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IntroductionLittle is known about how sheltering in place to contain the spread of COVID-19 over extended periods affects individuals’ psychological well-being. This study’s objective was to analyze the factors associated with MSM’s (men who have sex with men) low psychological well-being in the COVID-19 pandemic context.MethodThis cross-sectional study was conducted online across Brazil (26 states and federal district) in April and May 2020. The participants were recruited using snowball sampling and Facebook posts. Data were collected using social media and MSM dating apps. We estimated the prevalence, crude prevalence ratio (PR), and the respective confidence intervals (CI95%).ResultsThe prevalence of low psychological well-being found in the sample was 7.9%. Associated factors were belonging to the youngest group (PR 2.76; CI95% 1.90–4.01), having polyamorous relationships (PR 2.78; CI95% 1.51–5.11), not complying with social isolation measures (PR 6.27; CI95% 4.42–8.87), not using the social media to find partners (PR 1.63; CI95% 1.06–2.53), having multiple sexual partners (PR 1.80; CI95% 1.04–3.11), having reduced the number of partners (PR 2.67; CI95% 1.44–4.95), and group sex (PR 1.82; CI95% 1.23–2.69)ConclusionThe well-being of MSM living in Brazil was negatively affected during the social distancing measures intended to control the spread of COVID-19. The variables that contributed the most to this outcome include social isolation, relationships established with partners, and sexual behavior.Policy ImplicationsPlanning and implementing public policies and actions to promote psychological well-being are needed to improve MSM’s resilience by adopting safe strategies and behavior.

Background Different social segments from several regions of the world face challenges in order to achieve the sustainable development goals (SDGs). Nursing represents the greatest number of health workforce in the globe, dealing with these challenges in different paths, among them the training of human resources. In this context, the goal of this study was to compare the relationship between the objectives and research areas underlying nursing doctoral programs in Latin America and the SDGs. Method Documental research comparing data of all Latin American nursing doctoral programs and the SDGs, conducted between January and March 2020. Results From the total of 56 existing programs in Latin America, this study analyzed 52 of them, representing 92.8% of the total. Most nursing doctoral programs have contributed to SDG 3, in addition to goals 1, 2, 4, 5, 6, 8, 9, 10, 12 and 16. The SDGs 11, 13, 14, 15 and 17 were not related to any of the analyzed programs. Data reveal that the training of nursing PhDs is essential to fulfilling these goals. Results also indicate a need of programs to remain committed to relationships that enhance nursing skills to cope with the current challenges in terms of global health, such as investments for the reduction of social and gender inequities. Conclusion The doctoral training of nurses in Latin America needs to be better aligned with the sustainable development goals (SDGs), since there is a high concentration in SDG 3. We believe that nursing will bring a greater contribution to the movement to protect planetary health as the principles governing nursing practices are better aligned with international health demands and agendas.

ABSTRACT Objectives: to discuss the repercussions of chemsex on the health of men who have sex with men (MSM), contextualizing it in a global health scenario and pointing out the implications for nursing care. Methods: theoretical-reflexive study based on scientific literature and concepts related to global health. Results: we present the epidemiology of the chemsex phenomenon, the main demands of the field, the reasons why it has become a global public health problem, and the implications for nursing practice. Final Considerations: chemsex is growing in all age groups of MSM and is globally benefiting from location-based applications to gain magnitude, finding an important potential audience in the migrant population. Nursing structures can help accelerate the proposal and implementation of biomedical and behavioral measures to address chemsex in its entirety, qualifying care and inducing teamwork with interprofessional collaboration. RESUMEN Objetivos: discutir las repercusiones de chemsex en la salud de hombres que tienen sexo con hombres (HSH), contextualizándolas en un escenario de salud global y señalando las implicaciones para los cuidados de enfermería. Métodos: estudio teórico-reflexivo fundamentado en la literatura científica y en los conceptos relacionados con la salud global. Resultados: presentamos la epidemiología del fenómeno chemsex , las principales demandas del campo, los motivos por los cuales se ha convertido en un problema de salud pública global y las implicaciones para la actuación de enfermería. Consideraciones Finales: el chemsex está aumentando en todos los segmentos de edad de HSH y globalmente está beneficiándose de aplicaciones basadas en la geolocalización para aumentar su magnitud, encontrando en la población migrante un importante público potencial. Las estructuras de enfermería pueden ayudar a acelerar la propuesta e implementación global de medidas biomédicas y conductuales para abordar el chemsex en su totalidad, que califiquen el cuidado e induzcan al trabajo en equipo con colaboración interprofesional. RESUMO Objetivos: discutir as repercussões do chemsex na saúde de homens que fazem sexo com homens (HSH), contextualizando-a num cenário de saúde global e apontando as implicações para os cuidados da enfermagem. Métodos: estudo teórico-reflexivo fundamentado na literatura cientifica e nos conceitos relacionados a saúde global. Resultados: apresentamos a epidemiologia do fenômeno chemsex , as principais demandas do campo, os motivos pelo qual tornou-se um problema de saúde pública global e as implicações para a atuação da enfermagem. Considerações Finais: o chemsex vem crescendo em todos os segmentos etários de HSH e globalmente vem se beneficiando dos aplicativos baseado em geolocalização para ganhar magnitude, encontrando na população migrante, um importante público em potencial. Estruturas de enfermagem podem ajudar a acelerar a propor e implementar globalmente medidas biomédicas e comportamentais de enfrentamento ao chemsex em sua totalidade, que qualifiquem o cuidado e induzam ao trabalho em equipe com colaboração interprofissional.

Objective: to examine the characteristics of scientific production in Latin America and the Caribbean regarding virtual simulation in nursing education. Methods: a bibliometric study conducted in five stages: research design, compiling the bibliometric data, analysis, visualization, and interpretation; and based on the recommendations of the Preferred Reporting Items for Bibliometric Analysis (PRIBA). The search was conducted in the Latin American and Caribbean Health Sciences Literature (LILACS). VOSviewer version 1.6.20 was used for bibliometric analysis. Bradford’s and Zipf’s Laws were applied to interpret the data, considering the temporal dynamics of publications, an analytical approach to the structure of the selected studies and their repercussions in virtual simulation in nursing education in Latin America and the Caribbean. Results: 579 studies were identified, of which 46 were included in the final sample. The studies included were published between 1994 and 2022, and only Brazil, Chile, Colombia, and Cuba conducted research related to virtual simulation. The semantic map resulted in five clusters, highlighting “simulation training” as the most important term. Conclusion: our findings suggest a projected increase in Scholarly publications on virtual simulation in nursing education in Latin America and the Caribbean in the coming years. Objetivo: examinar as características da produção científica da América Latina e Caribe a respeito da simulação virtual na educação em enfermagem. Métodos: estudo bibliométrico conduzido em cinco etapas: delineamento de pesquisa, compilação de dados bibliométricos, análise, visualização e interpretação; e reportado a partir das recomendações do Preferred Reporting Items for Bibliometric Analysis (PRIBA). A busca foi conduzida na Literatura Latino-Americana e do Caribe em Ciências da Saúde (LILACS). Utilizou-se o VOSviewer version 1.6.20 para análise bibliométrica. As Leis de Bradford e Zipf foram aplicadas para a interpretação dos dados, na medida em que foi considerada a dinâmica temporal de publicações, abordagem analítica da estrutura dos estudos selecionados e suas repercussões no campo da simulação virtual na educação em enfermagem na América Latina e Caribe. Resultados: foram localizados 579 estudos, dos quais 46 compuseram a amostra final. Os estudos incluídos foram publicados entre 1994 e 2022, sendo que apenas Brasil, Chile, Colômbia e Cuba realizaram pesquisas relacionadas à simulação virtual. O mapa semântico resultou em cinco clusters, destacando “treinamento por simulação” como o termo de maior força. Conclusão: observa-se tendência crescente no desenvolvimento de estudos relacionados à simulação virtual na educação em enfermagem na América Latina e Caribe. Objetivo: examinar las características de la producción científica en América Latina y el Caribe sobre simulación virtual en educación en enfermería. Método: estudio bibliométrico realizado en cinco etapas: diseño de la Investigación, compilación de datos bibliométricos, análisis, visualización e interpretación; en informe basado en las recomendaciones de Preferred Reporting Items for Bibliometric Analysis (PRIBA). Búsqueda realizada en Literatura Latinoamericana y del Caribe en Ciencias de la Salud (LILACS). Para el análisis bibliométrico se utilizó VOSviewer versión 1.6.20. Para interpretar datos se aplicaron las Leyes de Bradford y Zipf, considerando la dinámica temporal de publicaciones, abordaje analítico de la estructura de los estudios seleccionados y sus repercusiones en la simulación virtual de la enseñanza de enfermería en América Latina y el Caribe. Resultados: fueron hallados 579 estudios, 46 de ellos integraron la muestra final. Los estudios incluidos fueron publicados entre 1994 y 2022, y solo Brasil, Chile, Colombia y Cuba realizaron investigaciones relacionadas con la simulación virtual. El mapa semántico dio como resultado cinco clusters, destacándose “entrenamiento simulado” como el término más fuerte. Conclusión: existe una tendencia creciente en el desarrollo de estudios relacionados con la simulación virtual en la educación en enfermería en América Latina y el Caribe.

Objective: to investigate the factors associated with the practice of sex under the influence of drugs (chemsex) among Portuguese men who have sex with men during the period of social distancing to prevent the COVID-19. Method: online survey applied in May 2020 to a sample of 1,301 participants living in Portugal, recruited according to Respondent Driven Sampling and via social media Facebook®. Descriptive and bivariate analyses were performed along with logistic regression to calculate adjusted Odds Ratio (ORa). Results: the prevalence of chemsex was 20.2%. The likelihood of practicing chemsex increased with group sex (ORa: 28.4, 95%CI 16.93–47.49); unprotected sex (ORa: 7.1 95%CI 4.57–10.99); the use of pre-exposure prophylaxis (PrEP) to prevent COVID-19 (ORa: 4.2, 95%CI 2.71–6.39) and COVID-19 testing (ORa: 1.9, 95%CI 1.15–3.10). Conclusion: the practice of chemsex among men who have sex with men during the COVID-19 pandemic in Portugal was very frequent and may support greater understanding of the role and impact of sexual behavior on the COVID-19 transmission rates and the current pandemic situation in Portugal. Objetivo: investigar los factores asociados a la práctica de sexo bajo el efecto de drogas (chemsex), entre hombres que tienen sexo con hombres portugueses, durante período de distanciamiento social por COVID-19. Método: encuesta online aplicada en mayo de 2020 a una muestra de 1.301 participantes, residentes en Portugal, reclutados por el método Respondent Driven Sampling en la red social Facebook®. Se realizó análisis descriptivo, bivariado y regresión logística para cálculo de los Odds Ratio ajustado (ORa). Resultados: la prevalencia de chemsex fue de 20,2%. La chance de practicar chemsex aumentó con: el sexo grupal (ORa: 28.4, IC95% 16.93 – 47.49); no usar preservativo (ORa: 7,1 IC95% 4,57 – 10,99); hacer uso de la profilaxis antes de la exposición (PrEP) como medida protectora para la COVID-19 (ORa: 4,2, IC95% 2,71 – 6,39) y realizar el test para COVID-19 (ORa: 1,9, IC95% 1,15 – 3,10). Conclusión: la práctica de chemsex entre hombres que tienen sexo con hombres, en el período de la pandemia de la COVID-19, en Portugal, fue elevada y puede suministrar informaciones para entender el papel e impacto que relaciones sexuales poseen en las tasas de transmisión y actual situación de la pandemia en el país. Objetivo: investigar os fatores associados à prática do sexo sob o efeito de drogas (chemsex) entre homens que fazem sexo com homens (HSH) portugueses durante o período de distanciamento social pela COVID-19. Método: inquérito on-line aplicado em maio de 2020 a uma amostra de 1301 participantes residentes em Portugal recrutados pelo método Respondent Driven Sampling na rede social Facebook®. Realizaram-se as análises descritiva e bivariada e a regressão logística para o cálculo dos Odds ratio ajustado (ORa). Resultados: a prevalência de chemsex foi de 20,2%. A chance de praticar chemsex aumentou com: o sexo grupal (ORa: 28.4, IC95% 16.93 – 47.49); o não uso de preservativo (ORa: 7,1 IC95% 4,57 – 10,99); fazer uso da profilaxia pré-exposição (PrEP) como medida protetiva para a COVID-19 (ORa: 4,2, IC95% 2,71 – 6,39) e realizar teste para a COVID-19 (ORa: 1,9, IC95% 1,15 – 3,10). Conclusão: a prática de chemsex entre homens que fazem sexo com homens, no período da pandemia da COVID-19 em Portugal, foi elevada e pode fornecer subsídios para entender o papel e o impacto que as relações sexuais possuem nas taxas de transmissão e na atual situação pandêmica no país.

The aim of the study was to assess the impact of the COVID-19 pandemic on the notification of new VL cases in Brazil in 2020. It is an ecological and time-series study (2015–2020) with spatial analysis techniques, whose units of analysis were the 5570 Brazilian municipalities. The study population consisted of all new cases of VL recorded between 2015 and 2020. The P-score was calculated to estimate the percentage variation in new VL cases. Global and local univariate Moran’s Indices and retrospective space–time scan statistics were used in spatial and space–time analyses, respectively. It was expected that there would be 3627 new cases of VL in Brazil in 2020, but 1932 cases were reported (−46.73%). All Brazilian regions presented a negative percentage variation in the registration of new VL cases, with the Southeast (−54.70%), North (−49.97%), and Northeast (−44.22%) standing out. There was spatial dependence of the disease nationwide in both periods, before and during the first year of the COVID-19 pandemic. There was a significant reduction in the incidence of new VL cases in Brazil during the first year of the COVID-19 pandemic. These findings reinforce the need for better preparedness of the health system, especially in situations of new epidemics.

Background: Infectious and parasitic diseases (IPDs) encompass a broad range of illnesses predominantly associated with poverty. They are more prevalent in low- and middle-income countries, including Brazil, where they continue to be among the leading causes of mortality. Objective: This study aims to analyze the spatiotemporal dynamics of mortality due to IPDs in Brazil from 2000 to 2019. Methods: We conducted an ecological study using data on mortality by IPDs from the Brazilian Mortality Information System. We applied the segmented log-linear regression model to assess temporal trends. For spatial analysis, we used the local empirical Bayesian estimator and Moran indices. Retrospective spatiotemporal scan statistics were performed using the Poisson Probability Distribution Model. Results: Between 2000 and 2019, there were 2,155,513 deaths related to IPDs in Brazil. The leading causes of death included acute respiratory infections (n = 1,130,069; 52.49%), septicemia (n = 289,817; 13.46%), human immunodeficiency virus/acquired immunodeficiency syndrome (n = 232,892; 10.82%), tuberculosis (n = 104,121; 4.84%), and neglected tropical diseases such as Chagas disease (n = 94,788; 4.40%) and schistosomiasis (n = 10,272; 0.48%). An increasing temporal trend in the mortality rate from IPDs was observed in Brazil and across all its regions. Additionally, our spatiotemporal scan identified high-risk clusters of death in the Southeast and Northeast regions. Conclusion: Mortality from IPDs remains a significant public health concern in Brazil, with an increasing trend observed in all regions. Our findings underscore the urgent need for comprehensive intersectoral public policies. These policies should focus on a greater allocation of resources and investments in the most critical areas, aiming to significantly reduce the number of deaths, particularly in the most vulnerable regions. Plain language summary Understanding mortality rates from infectious and parasitic diseases in Brazil over 20 years This study focuses on deaths caused by infectious and parasitic diseases (IPDs) in Brazil from 2000 to 2019. These diseases include conditions like acute respiratory infections, septicemia (a severe blood infection), HIV/AIDS, tuberculosis, and neglected tropical diseases such as Chagas disease and schistosomiasis. Our research aimed to understand the patterns and trends in deaths due to these diseases across different regions in Brazil. We found that between 2000 and 2019, there were over 2.1 million deaths due to IPDs in Brazil. The most common causes of death were respiratory infections, septicemia, and HIV/AIDS. The study showed that deaths from these diseases are increasing across the country, with significant high-risk areas identified in the Southeast and Northeast regions. We used various methods to analyze the data, including spatial analysis to identify regions with high death rates. This helped us to see where the most significant problems are and where resources are most needed. The study highlights the urgent need for targeted public health policies and resource allocation to reduce the number of deaths from these diseases, particularly in the most affected areas. It also underscores the importance of ongoing monitoring and intervention to address this critical public health issue. By understanding these patterns, health officials and policymakers can better plan and implement strategies to prevent and control infectious diseases, ultimately saving lives and improving public health across Brazil.

Objectives: To investigate sexual practices and HIV risk perception among MSM, identifying associated risk factors and determinants. Methods: A cross-sectional epidemiological study was conducted with 144 MSM in Teresina, Piauí, Brazil, using the snowball sampling technique. Participants were recruited via snowball sampling and underwent rapid HIV testing, in addition to completing questionnaires on sexual practices, risk perception, and illicit drug use. Results: The majority of participants showed an unsatisfactory perception of HIV risk. Factors associated with this perception include non-penetrative sex as an HIV preventive measure, which increased the chances of having an unsatisfactory risk perception by 1.45 times (P = .04), engaging with known HIV-positive individuals without knowledge of their viral load (ORa = 2.70; P = .043), and using illicit drugs before/during sex (ORa = 0.29; P = .048). Conclusions: The results indicate a high prevalence of risky sexual practices and an unsatisfactory HIV risk perception among the MSM studied. Plain Language Summary HIV Risk and Sexual Practices Among Men Who Have Sex with Men in Brazil This study examines sexual practices and perceptions of HIV risk among men who have sex with men (MSM) in Teresina, Brazil. MSM are significantly more likely to contract HIV compared to the general population, with various factors influencing their risk. Despite this high vulnerability, many MSM do not perceive themselves to be at significant risk of HIV infection. Researchers surveyed 144 MSM to understand their sexual behaviors and how they perceive the risk of HIV. The study found that many MSM engage in risky sexual practices, such as not using condoms during oral sex, even though most use them during anal sex. Additionally, the study revealed that MSM often has a false sense of security when having sex with steady partners compared to casual partners. Key factors associated with a poor perception of HIV risk included low family income, engaging in non-penetrative sex as a preventive measure, having sexual relations with known HIV-positive individuals without knowing their viral load, and using illicit drugs during sexual activity. For instance, using illicit drugs, known as “chemsex,” significantly increases risky behaviors, leading to a higher chance of HIV transmission. The study emphasizes the need for targeted health education and interventions for MSM. It suggests promoting regular condom use, better understanding of HIV transmission risks, and discouraging the use of drugs that impair judgment during sexual activities. Effective public health initiatives should be culturally sensitive and accessible to MSM of all income levels. By addressing these issues, health programs can better support MSM, reduce HIV transmission rates, and improve overall well-being.

Background Post-Exposure Prophylaxis (PEP) and Pre-Exposure Prophylaxis (PrEP) have been demonstrated to be crucial strategies in preventing HIV transmission. However, there is variability in the adoption of these measures within the population of men who have sex with men (MSM) in Brazil. Considering the Brazilian context of HIV prevention strategies, it is evident that the lack of awareness of these strategies is a primary and significant barrier to their dissemination. Our objective is to examine the factors associated with awareness of PEP and PrEP in a sample of Brazilian MSM. Methods We conducted a nationwide cross-sectional study, exclusively online, with a sample of 2,250 MSM. To assess the factors linked to higher or lower awareness, we employed adjusted odds ratios (ORs). Results The awareness of PEP and PrEP was reported by 1,228 (54.5%) and 1,044 (46.4%) MSM, respectively. Several factors were associated with awareness of both measures, including income, self-identification as heterosexual or bisexual, knowledge of one's HIV status, and more frequent utilization of healthcare services. Conclusion The barriers associated with personal, social, and structural determinants influence the awareness of PEP and PrEP among Brazilian MSM.