Article
A Cross-Sectional Survey of HIV Testing and Prevalence in Twelve Brazilian Correctional Facilities
Registro en:
SGARBI, R. V. E. et al. A Cross-Sectional Survey of HIV Testing and Prevalence in Twelve Brazilian Correctional Facilities. Plos One, v. 10, n. 10, p. e0139487, 2015.
1932-6203
10.1371/journal.pone.0139487
Autor
Sgarbi, Renata Viebrantz Enne
Carbone, Andrea da Silva Santos
Paião, Dayse Sanchez Guimarães
Lemos, Everton Ferreira
Simionatto, Simone
Puga, Marco Antonio Moreira
Castro, Ana Rita Coimbra Motta
Pompilio, Mauricio Antonio
Urrego, Juliana
Ko, Albert Icksang
Andrews, Jason R
Croda, Julio
Resumen
Prior studies have reported higher HIV prevalence among prisoners than the general population in Brazil, but data have been derived from single prisons. The aim of this study was to evaluate HIV testing practices, prevalence and linkage to care among inmates in a network of 12 prisons. Methods
We administered a questionnaire to a population-based sample of inmates from 12 prisons
in Central-West Brazil and collected sera for HIV and syphilis testing from January to
December 2013. We evaluated factors associated with HIV testing and infection using multivariable
logistic regression models. Six months after HIV testing, we assessed whether
each HIV-infected prisoner was engaged in clinical care and whether they had started antiretroviral
therapy.
Results
We recruited 3,362 inmates, of whom 2,843 (85%) were men from 8 prisons, and 519 (15%)
were women from 4 prisons. Forty-five percent of participants reported never having been
tested for HIV previously. In multivariable analysis, the variables associated with previous
HIV testing were lack of a stable partner (adjusted odds ratio [AOR]: 1.38; 95% CI: 1.18–
1.60), completed more than four years of schooling (AOR 1.40; 95% CI: 1.20–1.64), history
of previous incarceration (AOR: 1.68; 95% CI: 1.43–1.98), history of mental illness (AOR
1.52; 95% CI: 1.31–1.78) and previous surgery (AOR 1.31; 95% CI: 1.12–1.52). Fifty-four
(1.6%) of all participants tested positive for HIV; this included 44 (1.54%) men and 10
(1.92%) women. Among male inmates, HIV infection was associated with homosexuality
(AOR 6.20, 95% CI: 1.73–22.22), self-report of mental illness (AOR 2.18, 95% CI: 1.13–
4.18), history of sexually transmitted infections (AOR 3.28, 95% CI: 1.64–6.56), and syphilis
sero-positivity (AOR 2.54, 95% CI: 1.20–5.39). Among HIV-infected individuals, 34 (63%)
were unaware of their HIV status; only 23 of these 34 (68%) newly diagnosed participants
could be reached at six month follow-up, and 21 of 23 (91%) were engaged in HIV care.
Conclusions
HIV testing rates among prison inmates are low, and the majority of HIV-infected inmates
were unaware of their HIV diagnosis. Incarceration can be an opportunity for diagnosis and
treatment of HIV among vulnerable populations who have poor access to health services,
but further work is needed on transitional HIV care for released inmates.