Silva Jonatan da Rosa Pereira da, Knauth Daniela Riva, Leal Andréa Fachel, Magno Laio, Dourado Ines, Veras Maria Amelia de Sousa Mascena, Kerr Ligia Regina Sansigolo
Instituto de Psicologia, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brasil.
Instituto de Filosofia e Ciências Humanas, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brasil.
Cad Saude Publica. 2023 Jan 6;38(11):e00099822. doi: 10.1590/0102-311XPT099822. eCollection 2023.
We aimed to analyze the factors associated with inconsistent condom use among men who have sex with men (MSM) and their commercial sexual partners in Brazil. This is a cross-sectional study with adult MSM who were recruited via respondent-driven sampling (RDS) in 12 Brazilian capitals in 2016. MSM answered a sociobehavioral questionnaire which included questions on their sexual behavior. The inconsistent use of condoms with their clientele was measured via insertive and receptive anal sex in the six months prior to our research and in their last sexual intercourse. The association between independent variables and the inconsistent use of condoms was measured via a Poisson regression model with robust variance and estimation of adjusted prevalence ratios (aPR). Data from 461 MSM were analyzed. We found a 26% prevalence of inconsistent condom use with their clientele (95%CI: 19.0-34.3, n = 123). Belonging to the lowest economic classes (D/E), having medium or low knowledge about HIV, having practiced insertive and receptive anal sex, and having never tested for HIV throughout their lives were associated with inconsistent use of condoms with their clientele. The variables associated with inconsistent use indicated that commercial sex is practiced in a context of greater vulnerability to HIV infection, referring to the need for biomedical and behavioral interventions which focus on access to and use of prevention strategies together with public policies to reduce socioeconomic inequalities among MSM who practice commercial sexual.
我们旨在分析巴西男男性行为者(MSM)及其商业性伴侣中避孕套使用不一致的相关因素。这是一项横断面研究,研究对象为2016年通过应答驱动抽样(RDS)在巴西12个首府招募的成年男男性行为者。男男性行为者回答了一份社会行为问卷,其中包括有关其性行为的问题。通过研究前六个月及他们最近一次性交中的插入式和接受式肛交来衡量与客户使用避孕套不一致的情况。通过具有稳健方差和调整患病率比(aPR)估计的泊松回归模型来衡量自变量与避孕套使用不一致之间的关联。分析了461名男男性行为者的数据。我们发现,与客户避孕套使用不一致的患病率为26%(95%CI:19.0 - 34.3,n = 123)。属于最低经济阶层(D/E)、对艾滋病毒的了解程度中等或较低、有过插入式和接受式肛交行为以及一生中从未进行过艾滋病毒检测,均与与客户避孕套使用不一致有关。与使用不一致相关的变量表明,商业性行为是在更易感染艾滋病毒的背景下发生的,这意味着需要采取生物医学和行为干预措施,重点是获取和使用预防策略,同时制定公共政策以减少从事商业性行为的男男性行为者之间的社会经济不平等。