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https://www.arca.fiocruz.br/handle/icict/622
THE ROLE OF ‘‘LONG-TERM’’ AND ‘‘NEW’’ INJECTORS IN A DECLINING HIV/AIDS EPIDEMIC IN RIO DE JANEIRO, BRAZIL
Author
Affilliation
Oswaldo Cruz Foundation. Department of Health Information. Rio de Janeiro, RJ, Brazil.
National Development Research Institutes, Inc., New York City, New York, USA
State University of Rio de Janeiro. Rio de Janeiro Harm Reduction Project. Rio de Janeiro, RJ, Brazil.
Department of Immunology, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
Department of Immunology, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
Department of Immunology, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
Oswaldo Cruz Foundation. Department of Health Information. Rio de Janeiro, RJ, Brazil.
National Development Research Institutes, Inc., New York City, New York, USA
State University of Rio de Janeiro. Rio de Janeiro Harm Reduction Project. Rio de Janeiro, RJ, Brazil.
Department of Immunology, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
Department of Immunology, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
Department of Immunology, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
Oswaldo Cruz Foundation. Department of Health Information. Rio de Janeiro, RJ, Brazil.
Abstract in Portuguese
Background. A substantial decline of HIV prevalence has been observed in injection
drug users (IDUs) from Rio de Janeiro, in recent years. Differential characteristics
and behaviors of new (injecting for <6 years) and long-term (>¼6 y) injectors
may help to understand recent changes and to implement appropriate prevention
strategies. recruited from different communities, interviewed, and tested for HIV. Contingency table analysis and t-tests were used to assess differences between new and long-term injectors. Multiple logistic regression was used to identify independent predictors of HIV serostatus for long-term and new injectors. Results. HIV prevalence was 11.7% for 309 long-term injectors (95% CI 8.1– 15.3) and 4.3% for 300 new injectors (95% CI 2.0–6.6). New injectors reported
having engaged in treatment and having received syringes from needle exchange
programs (NEPs) more frequently than long-term injectors in the last 6 months, but
sharing behaviors remained frequent and even increased vis-a`-vis long-term injectors.
For male new injectors, ‘‘sexual intercourse with another man’’ was found to be the
sole significant risk factor for HIV infection (Adj OR¼8.03; 95% CI 1.52–42.48).
Among male long-term injectors, ‘‘to have ever injected with anyone infected with
HIV’’ (Adj OR¼3.91; 95% CI 1.09–14.06) and to have ‘‘ever been in prison’’ (Adj
OR¼2.56; 95% CI 1.05–6.24) were found to be significantly associated with HIV infection.
Discussion. New injectors are seeking help in drug treatment centers or needle exchange programs. They differ from long-term injectors in terms of their risk factors
for HIV infection and have lower prevalence levels for HIV. Such differences may help to understand the recent dynamics of HIV/AIDS in this population and highlight the need to reinforce new injectors’ help-seeking behavior and to reduce current unacceptably high levels of unprotected sex and syringe sharing in new injectors despite attendance of prevention/treatment programs.
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