Risk factors associated with HIV infection among male homosexuals and bisexuals followed in an open cohort study: Project Horizonte, Brazil (1994-2010)

PLoS One. 2014 Oct 3;9(10):e109390. doi: 10.1371/journal.pone.0109390. eCollection 2014.

Abstract

Background: There has recently been an increase in HIV infection rates among men who have sex with men (MSM). This study aimed at investigating risk factors associated with incident HIV infection in a MSM cohort-Project Horizonte, Belo Horizonte, Minas Gerais, Brazil.

Methodology: This is a nested case-control study in an ongoing open cohort of homosexual and bisexual men, carried out in 1994-2010, during which 1,085 volunteers were enrolled. Each HIV seroconverted volunteer (case) was compared with three randomly selected HIV negative controls, matched by admission date and age (±3 years). During follow-up, 93 volunteers seroconverted and were compared with 279 controls.

Principal findings: The risk factors associated with HIV seroconversion were: contact with partner's blood during sexual relations (OR 3.7; 95% CI 1.2-11.6), attendance at gay saunas in search for sexual partners (OR 2.6; 95% CI 1.3-5.4), occasional intake of alcohol when flirting and engaging in sexual activity (OR 2.5; 95% CI 1.3-5.1), inconsistent use of condoms in receptive anal sex (OR 2.4; 95% CI 1.1-5.4), little interest to look up information about AIDS (OR 2.6; 95% CI 1.0-6.7) particularly in newspapers (OR 3.4; 95% CI 1.4-8.1).

Conclusions: This study shows that MSM are still engaging in risk behavior, such as unprotected anal intercourse, despite taking part in a cohort study on various preventive measures. New preventive strategies in touch with the epidemic's development and the specificities of this particular population are needed.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Alcohol Drinking
  • Bisexuality*
  • Brazil / epidemiology
  • Cohort Studies
  • HIV Infections / epidemiology*
  • HIV Infections / transmission
  • HIV Seropositivity / epidemiology
  • Homosexuality, Male*
  • Humans
  • Incidence
  • Male
  • Multivariate Analysis
  • Risk Factors
  • Unsafe Sex

Grants and funding

Project Horizonte is supported by the Brazilian Ministry of Health, Department of STD, AIDS and Viral Hepatitis, grant number 19288. MC is grateful for the CNPq and the FAPEMIG/PPM research fellowship. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.