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Abreu Martins C, Leal Seabra I, Rocha Vila Nova PV, Barbosa Rodrigues T, Oeiras Pedroso A, Gir E, Karina Reis R, Tavares Parente A, Oliveira Naiff Ferreira GR, Botelho EP. Spatial analysis of HIV detection rates among Brazilian young men, 2007-2021. AIDS Care 2024; 36:771-780. [PMID: 38227972 DOI: 10.1080/09540121.2024.2301730] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Accepted: 12/31/2023] [Indexed: 01/18/2024]
Abstract
The main goal of this study was to spatially analyze the HIV epidemic scenario in young men in Brazil, 2007-2021. We used secondary data obtained from the Brazilian Information System for Notifiable Diseases. Individuals aged 15-29 years with permanent residence in Brazil who were diagnosed with HIV during the study period were included in the analysis. Municipality HIV age-adjusted detection rates were analyzed through spatial distribution, autocorrelation, and spatiotemporal risk analyses. During the study period, 108,392 HIV cases were reported in young Brazilian men. The HIV epidemic increased territorially in the northern, northeastern, midwestern, and southeastern regions but decreased in the southern region. Although the number of clusters comprising municipalities with high HIV detection rates (hotspots) decreased, new ones appeared, expanded, or stopped changing size. Hotspots and spatio-temporal risk zones (spatial areas with increased HIV detection in a specific period) comprised economically developed municipalities with high demographic density surrounded by less developed municipalities. The period of the spatiotemporal risk zones was between 2008 and 2021. Our study showed that HIV detection rates continue to increase among young Brazilian men, and health authorities should reinforce efforts mainly in capitals and surrounded municipalities in the north, northeast, southeast, and midwest regions.
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Affiliation(s)
| | | | | | | | | | - Elucir Gir
- Nursing School of RibeirãoPreto, University of São Paulo, Ribeirão Preto, Brazil
| | - Renata Karina Reis
- Nursing School of RibeirãoPreto, University of São Paulo, Ribeirão Preto, Brazil
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Bezerra ALL, de Almeida PRB, Reis RK, Ferreira GRON, Sousa FDJDD, Gir E, Botelho EP. Human immunodeficiency virus epidemic scenery among brazilian women: a spatial analysis study. BMC Womens Health 2023; 23:463. [PMID: 37658362 PMCID: PMC10474736 DOI: 10.1186/s12905-023-02616-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Accepted: 08/24/2023] [Indexed: 09/03/2023] Open
Abstract
BACKGROUND Approximately 37.7 million people worldwide are infected with human immunodeficiency virus (HIV). Although HIV detection among women, they still representing 53% of population living with the virus. Spatial analysis techniques are powerful tools for combating HIV allowing the association of the phenomenon with socioeconomic and political factors. Therefore, the main goal of this study was to spatially analyze HIV prevalence among Brazilian women from 2007 to 2020. METHODS ecological study was conducted using secondary databases of the Notifiable Diseases Information System (SINAN) for HIV and Acquired Immunodeficiency Syndrom (AIDS) in Brazilian women 15 years old and over. Age-adjusted HIV/AIDS incidence rates were analyzed using spatial distribution, autocorrelation, and spatiotemporal risk analysis techniques. RESULTS During the study period, 119,890 cases of HIV/AIDS were reported among Brazilian women. The southeastern region had a higher age-adjusted HIV/AIDS incidence than other Brazilian regions. Hotspot HIV/AIDS incidence rates decreased in all Brazil. Piauí, Paraná, and Minas Gerais were the only states with an increased number of cold spots. Previous spatiotemporal risk zones were observed in the states of São Paulo, Rio Grande do Sul, and Rio de Janeiro. Belém was a risk zone with a later spatiotemporal risk. CONCLUSIONS The efficiency of public policies fighting HIV has not been uniform among municipalities, although HIV/AIDS cases have decreased among Brazilian women. The social determinants of health in each municipality should be considered when local health authorities implement policies. Women empowerment should be promoted, and access to preventive, diagnostic, and treatment healthcare places should be expanded and guaranteed.
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Affiliation(s)
- Ana Luisa Lemos Bezerra
- Nursing Graduate Program, Universidade Federal do Pará, Rua Augusto Correia, 01 - Setor Saúde, Guamá - Belém, Pará, 66075-110, Brazil
| | - Paula Regina Barbosa de Almeida
- Nursing Graduate Program, Universidade Federal do Pará, Rua Augusto Correia, 01 - Setor Saúde, Guamá - Belém, Pará, 66075-110, Brazil
| | - Renata Karina Reis
- Escola de Enfermagem de Ribeirão Preto. Graduate Program in Fundamental Nursing, Universidade de São Paulo, Av.Bandeirantes, Ribeirão Preto, 3900, 14040-902, SP, Brazil
| | | | - Fabianne de Jesus Dias de Sousa
- Nursing Graduate Program, Universidade Federal do Pará, Rua Augusto Correia, 01 - Setor Saúde, Guamá - Belém, Pará, 66075-110, Brazil
| | - Elucir Gir
- Escola de Enfermagem de Ribeirão Preto. Graduate Program in Fundamental Nursing, Universidade de São Paulo, Av.Bandeirantes, Ribeirão Preto, 3900, 14040-902, SP, Brazil
| | - Eliã Pinheiro Botelho
- Nursing Graduate Program, Universidade Federal do Pará, Rua Augusto Correia, 01 - Setor Saúde, Guamá - Belém, Pará, 66075-110, Brazil.
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Transmission and Drug Resistance Characteristics of Human Immunodeficiency Virus-1 Strain Using Medical Information Data Retrieval System. COMPUTATIONAL AND MATHEMATICAL METHODS IN MEDICINE 2022; 2022:2173339. [PMID: 35734773 PMCID: PMC9208953 DOI: 10.1155/2022/2173339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Revised: 04/13/2022] [Accepted: 04/23/2022] [Indexed: 11/18/2022]
Abstract
This study was aimed at exploring the transmission and drug resistance characteristics of acquired immunodeficiency syndrome (AIDS) caused by human immunodeficiency virus-1 (HIV-1). The query expansion algorithm based on Candecomp Parafac (CP) decomposition was adopted to construct a data information retrieval system for semantic web and tensor decomposition. In the latent variable model based on tensor decomposition, the three elements in the triples generated feature vectors to calculate the training samples. The HIV patient data set was selected to evaluate the performance of the system, and then, the HIV gene resistance of 213 patients was retrospectively analyzed based on the electronic medical records. 43 cases showed failure of ribonucleic acid drug resistance, the ART virological failure rate was 24.43% (43/213), and one case was not reported. There was 1 case of RNA hemolysis that could not be detected. There were 50 resistant cases of nonnucleotide reverse transcriptase inhibitors (NNRTI), accounting for 29.94% (50/167), and there were 17 resistant cases of nucleotide reverse transcriptase inhibitors (NRTI), accounting for 10.18% (17/167) of all mutation cases. Among the HIV-1 strains, 19 cases failed the detection of drug resistance sites in the integrase region, and mutations in the integrase region were significantly more than those in the protease region. There were 12 types of HIV-1 strains with drug-resistant mutations. The fusion technical scheme constructed in this study showed excellent performance in medical information retrieval. In this study, the characteristics of HIV-1 of AIDS patients were analyzed from different directions, and effective treatment was performed for patients, so as to provide reference for clinical diagnosis of AIDS patients.
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HIV and Substance Use in Latin America: A Scoping Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19127198. [PMID: 35742448 PMCID: PMC9222977 DOI: 10.3390/ijerph19127198] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Revised: 06/08/2022] [Accepted: 06/10/2022] [Indexed: 12/13/2022]
Abstract
This scoping review aims to explore the interplay between substance use (SU) and HIV in Latin America (LA). Database searches yielded 3481 references; 196 were included. HIV prevalence among people who used substances (PWUS) ranged from 2.8–15.2%. SU definitions were variable throughout studies, and thus data were not easily comparable. In 2019, only 2% of new HIV infections were attributed to injection drug use (IDU) in LA. Factors associated with HIV among PWUS included being female, IDU and homelessness, and PWUS were likely to engage in risky sexual behaviors, start antiretroviral treatment late, have poor adherence, have treatment failure, be lost to follow-up, have comorbidities, and experience higher mortality rates and lower quality of life, as has been reported in PLWH with SU in other regions. Five intervention studies were identified, and only one was effective at reducing HIV incidence in PWUS. Interventions in other regions have varying success depending on context-specific characteristics, highlighting the need to conduct more research in the LA region. Though progress has been made in establishing SU as a major concern in people living with HIV (PLWH), much more is yet to be done to reduce the burden of HIV and SU in LA.
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Liu Y, Richards VL, Gebru NM, Spencer EC, Cook RL. Associations amongst form of cocaine used (powder vs crack vs both) and HIV-related outcomes. Addict Behav Rep 2021; 14:100374. [PMID: 34938835 PMCID: PMC8664776 DOI: 10.1016/j.abrep.2021.100374] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Revised: 07/20/2021] [Accepted: 09/01/2021] [Indexed: 11/06/2022] Open
Abstract
Among PWH, cocaine use vs no-use was associated with worse HIV treatment outcomes. Powder cocaine only users were more likely to be younger, Hispanic, and employed. Users of powder + crack cocaine had lower viral suppression than users of either alone. Harm reduction efforts addressing substance use should be a key component of HIV care.
Introduction Cocaine (including powder and crack) use is common among people with HIV (PWH). We identified socio-demographic and behavioral factors associated with cocaine use (overall and various forms) among PWH; we also examined differences in HIV treatment outcomes across cocaine exposure groups. Methods The study sample (N = 1166) was derived from two cohorts of PWH in Florida between 2014 and 2020. Baseline data were linked to the Enhanced HIV/AIDS Reporting System (eHARS) which tracks HIV viral load. Socio-demographics and polysubstance use were compared by cocaine use and the three cocaine use groups (powder only n = 101, crack only n = 91, or both n = 65). The association between the three cocaine use groups, ART adherence, and HIV viral suppression (<200 copies/mL) in the following year was assessed by multivariate logistic regression. Results People who used cocaine had lower HIV treatment adherence and viral suppression than those who did not use. People who used powder cocaine only were more likely to be younger, Hispanic/Latinx, and employed than those who used crack only or both. Compared to people who used both powder and crack cocaine, those who used one form of cocaine had 3 + odds of having durable viral suppression in the following year. Conclusion The dual use of both powder and crack cocaine was associated with significantly worse HIV outcomes compared to use of only one form of cocaine. Screening for powder and crack cocaine use and timely intervention are needed to improve HIV treatment outcomes among this high-risk population.
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Affiliation(s)
- Yiyang Liu
- Department of Epidemiology, College of Public Health and Health Professions and College of Medicine, University of Florida, Gainesville, FL, USA
| | - Veronica L Richards
- Department of Epidemiology, College of Public Health and Health Professions and College of Medicine, University of Florida, Gainesville, FL, USA
| | - Nioud Mulugeta Gebru
- Department of Health Education and Behavior, College of Health and Human Performance, University of Florida, Gainesville, FL, USA
| | - Emma C Spencer
- Florida Department of Health, Bureau of Communicable Diseases, Tallahassee, FL, USA
| | - Robert L Cook
- Department of Epidemiology, College of Public Health and Health Professions and College of Medicine, University of Florida, Gainesville, FL, USA
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Optimizing HIV prevention and treatment outcomes for persons with substance use in Central Asia: what will it take? Curr Opin HIV AIDS 2020; 14:374-380. [PMID: 31219889 PMCID: PMC6688715 DOI: 10.1097/coh.0000000000000565] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Purpose of review To summarize the status of HIV and substance use in Central Asia and discuss potential ways to move forward to effective epidemic control among people who inject drugs (PWID) in the region and beyond. Recent findings PWID and their partners remain the population most affected by HIV in Central Asia. Lack of effective substance use prevention and treatment options and limited involvement of PWID-led community-based organizations in HIV programs, combined with the requirement for official registration, stigma and discrimination of PWID, and criminalization of drug use remain key barriers to effective HIV prevention and treatment. Summary Sustainable HIV epidemic control among PWID will not be feasible without decriminalization of drug use, addressing stigma and discrimination and policy changes to enhance uptake of HIV-related prevention, treatment and support services by PWID. It is also critical to ensure adoption of innovations, particularly those that combine evidence-based biomedical, behavioral and structural interventions tailored to the needs of the PWID.
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Kostaki EG, Frampton D, Paraskevis D, Pantavou K, Ferns B, Raffle J, Grant P, Kozlakidis Z, Hadjikou A, Pavlitina E, Williams LD, Hatzakis A, Friedman SR, Nastouli E, Nikolopoulos GK. Near Full-length Genomic Sequencing and Molecular Analysis of HIV-Infected Individuals in a Network-based Intervention (TRIP) in Athens, Greece: Evidence that Transmissions Occur More Frequently from those with High HIV-RNA. Curr HIV Res 2019; 16:345-353. [PMID: 30706819 PMCID: PMC6446520 DOI: 10.2174/1570162x17666190130120757] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2018] [Revised: 01/21/2019] [Accepted: 01/27/2019] [Indexed: 11/25/2022]
Abstract
Background: TRIP (Transmission Reduction Intervention Project) was a network-based, contact tracing approach to locate and link to care, mostly people who inject drugs (PWID) with recent HIV infection. Objective: We investigated whether sequences from HIV-infected participants with high viral load cluster together more frequently than what is expected by chance. Methods: Paired end reads were generated for 104 samples using Illumina MiSeq next-generation se-quencing. Results: 63 sequences belonged to previously identified local transmission networks of PWID (LTNs) of an HIV outbreak in Athens, Greece. For two HIV-RNA cut-offs (105 and 106 IU/mL), HIV transmissions were more likely between PWID with similar levels of HIV-RNA (p<0.001). 10 of the 14 sequences (71.4%) from PWID with HIV-RNA >106 IU/mL were clustered in 5 pairs. For 4 of these clusters (80%), there was in each one of them at least one sequence from a recently HIV-infected PWID. Conclusion: We showed that transmissions are more likely among PWID with high viremia.
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Affiliation(s)
- Evangelia-Georgia Kostaki
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Daniel Frampton
- Department of Infection and Immunity, UCL, London, United Kingdom
| | - Dimitrios Paraskevis
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | | | - Bridget Ferns
- NIHR Biomedical Research Centre, UCLH/UCL, London, United Kingdom
| | - Jade Raffle
- Department of Infection and Immunity, UCL, London, United Kingdom
| | - Paul Grant
- Department of Clinical Virology, UCLH, London, United Kingdom
| | - Zisis Kozlakidis
- Division of Infection and Immunity, Faculty of Medical Sciences, UCL and Farr Institute of Health Informatics Research, London, United Kingdom
| | - Andria Hadjikou
- Medical School, University of Cyprus, Nicosia, Cyprus.,European University Cyprus, Nicosia, Cyprus
| | - Eirini Pavlitina
- Transmission Reduction Intervention Project, Athens site, Athens, Greece
| | - Leslie D Williams
- National Development and Research Institutes, New York, United States
| | - Angelos Hatzakis
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Samuel R Friedman
- National Development and Research Institutes, New York, United States
| | - Eleni Nastouli
- NIHR Biomedical Research Centre, UCLH/UCL, London, United Kingdom.,Department of Population, Policy and Practice, UCL GOS Institute of Child Health, London, United Kingdom
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Tanaka TSO, Leite TF, Freitas SZ, Cesar GA, de Rezende GR, Lindenberg ADSC, Guimarães ML, Motta-Castro ARC. HIV-1 Molecular Epidemiology, Transmission Clusters and Transmitted Drug Resistance Mutations in Central Brazil. Front Microbiol 2019; 10:20. [PMID: 30804893 PMCID: PMC6371026 DOI: 10.3389/fmicb.2019.00020] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2018] [Accepted: 01/09/2019] [Indexed: 12/16/2022] Open
Abstract
We aimed to characterize HIV-1 molecular epidemiology and transmission clusters among heterosexual (HET) and men who have sex with men (MSM) individuals, as well as transmitted drug resistance mutations (TDRM) in Central-Western Brazil. This cross-sectional survey was conducted among 190 antiretroviral naïve HIV-1 infected individuals. Proviral DNA was extracted, and nested PCR amplified partial polymerase gene (PR/RT). After sequencing, subtypes were assigned, and the sequences were analyzed for the occurrence of possible transmission networks. Calibrated Population Resistance (CPR) tool from Stanford HIV Database was used to investigate the presence of TDRM. Among 150 individuals whose samples were successfully sequenced, the most prevalent HIV-1 subtype was B, followed by recombinant forms. The occurrence of twenty transmission clusters composed by at least two sequences was verified, suggesting the existence of transmission clusters among individuals from the same or distinct sexual orientations. Intermediate level of TDRM (12%) was found in the study population, and almost half of the subjects with TDRM had more than one resistance mutation. No correlations between sexual orientation and the presence of TDRM, HIV-1 subtypes/recombinants forms were verified. Taken together, the necessity of the continuous monitoring of the TDRM to verify the importance of pre-genotyping and to delineate future strategies in primary antiretroviral therapy. Likewise, the knowledge of the HIV-1 transmission networks in Brazil would allow the implementation of effective HIV-1 prevention strategies in local settings.
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Affiliation(s)
- Tayana Serpa Ortiz Tanaka
- Programa de Pós-graduação em Doenças Infecciosas e Parasitárias, Faculdade de Medicina, Federal University of Mato Grosso do Sul, Campo Grande, Brazil
| | - Thaysse Ferreira Leite
- Laboratory of AIDS and Molecular Immunology, Oswaldo Cruz Institute, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
| | - Solange Zacalusni Freitas
- Universitary Hospital Maria Aparecida Pedrossian, HUMAP, Federal University of Mato Grosso do Sul, Campo Grande, Brazil
| | - Gabriela Alves Cesar
- Programa de Pós-graduação em Doenças Infecciosas e Parasitárias, Faculdade de Medicina, Federal University of Mato Grosso do Sul, Campo Grande, Brazil
| | - Grazielli Rocha de Rezende
- Laboratory of Clinical Immunology, FACFAN, Federal University of Mato Grosso do Sul, Campo Grande, Brazil
| | | | - Monick Lindenmeyer Guimarães
- Laboratory of AIDS and Molecular Immunology, Oswaldo Cruz Institute, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
| | - Ana Rita Coimbra Motta-Castro
- Programa de Pós-graduação em Doenças Infecciosas e Parasitárias, Faculdade de Medicina, Federal University of Mato Grosso do Sul, Campo Grande, Brazil.,Laboratory of Clinical Immunology, FACFAN, Federal University of Mato Grosso do Sul, Campo Grande, Brazil.,Laboratory of Molecular Virology, Oswaldo Cruz Foundation, Mato Grosso do Sul, Campo Grande, Brazil
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