Prevalence and risk factors associated with syphilis in women
Autor(a) principal: | |
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Data de Publicação: | 1998 |
Outros Autores: | , , |
Tipo de documento: | Artigo |
Idioma: | spa |
Título da fonte: | Revista de Saúde Pública |
Texto Completo: | https://www.revistas.usp.br/rsp/article/view/24421 |
Resumo: | INTRODUCTION: Although the incidence of syphilis is generally low, it remains an important global public health problem, given its interaction with other sexually transmitted diseases (STDs). It has been shown that syphilis, due to the genital ulcers it produces, is a co-factor for acquiring other STDs, principally those of viral origin such as herpes simples type 2, hepatitis B and HIV. Many female commercial sex workers (FCSW) in Mexico have been found to have acquired good levels of knowledge about STD prevention. Nevertheless, they constitute a heterogeneous group in terms of socio-economic level, health status and type of work site; these factors in turn appear to determine their attitudes, knowledge and behavior related to acquiring and transmitting STDs, including syphilis. This study, therefore, focused on the factors associated with Treponema pallidum infection in this group of women. METHOD: Based on a sample frame of sites where female commercial sex work takes place within Mexico City, a sample of 807 FCSWs was selected; after providing informed consent, they completed a structured questionnaire. A blood sample for identifying serologic markers for STDs was collected and analyzed according to a procedure manual for STD diagnosis. Treponema pallidum was diagnosed using the RPR (Bigaux Diagnostica) screening test, and FTA - ABS (Pasteur Diagnostics) for confirmation. RESULTS: The prevalence of syphilis in this sample of FCSWs was 6.4% (52/807), and was higher among women who worked at street sites than among those who worked in massage parlors. The age of the women interviewed ranged from 17 to 58 years, with a mean of 29.2 years (SD 7.3 years); syphilis was more prevalent among women over 30 years of age. Age at first sexual intercourse ranged from 11 to 30 years, with a mean of 16 years (SD 3.1 years), which is similar to that of the general female population in Mexico. Predictive factors for T. pallidum infection, determined adjusted logistic regression, included: tupe of by work site (bar and street sites); socio-economic level (middle and low); age (over 30 years); duration of involvement in sex work (>; 5 years) and number of clients per week (>; 10). CONCLUSION: In spite of some limitations regarding statistical precision, this study shows that FCSWs are heterogeneous in terms of risk of acquiring STDs, including syphilis; the principal differentiating factor was shown to be the type of work site. Given that it is not belonging to a risk group but rather participating in risky practices that leads to acquiring STDs, situations that facilitate riskier or safer practices (such as type of sex work site, for sex workers) should be taken into account when studying people's risk level. STD prevention campaigns must also consider these factors, in addition to focusing on FCSWs and their clients and personal partners, so that all involved assume their responsibility for safer sex. |
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Prevalence and risk factors associated with syphilis in women Prevalencia y factores de riesgo asociados a sífilis en mujeres Sífilis^i1^sprevencProstituciónInfecciones oportunistasConducta sexualSyphilis^i2^spreventProstitutionOpportunistic infectionsSex behavior INTRODUCTION: Although the incidence of syphilis is generally low, it remains an important global public health problem, given its interaction with other sexually transmitted diseases (STDs). It has been shown that syphilis, due to the genital ulcers it produces, is a co-factor for acquiring other STDs, principally those of viral origin such as herpes simples type 2, hepatitis B and HIV. Many female commercial sex workers (FCSW) in Mexico have been found to have acquired good levels of knowledge about STD prevention. Nevertheless, they constitute a heterogeneous group in terms of socio-economic level, health status and type of work site; these factors in turn appear to determine their attitudes, knowledge and behavior related to acquiring and transmitting STDs, including syphilis. This study, therefore, focused on the factors associated with Treponema pallidum infection in this group of women. METHOD: Based on a sample frame of sites where female commercial sex work takes place within Mexico City, a sample of 807 FCSWs was selected; after providing informed consent, they completed a structured questionnaire. A blood sample for identifying serologic markers for STDs was collected and analyzed according to a procedure manual for STD diagnosis. Treponema pallidum was diagnosed using the RPR (Bigaux Diagnostica) screening test, and FTA - ABS (Pasteur Diagnostics) for confirmation. RESULTS: The prevalence of syphilis in this sample of FCSWs was 6.4% (52/807), and was higher among women who worked at street sites than among those who worked in massage parlors. The age of the women interviewed ranged from 17 to 58 years, with a mean of 29.2 years (SD 7.3 years); syphilis was more prevalent among women over 30 years of age. Age at first sexual intercourse ranged from 11 to 30 years, with a mean of 16 years (SD 3.1 years), which is similar to that of the general female population in Mexico. Predictive factors for T. pallidum infection, determined adjusted logistic regression, included: tupe of by work site (bar and street sites); socio-economic level (middle and low); age (over 30 years); duration of involvement in sex work (>; 5 years) and number of clients per week (>; 10). CONCLUSION: In spite of some limitations regarding statistical precision, this study shows that FCSWs are heterogeneous in terms of risk of acquiring STDs, including syphilis; the principal differentiating factor was shown to be the type of work site. Given that it is not belonging to a risk group but rather participating in risky practices that leads to acquiring STDs, situations that facilitate riskier or safer practices (such as type of sex work site, for sex workers) should be taken into account when studying people's risk level. STD prevention campaigns must also consider these factors, in addition to focusing on FCSWs and their clients and personal partners, so that all involved assume their responsibility for safer sex. INTRODUCCIÓN: Se ha demostrado que la sífilis, debido a la ulceración genital que produce, es un cofactor asociado para adquirir otras enfermedades de transmisión sexual (ETS), principalmente de origen viral como herpes tipo-2, hepatitis B, y el VIH. Aunque las mujeres trabajadoras del sexo comercial (MTSC) han adquirido mejores conocimientos para prevenir las ETS, constituyen un grupo que por su heterogenicidad en términos de condición socioeconómica, estado de salud, ambiente y sitio de trabajo, manifiestan diferentes actitudes y conocimientos que hacen latente la posibilidad de adquirir y transmitir ETS incluyendo sífilis, por lo que lo estudio hace un acercamiento hacia los factores asociados a infección por Treponema pallidum en este grupo de mujeres. MÉTODO: Basado en un marco muestral, que identifica sitios donde se practica el comercio sexual femenino en la ciudad de México, se seleccionó una muestra de 807 MTSC, a quienes previo consentimiento informado, se entrevistó para que respondieran un cuestionario estructurado. Se obtuvo una muestra sanguínea para la identificación de diversos marcadores serológicos de ETS de acuerdo al manual de procedimientos para el diagnóstico de ETS. Para el diagnóstico de Treponema pallidum se utilizó una prueba de tamizaje de RPR (Bigaux Diagnóstica), y prueba confirmatoria de FTA-ABS (Pasteur Diagnostics). RESULTADOS: Las prevalencias de sífilis en la muestra de MTSC fue de 6,4% (52/807), siendo mayor en quienes trabajaban en sitios de calle comparadas con aquellas de estéticas. La edad de las mujeres entrevistadas osciló entre 17 y 58 años con una media de 29,2 años (d.s. 7,3 años). La prevalencia de sífilis fue mayor en los grupos etáreos mayores de 30 anos. La edad de inicio de relaciones sexuales varió desde 11 hasta 30 anos con una media de 16 años (d.s. 3,1 años). Los factores predictores de infección por T. pallidum, determinados mediante regresión logística ajustada, fueron: sitio de trabajo (bar y puntos de calle), NSE (medio y bajo), edad (mayores de 30 anos), antiguedad en el trabajo sexual (>; 5 años), y número de clientes en una semana (>;10). CONCLUSIONES: A pesar de las limitaciones de precisión estadística, queda demostrado que existe una heterogenicidad de MTSC, diferenciado principalmente por el sitio donde se desempeñan. Debe entenderse que más que grupos de riesgo de adquirir y transmitir ETS, existen prácticas sexuales de riesgo en cualquier individuo que tiene relaciones sexuales, que aunadas a infecciones predisponentes como sífilis, facilitan la transmisibilidad de otras ETS. Por lo tanto, las campañas de prevención y fomento de uso de condón, deben orientarse no sólo a las MTSC sino también a sus clientes y parejas, con la finalidad de que todos asuman la responsabilidad del sexo seguro. Universidade de São Paulo. Faculdade de Saúde Pública1998-12-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionapplication/pdfhttps://www.revistas.usp.br/rsp/article/view/2442110.1590/S0034-89101998000600012Revista de Saúde Pública; Vol. 32 No. 6 (1998); 579-586 Revista de Saúde Pública; Vol. 32 Núm. 6 (1998); 579-586 Revista de Saúde Pública; v. 32 n. 6 (1998); 579-586 1518-87870034-8910reponame:Revista de Saúde Públicainstname:Universidade de São Paulo (USP)instacron:USPspahttps://www.revistas.usp.br/rsp/article/view/24421/26345Copyright (c) 2017 Revista de Saúde Públicainfo:eu-repo/semantics/openAccessHernández-Girón, Carlos A.Cruz-Valdez, AurelioFigueroa, Luis JuárezHernández-Avila, Mauricio2012-05-29T17:01:27Zoai:revistas.usp.br:article/24421Revistahttps://www.revistas.usp.br/rsp/indexONGhttps://www.revistas.usp.br/rsp/oairevsp@org.usp.br||revsp1@usp.br1518-87870034-8910opendoar:2012-05-29T17:01:27Revista de Saúde Pública - Universidade de São Paulo (USP)false |
dc.title.none.fl_str_mv |
Prevalence and risk factors associated with syphilis in women Prevalencia y factores de riesgo asociados a sífilis en mujeres |
title |
Prevalence and risk factors associated with syphilis in women |
spellingShingle |
Prevalence and risk factors associated with syphilis in women Hernández-Girón, Carlos A. Sífilis^i1^sprevenc Prostitución Infecciones oportunistas Conducta sexual Syphilis^i2^sprevent Prostitution Opportunistic infections Sex behavior |
title_short |
Prevalence and risk factors associated with syphilis in women |
title_full |
Prevalence and risk factors associated with syphilis in women |
title_fullStr |
Prevalence and risk factors associated with syphilis in women |
title_full_unstemmed |
Prevalence and risk factors associated with syphilis in women |
title_sort |
Prevalence and risk factors associated with syphilis in women |
author |
Hernández-Girón, Carlos A. |
author_facet |
Hernández-Girón, Carlos A. Cruz-Valdez, Aurelio Figueroa, Luis Juárez Hernández-Avila, Mauricio |
author_role |
author |
author2 |
Cruz-Valdez, Aurelio Figueroa, Luis Juárez Hernández-Avila, Mauricio |
author2_role |
author author author |
dc.contributor.author.fl_str_mv |
Hernández-Girón, Carlos A. Cruz-Valdez, Aurelio Figueroa, Luis Juárez Hernández-Avila, Mauricio |
dc.subject.por.fl_str_mv |
Sífilis^i1^sprevenc Prostitución Infecciones oportunistas Conducta sexual Syphilis^i2^sprevent Prostitution Opportunistic infections Sex behavior |
topic |
Sífilis^i1^sprevenc Prostitución Infecciones oportunistas Conducta sexual Syphilis^i2^sprevent Prostitution Opportunistic infections Sex behavior |
description |
INTRODUCTION: Although the incidence of syphilis is generally low, it remains an important global public health problem, given its interaction with other sexually transmitted diseases (STDs). It has been shown that syphilis, due to the genital ulcers it produces, is a co-factor for acquiring other STDs, principally those of viral origin such as herpes simples type 2, hepatitis B and HIV. Many female commercial sex workers (FCSW) in Mexico have been found to have acquired good levels of knowledge about STD prevention. Nevertheless, they constitute a heterogeneous group in terms of socio-economic level, health status and type of work site; these factors in turn appear to determine their attitudes, knowledge and behavior related to acquiring and transmitting STDs, including syphilis. This study, therefore, focused on the factors associated with Treponema pallidum infection in this group of women. METHOD: Based on a sample frame of sites where female commercial sex work takes place within Mexico City, a sample of 807 FCSWs was selected; after providing informed consent, they completed a structured questionnaire. A blood sample for identifying serologic markers for STDs was collected and analyzed according to a procedure manual for STD diagnosis. Treponema pallidum was diagnosed using the RPR (Bigaux Diagnostica) screening test, and FTA - ABS (Pasteur Diagnostics) for confirmation. RESULTS: The prevalence of syphilis in this sample of FCSWs was 6.4% (52/807), and was higher among women who worked at street sites than among those who worked in massage parlors. The age of the women interviewed ranged from 17 to 58 years, with a mean of 29.2 years (SD 7.3 years); syphilis was more prevalent among women over 30 years of age. Age at first sexual intercourse ranged from 11 to 30 years, with a mean of 16 years (SD 3.1 years), which is similar to that of the general female population in Mexico. Predictive factors for T. pallidum infection, determined adjusted logistic regression, included: tupe of by work site (bar and street sites); socio-economic level (middle and low); age (over 30 years); duration of involvement in sex work (>; 5 years) and number of clients per week (>; 10). CONCLUSION: In spite of some limitations regarding statistical precision, this study shows that FCSWs are heterogeneous in terms of risk of acquiring STDs, including syphilis; the principal differentiating factor was shown to be the type of work site. Given that it is not belonging to a risk group but rather participating in risky practices that leads to acquiring STDs, situations that facilitate riskier or safer practices (such as type of sex work site, for sex workers) should be taken into account when studying people's risk level. STD prevention campaigns must also consider these factors, in addition to focusing on FCSWs and their clients and personal partners, so that all involved assume their responsibility for safer sex. |
publishDate |
1998 |
dc.date.none.fl_str_mv |
1998-12-01 |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
https://www.revistas.usp.br/rsp/article/view/24421 10.1590/S0034-89101998000600012 |
url |
https://www.revistas.usp.br/rsp/article/view/24421 |
identifier_str_mv |
10.1590/S0034-89101998000600012 |
dc.language.iso.fl_str_mv |
spa |
language |
spa |
dc.relation.none.fl_str_mv |
https://www.revistas.usp.br/rsp/article/view/24421/26345 |
dc.rights.driver.fl_str_mv |
Copyright (c) 2017 Revista de Saúde Pública info:eu-repo/semantics/openAccess |
rights_invalid_str_mv |
Copyright (c) 2017 Revista de Saúde Pública |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
application/pdf |
dc.publisher.none.fl_str_mv |
Universidade de São Paulo. Faculdade de Saúde Pública |
publisher.none.fl_str_mv |
Universidade de São Paulo. Faculdade de Saúde Pública |
dc.source.none.fl_str_mv |
Revista de Saúde Pública; Vol. 32 No. 6 (1998); 579-586 Revista de Saúde Pública; Vol. 32 Núm. 6 (1998); 579-586 Revista de Saúde Pública; v. 32 n. 6 (1998); 579-586 1518-8787 0034-8910 reponame:Revista de Saúde Pública instname:Universidade de São Paulo (USP) instacron:USP |
instname_str |
Universidade de São Paulo (USP) |
instacron_str |
USP |
institution |
USP |
reponame_str |
Revista de Saúde Pública |
collection |
Revista de Saúde Pública |
repository.name.fl_str_mv |
Revista de Saúde Pública - Universidade de São Paulo (USP) |
repository.mail.fl_str_mv |
revsp@org.usp.br||revsp1@usp.br |
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1800221779148406784 |