Estudantes universitários e a infecção pelo hiv: um estudo sobre comportamento sexual e vulnerabilidades / College students and hiv infectIon: a study of sexual behavior and vulnerabIiIies

Transformações emocionais, sociais e físicas marcam a adolescência. Nessa fase do desenvolvimento, o indivíduo mais vulnerável tende a se envolver em comportamentos de risco relacionados ao uso de álcool e drogas assim como em situações de sexo sem proteção. Objetivo: Avaliar as atitudes dos universitários em relação às doenças sexualmente transmissíveis (DST) e a influência da universidade nesse comportamento. Métodos: Questionários padronizados foram aplicados de forma anônima por uma equipe treinada, nas salas de aula, direcionados para: um primeiro grupo formado de calouros (alunos do primeiro ano de faculdade) e um segundo grupo formado de veteranos (alunos do quarto ano de faculdade) de 11 setores que compõem a Universidade Federal do Paraná (UFPR), sendo que o cálculo amostral definiu um total de 1.459 estudantes, sendo incluídos 1.350. Esse questionário foi baseado na Pesquisa de Conhecimentos, Atitudes e Práticas na População Brasileira de 15 a 64 anos (PCAP) de 2008, realizado pelo Ministério da Saúde (MS), Secretaria de Vigilância em Saúde Departamento de DST, Aids e Hepatites Virais. O questionário foi modificado e adaptado para a pesquisa sobre Vulnerabilidades às DST, infecção pelo HIV/Aids e gravidez não planejada entre estudantes universitários da UFPR. Resultados: Dos 1.350 estudantes abordados, 1.070 (79,2%) já tiveram relação sexual alguma vez na vida (74,9% dos calouros e 86,8% dos veteranos). Em relação ao gênero, 76,3% das mulheres e 82,7% dos homens já haviam iniciado a vida sexual. Dos 507 calouros que fizeram sexo vaginal, 42,0% não usaram camisinha, contra 56,7% dos 363 veteranos (p<0,0001). Cenário semelhante observa-se em relação ao sexo oral, sendo novamente os veteranos os que fizeram menor uso de proteção em relação aos calouros, 94,9 versus 88,6% (p=0,0021). O total de 273 pessoas respondeu ambas as questões sobre testagem para o HIV e sobre a prática de sexo vaginal desprotegido nos últimos 12 meses. Dos 163 universitários que não utilizaram preservativo, 55,2% fizeram a testagem no período. Por outro lado, dos 110 que utilizaram preservativo naquele período, apenas 41,8% testaram-se para o HIV (p=0,0359). Conclusão: Comportamento sexual de risco e deficiente autopercepção de vulnerabilidade marcam o perfil dos universitários participantes deste estudo. Os jovens expostos não têm consciência da sua real vulnerabilidade. A universidade não atua como fator protetor para esses estudantes. Para os adolescentes, há muitos fatores que se sobrepõem ao risco de adquirir uma DST. A universidade pode e deve contribuir de maneira mais efetiva na conscientização e na promoção da saúde de seus estudantes

Adolescence is marked by emotional, social and physical changes. In this stage of development, vulnerable individuals tend to engage in risk behaviors related to the use of alcohol and drugs as well as unprotected sex. Objective: To evaluate the attitude of university students with regard to sexually transmitted infections (STIs) and the influence of the university environment in this behavior. Methods: Standardized questionnaires were applied anonymously in classrooms by a trained team. The first group of respondents was made up of freshmen (first year college students) while the second group was composed of seniors (fourth year students) from 11 of the areas of the Universidade Federal do Paraná (UFPR). From a total of 1,459 respondents, 1,350 were included. The questionnaire applied was based on the Pesquisa de Conhecimentos, Atitudes e Práticas na População Brasileira de 15 a 64 anos (PCAP - Survey of Knowledge, Attitudes and Practices among the Brazilian Population aged from 15 to 64 years) of 2008, conducted by the STI, AIDS and Viral Hepatites Sector of the Health Surveillance Department of the Ministry of Health (MOH). The questionnaire was modified and adapted to the survey on vulnerability to AIDS/HIV infection, STIs, and unplanned pregnancy among UFPR students. Results: Of the 1,350 students covered, 1,070 (79.2%) had already had sexual intercourse at least once in their lives (74.9% of freshmen and 86.8% of seniors). 76.3% of female respondents and 82.7% of males had already started their sexual life. Out of the the 507 freshmen who had vaginal sex, 42.0% did not wear a condom, compared to 56.7% of 363 seniors (p<0.0001). Similar results are observed in relation to oral sex, where 94,9% of senior students wore condoms less often than freshmen (88,6%) (p=0.0021). A total of 273 people answered to both questions about HIV testing and unprotected vaginal sex in the past 12 months. Out of the 163 students who did not wear condoms, 55.2% undertook an HIV test in the period analyzed. On the other hand, only 41.8% of the 110 students who wore condoms during that period took HIV tests (p=0.0359). Conclusion: High-risk sexual behavior and poor risk assessment mark the profile of students participating in this study. The young people exposed are not aware of their real vulnerability. The university does not act as a protective factor for these students. For adolescents, many other factors surpass the risk of acquiring an STD. The university can and should contribute more effectively in raising awareness and promoting the health of their students.

Zika virus infection during pregnancy and microcephaly occurrence: a review of literature and Brazilian data

Abstract In November of 2015, the Ministry of Health of Brazil published an announcement confirming the relationship between Zika virus and the microcephaly outbreak in the Northeast, suggesting that infected pregnant women might have transmitted the virus to their fetuses. The objectives of this study were to conduct a literature review about Zika virus infection and microcephaly, evaluate national and international epidemiological data, as well as the current recommendations for the health teams. Zika virus is an arbovirus, whose main vector is the Aedes sp. The main symptoms of the infection are maculopapular rash, fever, non-purulent conjunctivitis, and arthralgia. Transmission of this pathogen occurs mainly by mosquito bite, but there are also reports via the placenta. Microcephaly is defined as a measure of occipto-frontal circumference being more than two standard deviations below the mean for age and gender. The presence of microcephaly demands evaluation of the patient, in order to diagnose the etiology. Health authorities issued protocols, reports and notes concerning the management of microcephaly caused by Zika virus, but there is still controversy about managing the cases. The Ministry of Health advises notifying any suspected or confirmed cases of children with microcephaly related to the pathogen, which is confirmed by a positive specific laboratory test for the virus. The first choice for imaging exam in children with this malformation is transfontanellar ultrasound. The most effective way to control this outbreak of microcephaly probably caused by this virus is to combat the vector. Since there is still uncertainty about the period of vulnerability of transmission via placenta, the use of repellents is crucial throughout pregnancy. More investigations studying the consequences of this viral infection on the body of newborns and in their development are required.