OBJECTIVE:Located in French-speaking Switzerland, this study investigated seventeen young women's talk about how their social media practices impact their (psychological) health and wellbeing. METHODS AND MEASURES:Embedded within a critical perspective in health psychology, we explored the discursive moves and resources participants mobilised to construct 'good' and 'bad' subject positions. Drawing on the concept of postfeminist healthism, our aim was to explore the normative and affective underpinnings of young women's sense-making activities on social media use to make visible the work on the self that is required of them to claim valued identities in the digital space. RESULTS:Participants in this study constructed 'unhealthy' and 'healthy' use across three continuums: (i) excessive versus controlled social media use; (ii) caring too much versus being a detached social media user; (iii) naïve versus aware social media use. CONCLUSION:We discuss the implications of integrating a gendered identity perspective into theorising and designing health interventions with regards to social media.

A growing body of empirical research investigates the impact that sexual objectification of young women on social media has on their well-being. The aim of the present study is to explore how young women navigate sexual objectification and body-focused posting practices on social media in the context of postfeminist sensibilities. Drawing on individual interviews, which we analyzed using critical discursive psychology, we found that while participants critiqued the sexual objectification of women on social media, they still engaged in body-focused posting practices for validation. This apparent contradiction was associated with affective struggles related to navigating societal expectations, which they managed through three interpretative repertoires: 'It's only 24 hours', which normalizes the temporary nature of posts as less 'risky'; 'Empowered to post, judged for posting', minimizing personal responsibility by situating practices within collective norms; and 'I show my body if I want to', reclaiming agency by reframing self-sexualization as empowerment. The study highlights the affective struggles participants face in balancing critique, conformity and resistance within a digital landscape shaped by postfeminist frameworks that promote sexualization while valuing individual responsibility and self-surveillance. This study contributes to understanding the nuanced ways young women negotiate agency and objectification in digital spaces.

Introduction: Access to health care for trans and gender-diverse individuals is marked by persistent inequalities, often rooted in stigma and discrimination. The limited involvement of health care and social service professionals further restricts these individuals' access to adequate care. This article offers a novel analytical perspective by examining the experiences, motivations, and perceived enablers highlighted by professionals in the medical and social fields who are actively engaged in supporting the health care of trans people. Methods: Thirteen professionals took part in the study through individual interviews and a focusgroup. Thematic analysis identified several key barriers and enablers in their practices. Results: Enablers included a strong commitment to social justice, the establishment of egalitarian care relationships, and prior familiarity with the trans community. Major barriers included alack of training and officialguidelines, fearofoverstep-ping one's professional boundaries, and structural constraints tied to a binary male/female health care model. Participants suggested several avenues for improvement, including the development of guidelines by the French National Health Authority, the generation of robust scientific data, and the integration of specific content on trans health into both initial and continuing education. These measures, they emphasized, must be developed collaboration with the communities concerned. Ultimately, participants stressed that reducing health care access inequalities depends on increasing the number of professionals who are both committed and adequately trained to support trans individuals. Discussion: Transforming the health care system into a more inclusive space for trans people requires the commitment of professionals, institutional reforms, and the active participation of those directly concerned, in order to improve access to care and enhance the quality and equity of health care for all.

We aimed to understand how COVID-19 impacted LGBTQIA+ adolescents’ and young people’s well-being and to explore self-care strategies developed by them to address such effects. A qualitative investigation was conducted with adolescents and young people including 39 men who have sex with men and transgender women aged 15–22 years in Brazil. Data collection comprised digital-based diaries and semi-structured interviews and occurred during physical distancing measures. We adopted an iterative thematic analysis from an intersectional lens to examine how participants’ multiple social identities—such as gender, sexuality, race, and class—influenced their self-care practices. The process of reflecting on and adapting to COVID-19-related restrictions prompted participants to recognize experiences that impacted their well-being throughout their lives, such as stigma, discrimination, and violence. Social class emerged as the primary factor in social differentiation, rather than race, leading to varied effects of the pandemic on participants’ lives. In their quest for a sense of wholeness, participants became more critical of their relationships, often choosing to end toxic and abusive connections while seeking new sources of social support as a key strategy for protecting their well-being. Transgender participants noted that certain aesthetics within the transgender community could be oppressive rather than emancipatory. Engaging with new social media circles and participating in volunteer work were important forms of community engagement, particularly among Black participants. Future research on the long-term effects of COVID-19 on the well-being of adolescents should prioritize articulating structural drivers of inequality in qualitative health research.

In the era of the Anthropocene and the ensuing transitions, the One Health approach is one of the possible answers to rethinking our place on the planet. The aim of this article is to propose an epistemological reflection on the psychosocial processes that concern researchers working with the One Health approach, developing some perspectives that have received limited attention to date. We argue for the importance of making these processes explicit, and to focus on the complexity associated with sticking to both a One Health and a community-based approach. Drawing on our experience as researchers engaged in participatory and community-based research in the field of social psychology of health and ecology, and involved in research projects oriented towards the One Health perspective, we outline four key challenges researchers may face: (1) moving beyond anthropocentric conceptions of health, particularly in human medicine, the social sciences, and public health; (2) integrating moral commitments, values, and plural identities into scientific reflection; (3) collaborating with other ‘disciplinary communities’; (4) integrating non-academic researchers into the co-construction of science, by legitimising the experiential knowledge. For each challenge, we propose theoretical and methodological tools, conceived as resources to support researchers navigating these transitions.

OBJECTIVE:A growing body of empirical research traces the impact of social media use on young women's psychological wellbeing. The aim of the present article is to explore young female users' affective relationship with social media platforms in the context of gendered, postfeminist self-making. DESIGN:Drawing on dialogical self-theory, this study analyses the interplay between different voices-of-the-self in participants' accounts of social media use. RESULTS:Participants construct social media use as a 'double-edged sword'. Being exposed to idealised content elicits self-othering, i.e. voices-of-the-self associated with postfeminist ideals devaluing various 'deficient' aspects of the self, and thus negative affects. To counter the adverse effects of self-othering, young women consume social media content aimed at normalising and thereby affectively re-integrating 'othered' aspects of the self. They also post selfies in order to be 'seen'. Our findings suggest that being negatively affected by social media requires young women to engage in ongoing affective labour to actively restore - if only temporarily - a sense of self-worth through social media use. CONCLUSION:The precariousness of the produced states of self-acceptance raises the question under what conditions social media use can have a positive impact on young women's self-understandings and thus psychological wellbeing.

INTRODUCTION:Access to health care for trans and gender-diverse individuals is marked by persistent inequalities, often rooted in stigma and discrimination. The limited involvement of health care and social service professionals further restricts these individuals' access to adequate care. This article offers a novel analytical perspective by examining the experiences, motivations, and perceived enablers highlighted by professionals in the medical and social fields who are actively engaged in supporting the health care of trans people. METHODS:Thirteen professionals took part in the study through individual interviews and a focus group. Thematic analysis identified several key barriers and enablers in their practices. RESULTS:Enablers included a strong commitment to social justice, the establishment of egalitarian care relationships, and prior familiarity with the trans community. Major barriers included a lack of training and official guidelines, fear of overstepping one's professional boundaries, and structural constraints tied to a binary male/female health care model. Participants suggested several avenues for improvement, including the development of guidelines by the French National Health Authority, the generation of robust scientific data, and the integration of specific content on trans health into both initial and continuing education. These measures, they emphasized, must be developed in collaboration with the communities concerned. Ultimately, participants stressed that reducing health care access inequalities depends on increasing the number of professionals who are both committed and adequately trained to support trans individuals. DISCUSSION:Transforming the health care system into a more inclusive space for trans people requires the commitment of professionals, institutional reforms, and the active participation of those directly concerned, in order to improve access to care and enhance the quality and equity of health care for all.

In Brazil, young transgender women (YTW) bear a disproportionate burden of HIV, which persists despite technological advances in biomedical prevention. This study explores how rights violations across different areas of life shape YTW's vulnerability to HIV through an intersectional lens. We conducted 13 in-depth interviews and one group interview with YTW participating in an HIV pre-exposure prophylaxis (PrEP) cohort. Thematic analysis with intersectional sensibility focused on six dimensions: family, schooling, romantic-sexual relationships, friendships, work, and health. The results show that gender transition impacted all areas. Rights violations prevailed in family and school settings, while supportive friendships and romantic relationships contributed to protecting their rights. A synergistic effect emerged: family disruptions hindered education, leading to precarious jobs and increased exposure to sexual exploitation. Conversely, family and school support promoted education continuity and access to basic needs. Though healthcare discrimination was reported, HIV services were largely respectful and extended care beyond prevention. The findings highlight how interconnected rights violations during youth can deepen HIV vulnerability. Effective prevention must extend beyond biomedical access to include strategies that protect rights and strengthen community and institutional support for YTW.

RESUMO OBJETIVO: Compreender as percepções e práticas de profissionais de saúde no contexto da oferta de profilaxia pré-exposição ao HIV (PrEP) entre adolescentes e jovens gays e trans. MÉTODOS: Trata-se de pesquisa qualitativa desenvolvida como parte do estudo PrEP1519, realizada entre 2018 e 2021, com o objetivo de analisar a efetividade de PrEP entre adolescentes e jovens. Os dados foram produzidos de julho de 2020 a fevereiro de 2021 no sítio de São Paulo, combinando técnicas de observação-participante e entrevistas semiestruturadas. O processo analítico envolveu imersão no material empírico, codificação e categorização, com apoio do software NVivo®. A interpretação seguiu o princípio hermenêutico-dialético e teve como horizonte o conceito de cuidado inserido nas práticas de saúde. RESULTADOS: A construção do vínculo de confiança foi informada por práticas que reconheciam a singularidade dos/as adolescentes/jovens e suas demandas e buscavam impulsionar sua autonomia. A escuta sensível e solidária foi apontada como uma prática de acolhimento propulsora de ações de cuidado. Atitudes acolhedoras e suporte frente a situações de estigma e violências, relacionadas ou não ao uso de PrEP, convergiram para o reconhecimento da necessidade de apoio no desenvolvimento de autonomia para a prevenção entre adolescentes e jovens. O uso de linguagem próxima do cotidiano favoreceu a construção de relações de confiança, influenciando positivamente o desenvolvimento da autonomia e a adesão a PrEP. A tensão entre êxito técnico e sucesso prático foi observada na busca idealizada pela normatividade adultocêntrica em contraposição à intersubjetividade. CONCLUSÃO: As percepções e práticas dos/as profissionais de saúde se mostram coerentes com o conceito de cuidado, pois compreendem ações além dos saberes técnicos e reconhecem os contextos que aumentam a vulnerabilidade dos/as adolescentes e jovens ao HIV.

OBJECTIVE:To understand the perceptions and experiences of transsexual and travesti women and non-binary or gender-fluid people (TGWT+) in health services where they took pre-exposure prophylaxis (PrEP) in the periods before and during the pandemic, focusing on the resignification in the relationship with services and the continuity of HIV prevention via PrEP. METHODS:Qualitative research and analysis of empirical material generated in the context of broader studies were conducted. A total of 45 semi-structured interviews were conducted with TGWT+ PrEP users in the city of São Paulo and analyzed using iterative thematic content analysis. RESULTS:The TGWT+ interviewees gave new meanings to their struggles, daily lives and ways of caring for their health and played a central role within them. With its particularities, the COVID-19 pandemic became one more event among all the others that TGWT+ face daily. Alongside the COVID-19 pandemic, the TGWT+ were faced with the HIV epidemic, but with the possibility of prevention via PrEP. CONCLUSION:Based on a situated and conscious perspective, more explicit in the context of the health crisis, the TGWT+ intertwined conscious actions and care practices in dialog with health services. Further research on these groups from a spatiotemporal dynamic situated in specific contexts of meaning production would make it possible to advance prevention and care strategies, especially in times of health crisis.

Este relato, com linguagens textual e imagética, sistematiza o processo de criação e produção de um material de educação em saúde e popularização científica: a graphic novel “180 graus: minhas reviravoltas com o câncer de mama”1. O livro aborda o câncer de mama por meio da linguagem dos quadrinhos para discutir este problema de saúde pública que, segundo estimativa do Instituto Nacional do Câncer (INCA), em 2023, afetaria mais de 73 mil mulheres no Brasil. O relato está organizado em cinco etapas: articulação de equipe e parcerias estratégicas; pesquisa e pré-produção do material para a história em quadrinhos (HQ); desenvolvimento da HQ; elaboração de materiais pedagógicos complementares à HQ; e edição e divulgação da HQ. Ao final, há também resultados, lições aprendidas e próximos passos.

This study aimed to analyze the challenges in demand creation for participation in an HIV pre-exposure prophylaxis (PrEP) project in two Brazilian capitals. This qualitative study was conducted with men who have sex with men and transgender women aged 15 to 19 years who lived in two Brazilian state capitals. For this analysis, 27 semi-structured interviews carried out from 2019 to 2020 were evaluated by reflexive thematic content analysis. For participants, PrEP demand creation was essential for their interaction, mediation, bonding, and attachment and proved effective for PrEP acceptability and adherence. Adolescents' narratives showed that the strategies promoted HIV combination prevention, opened up opportunities for recruitment meetings, helped to negotiate with and convince individuals to use PrEP, strengthened peer education, and evoked a feeling of "being with" and "walking together" despite the challenges. Face-to-face or online interactions using social technologies played a crucial role in recruiting adolescents for the project, expanding knowledge on PrEP and other combination prevention strategies and access to health services and self-care.

Global health faces the triple challenge of preparing for future pandemics while responding to current ones in the midst of a climate crisis. In this commentary, we discuss the heightened focus on pandemic preparedness after the COVID-19 pandemic and the risks that this may pose to addressing the elimination of AIDS, tuberculosis, hepatitis and malaria, established in the Sustainable Development Goals as target 3.3. Considering their interconnections with the climate crisis and advocating for global health justice, we identify impasses that such a dispute over priorities can imply, and comment on four fronts of actions that could contribute convergently to both agendas as well as to facing the consequences of climate change to health: strengthening health systems, global commitment to equitable access to strategic medicines, addressing social inequalities and joining efforts for health and climate justice We conclude that addressing these fronts safeguards the health rights of the most vulnerable to existing epidemics while enhancing readiness for future pandemics. Moreover, solutions must transcend technocratic approaches, necessitating the confrontation of inequalities perpetuated by systems of power and privilege fueling both health and climate crises. Ultimately, health justice should guide responses to this intricate triple global health challenge.

In this study, we systematically examined the importance of human rights standards and principles for rights-based pre-exposure prophylaxis (PrEP) provision for marginalized adolescents. Nested within a demonstration study of PrEP provision to adolescent men who have sex with men, travestis, and transgender women, we carried out interviews in São Paulo, Brazil with 25 adolescents, eight health providers, and six workers involved in community-based demand creation. Analysis focused on participants’ narratives about aspects of human rights within service delivery, including the availability, accessibility, acceptability, and quality of services; informed decision-making; nondiscrimination; and privacy and confidentiality. Clients and service providers highlighted the importance of availing a range of services beyond PrEP and described how community outreach and social media helped promote accessibility. Acceptability centered around clients feeling heard and respected. Health workers appreciated having time to build trusting relationships with clients to ensure quality of care and support informed decision-making. Nondiscrimination was valued by all, including using clients’ chosen pronouns. Privacy and confidentiality were primary concerns for clients who were not “out” about their sexuality or PrEP use; to mitigate this, health workers sought to accommodate clients’ preferred channels of communication. Rights-based PrEP services can help promote engagement and retention in PrEP services, particularly for marginalized populations.

RESUMO OBJETIVO: O objetivo deste estudo é analisar o conhecimento sobre o esquema de Profilaxia Pré-Exposição ao HIV sob demanda (PrEP-SD) e a percepção do seu uso potencial entre jovens homens que fazem sexo com homens (HSH), travestis e mulheres trans (TrMT) em acompanhamento na coorte. MÉTODOS: O estudo qualitativo incluiu 50 entrevistas com participantes das cidades de Salvador e São Paulo, entre 15 e 19 anos, que estavam usando PrEP diária ou outros métodos preventivos. Eles foram abordados por meio de diferentes estratégias de criação de demanda. As entrevistas em profundidade abordaram temas como práticas sexuais, conhecimento sobre PrEP-SD, aceitabilidade e motivações para o uso. Foi realizada análise temática em duas fases usando o software Nvivo versão 12. RESULTADOS: A maioria dos participantes desconhecia a PrEP-SD e muitos questionaram a sua efetividade e segurança ao receberem informações sobre ela. No entanto, ao conhecer o esquema, muitos jovens perceberam vantagens, como a não obrigatoriedade diária de medicamentos e a possibilidade de uso apenas em momentos de maior risco. Barreiras para o uso da PrEP-SD também foram identificadas pelos participantes, como a imprevisibilidade das relações sexuais e a dificuldade em administrar as dosagens nessa modalidade. CONCLUSÕES: O conhecimento limitado e as experiências com a PrEP oral diária influenciaram o interesse por ela, o que aponta a necessidade de estratégias informativas que permitam o letramento dos jovens HSH e TrMT na PrEP-SD. Os jovens valorizaram a autonomia e a gestão da prevenção mais alinhada à dinâmica de sua vida sexual propiciada pela nova modalidade, mas enfrentam desafios na gestão da PrEP-SD.

OBJECTIVE:To identify the factors associated with HIV self-testing (HIVST) uptake among adolescent men who have sex with men (AMSM) and adolescent transgender women (ATGW) before and during the COVID-19 pandemic. METHODS:A cross-sectional HIVST uptake study was conducted among AMSM and ATGW. Peer educators and health professionals began providing HIVST in February 2019. The outcome was the HIVST uptake before and during the COVID-19 pandemic. The association between each predictor and outcome in each period was analyzed using simple and multiple logistic regressions, estimating odds ratios, and their respective 95% confidence intervals. RESULTS:The uptake was 229/510 (44.9%) and 382/1,075 (35.5%) before and during the pandemic. During the pre-pandemic period, HIVST uptake was higher in participants who reported receptive anal sex. During the pandemic, uptake was lower in participants with a steady sexual partner and higher in those with frequent oral sex with a steady partner in the previous three months. Before and during the pandemic, HIVST uptake was lower in ATGW and higher in those aged 18-19 years and in participants who lived alone. CONCLUSIONS:Uptake decreased during the pandemic. Sexual behavioral factors associated with HIVST uptake changed during the COVID-19 pandemic, showing the fluid dynamics of sexuality in AMSM and ATGW during this period. HIV programs can optimize the implementation of HIVST among adolescents and young people by incorporating effective and differentiated service delivery models to increase HIV testing uptake and to reach undiagnosed individuals effectively.

Using textual language and imagery, this account systematizes the process of creating and producing an educational tool for health education and science popularization in the form of the graphic novel " 180 graus: Minhas reviravoltas com o c & acirc;ncer de mama ". The book addresses the issues of breast cancer, which, according to the National Cancer Institute (INCA), affected more than 73,000 women in Brazil in 2023, using comic book language to discuss a public health problem. The account is structured into five sections: coordination of the team and strategic partnerships; research and pre-production of the material for the comic book; development of the comic book; creation of complementary educational material; and editing and publicizing the book. At the end we present the results, lessons learned and next steps.

OBJECTIVE: This study aims to analyze the knowledge about the HIV event-driven pre- exposure prophylaxis (event-driven PrEP) scheme and the perception of its potential use among young men who have sex with men (MSM), travestis, , and transgender women (TrTW) who were followed up in the cohort. METHODS: This qualitative study included 50 interviews with participants from the municipalities of Salvador and S & atilde;o Paulo, aged 15 to 19 years, who made daily use of PrEP or other preventive methods. They were addressed by different demand creation strategies. The in-depth interviews covered topics such as sexual practices, event-driven PrEP knowledge, acceptability, and motivations for its use. A two-stage thematic analysis was carried out on Nvivo, version 12. RESULTS: Most participants were unaware of event-driven PrEP, and many questioned its effectiveness and safety when receiving information about it. However, on learning about the program, many young people saw advantages, such as not having to take daily medication and the possibility of using it only at times of greater risk. Participants also found barriers to using event-driven PrEP, such as the unpredictability of sexual relations and the difficulty in administering dosages in this modality. CONCLUSION: Limited knowledge and experiences with daily oral PrEP influenced interest in event-driven PrEP, which highlights the need for information strategies that enable young MSM and TrTW to read about event-driven PrEP. Young people valued the autonomy and management of preventive methods provides by this new modality, which is more in line with the dynamics of their sexual lives, but they face challenges in managing event-driven PrEP.

OBJECTIVE: This study aims to understand the perceptions and practices of healthcare providers regarding the offer of HIV pre-exposure prophylaxis (PrEP) to gay and trans adolescents and young adults. METHODS: This qualitative research was developed as part of the PrEP1519 study, which was conducted from 2018 to 2021 to analyze the effectiveness of PrEP in adolescents and young adults. Data were collected from July 2020 to February 2021 at the municipality of S & atilde;o Paulo by combining participant observations and semi-structured interviews. The analytical process involved immersion in the empirical material and coding and categorizing it with the support of NVivo (R). Interpretation followed the hermeneutic-dialectical principle and had the concept of Care in health practices as its horizon. RESULTS: The construction of trust-based relationships followed practices that acknowledge the uniqueness of youth and their demands and sought to strengthen their autonomy. Sensitive and supportive listening was pointed out as a welcoming practice that propelled care actions. Welcoming attitudes and support in facing stigma and violence (related or not to the use of PrEP) acknowledged the need to support adolescents and young adults to develop autonomy for prevention. The use of language close to young people's everyday life favored the construction of relationships of trust and positively influenced the development of autonomy and adherence to PrEP. The tension between technical and practical success occurred in the idealized search for adult-centric normativity as opposed to intersubjectivity. CONCLUSION: The perceptions and practices of healthcare providers are aligned with the concept of Care as they include actions beyond technical knowledge and recognize the contexts that increase the vulnerability of adolescents and young adults to HIV.

RESUMO OBJETIVO: Compreender as percepções e experiências de mulheres transexuais, travestis e pessoas não binárias ou de gênero fluido (MTrT+) em serviços de saúde que fazem segmento de profilaxia pré-exposição sexual (PrEP), antes e durante o contexto de pandemia, quanto às ressignificações na relação com os serviços e à continuidade da prevenção ao HIV por meio da PrEP. MÉTODOS: Investigação qualitativa e análise de material empírico produzido no âmbito de estudos mais amplos. Realizaram-se 45 entrevistas semiestruturadas com MTrT+ usuárias da PrEP da cidade de São Paulo, aplicando-se posteriormente a análise de conteúdo temática iterativa. RESULTADOS: As MTrT+ entrevistadas, com relação à pandemia de covid-19; protagonizam e ressignificam suas próprias lutas, seus cotidianos e suas formas de cuidar da saúde. Com suas particularidades, a pandemia se torna um acontecimento a mais dentre todos os demais que as MTrT+ enfrentam quotidianamente. Paralelamente, transitam pela epidemia de HIV, mas com a possibilidade de se prevenir por meio da PrEP. CONCLUSÃO: Por uma perspectiva situada e consciente, mais explícita no contexto da crise sanitária, as MTrT+ entrelaçam ações conscientes e práticas de cuidado em diálogo com os serviços de saúde. Aprofundar as investigações sobre esses grupos, a partir de uma dinâmica espaço-temporal situada em contextos específicos de produção de sentido, possibilita avançar em estratégias de prevenção e cuidado, especialmente em momentos de crise sanitárias.