ProblemEarly diagnosis of infections with human immunodeficiency virus (HIV) is needed – especially among key populations such as sex workers, transgender people, men who have sex with men and people who use drugs.ApproachThe Brazilian Ministry of Health developed a strategy called Viva Melhor Sabendo (“live better knowing”) to increase HIV testing among key populations. In partnership with nongovernmental organizations (NGOs), a peer point-of-care testing intervention, using an oral fluid rapid test, was introduced at social venues for key populations at different times of the day.Local settingKey populations in Brazil can have 40 times higher HIV prevalence than the general population (14.8% versus 0.4%).Relevant changesLegislation was reinterpreted, so that oral fluid rapid tests could be administered by any person trained in rapid testing by the health ministry. Between January 2014 and March 2015, 29 723 oral fluid tests were administered; 791 (2.7%) were positive. Among the key populations, transgender people had the greatest proportion of positive results (10.7%; 172/1612), followed by men who declared themselves as commercial sex workers (8.7%; 165/1889) and men who have sex with men (4.8%; 292/6055).Lessons learntThe strategy improved access to HIV testing. Testing done by peers at times and locations suitable for key populations increased acceptance of testing. Working with relevant NGOs is a useful approach when reaching out to these key populations.
Objective: Rapid HIV testing and counselling in community settings delivered by trained peers can allow easier access to and uptake of HIV testing and care. The programme 'Live Better Knowing' offers rapid HIV testing to key populations across Brazil. This cross-sectional study aims at describing the HIV prevalence in population subgroups and at assessing the association of sex work (SW) and/or drug use with a positive HIV result. Methods:Between January 2013 and April 2016, key populations were invited for HIV rapid oral fluid tests (DPP HIV-1/2 Bio-Manguinhos/Fiocruz, Rio de Janeiro, Brazil) by peers. HIV testing was offered in identified venues and areas where these populations socialize. Participants were interviewed using a brief questionnaire about their socio-demographic and risk behaviour. Multivariable logistic regression was used to assess the effect of SW and/or drug use on the risk of HIV.Results: Among the 43,358 participants, 42.9% were ciswomen, 2.9% were transvestites, 2.7% were transgender, 19.8% were men who have sex with men (MSM) and 31.9% were heterosexual men. Overall, 52.1% were first-time HIV testers. The HIV prevalence among the ciswomen, transvestites, transgender people, MSM and heterosexual men was 0.9%, 7.2%, 4%, 3.4% and 1%, respectively. Individuals who performed SW and used drugs had the highest HIV prevalence within each population group (ciswomen 1.7%, transvestites 8.1%, transgender 7.4%, MSM 5.9% and heterosexual men 2.6%). The adjusted odds ratios with 95% confidence intervals for selling sex combined with drug use were 2.90 (1.21-6.96) in ciswomen, 25.01 (2.67-234.57) in transgender people and 2.42 (1.31-4.48) in MSM. Conclusion:This outreach programme attracted persons with high risk practices who had never been tested. Our findings suggest that transvestites and transgender people (particularly those who sell sex) constitute a high risk population for HIV in urgent need of enhanced prevention, treatment and care services.
IntroductionPopulation-based studies help provide more-robust prevalence estimates and related factors, which are needed to drive sexually transmitted infection (STI) prevention and control programmes. We use data from the Brazilian Survey of Knowledge, Attitudes, and Practices (PCAP) to examine the prevalence of self-reported STIs and its association with demographics, behaviour, and the uptake of interventions.MethodsA probability sample survey was conducted in 2013 (PCAP-2013; n=12,000) and in 2008 (PCAP-2008; n=8,000) among men and women aged 15–64. The participants completed the survey in their homes through computer-assisted face-to-face interviews and self-interviews. We describe the age-specific and sex-specific prevalence of self-reported STIs in relation to demographics, behavioural factors, and the uptake of interventions and explore associated changes since the PCAP-2008.ResultsOverall, 9.4% of men and 5.3% of women reported having had an STI in 2013. This prevalence decreased from that in 2008 (15.9% in men and 8.8% in women). In 2013, self-reported STIs were mainly urethral discharge (5.8%) among men and genital ulcers (2.9%) among women. Men sought care and treatment more often than women did during their most recent experience of STI symptoms (care: 85.7% and 81.2%; treatment: 77.5% and 68.7%, respectively). Self-reported STI infections were associated with increasing age, decreasing socioeconomic status, current or previous drug use, sex with a casual partner in the last 12 months (for both sexes), sex with a same sex partner, and no condom use during the last sexual intercourse (for men), and non-indigenous status and one or more previous HIV tests (for women).ConclusionThis probability sample survey highlights a decrease in STIs for men and women in Brazil. Women carry a higher STI burden than men do. The increases in health care-seeking behaviour and treatment received when presenting symptoms are encouraging. Increasing age, casual sexual partners, and drug use are the main risk factors for STI acquisition.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
customersupport@researchsolutions.com
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.