Use este identificador para citar ou linkar para este item: http://ds.saudeindigena.icict.fiocruz.br/handle/bvs/1040
Título: HIV and syphilis in the context of community vulnerability among indigenous people in the Brazilian Amazon
Autor(es): Benzaken, Adele Schwartz
Sabidó, Meritxell
Brito, Ivo
Bermúdez, Ximena Pamela Díaz
Benzaken, Nina Schwartz
Galbán, Enrique
Peeling, Rosanna W
Mabey, David
Afiliação: Department of STI, AIDS and Viral Hepatitis, Secretary for Health Surveillance, Ministry of Health Brazil, Brasília, DF, Brazil / Tropical Medicine Foundation Doctor Heitor Vierira Dourado, Manaus, Brazil.
Department of STI, AIDS and Viral Hepatitis, Secretary for Health Surveillance, Ministry of Health Brazil, Brasília, DF, Brazil / Pan American Health Organization, Brasília, Brazil / TransLab. Department of Medical Sciences, Universitat de Girona, Catalonia, Spain / CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain.
Department of STI, AIDS and Viral Hepatitis, Secretary for Health Surveillance, Ministry of Health Brazil, Brasília, DF, Brazil.
Departamento de Saúde Coletiva, Universidade de Brasília, Brasília, Brazil / Pan American Health Organization, Brasília, Brazil.
Universidade Nilton Lins, Manaus, Amazonas, Brazil.
Facultad de Medicina Calixto García, La Habana, Cuba.
Department of Clinical Research, London School of Hygiene and Tropical Medicine, London, UK.
Department of Clinical Research, London School of Hygiene and Tropical Medicine, London, UK.
Resumo em inglês: Background Contextual factors shape the risk of acquiring human immunodeficiency virus (HIV) and syphilis. We estimated the prevalence of both infections among indigenous people in nine indigenous health districts of the Brazilian Amazon and examined the context of community vulnerability to acquiring these infections. Methods We trained 509 health care workers to screen sexually active populations in the community for syphilis and HIV using rapid testing (RT). We then assessed the prevalence of HIV and syphilis using RT. A multivariable analysis was used to identify factors associated with syphilis infection (sociodemographic, condom use, intrusion, population mobility, and violence). Results Of the 45,967 indigenous people tested, the mean age was 22.5 years (standard deviation: 9.2), and 56.5% were female. Overall, for HIV, the prevalence was 0.13% (57/43,221), and for syphilis, the prevalence was 1.82% (745/40,934). The prevalence in men, women, and pregnant women for HIV was 0.16%, 0.11%, and 0.07%, respectively, and for syphilis, it was 2.23%, 1.51%, and 1.52%, respectively. The district Vale do Javari had the highest prevalence of both infections (HIV: 3.38%, syphilis: 1.39%). This district also had the highest population mobility and intrusion and the lowest availability of prenatal services. Syphilis infection was independently associated with age (odds ratio [OR] 1.04, 95% confidence interval [CI]: 1.03–1.05), male sex (OR 1.32, 95% CI: 1.14–1.52), and mobility (moderate: OR: 7.46, 95% CI: 2.69–20.67; high: OR 7.09, 95% CI: 3.79–13.26). Conclusions The large-scale integration of RT in remote areas increased case detection among pregnant women, especially for syphilis, in districts with higher vulnerability. Mobility is an important risk factor, especially in districts with higher vulnerability. Contextually appropriate approaches that address this factor could contribute to the long-term success of HIV and syphilis control programs.
Palavras-chave: Amazonas
Brasil
Índios Sul-Americanos
Roraima
Saúde de Populações Indígenas
Região Amazônica
Epidemiologia
Síndrome de Imunodeficiência Adquirida
Doenças Sexualmente Transmissíveis
Distritos Sanitários Especiais Indígenas
Fatores de Risco
Estudos Epidemiológicos
Condições Socioeconômicas
Data do documento: 2017
Editor: Biomed Central
Referência: BENZAKEN, Adele Schwartz; SABIDó, Meritxell; BRITO, Ivo; BERMúDEZ, Ximena Pamela Díaz; BENZAKEN, Nina Schwartz; GALBáN, Enrique; PEELING, Rosanna W; MABEY, David. HIV and syphilis in the context of community vulnerability among indigenous people in the Brazilian Amazon. International Journal for Equity in Health, v. 16, n. , p. , 2017.
DOI: 10.1186/s12939-017-0589-8
ISSN: 1475-9276
Direito autoral: open access
Aparece nas coleções:EPI - Artigos de Periódicos

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