|
Recent trends in prevalence and incidence of HIV-1 infection in individuals seeking testing in the voluntary counseling and testing site of Nova Iguaçu city, Rio de Janeiro state, Brazil
C.A. Velasco-de-Castro1, B. Grinsztejn2, V. Veloso2, F. Bastos3, J.H. Pilotto2,4, M. Morgado5
1IOC / IPEC / IFF - FIOCRUZ, Rio de Janeiro, Brazil, 2IPEC - FIOCRUZ, Rio de Janeiro, Brazil, 3ICICT - FIOCRUZ, Rio de Janeiro, Brazil, 4Hospital Geral De Nova Iguacu - HGNI DST/AIDS, Nova Iguaçu, Brazil, 5IOC - FIOCRUZ, Rio de Janeiro, Brazil
Background: Nova Iguaçu (NI) is an inner city in the metropolitan area of Rio de Janeiro state, located in an outskirt area, 43 kilometers/27 miles far from the capital. There is only one Voluntary Counseling and Testing site (VCT) where almost one million people can be tested for free for HIV infection, the vast majority of them from poor social strata. The aim of this study was to assess recent trends in NI HIV epidemic based on the individuals seeking HIV testing in the VCT.
Methods: BED-CEIA protocol was performed to identify recent seroconverters in HIV-seropositive samples, screened in 20,180 individuals tested in the NI VCT (January 2005-December 2008). Behavior information was obtained from baseline data collection forms, administered in private by trained interviewers.
Results: Overall prevalence and incidence rates were, respectively, 3.83% (95%CI=3.78-3.88) and 1.59%/year (95%CI=1.57-1.61). Overall prevalence was reduced overtime from 4.54% (95%CI=4.41-4.67) in 2005 to 3.26% (95%CI=3.17-3.35) in 2008. The same was observed for the incidence rate [1.79%/year (95%CI=1.74-1.84) vs 1.49%/year (95%CI=1.45-1.53)]. Prevalence and incidence rates estimated by categories showed different patterns both overtime and between them. Non-pregnant women (n=7,109) were 5.6 times more affected by HIV-1 infection than pregnant women (n=8,668), as detected by their rates of prevalence [4.51% (95%CI=4.41-4.61) vs 0.8% (95%CI=0.78-0.82)] and incidence [1.98%/year (95%CI=1.93-2.03) vs 0.41%/year (95%CI=0.40-0.42)]. Of note, the rates obtained for man having sex with men (MSM; n=659) vs heterosexual men (n=3744) were, respectively, 19.73% (95%CI=18.22-21.24) and 6.76% (95%CI=6.54-6.98) for prevalence; and 10.67%/year (95%CI=9.86-11.48) and 2.30%/year (95%CI=2.23-2.37) for incidence.
Conclusions: Although prevalence and incidence rates of HIV-1 infection seems to be declining overtime in the population seeking testing in the VCT located in this poor outskirt metropolitan area of Rio de Janeiro, high rates are still found. Disproportional rates were found between men, suggesting that MSM remains the subpopulation more affected by HIV-1 infection.
|