[Trend, spatialization and circumstances associated with violence against vulnerable populations in Brazil, between 2009 and 2017]

Prevalence and factors associated with recurrent violence in a southeastern Brazilian state: Cross-sectional study

Violence is a serious public health problem and its repetitive character points to a chronic phenomenon and its insertion in the daily lives of victims. To identify the frequency of repeat violence reported in adults in a Brazilian state and its association with the characteristics of the victim, the aggressor, and the aggression. This is an epidemiological cross-sectional study conducted with data from the notifications of violence recorded in the Notifiable Diseases Information System in Espírito Santo, Brazil from 2011 to 2018. Bivariate analysis was performed using Pearson Chi-Squared test and the multivariate Poisson regression, using a widely used hierarchical model, with the victim's characteristics in the first level and the aggressor's characteristics and the occurrence in the second level. In the multivariate analysis, the variables that obtained P  < .2 in the bivariate analysis were included in the model, keeping those with P  < .05. Data were expressed by prevalence ratio (PR), with confidence intervals of 95%. During the period, 9933 cases of violence were registered in the adult population, referring to 1061 notifications of male adults and 8872 notifications of female adults. The prevalence of repeat violence was 56.7% (95% CI: 56.0 - 57.5). It was more prevalent among women (PR: 1.73; 95% CI: 1.63 - 1.83), in the age groups over 40 years (PR: 1.12; 95% CI: 1.08 - 1.16), black and mixed-race ( P : 1.04; 95% CI: 1.01 - 1.07), and with a partner ( P : 1.09; 95% CI: 1.05 - 1.12). Victims with disabilities or disorders suffered 34% more from this problem (95% CI: 1.29 - 1.38) and lived in urban or peri-urban areas (PR: 1.16; 95% CI: 1.10 - 1.23). As for the aggressors, they were under 25 years of age (PR: 1.06; 95% CI: 1.02 - 1.11), of both sexes (PR: 1.32; 95% CI: 1.06 - 1.64), and were the victim's intimate partner (PR: 3.91; 95% CI: 3.25 - 4.71). The aggressions had only 1 perpetrator (PR: 1.17; 95% CI: 1.07 - 1.28) and occurred in the residence (PR: 1.33; 95% CI: 1.26 - 1.41). Repeat violence showed high frequency among notifications and was associated with characteristics of the victim, aggressor, and event. The results point to a phenomenon present in the daily life of communities that is potentially capable of negatively impacting the different areas of the subjects lives. Studies on the subject are important to understand the phenomenon and implement strategic actions to confront it.

Influência das características da vítima, do agressor e do agravo na frequência de negligência contra a mulher

Objetivo: identificar a frequência da negligência contra meninas e mulheres no Espírito Santo, Brasil, e sua associação com as características da vítima, agressor e agressão. Métodos: estudo transversal com 802 notificações de negligência contra as mulheres entre os anos de 2011 e 2018. Os dados foram coletados a partir do Sistema de Informação de Agravos e Notificações (SINAN) do Espírito Santo e submetidos à análise comparativa por meio de regressão de Poisson e análise multivariada. Resultados: a negligência contra o sexo feminino representou uma frequência de 3% (IC95% 2,8-3,2) das notificações no período de 2011 a 2018. Esse agravo foi mais prevalente entre vítimas na faixa etária de 0 a 9 anos (RP = 108,67; IC95% 79,8 – 147,9); que referiram alguma deficiência/transtorno (RP= 2,55; IC95% 2,14 – 3,04); e ter como zona de residência a área urbana/periurbana (RP= 1,66; IC95% 1,23 – 2,24). Ao passo que as características do agressor associadas a uma maior ocorrência do fenômeno foram: ser do sexo feminino (RP= 7,12; IC95% 5,64 – 8,99); e possuir com a vítima o vínculo de Pai/Mãe/Padrasto/Madrasta/Ambos os pais (RP= 3,83; IC95% 3,00 – 4,89). Já em relação a característica da ocorrência foi ter dois ou mais em números de envolvidos com a negligência (RP= 1,87; IC95% 1,41 – 2,47). Conclusões: a negligência contra meninas e mulheres constitui um agravo de saúde presente que apresenta maiores prevalências em grupos mais vulneráveis. Nesse sentido, é fundamental, que os profissionais de saúde, estejam atentos a notificação desse agravo, com inserção da vítima na rede de proteção, contribuindo para a ruptura do ciclo da violência.

HIV epidemic among Brazilian women who have sex with women: An ecological study

The influences of public policies fighting HIV among women who have sex with women is scarcely studied. This study aimed to analyse the time series of human immunodeficiency virus (HIV) epidemic, between 2007 and 2020, among Brazilian women who have sex with women, in order to evaluate the effect of Brazilian policies for fighting HIV in this subpopulation compared to women who have sex with men (WSM). This ecological study employed HIV and acquired immunodeficiency syndrome (AIDS) new cases among women who have sex strictly with women (WSW), women who have sex with men and women (WSMW), and WSM reported to the Sistema de Informação de Agravos de Notificação from 2007 to 2020. Crude Brazilian and regional annual age-adjusted HIV/AIDS population-level incidence rates were calculated for WSW, WSMW and WSM. The rates were then analyzed using the Joinpoint regression model. A total of 102,890, 757, and 1,699 notifications of WSW, WSMW, and WSM living with HIV/AIDS were reported during the study period, respectively. South Brazilian region had the greatest HIV/AIDS incidence rates among WSM and bisexual women while the North region had the greatest incidence among WSW. In the WSM population, the temporal trends showed at least one stable or an increasing trend period from 2007 to 2013 or 2014, followed by one decreasing trend in all Brazilian regions. While among the WSMW most of the regions had a stable trend period from 2007 to 2020, in WSW group most of the trends had only one decreasing period. The decreasing trends were faster in WSM than in WSW. These results suggest a low efficiency of Brazilian policies for fighting HIV among WSW and WSMW and show the necessity of implementing new policies specific to this population.