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Introduction: the availability of high purity and low-cost drugs has increased the use of intravenous substances, which makes it a public health problem due to its association with HIV infection. Objective: to identify the factors associated with HIV infection in people who inject drugs. Materials and methods: a cross-sectional descriptive study was carried out between December 2017 and January 2018 in Medellin, Colombia. We use the sampling conducted by the respondent (RDS). Results: They have recruited 224 subjects, 86.2% were men, 82.0% were single and 67.0% belonged to the subsidized or linked health system. The prevalence of HIV infection was 3.6%. This study found that 38.8% of consumers have shared needles and syringes with up to three people, representing a risk of infection of 5.07 times, compared to those who do not share (RPc = 5.07 95% CI: 1.19-21.55), and if this practice is carried out with a close friend, the probability increases to almost double (10.69) (RPc = 10.69 IC 95%: 2.26-50.61) (p <0.05). Conclusion: Given the low prevalence of HIV, it is vital to develop and implement public policies whose objective is to create prevention programs that ultimately lead to the reduction of infection in this population.
Introducción: La disponibilidad de drogas con una alta pureza y un bajo costo, ha aumentado el consumo de sustancias por vía intravenosa; llevándolo a ser considerado como un problema de salud pública, por su asociación con la presencia de infección por VIH. Se estima que existen aproximadamente 16 millones de consumidores de drogas intravenosas en el mundo y en Colombia, 15.000. Objetivo: identificar los factores asociados con la infección por VIH en personas que se inyectan drogas. Materiales y métodos: estudio descriptivo transversal, realizado (diciembre 2017/ enero 2018) Medellín - Colombia, se utilizó la metodología Respondent Driven Sampling (RDS). Resultados: Fueron reclutados 224 participantes, un 86,2% fueron hombres, el 82,0% eran solteros, el (67,0%) pertenecía al régimen de salud subsidiado o vinculado. Con relación a la prevalencia de infección por VIH esta fue del 3,6%. Este estudio encontró que el 38,8% de los consumidores había compartido agujas y jeringas con hasta tres personas, lo cual representa una probabilidad de 5,07 veces de contraer la infección comparado con aquellos que no comparten (RPc=5,07 CI95% 1,19-21,55), si esta práctica se hace con un amigo cercano dicha probabilidad aumenta a casi el doble 10,69 (RPc= 10,69 CI95% 2,26-50,61), (p<0,05). Conclusión: Ante la baja prevalencia de VIH, es necesario, el desarrollo e implementación de políticas públicas que tengan como objetivo la creación de programas de prevención que finalmente, lleven a la reducción de la infección en esta población.
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Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , HIV , Estudos Transversais , Uso Comum de Agulhas e Seringas , Heroína , Usuários de Drogas , InfecçõesRESUMO
Histoplasmosis is common among persons living with human immunodeficiency virus/acquired immune deficiency syndrome (PLWHA) in Latin America, but its diagnosis is difficult and often nonspecific. We conducted prospective screening for histoplasmosis among PLWHA with signs or symptoms suggesting progressive disseminated histoplasmosis (PDH) and hospitalized in Hospital La María in Medellín, Colombia. The study's aim was to obtain a clinical and laboratory profile of PLWHA with PDH. During 3 years (May 2008 to August 2011), we identified 89 PLWHA hospitalized with symptoms suggestive of PDH, of whom 45 (51%) had histoplasmosis. We observed tuberculosis (TB) coinfection in a large proportion of patients with PDH (35%), so all analyses were performed adjusting for this coinfection and, alternatively, excluding histoplasmosis patients with TB. Results showed that the patients with PDH were more likely to have Karnofsky score ≤ 30 (prevalence ratio [PR] = 1.98, 95% confidence interval [CI] = 0.97-4.06), liver compromised with hepatomegaly and/or splenomegaly (PR = 1.77, CI = 1.03-3.06) and elevation in serum of alanine aminotransferase and aspartate aminotransferase to values > 40 mU/mL (PR = 2.06, CI = 1.09-3.88 and PR = 1.53, CI = 0.99-2.35, respectively). Using multiple correspondence analyses, we identified in patients with PDH a profile characterized by the presence of constitutional symptoms, namely weight loss and Karnofsky classification ≤ 30, gastrointestinal manifestations with alteration of liver enzymes and hepatosplenomegaly and/or splenomegaly, skin lesions, and hematological alterations. Study of the profiles is no substitute for laboratory diagnostics, but identifying clinical and laboratory indicators of PLWHA with PDH should allow development of strategies for reducing the time to diagnosis and thus mortality caused by Histoplasma capsulatum.
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Alanina Transaminase/sangue , Aspartato Aminotransferases/sangue , Coinfecção/sangue , Infecções por HIV/sangue , Histoplasmose/sangue , Tuberculose/sangue , Dor Abdominal/etiologia , Síndrome da Imunodeficiência Adquirida/sangue , Síndrome da Imunodeficiência Adquirida/complicações , Adulto , Coinfecção/complicações , Coinfecção/fisiopatologia , Colômbia , Tosse/etiologia , Diarreia/etiologia , Dispneia/etiologia , Feminino , Infecções por HIV/complicações , Infecções por HIV/fisiopatologia , Cefaleia/etiologia , Hepatomegalia/etiologia , Histoplasmose/complicações , Histoplasmose/fisiopatologia , Humanos , Avaliação de Estado de Karnofsky , Leucopenia/etiologia , Linfadenopatia/etiologia , Masculino , Náusea/etiologia , Úlcera Cutânea/etiologia , Esplenomegalia/etiologia , Trombocitopenia/etiologia , Tuberculose/complicações , Tuberculose/fisiopatologia , Vômito/etiologia , Redução de PesoRESUMO
BACKGROUND: Heroin production in Colombia has increased dramatically in recent decades, and some studies point to an increase in local heroin use since the mid-1990s. Despite this rapid increase, little is known about the effects of these activities on heroin injection within Colombia. One of the biggest concerns surrounding heroin injection is the potential spread of HIV through drug user networks. OBJECTIVES: This article examines injection risk behaviors among heroin injectors in the Colombian cities of Medellín and Pereira to explore the implications for possible increased HIV transmission within this group. METHODS: A cross-sectional study used respondent-driving sampling to recruit a sample of 540 people who inject drugs (PWID) over 18 years of age (Medellín: n = 242, Pereira: n = 298). Structured interviews with each participant were conducted using the World Health Organization Drug Injection Study Phase II Survey. An HIV test was also administered. RESULTS: Information regarding the socio-demographics, injection drug use, HIV risk and transmission behaviors, injection risk management, and HIV knowledge and prevalence of participants are reported. The study identified many young, newly initiated injectors who engage in risky injection practices. The study also found that HIV prevalence is fairly low among participants (2.7%). CONCLUSIONS/IMPORTANCE: Findings indicate a potential risk for the spread of HIV among PWID in Colombia given their widespread sharing practices, high rate of new injector initiation, and unsafe syringe cleaning practices. Colombia has a possibly time-limited opportunity to prevent an HIV epidemic by implementing harm reduction interventions among young, newly initiated PWID.
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Infecções por HIV/epidemiologia , Conhecimentos, Atitudes e Prática em Saúde , Dependência de Heroína/epidemiologia , Uso Comum de Agulhas e Seringas/estatística & dados numéricos , Assunção de Riscos , Abuso de Substâncias por Via Intravenosa/epidemiologia , Síndrome da Imunodeficiência Adquirida/epidemiologia , Síndrome da Imunodeficiência Adquirida/prevenção & controle , Síndrome da Imunodeficiência Adquirida/transmissão , Adolescente , Adulto , Colômbia/epidemiologia , Estudos Transversais , Feminino , Infecções por HIV/prevenção & controle , Infecções por HIV/transmissão , Redução do Dano , Humanos , Masculino , Prevalência , Inquéritos e Questionários , Adulto JovemRESUMO
Colombia, South America is currently transitioning to post-conflict status following 6 decades of armed conflict. The population has experienced extensive exposures to potentially traumatic events throughout the lifespan. Sources of trauma exposure include the prolonged armed insurgency, narco-trafficking violence, urban gang violence, violent actions of criminal bands, intra-familial violence, gender-based violence, and sex trafficking. Exposure to potentially traumatic events is related to a variety of psychiatric outcomes, in particular, posttraumatic stress disorder. Given this context of lifetime trauma exposure, socio-demographic patterns of posttraumatic stress disorder were explored in a sample of residents of Medellin, Colombia, the nation's second largest city and a nexus for multiple types of trauma exposure.
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OBJETIVO: determinar la prevalencia de VIH y explorar su relación con características sociales y demográficas de habitantes de calle de la ciudad de Medellín en el año 2014. METODOLOGIA: se realizó un estudio descriptivo-transversal para determinar la seroprevalencia de VIH y se exploraron factores sociales y demográficos asociados a la infección por VIH en habitantes de calle de la ciudad de Medellín en el año 2014. El procesamiento de datos fue realizado en el software SPSS 21.0. Los análisis incluyeron descripción univariada y bivariada, se utilizó la prueba estadística de Chi cuadrado; razón de prevalencia (RP) intervalos de confianza del 95% asumiendo un nivel de significación estadística menor del 5%. RESULTADOS: se encuestaron 184 habitantes de calle, el 80% eran hombres, con un promedio de edad de 40 (DE 11,4 años). Se identificó una prevalencia de VIH del 8,2%; para los hombres esta prevalencia fue de 6,1% y para las mujeres fue de 16,2%. Las mujeres tuvieron tres veces el riesgo de VIH comparado con los hombres; y las personas casadas y en unión libre cinco veces el riesgo de tener VIH comparado con los solteros, separados y divorciados. CONCLUSION: la prevalencia mayor del 5% en la población habitante de calle, muestra que la infección por VIH en Colombia está concentrada en poblaciones clave (alta prevalencia y vulnerables) y se requieren acciones focalizadas hacia grupos específicos.
OBJECTIVE:To determine the prevalence of HIV and describe the social and demographic characteristics of street dwellers Medellin in 2014. METHODOLOGY: A descriptive cross-sectional study where the authors determined the seroprevalence of HIV and explored the social and demographic factors associated with HIV infection among street dwellers of the city of Medellin in 2014. The data were processed using the SPSS 21.0 software. Analyses included univariate and bivariate descriptions, and the statistical Chi-square test was used. Prevalence ratio (PR) confidence interval 95% assuming a statistical significance level of less than 5%. RESULTS: a total of 184 street dwellers were surveyed, 80% were male, with an average age of 40 (SD 11.4 years). An HIV prevalence of 8.2% was found; for men, this prevalence was 6.1% and for women 16.2%. Women had three times the risk of HIV compared to men; those who were cohabiting and married had five times the risk of having HIV compared to single, separated and divorced individuals. CONCLUSION: The higher prevalence amounting to 5% for the street dwellers shows that HIV infection in Colombia is concentrated in key groups (i.e. those having high prevalence and vulnerability) requiring actions focusing on specific of groups.
OBJETIVO: determinar a prevalência de HIV e explorar a sua relação com características sociais e demográficas de moradores de rua da cidade de Medellín no ano 2014. METODOLOGIA: Realizou-se um estudo descritivo-transversal no qual se determinou a seroprevalência de HIV e se exploraram fatores sociais e demográficos associados à infecção por HIV em habitantes de rua da cidade de Medellín no ano 2014. O processamento dos dados foi realizado no software SPSS 21.0. As análises incluíram descrição univariada e bivariada, utilizou-se a prova estatística de Chi-quadrado; razão de prevalência (RP) intervalos de confiança de 95% atingindo um nível de significação estatística menor de 5%. RESULTADOS: foram inquiridos 184 moradores de rua, 80% eram homens, com uma média de idade de 40 (DE 11,4 anos).Foi identificada uma prevalência de HIV de 8,2%; para os homens esta prevalência foi de 6,1% e para as mulheres de 16,2%. As mulheres tiveram três vezes o risco de HIV comparado com os homens; e as pessoas casadas e em união livre cinco vezes o risco de ter HIV comparado com os solteiros, separados e divorciados. CONCLUSÃO: a prevalência maior de 5% na população moradora de rua, mostra que a infecção por HIV na Colômbia está concentrada em populações chave (alta prevalência e vulneráveis) e são requeridas ações visando grupos específicos.
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Pessoas Mal Alojadas , Prevalência , HIV , Vigilância em DesastresRESUMO
Objective To determine socio-demographic characteristics, prevalence of HIV risk, behaviors use. Methods We performed a cross-sectional study using sampling generated by the respondent; the sample consisted of 540 participants (Pereira: n=300; Medellin: n=240) over 18 years. The interview was conducted by an expert in counseling for HIV and sexually transmitted diseases. Ethical requirements were met. We used the software RDSAT. Results There are extensive networks of IDUs in both cities. The population of IDUs in both cities was characterized as mostly men between 18 and 24, with secondary school, indicating very young populations. The data suggest a recent introduction of HIV into networks and a high degree of risk behavior for HIV spread in networks and used syringes received from others in the past six months. Conclusions The data in this report indicate a high risk for a possible expansion of HIV among injecting networks in Colombia supported the introduction of HIV into networks of injectors, high rates of injecting risk and a lack of injection as a practice of risk associated with HIV.
Objetivo Determinar características socio-demográficas, prevalencia de VIH y comportamientos de riesgo en usuarios de drogas inyectables. Métodos Se realizó un estudio transversal, utilizando el muestreo generado por el entrevistado. Las muestras estuvieron compuestas por 540 participantes (Pereira: n=300; Medellín: n=240) mayores de 18 años. La entrevista la realizaba una persona experta en consejería para VIH y enfermedades de transmisión sexual. Se cumplieron los requerimientos éticos exigidos. Se utilizó la versión 6.01 del software RDSAT y la 8.0 de SPSS. Resultados En ambas ciudades existen amplias redes de usuarios de drogas inyectables. La población se caracterizó por ser en su mayoría hombres, entre 18 y 24 años, con estudios de secundaria. Los datos parecen indicar una reciente introducción de VIH en las redes y un alto grado de comportamiento de riesgo, incluyendo el uso de jeringas recibidas de otras personas en los últimos seis meses. Conclusiones Los datos indican una situación de alto riesgo para una posible expansión del VIH entre las redes de inyección en Colombia. Lo anterior se origina en la introducción del VIH en dichos grupos y un desconocimiento de la inyección como práctica de riesgo asociada con VIH.
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OBJETIVO: determinar la prevalencia de VIH y las características socio-demográficas del habitante de calle en la ciudad de Medellín, con la finalidad de ampliar la comprensión de la problemática en este grupo vulnerable. METODOLOGÍA: se realizó un estudio de corte transversal; se determinó la seroprevalencia de VIH y los comportamientos de riesgo. El procesamiento se realizó mediante el software SPSS 8.0. El análisis bivariado se acompañó con pruebas estadísticas. RESULTADOS: se encuestaron 230 habitantes de calle,de los cuales el 69,6% eran hombres, con promedio de edad de 38 ± 10,9 años; se identificó una prevalencia de VIH del 7,8%; entre los hombres esta prevalencia fue de 10% y entre las mujeres fue de 2,9%. Por grupos de edad, el 12% de las personas de 25 a 34 años tenían VIH, el 11% de los mayores de 55 años y el 8% de las personas de 18 a 24 años. El 41% de los hombres y el 30% de las mujeres tenían creencias correctas sobre la transmisión del VIH. DISCUSIÓN: la prevalencia del 7,8% muestra que la infección por VIH en Colombia está concentrada en poblaciones que se encuentran en condiciones de exclusión, estigma y discriminación, y que se requieren acciones focalizadas hacia grupos vulnerables.
OBJECTIVE: to determine the prevalence of HIV among the street dwellers of the city of Medellin (Colombia) as well as their socio-demographic characteristics in order to deepen the understanding of the problems faced by this vulnerable group. METHODOLOGY: a cross-sectional study was conducted in which HIV seroprevalence and risk behaviors were determined. Data was processed using the SPSS 8.0 software, and the bivariate analysis was conducted using statistical methods. RESULTS: a survey was conducted on 230 street dwellers, 69.6% of which were men. The average age was 38 ± 10.9 years, and HIV prevalence was 7.8%. This prevalence was 10% for men and 2.9% for women. The rate of infected individuals was 12% for those aged 25 to 34, 11% for individuals aged 55, and 8% for those aged 18 to 24. Additionally, 41% of men and 30% of women had correct beliefs regarding HIV transmission. DISCUSSION: the prevalence value of 7.8%, shows that HIV infections in Colombia are concentrated in populations in a state of exclusion, stigma, and discrimination. This value also shows a need for actions targeting vulnerable groups.