Publications (60) View all
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Article: HIV among MSM in a large middle-income country.
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ABSTRACT: OBJECTIVE:: To conduct the first national biological and behavioral surveillance survey for HIV among MSM in Brazil. DESIGN:: A cross-sectional surveillance study utilizing Respondent Driven Sampling (RDS) in 10 cities, following formative research. Planned sample: 350 MSM reporting sex with another man in the last 12 months, at least 18 years of age, and residing in the city of the study. METHODS:: Conventional RDS recruitment. Results were calculated for each city using RDSAT 5.6. For the national estimate, a new individual weight using a novel method was calculated. The 10 cities were aggregated, treated as strata and analyzed using STATA11.0. Self-reported HIV status and logistic regression was used to impute missing values for serostatus, an important issue for RDSAT. RESULTS:: A total of 3859 MSM were interviewed. Sample was diverse, most self-identified as mulatto or black, were social class C or below, and had relatively low levels of education. More than 80% reported more than one partner in the last 6 months. Only 49% had ever tested for HIV. HIV prevalence among MSM ranged from 5.2 to 23.7% in the 10 cities (3.7-16.5% without imputation) and was 14.2% for all cities combined with imputation. The overall prevalence was two and three times higher than that estimated for female sex workers and drug users, respectively, in Brazil. Half of those who tested HIV positive were not aware of their infection. CONCLUSION:: The AIDS epidemic in Brazil is disproportionately concentrated among MSM, as has been found in other countries. Renewed efforts to encourage testing, prevention and treatment are required.AIDS (London, England) 01/2013; 27(3):427-435. · 4.91 Impact Factor -
Article: HIV/AIDS and Serious Mental Illness: A Risky Conclusion.
Psychiatric services (Washington, D.C.) 12/2012; 63(12):1261. · 2.81 Impact Factor -
Article: HIV among MSM in Brazil.
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ABSTRACT: OBJECTIVE:: To conduct the first national biological and behavioral surveillance survey for HIV among MSM in Brazil. DESIGN:: A cross-sectional surveillance study utilizing Respondent Driven Sampling (RDS) in 10 cities, following formative research. Planned sample: 350 each city among MSM reporting sex with another man in the last 12 months, at least 18 years, and residing locally. METHODS:: Conventional RDS recruitment. Results were calculated for each city using RDSAT 5.6. For the national estimate, a new individual weight using a novel method was calculated. The 10 cities were aggregated, treated as strata and analyzed using STATA11.0. Self-reported HIV status and logistic regression was used to impute missing values for serostatus, an important issue for RDSAT. RESULTS:: A total of 3859 MSM were interviewed. Sample was diverse, most self-identified as mulatto or black, were social class C or below, and had relatively low levels of education. More than 80% reported more than one partner last 6 months. Only 49% had ever tested for HIV. HIV prevalence among MSM ranged from 5.2 to 23.7% in the 10 cities (3.7-16.5% without imputation) and was 14.2% for all cities combined with imputation. The overall prevalence is two and three times higher than that estimated for female sex workers and drug users, respectively, in Brazil. Half of those who tested HIV positive were not aware of their infection. CONCLUSION:: The AIDS epidemic in Brazil is disproportionately concentrated among MSM, as has been found in other countries. Renewed efforts to encourage testing, prevention and treatment are required.AIDS (London, England) 10/2012; · 4.91 Impact Factor -
Article: Behavior Surveillance: Prevalence and Factors Associated with High-Risk Sexual Behavior Among HIV-Infected Men in Brazil in the Post-HAART Era
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ABSTRACT: A cross-sectional analysis was conducted to describe unsafe sexual practices among HIV-infected men under care in two Brazilian urban areas. Data were collected by face-to-face interviews. Twenty-five percent practiced unprotected sex in the previous year, 16% were abstinent, 33% had sex with men only, 45% with women only, 48% had male/female stable partners, 84% were on HAART and 48% had AIDS. Illicit drug use, number of female partners, having stable partners, and STD diagnosis were associated with unsafe sex. Interventions to reduce risk taking behavior among HIV-positive men under care in these settings are urgent, especially among heterosexual stable couplesAIDS and Behavior 04/2012; 12(5):741-747. · 3.49 Impact Factor -
Article: Psychiatric patients' return for HIV/STI test results in mental health centers.
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ABSTRACT: To assess individual and/or health service factors associated with patients returning for results of HIV or sexually transmitted infection (STI) tests in mental health centers. Cross-sectional national multicenter study among 2,080 patients randomly selected from 26 Brazilian mental health centers in 2007. Multilevel logistic regression was used to assess the effect of individual (level 1) and mental health service characteristics (level 2) on receipt of test results. The rate of returning HIV/STI test results was 79.6%. Among health service characteristics examined, only condom distribution was associated with receiving HIV/STI test results, whereas several individual characteristics were independently associated including living in the same city where treatment centers are; being single; not having heard of AIDS; and not having been previously HIV tested. It is urgent to expand HIV/STI testing in health services which provide care for patients with potentially increased vulnerability to these conditions, and to promote better integration between mental health and health services.Revista de saude publica 02/2012; 46(2):290-9. · 1.01 Impact Factor
