Alarming patterns of moderate and high-risk alcohol use among transgender women in Goiás, Central Brazil.

Background: Scant studies have examined alcohol consumption among transgender women in Latin America. This cross-sectional study estimated the prevalence and associated factors of risky alcohol use among transgender women in Goiás, a state located in the center of Brazil. Methods: Participants were 440 transgender women (median age = 35 years, interquartile range = 9) recruited through respondent-driven sampling. All participants were interviewed about sociodemographic characteristics, violence, and risk behavior. Alcohol use was assessed using the alcohol use disorders identification test (AUDIT). An AUDIT score greater than or equal to eight was considered as risky alcohol consumption. Logistic regression analysis was used to examine predictors of risky alcohol use, and p-values <0.05 were considered significant. Results: The majority were young, single, sex workers. Most transgender women had used alcohol in the previous year (85.7%), and more than half (56.6%) reported binge drinking and risky alcohol consumption (60.2%). There was a high overlap between sexual behavior, drugs, and alcohol use. Using alcohol during sex (adjusted odds ratio [aOR]: 2.9; 95% confidence interval [CI]: 1.7-4.8), cocaine/crack use (aOR: 2.3; 95% CI: 1.5-3.7) and having a drug user as a sexual partner (aOR: 2.9; 95% CI: 1.5-5.9) were independently associated with risky alcohol consumption. Conclusion: Alcohol consumption was highly prevalent, and drugs seem to play an important role in risky alcohol consumption among transgender women Goiás. These findings support stakeholders to promote intervention strategies to reduce this pattern of alcohol consumption and reduce the burden of substance use disorders among transgender women.

Human T-lymphotropic virus 1/2 infection among immigrants and refugees in Central Brazil, an emerging vulnerable population.

Introduction: Migratory flows play a significant role in the spread of human T-lymphotropic virus 1/2 (HTLV-1/2). In the last decade, a substantial migration of individuals occurred from Haiti and Venezuela to Brazil. However, data on the prevalence of HTLV-1/2 infection among these international migrants in Brazil are scarce. This study describes the prevalence of this infection among immigrants and refugees in Central Brazil. Methods: A cross-sectional study was conducted with 537 international migrants in the State of Goiás, Central Brazil. Participants were interviewed, and blood samples were collected. Serological screening for anti-HTLV-1/2 was performed using an enzyme-linked immunosorbent assay (ELISA; Murex HTLV-I + II, DiaSorin, Dartford, UK), and seropositive samples were submitted for confirmation by a line immunoassay (INNO-LIA HTLV I/II, Fujirebio, Europe N.V., Belgium). Results: The majority of participants were males (54.4%), between 18 and 50 years old (78%; mean age: 29.1 years), self-declared black (55.1%), reported 1 to 12 years of formal education (70.9%), and were either Venezuelans (47.9%) or Haitians (39.7%). Additionally, 50.1% were immigrants, 49% were refugees, and five were Brazilian children (0.9%) born to Haitian immigrant parents. The overall prevalence of anti-HTLV-1/2 was 0.95% (95% CI: 0.31-2.28), with HTLV-1 at 0.19% and HTLV-2 at 0.76%. All seropositive individuals (n = 5) were refugees from Venezuela, resulting in a rate of 2.26% for anti-HTLV-1/2, HTLV-1 (0.45%) and HTLV-2 (1.81%) among Venezuelan refugees. Of the demographic and behavioral characteristics evaluated, unprotected sexual intercourse and having more than one sexual partner (≥2) in the previous 12 months were associated with HTLV-1/2 seropositivity among Venezuelans. Conclusion: This study revealed, despite the low seroprevalence of HTLV-1/2 among international migrants in Central Brazil, evidence of HTLV-1 and HTLV-2 infections in Venezuelan refugees. In addition, their characteristics highlight that specific social and health programs should be implemented for these emergent and socially vulnerable migrant groups.

Viral Hepatitis A, B and C in a Group of Transgender Women in Central Brazil.

Transgender women (TGW) have limited access to affordable viral hepatitis testing, hepatitis B vaccination, and treatment. We aimed to estimate the prevalence of viral hepatitis A, B, and C, as well as to compare the adherence and immunogenicity of two hepatitis B vaccine schedules among TGW in Central Brazil. A total of 440 TGW were interviewed and tested for hepatitis A, B, and C serological markers from 2017 to 2018. The hepatitis B vaccine was offered to 230 eligible TGW: 112 received a super accelerated hepatitis B vaccine schedule (G1) and 118 a standard schedule (G2). The antibody against the hepatitis A virus (HAV) was detected in 75.63% of the participants, and 12.3% of the TGW were exposed to the hepatitis B virus (HBV). Two (0.46%) participants were HBV carriers. Only 41.5% of the participants showed a serological profile of hepatitis B vaccination. The antibody against the hepatitis C virus (anti-HCV) was found in six participants (1.37%). Of the TGW who received the first vaccine dose, 62 (55.36%) and 49 (41.52%) in G1 and G2, respectively, received three doses (p = 0.036). The vaccine response was evaluated in 28 G1 and 22 G2 TGW; of these, 89.3% and 100% developed protective anti-hepatitis B surface-antigen titers, respectively (p = 0.113). Since one-third of younger transgender women are susceptible to HAV, hepatitis B immunization is low, and the anti-HCV rate is higher in this group than in the general population in Central Brazil, public-health attention is warranted. The super-accelerated scheme demonstrated better adhesion and good immunogenicity, suggesting that it would be a more cost-effective solution.

Travestis and transsexual women: who are at higher risk for sexually transmitted infections?

OBJECTIVE: To compare social characteristics, risk behaviors, and sexually transmitted infections among travestis and transsexual women. METHODOLOGY: A cross-sectional study was carried out in three cities in Goiás, Central Brazil. Trans women were interviewed on sociodemographic characteristics, discrimination, prejudice, sexual behavior, illicit drugs, and previous testing for HIV and syphilis between April 2018 and August 2019. RESULTS: A total of 166 travestis and 249 transsexual women were investigated. Although sexual, physical, and verbal violence were common to both groups, sexual behavior, use of illicit drugs, prison, and previous positive HIV and syphilis testing were more frequent among travestis than in transsexual women. CONCLUSION: The present findings confirm that Brazilian travestis are at greater risk for sexually transmitted infections (STI), indicating that health services should take this imbalance into account in terms of health intervention proportions.

Analysis of the trend of hospitalizations for asthma in children and adolescents in Brazil.

OBJECTIVE: To analyze the trend of hospitalizations for asthma in children and adolescents by region and age group in Brazil, from 2008 to 2017. METHOD: This is a time-series study with secondary data regarding hospitalizations for asthma in children and adolescents, according to age, region, and gender. Descriptive statistics procedures were used with measures of central tendency to calculate the variation between the periods of 2008 and 2017. Rates of hospitalizations were calculated specifically by age group and region. Time trend analysis was performed by simple linear regression, considered as stationary (p>0.05), declining (p<0.05 and negative regression coefficient), or ascending (p<0.05) and positive regression coefficient). RESULTS: The present study identified a higher proportion of hospitalizations for asthma in Brazil in children aged 5-9 years. Regarding gender, there were more hospitalizations in boys. The region that presented the highest proportion of hospitalizations, in all age groups investigated, was the Northeast. As for the trend analysis, this article showed that, in Brazil, there was a trend toward a reduction in hospitalization rates for asthma. CONCLUSION: In Brazil, there was a tendency to reduce hospitalizations for all investigated age groups. The Northeast was the only region that showed a decline in all age groups.

Travestis and transsexual women: who are at higher risk for sexually transmitted infections? / Travestis e mulheres transexuais: quem tem maior risco de infecções sexualmente transmissíveis?

ABSTRACT: Objective: To compare social characteristics, risk behaviors, and sexually transmitted infections among travestis and transsexual women. Methodology: A cross-sectional study was carried out in three cities in Goiás, Central Brazil. Trans women were interviewed on sociodemographic characteristics, discrimination, prejudice, sexual behavior, illicit drugs, and previous testing for HIV and syphilis between April 2018 and August 2019. Results: A total of 166 travestis and 249 transsexual women were investigated. Although sexual, physical, and verbal violence were common to both groups, sexual behavior, use of illicit drugs, prison, and previous positive HIV and syphilis testing were more frequent among travestis than in transsexual women. Conclusion: The present findings confirm that Brazilian travestis are at greater risk for sexually transmitted infections (STI), indicating that health services should take this imbalance into account in terms of health intervention proportions.

RESUMO: Objetivo: Comparar características sociais, comportamentos de risco e infecções sexualmente transmissíveis entre travestis e mulheres transexuais. Métodos: Estudo transversal conduzido em três cidades de Goiás, Brasil Central. De abril de 2018 a agosto de 2019, foram entrevistadas mulheres trans a respeito de características sociodemográficas, discriminação, preconceito, comportamentos sexuais, drogas ilícitas e testagem prévia para HIV e sífilis. Resultados: Um total de 166 travestis e 249 mulheres transexuais foram investigadas. Embora as violências sexual, física e verbal fossem comuns para ambos os grupos, comportamentos sexuais, uso de drogas ilícitas, prisão e teste positivo para HIV e sífilis foram mais frequentes entre as travestis quando comparadas às mulheres transexuais. Conclusão: Os presentes resultados ratificam que as travestis brasileiras apresentam maior risco para infecções sexualmente transmissíveis (IST); portanto, os gestores de saúde devem levar em conta esse desequilíbrio nas propostas de medidas de intervenção em saúde.