Discrimination based on sexual orientation against MSM in Brazil: a latent class analysis / Discriminação por orientação sexual entre HSH no Brasil: uma análise de classes latentes

ABSTRACT Introduction: Discrimination based on sexual orientation can influence vulnerability to HIV, increasing exposure to risky sexual behavior among men who have sex with men (MSM). Objectives: To analyze data using latent class analysis (LCA) to identify groups of individuals with specific patterns of discrimination based on sexual orientation (DSO). Methods: Cross-sectional study using respondent-driven sampling in 12 Brazilian cities in 2016. LCA was used to characterize discrimination among MSM based on 13 variables in the survey questionnaire. The proportions of men reporting DSO and other variables of interest were estimated using Gile's Successive Sampling estimator. Results: Most MSM were young, single, had a religion, had a high school or college degree, black or brown skin color, and socioeconomic status classified as average. More than half of the participants reported that they had been discriminated against during the last 12 months due to their sexual orientation (65%), more than a third said they had felt afraid of walking in public places during the past 12 months, and about one-fifth of participants reported having been victims of physical or sexual assault due to DSO. DSO was classified into four latent classes: "very high", "high", "moderate" and "low", with estimates of 2.2%, 16.4%, 35.1%, and 46.19%, respectively. Conclusion: We observed a high proportion of discrimination against MSM in this study. The use of LCA differentiated parsimoniously classes of discrimination.

RESUMO Introdução: A discriminação por orientação sexual (DPOS) pode influenciar a vulnerabilidade ao HIV aumentando a exposição a comportamentos sexuais de risco entre homens que fazem sexo com homens (HSH). Objetivos: Examinar dados utilizando a análise de classes latentes (ACL) para identificar grupos de indivíduos com padrões específicos de DPOS. Métodos: Estudo transversal com entrevistados recrutados pelo processo amostral respondent driven sampling em 12 cidades brasileiras em 2016. A ACL foi usada para caracterizar o DPOS entre HSH com base em 13 variáveis do bloco de discriminação do questionário da pesquisa. As proporções de DPOS e das variáveis de interesse, bem como seus intervalos de confiança (95%) foram ponderados usando o estimador de Gile. Resultados: A maioria era de jovens, solteiros, com alguma religião, escolaridade média ou superior, cor da pele preta ou parda e com nível socioeconômico médio. Mais da metade referiu ter sido discriminado nos últimos 12 meses por sua orientação sexual (65%), mais de um terço referiu ter tido medo de andar em lugares públicos nos últimos 12 meses e em torno de um quinto dos participantes reportaram ter sofrido agressão física ou sexual na vida. A DPOS foi classificada em 4 classes latentes, "muito alta", "alta", "média" e "baixa", com estimativas de 2,2%, 16,4%, 35,1% e 46,19%, respectivamente. Conclusão: Observou-se alta proporção de discriminação entre os HSH participantes deste estudo. A utilização da ACL discriminou de maneira parcimoniosa as classes de DPOS.

Human T cell lymphotropic virus type 1 infection among men who have sex with men in Central Brazil

ABSTRACT Human T cell lymphotropic virus type 1 (HTLV-1) was the first retrovirus discovered in humans and is endemic in several parts of the world. Because of risk behaviors, mainly sexual, men who have sex with men (MSM) are at high risk of acquiring HTLV-1 infection. A cross-sectional study was performed to estimate the prevalence of HTLV-1 infection, to characterize genetically HTLV-1 sequences and to identify risk behaviors associated with this infection among MSM in Central Brazil. A total of 430 MSM were enrolled in this study and three were shown to be HTLV-1 infected, prevalence of 0.7% (95% confidence interval: 0.4-0.9). Phylogenetic analysis showed that all HTLV-1 positive samples belonged to Cosmopolitan subtype Transcontinental subgroup A. Although the prevalence rate of HTLV-1 infection found in this study was similar to that observed among Brazilian blood donors, additional HTLV-1 preventive interventions need to be further implemented because this population is engaged in high-risk sexual behavior.

High-risk behaviors for hepatitis B and C infections among female sex workers

Abstract INTRODUCTION: The prevalence of hepatitis B and hepatitis C and risk behaviors among 402 female sex workers in Central Brazil were investigated by respondent-driven sampling. METHODS: Blood samples were tested for hepatitis B and C markers by enzyme-linked immunosorbent assay. Two hepatitis B vaccination schedules were performed. RESULTS: The prevalence of hepatitis B and C infections were 9.3% and 0.5%, respectively. Susceptibility to hepatitis B infection was observed in 61.5% of subjects. There was no significant difference in adherence index (p=0.52) between vaccination schedules and all participants had protective antibody titers. CONCLUSIONS: This hard-to-reach population requires hepatitis B and C surveillance.

Viral hepatitis in female sex workers using the Respondent-Driven Sampling

ABSTRACT OBJECTIVE To estimate the prevalence of hepatitis B virus and C virus infections and their genotypes and analyze the risk factors for the markers of exposure to hepatitis B virus in female sex workers in a region of intense sex trade. METHODS This is a cross-sectional study performed with four hundred and two female sex workers in Goiânia, Brazil. Data have been collected using the Respondent-Driven Sampling. The women have been interviewed and tested for markers of hepatitis B and C viruses. Positive samples have been genotyped. The data have been analyzed using the Respondent-Driven Sampling Analysis Tool, version 5.3, and Stata 11.0. RESULTS The adjusted prevalence for hepatitis B virus and C virus were 17.1% (95%CI 11.6-23.4) and 0.7% (95%CI 0.1-1.5), respectively. Only 28% (95%CI 21.1-36.4) of the participants had serological evidence of vaccination against hepatitis B virus. Being older (> 40 years), being single, having a history of blood transfusion and use of cocaine, and ignoring the symptoms of sexually transmitted infections were associated with positivity for hepatitis B virus (p < 0.05). We have detected the subgenotype A1 of hepatitis B virus (n = 3) and the subtypes of hepatitis C virus 1a (n = 3) and 1b (n = 1). CONCLUSIONS We can observe a low prevalence of infection of hepatitis B and C viruses in the studied population. However, the findings of the analysis of the risk factors show the need for more investment in prevention programs for sexual and drug-related behavior, as well as more efforts to vaccinate this population against hepatitis B. The genotypes of the hepatitis B virus and C virus identified are consistent with those circulating in Brazil.

Neospora caninum and Toxoplasma gondii serodiagnosis in human immunodeficiency virus carriers

ABSTRACTINTRODUCTION:Neospora caninum and Toxoplasma gondii belong to the Sarcocystidae family, and both have one definitive and various intermediary hosts. Owing to their weak immune systems, immunocompromised persons might be prone to opportunistic infections. The aim of this study was to investigate the presence of anti- N. caninum and anti- T. gondii antibodies in immunocompromised individuals.METHODS:This cross-sectional study investigated the rates of N. caninum and T. gondii , as assessed using immunofluorescent antibody reaction (IFAT) with 1:50 and 1:16 dilution, respectively, in patients with human immunodeficiency virus (HIV).RESULTS:The seropositivity for N. caninum was 26.1% (81/310) in Mato Grosso do Sul and 31.2% (10/32) in Paraná and for T. gondii was 76.8% (238/310) in Mato Grosso do Sul and 68.7% (22/32) in Paraná.CONCLUSIONS:There is evidence of anti- N caninum and anti- T. gondii antibodies in patients with HIV. Other aspects of T. gondii , which is a zoonosis, and N. caninum , which might affect immunodeficient individuals, need to be evaluated and reported.

Prevalence, risk factors and genotypes of hepatitis B infection among HIV-infected patients in the State of MS, Central Brazil

Objectives: A cross-sectional study on prevalence of HBV and HDV infection, risk factors and genotype distribution of HBV infection was conducted among 848 HIV-infected patients in Mato Grosso do Sul, Central Brazil. Methods: Serum samples of 848 participants were tested for hepatitis B surface antigen (HBsAg), hepatitis B core antibody (anti-HBc) and hepatitis surface antibody (anti-HBs). HBsAg positive samples were tested for anti-HBc IgM, HBeAg, anti-HBe, anti-HCV, and total anti-HDV. HBsAg and anti-HBc positive were subjected to DNA extraction. Viral DNA was amplified by semi-nested PCR for the regions pre-S/S and then purified and genotyped/subgenotyped by direct sequencing. Student's t-test, chi-square test and Fisher's exact test were used to compare variables and to evaluate association between HBV positivity (defined as anti-HBc and/or HBsAg positivity) and risk factors. Results: Among the 848 HIV infected patients investigated 222 had serological markers of HBV infection. The prevalence rate of HIV-HBV coinfection was 2.5% (21/848; 95% CI: 1.4–3.5%); 484 (57.1%) patients were susceptible for HBV infection. There were no cases of anti-HDV positive and only one (0.1%) anti-HCV-positive case among the HIV-HBV coinfected patients. Male gender, increasing age, family history of hepatitis, use of illicit drug, and homosexual activity were independent factors associated with HBV exposure. The phylogenetic analysis based on the S gene region revealed the presence of genotypes D (76.9%), F (15.4%) and A (7.7%) in the study sample. Conclusion: This study demonstrates the low prevalence of HIV-HBV infection and also highlights the need for early vaccination against HBV as well as testing for HBV, HCV and HDV in all HIV-infected individuals. .

Hepatitis B virus infection in a population exposed to occupational hazards: firefighters of a metropolitan region in central Brazil / Infecção pelo vírus da hepatite B em população exposta a risco ocupacional: bombeiros de região metropolitana do Brasil central

INTRODUCTION: By the nature of their activities, firefighters are exposed to a high risk of contracting hepatitis B virus (HBV) as most of the Fire Brigade occurrences in Campo Grande, State of Mato Grosso do Sul (MS), Brazil, are related to the rescue of victims of traffic accidents and the transportation of clinical and psychiatric emergencies. The aim of this study was to investigate the seroepidemiological profile of HBV infection in firefighters from the City of Campo Grande, central Brazil. METHODS: The research involved 308 firefighters. After giving written consent, they were interviewed and blood was collected for the detection of HBsAg, anti-HBs and total anti-HBc of enzyme-linked immunosorbent assays (ELISA). RESULTS: The participants had an average of 36.4 years of age (SD ± 6.5), being 89.9% male. Blood tests revealed 6.5% of seropositivity for hepatitis B (HB) infection (n=20), and 1% for HbsAg. Isolated anti-HBs markers, indicative of vaccine immunity, were found in 66.9% of the participants and 28.2% were susceptible to infection. With regard to risk factors for HB infection, multivariate regression analysis showed a statistically significant association with length of service; and prevalence was higher in individuals with over 20 years of service. CONCLUSIONS: The prevalence of HB found among the firefighters was low and length of time in the profession was found to be a risk factor. Non-occupational risk factors did not influence the occurrence of HB infection in the population studied.

INTRODUÇÃO: Os bombeiros pela natureza de suas atividades possuem elevado risco para aquisição da infecção pelo vírus da hepatite B (VHB), pois a maioria das ocorrências atendidas em Campo Grande, Estado do Mato Grosso do Sul (MS), Brasil, estão relacionadas ao resgate de vítimas de acidentes de trânsito e transporte de emergências clínicas e psiquiátricas. O objetivo deste estudo foi investigar o perfil soroepidemiológico da infecção pelo HBV em bombeiros do município de Campo Grande, Brasil Central. MÉTODOS: Participaram da pesquisa 308 bombeiros. Após consentimento, foram submetidos à entrevista, coleta de sangue e testes sorológicos para detecção dos marcadores HBsAg, anti-HBs e anti-HBc total por enzyme-linked immunosorbent assays (ELISA). RESULTADOS: A média de idade dos participantes da pesquisa foi de 36,4 anos (±6,5 DP), sendo 89,9% do sexo masculino. Foi encontrado percentual de soropositividade de infecção para hepatite B (HB) de 6,5% (n=20), sendo 1% para o HBsAg. A presença do marcador anti-HBs isolado, indicativo de imunidade vacinal foi encontrada em 66,9% e 28,2% dos indivíduos estavam susceptíveis à infecção. Com relação aos fatores de risco para infecção pelo VHB, a análise de regressão multivariada demonstrou associação estatística significativa com o tempo de serviço, sendo a prevalência maior em indivíduos com mais de 20 anos de serviço. CONCLUSÕES: A prevalência de HB encontrada nos bombeiros foi baixa, sendo encontrado como fator de risco muitos anos de profissão. Fatores de risco não ocupacionais não influenciaram na ocorrência de infecção por HB nos bombeiros estudados.

Prevalência da infecção pelo HTLV-1, em remanescentes de quilombos no Brasil Central / Prevalence of infection due to HTLV-1 in remnant quilombos in Central Brazil

O presente estudo teve como objetivo estimar a prevalência da infecção pelo HTLV-1 em remanescentes de comunidades de população negra, os quilombos no Brasil Central. 1.837 indivíduos foram avaliados, sendo nove soropositivos para HTLV-1/2 por ELISA. Todos esses foram positivos para HTLV-1 por Western blot e/ou PCR, resultando em uma prevalência de 0,5 por cento (IC 95 por cento: 0,2-1,0). A idade dos indivíduos infectados variou de 11 a 82 anos, sendo a maioria do sexo feminino. Quanto às características de risco, história de aleitamento materno, transfusão de sangue, múltiplos parceiros sexuais e doenças sexualmente transmissíveis foram relatadas por esses indivíduos. Os achados deste estudo evidenciam a importância da identificação dos indivíduos infectados pelo HTLV-1 na estratégia de controle e prevenção dessa infecção em remanescentes de quilombos.

This study aimed to determine the prevalence of HTLV-1 infection among remnant black quilombo communities in Central Brazil. A total of 1,837 individuals were evaluated, among whom nine were HTLV-1/2 seropositive according to ELISA. All of them were positive for HTLV-1 by means of Western blot and/or PCR, thus resulting in a prevalence of 0.5 percent (95 percent CI: 0.2-1.0). The HTLV-1 infected individuals ranged in age from 11 to 82 years. The majority of them were females. Regarding risk characteristics, histories of breastfeeding, blood transfusion, multiple sexual partners and sexually transmitted diseases were reported by these individuals. The findings from this study indicate the importance of identifying HTLV-1 infected individuals, as a strategy for infection control and prevention in these remnant quilombos.