AEGiS-11IAC: Prevention strategies and the resignification of common sense theories about the risk of HIV infection: the Bela Vista cohort study, Sao Paulo, Brazil.

11th International AIDS Conference

Vancouver, British Columbia — July 7-12, 1996

Prevention strategies and the resignification of common sense theories about the risk of HIV infection: the Bela Vista cohort study, Sao Paulo, Brazil.

Int Conf AIDS 1996 Jul 7-12; 11:456 (abstract no. Pub.C.1116)
Grangeiro A, Spink MJ; Pontificial Catholic University of Sao Paulo, Sao Paulo, Brazil. Fax: 00-55-11-6052772.

OBJECTIVE: To determine change patterns on sexual practices in a cohort of men who have sex with men in Sao Paulo, Brazil, with emphasis on three issues specially open to the construction of common sense theories: a) use of condoms with steady partners; b) oral sex and HIV infection; c) transmission of HIV in sexual intercourse with women.

METHODS: The Bela Vista is an open cohort study. Eligibility criteria include: 1) men who have sex with men; 2) aged between 18 and 59 years; 3) who did not use intravenous drugs in the past 6 months; 4) negative HIV tests. Volunteers undergo an initial interview in which the objectives and procedures are discussed, and an Informed Consent Form is signed if they agree to participate. Data collection procedures include collecting blood samples for HIV, syphilis, hepatitis B and C serology; clinical evaluation and a comprehensive socio-behavioral interview. These procedures are repeated every 6 months.

RESULTS: Of the 288 volunteers recruited in the 16 months since the beginning of the study, 113 had returned for the 6 months follow up visit by Nov.30, 1995. Data concerning sexual practices and use of condom by these 113 subjects in the first and second visits show a slight increase in the proportion of volunteers who report unprotected anal intercourse (43% in the first visit to 49% in the second). However, such increase concerned steady partnerships rather than casual ones.There was an increase in the proportion of volunteers who reported steady partnerships (52% to 68%) and a reduction in the proportion who reported casual partnerships (81% to 74%), as well as a reduction in the total number of partners (mean=9.3 to 7.1). Condoms were rarely used in oral sex : 81% and 87% reported unprotected oral sex in the 1st and 2nd interviews respectively. Condoms tended not to be used by bisexual men when having vaginal sex with their female steady partners (6/6 first visit; 6/8 second visit, of those who reported female steady partners).

CONCLUSION: Despite emphasis on the use of condoms in all situations on post interview counselling and safe sex workshops carried out in the cohort, comparative data concerning condom use in the first and second visits suggest that common sense theories concerning trust in more stable relationships; lack of risk in oral sex and low risk of infection by women partners still prevail. (Supported by WHO; MS/BR; SES/SP; FAPESP.)

Keywords: AEGIS, HIV Infections, Condoms, Cohort Studies, Bisexuality, Sex Behavior, Safe Sex, Risk-Taking, Risk, Coitus, Syphilis, Hepatitis B, Brazil, Human, Male, Female, ICA11

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