Perfil sócio-demográfico epidemiológico dos usuários de drogas injetáveis e características de mulheres e homens do projeto Ajude -Brasil II

Abstract

This study aimed to describe the socio-demographic and health profile of the injecting drugs users (IDUs) recruited in the AjUDE-Brasil II Project, focusing on comparisons between women and men, in regards to drug use initiation, drug use, sexual behavior and HIV infection. A cross-sectional multi-center study was conducted during 2000-2001 in six Brazilian Syringe Exchange Programs (SEPs). The majority of participants were male (82.9%) and reported to live at home (81.0%); about 20% were homeless in the six previous months prior to the interview. Unemployment was common (75.4%) and around 20%reported any source of income. History of detention was reported by 80.2% and 33.0% fulfilled their sentences, half for smuggling and robbery. Bodily assaults and involvement in fights were common for 44.4% of those interviewed. Marijuana was the reported drug of firstchoice (64.6%), followed by cocaine (11.9%) and inhalants (11.8%). Alcohol (90.1%), marijuana (86.7%), cigarettes (81.3%), injected and or snorted cocaine (76.4 and 76.0, respectively) and crack (46.9%) were the most used drugs reported in the six months prior the interview. The majority of the participants reported never having looked for treatment fordrug use in their life (65.2%). Contrarily, 73.3% of the participants reported seeking a general health practitioner. In the six preceding months to the interview, about 80.1% of the interviewed IDUs searched for treatment for any health problem including drug use. The SEPwas used by 70.3% of the interviewees. Overall, 146 females and 709 males comprise the sample, with the respective averages of 29.5 + 8.58 and 28.3 + 8.16 years old, 57% of males and 45% of women reported having competed the 5th to 8th grade (p=0.05). Age at initiation of injecting drugs did not differ between women and men (18.6 and 19.3 years, respectively). However, women were more likely than men to be initiated by their sexual partners in terms of obtaining the drug, syringes and needles or in the act of injection themselves. Women werealso more likely than men to report regular sexual partners (83% versus 72%, p<0.05), to have used drugs with either their regular sexual partners (57% versus 12%, p<0.001) or casual ones (50% versus 18%. p<0.001) and to have exchanged sex for drugs (43% versus 12%, p<0.001).In this study, 39.3% of female and 36.0% of male IDUs were HIV seropositive. Infected women are more likely than infected men to be married (OR=2.6; 95%CI:1.4-4.8) or to be non-white (OR=2.1; 95%CI:1.1-3.9). Women mention with greater frequency that a sexualpartner acted as facilitator in obtaining drugs (OR=21.0; 95%CI: 4.6-105.4), in obtaining injection materials (OR= 16.5; 96%CI+ 2.8-24.8), and in injecting the drugs for the first time (OR=31.4; 95%CI= 7.3-148.3). Infected women had a greater chance of having regular partners who also used drugs as compared to infected mens (OR= 10.4; 95%CI: 4.2-25.9) and among casual partners of having sexual relations in order to obtain drugs (OR= 4.3; 95%CI: 1.3-14.8). These data highlight greater vulnerability to HIV infection among female than male IDUs.