Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto Jovem , HIV , Sífilis , Infecções Sexualmente TransmissíveisRESUMO
BACKGROUND: Recent studies have sought to describe HIV infection and transmission characteristics around the world. Identification of early HIV-1 infection is essential to proper surveillance and description of regional transmission trends. In this study we compare people recently infected (RI) with HIV-1, as defined by Serologic Testing Algorithm for Recent HIV Seroconversion (STARHS), to those with chronic infection. METHODOLOGY/PRINCIPAL FINDINGS: Subjects were identified from 2002-2004 at four testing sites in São Paulo. Of 485 HIV-1-positive subjects, 57 (12%) were defined as RI. Of the participants, 165 (34.0%) were aware of their serostatus at the time of HIV-1 testing. This proportion was statistically larger (p<0.001) among the individuals without recent infection (n = 158, 95.8%) compared to 7 individuals (4.2%) with recently acquired HIV-1 infection. In the univariate analysis, RI was more frequent in <25 and >59 years-old age strata (p<0.001). The majority of study participants were male (78.4%), 25 to 45 years-old (65.8%), white (63.2%), single (61.7%), with family income of four or more times the minimum wage (41.0%), but with an equally distributed educational level. Of those individuals infected with HIV-1, the predominant route of infection was sexual contact (89.4%), with both hetero (47.5%) and homosexual (34.5%) exposure. Regarding sexual activity in these individuals, 43.9% reported possible HIV-1 exposure through a seropositive partner, and 49.4% reported multiple partners, with 47% having 2 to 10 partners and 37.4% 11 or more; 53.4% of infected individuals reported condom use sometimes; 34.2% reported non-injecting, recreational drug use and 23.6% were reactive for syphilis by VDRL. Subjects younger than 25 years of age were most vulnerable according to the multivariate analysis. CONCLUSIONS/SIGNIFICANCE: In this study, we evaluated RI individuals and discovered that HIV-1 has been spreading among younger individuals in São Paulo and preventive approaches should, therefore, target this age stratum.
Assuntos
Infecções por HIV/epidemiologia , Adolescente , Adulto , Brasil/epidemiologia , Feminino , HIV-1/isolamento & purificação , Humanos , Masculino , Fatores de RiscoRESUMO
No inicio da decada de 80, a epidemia de HIV/AIDS atingia principalmente homossexuais masculinos. Alem disso, dados epidemiologicos demonstraram que a infeccao se alastrou rapidamente alcancando heterossexuais, maioria mulheres em idade fertil, fato que trouxe um novo componente ao contexto: a transmissao vertical, que atualmente representa a principal via de contaminacao na populacao infantil. Medidas foram adotadas pela Coordenacao Municipal de DST/AIDS e Secretaria da Saude para a transmissao vertical na cidade de Sao Paulo. Um grupo de trabalho de profissionais da saude de diferentes universidades, setor privado, estadual e municipal foi criado para fazer um diagnostico da situacao. Como resultado as medidas seguintes foram imlementadas: investimento em informacao e vigilancia epidemiologica, treinamento de profissionais do SUS, parceria com o Conselho Regional de Medicina para estimular a participacao dos servicos de saude privados, treinamento de profissionais que trabalham envolvidos no pré-natal, para enfatizar a obrigatoriedade do oferecimento do teste HIV para gestantes e finalmente desenvolvimento de um fluxograma para estimular o diagnostico de mulheres infectadas pelo HIV no pre-natal, bem como medidas profilaticas para evitar a transmissao vertical. A implantacao deste protocolo reduziu a TV de 7 porcento em 2001 para 1 porcento em 2003. Esforcos estes que podem ser adotados como politica publica para melhoria na assistencia a gestante soropositiva
