Risk factors for HIV infection in a gynaeco - obstetric population in Vietnam — a case-control study

Contextos de vulnerabilidade para o HIV entre mulheres brasileiras

Este artigo tem como objetivo identificar os contextos de vulnerabilidade para o HIV entre mulheres brasileiras. Entre novembro de 2003 a dezembro de 2004 foi realizado um estudo de corte transversal em 13 municípios distribuídos nas cinco regiões do país, incluindo, respectivamente, 1.777 mulheres com diagnóstico positivo para HIV e 2.045 mulheres usuárias de serviços públicos de atenção à saúde da mulher sem diagnóstico conhecido de soropositividade para o HIV. A comparação entre os dois grupos mostrou que as mulheres com diagnóstico de HIV/AIDS não apresentaram um número de parceiros significativamente diferente com relação às mulheres sem diagnóstico de HIV/AIDS. No entanto, as mulheres vivendo com HIV/AIDS apresentaram início da vida sexual mais precoce, menor aderência ao uso de preservativos, e uma maior proporção dessas mulheres relatou uso de drogas, ocorrência de DST e de violência sexual na vida. Tais resultados sugerem a importância de pensar em estratégias de prevenção voltadas para o fortalecimento das mulheres e não apenas focadas em seus comportamentos individuais.

Household survey in two provinces in Viet Nam estimates HIV prevalence in an urban and a rural population

A household-based population study interviewed 2,553 women and 1,984 men aged 15-49 years in urban (Ho Chi Minh City) and rural (Thai Binh) provinces in Viet Nam between July and August 2005. The survey response rate was high--approximately 97% of households and 93% of adults overall, with a >92% acceptance of HIV testing among eligible adults. The unadjusted estimated population HIV prevalence was 0.3% (confidence interval [CI]: 0.1-0.6%) in Thai Binh and 0.7% (CI: 0.3-1.3) in Ho Chi Minh City (HCMC), compared with the national estimates and projections of 0.352% and 1.250%, respectively, for 2005. The ratio of male-to-female prevalence was 10.5:1 in Thai Binh and 1.3:1 in HCMC. A low level of men reported purchasing sex in the last 12 months (2.4%) and there were low self-reports of sexually transmitted infections in all adults (5%). A correct knowledge of HIV/AIDS prevention methods was high in both provinces (83%), although only 24.8% of women knew of the use of antiretroviral therapy to prevent vertical transmission of HIV. The observed population prevalence was consistent with recent projections in Thai Binh, although lower than expected in HCMC, indicating the substantial downward revisions of projected population HIV prevalence may need to be extended. The unequal sex prevalence ratio is consistent with the projected trends of increasing male-to-female sexual transmission in urban areas. The results and experience of this study will inform future population based surveys in Viet Nam and the broader Asian region.

Poverty, skin colour and HIV infection: a case-control study from southern Brazil

We investigated the association between socioeconomic and behavioral factors and HIV infection and aids in a medium-sized Brazilian city. Cases included HIV-positive women (n=144) and women with aids (n=130) seen at a specialized facility. Controls were a probabilistic, population-based sample of 1,537 women aged 15-49 years. Groups were compared using logistic regression. Both HIV infection and AIDS were more frequent among younger women of non-white skin colour, with lower schooling and income who began sexual activity early. This is the first Brazilian study using population-based controls to show that both HIV-seropositivity and AIDS are concentrated among young, non-white poor women. It is important to prioritize preventive measures targeting these groups.