HIV prevalence among female sex workers, drug users and men who have sex with men in Brazil: A Systematic Review and Meta-analysis
Summary: Malta and colleagues recently performed a systematic review and meta-analysis of studies assessing HIV prevalence among men who have sex with men (MSM), female sex workers (FSW), and drug users (DU) in Brazil. Whereas HIV prevalence in the general population is around 0.6%, combined HIV prevalence for FSW was 6.2 (95% CI: 4.4-8.3), 13.6 (95% CI: 8.2-20.2) for MSM, and 23.1 (95% CI: 16.7-30.2) for drug users, with injection drug use and syringe/needle sharing as key predictors of HIV-infection. While these populations show increased HIV prevalence in most, if not all epidemics, how do these numbers match up to what we know about the Brazilian response to the epidemic? What are some of the defining features of Brazil’s response that allowed it to keep HIV prevalence low in the general population? Has Brazil also achieved successes in MSM, FSWs, and DUs despite the expected higher prevalence in these populations? What do you make of the call of Malta and colleagues for focused prevention strategies that provide accurate information, counseling and testing, as well as concrete means to foster behavior change tailored to gender and culture-specific needs for these vulnerable populations?
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