Session 116Poster Presentations The HIV/STD Interface Session Day and Time: Tuesday 1:30 - 3:30 pm Room: Hall B
923 Risk Factors for HIV and STDs among Young Women Seeking HIV Testing in Rio de Janeiro R. Cook1, S. May2, L. Harrison1, R. Ismerio2, R. Ness1, M. Schechter*2 1Univ of Pittsburgh, PA and 2Fed Univ of Rio de Janeiro, Brazil
Background: In Brazil, the proportion of HIV infections resulting from heterosexual transmission to women is rising. Yet, very little is known about risk factors associated with HIV infection or other sexually transmitted diseases (STDs) in Brazil. The objectives of this study were to determine the prevalence of HIV and STDs among young women seeking HIV testing in Rio de Janeiro and to determine risk factors for prevalent infections.
Methods: In this cross-sectional study, we enrolled 200 consecutive women aged 14-29 yrs who voluntarily sought an HIV test from a public testing site in central Rio de Janeiro. None were injection drug users. Participants completed a nurse-administered questionnaire, provided serum for HIV and syphilis testing, and collected a vaginal swab for chlamydial and gonococcal testing. Persons positive for HIV were retested with a S/LS assay to identify recent infections (< 4 months).
Results: The prevalences of infections were HIV (8%), syphilis (6.5%), gonorrhea (9.5%), and chlamydia (8%). Women were significantly more likely to be infected with HIV if they did not complete high school (13% vs 1%) or if they had a partner with known HIV (33% vs 7%). There was also a strong trend towards increased HIV risk among women who ever exchanged sex for money or drugs (17% vs 7%), who recently had sex against their will (11% vs 7%), who had drinking problems (11% vs 6%), used marijuana (14% vs 6%), or used cocaine (20% vs 6%). In contrast, HIV risk was not related to sexual risk behaviors such as number of partners, anal sex, or condom use. Syphilis, gonorrhea, and chlamydia infections were common and were not related to marital status, presence of symptoms, or specific sexual behaviors. Alcohol problems and drug use were significantly associated with other STDs.
Conclusion: HIV infection and other STDs continue to be substantial health problems among young women in Brazil. Socioeconomic factors and substance abuse appear to be stronger risk factors for HIV and STDs, compared to traditional measures of sexual behavior. The findings suggest a need to integrate STD clinical services and substance abuse services among young women perceiving themselves to be at risk for HIV infection in Brazil.
