Aline Dayrell Ferreira

Saúde urbana: "a cidade é uma estranha senhora, que hoje sorri e amanhã te devora"

More than half of the worlds population is living in cities and the world is turning more and more urbanized. This literature review explores the ramifications of urban transformation, showing how cities take shape and impact human health in our times. While cities can offer positive opportunities, their negative impacts related to the lack of social organization, precarious urban living and working conditions, lack of governance and opportunities as well as the lack of strategies for promoting social equity tend to increase the adverse effects on the health of the urban communities. The article also advocates the study of urban health as a branch of knowledge related to public health, proposing a common conceptual model and taxonomy for urban health. Future directions for research and practice are discussed in the light of some examples from the Brazilian scientific literature.

Profile of male Brazilian injecting drug users who have sex with men

This study aims to characterize the profile of male injecting drug users who have sex with other men (MSM IDUs) recruited through a cross-sectional multi-city survey (AjUDE-Brasil II Project) in six Brazilian cities, in 2000-2001. MSM IDUs were compared to other male IDUs using bivariate and multivariate procedures (logistic regression and answer tree analysis with the CHAID algorithm). Among the 709 male IDUs, 187 (26.4%) reported ever having had sex with other men, while only 37 reported sex with other men in the previous six months. MSM IDUs were more likely to be unemployed (OR = 2.3), to have injected tranquilizers (OR = 3.6), and to be HIV-seropositive (OR = 2.1), compared to other male IDUs. Male same-sex relations in this subgroup appear to be associated with strategies to finance drug consuming habits, including sex for drugs with occasional female partners or obtaining injection paraphernalia from occasional sex partners. Further studies should focus on this especially vulnerable subgroup of IDUs, due to the bidirectional and complex interrelationships between their drug injecting habits and sexual risk behaviors.

Injecting drug users who are (un)aware of their HIV serostatus: findings from the multi-center study AjUDE-Brasil II

This study aimed to characterize the profiles of injecting drug users (IDUs) who were unaware of their HIV serostatus, given the importance of this information for prevention strategies, especially in this vulnerable population, key to the HIV/AIDS dynamic. As part of a cross-sectional multi-city survey, IDUs were interviewed and HIV-tested by the ELISA technique. IDUs were categorized according to knowledge of their own HIV status as either aware or unaware. Means, averages, and proportions were compared between the groups using bi- and multivariate analyses. Of 857 IDUs interviewed, 34.2% were unaware of their HIV serostatus. Those who were unaware were more likely: to have been recruited at sites where the HIV prevalence rate was considered medium (> 10 to 50%; odds ratio = 8.0) or high (> 50%; 4.0); to be illiterate (OR = 4.54); to have no prior HIV test (OR = 2.22); to be male (OR = 1.81); and to have been enrolled more recently in syringe-exchange programs (OR = 1.69). HIV prevention programs should target both individuals at risk and HIV-positive individuals. Programs to expand access to HIV testing are pivotal and should be tailored to specific contexts and populations.

Fatores associados à hipertensão arterial em usuários de serviço de promoção à saúde

Trata-se de estudo transversal com o objetivo de identificar fatores associados a hipertensao arterial sistemica (HAS) entre usuarios ≥ 20 anosque ingressaram em um servico de promocao a saude de Belo Horizonte-MG entre fevereiro a setembro de 2007. Foram coletados dadosdemograficos, antropometricos, morbidade referida e habitos alimentares. Dentre os 300 individuos avaliados, 87,3% eram mulheres, com mediade idade de 50,2±14,2 anos. Houve elevada prevalencia de morbidades e habitos alimentares desfavoraveis. Foram fatores associados a HAS:entre os adultos – idade ≥40 anos (OR=11,1 IC95%:3,6-34,3), excesso de peso (OR=8,0; IC95%:2,0-31,2), diabetes (OR=5,0; IC95%:2,0-12,8) ehabito de “beliscar” entre as refeicoes (OR=2,6; IC95%:1,3-5,4); e para os idosos, o sobrepeso (OR=2,9; IC95%:1,0-8,4). Identificaram-se exposicoesmodificaveis que possivelmente contribuiram para o desenvolvimento da HAS, principalmente entre os adultos. Sugere-se que esses fatoressejam trabalhados com o objetivo de contribuir para a prevencao e melhor controle da HAS.(AU) This is cross sectional study to identify factors associated with systemic arterial hypertension (SAH) among users ≥20 years who enrolled inhealth promotion service of Belo Horizonte-MG, between February and September 2007. Data were collected demographic, anthropometric,reported morbidity and dietary habit. Among the 300 individuals evaluated, 87.3% were women, mean age 50.2±14.2 years. High prevalencesof morbidities and unfavorable dietary habits were observed. The following factors were associated with SAH: among adults – age ≥ 40 years(OR=11.1; 95%CI:3.6-34.3), excess weight (OR=8.0; 95%CI:2.0-31.2), diabetes (OR=5.0; 95%CI:2.0-12.8) and “nibbling” between meals (OR=2.6;95%CI:1.3-5.4); and among elderly, overweight (OR=2.9; 95%CI:1.0-8.4). Modifiable exposures were identified that possibly contributed to thedevelopment of SAH, particularly among adults. It is suggested that these factors should be worked on, to contribute towards preventionand better control over SAH.(AU) Se trata de un estudio transversal para identificar los factores asociados con la hipertension arterial sistemica (HAS) entre usuarios ≥20 anos que seinscribieron en un servicio de promocion de la salud de Belo Horizonte-MG, de febrero a septiembre de 2007. Se recogieron los datos demograficos,antropometricos, se informo la morbilidad y las costumbres alimenticias. Entre los 300 individuos evaluados, 87,3% eran mujeres, edad media50,2±14,2 anos. Se observo alta prevalencia de morbilidad y costumbres alimenticias desfavorables. Los factores asociados con la HAS: entre losadultos fueron – edad ≥40 anos (OR=11,1 IC95%:3,6-34,3), exceso de peso (OR=8,0; IC95%:2,0-31,2), diabetes (OR=5.0; IC95%:2.0-12.8) y costumbrede pellizcar entre las comidas (OR=2,6; IC95%:1,3-5,4) y, entre los adultos mayores, sobrepeso (OR=2,9;IC95%:1,0-8,4). Se identificaron factores deriesgo modificables que, posiblemente, han contribuido al desarrollo de la HAS, en particular entre los adultos. Se sugiere que estos factores seantrabajados para contribuir a la prevencion y mejor control de la HAS.(AU)