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Blandón-Buelvas M, Palacios-Moya L, Berbesí-Fernández D. [Active syphilis infection in homeless people and associated factors]. Rev Salud Publica (Bogota) 2023; 21:357-361. [PMID: 36753181 DOI: 10.15446/rsap.v21n3.61039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2017] [Accepted: 04/28/2019] [Indexed: 11/09/2022] Open
Abstract
OBJECTIVE To identify the personal and sociodemographic factors associated with the syphilis infection in homeless people in Medellin city, 2016. MATERIALS AND METHODS Quantitative, observational and cross-sectional study. it surveyed 145 homeless people between 18 and 59 years of age. The study included univariate and bivariate analysis, it used the chi square test, the prevalence ratio, confidence intervals of the 95% with level of significance less than 5%. RESULTS For the development of the study a survey and a serological test of syphilis were applied to 145 homeless people. The 64,1% were men, the average age was 42 years (de 9,5), the predominant social stratum was low (71%), the syphilis infection in homeless people was 27.6%. the people with greater risk to acquire syphilis infection were: women (IC=1,57-4,57), single people (0,71-2,80), bazuco consumers (IC=0,86-3,06) and people with previous diagnosis of syphilis (IC=1,81-4,68). CONCLUSIONS In the homeless people there is a higher than expected presence of syphilis. The women, single people, bazuco consumers and people with previous diagnosis of syphilis are the most predisposed individuals to acquire the infection. This situation suggests the need to increase and focus the health promotion actions. It suggests fomenting the induced demand to sexual and reproductive health services with a differential approach of the population, too.
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Leite AGDS, Damasceno LM, Conceição SC, Motta PFC. Rapid tests for HIV, syphilis, and chronic hepatitis in a prison population in a prison complex in Salvador (BA), Brazil. CIENCIA & SAUDE COLETIVA 2022. [DOI: 10.1590/1413-812320222712.10462022en] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Abstract This study aimed to quantitatively analyze the results of rapid tests for Human Immunodeficiency Virus (HIV), Syphilis, and Chronic Hepatitis in the prison population in a prison complex in Salvador (BA), Brazil. This cross-sectional study consisted of a sample of men incarcerated from August 2018 to August 2020 submitted to rapid tests. Descriptive statistics and prevalence ratios with respective 95% confidence intervals were employed to analyze data. A total of 6,160 men were studied. Most were black and brown (93.1%) and resided in Salvador (BA), Brazil (65.8%), with predominantly elementary schooling level (65.3%). Five hundred eighty-one (9.4%) people deprived of their liberty were positive for one or more STIs, and Syphilis was the most prevalent (80%). The variables age greater than 25 years [PR = 1.37 95%CI (1.17-1.61)] and schooling level without Higher Education [PR = 2.16 95%CI (1.04-4.49)] were associated with a higher positivity rate in tests, while not sharing drugs was a protective factor for test positivity [PR = 1.28 95%CI (1.07-1.53)]. We concluded that there was a low prevalence of STIs in the sample studied, and Syphilis was the most prevalent.
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Leite AGDS, Damasceno LM, Conceição SC, Motta PFC. Testes rápidos de HIV, sífilis e hepatites crônicas na população carcerária em um complexo penitenciário de Salvador (BA), Brasil. CIENCIA & SAUDE COLETIVA 2022; 27:4467-4474. [DOI: 10.1590/1413-812320222712.10462022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Accepted: 06/30/2022] [Indexed: 11/16/2022] Open
Abstract
Resumo O objetivo do estudo foi analisar quantitativamente resultados de testes rápidos de vírus da imunodeficiência humana (HIV), sífilis e hepatites crônicas na população carcerária em complexo penitenciário de Salvador (BA). Trata-se de um estudo transversal. A amostra foi composta por homens privados de liberdade no período de agosto de 2018 a agosto de 2020, com testes rápidos sendo realizados. Para análise dos dados foi utilizada estatística descritiva e razão de prevalência com os respectivos intervalos de confiança de 95%. Foram estudados 6.160 homens, com maioria (93,1%) de pretos e pardos, residentes de Salvador (65,8%), com escolaridade predominante de ensino fundamental (65,3%). Das pessoas privadas de liberdade, 581 (9,4%) obtiveram resultado reagente para uma ou mais IST, sendo sífilis a mais prevalente (80%). As variáveis idade maior de 25 anos [RP = 1,37 IC95% (1,17-1,61)] e nível de escolaridade sem presença de ensino superior [RP = 2,16 IC95% (1,04-4,49)] se mostraram associadas à maior taxa de positividade nos testes, enquanto o não compartilhamento de drogas em algum momento da vida mostrou ser fator protetor à positividade nos testes [RP = 1,28 IC95% (1,07-1,53)]. Conclui-se que existiu uma baixa prevalência das IST na amostra estudada, sendo sífilis a mais prevalente.
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Grammatikopoulou MG, Gkiouras K, Pepa A, Persynaki A, Taousani E, Milapidou M, Smyrnakis E, Goulis DG. Health status of women affected by homelessness: A cluster of in concreto human rights violations and a time for action. Maturitas 2021; 154:31-45. [PMID: 34736578 DOI: 10.1016/j.maturitas.2021.09.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Revised: 09/10/2021] [Accepted: 09/17/2021] [Indexed: 10/20/2022]
Abstract
Health problems of women experiencing homelessness are driven either from the usual background characteristics of this population, or from the homeless lifestyle. Apart from poverty and unemployment, transition to homelessness is often associated with substance abuse, history of victimization, stress, poor mental health and human immunodeficiency virus (HIV). Water insecurity can undermine bodily hygiene and dental health, posing a greater risk of dehydration and opportunistic infections. Exposure to extreme environmental conditions like heat waves and natural disasters increases morbidity, accelerates aging, and reduces life expectancy. Nutrition-wise, a high prevalence of food insecurity, obesity, and micronutrient deficiencies are apparent due to low diet quality and food waste. Poor hygiene, violence, and overcrowding increase the susceptibility of these women to communicable diseases, including sexually transmitted ones and COVID-19. Furthermore, established cardiovascular disease and diabetes mellitus are often either undertreated or neglected, and their complications are more widespread than in the general population. In addition, lack of medical screening and contraception non-use induce a variety of reproductive health issues. All these health conditions are tightly related to violations of human rights in this population, including the rights to housing, water, food, reproduction, health, work, and no discrimination. Thus, the care provided to women experiencing homelessness should be optimized at a multidimensional level, spanning beyond the provision of a warm bed, to include access to clean water and sanitation, psychological support and stress-coping strategies, disease management and acute health care, food of adequate quality, opportunities for employment and support for any minor dependants.
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Affiliation(s)
- Maria G Grammatikopoulou
- Unit of Reproductive Endocrinology, 1st Department of Obstetrics and Gynecology, Medical School, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece; Department of Nutritional Sciences and Dietetics, Faculty of Health Sciences, Alexander Campus, International Hellenic University, Thessaloniki, Greece
| | - Konstantinos Gkiouras
- Medical School, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Aleks Pepa
- Department of Food Science and Human Nutrition, Agricultural University of Athens, Greece
| | | | - Eleftheria Taousani
- Department of Midwifery, Faculty of Health Sciences, International Hellenic University, Alexander Campus, Thessaloniki, Greece
| | - Maria Milapidou
- Dr. Juris, Post Doc Researcher, Faculty of Law, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Emmanouil Smyrnakis
- Laboratory of Primary Health Care, General Practice and Health Services Research, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Dimitrios G Goulis
- Unit of Reproductive Endocrinology, 1st Department of Obstetrics and Gynecology, Medical School, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece.
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Pinheiro RS, Carvalho PMRDS, Matos MAD, Caetano KAA, Paula ACD, Carneiro MADS, Reis MNDG, Martins RMB, Stefani MMDA, Teles SA. Human immunodeficiency virus infection and syphilis among homeless people in a large city of Central-Western Brazil: prevalence, risk factors, human immunodeficiency virus-1 genetic diversity, and drug resistance mutations. Braz J Infect Dis 2020; 25:101036. [PMID: 33248020 PMCID: PMC9392128 DOI: 10.1016/j.bjid.2020.11.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Revised: 10/14/2020] [Accepted: 11/02/2020] [Indexed: 12/15/2022] Open
Abstract
Homeless people are at high risk for sexually transmitted infections (STIs), such as human immunodeficiency virus (HIV) infection and syphilis. We investigated the epidemiology of HIV-1 infection and syphilis among homeless individuals in a large city in Central-Western Brazil. In this cross-sectional study, we interviewed and tested 355 individuals from September 2014 to August 2015. Rapid test samples positive for syphilis were retested using the Venereal Disease Research Laboratory (VDRL) test. Blood samples from HIV-infected participants were collected for POL sequencing using HIV-1 RNA extracted from plasma, reverse transcription, and nested polymerase chain reaction. Anti-HIV-1-positive samples were subtyped by sequencing the nucleotides of HIV-1 protease and part of the HIV-1 reverse transcriptase genes. Transmitted and acquired drug resistance mutations and susceptibility to antiretroviral drugs were also analyzed. Anti-HIV was positive in 14 patients (3.9%; 95% confidence interval [CI]: 2.3–6.4). HIV-1 RNA was detected in 8 of the 14 samples. Two of the eight (25%) isolates showed HIV-1 drug resistance mutations. Furthermore, 78 (22%; 95% CI: 17.9–26.5) and 29 (8.2%; 95% CI: 5.6–11.4) homeless individuals tested positive for syphilis using the rapid test and VDRL test, respectively. Two individuals were anti-HIV-1 and VDRL test positive. Daily alcohol use (adjusted odds ratio [AOR]: 3.2, 95% CI: 1.0–10.4), sex with people living with HIV (PLWH) infection (AOR: 6.8, 95% CI: 1.9–25.0), and sex with people of the same sex (AOR: 5.4, 95% CI: 1.7–17.5) were predictors of HIV infection. Age ≤35 years (AOR: 3.8, 95% CI: 1.4–10.8), previous syphilis testing (AOR: 3.5, 95% CI: 1.4–8.4), history of genital lesions (AOR: 4.9, 95% CI: 1.3–19.1), and crack use in the last six months (AOR: 3.1, 95% CI: 1.3–7.6) were predictors of syphilis. Our findings highlight the importance of STI prevention and control strategies among the homeless.
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Affiliation(s)
| | | | | | | | | | | | | | - Regina Maria Bringel Martins
- Universidade Federal de Goiás (UFG), Instituto de Patologia Tropical e Saúde Pública (IPTSP), Goiânia, GO, Brazil
| | | | - Sheila Araujo Teles
- Universidade Federal de Goiás (UFG), Faculdade de Enfermagem, Goiânia, GO, Brazil.
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Felipetto LG, Teider-Junior PI, da Silva FFV, Yamakawa AC, Kmetiuk LB, do Couto AC, Martins CM, Vaz ES, Ullmann LS, Langoni H, Timenetsky J, dos Santos AP, Biondo AW. Serosurvey of Anti- Toxoplasma gondii Antibodies in Homeless Persons of São Paulo City, Southeastern Brazil. Front Public Health 2020; 8:580637. [PMID: 33251175 PMCID: PMC7674916 DOI: 10.3389/fpubh.2020.580637] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Accepted: 10/13/2020] [Indexed: 12/14/2022] Open
Abstract
Seroprevalence of Toxoplasma gondii has been extensively studied in a variety of different human populations. However, no study has focused on homeless populations. Accordingly, the present study aimed to assess the seroprevalence of anti-T. gondii antibodies and the risk factors associated in homeless persons from homeless shelter of São Paulo city, southeastern Brazil. In addition, anti-HIV antibodies and associated risk of T. gondii and HIV coinfection have been evaluated. Anti-T. gondii antibodies were detected by indirect fluorescent antibody test. In addition, anti-HIV levels were tested by chemiluminescence enzyme immunoassay, with positive samples confirmed by rapid immunoblot assay. Overall, IgG anti-T. gondii seropositivity was found in 43/120 (35.8%) homeless persons, with endpoint titers varying from 16 to 1,024. The only two pregnant women tested were negative for IgM by chemiluminescence enzyme immunoassay, with normal parturition and clinically healthy newborns in both cases. There were no statistical differences in the risk factors for anti-T. gondii serology (p > 0.05). Anti-HIV seropositivity was found in 2/120 (1.7%) homeless persons, confirmed as HIV-1. One HIV seropositive individual was also sero-reactive to IgG anti-T. gondii, and both were negative to IgM anti-T. gondii. This is the first study that reports the serosurvey of T. gondii in homeless persons worldwide. Despite the limited sample size available in the present study, our findings have shown that the prevalence of anti-T. gondii antibodies in homeless persons herein was lower than the general population, probably due to homeless diet habit of eating mainly processed food intake. No statistical differences were found regarding risk factors for anti-T. gondii exposure in homeless persons. Future studies should be conducted to fully establish risk factors for anti-T. gondii exposure in homeless persons.
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Affiliation(s)
- Laís Giuliani Felipetto
- Department of Veterinary Medicine, Graduate College of Veterinary Science, Federal University of Paraná, Curitiba, Brazil
| | - Pedro Irineu Teider-Junior
- Department of Veterinary Medicine, Graduate College of Veterinary Science, Federal University of Paraná, Curitiba, Brazil
| | | | - Ana Carolina Yamakawa
- Department of Veterinary Hygiene and Public Health, São Paulo State University, Botucatu, Brazil
| | - Louise Bach Kmetiuk
- Graduate College of Cellular and Molecular Biology, Federal University of Paraná, Curitiba, Brazil
| | - Anahi Chechia do Couto
- Department of Veterinary Medicine, Graduate College of Veterinary Science, Federal University of Paraná, Curitiba, Brazil
| | - Camila Marinelli Martins
- Department of Nursing and Public Health, State University of Ponta Grossa, Ponta Grossa, Brazil
- AAC&T Research Consulting LTDA, Curitiba, Brazil
| | - Eduarda Stankiwich Vaz
- Department of Veterinary Medicine, Graduate College of Veterinary Science, Federal University of Paraná, Curitiba, Brazil
| | | | - Helio Langoni
- Department of Veterinary Hygiene and Public Health, São Paulo State University, Botucatu, Brazil
| | - Jorge Timenetsky
- Department of Medical Microbiology, University of São Paulo, São Paulo, Brazil
| | - Andrea Pires dos Santos
- Department of Comparative Pathobiology, Purdue University, West Lafayette, IN, United States
| | - Alexander Welker Biondo
- Department of Comparative Pathobiology, Purdue University, West Lafayette, IN, United States
- Department of Veterinary Medicine, Federal University of Paraná, Curitiba, Brazil
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Cavalin RF, Pellini ACG, Lemos RRGD, Sato APS. TB-HIV co-infection: spatial and temporal distribution in the largest Brazilian metropolis. Rev Saude Publica 2020; 54:e112. [PMID: 33146301 PMCID: PMC7593020 DOI: 10.11606/s1518-8787.2020054002108] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2019] [Accepted: 05/03/2020] [Indexed: 12/03/2022] Open
Abstract
OBJECTIVE To describe the spatial and temporal distribution of TB-HIV co-infection, as well as the profile of the characteristics of the co-infected population in the municipality of São Paulo. METHODS This is an ecological and time series study with data from the Tuberculosis Patient Control System (TBWeb), including all new cases of tuberculosis co-infected individuals with HIV living in the municipality from 2007 to 2015. Time trends of the disease were analyzed using Prais-Winsten regression. The cases were geocoded by the address of residence for the elaboration of maps with the incidence rates smoothed by the local empirical Bayesian method. The global and local Moran indexes evaluated spatial autocorrelation. Individuals' profiles were described and the characteristics of the cases with and without fixed residence were compared by Pearson's chi-square or Fisher's exact tests. RESULTS We analyzed 6,092 new cases of TB-HIV co-infection (5,609 with fixed residence and 483 without fixed residence). The proportion of TB-HIV co-infection ranged from 10.5% to 13.7%, with a drop of 3.0% per year (95%CI -3.4 - -2.6) and was higher in individuals without fixed residence. Incidence rates decreased by 3.6% per year (95%CI -4.4% - -2.7%), declining from 7.0 to 5.3 per 100,000 inhabitants/year. Co-infection showed positive and significant spatial autocorrelation, with heterogeneous spatial pattern and a high-risk cluster in the central region of the municipality. Cure was achieved in 55.5% of cases with fixed residence and in 32.7% of those without a fixed residence. CONCLUSIONS The data indicate an important advance in the control of TB-HIV co-infection in the period analyzed. However, we identified areas and populations that were unequally affected by the disease and that should be prioritized in the improvement of actions to prevent and control co-infection.
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Affiliation(s)
- Roberta Figueiredo Cavalin
- Universidade de São Paulo . Faculdade de Saúde Pública . Programa de Pós-Graduação em Saúde Pública . São Paulo , SP , Brasil
| | | | - Regina Rocha Gomes de Lemos
- Secretaria Municipal da Saúde . Coordenação de Vigilância em Saúde de São Paulo . Programa Municipal de Controle da Tuberculose . São Paulo , SP , Brasil
| | - Ana Paula Sayuri Sato
- Universidade de São Paulo . Faculdade de Saúde Pública . Departamento de Epidemiologia . São Paulo , SP , Brasil
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Wakgari N, Woyo T, Kebede E, Gemeda H, Gebremedhin S. Sexually transmitted disease among street dwellers in southern Ethiopia: a mixed methods study design. BMC Public Health 2020; 20:434. [PMID: 32245375 PMCID: PMC7118816 DOI: 10.1186/s12889-020-08584-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2019] [Accepted: 03/25/2020] [Indexed: 11/28/2022] Open
Abstract
Background Lack of knowledge about sexual violence, its consequences, substance use and homelessness are major problems that make street dwellers susceptible to sexually transmitted diseases. Hence, this study assessed knowledge, attitudes and treatment-seeking behaviors related to sexually transmitted diseases among street dwellers in southern Ethiopia. Methods An explanatory sequential mixed-methods study design was conducted among 842 respondents. A simple random sampling technique was used to select seven cities among fourteen major cities of the region. The sample was allocated proportionally to each selected city. In order to identify and fill in the required sample size, a snowball sampling technique was used. A pre-tested and structured interviewer-administered questionnaire was used to collect quantitative data. The collected data were entered using Epidata and exported to SPSS version 23.0 for further analysis. Unstructured questionnaires were also used to collect 21 in-depth interviews and 10 key informants’ interviews. Respondents for in-depth interviews were selected purposively during quantitative data collection. Results Most street dwellers were aware of (86.7%) and had a favourable attitude towards (84.4%) prevention and management of sexually transmitted diseases. A portion of respondents experienced bad-smelling genital discharge (13.8%), genital ulcers (11.2%) and a burning sensation (14.5%) during urination, in the previous year. Among those who experienced symptoms of sexually transmitted disease, only 15.3% of them received treatment from a health care provider. Fear of questions raised by providers was one of the reasons for not seeking care according to our qualitative findings. Conclusions In this study, a significant number of street dwellers reported experiencing symptoms of a sexually transmitted disease. Despite having awareness about sexually transmitted diseases, seeking treatment from a health center was found to be low based on both quantitative and qualitative findings. We recommend that health care providers should undergo special training to address the sexual and reproductive health problems of street dwellers.
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Affiliation(s)
- Negash Wakgari
- Department of Midwifery, Ambo University, Ambo, Ethiopia.
| | - Terefe Woyo
- Departments of Midwifery, Hawassa University, Hawassa, Ethiopia
| | - Emnet Kebede
- Departments of Midwifery, Hawassa University, Hawassa, Ethiopia
| | - Hirut Gemeda
- Departments of Midwifery, Hawassa University, Hawassa, Ethiopia
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Mendes KT, Ronzani TM, Paiva FSD. POPULAÇÃO EM SITUAÇÃO DE RUA, VULNERABILIDADES E DROGAS: UMA REVISÃO SISTEMÁTICA. PSICOLOGIA & SOCIEDADE 2019. [DOI: 10.1590/1807-0310/2019v31169056] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Resumo O presente artigo tem como objetivo realizar uma revisão sistemática sobre os determinantes pobreza, estigma, raça e vulnerabilidade entre a população em situação de rua usuária de drogas. Para tal, foi realizada uma revisão sistemática utilizando as bases de dados Scielo Br, PepSiC, PubMed e Redalyc. Ao final dos procedimentos foram selecionados 79 artigos. Foi percebida diferença significativa dos estudos realizados nos Estados Unidos e os latino-americanos. Enquanto os primeiros tendem a priorizar estudos com grandes amostras com o foco na análise de riscos e na quantificação de categorias, as pesquisas latinas tendem a contextualizar as condições de desigualdade e pobreza, ao passo que utilizam metodologias participativas e se aproximam de uma análise das vulnerabilidades. Os resultados indicam discussões ainda incipientes que articulem tais categorias e que pouco englobam as diversas vulnerabilidades a que esses sujeitos estão expostos ao longo de suas vidas, bem como apontam para a necessidade de uma nova categoria analítica de compreensão.
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Abstract
Rigorous HIV-related data for the homeless population in Jamaica is limited. A cross-sectional survey using a venue-based sampling approach was conducted in 2015 to derive HIV prevalence and associated risk factors. Three hundred twenty-three homeless persons from the parishes of St. James, St. Ann, Kingston, and St. Andrew (the main urban centers) participated. HIV prevalence was 13.8%, with a difference in gender (males 11.6%, females 26.7%, P = .007). Sex work, multiple partnerships, incarceration, non-injecting drug use, and female rape were common among the participants. Long-term, multilayered, HIV-specific, female-focused interventions are required for the population, along with additional female-centric research.
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Affiliation(s)
- Nicola Skyers
- HIV/STI/Tb Unit, Ministry of Health, Kingston, Jamaica.
| | | | - Willi McFarland
- University of California, San Francisco, San Francisco, CA, USA
| | - Dahlia Cole
- National Council of Drug Abuse, Kingston, Jamaica
| | - Uki Atkinson
- National Council of Drug Abuse, Kingston, Jamaica
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Brunini SM, Barros CVDL, Guimarães RA, Galdino Júnior H, Rezza G, Santos JR, da Cunha VE, Sousa JM, Ferreira PM, Barros DAC. HIV infection, high-risk behaviors and substance use in homeless men sheltered in therapeutic communities in Central Brazil. Int J STD AIDS 2018; 29:1084-1088. [PMID: 29862902 DOI: 10.1177/0956462418767188] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Homeless men present high vulnerability to HIV infection, mainly due to sexual risk behaviors and substance use. The objective was to estimate the prevalence of HIV infection, risk behaviors and substance use in homeless men. A cross-sectional study was conducted in 481 homeless men recruited in four therapeutic communities in the Goiás State, Central Brazil. All were interviewed about sociodemographic characteristics, substance use, and risk behaviors. Furthermore, all were tested for HIV. Poisson regression was used to verify factors associated with HIV infection. HIV prevalence was 1.24% (95.0% CI: 0.57 to 2.69%). Previous HIV testing (adjusted prevalence ratio [APR]: 10.0; 95.0% CI: 1.86-55.8) and years of education (APR: 0.76; 95.0% CI: 0.60-0.97) were factors associated with HIV infection. Participants had high rates of hazardous alcohol use and illicit drug use. The prevalence of HIV infection among homeless men was higher than that found in the Brazilian male population and we identified a high rate of risk behaviors for HIV among the homeless men investigated. Thus, it is necessary to expand HIV prevention measures in Brazil, such as health education, condom availability, regular HIV testing and increased testing coverage in this population, and treatment for alcohol and/or illicit drug dependence/abuse.
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Affiliation(s)
- Sandra M Brunini
- 1 Faculty of Nursing, Federal University of Goiás, Goiânia, Goiás, Brazil
| | | | - Rafael Alves Guimarães
- 2 Institute of Tropical Pathology and Public Health, Federal University of Goiás, Goiânia, Goiás, Brazil
| | | | | | - Jordana Rs Santos
- 1 Faculty of Nursing, Federal University of Goiás, Goiânia, Goiás, Brazil
| | - Vanessa E da Cunha
- 1 Faculty of Nursing, Federal University of Goiás, Goiânia, Goiás, Brazil
| | - Johnatan M Sousa
- 1 Faculty of Nursing, Federal University of Goiás, Goiânia, Goiás, Brazil
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Pinsky I, Bernal C, Vuolo L, Neighbors C. Introducing care management to Brazil's alcohol and substance use disorder population. ACTA ACUST UNITED AC 2017; 40:320-324. [PMID: 29267603 PMCID: PMC6899403 DOI: 10.1590/1516-4446-2017-2235] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2017] [Accepted: 06/13/2017] [Indexed: 12/26/2022]
Abstract
Brazil has a sizable alcohol and substance use disorder (ASUD) population, yet there are considerable gaps in treatment access and retention. ASUD, a chronic medical condition, is highly comorbid with medical and behavioral health disorders. This indicates a need for more targeted interventions in order to achieve health care integration (a major goal of Brazil's health care system). Care management - that is, the organization of patient care by an institution - is a viable strategy to engage individuals with ASUD who might benefit from treatment but are not aware of or do not use the available resources, as well as to help maintain patients in treatment. Care management is considered an essential supplement to the treatment of chronic disease. The objective of this article is to discuss the applicability of care management for the treatment of ASUD within the public health care system in Brazil. We describe models of care management that have been adopted internationally and identify the feasibility and advantages for its adoption in Brazil.
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Affiliation(s)
- Ilana Pinsky
- The National Center on Addiction and Substance Abuse, New York, USA.,Departamento de Psiquiatria, Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil
| | - Camila Bernal
- The National Center on Addiction and Substance Abuse, New York, USA
| | - Lindsey Vuolo
- The National Center on Addiction and Substance Abuse, New York, USA
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13
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Waldman EA, Sato APS. Path of infectious diseases in Brazil in the last 50 years: an ongoing challenge. Rev Saude Publica 2016; 50:68. [PMID: 28099652 PMCID: PMC5152805 DOI: 10.1590/s1518-8787.2016050000232] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2016] [Accepted: 09/05/2016] [Indexed: 12/14/2022] Open
Abstract
In this article, we comment on the main features of infectious diseases in Brazil in the last 50 years, highlighting how much of this path Revista de Saúde Pública could portray. From 1967 to 2016, 1,335 articles focusing on infectious diseases were published in Revista de Saúde Pública. Although the proportion of articles on the topic have decreased from about 50.0% to 15.0%, its notability remained and reflected the growing complexity of the research required for its control. It is noteworthy that studies design and analysis strategies progressively became more sophisticated, following the great development of epidemiology in Brazil in the recent decades. Thus, the journal has followed the success of public health interventions that permitted to control or eliminate numerous infectious diseases - which were responsible, in the past, for high rates of morbidity and mortality -, and also followed the reemergence of diseases already controlled and the emergence of until then unknown diseases, with a strong impact on the Brazilian population, establishing a little predictable and very challenging path. RESUMO Neste artigo, comentamos as principais características das doenças infecciosas no Brasil, nos últimos 50 anos, destacando o quanto a Revista de Saúde Pública conseguiu capturar essa trajetória. De 1967 a 2016, foram publicados 1.335 artigos na Revista de Saúde Pública com foco em doenças infecciosas. Ainda que a proporção de artigos sobre esse tema tenha declinado de cerca de 50,0% para 15,0%, seu destaque se manteve e refletiu a crescente complexidade das pesquisas necessárias para o seu controle. Nota-se que os desenhos dos estudos e as estratégias de análise ganharam progressivamente maior sofisticação, acompanhando o grande desenvolvimento da epidemiologia no Brasil, nas últimas décadas. Assim, foi registrado não apenas o sucesso de intervenções de saúde pública que permitiram o controle ou a eliminação de inúmeras doenças infecciosas responsáveis, no passado, por elevadas taxas de morbimortalidade, como também a reemergência de males já controlados e o surgimento de doenças até então desconhecidas, com forte impacto na população brasileira, desenhando uma trajetória pouco previsível e muito desafiadora.
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Affiliation(s)
- Eliseu Alves Waldman
- Departamento de Epidemiologia. Faculdade de Saúde Pública. Universidade de São Paulo. São Paulo, SP, Brasil
| | - Ana Paula Sayuri Sato
- Departamento de Epidemiologia. Faculdade de Saúde Pública. Universidade de São Paulo. São Paulo, SP, Brasil
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Kami MTM, Larocca LM, Chaves MMN, Piosiadlo LCM, Albuquerque GS. Tool and ideological knowledge in Street Outreach Office working process. Rev Esc Enferm USP 2016; 50:442-9. [PMID: 27556715 DOI: 10.1590/s0080-623420160000400010] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVE To identify ideological knowledge and tool knowledgethat provide support to the Street Outreach Office working process. METHOD Qualitative and exploratory research. TwentyStreet Outreach Office professionals and six users collected the data, applying different semi-structured interview schedules for each category of participants. The resulting categories were analyzed in light of tool and ideological knowledge presented in the working process. RESULTS From the participant discourses the following ideological knowledge emerged: public policies and the needs of the person ina street situation and tool knowledge, as well as devices and tools for the care of people in street situations and a weekly schedule. CONCLUSION The focus on the working process discourse, supported by ideological knowledge, was verified. The structural dimension of the objective reality of the population in street situations was perceptible in the social determination of being situating on the street. When daily situations were revealed, the limitations to be overcome in the working process context were noticed. OBJETIVO Identificar os saberes ideológicos e instrumentais que subsidiam o processo de trabalho do Consultório na Rua. MÉTODO Pesquisa qualitativa e exploratória. A coleta de dados foi realizada junto a 20 profissionais e seis usuários do Consultório na Rua de um município do sul do Brasil, por meio de entrevistas com roteiros semiestruturados distintos para cada categoria de participantes. As classes resultantes foram analisadas à luz dos saberes ideológicos e instrumentais presentes no processo de trabalho. RESULTADOS Dos discursos dos participantes emergiram os saberes ideológicos: políticas públicas e necessidades da pessoa em situação de rua e os saberes instrumentais: dispositivos e instrumentos no cuidado à pessoa em situação de rua e agenda semanal. CONCLUSÃO Constatou-se a centralidade dos discursos no processo de trabalho, sustentado pelos saberes ideológicos. A dimensão estrutural da realidade objetiva da população em situação de rua foi perceptível na determinação social do situar-se na rua. Ao descortinar contradições no cotidiano, apontam-se limites a serem superados no âmbito do processo de trabalho.
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Berbesí D, Segura-Cardona Á, Caicedo B, Cardona-Arango D. Prevalencia y factores asociados al VIH en habitante de calle de la ciudad de Medellín Colombia. REVISTA FACULTAD NACIONAL DE SALUD PÚBLICA 2015. [DOI: 10.17533/udea.rfnsp.v33n2a07] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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Duarte MTC, Parada CMGDL, Souza LDRD. Vulnerability of women living with HIV/AIDS. Rev Lat Am Enfermagem 2015; 22:68-75. [PMID: 24553705 PMCID: PMC4292701 DOI: 10.1590/0104-1169.2837.2377] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2012] [Accepted: 09/23/2013] [Indexed: 12/04/2022] Open
Abstract
Objective outline the profile of women living with the human immunodeficiency
virus/aids in interior cities in São Paulo State, in the attempt to
identify characteristics related to individual, social and programmatic
vulnerability and to analyze the conditions in which they discovered their
serological status. Method between October 2008 and December 2010, a cross-sectional study was
undertaken with 184 women attended at a specialized service. The data were
collected through an interview and gynecological test, including the
collection of samples for the etiological diagnosis of sexually
transmissible conditions. Results the women were predominantly white, between 30 and 49 years of age, lived
with a partner, had a low education level, multiple sexual partners across
the lifetime and unsafe sexual practices. The prevalence of sexually
transmitted diseases corresponded to 87.0%. Conclusion the study suggests the need to offer gynecological care in specialized
services and the accomplishment of multiprofessional actions to reinforce
the female autonomy in protective decision making.
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Affiliation(s)
- Marli Teresinha Cassamassimo Duarte
- Universidade Estadual Paulista Júlio de Mesquita Filho, Faculdade de Medicina de Botucatu, Departamento de Enfermagem, BotucatuSP, Brazil, PhD, Assistant Professor, Departamento de Enfermagem, Faculdade de Medicina de Botucatu, Universidade Estadual Paulista Júlio de Mesquita Filho, Botucatu, SP, Brazil
| | - Cristina Maria Garcia de Lima Parada
- Universidade Estadual Paulista Júlio de Mesquita Filho, Faculdade de Medicina de Botucatu, Departamento de Enfermagem, BotucatuSP, Brazil, PhD, Adjunct Professor, Departamento de Enfermagem, Faculdade de Medicina de Botucatu, Universidade Estadual Paulista Júlio de Mesquita Filho, Botucatu, SP, Brazil
| | - Lenice do Rosário de Souza
- Universidade Estadual Paulista Júlio de Mesquita Filho, Faculdade de Medicina de Botucatu, Departamento de Doenças Tropicais e Diagnóstico por Imagem, BotucatuSP, Brazil, PhD, Adjunct Professor, Departamento de Doenças Tropicais e Diagnóstico por Imagem, Faculdade de Medicina de Botucatu, Universidade Estadual Paulista Júlio de Mesquita Filho, Botucatu, SP, Brazil
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Berbesi D, Segura A, Montoya L. Cross-sectional study of HIV prevalence and the characteristics of injecting drug users in Colombia. JOURNAL OF SUBSTANCE USE 2013. [DOI: 10.3109/14659891.2013.824037] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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