ABSTRACT
OBJECTIVE: The Brazilian Carnival is thought to be a time when the risk of HIV infection is likely to be high. We therefore compared the risk during Carnival to risk in the past month among male samba school participants in São Paulo, Brazil. SUBJECTS AND METHODS: A cross-sectional study was conducted among 380 male samba school drummers randomly sampled during rehearsal for the 1993 Carnival in São Paulo by means of a 20-min interviewer-administered questionnaire. The main outcome variable was condom use with non-steady partners. RESULTS: The sexual behavior of 36.1% of subjects risked HIV infection, but only 9.7% of all subjects were at risk only during Carnival. Subjects with a sexual risk of HIV differed from those without risk in substance use, attitudes towards condoms and expectations about Carnival; those who were at risk only during Carnival did not differ from those who were at risk at other times. About half of the subjects had been given free condoms during Carnival, although few of the men at risk had actually used them. CONCLUSIONS: Though more than a third of the drummers were at risk of HIV infection, only a small per cent were at risk only during Carnival. The level of sexual risk of HIV infection is probably better explained by factors in the men's daily lives, rather than through information on risks taken during Carnival. These results raise questions concerning the efficacy of universal condom distribution during Carnival, since about half of the men were given condoms but few of those at risk actually used them. A targeted distribution of condoms to populations with a high demonstrated risk may be more effective in preventing new HIV infection.