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Introduction: In Colombia, HIV and gestational syphilis are notifiable events; however, they are poorly investigated infections in men who have sex with men (MSM). Objective: To determine the prevalence of HIV, Treponema pallidum, and their co-infection in MSM treated at a Health Services Provider Institution (HSPI) specialized in infectious diseases from Medellín. Methods: Cross-sectional study with 3454 MSM. Prevalence was determined with its 95% confidence interval; associated factors were identified using Fisher's Exact test, Pearson's Chi-square, and trend Chi-square. Multivariate adjustment was performed using logistic regression. Analyses were performed using SPSS 29.0. Results: The prevalence of HIV was 5.7%, T. pallidum 0.7%, and co-infection 0.6%. The prevalence of HIV was higher in MSM aged between 24-40 years (7.5%), with technical or university studies (10.0%), without health insurance affiliation (12.4%), and those who have had a sexual partner with HIV (36.2%). T. pallidum was higher in MSM without health insurance affiliation (3.4%), who had sexual relations with people diagnosed with an STI (5.9%), and a sexual partner with HIV (12.1%). Co-infection was higher in MSM without health insurance affiliation (2.7%), and those who had a partner with HIV (11.2%). Conclusion: Compared with the general Colombian population, MSM have a higher risk of HIV, but are similar to T. pallidum. The identification of the main associated factors in each infection demonstrates the need to prioritize subgroups of MSM that show greater vulnerability to these events. This research demonstrates the urgency of implementing health education strategies in MSM who have a sexual partner with HIV or other STIs. Large gaps were also evident in the magnitude of the three events according to the health insurance affiliation regime, which demonstrates problems of social and health injustice, especially with MSM without health insurance affiliation.

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Introducción: La bacteria Chlamydia trachomatis provoca una de las infecciones de transmisión sexual más frecuente. La Organización Mundial de la Salud reporta aproximadamente 131 millones de casos anuales. Objetivo: Evaluar el desempeño de la prueba rápida CROMATEST (Linear Chemicals. S.L. Barcelona España) en muestras clínicas. Métodos: Se estudiaron 72 muestras: 38 exudados vaginales de adolescentes de los hospitales pediátricos Juan Manuel Márquez y el Cerro; y 34 muestras de orina de voluntarios del Instituto de Medicina Tropical "Pedro Kourí. Se empleó el ensayo CROMATEST y como prueba de referencia la reacción en cadena de la polimerasa en tiempo real comercial. Se calculó sensibilidad, especificidad, valor predictivo positivo y negativo. Resultados: Seis muestras resultaron positivas por el test rápido, cinco por la reacción en cadena de la polimerasa en tiempo real y una por la prueba de referencia. De las 66 muestras negativas, una fue negativa para la reacción en cadena de la polimerasa en tiempo real y positiva en el CROMATEST. El porcentaje de concordancia entre ambas pruebas fue del 95 % y el valor de Kappa 0,8182. Se obtuvo una sensibilidad de 83,33 %, una especificidad del 98,48 % y valores predictivos positivo y negativo de 83,33 % y 98,48 %, respectivamente. Conclusiones: La prueba rápida CROMATEST tuvo un desempeño excelente contra la prueba de referencia; por tanto, se recomienda su utilización para la detección de Chlamydia trachomatis.

Introduction: The bacterium Chlamydia trachomatis causes one of the most common sexually transmitted infections. The World Health Organization reports approximately 131 million cases annually. Objective: To evaluate the performance of the CROMATEST rapid test (Linear Chemicals. S.L. Barcelona Spain) in clinical specimens. Methods: 72 samples were studied: 38 vaginal exudates from adolescents from the Juan Manuel Márquez and El Cerro pediatric hospitals; and 34 urine samples from volunteers from the "Pedro Kourí" Tropical Medicine Institute. The CROMATEST assay was used and the commercial real-time polymerase chain reaction was used as a reference test. Sensitivity, specificity, positive and negative predictive value were calculated. Results: Six samples were positive by the rapid test, five by the real-time polymerase chain reaction and one by the reference test. The negative samples were 66, of which one was negative for the real-time polymerase chain reaction and positive in the CROMATEST. The concordance between both tests was 95 % and the Kappa value 0.8182. A sensitivity of 83.33 %, a specificity of 98.48 % and positive and negative predictive values of 83.33 % and 98.48 %, respectively, were obtained. Conclusions: The CROMATEST rapid test performed excellently against the reference test; therefore, its use is recommended for the detection of Chlamydia trachomatis.

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Resumo Este estudo tem como objetivo analisar criticamente os mecanismos que desidratam o Fundo Nacional de Desenvolvimento Científico e Tecnológico (FNDCT), debilitando-o na sua função de promover o desenvolvimento econômico e social. Os dados foram extraídos das bases do sistema integrado de orçamento e planejamento (SIOP) e do relatório de execução orçamentária, entre 2012 e 2021, disponibilizados pela financiadora de estudos e projetos (FINEP). Os resultados da investigação apontam que, do ponto de vista quantitativo, há um processo de desidratação, por mecanismos como a desvinculação de receitas da união (DRU), a formulação do projeto de lei orçamentária anual (PLOA) e as reservas de contingência. Do lado qualitativo, há descompasso entre a promessa de uma política arrojada e inovadora e uma estrutura de governança centralizada e burocrática. Os fundos setoriais não enfrentam problemas de arrecadação, mas a gestão centralizada e subserviente a políticas fiscais de austeridade leva a uma execução orçamentária quantitativamente insuficiente e qualitativamente pobre em diversificação, quadro que descaracteriza a política de financiamento de ciência, tecnologia e inovação (CT&I), deixando de cumprir a promessa de desenvolvimento via inovação.

Resumen Este estudio tiene como objetivo analizar críticamente los mecanismos que deshidratan el fondo nacional de desarrollo científico y tecnológico (FNDCT), debilitándolo en su función de promover el desarrollo económico y social. Los datos fueron extraídos de las bases del sistema integrado de planificación y presupuesto y del informe de ejecución presupuestaria entre 2012 y 2021, puestos a disposición por la financiadora de estudios y proyectos. Los resultados de la investigación indican que, desde el punto de vista cuantitativo, existe un proceso de deshidratación, a través de mecanismos como la Desvinculación de Ingresos de la Unión Federal, la formulación del proyecto de ley presupuestaria anual y las reservas de contingencia. En el aspecto cualitativo, existe un desajuste entre la promesa de una política audaz e innovadora y una estructura de gobierno centralizada y burocrática. Los fondos sectoriales no enfrentan, en promedio, problemas de recaudación, pero la gestión centralizada supeditada a políticas fiscales de austeridad conduce a una ejecución presupuestaria cuantitativamente insuficiente y cualitativamente pobre en términos de diversificación, situación que descaracteriza la política de financiamiento para la ciencia, tecnología e innovación (CT&I), incumpliendo con la promesa de desarrollo a través de la innovación.

Abstract This study aims to critically analyze the mechanisms that depletethe Brazilian fund for the development of science and technology (FNDCT), jeopardizing its ability to promote economic and social development. Data were extracted from the integrated budget and planning system (SIOP) bases and the budget execution report between 2012 and 2021, made available by the Brazilian funding agency FINEP. The quantitative results indicate a process of "dehydration" due to changes such as the regulation that allows the executive to redirect resources previously earmarked for the fund (called DRU), the formulation of the legislation on the annual budget (PLOA) and the contingency reserves. The qualitative analysis shows a mismatch between the promise of a bold and innovative science and technology policy and a centralized and bureaucratic governance structure. Sectoral funds do not face, on average, problems in raising resources. However, the centralized management subservient to fiscal austerity policies leads to quantitative insufficient budget execution and qualitatively poor diversification. As outcomes, this situation mischaracterizes the ST&I funding policy, failing to comply with the promise of development through innovation.

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Human papillomavirus (HPV) is the most prevalent sexually transmitted infection (STI) worldwide, with popular screening methods including the Papanicolaou test and HPV genotyping. However, in clinical practice, coinfections with other pathogens are often underestimated. Therefore, our study aims to describe the prevalence of STIs and vaginosis in urogenital samples from patients who had been tested exclusively for HPV genotyping. METHODS: This analytical, prospective, cross-sectional study included 408 males and females. Eligible participants had positive and negative HPV genotyping test results and agreed to early detection or had HPV antecedents. They provided the same urogenital samples used for HPV detection and, through our multiplex in-house PCR assay, we screened for Candida spp., Ureaplasma spp., Trichomonas vaginalis, Neisseria gonorrhoeae, Chlamydia trachomatis, herpes simplex virus 1 and 2 (HSV), Mycoplasma spp., molluscum contagiosum virus (MCV), Treponema pallidum, Haemophilus spp., Staphylococcus aureus, and Klebsiella spp. The subsequent statistical analysis aimed to reveal correlations between HPV genotypes and the identified pathogens. RESULTS: Of the participants, 72.1% (n = 294) tested positive for HPV genotypes. HR-HPV (high-risk HPV) genotypes comprised 51 (8.1%), 66 (7.1%), and 58 (6.1%). Haemophilus spp., Ureaplasma spp., Candida spp., Staphylococcus aureus, and Mycoplasma spp. frequently co-occurred with HPV infection (p < 0.05). Gender-based variations were notorious for Ureaplasma spp., Mycoplasma spp., and MCV (p < 0.05). Coinfections were prevalent (43.9%), with a positive HPV result elevating the risk for Trichomonas vaginalis, Mycoplasma spp., Staphylococcus aureus, HSV, and MCV (OR > 1, p < 0.05). HPV 16 correlated with HSV and Ureaplasma spp., while HPV 6 was linked with HSV and MCV (p < 0.05). CONCLUSIONS: This screening strategy uncovered significant coinfections and associations between HPV genotypes and pathogens, underscoring the importance of routine screening to explore clinical implications in urogenital health.

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Background: Unprecedented numbers of migrant people transiting through the Darién Gap at the Panama-Colombia border were recorded in 2021 and 2022. Data on sexual and reproductive health (SRH) needs and service provision among migrant people in transit is generally extremely sparse. This study aimed to collect personal accounts of sexual behaviours and SRH needs and access to services among migrant people in transit through Panama. Methods: We conducted a rapid-assessment qualitative study using semi-structured interviews during June-July 2022. Participants were migrant people in transit at three locations across Panama: (i) at the Migrant Reception Station (MRS) in Darién province at the Panama-Colombia border, (ii) in the city of David near the Costa Rica-Panama border, and (iii) at the Costa Rica-Panama border. Migrant peoples (>18 years) were invited to participate using purposive sampling. Results: Overall, 26 adult migrant people (16 men, 10 women) across the three sites participated in the study. We identified three overarching themes from the interviews: (1) increased need for SRH service provision, (2) experiences of sex, relationships, and transactional sex, and (3) vulnerability to exploitation and sexual violence. All accounts reported that no formal SRH care was present during the journey through the Gap and described as inconsistent at the MRS in Darién. Provision of gynaecological or genital examinations, laboratory testing for urinary tract or STI, and prenatal care were mentioned to be the most pressing needs. Participants reported a change in their sexual behaviour while travelling, whether a decline in sexual libido or preference towards short-term partners. Most female participants recounted constantly fearing sexual violence during the journey through the Gap and several respondents reported witnessing incidents of sexual and other forms of violence. Conclusion: There are significant unmet needs regarding SRH care during the journey of migrant people transiting through the Darién Gap, at the MRS in the Darién province, and across Panama. Provision of antenatal care, rapid testing for HIV/STI, condom distribution, and care for victims of sexual violence would significantly reduce adverse SRH outcomes and improve the well-being of migrant people, even when in transit.

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The aim of this study was to classify the diversity of anal HPV and non-HPV sexually transmitted infections (STIs) and compare the concordance between anal and genital infections in HIV-infected and uninfected women living in the Tapajós region, Amazon, Brazil. A cross-sectional study was performed with 112 HIV-uninfected and 41 HIV-infected nonindigenous women. Anal and cervical scrapings were collected and analyzed for HPV, Chlamydia trachomatis (CT), Neisseria gonorrheae (NG), Trichomonas vaginalis (TV), Mycoplasma genitalium (MG), and Human alphaherpesvirus 2 (HSV-2). The Kappa test evaluated the concordance between anal and genital infections. The overall prevalence of anal HPV infection was 31.3% in HIV-uninfected and 97.6% in HIV-infected women. The most frequent anal high-risk HPV (hrHPV) types were HPV18 and HPV16 in HIV-uninfected women and HPV51, HPV59, HPV31, and HPV58 in HIV-infected women. Anal HPV75 Betapapillomavirus was also identified. Anal non-HPV STIs were identified in 13.0% of all participants. The concordance analysis was fair for CT, MG, and HSV-2, almost perfect agreement for NG, moderate for HPV, and variable for the most frequent anal hrHPV types. Thus, a high prevalence of anal HPV infection with moderate and fair concordance between anal and genital HPV and non-HPV STIs was observed in our study.

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In the present research the typical triangle on formative research was extended to a double triangle for an overall career programme (here expander/ compressor) and funnel proposal was explored in a single course (as a "fractal" method). Array processing and ElectroEncephaloGram (EEG) techniques have been incorporated into a Digital Signal Processing (DSP) course and research projects. The present research question was: is it possible to insert array sensing on formative research in an undergraduate course of DSP? From over eight years, two semesters with different homework loads (homogeneous triangle vs expander-compressor-supplier distributions) were analysed in detail within the DSP evaluations and students chose between experimental applied analysis and a formative research project. Results showed that cognitive load was influenced positively in the expander-compressor-supplier distribution, showing that an increase of the efficiency undertook more undergraduate research on array processing and the decrease of the number of formative applied projects. Over a longer term (48 months) students undertook more undergraduate research works on array processing and DSP techniques. Supplementary Information: The online version contains supplementary material available at 10.1007/s10639-023-11837-y.

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Introduction: Anal examination and videoanoscopy (VA) are rarely performed during colonoscopies. In recent years, there has been a considerable increase in lesions of sexually transmitted anal and rectal infections, but these conditions are not noticed or reported during routine colonoscopy. Objective: To raise awareness regarding the fortuitous findings of lesions and sexually transmitted infections (STIs) in colonoscopy exams and to demonstrate that anal examination and VA provide important information and should be routinely performed. Methods: We conducted a descriptive retrospective study in 16,132 patients screened by colonoscopy and VA between 2006 and 2018. Among numerous other findings, the presence of anal condylomata and sexually transmitted retitis or perianal dermatitis was observed. The rates of each finding were calculated, and the patients were subdivided by sex and into age groups by blocks of ten years. Results: Among the 16,132 colonoscopies performed, 26 cases of condyloma (0.16%) and 50 cases of proctitis or perianal dermatitis suspicious for STI (0.33%) were found. Conclusion: Performing anal examination and VA systematically in all routine colonoscopies enabled the identification of numerous anal conditions, including several fortuitous cases of STIs. The study proposes that anal examination and VA should be performed in all routine colonoscopies and, in suspected cases, complementary tests for STIs. (AU)

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BACKGROUND: Unsafe sex is one of the main morbidity and mortality risk factors associated with sexually transmitted infections (STIs) in young people. Behavioral change interventions for promoting safe sex have lacked specificity and theoretical elements about behavior in their designs, which may have affected the outcomes for HIV/AIDS and STI prevention, as well as for safe sex promotion. This study offers an analysis of the barriers and facilitators that, according to the university students who participated in the focus groups, impede or promote the success of interventions promoting healthy sexuality from the perspective of the actions stakeholders should undertake. In turn, this study proposes intervention hypotheses based on the Behavior Change Wheel which appears as a useful strategy for the design of intervention campaigns. METHODS: Two focus groups were organized with students from Universidad de Santiago de Chile (USACH). The focus groups gathered information about the perceptions of students about sex education and health, risk behaviors in youth sexuality, and rating of HIV/AIDS and STI prevention campaigns. In the focus groups, participants were offered the possibility of presenting solutions for the main problems and limitations detected. After identifying the emerging categories related to each dimension, a COM-B analysis was performed, identifying both the barriers and facilitators of safe sex behaviors that may help orient future interventions. RESULTS: Two focus groups were organized, which comprised 20 participants with different sexual orientations. After transcription of the dialogues, a qualitative analysis was performed based on three axes: perception about sex education, risk behaviors, and evaluation of HIV/AIDS and STI prevention campaigns. These axes were classified into two groups: barriers or facilitators for safe and healthy sexuality. Finally, based on the Behavior Change Wheel and specifically on its 'intervention functions', the barriers and facilitators were integrated into a series of actions to be taken by those responsible for promotion campaigns at Universidad de Santiago. The most prevalent intervention functions are: education (to increase the understanding and self-regulation of the behavior); persuasion (to influence emotional aspects to promote changes) and training (to facilitate the acquisition of skills). These functions indicate that specific actions are necessary for these dimensions to increase the success of promotional campaigns for healthy and safe sexuality. CONCLUSIONS: The content analysis of the focus groups was based on the intervention functions of the Behavior Change Wheel. Specifically, the identification by students of barriers and facilitators for the design of strategies for promoting healthy sexuality is a useful tool, which when complemented with other analyses, may contribute improving the design and implementation of healthy sexuality campaigns among university students.

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BACKGROUND: Some species of Mollicutes have been associated with different pathologies of the urogenital tract in humans, with a high prevalence among adult men who have sex with men (MSM) and transgender women (TGW). However, few studies have been performed to investigate its prevalence among adolescents. In this study, we estimated the initial prevalence of Mycoplasma genitalium (MG), Mycoplasma hominis (MH), Ureaplasma urealyticum (UU), and Ureaplasma parvum (UP); the rate of misdiagnosis at different anatomical sites; and the associated factors with positive tests for Mollicutes among MSM and TGW aged 15 to 19 years enrolled in the PrEP1519 study. METHODS: PrEP-1519 is the first study to investigate the effectiveness of pre-exposure prophylaxis for human immunodeficiency virus among adolescent MSM and TGW aged 15 to 19 in Latin America. Oral, anal, and urethral swabs were taken from 246 adolescents upon enrolment in the study to detect MG, MH, UU, and UP by quantitative polymerase chain reaction (qPCR). Bivariate and multivariate analyses were conducted by Poisson regression and 95% confidence intervals (95% CI) were estimated. RESULTS: The prevalence of Mollicutes was 32.1%. UU was the most prevalent species (20.7%), followed by MH (13.4%), MG (5.7%), and UP (3.2%); 67.3% of the positive samples would have been missed if only urethral samples had been taken. Receptive anal sex (prevalence ratio [PR] = 1.79; 95% CI = 1.07-3.01) and clinical suspicion of sexually transmitted infection (PR = 1.62; 95% CI = 1.01-2.61) were factors associated with the detection of Mollicutes in general. Group sex (PR = 1.98; 95% CI = 1.12-3.50) and receptive anal sex (PR = 2.36; 95% CI = 0.95-5.86) were associated with the detection of Mycoplasma spp. No sociodemographic, clinical, or behavioural variable was significantly associated with the detection of Ureaplasma spp. CONCLUSIONS: A high prevalence of Mollicutes was observed among adolescent MSM and TGW, especially at extragenital sites. Further research is required to understand the epidemiological profile of high-risk adolescents in different regions and contexts, and to investigate the pathogenesis of Mollicutes in the oral and anal mucosa before routine screening can be recommended in clinical practice.

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Objective: To determine the prevalence and risk factors of sexually transmitted infections (STIs) including Chlamydia trachomatis, Ureaplasma urealyticum and Mycoplasma genitalium among asymptomatic women with human papillomavirus (HPV) infection. Methods: A cross-sectional study was performed in 842 asymptomatic women from Cajamarca, Peru. The pathogens were detected using polymerase chain reaction (PCR) and the results were analyzed according to the HPV status: high-risk HPV, low-risk HPV and negative for HPV. Demographical and gyneco-obstetric data was analyzed to identify risk factors. Results: We found that 23.99% (202/842) women were positive for HPV, of whom 79.21% (160/202) were infected with a high-risk genotype. Co-infections were evaluated and 14.38% (23/160) were positive for Ureaplasma urealyticum, 9.38% (15/160) for Chlamydia trachomatis and 1.25% (2/160) for Mycoplasma genitalium. We found a significant association between HPV genotype and the number of children, partners, and history of sexual abuse. The co-infection between high-risk HPV and Chlamydia trachomatis was associated with number of abortions, number of sexual partners and no use of condom. Finally, co-infection between high-risk HPV and Ureaplasma urealyticum was associated with no use of condom and history of STIs. Conclusion: HPV infection continues to be a highly relevant problem in Peru, particularly due to the high prevalence of high-risk genotypes. In addition, we report high rates of co-infections with other STIs, such as U. urealyticum and C. trachomatis. We highlight the importance of active surveillance to promptly diagnose these infections, since they may lead to persistent HPV infections.

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Background: By October 30, 2022, 76,871 cases of mpox were reported worldwide, with 20,614 cases in Latin America. This study reports characteristics of a case series of suspected and confirmed mpox cases at a referral infectious diseases center in Rio de Janeiro, Brazil. Methods: This was a single-center, prospective, observational cohort study that enrolled all patients with suspected mpox between June 12 and August 19, 2022. Mpox was confirmed by a PCR test. We compared characteristics of confirmed and non-confirmed cases, and among confirmed cases according to HIV status using distribution tests. Kernel estimation was used for exploratory spatial analysis. Findings: Of 342 individuals with suspected mpox, 208 (60.8%) were confirmed cases. Compared to non-confirmed cases, confirmed cases were more frequent among individuals aged 30-39 years, cisgender men (96.2% vs. 66.4%; p < 0.0001), reporting recent sexual intercourse (95.0% vs. 69.4%; p < 0.0001) and using PrEP (31.6% vs. 10.1%; p < 0.0001). HIV (53.2% vs. 20.2%; p < 0.0001), HCV (9.8% vs. 1.1%; p = 0.0046), syphilis (21.2% vs. 16.3%; p = 0.43) and other STIs (33.0% vs. 21.6%; p = 0.042) were more frequent among confirmed mpox cases. Confirmed cases presented more genital (77.3% vs. 39.8%; p < 0.0001) and anal lesions (33.1% vs. 11.5%; p < 0.0001), proctitis (37.1% vs. 13.3%; p < 0.0001) and systemic signs and symptoms (83.2% vs. 64.5%; p = 0.0003) than non-confirmed cases. Compared to confirmed mpox HIV-negative, HIV-positive individuals were older, had more HCV coinfection (15.2% vs. 3.7%; p = 0.011), anal lesions (45.7% vs. 20.5%; p < 0.001) and clinical features of proctitis (45.2% vs. 29.3%; p = 0.058). Interpretation: Mpox transmission in Rio de Janeiro, Brazil, rapidly evolved into a local epidemic, with sexual contact playing a crucial role in its dynamics and high rates of coinfections with other STI. Preventive measures must address stigma and social vulnerabilities. Funding: Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz (INI-Fiocruz).

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Research increasingly recognizes the importance of social and built environments in shaping health, including risks for and outcomes related to HIV and sexually transmitted infections (STI), but research on sex work venues is limited. We use latent class analysis to identify patterns of sex work venue characteristics and factors associated with class membership in two México-US border cities. Among 603 female sex workers (FSW), three classes of sex work venues were identified: low, medium, and high disorder venues, characterized by level of violence, policing and drug activity. In multivariable analysis, risk exposures and outcomes varied by class, suggesting the need for place-based interventions that are tailored to specific venue profiles and that promote FSW health and safety in the workplace.

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In Brazil, transgender people are most affected by HIV, and crack cocaine addiction may contribute to social vulnerability and exposure to sexual and violence-related risks. This cross-sectional study comprised 2393 individuals seeking addiction treatment, consisting of 43 trans women, 1995 cisgender men, and 355 cisgender women. Records of rapid test results for HIV and syphilis and screening responses of trans women were compared to both cisgender groups using a logistic regression model to identify associated risk factors. HIV prevalence was higher in the transgender group (39.5%) than in cis women and men (5.9% and 3.6%, respectively). Our study showed an eightfold higher chance of a positive HIV test among transgender individuals who used drugs (OR: 8.79, p < .01, 95% CI: 3.90-19.78) compared to cisgender people who used drugs. A lifetime history of syphilis infection was more common in transgender people (60.0%) and cis women (32.8%) than in cis men (9.5%). Active syphilis was also more common in the transgender population (OR: 5.46, p < .01, 95% CI: 2.63 11.32). In our sample, 44.2% of transgender individuals had a history of at least one suicide attempt in their lifetime. Our results showed that transgender women were at higher risk of crack cocaine use (OR: 5.51, p < .01, 95% CI: 2.16-14.06) than cisgender men and women. The study showed that trans women had a higher prevalence of syphilis and HIV, and a greater chance of being homeless. The synergy of these vulnerabilities may have led to our findings of high psychotic symptoms and a history of suicide attempts in transgender individuals.

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Os jovens e adolescentes são um grupo desproporcionalmente acometido pelo HIV. Ser adolescente gay, bissexual, travesti ou transgênero, é enfrentar desafios ainda maiores em termos de risco e vulnerabilidade ao HIV e outras infecções sexualmente transmissíveis, fato pelo qual estes grupos representam uma população-chave para a implementação de intervenções estruturais, comportamentais e biomédicas. A PrEP é uma estratégia que tem se mostrado segura e eficaz na prevenção da infecção pelo HIV, entre esta e outras populações-chave. Entretanto, ainda se sabe muito pouco sobre o real impacto de seu uso no cotidiano dos jovens e adolescentes. O presente estudo tem como objetivo avaliar os fatores sociodemográficos e de práticas sexuais basais relacionados com à prevalência de sífilis na entrada e os marcadores ou preditores de adesão à PrEP por autorrelato entre adolescentes Gays, Bissexuais e outros Homens que fazem Sexo com Homens (HSH), Mulheres Transgênero e Travestis (MTTr) de 15-19 anos com riso de infecção pelo HIV. O projeto PrEP1519 é um estudo de coorte demonstrativo multicêntrico brasileiro, aprovado pelo comitê de ética em pesquisa da OMS, pela CONEP e COEP das Universidades participantes (UFMG, UFBA e USP). A inclusão foi voluntária após processo de consentimento livre e esclarecido e assinatura dos Termos de Consentimento ou Assentimento (TCLE, TALE). Os participantes foram alocados em dois grupos: com ou sem uso de PrEP, conforme avaliação de vulnerabilidade e preferência. As análises foram realizadas com as diversas dimensões de vulnerabilidade de infecção ao HIV, e modelos de regressão logística foram construídos para estimar as razões de chance da associação entre as variáveis preditoras e os níveis de adesão nas visitas M1, M6 e M12, assim como sua associação com um teste treponêmico positivo para sífilis na entrada do estudo. Foram analisados 935 participantes. A idade mediana foi 19 anos (IIQ: 18-19), 69% (645) se auto identificaram como negros (pardos/pretos), 91,1% (852) como homens cisgênero e 8,8% (82) como mulheres trans ou travestis. Aproximadamente 26% (251) dos participantes apresentaram ao longo dos 12 meses de seguimento uma adesão insuficiente, inferior a 90% por autorrelato. Na análise multivariada final, uma maior chance de adesão insuficiente foi associada com estar desempregado (OR = 1,34; IC95%: 1,00-1,81), ter relações sexuais em troca de dinheiro ou favores (OR =1,75; IC95%: 1,10-2,79) e ter uma autopercepção de risco de infecção pelo HIV <5 (OR = 1,51; IC95%: 1,06-2,16). Por outro lado, a prevalência de sífilis na linha de base foi de 21,3%. No modelo final de regressão logística, as seguintes variáveis estiveram associadas com chances maiores de sífilis: autorrelato de episódio de IST nos últimos 12 meses (OR = 5,92; IC95%: 3,74-9,37), ser profissional do sexo (OR = 3,39; IC95%: 1,32-8,78) e ter menos de 11 anos de escolaridade (OR = 1,76; IC95%: 1,13-2,74). Nossos dados reiteram conhecidos fatores de vulnerabilidade e apontam a necessidade de fortalecer os programas de PrEP na saúde pública com adequada discussão sobre classe social, raça, gênero, sexualidade e prevenção combinada, assim como, ampliar e facilitar o acesso a todas as ferramentas de prevenção combinada, incluída a PrEP, para esta faixa etária.

Young people and adolescents are a group disproportionately affected by HIV. Being a gay, bisexual, travesti, or transgender teenager means facing even greater challenges in terms of risk and vulnerability to HIV and other sexually transmitted infections, a fact for which these groups represent a key population for the implementation of structural, behavioral, and biomedical interventions. PrEP is a strategy that has proven to be safe and effective in preventing HIV infection among this population and other key populations. However, very little is known about the real impact of its use on the daily life of young people and adolescents. The aim of present study was to evaluate sociodemographic factors and baseline sexual practices related to the prevalence of syphilis at entry and to predictors of adherence to PrEP by self-report among adolescents which self-identified as Gay, Bisexual, and other Men who have Sex with Men (MSM), Travesti and Transgender Women (TGW) aged 15-19 years at risk of HIV Infection. The PrEP 15­19 project is a Brazilian multicenter demonstrative study approved by the WHO Ethics Review Committee, and by the Brazilian Research Ethics Commission and by the local Research Ethics Committees of the participating universities (UFMG, UFBA and USP). Inclusion was voluntary after the informed consent form was singed. Participants were allocated into two groups: with or without PrEP use, according to vulnerability assessment and preference. The analyses were carried out with different dimensions of vulnerability to HIV infection, and logistic regression models were constructed to estimate the odds ratios of the association between the predictive variables and the levels of adherence at visits M1, M6, and M12, as well as its association with a positive treponemal test for syphilis at study entry. In total, 935 participants were analyzed. The median age was 19 years (IQR: 18­19); 69% (645) self-identified as black; 91.1% (852) as cisgender men; and 8.8% (82) as travesti or trans women. Approximately 26% (251) of the participants showed, over the 12 months of follow-up, insufficient adherence, or less than 90% by self-report. In the final multivariate analysis, a greater chance of poor adherence was associated with being unemployed (OR = 1.34; 95%CI: 1.00­1.8), having transactional sex (OR = 1.75; 95%CI: 1.10­2.79), and having a self-perceived risk of HIV infection <5 (OR = 1.51; 95%CI: 1.06-2.16). On the other hand, the baseline prevalence of syphilis was 21.3%. In the final logistic regression model, the following variables were associated with higher odds of syphilis: self-report of an STI episode in the last 12 months (OR = 5.92; 95%CI: 3.74­9.37), being a sex worker (OR = 3.39; 95%CI: 1.32­8.78), and less than 11 years of schooling (OR = 1.76; 95%CI: 1.13-2.74). This data reiterates known vulnerability factors and point to the need to strengthen PrEP programs in public health with adequate discussion on social class, race, gender, sexuality, and combination prevention, as well as expanding and facilitating access to all combination prevention tools, including PrEP, for this age group.

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Este estudo teve o objetivo de analisar as representações sociais de mulheres que fazem sexo com mulheres (MSM) sobre as infecções sexualmente transmissíveis (IST) e as práticas de prevenção, e tem como um dos objetivos específicos, discutir as relações estabelecidas entre as representações sociais de MSM sobre as IST e as práticas de prevenção. Trata-se de um estudo descritivo, qualitativo, com abordagem qualitativa, ancorado na abordagem estrutural da Teoria das Representações Sociais. Participaram 100 jovens mulheres homossexuais, moradoras do município do Rio de Janeiro, na faixa etária entre 18 e 29 anos. Foram aplicados dois instrumentos de coleta de dados, um questionário para caracterização sociodemográfica, das práticas sexuais e de prevenção de IST; e um formulário para captação das evocações livres, com os termos indutores DST e Prevenção de DST. Os dados sociodemográficos foram organizados no software Excel. A análise das evocações foi feita através do software EVOC com a construção do quadro de quatro casas. Para o termo indutor DST, os possíveis núcleos centrais foram os cognemas sexo, doenças, prevenção e sífilis. A palavra sexo teve a maior frequência e foi a mais prontamente evocada no núcleo central, demonstrando a relevância da palavra para o grupo investigado, no entanto, as palavras relacionadas a ela se concentraram na zona de contraste e segunda periferia. Na análise de similitude, esse elemento estabeleceu conexões com todos os elementos da árvore, e teve o maior número de ligações (cinco). O termo indutor Prevenção de DST teve somente o cognema preservativos no provável núcleo central e sete nas periferias, onde mencionaram cuidado, relacionamento-afetivo, tratamento, entre outros relacionados ao autocuidado, sugerindo um imaginário alinhado com a temática. Já na análise de similitude pode-se notar que o termo preservativos é central e apresenta sete ligações com os demais termos presentes no quadro, tendo maior índice as ligações com os termos cuidado, exames, relacionamento-afetivo e informação. Conclui-se que, apesar de as jovens demonstrarem conhecimento acerca da temática, informaram o desuso do preservativo nas relações sexuais com parcerias fixas e casuais, corroborando com outras investigações. Ademais, apesar de reconhecerem a maioria das IST, o termo HPV que é uma infecção recorrente nesse grupo, foi mais tardiamente evocado pelas participantes. Desse modo, é notória a importância da disseminação de informação acerca da prevenção das IST nesse grupo, como também para os profissionais de saúde, que, em geral, possuem um comportamento heteronormativo nos atendimentos às mulheres lésbicas, subestimando o potencial de contaminação que pode existir nas relações homossexuais entre mulheres.

This study aimed to analyze the social representations of women who have sex with women (WSW) about sexually transmitted infections (STIs) and prevention practices, and has as one of the specific objectives, to discuss the relationships established between the social representations of WSW about STIs and prevention practices. This is a descriptive, qualitative study with a qualitative approach, anchored in the structural approach of the Theory of Social Representations. 100 young people participated, all homossexual women, living in the city of Rio de Janeiro, aged between 18 and 29 years. Two data collection instruments were applied, a questionnaire for sociodemographic characterization, sexual practices and STI prevention; and a form to capture the free evocations, with the terms STD inducers and STD Prevention. The sociodemographic data were organized in Excel software. The analysis of the evocations was made through the EVOC software with the construction of the frame of four houses. For the term STD inducer, the possible central nuclei were the cognames sex, diseases, prevention and syphilis. The word sex had the highest frequency and was the most readily evoked in the nucleus central, demonstrating the relevance of the word for the investigated group, however, the words related to it focused on the contrast zone and second periphery. In similitude analysis, this element established connections with all the elements of the tree, and had the highest number of calls (five). The inducing term STD Prevention had only the cognama condoms in the probable central nucleus and seven in the peripheries, where they mentioned care, affective relationship, treatment, among others related to self-care, suggesting an imaginary aligned with the theme. As for the analysis of similarity, it can be noted that the term condoms is central and has seven links with the other terms presente in the table, with a higher index of links with the terms care, examinations, relationship-affective and information. It is concluded that, although the young women demonstrate knowledge. On the subject, they reported the disuse of condoms in sexual relations with partners fixed and casual, corroborating with other investigations. Moreover, although they recognize the most STIs, the term HPV which is a recurrent infection in this group, were more belatedly evoked by the participants. Thus, the importance of dissemination of information about the prevention of STIs in this group, as well as for the health professionals, who, in general, have a heteronormative behavior in the care for lesbian women, underestimating the potential for contamination that can exist in homosexual relations between women.

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Abstract This study aimed to analyze the sexually transmitted infections (STIs) prevention campaigns promoted by the Brazilian Ministry of Health between 2008 and 2020. Fifty-three campaigns from the digital archive were included in the directed content analysis. The analysis was conducted based on the concepts of Combination Prevention and the Theory of Planned Behavior (TPB). Condom use and STI testing were constantly promoted, to the detriment of alternative preventive behaviors. The TPB concepts in the campaigns suggest the compatibility of the materials with the theory. We conclude that the campaigns present the desirable aspects of prevention. However, recent campaigns focused on aversive materials, which goes against studies that report negative effects from these strategies and is associated with the rise of moralist perspectives on prevention.

Resumo Objetivou-se analisar as campanhas de prevenção a infecções sexualmente transmissíveis (ISTs) veiculadas pelo Ministério da Saúde entre 2008 e 2020. Cinquenta e três campanhas disponíveis no acervo digital foram incluídas na análise de conteúdo dirigida. A análise foi realizada com base nos conceitos da Prevenção Combinada e da Teoria do Comportamento Planejado (TCP). O uso de camisinha e a realização de testagem para ISTs foram constantemente promovidos, em detrimento de comportamentos preventivos alternativos. Os conceitos da TCP nas campanhas indicam compatibilidade dos materiais com pressupostos teóricos. Conclui-se que as campanhas abordam os aspectos desejáveis da prevenção. Contudo, as campanhas mais recentes investiram em materiais aversivos, estratégia contraindicada por outros estudos, porém associada ao crescimento da perspectiva moralista de prevenção.

RESUMO

Background: The foot transit of migrant peoples originating from the Caribbean, South America, Asia, and Sub-Saharan Africa through the Darién Forest (DF) in Eastern Panamá towards North America has increased in recent years from approximately 30,000 people/year to >133,000 in 2021. In the DF, there is no food/housing provision nor healthcare access. Very little is known of sexual and reproductive health (SRH) among this population. This study used rapid epidemiological methods to describe the SRH situation among migrant peoples in transit through the DF. Methods: This cross-sectional study randomly selected migrant people in transit (men and women) at a Migrant Reception Station in Darién, Panamá, between January 4-11, 2022. Data collection included a self-applied questionnaire (≥18 years); clinical screening (≥12 years); and HCG, treponemal antibodies, and HIV(I/II) lateral-flow tests with blood samples (≥12 years). Descriptive analyses were used to report findings. Results: In all, 69 men and 55 women participated in the self-applied questionnaire, 70 men and 51 women in clinical screening; 78 men and 63 women in HCG, treponemal antibody and HIV testing. Overall, 26.1% (18/69) men and 36.4% (20/55) women reported sexual intercourse within the past month. The last sex partner was casual among 43.0% (21/49) of men and 27.8% (10/36) of women; of those, 42.9% (9/21) of men and 80.0% (8/10) of women reported this sex was condomless. Among women, 20.0% (11/55) tested positive for pregnancy; 5 of these pregnancies were planned. Of those screened, a reproductive tract infection symptom was reported by 5.7% (4/70) of men and 58.8% (30/51) of women. A total of 32.7% (18/55) of men and 18.2% (8/44) of women reported no prior HIV testing. Of 78 men, HIV and treponemal antibodies were found among 1.3% (n = 1) and 2.6% (n = 2), and among 63 women, 3.2% (n = 2) and 3.2% (n = 2), respectively. Conclusions: This rapid epidemiological assessment found high recent sexual activity, low condom use with casual partners, and a need for increased HIV and syphilis testing and treatment. There is a need for increased testing, condom provision, and SRH healthcare access at migrant reception stations that receive migrant peoples in transit through Panamá.

RESUMO

With syphilis cases on the rise, Brazil declared an epidemic in 2016. To address the consequent public health crisis, the Ministry of Health laid out a rapid response plan, namely, the "Syphilis No!" Project (SNP), a national instrument to fight the disease which encompasses four dimensions: (a) management and governance, (b) surveillance, (c) comprehensive care, and (d) strengthening of educommunication. In the dimension of education, the SNP developed the learning pathway "Syphilis and other Sexually Transmitted Infections (STIs)" to strengthen and promote Health Education. This pathway features 54 Massive Open Online Courses (MOOCs), delivered through the Virtual Learning Environment of the Brazilian Health System (AVASUS). This paper analyzes the impacts of the learning pathway "Syphilis and other STIs" on the response to the epidemic in Brazil, highlighting the educational process of the learning pathway and its social implications from the perspective of the United Nations' 2030 Agenda and its Sustainable Development Goals. Three distinct databases were used to organize the educational data: the learning pathway "Syphilis and other STIs" from AVASUS, the National Registry of HealthCare Facilities from the Brazilian Ministry of Health (MoH), and the Brazilian Occupation Classification, from the Ministry of Labor. The analysis provides a comprehensive description of the 54 courses of the learning pathway, which has 177,732 enrollments and 93,617 participants from all Brazilian regions, especially the Southeast, which accounts for the highest number of enrollees. Additionally, it is worth noting that students living abroad also enrolled in the courses. Data characterization provided a demographic study focused on the course participants' profession and level of care practiced, revealing that the majority (85%) worked in primary and secondary healthcare. These practitioners are the target audience of the learning pathway and, accordingly, are part of the personnel directly engaged in healthcare services that fight the syphilis epidemic in Brazil.

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The ubiquity of mobile devices and access to the internet has changed our daily life and, in some cases, promoted and facilitated social and sexual interrelationships. There are many applications of technology and campaigns promoting healthy behaviors and prevention of sexually transmitted infections. Can we develop a strategy for the same purpose using mobile devices, based on the theory of attitude change? We developed an app and tested it with 105 undergraduate students, where they had to actively think in favor of condom use with a high amount of elaboration, leading to attitudes and behavioral intention (BI) in concordance with contemporary theories about attitudes and behavioral change. PROCESS macro models were used to analyze potential mediations. Results show a significant correlation between thoughts and attitudes, and attitudes partially mediated the association between thoughts and condom use. Individuals with positive thoughts tended to positively correlate their thoughts with their attitudes, and, consequently, these attitudes with their BI. In this study, we showed that (1) it was possible to develop and test an app based on the elaboration likelihood model (ELM); (2) consistent with previous studies, attitudes partially mediated the association between thoughts and condom use (BI) in a mobile environment; and (3) applications of this strategy can be used to build new approaches for prevention in health care.

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