Prevalence and Risk Factors for Human Immunodeficiency Virus Infection Among Female Sex Workers: Distinct Offers of Sexual Services in a Municipality of the Brazilian Amazon

Costa, Luana Mota da; Raiol, Nairis Costa; Lisboa, Brenda Luena Assis; Frade, Paula Cristina Rodrigues; Blandtt, Lucinaldo da Silva; Silva-Oliveira, Gláucia Caroline; Machado, Luiz Fernando Almeida; Martins, Luisa Carí­cio; Oliveira-Filho, Aldemir Branco

doi:10.1089/aid.2019.0032

Cited by 15 publications

(32 citation statements)

References 21 publications

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“…Studies have shown that anal intercourse carries one of the highest-risk of sexual activity for getting HIV. Our results suggest that anal intercourse not only increases the risk of HIV acquisition but also from T. pallidum, and the same infection mechanism can be applied to men who have sex with men and heterosexuals [14,23,24].…”

Section: Discussionmentioning

confidence: 74%

“…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%

“…Unfavourable socioeconomic conditions, and consequently low living standards, may favour initiation and involvement in sex work, causing a negative influence self-care and vulnerability to STIs, such as syphilis [15,18,19]. Recently, unprotected sex has been linked to as an advantage to get higher payment on sex work reported by FSWs, which was associated to high rates of HIV and HBV infections [12,14].…”

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: 74%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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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“…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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Seroprevalence of HBV and HCV in female sex workers from four cities in the state of Pará, northern Brazil

Miranda

Souza

Monteiro

et al. 2020

Journal of Medical Virology

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Female sex workers (FSWs) represent a high vulnerability group for the acquisition of sexual and parenteral infections such as hepatitis B virus (HBV) and hepatitis C virus (HCV) infections. The present study aimed to determine the prevalence of serological markers and risk factors associated with exposure to HBV and HCV among FSWs in the state of Pará, Brazil. A cross‐sectional study using principles of the time location sampling (TLS) method was conducted in four cities (Belém, Bragança, Barcarena, and Augusto Corrêa) of the state of Pará, from 2005 to 2006. In total, 365 FSWs were interviewed using a standardized questionnaire. Blood samples were collected and tested for serological markers of exposure to HBV and HCV using an enzyme immunoassay. The overall prevalence of exposure to HBV and HCV was 36.7% and 7.7%, respectively. The prevalence of surface antigen of HBV was 3.0%. The prevalence of anti‐HBc and anti‐HBc+ anti‐HBs antibodies were 6.3% and 27.4%. Very few (4.7%) FSWs had vaccine immunity against HBV (anti‐HBs antibodies only). The prevalence of anti‐HCV antibodies was 7.7%. Low monthly income, drug usage, and unprotected sex were some of the social characteristics associated with exposure to the viruses using different analysis. The seroprevalence of HBV and HCV infections among FSWs in four cities of the state of Pará is high when compared to the general population of Brazil, but similar to those found in FSWs in other nondeveloped countries. The prevalence of HBV was higher in Belém, while the prevalence of HCV was higher in the other three cities, highlighting the importance of establishing control and prevention programs to reduce the risk of acquiring these viruses in Pará.

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Prevalence and Risk Factors for Human Immunodeficiency Virus Infection Among Female Sex Workers: Distinct Offers of Sexual Services in a Municipality of the Brazilian Amazon

Cited by 15 publications

References 21 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

Seroprevalence of HBV and HCV in female sex workers from four cities in the state of Pará, northern Brazil

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