Background The burden of HIV in transgender women (transwomen) in Brazil remains unknown. We aimed to estimate HIV prevalence among transwomen, and identify the factors associated with newly diagnosed HIV infections. Methods “Transcender” was a respondent driven sampling study of transwomen in Rio de Janeiro, Brazil, conducted from August 2015 to January 2016. Twelve seeds were recruited from social movements and formative phase. Eligibility criteria were: self-identification as transwomen, being 18 years of age or older, living in Rio de Janeiro or metropolitan area, and having a valid peer recruitment coupon. Participants were categorized as HIV-negative, known HIV infected, or newly diagnosed as HIV infected. Predictors of newly diagnosed HIV infections were assessed by comparing the newly diagnosed with the HIV-negative. Population estimates were adjusted using the RDSII estimator. Findings In total, 345 eligible transwomen were enrolled. The study sample was young and diverse on gender identity. Population estimates of no prior HIV testing, HIV-infection and newly diagnosed as HIV-infected were 29·1%, 32·1% and 7·0%, respectively (based on n=60 with no prior testing, n=141 HIV-infected, n=40 newly diagnosed). Syphilis, rectal chlamydia and gonorrhea infection were diagnosed in 28·9%, 14·6%, and 13·5%, respectively. Newly diagnosed HIV infections were associated with black race (22·8; 95%CI 2·9–178·9), travesti (34·1; 95%CI 5·8–200·2) or transsexual woman (41·3; 95%CI 6·3–271·2) gender identity, history of sex work (30·7; 95%CI 3·5–267·3), and history of sniffing cocaine (4·4; 95%CI 1·4–14·1). Interpretation Our results suggest that transwomen bear the largest burden of HIV among any population at risk in Brazil. The high proportion of HIV diagnosis among young participants points to the need for tailored long-term health care and prevention services in order to curb the HIV epidemic and improve the quality-of-life of transwomen in Brazil. Funding This work was supported by Brazilian Research Council (470056/2014-2) and NIAID-NIH (UM1AI069496).

The widespread occurrence of cryptococcosis mainly in immunocompromised patients and the side effects of available drugs which are effective against this mycosis have led investigators to search for new antimycotic agents. Caryocar brasiliensis derived compounds were investigated against Cryptococcus neoformans using the agar dilution method. Based on MIC values, the best results were obtained with a concentration of < 250 g/mL of cuticular waxes of the Caryocar brasiliensis leaf collected during the dry period (170.8mm of precipitation) which inhibited the growth of 91.3% (21/23) Cryptococcus neoformans isolates.

Introduction: Evidence suggests that, of all affected populations, transgender women (transwomen) may have the heaviest HIV burden worldwide. Little is known about HIV linkage and care outcomes for transwomen. We aimed to estimate population-level indicators of the HIV cascade of care continuum, and to evaluate factors associated with viral suppression among transwomen in Rio de Janeiro, Brazil. Methods: We conducted a respondent-driven sampling (RDS) study of transwomen from August 2015 to January 2016 in Rio de Janeiro, Brazil and collected data on linkage and access to care, antiretroviral treatment and performed HIV viral load testing. We derived population-based estimates of cascade indicators using sampling weights and conducted RDS-weighted logistic regression analyses to evaluate correlates of viral suppression (viral load ≤50 copies/mL). Results: Of the 345 transwomen included in the study, 89.2% (95% CI 55–100%) had been previously tested for HIV, 77.5% (95% CI 48.7–100%) had been previously diagnosed with HIV, 67.2% (95% CI 39.2–95.2) reported linkage to care, 62.2% (95% CI 35.4–88.9) were currently on ART and 35.4% (95% CI 9.5–61.4%) had an undetectable viral load. The final adjusted RDS-weighted logistic regression model for viral suppression indicated that those who self-identified as black (adjusted odds ratio [aOR] 0.06, 95% CI 0.01–0.53, p < 0.01), reported earning ≤U$160/month (aOR 0.11, 95% CI 0.16–0.87, p = 0.04) or reported unstable housing (aOR 0.08, 95% CI 0.01–0.43, p < 0.01) had significantly lower odds of viral suppression. Conclusions: Our cascade indicators for transwomen showed modest ART use and low viral suppression rates. Multi-level efforts including gender affirming care provision are urgently needed to decrease disparities in HIV clinical outcomes among transwomen and reduce secondary HIV transmission to their partners.

The seed and leaf essential oils of Caryocar brasiliensis were analysed by GC/MS. The major constituent of the seed oil was ethyl hexanoate, while the leaf oil contained octacosane, heptadecane and hexadecanol. The pattern of geographic variation indicated that essential oils are mainly produced in lower rainfall periods and with plants grown at higher latitudes. The seed essential oil was investigated against human pathogenic systemic and opportunistic fungi using the agar dilution method. Based on the MIC values, the most significant results were obtained against Cryptococcus neoformans and Paracoccidioides brasiliensis. It was observed that the yeast-form of P. brasiliensis was inhibited at a concentration of 500 mg/ml, whereas 24% of C. neoformans strains exhibited inhibition with MIC £ 250 mg/ml.

OBJETIVO: avaliação epidemiológica de pacientes com diagnóstico de lesão medular internados para reabilitação na enfermaria do Centro de Reabilitação e Readaptação Dr. Henrique Santillo (CRER) em Goiânia, Goiás. MÉTODOS: estudo epidemiológico retrospectivo baseado na coleta de dados dos prontuários médicos dos pacientes internados no período de Março de 2007 a Março de 2009. RESULTADOS: foram avaliados 208 pacientes, com predomínio do sexo masculino (78,85%) e idade média de 35,3 anos. O déficit neurológico mais prevalente foi paraplegia (64,90%), sendo 54,33% dos pacientes classificados como ASIA A (lesão completa) de acordo com a classificação da American Spinal Injury Association (ASIA). O tempo médio de lesão até a admissão no CRER foi de 129,7 dias, e o tempo médio de internação para reabilitação destes pacientes foi de 44,9 dias. A principal etiologia da lesão medular foi traumática, sendo 44,70% representadas por acidente de trânsito. A complicação mais comum na internação foi infecção do trato urinário. CONCLUSÃO: os dados epidemiológicos de pacientes com lesão medular, admitidos no CRER para reabilitação, se mostraram em conformidade com dados já descritos na literatura, demonstrando cada vez mais a importância da divulgação e realização de campanhas de prevenção do trauma raquimedular. Assim como a necessidade do encaminhamento precoce destes pacientes ao centro de reabilitação, uma vez que a grande maioria é jovem, com sequelas neurológicas graves e altamente incapacitantes.