High HIV Prevalence among Men who have Sex with Men in a Time-Location Sampling Survey, São Paulo, Brazil

Veras, Maria Amélia; Calazans, Gabriela Junqueira; Ribeiro, Mauro C. C.; Oliveira, Carmem Aparecida de Freitas; Giovanetti, Márcia Regina; Facchini, Regina; França, Isadora Lins; McFarland, Willi

doi:10.1007/s10461-014-0944-3

Cited by 30 publications

(18 citation statements)

References 28 publications

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“…This may have affected our results in the cities where our calculations required a larger sample size. However, in São Paulo our results are not statistically different from a previous study conducted in the city using Time Location Sampling 35 . The 2016 study took place at a time of both great political change in Brazil and with an HIV program focused on treatment.…”

Section: Limitationscontrasting

confidence: 99%

The 12 city HIV Surveillance Survey among MSM in Brazil 2016 using respondent-driven sampling: a description of methods and RDS diagnostics

Kendall

Kerr

Mota

et al. 2019

Rev. bras. epidemiol.

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Introduction: This paper details the methods used in the second national Biological and Behavioral Surveillance Survey (BBSS) of HIV, syphilis, and hepatitis B and C among men who have sex with men in Brazil. Methods: Respondent-driven sampling (RDS) was used in 12 cities in 2016. The targeted sample size was initiated with five to six seeds in each city. HIV, syphilis, and Hepatitis B and C rapid tests were offered to participants. RDS Analyst with Gile’s successive sampling (SS) estimator was used to adjust results as recommended and a weight for each individual was generated for further analysis. Data for the 12 cities were merged and analyzed using Stata 14.0 complex survey data tools with each city treated as its own stratum. Results: Duration of data collection varied from 5.9 to 17.6 weeks. 4,176 men were recruited in the 12 cities. Two sites failed to achieve targeted sample size due to a six-month delay in local IRB approval. No city failed to reach convergence in our major outcome variable (HIV). Conclusion: The comprehensive BBSS was completed as planned and on budget. The description of methods here is more detailed than usual, due to new diagnostic tools and requirements of the new STROBE-RDS guidelines.

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Section: Limitationscontrasting

confidence: 99%

The 12 city HIV Surveillance Survey among MSM in Brazil 2016 using respondent-driven sampling: a description of methods and RDS diagnostics

Kendall

Kerr

Mota

et al. 2019

Rev. bras. epidemiol.

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“…In 2010, prevalence amongst 18-24-year-old MSM in Belo Horizonte, MG was 2.8% [53]. Data from late 2011 and early 2012 reports a prevalence of 6.4% in MSM 18-24 year-olds in São Paulo, SP [54]. …”

Section: Resultsmentioning

confidence: 99%

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

2017

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BackgroundDespite young people being a key population for HIV prevention, the HIV epidemic amongst young Brazilians is perceived to be growing. We therefore reviewed all published literature on HIV prevalence and risk factors for HIV infection amongst 10-25 year olds in Brazil.MethodsWe searched Embase, LILACS, Proquest, PsycINFO, PubMed, Scopus and Web of Science for studies published up to March 2017 and analyzed reference lists of relevant studies. We included published studies from any time in the HIV epidemic which provided estimates specific to ages 10-25 (or some subset of this age range) for Brazilians on either: (a) HIV prevalence or incidence; or (b) the association between HIV and socio-demographic or behavioral risk factors.ResultsForty eight publications met the inclusion criteria: 44 cross-sectional, two case-control, two cohort. Four studies analysed national data. Forty seven studies provided HIV prevalence estimates, largely for six population subgroups: Counselling and Testing Center attendees; blood donors; pregnant women; institutional individuals; men-who-have-sex-with-men (MSM) and female sex workers (FSW); four provided HIV incidence estimates. Twelve studies showed HIV status to be associated with a wide range of risk factors, including age, sexual and reproductive history, infection history, substance use, geography, marital status, mental health and socioeconomic status.ConclusionsFew published studies have examined HIV amongst young people in Brazil, and those published have been largely cross-sectional and focused on traditional risk groups and the south of the country. Despite these limitations, the literature shows raised HIV prevalence amongst MSM and FSW, as well as amongst those using drugs. Time trends are harder to identify, although rates appear to be falling for pregnant women, possibly reversing an earlier de-masculinization of the epidemic. Improved surveillance of HIV incidence, prevalence and risk factors is a key component of efforts to eliminate HIV in Brazil.

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“…Considering that MSM frequently engage in unprotected anal intercourse [39–42], MSM who engage in risky sexual behaviour, but also male sex workers and TGW, could be candidates for the initial phase of implementation of PrEP programmes. The observation that higher willingness to use PrEP among MSM was significantly associated with exclusive or more frequent receptive anal sexual behaviour [31], history of unprotected anal intercourse with more than two men [28] and perceived risk of HIV infection [32] also supports this approach.…”

Section: Discussionmentioning

confidence: 99%

Towards a fair consideration of PrEP as part of combination HIV prevention in Latin America

Ravasi

Grinsztejn

Baruch

et al. 2016

Journal of the International AIDS Society

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IntroductionDespite progress in scaling up antiretroviral treatment, HIV prevention strategies have not been successful in significantly curbing HIV incidence in Latin America. HIV prevention interventions need to be expanded to target the most affected key populations with a combination approach, including new high impact technologies. Oral pre-exposure prophylaxis (PrEP) is recommended as additional prevention choice for individuals at higher risk of infection and could become a cost-effective prevention tool. We discuss the barriers and solutions for a fair consideration of PrEP as part of combination HIV prevention strategies in Latin America.DiscussionAlthough demonstration projects are ongoing or being planned in a number of countries, to date no Latin American country has implemented a public PrEP programme. The knowledge of policymakers about PrEP implementation needs to be strengthened, and programmatic guidance and cost estimate tools need to be developed to support adequate planning. Despite high levels of awareness among health providers, especially if engaged in HIV or key population care, willingness to prescribe PrEP is still low due to the lack of national policies and guidelines. Key populations, especially men who have sex with men, transgender women and sex workers, have been engaged in demonstration projects, and qualitative research shows high awareness and willingness to use PrEP, especially if accessible in the public sector for free or at affordable price. Concerns of safety, adherence, effectiveness and risk compensation need to be addressed through targeted social communication strategies to improve PrEP knowledge and stimulate demand. Alliance among policymakers, civil society and representatives from key populations, healthcare providers and researchers will be critical for the design and successful implementation of PrEP demonstration projects of locally adapted delivery models. The use of mechanisms of joint negotiation and procurement of antiretrovirals could reduce costs and significantly increase the cost-effectiveness of PrEP.ConclusionsPrEP is an additional prevention tool and should be implemented in combination and synergy with other prevention interventions. PrEP programmes should target high-risk individuals from key populations for higher cost-effectiveness. Demonstration projects may generate strategic information for and lead to the implementation of full-scale PrEP programmes.

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High HIV Prevalence among Men who have Sex with Men in a Time-Location Sampling Survey, São Paulo, Brazil

Cited by 30 publications

References 28 publications

The 12 city HIV Surveillance Survey among MSM in Brazil 2016 using respondent-driven sampling: a description of methods and RDS diagnostics

The 12 city HIV Surveillance Survey among MSM in Brazil 2016 using respondent-driven sampling: a description of methods and RDS diagnostics

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

Towards a fair consideration of PrEP as part of combination HIV prevention in Latin America

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