Jalil Cristina M, Jalil Emilia M, Hoagland Brenda, Cardoso Sandra W, Scarparo Rodrigo, Coutinho Carolina, Silva Mayara Secco Torres, Veloso Valdilea G, Wilson Erin C, McFarland Willi, Torres Thiago S, Grinsztejn Beatriz
Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz (INI-Fiocruz), Rio de Janeiro, Brazil.
Center for Public Health Research, San Francisco Department of Public Health, San Francisco, CA, United States.
Lancet Reg Health Am. 2024 Jun 15;36:100798. doi: 10.1016/j.lana.2024.100798. eCollection 2024 Aug.
Young gay, bisexual, and other men who have sex with men (YMSM) in Latin America experience disproportionately high rates of HIV. While new case numbers have stabilised in other demographics, the incidence of HIV in this particular group continues to rise. We estimated the prevalence of HIV and sexually transmitted infections (STI) and identified correlates of new HIV diagnoses among YMSM in Brazil.
Conectad@s was a respondent-driven sampling-based study to recruit and engage YMSM in HIV prevention and treatment services in Rio de Janeiro, Brazil (November 2021-October 2022). Eligibility criteria were age 18-24 years and self-identification as MSM (cis/trans) or non-binary person who have sex with men. Participants underwent HIV/STI testing and completed a socio-behavioural questionnaire. We described baseline characteristics by HIV status and used logistic regression models to identify correlates of new HIV diagnoses. Trial ID: DERR1-10.2196/34885.
Among 409 participants, 370 (90.5%) self-identified as cisgender men, nine (2.2%) transgender men, and 30 (7.3%) non-binary. Median age was 21 years (IQR: 20-23), with 80 (19.6%) aged 18-19 years. Most self-identified as Black or (70.6%); 109 (26.7%) never tested for HIV. HIV prevalence was 9.8%; 50% (n = 20/40) were newly diagnosed with HIV. Only nine participants ever used PrEP and three were currently using it. Overall, 133 (32.5%) reported sexual violence in their lifetime and 102 (24.9%) reported a suicide attempt. Prevalence of active syphilis, chlamydia, and gonorrhoea were 14.4%, 15.9%, and 14.7%, respectively. New HIV diagnoses were positively associated with engaging in high-risk behaviour (aOR 4.88 [95% CI: 1.88-13.40]) and anxiety (aOR 2.67 [95% CI: 1.01-7.70]), and negatively associated with ever disclosing sexual orientation (aOR 0.19 [95% CI: 0.04-0.92]) and HIV knowledge (aOR 0.77 [95% CI: 0.59-1.01]).
High prevalence of HIV coupled with a high proportion of new HIV diagnoses underscore a potentially growing HIV epidemic among YMSM in Brazil.
National Institutes of Health (NIH), Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq) and Ministry of Health of Brazil.
拉丁美洲的年轻男同性恋者、双性恋者以及其他与男性发生性行为的男性（YMSM）感染艾滋病毒的比例极高。在其他人群中新增病例数已趋于稳定的情况下，这一特定群体中的艾滋病毒感染率仍在持续上升。我们估算了巴西YMSM人群中艾滋病毒和性传播感染（STI）的患病率，并确定了新确诊艾滋病毒病例的相关因素。
“Conectad@s”是一项基于应答驱动抽样的研究，旨在招募巴西里约热内卢的YMSM并让他们参与艾滋病毒预防和治疗服务（2021年11月至2022年10月）。纳入标准为年龄在18至24岁之间，自我认定为男男性行为者（顺性别/跨性别）或与男性发生性行为的非二元性别者。参与者接受了艾滋病毒/性传播感染检测，并完成了一份社会行为问卷。我们按艾滋病毒感染状况描述了基线特征，并使用逻辑回归模型确定新确诊艾滋病毒病例的相关因素。试验编号：DERR1-10.2196/34885。
在409名参与者中，370人（90.5%）自我认定为顺性别男性，9人（2.2%）为跨性别男性，30人（7.3%）为非二元性别者。年龄中位数为21岁（四分位间距：20 - 23岁），其中80人（19.6%）年龄在18至19岁之间。大多数人自我认定为黑人或……（70.6%）；109人（26.7%）从未进行过艾滋病毒检测。艾滋病毒患病率为9.8%；50%（n = 20/40）为新确诊的艾滋病毒感染者。只有9名参与者曾使用过暴露前预防药物（PrEP），3人目前正在使用。总体而言，133人（32.5%）报告一生中遭受过性暴力，102人（24.9%）报告曾有过自杀未遂。活动性梅毒、衣原体和淋病的患病率分别为14.4%、15.9%和14.7%。新确诊艾滋病毒病例与从事高危行为（调整后比值比4.88 [95%置信区间：1.88 - 13.40]）和焦虑（调整后比值比2.67 [95%置信区间：1.01 - 7.70]）呈正相关，与曾披露性取向（调整后比值比0.19 [95%置信区间：0.04 - 0.92]）和艾滋病毒知识（调整后比值比0.77 [95%置信区间：0.59 - 1.01]）呈负相关。
艾滋病毒的高患病率以及高比例的新确诊艾滋病毒病例凸显了巴西YMSM人群中潜在的不断增长的艾滋病毒流行情况。
美国国立卫生研究院（NIH）、巴西国家科学技术发展委员会（CNPq）和巴西卫生部。
