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ORIGINAL ARTICLE • Cogitare Enferm. 30 • 2025 • https://doi.org/10.1590/ce.v30i0.97839 linkcopy

HIV, syphilis, hepatitis B and C, among women deprived of liberty: prevalence and associated factors^{^*}

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

Objective: Check the prevalence of infections by HIV, hepatitis B and C, and syphilis, and analyze the associated factors in women deprived of liberty in a municipality in Minas Gerais - Brazil. Method:Census conducted between September 2021 and January 2022 with the incarcerated female population, through interviews, rapid tests, collection of confirmatory exams, and referrals. Bivariate and multivariate logistic regression analysis was performed.

Results: Out of 206 women, 171 (83%) were screened. Of these, 57 (33.3%) were reactive for some of the infections; subsequently, 20.5% (n=35) confirmed the seroprevalence. Syphilis was the most prevalent infection. In the multivariate analysis, the significant variables were low education and violence inside or outside the prison system.

Conclusion: A positive outcome for some of the infections was associated with lower levels of education, exposure to violence, and a history of infectious diseases. These findings point to ways for effective monitoring through appropriate tracking, diagnosis, and treatment.

Keywords:
Deprived of Liberty Population; HIV Seropositivity; Syphilis; Hepatitis B; Hepatitis C.

HIGHLIGHTS

1. Recognition of the female prison population affected by infections.

2. Pathway pointing for assistance in infection control.

3. Make the diagnostic and treatment itinerary effective.

4. Identification of demands and planning of future actions.

Female population of the study (n=171)	Tracking		Confirmatory
Female population of the study (n=171)	n	%	n	%
HIVa	12	7,0	12	7,0
Syphilisb	51	29,8	24	14,0
Hepatitis B	0	0,0	0	0,0
Hepatitis Cc	8	4,7	5	4,0
Some STI (combined)
HIV+ Hepatitis	2	1,2	2	1,2
HIV+ Syphilis	2	1,2	2	1,2
HIV+Syphilis+Hepatitis C	1	0,6	1	0,6
Has any of the STIs	57	33,4	35	19,9

Variable (sample n=171)	Positive outcome for infections
	Tracking		Confirmatory
	n	%	n	%
Age
From 18 to 26 years old From 27 to 32 years old From 33 to 40 years Above 40 years	11 15 17 14	19,3 26,3 29,8 24,6	9 10 8 8	25,7 28,6 22,9 22,9
Color/race
White Black or Brown Yellow	9 48 0	15,8 84,2 0,0	4 31 0	11,4 88,6 0,0
Gender
Cisgender Transgender	55 2	96,5 3,5	34 1	97,1 2,9
Education
Up to 8 years of study From 9 to 11 years of study 12 years or more of study Does not know/Did not want to inform	37 11 7 2	64,9 19,3 12,3 3,5	23 4 6 2	65,7 11,4 17,1 5,7
Nationality
Prison system headquarters (JF) Outside of JF, other cities within MG Outside of MG Outside of Brazil Does not know/did not want to inform	27 23 6 0 1	47,4 40,4 10,5 0,0 1,8	20 12 2 0 1	57,1 34,3 5,7 0,0 2,9
Marital Status
Without a partner With companion Does not know/did not want to inform	29 27 1	50,9 47,4 1,8	19 15 1	54,3 42,9 2,9
Profession/link before imprisonment
Had a bond Did not have a bond Does not know/Did not want to inform	12 36 9	21,1 63,2 15,8	7 21 7	20 60 20
Sexual orientation
Heterosexual Homosexual Bisexual Asexual	46 4 5 2	80,7 7 8,8 3,5	32 1 0 2	91,4 2,9 0,0 5,7
Needle and/or syringe sharing
Yes No Does not know/Did not want to inform	7 42 8	12,3 73,7 14	5 25 5	14,3 71,4 14,3
Use of legal drugs (cigarette)
Yes, I am currently using it. I have never used I have used it, but at the moment I am not using it.	48 8 1	84,2 14 1,8	30 4 1	85,7 11,4 2,9
Use of legal drugs (alcohol)
Yes, I am currently using it. I have never used I have used it, but at the moment I am not using it.	4 25 28	7 43,9 49,1	2 17 16	5,7 48,6 45,7
Crack use
Yes, I am currently using it. I have never used I have used it, but at the moment I am not using it.	3 26 28	5,3 45,6 49,1	3 15 17	8,6 42,9 48,6
Has a tattoo
Yes No Does not know/Did not want to inform	47 9 1	82,5 15,8 1,8	28 6 1	80 17,1 2,9
Has a piercing
Yes No Does not know/Did not want to inform	29 26 2	50,9 45,6 3,5	20 14 1	57,1 40 2,9
Receives intimate visit
Yes No Does not know/Did not want to inform	1 55 1	1,8 96,5 1,8	0 34 1	0,0 97,1 2,9
Suffered violence inside or outside of prison (last 12 months)
Yes No	39 18	68,4 31,6	25 10	71,4 28,6
Have any unprotected intercourse in the last 12 months
I have and/or have had No I don’t know/ I don’t want to answer	35 19 3	61,4 33,3 5,3	22 12 1	62,9 34,3 2,9
Have/had any infectious disease
I have and/or have had No I don’t know/ I don’t want to answer	32 24 1	56,1 42,1 1,8	21 13 1	60 37,1 2,9
Incarceration regime
Closed Semi-open and open Temporary	14 19 24	24,6 33,3 42,1	8 12 15	22,9 34,3 42,9
Number of women residing in the cell
From 8 to 20 women 21 to 24 women 25 to 31 women Above 31 women Does not know/Did not want to inform	18 11 15 11 2	31,6 19,3 26,3 19,3 3,5	12 5 12 6 0	34,3 14,3 34,3 17,1 0,0
When he/she entered the unit, he/she went through some care.
Yes No Does not know/Did not want to inform	42 11 4	73,7 19,3 7	22 10 3	62,9 28,6 8,6
Did you receive medical assistance?
Yes. I did not receive any service.	41 16	71,9 28,1	22 13	62,9 37,1
Received gynecological consultation
Yes I didn’t receive	2 55	3,5 96,5	1 34	2,9 97,1
How long have you been incarcerated?
0.50 to 3.84 months 3.85 to 20 months 20.01 to 336 months	13 32 12	22,8 56,1 21,1	11 19 5	31,4 54,3 14,3
Do you have any non-communicable chronic disease?
Yes No Does not know/Did not want to inform	23 32 2	40,4 56,1 3,5	11 23 1	31,4 65,7 2,9
Uses medications for STIs
Yes, I make use No, I don’t use it. I don’t know/I don’t want to inform	9 47 1	15,8 82,5 1,8	9 26 0	25,7 74,3 0,0
Uses medications that act on the Central Nervous System
Yes, I make use No, I don’t use it. I don’t know/I don’t want to inform	34 22 1	59,6 38,6 1,8	17 18 0	48,6 51,4 0,0
I would say that your health is?
Excellent Very good Good Regular Bad	6 5 31 8 7	10,5 8,8 54,4 14 12,3	4 4 17 6 4	11,4 11,4 48,6 17,1 11,4

Variable (sample n=171)	Positive outcome for infections
	Tracking			Confirmatory
	OR RAW	IC95%	p value	OR RAW	IC95%	p value
Age
Up to 32 years More than 32 years	0,67 1	0,35;1,28	0,234	1,12 1	0,53;2,35	0,766
Color/race
White Black or brown	0,63 1	0,27;1,46	0,284	0,43 1	0,14;1,33	0,137
Gender
Cisgender Transgender	0,32 1	0,26;0,40	0,044	0,25 1	0,01;4,13	0,298
Education
Up to 8 years of study From 9 to 11 years of study 12 years or more of study	2,97 1,17 1	1,16;7,57 0,40;3,43	0,019 0,764	1,73 0,43 1	0,63;4,72 0,11;1,67	0,280 0,217
Nationality
At the headquarters of the prison system Outside of JF, other cities in Minas Gerais Fora de Minas Gerais	2,03 0,77 1	0,68;6,02 0,26;2,25	0,196 0,644	4,73 1,35 1	0,99;22,4 0,27;6,56	0,036 0,709
Marital Status
Without a partner With companion	0,56 1	0,29;1,08	0,086	0,76 1	0,35;1,64	0,498
Profession/link before imprisonment?
Yes, I had No, I didn’t have	0,47 1	0,22;0,99	0,047	0,48 1	0,19;1,20	0,115
Sexual orientation women
Heterosexual Homosexual Bisexual Asexual	0,37 0,21 0,19 1	0,29;0,46 0,08;0,50 0,08;0,42	0,069 0,019 0,011	0,25 0,05 -^* 1	0,19;0,34 0,00;0,35 -^*	0,019 <0,001 <0,001
Needle and/or syringe sharing
Yes No	3,54 1	0,98;12,7	0,042	3,40 1	0,96;12,0	0,047
Use of cigarette
Yes, I am currently using and/or have used it. I have never used	2,31 1	0,98;5,43	0,050	2,71 1	0,89;8,23	0,069
Alcohol use
Yes, I am currently using and/or have used it. I have never used	0,78 1	0,41;1,50	0,466	0,64 1	0,30;1,35	0,245
Crack use
Yes, I am currently using and/or have used it. I have never used	5,89 1	2,87;12,0	<0,001	4,66 1	2,13;10,2	<0,001
Do you have a tattoo?
Yes No	0,91 1	0,38;2,20	0,844	0,80 1	0,29;2,19	0,670
Do you have a piercing?
Yes No	0,90 1	0,47;1,72	0,756	1,25 1	0,58;2,67	0,566
Do you receive intimate visits?
Yes No	0,27 1	0,03;2,31	0,280	1,26 1	1,16;1,37	0,147
Have you experienced violence inside or outside of prison (in the last 12 months)?
Yes No	2,97 1	1,52;5,82	0,001	2,98 1	1,33;6,68	0,006
Have you ever received a blood transfusion?
Yes No	0,96 1	0,38;2,42	0,947	1,32 1	0,48;3,62	0,587
Use of the condom
No, I never use I rarely use Sometimes I use I often use	0,48 0,98 0,90 1	0,21;1,10 0,30;3,16 0,30;2,61	0,082 0,973 0,847	0,56 1,63 1,01 1	0,21;1,44 0,47;5,70 0,32;3,50	0,226 0,437 0,925
Have you had any unprotected intercourse in the last 12 months?
Yes No	1,45 1	0,74;2,85	0,273	1,36 1	0,62;2,99	0,431
Did you have any infectious disease?
No Yes, I have and/or have had	0,03 1	0,01;0,09	<0,001	0,08 1	0,03;0,19	<0,001
Type of incarceration
Closed Semi-open and open	1,04 1	0,53;2,03	0,909	0,98 1	0,44;2,14	0,959
Women who reside with you in the cell
Up to 24 women More than 24 women	1,0 1	0,56;2,05	0,828	0,86 1	0,40;1,81	0,692
When he/she entered the prison unit, did he/she receive any health care?
Yes No	1,39 1	0,63;3,06	0,403	0,66 1	0,28;1,56	0,351
You received a medical consultation
Yes, I received it. I didn’t receive	1,0 1	0,49;2,02	1,000	0,58 1	0,26;1,28	0,180
You received a gynecological consultation.
Yes, I received it. I didn’t receive	0,79 1	0,14;4,21	0,785	0,63 1	0,07;5,47	0,679
Have you been convicted?
I have already been convicted I have not yet been convicted	0,77 1	0,40;1,47	0,442	0,93 1	0,44;1,97	0,857
Time of incarceration
Up to 11 months More than 11 months	1,50 1	0,79;2,85	0,213	2,49 1	1,13;5,49	0,021
Do you have any non-communicable chronic disease?
Yes No	0,69 1	0,36;1,33	0,270	0,44 1	0,20;0,98	0,042
Does it use continuous medication (self-report)?
Yes No	1,95 1	0,88;4,32	0,094	1,22 1	0,51;2,94	0,647
Does it use medications for STIs?
Yes, I make use No, I don’t use it.	3,42 1	2,69;4,35	<0,001	6,19 1	4,35;8,80	<0,001
I would say that your health is?
Excellent the good Bad regular	1,89 1	0,94;3,80	0,071	1,50 1	0,66;3,37	0,325

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