Doutorado em Enfermagem e Saúde (FEN)
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Navegando Doutorado em Enfermagem e Saúde (FEN) por Por Orientador "Teles, Sheila Araújo"
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Item Pessoas em situação de rua abrigadas: uma população-chave na epidemiologia da sífilis e infecção pelo HIV em Goiânia-Goiás(Universidade Federal de Goiás, 2017-12-11) Pinheiro, Raquel Silva; Teles, Sheila Araújo; http://lattes.cnpq.br/4975298732179917; Teles, Sheila Araújo; Carneiro, Megmar Aparecida dos Santos; Gir, Elucir; Matos, Marcos André de; Souza, Sandra Maria Brunini deContact with the street exposes the individual to a high risk of physical, sexual exploitation and involvement in illicit activities as means of survival and maintenance of their basic needs. In addition, low levels of education, poor hygiene, low income, unemployment, malnutrition and limited access to health services increase the vulnerability of the homeless to sexually transmitted infections (STI), such as the human immunodeficiency virus (HIV) and syphilis. The objective of the present study was to investigate the epidemiological profile of HIV infection and syphilis in homeless individuals housed in Goiânia, Goiás. This is an observational, analytical, cross-sectional study carried out on individuals housed in the Casa de Acolhida Cidadã I (CAC) in Goiânia-GO. From September 2014 to August 2015, 355 individuals were recruited on the street. All participants were interviewed and tested for HIV serological markers (anti-HIV 1 and 2) and syphilis (anti-T. pallidum) by the rapid test. The samples positive for anti-T. pallidum were submitted to VDRL. Of the total number of recruited individuals, 81.4% were male, young (median: 36 years), unmarried (59.4%) and self-declared brown (60.6%). More than half had five to nine years of study, 35.7% reported having no income and most reported having some religion. The median length of stay in CAC was 10 days and 57.5% had an overnight stay experience. An anti-HIV prevalence of 3.9% (95% CI: 2.3-6.4%) was estimated. Of the 355 samples tested by the rapid test for syphilis, 22.0% (95% CI: 17.9-26.5%) were positive and 8.2% (95% CI: 5.6-11.4%) presented positive results VDRL titles. The prevalence of active HIV/syphilis coinfection was 0.6% (2/355; 95% CI: 0.09 - 1.85). In multivariate logistic regression analysis, daily use of alcoholic beverages (adjusted OR: 4.0, p=0.02), sex with HIV/aids carrier (adjusted OR: 8.1, p=0.00) and sex with people of the same sex (adjusted OR: 4.6, p=0.01) were independently associated with HIV infection. The variables age ≤ 36 years (adjusted OR: 3.3, p=0.02), married/stable union (adjusted OR: 2.9, p = 0.02), previous syphilis testing (adjusted OR: 2.6, p=0.03), previous IST (adjusted OR: 3.4, p=0.00) and crack use in the last six months (adjusted OR: 3.6; p ≤0,001) were predictors for syphilis active The results of the present study show that the prevalence of syphilis and HIV infection in sheltered homeless people is high, with the development of prevention and control strategies, including counseling and testing, as well as the provision of treatment for STI in the setting street and temporary and/or permanent shelters.Item Epidemiologia da Sífilis e HIV em cortadores manuais de cana-de-açúcar: bases para ações de promoção da saúde(Universidade Federal de Goiás, 2019-04-15) Rocha, Déborah Ferreira Noronha de Castro; Teles, Sheila Araújo; http://lattes.cnpq.br/4975298732179917; Teles, Sheila Araújo; Pinheiro, Raquel Silva; Carneiro, Megmar Aparecida dos Santos; Souza, Marcia Maria de; Souza, Sandra Maria Brunini deIn Brazil, manual cane harvesting is still common in less developed regions and is predominantly carried out by migrant seasonal workers, mainly from the Northeast of Brazil. Migration results in family isolation, remaining far from their sexual partners. This situation may favor unprotected sex and thus make them vulnerable to sexually transmitted infections (STIs), including syphilis and Human Immunodeficiency Virus (HIV). The objective of this study was to investigate the epidemiology of syphilis and HIV in cane cutters in Goiás and Paraíba. It is a cross-sectional and analytical study carried out from February to September 2016, in the states of Goiás and Paraíba, in five sugar-alcohol plants. A total of 937 cane cutters participated in the study. All were interviewed and tested for serological markers of HIV (anti-HIV 1 and 2) and syphilis (anti-T.pallidum) by the rapid test (TR). The samples were positive for anti-T. pallidum (syphilis in life) were retested by VDRL (active syphilis). All of them were male, ranging in age from 18 to 67 years and almost half (47.4%) had up to four years of study. The majority were married or had a stable union (77.5%), had no prison history (90.4%) and reported an occupational accident (53.4%). A state analysis showed a higher proportion of sugarcane cutters in Goiás that reported multiple sexual partners, which consistently used condoms during sexual intercourse, consumed alcoholic beverages and cocaine (p <0.05). On the other hand, the frequency of homosexual relationships was higher in Paraiba cutters (p <0.05). A global prevalence of anti-HIV-1 of 0.3% (95% CI: 0.1-1.0), syphilis in life of 2.4% (95% CI: 1.6-3.6) and active syphilis of 1.2% (95% CI: 0.6-2.1). The variables religion and marijuana consumption were independently associated with syphilis in life. However, the first variable was shown as a protective factor (adjusted OR: 0.3, 95% CI: 0.1-0.8), and the second was risk-adjusted (adjusted OR: 2.94, 95% CI: 1,1-7,7). The results of this study show sociodemographic and behavioral differences between Goiás and Paraíba sugarcane cutters and the circulation of syphilis and HIV-1 in this impoverished population that has the potential for viral dissemination. The agreement of the public health services with sugar and alcohol industries to carry out prevention and health promotion actions in sugarcane cutters' workplaces would be an important strategy directed at this population of male rural workers.