Migration process of Venezuelan women to Brazil: living conditions and use of health services in Manaus and Boa Vista, 2018-2021.

BACKGROUND: The last decade saw the emergence of a new significant migration corridor due to the mass migration of Venezuelans to neighboring countries in South America. Since 2018, Brazil became the third host country of Venezuelan displaced populations. Little is known about how migratory processes affect needs, access to social programs, and public health services of migrant women. The goal of this study is to shed light on the socio-economic profile, living conditions, and use of health services of Venezuelan migrant women in two main reception cities in Brazil. METHODS: A survey was conducted using respondent-driven sampling (RDS) in the cities of Boa Vista (Roraima), and Manaus (Amazonas). The study included 2012 Venezuelan migrant women aged between 15 and 49 years old who migrated from Venezuela to Brazil between 2018 and 2021. Relative prevalence was calculated, and the χ2 test was used to analyse the homogeneity of proportions. All analyses considered the complex sampling. RESULTS: The main reasons for migrating relate to difficulties obtaining food (54%) and accessing health services (37.8%) in their country of origin. They were young and mixed race (65.7%) and had high school education (69.9%). In Manaus, 3.7% of the interviewees declared that they had no family income in the last month, while in Boa Vista, it was higher (66.2%) (p-value < 0.001). Almost one-third of them sought health care in the last 15 days, and 95% of them received care. The residents of Boa Vista arrived more recently and family income and access to paid work improved with time of residence in Brazil. CONCLUSIONS: Given the increasing flow of Venezuelan migrants crossing to Brazil, a reception system was established for the provision of food, shelter, access to health services, and income transfer programs to migrants. This was the case despite high unemployment and poverty levels and income inequality, particularly in the city of Boa Vista. However, the majority had legal migrant status and had access to the public and universal healthcare system in Brazil (SUS). The use of the SUS was similar in both cities, acting as a buffer for the differences in opportunities offered.

Bodies of desire: use of nonprescribed hormones among transgender women and travestis in five Brazilian capitals (2019-2021).

OBJECTIVE: To analyze the experiences of transgender women and travestis regarding the use of hormones for body changes without a medical prescription. METHODS: This is a cross-sectional, quantitative and qualitative study, using data from "TransOdara", which estimated the prevalence of Sexually Transmitted Infections in transgender women and travestis recruited through Respondent-Driven Sampling, between December 2019 and July 2021, in São Paulo, Campo Grande, Manaus, Porto Alegre, and Salvador, Brazil. The main outcome was: use of hormones without medical prescription and associated risk factors. Descriptive analysis, mixed univariate logistic regression models, and semi-structured interviews were carried out. RESULTS: Of the 1,317 recruited participants, 85.9% had already used hormones. The current use of hormones was reported by 40.7% (536) of them. Of those who were able to inform the place where they obtained them, 72.6% (381/525) used them without a medical prescription. The variables associated with the outcome were: current full-time sex work (OR 4.59; 95%CI 1.90-11.06) or in the past (OR 1.92; 95%CI 1.10-3.34), not having changed their name (OR 3.59; 95%CI 2.23-5.76), not currently studying (OR 1.83; 95%CI 1.07-3.13), being younger (OR 2.16; 95%CI 1.31-3.56), and having suffered discrimination at some point in life for being a transgender women and travestis (OR 0.40; 95%CI 0.20-0.81). CONCLUSION: The use of nonprescribed hormones is high among transgender women and travestis, especially among those who are younger, did not study, have not changed their name, and with a history of sex work. This use is related to the urgency for gender transition, with excessive use and damage to health.

Hepatitis A, B and C prevalence among transgender women and travestis in five Brazilian capitals between 2019-2021.

OBJECTIVE: To estimate the prevalence and factors associated with hepatitis A, B, and C in transgender women and travestis's networks, in 5 regions of Brazil. METHODS: This cross-sectional study includedtransgender women and travestis in five Brazilian capitals (Campo Grande, Manaus, Porto Alegre, Salvador, and São Paulo), between December/2019 and July/2021. All samples were subjected to detection of serological markers of hepatitis virus A (HAV), B (HBV), and C (HCV) infections through rapid tests and chemiluminescent microparticle immunoassays. Positive samples in the screening tests were submitted to detect HBV DNA and HCV-RNA by real-time PCR and genotyped by Sanger sequencing. RESULTS: Analysis of 1,317 samples showed network prevalence rates of 69.1%, 25.1%, and 1.5% for HAV, HBV, and HCV exposure, respectively. A high susceptibility rate to HBV infection (35.7%) and low prevalence of vaccine response markers (40%) were also observed. Age greater than 26 years, self-declared black/brown skin color, having only primary education, history of incarceration, and use of a condom in the last sexual intercourse with a casual partner were associated with total anti-HAV. Exposure to HBV was associated with age greater than 26 years, self-declared black/brown, history of being a sex worker, and incarceration. Age > 37 years, history of sexual abuse, and frequent alcohol consumption were associated with hepatitis C infection. CONCLUSION: The highest prevalence of HAV in this population was found in the North and Northeast regions, and the prevalence found was higher than that in the general population, suggesting greater vulnerability. The prevalence of HCV infection in our study was similar to that observed in the general population.

Using satellite data to study the relationship between rainfall and diarrheal diseases in a Southwestern Amazon basin / O uso de dados de satélite para estudar a relação entre chuva e doenças diarreicas em uma bacia na Amazônia Sul-Ocidental

Abstract The North region is the second region in Brazil with the highest incidence rate of diarrheal diseases in children under 5 years old. The aim of this study was to investigate the relationship between rainfall and water level during the rainy season principally with the incidence rate of this disease in a southwestern Amazon basin. Rainfall estimates and the water level were correlated and both of them were correlated with the diarrheal incidence rate. For the Alto Acre region, 2 to 3 days’ time-lag is the best interval to observe the impact of the rainfall in the water level (R = 0.35). In the Lower Acre region this time-lag increased (4 days) with a reduction in the correlation value was found. The correlation between rainfall and diarrheal disease was better in the Lower Acre region (Acrelândia, R = 0.7) and rainfall upstream of the city. Between water level and diarrheal disease, the best results were found for the Brasiléia gauging station (Brasiléia, R = 0.3; Epitaciolândia, R = 0.5). This study’s results may support planning and financial resources allocation to prioritize actions for local Civil Defense and health care services before, during and after the rainy season.

Resumo A região Norte é a segunda no Brasil com a maior taxa de incidência de doenças diarreicas em crianças menores de 5 anos. O objetivo deste estudo foi investigar a relação entre chuva e nível do rio, principalmente durante a estação chuvosa, com a taxa de incidência da referida doença em uma bacia no sudoeste da Amazônia. Estimativas de chuva e nível do rio foram correlacionadas e ambos correlacionados com a taxa de incidência da diarreia. Para a região do Alto Acre, 2 a 3 dias de defasagem é o melhor intervalo para observar o impacto da chuva no nível do rio (R = 0.35). Na região do Baixo Acre essa defasagem aumentou (4 dias) com redução na correlação. A correlação entre chuva e doenças diarreicas foi melhor na região do Baixo Acre (Acrelândia, R = 0.7) e a chuva rio acima da cidade. Entre o nível do rio e as doenças diarreicas, os melhores resultados foram encontrados para a estação de Brasiléia (casos em Brasiléia, R = 0.3 e Epitaciolândia, R = 0.5). Os resultados deste estudo podem dar apoio ao planejamento e alocação de recursos financeiros para priorizar ações para Defesa Civil e serviços de saúde antes, durante e depois da estação chuvosa.