Increasing HIV prevalence rate among men who have sex with men: results of a comparison of two national surveys.

Our objective was to compare HIV prevalence between two national surveys among men who have sex with men in Brazil in 2009 and 2016. HIV prevalence was estimated stratifying by age and socioeconomic status. HIV prevalence increased from 11.9% [95% confidence interval (CI): 9.9-14.3], in 2009, to 19.1% (95% CI: 16.5 - 22.0), in 2016 [odds ratio (OR) = 1.8; 95% CI: 1.3-2.3] increasing 320% among Young MSM of low SES. Political leadership is needed to develop a scientifically sound and inclusive solution.

Differences in non-communicable diseases between women in prison and the general population in Brazil.

Women in prison have high risk for non-communicable diseases both in relation to men in prison and in relation to women in the general population. This study documented the health disparities related to diseases among women in prison and in the general female population in Brazil. Women in prisons (WP) < 30 years old had a prevalence of hypertension (PR = 4.5; 95% CI 3.4-6.1), cardiovascular disease (PR = 4.4; 95% CI 2.4-7.9) and asthma (PR = 3.0; 95% CI 2.3-3.8) higher than general female population in Brazil in the same age group. Women in prison > 50 years old also presented asthma prevalence (PR = 4.3; 95% CI 2.9-6.3) higher than the general female population in Brazil in the same age group. These women in prison, overwhelmingly young, could be mistaken for an elderly population in Brazil. Actively responding to early disease in these women can reduce overall health costs and improve health care for this population that may have limited access to health care outside of prison.

Reports from the frontline: health workers describe COVID-19 risks and fears in five cities in Brazil.

BACKGROUND: Health providers are under unprecedented pressures to perform in the COVID-19 health crisis and under unprecedented risks. We initiated a large mixed-method survey of health professionals in five large metropolitan areas in Brazil to document the risks and needs of health professionals. To initiate the study, we conducted formative research. METHODS: We conducted 77 open-ended semi-structured interviews online in a convenience sample of physicians, nurses, nurse technicians, and physiotherapists in Belem, Fortaleza, Porto Alegre, Recife, and São Paulo, Brazil. Design, data collection, and analysis were informed by Rapid Ethnographic Analysis (REA). RESULTS: Responses are organized into three themes that emerged in the interviews: the lack of preparation - both locally and nationally-for the pandemic and its effects on staffing and training; the overlap of personal, family, and professional risk and consequences; and inadequately addressed anxiety and suffering among health staff. CONCLUSIONS: Our respondents were unprepared for the epidemic, especially the institutional sequelae and psychological cost. These consequences were exacerbated by both lack of leadership and sweeping changes undercutting the Brazilian health system noted by almost all participants.

HIV testing inside Brazilian female prisons: results of a national survey.

This study aimed to identify the prevalence of women in prisons who have already had an HIV test inside prison and the factors associated with this test. A cross-sectional study was carried out with 1327 women in 15 prisons in 9 states in Brazil. Almost 60% (95% CI: 57.8-63.7) of women have already been tested for HIV in prison. The factors associated with this HIV test were age ≥41 years (OR = 1.9; 95% CI = 1.2-2.9), highest level of education (OR = 1.9; 95% CI = 1.3-2.8), having been arrested 3 or more times (OR = 1.9; 95% CI = 1.3-2.8), having received information about HIV/STI in the lifetime (OR = 1.4; 95% CI = 1.1-1.9) and perceived themselves to be at no risk for HIV infection (OR = 1.7; 95% CI = 1.2-2.5), black or mixed race (OR = 0.7; 95% CI = 0.5-0.9) and having a male sexual partner (OR = 0.6; 95% CI = 0.5-0.9). The routine HIV testing in prisons needs to be expanded to promote HIV prevention for a population with limited access to these services outside of prison.

Health of female prisoners in Brazil / Saúde de mulheres privadas de liberdade no Brasil

Abstract The majority of the women in prisons comes from the poorest strata of society with limited access to education, income and health services. This contributes to the fact that female prisoners have a higher burden of adverse health events than both male prisoners and women in general population We objectived to estimate the prevalence of different morbidities and risk factors among female prisoners in Brazil. A total of 1,327 women were recruited in this cross-sectional study. Data were collected using a using audio computer-assisted self-interviewing questionnaire, rapid antibody tests and physical examination. The higher prevalences was of syphilis, infection sexually disease, arterial hypertense, asthma, common mental disorders and severe physical violence. Regarding risk factors, 36.3% have good knowledge about HIV, 55.8% were smokers, 72.3% had ever used any illicit drug, 92.1% are sedentary and 92.1% maintained an unhealthy diet. Female prisoners are disproportionately affected by various adverse health conditions. There is a need for an effective surveillance system inside prisons for early diagnosis and treatment.

Resumo A maioria das mulheres nas prisões vem das camadas mais pobres da sociedade, com acesso limitado a educação, renda e serviços de saúde. Isso contribui para o fato de que presidiárias têm maior carga de eventos adversos à saúde do que presidiários do sexo masculino e mulheres da população em geral. Objetivamos estimar a prevalência de diferentes morbidades e fatores de risco entre presidiárias no Brasil. Um total de 1.327 mulheres foram recrutadas neste estudo transversal. Os dados foram coletados por meio de um questionário de autoentrevista com áudio assistido por computador, testes rápidos de anticorpos e exame físico. As maiores prevalências foram de sífilis, infecções sexualmente transmissíveis, hipertensão arterial, asma, transtornos mentais comuns e violência física grave. Em relação aos fatores de risco, 36,3% têm bom conhecimento sobre o HIV, 55,8% são fumantes, 72,3% já usaram alguma droga ilícita, 92,1% são sedentários e 92,1% mantêm alimentação não saudável. As presidiárias são desproporcionalmente afetadas por várias condições adversas de saúde. É necessário um sistema de vigilância eficaz dentro das prisões para o diagnóstico e tratamento precoce.

Leprosy among female prisoners in Brazil / Hanseníase entre mulheres privadas de liberdade no Brasil

Abstract To estimate the prevalence of leprosy among Brazilian female prisoners and identify factors associated with the disease. Cross-sectional study conducted between 2014 and 2015 in 15 Brazilian female prisons. The data of 1,327 women were collected using Audio Computer-Assisted Self-Interviewing and dermatological and neurological examination to identify suspicious lesions of leprosy. The average age was 33.4 years. Suspicion of leprosy was identified in 5.1% of women in prison, and lifetime self-reported prevalence was 7.5%. The variables that were associated with lifetime self-reported leprosy were: women in prison once being twice as likely to have leprosy; white women were 1.4 time more likely to have leprosy than non-white women; women who knew someone with leprosy was 1.9 time more likely to have leprosy; and women who shared a cell with 11 or more women were 2.5 times more likely to have leprosy than women who shared a cell with two or fewer people. The leprosy prevalence among female prisoners in Brazil were greater than that found in a Brazilian woman of the general population and show the extremely high vulnerability of this population generated through pre-incarceration poverty, as well as potential transmission in prison.

Resumo Objetivou-se estimar a prevalência de hanseníase entre presidiárias brasileiras e identificar fatores associados à doença. Estudo transversal realizado entre 2014 e 2015 em 15 presídios femininos brasileiros. Os dados de 1.327 mulheres foram coletados por meio de autoentrevista assistida por computador e exame dermatológico e neurológico para identificar lesões suspeitas de hanseníase. A idade média foi de 33,4 anos. A suspeita de hanseníase foi identificada em 5,1% das mulheres na prisão, e a prevalência autorreferida ao longo da vida foi de 7,5%. As variáveis que se associaram à hanseníase autorrelatada ao longo da vida foram: mulheres presas uma vez com duas vezes mais chance de ter hanseníase; mulheres brancas tinham 1,4 vez mais chance de ter hanseníase do que mulheres não brancas; mulheres que conheciam alguém com hanseníase tinham 1,9 vez mais chance de ter hanseníase; e mulheres que compartilhavam uma cela com 11 ou mais mulheres tinham 2,5 vezes mais chance de ter hanseníase do que mulheres que compartilhavam uma cela com duas ou menos pessoas. A prevalencia de hanseníase entre presidiárias no Brasil foi maior do que a encontrada entre mulheres da população geral e evidencia a vulnerabilidade dessa população gerada pela pobreza pré-reclusão, bem como o potencial de transmissão na prisão.

Leprosy among female prisoners in Brazil.

To estimate the prevalence of leprosy among Brazilian female prisoners and identify factors associated with the disease. Cross-sectional study conducted between 2014 and 2015 in 15 Brazilian female prisons. The data of 1,327 women were collected using Audio Computer-Assisted Self-Interviewing and dermatological and neurological examination to identify suspicious lesions of leprosy. The average age was 33.4 years. Suspicion of leprosy was identified in 5.1% of women in prison, and lifetime self-reported prevalence was 7.5%. The variables that were associated with lifetime self-reported leprosy were: women in prison once being twice as likely to have leprosy; white women were 1.4 time more likely to have leprosy than non-white women; women who knew someone with leprosy was 1.9 time more likely to have leprosy; and women who shared a cell with 11 or more women were 2.5 times more likely to have leprosy than women who shared a cell with two or fewer people. The leprosy prevalence among female prisoners in Brazil were greater than that found in a Brazilian woman of the general population and show the extremely high vulnerability of this population generated through pre-incarceration poverty, as well as potential transmission in prison.

Health of female prisoners in Brazil.

The majority of the women in prisons comes from the poorest strata of society with limited access to education, income and health services. This contributes to the fact that female prisoners have a higher burden of adverse health events than both male prisoners and women in general population We objectived to estimate the prevalence of different morbidities and risk factors among female prisoners in Brazil. A total of 1,327 women were recruited in this cross-sectional study. Data were collected using a using audio computer-assisted self-interviewing questionnaire, rapid antibody tests and physical examination. The higher prevalences was of syphilis, infection sexually disease, arterial hypertense, asthma, common mental disorders and severe physical violence. Regarding risk factors, 36.3% have good knowledge about HIV, 55.8% were smokers, 72.3% had ever used any illicit drug, 92.1% are sedentary and 92.1% maintained an unhealthy diet. Female prisoners are disproportionately affected by various adverse health conditions. There is a need for an effective surveillance system inside prisons for early diagnosis and treatment.