RESUMO
RESUMO Apresenta-se um ensaio crítico-reflexivo sobre a ocorrência da Covid-19 em espaços periféricos do município do Rio de Janeiro, tendo como metodologia principal a análise documental dos três boletins socioepidemiológicos Covid-19 nas favelas, publicados no âmbito do Observatório Covid-19 da Fiocruz. Os resultados dos referidos boletins foram apresentados e problematizados a partir do referencial teórico da epidemiologia crítica e da determinação social do processo saúde-doença, discutindo a magnitude da doença nas favelas. Ademais, compreendeu-se que este debate visibiliza e fortalece a reflexão sobre os impactos sanitários e sociais da Covid-19 nas áreas de periferia de todo o País. Foram descritos o processo de trabalho para a elaboração dos boletins, os desafios metodológicos enfrentados para monitorar processos epidêmicos em espaços periféricos, e problematizados os principais resultados à luz das desigualdades históricas que ficaram ainda mais evidentes com a atual pandemia.
ABSTRACT This is a critical reflection essay on COVID-19 in suburban areas in Rio de Janeiro through documental analysis of the three socio-epidemiological bulletins COVID-19 in the favelas, published in FIOCRUZ COVID-19 Observatory. The results of these bulletins were presented and discussed grounded on critical epidemiology and the social determination of the health-disease process, discussing the magnitude of the disease in the favelas. Furthermore, we understood that this debate elicits and strengthens the discussion about the health and social impacts of COVID-19 in the Brazilian suburbs. We described the work process to prepare the bulletins and the methodological challenges of monitoring diseases in the suburbs. Lastly, the main results were analyzed and discussed, considering the historical inequalities that became more evident with the current pandemic.
RESUMO
ABSTRACT Brazil is characterized by a concentrated AIDS epidemic, it has a prevalence of less than 1% in the general population. However, there are higher rates in specific populations, especially in men who have sex with men. The study's aim was to analyze the association between sociodemographic characteristics, sexual practices, sexual behaviors and the HIV infection in a group of men who have sex with men. Secondary data was collected between June 2014 and September 2015 in a research of cross-sectional design in the city of Rio de Janeiro, Brazil. Volunteers answered an online computerized questionnaire and took HIV test. Chi-squared distribution and multiple logistic regression was used. There were 341 participants. Most of them were racially mixed, single, average age of 30.6 years and with a higher education level. The HIV prevalence was 13.9%. Two logistic models were fit (insertive or receptive anal intercourse). Both models showed an association with HIV among those who had a HIV positive sexual partner (Odds Ratio ≈ 2.5) and a high self-perception of acquiring HIV (Model 1: Odds Ratio ≈ 7/Model 2: Odds Ratio ≈ 10). Low condom usage in receptive anal intercourse with casual partners had a direct association with HIV seropositivity, whereas insertive anal intercourse with casual partners with or without condoms were inversely related. The study identified a high prevalence of HIV infections among a group of men who sex with men with a high self-perception risk of acquiring HIV. The findings also showed a relation with sociodemographic and sexual behavior variables.