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  1. Article ; Online: Reality or utopia: eradication of the AIDS epidemic in Guinea-Bissau by 2030.

    Sanca, Amiry Monteiro / Silva, Daila Alena Raenck da / Rocha, Cristianne Maria Famer / Riquinho, Deise Lisboa

    Revista brasileira de enfermagem

    2020  Volume 73Suppl 5, Issue Suppl 5, Page(s) e20190137

    Abstract: 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 ... ...

    Abstract 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.
    MeSH term(s) Acquired Immunodeficiency Syndrome/epidemiology ; Acquired Immunodeficiency Syndrome/prevention & control ; Epidemics/prevention & control ; Guinea-Bissau/epidemiology ; HIV Infections/epidemiology ; HIV Infections/prevention & control ; Humans ; Utopias
    Language Portuguese
    Publishing date 2020-09-30
    Publishing country Brazil
    Document type Journal Article
    ZDB-ID 731983-6
    ISSN 1984-0446 ; 0034-7167
    ISSN (online) 1984-0446
    ISSN 0034-7167
    DOI 10.1590/0034-7167-2019-0137-2019-0137
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  2. Article ; Online: Preferences for pre-exposure prophylaxis (PrEP) among sexual and gender minorities: a discrete choice experiment in Brazil.

    Pereira, Claudia Cristina de Aguiar / Torres, Thiago Silva / Luz, Paula Mendes / Hoagland, Brenda / Farias, Alessandro / Brito, José David Urbaez / Lacerda, Marcus Vinícius Guimarães / Silva, Daila Alena Raenck / Benedetti, Marcos / Pimenta, Maria Cristina / Grinsztejn, Beatriz / Veloso, Valdilea Gonçalves

    Lancet regional health. Americas

    2023  Volume 19, Page(s) 100432

    Abstract: Background: Men who have sex with men (MSM) and transgender women (TGW) are disproportionally affected by HIV infection in Latin America. This study aims to assess pre-exposure prophylaxis (PrEP) preferences among sexual and gender minorities (SGM) and ... ...

    Abstract Background: Men who have sex with men (MSM) and transgender women (TGW) are disproportionally affected by HIV infection in Latin America. This study aims to assess pre-exposure prophylaxis (PrEP) preferences among sexual and gender minorities (SGM) and identify attributes and levels that are related to PrEP uptake and adherence, both crucial for PrEP success.
    Methods: We conducted a discrete choice experiment (DCE) among SGM from all Brazilian regions (September-December/2020). The survey was administered face-to-face (five Brazilian capitals) and online (entire country). We used a D-efficient zero-prior blocked experimental design to select 60 paired-profile DCE choice tasks.
    Findings: The total sample size was 3924 (90.5% MSM; 7.2% TGW and 2.3% non-binary or gender diverse persons). In random-effects logit models, highest levels of protection and "no side effects" were the most important attribute levels. For "presentation", injectable and implant were preferred over oral. Participants were willing to accept a 4.1% protection reduction to receive injectable PrEP or a 4.2% reduction if PrEP were taken monthly. The largest class in the latent class models was defined predominantly by the preference for the highest HIV protection level (p < 0.005). Respondents in this class also preferred no side effects, injectable and implant presentations.
    Interpretation: Higher HIV protection, no side effects, and presentation, whether injectable or implant, were the most important attributes in PrEP preferences. Protection against HIV was the most important attribute. PrEP programs should make available technologies such as long-acting presentations that could reunite the most desired attributes, thus maximizing acceptability and user-appropriateness.
    Funding: Unitaid.
    Language English
    Publishing date 2023-02-06
    Publishing country England
    Document type Journal Article
    ISSN 2667-193X
    ISSN (online) 2667-193X
    DOI 10.1016/j.lana.2023.100432
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  3. Article ; Online: Preferences for pre-exposure prophylaxis (PrEP) among men who have sex with men and transgender women at risk of HIV infection: a multicentre protocol for a discrete choice experiment in Brazil.

    Pereira, Claudia Cristina de Aguiar / Torres, Thiago Silva / Luz, Paula Mendes / Hoagland, Brenda / Farias, Alessandro / Brito, Jose David Urbaez / Guimarães Lacerda, Marcus Vinícius / da Silva, Daila Alena Raenck / Benedetti, Marcos / Pimenta, Maria Cristina / Grinsztejn, Beatriz / Veloso, Valdilea Gonçalves

    BMJ open

    2021  Volume 11, Issue 9, Page(s) e049011

    Abstract: Introduction: Pre-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. ... ...

    Abstract Introduction: Pre-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 analysis: We 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 dissemination: The 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.
    MeSH term(s) Brazil ; Female ; HIV Infections/drug therapy ; HIV Infections/prevention & control ; Homosexuality, Male ; Humans ; Male ; Multicenter Studies as Topic ; Pre-Exposure Prophylaxis ; Randomized Controlled Trials as Topic ; Transgender Persons
    Language English
    Publishing date 2021-09-27
    Publishing country England
    Document type Clinical Trial Protocol ; Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 2599832-8
    ISSN 2044-6055 ; 2044-6055
    ISSN (online) 2044-6055
    ISSN 2044-6055
    DOI 10.1136/bmjopen-2021-049011
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  4. Article ; Online: Factors associated with loss to follow up among HIV-exposed children: a historical cohort study from 2000 to 2017, in Porto Alegre, Brazil.

    da Silva Calvo, Karen / Knauth, Daniela Riva / Hentges, Bruna / Leal, Andrea Fachel / da Silva, Mariana Alberto / Silva, Danielle Lodi / Vasques, Samantha Correa / Hamester, Letícia / da Silva, Daila Alena Raenck / Dorneles, Fernanda Vaz / Fraga, Fernando Santana / Bobek, Paulo Ricardo / Teixeira, Luciana Barcellos

    BMC public health

    2022  Volume 22, Issue 1, Page(s) 1422

    Abstract: 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, ... ...

    Abstract 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.
    MeSH term(s) Brazil/epidemiology ; Child ; Cohort Studies ; Female ; Follow-Up Studies ; HIV Infections/diagnosis ; HIV Infections/drug therapy ; HIV Infections/epidemiology ; Humans ; Infectious Disease Transmission, Vertical/prevention & control ; Pregnancy ; Pregnancy Complications, Infectious/drug therapy
    Language English
    Publishing date 2022-07-26
    Publishing country England
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 2041338-5
    ISSN 1471-2458 ; 1471-2458
    ISSN (online) 1471-2458
    ISSN 1471-2458
    DOI 10.1186/s12889-022-13791-9
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  5. Article ; Online: Factors associated with directly observed treatment in tuberculosis/HIV coinfection cases in Porto Alegre, 2009-2013: A retrospective cohort.

    Brand, Évelin Maria / Rossetto, Maíra / Calvo, Karen da Silva / Winkler, Gerson Barreto / da Silva, Daila Alena Raenck / Hentges, Bruna / Machado, Frederico Viana / Duarte, Erica Rosalba Mallmann / da Silva, Lucas Cardoso / Vasques, Samantha Correa / Teixeira, Luciana Barcellos

    PloS one

    2019  Volume 14, Issue 10, Page(s) e0222786

    Abstract: Background: TB/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 ... ...

    Abstract Background: TB/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.
    Methods: A 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.
    Results: 2,400 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%.
    Conclusions: There 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.
    MeSH term(s) Adult ; Brazil/epidemiology ; Female ; Follow-Up Studies ; HIV Infections/drug therapy ; HIV Infections/epidemiology ; Humans ; Male ; Retrospective Studies ; Risk Factors ; Tuberculosis/drug therapy ; Tuberculosis/epidemiology
    Language English
    Publishing date 2019-10-02
    Publishing country United States
    Document type Journal Article
    ISSN 1932-6203
    ISSN (online) 1932-6203
    DOI 10.1371/journal.pone.0222786
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  6. Article ; Online: Squamous intraepithelial lesions in HIV-infected women: prevalence, incidence, progression and regression.

    Kreitchmann, Regis / Bajotto, Halim / da Silva, Daila Alena Raenck / Fuchs, Sandra Costa

    Archives of gynecology and obstetrics

    2013  Volume 288, Issue 5, Page(s) 1107–1113

    Abstract: Purpose: To evaluate the impact of HIV immune depletion, highly active antiretroviral therapy (HAART) and patient characteristics on the occurrence of cervical squamous intraepithelial lesions (SIL).: Methods: A total of 898 HIV-positive women were ... ...

    Abstract Purpose: To evaluate the impact of HIV immune depletion, highly active antiretroviral therapy (HAART) and patient characteristics on the occurrence of cervical squamous intraepithelial lesions (SIL).
    Methods: A total of 898 HIV-positive women were evaluated at the time of their first Pap smear and 388 of them received additional Pap smears during follow-up in a cohort study. The patients were enrolled from July 1997 to April 2007. Prevalence and incidence of SIL in Pap smears were studied. Progression and regression were evaluated in follow-up of patients presenting low-grade SIL.
    Results: Pap smear results at baseline were: 741 normal (82.5 %), 56 atypical squamous cells of indeterminate significance (ASCUS) (6.2 %), 78 low-grade SIL (8.7 %), 22 high-grade SIL (2.4 %), and 1 invasive cervical cancer (0.1 %). SIL cumulative incidence rate was 9.7 %. Progression and regression occurred in 15.9 and 62 %, respectively. Multivariate analysis of CD4 counts ≤ 200 cells/mm(3) (aHR = 2.1; 95 % CI 1.3-3.5; P = 0.004) and age less than 30 years (aHR = 3.2; 95 % CI 1.5-6.8; P = 0.01) or less than 40 years old (aHR = 2.6; 95 % CI 1.2-5.7; P = 0.01) were significantly associated with SIL prevalence. CD4 counts ≤ 200 cells/mm(3) (aHR = 3.0; 95 % CI 1.2-7.2; P = 0.01) and higher viral load counts (for each log increase) were associated with SIL incidence (aHR = 1.4; 95 % CI 1-1.9; P = 0.048).
    Conclusions: 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.
    MeSH term(s) Adult ; Age Factors ; Antiretroviral Therapy, Highly Active ; Brazil/epidemiology ; CD4 Lymphocyte Count ; Cervical Intraepithelial Neoplasia/epidemiology ; Cervical Intraepithelial Neoplasia/pathology ; Disease Progression ; Female ; HIV Infections/drug therapy ; HIV Infections/immunology ; Humans ; Incidence ; Neoplasm Grading ; Neoplasm Regression, Spontaneous ; Neoplasms, Squamous Cell/epidemiology ; Neoplasms, Squamous Cell/pathology ; Papanicolaou Test ; Prevalence ; Uterine Cervical Neoplasms/epidemiology ; Uterine Cervical Neoplasms/pathology ; Vaginal Smears ; Viral Load ; Young Adult
    Language English
    Publishing date 2013-11
    Publishing country Germany
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 896455-5
    ISSN 1432-0711 ; 0932-0067
    ISSN (online) 1432-0711
    ISSN 0932-0067
    DOI 10.1007/s00404-013-2871-3
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