Objective: To investigate the relation between the presence of spiritual distress and use of RSC and sociodemographic, clinical and religious/spiritual variables in people with cancer. Method: Cross-sectional study conducted in an association for support to people with cancer. The data obtained with the tools were analyzed using the Spearman‘s correlation coefficient and the Mann-Whitney Test. Results: 129 volunteers participated in the study, of which 57% showed moderate spiritual distress, 96% used medium and high positive religious/spiritual coping. Spiritual distress showed positive correlation with negative religious/spiritual coping (P<0.001) and inverse correlation with age (p 0.002). The use of positive religious coping was statistically significant in people who have religious practices (p 0.001). Conclusão: Spiritual distress is a phenomenon that is present in the lives of people with cancer and has significant relation with the use, in a negative manner, of religion/spirituality as a way of coping with the disease.

Introdução: O paciente oncológico em fim de vida está propenso a experienciar sinais e sintomas desagradáveis em virtude da progressão da doença. O enfermeiro, ao longo de toda a sua trajetória histórica, direcionou o cuidado para a identificação, o manejo e a avaliação do desconforto. Objetivo: Identificar o impacto da evolução histórica do conforto no cuidado de enfermagem ao paciente oncológico em fim de vida. Método: Revisão integrativa da literatura de carácter exploratório e descritivo utilizando as bases de dados LILACS, MEDLINE e SciELO sem recorte temporal para maior abrangência de resultados. Resultados: Os principais impactos das teorias de enfermagem pautadas no conforto foram a valorização do modelo holístico, o estímulo do vínculo enfermeiro-paciente, o controle de sintomas, a diminuição do sofrimento e as condutas alinhadas aos valores do paciente. Conclusão: O conforto é mencionado no estado da arte em textos históricos, teorias e na prática assistencial da enfermagem. As teorias que abordam o conforto direcionam o cuidado de enfermagem ao paciente oncológico em fim de vida buscando reduzir o desconforto e o sofrimento do paciente.

Background/Objectives: Sexualized drug use (SDU) and chemsex have emerged as a growing public health concern globally, reflecting complex intersections between sexual practices, psychoactive substance use, and structural vulnerabilities. In Brazil, however, evidence on healthcare access among individuals who engage in SDU/chemsex remains limited and fragmented. This scoping review aimed to map and analyze the available literature on healthcare access in this population, identifying barriers, facilitators, and gaps in care. Methods: The review followed the Arksey and O’Malley framework and Joanna Briggs Institute recommendations, with searches conducted in six databases (MEDLINE/PubMed, Embase, Scopus, SciELO, LILACS, and PsycINFO) for studies published between 2014 and 2025. Results: Eleven studies met the inclusion criteria, predominantly quantitative and concentrated in large urban centers. Findings indicate that healthcare access is shaped by persistent structural and symbolic barriers, including stigma, discrimination, fear of disclosure, and limited professional preparedness. Care remains largely centered on human immunodeficiency virus (HIV) and sexually transmitted infections (STIs) services, with insufficient integration of primary care, mental health, and substance use services, contributing to fragmented care. Significant gaps were identified, including the underrepresentation of women, transgender, and non-binary populations, and the absence of studies focusing on healthcare professionals. Conclusions: Substance use patterns reflect both global trends and local specificities, particularly the prominence of alcohol and cocaine in Brazil. This review provides the first synthesis of Brazilian evidence on chemsex from a healthcare access perspective. The findings highlight critical inequities and support the need for integrated, stigma-free, and context-sensitive care within the Brazilian Unified Health System. Based on these findings, the VIP-SDU/Chemsex Model is proposed as a multilevel framework to explain how structural, symbolic, and programmatic factors shape access and health outcomes.

Background/Objectives: Transgender (trans) individuals experience a disproportionate burden of HIV and other sexually transmitted infections (STIs), although evidence based on point-of-care testing remains limited in Brazil. This study aimed to estimate the prevalence of reactive STI rapid test results and associated factors among transgender individuals receiving care in specialized health services in São Paulo, Brazil. Methods: A cross-sectional study was conducted between July and December 2025 with 400 participants attending two specialized healthcare services. Sociodemographic, behavioral, substance use, clinical, and HIV prevention-related data were collected. The primary outcome was reactivity to at least one rapid test for HIV, syphilis, hepatitis B, or hepatitis C; reactive results could include previously known infections and therefore were not interpreted as newly diagnosed or active infections. Associations were estimated using Poisson regression with robust variance. Results: Overall, 19.2% of participants had at least one reactive rapid test result, with HIV accounting for the largest proportion of reactive results (14.8%). In the adjusted model, increasing age was associated with a higher prevalence of the outcome (PR = 1.04; 95% CI: 1.02–1.05), whereas transgender men had a lower prevalence than transgender women (PR = 0.38; 95% CI: 0.19–0.73). Reported HIV prevention through PrEP and/or PEP was inversely associated with the outcome (PR = 0.37; 95% CI: 0.17–0.82); however, this association should not be interpreted as a direct protective effect because most reactive HIV results occurred among participants with previously known HIV, who would not be eligible for PrEP. Conclusions: These findings indicate a substantial frequency of reactive STI rapid test results among transgender individuals attending specialized health services and support continued access to testing, prevention, and culturally competent sexual healthcare.

Background: Men who have sex with men (MSM) using HIV pre-exposure prophylaxis (PrEP) experience a high burden of human papillomavirus (HPV) infection and related diseases, yet data on HPV vaccination among this group in Brazil remain limited. Aims: The aims of this study were to estimate the prevalence of complete HPV vaccination and to identify factors associated with vaccination completion among MSM using PrEP in Brazil. Methods: We conducted a cross-sectional online survey between May and September 2025 among MSM aged ≥18 years, residing in Brazil and currently using oral PrEP. Participants were recruited through virtual snowball sampling and targeted advertisements on social media and a gay geosocial networking application. Data were collected using a structured, self-administered questionnaire hosted on REDCap^®. Complete HPV vaccination was defined as self-reported receipt of all doses recommended according to the participant’s age and clinical condition. Sociodemographic characteristics, relationship patterns, sexual behaviors, lubricant use during sexual activity, and history of sexually transmitted infections (STIs) were assessed. Adjusted prevalence ratios (aPRs) and 95% confidence intervals (95% CIs) were estimated using Poisson regression with robust (sandwich) variance. Results: A total of 872 MSM using PrEP were included, of whom 59.4% reported complete HPV vaccination. In adjusted analyses, complete vaccination was more frequent among participants reporting both steady and casual partners (aPR = 1.90; 95% CI: 1.36–2.65) or only casual partners (aPR = 1.72; 95% CI: 1.24–2.39), those reporting lubricant use during sexual activity (aPR = 1.41; 95% CI: 1.23–1.61), and those with a diagnosis of chlamydia and/or gonorrhea in the previous 12 months (aPR = 1.22; 95% CI: 1.08–1.36). Conclusions: Although HPV vaccination coverage among MSM using PrEP in Brazil is higher than that reported for MSM in general, it remains incomplete in a population with regular contact with specialized health services. Integrating systematic assessment and delivery of HPV vaccination into PrEP care may help increase vaccination completion and reduce missed opportunities for prevention.

Doxycycline post-exposure prophylaxis (Doxy-PEP) has emerged as a strategy to prevent bacterial sexually transmitted infections; however, in Brazil, its use occurs without formal clinical protocols, shifting prevention responsibilities to individuals. This qualitative descriptive study included 32 cisgender men ages ≥ 18 years who reported Doxy-PEP use. Data were collected through an online semi-structured questionnaire and analyzed using reflexive thematic analysis, guided by Orem's Self-Care Theory and the health vulnerability framework. Four interrelated themes were identified: reliance on informal information networks; ethical and biomedical tensions, including concerns about antimicrobial resistance; pharmacological self-management through informal or negotiated access; and weak institutional support leading to alternative therapeutic itineraries. Doxy-PEP use reflects a situated self-care practice shaped by intersecting vulnerabilities and institutional gaps, highlighting the need for equitable, evidence-based nursing interventions for sexually transmitted infection prevention.