Inaina Lara Fernandes

Transactional Sex among Noninjecting Illicit Drug Users: Implications for HIV Transmission

Noninjecting illicit drug users (NIDUs) present high risk for HIV infection, due especially to transactional sex. This study aimed to estimate the prevalence and risk factors for transactional sex among NIDUs in the Southwest region of Goiás State, Central Brazil. The prevalence of self-reported transactional sex was 22.8%. Prevalence in women and men was 52.7% and 16.8%, respectively, a significant difference (p < 0.001). Crack use and history of sexually transmitted infections (STI) were risk factors for transactional sex in men. Homelessness, crack use, sex under the influence of drugs, and history of sexual violence were risk factors for transactional sex in women. A high prevalence of transactional sex was observed among NIDUs. This risk behavior may contribute to the high rates of HIV among this population and their social networks and in the general population.

HIV testing in Non-Injection Drug Users: prevalence and associated factors

The objective of this study was to estimate the prevalence of and identify factors associated with lifetime testing for the human immunodeficiency virus (HIV) in non-injection drug users (NIDU). A cross-sectional study was conducted with 323 individuals in clinics for chemical dependency in the state of Goiás in the Central-West region of Brazil. Logistic regression analysis was used to identify factors associated with lifetime HIV testing. Testing for HIV was associated with age, female gender, crack use, history of sexually transmitted infections, acquaintance with people living with HIV/AIDS and/or who had died from AIDS, and history of having received some instruction on HIV/AIDS prevention methods. It was found that only 26.6% reported having access to the HIV rapid test. We concluded determinants for HIV testing must be taken into account when planning prevention and programming strategies. These include the widening of testing coverage among NIDU, educational health actions, establishment of links between sexually transmitted infection prevention services and addiction treatment services, and the use of rapid tests to help people who are in contact with the virus learn about their HIV status, enter treatment, and improve their quality of life.

Inconsistent use of condoms in non-injecting illicit drug users.

Non-injecting illicit drug users (NIDU) are a highly vulnerable group for the acquisition of the human immunodeficiency virus (HIV). The majority of these individuals present multiple risk behaviors, such as multiple sexual partners, exchange of sex for money or drugs, and inconsistent use of condoms.1 In addition, this group consists of individuals with low levels of income and education, which enhances the risk of viral acquisition. Studies have shown high rates of inconsistent use of condoms in NIDU, which increases the risk in this population for the acquisition and transmission of HIV.2,3 In this context, the objectives of this study were to estimate the prevalence of inconsistent condom use in NIDU and to identify the factors associated with unprotected sex with casual partners. A cross-sectional study was conducted with 323 NIDU hospitalized in two chemical dependency treatment clinics located in the southwest of Goiás, central west region of Brazil. The study included individuals aged 18 years or over who had used non-injection drugs in the month before the admission date (marijuana, intranasal cocaine, crack, intranasal heroin, inhalants, LSD, and ecstasy). Data collection was carried out between December 2014 and June 2015, through face to face interviews, covering sociodemographic characteristics, drug use pattern, and condom use with casual partners in the previous year. Inconsistent condom use was defined as irregular use (occasionally or never) by type of sexual intercourse (oral, anal, or vaginal).2 Univariate analysis was performed to verify the association between the variables and inconsistent use of condoms by sexual practice, using the STATA, version 12.0 program. The study was approved by the Research Ethics Committee of the Federal University of Goiás, authorization No. 926.819/2014. Informed consent was obtained from all participants. The mean age of the participants was 32.4 years (standard deviation: 11.3) and the majority were male (83.0%). Inconsistent use of condoms in oral, vaginal, and anal sex was reported by 72.2% (95% CI: 66.7–76.7%), 83.5% (95% CI: 79.3–87.4%) and 37.5% (95% CI: 32.3–43.1%) of the participants, respectively. A higher prevalence of inconsistent condom use during vaginal and anal sex was verified in females (Prevalence Ratio: 1.40; 95% CI: 1.16–1.69) and in those with a diagnosis of cannabis dependence (Prevalence Ratio: 1.24; 95% CI: 1.01–1.53). A high frequency of inconsistent condom use was observed in this study, confirming the vulnerability of NIDU for the acquisition of HIV. In this context, it is necessary to expand health promotion and prevention of sexually transmitted infections in these individuals, with the availability of condoms, encouraging safe sex practices, and health education of this population.

Professional knowledge in primary health care of the person/family in mental distress: Le Boterf perspective

O objetivo deste trabalho foi identificar os saberes e fazeres constituidos na pratica da Saude da Familia (SF), na visao dos enfermeiros, no que se refere ao atendimento a pessoa e familia em sofrimento mental na perspectiva dos saberes profissionais de Le Boterf. Metodo: Foi feito uma pesquisa descritiva exploratoria de abordagem qualitativa, delineada para apresentar e aprofundar a construcao de competencias dos profissionais enfermeiros, foi aplicada em 3 Unidades da SF. Resultados: fazendo uma analise tematica, chegou-se as seguintes categorias: “Saber agir com pertinencia”; “Saber mobilizar saberes e conhecimentos em um contexto profissional”; “Saber interagir saberes multiplos”; “Saber transpor”; “Saber aprender e saber aprender a aprender”; “Saber envolver-se”. Consideracoes finais: verificou-se que entre os saberes a maior dificuldade e a de “saber transpor”, e que o cotidiano das equipes de SF exige muito desse saber. Foi verificado pouca transposicao de saberes/fazeres em situacoes reais.

Risk behaviors for sexually transmitted infections in noninjecting drug users: A cross-sectional study

The objective of this study was to investigate risk behaviors for sexually transmitted infections (STIs) in noninjecting drug users (NIDUs), using STI diagnosis history as an indicator. A cross-sectional study was conducted in 323 NIDUs of two facilities for alcohol and/or drug dependence treatment in the Goiás State, Central Brazil. All participants were interviewed about risk behaviors and STI history. Multivariable analysis was performed in order to identify predictors of STIs. Adjusted prevalence ratio (APR) with confidence intervals of 95% was obtained using a Poisson regression model. Prevalence of self-reported STIs in the previous 12 months was 25.4% (95% confidence interval [95% CI]: 21.0–30.4%). A multivariable model verified that age (APR: 1.01; 95% CI: 1.00–1.01), sexual contact with partners diagnosed with STIs (APR: 1.27; 95% CI: 1.12–1.45) and injecting drug users (IDUs) (APR: 1.14; 95% CI: 1.14; 95% CI: 1.01–1.31), exchange sex for money and/or drugs (APR: 1.12; 95% CI: 1.02–1.21), and a history of sexual violence (APR: 1.04; 95% CI: 1.04–1.32) were predictors of STIs. Elevated rates of STI history and risk behaviors were observed in NIDUs, supporting the vulnerability of this group for these infections. Public policies and health outreach should be intensified in this population, principally regular STI testing of individuals in treatment for drug dependence and their sexual partners.

COMMON MENTAL DISORDER AMONG ALCOHOL AND DRUG ABUSERS: A CROSS-SECTIONAL STUDY

Objective: to estimate the prevalence of the probability of common mental disorders among abusers of alcohol and other drugs. Method: a cross-sectional study. The sample was made up of 234 individuals undergoing treatment and rehabilitation for chemical dependence in private clinics and in a Psychosocial Care Center in the Southeast area of the state of Goias, Brazil. Instruments on sociodemographic profile, use of licit and/or illicit drugs, and a questionnaire that tracks common mental suffering were applied. Results: the outcome variable was the probability of common mental disorder, with 37.2% of the total of the sample. Association between the probability of common mental disorders and the female gender (odds ratio=4.06; 95% CI 1.56-10.56), age ≤25 years old (odds ratio=3.00; 95% CCI 1.41-6.38), and use of marijuana in life (odds ratio=2.83; 95% CI 1.38-5.78) were found. Conclusion: the study showed an association between the use and abuse of drugs and risk for common mental disorders.

TRANSTORNO MENTAL COMUM ENTRE INDIVÍDUOS QUE ABUSAM DE ÁLCOOL E DROGAS: ESTUDO TRANSVERSAL

Objective: to estimate the prevalence of the probability of common mental disorders among abusers of alcohol and other drugs. Method: a cross-sectional study. The sample was made up of 234 individuals undergoing treatment and rehabilitation for chemical dependence in private clinics and in a Psychosocial Care Center in the Southeast area of the state of Goias, Brazil. Instruments on sociodemographic profile, use of licit and/or illicit drugs, and a questionnaire that tracks common mental suffering were applied. Results: the outcome variable was the probability of common mental disorder, with 37.2% of the total of the sample. Association between the probability of common mental disorders and the female gender (odds ratio=4.06; 95% CI 1.56-10.56), age ≤25 years old (odds ratio=3.00; 95% CCI 1.41-6.38), and use of marijuana in life (odds ratio=2.83; 95% CI 1.38-5.78) were found. Conclusion: the study showed an association between the use and abuse of drugs and risk for common mental disorders.

TRASTORNO MENTAL COMÚN ENTRE PERSONAS QUE ABUSAN DE ALCOHOL Y DROGAS: ESTUDIO TRASVERSAL

Objective: to estimate the prevalence of the probability of common mental disorders among abusers of alcohol and other drugs. Method: a cross-sectional study. The sample was made up of 234 individuals undergoing treatment and rehabilitation for chemical dependence in private clinics and in a Psychosocial Care Center in the Southeast area of the state of Goias, Brazil. Instruments on sociodemographic profile, use of licit and/or illicit drugs, and a questionnaire that tracks common mental suffering were applied. Results: the outcome variable was the probability of common mental disorder, with 37.2% of the total of the sample. Association between the probability of common mental disorders and the female gender (odds ratio=4.06; 95% CI 1.56-10.56), age ≤25 years old (odds ratio=3.00; 95% CCI 1.41-6.38), and use of marijuana in life (odds ratio=2.83; 95% CI 1.38-5.78) were found. Conclusion: the study showed an association between the use and abuse of drugs and risk for common mental disorders.

Prevalence and Factors Associated With Criminal Behavior Among Illicit Drug Users: A Cross-Sectional Study

ABSTRACT Background: Studies indicate high rates of criminal behavior, violent activities, and legal problems among illicit drug users (IDU) in Brazil. The aim of this study was to estimate the prevalence and factors associated with criminal behavior among IDU undergoing treatment for chemical dependency in Central Brazil. Methods: Cross-sectional study carried out with IDU undergoing treatment for chemical dependence. Data were collected by means of face-to-face interviews and analyzed using logistic regression. Results: Of the total participants (n = 274), 46.7%, 15.7%, and 10.9% reported involvement in robbery, drug trafficking and homicide, respectively. Robbery was associated with young age, withdrawal symptoms, prison record, sex work, and crack use, while drug trafficking was associated with young age, low education, and marijuana use. Homicides were associated with cocaine and marijuana use. Conclusion: The results show high rates of criminal behavior among drug users, demonstrating associations between socio-demographic and behavioral characteristics, illicit drug use, and practices of illegal activities. These variables must be considered when planning programs and policies to reduce harm related to drug use and abuse.

Saberes profissionais na atenção primária à saúde da pessoa/família em sofrimento mental: perspectiva Le Boterf

O objetivo deste trabalho foi identificar os saberes e fazeres constituidos na pratica da Saude da Familia (SF), na visao dos enfermeiros, no que se refere ao atendimento a pessoa e familia em sofrimento mental na perspectiva dos saberes profissionais de Le Boterf. Metodo: Foi feito uma pesquisa descritiva exploratoria de abordagem qualitativa, delineada para apresentar e aprofundar a construcao de competencias dos profissionais enfermeiros, foi aplicada em 3 Unidades da SF. Resultados: fazendo uma analise tematica, chegou-se as seguintes categorias: “Saber agir com pertinencia”; “Saber mobilizar saberes e conhecimentos em um contexto profissional”; “Saber interagir saberes multiplos”; “Saber transpor”; “Saber aprender e saber aprender a aprender”; “Saber envolver-se”. Consideracoes finais: verificou-se que entre os saberes a maior dificuldade e a de “saber transpor”, e que o cotidiano das equipes de SF exige muito desse saber. Foi verificado pouca transposicao de saberes/fazeres em situacoes reais.