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Baia KLN, Cordeiro ACC, Frade PCR, Gouveia AGN, Resque RL, Pinheiro LML, Fonseca RRS, Machado LFA, Martins LC, Kupek E, Fischer B, Oliveira-Filho AB. Syphilis and Co-Infections with HIV-1, HBV, and HCV among People Who Use Crack-Cocaine in Northern Brazil. Pathogens 2022; 11:1055. [PMID: 36145487 PMCID: PMC9502650 DOI: 10.3390/pathogens11091055] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Revised: 09/13/2022] [Accepted: 09/14/2022] [Indexed: 11/23/2022] Open
Abstract
The rates of syphilis and viral co-infections among people who use crack-cocaine (PWUCC) were assessed in this study. This cross-sectional study relied on biological and self-reported socio-behavioral data from a convenience sample of 990 PWUCC from twenty-six municipalities in the states of Amapá and Pará, northern Brazil. Blood samples were collected to assess the presence of Treponema pallidum using the Rapid Qualitative Test (RQT) and the Venereal Disease Research Laboratory (VDRL). Reactive samples by RQT were used to assess the presence of HBV, HCV, and HIV-1 using Enzyme Immunoassay (EIA) and Polymerase Chain Reaction (PCR). Logistic regression models were used to determine the association of variables assessed with syphilis. In total, 287 (29.0%) of the PWUCC sample had reactive results for syphilis. HBV (15.7%), HCV (5.9%), and HIV-1 (9.8%) were detected among PWUCC with syphilis. Young age, low monthly income and education level, long duration of crack-cocaine use, condomless sex, multiple sex partners, and exchange of sex for money/drugs were associated with syphilis. The present study provides unique insights on the epidemiological status of syphilis among PWUCC in northern Brazil, with multiple implications for improving urgent interventions for diagnosis, prevention, and treatment.
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Affiliation(s)
- Karen Lorena N. Baia
- Programa de Pós-Graduação em Doenças Tropicais, Universidade Federal do Pará, Belém 66075-110, Brazil
| | - Ana Caroline C. Cordeiro
- Residência Multiprofissional em Saúde da Mulher e da Criança, Hospital Santo Antônio Maria Zaccaria, Bragança 68600-000, Brazil
| | - Paula Cristina R. Frade
- Programa de Pós-Graduação em Doenças Tropicais, Universidade Federal do Pará, Belém 66075-110, Brazil
- Residência Multiprofissional em Saúde da Mulher e da Criança, Hospital Santo Antônio Maria Zaccaria, Bragança 68600-000, Brazil
- Grupo de Estudo e Pesquisa em Populações Vulneráveis, Instituto de Estudos Costeiros, Universidade Federal do Pará, Bragança 68600-000, Brazil
| | - Alanna Gabrielly N. Gouveia
- Grupo de Estudo e Pesquisa em Populações Vulneráveis, Instituto de Estudos Costeiros, Universidade Federal do Pará, Bragança 68600-000, Brazil
| | - Rafael Lima Resque
- Departamento de Ciências Biológicas e da Saúde, Universidade Federal do Amapá, Macapá 68903-419, Brazil
| | - Luiz Marcelo L. Pinheiro
- Residência Multiprofissional em Saúde da Mulher e da Criança, Hospital Santo Antônio Maria Zaccaria, Bragança 68600-000, Brazil
- Faculdade de Ciências Biológicas, Campus do Marajó, Universidade Federal do Pará, Soure 68870-000, Brazil
| | - Ricardo Roberto S. Fonseca
- Laboratório de Virologia, Instituto de Ciências Biológicas, Universidade Federal do Pará, Belém 66077-830, Brazil
| | - Luiz Fernando A. Machado
- Laboratório de Virologia, Instituto de Ciências Biológicas, Universidade Federal do Pará, Belém 66077-830, Brazil
| | - Luisa C. Martins
- Programa de Pós-Graduação em Doenças Tropicais, Universidade Federal do Pará, Belém 66075-110, Brazil
- Residência Multiprofissional em Saúde da Mulher e da Criança, Hospital Santo Antônio Maria Zaccaria, Bragança 68600-000, Brazil
- Laboratório de Patologia Clínica de Doenças Tropicais, Núcleo de Medicina Tropical, Universidade Federal do Pará, Belém 66055-240, Brazil
| | - Emil Kupek
- Departamento de Saúde Pública, Universidade Federal de Santa Catarina, Florianópolis 88040-900, Brazil
| | - Benedikt Fischer
- Centre for Applied Research in Mental Health and Addiction, Faculty of Health Sciences, Simon Fraser University, Vancouver, BC V6B 5K3, Canada
- Faculty of Medical and Health Sciences, University of Auckland, Auckland 1023, New Zealand
- Departamento de Psiquiatria, Universidade Federal de São Paulo, São Paulo 04038-000, Brazil
| | - Aldemir B. Oliveira-Filho
- Programa de Pós-Graduação em Doenças Tropicais, Universidade Federal do Pará, Belém 66075-110, Brazil
- Residência Multiprofissional em Saúde da Mulher e da Criança, Hospital Santo Antônio Maria Zaccaria, Bragança 68600-000, Brazil
- Grupo de Estudo e Pesquisa em Populações Vulneráveis, Instituto de Estudos Costeiros, Universidade Federal do Pará, Bragança 68600-000, Brazil
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Bezerra JMT, Castro PASVD, Machado CJ, Carneiro M. Burden of syphilis in Brazil and federated units, 1990-2016: estimates from the Global Burden of Disease Study 2019. Rev Soc Bras Med Trop 2022; 55:e00102022. [PMID: 35894394 PMCID: PMC9359340 DOI: 10.1590/0037-8682-0010-2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2022] [Accepted: 04/13/2022] [Indexed: 12/01/2022] Open
Abstract
Background: Syphilis is a chronic infectious disease that has created challenging situations for humanity for centuries. Transmission can occur sexually or vertically, with great repercussions on populations, particularly among women and children. The present study presents information on the main burden imposed by syphilis generated by the Global Burden of Disease (GBD) Study 2019 for Brazil and its 27 federated units. Methods: We described the metrics of incidence, deaths, years of life lost (YLLs), years lived with disability (YLDs), and disability-adjusted life years (DALYs), standardized by age and per 100,000 inhabitants, from 1990 to 2019, and we compared the disease burden between the years 1990 and 2019. Results: In Brazil, the disease burden increased between 2005 and 2019 for all metrics. Although a higher incidence of syphilis was found among women in 2019, DALYs [YLLs (males: 15.9%; females: 21.8%), YLDs (males: 25.0%; females: 50.0%), and DALYs (males: 16.2%; females: 22.4%)] were higher among men. In 2019, the highest DALY rate per 100,000 inhabitants was observed in individuals aged above 50 years. The State of Maranhão presented the highest values of DALYs {1990: 165.2 [95% uncertainty interval (UI) 96.2-264.4]; 2005: 43.8 [95% UI 30.3-62.4]; 2019: 29.1 [95% UI 19.8-41.1]} per 100,000 inhabitants in the three years analyzed. Conclusions: The burden of syphilis has increased in recent years. Men presented higher DALYs, although the incidence of the disease was higher in women. Syphilis affects a large number of people across all age groups, causing different degrees of disability and premature death (DALYs).
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Affiliation(s)
- Juliana Maria Trindade Bezerra
- Universidade Federal de Minas Gerais, Instituto de Ciências Biológicas, Departamento de Parasitologia, Programa de Pós-Graduação em Parasitologia, Belo Horizonte, MG, Brasil.,Universidade Estadual do Maranhão, Centro de Ciências Agrárias, Programa de Pós-Graduação em Ciência Animal, São Luís, MA, Brasil.,Universidade Estadual do Maranhão, Centro de Estudos Superiores de Lago da Pedra, Curso de Licenciatura em Ciências Biológicas, Lago da Pedra, MA, Brasil
| | | | - Carla Jorge Machado
- Universidade Federal de Minas Gerais, Faculdade de Medicina, Programa de Programa de Pós-Graduação em Promoção de Saúde e Prevenção da Violência, Belo Horizonte, MG, Brasil
| | - Mariângela Carneiro
- Universidade Federal de Minas Gerais, Instituto de Ciências Biológicas, Departamento de Parasitologia, Programa de Pós-Graduação em Parasitologia, Belo Horizonte, MG, Brasil.,Universidade Federal de Minas Gerais, Faculdade de Medicina, Programa de Pós-Graduação em Infectologia e Medicina Tropical, Belo Horizonte, MG, Brasil.,Universidade Federal de Ouro Preto, Núcleo de Pesquisas em Ciências Biológicas, Programa de Pós-Graduação em Ciências Biológicas, Ouro Preto, MG, Brasil
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Dos Santos DN, Sá KN, Queirós FC, Paixão AB, Santos KOB, de Andrade RCP, Camatti JR, Baptista AF. Pain, psychoaffective symptoms, and quality of life in human T cell lymphotropic virus type 1 (HTLV-1): a cross-sectional study. J Neurovirol 2021; 27:838-848. [PMID: 33405200 DOI: 10.1007/s13365-020-00914-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Revised: 09/02/2020] [Accepted: 09/28/2020] [Indexed: 11/29/2022]
Abstract
The objective of this study is to describe the chronic pain characteristics in individuals infected with human T cell lymphotropic virus type 1 (HTLV-1) per subgroup (asymptomatic, oligosymptomatic, and HTLV-1-associated myelopathy/tropical spastic paraparesis (HAM/TSP)) compared with controls with chronic pain without HTLV-1. This is a cross-sectional study investigating associations between pain profile, psychopathological symptoms, and quality of life. Individuals infected with HTLV-1 refer high-intensity pain compared with controls, with more severe characteristics being present in oligosymptomatic and HAM/TSP individuals. Oligosymptomatic individuals have a tendency of diffuse and frequent pain, mainly in the head/neck region and more depressive symptoms, resembling nociplastic pain. Neuropathic pain was localized in the lower limbs in all infected groups, worse in HAM/TSP individuals, and associated with a worse perception of quality of life. Pain was associated to higher levels of TNF-alpha and interferon-gamma. HTLV-1 pain is generally more severe when compared with other chronic pain syndromes, being present mainly in the lower limbs. Certain characteristics are typical, depending on the affected group. Oligosymptomatic and HAM/TSP individuals present more diffuse pain, with higher intensity and greater impact in quality of life. Increased levels of inflammatory cytokines are associated with HTLV-1-related pain.
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Affiliation(s)
- Dislene Nascimento Dos Santos
- Graduate, Program on Medicine and Health, Federal University of Bahia, Salvador, Bahia, Brazil
- Nucleus of Studies on Health and Functionality, Federal University of Bahia, Salvador, Bahia, Brazil
- Immunology Service, Professor Edgard Santos Hospital, Federal University of Bahia, Salvador, Bahia, Brazil
| | - Katia Nunes Sá
- Nucleus of Studies on Health and Functionality, Federal University of Bahia, Salvador, Bahia, Brazil
| | - Fernanda C Queirós
- Nucleus of Studies on Health and Functionality, Federal University of Bahia, Salvador, Bahia, Brazil
| | - Alaí Barbosa Paixão
- Nucleus of Studies on Health and Functionality, Federal University of Bahia, Salvador, Bahia, Brazil
| | | | | | - Janine Ribeiro Camatti
- Graduate Program on Neuroscience and Cognition, Federal University of ABC, Sao Paulo, Santo Andre, Brazil
| | - Abrahão Fontes Baptista
- Graduate, Program on Medicine and Health, Federal University of Bahia, Salvador, Bahia, Brazil.
- Nucleus of Studies on Health and Functionality, Federal University of Bahia, Salvador, Bahia, Brazil.
- Center for Mathematics, Computation and Cognition, Federal University of ABC, Santo Andre, Sao Paulo, Brazil.
- Graduate Program on Neuroscience and Cognition, Federal University of ABC, Sao Paulo, Santo Andre, Brazil.
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Yi S, Prem K, Chhoun P, Chann N, Tuot S, Mun P, Mburu G. Syphilis infection among people who use and inject drugs in Cambodia: a cross-sectional study using the respondent-driven sampling method. Int J STD AIDS 2020; 31:832-840. [PMID: 32623980 DOI: 10.1177/0956462420929132] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
This cross-sectional study explored the prevalence and correlates of syphilis infection among people who use and inject drugs (PWUD/PWID) in Cambodia. Data were collected in 2017 from 1,677 PWUD/PWID living in the capital city of Phnom Penh and 11 other major provinces using the respondent-driven sampling method. The SD Bioline HIV/Syphilis Duo test was used to determine human immunodeficiency virus (HIV) and current or past syphilis infection. A multivariable logistic regression analysis was conducted to identify risk factors associated with current or past syphilis infection. The prevalence of current or past syphilis infection was 3.8% (95% confidence interval = 2.4-4.6). After adjustment, current or past syphilis infection remained positively associated with being female, living on the streets, having an average monthly income of US$100-299, having transactional sex in the past three months, and having been to a rehabilitation centre in the past 12 months. Current or past syphilis infection was negatively associated with having attained at least high school level of formal education. The findings indicate vulnerability to syphilis infection among PWUD/PWID in Cambodia, particularly among subpopulations who are more marginalized. Syphilis prevention and control programmes should be systematically integrated into HIV and sexually transmitted infection policy and services in the country.
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Affiliation(s)
- Siyan Yi
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore.,KHANA Center for Population Health Research, Phnom Penh, Cambodia.,Center for Global Health Research, Touro University California, Vallejo, CA, USA.,School of Public Health, National Institute of Public Health, Phnom Penh, Cambodia
| | - Kiesha Prem
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore.,Department of Infectious Disease Epidemiology, Faculty of Epidemiology and Population Health, London, School of Hygiene & Tropical Medicine, London, UK
| | - Pheak Chhoun
- KHANA Center for Population Health Research, Phnom Penh, Cambodia
| | - Navy Chann
- National Center for HIV/AIDS, Dermatology and STD, Phnom Penh, Cambodia
| | - Sovannary Tuot
- KHANA Center for Population Health Research, Phnom Penh, Cambodia
| | - Phalkun Mun
- National Center for HIV/AIDS, Dermatology and STD, Phnom Penh, Cambodia
| | - Gitau Mburu
- Centre for Global Health Policy, University of Sussex, Brighton, UK
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Soares F, MacCarthy S, Magno L, da Silva LAV, Amorim L, Nunn A, Oldenburg CE, Dourado I. Factors Associated with PrEP Refusal Among Transgender Women in Northeastern Brazil. AIDS Behav 2019; 23:2710-2718. [PMID: 30972620 PMCID: PMC9982655 DOI: 10.1007/s10461-019-02501-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
Brazil has recently integrated HIV Pre-exposure Prophylaxis (PrEP) into its public health system and offered to key populations such as transgender women (TGW). This study investigates factors associated with PrEP refusal among TGW living in one of the largest and poorest cities of Brazil. We recruited 127 TGW using Respondent Driven Sampling (RDS) in Salvador, Brazil. Latent class analysis (LCA) was used to define acceptability of PrEP. Two latent classes were identified: "high acceptability of PrEP" (91.3%) and "PrEP refusal" (8.7%). PrEP was less acceptable among white TGW and among those age 25 or older, with income above minimum wage (≥ US$252.87), and reporting unprotected receptive anal intercourse with (URAI) causal partners. The findings highlight how nuanced strategies that takes into consideration unique characteristics are needed to effectively address the acceptability of PrEP.
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Affiliation(s)
- Fabiane Soares
- Institute of Collective Health, Federal University of Bahia (Universidade Federal da Bahia/Instituto de Saúde Coletiva), Rua Basílio da Gama, s/n, Campos Universitário do Canela, Salvador, Bahia, CEP: 40.110-040, Brazil.
| | | | - Laio Magno
- Institute of Collective Health, Federal University of Bahia (Universidade Federal da Bahia/Instituto de Saúde Coletiva), Rua Basílio da Gama, s/n, Campos Universitário do Canela, Salvador, Bahia CEP: 40.110-040, Brazil,Department of Life Science, State University of Bahia (Universidade do Estado da Bahia/Departamento de Ciências da Vida), Salvador, BA, Brazil
| | - Luís Augusto Vasconcelos da Silva
- Institute of Collective Health, Federal University of Bahia (Universidade Federal da Bahia/Instituto de Saúde Coletiva), Rua Basílio da Gama, s/n, Campos Universitário do Canela, Salvador, Bahia CEP: 40.110-040, Brazil,Institute of Humanities, Arts and Sciences Professor Milton Santos, Federal University of Bahia (Universidade Federal da Bahia/Instituto de Humanidades, Artes e Ciências Professor Milton Santos), Salvador, BA, Brazil
| | - Leila Amorim
- Institute of Collective Health, Federal University of Bahia (Universidade Federal da Bahia/Instituto de Saúde Coletiva), Rua Basílio da Gama, s/n, Campos Universitário do Canela, Salvador, Bahia CEP: 40.110-040, Brazil,Institute of Mathematics and Statistics, Federal University of Bahia (Universidade Federal da Bahia/Instituto de Matemática e Estatística), Salvador, BA, Brazil
| | - Amy Nunn
- School of Public Health, Brown University, Providence, RI, USA
| | - Catherine E. Oldenburg
- Francis I. Proctor Foundation and Department of Ophthalmology, University of California, San Francisco, CA, USA
| | - Inês Dourado
- Institute of Collective Health, Federal University of Bahia (Universidade Federal da Bahia/Instituto de Saúde Coletiva), Rua Basílio da Gama, s/n, Campos Universitário do Canela, Salvador, Bahia CEP: 40.110-040, Brazil
| | - The PopTrans Group
- Institute of Collective Health, Federal University of Bahia (Universidade Federal da Bahia/Instituto de Saúde Coletiva), Rua Basílio da Gama, s/n, Campos Universitário do Canela, Salvador, Bahia CEP: 40.110-040, Brazil
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Matias MDP, Jesus AOD, Resende RG, Caldeira PC, Aguiar MCFD. Diagnosing acquired syphilis through oral lesions: the 12 year experience of an Oral Medicine Center. Braz J Otorhinolaryngol 2019; 86:358-363. [PMID: 30956150 PMCID: PMC9422386 DOI: 10.1016/j.bjorl.2018.12.010] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2018] [Revised: 11/29/2018] [Accepted: 12/19/2018] [Indexed: 01/27/2023] Open
Abstract
INTRODUCTION A resurgence of syphilis in Brazil has been reported in recent years. OBJECTIVE With this in mind, the present study sought to investigate the frequency, demographics, and clinical characteristics of patients with acquired syphilis with oral involvement who received medical care at an Oral Medicine Reference Center in a Brazilian Public Hospital. METHODS A retrospective study, spanning a period of 12 years, was performed to identify changing trends in syphilis over time. Medical records from all patients diagnosed with acquired syphilis who received medical care at the Hospital's Oral Medicine Clinic from 2005 to 2016 were reviewed, and the demographic and clinical data were collected. RESULTS A total of 85 patients had been diagnosed with acquired syphilis, with a significant increase in the number of cases over the past 5 years. Patients ranged from 16 to 76 years of age, with a peak in the third and fourth decades. Forty-eight cases affected males (56.5%), while 37 cases affected females (43.5%). Most of the oral lesions appeared as unique ulcers or plaques, with the lips and tongue representing the most affected sites. All cases were positive for Venereal Disease Research Laboratory or Fluorescent Treponemal Antibody Absorption, and treatment was performed with Penicillin G benzathine in most cases (84.7%). CONCLUSION The frequency of oral syphilis has been rising over time and oral lesions may well represent a diagnostic clue; therefore, oral health professionals must be made aware and properly trained in an attempt to develop a high degree of clinical suspicion in the diagnosis of syphilis.
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Affiliation(s)
- Michelle Danielle Porto Matias
- Universidade Federal de Minas Gerais (UFMG), Faculdade de Odontologia, Departamento de Cirurgia Oral e Patologia Oral, Belo Horizonte, MG, Brazil
| | - Alessandro Oliveira de Jesus
- Universidade Federal de Minas Gerais (UFMG), Faculdade de Odontologia, Departamento de Cirurgia Oral e Patologia Oral, Belo Horizonte, MG, Brazil
| | | | - Patrícia Carlos Caldeira
- Universidade Federal de Minas Gerais (UFMG), Faculdade de Odontologia, Departamento de Cirurgia Oral e Patologia Oral, Belo Horizonte, MG, Brazil
| | - Maria Cássia Ferreira de Aguiar
- Universidade Federal de Minas Gerais (UFMG), Faculdade de Odontologia, Departamento de Cirurgia Oral e Patologia Oral, Belo Horizonte, MG, Brazil.
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7
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Barros CVDL, Galdino Júnior H, Rezza G, Guimarães RA, Ferreira PM, Souza CM, Guimarães LCDC, Barros DAC, Brunini SM. Bio-behavioral survey of syphilis in homeless men in Central Brazil: a cross-sectional study. CAD SAUDE PUBLICA 2018; 34:e00033317. [PMID: 29952395 DOI: 10.1590/0102-311x00033317] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2017] [Accepted: 10/31/2017] [Indexed: 11/22/2022] Open
Abstract
The objective of this study was to investigate the prevalence and factors associated with syphilis in homeless men in Central Brazil. It is a cross-sectional study conducted with 481 individuals attending four therapeutic communities between October and December 2015. A structured interview was conducted to collect sociodemographic data and risk factors for syphilis. Rapid/point-of-care and VDRL tests were performed to determine exposure to syphilis and the presence of active syphilis, respectively. Poisson regression analysis was used to verify the risk factors associated with the outcomes investigated. Of the study participants, 10.2% were reactive to the rapid test, and 5.4% had active syphilis. At the multiple regression analysis, schooling (adjusted prevalence ratio - APR: 0.89; p = 0.005), history of genital ulcer (APR: 2.59; p = 0.002), STI history (APR: 1.97; p = 0.042), and sexual intercourse under drug effects (APR: 1.60; p = 0.022) were independent factors associated with lifetime syphilis. Also, history of genital ulcer (APR: 2.19; p = 0.019), STI history (APR: 1.74; p = 0.033) and number of sexual partners in the last year (APR: 1.02; p = 0.044) were associated with active syphilis. The prevalence of syphilis among homeless men was rather high, confirming the vulnerability of this group to this infection. These results emphasize the need for educational intervention, improvement of risk reduction programs, availability of diagnostic tests, especially the rapid test, and treatment.
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Ferreira-Júnior ODC, Guimarães MDC, Damacena GN, de Almeida WDS, de Souza-Júnior PRB, Szwarcwald CL. Prevalence estimates of HIV, syphilis, hepatitis B and C among female sex workers (FSW) in Brazil, 2016. Medicine (Baltimore) 2018; 97:S3-S8. [PMID: 29912817 PMCID: PMC5991541 DOI: 10.1097/md.0000000000009218] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Female sex workers (FSW) bear a high burden of sexually transmitted infections (STI). In this paper, we estimate the prevalence of human immunodeficiency virus (HIV), HBV = hepatitis B virus (HBV), HCV = hepatitis C virus (HCV), syphilis and co-infections in the second Biological and Behavioral Surveillance Survey among FSW in Brazil. METHOD The survey was conducted in 12 Brazilian cities from July to November 2016. We used respondent-driven sampling (RDS) to recruit 350 FSW in each city. Rapid tests were used for screening HIV, syphilis, HCV, and HBV. Confirmatory tests were performed on all samples with reactive rapid test result. All testing algorithms and interpretations were done according to the recommendations of the Department of STI/AIDS and viral hepatitis, Ministry of Health. The STI diagnoses were given by: confirmed HIV infection by a positive result on Western blot; active syphilis infection, defined by a RPR titer equal or greater than 1/8; viremia period of HBV and HCV infections, characterized by a detectable (or quantifiable) viral load. Prevalence estimates and standard errors were calculated using statistical procedures suitable for data collected by RDS. RESULTS Excluding the seeds, 4245 FSW were enrolled. Prevalence estimates were: HIV 5.3% (95% CI: 4.4%-6.2%); active syphilis 8.5% (95% CI: 7.3%-9.7%); HBV 0.4% (95% CI: 0.2%-0.7%); and, HCV 0.9% (95% CI: 0.6%-1.3%). Among the 4154 FSW tested for the 4 infections, 13.3%; (95% CI 12.0%-14.8%) were diagnosed with at least one of the infections, of which 87.6% (95% CI: 83.3%-90.9%) had single infections. The prevalence of HIV/syphilis co-infection was 1.09% (95% CI: 0.7%- 1.6%) and of HIV/HCV or HBV infections was 0.4% (95% CI: 0.2%-0.7%). CONCLUSIONS Our results reveal the need to conduct more studies to estimate the prevalence of STI and co-infections among FSW in Brazil. Longitudinal trends in the prevalence estimates of HIV and other STI provide information to monitor changes in this high-risk population. Additionally, the study highlights the importance of measuring the hepatitis burden among FSW living with HIV, and the need of including FSW in all aspects of STI prevention, care, and treatment programs.
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Affiliation(s)
| | | | - Giseli Nogueira Damacena
- Health Information Laboratory, Institute of Communication and Scientific and Technological Information in Health, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
| | - Wanessa da Silva de Almeida
- Health Information Laboratory, Institute of Communication and Scientific and Technological Information in Health, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
| | - Paulo Roberto Borges de Souza-Júnior
- Health Information Laboratory, Institute of Communication and Scientific and Technological Information in Health, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
| | - Célia Landmann Szwarcwald
- Health Information Laboratory, Institute of Communication and Scientific and Technological Information in Health, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
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Guimarães RA, de Oliveira Landgraf de Castro V, do Valle Leone de Oliveira SM, Stabile AC, Motta-Castro ARC, dos Santos Carneiro MA, Araujo LA, Caetano KAA, de Matos MA, Teles SA. Gender differences in patterns of drug use and sexual risky behaviour among crack cocaine users in Central Brazil. BMC Psychiatry 2017; 17:412. [PMID: 29282091 PMCID: PMC5745789 DOI: 10.1186/s12888-017-1569-7] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2017] [Accepted: 12/05/2017] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND The aim of this study was to compare sociodemographic characteristics, patterns of drug use, and risky sexual behaviour among female and male users of crack cocaine. METHODS Between 2012 and 2013, we conducted a cross-sectional study of 919 crack cocaine users (783 men and 136 women) in Central Brazil using face-to-face interviews. Blood samples were collected to test for syphilis. The Chi-Square Automatic Interaction Detector (CHAID) was used to explore the differences between genders. We implemented two models: the first model included previous incarceration and variables related to patterns of drug use, and the second model included variables related to sexual risky behaviours and syphilis exposure. RESULTS Women consumed more crack cocaine than men on a regular basis; however, poly-drug use was more common among men. More women than men reported exchanging sex for money and/or drugs and inconsistent condom use during sexual intercourse; women also reported more sexual partners. In addition, the frequency of sexual violence was higher for women than men. A higher proportion of women than men were positive for syphilis (27.2% vs. 9.2%; p < 0.001). The CHAID decision tree analysis identified seven variables that differentiated the genders: previous incarceration, marijuana use, daily crack cocaine consumption, age at first illicit drug use, sexual violence, exchange of sex for money and/or drugs, and syphilis exposure. CONCLUSION Our findings demonstrate a difference in patterns of crack cocaine consumption and sexual risky behaviours between genders, thus indicating a need for gender-specific interventions in this population.
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Affiliation(s)
- Rafael Alves Guimarães
- 0000 0001 2192 5801grid.411195.9Institute of Tropical Pathology and Public Health, Federal University of Goiás, Goiânia, Goiás Brazil ,0000 0001 2192 5801grid.411195.9Faculty of Nursing, Federal University of Goiás, Goiânia, Goiás Brazil
| | | | | | - Andréa Cristina Stabile
- 0000 0001 2163 5978grid.412352.3Federal University of Mato Grosso do Sul, Campo Grande, Mato Grosso do Sul Brazil
| | - Ana Rita Coimbra Motta-Castro
- 0000 0001 2163 5978grid.412352.3Federal University of Mato Grosso do Sul, Campo Grande, Mato Grosso do Sul Brazil ,0000 0001 0723 0931grid.418068.3Oswaldo Cruz Foundation, Campo Grande, Mato Grosso do Sul Brazil
| | | | - Lyriane Apolinário Araujo
- 0000 0001 2192 5801grid.411195.9Institute of Tropical Pathology and Public Health, Federal University of Goiás, Goiânia, Goiás Brazil
| | | | - Marcos André de Matos
- 0000 0001 2192 5801grid.411195.9Faculty of Nursing, Federal University of Goiás, Goiânia, Goiás Brazil
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Souza ALR, Guimarães RA, de Araújo Vilela D, de Assis RM, de Almeida Cavalcante Oliveira LM, Souza MR, Nogueira DJ, Barbosa MA. Factors associated with the burden of family caregivers of patients with mental disorders: a cross-sectional study. BMC Psychiatry 2017; 17:353. [PMID: 29070012 PMCID: PMC5655908 DOI: 10.1186/s12888-017-1501-1] [Citation(s) in RCA: 55] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2017] [Accepted: 10/02/2017] [Indexed: 01/23/2023] Open
Abstract
BACKGROUND Caregivers are responsible for the home care of family members with mental-health disorders often experience changes in their life that can generate stress and burden. The aim of this study was to identify factors associated with the burden of caregivers of family members with mental disorders. METHODS This cross-sectional study was conducted with a non-probability sample of family caregivers, whose patients attended a community services program, the Psychosocial Care Centers, in three cities in the southwest region of Goiás State, Central Brazil. Data collection took place from June 2014 to June 2015. The participants were 281 caregivers who completed a sociodemographic questionnaire and the Zarit Burden Interview (ZBI). Bivariate analyses (t test, analysis of variance, and Pearson correlation) were performed, and variables with values of p < 0.10 and gender were included in a multiple-linear regression model. Values of p < 0.05 were considered significant. RESULTS The caregivers were mostly female and parents of the patients, were married, with low education, and of low income. The mean ZBI score was 27.66. The factors independently associated with caregivers' burden were depression, being over 60 years of age, receiving no help with caregiving, recent patient crisis, contact days, and having other family members needing care. CONCLUSIONS This study identified factors that deserve the attention of community services and can guide programs, such as family psycho-education groups, which may help to minimize or prevent the effects of burden on family caregivers responsible for patients' home care.
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Affiliation(s)
- Ana Lúcia Rezende Souza
- Physiotherapy Course, Federal University of Goiás, Jataí, Goiás Brazil
- Faculty of Medicine, Federal University of Goiás, Goiânia, Goiás Brazil
- Physical Education Course, Federal University of Goiás, Jataí, Goiás Brazil
| | - Rafael Alves Guimarães
- Institute of Tropical Pathology and Public Health, Federal University of Goiás, Goiânia, Goiás Brazil
| | | | | | | | - Mariana Rezende Souza
- Post Graduated Program in Social and Preventive Dentistry of the Faculty of Dentistry, Paulista State University, Araçatuba, São Paulo, Brazil
| | | | - Maria Alves Barbosa
- Faculty of Medicine, Federal University of Goiás, Goiânia, Goiás Brazil
- Faculty of Nursing, Federal University of Goiás, Goiânia, Goiás Brazil
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da Fonseca EM, Bastos FI. Evolution of HIV/AIDS response in Brazil: Policy innovations and challenges in the fourth decade of the epidemic. Int J Health Plann Manage 2017; 33:e238-e250. [PMID: 28875508 DOI: 10.1002/hpm.2452] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2017] [Accepted: 08/01/2017] [Indexed: 12/22/2022] Open
Abstract
Brazil was the first low- and middle-income country to provide universal treatment access to people living with the acquired immunodeficiency syndrome (AIDS), becoming a widely acclaimed model for best practice to managing this epidemic. However, we know little about important challenges to the key pillars of Brazil's response. This article discusses how the evolution of the country's health system institutions and international advancements in AIDS treatment and prevention affected the national response. Decentralization of health system resources and policy making brought fresh challenges to the centralized governance of the national AIDS program and to civil society, weakening their coordination and advocacy capacity. Regardless, AIDS treatment and prevention strategies in Brazil remain aligned with the current international protocols, but unfortunately have been restricted in some geographic areas and/or populations.
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