title: Risk factors for incident HIV infection among anonymous HIV testing site clients in Santos, Brazil: 1996-1999.
abstract: OBJECTIVE
  To determine temporal trends in HIV infection and risk factors among persons seeking anonymous HIV testing in Santos, Brazil.
  
  
  METHODS
  Data and sera from persons testing for HIV from 1996 to 1999 were used. Exposures were abstracted from HIV testing risk assessments. Stored HIV-positive sera were tested to identify recently acquired HIV infection using a serologic testing algorithm for detecting recent HIV seroconversion (STARHS). Independent associations between exposures and recently acquired HIV infection were determined using multivariate analyses.
  
  
  RESULTS
  Overall, estimated HIV incidence was 2.0% (95% CI: 1.1-3.5) for the 4-year period: 1.2% (95% CI: 0.5-2.6) in women and 2.7% (95% CI: 1.3-5.0) in men. Incidence increased among women but remained stable among men. Exposures independently associated with incident infection included a history of sex work (OR= 5.4, 95% CI: 1.5-18.7), concurrent syphilis infection (OR =4.1, 95% CI: 1.4-11.9), anal sex (OR = 3.0, 95% CI: 1.3-7.1), and having an HIV-positive sexual partner (OR= 1.4, 95% CI: 1.1-1.9).
  
  
  CONCLUSIONS
  This study further demonstrates the public health utility of using the STARHS for the assessment of emerging trends in the HIV epidemic. Results from this study will help to target appropriate prevention strategies directed toward at-risk populations in Santos.
authors.affiliation: Blood Centers of the Pacific, San Francisco, California, U.S.A.
authors.forename: Katia
authors.initials: K
authors.lastname: Alves
authors.forename: Kimberly Page
authors.initials: KP
authors.lastname: Shafer
authors.forename: Marcos
authors.initials: M
authors.lastname: Caseiro
authors.forename: George
authors.initials: G
authors.lastname: Rutherford
authors.forename: Maria Elvira
authors.initials: ME
authors.lastname: Falcao
authors.forename: Maria Cecília
authors.initials: MC
authors.lastname: Sucupira
authors.forename: Michael P
authors.initials: MP
authors.lastname: Busch
authors.forename: Bhupat D
authors.initials: BD
authors.lastname: Rawal
authors.forename: Ricardo S
authors.initials: RS
authors.lastname: Diaz
mesh_terms: D000328:Adult; D000465:Algorithms; D000554:Ambulatory Care Facilities; D035041:Anonymous Testing; D001938:Brazil / Q000453:epidemiology; D005260:Female; D015483:HIV Antibodies / Q000097:blood*; D015658:HIV Infections / Q000175:diagnosis* / Q000453:epidemiology* / Q000635:transmission; D015497:HIV-1 / Q000276:immunology*; D006801:Humans; D015994:Incidence; D008297:Male; D015999:Multivariate Analysis; D015995:Prevalence; D012307:Risk Factors; D012680:Sensitivity and Specificity; D012725:Sexual Behavior
chemical_list: D015483:HIV Antibodies