Epidemiologia das infecções sexualmente transmissíveis em um complexo penitenciário no nordeste brasileiro

Abstract

INTRODUCTION: The prison environment presents favorable conditions for the spread of sexually transmitted infections (STIs) such as HIV, syphilis, and hepatitis due to overcrowding, unsanitary conditions, and lack of prevention measures. In Brazil, the prison population is particularly affected, with alarming rates of contagion. Despite health policies like the National Policy for Comprehensive Health Care for People Deprived of Liberty in the Prison System (PNAISP), implementation is flawed. In Sergipe, the increasing prison population makes the situation concerning, highlighting the need for effective strategies for prevention and early diagnosis of STIs in the prison system. OBJECTIVE: To evaluate factors associated with the seroprevalence of human immunodeficiency virus, syphilis, and hepatitis B and C in a population deprived of liberty in northeastern Brazil. METHODOLOGY: This is an observational, analytical, cross-sectional study conducted in a Penitentiary Complex in the state of Sergipe, with 1,835 inmates. Data collection involved rapid testing for STIs and interviews, in addition to individual health education. For analysis, a database was constructed in Microsoft Excel® 2013 and analyzed using IBM SPSS, version 27, employing Pearson's Chi-square test with Monte Carlo permutation to verify the association between variables. RESULTS: The prevalence of STIs was 22.2%, with 5.6% for HIV, 47.1% for syphilis, 2.7% for hepatitis B, and 58.1% for hepatitis C, estimating that 31 inmates lived with two or more STIs. Bivariate analysis confirmed the following risk factors for acquiring an STI: being LGBTQIAP+; having some religious belief; not knowing if they had syphilis in the past; having suffered psychological, physical, and sexual violence; using crack and other drugs; partner's dislike of using condoms; sexual practices exclusively with men; receiving money for sex, and not knowing that a penile wart is an STI. CONCLUSION: There is a high prevalence of STIs in the prison population compared to the general population, explained by a lack of knowledge, distorted sexual practices and attitudes, and the peculiarities of the environment that increase this susceptibility. Therefore, integrated actions of health education, distribution of condoms, and regular testing are necessary to reduce these rates. A multidisciplinary and structural approach, considering the prison environment and the individuality of inmates, is essential to combat STIs in this context. This includes specific prevention programs, access to treatment, and improvement of conditions within prisons.