RESUMEN
OBJECTIVES: This study examined the impact of worksite-based AIDS prevention program among port workers in Santos, Brazil, on sexual risk behavior for HIV infection. METHODS: Male port workers (n = 226) were followed in a 3-wave prospective cohort study. A multifaceted intervention costing US $90,000 for 20,000 workers was conducted between waves 2 and 3. RESULTS: Heterosexual risk behavior showed no decline between waves 1 and 2 (before the intervention) but decreased substantially between waves 2 and 3 (after the intervention). This decrease resulted from both a decrease in nonprimary partners and an increase in condom use. CONCLUSIONS: This worksite-based AIDS program produced marked behavior change at modest cost.
Asunto(s)
Síndrome de Inmunodeficiencia Adquirida/prevención & control , Educación en Salud/organización & administración , Servicios de Salud del Trabajador/organización & administración , Adulto , Brasil , Conocimientos, Actitudes y Práctica en Salud , Humanos , Masculino , Evaluación de Programas y Proyectos de Salud , Estudios Prospectivos , Factores de Riesgo , Asunción de Riesgos , Conducta Sexual , Navíos , Encuestas y Cuestionarios , Salud UrbanaRESUMEN
OBJECTIVES: To describe sexual risk for HIV infection among adult night school students in São Paulo, Brazil, and to evaluate the effect of an HIV/AIDS prevention workshop to reduce sexual risk. SUBJECTS AND METHODS: A longitudinal study was conducted among four demographically similar public night schools in the inner city of São Paulo. Schools were randomized into intervention and control conditions. Of 394 young adults who took part in the baseline survey, 304 (77%) completed a postintervention questionnaire. INTERVENTIONS: In a workshop consisting of four sessions of 3 h each, the students discussed AIDS symbolism, the impact of AIDS on their lives, risk perception, the way in which sexual norms shape knowledge and attitudes, AIDS-related knowledge, reproduction and sexual pleasure, and condom use negotiation. We fostered community-building through AIDS training courses for teachers in the schools, peer support programs and public events. RESULTS: At baseline, 87% had been sexually active at some time and 76% had had sex in the past 6 months. Among those who reported vaginal intercourse and/or anal intercourse, condom use was low. The workshops were positively process-evaluated and supported by the community, the students, their teachers and their parents. We obtained statistically significant effects from the workshops for females only, who reported improved communication with partners about sex and AIDS and less unprotected sex with non-monogamous partners after the intervention. CONCLUSION: These data show that the sexual risk of HIV infection can be lowered when Brazilian disenfranchized communities support AIDS prevention workshops. Even more impressive results may be achieved if the need to address socioeconomic obstacles and gendered sexual roles is emphasized through further long-term community development programs.
Asunto(s)
Síndrome de Inmunodeficiencia Adquirida/prevención & control , Educación en Salud , Conducta Sexual , Síndrome de Inmunodeficiencia Adquirida/epidemiología , Adolescente , Adulto , Brasil/epidemiología , Femenino , Humanos , Masculino , Instituciones AcadémicasRESUMEN
OBJECTIVES: To determine the prevalence of HIV and syphilis and related risk behavior in a sample of truck drivers in Santos, Brazil. SUBJECTS AND METHODS: A cross-sectional study was performed of 300 male truck drivers recruited in the port of Santos, Brazil, including a face-to-face interview and blood sampling for HIV and syphilis serology. RESULTS: Of 300 subjects, 4 (1.3%) were positive for HIV, 25 (8.3%) for syphilis by the Venereal Disease Research Laboratory (VDRL) test and 38 (13%) were positive for syphilis by the fluorescent treponemal antibody (absorbed) test (FTA-Abs). Seventy-one per cent had been employed as truck drivers for more than 10 years and 93% lived outside of Santos. Most participants were married (72%); 40% reported having more than one sex partner; 21% reported sex with commercial sex workers; 14% reported sex with girls that they met on the road; 16% had sex with other men's wives; and 3.3% reported sex with men during the past year. The use of rebite, an oral stimulant, was reported by 43% and was associated with being FTA-Abs-positive (P = 0.04). Being HIV-positive was associated with having sex with friends (P = 0.04), partners usually considered 'safe' by truck drivers. Being syphilis-positive (VDRL) was significantly associated with sex with partners also considered as 'safe', namely primary sex partners, steady partners and other men's wives. DISCUSSION: This is the first study to determine HIV and syphilis seroprevalence among truck drivers in South America. Findings confirm that this group has a high potential risk for HIV infection and other sexually transmitted diseases, and thus currently presents an opportunity for prevention.
Asunto(s)
Infecciones por VIH/epidemiología , Enfermedades de Transmisión Sexual/epidemiología , Adulto , Brasil/epidemiología , Infecciones por VIH/transmisión , Humanos , Masculino , Persona de Mediana Edad , Prevalencia , Asunción de Riesgos , Enfermedades de Transmisión Sexual/transmisión , TransportesRESUMEN
OBJECTIVES: This paper measured the extent to which human immunodeficiency virus (HIV) infection has spread among the male working-class population of Santos, Brazil. METHODS: Questionnaires on risk behaviors and blood tests were administered to a random sample (n = 395) of male port workers employed by the Santos Port Authority. RESULTS: Although the rate of HIV infection among these men- the working-class male population of Santos-remains low (1.1%), self-reported behavioral risks for HIV infection are common. CONCLUSIONS: There is still time to prevent a widespread outbreak of HIV infection among the hetero-sexual population of Santos and of the transportation corridors emanating from that city.
Asunto(s)
Infecciones por VIH/etiología , Seroprevalencia de VIH , Conductas Relacionadas con la Salud , Ocupaciones , Asunción de Riesgos , Adulto , Brasil/epidemiología , Conocimientos, Actitudes y Práctica en Salud , Humanos , Masculino , Persona de Mediana Edad , Navíos , Encuestas y Cuestionarios , Salud UrbanaRESUMEN
OBJECTIVE: The Brazilian Carnival is thought to be a time when the risk of HIV infection is likely to be high. We therefore compared the risk during Carnival to risk in the past month among male samba school participants in São Paulo, Brazil. SUBJECTS AND METHODS: A cross-sectional study was conducted among 380 male samba school drummers randomly sampled during rehearsal for the 1993 Carnival in São Paulo by means of a 20-min interviewer-administered questionnaire. The main outcome variable was condom use with non-steady partners. RESULTS: The sexual behavior of 36.1% of subjects risked HIV infection, but only 9.7% of all subjects were at risk only during Carnival. Subjects with a sexual risk of HIV differed from those without risk in substance use, attitudes towards condoms and expectations about Carnival; those who were at risk only during Carnival did not differ from those who were at risk at other times. About half of the subjects had been given free condoms during Carnival, although few of the men at risk had actually used them. CONCLUSIONS: Though more than a third of the drummers were at risk of HIV infection, only a small per cent were at risk only during Carnival. The level of sexual risk of HIV infection is probably better explained by factors in the men's daily lives, rather than through information on risks taken during Carnival. These results raise questions concerning the efficacy of universal condom distribution during Carnival, since about half of the men were given condoms but few of those at risk actually used them. A targeted distribution of condoms to populations with a high demonstrated risk may be more effective in preventing new HIV infection.