Abstract
This study describes the epidemiological scenario of human immunodeficiency virus (HIV) and syphilis at the biggest specialist drug addiction center in Brazil. The great challenge is to find strategies to reduce the impact of inequality and discrimination and develop policies to protect individuals living with - or at risk of - infections. During the period from January 1 to May 31, 2016, a cross-sectional study was conducted on which all patients (N = 806) seeking inpatient treatment were enrolled. A structured diagnostic interview and rapid tests were conducted initially, and diagnoses were confirmed by tests conducted at a venereal disease research laboratory (VDRL). HIV and syphilis rates were 5.86% and 21.9%, respectively. Women were nearly 2.5 times more likely to have syphilis. HIV infection was associated with unprotected sex (odds ratio [OR]: 3.27, p = 0.003, 95% confidence interval [95%CI]: 1.51-7.11), and suicidal ideation (OR: 6.63, p = 0.001, 95%CI: 3.37-14.0). Although only 1.86% reported injecting drugs at any point during their lifetimes, this variable was associated with both HIV and syphilis. Elevated rates of HIV and syphilis were observed in the context of this severe social vulnerability scenario. The risk factors identified as associated with HIV and syphilis should be taken into consideration for implementation of specific prevention strategies including early diagnosis and treatment of sexually transmitted infections (STI) to tackle the rapid spread of STIs in this population.
Highlights
This study describes the epidemiological scenario of human immunodeficiency virus (HIV) and syphilis at the biggest specialist drug addiction center in Brazil
Measures and data The rapid sexually transmitted infections (STI)/BBV test data used in the analysis are based on results from the following immunochromatographic assays: (1) AlereTM anti-TP syphilis test, for qualitative detection of all Treponema pallidum antibody isotypes (IgG, IgM, IgA); (2) BioclinTM HIV Tri Line K087, for qualitative detection of total anti-HIV 1 antibodies (IgM, IgG, IgA, IgE), the O subtype and anti-HIV 2; (3) Alere® hepatitis C virus (HCV) test, for qualitative detection of immunoreactive antigens, such as those found in NS3, NS4 and NS5 regions of the HCV genome
Most subjects had interrupted their studies before reaching high school (69.8%, n = 563)
Summary
This study describes the epidemiological scenario of human immunodeficiency virus (HIV) and syphilis at the biggest specialist drug addiction center in Brazil. The great challenge is to find strategies to reduce the impact of inequality and discrimination and develop policies to protect individuals living with – or at risk of – infections. The burden of sexually transmitted infections (STIs) and crack cocaine use is higher in low and middleincome countries than in high-income ones and the great challenge is to find strategies to reduce the impact of inequality and discrimination and to develop policies to protect individuals living with or at risk of infections.[1,2,3,4]. 47% of all human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/ AIDS) cases in Latin America[5] are in Brazil, which is the country with the highest rate of crack cocaine use, affecting 0.8% of the total population.[6] no significant reductions in supply or demand for crack cocaine have occurred recently, HIV/AIDS prevention and treatment initiatives have reduced the incidence of Submitted Sep 23 2018, accepted for publication Apr 28 2019.
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