Raimunda Hermelinda Maia Macena

An Empirical Comparison of Respondent-driven Sampling, Time Location Sampling, and Snowball Sampling for Behavioral Surveillance in Men Who Have Sex with Men, Fortaleza, Brazil

Obtaining samples of populations at risk for HIV challenges surveillance, prevention planning, and evaluation. Methods used include snowball sampling, time location sampling (TLS), and respondent-driven sampling (RDS). Few studies have made side-by-side comparisons to assess their relative advantages. We compared snowball, TLS, and RDS surveys of men who have sex with men (MSM) in Forteleza, Brazil, with a focus on the socio-economic status (SES) and risk behaviors of the samples to each other, to known AIDS cases and to the general population. RDS produced a sample with wider inclusion of lower SES than snowball sampling or TLS—a finding of health significance given the majority of AIDS cases reported among MSM in the state were low SES. RDS also achieved the sample size faster and at lower cost. For reasons of inclusion and cost-efficiency, RDS is the sampling methodology of choice for HIV surveillance of MSM in Fortaleza.

Endothelial dysfunction after pregnancy-induced hypertension

To carry out long‐term analysis of the presence of endothelial dysfunction after the development of pregnancy‐induced hypertension (PIH).

Travestis, an unexplored population at risk of HIV in a large metropolis of northeast Brazil: a respondent-driven sampling survey.

Abstract Travestis are highly vulnerable to HIV infection in Brazil. We conducted a survey among 304 travestis using Respondent-Driven Sampling from August to December 2008. Travestis are young (49% <24 years), poorly educated (55% just elementary school), low social class (62% Class C-E), reside with families (49%) or friends/madam (22%), are victims of homophobia (91%) and violence (61%). They report early sexual debut (75% <14), many sexual partners, drug use during sex (43%), and unprotected sex (male partner, 47%, both male and female partners, 50%). Sex work is common (82%, 59% >10 partners last six months) and relatively low cost (median=US

HIV-testing among female sex workers on the border between Brazil and French Guiana: the need for targeted interventions

24). A majority report testing for HIV (69%), and report high prevalence (12% disclosed a positive result). Almost all the respondents refused to test in the study. Interventions, targeted to both travestis and to the general community about sexual discrimination, are necessary.

Population size, HIV, and behavior among MSM in Luanda, Angola: challenges and findings in the first ever HIV and syphilis biological and behavioral survey.

The border between Brazil and French Guiana is a place of economic, cultural, social and sexual exchange. Female sex workers represent a high risk population for HIV in this area where sexual tourism is particularly developed. HIV testing seems to be an important element in the fight against the epidemic. Indeed, early HIV testing gives access to treatments and prevention. An HIV/AIDS knowledge, attitudes, behaviors and practices survey was conducted in 2011 among sex workers along the border between Brazil and French Guiana. A total of 213 female sex workers were interviewed. One third (31.5%) of the interviewed had never tested for HIV. Factors associated with non HIV-testing were the lack of knowledge of places where to do an HIV test, to be 30 or older, feeling at risk of HIV, not evaluating ones own risk towards HIV, and living in Oiapoque. These results clearly suggest that targeted interventions are needed to encourage and assist female sex workers to get tested regularly.A fronteira entre Guiana Francesa e Brasil e um lugar de intercâmbio economico, cultural, social e sexual. Nessa area, onde o turismo sexual e particularmente desenvolvido, as mulheres profissionais do sexo representam uma populacao de alto risco de contagio pelo HIV. Os testes de HIV parecem ser um elemento importante da luta contra a epidemia. De fato, os primeiros testes de HIV dao acesso a prevencao e aos tratamentos. Foi realizada em 2011 uma pesquisa de conhecimento, atitudes, comportamentos e praticas sobre HIV/AIDS com mulheres profissionais do sexo ao longo da fronteira da Guiana Francesa com o Brasil. Foram entrevistadas 213 mulheres profissionais do sexo. Um terco (31,5%) delas nunca tinha feito o teste de HIV. Fatores associados a nao realizacao do teste de HIV foram: a falta de conhecimento dos locais onde fazer o teste, ter idade igual ou acima de 30 anos, sentir-se em risco de contagio pelo HIV, falta de avaliacao do risco de contagio pelo HIV e habitante do Oiapoque. Esses resultados sugerem claramente que intervencoes direcionadas as mulheres profissionais do sexo sao necessarias para que os testes sejam feitos regularmente.

Risk factors associated with resistance to HIV testing among transwomen in Brazil

Objectives:To conduct the first population size estimation and biological and behavioral surveillance survey among men who have sex with men (MSM) in Angola. Design:Population size estimation with multiplier method and a cross-sectional study using respondent-driven sampling. Setting:Luanda Province, Angola. Study was conducted in a large hospital. Participants:Seven hundred ninety-two self-identified MSM accepted a unique object for population size estimation. Three hundred fifty-one MSM were recruited with respondent-driven sampling for biological and behavioral surveillance survey. Methods:Interviews and testing for HIV and syphilis were conducted on-site. Analysis used Respondent-Driven Sampling Analysis Tool and STATA 11.0. Univariate, bivariate, and multivariate analyses examined factors associated with HIV and unprotected sex. Six imputation strategies were used for missing data for those refusing to test for HIV. Main Outcome:A population size of 6236 MSM was estimated. Twenty-seven of 351 individuals were tested positive. Adjusted HIV prevalence was 3.7% (8.7% crude). With imputation, HIV seroprevalence was estimated between 3.8% [95% confidence interval (CI): 1.6 to 6.5] and 10.5% (95% CI: 5.6 to 15.3). Being older than 25 (odds ratio = 10.8, 95% CI: 3.5 to 32.8) and having suffered episodes of homophobia (odds ratio = 12.7, 95% CI: 3.2 to 49.6) significantly increased the chance of HIV seropositivity. Conclusions:Risk behaviors are widely reported, but HIV seroprevalence is lower than expected. The difference between crude and adjusted values was mostly due to treatment of missing values in Respondent-Driven Sampling Analysis Tool. Solutions are proposed in this article. Although concerns were raised about feasibility and adverse outcomes for MSM, the study was successfully and rapidly completed with no adverse effects.

Características de saúde de mulheres em situação de violência doméstica abrigadas em uma unidade de proteção estadual

Transwomen are a high-risk population for HIV/AIDS worldwide. However, many transwomen do not test for HIV. This study aimed to identify factors associated with resistance to HIV testing among transwomen in Fortaleza/CE. A cross-sectional study was conducted between August and December 2008 with a sample of 304 transwomen recruited through respondent-driven sampling. Data analysis utilized Respondent-Driven Sampling Analysis Tool and SPSS 11.0. Univariate, bivariate, and multivariate analyses examined risk factors associated with resistance to HIV testing. Less than 18 years of age (OR = 4.221; CI = 2.419–7.364), sexual debut before 10 years of age (OR = 6.760; CI = 2.996–15.256), using illegal drugs during sex (OR = 2.384; CI = 1.310–4.339), experience of discrimination (OR = 3.962; CI = 1.540–10.195) and a belief that the test results were not confidential (OR = 3.763; CI = 2.118–6.688) are independently associated with resistance to testing. Intersectoral and targeted strategies aimed at encouraging the adoption of safer sexual behaviors and testing for HIV among transwomen are required.

Incentives and barriers to HIV testing in men who have sex with men in a metropolitan area in Brazil

The promotion of care for female victims of violence implies action that is not limited to combatting the problem, but also to the dimension of care provided to the victims. This study seeks to understand the sociodemographic and health characteristics of female victims of violence who are/have been under the protective custody of the state, before and after the Maria da Penha Law (MPL), and the healthcare offered to them. It is a cross-sectional, exploratory-descriptive documentary study, with a qualitative/quantitative approach, conducted in the second semester of 2013 in a special unit for the protection of female victims of violence in the State of Ceará. The sample was composed of 197 medical records of women attended between 2001 and 2012. Few changes occurred in the health profile of female victims of domestic violence sheltered by the State after the enactment of the MPL. Significant changes occurred in the pattern of care provided, such as increased investigation, promotion, and registration of health-related activities. The identification of the aftereffects of aggression per se is still scarce. A suggested addition would be the inclusion of a health professional in the staff at the shelters to meet this demand.Resumo A promocao do atendimento as mulheres vitimas de violencia implica uma acao nao limitada ao combate, mas tambem a dimensao da assistencia dada as vitimas. Este estudo visa conhecer as caracteristicas sociodemograficas e de saude das mulheres vitimas de violencia que estao/estiveram sob a tutela protetora do Estado, antes e apos a Lei Maria da Penha (LMP), bem como a assistencia a saude ofertada. Estudo seccional, exploratorio-descritivo, documental, quali-quatitativo realizado em uma unidade de protecao especial de mulheres vitimas de violencia do Estado do Ceara no segundo semestre de 2013. Amostra composta por 197 prontuarios das mulheres atendidas entre 2001 e 2012. Poucas mudancas ocorreram no perfil de saude de mulheres vitimas de violencia domestica atendidas pelo Estado, apos a promulgacao da LMP. Mudancas relevantes ocorreram no padrao de assistencia oferecido, tais como maior investigacao, promocao e registro de atividades relacionadas a saude. Ainda e escassa a identificacao de sequelas da agressao propriamente dita. Sugere-se inclusao de profissionais da saude na equipe do abrigo para suprir essa demanda.

USE OF SOFTWARES FOR POSTURE ASSESSMENT: INTEGRATIVE REVIEW

This study aimed to identify incentives and barriers to HIV testing in men who have sex with men (MSM). This was a cross-sectional study of MSM who had lived at least three months in greater metropolitan Fortaleza, Ceará State, Brazil, 2010. The study recruited 391 men ≥ 18 years of age who reported sexual relations with men in the previous six months, using Respondent Driven Sampling. Personal network and socio-demographic data were collected and HIV testing was offered, analyzed with RDSAT 6.0 and Stata 11.0. The majority were young (40.3%), had 5 to 11 years of schooling (57.3%), were single (85.1%), had low income (37.6%), and 58.1% had tested for HIV some time in life. Incentive to test: certainty of not being infected (34.1%) and the exposure to national campaign Fique Sabendo [Know your Status] (34%). Barriers: trust in partner(s) (21%) and fear of discrimination if tested positive (20.3%). Policies should be developed to ensure test confidentiality and communication campaigns focusing on information gaps and encouragement for testing.Identificar os incentivos e as barreiras aos testes de HIV entre homens que fazem sexo com homens (HSH). Estudo transversal entre HSH que residiram pelo menos tres meses na regiao metropolitana de Fortaleza, Ceara, Brasil, em 2010. Foram recrutados 391 homens, ≥ 18 anos, que relataram sexo com homens nos ultimos seis meses, utilizando Respondent Driven Sampling. Coletados os dados: rede social, sociodemograficos e oferecido o teste de HIV e analisados pelo RDSAT 6.0 e Stata 11.0. A maioria era jovem (40,3%), de 5 a 11 anos de escolaridade (57,3%), solteira (85,1%), baixa renda (37,6%), 58,1% testaram para o HIV alguma vez na vida. Incentivos ao teste: certeza de nao estar infectado (34,1%) e campanha nacional Fique Sabendo (34%). Barreiras: confiar no(s) parceiro(s) (21%) e medo de discriminacao se o resultado for positivo (20,3%). Politicas que assegurem a confidencialidade dos testes e campanhas de comunicacao voltadas as lacunas de informacao e incentivo ao teste devem ser desenvolvidas.

INCIDÊNCIA DE COMPLICAÇÕES PULMONARES EM MULHERES MASTECTOMIZADAS NO PÓS OPERATÓRIO IMEDIATO

Objetivo: Realizar uma revisao integrativa da literatura sobre os softwares de analise postural disponiveis na atualidade. Metodos: Trata-se de uma revisao integrativa-narrativa, de cunho metodologico e natureza qualitativa realizada no periodo de Abril a Julho de 2014. Como criterios de inclusao os artigos deveriam ser de cunho bibliografico ou de pesquisa original e disponibilizado acesso completo. A principio, realizou-se a identificacao de descritores relativos aos softwares relacionados a avaliacao postural comumente utilizados dentro do âmbito da saude, sendo assim, os descritores foram “postura”, “ software ” e “avaliacao postural”. As buscas foram estreitadas por data de publicacao de 2002 a 2014. Resultados: Diante das informacoes adquiridas a partir dos artigos e informacoes fornecidas dos desenvolvedores dos softwares , foram obtidas informacoes sobre 12 programas que auxiliam na avaliacao postural - Alcimage, All Body Scan 3D, Aplob, APPID, Biotonix, Corporis pro, Fisimetrix, Fisiometer posturograma, Physical fisio, Physio easy, Posture print e SAPO. Entretanto, apenas uma ferramenta possui maior quantidade de informacao e estudos realizados com o mesmo, o SAPO. Conclusao: Muitos sao os softwares de analise postural disponiveis na internet atualmente, entretanto, estes sao bastante dispares em relacao as possibilidades de resposta e ainda sao pouco difundidos como ferramentas de pesquisa.