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HIV Prevalence, Knowledge, Attitudes, and Practices Among Polydrug Users in Brazil: A Biological Survey Using Respondent Driven Sampling

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Abstract

Brazil has a concentrated HIV epidemic among key populations. In 2009, the Ministry of Health conducted a survey in 10 Brazilian cities aiming to estimate HIV prevalence, knowledge, and associated risk behaviors of polysubstance users (PSU). Using Respondent Driven Sampling (RDS), 3449 PSU were recruited, answered an Audio-Computer Self Assisted Interview (ACASI) and were tested for HIV and syphilis. Analyses were weighted by individual’s social network size generated on RDSAT. Pooled HIV prevalence was 5.8% but varied across cities. Most PSU were male, non-white, without income, unemployed, with low levels of education. Overall, 12.0% used injectable drugs, 48.7% had sex with occasional partners and 46.4% engaged in commercial sex. A majority received free condoms (71.4%) but 76.7% exhibited inconsistent condom use. Findings can support policies aiming to improve health care and preventive interventions tailored to this population that remains at high risk of acquiring and transmitting HIV/STI in multiple scenarios.

Resumen

Brasil tiene una epidemia concentrada de VIH en las poblaciones clave. En 2009, el Ministerio de Salud realizó una encuesta en 10 ciudades brasileñas con el objetivo de estimar la prevalencia del VIH y outros indicadores entre los consumidores de múltiples drogas (CMD). Em la muestra Respondent-driven-sampling (RDS), 3,449 CMD contestaron una entrevista auto-asistida con Audio-Computer (A-CASI) y hicieron pruebas del VIH y sífilis. Las estimativas fueron ponderadas – pesos RDS. La prevalência conjunta del VIH (5,8%) varió entre las ciudades. La mayoría eran hombres, no blancos, sin ingresos, desempleados, con bajos niveles de educación. Utilizó fármacos inyectables (12,0%), 48,7% tuvo relaciones sexuales con parejas ocasionales y 46,4% practicó sexo comercial. 71,4% recibió condones gratuitos pero 76,7% con uso inconsistente. Esos hallazgos pueden apoyar políticas destinadas a mejorar la atención y intervenciones preventivas adaptadas a los CMD que continúan en alto riesgo de adquirir y transmitir VIH/ITS en múltiples escenarios.

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Funding

This study was funded by The Brazilian National Department of Sexually Transmitted Diseases/HIV/AIDS and Viral Hepatitis-Ministry of Health.

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Authors and Affiliations

  1. Departamento de Ciência e Tecnologia – DECIT, Secretaria de Ciência, Tecnologia e Insumos Estratégicos – SCTIE, Ministério da Saúde – Unidade IX, SCN Quadra 2, Bloco C – Sl. 01 – Térreo, Brasília, DF, 70712-902, Brazil

    Cremildo João Baptista

  2. Instituto de Saúde Coletiva, Universidade Federal da Bahia, Salvador, Brazil

    Inês Dourado

  3. Faculdade de Medicina da Bahia, Universidade Federal da Bahia, Salvador, Brazil

    Tarcísio Matos de Andrade

  4. Instituto de Saúde Coletiva, Universidade Federal Fluminense, Niterói, Brazil

    Sandra Brignol

  5. Division of Epidemiology - Brazilian National Cancer Institute, Ministry of Health, Rio de Janeiro, Brazil

    Neilane Bertoni

  6. Instituto de Comunicação e Informação Científica e Tecnológica em Saúde (ICICT), Fiocruz, Rio de Janeiro, Brazil

    Francisco Inácio Bastos

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  1. Cremildo João Baptista
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Consortia

The Brazilian Multicity Study Group on Drug Misuse

  • Adriana Pinho
  • , Evely Marlene Pereira Koller
  • , Waleska Teixeira Caiaffa
  • , Maria Inês Costa Dourado
  • , Tarcísio Andrade
  • , Jessem Douglas Yamall Orellana
  • , Ana Maria de Brito
  • , Naíde Teodósio Valois Santos
  • , Paulo Cesar Duarte Paes
  • , Sandra Leone
  • , Neide Gravato da Silva
  • , Vicença Paula Soares Querrer
  • , Maria Lúcia Tozetto Vettorazzi
  •  & Simone Tetu Moyses

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Correspondence to Cremildo João Baptista.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. The study protocol was approved by the Ethical Council of the Sergio Arouca National School of Public Health (CEP/ENSP nº. 90/2008).

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Informed consent was obtained from all participants included in the study.

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The Brazilian Multicity Study Group on Drug Misuse—Adriana Pinho, Evely Marlene Pereira Koller, Waleska Teixeira Caiaffa, Maria Inês Costa Dourado, Tarcísio Andrade, Jessem Douglas Yamall Orellana, Ana Maria de Brito, Naíde Teodósio Valois Santos, Paulo Cesar Duarte Paes, Sandra Leone, Neide Gravato da Silva, Vicença Paula Soares Querrer, Maria Lúcia Tozetto Vettorazzi, and Simone Tetu Moyses.

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Baptista, C.J., Dourado, I., de Andrade, T.M. et al. HIV Prevalence, Knowledge, Attitudes, and Practices Among Polydrug Users in Brazil: A Biological Survey Using Respondent Driven Sampling. AIDS Behav 22, 2089–2103 (2018). https://doi.org/10.1007/s10461-017-1812-8

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