Objective: Learn the perceptions of patients with sexually transmitted infections and sexual partners who are notified of the infection. Method: A descriptive and qualitative study, based on the collective subject discourse technique, was conducted in four healthcare centers of reference in Fortaleza, Ceará, from March to July 2014. The sample comprised 21 subjects (11 index patients and 10 notified partners). Results: The index patients reported complicity, concern about the partner's health and revelation of diagnosis aiming to preserve the relationship. The partners showed antagonistic perceptions: tranquilitybetrayal, fear of death, of incurability and the diagnosis, especially of HIV. The reasons for coming to a healthcare center were: fear of being sick, attenuation of guilt of infection transmission, need for diagnosis, early start of treatment. Conclusion: Fear of losing trust, insecurities when dealing with a sexual infection and being responsible or coresponsible for the transmission were the predominant feelings. Various types of partner notification were reported (verbal, telephone, notification card), according to individual convenience. This study suggests the use of alternative methods of notification and an integrated system of notification.
Resumo Objetivou-se analisar os casos de doenças sexualmente transmissíveis (DST) atendidos em uma unidade primária de saúde em Fortaleza, Ceará, estudo retrospectivo que analisou 5.590 prontuários de casos de DST atendidos nos anos de 1999 a 2009. Os dados foram coletados de março a junho de 2010 e analisados pelo SPSS 18.0. Pessoas jovens com boa escolaridade e que tiveram múltiplos parceiros sexuais nos últimos três meses apresentaram mais úlcera e verruga. Encontrou-se associação entre apresentar verruga e ter resultado reagente para o HIV e apresentar úlcera e ter resultado reagente de VDRL. Quando analisados por sexo, as mulheres apresentaram mais úlcera, verruga, mais de uma síndrome genital no momento da consulta e aceitaram mais realizar os exames de VDRL e HIV. Já os homens tiveram mais resultado reagente para o HIV. Homens e mulheres com DST apresentaram especificidades comportamentais que os tornam mais vulneráveis ao HIV e sífilis.
BackgroundThe lack of information on the care for sexually transmitted infections (STI) associated syndromes may contribute for its non-inclusion as prevention and control strategy for STI in Brazil. This study aims to analyze the cases of STI – Associated Syndromes assisted in primary health care center in a city in Northeast Brazil associating them with socio-demographic and behavioral variables.MethodsThis is a retrospective study that analyzed 5148 consultation forms and medical records of patients assisted in a primary health care center who presented at least one genital syndrome from 1999 to 2008. Was considered as dependent variables the genital syndromes and serologies for syphilis and HIV and as independent variables the socio-demographic and behavioral aspects. It was used Pearson’s chi-square test to analyze the differences between the categorical variables, with a significance level of 5%. It was performed a multivariate analysis through the multivariate logistic regression model with the variables with p <0.05. We used odds ratio with a confidence interval of 95%.ResultsThe most frequent syndromes were vaginal discharge and/or cervicitis (44%) and genital wart (42.2%). Most people were between 20 and 39 years old (70%) and women (74.2%). Genital ulcer was most prevalent among men (OR = 2.67; CI 95% 1.99-3.58) and people who studied more than eight years (OR = 1.33; CI 95% 1.00-1.75) and wart prevailed among men (OR = 3.92; IC 95% 3.36-4.57), people under 29 years old (OR = 1.81; CI 95% 1.59-2.07) and who studied more than eight years (OR = 1.75; CI 95% 1.54-1.99). The Venereal Disease Research Laboratory (VDRL) was positive in 7.3% of men and in 7.1% of women and the Anti-HIV in 3.1% of men and 0.7% of women.ConclusionVaginal discharge was the most frequent syndrome assisted in primary health care, followed by genital wart. The high prevalence of genital wart justifies the greater effort for the proper follow-up of these cases. Men presented more genital wart and ulcer and reported having more sexual partners, showing their need for a greater access and inclusion in health activities developed in primary health care in Brazil.
Objective: to understand the difficulties and facilities of professionals to notify sexual partners with sexually transmitted infections. Methods: qualitative study carried out with 19 professionals from four referral services in sexually transmitted infections. A semistructured interview was conducted and the statements were analyzed through Content Analysis technique. Results: the difficulties identified were: diversity of types of sexual relationships, resistance of the index patient, emphasis on information transmission, ineffective verbal communication, insufficient time and absence of monitoring. The facilities were: respect for patient autonomy, counseling free of judgments, effective verbal communication, motivation and negotiation, written communication, confidential environment, partnership with the multiprofessional team, communication through card to evaluate effectiveness of notification. Conclusion: based on the competencies, communication was identified as a facilitator of empowerment of the index patient in the process of to reveal the infection to the contacts, and weaknesses emerged in the conduct of cases about the knowledge, planning, implementation, partnership and evaluation.
RESUMO Objetivo Comparar a efetividade da comunicação verbal e por cartão no comparecimento de parceiros sexuais de pessoas com infecções sexualmente transmissíveis com fatores associados ao seu êxito. Método Ensaio clínico, controlado, randomizado, cuja intervenção consistiu no oferecimento de um cartão de notificação para os pacientes-índices entregarem aos seus parceiros. Resultados A amostra foi de 189 pacientes-índices, 94 do grupo controle que convidaram verbalmente os parceiros sexuais para atendimento e 95 do grupo intervenção que levaram o cartão de notificação de parceiros como forma de convite para atendimento. Houve comparecimento de 52,6% dos parceiros convidados por cartão, e 43,6% dos convidados verbalmente, mas sem diferença estatística significativa (p=0,215). Os fatores associados ao não êxito no comparecimento de parceiros foram: não residir com o parceiro (p=0,0001), não ter parceiros fixos (p=0,0001), ter parceria casual (p=0,028) e usar preservativo com parceiro fixo (p=0,045). O tipo de infecção não influenciou a vinda do parceiro. Conclusão Face à ausência de maior efetividade na notificação por cartão, recomenda-se outro modelo de cartão contendo informações destinadas a parceiros para ser usado combinado a outros métodos. Registro Brasileiro de Ensaios Clínicos: RBR-7jp5mr.
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