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HIV and sexually transmitted infections at the borderlands: situational analysis of sexual health in the Brazilian Amazon
  1. Adele Benzaken1,2,
  2. Meritxell Sabidó3,4,
  3. Enrique Galban5,
  4. Daniel Lúcio Rodrigues Dutra1,
  5. André Luiz Leturiondo1,
  6. Philippe Mayaud6
  1. 1Fundação Alfredo da Matta, Manaus, Amazonas, Brazil
  2. 2Fiocruz Amazônia, Instituto Leônidas e Maria Deane, Manaus, Amazonas, Brazil
  3. 3Research and Public Health Department, Fundació Sida i Societat, Barcelona, Spain
  4. 4CIBER de Epidemiología y Salud Pública (CIBERESP), Spain
  5. 5Facultad de Medicina Calixto García, Habana, Cuba
  6. 6Clinical Research Department, Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, UK
  1. Correspondence to Dr Meritxell Sabidó, Fundació Sida i Societat, Ribes 91, baixos, 08013 Barcelona, Spain; msabido{at}


Objectives The borderlands are considered areas of increased vulnerability to HIV and sexually transmitted infections (STI). The study aimed to determine the STI/HIV prevalence and risk factors in the triple-border area of the Brazilian Amazon.

Methods A situational analysis of sexual health was conducted in three cities of the Alto Solimões region. This multicomponent research approach included key informant interviews, participant observations and mapping of places where people meet sexual partners. Volunteers recruited from the ‘hot spots’ in each city were invited for interview and STI/HIV testing.

Results Over 6 months, 598 participants were recruited, 285 men of median age 28 years (IQR, 23–37) and 313 women of median age 29 years (IQR, 24–37). Overall, 49.3% reported a casual partner during the past 3 months, but only 38.5% reported consistent condom use. The respective prevalences in men and women were Neisseria gonorrhoeae (1.1% and 0.3%), Chlamydia trachomatis (1.4% and 4.8%), high-risk human papillomavirus (14.4% and 24.0%), active syphilis (3.2% and 2.6%), herpes simplex virus type-2 (51.1% and 72.1%), hepatitis B virus (by hepatitis B virus surface antigen) (7.5% and 4.6%), hepatitis C virus (0.7% and 0.7%) and HIV (1.4% and 0.0%). Risk factors for viral STIs included female sex and age.

Conclusions While the main conditions that contribute to the spread of HIV are in place in the triple-border area, the prevalence of bacterial STIs and HIV are still relatively low, providing a window of opportunity for interventions.

  • HIV
  • sexually transmitted infections
  • rapid assessment methods
  • sexual behaviour
  • measurement
  • risk factors
  • vulnerable groups
  • Brazil
  • transmission dynamics
  • syphilis
  • syndromic management
  • sexual health
  • HIV testing
  • sexual health hepatitis
  • epidemiology (general)
  • epidemiology (clinical)
  • evidence-based medicine
  • RTI
  • STD control
  • HSV-2
  • epidemiology

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  • Funding The study was supported by a grant from the Fundação de Amparo à Pesquisa do Estado do Amazonas/FAPEAM.

  • Competing interests None.

  • Patient consent Obtained.

  • Ethics approval Ethical review committee of the Fundação Alfredo da Matta (FUAM), Manaus, Brazil.

  • Provenance and peer review Not commissioned; externally peer reviewed.