Incident HIV Infection in a High-Risk, Homosexual, Male Cohort in Rio de Janeiro, Brazil

Harrison, Lee H.; Lago, Regina Ferro do; Friedman, Ruth Khalili; Rodrigues, José Ariévilo Gurgel; Santos, Elizabeth Moreira dos; Melo, M. F. de; Moulton, Lawrence H.; Schechter, Mauro

doi:10.1097/00126334-199908150-00008

Cited by 30 publications

(15 citation statements)

References 10 publications

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“…This result is similar to other cohort studies with MSM 3 , 13 , 15 , which indicates that retention rate is higher after the initial period of the study and remains stable over time. It is possible that the connection and commitment to the study were not well established in the first years of participation.…”

Section: Discussionsupporting

confidence: 90%

“…In the Multicenter AIDS Cohort Study (MACS), the retention rate was 88.5% in 9.5 years of follow-up 3 . The Brazilian Praça Onze cohort study monitored seronegative MSM and reported retention rates of 97%, 91%, and 88% at six, 12, and 18 months of follow-up 13 , respectively. An American study with Latino population of homosexuals/bisexuals and transgender persons reported retention rates of 83% and 80% in three and six months of follow-up, respectively 6 .…”

Section: Discussionmentioning

confidence: 99%

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Loss to follow-up in a cohort of HIV-negative men who have sex with men: Project Horizonte

et al. 2017

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OBJECTIVEThe objective of this study is to estimate the attrition rates and evaluate factors associated with loss to follow-up between 1994 and 2011 in an open cohort of HIV-negative men who have sex with men.METHODSThe Project Horizonte is an open cohort study that aimed to assess the incidence of HIV infection, evaluate the impact of educational interventions, and identify potential volunteers for HIV vaccine trials. The rates of losses to follow-up were estimated for three periods (1994–1999, 2000–2005, and 2006–2011). The variables analyzed were collected in a psychosocial questionnaire. Volunteers who dropped out were compared with the ones who remained in the study using a Cox regression model.RESULTSA total of 1,197 volunteers were recruited. The median follow-up time in the study (n = 626) was 4.2 years. The median follow-up time for the volunteers who dropped out of the study (n = 571) was 1.46 years. The overall rate of loss to follow-up was 11.6/100 person-years. Attrition rates by period were: 12.60 (1994–1999), 11.80 (2000–2005), and 9.00 (2006–2011) per 100 person-years. Factors associated with losses to follow-up were: age group of 21–30 years old, monthly per capita income of more than six or less than one Brazilian minimum wage, having more than two dependents, report of bisexual practice, and inconsistent use of condoms for receptive anal sex.CONCLUSIONSA slight decrease of the loss to follow-up was observed over time. Higher attrition rates happened in the first three years of follow-up. It is possible that the link of the volunteers were not yet well established. Those who reported inconsistent condom use in receptive anal sex were more likely to leave the study, suggesting an underestimation of the incidence of HIV infection in a cohort population. For greater effectiveness, retention strategies must be reassessed considering the connection between the characteristics of homosexual and bisexual behavior and the motivations to engage in health research.

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Section: Discussionsupporting

confidence: 90%

Section: Discussionmentioning

confidence: 99%

Loss to follow-up in a cohort of HIV-negative men who have sex with men: Project Horizonte

et al. 2017

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“…Although not quite significant, there was a trend towards greater willingness to participate in rectal microbicide trials among men at higher risk of HIV infection (P 5 0.056) when only men who had definite opinions on participation were included. This association between an increased risk of HIV infection and willingness to participate in HIV prevention trials has been consistently identified in MSM who are potential trial participants, both in Australia [37] and in other countries [34,35,[38][39][40][41]. The combination of high HIV incidence and increased willingness to participate in trials further indicates the suitability of such a population for prevention trials.…”

Section: Discussionmentioning

confidence: 82%

“…Other risk factors for higher HIV incidence were identified from other published sources and examined within the HIM cohort. These included number of sexual partners in the past 6 months [32,33,34], alcohol consumption [33], previous hepatitis B virus (HBV) infection [35] and injecting drug use [33]. For each risk factor, the HIV incidence was calculated as the number of HIV seroconversions divided by the total PY of follow-up for participants who reported/experienced that risk factor.…”

Section: Factors Associated With An Hiv Incidence Of 2 Per 100 Pymentioning

confidence: 99%

Defining high HIV incidence subgroups of Australian homosexual men: implications for conducting HIV prevention trials in low HIV prevalence settings

et al. 2010

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Objectives The aim of the study was to assess whether subpopulations with sufficiently high HIV incidences for HIV prevention trials can be identified in low HIV incidence settings such as Australia. Methods In a community‐based cohort study of HIV‐negative homosexually active men in Sydney, Australia, potential risk factors associated with an annual HIV incidence of ≥2 per 100 person‐years (PY) were identified. A stepwise procedure ranked these factors according to HIV incidence, to create a ‘high‐incidence’ subgroup of participants. Willingness to participate in HIV prevention trials was assessed. Results Although the incidence in the cohort overall was only 0.78 per 100 PY, nine risk variables were associated with an HIV incidence of 2 per 100 PY or greater. Stepwise inclusion of these variables revealed a ‘high‐incidence’ subgroup of men representing 24% of the total follow‐up time with a combined HIV incidence of 2.71 per 100 PY, who reported at least one of three risk factors in the past 6 months. These men were more willing than others to participate in vaccine and antiretroviral therapy HIV prevention trials. Conclusions These findings demonstrate that it is possible to identify high HIV incidence subpopulations in low‐incidence settings such as Australia, and these men are of above average willingness to participate in HIV prevention trials.

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“…The HIV incidence among pregnant women did not show a decline; the rate was 0.72% in 1999, 1.11% in 2000, and 0.59% in 2002 (Saphonn, 2003). Although the incidence study showed declining trends of HIV incidence among the high-risk groups, one should be aware that HIV incidence among these groups is still high compared with the high-risk groups in other countries (Harrison et al, 1999;Vanichseni et al, 2001) (Figure 5). …”

Section: Hiv Incidencementioning

confidence: 97%

Current HIV/AIDS/STI Epidemic: Intervention Programs in Cambodia, 1993–2003

Saphonn¹,

Sopheab²,

Li-hua³

et al. 2004

AIDS Education and Prevention

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In the past decade, Cambodia has been experiencing the most serious HIV/AIDS epidemic in Southeast Asia. With full support from the top policy makers, good leadership in program management, and the commitment of the public health program officers, the HIV/AIDS prevention and care program in Cambodia has been successful, despite its resource constraints. Available data from surveillance and other studies in Cambodia indicate a downward trend in HIV prevalence and incidence among high-risk groups, an increase in condom use among commercial sex workers and their clients, and a declining trend of sexually transmitted infections. Although these findings reflect the success of programs to prevent transmission, the incidence of HIV infections is still high in high-risk populations, and transmission among the general population continues. Cambodia therefore needs to increase its efforts to reduce transmission. More research and prevention programs should focus on the vulnerable populations. HIV/AIDS modeling indicates that Cambodia needs to prepare for increasingly large numbers of AIDS patients who will require expensive medical care.

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Incident HIV Infection in a High-Risk, Homosexual, Male Cohort in Rio de Janeiro, Brazil

Cited by 30 publications

References 10 publications

Loss to follow-up in a cohort of HIV-negative men who have sex with men: Project Horizonte

Loss to follow-up in a cohort of HIV-negative men who have sex with men: Project Horizonte

Defining high HIV incidence subgroups of Australian homosexual men: implications for conducting HIV prevention trials in low HIV prevalence settings

Current HIV/AIDS/STI Epidemic: Intervention Programs in Cambodia, 1993–2003

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