Factors associated with exposure to hepatitis B virus in female sex workers from the Marajó Archipelago, northern Brazil

Frade, Paula Cristina Rodrigues; Raiol, Nairis Costa; Costa, Luana Mota da; Pinheiro, Luiz Marcelo de Lima; Silva-Oliveira, Gláucia Caroline; Pinho, J R R; Lemos, José Alexandre Rodrigues de; Martins, Luisa Carí­cio; Filho, Aldemir Branco de Oliveira

doi:10.1177/0956462419868641

Cited by 4 publications

(6 citation statements)

References 5 publications

(14 reference statements)

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“…In this region, the Amazon rainforest occupies large areas of the northern Brazil, which causes relative isolation, resulting (or because of) limited infrastructure and public services and low human development [11]. This scenario has a negative impact on sexual behaviour, increasing risk-taking activities [12][13][14]. Additionally, gender empowerment is an issue on the population of such regions, which are still male-centred, and women are marginalized in a social context.…”

Section: Discussionmentioning

confidence: 99%

“…Sex work is usually a matter of need, not of choice. So, governments and other human organizations can help risk groups, such as FSWs, by creating ways to promote self-esteem, self-confidence, and stimulate awareness of social rights and benefits, considering their vulnerability that place them in a group of risk, and also alerting them how they can be a key player in disease spread/control [13,14]. As an example, a comprehensive health program was planned and implemented with FSW in southern China, resulting in several public health benefits, including in the prevention and control of syphilis [28].…”

Section: Discussionmentioning

confidence: 99%

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Prevalence of syphilis in female sex workers in three countryside cities of the state of Pará, Brazilian Amazon

et al. 2020

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Background: Syphilis is a sexually transmitted infection (STI) transmitted from person to person mainly by sexual intercourse or through vertical transmission during pregnancy. Female sex workers (FSWs) are exposed especially to syphilis infection, and besides all the efforts to control the spread of STIs, syphilis prevalence is still rising, mainly occurring in low-income countries. This study aimed to investigate the syphilis prevalence, demographic characteristics and sexual habits among FSWs in the Amazon region of Brazil. Methods: A cross-sectional study was carried out including 184 FSWs from 3 countryside cities of the state of Pará, Amazon region of Brazil. A venereal disease research laboratory test and an indirect immunoenzyme assay to test antibodies against Treponema pallidum were used for screening syphilis infection, while sexual habits and demographic data information were collected through a semi-structured questionnaire. Data was analyzed comparing groups with/without syphilis. Poisson regression models were used to estimate the reasons of prevalence (RP). Results: The overall prevalence of syphilis was 14.1% (95% CI = 9.8-17.8). FSWs had between 15 and 56 years of age, most were unmarried (65.7%), had attended less than 8 years of formal education (64.1%), had between 10 and 20 partners per week (64.1%), and reported no previous history of STIs (76.1%) and regular use of condom (52.7%). Low level of education attending up to the primary school (RP adjusted = 3.8; 95% CI = 1.4-9.2) and high frequency of anal sex during the past year (RP adjusted = 9.3; 95% CI = 3.5-28.7) were associated with a higher prevalence of syphilis. Conclusions: A high prevalence of syphilis among FSWs in the Brazilian Amazon region was identified, showing that syphilis is more likely to be transmitted in FSW working in low-income areas, which is attributed to the low level of education. Anal intercourse was found as a risk factor associated with syphilis. Health programs focused on risk populations appear as a rational way to control syphilis spread, which is a rising problem in Brazil and in other several countries.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Prevalence of syphilis in female sex workers in three countryside cities of the state of Pará, Brazilian Amazon

et al. 2020

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“…to 2016-2018, when the use of illicit drugs as a risky behavior was associated with the spread of HIV-1 and other infectious agents among FSWs in northern Brazil, such as hepatitis B virus (HBV), hepatitis C virus (HCV) and Treponema pallidum (Cavalcante et al, 2019;da Costa et al, 2019;Frade et al, 2019a;Oliveira-Filho et al, 2019a).…”

Section: Discussionmentioning

confidence: 99%

“…Female sex workers (FSWs) represent a key population for the acquisition of sexually transmitted infections (STIs) due to their social vulnerability and the risks associated with their occupation, including multiple sexual partners, inconsistent use of condoms, use of injecting and non-injecting drugs and coinfections with other STIs (World Health Organization [WHO], 2016;Cavalcante et al, 2019;da Costa et al, 2019;Frade et al, 2019a). The role of FSWs is of relevance as they usually spread infectious agents, including Human immunodeficiency virus 1 (HIV-1) and human T-cell lymphotropic virus (HTLV), from high-risk groups to the general population (Malta et al, 2010;Oliveira-Filho et al, 2019b.…”

Section: Introductionmentioning

confidence: 99%

Molecular Epidemiology of HIV-1 and HTLV-1/2 Among Female Sex Workers in Four Cities in the State of Para, Northern Brazil

et al. 2020

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Female sex workers (FSWs) represent a key population for the acquisition of sexually transmitted infections (STI) due to their social vulnerability and the risks associated with their occupation. This study was conducted to describe the sociodemographic characteristics and sexual behavior among FSWs in cities in northern Brazil, to determine the prevalence of human immunodeficiency virus 1 (HIV-1) and human T-cell lymphotropic virus (HTLV-1/2) infections and to identify the circulating subtypes of these agents in this key population. A cross-sectional study using the Time Location Sampling (TLS) method was conducted among 339 FSWs in cities in the state of Pará from 2005 to 2006. Serological and molecular tests were performed to identify infections and viral subtypes, and bivariate and multivariate analyses were conducted to identify risk factors. Most FSWs were young, single, less educated and had at least one child. The prevalence of antibodies against HIV-1 and HTLV-1 was 2.3 and 1.7%, respectively. HIV-1 subtypes B (87.5%) and F1 (12.5%) were identified among FSWs, as were Cosmopolitan subtype (1a) and Transcontinental subgroup (A). Unprotected sex and illicit drug use were associated with HIV-1 and HTLV-1 infections using bivariate and multivariate analyses, and age ≥27 years was associated only with HIV. The important information highlighted here clearly indicates that the lack of actions to control and prevent pathogens in FSWs and the lack of strategies for health promotion in key populations can further aggravate the epidemiological scenario of viral infections in remote areas with low human development indices. Neglecting these facts may be causing the spread of these two viruses and their respective subtypes in the general population of northern Brazil.

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“…Epidemiological investigations among high-risk groups (FSWs and PWUD) showed prevalence rates of HBV infection ranging from 3.0% to 13.7% among FSWs that offered their services in municipalities and riverside communities in the state of Pará [121,141]. The rate of vaccine immunity (anti-HBs only) ranged from 0.7% to 4.7% [141,142] and genotype A (69.0%) was the predominant one [143]. Reduced monthly income, low education, unprotected sex, multiple sexual partners, unsafe sexual practices, illicit drug use and co-infection with other STIs have been associated with exposure to HBV [141,143].…”

Section: Hbv: the Impact Of The Geographical Area On The Prevalence Of The Virus In The Brazilian Amazonmentioning

confidence: 99%

The Epidemiological Impact of STIs among General and Vulnerable Populations of the Amazon Region of Brazil: 30 years of Surveillance

Machado

Fonseca

Queiroz

et al. 2021

Viruses

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Sexually transmitted infections (STIs) represent a worldwide public health problem and, although many of them are curable, they continue to be neglected, especially in areas with a low human development index, such as in the northern region of Brazil. This review describes the results of 30 years of studies at the Virus Laboratory at the Federal University of Pará, including the prevalence and molecular epidemiology of HIV-1, HTLV-1/2, HPV, HBV, Treponema pallidum and Chlamydia trachomatis among urban and non-urban populations, and also in vulnerable groups in the Brazilian Amazon. Control strategies and challenges in preventing STIs are discussed considering this immense geographic region, where essential health services are unable to reach the entire population, especially the most vulnerable, such as female sex workers, people who use illicit drugs, remnants of quilombolos and indigenous communities.

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Factors associated with exposure to hepatitis B virus in female sex workers from the Marajó Archipelago, northern Brazil

Cited by 4 publications

References 5 publications

Prevalence of syphilis in female sex workers in three countryside cities of the state of Pará, Brazilian Amazon

Prevalence of syphilis in female sex workers in three countryside cities of the state of Pará, Brazilian Amazon

Molecular Epidemiology of HIV-1 and HTLV-1/2 Among Female Sex Workers in Four Cities in the State of Para, Northern Brazil

The Epidemiological Impact of STIs among General and Vulnerable Populations of the Amazon Region of Brazil: 30 years of Surveillance

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