Introduction: This study aimed to identify factors associated with late diagnosis and clinically monitor newly diagnosed HIV/AIDS patients. Method: Retrospective study, based on secondary data from a specialized unit at the Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto of the University of Sao Paulo. Data collection included sociodemographic, behavioral, clinical, and laboratory data of newly diagnosed HIV patients between 2015 and 2019. Data analysis was undertaken using inferential statistical tests. Results: A total of 314 individuals were newly diagnosed with HIV/AIDS, 86.6% (272) had a late diagnosis and 53.8% (169) were diagnosed very late. Using the adjusted odds ratio, we observed that bisexual and MSM patients were less likely to have a late diagnosis compared to straight patients. Individuals who entered through the emergency department and Outpatient Clinic had a lower chance of having a very late diagnosis compared to those diagnosed in the ward/inpatient unit. Having a higher education and university education were protective factors against having a very late diagnosis of HIV infection compared to elementary school education only. In addition, male patients were more likely to have a very late diagnosis compared to female patients. Conclusions: This study evidenced a high prevalence of late and very late diagnoses. Therefore, attention should be directed towards factors related to late and very late presentation.

Background: After 40 years of its starting, the HIV epidemic in Brazilian Amazon region remains on an increasing trend. The young men who have sex with men (MSM) have been the most impacted by the HIV in the last decade. However, much more than attributing the risk behavior to HIV uniquely to the individual, behaviors are shaped by social determinants of health (SDH). Despite the problem, there is a scarcity of studies evaluating the impact of SDH on HIV among young MSM and none of them were done in the Northern of Brazil. Therefore, the main goal of this study was to analyse the HIV epidemic among Brazilian Amazonian young MSM using temporal trends and spatial analysis. Methods: We conducted an ecological study using reported cases of HIV/AIDS in young MSM living in Pará, the second larger Brazilian Amazonian province, between 2007 and 2018. Data were obtained from the Information System for Notifiable Diseases. For the temporal analysis, we employed a Seasonal and Trend decomposition using Loess Forecasting model (STLF), which is a hybrid time-series forecast model, that combines the Autoregressive-Integrated Moving Average (ARIMA) forecasting model with the Seasonal-Trend by Loess (STL) decomposition method. For the spatial analysis, Moran’s spatial autocorrelation, spatial scan, and spatial regression techniques were used. Results: A total of 2192 notifications were included in the study. Greater variabilities in HIV/AIDS population-level diagnosis rates were found in the festive months. The HIV/AIDS population-level diagnosis rates exhibited an upward trend from 2013 and this trend is forecasted to continue until 2022. Belém, the capital of Pará, presented the highest spatial risk for HIV/AIDS and was the only city to present spatiotemporal risk from 2014 to 2018. The geographic variation of the HIV epidemic was associated with the number of men with formal jobs, the average salary of men, and the percentage of people over 18 years old with elementary education. Conclusion: The upward trend of HIV/AIDS population-level diagnosis rate forecasted until 2022 and the variability of the epidemic promoted by the SDH brings an alert and subsidies to health authorities to implement more efficient and focalized public policies against HIV among young MSM in Pará.

Background: The main goal of this study was to analyze the HIV epidemic temporally and spatially among young people living in Pará, Brazil, from 2007 to 2018. Methods: For the temporal analysis, we employed an integrated autoregression of moving averages model associated with the seasonal trend using the LOESS decomposition method, which allowed for predictions to be made. In the spatial analysis, the techniques of autocorrelation, spatial and spatio-temporal risk analysis, and geographically weighted regression were used. Results: During the study period, there were 8143 notifications of HIV/AIDS cases. The temporal prediction indicated a trend of growth in the incidence rate in the 20–24-year-old group from January 2019 to December 2022 and a trend of stability in the 15- to 19-year-old and 25- to 29-year-old groups. There was a territorial expansion of the HIV epidemic in Pará. Novo Progresso and the Metropolitan Region of Belém (RMB) were the zones with the highest spatial and spatio-temporal risk for HIV. Social determinants including the Basic Education Development Index, the number of physicians per 10,000 inhabitants, and the municipal high school abandonment rate in the municipalities were associated with the risk of HIV/AIDS among young people in Pará. Conclusions: To eliminate HIV among young people in Pará, the access to treatment, diagnosis, and preventive healthcare services should be expanded. Sexual and reproductive health education should be reinforced in schools and communities. Furthermore, it is necessary to promote social equity and fight HIV stigma.

Anxiety, depression, and stress are prevalent psychosocial manifestations in Long COVID, and understanding their global impact can guide safe, effective, and evidence-based interventions. This study reviewed the literature to analyze the prevalence indicators and predictors of anxiety, depression, or stress experienced by adults and older adults with Long COVID. This systematic prevalence review was conducted using the databases MEDLINE via PubMed^®, CINAHL-EBSCO, Web of Science, Scopus, EMBASE, LILACS, and BDENF. Observational studies that assessed anxiety, depression, or perceived stress in adults and older adults with Long COVID were included, with no restrictions on time or language. Two reviewers independently conducted the selection process. Full texts were analyzed for their eligibility potential. Methodological quality was assessed using the JBI Critical Appraisal Checklist for Studies. Ten observational studies with moderate methodological quality were included. Anxiety and depression were the most prevalent psychosocial symptoms in Long COVID, reported in mild, moderate, and severe cases of COVID-19 infection. Prevalence rates reached up to 47.8% for anxiety, 37.3% for depression, and 23% for stress. The combined analysis revealed a pooled prevalence of 15.3% (95% CI: 10.8% to 20.2%). Being female, having pre-existing mental disorders or associated clinical comorbidities, experiencing severe infection in the acute phase, and receiving intensive care were predictors of greater mental burden. The experience of anxiety, depression, and stress in prolonged COVID-19 was reported in countries with different income levels and was disproportionately experienced, especially by women and individuals with associated clinical conditions or psychopathological comorbidities.

People living with HIV (PLHIV) are at greater risk of illness and death from vaccine-preventable diseases. This study aimed to identify the predictors associated with the recommended vaccination schedule for this group. This was a single-center cross-sectional study conducted in a large Brazilian municipality, evaluating the vaccination statuses of 645 PLHIV for nine immunizers. The primary outcome was the adequacy of the vaccination schedule. The vaccination status was assessed for the diphtheria/tetanus, hepatitis B, hepatitis A, measles/mumps/rubella, yellow fever, 13- and 23-valent pneumococcal, meningococcal C, and HPV vaccines. Those who had received all of the recommended vaccinations in accordance with the schedule established by the government at the time of the assessment, without any delays, were classified as having received an “adequate schedule”. The independent variables included sociodemographic, clinical–epidemiological, and social vulnerability factors, analyzed by multiple logistic regression with adjusted odds ratios (ORs) and 95% confidence intervals (95% CIs). Only 47 individuals (7.3%) had an adequate vaccination schedule for all vaccines. The vaccines with the highest adequacy rate were diphtheria and tetanus (533; 82.6%), and the one with the lowest rate was measles/mumps/rubella (MMR) (243; 37.7%). The main predictors of a complete vaccination schedule were the age group, place of clinical follow-up, and where they received their last doses of vaccines. Educational interventions for PLHIV and health professionals are needed to improve the vaccination coverage in this group.

Anxiety and stress are major challenges for public health and represent significant symptoms in long COVID. Despite the repercussions on quality of life and mental health, their impacts have not been systematically consolidated in the Brazilian population. Our objective was to analyze the indicators and predictors of anxiety and perceived stress in people who have experienced long COVID in different regional contexts in Brazil. This cross-sectional survey was carried out in the five regions of Brazil and included 4239 adult individuals who had at least one diagnosis of COVID-19. Participants responded to questions on the Depression, Anxiety, and Stress Scale (DASS-21). The GAMLSS class of regression models estimated the predictors associated with the outcomes investigated. The results showed a predominance of participants with a single diagnosis of COVID-19 (65.4%), mild clinical conditions (89.5%), and high adherence to immunization strategies (98.4%). Overall, 48.5% of participants had residual symptoms that started between 4 and 12 weeks after the acute phase of COVID-19 infection. Positive screening for anxiety and perceived stress was associated with female gender, diagnosis of chronic diseases, presence of physical symptoms, moderate or severe clinical condition in the acute phase of the infection, and the need for hospitalization. Through this study, we confirmed that anxiety and stress, developed or exacerbated during the post-COVID-19 phase, represent significant challenges in the Brazilian population. Sociodemographic, clinical, and care conditions were predictors of the outcomes assessed. Knowing these repercussions can allow for personalizing mental health care and help structure evidence-based public policies.