This study discusses the impacts of judicialization on the guarantee of the right to health in Brazil and the need to reassess the role of the Judicial system in its protection. We used evidence from the technical-scientific literature and information on the budgetary-financial execution and the acquisition of medicines from the Brazilian Ministry of Health to substantiate the arguments. In 2019, lawsuits consumed 25.2% of the resources of the Specialized Component of Pharmaceutical Care, 21% for 10 medicines. Although the Judicial promotes this right when the State fails to ensure access to medicines incorporated into the Brazilian Unified Health System (SUS), this system compromises access to medicines of the population with the determinations of acquisition of non-incorporated products. The Judicial needs to guide its control over compliance with constitutional and legal precepts in public policies, especially in fiscal policy, given its impact on the financing of the SUS. The judicialization of health can be understood as a situation of expansion of the activation of the Judicial by individuals or groups of individuals, citizens or consumers, to arbitrate conflicts of this system with the Executive Branch, with private companies and individuals in healthmatters2. On the other hand, judicialization would produce unequal treatment among citizens in a country marked by great socioeconomic inequalities and health inequities4.In cases where the defendant is the State, the impact of judicialization on the guarantee of the right to health is positive or negative. On one hand, judicialization would be beneficial because it constitutes a means to ensure the right to health and to induce improvement in the response of the State5 due to failures in the supply of incorporated products and request experimental or approved medicines for commercialization, but not incorporated into the system7. These situations may be prevalent, depending on the locality, and are important in assessing the impacts of health judicialization.In the SUS, lawsuits demand medicinesThus, considering the relevance of this theme, this study aimed to discuss the impacts of the current model of judicialization on the guarantee of the right to health in Brazil and the need to reevaluate the role of the Judicial in the protection of this right.We obtained evidence from the technical-scientific literature on the judicialization of health and the financing of the SUS by research done in the Virtual Health Library, in the field “title, abstract and subject”, for documents published since 2000, including all bases and using the words: i) “judicialization” and “health”; (ii) “financing” and “SUS”. We also consulted references on these topics in documents and publications of the National Council of Justice (CNJ). We selected studies addressing the following themes: consequences of lawsuits for health policy, theory of the reservation of the possible, and role of the Judicial in the protection of social rights.Siga Brasil tool: budget-financial execution of the MS (2012-2020).Data from the following information systems were also obtained to substantiate the arguments: i) Justice in Numbers Panel of CNJ: new cases of judicial demand (2014 to 2020); ii) Integrated General Services Administration System (SIASG): acquisition of medicines by the Brazilian Ministry of Health (MS) (2016-2020); and iii) 8. Since then, the demands have diversified and multiplied, mostly individually, favoring the perception that, although part of them is relevant to ensure the right to health, another part has the potential to disorganize the SUS9.The judicialization of public health began in the 1990s with lawsuits that demanded treatment for HIV-positive people. Decisions in favor of patients represented an advance in ensuring universal and integral access to health services and goods1, the new cases did not decrease , reaching R$ 1.5 billion last year. It decreased 26% between 2016 and 2017 and remained at R$ 1. billion from 2017 to 2019 .13 issues such as the disregard of the responsibilities of the federation entities in the organization of the SUS, the purchase of medicines not incorporated and without registration with Anvisa, and losses to equity.Studies in the 2000s already showed concern about the consequences of lawsuits. They explainedIn the last decade, authors linked to the justice system entered the debate, highlighting positive and negative aspects of the judicialization of health, which represents an advance by favoring the discussion on the subject among their peers.15.Regarding the positive aspects, we highlight the promotion of the formulation and review of public policies, the inclusion of health in the political agenda, the development of the evaluation of health technologies, and the expansion of dialogue between the powers15.Regarding the negative aspects, we highlight the disorganization of the SUS and public finances, the undue judicial choices of public policies, the weakening of isonomy, the disregard of the criteria for prioritizing the technologies available, and the expansion of health inequalities1.Moreover, the Judicial can consider scientific evidence and determine the supply of technologies not incorporated into the SUS, in a parallel and capillary process throughout the country, which competes with the evaluation of technologies performed by the health systemThis understanding has several implications. Two implications stand out: i) the weakening of policies as a means for guaranteeing the right to health because, with so many exceptions to the National List of Essential Medicines (Rename), the rule, which should be valid for all, is distorted; and (ii) the reduction of the resources provided in the budget of the year to ensure the population’s access to Rename medicines. This second implication is discussed below.Regarding the relationship between the public budget, the judicialization of health, and the theory of the reservation of the possible, the manifestations of public managers and magistrates are opposed. On one hand, managers use this theory to justify the impossibility of meeting the judicial demand, claiming the unavailability of resources to meet it. On the other hand, judges counter-argue that a secondary interest of the State cannot be superimposed on the right to health under the argument of the reservation of the possible. Both positions need to be rethought.16.The concept of reservation of the possible came from Germany, where they recognized that issues involving social rights suffer limitation in three dimensions: i) reservation of the factually possible: the satisfaction of demand needs to be feasible; (ii) reservation of the legally possible: the demand needs to be legally possible; and iii) reservation of the financially possible: the demand fulfillment is limited to the state’s financial capacity17. But a shortage of resources considering only the annual health budget cannot be claimed.Regarding the use of the theory of the reservation of the possible by managers, financial capacity of the State is different from the annual budget established for health. The financial capacity of the State is measured considering all the resources collected from society. Revenues limit the capacity to spend on policies that empower social rights, thus society’s participation in the discussion conducted by its representatives on the allocation of resources is fundamental18.Regarding the counter-argument of the magistrates, the financial capacity cannot be considered as a secondary interest of the State. The rights have costs, thus is necessary to measure them and define how they will be financed, as well as control who decides on the resources that will be allocated to realize them19. This occurs because the budget has planning nature and is defined in the year prior to its validity. The reallocation of resources between different areas requires prior legislative authorization, not only the simple will of the health manager20 and, depending on the economic conditions of the country, the budget constraint may imply tragic choices in the supply of goods and services.When the Judicial ignores the macro-issues related to the subject and determines the supply, for an individual, of medicines not provided for in public policies, it impacts the access of others to the medicines included in the policies22, which should have several determinants, but certainly one of them is judicialization.Only ten drugs accounted for 94.6% of the expenditure on lawsuits from the Brazilian Ministry of Health in 2019 (R$ 950.33 million) and consumed 21% of the resources allocated to CEAF. Thus, there is a lack of medicines under the responsibility of acquisition of the Ministry of Health23. Because this leads to decisions that disregard the country’s health legislation and that put people’s health at risk, as in the case of the phosphoethanolamine24. Finally, how could the Judicial better protect the right to health?This example explains how judicialization can cause more harm than promoting the right to health in Brazil. Decisions on resource allocation are complex and require democratic legitimacy. Moreover, they require solid technical knowledge in health. Decisions cannot have as a single foundation criteria denoting humanitarian feelings of solidarity, justice, and empathy for a single individual6.The Judicial plays an important role by determining that the State fulfills its duty to ensure the supply of medicines incorporated into the SUS, in compliance with the guidelines and regulations of public policies. In a recent survey, 46% of magistrates said that they did not observe guidelines and regulations25.Meanwhile, fiscal policy decisions are taken within the Union with a great negative impact on social rights, such as the implementation of the spending ceiling for primary expenditures, the freezing of minimum applications in health and education, the absence of limitation of financial expenses, and the expansion of tax expenditure26. The Judicial needs to exercise macrojustice, which demands control over processes involving macroeconomic policies that affect the funding of SUS27. If the Judicial does not exercise macrojustice, it will continue to promote health inequities.Given the importance of fiscal policy to guarantee rights, human rights principles for fiscal policy are discussed, aiming to approximate Economy and Law28 (2011), social rights would be adequately protected if the Judicial stopped interfering in the content of policies and began to act in the control of their formulation to ensure respect for constitutional and legal norms. Gebran Neto15 (2019) has the same position.Thus, it is necessary to reflect on the role of the Judicial in the protection of social rights. According to Ferraz30. Therefore, universality is impaired and the right to health remains denied to the most socioeconomically disadvantaged.Therefore, the role of the Judicial in ensuring access to medicines incorporated into the SUS, respecting the standards established within the health system, is not questioned. If the norms and procedures are questionable, considering the goals of the Federal Constitution of 1988 and the laws, the norms and procedures are discussed. But it is unreasonable to allocate resources by lawsuits for the purchase of unincorporated medicines. These allocations mischaracterize the general rule that should be applied to all and drain scarce resources, while the SUS is subjected to a chronic underfunding process No Brasil, as ações judiciais no campo da saúde ganharam importância nas últimas décadas em razão do aumento significativo dos casos e de seus impactos, especialmente para o Sistema Único de Saúde (SUS). A judicialização da saúde pode ser entendida como uma situação de ampliação do acionamento do Poder Judiciário por parte de indivíduos ou grupos de indivíduos, na condição de cidadãos ou de consumidores, a fim de que sejam arbitrados conflitos destes com o Poder Executivo, com empresas privadas e pessoas físicas em matéria de saúde3,4.Nos casos em que o réu é o Estado, o impacto da judicialização na garantia do direito à saúde tem sido apontado como positivo ou negativo. Por um lado, a judicialização seria benéfica por constituir um meio para garantir o direito à saúde e induzir melhora na resposta do Estado,,No SUS, as ações judiciais demandam medicamentosAssim, considerando a relevância desse tema, este texto tem por objetivo discutir os impactos do modelo atual de judicialização sobre a garantia do direito à saúde no Brasil e a necessidade de reavaliação do papel do Judiciário na proteção desse direito.Evidências da literatura técnico-científica sobre a judicialização da saúde e o financiamento do SUS foram obtidas a partir de pesquisa feita na Biblioteca Virtual em Saúde, no campo “título, resumo e assunto”, para documentos publicados a partir do ano 2000, incluindo-se todas as bases e utilizando-se das palavras: i) “judicialização” e “saúde”; ii) “financiamento” e “SUS”. Também foram consultadas referências sobre esses temas em documentos levantados e publicações do Conselho Nacional de Justiça (CNJ). Foram selecionados trabalhos que abordassem os seguintes temas: consequências das ações judiciais para a política de saúde, teoria da reserva do possível e papel do Judiciário na proteção de direitos sociais.Dados dos seguintes sistemas de informação também foram obtidos para fundamentar os argumentos: i) Painel Justiça em Números do CNJ: casos novos de demanda judicial (2014 a 2020); ii) Sistema Integrado de Administração de Serviços Gerais (SIASG): aquisição de medicamentos pelo Ministério da Saúde (MS) (2016-2020); e iii) Siga Brasil: execução orçamentário-financeira do MS (2012-2020).A judicialização da saúde pública teve início nos anos 1990 com as ações judiciais que demandavam tratamentos para pessoas HIV positivas. As decisões em favor dos pacientes representaram um avanço na garantia do acesso universal e integral aos serviços e bens de saúdeVárias instituições implementaram medidas para ampliar o diálogo entre os poderes e estabelecer balizas para as decisões judiciais. Contudo, a despeito dos esforços empreendidosTambém parecem ter sido pouco efetivos os enunciados do CNJ, publicados desde 2014 como orientações aos magistrados no enfrentamento da judicialização da saúdeEntre os itens judicializados adquiridos pelo Ministério da Saúde de 2016 a 2020, a maioria dos 10 medicamentos de maior impacto orçamentário não estava incorporada ao SUS . Houve tO gasto do Ministério da Saúde em ações judiciais de medicamentos cresceu significativamente entre 2012 e 2016 (221%), chegando a R$ 1,5 bilhão no último ano. Decresceu 26% entre 2016 e 2017, e manteve-se no patamar de R$ 1,1 bilhão de 2017 a 2019 .,Estudos realizados nos anos 2000 já evidenciavam preocupação com as consequências das demandas judiciais. Questões como a desconsideração das responsabilidades dos entes da federação na organização do SUS, a compra de medicamentos não incorporados e sem registro na Anvisa, além de prejuízos à equidade, foram explicitadasNa última década, autores vinculados ao sistema de justiça entraram no debate, destacando aspectos positivos e negativos da judicialização da saúde, o que representa um avanço por favorecer a discussão sobre o tema entre seus pares.,Quanto aos aspectos positivos, destacam-se o fomento à formulação e à revisão de políticas públicas, a inclusão da saúde na agenda política, o desenvolvimento da avaliação de tecnologias em saúde e a ampliação do diálogo entre os poderes,,Com relação aos aspectos negativos, ressaltam-se a desorganização do SUS e das finanças públicas, as escolhas judiciais indevidas de políticas públicas, a fragilização da isonomia, a desconsideração dos critérios de priorização das tecnologias disponibilizadas e a ampliação das desigualdades em saúdeAlém disso, permanece o entendimento de que o Judiciário pode considerar evidências científicas e determinar o fornecimento de tecnologias não incorporadas ao SUS, em um processo paralelo e capilarizado em todo o país, que concorre com a avaliação de tecnologias realizada pelo sistema de saúdeEsse entendimento tem várias implicações. Salientam-se duas delas: i) a fragilização das políticas como meio para a garantia do direito à saúde, pois, com tantas exceções à Relação Nacional de Medicamentos Essenciais (Rename), desvirtua-se a regra, que deveria valer para todos; e ii) a redução dos recursos previstos no orçamento do ano para garantir o acesso da população aos medicamentos da Rename. Esta segunda implicação é discutida a seguir.Sobre a relação entre o orçamento público, a judicialização da saúde e a teoria da reserva do possível, as manifestações de parte dos gestores públicos e dos magistrados se contrapõem. De um lado, gestores se utilizam dessa teoria para justificar a impossibilidade de atendimento da demanda judicial, alegando a indisponibilidade de recursos para atendê-la. De outro lado, juízes contra-argumetam que não se pode sobrepor um interesse secundário do Estado ao direito à saúde sob o argumento da reserva do possível. O fato é que ambas as posições precisam ser repensadas.O conceito de reserva do possível foi importado da Alemanha, onde houve reconhecimento de que questões envolvendo direitos sociais sofrem limitação em três dimensões: i) reserva do faticamente possível: a satisfação da demanda precisa ser viável; ii) reserva do juridicamente possível: a demanda precisa ser juridicamente possível; e iii) reserva do financeiramente possível: o atendimento à demanda fica limitado à capacidade financeira do EstadoEm relação ao uso da teoria da reserva do possível pelos gestores, ressalta-se que não se pode confundir capacidade financeira do Estado com o orçamento anual estabelecido para a saúde. A capacidade financeira do Estado é medida considerando todos os recursos que são arrecadados da sociedade. É claro que a capacidade de gasto com políticas que concretizam direitos sociais é limitada pelas receitas, sendo fundamental a participação da sociedade na discussão conduzida por seus representantes sobre a destinação dos recursosQuanto ao contra-argumento dos magistrados, tampouco se pode considerar a capacidade financeira um interesse secundário do Estado. Os direitos têm custos, sendo preciso mensurar qual é o seu custo e definir como serão financiados, assim como controlar quem decide sobre os recursos que serão alocados para concretizá-losQuando o Judiciário ignora as macroquestões relacionadas ao tema e determina o fornecimento, para um indivíduo, de medicamentos não previstos nas políticas públicas, ele impacta o acesso dos demais aos medicamentos que constam nas políticasAs ,Analisando-se a Esse exemplo explicita de que forma a judicialização pode causar mais danos do que promover o direito à saúde no Brasil. Decisões sobre alocação de recursos são complexas e demandam legitimidade democrática. Ademais, requerem sólido conhecimento técnico em saúde. Não podem ter por único fundamento critérios que denotam sentimentos humanitários de solidariedade, justiça e empatia para com um único indivíduoNão há dúvidas de que o Judiciário exerce importante papel quando determina que o Estado cumpra o seu dever de garantir o fornecimento de medicamentos incorporados ao SUS, em observância às diretrizes e normativos das políticas públicas. Diretrizes e normativos estes que 46% dos magistrados, em pesquisa recente, disseram não observarEnquanto isso, decisões de política fiscal são tomadas no âmbito da União com grande impacto negativo nos direitos sociais, como a implantação do teto de gastos para as despesas primárias, o congelamento das aplicações mínimas em saúde e educação, a ausência de limitação das despesas financeiras e a ampliação do gasto tributário,Dada a importância da política fiscal para a garantia de direitos, discutem-se hoje princípios de direitos humanos para a política fiscal, em uma iniciativa que busca aproximar os campos da economia e do direitoDessa forma, é necessário que se reflita sobre o papel do Judiciário na proteção dos direitos sociais. Segundo Ferraz,Assim, não se questiona a atuação do Judiciário na garantia do acesso aos medicamentos incorporados ao SUS, respeitadas as normas estabelecidas no âmbito do sistema de saúde. Se as normas e os procedimentos são questionáveis, considerando-se as balizas da Constituição Federal de 1988 e das leis, discutem-se as normas e os procedimentos. Mas não são razoáveis as alocações de recursos por ações judiciais para a compra de medicamentos não incorporados. Essas destinações descaracterizam a regra geral que deveria ser aplicada para todos e drenam recursos escassos, enquanto o SUS é submetido a um processo de subfinanciamento crônico


Review the reasons for condom use and non-use among transgender women in Colombia based on the information, motivation and behavioral skills (IMB) model. Qualitative study in which an iterative process analysis was carried out. A focal group participated in person, and in-depth interviews were conducted virtually. First study carried out in Colombia on condom use among transgender women under the IMB model. The information component finds that traditional sexual education does not have a positive impact. Regarding motivational aspects, the importance of family support and follow-up and community-based organizations to motivate sexual health care and condom use is highlighted. Regarding behavioral skills, it was found that distrust towards sexual partners and the acquisition of condoms promote their use. It is important to create spaces for sexual education delivered by and for the LGBTIQ population, followed by the medical knowledge of health centers, to have positive impacts on the sexual health of transgender women; studies with sexual partners of transgender women are encouraged in order to know the reasons why they request the non-use of condoms. This category frames a vindictive political positioning, and includes gender identities that do not fit the binary model1. Literature shows that the most frequently researched topic with respect to this population has to do with the prevalence of the human immunodeficiency virus (HIV)2. There are some quantitative studies with trans women, HIV and the information, motivation and behavioral skills (IMB) model7. It relates to practices that may predispose to the infection from sexually transmitted infections (STIs). In relation to this discussion, the research team takes an ontological stance in which it distances itself from the relationship between TW and HIV declared under the concept of key population; in line with it, empirical data8 support the fact that, in Colombia, people living with the disease are not necessarily identified in any key population. Therefore, at the national level, the challenge is to focus health promotion and disease prevention strategies on the Colombian population in general.In recent years, studies on trans women (TW) have been increasing. The term 10. However, their use by TW is not as consistent as expected12. This is due to several factors, both objective and subjective ones. The former has to do with material conditions, such as lack of money for access to condoms, and with external conditions, such as the reluctance of the partner to use them during sexual intercourse13. Subjective factors are associated with the so-called sexual education15, the history that is embodied and reproduced with respect to knowledge, beliefs, emotional state and the use of psychoactive substances, among others. Therefore, it is not possible to reduce the aforementioned practice to a rational choice tied to what is called the “logical acting”.In this context, condoms continue to be the best prevention tool16, the present study aims to analyze the reasons for condom use and non-use among TW based on the IMB model.Given the importance and need for qualitative studies on condom use among TW and the relevance gained by the IMB model in studies to understand risk behaviors associated with STIs, especially HIV, and to inform the development of preventive interventions in different population groups with limited resources20. In this sense, this model includes three main constructs that influence behavioral changes: information, motivation and behavioral skills to perform the behavior21. Information refers to relevant knowledge about condoms, such as their role in preventing pregnancy and STIs. Motivation includes personal and social motivations; the former encompasses positive attitudes or benefits and negative attitudes toward condom use, while social motivation includes the individual’s perceptions of the social support provided by supportive networks available to promote condom use. Behavioral skills refer to the objective ability of individuals to have sex  with a condom, and to the identification of factors that affect protected sexual practice by means of this method of protection22.The IMB model proposes that to the extent that people are informed and motivated, they engage in appropriate health care behaviors24. In-depth focal group interviews were conducted, and discussed components of information, motivation and behavioral skills.This is a qualitative study in which iterative process analysis was carried outThe foundation that works with trans women called the participants chosen for the focal group (n = 11); the research group called them for the in-depth interviews (n = 22) by phone to confirm their participation, and if they met the conditions for making the interview and scheduling the meeting. It was ensured that participants had the necessary tools to carry out the focal group and interviews. Transportation allowance was offered  and internet connectivity was ensured, specifically to Google Meet for the interviews. The focal group lasted 180 minutes, and was conducted in January 2020. The in-depth interviews lasted 90–120 minutes, and were conducted from November 2020 to January 2021.Participants (n = 33) were selected using the snowball strategy. Following were the eligibility criteria: trans women  of legal age (18 years old or more), residing in two of the main cities of the country , and who voluntarily decided to participate in the study. For the eligibility of trans women, the two-question method was used, which was included in the sociodemographic data collected prior to the interviews and focal groups. All of them provided written and audio-recorded informed consent. Participants were paid $12 as transportation allowance and to ensure internet connectivity. The research team transcribed the interviews verbatim, and two team members reviewed these prior to data analysis.During January and December 2020, an in-person focal group and in-depth interviews were conducted virtually, due to the covid-19 health contingency.The research team assembled both the focal group and the in-depth interview, which were reviewed by the foundation to ensure the greatest possible clarity in the use of language for the participants. This allowed for more in-depth information to enhance the analysis. The focal group had guidelines that encouraged participants to talk about information, motivation and behavioral skills on condom use through the dramatization of everyday scenes involving sexual health care, e.g., the relationship with the stable partner and with the client, contact with health centers and community-based organizations or foundations.The in-depth interview guideline addressed the constructs of the IMB model. Information on condom use, on the motivations they have for taking care of their sexual health and, finally, on their sexual practices were asked regarding behavioral skills. At the end of each field , participants filled out a sociodemographic questionnaire that allowed the identification of contextual characteristics .24 was used to create a codebook based on the theoretical component of the IMB model. Subsequently, each researcher reviewed the coding to rectify and establish them under agreement of the whole team. The information from all the transcripts was organized in a matrix where a primary code and a secondary code were assigned to each component, to each of which an exemplary quote from the transcripts was assigned , 51.5% (n = 17) have engaged in sex work at some point in their lives ; of these, 14 are currently engaged in sex work; the most frequent current occupations are styling  and human rights advocacy . Regarding the highest level of education attained, 21.2% (n = 7) did not complete basic education, 27.2% (n = 9) completed high school, 21.2% (n = 7) completed a technical or technological level, 15.1% (n = 5) have incomplete undergraduate degree, and 15.1% (n = 5) completed undergraduate degree. In terms of socioeconomic level, 93.4% (n = 31) are in strata 1, 2 and 3; in a disaggregated manner this corresponds to 24.2% (n = 8) in stratum 1, this same value for stratum 2, 45.4% (n = 15) in stratum 3, while only 6% (n = 2) are located in stratum 5 (see table of sociodemographic data). The sample characteristics are provided in Knowledge about condoms: All participants, at the time of the interviews, had information about condom. They knew that condoms are used to prevent pregnancy and sexually transmitted infections. The first information they received about condoms was at school and at their homes (families), and they referred to condoms as a pregnancy prevention method. Therefore, they associated condom use for cisgender women. Some participants associated condoms with HIV, gonorrhea, syphilis and papillomavirus. Most of the participants had information about where condoms are available, namely pharmacies, community-based organizations, and health centers. However, some of them did not buy condoms from these places because of embarrassment. All participants mentioned that as they experienced sexual life, they learned about STIs from their friends or sexual partners, which led them to learn more about condoms, and made condom use more important. The participants mentioned that the information on the use of condoms  was acquired through their friends and some through community-based organizations that work to defend transgender people’s rights.Misinformation about condoms: Most mentioned that at the time they started their first sexual relations they did not have information about condoms as a method of protection against STIs; for this reason, they had the erroneous idea that this method was only to prevent pregnancy, and should be used only by biological women. In addition, when they started having sex, they did not know the importance of using a condom for each penetration, and of opening the package carefully so as not to damage it. A quarter of the participants reported misunderstanding the use, thinking that by using two condoms at a single penetration they would be safer. Most respondents reported that at some point in their lives they were not clear about the use of condoms in oral sex, thinking it was not necessary to use them in this sexual practice. Participants were not sure about the different materials of condoms or the need for lubricants for their use in anal penetration.Motivational experiences: These experiences were probed at the personal and social levels. At the personal level, awareness of self-care becomes the main motivation for using condoms, to avoid the consequences of an STI in one’s body. With regard to social motivation, the following experiences are found: acceptance, support and interest in health care by the family or supportive networks that motivate them to take care of their sexual health. Participants are motivated to care for themselves to avoid the physical consequences and the social stigma generated by STIs. All participants who have practiced sex work reported that clients motivate them not to use condoms in exchange for money. Trust in the relationship is a motivation for not using condoms with their regular sexual partners, according to a large number of participants.Condom use: Participants use condoms when they are suspicious of their sexual partner, i.e., when they suspect they may become infected with a disease. Some participants demand and use condoms in sex work, and this involves not receiving additional money. Most participants use condoms if they have them available at the time of sexual intercourse; they purchase them at health centers and, to a greater extent, at foundations or community-based organizations.Non-use of condoms: The factors expressed by participants as affecting sexual practices with condoms are more abundant than those they refer with respect to use. Participants who had engaged in sex work reported not using condoms at some point in their work due to client’s request or demand. Most of the participants mentioned that it is common not to use condoms with their regular sexual partners. Participants in strata 1, 2 and 3 mentioned that sometimes they do not use condoms because of difficulties in purchasing them, either for economic reasons or because they are embarrassed to ask for them at a drugstore or health center. In addition to the above, all of the participants reported that they had not protected themselves during sexual intercourse at some point in their lives because they had had sex while consuming psychoactive substances and alcohol, as well as because of the excitement of the moment and the attraction they felt toward a casual sexual partner. A quarter of the participants reported not using condoms because of the characteristics of the condom, namely the size and material. Finally, all the participants mentioned that the sexual practice in which they were most likely not to use a condom was oral sex; they attributed this to the discomfort they and their sexual partners felt when using a condom.23 on this research topic, we found consistency with studies conducted in other contexts26 regarding the reasons for not using condoms. Results suggest challenges faced by TW in relation to contextual conditions of inequality that promote risky sexual practices.This study identified the reasons that TW have for condom use based on the IBM model. We identified external or contextual and internal elements, both relevant to the decision to use or not to use condoms. Despite the limited qualitative literature27. It is common to find that trans women do not use condoms due to client demand in cases of sex work32, which exposes this risk. In the Colombian context37, as well as in other countries39, it is common for TW to have to engage in sex work due to the structural barriers they face when accessing formal employment. The results of this study also coincide with research conducted with people with heterosexual and trans gender identity in stating that condoms are not usually used with stable sexual partners40.Findings were consistent with quantitative studies on non-use of condoms among TW in different contexts41 and the consumption of psychoactive substances and liquor42. The practice of oral sex was a recurrent expression in this and previous studies43. It is common to find in literature that the first knowledge about condoms is related to its function of preventing pregnancy; studies suggest that this is because this method of protection is designed more for heterosexual couples44.Other consistent findings are the recognition of the non-use of condoms due to disinhibition as a result of excitement45; this was also related to the use of condoms as a protected sexual practice. We noticed that the information, which turned out to be significant for participants, on the use of condoms did not come directly from their blood families, but from their social families . This study confirms the importance of the actions by community-based organizations, foundations and NGOs, in health care28. Similarly, these organizations promote the distribution of condoms, a factor that was mentioned in the behavioral skill to use condoms.New findings were also observed in this study. The motivational experiences of acceptance and support to gender identity received from their blood and social families were related to motivation for self-care in general46 and others suggest the opposite due to the lack of management and engagement of those who delivered the workshops on the topics47. This study proposes as challenge that pedagogical programs (which provide information) on condom use could have greater effect to the extent that they are delivered by the trans population that recognizes the experiences and life contexts of the TW. Additionally, participants were more open to the information delivered by community-based organizations, foundations, NGOs and social families, since these are spaces where they felt welcomed, cared for and defended through psychosocial accompaniment, in addition to being spaces of empowerment48. In this sense, information from these institutions is highly effective in the use of condoms.Although previous studies have found discrepancies between the relationship condom knowledge and practice, i.e., its use, some suggest that the relationship is effective32. The results of this study show that one of the main reasons for non-use of condoms is due to the client’s request and demand in exchange for money. In Colombia, it is common for TW to engage in street sex work, due to the barriers they encounter in the educational and formal work sectors because of the stigma associated with their gender identity. It means that the sources of income generation are through informal work, including street sex work, in which they are exposed to risky sexual practices. This study shows the need to carry out studies with the sexual partners of TW, since it is found that they are the ones who promote, to a large extent, unprotected sexual practices49.Studies place TW as one of the main populations carrying STIs, especially HIV50, there are no objectives specifically focused on the sexual health of transgender people or the living conditions that, as already mentioned, act as a risk factor for STIs. In this sense, it is recommended to include within these policies an axis that specifically addresses sexual health in which the distribution of condoms to trans women street sex workers is promoted, since the monthly income of the participants in this study does not allow them to cope with the monthly expenses with the condoms they use51.At the level of LGBTI public policy in ColombiaIn addition to the above, the findings of this study suggest strategies for disease prevention and sexual health promotion, specifically to promote increased condom use, thus reducing cases of STIs. Beyond promoting pedagogical spaces, it is essential that information about condoms and STIs be accompanied by the promotion of self-care. Likewise, the information should be provided by people they trust in, and who do not judge their gender identity, sexual orientation, and sexual practices.53. Therefore, the sample of this study presents a high degree of homogeneity, which in turn is related to the difficulties of access to the population studied.This study has some limitations: the sample size does not allow generalizations, as it was based on convenience and intentionality, as well as voluntary participation and snowball strategy, something that occurs very frequently in studies with transgender population, as shown in studiesThe snowball technique led us to recruit subjects from strata 1, 2 and 3 with incomes below the legal minimum wage in force in Colombia (approximately 280 dollars). This has limited the possibility of analyzing the wealthier population. We also recognize that there are other socio-cultural discourses and knowledge relevant to understanding the phenomenon studied, which did not emerge in our interviews.8, studies are needed to understand the sexual practices demanded by trans women’s sexual partners (clients or steady partners), as well as social and political efforts to improve the possibilities of access to formal work for trans women in Colombia. The findings of this study provide an important basis for the development of future interventions to promote condom use among trans women. For the positive impact of these interventions, strategies that are adapted to the population become indispensable, e.g., that leadership is carried out by the trans population that recognizes the dynamics and life experiences of participants.Although the term “key population” assigned to specific populations, including trans women, is currently being debated and analyzed in Colombia trans, en Colombia, y específicamente para este estudio, hace referencia a un concepto sombrilla que incluye diferentes expresiones e identidades de género, tales como transexual, transgénero, travesti, personas con género neutro/fluido/ gender queer, etc. Esta categoría enmarca un posicionamiento político reivindicativo e incluye identidades de género que se encuentran al margen del modelo binario1. La literatura da cuenta de que el tema que se investiga con mayor frecuencia respecto a esta población tiene que ver con la prevalencia del virus de inmunodeficiencia humana (VIH)2. Hay algunos estudios cuantitativos con mujeres trans, el VIH y el modelo de información, motivación y habilidades conductuales 7. Esto se relaciona a prácticas que pueden predisponer al contagio de infecciones de transmisión sexual (ITS). A propósito de esta discusión, el equipo de investigación marca un posicionamiento ontológico en el cual se distancia de la relación entre MT y VIH declarada bajo el concepto de población clave; en coherencia con esto, datos empíricos8 permiten soportar que, en Colombia, las personas que viven con la enfermedad no se identifican necesariamente en ninguna población clave, por lo tanto a nivel nacional la apuesta está en dirigir estrategias de promoción de la salud y prevención de la enfermedad a la población colombiana en general.En los últimos años los estudios sobre mujeres trans (MT) han ido en aumento. El término 10; no obstante, su uso por parte de las MT no presenta la consistencia esperada12. Esto obedece a varios factores, ya sean objetivos o subjetivos. Los primeros tienen que ver con condiciones materiales, como la falta de dinero para el acceso al preservativo, y con condiciones externas, como la renuencia de la pareja a usarlo durante en el encuentro sexual13. Los factores subjetivos se asocian con la denominada educación sexual15, lo historizado que se encarna y reproduce respecto al conocimiento, a las creencias, al estado emocional y al uso de sustancias psicoactivas, entre otros; por ello no es posible reducir la mencionada práctica a una elección racional anudada a lo que se llama el “lógico actuar”.En este marco, el condón sigue siendo aún la mejor herramienta de prevención16, el presente estudio tiene como objetivo analizar las razones del uso y no uso del condón que tienen las MT desde el modelo IMB.Debido a la importancia y necesidad de estudios cualitativos sobre el uso del preservativo en MT y a la relevancia que ha cobrado el modelo IMB en los estudios para comprender los comportamientos de riesgo asociados con las ITS, en especial el VIH, y para informar sobre el desarrollo de intervenciones preventivas en diferentes grupos poblacionales con recursos limitados20. En este sentido, este modelo incluye tres constructos principales que influyen en los cambios de comportamiento: la información, la motivación y las habilidades conductuales para realizar el comportamiento21. Por información se entenderá el conocimiento relevante sobre el preservativo, como su función de prevención de embarazos y de ITS. La motivación incluye motivaciones a nivel personal y social; la primera de estas abarca las actitudes positivas o beneficios y negativas hacia el uso del preservativo, y la motivación social incluye las percepciones que tiene el individuo del apoyo social de las redes de apoyo con las que cuenta para promover el uso del preservativo. Las habilidades conductuales hacen referencia a la capacidad objetivo de las personas para tener relaciones sexuales  con preservativo y a la identificación de factores que afectan la práctica sexual protegida por medio de este método de protección22.El modelo IMB propone que en la medida que las personas están informadas y motivadas, se involucran en conductas adecuadas del cuidado de la salud24. Se realizaron entrevistas a profundidad en un grupo focal en las cuales se discutieron los componentes de información, motivación y habilidades conductuales respecto al uso del preservativo.Este es un estudio cualitativo en el cual se llevó a cabo el análisis de proceso iterativoLa fundación que trabaja con mujeres trans convocó a las participantes elegidas para el grupo focal (n = 11); el grupo de investigación las llamó para las entrevistas a profundidad (n = 22), vía telefónica para que confirmaran la participación y cumplieran las condiciones para realizar la entrevista y programar el encuentro. Se aseguró que las participantes contaran con las herramientas necesarias para la realización del grupo focal y de las entrevistas. Se ofreció un auxilio de transporte  y se aseguró la conectividad a internet, específicamente a Google Meet para el caso de las entrevistas. El grupo focal tuvo una duración de 180 minutos y fue llevado a cabo en enero de 2020. Las entrevistas a profundidad tuvieron una duración de 90 a 120 minutos y se realizaron entre noviembre de 2020 y enero de 2021.Las participantes (n = 33) fueron seleccionadas utilizando la estrategia de bola de nieve, y los criterios de elegibilidad fueron: mujeres trans  mayores de edad (18 años), que residan en dos de las principales ciudades del país  y que decidan participar de manera voluntaria en el estudio. Para la elegibilidad de mujeres trans, se usó el método de las dos preguntas, las cuales estaban incluidas en los datos sociodemográficos recogidos previo a las entrevistas y grupos focales. Todas proporcionaron consentimiento informado por escrito y por grabación de audio. Las participantes recibieron 12 USD por concepto de auxilio de transporte y para asegurar la conectividad a internet. El equipo de investigación transcribió textualmente las entrevistas y dos miembros del equipo las revisó previo al análisis de la información.Durante enero y diciembre de 2020 se realizó un grupo focal de manera presencial y entrevistas a profundidad de manera virtual, debido a la contingencia sanitaria por el covid-19.El equipo de investigación construyó tanto el grupo focal como la entrevista a profundidad los que fueron revisados por la fundación con el objetivo de contar con la mayor claridad posible en el uso del lenguaje para las participantes, esto permitió profundizar información para potencializar el análisis. El grupo focal contó con una guía donde se motivó a las participantes a hablar sobre la información, la motivación y las habilidades conductuales sobre el uso del preservativo por medio de la dramatización de escenas cotidianas que involucren el cuidado de la salud sexual, por ejemplo, la relación con la pareja estable y con el cliente, el contacto con centros de salud y organizaciones de base comunitaria o fundaciones.La guía de la entrevista a profundidad abordó los constructos del modelo IMB. Se indagaron las informaciones del preservativo, sobre las motivaciones que tienen para cuidar de su salud sexual y, por último, sobre sus prácticas sexuales para indagar las habilidades conductuales. Al finalizar cada uno de los espacios , las participantes diligenciaron un cuestionario sociodemográfico que permitió conocer características contextuales .24 al crear un libro de códigos, teniendo como base el componente teórico del modelo IMB. Posterior a esto, cada investigador revisó las codificaciones para rectificarlos y establecerlos bajo acuerdo de todo el equipo. Se organizó la información de todas las transcripciones en una matriz donde se asignó un código primario y un código secundario por componente, a cada uno de estos se asignó una cita ejemplar de las transcripciones , el 51,5% (n = 17) han ejercido el trabajo sexual en algún momento de sus vidas ; de estas, en la actualidad lo ejercen 14; las ocupaciones actuales más frecuentes son el estilismo  y la defensa de derechos humanos . Con relación al máximo nivel educativo alcanzado, el 21,2% (n = 7) no finalizó la educación básica, el 27,2% (n = 9) concluyó el bachillerato, el 21,2% (n = 7) completó el nivel técnico o tecnológico, el 15,1% (n = 5) tiene un pregrado incompleto y el 15,1% (n = 5) culminó el pregrado. En cuanto al nivel socioeconómico, el 93,4% (n = 31) se encuentra en los estratos 1, 2 y 3, de manera desagregada esto corresponde al 24,2% (n = 8) en estrato 1, este mismo valor para el estrato 2, el 45,4% (n = 15) en el estrato 3, mientras que tan solo el 6% (n = 2) se ubica en el estrato 5 (verla tabla de datos sociodemográficos). Las características de la muestra se proporcionan en la Conocimiento del preservativo: Todas las participantes, al momento de realizar las entrevistas, tenían información sobre el preservativo. Sabían que el preservativo sirve para la prevención de embarazos y de infecciones de transmisión sexual. Las primeras informaciones que recibieron sobre el preservativo fueron en las escuelas y en sus hogares (familias) y referían al preservativo como método de prevención de embarazos, por lo tanto, relacionaban el uso del preservativo para mujeres cisgénero. Algunas participantes asociaron el preservativo con VIH, gonorrea, sífilis y papiloma. La mayoría de las participantes tenía informaciones sobre los lugares donde se pueden conseguir los preservativos, a saber, farmacias, organizaciones de base comunitaria y centros de salud; no obstante, algunas de ellas no lo compraban en estos lugares por vergüenza. Todas las participantes mencionaron que en la medida que experimentaban la vida sexual conocieron, por medio de sus amistades o parejas sexuales, sobre la existencia de las ITS; con esto profundizaron en la información del preservativo y cobró relevancia su uso. Las participantes mencionaron que la información sobre el uso  la adquirieron por sus amistades y algunas por medio de organizaciones de base comunitaria que trabajan en la reivindicación de derechos de personas trans.La desinformación sobre el preservativo: La mayoría mencionó que en la época en que iniciaron sus primeras relaciones sexuales no contaron con informaciones sobre el preservativo como método de protección de las ITS; por esta razón, tenían la idea errónea de que este método solo era para prevenir el embarazo, por lo tanto, lo debían usar únicamente mujeres biológicas. Sumado a esto, cuando iniciaron la vida sexual, no sabían de la importancia de utilizar un preservativo por cada penetración y de abrir el empaque con cuidado para no dañarlo. Una cuarta parte de las participantes relató haber tenido un malentendido sobre el uso, pensando que al utilizar dos preservativos en una sola penetración iban a estar más seguras. La mayoría refirió que en algún momento de su vida no tuvieron claridad sobre el uso del preservativo en el sexo oral, pues pensaban que no era necesario utilizarlo en esta práctica sexual. No había seguridad de las participantes sobre los diferentes materiales de los preservativos ni de la necesidad de lubricantes para su uso en la penetración anal.Experiencias motivadoras: Estas experiencias se indagaron a nivel personal y social. Con relación al nivel personal, la consciencia del autocuidado se convierte en la principal motivación de utilizar el preservativo, esto por el hecho de evitar las secuelas de una ITS en el propio cuerpo. Con relación a la motivación social, se encuentran las siguientes experiencias: aceptación, apoyo e interés del cuidado de la salud que tiene la familia o redes de apoyo sobre ellas que las motiva a cuidar de la salud sexual. Las participantes se motivan al cuidado por evitar las secuelas físicas y por el estigma social que generan las ITS. La totalidad de participantes que han ejercido el trabajo sexual han referido que los clientes las motivan a no utilizar el preservativo a cambio de dinero. La confianza en la relación es una motivación para no utilizar el preservativo con sus parejas sexuales estables según indica gran parte de las participantes.El uso del preservativo: Las participantes utilizan el preservativo cuando desconfían de su pareja sexual, es decir, cuando sospechan que pueden infectarse de una enfermedad. Algunas participantes exigen y utilizan el preservativo en el trabajo sexual y esto implica no recibir dinero adicional. La mayoría de las participantes utilizan el preservativo si lo tienen a disposición en el momento de la relación sexual, estos los adquieren en centros de salud y, en mayor cantidad, en fundaciones u organizaciones de base comunitaria.El no uso del preservativo: Los factores manifestados por las participantes que afectan las prácticas sexuales con preservativo son más abundantes que los que refieren respecto al uso. Las participantes que habían ejercido el trabajo sexual refirieron no haberlo utilizado en algún momento del ejercicio de su trabajo debido a la solicitud o exigencia del cliente. La mayoría de las participantes mencionó que es frecuente no utilizar el preservativo con sus parejas sexuales estables. Las participantes de estratos 1, 2 y 3 mencionaron que en ocasiones no utilizan el preservativo por dificultades en la compra, ya sea por razones económicas o por vergüenza de solicitarlo en una droguería o centro de salud. Sumado a lo anterior, la totalidad de las participantes refirió no haberse protegido en la relación sexual en algún momento de sus vidas por haber tenido relaciones sexuales en medio del consumo de sustancias psicoactivas y alcohol, como también por la excitación del momento y la atracción sentida hacia la pareja sexual casual. Una cuarta parte relató no utilizarlo por las características del preservativo, a saber el tamaño y el material. Para finalizar, todas las participantes mencionaron que la práctica sexual en la cual hay más probabilidades de no usar el preservativo es en el sexo oral; esto lo atribuyen a la incomodidad que les genera a ellas y a sus parejas sexuales realizarla con preservativo.23, en lo relacionado con las razones sobre el no uso del condón, se encuentra consistencia con estudios realizados en otros contextos26. Lo planteado en los resultados sugiere desafíos que enfrentan las MT a propósito de condiciones contextuales de desigualdad que promueve prácticas sexuales de riesgo.Este estudio identificó las razones que tienen las MT respecto al uso del preservativo desde el modelo IMB. Identificamos elementos externos o contextuales e internos, ambos relevantes para la toma de decisión del uso y del no uso del preservativo. A pesar de la poca literatura respecto a este tema de investigación de manera cualitativa27. Es común encontrar que las mujeres trans no utilizan el preservativo por exigencia del cliente en los casos de trabajo sexual32, lo que expone este riesgo. En el contexto colombiano37, como también en otros países39, es frecuente que las MT deban ejercer el trabajo sexual a causa de las barreras estructurales que tienen al momento de acceder a un trabajo formal. Los resultados de este estudio también coinciden con investigaciones realizadas con personas con identidad de género heterosexual y trans al plantear que con parejas sexuales estables no suele utilizarse el preservativo40.Los hallazgos fueron consistentes con estudios cuantitativos sobre el no uso del condón en MT en diferentes contextos41 y el consumo de sustancias psicoactivas y licor42. La práctica del sexo oral fue una expresión recurrente en este estudio y en previos43. Es frecuente encontrar en la literatura que los primeros conocimientos sobre el preservativo están relacionados con su función de prevención del embarazo; los estudios plantean que esto se debe a que este método de protección está pensado en mayor proporción para parejas heterosexuales44.Otros hallazgos consistentes radican en el reconocimiento del no uso del preservativo por la desinhibición a causa de la excitación45; esto mismo se relacionó con el uso del preservativo como práctica sexual protegida. Notamos que la información, que resultó ser significativa para las participantes, sobre el uso del preservativo no provenía directamente de las familias consanguíneas, sino de sus familias sociales ; este estudio ratifica la importancia de las acciones de las organizaciones de base comunitaria, las fundaciones y ONG, en el cuidado de la salud28. De igual manera, estas organizaciones promueven la distribución de los preservativos, un factor que se mencionó en la habilidad conductual del uso.En este estudio también se observaron hallazgos nuevos. Las experiencias motivadoras de aceptación y apoyo de la identidad de género recibido de sus familias consanguíneas y sociales se relacionan con la motivación al autocuidado de la salud –en general–46 y otros proponen lo contrario debido al poco manejo e implicación que tenían quienes dictaban los talleres sobre los temas47; este estudio plantea como hallazgo que los programas pedagógicos (que proporcionan información) sobre el uso del preservativo podrían tener mayor efecto en la medida que sean dictados por la población trans que reconozca las experiencias y contextos de vida de las MT. Adicionalmente, las participantes fueron más receptivas a las informaciones provenientes de las organizaciones de base comunitaria, fundaciones, ONG y familias sociales, ya que son espacios en los que se sintieron acogidas, cuidadas y defendidas por medio del acompañamiento psicosocial, además de ser espacios de empoderamiento48. En este sentido, la información proveniente de estas instituciones tiene una alta efectividad en el uso del preservativo.Aunque estudios previos han encontrado discrepancias entre la relación conocimiento del preservativo y la práctica, es decir, su uso, unos plantean que la relación es efectiva32. En los resultados de este estudio se expone que una de las principales razones del no uso del preservativo se debe a la solicitud y exigencia del cliente a cambio de dinero. En Colombia, es común que las MT se dediquen al trabajo sexual de calle, debido a las barreras que encuentran en el sector educativo y del trabajo formal por el estigma asociado a su identidad de género; esto hace que las fuentes de generación de ingresos económicos sean por medio del trabajo informal, dentro de esos el trabajo sexual de calle, en el que están expuestas a prácticas sexuales de riesgo. Este estudio muestra la necesidad de llevar a cabo estudios con las parejas sexuales de las MT, ya que se encuentra que son quienes promueven, en gran medida, las prácticas sexuales sin protección49.Estudios ubican a las MT como una de las principales poblaciones portadoras del ITS, en especial de VIH50, no se identifican objetivos centrados específicamente a la salud sexual de las personas trans ni a las condiciones de vida que, como ya se mencionó, actúan como factor de riesgo para las ITS. En este sentido, se recomienda incluir dentro de estas políticas un eje que aborde, en específico, la salud sexual en el que se promueva la distribución de preservativos a mujeres trans trabajadoras sexuales de calle, ya que los ingresos mensuales de las participantes de este estudio no permiten cubrir los gastos en preservativos mensuales que utilizan51.A nivel de política pública LGBTI en ColombiaSumado a lo anterior, los hallazgos de este estudio sugieren estrategias de prevención de la enfermedad y promoción de la salud sexual; en específico para promover el aumento en el uso del preservativo y con esto disminuir los casos de ITS. Más allá de promover espacios pedagógicos, es esencial que la información sobre el preservativo y las ITS esté acompañada de la promoción del autocuidado y que la información sea suministrada por personas con quienes tengan confianza y que no juzguen su identidad de género, orientación sexual y prácticas sexuales.53. Por lo anterior, la muestra de este trabajo presenta un alto grado de homogeneidad, lo que a su vez se relaciona con las dificultades de acceso a la población estudiada.Este estudio cuenta con algunas limitaciones: el tamaño de la muestra no permite hacer generalizaciones; pues esta fue por conveniencia e intencional, además por participación voluntaria y por estrategia bola de nieve, algo que ocurre con mucha frecuencia en estudios con población trans, tal como lo muestran los estudiosLa técnica de bola nieve nos condujo en mayor medida a reclutar sujetos de estratos 1, 2 y 3 con ingresos económicos por debajo del salario mínimo legal vigente en Colombia (280 dólares aproximadamente); esto limitó la posibilidad de atender el análisis en población con más recursos económicos. Reconocemos también que hay otros discursos y saberes de orden sociocultural relevantes para comprender el fenómeno estudiado, que no han surgido en nuestras entrevistas.8, se requieren estudios que permitan conocer las prácticas sexuales que exigen las parejas sexuales (clientes o parejas estables) de las mujeres trans, así como los esfuerzos sociales y políticos para mejorar las posibilidades de acceso al trabajo formal de estas en Colombia. Los hallazgos de este estudio proporcionan una base importante para el desarrollo de futuras intervenciones que promuevan el uso del preservativo entre mujeres trans. Para el impacto positivo de estas intervenciones se hacen indispensables estrategias que se adapten a la población, por ejemplo, que el liderazgo sea llevado a cabo por la población trans que reconozca las dinámicas y experiencias de vida de las participantes.Aunque en la actualidad el término de “población clave” que se atribuye a poblaciones específicas, entre esas las mujeres trans, está siendo debatido y analizado en Colombia


Trypanosoma cruzi) is transmitted to mammals, including humans, mainly by insect vectors of the subfamily Triatominae (Hemiptera: Reduviidae). Also known as “kissing bugs”, the subfamily currently includes 157 validated species (154 extant and three extinct), in 18 genera and five tribes. Here, we present a subdataset (7852 records) of American triatomine occurrences; an update to the most complete and integrated database available to date at a continental scale. New georeferenced records were obtained from a systematic review of published literature and colleague-provided data. New data correspond to 101 species and 14 genera from 22 American countries between 1935 and 2022. The most important novelties refer to (i) the inclusion of new species, (ii) synonymies and formal transferals of species, and (iii) temporal and geographical species records updates. These data will be a useful contribution to entomological surveillance implicated in Chagas disease.The causative agent of Chagas disease ( Trypanosoma cruzi) es transmitido a los mamíferos - incluyendo al ser humano - principalmente por insectos vectores de la subfamilia Triatominae (Hemiptera: Reduviidae). Actualmente, la subfamilia incluye 157 especies , agrupadas en 18 géneros y cinco tribus. Presentamos la descripción de un subconjunto de datos (7852 registros) de presencias de triatominos americanos, como una actualización de la más completa e integrada base de datos disponible hasta el momento a escala continental. Los nuevos registros georreferenciados fueron obtenidos de una revisión sistemática de referencias publicadas y datos cedidos por colegas. Los nuevos datos corresponden a 101 especies y 14 géneros de 22 países americanos en el intervalo de tiempo entre 1935 y 2022. Las novedades más importantes refieren a: (i) la incorporación de nuevas especies, (ii) sinonimias y transferencias formales de especies, y (iii) actualizaciones temporales y geográficas de registros de especies. Alentamos a la utilización de esta información, especialmente para contribuir a la vigilancia entomológica implicada en la Enfermedad de Chagas.El agente causal de la Enfermedad de Chagas ( Trypanosoma cruzi  (NCBI:txid5693) , is transmitted mainly through the feces of triatomine (Hemiptera: Reduviidae: Triatominae) insect vectors, but may also be transmitted from mother to child, by blood transfusions or some infected organ transplants, and by oral transmission through contaminated food and/or beverages. These multiple routes of transmission make Chagas disease an important public health problem, primarily in the Americas but also on other continents . Currently, the subfamily Triatominae consists of 154 extant and three fossil species (143 species present in America and 14 species present in Asia), grouped into five tribes and 18 genera . Assembling geographic and ecological information about triatomines is particularly important, given that these insect vectors are one of the main routes of T. cruzi transmission. Once available, such information may be used by public health agencies to carry out actions and support programs for disease prevention and vector control.Chagas disease, caused by the protozoan et al. , a new, complete and integrated database on triatomine occurrences, called DataTri  has been available. However, as the number of species has increased and there have been several changes in triatomine taxonomy, this information needs an update. In this context, the main goal of this work is to describe the features of a subdataset of American triatomine occurrences (henceforth referred to as the “American subdataset”), highlighting the most important updates and inclusions after 5 years spent reviewing new data sources. This American subdataset was integrated to update the current American triatomine occurrence dataset (henceforth referred to as the “New American dataset”), comprising 19,600 records and available via the Global Biodiversity Information Facility (GBIF) platform . In turn, this integrated New American dataset is complemented by a dataset on triatomine species present in Argentina (henceforth referred to as the “Argentinean dataset”), also stored in GBIF . Then, it was modified to Darwin Core format  and stored in the GBIF platform, split into two complementary datasets: the “American dataset”  and the “Argentinean dataset”   , P. guentheri Berg, 1879, P. megistus , P. rufotuberculatus , Psammolestes coreodes Bergroth, 1911, Triatoma breyeri Del Ponte, 1929, T. delpontei Romaña & Abalos, 1947, T. eratyrusiformis Del Ponte, 1929, T. garciabesi Carcavallo, Cichero, Martínez, Prosen & Ronderos, 1967, T. guasayana Wygodzinsky & Abalos, 1949, T. infestans , T. limai Del Ponte, 1929, T. patagonica Del Ponte, 1929, T. platensis Neiva, 1913, T. rubrofasciata , T. rubrovaria  and T. sordida ) that are included in the Argentinean dataset and recorded as having (or having had) at least part of their geographical distribution within Argentine territory.In 2018, an initial dataset  of triatomine species occurrence  was created, described N = 7852) are identified consecutively from the “catalogNumber = 27631” to the “catalogNumber = 35482” in the New American dataset. The most important novelties of the American subdataset are: (i) the incorporation of new triatomine species described between 2018 and 2021, as well as species (extant and extinct) not originally included in the DataTri dataset; (ii) synonymies and formal transferals of species; and (iii) new records that update several temporal and geographical species occurrences.To build a new subdataset of American triatomine occurrences (the American subdataset) and integrate it into the New American dataset available at present, a total of 7852 occurrence records were compiled from 2 years (2020–2022) of systematic reviews Figure . The newBolbodera scabrosa , Belminus santosmalletae , Rhodnius micki , Nesotriatoma obscura , Nesotriatoma confusa , Triatoma huehuetenanguensis  and T. mopan . The two extinct (†) ones were Triatoma dominicana † and Panstrongylus hispaniolae †. With these incorporations, the New American dataset includes 125 species that, together with the 17 species included in the Argentinean dataset, make a total of 142 triatomine species. Except for the particular case of the species T. rosai , which was described in 2020 after the last update of the Argentinean dataset (and therefore not included in the latter), occurrence records of all the American triatomine species described up to date  are included between both datasets  ; some records of Nesotriatoma bruneri were synonymized with Nesotriatoma flavida  ; some records of Triatoma dimidiata from Guatemala, Honduras and México were synonymized with T. huehuetenanguensis ; and (ii) formal transferals: Triatoma flavida was transferred into the genus Nesotriatoma with the resulting new combination, Nesotriatoma flavida  and Triatoma lecticularia was transferred into the genus Paratriatoma with the resulting new combination Paratriatoma lecticularia  .Taxonomic updates were: (i) synonymities: Triatoma mopan and T. huehuetenanguensis in Belize –16 or T. dispar , T. nitida , T. ryckmani , Cavernicola pilosa , Eratyrus cuspidatus , Belminus costaricensis  and Microtriatoma trinidadensis  in Costa Rica . Other cases worth mentioning are Triatoma sanguisuga  in Nebraska, USA , Triatoma protracta woodi , which until now had only been recorded in the wild  and now has been recorded in domiciliary habitats in a Texas county  and in peridomiciles in New Mexico county , and T. rubida uhleri , which has records in domiciliary habitats and one record in wild habitat . In French Guyana, records from Belminus laportei  were added  increasing the number of species represented in this country to 11. Mexico is another example, with records of Triatoma rubida sonoriana being a new inclusion for all habitat types  ; new records of Triatoma barberi  for Mexico state , as well as records of Triatoma rubida for Ocampo municipality and records of Triatoma gerstaeckeri  . Records of some species were also updated in new states of Brazil, such as Eratyrus mucronatus  and Rhodnius montenegrensis  in Roraima , as well as the presence of R. montenegrensis in the state of Amazonas . On the other hand, new occurrences of Microtriatoma borbai  were found in Espírito Santo , Psammolestes tertius  in the states of Sergipe , Paraná  and Rio Grande do Norte  in Brazil, and of Cavernicola pilosa and Microtriatoma trinidadensis in Amazonas, Brazil , 34.The incorporation of new records from the American subdataset contributes new information (compared with the DataTri dataset) and/or updates the geographic patterns of several species or subspecies in some countries. These are the cases of new occurrences of Nesotriatoma obscura species . In summary, more than 70% of the species present in the “American dataset” now have new records incorporated in the “New American dataset”  has been distributed in Trinidad and Tobago since 1985 .The new compiled information included in the American subdataset spans 1935 to 2022. Date information was available for 90% of the records, while 30% of them comprise data from the last 4 years. One noteworthy update to the temporal patterns of some species is that N = 7852) into the New American dataset , plus those records included in the Argentinean dataset  equates to a total of 35,517 occurrence records for 142 American triatomine species  and were reviewed using terms such as “Chagas disease”, “Triatominae” and “. If the geographic coordinates were not expressed in decimal degrees, they were converted using a coordinate conversion application . Where only the geographic coordinates were available, the corresponding administrative divisions were completed using GeoLoc . The datum (coordinate system and set of reference points used to locate places on Earth) used for all geographic records was WGS84 (World Geodetic System 1984). The final dataset was built after data quality control.To rigorously associate each record to a specific location in the geographical space, data must have information expressed in geographic coordinates (latitude and longitude). If no geographic coordinates were available, the site name was used together with information on administrative divisions to attain an accurate location using Google Earth ) used to systematize the information, they were grouped into the following six categories: (1) identifiers ; (2) systematic ; (3) geographical ; (4) temporal ; (5) sampling (including fields related to the sampling process such as name(s) of specimen collector(s), sampled habitat, sampling protocol and effort, etc.); and (6) individual . The independent fields are part of the datafile mentioned in the Data Availability section. The following subsections provide some details about some of the abovementioned fields requiring specific clarifications.We compiled all relevant and available information associated with each triatomine species and attached the data to each dataset field, including characteristics of the specimens collected and of the sampled sites. To better describe the fields  in the “eventDate” field (e.g. 2005/2006).The “habitat” field refers to the type of habitat where the triatomines were collected, and classified into three categories: domicile, peridomicile and sylvatic. When specific habitat information was aggregated, the habitat was expressed as a combination of two or three of those categories .For the “SamplingProtocols” field, the available information was classified into two major categories: (i) active search, when the searching involved specialized staff; and (iii) passive collection, when different types of traps  were used.SCR_021305) , which helps to detect these types of errors in large datasets.The American subdataset was subjected to exhaustive quality control. First, each datum was extracted by one person and checked by two other people to ensure accuracy and to verify no duplication of records. Subsequently, data were checked to avoid errors  that might have arisen during compilation or data entry. To correct and remove typographical errors and spelling mistakes in the names of administrative divisions, we used OpenRefine software (RRID:SCR_018507 ) to detect georeferenced errors and incorrect locations, ensuring that each point corresponded to a location on the continent and in the correct country. Any outlier coordinates that were geographically distant from the known distribution of a given species were investigated to ensure correctness. When validating geographic coordinates, we detected that some occurrence data from public sources were located outside the continent or within continental waterbodies. These data may have been erroneously georeferenced by the authors of the original scientific publication; however, when we considered these data were sufficiently valuable to be incorporated, we carried out the following procedure: if the “country”, “stateprovince”, “municipality” and “locality” fields were provided by the authors, we assigned the correct geographic coordinate, taking as a reference the name of the locality contributed by the authors. To detect taxonomic synonym errors, we used the most recent triatomine review of currently valid species . If any species name was suspected to be outdated, we consulted current bibliography or requested the expert opinion of colleagues.All geographic coordinates were checked using open GIS software .Finally, we improved the quality of our final dataset using the GBIF data validator , and are co-authors of this work (Rachel Curtis-Robles and Sarah A. Hamer). Three important notes about the data from that program are: (1) like all community science programs, records reflect locations and times where/when members of the public were aware of the program and chose to submit samples, which may not be fully representative of the true species distributions; (2) dates reflect when the sample was collected, but some samples were dead when collected and so do not reflect the phenology of the species; and (3) some samples have already been included in publications – linkages can be made using the “otherCatalogNumbers” field. In Costa Rica, an important number of records were integrated from the Instituto Nacional de Biodiversidad (INBio) and deposited in the Museo Nacional de Costa Rica, provided by a co-author of this work .As the information contained within the dataset has been collected using different procedures, this compilation may contain some inherent biases, which should be addressed when the data are used. Most of the data were obtained from papers published in scientific journals, accompanied by those provided by colleagues. Although data (from New American dataset + Argentinean dataset) span 25 countries, there were some countries, such as the USA, Costa Rica, Brazil and Mexico, for which the volume of data was higher than the others. In the case of the USA, the number of occurrence data included is influenced by the great contribution of colleagues who led a kissing bug community science program In Mexico and Brazil, the number of occurrence data records per country included seems to be mainly influenced by two factors: (i) the number of triatomine species present in each country (both countries have the highest number of triatomine species); and (ii) the number of occurrence data records published and provided by colleagues . An explanation for the latter factor goes beyond the goal of this paper. For habitat sampling, we recognize a potential bias in favor of the domiciliary and peridomiciliary habitats because these are the habitats of major epidemiological importance and the target of vector control campaigns. Additionally, the paucity of sylvatic habitat data also results from the difficulty of sampling procedures in the large variety of sylvatic habitats used by triatomines. Finally, it is worth noting that about 37% of the records lack available date information; thus, we recommend that any analysis based on this dataset should use methods that take such biases into account.Despite the information biases described above, the American subdataset described in this paper, and integrated in the New American dataset, plus the complementary Argentinean dataset, constitute a valuable compilation of geographic data on American triatomines, which is as complete, updated and integrated as possible. Thus, all datasets mentioned herein better represent the number of species and countries, and have more accurate geographic coordinates. Since these datasets are hosted in an open and public repository, we hope that they will contribute towards fulfilling national and international goals, such as promoting the exchange of biological information, increasing and improving the accessibility of such information, providing biological data produced and compiled in several countries, and enhancing knowledge of both the biodiversity and epidemiological data related to Chagas disease. Trypanosoma cruzi  , es transmitida principalmente por insectos vectores (a través de sus heces) conocidos como triatominos (Hemiptera: Reduviidae: Triatominae), aunque también puede transmitirse de madre a hijo, por transfusiones de sangre o por el trasplante de algunos órganos infectados, y por transmisión oral a través de la ingesta de alimentos y/o bebidas contaminadas. Estas múltiples vías de transmisión hacen de la enfermedad de Chagas un importante problema de salud pública, principalmente en América, pero también en otros continentes . Actualmente, la subfamilia Triatominae consta de 154 especies existentes y 3 fósiles (143 especies presentes en América y 14 especies presentes en Asia) agrupadas en cinco tribus y 18 géneros . Realizar una recopilación de información geográfica y ecológica sobre los triatominos es particularmente importante, dado que estos insectos vectores son una de las principales vías de transmisión de T. cruzi. Una vez disponible, dicha información podrá ser utilizada para llevar a cabo acciones y programas de apoyo para la prevención de enfermedades y el control de vectores por parte de las agencias de salud pública. Luego de la publicación sobre especies de triatominos americanos de Carcavallo et al. , una nueva base de datos completa e integrada sobre ocurrencias de triatominos se encuentra disponible desde la publicación de DataTri . Sin embargo, dado que el número de especies se ha incrementado y ha habido varios cambios en la taxonomía de los triatominos, esta información necesita una actualización. En este contexto, el objetivo principal de este trabajo es describir las características de un subconjunto de datos sobre la presencia de triatominos americanos , destacando las actualizaciones e inclusiones más importantes realizadas después de cinco años de revisión de nuevas fuentes de datos. Este Subconjunto de datos Americano se integró para actualizar el conjunto de datos de ocurrencia de triatominos Americano  disponible al día de la fecha en la plataforma “Global Biodiversity Information Facility” (GBIF) , con un total de 19600 registros. A su vez, este Nuevo conjunto de datos Americano se complementa con el conjunto de datos sobre las especies de triatominos presentes en Argentina , también almacenado en GBIF  de presencia de especies de triatominos llamado DataTri. Posteriormente, en 2020 se incorporaron 5893 registros ; luego, fueron modificados al formato Darwin Core  y finalmente se publicó en la plataforma Global Biodiversity Information Facility (GBIF) dividida en dos conjuntos de datos complementarios: el Conjunto de datos Americano  y el Conjunto de datos Argentino   , P. guentheri Berg, 1879, P. megistus , P. rufotuberculatus , Psammolestes coreodes Bergroth, 1911, Triatoma breyeri Del Ponte, 1929, T. delpontei Romaña & Abalos, 1947, T. eratyrusiformis Del Ponte, 1929, T. garciabesi Carcavallo, Cichero, Martínez, Prosen & Ronderos, 1967, T. guasayana Wygodzinsky & Abalos, 1949, T. infestans , T. limai Del Ponte, 1929, T. patagonica Del Ponte, 1929, T. platensis Neiva, 1913, T. rubrofasciata , T. rubrovaria  y T. sordida ) que se incluyen en el Conjunto de datos Argentino y que tienen (o han tenido) al menos parte de su distribución geográfica dentro del territorio Argentino.En 2018 se creó, describió N =7852) se identifican consecutivamente desde el “catalogNumber = 27631” al “catalogNumber = 35482” en el Nuevo conjunto de datos americano. Las incorporaciones más importantes del Subconjunto de datos Americano son: (i) la incorporación de nuevas especies de triatominos descritas entre 2018-2021, así como especies  no incluidas originalmente en el ‘Conjunto de datos DataTri’, (ii) sinonimias y transferencias formales de especies, y (iii) nuevos registros que actualizan varias presencias temporales y geográficas de especies.Para construir el nuevo subconjunto de datos de ocurrencias de triatominos americano (Subconjunto de datos Americano) e integrarlo en el Nuevo conjunto de datos Americano disponible actualmente, se compilaron un total de 7852 datos de ocurrencia a lo largo de dos años (2020–2022) de revisiones sistemáticas Figure . Los nueBolbodera scabrosa , Belminus santosmalletae , Rhodnius micki , Nesotriatoma obscura , Nesotriatoma confusa , Triatoma huehuetenanguensis  y T. mopan , y además se incorporaron dos especies extintas: Triatoma dominicana  † y Panstrongylus hispaniolae  †. Con estas incorporaciones, el Nuevo conjunto de datos Americano incluye 125 especies que, junto con las 17 especies incluidas en el Conjunto de datos Argentino, suman un total de 142 especies de triatominos. A excepción del caso particular de la especie T. rosai , que fue descrita en 2020 después de que la última actualización del Conjunto de datos Argentino fuese hecha (y por lo tanto no incluida en este último), los registros de ocurrencia de todas las especies de triatominos Americanos descritas hasta la fecha están incluídos entre ambos conjuntos de datos.  ; algunos registros de Nesotriatoma bruneri fueron sinonimizados con Nesotriatoma flavida  ; algunos registros de Triatoma dimidiata de Guatemala, Honduras y México fueron sinonimizados con T. huehuetenanguensis ; y (ii) transferencias formales: Triatoma flavida se transfirió al género Nesotriatoma con la nueva combinación resultante, Nesotriatoma flavida  y Triatoma lecticularia se transfirió al género Paratriatoma con la nueva combinación resultante Paratriatoma lecticularia  .Las actualizaciones taxonómicas fueron (i) sinonimias: Triatoma mopan y T. huehuetenanguensis en Belice –16. o T. dispar , T. nitida , T. ryckmani , Cavernicola pilosa , Eratyrus cuspidatus , Belminus costaricensis  y Microtriatoma trinidadensis  en Costa Rica . Otros casos para resaltar son el de Triatoma sanguisuga  en Nebraska, Estados Unidos , y T. protracta woodi , que hasta ahora solo habían sido registrados en el ámbito silvestre  y ahora han sido registrados en hábitats domiciliarios de un condado de Texas  y en peridomicilios del condado de Nuevo México , y T. rubida uhleri , que tiene registros en hábitats domiciliarios y un registro en hábitat silvestre . Con respecto a Guayana Francesa, se agregaron registros de Belminus laportei   aumentando a 11 el número de especies representadas para este país. México es otro ejemplo, con registros de T. rubida sonoriana que representan nuevas inclusiones para todos los tipos de hábitat  , nuevos registros de T. barberi  para el estado de México , así como registros de T. rubida para el municipio de Ocampo y registros de T. gerstaeckeri  . Se actualizaron además registros de algunas especies en nuevos estados de Brasil, como el caso de Eratyrus mucronatus  y Rhodnius montenegrensis  en Roraima , como así también la presencia de esta segunda especie en el estado de Amazonas . Por otra parte, se incorporaron nuevas ocurrencias de Microtriatoma borbai  en Espírito Santo , Psammolestes tertius  en los estados de Sergipe , Paraná  y Rio Grande do Norte , y de Cavernicola pilosa y Microtriatoma trinidadensis en Amazonas , 34..La incorporación de nuevos registros del Subconjunto de datos Americano aporta nueva información  y/o actualiza los patrones geográficos de algunas especies y/o subespecies para algunos países. Estos son los casos de nuevas ocurrencias de Nesotriatoma obscura . A modo de resumen, podemos mencionar que más del 70% de las especies que estaban presentes en el Conjunto de datos Americano tienen ahora nuevos registros incorporados en el Nuevo conjunto de datos Americano  que actualizan su distribución en Trinidad y Tobago desde 1985 .Respecto a los patrones temporales se puede mencionar que la nueva información incluida en el Subconjunto de datos Americano abarca el período desde el año 1935 al año 2022. El 90% de los registros posee información de las fechas, mientras que el 30% de ellos comprende datos de los últimos cuatro años. En cuanto a las actualizaciones de los patrones temporales de algunas especies, un caso destacable son los nuevos registros de ocurrencia de Como resumen general, la adición de nuevos registros N= 7852) en el Nuevo conjunto de datos Americano (llegando a los 19600 registros), más los registros incluidos en el Conjunto de datos Argentino (N= 15917) alcanza un total de 35517 registros de ocurrencias para 142 especies de triatominos americanos  utilizando términos como “Chagas disease”, “Triatominae”, “. Si las coordenadas geográficas no se encontraban expresadas en grados decimales, se convirtieron utilizando una aplicación de conversión de coordenadas . Cuando solo estaban disponibles las coordenadas geográficas, las divisiones administrativas correspondientes se completaron utilizando una herramienta llamada GeoLoc . El datum (sistema de coordenadas y conjunto de puntos de referencia utilizados para ubicar lugares en la Tierra) utilizado para todos los registros geográficos fue WGS84 (World Geodetic System 1984). El conjunto de datos final se construyó después de un control de calidad de datos .Para asociar rigurosamente cada registro a una ubicación específica en el espacio geográfico, los datos deben tener información expresada en coordenadas geográficas (latitud y longitud). Si no se disponía de coordenadas geográficas, se utilizaba el nombre del sitio junto con la información de las divisiones administrativas para lograr una ubicación precisa mediante Google Earth ) utilizados para sistematizar la información, los mismos se agruparon en las siguientes seis categorías: 1) identificadores , 2) sistemática , 3) geográfica , 4) temporal , 5) muestreo  y 6) individuo . Cada campo independiente forma parte del archivo de datos mencionado en la sección Declaración de Disponibilidad de Datos.Se recopiló toda la información relevante y disponible asociada a cada especie de triatomino y adjuntamos los datos a cada campo del conjunto de datos, incluyendo las características de los especímenes recolectados y de los sitios muestreados. Para describir mejor los campos  en el campo ‘eventDate’ .El campo ‘habitat’ refiere al tipo de hábitat donde se recolectaron los triatominos, clasificados en tres categorías: domicilio, peridomicilio y silvestre. Cuando la información específica del hábitat no podia desagregarse, el hábitat se expresó como una combinación de dos o tres de esas categorías .En el campo ‘samplingProtocols’ la información disponible se clasificó en dos categorías principales: (i) búsqueda activa, cuando la búsqueda involucró personal especializado, y (iii) recolección pasiva, cuando se utilizaron diferentes tipos de trampas .SCR_021305)  que ayuda en la detección de este tipo de errores en grandes conjuntos de datos.El Subconjunto de datos Americano fue sometido a un exhaustivo control de calidad. En primer lugar, cada dato fue extraído por una persona y verificado por otras dos personas para garantizar la precisión y verificar que los registros no estuvieran duplicados. Posteriormente, se revisaron los datos para evitar cualquier tipo de error  que pudiera haber ocurrido durante la compilación o el ingreso de datos. Para corregir y eliminar errores tipográficos y ortográficos en los nombres de las divisiones administrativas, utilizamos el software OpenRefine (RRID:SCR_018507 ) para detectar errores de georreferenciación y ubicaciones incorrectas, asegurando que cada punto correspondiera a una ubicación en el continente y en el país correcto. Cualquier coordenada atípica que detectamos que estuviera geográficamente distante de la distribución conocida de una especie determinada fue investigada para garantizar que fuera correcta. Durante la validación de las coordenadas geográficas, detectamos que algunos datos de ocurrencia estaban ubicados fuera del continente o dentro de cuerpos de agua continentales. Estos datos pueden haber sido georeferenciados erróneamente por los autores de la publicación científica original; sin embargo, cuando consideramos que estos datos eran lo suficientemente valiosos como para incorporarlos, llevamos a cabo el siguiente procedimiento: si los campos ‘country’, ‘stateProvince’, ‘municipality’ y ‘locality’ fueron proporcionados por los autores, asignamos la coordenada geográfica correcta, como se explica en el apartado Proceso de georreferenciación de datos, tomando como referencia el nombre de la localidad aportado por los autores. Para detectar errores de sinónimos taxonómicos, utilizamos la revisión más actualizada de los nombres válidos de las especies de triatominos . Si se sospechaba que el nombre de alguna especie estaba desactualizado, consultamos la bibliografía actual o solicitamos la opinión experta de colegas.Todas las coordenadas geográficas se verificaron utilizando el software SIG de acceso libre .Por último, mejoramos la calidad de nuestro conjunto de datos final utilizando el validador de datos de GBIF  y son coautoras de este trabajo (Rachel Curtis-Robles y Sarah A Hamer). Tres notas importantes sobre los datos de ese programa son: (1) como todos los programas de ciencia comunitaria, los registros reflejan lugares y momentos en los que los miembros de la comunidad conocían el programa y optaron por enviar muestras, que pueden no ser completamente representativas de la distribuciones verdaderas de las especies, (2) las fechas reflejan cuándo se recolectó la muestra, pero algunos ejemplares estaban muertos cuando se recolectaron y, por lo tanto, no reflejan la fenología de la especie y (3) algunas muestras ya se han incluido en publicaciones, y se pueden establecer vínculos utilizando el campo ‘otherCatalogNumbers’. En el caso de Costa Rica, pudimos integrar un número importante de registros del Instituto Nacional de Biodiversidad (INBio) y depositados en el Museo Nacional de Costa Rica, proporcionados por uno de los coautores de este trabajo . Para el caso de México y Brasil, el número de datos de presencia por país incluidos parece estar influenciado principalmente por dos factores: (i) el número de especies de triatominos presentes en cada país (ambos países tienen un gran número de especies de triatominos), y (ii) por la cantidad de datos de ocurrencia publicados y proporcionados por colegas (México y Brasil también son los países con la mayor cantidad de datos recopilados); la explicación para este último factor va más allá del objetivo de este artículo. Con respecto al muestreo de hábitats, reconocemos que existe un sesgo potencial a favor de los hábitats domiciliarios y peridomiciliarios porque son los hábitats de mayor importancia epidemiológica y el objetivo de las campañas de control de vectores. Además, la escasez de datos sobre hábitats silvestres también refiere a la dificultad de los procedimientos de muestreo en la gran variedad de hábitats silvestres utilizados por los triatominos. Finalmente, vale la pena señalar que alrededor del 37% de los registros carecen de información de fecha disponible; por lo tanto, recomendamos que cualquier análisis basado en este conjunto de datos utilice métodos que tengan en cuenta dichos sesgos.Dado que la información de los conjuntos de datos se ha recopilado mediante diferentes procedimientos, esta compilación puede contener algunos sesgos inherentes que deben abordarse cuando se pretenda utilizar los datos. La mayoría de los datos se obtuvieron de artículos publicados en revistas científicas, acompañados por aquellos proporcionados por colegas. Aunque los datos abarcan 25 países, hubo algunos países como Estados Unidos, Costa Rica, Brasil y México para los cuales el volumen de datos fue mayor que para el resto. En el caso de Estados Unidos, el número de datos de ocurrencia incluidos está influenciado por la gran contribución de datos de colegas que lideran un programa científico comunitario de triatominos A pesar de los sesgos mencionados anteriormente, el Subconjunto de datos Americano descrito en este documento e integrado en el Nuevo conjunto de datos Americano, más el Conjunto de datos Argentino complementario, constituyen una valiosa compilación de datos geográficos sobre los triatominos Americanos que actualmente es lo más completa, actualizada e integrada. Por lo tanto, todos los conjuntos de datos mencionados tienen una buena representatividad de los datos en cuanto a la cantidad de especies, la cantidad de países y a que cada registro tiene una coordenada geográfica precisa. Además, como estos conjuntos de datos están alojados en un repositorio abierto y público, esperamos que contribuyan a cumplir objetivos nacionales e internacionales como el de promover el intercambio de información biológica, aumentar y mejorar la accesibilidad de dicha información, proporcionar datos biológicos producidos y recopilados en varios países, mejorando el conocimiento tanto de la biodiversidad como de los datos epidemiológicos relacionados con la enfermedad de Chagas. Upload additional filesDRR-202203-02/form/Data release paper_Ceccarelli et al 2022 (1).docxReviewer name and names of any other individual's who aided in reviewer Jader de OliveiraDo you understand and agree to our policy of having open and named reviews, and having your review included with the published papers. YesIs the language of sufficient quality?YesPlease add additional comments on language quality to clarify if needed
Are all data available and do they match the descriptions in the paper? YesAdditional CommentsDear authors, I was very happy to see how much information was generated and updated, congratulations for the effort and the beautiful work.

My comments are to try to add and enrich the work. I inserted it as a comment in the file.

Any questions do not hesitate to write.Are the data and metadata consistent with relevant minimum information or reporting standards? See GigaDB checklists for examples <a href="http://gigadb.org/site/guide" target="_blank">http://gigadb.org/site/guide</a>YesAdditional CommentsIs the data acquisition clear, complete and methodologically sound?YesAdditional CommentsIs there sufficient detail in the methods and data-processing steps to allow reproduction?YesAdditional CommentsIs there sufficient data validation and statistical analyses of data quality? YesAdditional CommentsIs the validation suitable for this type of data?YesAdditional CommentsIs there sufficient information for others to reuse this dataset or integrate it with other data?YesAdditional CommentsAny Additional Overall Comments to the AuthorRecommendationMinor Revision Upload additional filesDRR-202203-02/form/DRR-202203-02_Data-Review-MAT.docx.pdfReviewer name and names of any other individual's who aided in reviewer Mary Ann TuliDo you understand and agree to our policy of having open and named reviews, and having your review included with the published papers. YesIs the language of sufficient quality?NoPlease add additional comments on language quality to clarify if needed
The language is fine, but it is hard to make complete sense of as there are lots of different dates and numbers (of records) and names for the different datasets.Are all data available and do they match the descriptions in the paper? YesAdditional CommentsAre the data and metadata consistent with relevant minimum information or reporting standards? See GigaDB checklists for examples <a href="http://gigadb.org/site/guide" target="_blank">http://gigadb.org/site/guide</a>YesAdditional CommentsIs the data acquisition clear, complete and methodologically sound?NoAdditional CommentsAs above, I think it is partly a language issue, but I think this section could be made more clear to readers. Maybe splitting the section "Description of new American triatomine occurrence data" into smaller sub-sections would make it easier to read and follow. It is very rich in names, dates and numbers. Is there sufficient detail in the methods and data-processing steps to allow reproduction?YesAdditional CommentsIs there sufficient data validation and statistical analyses of data quality? YesAdditional CommentsIs the validation suitable for this type of data?YesAdditional CommentsIs there sufficient information for others to reuse this dataset or integrate it with other data?YesAdditional CommentsAny Additional Overall Comments to the AuthorI believe all the information is available, but its value is somewhat lost in the presentation. RecommendationMinor Revision Comments to the AuthorPlease check the proofs