Determinantes sociais da saúde e fatores de risco para sífilis em mulheres de uma comunidade rural

Abstract

The social determinants of health are a set of factors that represent the particularities of individuals and make up a heterogeneous network of factors that harm, promote or protect health. According to the Health Ministry, syphilis remains as a public health problem for Brazil today. Among its risk factors in women from rural communities, the following stand out: restricted access to health services, delayed diagnosis and early intervention, unprotected sex and lack of knowledge about syphilis, directly affecting the social impacts of these women and the social determinants of health with regard to inequalities based on the conditions of daily life. The research objectives are: to identify the social determinants of health and the risk factors for syphilis in women from a rural community; to verify the association between social determinants of health and risk factors for syphilis in women from a rural area. This is a cross-sectional study conducted with 259 women from a rural community of Camaçari-BA. The data were collected from July 2019 to January 2020, by applying a form that contemplated sociodemographic characteristics and general health conditions. The SPSS statistical software, version 21.0, was used to process and analyze the data. Descriptive analysis was performed by using absolute numbers and percentage indices. To verify the association between social determinants of health and risk factors for syphilis, Pearson's Chi-square test was used, considering statistical significance when p <0.05, and multiple logistic regression analysis to determine which variables could be considered predictors of syphilis. There was a predominance of women over 30 years old (61.4%), black / brown (89.2%), with no previous history of chronic diseases (60.2%), with sexual onset after 16 years old (57.7%), with 1 to 3 sexual partners in life (72.9%), who used contraceptive methods (67.6%), without using condoms in all sexual relations (62.2%), knew about transmission and prevention of STIs (89.8%), have already gestated (91.5%) and have not aborted (74.1%). They had a religious belief (75.7%), lived with a partner (71.4%), had a child (89.6%), did not have a support group (57.1%), even had elementary school (47, 1%), engaged in paid activity (34.3%), resided in their own or ceded home (86.1%), received less than a minimum wage (33.7%), partially financially dependent on someone (39.4% ), does not receive government assistance (51.4%) and exclusively access public health services (53.3%). A statistically significant association was identified between: the use of condoms during sexual intercourse and the use of contraceptive methods with the housing situation (p = 0.03); number of income dependent (p = 0.01) and access to health services (p = 0.03). With regard to knowledge about the transmission and prevention of STIs and religious beliefs (p = 0.02), there was a significant association, as well as having children (p = 0.02), education (p <0.01) and monthly income (p = 0.02). The data revealed social inequalities that can interfere with the health of rural women, thus enabling the expansion of health actions and strategies in order to meet the needs of the population.