Open Drug Scenes Survey in Brazilian cities: main findings from São Paulo, Fortaleza, and Brasília

TL;DR

This survey studied drug users in three Brazilian cities, finding high social vulnerability and health risks, with differences in access to health services and unprotected sex rates.

Contribution

The study provides new data on drug scene attendees in Brazilian cities, highlighting regional differences in health access and vulnerability.

Findings

No significant differences in sociodemographic indicators among attendees in the three cities.

Fortaleza had lower homelessness and limited health access, while Brasília had higher emergency service use and better health access.

Unprotected sex was prevalent, and less than half of attendees were tested for tuberculosis and STIs.

Abstract

The latest edition of the Open Drug Scenes Survey in Brazilian Cities (LECUCA) investigated social vulnerability, health, and the use of the Psychosocial Care Network by attendees of open drug scenes (ODSs) involving crack cocaine in São Paulo, Fortaleza, and Brasília between 2021/2022.

Since 2016, LECUCA has used Time-Location Sampling (TLS) to select probabilistic samples representative of the population of ODS attendees.

We interviewed 579 participants in São Paulo, Fortaleza, and Brasília, obtaining a response rate of 75%. We found no difference in ODS attendees regarding the prevalence of sociodemographic indicators and time living in the ODS. The prevalence values of attendees who had never been homeless before living in the ODS and those living in their homes were equally high in the three capitals. Fortaleza stood out for having lower rates of homelessness and limited access to specialized health services, whereas Brasília had high rates of searching for emergency services due to drug use and greater access to all modalities of health and assistance services. Unprotected sex was prevalent over one third of ODSs attendees, and none of the capitals had more than half of the attendees testing for tuberculosis and sexually transmitted infections. Rates of pregnancy complications were high in all three capitals, with São Paulo accounting for the lowest rates.

LECUCA provides significant subsidies to governmental and institutional managers, aiming at catalyzing the formulation of public policies and care strategies based on data and evidence.

A última edição do Levantamento de Cenas de Uso de Capitais (LECUCA) investigou indicadores de vulnerabilidade social, de saúde e uso de serviços de saúde e assistência entre frequentadores das cenas abertas de uso (CAU) de crack em São Paulo, Fortaleza e Brasília entre 2021/2022.

Desde 2016, o LECUCA utiliza a amostragem por Tempo-Localização (TLS) para selecionar amostras probabilísticas representativas da população de frequentadores da CAU.

Foram entrevistados 579 participantes em São Paulo, Fortaleza e Brasília, com índice de resposta de 75%. Os frequentadores das CAUs não se diferenciam nas prevalências de indicadores sociodemográficos e tempo na cena. As prevalências de frequentadores que nunca estiveram em situação de rua antes de viver na CAU e provenientes de casa foram igualmente altas nas três capitais. Fortaleza se destaca com menores índices de situação de rua e de acesso a equipamentos de saúde especializados, enquanto Brasília apresenta índices elevados de busca por emergência devido ao consumo de drogas e maior acesso a todas as modalidades de serviço de saúde e assistência. Mais de um terço dos frequentadores das CAUs pratica sexo desprotegido e nenhuma das capitais teve mais da metade dos frequentadores testados para Tuberculose e Infecções Sexualmente Transmissíveis (ISTs). Os índices de problemas na gestação foram altos entre todas as capitais, com os menores índices em São Paulo.

O LECUCA oferece subsídios importantes para gestores governamentais e institucionais, com o intuito de catalisar o desenvolvimento de políticas públicas e estratégias de atendimento fundamentadas em dados e evidências.