Unprotected Sexual Practices Among Men Who Have Sex with Women and Men Who Have Sex with Men Living with HIV/AIDS in Rio de Janeiro (original) (raw)
Related papers
BMC Public Health, 2014
Background: Many countries are facing concentrated HIV epidemics among vulnerable populations, including men who have sex with men (MSM). Unprotected anal intercourse (UAI) is the main HIV transmission route among them and its understanding in the different cultures and how it relates to HIV transmission, re-infection and development of HIV antiretroviral resistance has important public health implications. Data on UAI among Brazilian MSM are scarce. This study aims to evaluate the prevalence and associated factors of UAI among HIV-infected MSM who had sex with seronegative or male partners with an unknown serostatus. Method: A cross-sectional study nested in a cohort was conducted in Rio de Janeiro, Brazil. The one hundred and fifty five MSM included in the study answered an ACASI interview and provided biological samples. Generalized linear models were used to identify variables associated with UAI.
AIDS, 1999
Objectives: To describe and identify sociodemographic and behavioural characteristics and other factors related to high-risk behaviour for HIV infection of men who have sex with men (MSM) living in Fortaleza, Brazil. A survey was carried out among 400 MSM aged 14-65 years and recruited through the snowball technique or in gay-identified venues. A semistructured questionnaire was conducted among them. Logistic regression analysis was used to model the dichotomous outcome (high risk or low risk). Results: Forty-four per cent of the participants reported engaging in high-risk sexual behaviour in the previous year. MSM less informed about AIDS, reporting more sexual partners, reporting at least one female partner in the previous year, having anal sex as the favourite way to have sex, and having great enjoyment of unprotected anal sex were more likely to be engaged in risky behaviour. Twentythree per cent of participants reported at least one sexual contact with women during the previous year. Two-thirds of men who had unprotected sex with their female partners also had unprotected anal sex with their male partners. A large proportion of MSM in Fortaleza still remain at elevated risk for contracting HIV infection. The factors predictive of high-risk sexual behaviour are significant in spreading HIV infection among the MSM population and also among their female partners. The lifestyles of these men are different to those of men from other parts of Brazil or outside the country. Preventive interventions need to be culturally and socially specific in order to be effective.
HIV Status and High Risk Behavior of Men having Sex with Men
Journal of Health and Allied Sciences, 2019
Voluntary counseling and testing (VCT) of HIV is important intervention for the prevention of HIV infection. Aim of this study was to find out HIV status and high risk behavior of men having sex with men. This descriptive cross sectional study was conducted among men having sex with men (MSM) by administering structured questionnaires. The number of risk factors in a single individual ranged from one to seven out of eight. The mean risk factor was 3.38, with standard deviation 1.3. More than half (55.33%) of them perceived at low risk, 33% perceived themselves at high risk. Regarding HIV status of respondents, 8% were found to be positive. In the past 30 days the respondents had large number of sex partners; majorities of them 90% and 87.3% had 0-20 regular and casual sex partners but 9.8% of MSM had 21-40 regular sex partners and 2.9% had 81-100 casual sex partners respectively. Among the MSM 46.6% were commercial sex worker, 35% were sex drives and 18.4% were intravenous drug user...
Memorias Do Instituto Oswaldo Cruz, 2003
Project Horizonte, an open cohort of homosexual and bisexual human immunodeficiency virus (HIV-1) negative men, is a component of the AIDS Vaccine Program, in Belo Horizonte, Minas Gerais, Brazil. The objective of this study was to compare volunteers testing HIV positive at cohort entry with a sample of those who tested HIV negative in order to identify risk factors for prevalent HIV infection, in a population being screened for enrollment at Project Horizonte. A nested case-control study was conducted. HIV positive volunteers at entry (cases) were matched by age and admission date to three HIV negative controls each. Selected variables used for the current analysis included demographic factors, sexual behavior and other risk factors for HIV infection. During the study period (1994-2001), among the 621 volunteers screened, 61 tested positive for HIV. Cases were matched to 183 HIV negative control subjects. After adjustments, the main risk factors associated with HIV infection were unprotected sex with an occasional partners, OR = 3.7 (CI 95% 1.3-10.6), receptive anal intercourse with an occasional partner, OR = 2.8 (95% CI 0.9-8.9) and belonging to the negro racial group, OR = 3.4 (CI 95% 1.1-11.9). These variables were associated with an increase in the risk of HIV infection among men who have sex with men at the screening for admission to an open HIV negative cohort.
AIDS and Behavior, 2009
Few studies have examined the psychosocial factors associated with sexual transmission behaviors among HIV-positive men who have sex with men (MSM), heterosexual men (MSW) and women. We enrolled 1,050 sexually active HIV-positive patients at seven HIV clinics in six US cities as part of a clinic-based behavioral intervention. We describe the sexual transmission behaviors and examine demographic, clinical, psychosocial, and clinic prevention variables associated with unprotected anal or vaginal intercourse (UAVI). Twenty-three percent of MSM, 12.3% of MSW and 27.8% of women engaged in UAVI with partners perceived to be HIV-negative or of unknown serostatus. Among MSM and MSW, having multiple partners and lower self-efficacy were associated with increased odds of UAVI. Self-rating one's health status as excellent/very good was a risk factor for UAVI among MSM. Among women, binge drinking and stressful life events were associated with UAVI. These findings identify variables that warrant attention in targeted interventions.
The Men Who Have Sex with Men HIV Care Cascade in Rio de Janeiro, Brazil
PLOS ONE, 2016
Brazil has a concentrated HIV epidemic and men who have sex with men (MSM) are disproportionately affected. Yet, no data is available on the HIV care cascade for this population. This study aimed to assess the HIV care cascade among MSM newly diagnosed through innovative testing strategies in Rio de Janeiro. Data from 793 MSM and travestites/transgender women (transwomen) tested for HIV at a non-governmental LGBT organization and a mobile testing unit located at a gay friendly venue were analyzed. A 12-month-after-HIVdiagnosis-censored cohort was established using CD4, viral load and combination antiretroviral therapy (cART) longitudinal data from those diagnosed with HIV. A cross-sectional HIV care cascade was built using this data. The relative risks of achieving each cascade-stage were estimated using generalized linear models according to age, self-declared skin-color, education, history of sexually transmitted diseases (STD), drug use and prior HIV testing. From Jan-2013 to Jan-2014, 793 MSM and transwomen were tested, 131 (16.5%) were HIV-infected. As of January 2015, 95 (72.5%) were linked to HIV care, 90 (68.7%) were retained in HIV care, 80 (61.1%) were on cART, and 50 (38.2%) were virally suppressed one year after HIV diagnosis. Being non-white (Relative risk [lower bound; upper bound of 95% confidence interval] = 1.709 [1.145; 2.549]) and having a prior HIV-test (1.954 [1.278; 2.986]) were associated with an HIV-positive diagnosis. A higher linkage (2.603 [1.091; 6.211]) and retention in care (4.510 [1.880; 10.822]) were observed among those who were older than 30 years of age. Using community-based testing strategies, we were able to access a high-risk MSM population and a small sample of transwomen. Despite universal care coverage and the test-and-treat policy adopted in Brazil, the MSM cascade of care indicates that strategies to increase linkage to care and prompt cART initiation targeted to these populations are critically needed. Interventions targeting non-white and young MSM should be prioritized.
Journal of AIDS & Clinical Research, 2014
The purpose of this study is to assess the types of sexual behaviors among men who have sex with men (MSM), with and without a condom, and to assess the predictive relationship between sexual pleasure and risky sexual practices among MSM. Methods: A total 304 MSM (Mean age 32.30, SD=11.28) recruited through informal social networks and the Internet participated in this study. Most participants were single and self-identified as gay (70%). Sexual pleasure was operationalized using one measure with 8 items (reliability analysis was good α=0.76). Participants were asked to recall their sexual experiences and their sexual behaviors over the last two months. Results: Only 7.2% of participants reported being HIV positive and approximately 26% reported not knowing their status. All participants indicated that they would feel higher levels of sexual pleasure if they were not using a condom during their sexual interaction, and all differences were statistically significant. Differences were also found between the following scenarios: a) having sex with or without a condom for receptive anal sex (p=0.036), b) having sex with or without a condom for insertive anal sex (p=0.012), and c) having sex with or without a condom for oral sex (p<0.001). Linear regression indicated that pleasure is a predictor of how many times a man was penetrated without a condom (β=0.255; R2=0.084; p<0.05) and a predictor of how many times a man penetrated another man without a condom (β=0.291; R2=0.066; p<0.05). Sexual pleasure needs to be prioritized in the development of condoms and other sexual safety measures as well as in the promotion of their use when working with HIV prevention among MSM. J o ur nal o f A ID S & Cli n ic a l R es earc h
PLoS ONE, 2013
Objective: We assessed changes in sexual behavior among men who have sex with men (MSM), before and for several years after HIV diagnosis, accounting for adoption of a variety of seroadaptive practices. Methods: We collected self-reported sexual behavior data every 3 months from HIV-positive MSM at various stages of HIV infection. To establish population level trends in sexual behavior, we used negative binomial regression to model the relationship between time since diagnosis and several sexual behavior variables: numbers of (a) total partners, (b) potentially discordant partners (PDP; i.e., HIV-negative or unknown-status partners), (c) PDPs with whom unprotected anal intercourse (UAI) occurred, and (d) PDPs with whom unprotected insertive anal intercourse (uIAI) occurred. Results: A total of 237 HIV-positive MSM contributed 502 interviews. UAI with PDPs occurred with a mean of 4.2 partners in the 3 months before diagnosis. This declined to 0.9 partners/3 months at 12 months after diagnosis, and subsequently rose to 1.7 partners/3 months at 48 months, before falling again to 1.0 partners/3 months at 60 months. The number of PDPs with whom uIAI occurred dropped from 2.4 in the pre-diagnosis period to 0.3 partners/3 months (an 87.5% reduction) by 12 months after enrollment, and continued to decline over time. Conclusion: Within months after being diagnosed with HIV, MSM adopted seroadaptive practices, especially seropositioning, where the HIV-positive partner was not in the insertive position during UAI, resulting in a sustained decline in the sexual activity associated with the highest risk of HIV transmission.
Sexually Transmitted Diseases, 2020
Background:We assessed sexual behavior and incidence of sexually transmitted infections among men who have sex with men (MSM) and transgender women (TW) participating in Sabes, a study of an expanded treatment as prevention strategy focused on early diagnosis and treatment of HIV infection in Lima, Peru (2013-2017).Methods:Sabes participants were tested monthly for HIV to identify acute or early infections, and HIV-positive participants were randomized to receive ART immediately (Immediate Arm) or after 24 weeks (Deferred Arm) during a 48-week follow-up period. Sexual behavior was assessed at randomization (baseline) and every 12 weeks thereafter. Participants were tested for urethral and rectal chlamydia and gonorrhea and for syphilis at baseline, 12, 24, and 48 weeks. We describe patterns of sexual behavior over the 48-week follow-up period, and compare sexual behavior and STI incidence between study arms.Results:After randomization, 207 HIV-positive participants completed questionnaires and STI testing at 2 or more visits. After HIV diagnosis, participants in both arms reported increases in condom use with main and casual partners and decreased drug and alcohol use before or during anal sex. We observed no between-arm differences in sexual behavior. Deferred Arm participants had higher incidence of chlamydia (Incidence Rate Ratio [IRR]: 2.33; 95% CI: 1.14 – 4.77), but not gonorrhea or syphilis.Conclusions:Despite reported increases in condom use, the overall high incidence of STIs reflects some ongoing condomless sex among HIV-positive MSM and TW, highlighting the importance of regular STI screening and counseling to support consistent condom use among HIV-positive individuals at risk for STIs.