Background: Low back pain (LBP) is the most frequent complaint in clinical practice. Electroacupuncture treatment may be effective; however, the supporting evidence is still limited, especially in older adults.Objective: The current study is a randomized controlled trial that aims to evaluate the clinical efficacy of electroacupuncture in older adults with LBP.Methods: A five-arm randomized controlled trial with patients and evaluators blinded to the group allocation. A total of 125 participants with non-specific LBP will be randomly assigned into one of five groups: three electroacupuncture groups (low, high, and alternating frequency); one control group; and one placebo group. The electroacupuncture will be applied twice a week (30 min per session) for five weeks. The primary clinical outcome measure will be pain intensity. The secondary outcomes include: quality of pain; physical functioning; perceived overall effect; emotional functionality; patient satisfaction; and psychosocial factors. Patients will be evaluated before the first session, immediately after the last, and followed up after six and 12 months to check the medium- and long-term effects.Discussion: Although electroacupuncture is increasingly used to treat LBP, there is no guidance regarding the parameters used, which leads to inconsistent results. Thus, the effect of electroacupuncture (EA) on LBP remains controversial and requires more studies, especially in the older adult population.Conclusion: This is the first randomized controlled trial to evaluate the efficacy of different frequencies of electroacupuncture for treating chronic LBP in older adults. This study will provide evidence on the effectiveness of electroacupuncture as an alternative treatment method for LBP and will entail wider debate about an appropriate acupuncture intervention in this population.Trial registration: Clinicaltrials.gov,NCT03802045. Registered on 14 January 2019.

The HIV-1 epidemic in Brazil has been growing in northeast and north regions, particularly an increase in AIDS cases among the younger male population has been observed. This study aims to characterize the HIV-1 genetic diversity and to evaluate its antiretroviral resistance profile among individuals presenting virological failure in the state of Maranhão—Brazil. HIV-1 pol gene sequences from 633 patients on antiretroviral therapy were obtained from the Department of Surveillance, Prevention and Control of Sexually Transmitted Infections, HIV/AIDS and Viral Hepatitis of the Brazilian Ministry of Health. Phylogenetic and recombination analyses were performed to characterize viral genetic diversity. The presence of antiretroviral resistance mutations was assessed using the HIV Drug Resistance Database online platform of Stanford University. A predominance of subtype B (84.5%) was observed, followed by recombinant BF (9.5%), where more than half of the sequences were dispersed in 3 clusters. Antiretroviral resistance was detected in 74.1% of the sequences, and it was significantly higher for nucleoside analogue reverse-transcriptase inhibitors (NRTIs) than for non-nucleoside analogue reverse-transcriptase inhibitors (NNRTIs) and protease inhibitors (PIs). Inference of putative transmissions clusters identified 11 clusters with 22 query sequences (22/633, 3.5%). Thus, we conclude that continuous monitoring of the molecular epidemiology of HIV-1 is essential for prevention strategies, epidemic control, and treatment adequacy.

Introducción: La espiritualidad en pacientes que viven con el VIH ayuda a afrontar los pensamientos negativos provocados por la enfermedad. El objetivo del estudio fue conocer el impacto de la espiritualidad en la vida de las mujeres que viven con el VIH. Materiales y Métodos: Investigación cualitativa sobre historias de vida temáticas. La muestra está compuesta por siete mujeres que fueron diagnosticadas con VIH/SIDA hace más de un año. Para la recolección de datos se utilizó una entrevista semiestructurada con preguntas sobre el contexto social, situación sociodemográfica y clínica, religión y espiritualidad. Para el análisis de datos se empleó la técnica de análisis de contenidos. Los resultados se organizaron en dos categorías: la búsqueda de la fuerza en la espiritualidad y la esperanza de curación. Resultados: En momentos de angustia causados por el VIH/SIDA, todas las entrevistadas recurrieron a la espiritualidad a través de la oración e incluso a la materialización de la presencia de Dios como estrategias para afrontar la enfermedad. El anhelo de sanación mediante revelaciones divinas se expresa en los discursos de los entrevistados. Discusión: Según las historias de vida de las entrevistadas, la figura divina las ha fortalecido para hacer frente a los retos generados por el VIH/SIDA. Conclusiones: A través de esta investigación se pudo comprobar que la espiritualidad está presente en las vidas de las mujeres que viven con el VIH y que mitiga las adversidades producidas por la enfermedad. Cómo citar este artículo: Santos FDRP, Amaral LROG, Santos MA, Ferreira AGN, Moura JF, Brito LB. Repercussions of spirituality in the lives of women living with HIV. Rev Cuid. 2019; 10(3): e771. http://dx.doi.org/10.15649/cuidarte.v10i3.711

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