Cadernos de Saúde Pública最新文献_第5页

HIV epidemic, prevention technologies, and the new generations: trends and opportunities for epidemic response 艾滋病毒疫情、预防技术和新一代：疫情应对的趋势和机遇

Cadernos de Saúde Pública Pub Date : 2023-12-08 DOI: 10.1590/0102-311XEN144223

Alexandre Grangeiro, Dulce Ferraz, Laio Magno, Eliana Miura Zucchi, Márcia Thereza Couto, Inês Dourado

{"title":"HIV epidemic, prevention technologies, and the new generations: trends and opportunities for epidemic response","authors":"Alexandre Grangeiro, Dulce Ferraz, Laio Magno, Eliana Miura Zucchi, Márcia Thereza Couto, Inês Dourado","doi":"10.1590/0102-311XEN144223","DOIUrl":"https://doi.org/10.1590/0102-311XEN144223","url":null,"abstract":"Abstract: The United Nations has underscored the possibility of ending the HIV epidemic as a public health problem. However, an increase in the incidence among adolescents and youth has indicated a greater distance between HIV responses and the specificities of the new generations, which can maintain the epidemic for an extended period. Regards this matter, it is debated that the provision of a range of preventive methods, even if highly effective, and a conservatism that has internalized stigma within government policies, hinder the proper and essential dialogue between current preventive policies and the needs of the new generations. These generations are marked by a social representation of AIDS as a mild disease, by new gender and sexuality performances, and by the search for a more critical role in affective and sexual encounters, which includes frequent use of dating apps and substances. The hierarchy of the delivery of prevention methods is presented as a proposal for a new policy, prioritizing pre-exposure prophylaxis (PrEP) and addressing the social determinants of the HIV epidemic, including strategies to mitigate stigma. The importance of the participation of adolescents and youth in constructing the policy and the need for an intersectoral response are also reinforced.","PeriodicalId":122102,"journal":{"name":"Cadernos de Saúde Pública","volume":"54 13","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138587449","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 6

Rethinking HIV prevention in young people: “hierarchization” or “deinstitutionalization”? 重新思考年轻人的艾滋病毒预防问题：是 "等级化 "还是 "非制度化"？

Cadernos de Saúde Pública Pub Date : 2023-12-08 DOI: 10.1590/0102-311ent164823

Draurio Barreira, Tatianna Meireles Dantas de Alencar

引用次数: 2

Forty years of the Brazilian response to HIV: reflections on the need for a programmatic shift and policy as a common good 巴西应对艾滋病毒四十年：关于需要转变计划和政策作为共同利益的思考

Cadernos de Saúde Pública Pub Date : 2023-12-08 DOI: 10.1590/0102-311xen199423

Alexandre Grangeiro, Dulce Ferraz, Laio Magno, Eliana Miura Zucchi, Márcia Thereza Couto, Inês Dourado

引用次数: 0

Adverse effects of daily oral pre-exposure prophylaxis in men who have sex with men and transgender women: a systematic review and meta-analysis 男男性行为者和变性妇女每日口服暴露前预防药物的不良影响：系统回顾和荟萃分析

Cadernos de Saúde Pública Pub Date : 2023-12-08 DOI: 10.1590/0102-311XEN089522

Marcos Pereira, C. Castro, Laio Magno, Tarcio de Almeida Oliveira, Fabiane Soares Gomes, Fabiane Maria Fernandes Neves, Pedro Rafael dos Santos do Nascimento, Inês Dourado

{"title":"Adverse effects of daily oral pre-exposure prophylaxis in men who have sex with men and transgender women: a systematic review and meta-analysis","authors":"Marcos Pereira, C. Castro, Laio Magno, Tarcio de Almeida Oliveira, Fabiane Soares Gomes, Fabiane Maria Fernandes Neves, Pedro Rafael dos Santos do Nascimento, Inês Dourado","doi":"10.1590/0102-311XEN089522","DOIUrl":"https://doi.org/10.1590/0102-311XEN089522","url":null,"abstract":"Abstract: The adverse effects of oral pre-exposure prophylaxis (PrEP) using tenofovir disoproxil fumarate are barriers to PrEP initiation and continuation. Although serious effects are rare and predictable, evidence for this assessment among men who have sex with men (MSM) and transgender women (TGW) is still limited. This study assesses the adverse effects of daily oral PrEP in MSM and TGW. This is a systematic review and meta-analysis of clinical trials and cohort studies on the use of daily oral PrEP selected from the PubMed/MEDLINE, Embase, LILACS, and Cochrane CENTRAL databases. Data extraction included adverse effects and changes in renal and hepatic markers. Random effects models were used to summarize the risk of adverse effects throughout the study. Heterogeneity was assessed using the Cochran’s Q test and the inconsistency test (I2). The risk of bias and the certainty of the evidence were assessed using the Cochrane Collaboration recommendations. The search identified 653 references. Of these, 10 were selected. All studies assessed the eligibility of renal and hepatic markers. The use of daily oral PrEP was not associated with grade 3 or 4 adverse events (RR = 0.99; 95%CI: 0.83-1.18; I2 = 26.1%), any serious adverse event (RR = 1.04; 95%CI: 0.58-1.87; I2 = 88.4%), grade 3+4 creatinine level (RR = 0.66; 95%CI: 0.24-1.84; I2 = 79.9%), and grade 3 or 4 hypophosphatemia (RR = 0.56; 95%CI: 0.15-2.10). The certainty of the evidence ranged from high to moderate for the outcomes analyzed. Daily oral PrEP is safe and well tolerated by MSM and TGW. Adverse effects were minimal and evenly distributed between intervention and control.","PeriodicalId":122102,"journal":{"name":"Cadernos de Saúde Pública","volume":"19 22","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138589207","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Violence, discrimination, and sexual health practices among adolescent men who have sex with men, transgender women and travestis in three cities in Brazil 巴西三座城市中男男性行为者、变性妇女和男男性行为者青少年中的暴力、歧视和性健康做法

Cadernos de Saúde Pública Pub Date : 2023-12-08 DOI: 10.1590/0102-311XEN142922

M. Ryngelblum, Alexandre Grangeiro, Eliana Miura Zucchi, Márcia Thereza Couto, Inês Dourado, Laio Magno, U. Tupinambás, Maria Fernanda Tourinho Peres

{"title":"Violence, discrimination, and sexual health practices among adolescent men who have sex with men, transgender women and travestis in three cities in Brazil","authors":"M. Ryngelblum, Alexandre Grangeiro, Eliana Miura Zucchi, Márcia Thereza Couto, Inês Dourado, Laio Magno, U. Tupinambás, Maria Fernanda Tourinho Peres","doi":"10.1590/0102-311XEN142922","DOIUrl":"https://doi.org/10.1590/0102-311XEN142922","url":null,"abstract":"The HIV epidemic has a disproportionate impact on adolescent and young men who have sex with men (AMSM) and transgender women and travestis (ATGW), with an increased HIV prevalence over the last 10 years. Violence affects the lives of these populations, undermining their ability to self-care and making them more vulnerable to HIV infection. In this study, we aimed to examine the association between different types of victimization by violence and discrimination and sexual health practices of these adolescent populations in steady and casual relationships. We conducted a cross-sectional study using baseline data from the cohort of PrEP1519 project. We used the mean score of sexual health practices as our outcome and the cumulative score of discrimination (within family, community, education, religious, online and public spaces) and violence (physical, sexual and intimate partner) as our exposure variable. We performed linear regression analyses to estimate the association between exposure and outcome. We found that 90% of AMSM and 95% of ATGW experienced at least one form of violence in the three months prior to this study and about 45% of ATGW suffered sexual violence during the same period. Experiencing discrimination within healthcare settings (from facilities or providers) was negatively associated with sexual health practices. Discrimination and violence negatively affect sexual health practices. HIV prevention and care of AMSM and ATGW people should involve listening to their experiences and addressing discrimination and violence in this population.","PeriodicalId":122102,"journal":{"name":"Cadernos de Saúde Pública","volume":"3 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138589960","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Adaptação transcultural e evidências de validade psicométricas da Family Health Scale para o português brasileiro 巴西葡萄牙语家庭健康量表的跨文化适应性和心理测量有效性证据

Cadernos de Saúde Pública Pub Date : 2023-12-08 DOI: 10.1590/0102-311XPT048823

Evanizia Pinheiro de Oliveira, José Cláudio Garcia Lira Neto, I. Barreto, Ana Clara Pereira Resende da Costa, Roberto Wagner Freire de Freitas Júnior, Danilo Ferreira de Sousa, Márcio Flávio Moura de Araújo

{"title":"Adaptação transcultural e evidências de validade psicométricas da Family Health Scale para o português brasileiro","authors":"Evanizia Pinheiro de Oliveira, José Cláudio Garcia Lira Neto, I. Barreto, Ana Clara Pereira Resende da Costa, Roberto Wagner Freire de Freitas Júnior, Danilo Ferreira de Sousa, Márcio Flávio Moura de Araújo","doi":"10.1590/0102-311XPT048823","DOIUrl":"https://doi.org/10.1590/0102-311XPT048823","url":null,"abstract":"Resumo: Os objetivos deste estudo foram realizar a tradução e adaptação transcultural da Family Health Scale (Escala de Saúde Familiar) para a língua portuguesa brasileira e analisar evidências de validade psicométricas dessa escala. Os 32 itens sobre a saúde familiar foram adaptados transculturalmente. Para a mensuração das evidências de validade do conteúdo, utilizou-se o cálculo do índice de validade de conteúdo das características semântica, idiomática, cultural e conceitual de cada item e da escala. Um pré-teste para identificação de evidência de validade foi realizado com 40 famílias. Em outro momento, a aplicação do instrumento foi executada com 354 famílias, em uma cidade no Nordeste do Brasil. O índice de concordância entre os juízes variou de 0,84, para os itens da escala, a 0,98, para a escala total, conforme o coeficiente de Kendall. As evidências de validade psicométricas mostram-se adequadas, conforme alfa de Cronbach. A maior parte das famílias teve um grau de saúde moderado, conforme aplicação da escala. Assim, a Family Health Scale, versão brasileira, apresentou equivalência conceitual, semântica, cultural e operacional em relação aos itens originais e propriedades psicométricas satisfatórias para a aplicação direcionada à população brasileira, atestando eficácia e segurança de sua utilização.","PeriodicalId":122102,"journal":{"name":"Cadernos de Saúde Pública","volume":"59 9","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138587645","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Human rights, vulnerability, and critical reflection on HIV/AIDS prevention in the syndemic context 人权、脆弱性和在综合症背景下对艾滋病毒/艾滋病预防工作的批判性思考

Cadernos de Saúde Pública Pub Date : 2023-12-08 DOI: 10.1590/0102-311XEN186423

Vera Silvia Facciolla Paiva, José Ricardo Ayres

引用次数: 2

Unsupervised natural language processing in the identification of patients with suspected COVID-19 infection 识别疑似 COVID-19 感染者的无监督自然语言处理技术

Cadernos de Saúde Pública Pub Date : 2023-12-04 DOI: 10.1590/0102-311XEN243722

Rildo Pinto da Silva, Juliana Tarossi Pollettini, Antonio Pazin Filho

{"title":"Unsupervised natural language processing in the identification of patients with suspected COVID-19 infection","authors":"Rildo Pinto da Silva, Juliana Tarossi Pollettini, Antonio Pazin Filho","doi":"10.1590/0102-311XEN243722","DOIUrl":"https://doi.org/10.1590/0102-311XEN243722","url":null,"abstract":"Patients with post-COVID-19 syndrome benefit from health promotion programs. Their rapid identification is important for the cost-effective use of these programs. Traditional identification techniques perform poorly especially in pandemics. A descriptive observational study was carried out using 105,008 prior authorizations paid by a private health care provider with the application of an unsupervised natural language processing method by topic modeling to identify patients suspected of being infected by COVID-19. A total of 6 models were generated: 3 using the BERTopic algorithm and 3 Word2Vec models. The BERTopic model automatically creates disease groups. In the Word2Vec model, manual analysis of the first 100 cases of each topic was necessary to define the topics related to COVID-19. The BERTopic model with more than 1,000 authorizations per topic without word treatment selected more severe patients - average cost per prior authorizations paid of BRL 10,206 and total expenditure of BRL 20.3 million (5.4%) in 1,987 prior authorizations (1.9%). It had 70% accuracy compared to human analysis and 20% of cases with potential interest, all subject to analysis for inclusion in a health promotion program. It had an important loss of cases when compared to the traditional research model with structured language and identified other groups of diseases - orthopedic, mental and cancer. The BERTopic model served as an exploratory method to be used in case labeling and subsequent application in supervised models. The automatic identification of other diseases raises ethical questions about the treatment of health information by machine learning.","PeriodicalId":122102,"journal":{"name":"Cadernos de Saúde Pública","volume":"25 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138603617","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

A questão das urgências: uma porta para os direitos humanos em saúde 紧急情况问题：通向卫生领域人权的大门

Cadernos de Saúde Pública Pub Date : 2023-12-04 DOI: 10.1590/0102-311xpt168123

José Ricardo de C. M. Ayres

引用次数: 0

Para uma sociologia do câncer 迈向癌症社会学

Cadernos de Saúde Pública Pub Date : 2023-12-04 DOI: 10.1590/0102-311xpt161023

Ana Beatriz Caetano Vieira, Gracielle Soares Silva Ruas, Nelson Filice de Barros

引用次数: 0