Epidemiological and molecular characteristics of HIV-1 infection among female commercial sex workers, men who have sex with men and people living with AIDS in Paraguay

Abstract

Características epidemiológicas e moleculares da infecção por HIV-1 entre as mulheres que trabalham no comércio do sexo, entre homens que mantém relações sexuais com homens e nas pessoas convivendo com AIDS no Paraguai ABSTRACTAn HIV seroprevalence and molecular study was conducted among 935 subjects: 723 female commercial sex workers, 92 men who have sex with men and 120 HIV-positive volunteers. The reported injection drug use rates were 0.7% in female commercial sex workers and 3% in men who have sex with men. Sexually transmitted infections were reported in 265 (37%) of the female commercial sex workers and 38 (41%) of the men who have sex with men. A total of 20 (2.8%) female commercial sex workers and 12 (13%) men who have sex with men became HIV infected during the study period. A history of sexually transmitted infection increased the risk of subsequent HIV infection twofold (adjusted odds ratio of 2.5) among the female commercial sex workers, while cocaine use had an adjusted odds ratios of 6.61 among men who have sex with men. From 130 samples, and based on heteroduplex mobility assaying for the env gene, with sequencing of part of pol and/or full genomes, subtype B was the predominant subtype identified (66%); followed by subtype F (22%) and subtype C (4%). Recombinant CRF12-BF strains were identified in 6% and CRF17_BF was identified in 2%. Key

Heterosexual transmission of human immunodeficiency virus type 1 subtype C in southern Brazil

“…Previous research conducted in Argentina, Uruguay and Paraguay showed only marginal circulation of HIV-1C, with prevalence rates below 1%. [30][31][32][33] Conversely, seven different viral isolates harboring CRF12 BF-derived fragments were found inwards of the border to Uruguay, an observation not previously reported in the region. 10 The identification of this CRF in inland Brazil shows the changing dynamics of the circulation of HIV-1 strains, which warrants periodic molecular surveillance.…”

An action agenda for HIV and sex workers

“…(Table 2) Male and Transgender SW, in contrast, typically cluster with MSM populations, and less so with either FSW or other heterosexual networks. 21,42,43 …”

The global epidemic of HIV infection among men who have sex with men

“…In Peru, where MSM are included in the national biobehavioral HIV surveillance program, the HIV prevalence ranged from 9.8 to 22.3% between sites, and was highest in Lima [74,75]. High prevalence has been observed in cross-sectional studies [7 , 76,77] among MSM in Bolivia (21.2%), Ecuador (15.1%), Colombia (19.4%), Brazil (7.0-9.8%) and Paraguay (13%). In Mexico, biobehavioral HIV surveillance among MSM showed HIV prevalence of 25.6% across urban centers [7 ].…”