AEGiS-11IAC: Prevalence of HIV among IDUs in Santos - Brazil: analysis of HIV risk factors and gender differences in behavior.

11th International AIDS Conference

Vancouver, British Columbia — July 7-12, 1996

Prevalence of HIV among IDUs in Santos - Brazil: analysis of HIV risk factors and gender differences in behavior.

Int Conf AIDS 1996 Jul 7-12; 11:454 (abstract no. Pub.C.1099)
Carvalho HB, Burattini MN, Massad E, Mesquita F, Bueno RC, Lopes GT, Ruiz MA; NUPAIDS, University of Sao Paulo, Medical Informatics Discipline, School of Medicine, University of Sao Paulo, Sao Paulo, Brazil.

OBJECTIVES: To analyse the risk factors related to HIV transmission and the gender differences in sexual behavior among IDUs of the city of Santos, Brazil.

METHODS: We interviewed 220 IDUs (125 male and 89 female), sampled by snowballing. Risk behavior related to HIV were assessed by a questionnaire. Seroprevalence of HIV, Hepatitis B and C, and Syphilis were assessed. Uni and multivariate analysis of the risk factors and a comparison between male and female behavior were performed.

RESULTS: Seroprevalences found were 62% to HIV, 75% for HCV, 75% for HBV and 34% for Syphilis. The risk for parenterally transmitted infections in this IDUs community was shown to be higher than that for sexually transmitted ones (Odds Ratio for Syphilis=3.57, HBV=10.0, HCV=100.0, respectively, when compared with blood donors matched for age and sex). The results of the multivariate risk analysis showed that daily rates of ID use greater than 5 times/day (OR=6.73), not changing behavior to avoid AIDS (OR=3.28), ID use greater than 15 days/month (OR=2.72), and ID use in the last 2 months (OR=2.23) were the risk factors significantly associated with HIV infection. Gender differences showed that females use ID every day more frequently than males (0.42 vs 0.25, p=0.011, respectively); use of ID greater than 5 times/day (0.52 vs 0.40, p=0.095, respectively), but no differences were seen in the ID use in the last two months (0.46 vs 0.50, p=0.542, respectively), nor in not changing behavior to avoid AIDS (p=0.62). Gender differences in sexual behavior show that females have more frequent commercial sex work (0.53 vs 0.07, p=0.0001, respectively), more frequent sexual intercourses (p=0.042), and a significantly higher number of clients/month as compared to male sexworkers (41 vs 14, p=0.002). There are no gender differences in the use of condoms with regular partners or clients (p=0.66 and 0.58, respectively), but there is a significant difference with occasional sexual partners, with female using more than male (p=0.0056). There were no gender differences in the prevalences for HIV (female 0.67 and male 0.59) and HCV (female 0.77 and male 0.72), p=0.222 and 0.332, respectively. There were significant differences in the prevalence of Syphilis (female 0.46 and male 0.25) and HBV (female 0.82 and male 0.70), p=0.003 and 0.048, respectively.

CONCLUSION: Although parenteral exposure is significantly stronger than sexual exposure to HIV in this community, the higher sexual activities of females exposes them more frequently to other STDs, such as syphilis and hepatitis B. The high rate of female sexual activity could also account for facilitating the spread of HIV to the community at large.

Keywords: AEGIS, Prevalence, HIV Infections, Sexually Transmitted Diseases, Hepatitis B, Acquired Immunodeficiency Syndrome, Sexual Partners, Risk-Taking, Prostitution, Seroepidemiologic Studies, Hepatitis B Virus, Syphilis, Condoms, Hepacivirus, Multivariate Analysis, Risk Factors, Brazil, Case-Control Studies, Human, Female, Male, epidemiology, ICA11

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PubC1099