Vulnerabilidades associadas às infecções sexualmente transmissíveis na população privada de liberdade cearense

Abstract

Introduction: The concept of health vulnerability highlights that certain subjects and populations may have a series of individual, social and programmatic factors that influence the health-disease process. Thus, prisoners are subjects already vulnerable before imprisonment, a phenomenon that intensifies these people's vulnerabilities. Among the main vulnerabilities of prisoners, the incidence of Sexually Transmitted Infections (STIs) stands out. Objective: To analyze individual, social and structural vulnerabilities to HIV/STI in prisoners of Ceará. Methodology: Cross-sectional study carried out between may to september 2022 in all prison units in Ceará, with a sample of 20,637 prisoners (92.4% of the total population), data was collected in the units by trained professionals with a questionnaire about sociodemographic, family, prison and health characteristics, the outcome variable was the diagnosis of any STI during or after entry into the prison. Data were analyzed using SPSS with Pearson's Chi-square Test and Multiple Logistic Regression. The research was approved by the UFC’s Research Ethics Committee under opinion No. 5,379,780. Results: The overall prevalence of STIs in the sample was 2.2%, with Syphilis (1.4%) and HIV (0.3%) being the most prevalent, with 54% of diagnoses at prison admission. The associations revealed that the prisoners most vulnerable to HIV/STI were male, with mental health problems or chronic illnesses, who lived on the streets, received government benefits, had been arrested for drug crimes, had family members in prison, suffered sexual abuse before the age of 18, older, imprisoned for less than a year, had relationships with other inmates, were diagnosed with STIs upon admission, users of legal and illicit drugs, with a history of violence by other inmates and those who shared the cell with fewer people. The least vulnerable were those with less education, married or in a stable union, without religion, people with disabilities, who have already worked formally, with conjugal visits in prison, suffering police violence, history of previous arrest, transferred from unit, unsatisfied with the prison health service or without couseling on HIV/STI. Conclusion: It is concluded that the prisoners were already vulnerable to HIV/STI prior to incarceration, in addition to this, some situations during deprivation of liberty can increase vulnerability to HIV/STI. Therefore, the prisonal health system must focus on sexual health promotion and prevention to reduce vulnerabilities to STIs.