1 Escola de Enfermagem de Ribeirão Preto, Universidade de São Paulo (USP), Brazil.
2 Global Health and Tropical Medicine, Instituto de Higiene e Medicina Tropical, Universidade NOVA de Lisboa, Portugal.
Am J Mens Health. 2019 Jul-Aug;13(4):1557988319863542. doi: 10.1177/1557988319863542.
Middle-aged and older men who have sex with men (MSM) are one of the most underestimated populations with regard to HIV/AIDS infection, despite the worldwide trend of increasing prevalence in recent years. This population also has low rates of testing, although rare studies are done exclusively with middle-aged and older MSM assessing the factors associated with this prevalence. Thus, based on data from an exclusive online survey with middle-aged and older MSM who use geolocation-based dating applications, the purpose of the study was to analyze factors associated with not taking the HIV test among middle-aged (50 years old) and older MSM in Brazil. Using a modification of time-location sampling adapted to virtual reality, 412 volunteers were approached in Grindr, Hornet, SCRUFF, and Daddyhunt. The multivariate logistic regression model was adopted to produce adjusted odds ratios (ORa), considering a significance level at .05. There were factors associated with not taking the test: being in a relationship (ORa: 0.24; 95% CI [0.10, 0.53]); knowing partner through the applications (ORa: 1.84; 95% CI [1.07, 3.15]); not knowing the serological status (ORa: 5.07; 95% CI [1.88, 13.67]); ejaculating outside of anal cavity (ORa: 1.79; 95% CI [1.04, 3.05]); practicing sex without penetration (ORa: 2.30; 95% CI [1.17, 4.50]); not taking the test as a form of prevention (ORa: 2.83; 95% CI [1.05, 7.68]); and rarely using Viagra in sexual intercourse (ORa: 1.91; 95% CI [1.20, 3.65]). There is a blind spot in the prevalence of HIV testing in older MSM because this population is not being covered by services, which compromises the overall response to HIV, the goals set for universal health coverage.
中年和老年男男性行为者（MSM）是感染艾滋病毒/艾滋病被低估最严重的人群之一，尽管近年来全球范围内这一人群的感染率呈上升趋势。该人群的检测率也很低，尽管很少有专门针对中年和老年 MSM 的研究评估与这一流行率相关的因素。因此，本研究基于一项针对使用基于地理位置的约会应用程序的中年和老年 MSM 的独家在线调查数据，旨在分析巴西中年（50 岁）和老年 MSM 不接受 HIV 检测的相关因素。研究采用了一种适用于虚拟现实的时间-地点抽样方法的改良版，在 Grindr、Hornet、SCRUFF 和 Daddyhunt 中联系了 412 名志愿者。采用多变量逻辑回归模型计算调整后的优势比（ORa），置信水平为.05。存在与不接受检测相关的因素：处于恋爱关系中（ORa：0.24；95%CI [0.10，0.53]）；通过应用程序认识伴侣（ORa：1.84；95%CI [1.07，3.15]）；不知道血清学状况（ORa：5.07；95%CI [1.88，13.67]）；在肛门外射精（ORa：1.79；95%CI [1.04，3.05]）；进行无插入的性行为（ORa：2.30；95%CI [1.17，4.50]）；不将检测作为一种预防形式（ORa：2.83；95%CI [1.05，7.68]）；以及在性行为中很少使用伟哥（ORa：1.91；95%CI [1.20，3.65]）。中年 MSM 的 HIV 检测流行率存在盲点，因为该人群未被服务覆盖，这影响了对 HIV 的整体应对，也影响了实现全民健康覆盖的目标。
