AEGiS-13IAC: Trends of HIV epidemic related to the changes in drug using pattern among injection drug users in Santos, Brazil, during the 1990's.

13th International AIDS Conference

Durban, South Africa - July 9-July 14, 2000

Trends of HIV epidemic related to the changes in drug using pattern among injection drug users in Santos, Brazil, during the 1990's.

Int Conf AIDS 2000 Jul 9-14; 13:(abstract no. WeOrC499)

Mesquita F, Bueno R, Kral A, Reingold A, Araujo P, Piconez D; F.Mesquita, FSP/USP & IEPAS, Av Campos Sales 59, Santos - SP, 11013.401, Brazil, Tel.: +55 13 2354 842, Fax: +55 13 2342 576, E-mail: iepasede@atribuna.com.br

BACKGROUND: Santos Metropolitan Region (SMR), State of Sao Paulo, historically is well known as having one of the areas with the largest number of AIDS cases in Brazil, especially among IDUs. The main objective of this study is to analyze the implications of the IDU behavior on the trends of the AIDS epidemic in the region.

METHODOLOGY: During 1991/1992 (first wave), 1994/1996 (second wave), and 1999 (third wave) we conducted three cross sectional studies as part of the WHO Multicity Study among Injecting Drug Users and Projeto Brasil, using a standard questionnaire. We recruited 220, 140, and 108 IDUs, respectively; interviewed them; and collected blood samples for HIV testing.

RESULTS: The overall sample was 70% male, 87% under 40 years old. 84% had less than 9 years of education, and 32% injected more than 5 times per day. 20% were gay men. HIV seroprevalence was 63% in wave 1, 65% in wave 2, and 42% in wave 3 (p>0.001). Crack cocaine use increased from 11% in wave 1 to 60% in wave 2 and 67% in wave 3 (p>0.001). The prevalence of frequent injection (>5 per day) decreased from 42% in wave 1 to 30% in wave 2 and 15% in wave 3 (p>0.001). Using logistic regression, the following factors were predictive of HIV antibody positive status: sharing syringes (Adjusted Odds Ratio `AOR' = 2.64; 95% Confidence Interval `CI' = 1.77, 3.95), injecting over 5 times a day (AOR = 2.09; 95%CI = 1.33, 3.26), and female gender (AOR = 2.03; 95%CI = 1.29, 3.21). Crack cocaine use was protective, though not statistically significant (AOR = 0.78; 95% CI = 0.52, 1.18).

CONCLUSION: The increase in the use of smoking crack cocaine and the decrease in injecting risk practices, may have played a role in the AIDS epidemic in Santos Metropolitan Area, Brazil.

Keywords: AEGIS, HIV Infections, Substance Abuse, Intravenous, HIV Seropositivity, HIV Seroprevalence, Crack Cocaine, Substance-Related Disorders, Disease Outbreaks, Prevalence, Homosexuality, Male, Acquired Immunodeficiency Syndrome, Cocaine-Related Disorders, Cross-Sectional Studies, Logistic Models, Brazil, Human, Male, Female
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WeOrC499