HIV/AIDS em usuários de crack institucionalizados em Goiânia, Goiás: perfil epidemiológico e subtipos virais
Autor(a) principal: | |
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Data de Publicação: | 2016 |
Tipo de documento: | Tese |
Idioma: | por |
Título da fonte: | Repositório Institucional da UFG |
Texto Completo: | http://repositorio.bc.ufg.br/tede/handle/tede/6564 |
Resumo: | Infection by human immunodeficiency virus (HIV) is a serious global public health problem. An estimated 78 million people have been infected. The burden of this infection is concentrated in high vulnerability groups, such as drug users. The objective of this study was to analyze the serological, epidemiological, and molecular profile of HIV infection in institutionalized crack users in Goiania, a large city in Central Brazil. This is an observational, analytical, cross-sectional study conducted among crack users in treatment in a mental health referral facilityin Midwestern Brazil. From August 2012 to April 2013, 600 crack users were recruited. All were interviewed and tested for HIV by enzyme-linked immunosorbent assay (ELISA). The samples that tested positive for anti-HIV1 were subjected to detection of HIV RNA by RT-PCR and genotyped by sequencing. Of the total enrolled participants: about half came from outside the city (50.3%), were predominantly male (84.5%), young (median: 30 years), had low education (8.4 years of school), were self-declared mixed race (61.5%), single (66.5%) and religious (74.3%). Nearly three-quarters were not formally employed, and 20.3% reported a history of life on the street in the last 180 days. Of the total, 2.8% (95% CI: 1.7 – 4.4%) were anti-HIV1 positive, ranging from 2.2% (95% CI 1.2 – 3.9) in men and 6.5% (95% CI 3.2 – 14.2) in women (p = 0.04). Logistic regression analysis revealed that history of sexual intercourse with a carrier of HIV (adjusted OR: 12.60; p = 0.001) and history of life on the street (adjusted OR: 4.43; p = 0.025) were predictors of HIV- 1. The variables: history of sexually transmitted infections (adjusted OR: 3.24; p = 0.057), not using a condom (adjusted OR: 2.84; p = 0.088) and consumption of more than 10 rocks/portions of crack daily (adjusted OR: 2.81; p = 0.085) were marginally associated with HIV infection. In 12 of 17 HIV-1 samples, subtype identification was possible with subtype B being detected in eight samples (66.7%), F1 and C in one sampleeach (8.3%), and recombinant BF in two samples (16.7%). These results highlight the need for effective strategies to prevent HIV infection in crack users, with an emphasis on health education, implementation of harm reduction measures and control of sexually transmitted diseases. |
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Teles, Sheila Araujohttp://lattes.cnpq.br/4975298732179917Teles , Sheila Araujohttp://lattes.cnpq.br/4975298732179917Martins, Regina Maria BringelCarneiro, Megmar Aparecida dos SantosMedeiros, MarceloSouza, Marcia Maria dehttp://lattes.cnpq.br/8409188374750691França, Divânia Dias da Silva2016-12-13T15:29:33Z2016-06-29FRANÇA, Divânia Dias da Silva. HIV/AIDS em usuários de crack institucionalizados em Goiânia, Goiás: perfil epidemiológico e subtipos virais. 2016. 164 f. Tese (Doutorado em Ciências da Saúde) - Universidade Federal de Goiás, Goiânia, 2016.http://repositorio.bc.ufg.br/tede/handle/tede/6564ark:/38995/0013000001m83Infection by human immunodeficiency virus (HIV) is a serious global public health problem. An estimated 78 million people have been infected. The burden of this infection is concentrated in high vulnerability groups, such as drug users. The objective of this study was to analyze the serological, epidemiological, and molecular profile of HIV infection in institutionalized crack users in Goiania, a large city in Central Brazil. This is an observational, analytical, cross-sectional study conducted among crack users in treatment in a mental health referral facilityin Midwestern Brazil. From August 2012 to April 2013, 600 crack users were recruited. All were interviewed and tested for HIV by enzyme-linked immunosorbent assay (ELISA). The samples that tested positive for anti-HIV1 were subjected to detection of HIV RNA by RT-PCR and genotyped by sequencing. Of the total enrolled participants: about half came from outside the city (50.3%), were predominantly male (84.5%), young (median: 30 years), had low education (8.4 years of school), were self-declared mixed race (61.5%), single (66.5%) and religious (74.3%). Nearly three-quarters were not formally employed, and 20.3% reported a history of life on the street in the last 180 days. Of the total, 2.8% (95% CI: 1.7 – 4.4%) were anti-HIV1 positive, ranging from 2.2% (95% CI 1.2 – 3.9) in men and 6.5% (95% CI 3.2 – 14.2) in women (p = 0.04). Logistic regression analysis revealed that history of sexual intercourse with a carrier of HIV (adjusted OR: 12.60; p = 0.001) and history of life on the street (adjusted OR: 4.43; p = 0.025) were predictors of HIV- 1. The variables: history of sexually transmitted infections (adjusted OR: 3.24; p = 0.057), not using a condom (adjusted OR: 2.84; p = 0.088) and consumption of more than 10 rocks/portions of crack daily (adjusted OR: 2.81; p = 0.085) were marginally associated with HIV infection. In 12 of 17 HIV-1 samples, subtype identification was possible with subtype B being detected in eight samples (66.7%), F1 and C in one sampleeach (8.3%), and recombinant BF in two samples (16.7%). These results highlight the need for effective strategies to prevent HIV infection in crack users, with an emphasis on health education, implementation of harm reduction measures and control of sexually transmitted diseases.A infecção pelo vírus da imunodeficiência humana (HIV) é um grave problema de saúde pública mundial. Estima-se que 78 milhões de pessoas já se infectaram pelo HIV. A carga dessa infecção está concentrada em grupos com elevada vulnerabilidade, como usuários de drogas. O objetivo do presente estudo foi analisar o perfil soroepidemiológico e molecular da infecção pelo HIV em usuários de crack institucionalizados em Goiânia-GO. Trata-se de um estudo observacional, analítico, de corte transversal realizado com usuários de crack em tratamento em uma instituição de referência em saúde mental da Região Centro-Oeste do Brasil. No período de agosto de 2012 a abril de 2013, foram recrutados 600 usuários de crack. Todos foram entrevistados e testados para anti-HIV pelo ensaio imunoenzimático (ELISA). As amostras que apresentaram positividade para anti-HIV foram submetidas à detecção do RNA-HIV por RT-PCR e genotipadas por sequenciamento. Do total dos indivíduos recrutados, 50,3% eram procedentes de outros munícipios, predominantemente do sexo masculino (84,5%), jovens (mediana: 30 anos), de baixa escolaridade (média: 8,4 anos de estudo), se autodeclaram de cor parda (61,5%), solteiros (66,5%) e possuíam alguma religião (74,3%). Quase três quartos não desenvolviam suas atividades laborais no mercado formal de trabalho, e 20,3% relataram antecedentes de vida na rua nos últimos 180 dias. Do total, 2,8% (IC 95%: 1,7 – 4,4%) foram anti-HIV positivos, variando de 2,2% (IC 95%: 1,2 – 3,9) em homens e 6,5% (IC 95%: 3,2 – 14,2) em mulheres (p=0,04). Análise de regressão logística revelou que história de relação sexual com portador (a) do HIV (OR ajustado: 12,60; p= 0,001) e antecedente de vida na rua (OR ajustado: 4,43; p= 0,025) foram preditores da infecção pelo HIV. As variáveis: história de infecções sexualmente transmissíveis (OR ajustado: 3,24; p= 0,057), não adesão ao uso de preservativo (OR ajustado: 2,84; p= 0,088) e consumo de mais de 10 pedras/porções de crack diariamente (OR ajustado: 2,81; p= 0,085) foram marginalmente associadas à infecção pelo HIV. Em 12/17 amostras anti-HIV-1 foi possível a identificação subtípica, sendo detectados os subtipos B em oito amostras (66,7%), F1 e C em uma amostra cada (8,3%) e o recombinante BF em duas amostras (16,7%). Os resultados evidenciam a necessidade de estratégias efetivas de prevenção da infecção pelo HIV em usuários de crack institucionalizados, com ênfase em educação em saúde, implementação de medidas de redução de danos e controle de infecções de transmissão sexual.Submitted by JÚLIO HEBER SILVA (julioheber@yahoo.com.br) on 2016-12-02T16:31:53Z No. of bitstreams: 2 Tese - Divânia Dias da Silva França - 2016.pdf: 6690310 bytes, checksum: d6296e6724c1e38111bd12b6d97a4f46 (MD5) license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5)Approved for entry into archive by Jaqueline Silva (jtas29@gmail.com) on 2016-12-13T15:29:33Z (GMT) No. of bitstreams: 2 Tese - Divânia Dias da Silva França - 2016.pdf: 6690310 bytes, checksum: d6296e6724c1e38111bd12b6d97a4f46 (MD5) license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5)Made available in DSpace on 2016-12-13T15:29:33Z (GMT). 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dc.title.por.fl_str_mv |
HIV/AIDS em usuários de crack institucionalizados em Goiânia, Goiás: perfil epidemiológico e subtipos virais |
dc.title.alternative.eng.fl_str_mv |
HIV/SIDA in crack users institutionalized in Goiânia, Goiás: epidemiological profile and viral subtitles |
title |
HIV/AIDS em usuários de crack institucionalizados em Goiânia, Goiás: perfil epidemiológico e subtipos virais |
spellingShingle |
HIV/AIDS em usuários de crack institucionalizados em Goiânia, Goiás: perfil epidemiológico e subtipos virais França, Divânia Dias da Silva Epidemiologia HIV Usuários de crack Epidemiology HIV Crack users CIENCIAS DA SAUDE |
title_short |
HIV/AIDS em usuários de crack institucionalizados em Goiânia, Goiás: perfil epidemiológico e subtipos virais |
title_full |
HIV/AIDS em usuários de crack institucionalizados em Goiânia, Goiás: perfil epidemiológico e subtipos virais |
title_fullStr |
HIV/AIDS em usuários de crack institucionalizados em Goiânia, Goiás: perfil epidemiológico e subtipos virais |
title_full_unstemmed |
HIV/AIDS em usuários de crack institucionalizados em Goiânia, Goiás: perfil epidemiológico e subtipos virais |
title_sort |
HIV/AIDS em usuários de crack institucionalizados em Goiânia, Goiás: perfil epidemiológico e subtipos virais |
author |
França, Divânia Dias da Silva |
author_facet |
França, Divânia Dias da Silva |
author_role |
author |
dc.contributor.advisor1.fl_str_mv |
Teles, Sheila Araujo |
dc.contributor.advisor1Lattes.fl_str_mv |
http://lattes.cnpq.br/4975298732179917 |
dc.contributor.referee1.fl_str_mv |
Teles , Sheila Araujo |
dc.contributor.referee1Lattes.fl_str_mv |
http://lattes.cnpq.br/4975298732179917 |
dc.contributor.referee2.fl_str_mv |
Martins, Regina Maria Bringel |
dc.contributor.referee3.fl_str_mv |
Carneiro, Megmar Aparecida dos Santos |
dc.contributor.referee4.fl_str_mv |
Medeiros, Marcelo |
dc.contributor.referee5.fl_str_mv |
Souza, Marcia Maria de |
dc.contributor.authorLattes.fl_str_mv |
http://lattes.cnpq.br/8409188374750691 |
dc.contributor.author.fl_str_mv |
França, Divânia Dias da Silva |
contributor_str_mv |
Teles, Sheila Araujo Teles , Sheila Araujo Martins, Regina Maria Bringel Carneiro, Megmar Aparecida dos Santos Medeiros, Marcelo Souza, Marcia Maria de |
dc.subject.por.fl_str_mv |
Epidemiologia HIV Usuários de crack |
topic |
Epidemiologia HIV Usuários de crack Epidemiology HIV Crack users CIENCIAS DA SAUDE |
dc.subject.eng.fl_str_mv |
Epidemiology HIV Crack users |
dc.subject.cnpq.fl_str_mv |
CIENCIAS DA SAUDE |
description |
Infection by human immunodeficiency virus (HIV) is a serious global public health problem. An estimated 78 million people have been infected. The burden of this infection is concentrated in high vulnerability groups, such as drug users. The objective of this study was to analyze the serological, epidemiological, and molecular profile of HIV infection in institutionalized crack users in Goiania, a large city in Central Brazil. This is an observational, analytical, cross-sectional study conducted among crack users in treatment in a mental health referral facilityin Midwestern Brazil. From August 2012 to April 2013, 600 crack users were recruited. All were interviewed and tested for HIV by enzyme-linked immunosorbent assay (ELISA). The samples that tested positive for anti-HIV1 were subjected to detection of HIV RNA by RT-PCR and genotyped by sequencing. Of the total enrolled participants: about half came from outside the city (50.3%), were predominantly male (84.5%), young (median: 30 years), had low education (8.4 years of school), were self-declared mixed race (61.5%), single (66.5%) and religious (74.3%). Nearly three-quarters were not formally employed, and 20.3% reported a history of life on the street in the last 180 days. Of the total, 2.8% (95% CI: 1.7 – 4.4%) were anti-HIV1 positive, ranging from 2.2% (95% CI 1.2 – 3.9) in men and 6.5% (95% CI 3.2 – 14.2) in women (p = 0.04). Logistic regression analysis revealed that history of sexual intercourse with a carrier of HIV (adjusted OR: 12.60; p = 0.001) and history of life on the street (adjusted OR: 4.43; p = 0.025) were predictors of HIV- 1. The variables: history of sexually transmitted infections (adjusted OR: 3.24; p = 0.057), not using a condom (adjusted OR: 2.84; p = 0.088) and consumption of more than 10 rocks/portions of crack daily (adjusted OR: 2.81; p = 0.085) were marginally associated with HIV infection. In 12 of 17 HIV-1 samples, subtype identification was possible with subtype B being detected in eight samples (66.7%), F1 and C in one sampleeach (8.3%), and recombinant BF in two samples (16.7%). These results highlight the need for effective strategies to prevent HIV infection in crack users, with an emphasis on health education, implementation of harm reduction measures and control of sexually transmitted diseases. |
publishDate |
2016 |
dc.date.accessioned.fl_str_mv |
2016-12-13T15:29:33Z |
dc.date.issued.fl_str_mv |
2016-06-29 |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/doctoralThesis |
format |
doctoralThesis |
status_str |
publishedVersion |
dc.identifier.citation.fl_str_mv |
FRANÇA, Divânia Dias da Silva. HIV/AIDS em usuários de crack institucionalizados em Goiânia, Goiás: perfil epidemiológico e subtipos virais. 2016. 164 f. Tese (Doutorado em Ciências da Saúde) - Universidade Federal de Goiás, Goiânia, 2016. |
dc.identifier.uri.fl_str_mv |
http://repositorio.bc.ufg.br/tede/handle/tede/6564 |
dc.identifier.dark.fl_str_mv |
ark:/38995/0013000001m83 |
identifier_str_mv |
FRANÇA, Divânia Dias da Silva. HIV/AIDS em usuários de crack institucionalizados em Goiânia, Goiás: perfil epidemiológico e subtipos virais. 2016. 164 f. Tese (Doutorado em Ciências da Saúde) - Universidade Federal de Goiás, Goiânia, 2016. ark:/38995/0013000001m83 |
url |
http://repositorio.bc.ufg.br/tede/handle/tede/6564 |
dc.language.iso.fl_str_mv |
por |
language |
por |
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dc.relation.confidence.fl_str_mv |
600 600 600 600 600 |
dc.relation.department.fl_str_mv |
1545772475950486338 |
dc.relation.cnpq.fl_str_mv |
8765449414823306929 |
dc.relation.sponsorship.fl_str_mv |
-961409807440757778 -2555911436985713659 |
dc.rights.driver.fl_str_mv |
http://creativecommons.org/licenses/by-nc-nd/4.0/ info:eu-repo/semantics/openAccess |
rights_invalid_str_mv |
http://creativecommons.org/licenses/by-nc-nd/4.0/ |
eu_rights_str_mv |
openAccess |
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Universidade Federal de Goiás |
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Programa de Pós-graduação em Ciências da Saúde (FM) |
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UFG |
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Brasil |
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Faculdade de Medicina - FM (RG) |
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Universidade Federal de Goiás |
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Repositório Institucional da UFG |
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