Introduction The goal to end HIV/aids pandemic by 2030 has set a number of policies such as 90% of people living with HIV knowing their HIV status, therefore early diagnosisis is fundamental as component of a comprehensive HIV prevention. In Brazil, 33.6% of interviewees in the general population reported ever been tested for HIV in 2005. Little is known about HIV testing among illicit polysubstance users (PSUs). We aim to assess correlates of never been tested for HIV among illicit PSUs.
Methods A cross-sectional study recruited 3.449 PSUs in 10 Brazilian cities through respondent driven sampling in 2009. Data was collected using computer-assisted self-interview. To determine correlation, multivariate logistic regression with adjusted odds ratio (aOR, 95% confidence intervals) was performed. Estimates were weighted by the inverse of the participant social network size.
Results Overall, 56% had never tested for HIV. Statistically significant odds ratios of never tested were: being male 0.43 (0.36–0.51), non-white 0.75 (0.64–0.88), < = 30 years old 0.65 (0.57–0.76), income <US$200 (0.71, 0.60–0.86), no-income 0.62 (0.51–0.74), < = 10 years of education (0.82, 0.69–0.98), and no formal education (0.48, 0.35–0.65). Never testing for HIV were also correlated to the following factors: sex exchange (0.85, 0.73–0.98), disagree that sex without condom can transmit HIV (0.30, 0.18–0.50) and that people apparently healthy should be HIV infected (0.53, 0.36–0.77); not receiving counselling on STIs in the last 12 months before the interview (0.73, 0.61–0.88), not knowing free HIV testing services (0.22, 0.19–0.26), and never had syphilis in lifetime (0.77, 0.60–0.99).
Conclusion There is a need to increase access to and uptake of HIV testing among PSUs in Brazil. The availability of self-testing is a possibility to further expand early diagnosis of HIV. However, sociodemographic disparities, stigma and discrimination among PSUs need to be addressed before implementation.
Disclosure of interest statement This study was funded by the Brazilian Ministry of Health/Department of SDT/AIDS and viral hepatitis, with technical advisor from CDC Brazil. The first author is supported by a grant from the Brazilian National Research Council (CNPq) for his PhD studies.
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