Universidade Federal do Rio Grande do Sul, School of Medicine, Epidemiology Undergraduate Program - Porto Alegre (RS), Brazil.
Universidade Federal do Rio Grande do Sul, Department of Social Medicine - Porto Alegre (RS), Brazil.
Rev Bras Epidemiol. 2023 Mar 24;26:e230019. doi: 10.1590/1980-549720230019. eCollection 2023.
OBJECTIVE: This study aimed to evaluate factors associated with inconsistent condom use with casual partners in a population of men who have sex with men (MSM) in Brazil. METHODS: In 2016, 4,176 MSM >18 years were enrolled in 12 capitals of Brazil using a Respondent Driven Sampling (RDS) method. For the construction of the outcome, we evaluated questions about condom use in all anal intercourse (receptive and insertive) in the previous six months and the last sexual intercourse. Estimates were calculated using a weighted complex sample design. We performed a logistic regression analysis to determine the associations between sociodemographic and behavioral factors and inconsistent condom use in sexual relationships with casual male partners. RESULTS: More than half of our sample (50.8%) had not used condoms consistently with casual partners in the previous six months. Inconsistent condom use was significantly associated with: low education (weighted odds ratio - wOR: 1.55; 95% confidence interval - CI 0.99-2.40), lack of counseling on sexually transmitted infections STI (wOR: 1.51; 95%CI 1.05-2.17), non-use of condoms at sexual debut (wOR: 3.05; 95%CI 2.12-4.40) and moderate and high perceived risk for HIV (wOR: 1.51; 95%CI 1.07-2.14). Higher age was negatively associated with inconsistent condom use (wOR=0.97, 95%CI 0.89-0.99). CONCLUSION: Despite being an individual behavior, condom use is related to factors beyond the individual scope. HIV/Aids prevention policies should focus on younger MSM, providing qualified information about condom use, preferably before the beginning of their sexual life.
目的:本研究旨在评估巴西男男性行为者(MSM)人群中与与偶然伴侣发生性行为时不坚持使用安全套相关的因素。
方法:2016 年,采用应答驱动抽样(RDS)方法在巴西 12 个首府招募了 4176 名年龄大于 18 岁的 MSM。为构建该结果,我们评估了过去 6 个月和最近一次性行为中所有肛交(被动和主动)时使用安全套的问题。使用加权复杂样本设计计算估计值。我们进行了逻辑回归分析,以确定社会人口统计学和行为因素与与偶然男性伴侣发生性行为时不坚持使用安全套之间的关联。
结果:我们的样本中超过一半(50.8%)在过去 6 个月中与偶然伴侣发生性行为时没有坚持使用安全套。不坚持使用安全套与以下因素显著相关:教育程度低(加权优势比 - wOR:1.55;95%置信区间 - CI 0.99-2.40)、未接受过性传播感染(STI)咨询(wOR:1.51;95%CI 1.05-2.17)、首次发生性行为时不使用安全套(wOR:3.05;95%CI 2.12-4.40)和中度及高度 HIV 感知风险(wOR:1.51;95%CI 1.07-2.14)。年龄较大与不坚持使用安全套呈负相关(wOR=0.97,95%CI 0.89-0.99)。
结论:尽管使用安全套是一种个人行为,但它与个人范围之外的因素有关。艾滋病预防政策应重点关注年轻的 MSM,提供有关安全套使用的优质信息,最好在他们开始性生活之前。
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