Guimarães Mark Drew Crosland, Kendall Carl, Magno Laio, Rocha Gustavo Machado, Knauth Daniela Riva, Leal Andrea Fachel, Dourado Ines, Veras Maria Amélia, Brito Ana Maria de, Kerr Ligia Regina Franco Sansigolo
Department of Preventive and Social Medicine, Federal University of Minas Gerais, Belo Horizonte, Brazil.
Center for Global Health Equity, Tulane School of Public Health and Tropical Medicine, New Orleans, LA, USA.
Medicine (Baltimore). 2018 May;97(1S Suppl 1):S62-S68. doi: 10.1097/MD.0000000000009079.
Periodic monitoring of sociobehavior characteristics at a national level is an essential component of understanding the dynamics the human immunodeficiency virus (HIV) epidemic worldwide, including Brazil.
This paper compares descriptive sociobehavior characteristics in 2 national cross-sectional HIV biological behavioral surveillance surveys (BBSS) conducted in 2009 and 2016 among men who have sex with men (MSM) in Brazil. Respondent driven sampling (RDS) was used for recruitment in both years. Overall proportions were weighted according to Gile's estimator using RDS Analyst Software and 95% confidence intervals were calculated for comparisons between the 2 periods. Further comparisons were stratified by age groups (<25 and 25+ years old).
Overall, 3749 and 4176 MSM were recruited in 2009 and 2016, respectively. In 2016, participants were younger than 25 years old (58.3%), with 12 or more years of education (70.4%), with higher socioeconomic status (40.7%), and had a higher proportion of whites (31.8%), as compared to 2009. Also, participants in 2016 reported less alcohol use and binge drinking, but used illicit drugs more frequently. There was an increase among MSM who self-reported their HIV risk as low and had low HIV knowledge while the proportion of those who were never tested for HIV dropped from 49.8% in 2009 to 33.8% in 2016. Although more than three-quarters received free condoms in both years, STD counseling remained low (32% and 38% for 2009 and 2016, respectively). Sexual risk behavior remained at high levels, especially unprotected anal receptive sex and sex with multiple partners. Younger MSM (<25 years old) showed riskier sexual practices than those 25+ years old, when comparing 2016 to 2009.
Our results indicate a worrisome risk behavior trend among Brazilian MSM, especially among younger ones. These results can contribute for a better understanding of the HIV epidemics in Brazil, with timely shift in strategies so improved effectiveness in public health prevention efforts can be achieved.
在国家层面定期监测社会行为特征是了解包括巴西在内的全球人类免疫缺陷病毒（HIV）流行动态的重要组成部分。
本文比较了2009年和2016年在巴西对男男性行为者（MSM）进行的两项全国性横断面HIV生物行为监测调查（BBSS）中的描述性社会行为特征。这两年均采用应答者驱动抽样（RDS）进行招募。使用RDS分析软件根据吉尔估计量对总体比例进行加权，并计算95%置信区间以比较两个时期。进一步按年龄组（<25岁和25岁及以上）进行分层比较。
总体而言，2009年和2016年分别招募了3749名和4176名男男性行为者。与2009年相比，2016年的参与者年龄小于25岁（58.3%），接受过12年或以上教育（70.4%），社会经济地位较高（40.7%），白人比例较高（31.8%）。此外，2016年的参与者报告饮酒和暴饮情况较少，但使用非法药物更为频繁。自我报告HIV风险较低且HIV知识较少的男男性行为者有所增加，而从未接受过HIV检测的比例从2009年的49.8%降至2016年的33.8%。尽管两年中超过四分之三的人获得了免费避孕套，但性传播感染咨询率仍然较低（2009年和2016年分别为32%和38%）。性风险行为仍然处于较高水平，尤其是无保护的肛交和与多个性伴侣发生性行为。将2016年与2009年相比，年龄小于25岁的年轻男男性行为者的性行为风险比25岁及以上者更高。
我们的结果表明巴西男男性行为者中存在令人担忧的风险行为趋势，尤其是在年轻人群体中。这些结果有助于更好地了解巴西的HIV疫情，及时调整策略，从而提高公共卫生预防工作的有效性。
