Sexual violence against women and care in the health sector in Santa Catarina – Brazil

Delziovo, Carmem Regina; Coelho, Elza Berger Salema; d'Orsi, Eleonora; Lindner, Sheila Rubia

doi:10.1590/1413-81232018235.20112016

Acessibilidade / Reportar erro

Brasil

Español English

sumário « anterior atual seguinte »

Sumário

Free Themes • Ciênc. saúde colet. 23 (5) • May 2018 • https://doi.org/10.1590/1413-81232018235.20112016 copy

Sexual violence against women and care in the health sector in Santa Catarina – Brazil

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

This is a study on sexual violence against women in the Brazilian State of Santa Catarina notified to the Notifiable Diseases Information System (SINAN) in the period 20082013. It aimed to estimate pregnancy and sexually transmitted infections (STIs) resulting from sexual violence and to test the association between pregnancy, STIs and care provided in health services. In total, 1,230 pregnancy notifications and 1.316 STI notifications were analyzed. Variables were age, schooling, time to receive care, STI prophylaxis, emergency contraception, number of perpetrators and recurrent violence, which were analyzed using proportions and 95% confidence intervals. Associations were tested by adjusted and non-adjusted logistic regression with values expressed in odds ratio. The occurrence of pregnancy was 7.6%. Receiving care within 72 hours and emergency contraception were protective factors. The occurrence of STIs was 3.5%. Care within 72 hours and prophylaxis did not result in lower proportions of STIs. Further studies are required regarding this issue.

Key words
Sexual violence; Women; Pregnancy; Sexually transmitted diseases; Health services

Variable		Sample distribution			Pregnancy		p^* * P-value ≤0.05 statistically significant.
Variable		N	%	n	%	CI95%	p^* * P-value ≤0.05 statistically significant.
Age (n = 1,230)							<0.001
	10-14 years	546	44.3	60	10.8	(8.4-13.7)
	15-19 years	297	24.1	20	6.7	(4.3-10.2)
	20-49 years	387	31.4	14	3.8	(2.3-6.3)
Schooling (n = 1,230)
	0-4 years	165	13.4	22	13.3	(8.9-19.4)
	5-8 years	549	44.6	50	9.1	(6.9-11.8)
	9 years and over	338	27.4	15	4.4	(2.6-7.2)
	Unknown	178	14.4	7	3.9	(1.8-8.0)
Recurrent Violence (n = 1,174)							< 0.001
	Yes	421	35.8	52	12.3	(9.5-15.8)
	No	753	64.1	32	4.3	(3.1-6.1)
Time to provide care and use of emergency contraception (n = 1,230)							< 0.001
	Did not receive treatment within 72 hours and did not receive contraception	387	31.4	55	14.2	(11.0-18.0)
	Did not receive treatment within 72 hours and received contraception	71	5.7	3	4.2	(1.3-12.3)
	Received treatment within 72 hours and did not receive contraception	343	27.8	29	8.4	(5.9-11.9)
	Received treatment within 72 hours and received contraception	429	34.8	7	1.6	(0.7-3.3)

Variable		OR (CI95%) Non-Adjusted	p^† † P-value ≤ 0.05 statistically significant.	OR (CI95%) Adjusted^* * Adjusted analysis with entry into the two-level model. At the first level, age and schooling. In the second, time to provide care, recurrent violence and use of emergency contraception.	p^† † P-value ≤ 0.05 statistically significant.
Age
	20-49 years	1.00		1.00
	10-14 years	3.00(1.67-5.38)	< 0.001	2.00(0.98-4.67)	0.052
	15-19 years	1.79(0.90-3.56)	0.097	2.70(1.17-4.67)	0.002
Schooling
	9 years and over	1.00		1.00
	5-8 years	2.15(1.19-3.90)	0.011	1.47(0.76-2.86)	0.245
	0-4 years	3.31(1.66-6.57)	0.001	2.74(1.32-5.71)	0.007
Recurrent Violence
	No	1.00		1.00
	Yes	3.07	< 0.001	1.69(1.03-2.76)	0.035
Time to provide care and use of emergency contraception
	Did not receive treatment within 72 hours and did not receive contraception	1.00		1.00
	Did not receive treatment within 72 hours and received contraception	0.26(0.08- 0.87)	0.029	0.26(0.62-1.15)	0.077
	Received treatment within 72 hours and did not receive contraception	0.55(0.34-0.89)	0.016	0.63(0.37-1.07)	0.090
	Received treatment within 72 hours and received contraception	0.10(0.04-0.22)	< 0.001	0.16(0.72-0.39)	< 0.001

Variable		Sample distribution		STI		IC95%	p^* * P-value ≤ 0.05 statistically significant.
Variable		N	%	n	%	IC95%	p^* * P-value ≤ 0.05 statistically significant.
Age (n = 1,316)							0.033
	10 a 14 years	561	42.6	17	3.0	1.8-4.8
	15 a 19 years	308	23.4	18	5.8	3.7-9.0
	20 years and over	447	33.9	11	2.4	1.3-4.3
Schooling (n = 1,129)							0.119
	0-4 years	194	14.7	5	2.5	1.0-6.0
	5-8 years	572	43.4	23	4.1	2.8-6.1
	9 years and over	363	27.5	7	1.9	0.9-3.9
Number of perpetrators (n = 1,296)							0.019
	One	1,091	84.1	33	3.0	2.1-4.2
	Two or more	205	15.8	13	6.3	3.7-10.6
Recurrent Violence (n = 1,261)							0.512
	Yes	457	36.2	18	3.9	2.4-6.1
	No	804	63.7	26	3.2	2.2-4.7
Received care within 72 hours (n = 1,316)							0.971
	Yes	833	63.3	28	3.4	2.4-4.9
	No	483	36.7	17	3.5	2.1-5.5
Hepatitis B prophylaxis (n = 1,279)							0.094
	Yes	442	34.5	20	4.5	2.9-6.9
	No	837	65.4	23	2.7	1.8-4.1
HIV prophylaxis (n = 1,288)							0.207
	Yes	670	52.0	27	4.0	2.7-5.8
	No	618	47.9	17	2.7	1.7-4.3
Bacterial STI prophylaxis (n = 1,286)							0.045
	Yes	686	53.3	29	4.3	3.0-6.1
	No	600	46.6	14	2.3	1.3-3.9

Variável		OR (CI95%) Non-adjusted	p^† † P-value ≤ 0.05 statistically significant.	OR (CI95%) Adjusted^* * Adjusted analysis with entry into the two-level model. At the first level, age and schooling. In the second, the remaining variables.	p^† † P-value ≤ 0.05 statistically significant.
Age
	20 years and over	1.00		1.00
	15-19 years	2.46(1.14-5.28)	0.021	2.47(1.12-5.41)	0.024
	10-14 years	1.23(0.57-2.67)	0.585	0.91(0.40-2.06)	0.836
Schooling
	9 years and over	1.00		1.00
	5-8 years	2.22(0.94-5.22)	0.066	2.90(1.17-7.14)	0.021
	0-4 years	1.34(0.42-4.29)	0.616	1.94(0.58-6.42)	0.276
	Unknown	2.87(1.07-7.67)	0.035	3.57(1.31-9.71)	0.013
Number of perpetrators
	One	1.00		1.00
	Two and over	2.17(1.12-4.19)	0.021	2.39(1.16-4.89)	0.017
It happened before
	No	1.00		1.00
	Yes	1.22(0.66-2.26)	0.513	1.39(0.67-2.89)	0.374
Received care within 72hs
	No	1.00		1.00
	Yes	0.98 (0.53-1.81)	0.971	0.85(0.39-1.84)	0.689
Hepatitis B prophylaxis
	No	1.00		1.00
	Yes	1.67(0.91-3.08)	0.097	1.39(0.62-3.13)	0.415
HIV prophylaxis
	No	1.00		1.00
	Yes	1.48(0.80-2.75)	0.209	0.60(0.20-1.83)	0.378
Bacterial STI prophylaxis
	No	1.00		1.00
	Yes	1.91(1.00-3.64)	0.048	2.51(0.84-7.48)	0.096

ABRASCO - Associação Brasileira de Saúde Coletiva Av. Brasil, 4036 - sala 700 Manguinhos, 21040-361 Rio de Janeiro RJ - Brazil, Tel.: +55 21 3882-9153 / 3882-9151 - Rio de Janeiro - RJ - Brazil
E-mail: cienciasaudecoletiva@fiocruz.br

Acompanhe os números deste periódico no seu leitor de RSS

[1] Collaborations

CR Delziovo and EBS Coelho were responsible for the design, description of the method, analysis, writing of the paper and approval of the final version to be published. E D'orsi participated in the design, description of the method, analysis and approval of the final version to be published. SR Lindner participated in the writing of the paper, analysis, critical review and approval of the final version to be published.