Name: Jerusa Araújo Dias
Type: PhD thesis
Publication date: 06/08/2020
Advisor:

Namesort descending Role
Angelica Espinosa Barbosa Miranda Advisor *

Examining board:

Namesort descending Role
Angelica Espinosa Barbosa Miranda Advisor *
Eliana Zandonade Internal Alternate *
Fernanda Lopes External Examiner *
Gerson Fernando Mendes Pereira Advisor *
Liliana Cruz Spano Co advisor *
Neide Aparecida Tosato Boldrini External Alternate *
Rita de Cássia Duarte Lima Internal Examiner *
Thiago Nascimento do Prado Internal Examiner *

Summary: Background: Black women have the highest rates of cervical cancer mortality, as
well as the highest rates of prevalence of sexually transmitted infections, including
HPV. Socioeconomic inequalities, access to health care, and institutional racism may
explain the differences mortality and infection rates in this invisible population group.
All this issues of inequalities remain in quilombola communities, making this
population of women vulnerable to cervical cancer and sexually transmitted infections
(STI). Aims: to estimate the prevalence of cervical cytology abnormalities, STI and
associated factors in women from quilombola communities in the north of Espírito
Santo. Methods: A cross-sectional population-based study carried out with

quilombola women from March 2017 to January 2019. A survey with socio-
demographics, behavioral and clinical data were collected. A gynecological

examination was performed to collect cervical cells for oncotic cytology and to detect
Chlamydia trachomatis (CT), Neisseria gonorrhea (NG) Trichomonas vaginalis (TV),
Human Papillomavirus (HPV) by means of a polymerase chain reaction test. Rapid
test for HIV and syphilis were used. The major outcome of the study has been

defined as infection with one or more sexually transmitted infectious agents. The chi-
square test and hierarchical logistic regression were used for analysis.Results: A

total of 380 women, 352 (92.6%) were included in the study. The prevalence of at
least one STI was 18.5% (95% CI: 14.76-22.85). The highest prevalence was for
HPV 11.1%, followed by 6.3% for TV and 4.3% for CT. No case of NG. The HIV
prevalence was 0.3%, and syphilis was 4.3%.The cervico-vaginal cytology was
altered by 7.7%. The detection of one or more STI was significantly associated with
age between 25 to 44 years old [OR = 2.33 (95% CI: 1.05-5.18)], alcohol
consumption [OR = 1.96 (95% CI %: 1.06-3.64)], altered cytology result [OR = 3.96
(95% CI: 1.65-9.48)] and bacterial vaginosis [OR = 3.61 (95% CI: 2, 01-6.47)].
Conclusion: Quilombola women had a high prevalence of one or more STI, which
makes it important to develop prevention strategies aimed at these women.

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