Awareness of U = U among Sexual and Gender Minorities in Brazil, Mexico, and Peru: Differences According to Self-reported HIV Status

The slogan Undetectable equals Untransmittable (U = U) communicates that people living with HIV (PLHIV) who are on antiretroviral therapy (ART) will not transmit HIV to their sexual partners. We describe awareness of U = U among sexual and gender minorities (SGM) living in Brazil, Mexico, and Peru by self-reported HIV status (PLHIV, negative, unknown) during 2021 using an online survey. We estimated two models using Poisson regression for each population group: Model A including socio-demographic factors (country, gender, age, race, education, and income), and then Model B including taking ART (for PLHIV) or risk behavior, ever-taking PrEP, and HIV risk perception (for HIV-negative or of unknown HIV status). A total of 21,590 respondents were included (Brazil: 61%, Mexico: 30%, Peru: 9%). Among HIV-negative (74%) and unknown status (12%), 13% ever used PrEP. Among PLHIV (13%), 93% reported current use of ART. Awareness of U = U was 89% in both Brazil and Mexico, which was higher than in Peru 64%. Awareness of U = U was higher among PLHIV (96%) than HIV-negative (88%) and HIV-unknown (70%). In multivariate models, PLHIV with lower education were less aware of U = U, while those taking ART were more aware. Among HIV-negative, non-cisgender, lower income, and those with lower education had lower awareness of U = U, while individuals ever using PrEP had higher awareness. In conclusion, awareness of U = U varied by HIV status, socio-demographic characteristics, and HIV risk behavior. The concept of U = U should be disseminated through educational strategies and include a focus on SGM to combat HIV stigma.

The effect of TB treatment on health-related quality of life for people with advanced HIV

BACKGROUND: Study A5274 was an open-label trial of people with HIV (PLHIV) with CD4 cell count <50 cells/µL who were randomized to empirical TB treatment vs. isoniazid preventive therapy (IPT) in addition to antiretroviral therapy (ART). We evaluated health-related quality of life (HRQoL) by study arm, changes over time, and association with sociodemographic and clinical factors.METHODS: Participants aged >13 years were enrolled from outpatient clinics in 10 countries. HRQoL was assessed at Weeks 0, 8, 24 and 96 with questions about daily activity, hospital or emergency room visits, and general health status. We used logistic regression to examine HRQoL by arm and association with sociodemographic and clinical factors.RESULTS: Among 850 participants (424 empiric arm, 426 IPT arm), HRQoL improved over time with no difference between arms. At baseline and Week 24, participants with WHO Stage 3 or 4 events, or those who had Grade 3 or 4 signs/symptoms, were significantly more likely to report poor HRQoL using the composite of four HRQoL measures.CONCLUSION: HRQoL improved substantially in both arms during the study period. These findings show that ART, TB screening, and IPT can not only reduce mortality, but also improve HRQoL in PLHIV with advanced disease.

Diferenciação de populações ovinas encontradas no estado do Piauí

Objetivou-se analisar a semelhança fenotípica entre genótipos de ovinos localizados em oito microrregiões do Estado do Piauí, para averiguação da semelhança de caracteres morfométricos de animais da raça Santa Inês com os de outras raças da região, utilizando-se de análise multivariada. Nos rebanhos amostrados foram encontrados animais das raças Santa Inês, Dorper e Morada Nova, presente uma ou mais raça simultaneamente. As características morfológicas avaliadas foram tipo de pelagem e perfil do chanfro, já as métricas foram a altura de cernelha, a altura de garupa, a circunferência torácica, o comprimento corporal e o comprimento de orelha. Essas características foram avaliadas com as raças estratificadas por microrregião e, através da análise de componentes principais e de agrupamento de Ward, analisou-se a semelhança fenotípica entre as raças e também a variação dentro da raça Santa Inês, com base na relação entre as características medidas. Constatou-se que a raça Santa Inês apresentou variação no tamanho de acordo com a microrregião e que se apresenta com maior altura, mas com menor comprimento e perímetro corporal que a Dorper no Piauí. Já a Morada Nova foi a menor em tamanho. A raça Santa Inês apresentou um grupo de animal com maior tamanho corporal, localizado nas microrregiões de Floriano, Médio Parnaíba Piauiense, Campo Maior e Teresina. Outro grupo de tamanho intermediário, porém com comprimento corporal e circunferência torácica maior e orelha pequena, localizado na microrregião de São Raimundo Nonato, e um terceiro grupo, com tamanho intermediário, orelhas grandes e animais menores, localiza-se nas microrregiões do Litoral Piauiense e Valença. Pela análise de correspondência das características morfológicas com tipo de chanfro e o tipo de pelagem, foi possível identificar que os animais da raça Dorper no Estado apresentam alta correspondência com a característica lanada, que pode ser considerado uma desvantagem por estar numa região que prevalece alta temperatura ao durante o ano.