Objective: In this study we aim to characterize a sample of 85 pregnant crack addicts admitted for detoxification in a psychiatric inpatient unit. Method: Cross-sectional study. Sociodemographic, clinical, obstetric and lifestyle information were evaluated. Results: Age of onset for crack use varied from 11 to 35 years (median = 21). Approximately 25% of the patients smoked more than 20 crack rocks in a typical day of use (median = 10; min-max = 1-100). Tobacco (89.4%), alcohol (63.5%) and marijuana (51.8%) were the drugs other than crack most currently used. Robbery was reported by 32 patients (41.2%), imprisonment experience by 21 (24.7%), trade of sex for money/drugs by 38 (44.7%), home desertion by 33 (38.8%); 15.3% were positive for HIV, 5.9% for HCV, 1.2% for HBV and 8.2% for syphilis. After discharge from the psychiatric unit, only 25% of the sample followed the proposed treatment in the chemical dependency outpatient service. Conclusion: Greater risky behaviors for STD, as well as high rates of maternal HIV and Syphilis were found. Moreover, the high rates of concurrent use of other drugs and involvement in illegal activities contribute to show their chaotic lifestyles. Prevention and intervention programs need to be developed to address the multifactorial nature of this problem. RESUMOObjetivo: Caracterizar uma amostra de 85 gestantes dependentes de crack admitidas para desintoxicação numa unidade de internação psiquiátrica. Método: Foram avaliadas, de forma transversal, variáveis sociodemográficas, clínico-obstétricas e informações sobre o seu estilo de vida. Resultados: A idade de início de uso do crack variou dos 11 aos 35 anos (mediana = 21). Aproximadamente, 25% das pacientes fumavam mais de 20 pedras de crack em um dia típico de uso (mediana = 10; mín-máx = 1-100). Além do crack, as drogas mais utilizadas eram: tabaco (76; 89,4%), álcool (54; 63,5%) e maconha (44; 51,8%). Roubo foi relatado por 41,2% (32 pacientes), prisão por 24,7% (21), troca de sexo por dinheiro/drogas por 44,7% (38) e abandono do lar por 38,8% (33); 15,3% (13) tinham soropositividade para HIV, Recebido em 25/7/2011 Aprovado em
Introdução: O estudo descreve uma amostra de usuários de droga injetável (UDI) que buscam atendimento na cidade de Porto Alegre, a fim de conhecer melhor os métodos de exposição ao vírus HIV, gerando hipóteses para estudos futuros e diretrizes para programas preventivos. Métodos: Foram entrevistados 142 UDI, utilizando uma entrevista estruturada para levantamento de fatores de risco. Foram analisadas características demográficas e das relações sexuais, utilizando-se como desfechos de interesse o status sorológico e as características do uso de drogas, tais como freqüência e tipo de droga utilizada. Resultados: 97% dos indivíduos havia injetado cocaína (8,6 dias do mês, 9,3 vezes por dia) e usado álcool e maconha no mês prévio à entrevista; apenas 44 apresentavam testes HIV (54,5% soropositivos). Quase 90% haviam recebido aconselhamento para HIV, porém a mudança de condutas aconteceu somente numa parcela dos casos, sem informação adequada sobre limpeza de seringas; 53% dos indivíduos relataram compartilhamento de equipamento prévio à coleta de dados, utilizando 16,2 vezes a mesma seringa. Os entrevistados eram sexualmente ativos e predominantemente heterossexuais, com uma média de sete relações por mês; 44% não usou camisinha nas relações sexuais e 48% afirmou ter utilizado pelo menos álcool antes ou durante as relações. Conclusões: Os achados sugerem que o aconselhamento é importante para modificar hábitos dos UDI mas não contempla necessidades de usuários recreacionais. A limpeza de seringas é infreqüente, talvez produto da pouca informação sobre práticas de risco. Os UDI são sexualmente ativos, heterossexuais e na maioria têm poucos parceiros, o que pode justificar o baixo uso de preservativos nessa amostra. É possível que o uso freqüente de drogas antes ou durante as relações contribua para tal fato.
Objective: To analyze associations between attempted suicide and childhood trauma. Methods: A seven month comparative case-control study (28 subjects-patients with suicide attempt; 56 controls-patients without suicide attempt). The following instruments were used: Childhood Trauma Questionnaire (CTQ), Mini International Neuropsychiatric Interview (MINI), and Medical Outcomes Study (MOS). Results: The group with suicide attempt had significantly higher scores for some variables: emotional abuse (p < 0.001), physical abuse (p < 0.001), emotional neglect (p < 0.001), and physical neglect (p < 0.001). Conclusions: The results suggest that variables related to previous trauma may influence future suicide attempts. The adoption of preventive and therapeutic actions related to mistreatments during child development is a crucial factor in reduction of suicide risk.
The authors describe the preliminary data from a research project to assess risk behaviors for HIV transmission among drug abusers in the south of Brazil, with particular emphasis on IDUs. Two questionnaires developed by U.S. researchers (the risk for AIDS behavior inventory {RAB} and the risk behavior assessment [RBAJ] were translated and adapted to be used as assessment tools for the first 61 cases of the project. The preliminary findings are reported, as well as implications for the development of future interventions to deal with the spread of HIV in Brazil.
The authors describe the development of a preventive program focused on intravenous drug users at risk of HIV infection, using the Social Network Approach as the intervention model. The authors describe the project's steps in a large university hospital in southern Brazil, emphasizing the unique methods and techniques developed by the treatment staff. Problems encountered during the project development are discussed, aimed at identifying the reasons why the program only achieved partial success. The authors identify critical issues, such as the use of a new technique not previously tried in Brazil, difficulties in maintaining IV drug users in treatment, lack of infrastructure for walk-in treatment, and the challenge of motivating staff and patients to continue treatment. The authors conclude by listing suggestions aimed at facilitating the development of new projects based on the same conceptual model.
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