RESUMO
Understanding the factors associated with pre-exposure prophylaxis (PrEP) adherence may help in the development of strategies to support, motivate and sustain PrEP use. This study estimated self-reported adherence, described perceived barriers and facilitators and investigated factors associated with adherence to daily oral PrEP among men who have sex with man (MSM) and transgender women after 1 year of PrEP use in Brazil. PrEP Brasil was a prospective, multicentre, open-label demonstration study with MSM and transgender women at high risk for HIV infection. We used logistic regression to evaluate factors associated with complete adherence (not forgetting to take any pills in the past 30 days) at week 48. Of 338 participants included in this analysis, 60% reported complete adherence to daily oral PrEP at week 48. Perceived barriers and facilitators to daily oral PrEP were reported by 38.2% and 98.5%, respectively. The most reported barrier and facilitator were 'I forgot to take my pills' (19.2%) and 'Associate PrEP with a daily activity/task' (58.6%), respectively. In final multivariable analysis, living in Rio de Janeiro (aOR: 0.38; 95% CI: 0.20-0.73), being transgender women (aOR: 0.22; 95% CI: 0.07-0.73), reporting stimulant use (a OR: 0.40; 95% CI: 0.20-0.80) and having any perceived barriers to daily oral PrEP (aOR: 0.12; 95% CI: 0.07-0.23) were associated with decreased odds of complete adherence. Our findings provide information for developing the best practices to promote PrEP adherence in the Brazilian context.
Assuntos
Fármacos Anti-HIV , Infecções por HIV , Profilaxia Pré-Exposição , Minorias Sexuais e de Gênero , Pessoas Transgênero , Fármacos Anti-HIV/uso terapêutico , Brasil , Feminino , Infecções por HIV/tratamento farmacológico , Infecções por HIV/prevenção & controle , Homossexualidade Masculina , Humanos , Masculino , Adesão à Medicação , Estudos Prospectivos , AutorrelatoRESUMO
This study aimed to evaluate the effect of rosuvastatin upon structural and ultrastructural aortic remodeling in a rat model of hypertension induced by NO synthase blockade. Wistar rats were divided into 4 groups: Control group (C); control treated with rosuvastatin 20mg/kg/day (CR); L-NAME group 40 mg/kg/day (LN) and L-NAME treated with rosuvastatin (LNR) (same doses). Body mass and blood pressure were measured weekly; the experiment lasted 5 weeks. L-NAME administration augmented blood pressure (BP) in the LN group in comparison to the C group (123.3 vs. 180.5 mm Hg at week 5). In LNR rats, rosuvastatin slightly attenuated BP rise, but it had no effect on the BP of CR group. Intima and media thickening of the thoracic aorta were observed in the LN group, and increased elastic fiber content as well. Rosuvastatin prevented all these alterations as seen in the LNR group. Ultrastructural changes due to L-NAME intake (intracellular vesicles and altered membrane morphology in endothelial cells, extracellular matrix deposition, and cytoplasmatic projections from smooth muscle cells toward the internal elastic lamina) were also prevented by rosuvastatin. All in all, rosuvastatin administration is capable of attenuating ultrastructural aortic wall remodeling in NO-deficient rats despite small changes in blood pressure.
Assuntos
Aorta Torácica/efeitos dos fármacos , Fluorbenzenos/farmacologia , Inibidores de Hidroximetilglutaril-CoA Redutases/farmacologia , Hipertensão/patologia , Óxido Nítrico/deficiência , Pirimidinas/farmacologia , Sulfonamidas/farmacologia , Animais , Aorta Torácica/metabolismo , Aorta Torácica/ultraestrutura , Pressão Sanguínea/efeitos dos fármacos , Modelos Animais de Doenças , Células Endoteliais/efeitos dos fármacos , Células Endoteliais/metabolismo , Células Endoteliais/ultraestrutura , Fluorbenzenos/uso terapêutico , Inibidores de Hidroximetilglutaril-CoA Redutases/uso terapêutico , Hipertensão/tratamento farmacológico , Hipertensão/metabolismo , Imuno-Histoquímica , Lipídeos/sangue , Microscopia Eletrônica de Transmissão , NG-Nitroarginina Metil Éster/farmacologia , Óxido Nítrico Sintase Tipo III/antagonistas & inibidores , Pirimidinas/uso terapêutico , Ratos , Ratos Wistar , Rosuvastatina Cálcica , Sulfonamidas/uso terapêutico , Túnica Íntima/efeitos dos fármacos , Túnica Íntima/metabolismo , Túnica Íntima/ultraestruturaRESUMO
Con el objetivo de aportar datos anatómicos, que posibiliten el acceso a la región pre-auricular, con menor riesgo de lesión del nervio auriculotemporal en procedimientos quirúrgicos, fue realizada esta investigación, sobre las relaciones topográficas y biométricas de este nervio con la arteria y vena temporales superficiales y el trago. Fueron disecadas 24 hemicaras de cadáveres fijados con formaldehído al 10 por ciento, disponibles en el Laboratorio de Anatomía del Departamento de Morfología Humana de la Universidad Federal de Alagoas, Brasil. En siete casos (29,2 por ciento) el nervio subía posteriormente a los vasos temporales superficiales, y en otros siete (29,2 por ciento), subía junto a la vena. En tres casos (12,5 por ciento) el nervio emergía junto con la arteria. En dos casos (8,3 por ciento), el nervio estaba en posición intermedia. En cinco casos (20,8 por ciento), el nervio subía junto con ambos vasos. La menor distancia del nervio auriculotemporal a la línea pre-auricular fue de 0,3 mm, y la mayor fue de 11,5 mm, con media de 1,89 mm. La menor distancia del nervio con la arteria temporal superficial fue de 0,1 mm, y la mayor fue de 14,6 mm, con media de 8,66 mm, situándose la arteria anterior. Cuando la vena era anterior al nervio, la menor distancia entre sí, fue de 0,2 mm y la mayor, 10,9 mm, con media de 2,91 mm. Cuando la vena estaba en posición posterior, la distancia mínima fue de 0,1 mm, y la máxima de 9,4 mm, siendo la media de 2,54 mm. Concluimos que el nervio auriculotemporal presenta posición variable en la región pre-auricular y es la estructura más próxima a la línea pre-auricular.