HIV and syphilis infections and associated factors among patients in treatment at a Specialist Alcohol, Tobacco, and Drugs Center in São Paulo’s “Cracolândia”

Abstract

Introduction: This study describes the epidemiological scenario of human immunodeficiency virus (HIV) and syphilis at the biggest specialist drug addiction center in Brazil. The great challenge is to find strategies to reduce the impact of inequality and discrimination and develop policies to protect individuals living with-or at risk of-infections. Methods: During the period from January 1 to May 31, 2016, a cross-sectional study was conducted on which all patients (N = 806) seeking inpatient treatment were enrolled. A structured diagnostic interview and rapid tests were conducted initially, and diagnoses were confirmed by tests conducted at a venereal disease research laboratory (VDRL). Results: HIV and syphilis rates were 5.86% and 21.9%, respectively. Women were nearly 2.5 times more likely to have syphilis. HIV infection was associated with unprotected sex (odds ratio [OR]: 3.27, p = 0.003, 95% confidence interval [95%CI]: 1.51-7.11), and suicidal ideation (OR: 6.63, p = 0.001, 95%CI: 3.37-14.0). Although only 1.86% reported injecting drugs at any point during their lifetimes, this variable was associated with both HIV and syphilis. Elevated rates of HIV and syphilis were observed in the context of this severe social vulnerability scenario. Conclusion: The risk factors identified as associated with HIV and syphilis should be taken into consideration for implementation of specific prevention strategies including early diagnosis and treatment of sexually transmitted infections (STI) to tackle the rapid spread of STIs in this population.

Social Interaction of Women Exposed to Hiv/Aids: A Representative Model

“…Despite this relationship, what this study discusses is conservative thinking, which largely attributes exposure to HIV to drug and alcohol users. For example, alcohol is part of the daily life of Brazilian women and, as well as HIV/AIDS, which seems to be "the other person's problem", the same seems to happen with the increased exposure resulting from the use of these substances [14][15] . The idea of lack of care and recklessness also appears in the dimension of direct contact with contaminated blood and needles, a form of contagion that is not very prevalent in Brazil, since less than 0.5% of the people report using them in Brazil 16 .…”

Comportamento Sexual De Pacientes Coinfectados Hiv/Sífilis Atendidos Em Centro De Referência No Norte Do Brasil

“…Em contrapartida, é necessário frisar que possuir parceiro fixo não é absolutamente um fator protetor, que garante a proteção contra essas patologias, haja vista que estudos apontam que o sexo sem uso de preservativos pode ser considerado como confiança entre casais (PANARRA et al, 2017), somado ao fato de muitos homens rejeitarem o uso de preservativos (ROSSETTO et al, 2019), possibilitando assim a infecção. A utilização prévia de drogas, apesar de no presente estudo não ter sido notório tal comportamento, é um fator importante a ser considerado, em especial, em jovens que visam aumentar o prazer sexual (THIENKRUA et al, 2016), visto que, além das drogas endovenosas serem uma via importante de transmissão, tais substâncias incapacitam comportamento sexual responsável (PIRES et al, 2020;RIBEIRO et al, 2020).…”

“…Além dos fatores supracitados, populações específicas demandam mais atenção, devido ao alto risco de infecção por sífilis ativa, além da contaminação do HIV, como pessoas trans, homens que fazem sexo com homens e profissionais do sexo (CHEN et al 2019;RIBEIRO et al, 2020), pois o sexo anal desprotegido pode gerar microlesões na mucosa local que facilitam a transmissão dos patógenos (THIENKRUA et al, 2016), ademais, a sífilis anal é de difícil diagnóstico, uma vez que as úlceras são indolores e imperceptíveis, tornando mais provável a progressão para estágios secundários e terciários (HERNANDEZ et al, 2017). Outrossim, altas taxas de sífilis ativas entre mulheres são preocupantes porque os filhos de mulheres com sífilis possuem risco maior de sífilis congênita, além da correlação com a alta prevalência de HIV, aumentando as chances de transmissão do vírus para os filhos (SOLOMON et al, 2020), no presente estudo certas mulheres estavam grávidas e outas não souberam informar, representando um risco no desenvolvimento dessas crianças.…”

Sociodemographic and clinical profile of crack cocaine treatment-seeking individuals living in “Crackland”, Brazil

“…When compared to the general population, individuals who use crack are more likely to be unemployed, homeless, involved in illegal activities such as drug trafficking, and have a history of incarceration 2,5,10,11 . Crack use is also associated with early school drop-out, exposure to violence, prostitution, risky sexual behaviors, and high rates of sexually transmitted diseases such as HIV, hepatitis, and syphilis [11][12][13] . Consequently, mortality among crack users is 12 times higher than in the general population 14 .…”