Skip to main content

ETHNOS_APP

Home • Search • Journals • List 0

Awareness of pre-exposure prophylaxis (PrEP) among women who inject drugs in NYC

The importance of networks and syringe exchange programs for HIV prevention

Bibliographic Data

ID23388317
AuthorsSuzan M Walter (0000-0002-2975-2893, State University of New York, corresponding author), Suzan M Walters, Kathleen H Reilly (0000-0002-5078-286X, New York City Department of Health and Mental Hygiene), Alan Neaigus (Columbia University), Sarah Braunstein (0000-0002-9670-4314, New York City Department of Health and Mental Hygiene)
Year2017
Volume14
Issue1
Pages40-40
Publication date2017-12-01
Peer ReviewedYes
Open AccessYes
TypeARTICLE
VenueHarm Reduction Journal (JOURNAL)
Journal identifiersISSN: 1477-7517 • E-ISSN: 1477-7517
PublisherSpringer Science and Business Media LLC (PUBLISHER)
DOI10.1186/s12954-017-0166-x
PMID28662716
OpenAlexW2732712854
LanguageEN
Citations received53
References cited100

BACKGROUND: Women who inject drugs (WWID) are at heightened risk for HIV due to biological, behavioral, and structural factors. Pre-exposure prophylaxis (PrEP) could aid in HIV prevention for WWID. However, little is known about WWID awareness of PrEP, which is a necessary step that must occur before PrEP uptake. We report factors associated with greater awareness among WWID to identify efficient means of awareness dissemination. METHODS: Data from the 2015 National HIV Behavioral Surveillance (NHBS) system cycle on injection drug use collected in New York City (NYC) were used. Bivariable analyses, using chi-squared statistics, were conducted to examine correlates of awareness of PrEP with socio-demographic, behavioral, and health care variables. Multivariable logistic regression was used to estimate adjusted associations and determine differences in awareness of PrEP. RESULTS: The analysis consisted of 118 WWID. Awareness of PrEP was relatively low (31%), and risk factors were high. In the last 12 months, almost two thirds (65%) reported condomless sex, approximately one third (31%) reported transactional sex, and one third (32%) reported sharing injection equipment. In multivariable logistic regression, increased PrEP awareness was associated with reported transactional sex (AOR 3.32, 95% CI 1.22-9.00) and having a conversation about HIV prevention at a syringe exchange program (SEP) (AOR 7.61, 95% CI 2.65-21.84). We did not find race, education, household income, age, binge drinking, or sexual identity to be significantly associated with PrEP awareness. CONCLUSIONS: Large proportions of WWID were unaware of PrEP. These findings suggest that social networks (specifically sex work and SEP networks) are an efficient means for disseminating messaging about prevention materials such as PrEP. We recommend that SEP access increase, SEP processes be adopted in other health care settings, and WWID networks be utilized to increase PrEP awareness.

Environmental health · Family medicine · Health psychology · Human immunodeficiency virus (HIV) · Logistic regression · Men who have sex with men · Needle sharing · Population · Pre-exposure prophylaxis · Psychiatry · Public health · Sex work · Substance abuse · Syphilis · Transactional sex · Demography · HIV, Drug Use, Sexual Risk · HIV/AIDS Research and Interventions · Internal Medicine · Medicine · Nursing · Sex work and related issues

  • Awareness and willingness to use HIV oral pre-exposure prophylaxis among people who inject drugs in Dar es Salaam, Tanzania

    Open Access•Masunga K Iseselo, Edith A M Tarimo et al.•PLOS Global Public Health•2022

  • I Don’t Really Know Much About PrEP

    Open Access•Marissa N Robinson, Brittany M Williams et al.•International Journal of…•2025

  • “They look at us like junkies”

    Open Access•Brandon Muncan, Suzan M Walter et al.•Harm Reduction Journal•2020

  • I Don’t Believe a Person Has to Die When Trying to Get High

    Open Access•Suzan M Walter, Marisa Felsher et al.•International Journal of…•2023

  • The Impact of the Covid-19 Pandemic on Drug Use Behaviors, Fentanyl Exposure, and Harm Reduction Service Support among People Who Use Drugs in Rural Settings

    Open Access•Rebecca Bolinski, Rebecca S Bolinski et al.•International Journal of…•2022

  • Empowering women at risk

    Open Access•Ndumiso Tshuma, Daniel N Elakpa et al.•BMC Public Health•2025

  • Protocol

    Open Access•Rebecca Schnall, M C Kempf et al.•BMC Public Health•2024

  • Responding to the HIV Health Literacy Needs of Clients in Substance Use Treatment

    Open Access•Yusen Zhai, Kyesha M Isadore et al.•International Journal of…•2023

  • State-level clustering in PrEP implementation factors among family planning clinics in the Southern United States

    Open Access•Anandi N Sheth, Kimberly P Enders et al.•Frontiers in Public Health•2023

  • Acceptability and Effectiveness of Hepatitis C Care at Syringe Service Programs for People Who Inject Drugs in New York City

    Brandon Muncan, Ashly E Jordan et al.•Substance Use & Misuse•2021

  • HIV Pre-Exposure Prophylaxis Prevention Awareness, Willingness, and Perceived Barriers among People Who Inject Drugs in Los Angeles and San Francisco, CA, 2016–2018

    Suzan M Walter, Alex H Kral et al.•Substance Use & Misuse•2020

  • Awareness and Correlates of HIV Pre-Exposure Prophylaxis (PrEP) Among HIV-negative People Who Access Syringe Services in Seattle, Washington

    Maria A Corcorran, John D Scott et al.•Substance Use & Misuse•2022

  • Multilevel Factors Shaping Awareness of and Attitudes Toward Pre-exposure Prophylaxis for HIV Prevention among Criminal Justice-Involved Women

    Open Access•Emily F Dauria, Andrew Levine et al.•Archives of Sexual Behavior•2021

  • Pre-Exposure Prophylaxis (PrEP) for HIV Infection in Cisgender and Transgender Women in the U.S

    Open Access•Adrienne Baldwin, Lauren Haberstock et al.•Archives of Sexual Behavior•2021

  • Interrogating perceived relevance and feasibility of HIV pre-exposure prophylaxis

    Open Access•Leanne Zhang, Joseph G Rosen et al.•SSM - Qualitative Research in…•2023

  • Assessment of PrEP Awareness, PrEP Discussion with a Provider, and PrEP Use by Transmission Risk Group with an Emphasis on the Southern United States

    Open Access•Jamal Jones, Dawn K Smith et al.•AIDS and Behavior•2021

  • Rural and urban differences in HIV pre-exposure prophylaxis (PrEP) awareness and acceptability among Black cisgender women living in the U.S. South

    Acacia Sharma, Jaquetta Revees et al.•AIDS Care•2025

  • Breaching Trust

    Open Access•Kaitlin Ellis, Suzan M Walter et al.•Frontiers in Sociology•2020

  • Development and Validation of a Provider-Specific Anticipated Stigma Scale for People Who Inject Drugs

    Open Access•Roman Ivasiy, Valerie A Earnshaw et al.•AIDS and Behavior•2026

  • Factors Associated with Awareness of Pre-exposure Prophylaxis for HIV Among Persons Who Inject Drugs in Philadelphia

    Open Access•Alexis M Roth, Alexis Roth et al.•AIDS and Behavior•2018

  • Exchange Sex Among Persons Who Inject Drugs in the New York Metropolitan Area

    Open Access•Suzan M Walter, Alexis V Rivera et al.•AIDS and Behavior•2018

  • Considerations for the Design of Pre-exposure Prophylaxis (PrEP) Interventions for Women

    Open Access•Suzan M Walter, Joey Platt et al.•AIDS and Behavior•2021

  • Barriers and Facilitators to HIV Pre-Exposure Prophylaxis Uptake Among Men Who have Sex with Men Who Use Stimulants

    Open Access•Adam Viera, Jacob J Van Den Berg et al.•AIDS and Behavior•2022

  • A Pilot Study to Evaluate a Novel Pre-exposure Prophylaxis Peer Outreach and Navigation Intervention for Women at High Risk for HIV Infection

    Open Access•Oni J Blackstock, Joey Platt et al.•AIDS and Behavior•2020

  • Living at the Confluence of Stigmas

    Open Access•Gregory A Carter, Beth E Meyerson et al.•AIDS and Behavior•2021

  • The Influence of PrEP-Related Stigma and Social Support on PrEP-Use Disclosure among Women Who Inject Drugs and Social Network Members

    Open Access•Marisa Felsher, Karley Dutra et al.•AIDS and Behavior•2021

  • Pre-exposure Prophylaxis (PrEP) Awareness and Prescribing Behaviors Among Primary Care Providers

    Open Access•Jamal Jones, B Rey deCastro et al.•AIDS and Behavior•2020

  • A Capacity-Strengthening Intervention to Support HIV Pre-exposure Prophylaxis (PrEP) Awareness-Building and Promotion by Frontline Harm Reduction Workers in Baltimore, Maryland

    Open Access•Joseph G Rosen, Leanne Zhang et al.•AIDS and Behavior•2023

  • Barriers and Facilitators to PrEP Use Among People Who Inject Drugs in Rural Appalachia

    Open Access•Sean T Allen, Allison O’Rourke et al.•AIDS and Behavior•2019

  • Cultivating Pearl (Promoting Empowerment and Risk Reduction)

    Open Access•Jennifer L Glick, Belinda Jivapong et al.•AIDS and Behavior•2022

  • Predictors of Willingness to Diffuse PrEP Information within Ego-Centric Networks of Women Who Inject Drugs

    Open Access•Marisa Felsher, E F Koku et al.•AIDS and Behavior•2021

  • PrEP Care Continuum Engagement Among Persons Who Inject Drugs

    Open Access•Suzan M Walter, David Frank et al.•AIDS and Behavior•2021

  • Acceptability and Feasibility of a Mobile Phone Application to Support HIV Pre-exposure Prophylaxis Among Women with Opioid Use Disorder

    Open Access•Aaron Richterman, Fatemeh Ghadimi et al.•AIDS and Behavior•2023

  • A Randomized Controlled Pilot Study of Just4Us, a Counseling and Navigation Intervention to Promote Oral HIV Prophylaxis Uptake Among PrEP-Eligible Cisgender Women

    Open Access•Anne M Teitelman, Hong‐van Tieu et al.•AIDS and Behavior•2023

  • Variations in Pre-exposure Prophylaxis (PrEP) Awareness and Healthcare Provider Interactions in a Nationally Representative Sample of American Men Aged 15–49 Years

    Open Access•John Ferrand, Eric R Buhi et al.•AIDS and Behavior•2023

  • A Qualitative Study of Barriers and Facilitators of PrEP Uptake Among Women in Substance Use Treatment and Syringe Service Programs

    Open Access•Melissa M Ertl, Susan Tross et al.•AIDS and Behavior•2022

  • PrEP Use Willingness and Perceptions Among Young Female Sex Workers in Kisumu, Kenya

    Open Access•Dan Omollo, Pam Murnane et al.•AIDS and Behavior•2026

  • HIV-Stigmatizing Beliefs and Attitudes as a Barrier to Early PrEP Care Continuum Engagement Among People Who Inject Drugs

    Open Access•Suzan M Walter, Suzan M Walters et al.•AIDS and Behavior•2026

  • Using epidemiological data to explore the impact of mental health and substance use disorder treatment facilities and family planning clinic availability on pre-exposure prophylaxis use for women in the U.S

    Dion C Allen, Silvia E Rabionet et al.•AIDS Care•2025

  • PrEP awareness among people living with HIV in Florida

    Angel B Algarin, Zhi Zhou et al.•AIDS Care•2021

  • Intention to initiate and uptake of PrEP among women who injects drugs in a demonstration project

    Nguyen Khai Tran, Marisa Felsher et al.•AIDS Care•2021

  • Individual, social and structural factors influencing PrEP uptake among cisgender women

    Anne M Teitelman, Hong‐van Tieu et al.•AIDS Care•2022

  • Substance use patterns and awareness of biomedical HIV prevention strategies among sexual and gender minority men in Canada

    Kiffer G Card, Anabelle Bernard Fournier et al.•AIDS Care•2020

  • Barriers to preexposure prophylaxis use among individuals with recently acquired HIV infection in Northern California

    Julia L Marcus, Leo B Hurley et al.•AIDS Care•2019

  • How the rural risk environment underpins hepatitis C risk

    Open Access•Suzan M Walter, David Frank et al.•International Journal of Drug…•2023

  • Injecting drug use

    Open Access•Renee Zahnow, Adam Winstock et al.•International Journal of Drug…•2018

  • The role of syringe exchange programs and sexual identity in awareness of pre-exposure prophylaxis (PrEP) for male persons who inject drugs

    Open Access•Suzan M Walter, B Ethan Coston et al.•International Journal of Drug…•2020

  • Ongoing Disparities in Prediagnosis Preexposure Prophylaxis Use Among Persons Recently Diagnosed With HIV in New York City, 2015–2017

    Kavita Misra, Jamie S Huang et al.•American Journal of Public Health•2019

  • Beliefs Associated with Intention to Use PrEP Among Cisgender U.S. Women at Elevated HIV Risk

    Open Access•Anne M Teitelman, Deepti Chittamuru et al.•Archives of Sexual Behavior•2020

  • PrEP just isn't my priority

    Open Access•Marisa Felsher, Eliza Ziegler et al.•Social Science & Medicine•2021

  • Motivations for PrEP-Related Interpersonal Communication Among Women Who Inject Drugs

    Open Access•Marisa Felsher, E F Koku et al.•Qualitative Health Research•2021

  • "I Heard of PrEP-I Didn't Think I Needed it." Understanding the Formation of HIV Risk Perception Among People Who Inject Drugs

    Open Access•Sarah G Mar, Jeff Ondocsin et al.•Culture Medicine and Psychiatry•2024

  • You're friends until everybody runs out of dope

    Open Access•J M Ezell, Suzan M Walter et al.•Social Networks•2022

  • Applied Logistic Regression

    Open Access•David W Hosmer, David W Jr Hosmer et al.•Applied Logistic Regression•2013

  • Antiretroviral Prophylaxis for HIV Prevention in Heterosexual Men and Women

    Jared M Baeten, Deborah Donnell et al.•New England Journal of Medicine•2012

  • Concurrent Sexual Partnerships Among Women in the United States

    Adaora A Adimora, Victor J Schoenbach et al.•Epidemiology•2002

  • Correlates of injection drug use among female sex workers in two Mexico–U.S. border cities

    Open Access•Steffanie A Strathdee, Morgan M Philbin et al.•Drug and Alcohol Dependence•2008

  • Contextual Factors and the Black-White Disparity in Heterosexual HIV Transmission

    Adaora A Adimora, Victor J Schoenbach•Epidemiology•2002

  • Application of the Theory of Gender and Power to Examine HIV-Related Exposures, Risk Factors, and Effective Interventions for Women

    Open Access•Gina M Wingood, Ralph J Diclemente•Health Education & Behavior•2000

  • Sexual transmission of HIV-1 among injection drug users in San Francisco, USA

    Open Access•Alex H Kral, Ricky N Bluthenthal et al.•The Lancet•2001

  • Antiretroviral Preexposure Prophylaxis for Heterosexual HIV Transmission in Botswana

    Michael C Thigpen, Poloko Kebaabetswe et al.•New England Journal of Medicine•2012

  • Knowledge, Attitudes, and Likelihood of Pre-Exposure Prophylaxis (PrEP) Use Among US Women at Risk of Acquiring HIV

    Open Access•Judith D Auerbach, Suzanne Kinsky et al.•AIDS Patient Care and STDs•2015

  • Antiretroviral prophylaxis for HIV infection in injecting drug users in Bangkok, Thailand (the Bangkok Tenofovir Study)

    Kachit Choopanya, Michael E Martins et al.•The Lancet•2013

  • Vital Signs

    Open Access•Dawn K Smith, Michelle Van Handel et al.•MMWR. Surveillance Summaries•2015

  • How Acceptable are Antiretrovirals for the Prevention of Sexually Transmitted HIV?

    Open Access•Isabel Young, Ingrid Young et al.•AIDS and Behavior•2014

  • Minority stress and health

    Cathy Kelleher•Counselling Psychology Quarterly•2009

  • Reliability of Drug Users' Self-Reported HIV Risk Behaviors and Validity of Self-Reported Recent Drug Use

    Open Access•Seana Dowling-Guyer, Mark E Johnson et al.•Assessment•1994

  • Are needle and syringe programmes associated with a reduction in HIV transmission among people who inject drugs

    Esther J Aspinall, Dhanya Nambiar et al.•International Journal of…•2014

  • Global epidemiology of HIV among female sex workers

    Open Access•Kate Shannon, Steffanie A Strathdee et al.•The Lancet•2015

  • Evaluation of Respondent-driven Sampling

    Nicky McCreesh, Simon D W Frost et al.•Epidemiology•2012

  • Burden of HIV among female sex workers in low-income and middle-income countries

    Open Access•Stefan D Baral, Stefan Baral et al.•The Lancet Infectious Diseases•2012

  • Social Context, Sexual Networks, and Racial Disparities in Rates of Sexually Transmitted Infections

    Open Access•Adaora A Adimora, Victor J Schoenbach•The Journal of Infectious Diseases•2005

  • Preexposure Chemoprophylaxis for HIV Prevention in Men Who Have Sex with Men

    Robert M Grant, Javier R Lama et al.•New England Journal of Medicine•2010

  • Gender Differences in Sexual and Injection Risk Behavior Among Active Young Injection Drug Users in San Francisco (the UFO Study)

    Jennifer L Evans•Journal of Urban Health•2003

  • The Role of Sexual Transmission of HIV Infection Among Injection and Non-Injection Drug Users

    Steffanie A Strathdee•Journal of Urban Health•2003

  • HIV Risk Profile and Prostitution Among Female Street Youths

    Amy E Weber•Journal of Urban Health•2002

  • Migration, Agency and Citizenship in Sex Trafficking

    Open Access•Rutvica Andrijasevic•Migration, Agency and Citizenship…•2010

  • Sex Work Politics

    Samantha Majic•Sex Work Politics•2014

  • Sex Worker Union Organising

    Open Access•Gregor Gall•Sex Worker Union Organising•2006

  • Black Sexual Politics

    Patricia Hill Collins•Black Sexual Politics•2004

  • Relationship power, condom use and HIV risk among women in the USA

    Julie Pulerwitz, Hortensia Amaro et al.•AIDS Care•2002

  • Gender differences in sharing injecting equipment by drug users in England

    Gerald Bennett, G A Bennett et al.•AIDS Care•2000

  • HIV providers’ likelihood to prescribe pre-exposure prophylaxis (PrEP) for HIV prevention differs by patient type

    Leah M Adams, L Adams et al.•AIDS Care•2016

  • ‘Professional Girlfriends’

    H Hoefinger•Cultural Studies•2011

  • Anger, Economy, and Female Agency

    Holly Wardlow•Signs: Journal of Women in…•2004

  • From Sex as Sin to Sex as Work

    Valerie Jenne, Valerie Jenness•Social Problems•1990

  • Incarcerated Black Women in the Southern USA

    Open Access•Nicole Pelligrino, Barbara H Zaitzow et al.•Journal of Racial and Ethnic…•2017

  • Dual HIV Risk

    Open Access•Alan Neaigus, Kathleen H Reilly et al.•AIDS and Behavior•2013

  • Non-Injection and Injection Drug Use and STI/HIV Risk in the United States

    Open Access•Maria R Khan, Amanda Berger et al.•AIDS and Behavior•2012

  • Estimating Design Effect and Calculating Sample Size for Respondent-Driven Sampling Studies of Injection Drug Users in the United States

    Open Access•C Wejnert, Huong Pham et al.•AIDS and Behavior•2012

  • Knowledge of Pre-exposure Prophylaxis (PrEP) for HIV Prevention Among Men Who Have Sex with Men in Denver, Colorado

    Open Access•Alia Al‐tayyib, Alia A Al-Tayyib et al.•AIDS and Behavior•2013

  • Willingness to Use HIV Pre-Exposure Prophylaxis Among Opiate Users

    Open Access•Michael Stein, Michael D Stein et al.•AIDS and Behavior•2014

  • HIV Providers’ Perceived Barriers and Facilitators to Implementing Pre-exposure Prophylaxis in Care Settings

    Open Access•Douglas Krakower, N C Ware et al.•AIDS and Behavior•2014

  • Awareness and Acceptability of Pre-exposure HIV Prophylaxis Among Men Who have Sex with Men in Baltimore

    Open Access•Susan Fallon, Susan A Fallon et al.•AIDS and Behavior•2016

  • HIV, HBV, and HCV Infections Among Drug-Involved, Inner-City, Street Sex Workers in Miami, Florida

    Open Access•James A Inciardi, Hilary L Surratt et al.•AIDS and Behavior•2005

  • The Importance of Measuring and Accounting for Potential Biases in Respondent-Driven Samples

    Open Access•Abby E Rudolph, Crystal M Fuller et al.•AIDS and Behavior•2013

  • Variance Estimation, Design Effects, and Sample Size Calculations for Respondent-Driven Sampling

    Open Access•M J Salganik•Journal of Urban Health•2006

  • Doctor-patient communication

    Open Access•L M L Ong, J C J M De Haes et al.•Social Science & Medicine•1995

  • Love, sex, and power

    Hortensia Amaro•American Psychologist•1995

  • Greater Drug Injecting Risk for HIV, HBV, and HCV Infection in a City Where Syringe Exchange and Pharmacy Syringe Distribution are Illegal

    Open Access•Alan Neaigus, Mingfang Zhao et al.•Journal of Urban Health•2008

  • Patterns of Exchange Sex and HIV Infection in High-Risk Heterosexual Men and Women

    Open Access•Samuel M Jenne, Samuel M Jenness et al.•Journal of Urban Health•2011

  • The prevalence of homelessness among injection drug users with and without HIV infection

    Open Access•John Song, John Y Song et al.•Journal of Urban Health•2000

  • Factors Affecting HIV Contraceptive Decision-Making Among Women

    Open Access•Gail E Wyatt, Jennifer Vargas Carmona et al.•Sex Roles•2000

  • Making It Work

    Joseph Gusfield, Joseph R Gusfield et al.•Contemporary Sociology A Journal…•1994

  • The trading of sex for drugs or money and HIV seropositivity among female intravenous drug users

    Jacquie Astemborski, David Vlahov et al.•American Journal of Public Health•1994

  • Mental Health Correlates of Perceived Discrimination Among Lesbian, Gay, and Bisexual Adults in the United States

    Vickie M Mays, Susan D Cochran•American Journal of Public Health•2001

  • Stigma as a Fundamental Cause of Population Health Inequalities

    Mark L Hatzenbuehler, Jo C Phelan et al.•American Journal of Public Health•2013

  • HIV Incidence Among Injection Drug Users in New York City, 1990 to 2002

    Don C Des Jarlais, Theresa E Perlis et al.•American Journal of Public Health•2005

  • HIV risk-related sex behaviors among injection drug users, crack smokers, and injection drug users who smoke crack

    R E Booth, J K Watters et al.•American Journal of Public Health•1993

  • Black women and aids prevention

    Mindy Thomson Fullilove, Mindy Thompson Fullilove et al.•The Journal of Sex Research•1990

  • HIV infection among people who inject drugs

    Don C Des Jarlais, Dennis Mccarty et al.•American Psychologist•2013

  • Stigma, discrimination and the health of illicit drug users

    Open Access•John Ahern, Jennifer Ahern et al.•Drug and Alcohol Dependence•2006

  • Temporarily Yours

    Elizabeth Bernstein•Temporarily Yours•2007

  • Mapping the Margins

    Kimberlé Crenshaw, Kimberlé W Crenshaw•Stanford Law Review•1991

  • Black Feminist Thought

    Patricia Hill Collins, Rose M Brewer•Black Feminist Thought•2002

  • The Problem With the Phrase Women and Minorities

    Lisa Bowleg•American Journal of Public Health•2012

  • The social structural production of HIV risk among injecting drug users

    Open Access•Tammy Rhodes, M Singer et al.•Social Science & Medicine•2005

  • Social and structural violence and power relations in mitigating HIV risk of drug-using women in survival sex work

    Open Access•Kate Shannon, Thomas Kerr et al.•Social Science & Medicine•2008

  • Making It Work

    Nelson A Pichardo, Valerie Jenne•Social Forces•1994

  • Minority Stress and Mental Health in Gay Men

    Ilan H Meyer•Journal of Health and Social…•1995

  • Respondent-Driven Sampling II

    Douglas D Heckathorn•Social Problems•2002

Unique citing works53
Citations per year6,63
Citation span2018 - 2026 (9)
Citation velocitycurrent
Highly citedNo
Citation typesNeutral: 51

Tools

Open DOISci-HubOpen Access
Ethnos_APP • Open Source Project • MIT License • Frontend v2.0.0 • Privacy and Cookies • API Documentation: api.ethnos.app/docs • API Source Code: GitHub • DOI: 10.5281/zenodo.17049435 • Frontend Source Code: GitHub • DOI: 10.5281/zenodo.17050053 • cruz.rio.br • Expectantes Misericordiae