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      Assessing risk behaviors and prevalence of sexually transmitted and blood-borne infections among female crack cocaine users in salvador - Bahia, Brazil

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          Abstract

          Crack cocaine use is associated with risky sexual behaviors and sexually transmitted infections (STIs), including HIV. We investigated sociodemographic and behavioral characteristics and infection rates in female crack cocaine users from impoverished communities of Salvador, Bahia, Brazil. A sample of 125 female crack cocaine users was recruited. Overall, the interviewees had low educational level and high rate of unemployment (close to 90%). One-third (37%) reported having traded sex for money or drugs, and 58% reported that they had not used condoms during intercourse in the last 30 days. The prevalence of infections was low: HIV-1.6%; HCV-2.4%; HBV- 0.8%; HTLV I/II-4.0%; and syphilis-4.0%. The combination of dire poverty and high prevalence of risk behaviors turn such populations a preferential target of initiatives aiming to reduce drug-related harm and promote social development. Low infection rates should not be viewed with complacency, but as a window of opportunity to implement prevention initiatives and reduce social marginalization.

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          HTLV-I in the general population of Salvador, Brazil: a city with African ethnic and sociodemographic characteristics.

          The city of Salvador has the highest prevalence of HTLV-I among blood donors in Brazil. To study the prevalence of HTLV-I among the general population of Salvador, 30 "sentinel surveillance areas" were selected for the investigation of various infectious diseases, and 1385 individuals within these areas were surveyed according to a simple random sample procedure. ELISA was used to screen plasma samples for antibodies to HTLV-I, and the positive samples were tested by a confirmatory assay (Western blotting). The overall prevalence of HTLV-I was 1.76% (23/1385). Infection rates were 1.2% for males and 2.0% for females. Specific prevalence demonstrated an increasing linear trend with age. No one younger than 13 years of age was infected. Multivariate analysis estimated adjusted odds ratios for the association of HTLV-I with age of 9.7 (3.3; 30.4) for females and 12.3 (1.47; 103.1) for males. Less education and income might be associated with HTLV-I infection in females. Phylogenetic analysis of the long terminal repeat fragments showed that most of the samples belonged to the Latin American cluster of the Transcontinental subgroup (Cosmopolitan subtype). For the entire city of Salvador, it is estimated that approximately 40000 individuals are infected with HTLV-I. Our results suggest multiple post-Colombian introductions of African HTLV-Ia strains in Salvador.
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            Intersecting epidemics--crack cocaine use and HIV infection among inner-city young adults. Multicenter Crack Cocaine and HIV Infection Study Team.

            The smoking of "crack" cocaine is thought to be associated with high-risk sexual practices that accelerate the spread of infection with the human immunodeficiency virus (HIV). We studied 2323 young adults, 18 to 29 years of age, who smoked crack regularly or who had never smoked crack. The study participants, recruited from the streets of inner-city neighborhoods in New York, Miami, and San Francisco, were interviewed and tested for HIV. This report presents the findings for the 1967 participants (85 percent) who had never injected drugs. Of the 1137 crack smokers, 15.7 percent were positive for HIV antibody, as compared with 5.2 percent of the 830 nonsmokers (prevalence ratio adjusted for the city, 2.4; 99 percent confidence interval, 1.7 to 3.6). The prevalence of HIV was highest among the crack-smoking women in New York (29.6 percent) and Miami (23.0 percent). Of the 283 women who had sex in exchange for money or drugs, 30.4 percent were infected with HIV as compared with 9.1 percent of the 286 other women (prevalence ratio, 3.1; 99 percent confidence interval, 1.9 to 5.1); of the 91 men who had anal sex with other men, 42.9 percent were infected with HIV as compared with 9.3 percent of the 582 men who did not have anal sex with other men (prevalence ratio, 4.7; 99 percent confidence interval, 3.0 to 7.4). In multivariable analyses, these high-risk sexual practices accounted for the higher prevalence of HIV infection among the crack smokers, as compared with those who did not smoke crack. Women who had recently had unprotected sex in exchange for money or drugs were as likely to be infected as men who had had sex with men (40.9 percent vs. 42.9 percent). In poor, inner-city communities young smokers of crack cocaine, particularly women who have sex in exchange for money or drugs, are at high risk for HIV infection. Crack use promotes the heterosexual transmission of HIV.
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              Report on the global AIDS epidemic.

              (2008)
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                Author and article information

                Journal
                bjid
                Brazilian Journal of Infectious Diseases
                Braz J Infect Dis
                Brazilian Society of Infectious Diseases (Salvador, BA, Brazil )
                1413-8670
                1678-4391
                December 2007
                : 11
                : 6
                : 561-566
                Affiliations
                [01] orgnameBahiana Foundation for Science Development orgdiv1Bahiana School of Medicine
                [02] orgnameFederal University of Bahia orgdiv1School of Medicine orgdiv2Center for the Study and Treatment of Drug Abuse
                [05] orgnameUniversity of California at Berkeley orgdiv1School of Public Health orgdiv2Department of Epidemiology USA
                [04] RJ orgnameOswaldo Cruz Foundation Brazil
                [03] Salvador BA orgnameOswaldo Cruz Foundation orgdiv1Gonçalo Muniz Research Center
                Article
                S1413-86702007000600007 S1413-8670(07)01100607
                10.1590/S1413-86702007000600007
                c41a213d-f7d6-4e61-9bf5-09719733d165

                This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

                History
                : 04 July 2007
                : 22 October 2007
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 58, Pages: 6
                Product

                SciELO Brazil

                Categories
                Original Papers

                female crack cocaine users,prevalence of sexually transmitted and blood-borne infections,Risk behaviors

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