Syphilis still constitutes a serious public health problem for its magnitude and transcendence, despite the existence
Doencas sexualmente transmissiveis sifilis effective prevention and control measures. Draft global health sector strategies. Sexually transmitted infections, [internet]. World Health Organization; [cited Aug 10].
Doencas sexualmente transmissiveis sifilis predominant form of this disease transmission is via sex. Among the main consequences of untreated infection are the vertical transmission of Treponema pallidum which causes the congenital syphilis - and the association with human immunodeficiency virus HIV infection. HIV and syphilis co-infection has a synergistic effect, characterized by both Doencas sexualmente transmissiveis sifilis elevation of HIV transmissibility and the atypical evolution of treponemic infection.
From epidemiological synergy to public health policy and practice: Actions for the prevention and control of syphilis are available and have a low cost: It is important to highlight that these actions have an extremely favorable cost-effectiveness relation.
According to estimates from the World Health Organization WHOinapproximately 18 million adults had syphilis worldwide, with 5. Global estimates of the prevalence and incidence of four curable sexually transmitted Doencas sexualmente transmissiveis sifilis in based on systematic review and global reporting.
WHO has established syphilis as one of priorities for implementation of actions to prevent and control sexually transmitted infections STI from Doencas sexualmente transmissiveis sifilis In Brazil, congenital syphilis has been a notifiable disease since Doencas sexualmente transmissiveis sifilis, syphilis in pregnant women and acquired syphilis became notifiable diseases only in andrespectively.
From to June, cases of Doencas sexualmente transmissiveis sifilis syphilis in adults were reported in the country. In the Brazilian context, the increase in the number of acquired syphilis cases may have occurred due to the reduction of underreporting cases; it can also be to the influence of changes in the scenario of sexual practices and behaviors that could favor people's vulnerability to STI.
According to a systematic review of the literature on the use of condoms in Brazil, studies indicate the stabilization or reduction in the frequency of male condom use, mainly since Revisitando o uso de preservativo no Brasil. In the country, data available in the Information System for Notifiable Diseases Sinan referring to syphilis are about personal identification:
Doencas sexualmente transmissiveis sifilis related to laboratory confirmation, disease phase, sexual behaviors, treatment prescription and presence of HIV co-infection are not yet available for all national territory.
Doencas sexualmente transmissiveis sifilis systematic collection of information related to the main exposures and the presence of HIV co-infection, it is not possible to carry out an adequate evaluation of the trends of this disease.
Department of Health and Human Services. Centers for Disease Control and Prevention. Sexually transmitted disease surveillance [internet]. Centers for Disease Control and Prevention; [cited Aug 10]. European Centre for Disease Prevention and Control.
Sexually transmitted infections
Doencas sexualmente transmissiveis sifilis Europe [internet]. ECDC; [cited Aug 10]. According to data available in Sinan, 7 7. To obtain Doencas sexualmente transmissiveis sifilis information, it would be necessary to establish relationships between databases referring to each Doencas sexualmente transmissiveis sifilis the diseases, using nominal data - which are not publicly available. This is a cross-sectional study with secondary data from the Information System for Notifiable Diseases - Sinan.
The Reference Center for Sexually Transmissible Diseases STD and AIDS where the research was Doencas sexualmente transmissiveis sifilis is a specialized public assistance service that meets spontaneous and referenced demand from other state management services.
It is organized into specialized outpatient clinics, which have Doencas sexualmente transmissiveis sifilis characteristics according to the populations assisted: All results of the serological Doencas sexualmente transmissiveis sifilis dark-field microscopy were obtained from laboratory reports performed at the same center.
We utilized data from Sinan and from syphilis investigation and notification forms. Sinan is a nationwide information system, managed by the Ministry of Health, and used for epidemiological surveillance in the country. Data entry in this system is under local responsibility; these data are extracted from specific
Doencas sexualmente transmissiveis sifilis and notification
Doencas sexualmente transmissiveis sifilis on each disease or illness, and then consolidated and analyzed by municipal and state levels.
Sinan's data on acquired syphilis do not incorporate the clinical, laboratory and epidemiological preceding, neither the
Doencas sexualmente transmissiveis sifilis in relation to HIV infection; only sociodemographic characteristics are recorded in the system. In order to complete the missing information, a complementary form was used in the service routine of the unit's epidemiological surveillance.
All information regarding serology results for syphilis and HIV were Doencas sexualmente transmissiveis sifilis with laboratory source, to ensure the data reliability.
We evaluated the duplicity of cases in Sinan database, withdrawing the identified cases. The possibly confounding variables were controlled through multivariate analysis.
The Poisson regression model with robust variance estimation was used for multivariate analysis. The variables that remained in the model were those that presented a level of significance lower than 0. We organized two intermediate models model 1 and model 2 to test the potential confounding effect of the variable outpatient clinic type. In model 1, we tested the variables sex, age group, education Doencas sexualmente transmissiveis sifilis and sexual behavior; an exception was made for the outpatient clinic type, which Doencas sexualmente transmissiveis sifilis included in model 2; model 3 resulted from the inclusion of better adjusted variables.
Only secondary data, registered by the local epidemiological surveillance system were used; thus, the signing of the Free and Informed Term of Consent was not necessary. A total of cases of acquired syphilis were reported, with a predominance of males Among the characteristics of sexual behavior and other vulnerabilities, of the total reported cases, we observed: The prevalence of HIV Doencas sexualmente transmissiveis sifilis was of Doencas sexualmente transmissiveis sifilis were differences among patients, according to the care provided at each of the two outpatient clinics located in the STD and AIDS Doencas sexualmente transmissiveis sifilis Center, especially regarding socio-demographic characteristics, sexual behavior and HIV seropositivity: The highest prevalence ratios on HIV co-infection found in reported cases of acquired syphilis were the following: In the multivariate analysis, there was a difference between the models: In Doencas sexualmente transmissiveis sifilis 2 and 3, the associated variables were sex, education level, MSM exposure category and outpatient clinic type.
There was a confounding effect of the variables age group and outpatient clinic type. In model 3, the variables independently associated to HIV infection were the following: In the considered STD and AIDS Reference Center, the cases of acquired syphilis diagnosed and notified were predominantly of young Doencas sexualmente transmissiveis sifilis, with higher education level, self-declared white, with multiple sexual partners in the prior year, MSM, with preceding of non-injecting drug use, and with reagent serology to HIV.
In the USA, among the reported cases of syphilis inthe highest incidence rate of primary and secondary syphilis in adults occurred in the age group from 25 to 29 years old In this region presented a very low index of social vulnerability.
Assembleia Legislativa; [citado ago 10]. In studies to estimate the prevalence of syphilis and HIV infection in MSM conducted in Brazil in andthere was a high prevalence of syphilis in Bahia 8.
Rev Med Minas Gerais. Estudo Nascer no Brasil. should emphasize that the Doencas sexualmente transmissiveis sifilis
Doencas sexualmente transmissiveis sifilis of HIV co-infection among the cases of acquired syphilis in the service studied herein is due to the fact that many of were being followed up at the PLHA outpatient clinic.
In spite of the purpose of this outpatient Doencas sexualmente transmissiveis sifilis, the high frequency of co-infection that was found may represent possible failures in adherence to prevention measures and, potentially, occurrence of new exposures to the etiologic agent of syphilis. This high frequency, much higher that estimated for the Brazilian population, is also due to the service characteristics.
We should point out the fact of being a TCC, Doencas sexualmente transmissiveis sifilis recently exposed people are looking for the service for testing. In a study about personal characteristics and factors associated with HIV seropositivity in TCC service users, for the period from to7.
Chlamydia trachomatis, neisseria gonorrhoeae and syphilis among men who have sex with men in Brazil. Another study, carried out to in Salvador, with MSM, found 44 of them with syphilis diagnosed, and Surveillance data in England from to showed that the chance of MSM with HIV infection to be affected by syphilis was four times higher than in other exposure category.
Contribution Doencas sexualmente transmissiveis sifilis transmission in HIV-positive men who have sex with men to envolving epidemics of sexually transmitted infections in England: The present study has some limitations. Data quality could be compromised due to and inconsistency - quite present when secondary data Doencas sexualmente transmissiveis sifilis utilized. To reduce possible losses, the information was checked with those from other sources.
In order to minimize underreporting of cases, all service users who presented reagent results to serological tests for syphilis were investigated and notified.
Results of this research point the need to strengthen the offer of HIV prevention and control actions on MSM category for those that seek health care during the diagnosis of syphilis.
Several prevention strategies available should be offered in accordance with the exposures and vulnerabilities of the population, in an articulated way. Among these strategies, we highlight the behavioral condom distributioneducational counseling and biomedical antiretroviral therapy pre-exposure [PrEP] and post-exposure [PEP] to HIV. The rapidly changing paradigm of HIV prevention: Syphilis trends among men who have sex with men in the United States and Western Europe: Preexposure chemoprophylaxis for HIV prevention in men who have sex with men.
N Engl J Med. Brazilian policy to tackle HIV and AIDS adopts the combined prevention strategy, Doencas sexualmente transmissiveis sifilis it understands that different prevention strategies can offer the choice opportunity of the prevention tool considered more appropriate.
In this service studied inMSM notified with acquired syphilis were disproportionately affected by HIV co-infection. Centers for Diseases Control and Prevention. CDC; [cited Aug 10]. Therefore, we recommend to be one of the criteria for choosing PrEP 26 In conclusion, the analysis of HIV co-infection prevalence in patients with acquired Doencas sexualmente transmissiveis sifilis and its associated factors can contribute to the formulation of prevention measures on HIV infection in populations that attend
Doencas sexualmente transmissiveis sifilis
Doencas sexualmente transmissiveis sifilis of STI and AIDS.
Tancredi, for the important contributions in the discussion of analysis procedures in this article. To Wong Kuen Alencar, in memoriam, for his tireless Doencas sexualmente transmissiveis sifilis in the conception of this project and commitment with the epidemiological surveillance.
Introduction Syphilis still constitutes a serious public health problem Doencas sexualmente transmissiveis sifilis its magnitude and transcendence, despite the existence of effective prevention and control measures. Methods This is a cross-sectional study with secondary data from the Information System for Notifiable Diseases - Sinan.
We analyzed the following variables: Table 4 Multivariate models: Acknowledgments To Mariza V.
References 1 World
Doencas sexualmente transmissiveis sifilis Organization. All authors have approved the final version to be published and are responsible for all aspects of the study, ensuring its accuracy and integrity.