Factors associated with HIV prevalence in a prison population

Epidemiological, cross-sectional study carried out with prisoners. Interviews were conducted using a form and a rapid test for the diagnosis. Bivariate and multivariate hypothesis testing, with a simple logistic ratio (unadjusted odds ratio) and multiple ratio (adjusted odds ratio) were applied. Significance level was set at p≤0.05.

Results:

A total of 2,131 inmates participated in the study. The HIV prevalence was 1.0%. Seropositive individuals were mostly Afro-American; their marital status was predominantly single/separated/widower. The mean age was of 31.3 years, and the mean educational level was 6.29 years. There was a link between the HIV virus and the variables: selection of partners based on physical attributes and vaginal sexual intercourse.

Conclusion:

Tackling the HIV infection represents a major challenge for prison and sanitary authorities, considering that the issues related to the HIV context inside and outside the prison environment are interconnected and, therefore, demands coordinated action.

DESCRIPTORS
HIV; Prisoners; Prisons; Health Services Accessibility; Public Health Nursing

Variables		HIV		Unadjusted Odds	CI95%	p value
		Positive	Negative	Unadjusted Odds	CI95%	p value
		n(%)	n(%)
Gender
	Male	19(1.0)	1,958(99.0)	0.74	0.17-3.20	0.70
	Female^* * Reference category. Grade: (n=2,131).	02(1.3)	152(98.7)	0.74	0.17-3.20	0.70
Race/Color
	White^* * Reference category. Grade: (n=2,131).	3(0.7)	417(99.3)	1.48	0.43-5.04	0.53
	Afro-American / other	18(1.1)	1,693(98.8)	1.48	0.43-5.04	0.53
Marital Status
	Single/separated Widower	13(1.1)	1,222(98.9)	1.18	0.48-2.86	0.71
	Married/living together/stable union^* * Reference category. Grade: (n=2,131).	8(0.9)	888(99.1)	1.18	0.48-2.86	0.71
Age		Mean (sd)	Mean (sd)	1.00	0.96-1.05	0.84
Age		31.3 (9.7)	30.9 (10.1)	1.00	0.96-1.05	0.84
Years of Education		Mean (sd)	Mean (sd)	1.00	0.89-1.11	0.97
Years of Education		6.29 (4.17)	6.32 (3.88)	1.00	0.89-1.11	0.97
Monthly Income		Mean (sd)	Mean (sd)	1.00	0.99-1.00	0.19
Monthly Income		438.10 (647.47)	792.55 (1720.80)	1.00	0.99-1.00	0.19

Variables		HIV		Unadjusted Odds	CI95%	p value
		Positive	Negative		CI95%	p value
		n(%)	n(%)
Use of alcohol
	Yes/used	17(1.0)	1,661(99.0)	1.15	0.38-3.43	0.80
	No ^* * Reference category. Grade: (n=2,131).	4(0.9)	449(99.1)	1.15	0.38-3.43	0.80
Use of illegal drugs
	Yes/used	14(1.0)	1,392(99.0)	1.03	0.41-2.57	0.95
	No ^* * Reference category. Grade: (n=2,131).	7(1.0)	718(99.0)	1.03	0.41-2.57	0.95
Types of Drugs
Crack
	Yes/used	9(1.4)	639(98.6)	1.72	0.72-4.11	0.21
	No^* * Reference category. Grade: (n=2,131).	12(0.8)	1,471(99.2)	1.72	0.72-4.11	0.21
Cocaine
	Yes/used	7(1.1)	656(98.9)	1.10	0.44-2.76	0.82
	No^* * Reference category. Grade: (n=2,131).	14(1.0)	1,454(99.0)	1.10	0.44-2.76	0.82
Marijuana
	Yes/used	12(1.0)	1,179(99.0)	1.05	0.44-2.51	0.90
	No^* * Reference category. Grade: (n=2,131).	9(1.0)	931(99.0)	1.05	0.44-2.51	0.90
Other drugs (inhaled, injected, derived from crack and marijuana)
	Yes/used	7(2.1)	327(97.9)	4.24	0.96-18.71	0.05
	No^* * Reference category. Grade: (n=2,131).	14(0.7)	1,783(99.3)	4.24	0.96-18.71	0.05

Variables		HIV		Unadjusted Odds	CI95%	p value
		Positive	Negative	Unadjusted Odds	CI95%	p value
		n(%)	n(%)
Sexual practices
	Opposite sex^* * Reference category. Grade: (n=2,131).	14(0.7)	1,902(99.3)	4.57	1.82-11.45	0.00
	Same sex	7(3.3)	208(96.7)	4.57	1.82-11.45	0.00
Select partners
	Yes^* * Reference category. Grade: (n=2,131).	9(0.7)	1,332(99.3)	2.22	0.95-5.44	0.06
	No	12(1.5)	778(98.5)	2.22	0.95-5.44	0.06
Type of selection (n=1.341)
	Trust/Acquaintance	7(1.2)	609(98.8)	1.05	0.31-3.59	0.93
	Physical attribute selections	2(0.3)	723(99.7)	5.04	1.17-21.72	0.03
Use of condoms
	Always^* * Reference category. Grade: (n=2,131).	7(1.4)	511(98.6)	0.64	0.25-1.59	0.33
	Never/sometimes	14(0.9)	1,599(99.1)	0.64	0.25-1.59	0.33
Reasons for not using condom (n=1,613)
	Dislike/Trust	7(0.6)	1,235(99.4)	0.22	0.03-1.65	0.14
	Not always available	7(1.9)	364(98.1)	2.79	1.11-6.96	0.02
Drink before sexual relations
	Yes	13(0.9)	1,352(99.1)	0.94	0.39-2.29	0.90
	No^* * Reference category. Grade: (n=2,131).	8(1.0)	758(99.0)	0.94	0.39-2.29	0.90
Use illegal drugs before sexual relations
	Yes	11(1.1)	958(98.9)	1.22	0.51-2.89	0.64
	No^* * Reference category. Grade: (n=2,131).	10(0.8)	1,152(99.2)	1.22	0.51-2.89	0.64
Type of sexual intercourse
Vaginal
	Yes	17(0.8)	2,082(99.2)	0.57	0.02-0.18	0.00
	No^* * Reference category. Grade: (n=2,131).	4(12.5)	28(87.5)
Anal
	Yes	16(1.3)	1,203(98.7)	2.41	0.88-6.61	0.08
	No^* * Reference category. Grade: (n=2,131).	5(0.5)	907(99.5)
Oral
	Yes	17(1.3)	1,274(98.7)	2.78	0.93-8.31	0.06
	No^* * Reference category. Grade: (n=2,131).	4(0.5)	836(99.5)
Sexual partners in the last 6 months (considering currently)		Mean (sd)	Mean (sd)	0.97	0.82-1.13	0.67
		1.48(1.86)	1.78(3.64)	0.97	0.82-1.13	0.67
	None	6(0.9)	635(99.1)
	One to ten	15(1.0)	1,475(99.0)

Variables		HIV		Unadjusted Odds	CI95%	p value
		Positive	Negative
		n(%)	n(%)
Have information about HIV
	Yes^* * Reference category. Grade: (n=2,131).	16(1.0)	1,513(99)	0.79	0.29-2.17	0.65
	No	5(0.8)	597(99.2)	0.79	0.29-2.17	0.65
Know how is transmitted
	Yes^* * Reference category. Grade: (n=2,131).	13(1.1)	1,141(98.9)	0.77	0.29-2.04	0.60
	No/partially	8(0.8)	969(99.2)	0.77	0.29-2.04	0.60
How the HIV is transmitted
	Blood	8(1.0)	773(99.0)	0.77	0.31-1.91	0.57
	Unprotected sexual intercourse	14(1.0)	1,336(99.0)	0.77	0.31-1.91	0.57
Source of information (n=1,529)
	TV/Internet/others	15(1.7)	870(98.3)	1.30	0.52-3.23	0.57
	Healthcare service	4(0.6)	640(99.4)	1.14	0.38-3.42	0.80
Have/had some STI before
	Yes	7(1.5)	468(98.5)	1.75	0.70-4.37	0.23
	No^* * Reference category. Grade: (n=2,131).	14(0.8)	1,642(99.2)	1.75	0.70-4.37	0.23
Know how to prevent STI
	Yes^* * Reference category. Grade: (n=2,131).	16(0.9)	1,692(99.1)	1.26	0.46-3.47	0.65
	No/partially	5(1.2)	418(98.8)	1.26	0.46-3.47	0.65
Forms of prevention
Use of condom
	Yes^* * Reference category. Grade: (n=2,131).	16(1.0)	1,653(99.0)	1.13	0.41-3.10	0.81
	No	5(1.1)	457(98.9)	1.13	0.41-3.10	0.81
Are afraid to get STI
	Yes^* * Reference category. Grade: (n=2,131).	17(0.9)	1,867(99.1)	1.80	0.60-5.41	0.29
	No	4(1.6)	243(98.4)	1.80	0.60-5.41	0.29
Reason for the fear (n=1.884)
	Fall ill and die	18(1.0)	1,711(99.0)	0.66	0.28-1.57	0.35
	Transmit to the family	2(1.3)	153(98.7)	0.76	0.17-3.33	0.72

Risk factors	Adjusted Odds	p value	CI95%
Use of other drugs	3.81	0.08	0.82-17.66
Having sexual intercourse with same-sex people	2.66	0.05	0.97-7.24
Selecting partners by physical attributes	4.57	0.04	1.04-19.99
Not using condoms because they are not always available	2.22	0.10	0.85-5.76
Vaginal sexual intercourse	0.08	0.00	0.02-0.28

Universidade de São Paulo, Escola de Enfermagem Av. Dr. Enéas de Carvalho Aguiar, 419 , 05403-000 São Paulo - SP/ Brasil, Tel./Fax: (55 11) 3061-7553, - São Paulo - SP - Brazil
E-mail: reeusp@usp.br

Acompanhe os números deste periódico no seu leitor de RSS

[1] Corresponding author: Karinna Alves Amorim de Sousa Universidade Federal do Piauí Campus Ministro Petrônio Portella – Bairro Ininga CEP 64049-550 – Teresina, Piauí, Brazil. karinnaduda@gmail.com