Condom use and vulnerabilities to sexually transmitted infections in <i>quilombola</i> communities: a descriptive study, Sergipe, Brazil, 2016-2017

Passos, Taciana Silveira; Almeida-Santos, Marcos Antonio; Hora, Aline Barreto; Oliveira, Cristiane Costa da Cunha

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Epidemiologia e Serviços de Saúde

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Original Article • Epidemiol. Serv. Saúde 30 (2) • 2021 • https://doi.org/10.1590/S1679-49742021000200011 copy

Condom use and vulnerabilities to sexually transmitted infections in quilombola communities: a descriptive study, Sergipe, Brazil, 2016-2017^* * Article derived from the master’s degree dissertation entitled ‘Vulnerabilities to HIV/AIDS and Syphilis in a Northeast Brazilian Quilombola Population’, defended by Taciana Silveira Passos at the Tiradentes University Health and Environment Postgraduate Program in 2017. The study received funding from the Coordination for the Improvement of Higher Education Personnel (Funding Code 001).

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

Objective

To analyze frequency of condom use according to vulnerability factors for sexually transmitted infections in quilombola communities in Sergipe state, Brazil.

Methods

This was a descriptive cross-sectional study carried out in 2016-2017. A structured questionnaire with sociodemographic and behavioral questions was used; rapid HIV and syphilis tests were performed. Comparisons between categorical variables were performed using Fisher’s exact test.

Results

Among the 367 individuals from 14 communities, the majority had low levels of education (72.8%), were not working (59.7%) and had a stable sex partner (90.7%). Lack of access to prevention supplies and information accounted for respondent programmatic vulnerability. There was a higher proportion of inconsistent condom use with a stable partner (90.1%) among individuals who reported lack of access to information (p=0.001) and inconsistent use with a casual partner (p<0.001).

Conclusion

Frequency of condom use with a stable partner was significantly proportional to condom use with a casual partner and access to information on prevention.

Keywords:
HIV; Syphilis; Condoms; Health Vulnerability; African Continental Ancestry Group; Epidemiology, Descriptive

Variable	N	%
Sex
Female	268	73.0
Male	99	27.0
Self-reported race/skin color
Black (brown and black)	342	93.2
White	25	6.8
Schooling
No schooling or incomplete elementary education	214	72.8
Complete elementary education, or complete or incomplete high school/higher education	53	27.2
Family income
Up to BRL 600	244	66.5
More than BRL 600	123	33.5
Economic classification^a
Class B1-C2	90	24.6
Class D/E	277	75.4
Current work situation
Not working	219	59.7
Working	148	40.3
Alcohol consumption
No	143	38.9
Occasional or low-risk consumption	161	43.9
Risk or harmful consumption/high chance of dependency	63	17.2

Individual vulnerability factors	N	%
Age group (years)
18-39	148	40.3
40-59	139	37.9
60-101	80	21.8
History of STI (interviewee)
Yes	25	6.8
No	342	93.2
History of STI (partner)
Yes	4	1.1
No	363	98.9
Partner uses drugs
Yes	20	5.4
No	347	94.6
Age at first sexual intercourse
15 years old or over	261	71.1
Under 15 years old	106	28.9
Number of sex partners in the last 12 months
Up to 5	64	96.7
More than 5	256	3.3
Type of sexual intercourse
Vaginal
Yes	346	94.3
No	21	5.7
Anal
Yes	28	7.6
No	339	92.4
Oral
Yes	12	3.3
No	355	96.7

Programmatic vulnerability factors	N	%
Tested for HIV in lifetime
Yes	151	41.1
No	216	58.9
Tested for syphilis in lifetime
Yes	130	35.4
No	237	64.6
Access to information on STI prevention in the last 12 months
Yes	216	58.9
No	151	41.1
Receipt of prevention supplies - condoms and lubricant gel - in the last 12 months
No	304	82.8
Yes	63	17.2
Place where you have health checkups
Primary health care center	308	83.9
Private health service	39	10,6
Does not have checkups	20	5.5
Treatment in case of STI
Health service	16	66.7
Pharmacy	3	12.5
Did not treat	5	20.8
Governmental social STI prevention programs that include people from where you live
No	292	79.6
Yes	75	20.4
Perception of racial discrimination in health services
None or low	110	95.4
Medium	16	4.3
High	1	0.3

Vulnerability factors	Result as to condom use				Total N (%)	p-value^b
	Inconsistent use		Consistent use
	N (%)	95%CI^a	N (%)	95%CI^a
Sex						0.077
Female	215 (71.7)	66.2;76.5	26 (78.8)	61.3;89.6	241 (72.4)
Male	85 (28.3)	23.4;33.7	7 (21.2)	10.3;38.6	92 (27.6)
Able to read and write						0.383
Yes	175 (58.3)	52.6;63.8	24 (72.7)	54.9;85.3	199 (59.8)
No	125 (41.7)	36.1;47.3	9 (27.3)	14.6;45.0	134 (40.2)
Not working						0.059
Yes	175 (58.3)	52.6;63.8	23 (69.7)	51.9;83.0	198 (59.5)
No	125 (41.7)	36.1;47.3	10 (30.3)	16.9;48.0	135 (40.5)
Alcohol consumption						0.791
No	115 (38.3)	32.9;43.9	9 (27.3)	14.6;45.0	124 (37.2)
Occasional or low risk user	131 (43.7)	38.1;49.3	19 (57.6)	40.1;73.2	150 (45.1)
Risk/harmful use	45 (15.0)	11.3;19.5	5 (15.1)	6.3;3.2	50 (15.0)
High risk use	9 (3.0)	1.5;5.6	-	-	9 (2.7)
Age group (years)						0.825
18-39	118 (39.3)	33.9;45.0	18 (54.5)	37.3;70.6	136 (40.8)
40-59	116 (38.7)	33.2;44.3	13 (39.4)	24.1;56.9	129 (38.8)
60-101	66 (22.0)	17.6;27.0	2 (6.1)	1.47;21.6	68 (20.4)
Previous STIs						0.396
Yes	23 (7.7)	5.1;11.2	-	-	23 (6.9)
No	277 (92.3)	88.7 (94.8)	33 (100.0)	-	310 (93.1)
Condom with casual partner						<0.001
Inconsistent use	154 (90.6)	85.2;94.2	3 (20.0)	6.3;48.3	157 (84.9)
Consistent use	16 (9.4)	5.8;14.8	12 (80.0)	51.7;93.7	28 (15.1)
Receipt of prevention supplies						0.185
Yes	47 (51.4)	11.9;20.2	10 (5.6)	16.9;48.0	57 (17.1)
No	253 (84.3)	79.7;88.0	23 (69.7)	51.9;83.0	276 (82.9)
Access to information on sexual health						0.001
Yes	177 (59.0)	49.2;68.1	29 (87.9)	80.0;92.9	206 (61.9)
No	123 (41.0)	31.8;50.8	4 (12.1)	7.1;19.9	127 (38.1)

Secretaria de Vigilância em Saúde e Ambiente - Ministério da Saúde do Brasil SRTVN Quadra 701, Via W5 Norte, Lote D, Edifício P0700, CEP: 70719-040, +55 61 3315-3464, Fax: +55 61 3315-3464 - Brasília - DF - Brazil
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[1] Correspondence: Cristiane Costa da Cunha Oliveira - Avenida Murilo Dantas, No. 300, Farolândia, Aracaju, SE, Brazil. Postcode: 49032-490. E-mail: criscunhaoliva@yahoo.com.br