Risk behavior score: a practical approach for assessing risk among men who have sex with men in Brazil

ABSTRACT HIV/AIDS epidemic is not well controlled, and multiple sexual behavior factors help explain high rates of HIV infection among men who have sex with men (MSM). This article proposes to exam the use of a potential risk behavior score for HIV infection, based on the type and number of sexual partners, and condom use, and their associated factors in a sample of MSM in Brazil. A cross sectional RDS (Respondent Driven Sampling) study was performed among 3738 MSM aged 18+ years old from ten Brazilian cities. The risk behavior score was composed by the number of male partners and anal condom use in the last year with steady, casual, and commercial partners. Most participants were 25+ years old (58.1%), non-white (83.1%), and single (84.9%). Final weighted ordinal logistic model showed that age ≤ 25 years old (p = 0.037), homosexual or bisexual identity (p < 0.001), sexual initiation before 15-year-old (p < 0.001), having sex with men only in the last 12 months (p < 0.001), frequent alcohol and illicit drug use (p < 0.001), and use of local sites to meet sexual partners in the last month were independently associated with higher scores of risky behavior. Specific strategies should be developed aimed at the MSM population. Additionally, pre-exposed prophylaxis (Prep) should be considered for those at higher score as a strategy for reducing risk for HIV infection in this population.

Survey of prevalence of HIV infection, syphilis and HCV infection and related risk behaviors among club drug users in Zhejiang, 2011 / 中华流行病学杂志

Objective To understand the prevalence of HIV infection,syphilis and hepatitis C infection and related risk behaviors among club drug users in Zhejiang province.Methods The drug users were interviewed with questionnaires in 2011 to collect the information about their demographic characteristics,sexual behaviors,drug use behaviors and the utilization of intervention services.Blood samples were collected from them to detect HIV,syphilis and HCV antibodies.Results A total of 3 253 drug users were surveyed,in which 1 298 were club drug users,accounted for 39.9％.The proportion of club drug users was high in northern and central Zhejiang,in females,in age group ≤25 years,in local residents and in those having commercial sexual behaviors during previous 12 months.Of the 1 298 club drug users,91.2％ were methamphetamine users,0.1％ were infected with HIV(95％CI:0.0％-0.2％),8.1％ suffered from syphilis (95％CI:6.6％-9.6％),17.3％ were infected with HCV(95％CI:15.2％-19.4％).Among the interviewed club drug users,12.7％ were aware of AIDS,9.2％ had injecting drug use histories,29.6％ reported having commercial sex during the previous 12 months,only 33.4％ received free condom and counsel,14.0％ received HIV test.Multivariate logistic regression analysis indicated that living in central and southern Zhejiang was associated with syphilis prevalence,HCV infection and injecting drug use behavior,being female was associated with syphilis prevalence.Injecting drug use and commercial sex during the previous 12 months were associated with HCV infection,and injecting drug use and commercial sex during the previous 12 months were associated with each other.Among the 1 285 club drug users,males,local residents in Zhejiang and those who never received free condom or counsel were more likely to have commercial sex.Conclusion The prevalence of syphilis and HCV infection are high and unprotected sexual behaviors are common among the club drug users in Zhejiang,but less intervention services were received by them,suggesting that more attention should be paid to the prevention and control of HIV,HCV infections and syphilis in club drug users by taking effective intervention measures and increasing intervention coverage.