Cristina Moreira Jalil, Sylvia Lopes Maia Teixeira, Carolina Coutinho, Sandro Coutinho Nazer, Eduardo Carvalheira, Brenda Hoagland, Sandra Wagner, Paula M Luz, Valdilea G Veloso, Beatriz Grinsztejn, Emilia Moreira Jalil, Thiago S Torres
{"title":"Covid-19 大流行对巴西男男性行为者和变性女性中艾滋病毒检测、近期感染和年化发病率的影响。","authors":"Cristina Moreira Jalil, Sylvia Lopes Maia Teixeira, Carolina Coutinho, Sandro Coutinho Nazer, Eduardo Carvalheira, Brenda Hoagland, Sandra Wagner, Paula M Luz, Valdilea G Veloso, Beatriz Grinsztejn, Emilia Moreira Jalil, Thiago S Torres","doi":"10.1097/QAI.0000000000003531","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>The Covid-19 pandemic had great impact on HIV care and prevention worldwide, including in Brazil. We compared HIV testing, recent infection, and annualized incidence according to Covid-19 pandemic period among men who have sex with men (MSM) and transgender women (TGW).</p><p><strong>Setting: </strong>HIV/STI testing, prevention and treatment referral service in Rio de Janeiro, Brazil.</p><p><strong>Methods: </strong>We used Maxim HIV-1 Limiting Antigen Avidity EIA as part of recent infection testing algorithm to identify recent HIV infections and estimate annualized HIV incidences in pre- (March/2018-February/2020) and post-Covid-19 pandemic onset period (March/2020-January 2022). Multivariable logistic regression model assessed factors associated with recent HIV infection.</p><p><strong>Results: </strong>Among 4590 MSM and TGW, 593 (12.9%) tested positive for HIV and 119 (2.6%) were identified as having recent infection. Percentage of recent HIV infection did not differ between Covid-19 periods. Overall annualized HIV incidence rates were 6.0% (95%CI:4.2-7.7) and 6.6% (95%CI:4.3-9.0) in pre- and post-Covid-19 periods, respectively. During the post-Covid-19 period, higher incidence rates were observed among TGW (8.4%[95%CI:2.9-13.9]), those aged 18-24 years (7.8%[ 95%CI:4.0-11.7]), Black race (7.9%[95%CI:3.8-12.0]), and with <12 years of schooling (7.8%[95%CI:4.8-10.8]). Incidence rates were significantly higher in the post-Covid-19 period for those aged>30 years and TGW, and lower for those with more years of schooling.</p><p><strong>Conclusion: </strong>HIV incidence estimates remain high among MSM and TGW in Brazil, especially among the most vulnerable. The consequences of the Covid-19 pandemic on the HIV epidemic will likely persist and contribute to worsening HIV outcomes.</p>","PeriodicalId":14588,"journal":{"name":"JAIDS Journal of Acquired Immune Deficiency Syndromes","volume":" ","pages":""},"PeriodicalIF":2.9000,"publicationDate":"2024-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Impact of Covid-19 pandemic on HIV testing, recent infections and annualized incidence among cisgender men who have sex with men and transgender women in Brazil.\",\"authors\":\"Cristina Moreira Jalil, Sylvia Lopes Maia Teixeira, Carolina Coutinho, Sandro Coutinho Nazer, Eduardo Carvalheira, Brenda Hoagland, Sandra Wagner, Paula M Luz, Valdilea G Veloso, Beatriz Grinsztejn, Emilia Moreira Jalil, Thiago S Torres\",\"doi\":\"10.1097/QAI.0000000000003531\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>The Covid-19 pandemic had great impact on HIV care and prevention worldwide, including in Brazil. We compared HIV testing, recent infection, and annualized incidence according to Covid-19 pandemic period among men who have sex with men (MSM) and transgender women (TGW).</p><p><strong>Setting: </strong>HIV/STI testing, prevention and treatment referral service in Rio de Janeiro, Brazil.</p><p><strong>Methods: </strong>We used Maxim HIV-1 Limiting Antigen Avidity EIA as part of recent infection testing algorithm to identify recent HIV infections and estimate annualized HIV incidences in pre- (March/2018-February/2020) and post-Covid-19 pandemic onset period (March/2020-January 2022). Multivariable logistic regression model assessed factors associated with recent HIV infection.</p><p><strong>Results: </strong>Among 4590 MSM and TGW, 593 (12.9%) tested positive for HIV and 119 (2.6%) were identified as having recent infection. Percentage of recent HIV infection did not differ between Covid-19 periods. Overall annualized HIV incidence rates were 6.0% (95%CI:4.2-7.7) and 6.6% (95%CI:4.3-9.0) in pre- and post-Covid-19 periods, respectively. During the post-Covid-19 period, higher incidence rates were observed among TGW (8.4%[95%CI:2.9-13.9]), those aged 18-24 years (7.8%[ 95%CI:4.0-11.7]), Black race (7.9%[95%CI:3.8-12.0]), and with <12 years of schooling (7.8%[95%CI:4.8-10.8]). Incidence rates were significantly higher in the post-Covid-19 period for those aged>30 years and TGW, and lower for those with more years of schooling.</p><p><strong>Conclusion: </strong>HIV incidence estimates remain high among MSM and TGW in Brazil, especially among the most vulnerable. The consequences of the Covid-19 pandemic on the HIV epidemic will likely persist and contribute to worsening HIV outcomes.</p>\",\"PeriodicalId\":14588,\"journal\":{\"name\":\"JAIDS Journal of Acquired Immune Deficiency Syndromes\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":2.9000,\"publicationDate\":\"2024-09-18\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"JAIDS Journal of Acquired Immune Deficiency Syndromes\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1097/QAI.0000000000003531\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"IMMUNOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"JAIDS Journal of Acquired Immune Deficiency Syndromes","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1097/QAI.0000000000003531","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"IMMUNOLOGY","Score":null,"Total":0}
引用次数: 0
摘要
背景：Covid-19 大流行对包括巴西在内的全球 HIV 护理和预防产生了重大影响。我们比较了男男性行为者（MSM）和变性女性（TGW）在 Covid-19 大流行期间的 HIV 检测、近期感染率和年发病率：环境：巴西里约热内卢的 HIV/STI 检测、预防和治疗转介服务机构：我们使用 Maxim HIV-1 限制性抗原阳性 EIA 作为近期感染检测算法的一部分，以确定近期 HIV 感染情况，并估算 Covid-19 流行前（2018 年 3 月至 2020 年 2 月）和 Covid-19 流行后（2020 年 3 月至 2022 年 1 月）的 HIV 年发病率。多变量逻辑回归模型评估了与近期 HIV 感染相关的因素：在 4590 名 MSM 和 TGW 中，593 人（12.9%）的 HIV 检测呈阳性，119 人（2.6%）被确定为近期感染。最近感染 HIV 的比例在 Covid-19 期间没有差异。在 Covid-19 之前和之后，HIV 的总体年化发病率分别为 6.0% (95%CI:4.2-7.7) 和 6.6% (95%CI:4.3-9.0)。在后 Covid-19 时期，TGW（8.4%[95%CI:2.9-13.9]）、18-24 岁人群（7.8%[95%CI:4.0-11.7]）、黑人（7.9%[95%CI:3.8-12.0]）、30 岁以上人群和 TGW 的发病率较高，而受教育年限较长人群的发病率较低：结论：在巴西，男男性行为者和男男性行为者中的艾滋病毒感染率仍然很高，尤其是在最脆弱人群中。Covid-19 大流行对艾滋病毒疫情的影响很可能会持续下去，并导致艾滋病毒结果的恶化。
Impact of Covid-19 pandemic on HIV testing, recent infections and annualized incidence among cisgender men who have sex with men and transgender women in Brazil.
Background: The Covid-19 pandemic had great impact on HIV care and prevention worldwide, including in Brazil. We compared HIV testing, recent infection, and annualized incidence according to Covid-19 pandemic period among men who have sex with men (MSM) and transgender women (TGW).
Setting: HIV/STI testing, prevention and treatment referral service in Rio de Janeiro, Brazil.
Methods: We used Maxim HIV-1 Limiting Antigen Avidity EIA as part of recent infection testing algorithm to identify recent HIV infections and estimate annualized HIV incidences in pre- (March/2018-February/2020) and post-Covid-19 pandemic onset period (March/2020-January 2022). Multivariable logistic regression model assessed factors associated with recent HIV infection.
Results: Among 4590 MSM and TGW, 593 (12.9%) tested positive for HIV and 119 (2.6%) were identified as having recent infection. Percentage of recent HIV infection did not differ between Covid-19 periods. Overall annualized HIV incidence rates were 6.0% (95%CI:4.2-7.7) and 6.6% (95%CI:4.3-9.0) in pre- and post-Covid-19 periods, respectively. During the post-Covid-19 period, higher incidence rates were observed among TGW (8.4%[95%CI:2.9-13.9]), those aged 18-24 years (7.8%[ 95%CI:4.0-11.7]), Black race (7.9%[95%CI:3.8-12.0]), and with <12 years of schooling (7.8%[95%CI:4.8-10.8]). Incidence rates were significantly higher in the post-Covid-19 period for those aged>30 years and TGW, and lower for those with more years of schooling.
Conclusion: HIV incidence estimates remain high among MSM and TGW in Brazil, especially among the most vulnerable. The consequences of the Covid-19 pandemic on the HIV epidemic will likely persist and contribute to worsening HIV outcomes.
期刊介绍：
JAIDS: Journal of Acquired Immune Deficiency Syndromes seeks to end the HIV epidemic by presenting important new science across all disciplines that advance our understanding of the biology, treatment and prevention of HIV infection worldwide.
JAIDS: Journal of Acquired Immune Deficiency Syndromes is the trusted, interdisciplinary resource for HIV- and AIDS-related information with a strong focus on basic and translational science, clinical science, and epidemiology and prevention. Co-edited by the foremost leaders in clinical virology, molecular biology, and epidemiology, JAIDS publishes vital information on the advances in diagnosis and treatment of HIV infections, as well as the latest research in the development of therapeutics and vaccine approaches. This ground-breaking journal brings together rigorously peer-reviewed articles, reviews of current research, results of clinical trials, and epidemiologic reports from around the world.
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