Syphilis in female sex workers: an epidemiological study of the highway system of the state of Pará, northern Brazil

Abstract

Introduction: Female sex workers (FSWs) are considered a bridge for transmission of pathogens from high-risk to general populations. We assessed the epidemiological status of syphilis in FSWs along the Pará highway system. Methods: Two hundred and twenty-two FSWs were interviewed and samples were analyzed using rapid qualitative tests and real-time polymerase chain reaction. Results: The prevalence of syphilis was high (36.94%). The high rate of prostitution, use of illicit drugs, and search for financial resources increased Treponema pallidum transmission through unprotected sex. Conclusions: Several characteristics of FSWs were identified, which reinforce the need for measures guaranteeing their health and protection.

Hepatitis C Virus among Female Sex Workers: A Cross-Sectional Study Conducted along Rivers and Highways in the Amazon Region

“…It is a regional center of the local lumber industry and therefore an attractive place for intense sex trade [30]. Santa Maria do Pará is the meeting point of the two main highways in the state of Pará, with an intense circulation of products and people, which makes it a strategic place for sex trade [35]. Given this, most collection points were located in or near the towns of Breves and Santa Maria do Pará and were reached by car, ship, or boat.…”

“…Blood samples were collected by venipuncture using disposable syringes and tubes containing anticoagulant [30]. Personal data were collected in direct interviews using a standardized questionnaire that focused on the social, demographic, and economic characteristics of the participants, and their working conditions and health [30,35]. All blood samples obtained were stored and transported to laboratories in the cities of Bragança and Belém to perform laboratory procedures.…”

“…Low adherence to condom use, multiple sexual partners, unsafe sexual practices, illicit drug use, presence of genital ulcerative disease, and co-infection with other STIs increase the risk of HCV transmission [31][32][33][34]. In the state of Pará (Amazon region), a high prevalence of hepatitis B virus infections (13.7%) and Treponema pallidum (36.9%) were detected in FSWs; the consumption of illicit drugs, unprotected intercourse, exemption of condoms for regular clients or those paying an extra fee, and more than five years of sex trade were all shown to be risk factors for acquiring these pathogens [30,35]. Although best known for its extraordinary biological diversity and environmental importance to the world, the Amazon region is also an underdeveloped area, with high levels of poverty, limited transport infrastructure, and inadequate health services, thus allowing the spread of various pathogens and the occurrence of numerous infectious diseases [30,[35][36][37][38].…”

“…In the state of Pará (Amazon region), a high prevalence of hepatitis B virus infections (13.7%) and Treponema pallidum (36.9%) were detected in FSWs; the consumption of illicit drugs, unprotected intercourse, exemption of condoms for regular clients or those paying an extra fee, and more than five years of sex trade were all shown to be risk factors for acquiring these pathogens [30,35]. Although best known for its extraordinary biological diversity and environmental importance to the world, the Amazon region is also an underdeveloped area, with high levels of poverty, limited transport infrastructure, and inadequate health services, thus allowing the spread of various pathogens and the occurrence of numerous infectious diseases [30,[35][36][37][38]. Based on that, this study assessed FSWs in different locations in the Amazon region to estimate the prevalence of infections and factors associated with HCV exposure, as well as to determine the frequency of HCV genotypes and to assess the presence of RASs, aiming to provide consistent information for targeting control measures and prevention.…”

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

“…Although a few northern cities can eventually be included in national surveys, epidemiological information on STIs, especially syphilis, is still scarce in northern Brazil, which reflects the socioeconomic attention given to this region that is the poorest and less developed in the country. To date, the only epidemiological study focusing on syphilis in FSWs in this region pointed out a high prevalence of T. pallidum (37%) associated with the use of illicit drug and having sex without condom [10]. Thus, this study aimed to investigate the seroprevalence of syphilis and risk factors associated with syphilis acquisition among FSWs in three countryside cities of the state of Pará, Brazilian Amazon region.…”