RESUMO
BACKGROUND: The increased incidence of sexually transmitted infections (STIs) in Brazil represents a significant public health issue. This issue has raised awareness among health authorities regarding the quality of condoms. In Brazil, male condoms need to be certified. The certification process evaluates in detail the manufacturing and quality of the final product; however, post-market surveillance is not part of the normal certification practice. METHODS: From 2009 to 2011, we evaluated 20 male condoms brands per lot of 8 manufactures-both domestic and imported-marketed in Rio de Janeiro, Brazil. Sampling was performed per ISO 2859-1, and the condoms were evaluated on length, width, thickness, holes, integrity of primary packaging, bursting volume, bursting pressure, label and secondary packaging, following the criteria established in the Brazilian National Health Oversight Agency Resolution no. RDC 62/2008. RESULTS: Of the 20 evaluated brands, 17 brands were found to be noncompliant with the guidelines of the Brazilian National Health Oversight Agency Resolution no. RDC 62/2008 in at least one of the analyses performed. CONCLUSIONS: Any nonconforming unit has serious public health implications.
Assuntos
Preservativos , Saúde da População Urbana , Brasil , Fenômenos Químicos , Preservativos/economia , Preservativos/normas , Qualidade de Produtos para o Consumidor , Guias como Assunto , Humanos , Masculino , Teste de Materiais , Fenômenos Físicos , Porosidade , Rotulagem de Produtos , Vigilância de Produtos Comercializados , Controle de Qualidade , Infecções Sexualmente Transmissíveis/prevenção & controle , Saúde da População Urbana/etnologiaRESUMO
The adult film industry nowadays represents a legal multi-billion dollar business. The main health risks of adult performers are well known. They mainly include the transmission of sexually transmitted diseases such as HIV, hepatitis, gonorrhoea, Chlamydia, herpes and papillomavirus. However, despite regular follow-up, the frequency of STD remains significant in this high-risk population since a large part of the industry continues to reject systematic use of condoms. Besides, performers are also exposed to other physical and mental health issues often not known to the public. This article provides a comprehensive review of what is known about STD and other risks among the community of performers in the adult film industry.
Assuntos
Literatura Erótica , Filmes Cinematográficos , Doenças Profissionais/epidemiologia , Infecções Sexualmente Transmissíveis/epidemiologia , Adulto , Modificação Corporal não Terapêutica , Brasil , Preservativos/economia , Preservativos/estatística & dados numéricos , Literatura Erótica/legislação & jurisprudência , Feminino , Seguimentos , Promoção da Saúde , Humanos , Internet , Masculino , Programas de Rastreamento , Transtornos Mentais/epidemiologia , Transtornos Mentais/etiologia , Filmes Cinematográficos/economia , Filmes Cinematográficos/legislação & jurisprudência , Doenças Profissionais/etiologia , Doenças Profissionais/prevenção & controle , Doenças Profissionais/psicologia , Distância Psicológica , Risco , Salários e Benefícios , Comportamento Sexual , Infecções Sexualmente Transmissíveis/prevenção & controle , Estados Unidos/epidemiologia , Sexo sem ProteçãoRESUMO
BACKGROUND: Previous research demonstrated efficacy of a brief behavioral intervention to reduce incidence of HIV and sexually transmitted infections (STIs) among female sex workers (FSWs) in Tijuana and Ciudad Juarez, Mexico, cities on Mexico's border with the US. We assessed this intervention's cost-effectiveness. METHODOLOGY AND PRINCIPAL FINDINGS: A life-time Markov model was developed to estimate HIV cases prevented, changes in quality-adjusted life expectancy (QALE), and costs per additional quality-adjusted life year gained (QALY), comparing (in US$2,009) no intervention to a once-only and annual intervention. Future costs and health benefits were discounted annually at 3%. Sensitivity analyses evaluated model robustness. We found that for a hypothetical 1,000 FSWs receiving the once-only intervention, there were 33 HIV cases prevented and 5.7 months of QALE gained compared to no intervention. The additional cost per QALY gained was US$183. For FSWs receiving the intervention annually, there were 29 additional HIV cases prevented and 4.5 additional months of QALE compared to the once-only intervention. The additional cost per QALY was US$1,075. When highly active antiretroviral therapy (HAART) was included in the model, the annual intervention strategy resulted in net savings and dominated both once-only and no intervention strategies, and remained robust across extensive sensitivity analyses. Even when considering clinical benefits from HAART, ignoring added costs, the cost per QALY gained remained below three times the Mexican GDP per capita, and below established cost-effectiveness thresholds. CONCLUSIONS/SIGNIFICANCE: This brief intervention was shown to be cost-effective among FSWs in two Mexico-US border cities and may have application for FSWs in other resource-limited settings. TRIAL REGISTRATION: ClinicalTrials.gov NCT00338845.
Assuntos
Preservativos/economia , Preservativos/estatística & dados numéricos , Infecções por HIV/prevenção & controle , Trabalho Sexual , Infecções Sexualmente Transmissíveis/prevenção & controle , Terapia Antirretroviral de Alta Atividade/economia , Calibragem , Análise Custo-Benefício , Feminino , Infecções por HIV/tratamento farmacológico , Infecções por HIV/economia , Humanos , Expectativa de Vida , Cadeias de Markov , México , Infecções Sexualmente Transmissíveis/economia , Transtornos Relacionados ao Uso de Substâncias , Estados UnidosRESUMO
OBJECTIVE: To describe a case study of community-based intervention, developed in a constructionist-emancipatory framework to control STD/AIDS. METHODS: Descriptive study developed in the town of Manacapuru, in the state of Amazonas, from 1997 to 2004, focusing on procedures designed in collaboration with government agents, health professionals and the community. Data on the dynamics of prostitution and condom sales in this town, preventive practices and STD/AIDS care and process assessment were collected. Actions targeting STD prevention and care in the public healthcare system, a testing center, an epidemiological surveillance system and sex workers' qualification were established concomitantly. RESULTS: It was observed the strengthening of sex workers as peer educators and their legitimization as citizens and health agents in projects involving transvestites, homosexuals and students. There was an increase in condom sales in town, as well as in condom use among sex workers; reduction in bacterial STD; and stabilization of the incidence of HIV/AIDS infections and congenital syphilis. The sustainability of the intervention program studied, organized within the sphere of action of the Sistema Unico de Saúde (National Health System), was promoted by a political pact, which guaranteed headquarters and municipal law-regulated budget, as well as by the constant debate over the process and program results. CONCLUSIONS: The study strengthened the notion that effective control of STD/AIDS depends on a synergic approach that combines interventions on individual (biological-behavioral), sociocultural and programmatic levels.
Assuntos
Redes Comunitárias , Participação da Comunidade , Educação em Saúde/métodos , Promoção da Saúde , Trabalho Sexual , Infecções Sexualmente Transmissíveis/prevenção & controle , Mulheres Trabalhadoras , Síndrome da Imunodeficiência Adquirida/prevenção & controle , Síndrome da Imunodeficiência Adquirida/transmissão , Brasil , Preservativos/economia , Preservativos/estatística & dados numéricos , Feminino , Humanos , Masculino , Preconceito , Infecções Sexualmente Transmissíveis/transmissão , Meio SocialRESUMO
The paper aims to provide evidence on consistent condom use dynamics among sex workers in Central America between 1997 and 2000, and to examine the most important predictors of use behaviour important for policy and programme interventions in the region. Data on 3500 sex workers, 1500 from 1997 and 2000 from the year 2000, were analysed. The samples represented sex workers in low socioeconomic neighbourhoods who met their clients at known sex establishments or by the roadside. Sex workers were more likely to have used condoms consistently in 2000 than in 1997 (Odds Ratio (OR) = 1.4, p < or = 0.05). Sex workers who discussed condoms with their partners or lovers used them consistently with all clients more than those who did not (OR = 1.3, p < or = 0.10). Knowledge of condom advantages had a positive influence on consistent use. Sex workers who reported using condoms to prevent pregnancy or STDs used them consistently with all clients more than those who did not (OR = 1.2, and 1.3 respectively, p < or = 0.10). The source of condoms is an important predictor of consistent condom use. Sex workers who bought condoms from health establishments or from brothels used them consistently more than those who did not (both OR = 1.3, p < or = 0.10, and p < or = 0.05, respectively). Self-efficacy had a positive effect on consistent condom use. Sex workers who reported that they would use condoms even if clients offered to pay more for unprotected sex used them consistently with all clients more than those who did not (OR = 18, p < or = 0.001). The findings suggest that having condom skill is positively related to condom use. Sex workers who had all four skills used condoms more consistently than those who had none (OR = 1.6, p < or = 0.01). In order to increase consistent condom use and avert more incidences of HIV/AIDS and other STIs, programme interventions need to use the most efficient way to provide quality information, and provide repeated training on condom negotiation and use skills to sex workers.
Assuntos
Síndrome da Imunodeficiência Adquirida/prevenção & controle , Preservativos/estatística & dados numéricos , Conhecimentos, Atitudes e Prática em Saúde , Trabalho Sexual/psicologia , Infecções Sexualmente Transmissíveis/prevenção & controle , Adulto , América Central , Preservativos/economia , Coleta de Dados , Escolaridade , Feminino , HumanosRESUMO
Aos dias cinco e seis de novembro de mil e novecentos e noventa e sete, foi realizada, na Sala de Reuniões do Conselho Nacional de Saúde, a Septuagésima Primeira Reunião Ordinária do Conselho Nacional de Saúde. ABERTURA E ESCOLHA DA COORDENAÇÃO - Dr. Nelson Rodrigues dos Santos, Coordenador Geral do Conselho Nacional de Saúde, procedeu a abertura da reunião cumprimentando a todos informando que, segundo a relação dos Conselheiros, o Conselheiro Jocélio coordenaria os trabalhos no período da manhã e o Conselheiro Omilton no período da tarde. Após, passou a palavra ao Conselheiro Jocélio que saudou os presentes e iniciou os trabalhos, solicitando aos Conselheiros que lessem as duas últimas atas para que fossem aprovadas no final da manhã ou no início da tarde. Na sequência, a palavra foi repassada ao Dr. Nelson Rodrigues para que apresentasse o item dos Informes, ressaltando que o primeiro item se referia a uma série de informações solicitadas pelo CNS à Direção Nacional do SUS
Assuntos
Infecções Sexualmente Transmissíveis/prevenção & controle , Preservativos/economia , Isenção Fiscal , Parcerias Público-Privadas , Financiamento da Assistência à Saúde , Organização Pan-Americana da Saúde , HemoderivadosRESUMO
Sexually transmitted diseases (STDs) are an important worldwide health problem. Their association with AIDS an other insidious viral processes have brought them to the foreground of sanitary authorities and general population concern. Often, health services have to struggle with reinfections, which concentrate in pockets of risk that consume large amount of care and constitute an important link in the transmission of these diseases. General publicity have little impact among high risk groups. Thus, it becomes necessary to be more precise and divide into segments the target population we want to reach. Prevention of reinfection in these communities requires the implementation of healthy behaviours through the promotion of a tangible product (condom). Regarding these considerations, social marketing emerges as the right instrument to be used. Through individual focused interviews with prostitutes, homosexual and young promiscuous heterosexual patients from a STDs Prevention, Diagnosis and Treatment Centre, determining factors of the use condoms and related behaviour guidelines have been identified. Also, a social marketing strategy is suggested to prevent these diseases among groups at risk by means of condom promotion.