Results from a Nationwide Study

Publisher Copyright: © 2021, The Author(s), under exclusive licence to Springer Science+Business Media, LLC part of Springer Nature.Introduction: Little is known about how sheltering in place to contain the spread of COVID-19 over extended periods affects individuals’ psychological well-being. This study’s objective was to analyze the factors associated with MSM’s (men who have sex with men) low psychological well-being in the COVID-19 pandemic context. Method: This cross-sectional study was conducted online across Brazil (26 states and federal district) in April and May 2020. The participants were recruited using snowball sampling and Facebook posts. Data were collected using social media and MSM dating apps. We estimated the prevalence, crude prevalence ratio (PR), and the respective confidence intervals (CI95%). Results: The prevalence of low psychological well-being found in the sample was 7.9%. Associated factors were belonging to the youngest group (PR 2.76; CI95% 1.90–4.01), having polyamorous relationships (PR 2.78; CI95% 1.51–5.11), not complying with social isolation measures (PR 6.27; CI95% 4.42–8.87), not using the social media to find partners (PR 1.63; CI95% 1.06–2.53), having multiple sexual partners (PR 1.80; CI95% 1.04–3.11), having reduced the number of partners (PR 2.67; CI95% 1.44–4.95), and group sex (PR 1.82; CI95% 1.23–2.69) Conclusion: The well-being of MSM living in Brazil was negatively affected during the social distancing measures intended to control the spread of COVID-19. The variables that contributed the most to this outcome include social isolation, relationships established with partners, and sexual behavior. Policy Implications: Planning and implementing public policies and actions to promote psychological well-being are needed to improve MSM’s resilience by adopting safe strategies and behavior.publishersversionpublishe

what is the evidence?

Background: This study's aims are to assess the current evidence presented in the literature regarding the potential risks of COVID-19 infection among pregnant women and consequent fetal transmission. Methods: a systematic literature review assessing papers published in the most comprehensive databases in the field of health intended to answer the question, "What are the effects of COVID-19 infection during pregnancy, and what is the neonatal prognosis?" Results: 49 papers published in 2020 were eligible, presenting low levels of evidence. A total of 755 pregnant women and 598 infants were assessed; more than half of pregnant women had C-sections (379/65%). Only 493 (82%) infants were tested for SARS-CoV-2, nine (2%) of whom tested positive. There is, however, no evidence of vertical transmission based on what has been assessed so far, considering there are knowledge gaps concerning the care provided during and after delivery, as well as a lack of suitable biological samples for testing SARS-CoV-2. Conclusions: We cannot rule out potential worsening of the clinical conditions of pregnant women infected with SARS-CoV-2, whether the infection is associated with comorbidities or not, due to the occurrence of respiratory disorders, cardiac rhythm disturbances, and acid-base imbalance, among others. We recommend relentless monitoring of all pregnant women in addition to testing them before delivery or the first contact with newborns.publishersversionpublishe

Suspected COVID-19 flu-like syndrome in men who have sex with men and have been involved in casual sex

OBJECTIVE: To evaluate the presence of flu-like syndrome suggestive of COVID-19 in men who have sex with men (MSM) and engaged in casual sex during a period of social isolation. METHOD: National epidemiological survey, applied in April and May 2020, by adaptation of Respondent Drive Sampling. RESULTS: 1,337 MSM participated in the survey, of which 514 (38.4%) had fever associated with another sign or symptom of flu-like syndrome. Social, demographic characteristics, sexual practices and activities during the period of social isolation were statistically associated with the presence of flu-like syndrome. There was a statistical difference (p < 0.001) in the average of partners between those who had signs and symptoms of flu-like syndrome (3.5) and those who did not (1.7). CONCLUSION: Evidence of signs and symptoms indicative of flu-like syndrome suggestive of COVID 19 in Brazilian MSM who were involved in casual sex during the period of social isolation. Objetivo: Evaluar la presencia de síndrome gripal sospecha de COVID-19 en hombres que tienen sexo con hombres (HSH) y se envolvieron en sexo con pareja ocasional durante distanciamiento social. Método:  Averiguación epidemiológica, de abarcamiento nacional, aplicado en abril y mayo de 2020, por adaptación delRespondent Drive Sampling. Resultados:  1.337 HSHs participaron de la investigación, de los cuales 514 (38,4%) tuvieron fiebre relacionada a otra señal o síntoma de síndrome gripal. Características sociales, demográficas, prácticas y actividades sexuales durante el distanciamiento social han estáticamente relacionadas a la presencia de síndrome gripal. Hubo diferencia estadística (p < 0,001) en la media de parejas entre aquellos que tuvieron señales y síntomas de síndrome gripal (3,5) y aquellos que no los tuvieron (1,7). Conclusión:  Se evidencia ocurrencia de señales y síntomas indicativos de síndrome gripal sugestivo de COVID-19 en HSHs brasileños que se envolvieron en sexo ocasional durante el período del distanciamiento social. Objetivo:  Avaliar a presença de síndrome gripal suspeita de COVID-19 em homens que fazem sexo com homens (HSH) e se envolveram em sexo com parceiro casual durante período de distanciamento social. Método:  Inquérito epidemiológico, de abrangência nacional, aplicado em abril e maio de 2020, por adaptação doRespondent Drive Sampling. Resultados:  1.337 HSHs participaram da pesquisa, dos quais 514 (38,4%) tiveram febre associada a outro sinal ou sintoma de síndrome gripal. Características sociais, demográficas, práticas e atividades sexuais durante o período de distanciamento social foram estaticamente associadas à presença de síndrome gripal. Houve diferença estatística (p < 0,001) na média de parceiros entre aqueles que tiveram sinais e sintomas de síndrome gripal (3,5) e aqueles que não os tiveram (1,7). Conclusão: Evidencia-se ocorrência de sinais e sintomas indicativos de síndrome gripal sugestiva de COVID19 em HSHs brasileiros que se envolveram em sexo casual durante o período do distanciamento social.publishersversionpublishe

Meanings assigned by primary care professionals to male prenatal care: a qualitative study

Background: Considering recent strategies used in prenatal care, the involvement of fathers has been considered an important factor in ensuring that pregnancy and delivery are successful. Objective: The aim of this study is to identify the meanings assigned by primary health care professionals to male prenatal care. Methods: This is a descriptive study with a qualitative approach. A total of 19 interviews were conducted with primary health care professionals registered in the City Health Department of Teresina, Piauí, Brazil. Data were collected through semi-structured interviews and analyzed according to the Collective Subject Discourse methodology. Results: Three themes emerged from the reports’ analysis: The importance of the role of fathers in the gestational process, attitudes of men toward male prenatal care and formal education and training in primary health care. Health practitioners understand the importance of male prenatal care but reported they lack proper training to provide effective care. Conclusion: The expansion of continuing education strategies focusing on male prenatal care and directed to primary health care professionals is recommended to promote greater adherence on the part of fathers in prenatal care, with the purpose of strengthening bonds and improving the care provided to the entire family. The humanized care can facilitate the approach of the paternal figure during male prenatal care.info:eu-repo/semantics/publishedVersio

SARS-CoV-2 in Brazil and Psychosocial Repercussions on Men’s Health: Health Literacy Is Important

This study aimed at analyzing the psychosocial repercussions of the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) pandemic on the health of men living in Brazil. For this, we carried out a socio-historical and qualitative study, with the participation of 200 men who answered an online questionnaire. The data collected were processed in the NVIVO12® software, structured by the Collective Subject Discourse method, and analyzed from the epidemic disease theoretical framework proposed by Charles Rosenberg. Our results showed that the SARS-CoV-2 pandemic brought about repercussions of different dimensions that compromised the health of men living in Brazil. The repercussions evidenced were behavioral changes and emergence of new habits due to the pandemic; uncomfortable family situations; impaired affective and sexual relationships; harms in marital relationships; and insecurity and psychological distress. It is important to implement strategies that maximize men’s health literacy, promoting better communication in terms of health, and search for help and suitable information about health/mental health.info:eu-repo/semantics/publishedVersio

Adherence to Pre-Exposure Prophylaxis (PrEP) among Men Who Have Sex with Men (MSM) in Portuguese-Speaking Countries

Funding Information: National Research Council–CNPq. Process: 159908/2019-1. Publisher Copyright: © 2023 by the authors.Strengthening strategies to improve adherence to the use of pre-exposure prophylaxis (PrEP) in key populations constitutes a global health priority to be achieved across countries, especially in countries that share a high flow of people such as Brazil and Portugal. This study aimed to analyze the factors associated with adherence to PrEP among MSM from two Portuguese-speaking countries, highlighting the opportunities and preventive strategies for the global health scenario. This was a cross-sectional analytical online survey conducted from January 2020 to May 2021 with MSM in Brazil and Portugal. For analysis of the data, the Poisson regression model was used to estimate the prevalence ratio (PR) for developing a model to evaluate the associated factors in both countries in a comparative and isolated way. Adherence to PrEP use corresponded to 19.5% (n = 1682) of the overall sample: 18.3% (n = 970) for Brazil and 21.5% (n = 712) for Portugal. Having more than two sex partners in the last 30 days (aPR: 30.87) and routinely undergoing HIV tests (aPR: 26.21) increased the use of this medication. Being an immigrant (PR: 1.36) and knowing the partner’s serological status (PR: 1.28) increased adherence to PrEP in Portugal, whereas, in Brazil, it was being an immigrant (PR: 0.83) and not knowing the serological status (PR: 2.24) that promoted the use of this medication. Our findings reinforce the need to invest in programs and strategies to improve access and adherence to PrEP, especially in key populations.publishersversionpublishe

SÍNDROME GRIPAL SUSPEITA DE COVID-19 EM HOMENS QUE FAZEM SEXO COM HOMENS E SE ENVOLVERAM EM SEXO CASUAL

Objective: To evaluate the presence of flu-like syndrome suggestive of COVID-19 in men who have sex with men (MSM) and engaged in casual sex during a period of social isolation. Method: National epidemiological survey, applied in April and May 2020, by adaptation of Respondent Drive Sampling. Results: 1,337 MSM participated in the survey, of which 514 (38.4%) had fever associated with another sign or symptom of flu-like syndrome. Social, demographic characteristics, sexual practices and activities during the period of social isolation were statistically associated with the presence of flu-like syndrome. There was a statistical difference (p &lt; 0.001) in the average of partners between those who had signs and symptoms of flu-like syndrome (3.5) and those who did not (1.7). Conclusion: Evidence of signs and symptoms indicative of flu-like syndrome suggestive of COVID 19 in Brazilian MSM who were involved in casual sex during the period of social isolation.  Objetivo: Evaluar la presencia de síndrome gripal sospecha de COVID-19 en hombres que tienen sexo con hombres (HSH) y se envolvieron en sexo con pareja ocasional durante distanciamiento social. Método: Averiguación epidemiológica, de abarcamiento nacional, aplicado en abril y mayo de 2020, por adaptación del Respondent Drive Sampling. Resultados: 1.337 HSHs participaron de la investigación, de los cuales 514 (38,4%) tuvieron fiebre relacionada a otra señal o síntoma de síndrome gripal. Características sociales, demográficas, prácticas y actividades sexuales durante el distanciamiento social han estáticamente relacionadas a la presencia de síndrome gripal. Hubo diferencia estadística (p &lt; 0,001) en la media de parejas entre aquellos que tuvieron señales y síntomas de síndrome gripal (3,5) y aquellos que no los tuvieron (1,7). Conclusión: Se evidencia ocurrencia de señales y síntomas indicativos de síndrome gripal sugestivo de COVID-19 en HSHs brasileños que se envolvieron en sexo ocasional durante el período del distanciamiento social.Objetivo: Avaliar a presença de síndrome gripal suspeita de COVID-19 em homens que fazem sexo com homens (HSH) e se envolveram em sexo com parceiro casual durante período de distanciamento social. Método: Inquérito epidemiológico, de abrangência nacional, aplicado em abril e maio de 2020, por adaptação do Respondent Drive Sampling. Resultados: 1.337 HSHs participaram da pesquisa, dos quais 514 (38,4%) tiveram febre associada a outro sinal ou sintoma de síndrome gripal. Características sociais, demográficas, práticas e atividades sexuais durante o período de distanciamento social foram estaticamente associadas à presença de síndrome gripal. Houve diferença estatística (p &lt; 0,001) na média de parceiros entre aqueles que tiveram sinais e sintomas de síndrome gripal (3,5) e aqueles que não os tiveram (1,7). Conclusão: Evidencia-se ocorrência de sinais e sintomas indicativos de síndrome gripal sugestiva de COVID‑19 em HSHs brasileiros que se envolveram em sexo casual durante o período do distanciamento social

Factors Associated with Emotion Regulation in Men with Internet Access Living in Brazil during the COVID-19 Pandemic

Publisher Copyright: © 2022 by the authors. Licensee MDPI, Basel, Switzerland.Objective: to evaluate the factors associated with emotion regulation in men with internet access living in Brazil during the COVID-19 pandemic. Method: an epidemiological survey, conducted with 1015 men. An electronic form was applied containing sociodemographic and occu-pational characteristics, support and coping strategies, as well as emotional and behavioral aspects. Emotion regulation was assessed using the Emotion Regulation Questionnaire. Results: The prevalence values observed were 44.6% for Low Cognitive Reappraisal and of 47.1% for High Emotional Sup-pression. The following factors were identified as associated: (a) with Low Cognitive Reappraisal: being aged 30 years old or more, practicing physical activity, worrying about social distancing and having positive emotions and feelings; and (b) with High Emotional Suppression: being heterosexual, non-white race/skin color, having security support or public administration, not sanitizing food, worrying about lack of physical activity and not having negative emotions. Conclusion: the adoption of emotion regulation strategies was associated with individual, contextual and emotional/behavioral characteristics. Masculinity ideals seem to exert an influence on these relationships.publishersversionpublishe

Psychological Distress in Men during the COVID-19 Pandemic in Brazil: The Role of the Sociodemographic Variables, Uncertainty, and Social Support

Objective: To analyze the relationships between sociodemographic variables, intolerance to uncertainty (INT), social support, and psychological distress (i.e., indicators of Common Mental Disorders (CMDs) and perceived stress (PS)) in Brazilian men during the COVID-19 pandemic. Methods: A cross-sectional study with national coverage, of the web survey type, and conducted with 1006 Brazilian men during the period of social circulation restriction imposed by the health authorities in Brazil for suppression of the coronavirus and control of the pandemic. Structural equation modeling analysis was performed. Results: Statistically significant direct effects of race/skin color ( = 0.268; p-value < 0.001), socioeconomic status (SES) ( = 0.306; p-value < 0.001), household composition( = 0.281; p-value < 0.001), PS ( = 0.513; p-value < 0.001), and INT ( = 0.421; p-value < 0.001) were evidenced in the occurrence of CMDs. Black-skinned men with higher SES, living alone, and with higher PS and INT levels presented higher prevalence values of CMDs. Conclusions: High levels of PS and INT were the factors that presented the strongest associations with the occurrence of CMDs among the men. It is necessary to implement actions to reduce the stress-generating sources as well as to promote an increase in resilience and the development of intrinsic reinforcements to deal with uncertain threats.info:eu-repo/semantics/publishedVersio

Pre-exposure prophylaxis among Brazilian men who have sex with men: a comparative study between migrants and non-migrants

IntroductionInvestigating the use and adherence to pre-exposure prophylaxis (PrEP) in MSM is a global health priority in the fight against HIV. Strategies must be capable of increasing usage and reaching not only the population living in the country but also those who immigrate, who face additional vulnerabilities. Based on this, in this observational, cross-sectional, and analytical study, our aim is to analyze the use of PrEP among Brazilian men who have sex with men, whether they are migrants or not. We aim to highlight preventive opportunities and strategies for the global health scenario.MethodsWe utilized a sample of Brazilians living in the country and Brazilian immigrants residing in Portugal, one of the main destinations for Brazilians in recent years. To estimate the prevalence ratio (PR) of PrEP use, we employed the Poisson regression model with robust variance estimation using a covariance matrix.ResultsA total of 1,117 Brazilian MSM PrEP users participated in this study, with 788 residing in Brazil and 328 in Portugal. Multivariate analysis was conducted in three stages: overall, and for subgroups of residents in Brazil and immigrants in Portugal. We identified four convergent factors that increased the prevalence of PrEP use in Brazilians regardless of migration status: having two or more casual sexual partners per month, engaging in challenging sexual practices as the receptive partner, disclosing serological status on apps, and being single. Among native Brazilians, four unique factors stood out: being in a polyamorous relationship, having sexual relations with unknown casual partners, and having higher levels of education.DiscussionThis study highlights the need to implement strategies to strengthen PrEP adherence in Brazil and create international programs that facilitate its usage among populations migrating between these two countries