HIV Seroprevalence and Risk Factors in a Brazilian Prison

The burden of the AIDS epidemic in Brazil is characterized by high prevalence rates in specific groups, including prison populations. Reports o HIV seroprevalence rates from several, prisons in different countries have varied widely. Those rates have usually reflected the HIV seroprevalence in the community served by the correctional facility studied and the risk factors of inmates for HIV infection. The present study was designed: 1) to determine the HIV seroprevalence among inmates of Casa de Detenção de São Paulo; 2) to identify independent risk factors for HIV acquisition; and 3) to determine the relevance of transmission of HIV infection within the prison. From December 20, 1993, through January 5, 1994, 780 inmates were interviewed using a standardized questionnaire and had their blood drawn for HIV testing by ELISA with confirmatory Western Blot. Out of 766 inmates tested, 637 (83.1%) were negative for HIV, 105 (13.7%) were positive, and 24 (3.1%) had indeterminate test results. Multivariate logistic regression analysis identified the following variables as independent risk factors for HIV seropositivity: 1) age less than 29 years-old; 2) previous incarceration in Casa de Detençã; 3) more than one sexual partner in the last year in Casa de Detençã; and 4) intravenous drug use before admission to Casa de Detençã. We conclude from this study that HIV infection among prisoners is high (13.7%) and that several risk factors are responsible. Of these, intravenous drug use before imprisonment is the most likely factor, but HIV transmission can also occur during incarceration.