HIV/aids, hepatites B e C e sífilis: prevalência e fatores associados à ocorrência dessas infecções em uma população feminina privada de liberdade

Abstract

In recent years, there has been a noticeable increase in the female incarcerated population in various countries, including Brazil. Brazil is among the countries with the highest rates of female incarceration worldwide. This population is particularly vulnerable to communicable infections, given a multifactorial context of vulnerabilities. This includes disparities in disease onset and death rates, as well as access to fundamental rights compared to men. The aim of this study was to analyze the prevalence of infections such as HIV/AIDS, hepatitis B and C, and syphilis, and their associated factors among the female incarcerated population in a municipality in Minas Gerais, Brazil. This cross-sectional study was conducted with the entire female incarcerated population in the municipality between September 2021 and January 2022. The research involved screening tests, confirmatory tests, and referrals to the municipal reference service when necessary. Data analysis was performed using the SPSS software version 29.0, and both bivariate and multivariate linear regression analyses were conducted. Out of a total of 206 women, 171 (83%) were screened using rapid immunochromatographic tests. 57 (33.3%) tested positive for one of the infections, and subsequently, 20.5% (n=35) confirmed the seroprevalence. Syphilis was the most common infection, followed by HIV/AIDS, and hepatitis C. Hepatitis B was not detected. The average age of the women was 32, with a median of 34, ranging from 18 to 63 years. 84.2% (n=48) identified as Black or mixed-race, 96.5% (n=55) were cisgender, 64.9% (n=37) had up to eight years of education, 47.4% (n=27) were from the municipality where the prison is located, 50.9% (n=29) were single or without a partner, and 63.2% (n=36) were unemployed before incarceration. Significant variables associated with a positive outcome for any of the infections in the bivariate analysis included: having up to eight years of education, being from the municipality where the prison is located, sharing needles and syringes, using or having used crack cocaine, having a history of violence (with physical and verbal violence being the most significant), using medications for Sexually Transmitted Infections (STIs), and having a shorter incarceration period (up to 11 months). In the adjusted multivariate analysis, the significant variables remained: having a low level of education, being from the municipality and its surroundings, experiencing violence in the last 12 months, and already having a communicable infection. In conclusion, the presence of infections among incarcerated women is influenced by social, economic, educational factors, and especially by women's exposure to various forms of violence. The findings could also suggest ways to improve the monitoring of this population, considering the importance of screening, accurate diagnosis, and treatment, along with the continued care of these incarcerated women.