Barriers and facilitators to PrEP for transwomen in Brazil

Pre-exposure prophylaxis (PrEP) is an important biomedical intervention that may help reduce the risk of HIV transmission among transwomen. To date, little research is available to inform interventions to increase uptake and adherence to PrEP among transwomen, especially in places outside the U.S. We conducted a qualitative study in 2015 with 34 adult transwomen in Rio de Janeiro, Brazil and assessed awareness, interest, barriers and facilitators to PrEP uptake and adherence for transwomen. Almost one third of participants had heard of PrEP, and most were interested and thought it would be beneficial for transwomen in their community. Barriers to PrEP included fear of being HIV positive resulting in low HIV testing and concerns about the ability to adhere to a daily PrEP regimen. The most prominent barrier to uptake was past experiences of transgender-identity related discrimination in the universal health care system that reduced willingness to seek PrEP or health care in general. Participants recommended technological solutions to PrEP health education information that could address uptake and adherence. This study informs efforts to increase PrEP use among transwomen in Brazil

Barriers and facilitators to PrEP for transwomen in Brazil

Pre-exposure prophylaxis (PrEP) is an important biomedical intervention that may help reduce the risk of HIV transmission among transwomen. To date, little research is available to inform interventions to increase uptake and adherence to PrEP among transwomen, especially in places outside the U.S. We conducted a qualitative study in 2015 with 34 adult transwomen in Rio de Janeiro, Brazil and assessed awareness, interest, barriers and facilitators to PrEP uptake and adherence for transwomen. Almost one third of participants had heard of PrEP, and most were interested and thought it would be beneficial for transwomen in their community. Barriers to PrEP included fear of being HIV positive resulting in low HIV testing and concerns about the ability to adhere to a daily PrEP regimen. The most prominent barrier to uptake was past experiences of transgender-identity related discrimination in the universal health care system that reduced willingness to seek PrEP or health care in general. Participants recommended technological solutions to PrEP health education information that could address uptake and adherence. This study informs efforts to increase PrEP use among transwomen in Brazil

Hardware development for zero crossing of a multilevel single phase rectifier chopper for plug-in electric car battery charger using a PIC microcontroller

This paper focuses on developing the hardware for a controller and of a zero crossing circuit for an electric car battery charger. A novel topology of a battery charger is studied and tested. A conventional rectifier has drawbacks in terms of harmonic currents. This paper describes a five-level single-phase rectifier associated with buck chopper with a control signal which draws a clean sinusoidal line current for the application in a plug-in battery charger. The MATLAB/Simulink results reveal that the proposed battery charger performance is better compared to the conventional method

Time trend analysis of cervical high-risk human papillomavirus (HPV) in HIV-infected women in an urban cohort from Rio de Janeiro, Brazil: the rise of non-16/18 HPV

Submitted by Fábio Marques ([email protected]) on 2018-10-18T16:00:10Z No. of bitstreams: 1 Time trend analysis of cervical high-risk human_Beatriz_Grinsztejn_etal_INI_Lapclin-AIDS_2015.pdf: 284898 bytes, checksum: 851b34477496d8830755104ac0c14044 (MD5)Approved for entry into archive by Regina Costa ([email protected]) on 2018-10-18T19:24:56Z (GMT) No. of bitstreams: 1 Time trend analysis of cervical high-risk human_Beatriz_Grinsztejn_etal_INI_Lapclin-AIDS_2015.pdf: 284898 bytes, checksum: 851b34477496d8830755104ac0c14044 (MD5)Made available in DSpace on 2018-10-18T19:24:56Z (GMT). No. of bitstreams: 1 Time trend analysis of cervical high-risk human_Beatriz_Grinsztejn_etal_INI_Lapclin-AIDS_2015.pdf: 284898 bytes, checksum: 851b34477496d8830755104ac0c14044 (MD5) Previous issue date: 2015UCLA David Geffen School of Medicine. Department of Medicine. Division of Infectious Diseases. Program in Global Health. Los Angeles, CA, USA./ Montefiore University Hospital of Albert Einstein College of Medicine. Department of Internal Medicine. Bronx, New York, USA.Universidade de São Paulo. Instituto de Medicina Tropical. Laboratório de Virologia. São Paulo, SP, Brasil.UCLA David Geffen School of Medicine. Department of Medicine. Division of Infectious Diseases. Program in Global Health. Los Angeles, CA, USA./ Montefiore University Hospital of Albert Einstein College of Medicine. Department of Internal Medicine. Bronx, New York, USA.Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Laboratório de Pesquisa Clínica em DST/AIDS. Rio de Janeiro, RJ, Brasil.Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Laboratório de Pesquisa Clínica em DST/AIDS. Rio de Janeiro, RJ, Brasil.Fundação Oswaldo Cruz. Instituto Fernandes Figueira. Rio de Janeiro, RJ, Brasil.Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Laboratório de Pesquisa Clínica em DST/AIDS. Rio de Janeiro, RJ, Brasil.Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Laboratório de Pesquisa Clínica em DST/AIDS. Rio de Janeiro, RJ, Brasil.Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Laboratório de Pesquisa Clínica em DST/AIDS. Rio de Janeiro, RJ, Brasil.Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Laboratório de Pesquisa Clínica em DST/AIDS. Rio de Janeiro, RJ, Brasil.Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Laboratório de Pesquisa Clínica em DST/AIDS. Rio de Janeiro, RJ, Brasil.HIV-infected women are at increased risk of human papillomavirus (HPV) infection. Time trends in annual prevalences of cervical high-risk human papillomavirus (HR-HPV) genotypes among a non-vaccinated, HIV-infected female cohort in urban Brazil were assessed for the period 2006-2012

Hybrid capture as a tool for cervical lesions screening in HIV-infected women: insights from a Brazilian cohort

Introduction: Cervical cancer remains an important burden for HIV-infected women in the era of combination antiretroviral therapy. Recommendations for cervical screening in these women diverge and may include high-risk HPV (HRHPV) testing. We aimed to evaluate the clinical usefulness of a single HRHPV testing for cervical screening of HIV-infected women. Methods: 723 HIV-infected women from a Brazilian prospective cohort were included between 1996 and 2012. Inclusion criteria were: normal cervical cytology at baseline and having a HRHPV-test at baseline. We calculated incidence rates of any squamous intraepithelial lesion (SIL) and high grade SIL+ (HSIL+) and negative predictive values (NPV) within 12 and 36 months. Hazard Ratios were obtained using Cox proportional hazards regression models. Results: Incidence rate for both outcomes was low (9.9 cases per 100 PY [95% CI 8.8–11.0] for any SIL and 1.3 cases per 100 PY [95% IC 0.9–1.8] for HSIL+). Women with a HRHPV positive status at baseline had 1.7-fold (95% CI 1.3–2.2) and 3.2-fold (95% CI 1.5–7.1) increased risk of presenting any SIL and HSIL+, respectively, during follow-up. Negative-HRHPV test presented high NPV for both periods and outcomes (any SIL: 92.4% [95% CI 89.7–94.6] for 12 months and 80.9% [95% CI 77.2–84.3] for 36 months; and HSIL+: 99.8% [95% CI 98.9–100.0] for 12 months and 99.0 [95% CI 97.6–99.7] for 36 months). Conclusions: Incidence of any and high grade cytological abnormality was significantly higher among HIV-infected women with positive-HRHPV test. A single negative-HRHPV test helped reassure follow-up free of cytological abnormalities through three years of follow-up in HIV-infected women with negative cytology. Keywords: HPV, HIV, Women, Cohort, Incidenc

HIV testing and the care continuum among transgender women: population estimates from Rio de Janeiro, Brazil

Submitted by Fábio Marques ([email protected]) on 2018-03-26T16:11:23Z No. of bitstreams: 1 ve_Emilia_Jalil_etal_INI_Lapclin_2017.pdf: 146630 bytes, checksum: 6038967edb65c8c974212141541f17c7 (MD5)Approved for entry into archive by Raquel Dinelis ([email protected]) on 2018-04-12T14:35:29Z (GMT) No. of bitstreams: 1 ve_Emilia_Jalil_etal_INI_Lapclin_2017.pdf: 146630 bytes, checksum: 6038967edb65c8c974212141541f17c7 (MD5)Made available in DSpace on 2018-04-12T14:35:29Z (GMT). No. of bitstreams: 1 ve_Emilia_Jalil_etal_INI_Lapclin_2017.pdf: 146630 bytes, checksum: 6038967edb65c8c974212141541f17c7 (MD5) Previous issue date: 2017Fundação Oswaldo Cruz.Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brasil.Bridge HIV, San Francisco Department of Public Health, San Francisco, CA, USA.Fundação Oswaldo Cruz.Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brasil.Fundação Oswaldo Cruz.Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brasil. / Departamento de Matemática e Estatística, Universidade Federal do Estado do Rio de Janeiro, Rio de Janeiro, Brazil.Fundação Oswaldo Cruz.Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brasil.Fundação Oswaldo Cruz.Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brasil.Fundação Oswaldo Cruz.Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brasil.Fundação Oswaldo Cruz.Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brasil.Fundação Oswaldo Cruz.Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brasil.Fundação Oswaldo Cruz.Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brasil.Departments of Medicine, Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA, USA.Bridge HIV, San Francisco Department of Public Health, San Francisco, CA, USA.Fundação Oswaldo Cruz.Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brasil.Bridge HIV, San Francisco Department of Public Health, San Francisco, CA, USA. / Departments of Medicine, Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA, USA.Fundação Oswaldo Cruz.Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brasil.Evidence suggests that, of all affected populations, transgender women (transwomen) may have the heaviest HIV burden worldwide. Little is known about HIV linkage and care outcomes for transwomen. We aimed to estimate population-level indicators of the HIV cascade of care continuum, and to evaluate factors associated with viral suppression among transwomen in Rio de Janeiro, Brazil

ALTA TAXA DE MORTALIDADE E FATORES ASSOCIADOS EM TRAVESTIS E MULHERES TRANS VIVENDO OU NÃO COM HIV NO RIO DE JANEIRO, BRASIL

Introdução: Travestis e mulheres trans (TMT) carregam uma carga desproporcional de resultados adversos à saúde, incluindo a infecção pelo HIV. No entanto, dados sobre mortalidade nesse grupo são escassos no Brasil. Esse estudo objetivou caracterizar as mortes ocorridas em uma coorte trans-específica e analisar fatores associados à mortalidade. Métodos: Trata-se de análise transversal a partir dos dados de entrada de uma coorte prospectiva e das informações do sistema de mortalidade (SIM) por meio de linkage probabilístico. A coorte Transcendendo foi estabelecida em 2015 e inclui TMT vivendo com HIV (TMTVHIV) ou HIV-negativas com 18+ anos, do Rio de Janeiro, Brasil. Foi realizada análise de regressão logística para identificar fatores associados ao óbito na coorte. Resultados: Entre 2015-2020, 537 TMT foram incluídas na coorte (56,4% TMTVHIV). A idade mediana foi 31 anos (intervalo interquartil [IIQ]:25-38), 69,6% se declararam Negras/Pardas, e 38,7% eram profissionais do sexo. Foram identificados 24 óbitos (4,5%), dos quais 20(83,3%) ocorreram entre TMTVHIV e 4[16,7%] entre TMT HIV-negativas. Entre as 20 TMTVHIV que foram a óbito, 14(70%) estavam em uso de terapia antirretroviral na entrada da coorte, e a contagem mediana do CD4+ nadir era 168 células/mm3 (IIQ:44-271). As causas de óbito nas TMT-VHIV foram infecções relacionadas ao HIV/AIDS (n = 11[55,0%]), seguidas de câncer (n = 4[20,0%] dos seguintes sítios: espaço retroperitoneal/peritônio [n = 1], pulmão/brônquio [n = 1], mama [n = 1] e ânus [n = 1]), causas externas (n = 2[10,0%]), causa desconhecida (n = 2[10,0%]) e enfisema pulmonar (n = 1[5,0%]). Entre as TMT HIV-negativas, as causas de morte foram: causa externa (n = 1[25,0%]), COVID-19 (n = 1[25,0%]), infarto agudo do miocárdio (n = 1[25,0%]) e sepse (n = 1[25,0%]). Além da idade (OR 1,07[IC95%:1,03-1,11, p = 0,001), tiveram maior chance de morte as TMT com moradia instável (OR 6,92[IC95%:2,45-18,79, p < 0,001), que reportaram trabalho sexual (OR 3,57[IC95%:1,40-10,03], p = 0,010) e que viviam com HIV (OR 3,46 [IC95%:1,23-12,43, p = 0,031). Conclusões: TMT-VHIV tiveram uma chance aumentada de mortalidade. Além da idade, fatores relacionados à alta vulnerabilidade das TMT se associaram à maior chance de óbito. Nossos achados reforçam a necessidade de prevenção e cuidado com o HIV para considerar uma abordagem mais ampla de saúde, que aborde as desigualdades de saúde e suas causas entre as TMT no Brasil

High Rates of Sexualized Drug Use or Chemsex among Brazilian Transgender Women and Young Sexual and Gender Minorities

(1) Background: We aimed to estimate sexualized drug use (SDU) prevalence and its predictors among sexual and gender minorities. (2) Methods: We used an online and on-site survey to enroll sexual/gender minorities people between October&ndash;December/2020, and multivariate logistic regression to obtain SDU correlates. (3) Results: We enrolled 3924 individuals (280 transgender women [TGW], 3553 men who have sex with men [MSM], and 91 non-binary), 29.0% currently on pre-exposure prophylaxis (PrEP). SDU prevalence was 28.8% (95% confidence interval [CI] 27.4&ndash;30.2). TGW had 2.44-times increased odds (95%CI 1.75&ndash;3.39) of engaging in SDU compared to MSM, regardless of PrEP use. PrEP use (aOR 1.19, 95%CI 1.00&ndash;1.41), South/Southeast region (aOR 1.26, 95%CI 1.04&ndash;1.53), younger age (18&ndash;24 years: aOR 1.41, 95%CI 1.10&ndash;1.81; 25&ndash;35 years: aOR 1.24, 95%CI 1.04&ndash;1.53), white race/color (aOR 1.21, 95%CI 1.02&ndash;1.42), high income (aOR 1.32, 95%CI 1.05&ndash;1.67), binge drinking (aOR 2.66, 95%CI 2.25&ndash;3.14), &gt;5 sexual partners (aOR 1.88, 95%CI 1.61&ndash;2.21), condomless anal sex (aOR 1.49, 95%CI 1.25&ndash;1.79), self-reported sexually transmitted infection (aOR 1.40, 95%CI 1.14&ndash;1.71), and higher perceived HIV-risk (aOR 1.37, 95%CI 1.14&ndash;1.64) were associated with SDU. (4) Conclusions: TGW had the highest SDU odds. SDU may impact HIV vulnerability among key populations and should be addressed in HIV prevention approaches