Bio-behavioral survey of syphilis in homeless men in Central Brazil: a cross-sectional study

Abstract

The objective of this study was to investigate the prevalence and factors associated with syphilis in homeless men in Central Brazil. It is a cross-sectional study conducted with 481 individuals attending four therapeutic communities between October and December 2015. A structured interview was conducted to collect sociodemographic data and risk factors for syphilis. Rapid/point-of-care and VDRL tests were performed to determine exposure to syphilis and the presence of active syphilis, respectively. Poisson regression analysis was used to verify the risk factors associated with the outcomes investigated. Of the study participants, 10.2% were reactive to the rapid test, and 5.4% had active syphilis. At the multiple regression analysis, schooling (adjusted prevalence ratio - APR: 0.89; p = 0.005), history of genital ulcer (APR: 2.59; p = 0.002), STI history (APR: 1.97; p = 0.042), and sexual intercourse under drug effects (APR: 1.60; p = 0.022) were independent factors associated with lifetime syphilis. Also, history of genital ulcer (APR: 2.19; p = 0.019), STI history (APR: 1.74; p = 0.033) and number of sexual partners in the last year (APR: 1.02; p = 0.044) were associated with active syphilis. The prevalence of syphilis among homeless men was rather high, confirming the vulnerability of this group to this infection. These results emphasize the need for educational intervention, improvement of risk reduction programs, availability of diagnostic tests, especially the rapid test, and treatment.

Epidemiological profile of the homeless population assisted by voluntary initiative and the social impact on access to healthcare: an investigative study in Curitiba, Brazil

“…Something curious about the average duration in years of living on the streets was that in our study we found a predominance of less than a year (of individuals living in this condition), while studies from the central-west region reported an average time of 90 days [22,23,25], from the southern region, less than ive years [11] and from the northeast, 13 years [15]. We were unable to establish an adequate reason for such variability.…”

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Common mental disorders and resilience in homeless persons

“…In this study, length of homelessness ranged from three days to 31 years. In Goiânia-Goiás, a study with 150 homeless persons found that 60.7% people studied have been in this situation for less than six months, and 30.7% for more than six months (18) . A…”

Condições de risco à saúde: pessoas em situação de rua

“…Pesquisa realizada em Belo Horizonte/MG detectou influência de bebida alcoólica nos comportamentos de risco e afirmou da possibilidade que o álcool apresenta de reduzir a percepção de risco, potencializando comportamentos vulneráveis 14 , como o não uso de preservativo 15 que potencializa os casos de sífilis, além de múltiplos parceiros sexuais, sexo sob uso de drogas 16 .…”