Departamento de Ciências da Vida, Universidade do Estado da Bahia, Salvador, Brasil.
Instituto de Saúde Coletiva, Universidade Federal da Bahia, Salvador, Brasil.
Cad Saude Publica. 2022 Apr 29;38(4):EN199121. doi: 10.1590/0102-311XEN199121. eCollection 2022.
Discrimination due to sexual orientation (DDSO) has an important association with health outcomes among men who have sex with men (MSM). This study aimed to analyze factors associated with DDSO among MSM in 12 Brazilian cities. This is a cross-sectional study with 4,176 MSM participants recruited in 2016 which used a respondent-driven sampling method in 12 Brazilian cities. DDSO levels were previously identified by a latent class analysis based on 13 variables from the discrimination section. An ordinal logistic regression was used to assess associations with these DDSO levels, and weighted ordinal odds ratios (OR) and their respective 95% confidence intervals (95%CI) were estimated using Gile's estimator. Most participants were young (< 25 years old) black or of mixed-race (pardo), single individuals who had a religious affiliation, primary or incomplete secondary education, and a high and average socioeconomic status. More than half (65%) reported DDSO in the 12 months prior to this study. We observed an independent association among the four latent DDSO classes and the following variables: age < 25 years old (OR = 1.66; 95%CI: 1.21-2.27), white skin color (OR = 1.43; 95%CI: 1.02-2.01), history of sexual (OR = 2.33; 95%CI: 1.58-3.43) and physical violence (OR = 3.08; 95%CI: 2.11-4.49), disclosure of their sexual orientation as MSM to their fathers (OR = 2.00; 95%CI: 1.47-2.72), experienced suicidal ideation in the two weeks prior to this study (OR = 2.09; 95%CI: 1.46-2.98), and use of any illicit drugs in the last six months (OR = 1.61; 95%CI: 1.19-2.18). Our results indicate that contextual factors may contribute to high DDSO levels among MSM in Brazil. Public health policies toward human rights surveillance and protection among MSM must be urgently addressed.
性取向歧视（DDSO）与男男性行为者（MSM）的健康结果有重要关联。本研究旨在分析巴西 12 个城市 MSM 中与 DDSO 相关的因素。这是一项横断面研究，共有 4176 名 MSM 参与者于 2016 年参加，在巴西 12 个城市采用了响应驱动抽样方法。DDSO 水平先前通过基于歧视部分的 13 个变量的潜在类别分析来确定。使用有序逻辑回归评估与这些 DDSO 水平的关联，并用 Gile 的估计量估计加权有序优势比（OR）及其各自的 95%置信区间（95%CI）。大多数参与者年龄小于 25 岁（<25 岁），为黑人或混血儿（pardo），未婚，有宗教信仰，接受过小学或不完全中学教育，社会经济地位较高或中等。超过一半（65%）的人在研究前的 12 个月内报告了 DDSO。我们观察到四个潜在的 DDSO 类别与以下变量之间存在独立关联：年龄<25 岁（OR=1.66；95%CI：1.21-2.27）、白色皮肤（OR=1.43；95%CI：1.02-2.01）、性（OR=2.33；95%CI：1.58-3.43）和身体暴力（OR=3.08；95%CI：2.11-4.49）史、向父亲公开自己的性取向（OR=2.00；95%CI：1.47-2.72）、研究前两周有自杀意念（OR=2.09；95%CI：1.46-2.98）和在过去 6 个月内使用任何非法药物（OR=1.61；95%CI：1.19-2.18）。我们的研究结果表明，背景因素可能导致巴西 MSM 中 DDSO 水平较高。公共卫生政策必须紧急解决 MSM 中的人权监测和保护问题。
