HIV Seroprevalence Among Homeless and Marginally Housed Adults in San Francisco

Robertson, Marjorie J.; Clark, Richard A.; Charlebois, Edwin D.; Tulsky, Jacqueline P.; Long, Heather L.; Bangsberg, David R.; Moss, Andrew R.

doi:10.2105/ajph.94.7.1207

Cited by 198 publications

(158 citation statements)

References 64 publications

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“…In San Francisco, US, 18 there was found higher HIV prevalence (29.6%) in individuals engaging in homosexual sex (user and non-users of injectable drugs) than in homeless individuals who were injectable drug users and did not engage in homosexual sex (7.7%) and other groups studied (5.0%) of non-homosexual/noninjectable drug users. A high prevalence (17%) was also reported in a probabilistic sample of young (15-24 years) homeless living on the streets of three cities of Ukraine 10 in 2008.…”

Section: Discussionmentioning

confidence: 90%

Prevalência e vulnerabilidade à infecção pelo HIV de moradores de rua em São Paulo, SP

et al. 2012

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OBJETIVO: Analisar a prevalência e o perfil de vulnerabilidade ao HIV de moradores de rua. MÉTODOS: Estudo transversal com amostra não probabilística de 1.405 moradores de rua usuários de instituições de acolhimento de São Paulo, SP, de 2006 a 2007. Foi realizado teste anti-HIV e aplicado questionário estruturado. O perfil de vulnerabilidade foi analisado pela frequência do uso do preservativo, considerando mais vulneráveis os que referiram o uso nunca ou às vezes. Foram utilizadas regressões logística e multinomial para estimar as medidas de efeito e intervalos de 95% de confiança. RESULTADOS: Houve predominância do sexo masculino (85,6%), média de 40,9 anos, ter cursado o ensino fundamental (72,0%) e cor não branca (71,5%). A prática homo/bissexual foi referida por 15,7% e a parceria ocasional por 62,0%. O número médio de parcerias em um ano foi de 5,4 e mais da metade (55,7%) referiu uso de drogas na vida, dos quais 25,7% relataram uso frequente. No total, 39,6% mencionaram ter tido uma doença sexualmente transmissível e 38,3% relataram o uso do preservativo em todas as relações sexuais. A prevalência do HIV foi de 4,9% (17,4% dos quais apresentaram também sorologia positiva para sífilis). Pouco mais da metade (55,4%) tinha acesso a ações de prevenção. A maior prevalência do HIV esteve associada a ser mais jovem (OR 18 a 29 anos = 4,0 [IC95% 1,54;10,46]), história de doença sexualmente transmissível (OR = 3,3 [IC95% 1,87;5,73]); prática homossexual (OR = 3,0 [IC95% 1,28;6,92]) e à presença de sífilis (OR = 2,4 [IC95% 1,13;4,93]). O grupo de maior vulnerabilidade foi caracterizado por ser mulher, jovem, ter prática homossexual, número reduzido de parcerias, parceria fixa, uso de drogas e álcool e não ter acesso a ações de prevenção e apoio social. CONCLUSÕES: O impacto da epidemia entre moradores de rua é elevado, refletindo um ciclo que conjuga exclusão, vulnerabilidade social e acesso limitado à prevenção.

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Section: Discussionmentioning

confidence: 90%

Prevalência e vulnerabilidade à infecção pelo HIV de moradores de rua em São Paulo, SP

et al. 2012

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“…21 In a study conducted in San Francisco, the HIV seroprevalence registered in the homeless population was fi ve times higher than the one in the general population. 14 All the women who were HIV positive and in a homeless condition related exchanging sex for money. An American study showed prevalence of 22.4% for HIV, 53.4% for HBV and 29.7% HCV among female sex workers.…”

Section: Discussionmentioning

confidence: 99%

“…13,14,20 Behavior related to both sexual practice and shared use of injecting drugs may cause the homeless population to be predisposed to hepatitis B infection. 3 The risk of this population to contract hepatitis C also increases when compared to the general population.…”

Section: Introductionmentioning

confidence: 99%

Infecção pelo HIV, hepatites B e C e sífilis em moradores de rua, São Paulo

et al. 2007

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OBJECTIVE:To estimate the prevalence of HIV infections, as well as hepatitis B and C and syphilis viruses in homeless people. METHODS:Cross-sectional study with educational intervention, conducted in the city of São Paulo, between 2002 and 2003. A convenience sample of homeless people who used night shelters was selected, according to the following criteria: aged 18 or older and not showing psychiatric disturbances. During interviews, sociodemographic and behavioral data were gathered and HIV, hepatitis B and C and syphilis laboratorial tests and post-test counseling were carried out. RESULTS:A total of 330 shelter users participated, with an average age of 40.2 years, 80.9% of them male, having lived on the streets for one year in average. Prevalences of 1.8% for HIV, 8.5% for hepatitis C virus, 30.6% for previous hepatitis B infection, 3.3% for chronic or acute infection by hepatitis B virus, and 5.7% for syphilis. The consistent use of condoms was referred to by 21.3% of interviewees and the use of injecting drugs by 3% of them. Positivity was 10% for HIV and 50% for hepatitis C virus among injectable drug users, versus 1.5% for HIV and 7.3% for hepatitis C among the others, showing an association between the virus and the use of injecting drugs. Previous imprisonment was referred to by 7.9% of women and 26.6% of men, with a prevalence of 2.6% for HIV and 17.1% for hepatitis C virus. CONCLUSIONS:The high prevalences of HIV and hepatitis B and C viruses require prevention programs based on vaccination against hepatitis B, early diagnosis of these infections and placement of homeless people into health services.

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“…42,43 REACH participants received quarterly blood draws and structured interviews. All participants signed a written consent form at the onset of the study and were reimbursed $15 per interview.…”

Section: Methodsmentioning

confidence: 99%

Food Insecurity Is Associated with Greater Acute Care Utilization among HIV-Infected Homeless and Marginally Housed Individuals in San Francisco

et al. 2012

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HIV Seroprevalence Among Homeless and Marginally Housed Adults in San Francisco

Abstract: HIV seroprevalence was 5 times greater for indigent adults than in San Francisco generally. Sexual behavior predicted HIV infection better than drug use, even among IDUs.

Cited by 198 publications

References 64 publications

Prevalência e vulnerabilidade à infecção pelo HIV de moradores de rua em São Paulo, SP

Prevalência e vulnerabilidade à infecção pelo HIV de moradores de rua em São Paulo, SP

Infecção pelo HIV, hepatites B e C e sífilis em moradores de rua, São Paulo

Food Insecurity Is Associated with Greater Acute Care Utilization among HIV-Infected Homeless and Marginally Housed Individuals in San Francisco

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