Risk Factors for Incident HIV Infection Among Anonymous HIV Testing Site Clients in Santos, Brazil: 1996–1999

Abstract

This study further demonstrates the public health utility of using the STARHS for the assessment of emerging trends in the HIV epidemic. Results from this study will help to target appropriate prevention strategies directed toward at-risk populations in Santos.

Estimating HIV-1 incidence using the serologic testing algorithm for recent HIV infections at HIV counseling and testing centers in the city of São Paulo, Brazil

“…The HIV-1 prevalence that we observed (3.2%) was lower than the 4.4% reported among HIV CT center users in a previous study conducted in the city of São Paulo [10] and the 7.1% found among such clients in the city of Santos, also located in the state of São Paulo [11]. However, it was higher than the 2.1% observed in the city of San Francisco, California (USA) [2].…”

“…Studies conducted in Brazil have reported incidence rates varying from 1.2 to 2.8/ 100/year [10,11]. In our study, 60% of the individuals tested were men who have sex with men.…”

“…However, HIV-1 infections were more prevalent among men, likely reflecting historical aspects of the local epidemic in terms of demographics and exposure. Alves et al found the same to be true for HIV CT center users in the city of Santos [11]. We found that the incidence of recent HIV-1 infection was similar for men and women, which is also in agreement with the findings of Alves et al [11] In view of the trend towards a decrease in the male-to-female ratio of AIDS cases in Brazil, which dropped from 23:1 in the mid-1980s to 1.5:1 in 2005 (www.prefeitura.sp.gov.br/dstaids), these findings were expected.…”

Estimates of HIV-1 incidence based on serological methods: a brief methodological review

“…A non-significant increase of recent HIV-1 infections (0% vs. 0.8%) was observed among injection drug users (IDU) and ex-IDU 44,45 surveyed in 1994-96 and 1999-2001, in Rio de Janeiro. Similar studies were conducted in Sao Paulo, estimating the incidence of HIV-1 infection in inmates 46 , cocaine users 47 , and among people seeking HIV diagnosis in voluntary centers for counseling and testing from Santos (São Paulo State) 48 and Sao Paulo city 49,50 . In the former study, sera collected between 1996 and 1999 in Santos yielded an overall estimated HIV incidence of 2% (95%CI: 1.1-3.5), with 1.2% (95%CI: 0.5-2.6) in women and 2.7% (95%CI: 1.3-5.0) in men, quite similar to the results obtained in a voluntary center for counseling and testing in Rio de Janeiro for the same period 42 .…”

HIV-1 incidence among people seeking voluntary counseling and testing centers, including pregnant women, in Pernambuco State, Northeast Brazil

“…Although the rate of recent infection was around 20% in all study groups, pregnant women had lower incidence rates (0.15% per year; 95%CI: 0.00-0.33) than non-pregnant women (0.50% per year; 95%CI: 0.11-0.89; p = 0.0015) and men (1.03% per year; 95% CI: 0.45-1.61, p < 0.000001). There are few HIV incidence estimates by serological methods in Brazil; however, it has been demonstrated that in the South and Southeast of the country there are usually higher rates, such as 2.86% (95%CI: 1.04-4.68) in the South 8 and between 1.2-2.7% for men and 0.6-1.2% for women in the Southeast 9,10 . We should emphasize that we did not have enough data to determine HIV-1 incidence and prevalence among men who have sex with men (MSM), and as demonstrated by Merçon et al 10 , in Rio de Janeiro, the incidence in this group was five times higher than in heterosexual men, supposing that the presence of MSM may have inflated HIV-1 incidence and prevalence estimates among males.…”