables in the adjusted model. Results Of 6,836 children exposed to HIV, 1,763 (25.8%) were classified as lost to follow-up. The factors associated were: maternal age of up to 22 years (aRR 1.25, 95% CI: 1.09–1.43), the mother’s self-declared race/color being black or mixed (aRR 1.13, 95% CI: 1.03–1.25), up to three years of schooling (aRR 1.45, 95% CI: 1.26–1.67), between four and seven years of schooling (aRR 1.14, 95% CI: 1.02–1.28), intravenous drug use (aRR 1.29, 95% CI: 1.12–1.50), and HIV diagnosis during prenatal care or at delivery (aRR 1.37, 95% CI: 1.24–1.52). Conclusion Variables related to individual vulnerability, such as race, age, schooling, and variables related to social and programmatic vulnerability, remain central to reducing loss to follow-up among HIV-exposed children.

Introdução: A epidemia do vírus da imunodeficiência humana possui taxas de prevalência distintas no que se refere às macrorregiões de estados e também dentro de municípios brasileiros. Porto Alegre (RS) possui elevada taxa de transmissão vertical. A identificação das singularidades dentro de territórios distintos na cidade, no que tange às gestantes com vírus da imunodeficiência humana e crianças expostas ao vírus da imunodeficiência humana, possibilita avanços em termos de políticas públicas. Objetivo: Analisar variáveis sociodemográficas e de saúde de gestantes com vírus da imunodeficiência humana e crianças expostas ao vírus da imunodeficiência humana, comparando-as nas oito gerências distritais de Porto Alegre, a fim de identificar regiões com maior vulnerabilidade. Métodos: Estudo de coorte histórica, com dados coletados entre 2000 a 2017 do Sistema de Informação de Agravos de Notificação. Comparações foram realizadas por meio do teste de homogeneidade de proporções baseado na estatística de qui-quadrado de Pearson. O nível de significância utilizado foi de 5%. Considerou-se a divisão das oito gerências distritais em Porto Alegre. Resultados: Foram analisadas 8.520 gestantes e crianças. Observou-se diferença entre as gerências quanto à raça/cor das gestantes, escolaridade, início do pré-natal e perda de seguimento. Houve maior predomínio de mulheres pretas nas gerências RES e LENO (p<0,001). Maior predomínio de gestantes sem nenhuma escolaridade nas gerências RES, CEN e SCS (p<0,001). Maior percentual de gestantes com diagnóstico de vírus da imunodeficiência humana antes do pré-natal nas gerências LENO e RES (p<0,001). Maior percentual de gestantes que iniciaram o pré-natal após a 12ª semana na gerência RES (p<0,001). Maiores percentuais de perda de seguimento nas gerências CEN, NHNI e RES (p<0,001), e maiores percentuais de crianças infectadas nas gerências NHNI, PLP, GCC, LENO e PES (p<0,001). Conclusão: Evidencia-se um maior perfil de vulnerabilidade na gerência RES, uma área geográfica com alta vulnerabilidade social. Recomenda-se a consideração das especificidades dos territórios para o desenvolvimento de ações de prevenção.