{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T23:32:25Z","timestamp":1792798345947,"version":"4.5.0"},"reference-count":29,"publisher":"Public Library of Science (PLoS)","issue":"11","license":[{"start":{"date-parts":[[2024,11,27]],"date-time":"2024-11-27T00:00:00Z","timestamp":1732665600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000030","name":"Centers for Disease Control and Prevention","doi-asserted-by":"publisher","award":["6 NU50CK000494-01-04"],"award-info":[{"award-number":["6 NU50CK000494-01-04"]}],"id":[{"id":"10.13039\/100000030","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:p>The rapid diagnosis of opportunistic infections (OIs) is critical for improving the health outcomes of people living with HIV\/AIDS (PLWHA). This study aimed to describe the feasibility of implementing a package for the rapid diagnosis of tuberculosis, histoplasmosis, and cryptococcosis in patients with advanced HIV\/AIDS disease in Porto Alegre, Brazil. The research involved two focus groups with health professionals, four in-depth interviews with healthcare managers, and twelve interviews with PLWHA. The corpus was analyzed using Descending Hierarchical Classification (DHC). The study found that the rapid test diagnosis intervention was generally well-received by patients and health professionals, improving diagnosis and treatment outcomes. However, it also identified several areas for improvement, including the need for expanded psychosocial support and enhanced coordination between health services. The findings have important implications for the development and implementation of policies and programs aimed at enhancing the diagnosis and treatment of OIs among PLWHA with advanced diseases. Further research should explore social determinants of HIV\/AIDS mortality to offer valuable insights into improving prevention and treatment strategies. By prioritizing patient-centered care and improving coordination between health services, policymakers and health professionals can improve the health outcomes of PLWHA with advanced disease in Porto Alegre and other similar settings.<\/jats:p>","DOI":"10.1371\/journal.pone.0312204","type":"journal-article","created":{"date-parts":[[2024,11,27]],"date-time":"2024-11-27T18:29:51Z","timestamp":1732732191000},"page":"e0312204","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":1,"title":["Experiences and perspectives on rapid-test diagnosis of tuberculosis, histoplasmosis and cryptococcosis in people with advanced HIV\/AIDS disease in Porto Alegre, Brazil"],"prefix":"10.1371","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0742-8152","authenticated-orcid":true,"given":"Angelo","family":"Brandelli Costa","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura dos Santos","family":"Boeira","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2407-0583","authenticated-orcid":true,"given":"Dami\u00e3o Soares","family":"de Almeida-Segundo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-6106-7546","authenticated-orcid":true,"given":"Lara Wiehe","family":"Chaves","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Sainz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Larissa","family":"Silva","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9858-2878","authenticated-orcid":true,"given":"Leonardo Mello","family":"Garcia Dos Santos","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicole","family":"Reis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6782-5395","authenticated-orcid":true,"given":"Alessandro C.","family":"Pasqualotto","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Omar","family":"Sued","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2001-0057","authenticated-orcid":true,"given":"Freddy","family":"Perez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2024,11,27]]},"reference":[{"key":"pone.0312204.ref001","author":"Joint United Nations Programme on HIV\/AIDS.","year":"2023","journal-title":"The path that ends AIDS: UNAIDS Global AIDS Update"},{"key":"pone.0312204.ref002","article-title":"Boletim Epidemiol\u00f3gico-HIV e Aids 2023","author":"MINIST\u00c9RIO DA SA\u00daDE"},{"issue":"3","key":"pone.0312204.ref003","doi-asserted-by":"crossref","first-page":"76","DOI":"10.3390\/jof5030076","article-title":"Diagnosis of Progressive Disseminated Histoplasmosis in Advanced HIV: A Meta-Analysis of Assay Analytical Performance","volume":"5","author":"DH Caceres","year":"2019","journal-title":"Journal of Fungi"},{"issue":"6","key":"pone.0312204.ref004","doi-asserted-by":"crossref","first-page":"1612","DOI":"10.1128\/JCM.02430-16","article-title":"Laboratory Diagnostics for Histoplasmosis","volume":"55","author":"MM Azar","year":"2017","journal-title":"J Clin Microbiol"},{"key":"pone.0312204.ref005","article-title":"Cryptococcal Meningitis Diagnostics and Screening in the Era of Point-of-Care Laboratory Testing","author":"R Rajasingham","year":"2019","journal-title":"J Clin Microbiol"},{"key":"pone.0312204.ref006","unstructured":"Pan American Health Organization and World Health Organization. Diagnosing and Managing Disseminated Histoplasmosis among People Living with HIV. Washington, D.C.; 2020 Apr."},{"key":"pone.0312204.ref007","unstructured":"World Health Organization. Guidelines on the diagnosis, prevention and management of cryptococcal disease in HIV-infected adults, adolescents and children: supplement to the 2016 consolidated guidelines on the use of antiretroviral drugs for treating and preventing HIV infection. Geneva; 2018."},{"issue":"8","key":"pone.0312204.ref008","doi-asserted-by":"crossref","first-page":"873","DOI":"10.1016\/S1473-3099(17)30243-8","article-title":"Global burden of disease of HIV-associated cryptococcal meningitis: an updated analysis","volume":"17","author":"R Rajasingham","year":"2017","journal-title":"Lancet Infect Dis"},{"key":"pone.0312204.ref009","article-title":"The Diagnostic Laboratory Hub: A New Health Care System Reveals the Incidence and Mortality of Tuberculosis, Histoplasmosis, and Cryptococcosis of PWH in Guatemala.","author":"B Samayoa","year":"2020","journal-title":"Open Forum Infect Dis"},{"issue":"1","key":"pone.0312204.ref010","doi-asserted-by":"crossref","first-page":"42","DOI":"10.4269\/ajtmh.16-0009","article-title":"High Mortality and Coinfection in a Prospective Cohort of Human Immunodeficiency Virus\/Acquired Immune Deficiency Syndrome Patients with Histoplasmosis in Guatemala","volume":"97","author":"B Samayoa","year":"2017","journal-title":"Am J Trop Med Hyg"},{"issue":"1","key":"pone.0312204.ref011","first-page":"1","article-title":"Frequency of Invasive Fungal Disease in Adults: Experience of a Specialized Laboratory in Medell\u00edn, Colombia (2009\u20132015).","volume":"6","author":"Y Valencia","year":"2020","journal-title":"J Fungi (Basel)"},{"key":"pone.0312204.ref012","article-title":"Histoplasmosis, An Underdiagnosed Disease Affecting People Living With HIV\/AIDS in Brazil: Results of a Multicenter Prospective Cohort Study Using Both Classical Mycology Tests and Histoplasma Urine Antigen Detection.","author":"Monteiro AA Falci DiR","year":"2019","journal-title":"Open Forum Infect Dis"},{"issue":"2","key":"pone.0312204.ref013","doi-asserted-by":"crossref","first-page":"231","DOI":"10.1097\/QAI.0000000000001669","article-title":"A Prospective Evaluation of a Multisite Cryptococcal Screening and Treatment Program in HIV Clinics in Uganda.","volume":"78","author":"E Nalintya","year":"2018","journal-title":"J Acquir Immune Defic Syndr"},{"issue":"12","key":"pone.0312204.ref014","doi-asserted-by":"crossref","first-page":"2126","DOI":"10.1093\/cid\/cix613","article-title":"Inadequacy of High-Dose Fluconazole Monotherapy Among Cerebrospinal Fluid Cryptococcal Antigen (CrAg)-Positive Human Immunodeficiency Virus-Infected Persons in an Ethiopian CrAg Screening Program.","volume":"65","author":"T Beyene","year":"2017","journal-title":"Clin Infect Dis"},{"key":"pone.0312204.ref015","article-title":"Care for persons living with HIV in primary health care: reconfigurations of the healthcare network?","author":"EA Melo","year":"2021","journal-title":"Cad Saude Publica"},{"issue":"4","key":"pone.0312204.ref016","doi-asserted-by":"crossref","first-page":"169","DOI":"10.1007\/s11904-006-0012-3","article-title":"Rapid HIV testing: a review of the literature and implications for the clinician.","volume":"3","author":"C Franco-Paredes","year":"2006","journal-title":"Curr HIV\/AIDS Rep"},{"key":"pone.0312204.ref017","article-title":"Stigma, HIV and health: a qualitative synthesis.","author":"LA Chambers","year":"2015","journal-title":"BMC Public Health"},{"key":"pone.0312204.ref018","doi-asserted-by":"crossref","first-page":"103064","DOI":"10.1016\/j.bjid.2023.103064","article-title":"Uso de testes r\u00e1pidos para determinar a preval\u00eancia de Histoplasmose, criptococose e tuberculose em pessoas vivendo com HIV em cinco Hospitais do Brasil\u2014resultados preliminares","volume":"27","author":"LR da Silva","year":"2023","journal-title":"The Brazilian Journal of Infectious Diseases"},{"issue":"4","key":"pone.0312204.ref019","first-page":"233","article-title":"Addressing the Drivers of Medical Test Overuse and Cascades: User-Centered Design to Improve Patient-Doctor Communication.","volume":"48","author":"RS Rudin","year":"2022","journal-title":"Jt Comm J Qual Patient Saf [Internet]."},{"key":"pone.0312204.ref020","volume-title":"Guidelines for managing advanced HIV disease and rapid initiation of antiretroviral therapy","author":"World Health Organization","year":"2017"},{"key":"pone.0312204.ref021","article-title":"Cost-effectiveness evaluation of routine histoplasmosis screening among people living with advanced HIV disease in Latin America and the Caribbean. PLOS Global Public Health","author":"R Rajasingham","year":"2023","journal-title":"Internet]"},{"key":"pone.0312204.ref022","article-title":"Cost-effectiveness analysis and budgetary impact of the Cryptococcal Antigen Lateral Flow Assay (CRAG-LFA) implementation for the screening and diagnosis of cryptococcosis in asymptomatic people living with HIV in Brazil","author":"M Vianna CM de","year":"2021","journal-title":"Rev Inst Med Trop Sao Paulo"},{"issue":"7","key":"pone.0312204.ref023","doi-asserted-by":"crossref","first-page":"E2077","DOI":"10.1093\/cid\/ciaa1698","article-title":"Cost-effectiveness of a Novel Lipoarabinomannan Test for Tuberculosis in Patients With Human Immunodeficiency Virus","volume":"73","author":"KP Reddy","year":"2021","journal-title":"Clin Infect Dis"},{"issue":"3","key":"pone.0312204.ref024","doi-asserted-by":"crossref","first-page":"181","DOI":"10.1521\/aeap.2009.21.3.181","article-title":"Effectiveness of Peer Education Interventions for HIV Prevention in Developing Countries: A Systematic Review and Meta-Analysis","volume":"21","author":"A Medley","year":"2009","journal-title":"AIDS Educ Prev"},{"issue":"10","key":"pone.0312204.ref025","doi-asserted-by":"crossref","first-page":"e690","DOI":"10.1016\/S2352-3018(22)00221-1","article-title":"Effect of a conditional cash transfer programme on AIDS incidence, hospitalisations, and mortality in Brazil: a longitudinal ecological study.","volume":"9","author":"GA de Sampaio Morais","year":"2022","journal-title":"Lancet HIV"},{"key":"pone.0312204.ref026","article-title":"The effects of social determinants of health on acquired immune deficiency syndrome in a low-income population of Brazil: a retrospective cohort study of 28.3 million individuals","author":"I Lua","year":"2023","journal-title":"Lancet regional health Americas"},{"issue":"3","key":"pone.0312204.ref027","first-page":"895","article-title":"Analysis of the trend of mortality from HIV\/AIDS according to sociodemographic characteristics in Brazil, 2000 to 2018.","volume":"27","author":"AP da Cunha","journal-title":"Cien Saude Colet"},{"issue":"1","key":"pone.0312204.ref028","doi-asserted-by":"crossref","first-page":"16","DOI":"10.1080\/09540121.2021.1876836","article-title":"Key and general population HIV-related stigma and discrimination in HIV-specific health care settings: results from the Stigma Index Brazil","volume":"34","author":"A Brandelli Costa","year":"2022","journal-title":"AIDS Care"},{"key":"pone.0312204.ref029","doi-asserted-by":"crossref","DOI":"10.1186\/1478-4491-8-8","article-title":"A systematic review of task- shifting for HIV treatment and care in Africa","volume":"8","author":"M Callaghan","year":"2010","journal-title":"Hum Resour Health"}],"container-title":["PLOS ONE"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0312204","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,11,27]],"date-time":"2024-11-27T18:30:04Z","timestamp":1732732204000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0312204"}},"subtitle":[],"editor":[{"given":"Maria Carlota","family":"Borba Brum","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2024,11,27]]},"references-count":29,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2024,11,27]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0312204","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,11,27]]}}}