Leite Franciele Marabotti Costa, Amorim Maria Helena Costa, Gigante Denise Petrucci
Universidade Federal do Espírito Santo. Departamento de Enfermagem. Vitória, ES, Brasil.
Universidade Federal de Pelotas. Departamento de Nutrição. Programa de Pós-Graduação em Epidemiologia. Pelotas, RS, Brasil.
Rev Saude Publica. 2018 Nov 23;52:89. doi: 10.11606/S1518-8787.2018052000496.
To analyze the association between intimate partner violence and not performing the cytopathologic test in the last three years.
It is a transversal study, performed in 26 health units in the city of Vitória, state Espírito Santo, from march to September 2014. The sample was constituted by 106 primary care female users, aging from 30 to 59 years-old. Data on cervical cancer screening were collected, besides the women's sociodemographic, behavior, obstetric, and gynecological characteristics by an interview, and the World Health Organization recommended tool for identifying violence experiences was applied. The analysis was performed through the chi-square test for association, linear trend for ordinal variables, and the Poisson regression analysis with robust variance.
Among the participating women, 14% (95%CI 12.0-17.2) had overdue Pap tests. Most women who did not perform the test had lower schooling levels, lower income, were smokers, in an unmarried union, having had their sexual debut before 15 years-old, three or more pregnancies, and two or more partners in the last 12 months. Women who suffered intimate partner sexual and physical violence were, respectively, 1.64 (95%CI -1.03-2.62) and 1.94 (95%CI 1.28-2.93) times more delayed in the Pap tests than non-victims.
Violence is a significant exacerbating factor and affects women's health negatively. Women who are physically or sexually victimized by their partners are more vulnerable to not performing Pap tests and, consequently, have fewer chances of early diagnosing cervical cancer.
分析亲密伴侣暴力与过去三年未进行细胞病理学检查之间的关联。
这是一项横断面研究,于2014年3月至9月在圣埃斯皮里图州维多利亚市的26个卫生单位进行。样本由106名年龄在30至59岁之间的初级保健女性使用者组成。除了通过访谈收集女性的社会人口学、行为、产科和妇科特征数据外,还收集了宫颈癌筛查数据,并应用了世界卫生组织推荐的识别暴力经历的工具。通过卡方检验进行关联性分析,对有序变量进行线性趋势分析,并采用稳健方差的泊松回归分析。
在参与研究的女性中,14%(95%可信区间12.0 - 17.2)的巴氏试验逾期未做。大多数未进行该项检查的女性受教育程度较低、收入较低、吸烟、处于未婚伴侣关系、15岁之前开始有性行为、怀孕三次或以上,以及在过去12个月中有两个或以上伴侣。遭受亲密伴侣性暴力和身体暴力的女性,其巴氏试验延迟的可能性分别是非受害者的1.64倍(95%可信区间 - 1.03 - 2.62)和1.94倍(95%可信区间1.28 - 2.93)。
暴力是一个显著的加剧因素,对女性健康有负面影响。遭受伴侣身体或性暴力的女性更易出现未进行巴氏试验的情况,因此早期诊断宫颈癌的机会更少。