Behavior assessment of women attending a sexually transmitted disease clinic in Vitória, Brazil / Práticas comportamentais em mulheres atendidas em clínica de doenças sexualmente transmissíveis em Vitória, Brasil

BACKGROUND: Studies about sexual risk behaviors can provide information to support design strategies to control the spread of HIV infection. OBJECTIVE: To assess sexual risk behaviors among women attending a sexually transmitted diseases clinic in Vitória, Brazil. METHODS: A cross-sectional study was performed among women attending an STD/AIDS reference center. Enrolled participants were interviewed and provided a blood sample to determine HIV status. RESULTS: A total of 276 women participated. among 284 selected; 109 (39.5%) were HIV-positive and 167 (60.5%) HIV-negative. Median age was 31 years (interquartile range (IQR)24-36) and 69% of women were between 18 and 34 years of age. Women reported high access to information about STD (87%) and AIDS (90%) but information about sexuality was less common (55%). HIV-positive women asked their partners to use condoms more often than HIV-negatives (31% vs. 5%, p=0.02), and were more likely to have used a condom at last intercourse (65% vs. 33%, p<0.01). Among all patients, questions regarding risk of HIV transmission through sexual intercourse (99.6%) and needle sharing (99.2%) were most frequently answered correctly, while questions regarding risk of HIV transmission through blood donation (57%) were least. CONCLUSION: Though this population reports easy access to information and services for HIV/sexually transmitted diseases, most report little understanding of unsafe sexual behaviors, particularly HIV-negative women.

FUNDAMENTOS: Estudos sobre comportamentos sexuais de risco fornecem informações para programar estratégias para o controle da expansão da infecção pelo HIV/AIDS. OBJETIVO: Avaliar os comportamentos de risco sexual entre mulheres atendidas em clínica de doenças sexualmente transmissíveis em Vitória, Brazil. MÉTODOS: Estudo de corte-transversal foi realizado com mulheres atendidas no Centro de Referência para DST/Aids. As pacientes selecionadas foram entrevistadas e autorizaram a coleta de uma amostra de sangue para determinar sorologia para HIV. RESULTADOS: Um total de 276 mulheres participou, entre as 284 selecionadas; 109 (39,5%) eram HIV-positivas e 167 (60,5%) HIV-negativas. A mediana de idade foi 31 anos (distância interquartil 24-36) e 69% das mulheres tinham entre 18 e 34 anos de idade. As mulheres relataram alto grau de acesso a informações sobre doenças sexualmente transmissíveis (87%) e Aids (90%), mas as informações sobre saúde sexual foram menos comuns (55%). Mulheres HIV-positivas pediram a seus parceiros para usar preservativos mais comumente do que as HIV-negativas (31% vs. 5%, p=0,02), e relataram com maior frequência o uso do preservativo na ultima relação sexual (65% vs. 33%, p<0,01). Entre todas as pacientes, questões sobre o risco da transmissão de HIV através da relação sexual (99,6%) e compartilhar agulhas durante uso de drogas (99,2%) foram mais frequentemente respondidas de forma correta, enquanto que questões relacionadas ao risco de HIV através da doação de sangue (57%) foi menor. CONCLUSÕES: Apesar desta população relatar fácil acesso aos serviços e informações sobre doenças sexualmente transmissíveis/Aids, a maioria relatou entendimento inadequado sobre comportamentos sexuais inseguros, particularmente as mulheres HIV-negativas.

Diversity and uncommon HPV types in HIV seropositive and seronegative women attending an STI clinic

Given the causal relationship between specific types of HPV with cervical cancer and precursor lesions, it is important to identify the viral type involved. The aim of this study is to access the prevalence of HPV types in HIV seropositive and seronegative women. Accordingly, 77 HPV positive cervical samples were obtained from 284 women (seropositive (n=112) and seronegative (n=172) for HIV) who attended a Sexually Transmitted Infection clinic, in Vitoria, Southeastern Brazil. Viral DNA was amplified by PCR using MY09/MY11 degenerated primers and the genotyping was performed by Restriction Fragment Length Polymorphism. Seventy five out of the 77 HPV samples were genotyped: 6, 11, 13, 16, 18, 26, 31, 31b, 32, 33, 34, 35, 52, 53, 55, 56, 58, 59, 61, 62, 64, 66, 71, 81, 83, 84. The most prevalent type was HPV16 followed by HPV types 6, 11 and 53. Fifty five percent and 45 percent belonged to high and low risk types, respectively. High risk types corresponded to 59 percent and 54.5 percent of the HPV detected in HIV seronegative and seropositive women, respectively. The uncommon HPV 13 type in cervical samples was also observed in this study. The oncogenic types were more common in the HIV seronegative samples and the number of cases with multiple infections was similar for the two groups. HPV typing is not only important clinically for the establishment of monitoring and treatment of a patient, it also provides knowledge of the viral types circulating in a population, which is of interest in the development of prevention and treatment programs for this disease.