Men who have sex with men (MSM) and transgender women are disproportionately affected by HIV in Guatemala, yet little is known about their experiences with diagnosis, linkage to care, and retention. We conducted qualitative interviews with 26 MSM and transgender women living with HIV in Guatemala City. HIV diagnosis experiences changed over time with increasing asymptomatic testing at non-governmental organizations. Fear of the physical and social impacts of HIV delayed testing, acceptance of diagnosis, and linkage to HIV care. These fears were driven by layered stigma and discrimination due to non-normative gender expressions and/or sexual orientation. Retention-specific determinants included HIV clinic dynamics and limited employment opportunities. There is an urgent need to improve support systems for early testing and linkage to care and to expand employment opportunities. Stigma and discrimination must be addressed at the family, clinic and contextual levels to reduce fear of diagnosis and improve access to care.

Men who have sex with men (MSM) are disproportionately affected by HIV in Guatemala and may benefit from health navigation programs designed to support timely linkage to HIV care. We conducted qualitative in-depth interviews with MSM (n = 19) linked to care within days of their diagnosis with the support of a health navigator. We used narrative analysis and systematic coding to identify themes related to HIV diagnosis and experiences with navigators. Participants experienced strong feelings of fear upon receiving a positive HIV test result. This fear led to social isolation and limited reliance on family and friend networks for support. Health navigators developed strong relationships with participants by providing the emotional support they were lacking and supporting them to overcome their fear and other structural barriers to HIV care, including stigma. Findings support the important role of navigation for MSM in Guatemala and could be transferable to other settings in Latin America.

La presente investigación tiene como propósito la estimación de un modelo de regresión espacial lineal generalizada de distribución estadística Poisson que permita explicar el comportamiento espacio-geográfico de una enfermedad transmitida por vectores como la malaria para el caso puntual del departamento de Chocó en el año 2016. Se emplean técnicas de estadística espacial basada en el análisis de áreas o datos tipo Lattice tales como criterios de figuras, criterios de distancias y los más usados los criterios de contigüidad física, con el fin de determinar la existencia de autocorrelación espacial de dicho fenómeno en los municipios del departamento de la costa pacífica. Para realizar este análisis estadístico-espacial se hace uso de una serie de factores sanitarios que soportan la base de datos implícita en la estructura espacial que influyen en la propagación de dicha enfermedad y tienen como propósito estadístico ser las variables que explican dicha enfermedad y su relación con la propagación entre municipios.  Sin embargo, es necesario realizar un proceso de anamorfosis gaussiana para garantizar la normalización de los datos en tasas de morbilidad estandarizada (SMR) y de esta forma identificar la estructura estadística de los datos que para este año fueron provenientes de una distribución Poisson. El estudio permite encontrar la presencia positiva de una autocorrelación espacial lo que verifica la hipótesis que la Malaria para el departamento del Choco es afectada entre algunos municipios debido a ciertas variables físicas, climática y de higiene que permite la propagación de la enfermedad a causa de la incubación del mosquito transmisor. De esta manera el estudio muestra el mapa de probabilidad de la Malaria para el año 2016 y las variables empleadas para el modelo de regresión empleado para la estimación de dicho mapa.

ABSTRACT:The aim of this study is to compare patients with Asperger syndrome (AS) and control participants on social cognition tasks and communication skills. Twenty young adults were assessed in three social cognition domains; recognition of basic emotions, recognition of complex emotions and Theory of Mind (ToM). In addition participants completed a self-report questionnaire as a measure of social communication skills. The results indicate that adults with AS perform below neurotypical control participants in emotion processing, ToM and communication skills. There were no significant correlations between the variables of social cognition and communication skills in the group of AS. Taken together, results suggest that people with a diagnosis of AS present a deficit in ToM and emotional processing as well as in communication skills. However, it was not possible to identify a significant association between the variables of social cognition and communication skills.

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