Keywords
cytomorphologic analysis
sex worker
STD
multivariate analysis
How to Cite
Abstract
This study aimed at identifying the multivariate associations between the cervical cytological abnormalities and the risk behavior of sex workers (SW) enrolled at CRESSER – Sumaré, São Paulo. The study included 90 PS, and the uterine cervix samples were collected for performing Pap smear, and also the socio-behavioral data through a questionnaire. Hierarchical Cluster Analysis (AHA) was used as statistical test. Atypical cytology were found in 33 PS (36.7%), being 18 (20.0%) ASC-US, four (4.4%) ASC-H, seven (7.8%) LSIL and four (4.4%) HSIL. By comparing the SW with normal and abnormal cytology, significant differences were detected regarding smoking habit, early sexual activity, sexual intercourse with the members of the same sex, and Gardnerella vaginalis detection. According to the AHA classification, the group with the highest prevalence of atypical cells showed highest proportion of STD, HIV and low condom use. The group with the lowest average age showed lower prevalence of atypical cells, STD, HIV negative, and no early sexual activity.References
1. Pinto AP, Tulio S, Cruz OR. Cofatores do HPV na oncogênese cervical. Rev Assoc Med Bras. 2002;48(1):73-8.
2. Castellsagué X, Muñoz N. Chapter 3: Cofactors in human papillomavirus carcinogenesis − role of parity, oral contraceptives and tobacco smoking. J Nat Cancer Inst Monogr. 2003;31:20-8.
3. Baldwin SB, Wallace DR, Papenfuss MR, Abrahamsen M, Vaught LC, Giuliano AR. Condom use and other factors affecting penile human papillomavirus detection in men attending a sexually transmitted disease clinic. Sex Transm Dis. 2004;31(10):601-7.
4. Kjellberg L, Hallmans G, Ahren A-M, Johansson R, Bergman F, Wadell G, et al. Smoking, diet, pregnancy and oral contraceptive use as risk factors for cervical intra-epithelial neoplasia in relation to human papillomavirus infection. Br J Cancer. 2000;82(7):1332-8.
5. WHO. Sexually transmitted infections [acesso 2011 Nov 11]. Disponível em: [http://www.who.int/mediacentre/factsheets/fs110/en/index.html].
6. Brasil. Ministério da Saúde. Secretaria de Atenção à Saúde. Departamento de Atenção Básica. HIV/Aids, hepatites e outras DST. Brasília (DF): Ministério da Saúde; 2006. 196p. il. (Cadernos de Atenção Básica, n.18). (Série A. Normas e Manuais Técnicos). p. 7.
7. Oltramari LC, Camargo BV. Representações sociais de mulheres profissionais do sexo sobre a AIDS. Est Psicol. 2004;9(2):317-23.
8. Salmeron NA, Pessoa TAM. Profissionais do sexo: perfil socioepidemiológico e medidas de redução de danos. Acta Paul Enferm. 2012;25(4):549-54.
9. Aquino PS, Ximenes LB, Pinheiro AKB. Políticas públicas de saúde voltadas à atenção à prostituta: breve resgate histórico. Enf Foco. 2010;1(1):10-22.
10. Fornasa CV, Gai F, Tarantello M, Gallina P. Knowledge of sexually transmitted diseases and condom use among female street sex workers in Padua. Acta Derm Venereol. 2005;14(3):107-10.
11. Steen R, Dallabetta G. Sexually transmitted infection control with sex workers: regular screening and presumptive treatment augment efforts to reduce risk and vulnerability. Reprod Health Matters. 2003;11:74-90.
12. Passos ADC, Figueiredo JFC. Fatores de risco para doenças sexualmente transmissíveis entre prostitutas e travestis de Ribeirão Preto (SP), Brasil. Rev Panam Salud Publica. 2004;16(2):95-101.
13. Correa NAB, Matumoto FH, Lonardoni MVC. Doenças sexualmente transmissíveis em mulheres profissionais do sexo, Umuarama, Estado do Paraná. RBAC. 2008;40(3):209-13.
14. Li Yan, Detels R, Lin Peng, Fu Xiaobing, Deng Zhongming, Liu Yongying, et al. Prevalence of Human Immunodeficiency virus and sexually transmitted infections and associated risk factors among female sex workers in Guangdong Province, China. J Acquir Immune Defic Syndr. 2010;53(Suppl):S48-S53.
15. Ministério da Saúde/INCA. Nomenclatura brasileira para laudos cervicais e condutas preconizadas: Recomendações para profissionais de saúde. J Bras Patol Med Lab. 2006;42(5):351-73.
16. Granato D, Castro IA, Katayama F. Phenolic composition of South-American red wines classified according to their antioxidant activity, retail price, and sensory quality. Food Chem. 2011;129:366-73.
17. Altman DG. Practical Statistics for Medical Research. 8.ed. Boca Raton: Chapman & Hall/CRC; 2001.
18. McLaughlin-Drubin ME, Münger K. Oncogenic Activities of human papillomaviruses. Virus Res. 2009;143(2):195-208.
19. Walboomers JMM, Jacobs MV, Manos MM, Bosch FX, Kummer JA, Shah KV, et al. Human papillomavirus is a necessary cause of invasive cervical cancer worldwide. J Pathol. 1999;189(1):12-9.
20. Tideman RL, Thompson C, Rose B, Gilmour S, Marks C, Beek IV, et al. Cervical human papillomavirus infections in commercial sex workers- risk factors and behaviours. Int J STD AIDS. 2003;14:840-7.
21. Yamamoto LSU, Pereira SMM, Etlinger D, Aguiar LS, Sakai YI, Shirata NK, et al. Frequência de diagnóstico de lesões do colo uterino por faixa etária em mulheres atendidas no Programa de Rastreamento Viva Mulher no período de 2004 a 2008. Rev Inst Adolfo Lutz. 2009;68(1):126-32.
22. Etlinger D, Sakai YI, Aguiar LS, Feres CL, Rodrigues ROL, Teixeira MS, et al. Frequência dos diagnósticos citopatológicos cérvico-vaginais detectados no Núcleo de Anatomia Patológica do Instituto Adolfo Lutz no ano de 2009. Bol Inst Adolfo Lutz. 2010;20(1):30-2.
23. Luchters SMF, Broeck DV, Chersich MF, Nel A, Delva W, Mandaliya K, et al. Associaton of HIV infection wlth distribution and viral load of HPV types in Kenya: a survey with 820 female sex workers. BMC Infect Dis. 2010;10(18):1-10.
24. Lu F, Jia Y, Sun X, Wang L, Liu W, Xiao Y, et al. Prevalence of HIV infection and predictors for syphilis infection among female sex workers in southern China. Southeast Asian J Trop Med Public Health. 2009;40(2):263-72.
25. Giraldo PC, Amaral RLG, Gonçalves AK, Vicentini R, Martins CH, Giraldo H, et al. Influência da frequência de coitos vaginais e da prática de duchas higiênicas sobre o equilíbrio da microbiota vaginal. Rev Bras Ginecol Obstet. 2005;2795:257-62.
26. Moura ADA, Lima GG, Farias LM, Feitoza AR, Barroso MGT. Prostituição x DST/AIDS: um estudo descritivo com perpectivas de práticas de prevenção. DST-J Bras Doenças Sex Transm. 2009;2(3):143-8.
27. Singer A. The uterine cervix from adolescence to the menopause. Br J Obstet Gynaecol. 1975;82(2):81-99.
28. Mendonça VG, Guimarães MJB, De Lima Filho JL, Mendonça CG, Martins DBG, Crovella S, et al. Infecção cervical por papillomavirus humano; genotipagem viral e fatores de risco para lesão intraepitelial de alto grau e câncer de colo do útero. Rev Bras Ginecol Obstet. 2010;32(10):476-85.
29. Qyra S, Basho M, Bani R, Dervishi M, Ulqinaku D, Bino S, et al. Behavioral risk factors and prevalence of HIV and other STIs among female sex workers in Tirana, Albânia. New Microbiol. 2011;34:105-8.
30. Brasil. Lei n° 8.069, de 13 de julho de 1990. Estatuto da Criança e do Adolescente [acesso 2011 Out 21]. Disponível em: [http://planalto.gov.br/ccivil_03/leis/L8090.htm].
31. Hernandez BY, Nguyen TV. Cervical human papillomavirus infection among female sex workers in Southern Vietnam. Inf Agent Cancer. 2008;2(7):1-9.
This work is licensed under a Creative Commons Attribution 4.0 International License.
Copyright (c) 2012 Instituto Adolfo Lutz Journal