title: Efficient Identification of HIV Serodiscordant Couples by Existing HIV Testing Programs in South Brazil.
abstract: OBJECTIVE
  To examine the feasibility of identifying HIV negative at risk individuals in HIV serodiscordant couples, during voluntary HIV testing in South Brazil.
  
  
  METHODS
  We surveyed HIV testers at 4 public testing sites in Rio Grande do Sul. We obtained information on risk behaviors and sexual partnerships. HIV testing and testing for recent infection were performed; HIV prevalence and risk behaviors were assessed among subjects who reported having a steady partner who was HIV positive (serodiscordant group) and compared with the general testing population.
  
  
  RESULTS
  Among 3100 patients, 490 (15.8%) reported being in a steady relationship with an HIV positive partner. New HIV infections were diagnosed in 23% of the serodiscordant group (vs. 13% in the general population, p = 0.01); among newly positive subjects, recent HIV infections were more frequent (23/86, 26.7%) among testers with positive partners than among the general testing group (52/334; 15.6%; p = 0.016). Less than half of the serodiscordant testers reported having used a condom during the last sexual intercourse with their HIV-positive partner. Participants with inconsistent condom use with steady partner were four times more likely to test positive for HIV compared to those who reported always using condoms with the steady partner (OR: 4.2; 95% CI: 2.3 to 7.5).
  
  
  CONCLUSIONS
  It is highly feasible to identify large numbers of HIV susceptible individuals who are in HIV serodiscordant relationships in South Brazil testing sites. Condom use within HIV serodiscordant couples is low in this setting, suggesting urgent need for biomedical prevention strategies to reduce HIV transmission.
authors.affiliation: Division of HIV, Infectious Diseases, and Global Medicine, Department of Medicine, University of California San Francisco, San Francisco, CA, United States of America.
authors.forename: Christopher D
authors.initials: CD
authors.lastname: Pilcher
authors.affiliation: Laboratório de Pesquisa em HIV/AIDS, Centro de Ciências Biológicas e da Saúde, Universidade do Caxias do Sul, Caxias do Sul, Brazil.
authors.forename: Claudia Alquati
authors.initials: CA
authors.lastname: Bisol
authors.affiliation: Laboratório de Pesquisa em HIV/AIDS, Centro de Ciências Biológicas e da Saúde, Universidade do Caxias do Sul, Caxias do Sul, Brazil.
authors.forename: Machline Paim
authors.initials: MP
authors.lastname: Paganella
authors.affiliation: Division of HIV, Infectious Diseases, and Global Medicine, Department of Medicine, University of California San Francisco, San Francisco, CA, United States of America.
authors.forename: Snigdha
authors.initials: S
authors.lastname: Vallabhaneni
authors.affiliation: Laboratório de Pesquisa em HIV/AIDS, Centro de Ciências Biológicas e da Saúde, Universidade do Caxias do Sul, Caxias do Sul, Brazil.
authors.forename: Leonardo Rapone
authors.initials: LR
authors.lastname: da Motta
authors.affiliation: Laboratório de Pesquisa em HIV/AIDS, Centro de Ciências Biológicas e da Saúde, Universidade do Caxias do Sul, Caxias do Sul, Brazil.
authors.forename: Sergio Kakuta
authors.initials: SK
authors.lastname: Kato
authors.affiliation: Laboratório de Pesquisa em HIV/AIDS, Centro de Ciências Biológicas e da Saúde, Universidade do Caxias do Sul, Caxias do Sul, Brazil.
authors.forename: Rosa Dea
authors.initials: RD
authors.lastname: Sperhacke
authors.affiliation: Division of Clinical Immunology and Allergy, School of Medicine, University of São Paulo, São Paulo, Brazil.
authors.forename: Esper G
authors.initials: EG
authors.lastname: Kallas
authors.affiliation: Division of HIV, Infectious Diseases, and Global Medicine, Department of Medicine, University of California San Francisco, San Francisco, CA, United States of America.
authors.forename: Frederick M
authors.initials: FM
authors.lastname: Hecht
authors.affiliation: Retrovirlogy Lab, Paulista School of Medicine, Federal University of São Paulo, São Paulo, Brazil.
authors.forename: Ricardo Sobhie
authors.initials: RS
authors.lastname: Diaz
mesh_terms: D000328:Adult; D001938:Brazil / Q000453:epidemiology; D017280:Condoms / Q000706:statistics & numerical data; D005260:Female; D015658:HIV Infections / Q000097:blood / Q000175:diagnosis* / Q000453:epidemiology; D006801:Humans; D016015:Logistic Models; D008297:Male; D008403:Mass Screening / Q000379:methods* / Q000706:statistics & numerical data; D008875:Middle Aged; D015999:Multivariate Analysis; D015995:Prevalence; D012307:Risk Factors; D012725:Sexual Behavior / Q000706:statistics & numerical data*; D012747:Sexual Partners; D055815:Young Adult