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Introdução: A incorporação da PrEP como política de saúde pública ampliou a testagem de IST no Brasil. O país é um dos mais afetados pela sífilis a nível global, no entanto carece de dados populacionais sobre clamídia (CT) e gonorreia (NG). O ImPrEP foi um estudo que avaliou a implementação da PrEP no Brasil, México e Peru. No Brasil, incluiu 3.928 HSH e TMT. O objetivo desse trabalho é explorar dados relacionados às vulnerabilidades para IST no Brasil entre participantes acompanhados no ImPrEP. Métodos: De 2018 a 2020, incluímos HSH e TMT ≥ 18 anos, com seguimento até 2021. Exames para IST bacterianas foram coletados na inclusão e trimestralmente (sífilis) ou anualmente (CT/NG). Consideramos todos os participantes do ImPrEP no Brasil com realização de pelo menos um exame para qualquer IST bacteriana (sífilis, CT/NG) durante o estudo. Realizamos análise descritiva das frequências de IST por unidade federativa (UF) e das características sociodemográficas e comportamentais dos participantes. Resultados: Incluímos 3.478 participantes de 8 UF de todas as regiões do país, com maior concentração no Rio de Janeiro (RJ) (30%) e São Paulo (SP) (27%). Desses, 25% tinham 18-24 anos, 51% eram não brancos, 80% com escolaridade pós-secundária, 96% HSH e 4% TMT. Na inclusão, a prevalência de sífilis foi maior no Distrito Federal (DF) (17%) e no Amazonas (AM) (15.6%), enquanto CT/NG não apresentaram diferenças significativas entre UF. Maior incidência de sífilis foi identificada em Santa Catarina (SC) (15.8/100 pessoas-ano), DF (14.8/100 pessoas-ano) e Bahia (BA) (13.5/100 pessoas-ano). Após iniciar PrEP, 35% dos participantes foram diagnosticados com alguma IST bacteriana, sem associação com a UF de origem. Em SC, participantes reportaram mais frequentemente múltiplas parcerias sexuais (53%), no entanto menos relações anais receptivas sem uso de preservativo (39%). O uso excessivo de álcool foi mais frequente em AM (82%) e BA (80%), enquanto o uso de drogas estimulantes ocorreu mais no DF (35%), SP (24%) e RJ (18%). Conclusão: Nossos achados contribuem para caracterização da prevalência de IST entre usuários de PrEP de diferentes estados brasileiros, trazendo dados inéditos sobre infecção por CT/NG nessa população. Considerando a diversidade territorial e cultural do Brasil, vulnerabilidades distintas podem estar envolvidas na dinâmica de transmissão de IST, e a implementação de políticas públicas de prevenção para o HIV e IST deve ser adaptada às realidades locais.

Summary: Background: By October 30, 2022, 76,871 cases of mpox were reported worldwide, with 20,614 cases in Latin America. This study reports characteristics of a case series of suspected and confirmed mpox cases at a referral infectious diseases center in Rio de Janeiro, Brazil. Methods: This was a single-center, prospective, observational cohort study that enrolled all patients with suspected mpox between June 12 and August 19, 2022. Mpox was confirmed by a PCR test. We compared characteristics of confirmed and non-confirmed cases, and among confirmed cases according to HIV status using distribution tests. Kernel estimation was used for exploratory spatial analysis. Findings: Of 342 individuals with suspected mpox, 208 (60.8%) were confirmed cases. Compared to non-confirmed cases, confirmed cases were more frequent among individuals aged 30–39 years, cisgender men (96.2% vs. 66.4%; p

Background Trans women face disproportionate burden of adverse health outcomes, including mental health issues. Very little is known about suicidal behavior among trans women in low- and middle-income settings, such as Brazil. We aimed to estimate the prevalence of lifetime suicidal behavior and to identify its associated factors among Brazilian trans women. Methods This was a cross-sectional study conducted among 345 trans women living in Rio de Janeiro, Brazil. We examined the prevalence of suicidal behavior (ideation and suicide attempt) and its associated factors using stepwise backward Poisson regression analysis with robust variance. Results Suicidal ideation was present among 47.25% of participants, and the prevalence of lifetime suicide attempt was 27.25%. Trans women with prior physical violence perpetrated by a family member had significantly higher prevalence of suicidal ideation (adjusted prevalence ratios [aPR]1.37), whereas those who reported sex work had lower prevalence ratio of suicidal ideation (aPR 0.76). Suicide attempt was significantly associated with living alone (aPR 1.48), physical violence by a casual partner (aPR 1.92), and sexual violence by a family member (aPR 1.69). Depression was significantly associated with both outcomes (aPR 1.90 for suicidal ideation and aPR 2.21 for suicide attempt). Conclusion Suicidal behavior prevalence rates among Brazilian trans women were alarming and directly linked to violence and poor mental health. Effective mental health and public health policies addressing violence against trans women are urgently needed to prevent suicidal behavior among this highly vulnerable population.

Objectives: To describe the access to the interventions for the prevention of Human Immunodeficiency Virus (HIV) mother to child transmission and mother to child transmission rates in the outskirts of Rio de Janeiro, from 1999 to 2009. Methods: This is a retrospective cohort study. Prevention of HIV mother to child transmission interventions were accessed and mother to child transmission rates were calculated. Results: The study population is young (median: 26 years; interquartile range: 22.0–31.0), with low monthly family income (40.4% up to one Brazilian minimum wage) and schooling (62.1% less than 8 years). Only 47.1% (n = 469) knew the HIV status of their partner; of these women, 39.9% had an HIV-seronegative partner. Among the 1259 newborns evaluated, access to the antenatal, intrapartum and postpartum prevention of HIV mother to child transmission components occurred in 59.2%, 74.2%, and 97.5% respectively; 91.0% of the newborns were not breastfed. Overall 52.7% of the newborns have benefited from all the recommended interventions. In subsequent pregnancies (n = 289), 67.8% of the newborns received the full package of interventions. The overall rate of HIV vertical transmission was 4.7% and the highest annual rate occurred in 2005 (7.4%), with no definite trend in the period. Conclusions: Access to the full package of interventions for the prevention of HIV vertical transmission was low, with no significant trend of improvement over the years. The vertical transmission rates observed were higher than those found in reference services in the municipality of Rio de Janeiro and in the richest regions of the country. Keywords: HIV, HIV vertical transmission, Antiretroviral chemoprophylaxis, Cohort studies, Brazil

Many human cancers develop as a result of exposure to risk factors related to the environment and ways of life. The aim of this study was to estimate attributable fractions of 25 types of cancers resulting from exposure to modifiable risk factors in Brazil. The prevalence of exposure to selected risk factors among adults was obtained from population-based surveys conducted from 2000 to 2008. Risk estimates were based on data drawn from meta-analyses or large, high quality studies. Population-attributable fractions (PAF) for a combination of risk factors, as well as the number of preventable deaths and cancer cases, were calculated for 2020. The known preventable risk factors studied will account for 34% of cancer cases among men and 35% among women in 2020, and for 46% and 39% deaths, respectively. The highest attributable fractions were estimated for tobacco smoking, infections, low consumption of fruits and vegetables, excess weight, reproductive factors, and physical inactivity. This is the first study to systematically estimate the fraction of cancer attributable to potentially modifiable risk factors in Brazil. Strategies for primary prevention of tobacco smoking and control of infection and the promotion of a healthy diet and physical activity should be the main priorities in policies for cancer prevention in the country.

OBJECTIVES: To assess the temporal trends in incidence of AIDS-defining opportunistic illnesses in an urban cohort of a middle-income country. METHODS: HIV infected patients aged ≥ 18 years at cohort entry were included in this analysis. We calculated incidence rates per 1000 persons-years of observation for the first opportunistic illness presented after cohort enrollment, from 1987 to 2012. Trends for overall and specific opportunistic illnesses were tested and incidence rate ratios for the most recent calendar period were calculated as the ratio between the incidence rate observed in the most recent period of the study (2009-2012) and the incidence rate observed in first period of the study (1987-1990). RESULTS: Overall, 3378 patients were included in this analysis; of which 1119 (33%) patients presented an opportunistic illness during follow up. Incidence rates of all opportunistic illnesses decreased over time, and the overall opportunistic illness incidence rates fell from 295.4/1000 persons-years in 1987-1990 to 34.6/1000 persons-years in 2009-2012. Tuberculosis, esophageal candidiasis, cerebral toxoplasmosis and Pneumocystis jirovecii pneumonia were the most incident opportunistic illnesses in the cohort. Tuberculosis had the highest incidence rate in the study period. The peak in tuberculosis incidence occurred in 1991-1993 (80.8/1000 persons-years). Cerebral toxoplasmosis was the third most incident opportunistic illness in the study, with a peak of incidence of 43.6/1000 persons-year in 1987-1990. CONCLUSIONS: All opportunistic illnesses incidence rates decreased over the years but they still occur in an unacceptable frequency. Tuberculosis co-infection among HIV-infected persists as an important challenge for health care professionals and policy makers in our setting. Impressively high rates of cerebral toxoplasmosis were found suggesting that its incidence among HIV-infected is linked to the high prevalence of Toxoplasma gondii infection in the general population.

With the introduction of combined active antiretroviral therapy and the improved survival of HIV-infected patients, degenerative diseases and drug toxicity have emerged as long-term concerns. We studied the prevalence of decreased glomerular filtration rate (GFR) and associated risk factors in a cohort of HIV-infected patients from a middle-income country. Our cross-sectional study included all adult patients who attended an urban outpatient clinic in 2008. GFR was estimated using the CKD-EPI equation. The prevalence ratio (PR) of decreased GFR (defined as

ObjectiveTo compare the effectiveness of first-line combination antiretroviral therapy (cART) between premenopausal and postmenopausal women.MethodsART-naïve women initiating cART between January 2000/June 2010 at the Instituto de Pesquisa Clínica Evandro Chagas Cohort were studied. Women were defined as postmenopausal after 12 consecutive months of amenorrhea. CD4 cell counts and HIV-1 RNA viral load (VL) measurements were compared between pre- and postmenopausal at 6, 12 and 24 months after cART initiation. Women who modified/discontinued a drug class or died due to an AIDS defining illness were classified as ART-failures. Variables were compared using Wilcoxon test, χ2 or Fisher's exact test. The odds of cART effectiveness (VLResultsAmong 383 women, 328 (85%) were premenopausal and 55 (15%) postmenopausal. Median pre cART CD4 counts were 231 and 208 cells/mm(3) (p = 0.14) in pre- and postmenopausal women, respectively. No difference in the median pre cART VL was found (both 4.8 copies/mL). Median CD4 changes were similar at 6 and 12 months. At 24 months after cART initiation, CD4 changes among postmenopausal women were significantly lower among premenopausal women (p = 0.01). When the analysis was restricted to women with VLConclusionMenopause status at the time of first-line cART initiation does not impact CD4 cell changes at 24 months among women with a virologic response. No relationship between menopause status and virologic response was observed.

Following the 2022 global mpox outbreak, diagnoses decreased worldwide, even in settings with limited vaccine access. In 2023–2024, a new outbreak emerged in Rio de Janeiro, Brazil, highlighting the importance of continuous surveillance, preventive measures such as vaccination in vulnerable populations, and treatment options, emphasizing equitable global health technology distribution. [ABSTRACT FROM AUTHOR]

Trans women are specifically vulnerable to interpersonal violence. Being perceived as the gender that a transgender person identifies with, defined in some contexts as passing, may influence violence ratings. The EVAS (Violence and Health Self-Evaluation) study was a cross-sectional study that enrolled 121 trans women between 2019 and 2020 in Rio de Janeiro, Brazil, aiming to investigate the association between self-reported passing and different types of interpersonal violence. We enrolled 121 participants who had a median age of 36.3 (interquartile range [IQR] 13.7). Most of them were Black/mixed (78.5%) and had at least a high school education (63%). Most participants considered themselves as trans women (71.9%). Their median monthly income was $252.50 (IQR $302.50). Only 40 (33.1%) trans women had a main partner. Trans women with high passing had a higher prevalence of family violence and lower prevalence of observed police violence, violence in open and closed public spaces. Participants that reported a high passing had higher prevalence of family violence (p =.016); moreover, they reported observing less frequently police violence in the neighborhood they lived in for the last 12 months (p =.012) as well as having lower rates of suffering violence. Trans women who reported high passing had 81% (56%-92%) lower chance of suffering violence in open public places more than once, while prior racism experience had a positive association with violence in an open public place (aOR = 3.93, 95% CI [.48, 15.40]). Passing seems to protect from violence in public spaces, whilst it increases family violence. Data also suggest that observing police violence and violence in close public spaces. There is an urgent need to better understand the complex relationships around violence and foster its prevention. [ABSTRACT FROM AUTHOR]

A dengue pode estar associada a variáveis de nível individual, como escolaridade, aumentando o risco de adoecimento. O objetivo deste trabalho é analisar as disparidades da mortalidade por dengue entre os menos e mais escolarizados no Brasil entre os anos de 2010 e 2018. Este é um estudo do tipo ecológico retrospectivo das diferenças na taxa de mortalidade por dengue entre menos e mais escolarizados no Brasil, através das taxas de mortalidade por dengue geral, por idade, sexo e Unidade Federativa (UF). Um procedimento de bootstrap e imputação múltipla para a variável escolaridade foram implementados de modo a considerar a estrutura multinível em cada UF dos dados ao longo dos anos. Para cada banco agregado gerado, foi ajustado um modelo de Poisson multinível. A melhoria na escolaridade da população brasileira não refletiu na diminuição da mortalidade por dengue. Houve um aumento na taxa de mortalidade por dengue no Brasil e um crescimento da diferença de taxas de mortalidade entre menos e mais escolarizados. Independentemente do processo de imputação, os resultados mostraram maiores taxas de mortalidade por dengue entre os menos escolarizados. A baixa escolaridade afetou de forma mais pronunciada os mais jovens.

BackgroundLong-acting injectable cabotegravir (CAB-LA) for preexposure prophylaxis (PrEP) has proven efficacious in randomized controlled trials. Further research is critical to evaluate its effectiveness in real-world settings and identify effective implementation approaches, especially among young sexual and gender minorities (SGMs). ObjectiveImPrEP CAB Brasil is an implementation study aiming to generate critical evidence on the feasibility, acceptability, and effectiveness of incorporating CAB-LA into the existing public health oral PrEP services in 6 Brazilian cities. It will also evaluate a mobile health (mHealth) education and decision support tool, digital injection appointment reminders, and the facilitators of and barriers to integrating CAB-LA into the existing services. MethodsThis type-2 hybrid implementation-effectiveness study includes formative work, qualitative assessments, and clinical steps 1 to 4. For formative work, we will use participatory design methods to develop an initial CAB-LA implementation package and process mapping at each site to facilitate optimal client flow. SGMs aged 18 to 30 years arriving at a study clinic interested in PrEP (naive) will be invited for step 1. Individuals who tested HIV negative will receive mHealth intervention and standard of care (SOC) counseling or SOC for PrEP choice (oral or CAB-LA). Participants interested in CAB-LA will be invited for step 2, and those with undetectable HIV viral load will receive same-day CAB-LA injection and will be randomized to receive digital appointment reminders or SOC. Clinical appointments and CAB-LA injection are scheduled after 1 month and every 2 months thereafter (25-month follow-up). Participants will be invited to a 1-year follow-up to step 3 if they decide to change to oral PrEP or discontinue CAB-LA and to step 4 if diagnosed with HIV during the study. Outcomes of interest include PrEP acceptability, choice, effectiveness, implementation, and feasibility. HIV incidence in the CAB-LA cohort (n=1200) will be compared with that in a similar oral PrEP cohort from the public health system. The effectiveness of the mHealth and digital interventions will be assessed using interrupted time series analysis and logistic mixed models, respectively. ResultsDuring the third and fourth quarters of 2022, we obtained regulatory approvals; programmed data entry and management systems; trained sites; and performed community consultancy and formative work. Study enrollment is programmed for the second quarter of 2023. ConclusionsImPrEP CAB Brasil is the first study to evaluate CAB-LA PrEP implementation in Latin America, one of the regions where PrEP scale-up is most needed. This study will be fundamental to designing programmatic strategies for implementing and scaling up feasible, equitable, cost-effective, sustainable, and comprehensive alternatives for PrEP programs. It will also contribute to maximizing the impact of a public health approach to reducing HIV incidence among SGMs in Brazil and other countries in the Global South. Trial RegistrationClinicaltrials.gov NCT05515770; https://clinicaltrials.gov/ct2/show/NCT05515770 International Registered Report Identifier (IRRID)PRR1-10.2196/44961

BackgroundThe HIV epidemic continues to disproportionately burden marginalized populations despite the availability of effective preventive and therapeutic interventions. Transgender women are severely affected by HIV worldwide including in Brazil and other low- and middle-income countries, with evidence of increasing new infections among young people. There is an urgent need for youth-specific HIV prevention and care interventions for young transgender women in Brazil. ObjectiveThis study aims to (1) address stigma in the Brazilian public health system and (2) reduce barriers to HIV care and prevention with systems navigation among young transgender women aged 18-24 years in Rio de Janeiro, Brazil. MethodsThe Brilhar e Transcender (BeT) study is a status-neutral, peer-led, single-arm digital intervention study enrolling 150 young transgender women in Rio de Janeiro, Brazil. The intervention was pilot tested and refined using data from a formative phase. The BeT intervention takes place over 3 months, is delivered remotely via mobile phone and in person by peers, and comprises three components: (1) BeT sessions, (2) digital interactions, and (3) automated messages. Eligibility criteria include identifying as transgender women, being aged 18-24 years, speaking in Portuguese, and living in the Rio de Janeiro metropolitan area in Brazil. The primary outcomes are HIV incidence, pre-exposure prophylaxis uptake, linkage to HIV care, and viral suppression. Primary outcomes were assessed at baseline and quarterly for 12 months. Participants respond to interviewer-based surveys and receive tests for HIV and sexually transmitted infections. ResultsThe study has been approved by the Brazilian and the US local institutional review boards in accordance with all applicable regulations. Study recruitment began in February 2022 and was completed in early July 2022. Plans are to complete the follow-up assessment of study participants on July 2023, analyze the study data, and disseminate intervention results by December 2023. ConclusionsInterventions to engage a new generation of transgender women in HIV prevention and care are needed to curb the epidemic. The BeT study will evaluate a digital peer-led intervention for young transgender women in Brazil, which builds on ways young people engage in systems and uses peer-led support to empower transgender youth in self-care and health promotion. A promising evaluation of the BeT intervention may lead to the availability of this rapidly scalable status-neutral HIV intervention that can be translated throughout Brazil and other low- and middle-income countries for young transgender women at high risk of or living with HIV. Trial RegistrationClinicalTrials.gov NCT05299645; https://clinicaltrials.gov/ct2/show/NCT05299645 International Registered Report Identifier (IRRID)DERR1-10.2196/44157

O Brasil é um dos países mais afetados pela pandemia de COVID-19 e o real número de mortes pela doença torna o cenário ainda mais desafiador. O objetivo deste estudo foi estimar o excesso de mortes e suas diferenças em adultos com 20 anos e mais em Manaus (Amazonas), Fortaleza (Ceará), Rio de Janeiro e São Paulo, de acordo com o local de ocorrência do óbito, características demográficas e trajetória ao longo do tempo. Os dados foram obtidos no Sistema de Informações sobre Mortalidade e na Central de Informações do Registro Civil Nacional. As estimativas de óbitos esperados foram obtidas por meio de modelos aditivos generalizados quasi-Poisson com ajuste de sobredispersão. Entre 23 de fevereiro e 13 de junho de 2020, foram registradas 74.410 mortes naturais nas quatro cidades, com excesso de mortes de 46% (IC95%: 44-47). O maior excesso de mortes ocorreu em Manaus, 112% (IC95%: 103-121), seguido por Fortaleza, 72% (IC95%: 67-78), Rio de Janeiro, 42% (IC95%: 40-45) e São Paulo, 34% (IC95%: 32-36). O excesso de mortes foi maior nos homens e não significativo nas Semanas Epidemiológicas (SE) 9-12, exceto em São Paulo, 10% (IC95%: 6-14). Em geral, o pico de mortes excedentes ocorreu nas SE 17-20. O excesso de mortes não explicado diretamente pela COVID-19 e de mortes em domicílios/via pública foi alto, especialmente em Manaus. A elevada porcentagem de mortes excedentes, de mortes não explicadas diretamente pela COVID-19 e de mortes fora do hospital sugerem alta subnotificação de mortes por COVID-19 e reforça a extensa dispersão do SARS-CoV-2, como também a necessidade da revisão de todas as causas de mortes associadas a sintomas respiratórios pelos serviços de vigilância epidemiológica.

Background World-wide, the notable expansion of HIV/AIDS treatment programs in resource-limited settings has lead to an increasing number of patients in need of second-line cART. To adequately address and prepare for this scenario, critical assessments of the outcomes of second-line cART are particularly relevant in settings where monitoring strategies may be inadequate. We evaluated virologic outcomes of second-line combination antiretroviral therapy (cART) among HIV-infected individuals from Brazil. Methods This study was conducted at the Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, at Rio de Janeiro, Brazio. For this study we included all patients who started first-line and second-line cART between 2000 and 2013. Second-line cART required a switch in the anchor drug of first-line cART. We evaluated time from second-line start to virologic failure and factors associated with increased risk of failure using multivariable Cox proportional hazards regression models. Results Among the 1,311 patients who started first-line cART a total of 386 patients (29.5%) initiated second-line cART, out of which 35.0% and 60.6% switched from their first-line to their second-line cART when their HIV RNA was undetectable and after documented virologic failure, respectively. At second line cART initiation, median age was 38 years [interquartile range (IQR): 31-45years]. Median CD4 count was significantly different for patients starting second-line cART undetectable [412 cells/mm³ (IQR: 240-617)] compared to those starting second-line cART after documented virologic failure [230 cells/mm³ (IQR: 118-322.5)] (p < 0.01). Median time from second-line cART initiation to failure was also significantly different for patients starting second-line cART undetectable compared to those who with documented virologic failure (log-rank test p < 0.01). Multivariable Cox models showed that younger age, lower education, and HIV RNA level were independently associated with an increased hazard of second-line failure among those with documented virologic failure at start of second-line cART. Conclusions We have shown that in a middle-income country with universal access to cART, having a detectable HIV RNA at the start of second-line cART as well as younger age and lower education negatively impact second-line outcomes. Our findings could guide HIV treatment efforts as to which strategies would help maximize the durability of these regimens. [ABSTRACT FROM AUTHOR]

Background: In high-income settings, the spectrum of morbidity and mortality experienced by Human Immunodeficiency Virus (HIV)-infected individuals receiving combination antiretroviral therapy (cART) has switched from predominantly AIDS-related to non-AIDS-related conditions. In the context of universal access to care, we evaluated whether that shift would apply in Brazil, a middle-income country with universal access to treatment, as compared to France.Methods: Two hospital-based cohorts of HIV-infected individuals were used for this analysis: the ANRS CO3 Aquitaine Cohort in South Western France and the Evandro Chagas Research Institute (IPEC) Cohort of the Oswaldo Cruz Foundation in Rio de Janeiro, Brazil. Severe morbid events (AIDS- and non-AIDS-related) were defined as all clinical diagnoses associated with a hospitalization of ≥48 hours. Trends in the incidence rate of events and their determinants were estimated while adjusting for within-subject correlation using generalized estimating equations models with an auto-regressive correlation structure and robust standard errors.Result: Between January 2000 and December 2008, 7812 adult patients were followed for a total of 41,668 person-years (PY) of follow-up. Throughout the study period, 90% of the patients were treated with cART. The annual incidence rate of AIDS and non-AIDS events, and of deaths significantly decreased over the years, from 6.2, 21.1, and 1.9 AIDS, non-AIDS events, and deaths per 100 PY in 2000 to 4.3, 14.9, and 1.5/100 PY in 2008. The annual incidence rates of non-AIDS events surpassed that of AIDS-events during the entire study period. High CD4 cell counts were associated with a lower incidence rate of AIDS and non-AIDS events as well as with lower rates of specific non-AIDS events, such as bacterial, hepatic, viral, neurological, and cardiovascular conditions. Adjusted analysis showed that severe morbidity was associated with lower CD4 counts and higher plasma HIV RNAs but not with setting (IPEC versus Aquitaine).Conclusions: As information on severe morbidities for HIV-infected patients remain scarce, data on hospitalizations are valuable to identify priorities for case management and to improve the quality of life of patients with a chronic disease requiring life-long treatment. Immune restoration is highly effective in reducing AIDS and non-AIDS severe morbid events irrespective of the setting. [ABSTRACT FROM AUTHOR]

O objetivo deste estudo é verificar a prevalência e os fatores associados ao aborto induzido no ingresso em uma coorte de mulheres vivendo com HIV/aids, no Município do Rio de Janeiro, Brasil, no período 1996-2016. O critério de elegibilidade para o ingresso na coorte era ser do sexo feminino ao nascimento, ter mais de 18 anos de idade e ter infecção comprovada pelo HIV. Na visita inicial, dados sobre aspectos sexuais, reprodutivos, comportamentais e da infecção pelo HIV foram obtidos durante entrevista face a face com o médico assistente. Foi calculada a prevalência de aborto induzido na vida e verificados os fatores associados ao aborto induzido por meio de regressão logística múltipla, para o total de mulheres e entre aquelas com gestação prévia. Do total de mulheres, 30,4% referiram algum aborto induzido na vida, sendo este valor de 33,5% em mulheres com gestação prévia. A frequência de aborto induzido relatado apresentou queda significativa no período analisado (41,7% de 1996-2000 vs. 22,5% de 2011-2016, p < 0,001). Os fatores associados ao aborto induzido, tanto para o total de mulheres quanto para aquelas com gestação prévia, foram o aumento da idade, escolaridade mais elevada, número de parceiros sexuais na vida ≥ 5, gestação na adolescência, uso de qualquer droga ilícita na vida e período de ingresso na coorte após 2005. Mudanças no perfil socioeconômico, sexual, reprodutivo e da infecção pelo HIV são explicações possíveis para a redução da prática do aborto no período. Estudos que utilizem métodos de aferição direta do aborto devem ser conduzidos em outras populações, para confirmar a tendência de queda do aborto induzido no país e seus determinantes.