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

Comparative morphology of the odoriferous system in three predatory stink bugs (Heteroptera: Asopinae)

The metathoracic scent system in Heteroptera produces and releases defensive volatile compounds. The odor produced by predatory stink bugs differs from phytophagous bugs, suggesting a variation between the structure and function of the metathoracic scent system. The anatomy and ultrastructure of the external thoracic efferent system, scent gland, and reservoir in the stink bug predators Brontocoris tabidus, Podisus nigrispinus, and Supputius cincticeps (Heteroptera: Pentatomidae: Asopinae) were studied. External thoracic efferent systems of B. tabidus, P. nigrispinus, and S. cincticeps have anatomical differences in ostiole, peritreme, and evaporatorium. Scent glands have a secretory portion and a reservoir. The reservoir has irregular projections, and in B. tabidus, it is enlarged and heart shaped, whereas in P. nigrispinus and S. cincticeps it is flattened and semicircular. The secretory tissue of the scent gland has well-developed globular secretory cells that produce odorous compounds, and the reservoir has a single layer of cubical cells lined by a cuticular intima. Secretory cells are type III with an intracellular end apparatus, well-developed nucleus with decondensed chromatin, and cytoplasm rich in mitochondria, lysosomes, granules, and smooth endoplasmic reticulum. These findings suggest that there are differences in physiological function of the odoriferous system and the volatile compounds produced by the secretory cells, which may indicate variation in defensive behavior of these species