This is an R21 application. With over 600,000 estimated HIV infections, Brazil accounts for over half of the estimated HIV cases in Latin America. Injection drug users (IDUs) make up an increasing proportion of the new HIV infections in Brazil; there is also a clear relationship between illicit drug use and HIV sexual risk in Brazil. While the success of Brazil providing free access to antiretroviral therapy to all HIV + individuals since 1997 has been well documented, there are important gaps in Brazil's HIV prevention system that need to be addressed. Of particular note is the need to increase the use of HIV/AIDS diagnostic and counseling services among drug users. Recent advances in oral HIV testing makes this goal more feasible. OraSure (Epitope, Beaverton, OR) testing is being widely and effectively used in the U.S but is currently not being used in Brazil. However, recent research by our team suggests that there may be unintended negative consequences associated with oral HIV testing, specifically, those testing with oral methods are more likely subsequently to believe that HIV can be transmitted through saliva (Clair, et al., in press). Therefore the specific aims of the proposed project are 1) To make oral HIV testing available to street drug users in Rio De Janeiro and to determine the comparative change in testing rates as a result of making oral testing available in three distinct locations in the Rio area. 2)To determine the factors associated with individual willingness to test using oral testing methods and the impact of oral testing on their likelihood of returning for their posttest counseling session. 3) To compare those individuals who have never received an HIV test prior to the current project with those individuals who have previously been tested for HIV. 4) To compare the effectiveness of limiting mis-messaging of an enhanced counseling and testing protocol based on verbal and experiential messages against a standard oral testing and counseling protocol based only on verbal messages.
| Singer, Merrill; Clair, Scott; Malta, Monica et al. (2011) Doubts remain, risks persist: HIV prevention knowledge and HIV testing among drug users in Rio de Janeiro, Brazil. Subst Use Misuse 46:511-22 |
