Introduction Mortality rates among the homeless are greater than the general population, presenting a high prevalence of comorbidities and exposure to risk factors. Housing insecurity has been associated with a high risk of sexual and physical exploitation and involvement in illicit activities as means of survival, contributing to the acquisition of sexually transmitted infections (STI), such as human immunodeficiency virus (HIV). The aim of this study, cross sectional, was to identify risk behaviours for infection by HIV among the homeless in Goiás, Central Brazil.
Methods Between September 2014 to August 2015, 356 individuals served by a public shelter in the City of Goiânia, Central Brazil, were interviewed and tested for HIV. Multivariable logistic regression model was used to identify variables associated with HIV infection.
Results Of the 356 recruited individuals, 81.2% were male, young (median: 36 years), with a low level of education (median: 7 years of study), self-reported mixed race (60.4%), single (59.6%) and religious (82.3%). Of the total, 3.9% (95% CI: 2.2%–6.4%) were HIV positive. Individuals infected by HIV reported greater risk behaviours, such as: homosexuality/bisexuality (35.7%), consumption of illicit drugs (92.9%), sexual relations with HIV carriers (45.5%), and a history of STI (61.5%) (all p≤0,05). Logistic regression analysis revealed that the number of sexual partners (adjusted odds ratio [AOR]: 6.49; p=0.02) and a history of sexual relations with HIV carriers (AOR: 7.40; p=0.00) were predictors for HIV infection.
Conclusion The results of this study support high rates of risk behaviours for HIV infection among the homeless, evidence of the necessity of actions involving the prevention and treatment of STI on the streets and in temporary and permanent housing. Furthermore, it is extremely important to reach out to intersectoral networks (education, justice, culture and health), with the goal of reintegrating an individual into the job market, supporting the restoration of family and social ties, as well as autonomous living.