Abstract Body


HIV incidence estimation is critical for monitoring the HIV epidemic dynamics, transmission trends and effectiveness of public health prevention interventions. We aimed to identify HIV recent infection (RI) cases, its associated factors and to estimate annualized HIV incidence using recency testing among sexual and gender minorities (SGM) undergoing HIV testing in Brazil and Peru.


Cross-sectional multicenter study in HIV testing services in Brazil (6 cities) and Peru (7 cities) from Jan/21-May/22. Inclusion criteria: 18+ years, cisgender men who have sex with men (cis-MSM), transgender women (TGW) and other SGM. Exclusion criteria: HIV+, current PrEP/PEP use. Rapid HIV 4th generation test was used; dried blood spots (DBS) were obtained from the HIV+ cases. We identified HIV RI using the Maxim HIV-1 Lag-Avidity EIA assay as part of RI testing algorithm (RITA), which includes HIV-1 RNA < 400 copies/mL, CD4 count < 200 cells/mm3, and prior/current ART use (to exclude long-standing infections). We assumed mean duration of recent infection of 214 days (95%CI: 193-237) and a false recent ratio (FRR) of 0%. Annualized HIV incidence was calculated per country using the WHO mathematical formula. Multivariable logistic regression models per country were used to estimate factors associated with HIV RI.


Of 7362 individuals approached, 7116 (97%) were eligible and enrolled [Brazil: 4700 (66%); Peru 2416 (34%)]; 86% cis-MSM, 11% TGW, 3% other SGM. Median age was 27 years (IQR:23-34), 64% ≤ 30 years, 72%≤ secondary education, 74% low income. In the prior 6 months, 35% reported >5 sex-partners, 79% condomless sex, 20% STI symptoms, 14% sex work, 27% substance use and 57% binge drinking. HIV prevalence was 13.7% [N&#3f971; Brazil: 470/4700 (10.0%); Peru: 501/2416 (20.7%)]. DBS were available for 959 (99%); 165 (17.2%) were classified as recently infected [Brazil: 81/4700 (1.7%), Peru: 84/2416 (3.5%)]. The overall annualized HIV incidence rate was 4.64% (95% CI: 4.11-5.17); Brazil: 3.30% (95% CI: 2.76-3.84); Peru: 7.59% (95% CI: 6.40-8.78). Multivariable models showed that in both countries engaging in condomless sex increased the odds of HIV RI and in Peru being 30 years or younger (see Table).


High levels of HIV prevalence, HIV RI and annualized HIV incidence among SGM in Brazil and Peru highlight the burden of the HIV epidemic among these populations. Public Heath policies and interventions to increase PrEP access in Latin America are urgently needed.

Factors associated with HIV recent infection among sexual and gender monorities from Brazil and Peru: ImPrEP Seroincidence Study.