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OBJECTIVES: Comprehensive care for people living with human immunodeficiency virus (HIV) (PLH) includes the promotion of healthier habits, including physical activity (PA). This study aimed to describe a multicomponent pragmatic trial protocol to assess the effect of PA in preventing body changes and metabolic disturbances, improving the quality of life of PLH starting antiretroviral therapy (ART) and present cohort characteristics. METHODS: PLH undergoing ART for ≤4 months were recruited for a randomized trial. The intervention comprised three cardiorespiratory and/or strength training sessions per week at the clinic or in public spaces for 6 months under on-site or remote supervision, and educational sessions. Participants’ PA levels, cardiorespiratory fitness, anthropometric measures, strength, flexibility, quality of life, and laboratory monitoring (blood glucose and lipids, CD4 counts) at baseline and post-intervention will be compared. The pragmatic design aims to enable the assessment of intervention effectiveness in real-life conditions. RESULTS: At baseline, our cohort of 38 recently diagnosed patients (mean time since HIV diagnosis and duration of ART were 3 and 2.58 months, respectively) were predominantly male, young, with high schooling and good immune status (median CD4 count=498 cells/mm3). Twenty-two (57.9%) patients reported a PA below the World Health Organization recommendations. We found baseline normal anthropometric measures and metabolic parameters: below-average trunk flexion and elbow extension strength, poor handgrip strength and flexibility, and high quality of life scores in all except the physical domain. CONCLUSIONS: Understanding how effective PA is in preventing body changes and metabolic disturbances, and in improving the quality of PLH starting ART may help establish guidelines to better incorporate PA in HIV care.

https://doi.org/10.6061/clinics/2021/e2457 429 downloads

Use and misuse of biomarkers and the role of D-dimer and C-reactive protein in the management of COVID-19: A post-hoc analysis of a prospective cohort study
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Gonçalves, Fabio Augusto Rodrigues

; Besen, Bruno Adler Maccagnan Pinheiro

; Lima, Clarice Antunes de

; Corá, Aline Pivetta

; Pereira, Antônio José Rodrigues

; Perazzio, Sandro Félix

; Gouvea, Christiane Pereira

; Fonseca, Luiz Augusto Marcondes

; Trindade, Evelinda Marramon

; Sumita, Nairo Massakazu

; Duarte, Alberto José da Silva

; Lichtenstein, Arnaldo

; Bonfa, Eloisa

; Utiyama, Edivaldo M.

; Segurado, Aluisio C.

; Perondi, Beatriz

; Miethke-Morais, Anna

; Montal, Amanda C.

; Harima, Leila

; Fusco, Solange R. G.

; Silva, Marjorie F.

; Rocha, Marcelo C.

; Marcilio, Izabel

; Rios, Izabel Cristina

; Kawano, Fabiane Yumi Ogihara

; Jesus, Maria Amélia de

; Kallas, Ésper George

; Carmo, Carolina

; Tanaka, Clarice

; Souza, Heraldo Possolo de

; Marchini, Julio F. M.

; Carvalho, Carlos

; Ferreira, Juliana C.

; Levin, Anna Sara Shafferman

; Oliveira, Maura Salaroli

; Guimarães, Thaís

; Lázari, Carolina dos Santos

; Sabino, Ester

; Magri, Marcello M. C.

; Barros-Filho, Tarcisio E. P.

; Francisco, Maria Cristina Peres Braido

; Costa, Silvia F.

Clinics

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2021, Volume 76 elocation e3547

Resumo: En | Texto: En | PDF: En

OBJECTIVE: Coronavirus disease 2019 (COVID-19) is associated with high mortality among hospitalized patients and incurs high costs. Severe acute respiratory syndrome coronavirus 2 infection can trigger both inflammatory and thrombotic processes, and these complications can lead to a poorer prognosis. This study aimed to evaluate the association and temporal trends of D-dimer and C-reactive protein (CRP) levels with the incidence of venous thromboembolism (VTE), hospital mortality, and costs among inpatients with COVID-19. METHODS: Data were extracted from electronic patient records and laboratory databases. Crude and adjusted associations for age, sex, number of comorbidities, Sequential Organ Failure Assessment score at admission, and D-dimer or CRP logistic regression models were used to evaluate associations. RESULTS: Between March and June 2020, COVID-19 was documented in 3,254 inpatients. The D-dimer level ≥4,000 ng/mL fibrinogen equivalent unit (FEU) mortality odds ratio (OR) was 4.48 (adjusted OR: 1.97). The CRP level ≥220 mg/dL OR for death was 7.73 (adjusted OR: 3.93). The D-dimer level ≥4,000 ng/mL FEU VTE OR was 3.96 (adjusted OR: 3.26). The CRP level ≥220 mg/dL OR for VTE was 2.71 (adjusted OR: 1.92). All these analyses were statistically significant (p<0.001). Stratified hospital costs demonstrated a dose-response pattern. Adjusted D-dimer and CRP levels were associated with higher mortality and doubled hospital costs. In the first week, elevated D-dimer levels predicted VTE occurrence and systemic inflammatory harm, while CRP was a hospital mortality predictor. CONCLUSION: D-dimer and CRP levels were associated with higher hospital mortality and a higher incidence of VTE. D-dimer was more strongly associated with VTE, although its discriminative ability was poor, while CRP was a stronger predictor of hospital mortality. Their use outside the usual indications should not be modified and should be discouraged.

https://doi.org/10.6061/clinics/2021/e3547

Incidence and associated factors of type 2 diabetes mellitus onset in the Brazilian HIV/AIDS cohort study
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Cassenote, Alex J.F.

; Grangeiro, Alexandre

; Escuder, Maria M.

; Abe, Jair M.

; Santos, Raul D.

; Segurado, Aluisio C.

Brazilian Journal of Infectious Diseases

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2021, Volume 25 Nº 4 elocation 101608

Resumo: En | Texto: En | PDF: En

ABSTRACT Background: People living with HIV (PLH) under combined antiretroviral therapy (cART) are at risk of developing type 2 diabetes mellitus (T2DM). Objective: We examined the incidence of T2DM, associated factors and mean time to outcome in PLH under cART. Method: Data for this multicenter cohort study were obtained from PLH aged over 18, who started cART in 13 Brazilian sites from 2003 to 2013. Factors associated with incident T2DM were evaluated by Cox multiple regression models. Results: A total of 6724 patients (30,997.93 person-years) were followed from January 2003 to December 2016. A T2DM incidence rate of 17.3/1000 person-years (95%CI 15.8-18.8) was observed. Incidence of isolated hypertriglyceridemia and impaired fasting glucose (IFG) were 84.3 (95%CI 81.1-87.6) and 14.5/1000 person-years (95%CI 13.2-15.9), respectively. Mean time to T2DM onset was 10.5 years (95%CI 10.3-10.6). Variables associated with incident T2DM were age 40-50 [Hazard Ratio (HR) 1.7, 95%CI 1.4-2.1] and ≥ 50 years (HR 2.4, 95%CI 1.9-3.1); obesity (HR 2.1, 95%CI 1.6-2.8); abnormal triglyceride/HDL-cholesterol ratio (HR 1.8, 95%CI 1.51-2.2). IFG predicted T2DM (HR 2.6, 95%CI 1.7-2.5) and occurred on average 3.3 years before diabetes onset. Exposure to stavudine for ≥ 2 years was independently associated with incident T2DM [HR 1.6, 95%CI 1.0-2.2). Conclusion: Brazilian PLH under cART are at significant risk of developing T2DM and share risk factors for diabetes onset with the general population, such as older age, obesity, and having metabolic abnormalities at baseline. Moreover, stavudine use was independently associated with incident T2DM. Identifying PLH at a higher risk of T2DM can help caretakers trigger health promotion and establish specific targets for implementation of preventive measures.

https://doi.org/10.1016/j.bjid.2021.101608 34 downloads

Suspected vertical transmission of Chagas disease caused by DTU TcIV in an infection probably transmitted orally, during anoutbreak in the Brazilian Amazon
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Freitas, Vera Lúcia Teixeira de

; Esper, Helena Rangel

; Nakanishi, Erika Shimoda

; Piotto, Mariana Ramos

; Assy, João Guilherme Pontes Lima

; Berreta, Olívia Campos Pinheiro

; Said, Renato do Carmo

; Segurado, Aluisio Augusto Cotrim

; Carvalho, Noemia Barbosa

; França, Francisco Oscar de Siqueira

; Lopes, Marta Heloísa

Revista do Instituto de Medicina Tropical de São Paulo

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2021, Volume 63 elocation e48

Resumo: En | Texto: En | PDF: En

ABSTRACT This study describes difficulties in the monitoring of a child born during an oral outbreak of Chagas disease, in which there are several indications that the transmission occurred through the congenital route: 1. the mother was in the third trimester of pregnancy when she was infected; 2. She presented high parasitemia at the time of delivery; 3. In both, the mother and her daughter, T. cruzi was classified as DTU TcIV. The parasites were not found in the blood at birth and the infection was detected only three months later in an asymptomatic infant. As the mother and her child live in a highly endemic area, vector transmission could not be excluded during this period.

https://doi.org/10.1590/s1678-9946202163048 210 downloads

Setting up hospital care provision to patients with COVID-19: lessons learnt at a 2400-bed academic tertiary center in São Paulo, Brazil
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Perondi, Beatriz

; Miethke-Morais, Anna

; Montal, Amanda C.

; Harima, Leila

; Segurado, Aluisio C.

Brazilian Journal of Infectious Diseases

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Dez 2020, Volume 24 Nº 6 Páginas 570 - 574

Resumo: En | Texto: En | PDF: En

ABSTRACT As of August 30, 2020, Brazil ranked second among countries with the highest number of COVID-19 cases, with the city of São Paulo as the national epidemic epicenter. Local public healthcare institutions were challenged to respond to a fast-growing hospital demand, reengineering care provision to optimize clinical outcomes and minimize intra-hospital coronavirus infection. In this paper we describe how the largest public hospital complex in Latin America faced this unprecedented burden, managing severe COVID-19 cases while sustaining specialized care to patients with other conditions. In our strategic plan a 900-bed hospital was exclusively designated for COVID-19 care and continuity of care to those not infected with coronavirus ensured in other inpatient facilities. After 152 days, 4241 patients with severe COVID-19 were hospitalized, 70% of whom have already been discharged, whereas the remaining Institutes of the complex successfully maintained high complexity inpatient and urgent/emergency care to non-COVID-19 patients.

https://doi.org/10.1016/j.bjid.2020.09.005 313 downloads

Overcoming barriers to providing comprehensive inpatient care during the COVID-19 pandemic
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Miethke-Morais, Anna

; Perondi, Beatriz

; Harima, Leila

; Montal, Amanda C.

; Baldassare, Renato Madrid

; Moraes, Danielle P.

; Pedroso, Lucila

; Ramos, Marcelo C.A.

; Fusco, Solange R.G.

; Pereira, Antonio José

; Barros-Filho, Tarcísio E.P.

; Bonfá, Eloisa

; Utiyama, Edivaldo M.

; Segurado, Aluisio C.

Clinics

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2020, Volume 75 elocation e2100

Resumo: En | Texto: En | PDF: En

https://doi.org/10.6061/clinics/2020/e2100 1240 downloads

HIV-infected youths transitioning from pediatric to adult outpatient care in a teaching tertiary care hospital in São Paulo city, Brazil
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Freitas, Angela Carvalho

; Avelino-Silva, Vivian Iida

; Gutierrez, Eliana Battaggia

; Marques, Heloisa Helena de Souza

; Durigon, Giuliana Stravinskas

; Segurado, Aluisio Cotrim

Brazilian Journal of Infectious Diseases

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Out 2019, Volume 23 Nº 5 Páginas 291 - 297

Resumo: En | Texto: En | PDF: En

ABSTRACT Background: HIV-infected children surviving until adulthood have been transitioning to adult outpatient health care service in Brazil since the late 2000's. Deterioration of clinical condition is expected during this period, as reported among youths with non-communicable chronic diseases. Despite their young age, they are long-term hosts of the virus, have prolonged exposure to antiretroviral therapy and have suffered from the social determinants and stigma of HIV infection since early childhood. Objectives: This study aimed to 1) describe demographic and clinical characteristics at the first appointment at adult care service following pediatric care of a cohort of Brazilian youths living with HIV since childhood; and 2) retrospectively address adherence and clinical variables in the last two years of pediatric follow-up. Methods: Descriptive study. Results: 41 consecutive patients referred to adult outpatient care from a pediatric HIV unit were enrolled, median age 19 years, and median lifetime CD4 + nadir 117 cell/mm3; 89% reported previous AIDS-defining conditions. At first laboratory assessment in adult care, only 46% had undetectable (<400 copies/ml) HIV viral load and the median CD4 + count was 250 cell/mm3. Conclusion: Youths living with HIV at the transition from pediatric to adult care had poor treatment adherence, low lifetime CD4 + cell nadir, low CD4 cell count and detectable HIV viral load. Health care providers should closely monitor these adolescents in a youth friendly environment, prepared for open communication about all aspects of their health.

https://doi.org/10.1016/j.bjid.2019.07.004 424 downloads

Zika virus infection among symptomatic patients from two healthcare centers in Sao Paulo State, Brazil: prevalence, clinical characteristics, viral detection in body fluids and serodynamics
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Tozetto-Mendoza, Tania Regina

; Avelino-Silva, Vivian Iida

; Fonseca, Silvia

; Claro, Ingra Morales

; Paula, Anderson Vicente de

; Levin, Anna Sara

; Sabino, Ester Cerdeira

; Mendes-Correa, Maria Cassia

; Figueiredo, Walter Manso

; Felix, Alvina Clara

; Souza, Nathalia C. Santiago

; Costa, Angela Aparecida

; Inenami, Marta

; Silva, Rosangela M. Gasparetto da

; Levi, José Eduardo

; Romano, Camila Malta

; Paranhos-Baccalà, Glaucia

; Segurado, Aluisio Cotrim

; Mayaud, Philippe

Revista do Instituto de Medicina Tropical de São Paulo

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2019, Volume 61 elocation e19

Resumo: En | Texto: En | PDF: En

ABSTRACT Zika virus (ZIKV) clinical presentation and frequency/duration of shedding need further clarification. Symptomatic ZIKV-infected individuals identified in two hospitals in Sao Paulo State, Brazil, were investigated regarding clinical characteristics, shedding in body fluids, and serodynamics. Ninety-four of 235 symptomatic patients (Site A: 58%; Site B: 16%) had Real-Time PCR-confirmed ZIKV infection; fever, headache and gastrointestinal symptoms were less frequent, and rash was more frequent compared to ZIKV-negative patients. Real-Time PCR in serum had worse performance compared to plasma, while urine had the highest sensitivity. Shedding in genital fluids and saliva was rare. IgM positivity was the highest <14 days after the symptoms onset (86%), decreasing >28 days (24%); IgG positivity increased >14 days (96%) remaining positive in 94% of patients >28 days. ZIKV prevalence varied importantly in two neighboring cities during the same transmission season. Urine Real-Time PCR can improve diagnostic sensitivity; serum testing is less useful. Accurate serological tests are needed to improve diagnosis and surveillance.

https://doi.org/10.1590/s1678-9946201961019 2345 downloads

Audiological and electrophysiological alterations in HIV-infected individuals subjected or not to antiretroviral therapy
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Matas, Carla Gentile

; Samelli, Alessandra Giannella

; Magliaro, Fernanda Cristina Leite

; Segurado, Aluisio

Brazilian Journal of Otorhinolaryngology

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Out 2018, Volume 84 Nº 5 Páginas 574 - 582

Resumo: Pt En | Texto: Pt En | PDF: Pt | PDF: En

Resumo Introdução: O HIV e as infecções relacionadas a ele podem afetar vários locais do sistema auditivo. O uso de terapia antirretroviral altamente ativa pode causar efeitos colaterais, como ototoxicidade. Assim, não foram estabelecidos padrões consistentes de deficiência auditiva em adultos com HIV/Aids e os problemas que afetam o sistema auditivo dessa população justificam pesquisas futuras. Objetivos: Este estudo teve como objetivo comparar os dados audiológicos e eletrofisiológicos de pacientes HIV positivos com e sem Aids que recebiam terapia antirretroviral altamente ativa com os de indivíduos saudáveis. Método: Estudo transversal com 71 indivíduos (30-48 anos), divididos em grupos: Grupo de Pesquisa I: 16 indivíduos HIV-positivos sem Aids (não recebiam tratamento antirretroviral); Grupo de Pesquisa II: 25 indivíduos HIV-positivos com Aids (recebiam tratamento antirretroviral); Grupo Controle: 30 indivíduos saudáveis. Todos os indivíduos foram testados para limiares de condução aérea de tons puros a 0,25-8 kHz, altas frequências de 9-20 kHz, testes eletrofisiológicos (potencial evocado auditivo de tronco encefálico, potencial evocado auditivo de média latência, potencial cognitivo). Resultados: Os grupos de pesquisa I e II apresentaram limiares auditivos mais elevados em audiometria convencional e nas frequências altas quando comparados com o grupo controle, latência prolongada das ondas I, III, V e interpico I-V em resposta auditiva de tronco encefálico e latência prolongada de P300. Em relação às respostas de latência média, houve uma diminuição na amplitude da onda Pa do Grupo de pesquisa II em comparação com o grupo de pesquisa I. Conclusões: Ambos os grupos com HIV apresentaram limiares auditivos mais elevados quando comparados aos indivíduos saudáveis (o grupo exposto ao tratamento antirretroviral apresentou o pior limiar auditivo) e parecem ter menor velocidade de transmissão neuroelétrica ao longo da via auditiva nas regiões do tronco encefálico, subcortical e cortical.

Abstract Introduction: The Human Immunodeficiency Virus (HIV) and infections related to it can affect multiple sites in the hearing system. The use of High Activity Anti-Retroviral Therapy (HAART) can cause side effects such as ototoxicity. Thus, no consistent patterns of hearing impairment in adults with Human Immunodeficiency Virus / Acquired Immune Deficiency Syndrome have been established, and the problems that affect the hearing system of this population warrant further research. Objectives: This study aimed to compare the audiological and electrophysiological data of Human Immunodeficiency Virus-positive patients with and without Acquired Immune Deficiency Syndrome, who were receiving High Activity Anti-Retroviral Therapy, to healthy individuals. Methods: It was a cross-sectional study conducted with 71 subjects (30-48 years old), divided into groups: Research Group I: 16 Human Immunodeficiency Virus-positive individuals without Acquired Immunodeficiency Syndrome (not receiving antiretroviral treatment); Research Group II: 25 Human Immunodeficiency Virus-positive individuals with Acquired Immunodeficiency Syndrome (receiving antiretroviral treatment); Control Group: 30 healthy subjects. All individuals were tested by pure-tone air conduction thresholds at 0.25-8 kHz, extended high frequencies at 9-20 kHz, electrophysiological tests (Auditory Brainstem Response, Middle Latency Responses, Cognitive Potential). Results: Research Group I and Research Group II had higher hearing thresholds in both conventional and high frequency audiometry when compared to the control group, prolonged latency of waves I, III, V and interpeak I-V in Auditory Brainstem Response and prolonged latency of P300 Cognitive Potential. Regarding Middle Latency Responses, there was a decrease in the amplitude of the Pa wave of Research Group II compared to the Research Group I. Conclusions: Both groups with Human Immunodeficiency Virus had higher hearing thresholds when compared to healthy individuals (group exposed to antiretroviral treatment showed the worst hearing threshold) and seemed to have lower neuroelectric transmission speed along the auditory pathway in the brainstem, subcortical and cortical regions.

https://doi.org/10.1016/j.bjorl.2017.07.003 1061 downloads

10.

Saúde nas metrópoles - Doenças infecciosas
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Segurado, Aluisio Cotrim

; Cassenote, Alex Jones

; Luna, Expedito de Albuquerque

Estudos Avançados

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Abr 2016, Volume 30 Nº 86 Páginas 29 - 49

Resumo: Pt En | Texto: Pt En | PDF: Pt | PDF: En

A urbanização é um processo irreversível em escala mundial e estima-se que o número de pessoas que vivem em cidades deverá atingir 67% da população do planeta até 2050. Os países de baixa ou média renda, por sua vez, possuem 30% a 40% da população urbana vivendo atualmente em favelas, em situação de risco para diversos agravos de saúde. No Brasil, embora 84,3% da população residissem em áreas urbanas já em 2010, não se verificam no momento ações consistentes voltadas ao enfrentamento das questões de saúde urbana. Neste artigo discute-se a situação epidemiológica de agravos infecciosos de interesse para a saúde pública (dengue, infecção por HIV/aids, leptospirose, hanseníase e tuberculose) a partir do ano 2000 nas 17 metrópoles do país, de modo a esclarecer o papel atual das doenças infecciosas no contexto da saúde urbana brasileira.

Urbanization is an irreversible global process and the number of people living in cities is estimated to reach 67% of the world population by 2050. In low- and middle-income countries, 30% to 40% of the population currently lives in slum areas, under risk of several diseases. Even though 84.3% of the Brazilian population already lived in urban areas in 2010, no consistent initiatives have been implemented to address urban health issues. We discuss here the epidemiological features of communicable diseases that are relevant to public health (dengue, HIV/aids, leptospirosis, leprosy and tuberculosis) in Brazil's 17 metropolitan areas since 2000 to help clarify the current role of infections in the context of Brazilian urban health.

https://doi.org/10.1590/S0103-40142016.00100003 42549 downloads

11.

HIV testing and clinical status upon admission to a specialized health care unit in Pará, Brazil
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Abati, Paulo Afonso Martins

; Segurado, Aluisio Cotrim

Revista de Saúde Pública

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2015, Volume 49 elocation 16

Resumo: Pt En | Texto: Pt En | PDF: Pt | PDF: En

OBJETIVO Analisar as características clínicas e laboratoriais de indivíduos infectados pelo HIV na admissão em serviço de referência em saúde.MÉTODOS Estudo transversal realizado entre 1999 e 2010, com 527 indivíduos com diagnóstico sorológico confirmado de infecção pelo HIV, matriculados em serviço de saúde ambulatorial, em Santarém, PA, Brasil. Foram coletadas informações de prontuários referentes à população estudada sobre o motivo de realização da testagem anti-HIV, estadio clínico e número de linfócitos T CD4+ periféricos, no ato da matrícula. Os dados foram distribuídos em três grupos, segundo ano de admissão do paciente: 1999 a 2002 (P1), 2003 a 2006 (P2) e 2007 a 2010 (P3), para a análise comparativa das variáveis de interesse.RESULTADOS Do total estudado, 62,0% dos pacientes foram admitidos no grupo P3. O motivo de realização da testagem anti-HIV diferiu entre os sexos. Houve preponderância da realização do teste por presença de sintomas sugestivos da infecção na população masculina e pelo conhecimento da soropositividade do parceiro entre as mulheres nos grupos P1 e P2. A maior proporção de mulheres testadas por apresentarem sintomas de infecção pelo HIV/aids fez desaparecer essa diferença entre os gêneros no período mais recente. Observou-se maior participação de matriculados em fase mais avançada da doença no grupo P3.CONCLUSÕES Apesar do maior reconhecimento de casos de HIV/aids, os pacientes seguem descobrindo seu status sorológico tardiamente e apresentando-se à admissão no serviço de saúde com doença em atividade. A epidemia de HIV/aids no Pará apresenta especificidades em evolução que compõem o complexo mosaico da epidemia na região Norte e no Brasil.

OBJECTIVE To analyze the clinical and laboratory characteristics of HIV-infected individuals upon admission to a reference health care center.METHODS This cross-sectional study was conducted between 1999 and 2010 on 527 individuals with confirmed serological diagnosis of HIV infection who were enrolled in an outpatient health care service in Santarém, PA, Northern Brazil. Data were collected from medical records and included the reason for HIV testing, clinical status, and count of peripheral CD4+ T lymphocytes upon enrollment. The data were divided into three groups, according to the patient’s year of admission – P1 (1999-2002), P2 (2003-2006), and P3 (2007-2010) – for comparative analysis of the variables of interest.RESULTS In the study group, 62.0% of the patients were assigned to the P3 group. The reason for undergoing HIV testing differed between genders. In the male population, most tests were conducted because of the presence of symptoms suggesting infection. Among women, tests were the result of knowledge of the partner’s seropositive status in groups P1 and P2. Higher proportion of women undergoing testing because of symptoms of HIV/AIDS infection abolished the difference between genders in the most recent period. A higher percentage of patients enrolling at a more advanced stage of the disease was observed in P3.CONCLUSIONS Despite the increased awareness of the number of HIV/AIDS cases, these patients have identified their serological status late and were admitted to health care units with active disease. The HIV/AIDS epidemic in Pará presents specificities in its progression that indicate the complex characteristics of the epidemic in the Northern region of Brazil and across the country.

https://doi.org/10.1590/S0034-8910.2015049004625 1901 downloads

12.

HIV testing and clinical status upon admission to a specialized health care unit in Pará, Brazil
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Abati, Paulo Afonso Martins

; Segurado, Aluisio Cotrim

Revista de Saúde Pública

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2015, Volume 49 elocation 16

Resumo: Pt En | Texto: Pt En | PDF: Pt | PDF: En

https://doi.org/10.1590/S0034-8910.2015049004625 7665 downloads

13.

Audiological manifestations in HIV-positive adults
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Matas, Carla Gentile

; Angrisani, Rosanna Giaffredo

; Magliaro, Fernanda Cristina Leite

; Segurado, Aluisio Augusto Cotrim

Clinics

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Jul 2014, Volume 69 Nº 7 Páginas 469 - 475

Resumo: En | Texto: En | PDF: En

OBJECTIVE:To characterize the findings of behavioral hearing assessment in HIV-positive individuals who received and did not receive antiretroviral treatment.METHODS:This research was a cross-sectional study. The participants were 45 HIV-positive individuals (18 not exposed and 27 exposed to antiretroviral treatment) and 30 control-group individuals. All subjects completed an audiological evaluation through pure-tone audiometry, speech audiometry, and high-frequency audiometry.RESULTS:The hearing thresholds obtained by pure-tone audiometry were different between groups. The group that had received antiretroviral treatment had higher thresholds for the frequencies ranging from 250 to 3000 Hz compared with the control group and the group not exposed to treatment. In the range of frequencies from 4000 through 8000 Hz, the HIV-positive groups presented with higher thresholds than did the control group. The hearing thresholds determined by high-frequency audiometry were different between groups, with higher thresholds in the HIV-positive groups.CONCLUSION:HIV-positive individuals presented poorer results in pure-tone and high-frequency audiometry, suggesting impairment of the peripheral auditory pathway. Individuals who received antiretroviral treatment presented poorer results on both tests compared with individuals not exposed to antiretroviral treatment.

https://doi.org/10.6061/clinics/2014(07)05 1410 downloads

14.

Self-disclosure of HIV diagnosis to sexual partners by heterosexual and bisexual men: a challenge for HIV/AIDS care and prevention
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Paiva, Vera

; Segurado, Aluisio C.

; Filipe, Elvira Maria Ventura

Cadernos de Saúde Pública

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Set 2011, Volume 27 Nº 9 Páginas 1699 - 1710

Resumo: Pt En | Texto: Pt En | PDF: Pt | PDF: En

Este estudo investigou a revelação da soropositividade para parceiro/as sexuais por homens, hetero e bissexuais, usuários de serviços especializados no cuidado ao HIV/AIDS. Por meio de 250 entrevistas individuais e grupo focal descrevemos a revelação segundo características das parcerias e discutimos as dificuldades para manter ou estabelecer novas relações afetivo-sexuais e com o sexo protegido. Observamos que o temor à rejeição provoca isolamento e sofrimento e dificultava a revelação para parceira/os atuais ou futuro/as. Revelar requer confiança e foi mais frequente para parceira/os fixa/os, para soropositiva/os, para mulheres, e menos frequente para parceiro/as pagos por "programa". Heterossexuais revelavam mais. A maioria usava preservativos consistentemente, embora menos frequentemente com parceiros soropositivos. Para melhorar o cuidado integral de homens soropositivos, sugere-se a "gestão do estigma", atividades em grupo e abordagens baseadas em direitos humanos que capacitem profissionais para o cuidado da vida sexual-afetiva, da revelação e ao apoio ao viver com HIV.

This study investigated the disclosure of HIV-positive serostatus to sexual partners by heterosexual and bisexual men, selected in centers for HIV/AIDS care. In 250 interviews, we investigated disclosure of serostatus to partners, correlating disclosure to characteristics of relationships. The focus group further explored barriers to maintenance/establishment of partnerships and their association with disclosure and condom use. Fear of rejection led to isolation and distress, thus hindering disclosure to current and new partners. Disclosure requires trust and was more frequent to steady partners, to partners who were HIV-positive themselves, to female partners, and by heterosexuals, occurring less frequently with commercial sex workers. Most interviewees reported consistent condom use. Unprotected sex was more frequent with seropositive partners. Suggestions to enhance comprehensive care for HIV-positive men included stigma management, group activities, and human rights-based approaches involving professional education in care for sexual health, disclosure, and care of "persons living with HIV".

1975 downloads Citado 5 vezes em SciELO

15.

Self-disclosure of HIV diagnosis to sexual partners by heterosexual and bisexual men: a challenge for HIV/AIDS care and prevention
Facebook Twitter

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Google+
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Métricas
- SciELO Analytics

Paiva, Vera

; Segurado, Aluisio C.

; Filipe, Elvira Maria Ventura

Cadernos de Saúde Pública

Métricas do periódico
- Sobre o periódico
- SciELO Analytics

Set 2011, Volume 27 Nº 9 Páginas 1699 - 1710

Resumo: Pt En | Texto: Pt En | PDF: Pt | PDF: En

4433 downloads Citado 5 vezes em SciELO

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