The association of socioeconomic status and use of crack/cocaine with unprotected anal sex in a cohort of men who have sex with men in Rio de Janeiro, Brazil.

To evaluate the relation between illicit drug use, sexual practices, and socioeconomic status, we analyzed data from the baseline interview of a cohort of 675 men who have sex with men conducted from 1994 to 1999 in Rio de Janeiro, Brazil. Bivariate analyses of factors associated with crack/cocaine use with sex revealed that men who reported crack/cocaine use were significantly ( p <.05) more likely than men who did not report drug use to be unemployed (42.7% vs. 29.1%), to have an income of <$250 per month (70.7% vs. 60.9%), to have <8 years of education (69.5% vs. 50.9%), to report bisexual activity (81.7% vs. 41.7%), and to engage in commercial sex (72.0% vs. 37.9%). Multivariate analysis of factors associated with unprotected anal sex with casual male partners in the last 6 months demonstrated that the following variables were associated with this outcome: an income <$250 per month (adjusted odds ratio [AOR] = 1.73, 95% confidence interval [CI]: 1.04-2.87), less than 8 years of education (AOR = 2.21, CI: 1.38-3.53), a greater sense of vulnerability (AOR = 2.58, CI: 1.54-4.33), a willingness to participate in vaccine trials (AOR = 1.91, CI: 1.20-3.05), and use of crack/cocaine (AOR = 1.91, CI: 1.05-3.46). Our findings suggest that HIV prevention programs for these men need to address drug use and how drug use may influence sexual behaviors.

Human immunodeficiency virus incidence and risk behavior in the 'Projeto Rio': results of the first 5 years of the Rio de Janeiro open cohort of homosexual and bisexual men, 1994-98.

OBJECTIVES: In preparation for a phase III HIV vaccine trial, we report the results of men who have sex with men (MSM) cohort ('Projecto Rio'). METHODS: HIV-negative MSM were followed 6-monthly over a 3-year period. RESULTS: High seroprevalence for sexually transmitted disease (HIV, syphilis and hepatitis B seropositivities of 24%, 29%, and 37%, respectively) was seen in the 1165 potential volunteers, and this seroprevalence showed significant differences according to HIV serologic status. Among the 647 HIV-negative cohort participants, HIV incidence rate (IR) was 3.33 (95% CI 1.93-4.67) per 100 men-years, with 21 newly acquired HIV infections during 7572 men-months of observation. IR differences were observed in four categories: (1) non-commercial sex workers and non-transvestites who had protected sex prior to study entry (IR 1.6 per 100 men-years); (2) non-commercial sex workers and non-transvestites who had unprotected sex prior to study entry (IR 2.7 per 100 men-years); (3) commercial sex workers (IR 3.5 per 100 men-years); and (4) transvestite groups (IR 16.8 per 100 men-years). Unprotected penetrative anal sex was frequent (66%) in the 6 months before study entry, and when we take into consideration the fact that bisexual men engaged in unprotected vaginal intercourse with their female partners, the risk behavior in this group escalates to 73%. HIV seroconverters had high risk behavior prior to study entry (76%), and all but one admitted to having unprotected penetrative sex prior to infection. CONCLUSIONS: MSM in this study had a high rate of unprotected penetrative sexual practices, which caused a significant HIV incidence rate, and, with improved study adherence, this study site could be used for future vaccine trials.

The Rio de Janeiro HIV vaccine site - I. Recruitment strategies and socio-demographic data of a HIV negative homosexual and bisexual male cohort in Rio de Janeiro, Brazil

The initial effort of the Brazilian Ministry of Health to be an active partner in the world effort in the preparation of future accurate human immune deficiency virus (HIV) efficacy trial was the establishment of a multi-centered cohort of homosexual and bisexual men. An open cohort of homosexual and bisexual men. An open cohort was established to determine the HIV incidence and the socio-behavioral aspects involved in Rio de Janeiro. A total of 318 potencial participants, originated from multiple sources (health units, public information, snowball recruitment), were screened and recruitment became effective through the direct involvement of target communities (with the support of Non Governmental Organizations) and the population, Among this group, seropositivity for sexually transmitted diseases was high with 23, 32 and 46 per cent for HIV, syphilis and hepatite B, respectively. The socio-demographic data from the first 200 participants of this HIV negative cohort suggests that the cohort volunteers are an appropriate sample of the general male population of the State of Rio de Janeiro.

Acute respiratory infections in children living in two low income communities of Rio de Janeiro, Brazil

Community studies of non-hospitalized children are essential to obtain a more thorough understanding of acute respiratory infections (ARI) and provide important information for public health authorities. This study identified a total ARI incidence rate (IR) of 4.5 per 100 child-weeks at risk and 0.78 for lower respiratory tract infections (LRI). Disease duration averaged less than one week and produced a total time ill with ARI of 5.8 por cento and for LRI 1.2 por cento. No clear seasonal variation was observed, the sex-specific IR showed a higher proportion of boys becoming ill with ARI and LRI and the peak age-specific IR occurred in infants of 6-11 months. Correlation with risk factors of the child (breastfeeding, vaccination, diarrheal disease, undernourishment) and the environment (crowding, living conditions, maternal age and education) showed marginal increases in the rate ratios, making it difficult to propose clear-cuts targets for action to lower the ARI and LRI morbidity. The importance of an integral maternal-child health care program and public education in the early recognition of LRI is discussed.

Influenza surviellance in Rio de Janeiro between 1980-1981: a virological and serological study

Dados laboratoriais indicam que a atividade do vírus influenza durante os anos de 1980 e 1981 foi limitada no Rio de Janeiro. Poucas amostras de vírus influenza A (H3N2) foram isoladas durante o inverno em ambos os anos. Estudos sorológicos indicam que esta variante do vírus H3N2 circulou principalmente entre crianças menores de 10 anos. Nenhum vírus H1N1 foi isolado mas sua circulaçäo foi detectada pelo aumento dos titulos de anticorpos específicos nos soros de adultos coletados em 1981. O vírus influenza B foi isolado de crianças durante a primavera de 1981, e nos soros de adultos coletados em 1981 houve uma elevaçäo nos titulos de anticorpos também para este vírus