Epidemiologia e Servicos de Saude最新文献

Objective: To describe HIV prevention strategies and gender-based discrimination among adolescent travestis and transgender women.

Methods: This was a cross-sectional study involving 148 adolescent travestis and transgender women aged 15 to 19 years in Salvador, Bahia state, São Paulo, São Paulo state, and Belo Horizonte, Minas Gerais state, conducted between February 2019 and March 2023. Fisher's exact test was performed to assess differences between prevention strategies and gender-based discrimination within healthcare services.

Results: 18.9 % reported engaging in receptive anal sex using condom in the past 6 months; 62.2% had undergone HIV test at least once in their lifetime; and 88.5% had started pre-exposure prophylaxis (PrEP) for HIV. Adolescents aged 15 to 17 years with previous experiences of discrimination in healthcare services had undergone fewer HIV tests in their lifetime or had started PrEP less frequently.

Conclusion: There is an urgent need for the implementation of public policies that eradicate gender-based discrimination and expand access to HIV prevention.

Objective: The study aims to describe the violence perceived by transvestigender people in Brazil, linking it to primary healthcare.

Methods: Fourteen transvestigender people in Brazil were interviewed through 2 focus groups and 8 interviews, conducted between December 2021 and April 2022. Data analysis was performed using a phenomenological-hermeneutic approach.

Results: The statements were categorized into the following themes: "the unintentional nature of violence", "violence in health services" and "the family as a producer of violence". These categories show that the phenomenon of violence extends beyond intentional acts directed at a person, as originally conceptualized by the World Health Organization.

Conclusion: The transvestigender population experiences both intentional and unintentional violence, which impacts their physical and emotional well-being. Primary healthcare can serve as an ally in addressing these forms of violence by ensuring comprehensive care.

Objectives: To analyze access to pre-exposure prophylaxis (PrEP) for HIV in Brazil, comparing transgender and cisgender populations.

Methods: This was a descriptive study using data from the Medication Logistics Control System (Sistema de Controle Logístico de Medicamentos - SICLOM), related to the monitoring of PrEP between January 2018 and December 2023.

Results: During the period analyzed, 149,022 people initiated PrEP, of whom 139,423 (94%) were cisgender and 9,599 (6%) were transgender. 54% cisgender and 46% transgender people were of White/Asian skin color, 67% cisgender and 48% transgender people had 12 or more years of study, and 40% cisgender and 52% transgender people were aged 15 to 29 years.

Conclusion: The data showed disparities in access to PrEP, with the transgender population still underrepresented. Expanding targeted strategies may mitigate specific barriers faced by this population and promote greater equity in access to prophylaxis.

Objective: To describe the profile of transgender children and adolescents receiving care at a gender affirming outpatient clinic within the Brazilian National Health System (Sistema Único de Saúde - SUS) in São Paulo.

Methods: This was a descriptive study involving 555 participants, who received care between 2009 and 2020, in tertiary care services of the SUS. Data were analyzed using Pearson's chi-square test and standard deviation, considering gender, age, and origin.

Results: Between 2009 and 2020, there was an increase among males (2009, 0%; 2020, 83.3%) and a decrease among females (2009, 100%; 2020, 16.6%), with an average age of 13.7 and 14.3 years. The majority (93.7%) of consultations was performed in the Southeast region.

Conclusion: Over the two decades analyzed, there was an increase in healthcare demand from male transgender children and adolescents, while there was a proportional reduction among females. Care for children and adolescents was concentrated in the Southeast region.

Objective: To identify social vulnerability profiles of transgender people who have experienced intimate partner violence in Brazil and to assess the association with recurrent violence and referrals to support services.

Methods: This was a cross-sectional study of reported cases of violence against transgender people in Brazil (2015-2021) utilizing data from SINAN/DATASUS. Sociodemographic profiles were defined using two-step cluster analysis and associations estimated by means of binary logistic regression, with odds ratios (OR) and confidence intervals (CI).

Results: A total of 3,384 cases were reported, identifying five profiles. Recurrent violence was more frequent in the South region (71.1%), among individuals with elementary education (64.9%) and those with disabilities (74.0%) (p<0.001). Fewer referrals were observed in the North region (76.6%), among Asian and Indigenous people (74.5%) and among lesbians (81.6%) (p<0.05). No significant differences were found between the profiles (p>0.05).

Conclusion: Social disparities influence intimate partner violence, but no significant differences were observed between the identified profiles.

Objective: To describe the socioeconomic and demographic characteristics of the trans population in the Baixada Santista region, São Paulo state.

Methods: This was a descriptive study involving adult trans people, selected through convenience sampling in 2023. A quantitative questionnaire was administered and in-depth interviews were conducted, which were analyzed using thematic grouping.

Results: A total of 237 people were recruited. Of these, 42.2% identified as trans women/travestis and 36.3% as trans men/ transmasculine; 65.4% were aged up to 29 years; 51.1% self-identified as White race/skin color; 52.7% were single; 80.5% had completed at least high school; 32.5% reported no income. Self-perception of transgender identity occurred predominantly between the ages of 10 and 19 (55.7%), with social transition beginning between the ages of 15 and 19 (41.8%). Fourteen in-depth interviews were conducted.

Conclusion: Socioeconomic factors - education level, employment and income - are central to gender identity. Public actions and policies need to be developed and improved.

Objective: To analyze the relationship between childhood abuse and self-harm in a group of transvestites and transgender women from the state of Rio de Janeiro.

Methods: This was a cross-sectional study conducted with 139 participants selected through convenience sampling between 2019 and 2020. A structured questionnaire was used for data collection. The odds ratio (OR) and 95% confidence intervals (95%CI) for suicidal ideation, suicide attempts, and self-harm were calculated using logistic regression.

Results: Having experienced emotional abuse in childhood increased the suicide attempt (OR=9.00; 95%CI 1.13;71.34), having experienced psychological violence in childhood increased self-injurious behavior (OR=11.64; 95%CI 2.35;57.5), HIV infection increased suicidal ideation (OR=2.38; 95%CI 1.09;5.21).

Conclusion: Childhood abuse, as well as the experience of stigmatizing diseases, increased the risk of self-harm among this population.

Objective: To estimate and compare vaccination coverage among children born in 2017-2018 in São Paulo and Campinas, according to the Vaccination Coverage Survey (ICV 2020) and the National Immunization Program Information System (SI-PNI).

Methods: ICV 2020 analyzed vaccination card records. Coverage was calculated and compared to doses recorded on the SI-PNI, divided by the target population.

Results: In São Paulo, according to ICV, in 2017 only BCG (91.7%; 95%CI 87.0;94.7) and rotavirus first dose (90.6%; 95%CI 86.5;93.5) achieved the goals; in 2018, BCG (93.4%; 95%CI 89.5;95.8), rotavirus first dose (90.5%; 95%CI 85.3;94.0), pneumococcal first dose (95.3%; 95%CI 91.7;97.4), meningococcal C first dose (95.1%; 95%CI 91.5;97.2) and pneumococcal second dose (95.0%; 95%CI 91.4;95.0). In Campinas, only BCG achieved the target in 2017 (93.0%; 95%CI 88.8;95.7) and none in 2018. According to the SI-PNI, no vaccine achieved the target in either city.

Conclusion: Vaccination coverage was lower than expected and more precise estimates are necessary for adequate monitoring of childhood vaccination status.

Objective: To describe the polio vaccination status in 26 state capitals, the Federal District, and 12 municipalities in Brazil, among children born between 2017 and 2018.

Methods: This was a population-based household survey conducted from 2020 to 2022, which assessed polio vaccination coverage in children, considering valid, administered, and timely doses by municipality.

Results: Data were collected from 37,801 children. Vaccination coverage for the complete valid dose schedule was 87.5% (95%CI 86.2;88.7), dropping to 79.6% (95%CI 78.1;81.0), when the booster dose was considered. The dropout rate was 4.5% for the complete schedule, and 11.7% for the first booster. There was no correlation between campaign implementation and high coverage.

Conclusion: Vaccination coverage for the complete valid dose schedule and the first booster did not meet the 95.0% target. Regional disparities and the association between vaccination coverage and social indicators should be taken into consideration in strategies to increase coverage.