Strengthening strategies to improve adherence to the use of pre-exposure prophylaxis (PrEP) in key populations constitutes a global health priority to be achieved across countries, especially in countries that share a high flow of people such as Brazil and Portugal. This study aimed to analyze the factors associated with adherence to PrEP among MSM from two Portuguese-speaking countries, highlighting the opportunities and preventive strategies for the global health scenario. This was a cross-sectional analytical online survey conducted from January 2020 to May 2021 with MSM in Brazil and Portugal. For analysis of the data, the Poisson regression model was used to estimate the prevalence ratio (PR) for developing a model to evaluate the associated factors in both countries in a comparative and isolated way. Adherence to PrEP use corresponded to 19.5% (n = 1682) of the overall sample: 18.3% (n = 970) for Brazil and 21.5% (n = 712) for Portugal. Having more than two sex partners in the last 30 days (aPR: 30.87) and routinely undergoing HIV tests (aPR: 26.21) increased the use of this medication. Being an immigrant (PR: 1.36) and knowing the partner’s serological status (PR: 1.28) increased adherence to PrEP in Portugal, whereas, in Brazil, it was being an immigrant (PR: 0.83) and not knowing the serological status (PR: 2.24) that promoted the use of this medication. Our findings reinforce the need to invest in programs and strategies to improve access and adherence to PrEP, especially in key populations.
Objective: to analyze the direct and indirect effects of determinants of sexual exposure to the human immunodeficiency virus among male adolescents who have sex with men and the implications for nursing care. Method: cross-sectional study carried out with 578 Portuguese and Brazilian adolescents aged 18 and 19. Interrelationships of conjugal status, use of dating apps, practice of chemsex, unawareness, partner credibility, challenging sexual practices and ineffective forms of protection against sexual exposure to the human immunodeficiency virus were evaluated using the Path Analysis technique. Results: significant direct effect on sexual exposure to the human immunodeficiency virus: conjugal status (β=-0.16), use of apps (β=-0.30), challenging sexual practices (β=0.48) and ineffective forms of protection (β=0.35). Indirect paths: partner credibility influenced ineffective forms of protection (β=0.77); having a steady/polyamorous relationship influenced the use of dating apps (β=-0.46); chemsex, mediated by challenging sexual practices (β=0.67), determined greater sexual exposure. Conclusion: adolescent sexual behaviors and forms of amorous/sexual relationship must be considered in nursing care planning to reduce sexual exposure to the human immunodeficiency virus.
Resumo Introdução Crianças com doenças hepáticas crônicas são expostas a fatores de risco biológicos e/ou ambientais que podem comprometer suas aquisições neuromotoras e o desenvolvimento de suas habilidades funcionais. Objetivo Descrever o desenvolvimento neuropsicomotor (DNPM) e habilidades funcionais de crianças com doenças hepáticas crônicas. Métodos Estudo seccional, descritivo e exploratório realizado com crianças de até 6 anos, que foram selecionadas em um hospital de referência do estado da Bahia, Brasil, no período de novembro de 2019 a março de 2020. Foram consideradas elegíveis para o estudo crianças em atendimento ambulatorial, com diagnóstico clínico, laboratorial e histológico compatíveis com doença hepática crônica. O instrumento de avaliação do desenvolvimento neuropsicomotor foi o Denver II. As habilidades funcionais foram obtidas pela aplicação do Inventário de Avaliação Pediátrica de Incapacidade Testagem Computadorizada Adaptativa (PEDI-CAT) aos pais ou cuidadores principais, versão rápida (Speedy-CAT). Resultados Das 34 crianças com hepatopatias crônicas, 52,9% eram do sexo feminino, com idade entre 4 e 6 anos (64%). Os resultados do teste de Denver II demonstraram que 68,7% (22/32) da amostra apresentaram risco para DNPM. No PEDI-CAT, os escores das crianças hepatopatas com risco para DNPM foram de 60,7 ± 9,1 nos domínios atividade diária, 57,6 ± 11,8 em mobilidade e 48,3 ± 6,2 em social/cognitivo. Conclusão Crianças com hepatopatias crônicas apresentam risco para DNPM, apesar de não possuírem comprometimento de suas habilidades funcionais quando avaliadas pelo PEDI-CAT.
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