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. 2023 Dec 2:28:100642.
doi: 10.1016/j.lana.2023.100642. eCollection 2023 Dec.

Recent HIV infection and annualized HIV incidence rates among sexual and gender minorities in Brazil and Peru (ImPrEP seroincidence study): a cross-sectional, multicenter study

Thiago S Torres  1 , Sylvia L M Teixeira  2 , Brenda Hoagland  1 , Kelika A Konda  3 , Monica Derrico  1 , Ronaldo I Moreira  1 , Juan V Guanira  3 , Marcos Benedetti  1 , Sandro Nazer  1 , Gino M Calvo  3 , Silver Vargas  3 , Carlos Benites  4 , Álisson Bigolin  5 , José Boullosa Alonso Neto  5 , Alessandro Farias  6 , Marcos Vinícius Guimarães Lacerda  7 , Daila Alena Raenck Silva  8 , Leidijany Costa Paz  9 , José Valdez Madruga  10 , Hector Javier Salvatierra Flores  11 , Ginjaylan Prada Boluarte  12 , Cesar Vidal Osco Tamayo  12 , Hardy Teresa Castro Antezana  13 , M Cristina Pimenta  5 , Annick Bórquez  11   14 , Paula M Luz  1 , Beatriz Grinsztejn  1 , Celia Landmann Szwarcwald  12   15 , Carlos F Cáceres  3 , Valdilea G Veloso  1 ; ImPrEP Seroincidence Study Group
Collaborators, Affiliations

Recent HIV infection and annualized HIV incidence rates among sexual and gender minorities in Brazil and Peru (ImPrEP seroincidence study): a cross-sectional, multicenter study

Thiago S Torres et al. Lancet Reg Health Am. .

Abstract

Background: HIV incidence estimation is critical for monitoring the HIV epidemic dynamics and the effectiveness of public health prevention interventions. We aimed to identify sexual and gender minorities (SGM) with recent HIV infections, factors associated with recent HIV infection, and to estimate annualised HIV incidence rates.

Methods: Cross-sectional multicentre study in HIV testing services in Brazil and Peru (15 cities). Inclusion criteria: 18+ years, SGM assigned male at birth, not using pre-/post-exposure prophylaxis. We identified recent HIV infection using the Maxim HIV-1 LAg-Avidity EIA assay as part of a recent infection testing algorithm (RITA). Annualized HIV incidence was calculated using the UNAIDS/WHO incidence estimator tool. Multivariable logistic regression models were used to estimate factors associated with recent HIV infection. Trial registration: NCT05674682.

Findings: From 31-Jan-2021 to 29-May-2022, 6899 individuals participated [Brazil: 4586 (66.5%); Peru: 2313 (33.5%)]; 5946 (86.2%) cisgender men, 751 (10.9%) transgender women and 202 (2.9%) non-binary/gender diverse. Median age was 27 (IQR: 23-34) years. HIV prevalence was 11.4% (N = 784/6899); 137 (2.0%) SGM were identified with recent HIV infection. The overall annualized HIV incidence rate was 3.88% (95% CI: 2.86-4.87); Brazil: 2.62% (95% CI: 1.78-3.43); Peru: 6.69% (95% CI: 4.62-8.69). Participants aged 18-24 years had higher odds of recent HIV infection compared to those aged 30+ years in both countries.

Interpretation: Our results highlight the significant burden of HIV epidemic among SGM in large urban centres of Brazil and Peru. Public health policies and interventions to increase access to effective HIV prevention methods such as PrEP are urgently needed in Latin America.

Funding: Unitaid, WHO (Switzerland), Ministry of Health from Brazil and Peru.

Keywords: HIV; HIV incidence rate; HIV recency; HIV seroincidence; Latin America; Public health; Sexual and gender minorities.

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Conflict of interest statement

Nothing to declare.

Figures

Fig. 1
Fig. 1
Flow-chart for HIV recent infection screening among SGM from Brazil and Peru.
See this image and copyright information in PMC

References

    1. UNAIDS . 2022. UNAIDS data.https://www.unaids.org/en/resources/documents/2022/UNAIDS_FactSheet
    1. Coelho L.E., Torres T.S., Veloso V.G., et al. The prevalence of HIV among men who have sex with men (MSM) and young MSM in Latin America and the caribbean: a systematic review. AIDS Behav. 2021;25(10):3223–3237. - PubMed
    1. Stutterheim S.E., van Dijk M., Wang H., Jonas K.J. The worldwide burden of HIV in transgender individuals: an updated systematic review and meta-analysis. PLoS One. 2021;16(12) - PMC - PubMed
    1. Luz P.M., Veloso V.G., Grinsztejn B. The HIV epidemic in Latin America: accomplishments and challenges on treatment and prevention. Curr Opin HIV AIDS. 2019;14(5):366–373. - PMC - PubMed
    1. Brasil, Ministério da Saúde . Boletim epidemiológico. 2022. Secretaria de Vigilância em Saúde.https://www.gov.br/aids/pt-br/centrais-de-conteudo/boletins-epidemiologi...

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