HIV prevalence in men hospitalized for alcohol use disorder in Brazil: a silent epidemic?

Alcohol is widely consumed in Brazil, yet the prevalence of sexually transmitted infections (STIs)-particularly human immunodeficiency virus (HIV)-among individuals with alcohol use disorder (AUD) remains underexplored. This study aimed to assess HIV prevalence in a sample of hospitalized alcohol users undergoing detoxification and to explore associations with demographic and clinical factors. A consecutive sample of 445 men with AUD was recruited from a treatment unit in a capital city in southern Brazil between 2013 and 2020. HIV testing was conducted, and associations with sociodemographic variables and addiction severity were analyzed. The prevalence of HIV among patients with AUD was 4.04% (n = 18; 95% confidence interval: 2.4%-6.3%), substantially higher than the 0.46% prevalence reported in the general Brazilian population. No significant associations were found between HIV status and age, marital status, education, homelessness, incarceration or prior cocaine use (p > 0.05). Notably, none of the HIV-positive individuals reported prior injection drug use. The high HIV prevalence in this population underscores the urgent need for targeted prevention strategies, particularly in light of the established links between alcohol use, risky sexual behaviour and immune dysfunction. Tailored interventions are essential to effectively address this often-overlooked public health issue.