Post Graduation Program in Infectious Diseases, Federal University of Espirito Santo, Brazil.
Global Health Sciences, University of California San Francisco, San Francisco, CA.
Sex Transm Dis. 2019 Apr;46(4):246-249. doi: 10.1097/OLQ.0000000000000946.
The objective of this study was to measure the prevalence of syphilis among women of reproductive age from 5 distinct indigenous populations in Paraguay. We also sought to identify the demographic profile and behaviors of women with elevated prevalence of syphilis.
We conducted a population-based, cross-sectional survey among women aged 15 to 49 years from 5 distinct language families in Paraguay in 2016. The 5 language families were Guaraní, Maskoy, Mataco, Guaicurú, and Zamuco, sampled through a probability-based, multistage cluster design. Participants completed a questionnaire on demographic characteristics and risk-related behavior. Blood samples were drawn for rapid testing for syphilis with confirmation and titers. Participants provided written informed consent; minors had written parental consent and provided their own assent.
A total of 1732 indigenous women were enrolled. Overall syphilis prevalence was 6.8% (95% confidence interval [CI], 5.6-8.0). Syphilis prevalence varied by language family/ethnic group (P = 0.010), with Mataco having the highest prevalence (8.2%; 95% CI, 5.3-11.9) and Maskoy having the lowest (2.5%; 95% CI, 1.1-4.7). Women reporting multiple partners (11.3%; 95% CI, 6.9-17.1; P = 0.031) and transactional sex in the last year (18.7%; 95% CI, 7.2-36.4; P = 0.010) had higher prevalence of syphilis.
Our survey found high prevalence of syphilis in indigenous women in Paraguay, in association with transactional sex and multiple partners. Interventions to reduce sexual behaviors associated with an increased risk of sexually transmitted infections (STI) in indigenous women must be carried out with programs aimed at addressing transactional sex, appropriately framed to respect interculturality and an indigenous worldview.
本研究旨在衡量 5 个不同的巴拉圭土著群体中育龄妇女的梅毒流行率。我们还试图确定梅毒发病率较高的妇女的人口统计学特征和行为。
我们于 2016 年在巴拉圭 5 个不同的语言群体中进行了一项基于人群的、横断面调查，参与者为 15 至 49 岁的女性。这 5 个语言群体是瓜拉尼语、马斯科语、马塔科语、瓜乌库里语和萨穆科语，通过概率多阶段聚类设计进行抽样。参与者完成了一份关于人口统计学特征和与风险相关的行为的问卷。采集血样进行梅毒快速检测，并进行确认和滴定。参与者提供了书面知情同意书；未成年人有书面的父母同意书，并提供了自己的同意。
共纳入 1732 名土著妇女。总的梅毒患病率为 6.8%（95%置信区间[CI]，5.6-8.0）。梅毒患病率因语言群体/族群而异（P = 0.010），马塔科语族群的患病率最高（8.2%，95%CI，5.3-11.9），马斯科语族群的患病率最低（2.5%，95%CI，1.1-4.7）。报告有多个性伴侣（11.3%，95%CI，6.9-17.1；P = 0.031）和去年有交易性行为（18.7%，95%CI，7.2-36.4；P = 0.010）的妇女梅毒患病率更高。
我们的调查发现，巴拉圭土著妇女的梅毒流行率较高，与交易性行为和多个性伴侣有关。必须开展减少与性传播感染（STI）风险增加相关的性行为的干预措施，这些措施必须针对交易性行为，并以适当的方式制定框架，以尊重文化间性和土著世界观。
