Background: BED-EIA HIV-1 Incidence Test (BED-CEIA) has been described as a tool to discriminate recent (RS)
from long-term (LTS) seroconversion of HIV-1 infection, contributing to a better understanding of the dynamics of
the HIV/AIDS epidemic over time. This study determined the prevalence, estimated incidence and HIV-1 subtype
infection among individuals seeking testing in Voluntary Counseling and Testing centers (VCTs) from Rio de
Janeiro, Brazil.
Methods: Demographics and behavioral data were obtained from 434 individuals, diagnosed as HIV-positive
among 9,008 volunteers screened from November 2004 to October 2005 in three VCTs located in the Rio de
Janeiro Metropolitan area, Brazil. BED-CEIA protocol was performed to identify RS. DNA samples from RS and a
subset of LTS (under a proportion of 1:2) were selected for gp120 C2-V3 and pol (protease and reverse
transcriptase) regions genomic sequencing.
Results: Overall HIV-1 prevalence was 4.8%. Sixty-one of 434 seropositive individuals were classified as RS,
corresponding to an incidence rate of 1.68%/year (95%CI 1.26% -2.10%). Estimated incidence between Men Who
Have Sex with Men (MSM) was 11 times higher than among heterosexual men and 55% of the new cases were
identified in volunteers aged 25-40 years. A similar distribution of different HIV-1 subtypes was found among RS
and LTS.
Conclusions: Our data suggest that prevention for MSM remains a challenge and efforts focusing on prevention
targeting this population should be prioritized. No significant changes in HIV-1 subtypes were observed among the
RS and LTS subgroups. One case of HIV-1 AUK (pol)/A (env) recombinant genome was detected for the first time
in Brazil
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