Estimation of HIV incidence in two Brazilian municipalities, 2013

Abstract

OBJECTIVE To estimate HIV incidence in two Brazilian municipalities, Recife and Curitiba, in the year of 2013.METHODS The method for estimating incidence was based on primary information, resulting from the Lag-Avidity laboratory test for detection of recent HIV infections, applied in a sample of the cases diagnosed in the two cities in 2013. For the estimation of the HIV incidence for the total population of the cities, the recent infections detected in the research were annualized and weighted by the inverse of the probability of HIV testing in 2013 among the infected and not diagnosed cases. After estimating HIV incidence for the total population, the incidence rates were estimated by sex, age group, and exposure category.RESULTS In Recife, 902 individuals aged 13 years and older were diagnosed with HIV infection. From these, 528 were included in the study, and the estimated proportion of recent infections was 13.1%. In Curitiba, 1,013 people aged 13 years and older were diagnosed, 497 participated in the study, and the proportion of recent infections was 10.5%. In Recife, the estimated incidence rate was 53.1/100,000 inhabitants of 13 years and older, while in Curitiba, it was 41.1/100,000, with male-to-female ratio of 3.5 and 2.4, respectively. We observed high rates of HIV incidence among men who have sex with men, of 1.47% in Recife and 0.92% in Curitiba.CONCLUSIONS The results obtained in the two cities showed that the group of men who have sex with men are disproportionately subject to a greater risk of new infections, and indicate that strategies to control the spread of the epidemic in this population subgroup are essential and urgent.

A scoping review of prevalence, incidence and risk factors for HIV infection amongst young people in Brazil

“…In 2002, none of the 70 women aged 18-21 attending a public family planning clinic in Salvador, BA were HIV seropositive; however 4% of 22-25 year-olds were HIV-positive [59]. In 2013, a study estimated the HIV incidence for 13-24 year olds in the general population in the cities of Recife, PE and Curitiba, PR to be 0.06% in both cities, using Sedia™ HIV-1LAg-Avidity tests [60]. …”

“…Second, a large proportion of infections amongst both adolescents and young people were recent: 9.6% of HIV-positive individuals aged under 25 in Santos [15]; 17.9% of HIV-positive 20-24 year olds attending antenatal care in Sao Paulo [31]; 18.8% and 19.4% of HIV-positive 18-24 year olds Recife and Curitiba respectively in 2013 [60]; 25% of HIV-positive 15-24 year olds in Sao Paulo CTAs [21]; and 44.4% of HIV-positive adolescents seeking care in Recife CTAs [26]. While unsurprising, given the briefer sexual history of younger people and the predominantly sexual transmission route for HIV in Brazil, these data highlight the importance of developing preventive strategies focusing this age group, based on the behavioral risk factors to which they are more susceptible.…”

Results from a Method for Estimating HIV Incidence Based on the First Cd4 Count among Treatment-Naïve Cases: Brazil, 2004-2013

“…This method has been widely used to estimate the incidence of HIV in several countries and different epidemiological settings [3,[23][24][25][26], including HIV incidence estimation in two Brazilian cities [27]. However, validation studies have consistently shown that assay-based estimates of HIV incidence vary according to which assay is used to identify recent infections [28].…”

Evolution of HIV/AIDS response in Brazil: Policy innovations and challenges in the fourth decade of the epidemic

“…The current epidemiological profile of the epidemic in Brazil sends a warning message and invites us to revisit Brazil's AIDS policies. Although AIDS incidence has been stable in the last several years in Brazil, with a detection rate of around 20 cases per 100 000 inhabitants between 2010 and 2015, there are some regions of the country with an increasing number of new cases, as well as unacceptably high prevalence of HIV and syphilis among some vulnerable populations, such as transsexuals, young gay men, and drug‐dependent people …”

“…Although AIDS incidence has been stable in the last several years in Brazil, with a detection rate of around 20 cases per 100 000 inhabitants between 2010 and 2015, there are some regions of the country with an increasing number of new cases, 12,13 as well as unacceptably high prevalence of HIV and syphilis among some vulnerable populations, such as transsexuals, young gay men, and drug-dependent people. 14,15 Some deep contrasts have been observed in logically interrelated issues, yet to be minimally integrated, such as the prevention of the vertical transmission of HIV and the proper prophylaxis of congenital syphilis. Whereas the DA FONSECA AND BASTOS e239…”