a scoping review

Background: The interest in Global Health (GH) as an academic discipline has increased in the last dec-ade. This article reports the findings of a scoping review of studies about Global Health education in the Americas. Objective: To analyse educational programs on global health in the Americas. Method: Five electronic databases were used in a scoping review: PubMed, Scopus, Web of Knowledge, CINAHL, and Lilacs. Data collection happened in November 2017–March 2018. The following stages were rigorously observed: identification, selection, charting, and summarizing the studies that were included. To process the data, we used IRaMuTeQ software. Findings: Forty-six studies were identified and organized in categories: 1) diversity of the topics addressed in GH; 2) models of teaching; 3) emotional, cultural, and collaborative aspects in teaching GH; 4) student preparation for GH experiences; and 5) structures required for a GH course. Conclusions: The existing global health curriculum in the Americas is diffuse and limited, with a greater focus on clinical aspects. Thus, a minimum curriculum for students from different areas is needed. Results evidenced that the teaching of global health in the Americas is still incipient, although it is promising. The lack of a common curriculum for the courses in the region makes it difficult to train sensitive and capable professionals to achieve the 2030 Sustainable Development Goals.publishersversionpublishe

Systematic literature review, technology prospecting of patent databases, and systematic search on app stores

Background: Globally, the number of HIV cases continue to increase, despite the development of multiple prevention strategies. New cases of HIV have been reported disproportionately more in men who have sex with men and other vulnerable populations. Issues such as internalized and structural homophobia prevent these men from accessing prevention strategies such as postexposure prophylaxis (PEP). Mobile health (mHealth) interventions are known to be one of the newest and preferred options to enhance PEP knowledge and access. Objective: The aim of this study was to identify and analyze the mobile apps addressing PEP for HIV infections. Methods: We conducted a descriptive exploratory study in 3 sequential phases: systematic literature review, patent analysis, and systematic search of app stores. For the systematic review, we followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines adapted for an integrative review in the databases of PubMed, Web of Knowledge, Scopus, Cochrane, Embase, Science Direct, Eric, Treasure, and CINAHL. The patent analysis was performed by exploring the databases of the Brazilian National Institute of Industrial Property, the United States Patent and Trademark Office, and the European Patent Office. For the systematic search, we analyzed mHealth apps related to HIV in 2 major app libraries, that is, Google Play Store and App Store. The apps were evaluated by name, characteristics, functions, and availability in iPhone operating system/Android phones. Results: We analyzed 22 studies, of which 2 were selected for the final stage. Both studies present the use of apps as mHealth strategies aimed at improving the sexual health of men who have sex with men, and they were classified as decision support systems. The search in the patent databases showed only 1 result, which was not related to the topic since it was a drug intervention. In the app libraries, 25 apps were found and analyzed, with 15 (60%) apps available for Android systems but only 3 (12%) addressing PEP. In general, the apps inform about HIV and HIV prevention and treatment, with the focus users being health care providers, people with HIV, or the general population, but they have only limited features available, that is, mainly text, images, and videos. The 3 apps exclusively focusing on PEP were created by researchers from Brazilian universities. Conclusions: Our review found no connection between the scientific studies, registered patents, and the available apps related to PEP; this finding indicates that these available apps do not have a theoretical or a methodological background in their creation. Thus, since the scientific knowledge on HIV is not translated into technological products, preventing the emergence of new infections, especially in the more vulnerable groups, is difficult. In the future, researchers and the community must work in synergy to create more mHealth tools aimed at PEP.publishersversionpublishe

A Blind Spot?

Middle-aged and older men who have sex with men (MSM) are one of the most underestimated populations with regard to HIV/AIDS infection, despite the worldwide trend of increasing prevalence in recent years. This population also has low rates of testing, although rare studies are done exclusively with middle-aged and older MSM assessing the factors associated with this prevalence. Thus, based on data from an exclusive online survey with middle-aged and older MSM who use geolocation-based dating applications, the purpose of the study was to analyze factors associated with not taking the HIV test among middle-aged (50 years old) and older MSM in Brazil. Using a modification of time-location sampling adapted to virtual reality, 412 volunteers were approached in Grindr®, Hornet®, SCRUFF®, and Daddyhunt®. The multivariate logistic regression model was adopted to produce adjusted odds ratios (ORa), considering a significance level at.05. There were factors associated with not taking the test: being in a relationship (ORa: 0.24; 95% CI [0.10, 0.53]); knowing partner through the applications (ORa: 1.84; 95% CI [1.07, 3.15]); not knowing the serological status (ORa: 5.07; 95% CI [1.88, 13.67]); ejaculating outside of anal cavity (ORa: 1.79; 95% CI [1.04, 3.05]); practicing sex without penetration (ORa: 2.30; 95% CI [1.17, 4.50]); not taking the test as a form of prevention (ORa: 2.83; 95% CI [1.05, 7.68]); and rarely using Viagra in sexual intercourse (ORa: 1.91; 95% CI [1.20, 3.65]). There is a blind spot in the prevalence of HIV testing in older MSM because this population is not being covered by services, which compromises the overall response to HIV, the goals set for universal health coverage.publishersversionpublishe

The meaning of a young service attempted suicide for nurses of pre-hospital

Objective: To grasp the meaning of the attending to youth who attempted suicide for the pre-hospital nurse and analyze how that meaning can influence the treatment of these young people. Method: An exploratory and descriptive study, with qualitative approach. Research participants were nine nurses who fulfilled the inclusion criteria. Results: From the analysis there emerged three categories: Significance of care to young suicidal; Feelings of nurses to meet a young suicide; Influence of significance in attending a young suicide and its relation to professional conduct. Conclusion: Attending a young suicide has special meaning to the study subjects and awakens feelings such as anxiety, sadness, fear and suffering. The prehospital nurse shows itself compromised in the patient care and family, regardless of the nature of the occurrence, however, puts the fact of suicide as relevant to the care provided

Sex education for adolescents by teachers from a community education center

Objective: raising teachers' knowledge about sexuality, to provide subsidies for the development of education practices in health care by Nursing. Methods: a descriptive study of a qualitative approach developed in a Community Education Center, with middle and high school teachers (n: 15). After compiling the data, there were analyzed and structured by semantic similarities. This study was a research project approved by the Research Ethics Committee, CAAE: 02700212.4.0000.5214. Results: in the research, four categories emerged: "The importance of the theme approach in School", "Sexuality demonstrations by students", "The role of teachers in sexual education of students" and "How the school should address the theme?". Conclusion: the approach is based on a vertical transmission of knowledge, based mainly on biological aspects

Parcerias sexuais de pessoas vivendo com HIV/Aids: orientação sexual, aspectos sociodemograficos, clinicos e comportamentais

Objective: To analyze the influence of sexual orientation on sociodemographic, clinical and behavioral variables among sexual partners of people living with Human immunodeficiency virus/Acquired immunodeficiency syndrome. Methods: A cross-sectional study carried out in a medical assistance service specialized in the treatment of people with Human Immunodeficiency Virus, with 173 participants. Pearson's Chi-square or Fisher's exact test was used to analyze the results. Results: We identified an association between sexual orientation and variables such as gender, age, marital status, age, education, income, type of exposure, type of birth, consistent condom use, presence of infection, sexual practice, partner in routine consultations, disclosure of HIV to the partner and considers disclosure of their condition to the partner. Conclusion: Establishing a sexual partnership in the context of HIV and having a non-heterosexual orientation presented statistical differences between sociodemographic and behavioral variables.Objetivo: Analizar la influencia de la orientación sexual de las variables socio-demográficas, clínicas y de comportamiento entre las parejas sexuales de las personas que viven con el Virus de la inmunodeficiencia humana/Síndrome de inmunodeficiencia adquirida. Métodos: Estudio transversal realizado en un servicio de asistencia médica especializada en el tratamiento de personas con el Virus de la Inmunodeficiencia Humana, con 173 participantes. En el análisis de los resultados se utilizó el test Chi-cuadrado de Pearson o exacto de Fisher. Resultados: Se identificó asociación entre la orientación sexual y las variables: sexo, edad, estado civil, grupo de edad, escolaridad, renta, forma de exposición, tipo de asociación, uso consistente del preservativo, presencia de infección, práctica sexual, presencia del compañero en las consultas de rutina, divulgación del VIH al compañero y considerar importante la divulgación de su condición serológica para el compañero. Conclusión: Establecer un emparejamiento sexual en el contexto del VIH y tener una orientación no heterosexual presentó diferencias estadísticas entre las variables sociodemográficas y comportamentales.Objetivo: Analisar a influência da orientação sexual sobre as variáveis sociodemograficas, clínicas e comportamentais entre parcerias sexuais de pessoas que vivem com vírus da imunodeficiência humana/Síndrome da imunodeficiência adquirida. Métodos: Estudo transversal realizado em um serviço de assistência médica especializada no tratamento de pessoas com o Vírus da Imunodeficiência Humana, com 173 participantes. Na análise dos resultados utilizou-se o teste Qui-quadrado de Pearson ou exato de Fisher. Resultados: Identificou-se associação entre a orientação sexual e as variáveis: sexo, idade, estado civil, faixa etária, escolaridade, renda, forma de exposição, tipo de parceria, uso consistente do preservativo, presença de infecção, prática sexual, acompanhamento do parceiro nas consultas de rotina, divulgação do HIV para o parceiro e considerar importante a divulgação da sua condição sorológica para o parceiro. Conclusão: Estabelecer uma parceria sexual no contexto do HIV e ter uma orientação não-heterossexual apresentou diferenças estatísticas entre as variáveis sociodemográficas e comportamentais

Sexuality for the ostomized woman: contribution to nursing care

Objetivo: Conhecer qual o significado atribuído à sexualidade para mulheres estomizadas. Métodos: estudo de natureza qualitativa na perspectiva da história oral de vida. Participaram 10 mulheres cadastradas no centro integrado de saúde Lineu Araújo de Teresina-Piauí, no mês de junho de 2012. Resultados: emergiram quatro categorias: o significado da sexualidade; o significado da vivência da sexualidade; o significado do apoio do parceiro no processo de aceitação do estoma e o significado de ser mulher e conviver com o estoma. A sexualidade possui uma multiplicidade de significados que por sua vez encontram-se ligadas a diversos fatores. Conclusão: através do conhecimento, pode-se completar e implementar ações assistências que influenciaram na qualidade de vida e assistência prestada às estomizadas.&nbsp

Sexuality for the ostomized woman: contribution to nursing care

Objetivo: Conhecer qual o significado atribuído à sexualidade para mulheres estomizadas. Métodos: estudo de natureza qualitativa na perspectiva da história oral de vida. Participaram 10 mulheres cadastradas no centro integrado de saúde Lineu Araújo de Teresina-Piauí, no mês de junho de 2012. Resultados: emergiram quatro categorias: o significado da sexualidade; o significado da vivência da sexualidade; o significado do apoio do parceiro no processo de aceitação do estoma e o significado de ser mulher e conviver com o estoma. A sexualidade possui uma multiplicidade de significados que por sua vez encontram-se ligadas a diversos fatores. Conclusão: através do conhecimento, pode-se completar e implementar ações assistências que influenciaram na qualidade de vida e assistência prestada às estomizadas.

CONSUMO DE MÍDIAS SEXUALMENTE EXPLÍCITAS E SEXO ANAL DESPROTEGIDO EM HOMENS QUE FAZEM SEXO COM HOMENS

The aim of this study was to evaluate the influence of sexually explicit media (MSE) consumption of the "bareback" type in the practice of anal sex without a condom by men who have sex with men (MSM). To this end, a Facebook® page was created, with a link that directed participants to the study questionnaire. Users who identified themselves as cisgendered men, aged 18 or over and who had sex with another man in the 12 months prior to the survey were included. Data were collected in 2017 across Brazil and analyzed using univariate and bivariate inferential statistics and multivariate logistic regression. 2248 MSM participated in the research, with a mean age of 24.4 years. Most were single (69.1%), with casual sexual partner (68.9%) and an average of 3.9 partners in the last 30 days. Have multiple sexual partners (ORa: 9.4; 95% CI 3.9-22.4), prefer films with bareback scenes (ORa: 2.6; 95% CI 1.5-4.6), judge this practice a fetish and perform it (ORa: 3.52; 95% CI 2.3-5.4), have casual partnership (ORa: 1.8; 95% CI 1.5-1.9) and awareness of the partner's negative serological status for HIV (ORa: 1.4; 95% CI 1.1-2.3) were factors that increased the chances of engaging in anal sex without a condom. Thus, we verified an association between the consumption of MSE in the "bareback" modality and the practice of sex without a condom among MSM.O objetivo deste estudo foi avaliar a influência do consumo de mídia sexualmente explicita (MSE) do tipo “bareback” na prática de sexo anal sem preservativo por homens que fazem sexo com homens (HSH). Para tanto, foi criada uma página no Facebook®, com um link que direcionava os participantes para o questionário do estudo. Foram incluídos os usuários que se identificavam como homem cisgênero, com 18 anos ou mais de idade e que praticaram sexo com outro homem nos 12 meses anteriores a pesquisa. Os dados foram coletados em 2017 em todo o Brasil e analisados por meio de estatística inferencial uni e bivariada e regressão logística multivariada. Participaram da pesquisa 2248 HSH, com média de idade de 24,4 anos. A maioria era solteira (69,1%), com parceria sexual casual (68,9%) e média de 3,9 parceiros nos últimos 30 dias. Possuir múltiplos parceiros sexuais (ORa:9,4; IC95% 3,9-22,4), preferir filmes com cenas bareback (ORa:2,6; IC95% 1,5-4,6), julgar essa prática um fetiche e realizá-lo (ORa:3,52; IC95% 2,3-5,4), ter parceria casual (ORa:1,8; IC95% 1,5-1,9) e ciência do status sorológico negativo do parceiro para o HIV (ORa:1,4; IC95% 1,1-2,3) foram fatores que aumentaram as chances de envolvimento em sexo anal sem preservativo. Dessa forma, verificamos associação entre o consumo de MSE na modalidade “bareback” e a prática de sexo sem preservativo entre HSH