INTRODUCTION:
Homeless
people are a vulnerable group to sexually transmitted diseases (STD) with high
prevalence of syphilis and hepatitis.
OBJECTIVES:
To
estimate the prevalence of syphilis infection and its association with risky
behaviors for STDs in a sample of homeless people, and to assess the
feasibility of the use of rapid syphilis test (RST) in this population.
METHODS:
Cross-sectional
study, in a convenience sample of homeless people assisted in social support
services of São Paulo, between 2006 and 2007. A structured questionnaire was
applied and RST was performed. In addition, a blood sample for syphilis
detection was also collected. The sensitivity and specificity of the RST was
estimated using conventional laboratory diagnosis (VDRL + TPHA) as reference.
RESULTS:
1,405
volunteers were included in the study. The prevalence rate of syphilis was
7.0%, and was associated with homosexual practices (OR(adj) 4.9; 95%CI 2.6 -
9.4), prior history of STD (OR(adj) 2.6; 95%CI 1.7 - 4.0) and with
self-referred non-white race (OR(adj) 1.9; 95%CI 1.1 - 3.4). The sensitivity
and specificity of the RST for syphilis were, respectively, 81.4 and 92.1%.
CONCLUSION:
The
high prevalence of syphilis infection among homeless people shows the need for
actions for its control and the utilization of RST that can be considered an
efficient strategy due to its sensitivity and specificity. Public Health
policymakers must strengthen actions for syphilis control, with screening tests
for syphilis and early treatment, decreasing morbidity with the improvement of
sexual and reproductive health of the population in general and especially the
most vulnerable.
[Article in English, Portuguese]
1São
Paulo State Department of Health, São Paulo, SP, Brazil.
2Universidade
Federal do Estado de São Paulo, São Paulo, SP, Brazil.
3School
of Medicine, Universidade de São Paulo, São Paulo, SP, Brazil.
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