HIV and syphilis in the context of community vulnerability among indigenous people in the Brazilian Amazon

dc.contributor.authorBenzaken, Adele Schwartz
dc.contributor.authorSabidó, Meritxell
dc.contributor.authorBrito, Ivo
dc.contributor.authorBermúdez, Ximena Pamela Díaz
dc.contributor.authorBenzaken, Nina Schwartz
dc.contributor.authorGalbán, Enrique
dc.contributor.authorPeeling, Rosanna W
dc.contributor.authorMabey, David
dc.creator.affilliationDepartment of STI, AIDS and Viral Hepatitis, Secretary for Health Surveillance, Ministry of Health Brazil, Brasília, DF, Brazil / Tropical Medicine Foundation Doctor Heitor Vierira Dourado, Manaus, Brazil.en_US
dc.creator.affilliationDepartment of STI, AIDS and Viral Hepatitis, Secretary for Health Surveillance, Ministry of Health Brazil, Brasília, DF, Brazil / Pan American Health Organization, Brasília, Brazil / TransLab. Department of Medical Sciences, Universitat de Girona, Catalonia, Spain / CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain.en_US
dc.creator.affilliationDepartment of STI, AIDS and Viral Hepatitis, Secretary for Health Surveillance, Ministry of Health Brazil, Brasília, DF, Brazil.en_US
dc.creator.affilliationDepartamento de Saúde Coletiva, Universidade de Brasília, Brasília, Brazil / Pan American Health Organization, Brasília, Brazil.en_US
dc.creator.affilliationUniversidade Nilton Lins, Manaus, Amazonas, Brazil.en_US
dc.creator.affilliationFacultad de Medicina Calixto García, La Habana, Cuba.en_US
dc.creator.affilliationDepartment of Clinical Research, London School of Hygiene and Tropical Medicine, London, UK.en_US
dc.creator.affilliationDepartment of Clinical Research, London School of Hygiene and Tropical Medicine, London, UK.en_US
dc.date.accessioned2019-09-16T17:59:19Z
dc.date.available2019-09-16T17:59:19Z
dc.date.issued2017
dc.description.abstractenBackground Contextual factors shape the risk of acquiring human immunodeficiency virus (HIV) and syphilis. We estimated the prevalence of both infections among indigenous people in nine indigenous health districts of the Brazilian Amazon and examined the context of community vulnerability to acquiring these infections. Methods We trained 509 health care workers to screen sexually active populations in the community for syphilis and HIV using rapid testing (RT). We then assessed the prevalence of HIV and syphilis using RT. A multivariable analysis was used to identify factors associated with syphilis infection (sociodemographic, condom use, intrusion, population mobility, and violence). Results Of the 45,967 indigenous people tested, the mean age was 22.5 years (standard deviation: 9.2), and 56.5% were female. Overall, for HIV, the prevalence was 0.13% (57/43,221), and for syphilis, the prevalence was 1.82% (745/40,934). The prevalence in men, women, and pregnant women for HIV was 0.16%, 0.11%, and 0.07%, respectively, and for syphilis, it was 2.23%, 1.51%, and 1.52%, respectively. The district Vale do Javari had the highest prevalence of both infections (HIV: 3.38%, syphilis: 1.39%). This district also had the highest population mobility and intrusion and the lowest availability of prenatal services. Syphilis infection was independently associated with age (odds ratio [OR] 1.04, 95% confidence interval [CI]: 1.03–1.05), male sex (OR 1.32, 95% CI: 1.14–1.52), and mobility (moderate: OR: 7.46, 95% CI: 2.69–20.67; high: OR 7.09, 95% CI: 3.79–13.26). Conclusions The large-scale integration of RT in remote areas increased case detection among pregnant women, especially for syphilis, in districts with higher vulnerability. Mobility is an important risk factor, especially in districts with higher vulnerability. Contextually appropriate approaches that address this factor could contribute to the long-term success of HIV and syphilis control programs.en_US
dc.identifier.citationBENZAKEN, Adele Schwartz; SABIDó, Meritxell; BRITO, Ivo; BERMúDEZ, Ximena Pamela Díaz; BENZAKEN, Nina Schwartz; GALBáN, Enrique; PEELING, Rosanna W; MABEY, David. HIV and syphilis in the context of community vulnerability among indigenous people in the Brazilian Amazon. International Journal for Equity in Health, v. 16, n. , p. , 2017.en_US
dc.identifier.doi10.1186/s12939-017-0589-8
dc.identifier.issn1475-9276
dc.identifier.urihttps://repositorio.bvspovosindigenas.fiocruz.br/handle/bvs/1040
dc.language.isoeng
dc.publisherBiomed Centralen_US
dc.rightsopen accessen_US
dc.subject.otherAmazonasen_US
dc.subject.otherBrasilen_US
dc.subject.otherÍndios Sul-Americanosen_US
dc.subject.otherRoraimaen_US
dc.subject.otherSaúde de Populações Indígenasen_US
dc.subject.otherRegião Amazônicaen_US
dc.subject.otherEpidemiologiaen_US
dc.subject.otherSíndrome de Imunodeficiência Adquiridaen_US
dc.subject.otherDoenças Sexualmente Transmissíveisen_US
dc.subject.otherDistritos Sanitários Especiais Indígenasen_US
dc.subject.otherFatores de Riscoen_US
dc.subject.otherEstudos Epidemiológicosen_US
dc.subject.otherCondições Socioeconômicasen_US
dc.titleHIV and syphilis in the context of community vulnerability among indigenous people in the Brazilian Amazonen_US
dc.typeArticleen_US
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