Prevalence of and risk factors for HIV infection in individuals testing for HIV at counseling centers in Brazil

Background: Risk factors for HIV infection have been scarcely studied in developing countries. Goal: The goal was to examine the seroprevalence and the risk factors for HIV infection among individuals submitting to voluntary and anonymous testing at counseling and testing centers in Porto Alegre, Brazil. Study Design: In this cross-sectional study HIV infection was diagnosed by enzyme-linked immunosorbent assays (ELISAs) and indirect immunofluorescence. Risk factors for HIV infection were investigated and fitted to logistic regression models according to a hierarchical framework. Results: The overall prevalence of HIV infection was 11.9%. It was greater among homosexual men, individuals with an HIV-positive partner, and intravenous cocaine users. The factors independently associated with risk for HIV infection were: history of detention, homosexual or bisexual orientation, positive VDRL, sex with male prostitutes, HIV-positive sex partner, sex with injectable drug user (IDU), use of cocaine, and sharing needles or syringes. Conclusion: A high prevalence of HIV infection among individuals attending anonymous testing centers was related to sexual behavior and IDU. Other risk factors might be just proxies of true risk behaviors.