17 research outputs found
Política Nacional de Saúde Integral Lésbicas, Gays, Bissexuais, Travestis e Transexuais
O módulo Política Nacional de Saúde Integral LGBT foi organizado de forma a contribuir com os profissionais de saúde, notadamente os trabalhadores do SUS, para que realizem suas ações de cuidado, promoção e prevenção, com qualidade, de forma equânime, garantindo à população LGBT acesso à saúde integral. O curso é um dos módulos desenvolvidos pela UNA-SUS UERJ que integram o Programa de Valorização da Atenção Básica (PROVAB) e se divide em 03 unidades cujas áreas temáticas são: Gênero e sexualidade; O estudo da Política LGBT e seus marcos; Realizando o acolhimento e o cuidado à População LGBT. Este recurso é referente a 2ª oferta do módulo pela UERJ.Oferta 02Ministério da Saúd
Análise dos padrões de difusão espacial dos casos de AIDS por estados brasileiros
Ações preventivas ainda são essenciais ao controle da epidemia de AIDS; contudo, programas de prevenção eficazes dependem da distribuição correta e eficiente dos recursos de saúde. Assim, informações acerca de onde, quando, com que intensidade e como se difundirá a epidemia são valiosos. Este estudo visou obter melhor compreensão do processo de difusão espacial dos casos de AIDS em quatro Estados brasileiros. Tais padrões foram avaliados qualitativamente - estudo de mapas seqüenciais - e quantitativamente - análise de correlogramas espaciais - ao longo de dez anos, agrupados em três períodos: 1987-1989, 1990-1992 e 1993-1996. O processo de difusão foi estudado para o total de casos de AIDS e para os do sexo feminino e masculino. De modo geral, houve difusão significativa dos casos de AIDS nos períodos, mas o processo exibiu características específicas a cada Estado. As informações obtidas - em especial, os resultados da análise de correlogramas - permitem entender melhor os padrões de difusão espacial da epidemia em diferentes partes do País e podem ser empregadas para fixar parâmetros a outros modelos epidemiológicos da AIDS
O contexto do uso de drogas em cinco cidades brasileiras
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Previous issue date: 1995Made available in DSpace on 2010-11-04T14:19:39Z (GMT). No. of bitstreams: 3
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Previous issue date: 1995Universidade do Estado do Rio de Janeiro. Núcleo de Estudos e Pesquisas em Atenção ao Uso de Drogas. Rio de Janeiro, RJ, Brasil.Fundação Oswaldo Cruz. Centro de Informação Científica e Tecnológica. Departamento de Informações em Saúde. Rio de Janeiro, RJ, Brasi
A geo-política da AIDS entre usuários de drogas injetáveis no Brasil
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Previous issue date: 1995Fundação Oswaldo Cruz. Centro de Informação Científica e Tecnológica. Departamento de Informações em Saúde. Rio de Janeiro, RJ, Brasil.Fundação Oswaldo Cruz. Centro de Informação Científica e Tecnológica. Departamento de Informações em Saúde. Rio de Janeiro, RJ, Brasil.Núcleo de Estudos e Pesquisas em Atenção ao Uso de Drogas. Rio de Janeiro, RJ, Brasil
HIV-infection among injecting drug users: analysis of risk factors in Rio de Janeiro City, Brazil.
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Previous issue date: 1998Auxílio financeiro
Ministério da Saúde/Coordenação Nacional de DST/AIDS e Programa de AIDS da Fundação Oswaldo Cruz (PIAFI/FIOCRUZ). Testes laboratoriais realizados no Departamento de Imunologia, Fundação Oswaldo Cruz (IOC/FIOCRUZ), sob a responsabilidade da Dra. Mariza G. Morgado. Apoio da Fundação de Amparo à Pesquisa do Rio de Janeiro - FAPERJ (PRT) e do Conselho Nacional de Desenvolvimento Científico e Tecnológico - CNPq (FIB).Universidade Federal do Rio de Janeiro. Programa de Engenharia Biomédica. Rio de Janeiro, RJ, Brasil / Universidade do Estado do Rio de Janeiro. Núcleo de Estudos em Atenção ao Uso de drogas. Rio de Janeiro, RJ, Brasil.Universidade Federal do Rio de Janeiro. Programa de Engenharia Biomédica. Rio de Janeiro, RJ, Brasil.Fundação Oswaldo Cruz. Centro de Informação Científica e Tecnológica. Departamento de Informações em Saúde. Rio de Janeiro, RJ, Brasil.O trabalho visa a determinar os fatores de
risco para a infecção pelo HIV (Human
Immunodeficiency Virus – vírus da aids) entre
usuários de drogas injetáveis (UDI), no
Município do Rio de Janeiro. Os entrevistados
foram recrutados em centros de tratamento
para usuários de drogas e nas “cenas
de uso” (“ruas”). Foram utilizados três
questionários: um destinado a colher informações mais gerais acerca dos UDI, adaptado de estudo anterior da Organização
Mundial da Saúde (OMS); um segundo voltado
para a pesquisa de informações suplementares
sobre conhecimentos, comportamentos e atitudes em relação à aids; além de um terceiro instrumento destinado a avaliar níveis de disfunção psicológica.
O estudo consistiu de 110 entrevistados
que voluntariamente realizaram testes
laboratoriais para a presença do HIV, além
de outros agentes infecciosos de transmissão
sangüínea (HBV, HCV, HDV, HGV/GBVC,
HTLV-I/II). A soroprevalência para o HIV-1 foi de 28,7%. Utilizando-se um modelo
de regressão logística múltipla (Estatística
de Hosmer-Lemeshow, c2 = 1,89; p=0,98), foram identificados como fatores de risco para a infecção pelo HIV: “local de moradia de baixa renda” (OR=5,57; IC 95%: [1,39 - 22,27]), “fonte de renda irregular”
(OR=3,26; IC 95%: [1,01 - 10,51]), “menor
idade de início quando do consumo de drogas
injetáveis” (OR=2,50; IC: 90%: [0,99 -6,28]), “local de recrutamento nos centros de tratamento para uso de drogas” (vs. recrutamento nas “ruas”) (OR=7,91; IC 95%:
[2,03 - 30,87]) e “maior freqüência de
compartilhamento do material de injeção
nos 6 meses anteriores à entrevista”
(OR=4,41; IC 95%: [1,33 - 14,64])
Risk behavior and HIV seroprevalence among injecting drug users in Rio de Janeiro, Brazil
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Previous issue date: 1997The WHO project reported here was sponsored by PSA/WHO and was also supported by the State University of Rio de janeiro (UERJ). Projeto Brasil was sponsored by the Brazilian Ministry of Health and the Oswaldo Cruz Foundation. P.R.T. is the recipient of a PhD scholarship from the Rio de Janeiro State Reseaech ouncil (FAPERJ) of Brazil. F.I.B. was supported by FAPERJ grant 2A, 1994/7. The Proviva Project was supported by grant UO1DA08510 from the United States Departament of Health and Human Services, Nacional Institute of Drug Abuse.Nucleo de Estudos e Pesquisa em Atenção ao uso de Drogas (NEPAD), State University of Rio de Janeiro, Rio de Janeiro, BrazilDepartamento de Informações para a Saúde/Centro de Informação en Ciencia e Tecnologia, Oswaldo Cruz Foundation, Rio de janeiro, BrazilInstitute for Health Policy Studies, University of California, San Francisco, California, USAComprehensive Drug Research Center, University of Miami School of Medicine, Miami, FloridaComprehensive Drug Research Center, University of Miami School of Medicine, Miami, FloridaInstitute for Health Policy Studies, University of California, San Francisco, California, USACenter for AIDS Prevention Studies, University of California, San Francisco, California, USAObjective: To characterize HIV seroprevalence and reisk behavior among injecting drug users (IDUS) in Rio de Janeiro, Brazil, between 1990 and 1996. Design: We report data from three separate cross-sectional samples of IDUS in Rio de Janeiro: the World Health Organization (WHO) sample (n=479), the Proviva sample (n=138) and thr Brasil sample (n=110). These data provide the most comprehensive view available, to date, of this understudied population im Rio. Methods: Demographic characteristics, HIV/AIDS risk behavior and HIV seroprevalence were compared across the three samples and combined analyses were performed to determine the factors associated with injecting risk behavior, sexual risk behavior and HIV seropositivity. Results: The overal HIV seroprevalence among IDUS 25%. Two encouraging findings of the present analysis were the lower levels of needle-sharing among participants recruited in the latest years (1995-1996) andthe lower HIV serprevalence in the Proviva sample composed mainly of less educated, poorer IDUS living im deprived neighborhoods. No trends toward safer behavior were foundfor sexual risk, younger age being the principal factor associated with high risk. Conclusions: Levels of needle-sharing and sexual risk among IDUS in Rio remain high, demonstrating the urgent need to increase the limites preventive measures under-taken so far. Seroprevalence levels for HIV remain significantly lower in the most deprived sample, arguing for the fundamental importance of prompt and effective prevention strategies to keep infections rates from rising among the poorest and largest strata of Rio's IDUS
Post-traumatic stress disorder as a predictor for incident hypertension: a 3-year retrospective cohort study
Background. The goal of the present study was to investigate the association between PTSD and the onset of hypertension in previously normotensive individuals in a population living in the stressful environment of the urban slums while controlling for risk factors for cardiovascular disease (CVD). Methods. Participants were 320 normotensive individuals who lived in slums and were attending a family doctor program. Measurements included a questionnaire covering sociodemographic characteristics, clinical status and life habits, the Posttraumatic Stress Disorder Checklist – Civilian Version, and the Beck Depression Inventory. Incident hypertension was defined as the first occurrence at the follow-up review of the medical records of (1) systolic blood pressure of 140mm Hg or higher or diastolic blood pressure of 90mm Hg or higher, (2) the participant started taking antihypertensive medication, or (3) a new diagnosis of hypertension made by a physician. Differences in sociodemographic, clinical, and lifestyle characteristics between hypertensive and non-hypertensive individuals were compared using the χ2 and t tests. Multivariate Cox proportional hazards models were used to calculate hazard ratios (HR) and 95% confidence intervals (CI). Results. Six variables – age, educational level, bodymass, smoking, diabetes, and PTSD diagnosis – showed a statistically significant (p ≤ 0.20) association with the hypertensive status. In the Cox regression, only PTSD diagnosis was significantly associated with incident hypertension (multivariate HR = 1.94; 95% CI 1.11–3.40). Conclusions. The present findings highlight the importance of considering a diagnostic hypothesis of PTSD in the prevention and treatment of cardiovascular diseases.SimBackground. The goal of the present study was to investigate the association between PTSD
and the onset of hypertension in previously normotensive individuals in a population living
in the stressful environment of the urban slums while controlling for risk factors for cardiovascular
disease (CVD).
Methods. Participants were 320 normotensive individuals who lived in slums and were attending
a family doctor program. Measurements included a questionnaire covering sociodemographic
characteristics, clinical status and life habits, the Posttraumatic Stress Disorder Checklist –
Civilian Version, and the Beck Depression Inventory. Incident hypertension was defined as the
first occurrence at the follow-up review of the medical records of (1) systolic blood pressure of
140mm Hg or higher or diastolic blood pressure of 90mm Hg or higher, (2) the participant
started taking antihypertensive medication, or (3) a new diagnosis of hypertension made by a
physician. Differences in sociodemographic, clinical, and lifestyle characteristics between hypertensive
and non-hypertensive individuals were compared using the χ2 and t tests. Multivariate
Cox proportional hazards models were used to calculate hazard ratios (HR) and 95% confidence
intervals (CI).
Results. Six variables – age, educational level, bodymass, smoking, diabetes, and PTSD diagnosis –
showed a statistically significant (p ≤ 0.20) association with the hypertensive status. In the Cox
regression, only PTSD diagnosis was significantly associated with incident hypertension (multivariate
HR = 1.94; 95% CI 1.11–3.40).
Conclusions. The present findings highlight the importance of considering a diagnostic
hypothesis of PTSD in the prevention and treatment of cardiovascular diseases
Retrovirus infections in a sample of injecting drug users in Rio de Janeiro City, Brazil: prevalence of HIV-1 subtypes, and co-infection with HTLV-I/II
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Previous issue date: 2001The HIV-1 en Subtyping Kit was kindly provided by the NIH AIDS Research and Reference Reagent Program and UNAIDS. M.L.G., F.I.B. and P.T. are personally supported by grants from CNPq and FAPERJ. This project was supported by the National Coordination of STD and AIDS/
UNDCP/World Bank; World Health Organization
–Global Programme on AIDS/United
Nations Programme on AIDS (UNAIDS), the
FIOCRUZ Integrated AIDS Program/Brazilian
Ministry of Health, the Brazilian Research Council (CNPq), and Rio de Janeiro State Council (FAPERJ).Oswaldo Cruz Foundation. Oswaldo Cruz Institute. Department of Immunology. Laboratory of AIDS and Molecular Immunology. Rio de Janeiro, RJ, Brasil.Department of Health Information, Center for Information on Science and Technology, FIOCRUZ (UNAIDS Collaborative Centre), Rio de Janeiro, BrazilCenter for Drug Abuse Treatment and Research (NEPAD), State University of Rio de Janeiro, Rio de Janeiro, BrazilAdvanced Public Health Laboratory, Gonçalo Moniz Research Center, FIOCRUZ (UNAIDS Collaborative Centre), Bahia, BrazilLaboratory of Retrovirology, Federal University of São Paulo, São Paulo, BrazilOswaldo Cruz Foundation. Oswaldo Cruz Institute. Department of Immunology. Laboratory of AIDS and Molecular Immunology. Rio de Janeiro, RJ, Brasil.Oswaldo Cruz Foundation. Oswaldo Cruz Institute. Department of Immunology. Laboratory of AIDS and Molecular Immunology. Rio de Janeiro, RJ, Brasil.Background :Retrovirus infections among injecting drug users (IDUs), a core at-risk population for both HIV-1 and HTLV-I/II infections in Brazil, were assessed within an ongoing cooperative research. Objecti e : The study assessed the seroprevalences of HIV-1 and HTLV-I/II infections, as well as the prevalence of HIV-1 subtypes in a sample of IDUs from Rio de Janeiro, Brazil. An attempt to evaluate HIV incidence was carried out using a dual ‘sensitive/less
sensitive’ testing strategy. Study design : Cross-sectional evaluation of 175 IDUs. Serostatus for HIV-1 and HTLV-I/II
were established by enzyme-linked immunosorbent assays, and confirmed by western blot. The dual testing strategy
aimed to estimate HIV-1 incidence rates. Differentiation between HTLV-I and -II was performed by western blot.
DNA samples were polymerase chain reaction amplified by a nested protocol, and HIV-1 subtyping was determined by heteroduplex mobility assay. Results : Forty-six and 29 samples were found to be, respectively, positive for HIV-1 and HTLV-I/II, 15 of them co-infected by both viruses. Among HTLV-I/II-infected patients, 75.9% were infected by
HTLV-I. Thirty-one HIV samples were identified as B subtype, with seven of them showing the typical ‘Brazilian B’
pattern in the gp120 V3 loop, and ten were identified as F subtype. The use of less sensitive assays for HIV infection
wrongly identified a deeply immunocompromised patient as an incident case. Conclusion :Moderately high seroprevalences were found for both HIV-1 and HTLV-I/II infections, HIV-1/HTLV-I co-infections being of special concern.
A non-statistically significant higher prevalence of F subtype was observed, when compared with the distribution of
F/B subtypes among Brazilian patients from other exposure categories. No recent HIV-1 infections were detected, but a limitation of the ‘sensitive/less-sensitive’ testing strategy was made evident
The role of ‘‘long-term’’ and ‘‘new’’ injectors in a declining HIV/AIDS epidemic in Rio de Janeiro, Brazil
MARIANA A. HACKER,1 SAMUEL R. FRIEDMAN,2
PAULO ROBERTO TELLES,3 SYLVIA LOPES TEIXEIRA,4 VERA BONGERTZ,4 MARIZA G. MORGADO,4 AND FRANCISCO INÁCIO BASTOS1 - 1Department of Health Information, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil -
2National Development Research Institutes, Inc., New York City, New York, USA - 3Rio de Janeiro Harm Reduction Project, State University of Rio de Janeiro, Rio de Janeiro, Brazil - 4Department of Immunology, Oswaldo Cruz Foundation, Rio de Janeiro, BrazilMade available in DSpace on 2010-08-23T16:58:32Z (GMT). No. of bitstreams: 3
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Previous issue date: 2005The project in its different phases and components was funded by the Oswaldo Cruz
Foundation/Brazilian Ministry of Health, the Rio de Janeiro State Research Council (FAPERJ) and the National Research Council (CNPq), and the World Health Organization (WHO). SRF was supported by the US National Institute on Drug Abuse grants R01 DA03574 (Risk Factors for AIDS Among Intravenous Drug
Users) and R01 DA13128 (Networks, Norms and HIV Risk Among Youth).Oswaldo Cruz Foundation. Department of Health Information. Rio de Janeiro, RJ, Brazil.National Development Research Institutes, Inc., New York City, New York, USAState University of Rio de Janeiro. Rio de Janeiro Harm Reduction Project. Rio de Janeiro, RJ, Brazil.Department of Immunology, Oswaldo Cruz Foundation, Rio de Janeiro, BrazilDepartment of Immunology, Oswaldo Cruz Foundation, Rio de Janeiro, BrazilDepartment of Immunology, Oswaldo Cruz Foundation, Rio de Janeiro, BrazilOswaldo Cruz Foundation. Department of Health Information. Rio de Janeiro, RJ, Brazil.Background. A substantial decline of HIV prevalence has been observed in injection
drug users (IDUs) from Rio de Janeiro, in recent years. Differential characteristics
and behaviors of new (injecting for ¼6 y) injectors
may help to understand recent changes and to implement appropriate prevention
strategies. recruited from different communities, interviewed, and tested for HIV. Contingency table analysis and t-tests were used to assess differences between new and long-term injectors. Multiple logistic regression was used to identify independent predictors of HIV serostatus for long-term and new injectors. Results. HIV prevalence was 11.7% for 309 long-term injectors (95% CI 8.1– 15.3) and 4.3% for 300 new injectors (95% CI 2.0–6.6). New injectors reported
having engaged in treatment and having received syringes from needle exchange
programs (NEPs) more frequently than long-term injectors in the last 6 months, but
sharing behaviors remained frequent and even increased vis-a`-vis long-term injectors.
For male new injectors, ‘‘sexual intercourse with another man’’ was found to be the
sole significant risk factor for HIV infection (Adj OR¼8.03; 95% CI 1.52–42.48).
Among male long-term injectors, ‘‘to have ever injected with anyone infected with
HIV’’ (Adj OR¼3.91; 95% CI 1.09–14.06) and to have ‘‘ever been in prison’’ (Adj
OR¼2.56; 95% CI 1.05–6.24) were found to be significantly associated with HIV infection.
Discussion. New injectors are seeking help in drug treatment centers or needle exchange programs. They differ from long-term injectors in terms of their risk factors
for HIV infection and have lower prevalence levels for HIV. Such differences may help to understand the recent dynamics of HIV/AIDS in this population and highlight the need to reinforce new injectors’ help-seeking behavior and to reduce current unacceptably high levels of unprotected sex and syringe sharing in new injectors despite attendance of prevention/treatment programs