Symptomatic Sexually Transmitted Infections in Brazil's Emerging Rural Populations.

We used a cross-sectional study in 2011 to estimate prevalence and risk behaviors for self-reported symptomatic sexually transmitted infections (STI) in rural settlers in Midwestern Brazil. There were 353 individuals recruited who had been living in the settlement for more than 6 months. The endpoint variable was having reported vaginal discharge, urethral discharge, genital ulcers, or anogenital warts in the previous 12 months. Univariate and multivariate Poisson regressions were performed to identify STI correlates. A prevalence of 22.4% of self-reported symptomatic STI was found. Being female, homosexual, and/or having lived in camps were associated with self-report of STI (p < .05). The high prevalence of self-reported symptomatic STI among settlers suggested that this was a key population in the epidemiology of STI in rural regions and demands the strengthening of health promotion actions in this vulnerable population, especially for women, homosexuals, and those who previously lived in camps.

Epidemiological and clinical profile of HIV-infected patients from Southwestern Goias State, Brazil.

Knowledge about epidemiological distribution patterns of HIV infection in different geographic regions is relevant to understand the dynamics of the disease in Brazil. This study aims to characterize the epidemiological and clinical profile of HIV-infected patients from Southwestern Goias State, from 2005 to 2015. A standardized questionnaire was used to collect clinical-epidemiological, virological, and immunological data from the medical records of all HIV-infected patients (n=539) who were followed at the regional reference center of Jatai, Goias State, Brazil, from 2005 to 2015. We detected the prevalence of male patients and the heterosexual route of transmission, as well as an expressive number of young women infected with HIV. The HIV infection was more prevalent in reproductive ages (55.3%). Most patients presented clinical manifestations related to HIV infection at the time of diagnosis. Twenty-four patients presented coinfection with hepatitis C virus, syphilis, hepatitis B virus, leprosy or Chagas disease. Pneumonia caused by Pneumocystis jirovecii was the most common opportunistic infection, followed by neurotoxoplasmosis, tuberculosis, and neurocryptococcosis. Combined antiretroviral therapy improved CD4+ T-cell counts: the mean CD4+ T-cell counts after treatment was twice as high as those found at the first medical appointment; and highly active antiretroviral therapy promoted viral suppression in a significant number of patients. Considering the increasing distribution of HIV infection to the interior of Brazil, this descriptive study outlines the clinical-epidemiological characteristics of HIV infection in Southwestern Goias and contributes to develop local prevention strategies and public service plans.

Vulnerability to sexually transmitted infections in women who sell sex on the route of prostitution and sex tourism in central Brazil.

OBJECTIVE: to investigate knowledge on sexually transmitted diseases (STDs), STD-related risk behaviors, and signs/symptoms of STDs among female sex workers (FSWs). METHODS: a cross-sectional study was conducted with a probabilistic sample comprising 395 women recruited using a respondent-driven sampling method between 2009 and 2010. The data were collected during face-to-face interviews. RESULTS: most of the participants were young adults, had a low educational level, and had poor knowledge on the transmission paths of the human immunodeficiency virus (HIV). Over one-third of the participants were not able to describe the signs/symptoms of STDs. The prevalence rates of vaginal discharge and wounds/ulcers were 49.0% and 8.6%, respectively, but 41.7% of the women had not sought treatment. CONCLUSION: the results indicate the need for public health policies focusing on the control and prevention of STDs in this population, especially for the FSWs who are active in an important prostitution and sex tourism route in central Brazil.

Vulnerability to Sexually Transmitted Infections in women who sell sex on the route of prostitution and sex tourism in Central Brazil / Vulnerabilidade às Doenças Sexualmente Transmissíveis em mulheres que comercializam sexo em rota de prostituição e turismo sexual na Região Central do Brasil / La vulnerabilidad a las enfermedades de transmisión sexual en mujeres que venden sexo en ruta de prostitución y turismo sexual en Brasil Central

OBJECTIVE: to investigate knowledge on sexually transmitted diseases (STDs), STD-related risk behaviors, and signs/symptoms of STDs among female sex workers (FSWs). METHODS: a cross-sectional study was conducted with a probabilistic sample comprising 395 women recruited using a respondent-driven sampling method between 2009 and 2010. The data were collected during face-to-face interviews. RESULTS: most of the participants were young adults, had a low educational level, and had poor knowledge on the transmission paths of the human immunodeficiency virus (HIV). Over one-third of the participants were not able to describe the signs/symptoms of STDs. The prevalence rates of vaginal discharge and wounds/ulcers were 49.0% and 8.6%, respectively, but 41.7% of the women had not sought treatment. CONCLUSION: the results indicate the need for public health policies focusing on the control and prevention of STDs in this population, especially for the FSWs who are active in an important prostitution and sex tourism route in central Brazil. .

OBJETIVO: investigar o conhecimento, comportamentos de risco e sinais/sintomas de doenças sexualmente transmissíveis de mulheres profissionais do sexo. MÉTODO: estudo de coorte transversal, de uma amostra probabilística de 395 mulheres, recrutadas pelo método Respondent Driven Sampling, de 2009 a 2010. Os dados foram obtidos por meio de entrevista face a face. RESULTADOS: a maioria era de mulheres adultas jovens, com baixa escolaridade e conhecimento insuficiente sobre formas de transmissão do vírus da imunodeficiência humana. Mais de um terço das mulheres não soube informar os sinais/sintomas das doenças sexualmente transmissíveis. A prevalência de corrimento vaginal e ferida/úlcera foi de 49,0 e 8,6%, respectivamente, sendo que 41,7% dessas não procuraram tratamento. CONCLUSÃO: os resultados evidenciam a necessidade de políticas públicas de saúde voltadas para o controle e prevenção das doenças sexualmente transmissíveis nessa população, especialmente, em mulheres que comercializam sexo em importante rota de prostituição e turismo sexual do Brasil Central. .

OBJETIVO: investigar el conocimiento, conductas de riesgo y signos/síntomas de enfermedades de transmisión sexual de mujeres profesionales del sexo. MÉTODO: estudio transversal con una muestra probabilística compuesta por 395 mujeres reclutadas mediante el método Respondent Driven Sampling entre el 2009 y 2010. Los datos fueron recolectados en entrevistas personales. RESULTADOS: la mayoría de las participantes eran jóvenes adultas, con bajo nivel de educación y poco conocimiento acerca de las formas de transmisión del virus de la inmunodeficiencia humana (VIH). Más de un tercio de las participantes no pudo identificar cuáles son los signos/síntomas de las enfermedades de trasmisión sexual. La prevalencia de flujo vaginal y heridas/úlceras genitales fue del 49,0% y 8,6%, respectivamente, siendo que un 47,7% no solicitó tratamiento. CONCLUSIÓN: los resultados indican la necesidad de políticas públicas de salud dirigidas al control y prevención de enfermedades de trasmisión sexual en la población de profesionales del sexo, especialmente en el caso de las mujeres que actúan en una importante ruta de prostitución y turismo sexual en el centro de Brasil. .