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.

IF 2.9 3区医学 Q3 IMMUNOLOGY JAIDS Journal of Acquired Immune Deficiency Syndromes Pub Date : 2025-01-01 Epub Date: 2024-12-05 DOI:10.1097/QAI.0000000000003531

Cristina M Jalil, Sylvia L M Teixeira, Carolina Coutinho, Sandro C Nazer, Eduardo Carvalheira, Brenda Hoagland, Sandra W Cardoso, Paula M Luz, Valdilea G Veloso, Beatriz Grinsztejn, Emilia M Jalil, Thiago S Torres

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Abstract

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 the COVID-19 pandemic period among cisgender men who have sex with men (MSM) and transgender women (TGW).

Setting: HIV and sexually transmitted infection testing, prevention, and treatment referral service in Rio de Janeiro, Brazil.

Methods: We used Maxim HIV-1 Limiting Antigen Avidity EIA as part of a recent infection testing algorithm to identify recent HIV infection cases and estimate annualized HIV incidences in the 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 3814 MSM and 776 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 the COVID-19 periods. Overall annualized HIV incidence rates were 6.0% (95% confidence interval [CI]: 4.2 to 7.7) and 6.6% (95% CI: 4.3 to 9.0) in the 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 to 13.9]), those aged 18-24 years (7.8% [95% CI: 4.0 to 11.7]), of Black race (7.9% [95% CI: 3.8 to 12.0]), and those with <12 years of schooling (7.8% [95% CI: 4.8 to 10.8]). Compared to the pre-COVID-19 period, incidence rates were significantly higher in the post-COVID-19 period for those aged >30 years and TGW, while being 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.

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2019冠状病毒病大流行对巴西同性性行为男性和变性女性艾滋病毒检测、近期感染和年化发病率的影响

背景：2019冠状病毒病大流行对包括巴西在内的世界范围内的艾滋病毒护理和预防产生了重大影响。根据COVID-19大流行时期，我们比较了男男性行为的顺性男性（MSM）和变性女性（TGW）的HIV检测、近期感染和年化发病率。环境：巴西里约热内卢里约热内卢的艾滋病毒和性传播感染检测、预防和治疗转诊服务。方法：我们使用Maxim HIV-1限制性抗原亲和力EIA作为近期感染检测算法的一部分，以确定近期HIV感染病例，并估计2019冠状病毒病大流行前（2018年3月至2020年2月）和后发病期（2020年3月至2022年1月）的年化HIV发病率。多变量logistic回归模型评估了与近期HIV感染相关的因素。结果：3814例MSM和776例TGW中，HIV阳性593例（12.9%），近期感染119例（2.6%）。最近感染艾滋病毒的百分比在COVID-19期间没有差异。总体年化艾滋病毒感染率在covid -19之前和之后分别为6.0%（95%可信区间[CI]: 4.2至7.7）和6.6% （95% CI: 4.3至9.0）。在covid -19后时期，TGW （8.4% [95% CI: 2.9至13.9]）、18-24岁（7.8% [95% CI: 4.0至11.7]）、黑人（7.9% [95% CI: 3.8至12.0]）和30岁和TGW的发病率较高，而受教育年限较长的人群发病率较低。结论：巴西MSM和TGW人群的艾滋病毒感染率估计仍然很高，特别是在最脆弱的人群中。2019冠状病毒病大流行对艾滋病毒流行的影响可能会持续下去，并导致艾滋病毒结果恶化。

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来源期刊

JAIDS Journal of Acquired Immune Deficiency Syndromes 医学-传染病学

CiteScore

5.80

自引率

5.60%

发文量

490

审稿时长

3-6 weeks

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.