RESUMO
We assessed HIV and STI prevalence, risk behaviors and factors associated with HIV infection in men who have sex with men (MSM) in Guayaquil, Ecuador. Respondent-driven sampling was used to recruit 400 MSM in 2011-2012. Participants completed a computer-assisted self-interview and provided blood samples. Statistical analysis accounted for differential probability of selection and for recruitment patterns. HIV prevalence was 11.3 %, HSV-2 30.2 %, active syphilis 6.9 % and hepatitis B 1.2 %. In the previous 12 months, 84 % of MSM reported casual male sex partners and 25 % sex work. Only 48 % of MSM consistently used condoms with male partners and 54 % had ever been tested for HIV. Of 17 % of MSM reporting a female partner, consistent condom use was 6 %. HIV infection was associated with age 25 or older, active syphilis and homosexual self-identification. Findings suggest continuing HIV risk and a need to strengthen prevention and testing among MSM.
Assuntos
Infecções por HIV/prevenção & controle , Homossexualidade Masculina/psicologia , Assunção de Riscos , Infecções Sexualmente Transmissíveis/prevenção & controle , Adolescente , Adulto , Equador/epidemiologia , Infecções por HIV/epidemiologia , Hepatite B/epidemiologia , Herpes Genital/epidemiologia , Homossexualidade Masculina/estatística & dados numéricos , Humanos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Prevalência , Trabalho Sexual , Parceiros Sexuais , Infecções Sexualmente Transmissíveis/epidemiologia , Fatores Socioeconômicos , Sífilis/epidemiologia , Adulto JovemRESUMO
Few studies have characterised the degree of engagement in transactional sex among men and transgender women who have sex with men and explored its association with sexually transmitted infections and human immunodeficiency virus in Ecuador. We screened 642 men who have sex with men and transgender women for a pre-exposure prophylaxis clinical trial (iPrEx) in Guayaquil, Ecuador, 2007-2009. We analysed the association of degree of engagement in transactional sex and prevalence of sexually transmitted infections including human immunodeficiency virus using chi-square and analysis of variance tests. Although just 6.2% of those who screened self-identified as sex workers, 52.1% reported having engaged in transactional sex. Compared to those who had never been paid for sex, those who had been paid were more likely to have a sexually transmitted infection (56.6% vs. 45.0%, p = 0.007) and trended towards a higher human immunodeficiency virus prevalence (16.6% vs. 10.4%, p = 0.082) at screening. Transgender women compared to other men who have sex with men were more likely to have sexually transmitted infections diagnosed at screening (75.6% vs. 50.0%, p = 0.001). Transactional sex is practiced widely but occasionally among the men who have sex with men and transgender women in Guayaquil who screened for the iPrEx study; however, engaging in transactional sex may not lead to a sex worker self-identification. Both transactional sex and being a transgender woman are associated with sexually transmitted infections prevalence.
Assuntos
Infecções por HIV/prevenção & controle , Homossexualidade Masculina/estatística & dados numéricos , Testes Sorológicos/estatística & dados numéricos , Trabalho Sexual , Infecções Sexualmente Transmissíveis/epidemiologia , Pessoas Transgênero/estatística & dados numéricos , Adulto , Estudos Transversais , Equador/epidemiologia , Feminino , Humanos , Masculino , Programas de Rastreamento/métodos , Profilaxia Pré-Exposição , Prevalência , Fatores de Risco , Parceiros Sexuais , Infecções Sexualmente Transmissíveis/diagnóstico , Infecções Sexualmente Transmissíveis/psicologiaRESUMO
This study characterized the HIV epidemic among men who have sex with men (MSM) in Quito, Ecuador and contrasted risk patterns with other STI's. 416 MSM ages 15 years and older were recruited using respondent-driven sampling in 2010-2011. Biological testing and a self-interview survey assessed HIV and STI infections and risk behaviors. Analysis incorporated recruiter-level variables and clustering adjustments to control for recruitment patterns. We identify high levels of HIV (11 %), HSV-2 (14 %) and active syphilis (5.5 %) infections, low levels of lifetime HIV testing (57 %), limited knowledge of HIV and STI's (<48 %) and limited consistent condom use independent of partner type (<40 %). Sex work was associated with all infections while associations with residential location, how casual partners are met and other variables, varied. Scale-up of behavioral prevention and HIV testing is urgently needed. Interventions should target male sex workers and exploit differential patterns of HIV-STI risk to stay ahead of the epidemic.
Assuntos
Infecções por HIV/epidemiologia , Necessidades e Demandas de Serviços de Saúde , Homossexualidade Masculina/estatística & dados numéricos , Prevenção Primária/organização & administração , Infecções Sexualmente Transmissíveis/epidemiologia , Adolescente , Adulto , Equador/epidemiologia , Infecções por HIV/diagnóstico , Infecções por HIV/psicologia , Hepatite B/epidemiologia , Herpes Genital/epidemiologia , Herpes Simples/epidemiologia , Herpesvirus Humano 2 , Humanos , Masculino , Prevenção Primária/normas , Assunção de Riscos , Infecções Sexualmente Transmissíveis/diagnóstico , Infecções Sexualmente Transmissíveis/prevenção & controle , Infecções Sexualmente Transmissíveis/psicologia , Sífilis/epidemiologia , Adulto JovemRESUMO
HIV cross-sectional studies were conducted among high-risk populations in 9 countries of South America. Enzyme-linked immunosorbent assay screening and Western blot confirmatory testing were performed, and env heteroduplex mobility assay genotyping and DNA sequencing were performed on a subset of HIV-positive subjects. HIV prevalences were highest among men who have sex with men (MSM; 2.0%-27.8%) and were found to be associated with multiple partners, noninjection drug use (non-IDU), and sexually transmitted infections (STIs). By comparison, much lower prevalences were noted among female commercial sex workers (FCSWs; 0%-6.3%) and were associated mainly with a prior IDU and STI history. Env subtype B predominated among MSM throughout the region (more than 90% of strains), whereas env subtype F predominated among FCSWs in Argentina and male commercial sex workers in Uruguay (more than 50% of strains). A renewed effort in controlling STIs, especially among MSM groups, could significantly lessen the impact of the HIV epidemic in South America.
Assuntos
Infecções por HIV/epidemiologia , Infecções por HIV/transmissão , HIV/genética , Adulto , Estudos Transversais , Transmissão de Doença Infecciosa , Feminino , Produtos do Gene env/genética , Análise Heteroduplex , Homossexualidade Masculina , Humanos , Entrevistas como Assunto , Modelos Logísticos , Masculino , Epidemiologia Molecular , Prevalência , Fatores de Risco , Trabalho Sexual , Comportamento Sexual , América do Sul/epidemiologia , Abuso de Substâncias por Via IntravenosaRESUMO
La infección por el Virus de la Inmunodeficiencia Humana (VIH) está distribuida en todo el mundo y el número de casos se incrementa de una manera dramática. En el Ecuador, muy pocos estudios relacionados a la prevalencia real de la infección se hallan disponibles, la mayoría de ellos provienen de datos derivados de instituciones privadas y organizaciones no gubernamentales con enfoques a la educación, diagnóstico, tratamiento y monitoreo de la infección por VIH. Dentro de la red de vigilancia creada en ocho países de América del Sur, en nuestro laboratorio analizamos 403 muestras de suero de personas de un grupo de riesgo (HSH=hombres sexo hombres) de Quito, Guayaquil y Portoviejo. Se utilizaron pruebas de tamizaje...
Assuntos
Grupos de Risco , Soroprevalência de HIV , Sexo , Ensaio de Imunoadsorção EnzimáticaRESUMO
Se realizó un estudio descriptivo, retrospectivo de pacientes embarazzadas y con enfermedad tiroidea asociada, que consultaron al Servicio de Alto Riesgo Obstétrico del Hospital Universitario San Vicente de Paul de Medellín, en el período comprendido entre el 1§ de enero de 1982 y el 31 de diciembre de 1990. Se incluyeron aquellas a las que fue posible recopilar todos los datos del formato diseñado para tal fin y que además del control de alto riesgo tuvieron su parto en el Hospital Universitario San Vicente de Paúl. Se seleccionaron 83 pacientes, siendo el 48.2 por ciento hipertiroideas y el 51.8 por ciento hipotiroideas. El 50 por ciento de las pacientes hipertiroideas tenían enfermedad de Graves y el 20 por ciento de las hipotiroideas enfermedad de Hashimoto. El antecedente de infertilidad fue tres veces más frecuente entre las hipotiroideas. Los partos intervenidos se presentaron como antecedente del embarazo anterior en el 25 por ciento de las hipertiroideas y sólo en el 13.8 por ciento de las hipotiroideas. El 7.2 por ciento de las pacientes terminaron en aborto. Las hipotiroideas presentaron el doble de abortos en el embarazo actual que las hipertiroideas(4 versus 2). El 18.4 por ciento de las pacientes hipertiroideas presentaron meconio en el líquido amniótico y el 37.1 por ciento sufrimiento fetal. La hipertensión inducida por el embarazo fue dos veces más frecuente en las hipertiroideas que en las hipotiroideas. Se halló una fuerte asociación estadísticamente significativa entre las pacientes con hipertensión arterial crónica asociada a meconio en el líquido amniótico(L.A.) (R.R.- 5.92; P-0.00456)