Epidemiologia e Servicos de Saude最新文献

Objective: To describe the prevalence of hormone use, sociodemographic profile, and access to health services among the transgender, transvestite, and nonbinary population in Porto Alegre, capital city of Rio Grande do Sul state.

Methods: A cross-sectional study was conducted between September and November 2021, using a snowball sampling method (n=65). Data were collected through a self-administered questionnaire with transgender people aged 18 years or older.

Results: High hormone use was observed (n=47), with a higher occurrence of self-medication among transgender women, transvestites, and transfeminine people (n=10). Health monitoring predominantly occurs in gender identity outpatient clinics (n=56). Episodes of transphobia when accessing health services were reported by 28 individuals.

Conclusion: This study demonstrated high prevalence of hormone use, highlighted specific patterns of use across different gender identities, and the need for improvements in access to healthcare services.

Main results: High prevalence of hormone use was observed (n=47), with emphasis on formulations containing estrogen (n=12) or testosterone cypionate (n=22). Self-administered hormone therapy was higher among transgender women, transvestites and transfeminine people (n=10).

Implications for services: This study contributes to understanding the process of self-administered hormone therapy and the need for appropriate interventions. It highlights the importance of establishing strategies that ensure access without discrimination based on gender identity.

Perspectives: Further studies are needed on this topic to encourage the inclusion of medications used in hormone therapy in the National List of Essential Medicines, with the aim of making access to hormones more equitable and universal.

Objective: To describe the sociodemographic and clinical follow-up profile of the use of pre-exposure prophylaxis (PrEP) of HIV among transgender people receiving care at a reference health service for sexually transmitted infections and HIV/AIDS in São Paulo, the capital city of São Paulo state, between 2018 and 2021.

Method: This was a descriptive study with an analysis of sociodemographic data, reasons for seeking PrEP , discontinuation of use and experiences of clinical follow-up. Descriptive statistics were used.

Results: Among the 53 individuals, the majority were mixed-race (n= 25), transgender women (n= 48), heterosexual (n= 38) and had more than 11 years of study (n= 22). There was a decrease in follow-up visits (n= 14 to n= 3) after the second medical consultation.

Conclusion: It is necessary to develop strategies to increase PrEP dispensing and continuation among transgender people, especially among Black people and those with lower level of education.

Main results: The majority of pre-exposure prophylaxis (PrEP) users were young, mixed-race, educated transgender women, reflecting a portion of the transgender population with access to healthcare. The discontinuation of clinical follow-up, especially after the second medical consultation, requires attention.

Implications for services: Individualized strategies should be prioritized to improve the dispensing of PrEP and clinical follow-up for both transgender men and transgender women.

Perspectives: Further research should focus on investigation of strategies to increase PrEP dispensing and clinical follow-up for transgender people, with an emphasis on transgender men, Black people and those with lower level of education.

Objective: To analyze measles, mumps, and rubella vaccination coverage among children up to 24 months old and factors associated with non-vaccination in a 2017-2018 live birth cohort, in state capitals and large interior region cities in Northeast Brazil.

Methods: Population-based survey analyzing vaccination coverage and sociodemographic factors through logistic regression.

Results: For 12,137 children, vaccination coverage was 79.3% (95%CI 76.5;81.8), and the dropout rate was 10.6%. Association with non-vaccination: socioeconomic stratum A (OR-a 1.29; 95%CI 1.10;1.50), living in the interior region (OR-a 1.22; 95%CI 1.07;1.39), no access to the Bolsa Família Program (OR-a 1.19, 95%CI 1.05;1.34), family income ≤BRL 1,000 (OR-a 1.17, 95%CI 1.03;1.31), mother not working (OR-a 1.28, 95%CI 1.15;1.42), >1 child per mother (OR-a 1.12, 95%CI 1.08;1.17), and no vaccination card (OR-a 10.69, 95%CI 6.27;18.20).

Conclusion: Low vaccination coverage and a high dropout rate in state capitals and municipalities in the interior region of Northeast Brazil.

Main results: 79.3% vaccination coverage with incomplete vaccination associated with living in higher socioeconomic strata and in interior region municipalities, and children without vaccination records. High dropout rates in the state capitals Natal and João Pessoa.

Implications for services: Recognition of low coverage and factors associated with non-vaccination provides health services with relevant information with a view to planning strategic actions to increase measles, mumps and rubella vaccination coverage.

Perspectives: Low coverage and identification of non-vaccination indicate the importance of targeting actions in the Brazilian National Health System to achieve the targets recommended by the National Immunization Program, for populations in Northeast Brazil.

Objective: To report the experience of workshops designed for action plans in microplanning vaccination in Brazilian states and municipalities.

Methods: This was a report on microplanning workshops aimed at mapping the local population, target population and identifying appropriate and effective vaccination actions. Vaccination actions were planned according to the reality of the municipalities using the microplanning method for high-quality vaccination activities.

Results: The workshops aimed at establishing effective vaccination strategies were held between July 15 (Macapá, capital city of Amapá state) and September 14, 2023 (Belo Horizonte, capital city of the state of Minas Gerais), with a total of 1,232 participants, including surveillance technicians, primary care and other health sectors. The diversity of participants highlighted distinct challenges and the importance of cooperation in addressing low vaccination coverage across the country.

Conclusion: The workshops served as a platform for raising awareness and exchanging experiences among stakeholders involved in vaccination.

Main results: The workshops promoted detailed mapping of the local context and the target population, in addition to providing opportunities for raising awareness and exchanging experiences among participants involved in vaccination programs.

Implications for services: It is suggested that the workshops be replicated and expanded to promote a continuous and contextualized assessment of local realities. The process also fosters a more collaborative and participatory approach, enabling professionals to adjust their practices based on local demands and actual needs.

Perspectives: The next steps are expected to include the sustainable incorporation of this strategy across states and municipalities, in order to eliminate and control vaccine-preventable diseases.

Objective: This article explores the complexities and challenges of healthcare access for transgender people in Minas Gerais.

Methods: : This study is based on a subsample from the Manas Survey, comprised of 15 semi-structured interviews with transgender people, conducted between May 2018 and May 2020, analyzed using the content analysis method and organized into a thematic network.

Results: : The results highlight the need for adequate structures, specific training for healthcare professionals, the influence of support networks and challenges in mental health.

Conclusions: : Despite advances in transgender health policies, access barriers persist, underscoring the importance of training strategies, accurate record-keeping and the expansion of specialized services and the role of primary health care. The study makes progress by including the perceptions from residents of small and medium-sized cities across different regions of the state, aiming to improve access and care for the transgender population via the Brazilian National Health System in Minas Gerais.

Main results: The findings underscore the need for adequate structures, specific training for healthcare professionals, the influence of support networks and challenges in mental health, in addition to including the perceptions of residents from small and medium-sized cities.

Implications for services: Improving the use of social name and gender identity in records. There is a need for training healthcare professionals in gender identity, expanding transgender-specific services and the role of primary health care (PHC) in this topic.

Perspectives: Expansion of specialized services and the role of PHC for this population, in order to improve access and care for the transgender population via the Brazilian National Health System in Minas Gerais state.