Tendência temporal dos casos de HIV/aids no estado de Minas Gerais, 2007 a 2016 / Tendencia temporal de los casos de VIH/sida en el estado de Minas Gerais, Brasil, 2007-2016 / Temporal trend of HIV/AIDS cases in the state of Minas Gerais, Brazil, 2007-2016

Objetivo: analisar a tendência temporal dos coeficientes de incidência, detecção e mortalidade pelo vírus da imunodeficiência humana (HIV) e síndrome da imunodeficiência adquirida (aids) no estado de Minas Gerais, de 2007 a 2016. Métodos: estudo de séries temporais, com dados do Sistema de Informação de Agravos de Notificação (Sinan), por regressão de Prais-Winsten. Resultados: no período estudado, foram notificados 35.349 casos,entre os quais predominou a transmissão por via sexual (81,7%); destes, 50,3% foram entre heterossexuais e 22,8% entre homossexuais. Houve aumento da taxa de incidência de aids (variação anual 1,6%; IC95%0,0;3,3) e de detecção de HIV+ (variação anual 60,3%; IC95%22,9;109,0). A taxa de mortalidade foi estacionária. O percentual de notificações pelo critério HIV+ aumentou de 3,8% em 2007 para 65,1% em 2016. Conclusão: a tendência de crescimento da detecção de HIV coincide com a estratégia para identificação dos casos; a incidência de aids foi crescente.

Objetivo: analizar la tendencia temporal de los coeficientes de incidencia, detección y mortalidad por el Virus de la Inmunodeficiencia Humana (VIH) y Síndrome de Inmunodeficiencia Adquirida (Sida) en el estado de Minas Gerais, entre 2007-2016. Métodos: estudio de las series temporales de casos notificados del Sistema de Información de Agravamientos de Notificación (Sinan) por la regresión de Prais-Winsten. Se utilizó estadística descriptiva y análisis de series temporales. Resultados: había 35.349 casos y predominio de contaminación por vía sexual (81,7%), en heterosexuales (50,3%) y homosexuales (22,8%). Aumentó la tendencia de la incidencia de sida y detección de VIH +, con variación anual del 1,6% y del 60,3% (p <0,05), respectivamente. La mortalidad fue estacionaria. Aumentaron las notificaciones por el criterio de VIH +. Conclusión: el aumento de la tendencia de detección de VIH +, indica que la estrategia para identificación de portadores se ha mostrado apropiada, pero la incidencia de sida continua creciente.

Objective: to analyze the temporal trend of Human Immunodeficiency Virus (HIV) and Acquired Immune Deficiency Syndrome (AIDS) incidence, detection and mortality coefficients in the state of Minas Gerais between 2007 and 2016. Methods: this was a time series study of data held on the Notifiable Health Conditions Information System (Sinan) using Prais-Winsten regression. Results: in the period studied, 35,349 cases were notified, with predominance of sexually transmitted cases (81.7%), 50.3% of which were heterosexual cases and 22.8% were homosexual cases. AIDS incidence increased (annual change 1.6%; 95%CI 0.0;3.3) as did HIV detection (annual change 60.3%; 95%CI 22.9;109.0). The mortality rate was stationary; HIV+ notifications increased from 3.8% in 2007 to 65.1% in 2016. Conclusion: the growing trend of HIV+ detection coincided with the government strategy to identify cases. AIDS incidence increased.

Epidemiological aspects of HIV infection and AIDS among indigenous populations / Aspectos epidemiológicos da infecção pelo HIV e da aids entre povos indígenas

ABSTRACT OBJECTIVE To describe the epidemiological aspects of HIV infection and AIDS among indigenous peoples of the state of Mato Grosso do Sul, Brazil. METHODS This is a descriptive epidemiological study on the occurrence and distribution of HIV infection and AIDS in the indigenous population assisted by the Distrito Sanitário Especial Indígena (Indigenous Special Health District) Mato Grosso do Sul between 2001 and 2014, based on three secondary databases. Annual rates of HIV and AIDS detection and prevalence were calculated, considering case distribution according to village, Health Base Pole and sociodemographic variables. Accumulated rates of detection, mortality and case fatality were calculated by ethnic group and for the Health Base Pole with the highest number of cases. RESULTS The HIV detection rate fluctuated between 0.0 and 18.0/100 thousand people in the study period. For AIDS, there was no notification before 2007, but in 2012 its rate reached 16.6/100 thousand. HIV prevalence grew between 2001 and 2011, and it continuously grew for AIDS starting from 2007. The highest HIV detection rates occurred among Guarani peoples (167.1/100 thousand) and for AIDS, among the Kaiowá peoples (79.3/100 thousand); mortality and fatality rates were higher among the Kaiowá. Regarding the Dourados Health Base Pole, the AIDS detection rate increased, and the mortality and fatality rates decreased. CONCLUSIONS HIV infection and AIDS have been increasing among indigenous peoples, with distribution of the disease mainly in the Health Base Poles of the southern region of the state, where greater economic and social vulnerability are also observed. The endemic character of HIV and AIDS can become epidemic in some years given the existence of cases in other villages in the state. Its occurrence among the Guarani and Kaiowá populations indicates the need for expanded diagnosis, access to treatment and prevention measures.

RESUMO OBJETIVO Descrever os aspectos epidemiológicos da infecção pelo HIV e da aids entre povos indígenas do Mato Grosso do Sul. MÉTODOS Estudo epidemiológico descritivo sobre ocorrência e distribuição da infecção pelo HIV e aids na população indígena assistida pelo Distrito Sanitário Especial Indígena Mato Grosso do Sul, entre 2001 e 2014, a partir de três bases de dados secundários. Calcularam-se as taxas anuais de detecção e de prevalência de HIV e aids, com distribuição dos casos segundo aldeia, Polo Base e variáveis sociodemográficas. As taxas acumuladas de detecção, mortalidade e letalidade foram calculadas por etnia e para os Polos Base com o maior número de casos. RESULTADOS A taxa de detecção de HIV flutuou entre 0,0 e 18,0/100 mil pessoas no período. Para a aids, não houve notificação antes de 2007, mas em 2012 sua taxa chegou a 16,6/100 mil. A prevalência de HIV indicou crescimento entre 2001 e 2011, e para a aids observou-se aumento contínuo a partir de 2007. As maiores taxas de detecção de HIV ocorreram entre os Guarani (167,1/100 mil) e de aids, entre os Kaiowá (79,3/100 mil); as taxas de mortalidade e letalidade foram superiores entre os Kaiowá. Para o Polo Base de Dourados, observou-se elevação da taxa de detecção de aids e diminuição das taxas de mortalidade e letalidade. CONCLUSÕES A infecção pelo HIV e a aids mostraram-se crescentes entre povos indígenas, com distribuição da doença principalmente nos Polos Base da região sul do estado, onde observa-se também maior vulnerabilidade econômica e social. O caráter endêmico do HIV e da aids pode se tornar epidêmico em alguns anos, considerando a existência de casos em outras aldeias do estado. Sua ocorrência entre os Guarani e Kaiowá sinaliza a necessidade de ampliação do diagnóstico, do acesso ao tratamento e de medidas de prevenção.

Perfil clínico-epidemiológico del VIH/SIDA en la población femenina de Ciudad Habana 1986 - 2006 / Clinical epidemiological profile of HIV-AIDS in female population in Havana City 1986-2006

Se realizó un estudio observacional, descriptivo y retrospectivo de la población VIH/SIDA femenina de Ciudad Habana desde 1986 hasta diciembre del 2006. Se evidenció un incremento en las tasas de incidencia de VIH/SIDA y de caso SIDA por año. El grupo de edad más afectado fue de 20 a 24 años. El debut clínico se presentó en 3,7 por ciento y el tiempo promedio entre el diagnóstico de VIH y caso SIDA fue 4 años. El síndrome de desgaste y la tuberculosis pulmonar fueron las enfermedades marcadoras de SIDA más frecuentemente encontradas(AU)

A retrospective and descriptive study on HIV/AIDS female population was carried out in Havana City from 1986 to December 2006. An increase in the rates of incidence per year in relation to HIV/AIDS and AIDS case were evidenced. The most affected age group was from 20 to 24 years. The clinical debut became evident in 3,7 percent and the average time between the HIV diagnostic and AIDS case was 4 years. The wasting syndrome and the lung tuberculosis were the most frequent indicative illnesses of AIDS(AU)

HIV seroprevalence and associated risk factors among male inmates at the Belize Central Prison / Seroprevalencia al VIH y factores de riesgo asociados en hombres internados en la Prisión Central de Belice

OBJECTIVES: To determine the seroprevalence of HIV and identify associated risk factors among inmates at the Belize Central Prison, managed by the Kolbe Foundation, Belize. METHODS: A voluntary sample of 623 participants was obtained from the male inmate population incarcerated during the period from 15 January to 5 March 2005. HIV serostatus was determined on location using the Abbott Determine Assay for HIV-1/2 for screening, and the MedMira MiraWell Rapid HIV-1/2 Test for confirmatory testing. Remaining serum was tested by ELISA at the Central Medical Laboratory, Belize. Demographic and risk behavior data were collected using an interviewer administered pre-tested questionnaire. A multivariate logistic regression was used to adjust for potential confounders and to identify independent associations with HIV seropositivity. RESULTS:Of the 623 inmates in the sample, 25 tested positive for HIV-1/2 antibody for a seroprevalence of 4.0 percent (95 percent Confidence Interval 2.7, 6.0). After adjustment for confounding, HIV serostatus was positively associated with male-to-male sexual activity outside prison, age, and district of residence before current incarceration. CONCLUSIONS: The seroprevalence in the Central Prison was almost twice that estimated for the adult population of Belize in 2004 (2.4 percent). However, the social variables of importance to inmates appeared to reflect the epidemic in the general population, with the exception that male-to-male sex outside prison is likely more important to the male inmate population in Belize. The findings suggest that HIV is likely contracted by most inmates before their incarceration, largely due to same-sex activity.

OBJETIVOS: Determinar la seroprevalencia al VIH e identificar los factores de riesgo asociados en hombres internados en la Prisión Central de Belice, administrada por la Fundación Kolbe. MÉTODOS: La muestra estuvo compuesta por 623 voluntarios hombres que se encontraban encarcelados entre el 15 de enero y el 5 de marzo de 2005. El estatus serológico con respecto al VIH se determinó en la prisión mediante la prueba de tamizaje Abbot Determine Assay y se confirmó con la prueba MedMira MiraWell Rapid, ambas para anticuerpos contra el VIH 1 y 2. El suero restante se analizó por ELISA en el Laboratorio Médico Central de Belice. Se recabaron los datos demográficos y sobre las conductas de riesgo mediante una encuesta preevaluada aplicada por un entrevistador. Se identificaron las asociaciones independientes con la seropositividad al VIH mediante análisis de regresión logística multifactorial ajustado por posibles factores de confusión. RESULTADOS: De los 623 prisioneros de la muestra, 25 resultaron positivos a anticuerpos contra el VIH-1/2, para una seroprevalencia de 4,0 por ciento (IC95 por ciento: 2,7 por ciento a 6,0 por ciento). Después de ajustar por los factores de confusión, la seropositividad se asoció con la actividad sexual con otros hombres fuera de la prisión, la edad y el distrito de residencia antes de su encarcelamiento actual. CONCLUSIONES: La seroprevalencia en la Prisión Central casi duplicó el estimado para la población adulta de Belice en 2004 (2,4 por ciento). Sin embargo, las variables sociales de importancia en los prisioneros parecieron reflejar la epidemia en la población general, aunque la relación sexual con hombres fuera de la prisión pareció tener mayor importancia en la población masculina encarcelada en Belice. Estos resultados indican que la mayoría de los prisioneros habría contraído la infección por el VIH antes de su encarcelamiento, en gran parte debido a prácticas homosexuales.

Trends of HIV seropositivity at Siriraj Hospital: 13 year's observation from 1992-2004.

OBJECTIVE: The aim of the present report was to observe the trend of seroprevalence rates of HIV seropositivity for routine services at Siriraj Hospital for 13 years. MATERIAL AND METHOD: The prevalence rate of HIV seropositivity was analyzed in three groups of subjects: 1) patients who attended the hospital with HIV related diseases; 2) pregnant women at first visit to the antenatal care clinic; 3) emigrating workers who have applied for employment in foreign countries. RESULTS: Of the 13 year-observation, HIV seroprevalence rates in the groups of patients, pregnant women and emigrating workers was 10.6% (95%CI 8.9-12.3%), 2.0% (95%CI 1.8-2.2%) and 0.6% (95%CI 0.4-0.8%), respectively. CONCLUSION: The low prevalence of HIV seropositivity in the group of emigrating workers may be due to self selection, whereas the prevalence in pregnant women, which was rather consistent at about 2.0%, may represent the infection rate in the general population. The seroprevalence rate measured in the group of pregnant women demonstrates that Thailand should increase efforts to confine the spread of HIV infection in the community.

Seroprevalence of human immunodeficiency virus infection in pregnancy in a tertiary care hospital.

BACKGROUND: Human Immunodeficiency Virus (HIV) /Acquired Immunodeficiency Syndrome (AIDS) is increasing at an alarming rate globally. It has now become a major challenge & threat to public health. HIV infection in women occur primarily during their reproductive years, hence pregnancy provides a unique opportunity for implementing prevention strategies against HIV infection. If we estimate seroprevalence in pregnancy, the effective & timely intervention will reduce the transmission of infection to newborns. AIMS: To study the seroprevalence of HIV infection in pregnancy in a tertiary care hospital. SETTING: Antenatal Care Clinic of a Tertiary Care Hospital. DESIGN: A cross-sectional study. MATERIAL AND METHODS: Blood samples of all the pregnant women with written consent were collected and tested for HIV antibodies as per National AIDS Control Organization (NACO) guidelines over a period from September 2002 to August 2004. However only those who were HIV sero-reactive were included in this study. Spouses of sero-reactive pregnant women were also counselled and tested. Statistical analysis was done using Chi-square test. RESULTS: Out of the total 10683 blood samples from pregnant women tested, 147 (1.38%) were found to be HIV sero-reactive. Sero-reactive cases when compiled year-wise, showed increase in the seroprevalence from 1.24% in September 2002 -- August 2003 to 1.45% in September 2003 -- August 2004. Majority 69 (46.94%) sero-reactive pregnant women were in the age group of 19--24 years followed by 25--29 years age group (31.29%). Out of 88 spouses of HIV sero-reactive pregnant women, 85 (96.59%) were found to be HIV sero-reactive. CONCLUSION: In the present study, seroprevalence of HIV infection was found to be 1.38% amongst pregnant women.

Increasing HIV seropositivity among adult tuberculosis patients in Delhi.

We report the HIV seropositivity among adult TB patients from our hospital, a tertiary care hospital in north India between 2000-2002. Of the 555 patients with various forms of tuberculosis, 52 were found to be seropositive (9.4%). In 1994-1999, the HIV seropositivity in this hospital was only 0.4 per cent (2 of 500 patients). This communication describes a dramatic increase in seropositivity and highlights the importance of continued HIV serosurveillance in patients with TB.

Monitoring HIV through sentinel surveillance in Morocco

HIV sentinel surveillance was performed in five provinces of Morocco in 1993, expanded to 10 provinces in 1996. The activity was done by unlinked anonymous testing procedures. We analysed the data from 1993 to 1999. The groups studied were sexually transmitted infections, clinic attendees, pregnant women and patients with pulmonary tuberculosis. The results show that overall HIV prevalence rate over the whole period in 10 cities was 0.10% [45/44,233]. Casablanca had a significantly high rate with 0.39% [10/2567]. The patients with pulmonary tuberculosis displayed the highest prevalence with 0.36% [9/2530]. These data confirm the assumption that the HIV epidemic is low in Morocco. However, the increase of HIV prevalence lately calls for reinforcing preventive measures to limit its spread

Seroprevalence of HIV in Manipal.

A total of 32,406 persons were screened for HIV 1 and 2 antibodies between 1991 to 1999 by Enzyme Linked Immuno Sorbent Assay at Dept. of Microbiology, KMC, Manipal which is a rural teaching hospital. There was steady increase in seropositivity from 0.38% (1991) to 9.31% (1995) and thereafter there is decrease in the seropositivity rate to 4.15% (1999); but the number of cases screened increased from 1995 onwards. The HIV seropositivity is more in males 7.49% than in females (2.52%). The male to female positivity ratio is 2.72:1, inspite of the total number of samples screened of either sexes being equal. The prevalence of HIV among STD Clinic attendants was 8.22%. The foci of infection can be traced to cities such as Mumbai and the main mode of transmission is through unprotected heterosexual contact. The decrease in the seropositivity rate from 1996 onwards could be due to the AIDS awareness among public due to the control programmes. More awareness and public education is needed towards healthy sexual practices to avoid fresh HIV cases.

AIDS entre usuários de drogas injetáveis na última década do século XX, na regiäo metropolitana de Santos Estado de São Paulo - Brasil / Aids among injectin drug users in the 1990's at Santos Metropolitan Region, State of Säo Paulo, Brazil

Objetivo: Estuda a tendência da epidemia de HIV e seus determinantes, entre os usuários de drogas injetáveis (UDIs), durante a década de 90, na Região Metropolitana de Santos (RMS), SP. Métodos: Durante 1991/1992 (Estudo I; N=220), 1994/1996 (Estudo II; N=140) e 1999 (Estudo III; N=108) foram conduzidos três estudo transversais, com entrevistas e testes para o HIV e hepatites B e C de todos os participantes. Resultados: Através de amostra com 468 UDIs, observou-se que as taxas de soroprevalência para HIV foram de 63 por cento, 65 por cento e 42 por cento nos respectivos estudos (p<0,001). O uso de crack cresceu de 11 por cento para 60 por cento e 67 por cento nos respectivos estudos (p<0,001). A freqüência de uso injetável (>5 vezes por dia) diminuiu de 42 por cento no Estudo I, para 30 por cento no Estudo II e para 15 por cento no Estudo III (p<0,001). Não houve alteração significativa do padrão de sexo seguro na população. Conclusões: A taxa de prevalência de HIV decresceu entre o 2§ e o 3§ estudos, assim como a freqüência de uso de drogas injejetáveis decresceu e o uso de crack aumentou. As mudanças padrões de consumo provavelmente afetaram mais a epidemia de HIV do que as modestas intervenções que a saúde pública pôde fazer nos últimos 10 anos

Seroprevalence of human immunodeficiency virus infection in an infectious disease hospital.

AIMS AND OBJECTIVES: To analyse clinicopathological features of HIV infected patients admitted in an infectious disease hospital in Mumbai. MATERIAL AND METHODS: Retrospective study of 501 patients admitted from 1st September, 1996 to 28th February, 1998 and screened for HIV status out of clinical suspicion was carried out. HIV seropositivity was established by double confirmation of spot test results with microwell Elisa test. RESULTS: HIV seropositivity was seen in 39.92%. Out of these 94% were adults with male preponderance and 96.5% had only HIV-1 infection. The significant clinical features in HIV positive patients were chronic diarrhea (51.5%), prolonged fever (41.5%) and history of exposure (34%). Pulmonary tuberculosis could be diagnosed in 19.5% of HIV positive patients. In patients with prolonged/recurrent jaundice HBsAg and HIV was noted as a coinfection within 10/42 cases tested. CONCLUSIONS: Increasing prevalence of HIV seropositivity was noted in patients admitted to an infectious disease hospital. Association of HIV infection with tuberculosis and in icteric cases with HBsAg was significant. The HIV screening should be carried out in patients with prolonged illness resistant to usual mode of treatment.

Survey and surveillance development in settings with low human immunodeficiency virus prevalence

In most countries, during the early phases of a human immunodeficiency virus epidemic, independently initiated surveys of perceived high-risk groups tend to precede the development of formal surveillance systems. Unfortunately, in low-prevalence settings, small sample sizes produce unreliable estimates of prevalence and trends, with an inevitable tendency towards positive results. In our study, we present sample size calculations and typical samples used in actual surveys, with Pakistan as our example. More useful data on risk behaviour and potential for spread can be derived from the study of commoner sexually transmitted diseases and associated risk behaviours, including assessments of knowledge, attitudes, beliefs and practices

Seroprevalencia del VIH en embarazadas de la maternidad "Percy Boland" en Santa Cruz - Bolivia año 1997 / Seroprevalencia of the V.I.H. in pregnant of the Maternidad Percy Boland in Santa Cruz - Bolivia, 1997

Para conocer la seroprevalencia del virus de la inmunodeficiencia humana (VIH) en embarazadas que asisten a su primer control prenatal en la meternidad "Percy Boland" se analizaron 630 muestras durante el periodo de abril a diciembre de 1997. Las muestras de suero recolectadas fueron procesadas a traves del metodo de Enzimoinmunoensayo (ELISA) para la detección de anticuerpos para el VIH1/2, en el laboratorio de Virología del CENETROP. Los resultados serológicos obtenidos de las 630 muestras analizadas, fueron no reactivos para el Test de ELISA para VIH. Este datos nos permite establecer con un nivel de confianza del95

Increasing prevalence of dual HIV-1-2 infections among voluntary blood donors in Mumbai (Bombay).

Between 1993 and 1996, we carried out a serological screening for differentially identifying HIV-1 and HIV-2 infections among the high risk group persons admitted in the various wards of BYL Nair Hospital, Mumbai, using the ImmunoComb kit. This study indicates that although HIV-1 is the predominant virus prevalent in Mumbai, dual HIV-1-2 and HIV-2 infections are gradually increasing.

Percepción del riesgo, comportamientos riesgosos y seroprevalencia del VIH en trabajadoras sexuales de Georgetown, Guyana / HIV risk perception, risk behavior, and seroprevalence among female commercial sex workers in Georgetown, Guyana

En abril de 1993 se realizó un estudio en 108 trabajadoras sexuales que ejercían la prostitución en Georgetown, Guyana. Mediante entrevistas y pruebas de sangre, se investigaron las relaciones entre la seroprevalencia del VIH y conocimientos sobre el sida, prácticas riesgosas, características de los clientes y uso de condones. Las mujeres que trabajaban en la calle - a diferencia de las que trabajaban en bares, hoteles y Puerto Georgetown - solían cobrar menos, estaban en peor situación socioeconómica y tenían clientes en circunstancias similares; por lo tanto, estas mujeres se clasificaron dentro de un estrato socioeconómico "inferior" y las restantes dentro de uno "superior". La seroprevalencia general del VIH observada en las trabajadoras sexuales fue de 25 por ciento (IC95 por ciento=17 a 33 por ciento). Las 50 mujeres del estrato inferior tuvieron, sin embargo, una seroprevalencia relativamente alta (42 por ciento en comparacaión con 10 por ciento de las del estrato superior) y a ese grupo pertenecían 21 de las 27 mujeres seropositivas al VIH. El origen declarado de los clientes(guyaneses o extranjeros), la disposición de las trabajadoras a tener relaciones sexuales sin condón y el uso de condones por los clientes variaron según el estrato. Las participantes del estrato más alto estaban más dispuestas a tener relaciones sexuales sin condón y en ambos estratos las mujeres sabían poco sobre la causa del sida y la transmisión del VIH. Muchas trabajadoras declararon haber contraído una enfermedad de transmisión sexual (ETS) en los 2 años anteriores o haber consumido drogas ilícitas. Según los datos recogidos, los clientes guyaneses usan condones con menos frecuencia que los extranjeros, fenómeno que implica un mayor riesgo de contraer el VIH por contacto con un guyanés o de transmitirlo a un guyanés. La seroprevalencia del VIH en trabajadoras que dijeron tener solo clientes guyaneses fue estadísticamente mayor que la obsevada en las que declararon que sus clientes eran solo extranjeros. La seroprevalencia del VIH en mujeres que declararon tener más de cinco clientes a la semana fue estadísticamente mayor que en las que tenían menos clientes. La seropositividad al VIH fue relativamente frecuente entre las 12 trabajadoras que declararon haber usado cocaína. En general, los resultados confirman la necesidad de fortalecer las intervenciones dirigidas a las trabajadoras sexuales y a sus clientes

A study of 108 female sex workers engaged in prostitution in Georgetown, Guyana, was made in April 1993. Based on interviews and procurement of blood samples, the study investigated relationships between HIV seroprevalences and AIDS knowledge, risk behaviors, client characteristics, and condom use. Street-walkers­as distinct from sex workers in bars, hotels, and Port Georgetown­tended to charge less, be worse off socioeconomically, and have clients who were similarly disadvantaged; they were therefore classified as belonging to a "lower" socioeconomic stratum, while the other workers were classified as belonging to a "higher" stratum. The overall HIV seroprevalence found among the sex workers was 25% (95%CI: 17%­33%). But the 50 subjects in the lower stratum had a relatively high seroprevalence (42%, as compared to 10% among those in the higher stratum), accounting for 21 of the 27 HIV-seropositive subjects. Reported patterns of client origins (Guyanese or foreign), worker willingness to have sex without a condom, and condom use by clients differed by stratum. Participants in the higher stratum were more disposed to having sex without a condom. The workers' knowledge of what causes AIDS and how HIV is transmitted was low in both strata; substantial numbers of workers said they had contracted a sexually transmitted disease within the past two years or were users of illicit drugs. Condom use is reportedly less common among Guyanese than foreign clients, suggesting a greater risk of contracting HIV from Guyanese clients or infecting Guyanese clients with it. The HIV seroprevalence among workers who said they had only Guyanese clients was statistically greater than the rate among those who said they had only foreign clients. The HIV seroprevalence among those reporting more than five clients per week was statistically greater than among those reporting fewer. HIV seropositivity was relatively high among the 12 workers who said they used cocaine. Overall, the findings supported the view that interventions targeted at female sex workers and their clients should be strengthened­more specifically, that concerted efforts should be made to intensify condom promotion, distribution, and social marketing; to improve STD services that provide treatment and counseling for female sex workers; and to increase educational activities among the workers' Guyanese clients

Increasing trend of HIV seroprevalence among pulmonary tuberculosis patients in Pune, India.

A total of 4618 tuberculosis patients attending the TB clinic at the Sassoon General Hospitals, Pune between 1991 and 1996 were screened for anti-HIV antibodies. Of these 694 were found reactive in enzyme immuno assay (EIA) and 624 were further confirmed by a second test, either rapid EIA or Western blot. HIV-1 reactivity was predominant among tuberculosis patients with HIV-2 reactivity appearing only in 1995. HIV-2 seroreactivity accounted for 0.54 and 1.02 per cent of all HIV reactive samples in 1995 and 1996. HIV-1 and HIV-2 dual reactivity accounted for 1.63 and 2.04 per cent of all infections in 1995 and 1996. The overall seroprevalence of HIV among newly diagnosed tuberculosis patients rose from 3.2 per cent in 1991 to 20.1 per cent in 1996.

Infectados HIV de 15 a 49 años durante el período 1986-1992 con residencia en el Partido Gral. Pueyrredón - Bs. As. Argentina / HIV infected patients during the lapse 1986-1992 homebound in the General Pueyrredón County , province Buenos Aires, Argentina

Se estudiaron 506 infectados de HIV en el período entre 1987 y 1992, residentes en el Partido de Gral. Pueyrredón, Pcia. de Bs. As. Se observaron distribución por edad, sexo, tendencia, prevalencia de período, comportamiento sexual, adicción a drogas, vías utilizadas y motivo de la consulta. Los datos secundarios se obtuvieron a través de los registros de notificación de la Zona Sanitaria VIII. La tendencia del proceso se presentó en aumento con incremento mayor en el año 1991. La prevalencia fue de 200 por 100 habitantes de 15 a 49 años. El grupo más afectado el de 20 a 39 años, y la relación entre sexos fue uniforme globalmente, aumentando en algunas edades en las mujeres. En el grupo donde pudo establecerse el mecanismo de transmisión de la infeccion se observó una importante proporción de embarazadas hecho relevante por la implicancia que ello tiene tanto para la madre como para el hijo y la sociedad