Since 1996, the Brazilian Department of Sexually Transmitted Infections (STI), AIDS and Viral Hepatitis (Departamento de Vigilância, Prevenção e Controle das IST, do HIV, AIDS e Hepatites Virais, Secretaria de Vigilância em Saúde, Ministério da Saúde) in collaboration with the Brazilian Ministry of Defense has conducted periodic and anonymous probability sample surveys to determine the human immunodeficiency virus (HIV) prevalence, the sexual and risk behaviors among conscripts of the Brazilian army. This study aimed to estimate the HIV seroprevalence of conscripts in Brazil by geographic region and to describe behavior in relation to the risk of HIV transmission by analyzing data from the Brazilian Conscripts Survey 8th edition performed in 2016.Conscripts were selected with a 2-stage sampling method stratified by geographical region. The study included a self-reported questionnaire and blood collection for HIV, hepatitis, and syphilis testing. Data from 37,282 conscripts between 17 and 22 years of age were analyzed. Of these conscripts, 73.7% stated that they were sexually active. The overall country-wide prevalence of HIV was 0.12%. The geographic prevalence rates were as follows: north (0.24%), northeast (0.15%), central-west (0.13%), southeast (0.07%), and south (0.10%). The proportion of conscripts who reported having sex with other men was 4.4%, and the estimated HIV prevalence in this group was 1.32%. Regarding prophylaxis use, 45.6% of the participants reported consistent condom use with casual partners within the last year, and 34.5% reported condom use with steady partners within the last year. The independent factors associated with HIV infection were: MSM status (odds ratio [OR] = 14.62; P = .000) and having more than 10 partners over their lifetime (OR = 3.32; P = .028).Our data suggest that the HIV prevalence among young men in Brazil remains stable except for the north region, and MSM continue to be associated with a high risk for HIV infection at a rate that is approximately 13-fold higher than the rate among men without a history of sex with another man. Our findings confirm the need to scale up combination HIV prevention for young men, including MSM, in Brazil.

The Conscripts Survey has been conducted periodically by the Brazilian Department of Sexually Transmitted Infections (STIs), AIDS, and Viral Hepatitis (DIAHV) in collaboration with the Brazilian Ministry of Defense for over 2 decades. It aims to assess the syphilis prevalence and obtain data on knowledge regarding STIs and their risk factors among conscripts enlisted for the Brazilian Army. This cross-sectional study was conducted among conscripts across Brazil aged 17 to 22 years from August to December 2016. It included a self-reported questionnaire and blood testing for syphilis, HIV, and hepatitis B and C. In total 38,247 conscripts were enrolled; after exclusion due to a lack of information, 37,282 (93.2%) conscripts were included. The estimated syphilis prevalence rates were: 1.63%, 1.09%, and 0.62% for screened, confirmed, and active syphilis, respectively. Among those with active syphilis, 81.1% reported not having syphilis infection in their lifetime. Higher confirmed syphilis prevalence rates were observed in the South region, followed by North and Southeast regions. Independent factors associated with confirmed syphilis infection were: self-reported STIs in one's lifetime (odds ratio [OR] = 7.24; P < .001), same-sex sexual relationships (OR = 3.43; P = .001), and having the 1st sexual intercourse encounter before 15 years of age (OR = 2.62; P = .04). The proportion of conscripts who reported having sex with other men (MSM) was 4.3%, and the estimated syphilis prevalence in this group was 5.23%, 4.61%, and 3.60% for screened, confirmed, and active syphilis, respectively. The sexual behaviors most frequently associated with confirmed syphilis were: sexual relationship with casual partners in the last year ( P < .001), same-sex sexual relationships ( P < .001), more than 10 partners ( P = .006), and having sexual intercourse before 15 years of age ( P = .003). Although not significant, only 25.4% of the conscripts who had a confirmed syphilis reported the use of condoms with steady partners, 32.4% with casual partner, and 24.3% with any partner. We found that syphilis is on the rise among the young Brazilian male population. The increase in its prevalence, particularly among MSM, highlights the need for urgent public health interventions, action plans, and implementation of risk reduction strategies aimed at this population.

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Introduction: Knowledge about risky sexual behavior among young people has been widely acknowledged as a key tool to controlling the spread of HIV. This article aimed at presenting the risk behavior of Brazilian Army conscripts toward HIV infection according to the country’s geographic regions. . Method: We collected data from 37,282 conscripts, aged 17 to 22, during enlistment in the Brazilian Army in 2016. The prevalence of HIV infection, both self-reported and measured through laboratory results, and risk behavior factors were estimated by region. Results: 75% of the sample of conscripts reported to have already started sexual activity, and the average age of their sexual initiation was 15. Condom use varied according to the type of sexual relationship, being lower among steady partners and greater among less stable relationships. HIV prevalence assessed by laboratory tests was 0.12% across the country and the highest prevalence was observed in the North region (0.24%). Alcohol and illicit drug usage was higher in the South region. Discussion: The study allowed the observation of risk behavior monitoring for HIV infection among young Brazilians. Lower condom usage among steady partners may be contributing to an increase in the number of HIV-infected individuals. Conclusion: Results suggest the need to intensify prevention campaigns to disseminate safe sex practices among young people, in addition to the expansion of testing offer to this population.

Programa NacioNal de imuNizações (PNi): 40 aNos Programa NacioNal de imuNizações (PNi): 40 aNos Ministério da saúde secretaria de Vigilância em saúde departamento de Vigilância das doenças transmissíveis Brasília -DF • 2013

Objectives In 2012, the WHO estimated that 6 million new cases of syphilis per year would occur worldwide, including 937 000 in Brazil. Early diagnosis and treatment of syphilis are essential to reduce morbidity and prevent transmission. The availability of rapid tests (RTs) for this diagnosis means that testing can be performed more quickly, as a point-of-care test, even in non-laboratory environments and requires only simple technical training to antibodies detection. The objective of this study was to evaluate the performance and operational aspects of seven commercially available RTs for syphilis in Brazil. Methods Seven rapid treponemal tests were evaluated for sensitivity, specificity, accuracy and Kappa value, according to a panel composed of 493 members. The operational performance of the assay was also determined for these tests. results The seven RTs showed sensitivity ranging from 94.5% to 100% when compared with the reference tests and specificity of between 91.5% and 100%. All the RTs evaluated presented good operational performance, and only one failed to present the minimum specificity as defined by Brazil's Ministry of Health. conclusion All the tests presented good operational performance, and the professionals who performed them considered them to be easy to use and interpret. This evaluation is important for making informed choices of tests to be used in the Brazilian Unified Health System. IntrOductIOnSyphilis constitutes a major public health problem. In 2012, the WHO estimated that six million new cases of syphilis per year would occur worldwide.

ObjectiveTo examine the feasibility of identifying HIV negative at risk individuals in HIV serodiscordant couples, during voluntary HIV testing in South Brazil.MethodsWe surveyed HIV testers at 4 public testing sites in Rio Grande do Sul. We obtained information on risk behaviors and sexual partnerships. HIV testing and testing for recent infection were performed; HIV prevalence and risk behaviors were assessed among subjects who reported having a steady partner who was HIV positive (serodiscordant group) and compared with the general testing population.ResultsAmong 3100 patients, 490 (15.8%) reported being in a steady relationship with an HIV positive partner. New HIV infections were diagnosed in 23% of the serodiscordant group (vs. 13% in the general population, p = 0.01); among newly positive subjects, recent HIV infections were more frequent (23/86, 26.7%) among testers with positive partners than among the general testing group (52/334; 15.6%; p = 0.016). Less than half of the serodiscordant testers reported having used a condom during the last sexual intercourse with their HIV-positive partner. Participants with inconsistent condom use with steady partner were four times more likely to test positive for HIV compared to those who reported always using condoms with the steady partner (OR: 4.2; 95% CI: 2.3 to 7.5).ConclusionIt is highly feasible to identify large numbers of HIV susceptible individuals who are in HIV serodiscordant relationships in South Brazil testing sites. Condom use within HIV serodiscordant couples is low in this setting, suggesting urgent need for biomedical prevention strategies to reduce HIV transmission.

O objetivo foi caracterizar aspectos sociodemográficos, comportamentais e clínicos entre conscritos brasileiros, segundo a prevalência de sífilis. Estudo descritivo desenvolvido valendo-se de pesquisa nacional de base populacional, realizada em 2016, com amostra probabilística de jovens conscritos de 17 a 22 anos de idade. Realizou-se autoaplicação de questionários confidenciais. As amostras de sangue total dos participantes foram coletadas para testagem de sífilis, com a utilização de testes treponêmicos e não treponêmicos. Empregaram-se técnicas de estatística descritiva para estimar as prevalências de sífilis e a distribuição de frequências entre as variáveis pesquisadas, considerando os intervalos de 95% de confiança (IC95%), após a ponderação dos dados. Do total de 37.282 participantes, 73,7% haviam iniciado a vida sexual. As prevalências de sífilis na vida e de sífilis confirmada foram de 1,6% e 1,1%, respectivamente. As seguintes variáveis populacionais apresentaram maior prevalência de sífilis: ausência de acesso à Internet no domicílio; início da atividade sexual antes dos 14 anos; categoria de exposição homens que fazem sexo com homens; práticas sexuais com mais de cinco parcerias; recebimento de presentes, drogas ou outros incentivos em troca de sexo; e história prévia de sintomatologia de infecções sexualmente transmissíveis. Observou-se o aumento de sífilis entre os jovens conscritos brasileiros, em comparação aos inquéritos anteriores. Tal incremento reforça a importância dessa população sentinela para realizar vigilância ativa, de forma a subsidiar estratégias de atenção à saúde dos jovens, incluindo cenários escolares.