Sexual abuse leads to physical harm and devastating psychosocial consequences. It increases risk of HIV transmission and is associated with risky behaviour. Little is known about sexual abuse victimisation (SAV) and perpetration (SAP) among HIV-positive men who have sex with women (MSW). We investigated self-reported SAV and SAP among 242 Brazilian MSW selected at HIV care centres. Patients were questioned about sociodemographic data, mode of HIV acquisition, sexual practices, drug use and history of SAV or SAP. Prevalence of outcomes was estimated and risk factors for SAP investigated by logistic regression. Fifty-eight (24.1%) interviewees reported SAV. Of patients abused before 15 years of age, 64.3% reported events before the age of ten. Aggressors included relatives, friends and teachers. Among those victimised after 15 years old, 57.7% described events before 17 and 38.5% had acquainted aggressors. Fourteen (5.8%) interviewees reported SAP and most knew their victims. Sexual abuse perpetration was associated with lower schooling, marital status, illicit drug use and self-reported SAV. Sexual abuse was frequently reported by MSW from this cohort. Identifying predictors of violence and addressing SAV and SAP in comprehensive HIV care may help reduce violent behaviour, psychological distress and contribute to maximise benefits of preventive and care interventions.
The aim of this cross-sectional study, carried out among 250 HIV-positive (HIV+) men who have sex with women, was to describe their risk perception before learning of their HIV+ status and their sexual and drug use behaviour. Of the 250 men, 62.0% were heterosexuals and 38.0% where bisexuals. They most often reported becoming infected through unprotected sex (24.5%) and injecting drug use (11.0%). They were usually tested because they became ill (42.2%). Condom use with women in all episodes of sexual intercourse before HIV+ diagnosis was reported by 22.6% of heterosexuals and 34.7% of bisexuals (P < 0.05). With respect to drug use, 58.0% reported the use of drugs at some period in their lifetime. A higher proportion of individuals who had used drugs perceived themselves at risk (P < 0.05). Findings showed that most HIV+ men who have sex with women, regardless of sexual orientation or injecting drug use, did not use condoms and did not perceive themselves at risk before learning of their HIV+ status, and only undergo testing due to illness. The implications for heterosexual transmission of HIV are discussed.
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