HIV prevalence among female sex workers, drug users and men who have sex with men in Brazil: A Systematic Review and Meta-analysis

<p>Abstract</p> <p>Background</p> <p>The Brazilian response towards AIDS epidemic is well known, but the absence of a systematic review of vulnerable populations ─ men who have sex with men (MSM), female sex workers (FSW), and drug users (DU) remains a main gap in the available literature. Our goal was to conduct a systematic review and meta-analysis of studies assessing HIV prevalence among MSM, FSW and DU, calculating a combined pooled prevalence and summarizing factors associated the pooled prevalence for each group.</p> <p>Methods</p> <p>Nine electronic databases (MEDLINE via PubMed, EMBASE, Cochrane CENTRAL, AIDSLINE, AMED, CINAHL, TOXNET, SciELO, and ISI-Web of Science) were searched for peer-reviewed papers published in English, French, Spanish or Portuguese, from 1999 to 2009. To be included in the review, studies had to measure HIV prevalence and/or incidence as the primary outcome among at least one specific population under analysis.</p> <p>Results</p> <p>The studies targeting the three populations analyzed mostly young participants aged 30 years or less. Among FSW, eight studies were selected (3,625 participants), consistently identifying higher condom use with sexual clients than with occasional and stable partners. The combined HIV prevalence for FSW was 6.2 (95% CI: 4.4-8.3). Ten studies targeting MSM were identified (6,475 participants). Unprotected anal intercourse was commonly reported on those studies, but with great variability according to the nature of the relationship - stable vs. occasional sex partners - and sexual practice - receptive vs. insertive anal sex. Pooled HIV prevalence for MSM was 13.6 (95% CI: 8.2-20.2). Twenty nine studies targeting DU were identified (13,063 participants). Those studies consistently identified injection drug use and syringe/needle sharing as key predictors of HIV-infection, as well as engagement in sex work and male-to-male sex. The combined HIV prevalence across studies targeting DU was 23.1 (95% CI: 16.7-30.2).</p> <p>Conclusions</p> <p>FSW, MSM and DU from Brazil have a much risk of acquiring HIV infection compared to the general population, among which HIV prevalence has been relatively low (~0.6%). Those vulnerable populations should be targeted by focused prevention strategies that provide accurate information, counseling and testing, as well as concrete means to foster behavior change (e.g. access to condoms, drug abuse treatment, and clean syringes in the case of active injecting drug users), tailored to gender and culture-specific needs. Programs that provide these services need to be implemented on public health services throughout the country, in order to decrease the vulnerability of those populations to HIV infection.</p

Níveis de fósforo, cobre, cobalto e zinco em bubalinos (Bubalus bubalis) na Ilha de Marajó, Estado do Pará

Foram estudados 104 bubalinos, adultos, sem distinção de raça e sexo, criados extensivamente, sem suplementação, em pastagens nativas de baixa qualidade nutricional, dos municípios de Breves, Cachoeira do Arari, Salvaterra e Soure, Ilha de Marajó, Pará. Realizou-se coleta de amostras de fígado, osso e sangue de 26 animais do município de Salvaterra, 38 animais do município de Soure, 20 animais do município de Breves e 20 animais do município de Cachoeira do Arari. Foram realizadas determinações dos teores de fósforo, no soro sanguíneo e no osso, do percentual de cinzas e da densidade específica no tecido ósseo, e de cobalto, cobre e zinco no tecido hepático. Observou-se que a média das concentrações de fósforo no soro sanguíneo (6,26mg/dl) e no osso (10,77%), a percentagem de cinzas (60,87%) e a densidade específica (1,59g/ml) do osso foram inferiores aos níveis críticos estabelecidos para bovinos, caracterizando deficiência de fósforo. As concentrações médias de cobre (5,57ppm), e zinco (27,05ppm) foram consideradas baixas quando comparadas com valores de referência, caracterizando deficiência para estes elementos. No caso do cobalto, quando se considerou os valores detectáveis e não detectáveis pela metodologia observou-se que 51,92% dos animais apresentaram níveis inferiores aos de referência, demonstrando a ocorrência da deficiência de cobalto nesses animais. Ressalta-se que as deficiências de cobre e zinco demonstraram uma maior gravidade já que todos os animais estudados apresentaram níveis deficientes nesses elementos