The vulnerability of Brazilian female prisoners to HIV infection

Abstract

The purpose of the present study was to determine the vulnerability of women in prison to HIV infection. The study was carried out from August to October 2000 in a São Paulo State Penitentiary, where 299 female prisoners were serving time. We interviewed and obtained a blood sample from 290 females who agreed to enter the study. Sera were tested for the presence of antibodies to HIV, hepatitis C virus (HCV) and syphilis and the odds ratio (OR) was calculated for variables related to HIV positivity on the basis of a questionnaire. The overall prevalence data were: 13.9% for HIV (37 of 267), 22.8% for syphilis (66 of 290), and 16.2% for HCV (47 of 290). Sexual partnership variables were significantly related to HIV infection. These included HIV-positive partners (OR = 7.36, P = 0.0001), casual partners (OR = 8.96, P = 0.009), injectable drug user partners (OR = 4.7, P = 0.0001), and history of sexually transmitted disease (OR = 2.07, P = 0.05). In addition, a relationship was detected between HIV infection and drug use (OR = 2.48, P = 0.04) and injectable drug use (OR = 4.2, P = 0.002). Even women with only one partner presented a significant OR for HIV infection (OR = 2.57, P = 0.009), reflecting their vulnerability due to their trust in their partner, who did not use a condom. Although the use of injectable substances is associated with HIV infection, our results point to sexual behavior as the most important component of HIV transmission in the female prisoner population.

Increase in Tuberculosis Cases among Prisoners, Brazil, 2009–20141

“…A potential explanation is the higher rate of HIV-associated TB among female prisoners than among men (24.1% vs. 15.2%). We previously reported a higher prevalence of HIV among female prisoners in Brazil (10), as have others (11,12). HIV alone is unlikely to explain the large disparities in TB rates between male and female prisoners; more data are needed to explain the inverted sex disparities (compared with the general population) in TB patients in prisons in Brazil.…”

Prevalence of syphilis and HIV infection during pregnancy in incarcerated women and the incidence of congenital syphilis in births in prison in Brazil

“…The availability of the results of a national study with free women, carried out at practically the same time, using the same methodological procedures for data collection and identification of cases, allowed the comparison of the data of these two groups. The prevalence of HIV infection during pregnancy in incarcerated women estimated by this study (3.3%) was lower than findings reported by Miranda et al 14 (9.9%), Lopes et al 15 (14.5%), and Strazza et al 16 (13.9%), in studies carried out in Brazil in the early 2000s, but similar to results in more recent studies conducted by Berra et al 17 (3.6%) and Sgarbi et al 3 (1.9%). A reduction in the prevalence of HIV infection for incarcerated men has also been reported in recent studies 3,13 , although it remained higher than in free men.…”

“…Studies carried out in several countries, including Brazil, showed a high prevalence of HIV and syphilis infections in incarcerated men 3,5,10,11,12,13 and women 2,3,6,14,15,16,17,18,19,20,21 , reinforcing the importance of serological diagnosis in prisons for the implementation of available intervention. However, Brazilian studies have been carried out in isolated prison units.…”

HIV/AIDS in prison: state of the art of scientific productions

“…Even if the condemned has a single partner makes vulnerable to abandon the condom for the trust in the other. the use of drugs by invasive routes is also noted as a risk factor, however sexual behavior has featured as the main HIV transmission component in the female prison population [28].…”