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A cohort study of AIDS risk and serology among male port workers in Santos, Brazil.


Int Conf AIDS. 1996 Jul 7-12;11(1):132 (abstract no. Mo.C.1441). Unique

Objective: The city of Santos has the highest cumulative incidence of AIDS in Brazil. We are following a cohort of male port workers in Santos to measure their prevalence and incidence of HIV infection and to examine changes in their patterns of risk behavior over time. Methods: In early 1994, we began recruiting a random sample of 395 male employees of CODESP (the Santos Port Authority). These men are being followed over a three-year period, during which they complete a KAPB questionnaire and undergo serologic testing for HIV antibodies every 12 months. 313 79%) of the men who participated in Wave 1 have so far returned for follow-up in Wave 2. Sera collected in Wave 2 were also tested for syphilis. Results: Four of 395 men (1.1%) were HIV-positive in Wave 1; three of these gave a history of sex with men. Thirty-eight percent of all men reported a lifetime history of at least one STD. No new HIV-positives have been found so far in Wave 2, though six men were positive for syphilis (VDRL and FTA). Questionnaires from Wave 1 showed high levels of knowledge but low levels of condom use. The qualitative impression of interviewers is that men were much more open to talk about their risk activities and barriers to behavior change in Wave 2, but that levels of risk behavior have changed little. Conclusion: Despite good levels of information, adoption of safe sex practices does not seem to be a high priority for these men. They generally do not consider themselves at risk for HIV, despite high rates of other STD's. Perhaps the most important lesson so far from this study is that longitudinal cohort studies of this type are feasible in the developing world. In this case, the results of this research are forming the basis for a major new AIDS prevention campaign directed at over 20,000 port workers in Santos.

*Acquired Immunodeficiency Syndrome/EPIDEMIOLOGY


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