Presenting national HIV/AIDS and sexually transmitted disease research in Brazil

Benzaken, Adèle Schwartz; Oliveira, Maria Cristina Pimenta de; Pereira, Gérson Fernando Mendes; Giozza, Silvana Pereira; Souza, Flávia Moreno Alves de; Cunha, Alessandro Ricardo Caruso da; Girade, Renato

doi:10.1097/md.0000000000010109

Cited by 54 publications

(6 citation statements)

References 4 publications

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“…The results showed a high prevalence of HIV among MSM aged 50 years or older (11.7%) who are users of dating apps in Brazil, especially when compared with the general Brazilian population (0.39%). 16 However, this prevalence is still lower than that found in a recent study with MSM in 12 Brazilian cities, which reported a prevalence of 18.4%. 17 It is worth noting that these studies used different methodological approaches to estimate prevalence rates.…”

Section: Discussionmentioning

confidence: 59%

Vulnerability to HIV among older men who have sex with men users of dating apps in Brazil

Queiroz

Sousa

Brignol

et al. 2019

The Brazilian Journal of Infectious Diseases

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Section: Discussionmentioning

confidence: 59%

Vulnerability to HIV among older men who have sex with men users of dating apps in Brazil

Queiroz

Sousa

Brignol

et al. 2019

The Brazilian Journal of Infectious Diseases

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“…Mirroring the dynamics of the HIV epidemic in Latin America, North America, and Western Europe, the Brazilian HIV epidemic is concentrated in key populations, such as gay, bisexual, and other men who have sex with men (MSM) [ 1 , 2 ] and transgender women [ 3 ]. In Brazil, the causes for this epidemiological profile are inherently multidimensional, involving vulnerability, risk, stigma, and discrimination, as well as behavioral, political, and programmatic issues [ 4 , 5 ].…”

Section: Introductionmentioning

confidence: 99%

Development and Evaluation of Short-Form Measures of the HIV/AIDS Knowledge Assessment Tool Among Sexual and Gender Minorities in Brazil: Cross-sectional Study

Ferreira¹,

Torres²,

Ceccato³

et al. 2022

JMIR Public Health Surveill

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Background In theoretical models of health behavior, knowledge about disease transmission and self-protective behaviors are conceptualized as important drivers of behavior change. Several studies conducted in Brazil point to an unfortunate convergence of sexual and gender minority (SGM) populations with low levels of HIV knowledge and younger age, lower education, engagement in higher-risk sexual behavior, and never having tested for HIV. Measures to assess level of HIV knowledge have been previously published, including the 12-item HIV/AIDS Knowledge Assessment (HIV-KA) tool. However, measure length can be a barrier to assessment. Objective We started from the 12-item HIV-KA tool and developed candidate short forms using statistical procedures, evaluated their psychometric properties, and tested the equivalency of their associations with other measures of HIV knowledge compared to the 12-item version. Methods A convenience sample of SGM was recruited during September 2020 to complete an online survey through advertisements on two social networking apps (Grindr and Hornet). The survey instrument included items on sociodemographic information, prior HIV testing and HIV test results, preexposure prophylaxis (PrEP) and antiretroviral treatment use, sexual behavior, and 3 HIV knowledge measures: the HIV-KA, World Health Organization Knowledge About HIV Transmission Prevention Indicator, and the Brief HIV Knowledge Questionnaire. We used exploratory factor analysis and confirmatory factor analysis (CFA) to assess the factor structure of the of the HIV-KA. We used optimal test assembly (OTA) methods to develop candidate short forms of the HIV-KA and evaluated them based on prespecified reliability, concurrent validity, and statistically equivalent convergent validity criteria. Results Among 2552 SGM individuals from Brazil, mean age was 35.1 years, 98.2% (2507/2552) cisgender men and 1.8% (45/2552) transgender/nonbinary, 56.5% (1441/2552) White, and 31.0% (792/2552) self-reported HIV positive. CFA indicated a 1-factor structure for the 12-item HIV-KA. Concurrent validity correlations were high for all short forms with 6 items, but only versions with 9 items were as reliable as the full-length form and demonstrated equivalency for convergent validity correlations. Suggesting post hoc convergent validity, HIV knowledge scores using the 9- and 10-item short forms were higher for participants who perceived the Undetectable Equals Untransmittable (U=U) slogan as completely accurate versus not accurate. Suggesting post hoc concurrent validity, participants of younger age, of Black, Pardo or indigenous race, and reporting lower education and lower income scored lower on HIV knowledge. Participants who never tested for HIV scored lower than those who tested negative or positive, while those currently using PrEP scored higher than those reporting past or never use. Conclusions OTA methods were used to shorten the 12-item HIV-KA to 9-item and 10-item versions while maintaining comparable reliability and validity among a large sample of Brazilian SGM. However, these short forms did not shorten sufficiently to justify deviation from the full measure.

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“…Brazil’s HIV epidemic has, since its onset, been concentrated in key populations such as sex workers; people who use drugs; gay, bisexual and other men who have sex with men (GBM); and transgender people [ 1 ]. Indeed, though the epidemic is classified as stable at the national level, with prevalence of 0.4% in the general population [ 2 ], HIV prevalence is significantly higher in these key populations [ 2 ]. Moreover, prevalence varies geographically with a marked spatial–temporal expansion of the HIV epidemic from the major cities of the Southeast to the other regions [ 3 ].…”

Section: Introductionmentioning

confidence: 99%

Translation and validation of the Short HIV Stigma scale in Brazilian Portuguese

Luz

Torres

Almeida-Brasil

et al. 2020

Health Qual Life Outcomes

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Background HIV-related stigma, or the degree to which people living with HIV endorse negative stereotypes associated with HIV, is associated with poor continuum of care outcomes. We translated the 12-item Short HIV Stigma scale and evaluated its psychometric properties in a Brazilian context with regard to construct validity and reliability. Methods The first step included translation, back-translation, evaluation, peer review, and pre-testing of the Short HIV Sigma scale developed by Reinius et al. (Health Qual Life Outcomes 15(1):115, 2017). The second step involved piloting the scale in three convenience samples of adults recruited online through advertisements on different platforms: Grindr (October/2019) and Hornet (February–March/2020), geospatial network apps for sexual encounters for gay, bisexuals and other men who have sex with men, and social media apps (Facebook and WhatsApp, October/2019). The psychometric evaluation included confirmatory factor analysis, differential item functioning using the Multiple-Indicator Multiple-Cause model, and correlations between subscale scores and antiretroviral treatment use and adherence. Reliability was assessed using Cronbach’s alpha, and ordinal alpha and omega from the polychoric correlation matrix. Results In total, 114, 164, and 1824 participants completed the measure items through Grindr, social media, and Hornet, respectively. We confirmed a 4-factor structure with factors for personalized stigma (3 items), disclosure concerns (3 items), concerns with public attitudes (3 items), and negative self-image (3 items). Small differential item functioning with respect to sample was found for one item (“I feel guilty because I have HIV”), which did not substantively influence estimates of latent factor scores. Grindr and Hornet’s participants scored significantly higher than social media participants on all factors except personalized stigma. Higher subscale scores correlated with antiretroviral treatment use among participants from Hornet and with lower treatment adherence in participants from Grindr and Hornet. Reliability as measured by Cronbach’s alpha, ordinal alpha and omega were 0.83, 0.88 and 0.93 for the entire scale. Discussion The Brazilian Portuguese version of the Short HIV Stigma scale had satisfactory psychometric properties with present results suggesting that scores from different samples may be compared without concern that measurement differences substantively influence results though further studies with greater representation of women and heterosexual men are warranted.

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Presenting national HIV/AIDS and sexually transmitted disease research in Brazil

Cited by 54 publications

References 4 publications

Vulnerability to HIV among older men who have sex with men users of dating apps in Brazil

Vulnerability to HIV among older men who have sex with men users of dating apps in Brazil

Development and Evaluation of Short-Form Measures of the HIV/AIDS Knowledge Assessment Tool Among Sexual and Gender Minorities in Brazil: Cross-sectional Study

Translation and validation of the Short HIV Stigma scale in Brazilian Portuguese

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