REPORTING OF SEXUAL VIOLENCE AGAINST WOMEN IN BRAZIL

Objetivo: Apresentar o quadro de violência sexual contra a mulher no Brasil, com base nas notificações realizadas no Sistema de Informação de Agravos de Notificação (SINAN). Métodos: Trata-se de um estudo descritivo, com abordagem quantitativa, que analisou informações referentes às notificações de violência sexual contra a mulher, no período de 2009 a 2013, considerando a unidade da federação, perfil das mulheres, características da ocorrência e encaminhamentos realizados pelo setor saúde. Os dados foram analisados por meio da estatística descritiva, sendo apresentados números absolutos e relativos derivados das notificações. Resultados: No Brasil, foram registradas 21.871 notificações no período estudado. Observaram-se maiores taxas de registros no ano de 2013 e na região Norte. Predominou o ciclo de vida de 10 a 19 anos (10.806/49,4%), as raças branca (8.894/40,7%) e parda (8.535/39,0%), e a escolaridade ensino fundamental incompleto (5.444/24,9%). Os casos de violência sexual ocorreram com maior frequência na residência da mulher (13.259/60,6%), com agressor conhecido (5.649/25,8%) e sem suspeita do uso de álcool (9.249/42,3%). A maior parte do atendimento no setor saúde foi de nível ambulatorial (15.842/72,6%), e os casos evoluíram para alta (16.879/77,2%). Conclusão: As notificações cresceram progressivamente no período estudado, e a violência sexual contra a mulher no país, registrada pelo setor saúde, atingiu, principalmente, adolescentes, no ambiente doméstico e com agressor conhecido.

Maximizing HIV partner notification opportunities for index patients and their sexual partners in Malawi

Introduction HIV testing and counselling (HTC) is important to effect positive sexual behaviour change and is an entry point to treatment, care, and psychosocial support. One of the most practical initiatives to increase HTC is to encourage sexual partners of HIV-infected persons to test for HIV. However, partner notification strategies must be feasible in the healthcare setting and acceptable to the population. Methods We conducted a qualitative study during the pilot phase of an HIV partner notification trial to complement its assessment of feasibility and acceptability of methods of partner notification. We performed in-depth interviews with 16 consecutive HIV-positive index participants who consented and their 12 identifiable sexual partners. We also conducted two focus group discussions with healthcare workers to supplement the patient perspectives. In the main study, newly diagnosed HIV cases (index cases) were randomized to one of three methods of partner notification: passive, contract, and provider referral. Clients in the passive referral group were responsible for notifying their sexual partners themselves. Individuals in the contract referral group were given seven days to notify their partners, after which a healthcare provider contacted partners who had not reported for counselling and testing. In the provider group, a healthcare provider notified partners directly. Results Although most index participants and partners expressed a preference for passive notification, they also highlighted benefits for provider-assisted notification and the universal right for all HIV-exposed persons to know their HIV exposure and benefit from HIV testing and access antiretroviral treatment. Several participants mentioned couples counselling as a way to diffuse tension and get accurate information. All mentioned benefits to HIV testing, including the opportunity to change behaviour. Conclusions Provider-assisted partner notification is not preferred, but it is acceptable and may complement the passive method of notification. Couples counselling should also be encouraged.