Risk behavior score: a practical approach for assessing risk among men who have sex with men in Brazil

Abstract

HIV/AIDS epidemic is not well controlled, and multiple sexual behavior factors help explain high rates of HIV infection among men who have sex with men (MSM). This article proposes to exam the use of a potential risk behavior score for HIV infection, based on the type and number of sexual partners, and condom use, and their associated factors in a sample of MSM in Brazil. A cross sectional RDS (Respondent Driven Sampling) study was performed among 3738 MSM aged 18+ years old from ten Brazilian cities. The risk behavior score was composed by the number of male partners and anal condom use in the last year with steady, casual, and commercial partners. Most participants were 25+ years old (58.1%), non-white (83.1%), and single (84.9%). Final weighted ordinal logistic model showed that age≤25 years old (p=0.037), homosexual or bisexual identity (p<0.001), sexual initiation before 15-year-old (p<0.001), having sex with men only in the last 12 months (p<0.001), frequent alcohol and illicit drug use (p<0.001), and use of local sites to meet sexual partners in the last month were independently associated with higher scores of risky behavior. Specific strategies should be developed aimed at the MSM population. Additionally, pre-exposed prophylaxis (Prep) should be considered for those at higher score as a strategy for reducing risk for HIV infection in this population.

Willingness to Use and Adhere to HIV Pre-Exposure Prophylaxis (PrEP) among Men Who Have Sex with Men (MSM) in China

“…We did not find significant associations between alcohol consumption and the willingness to use and intention to adhere to PrEP among MSM, which is consistent with some previous studies [50]. However, other studies have argued that substance use leads to risky sexual behavior, which in turn affects PrEP use [51,52]. Different types of substances (e.g., alcohol, drugs) might produce different effects on PrEP use [53], and further studies are suggested.…”

Syphilis prevalence and risk factors among young men presenting to the Brazilian Army in 2016

“…Recent studies conducted in different regions of Brazil showed syphilis prevalence among MSM ranging from 9% to 26.3% emphasizing the need for interventions among this group. [6–9,13,19,23]…”

“…These findings indicate that the earlier the onset of sexual activity, the more frequently participants partook in risk behaviors for syphilis infection. [19] This increased risk could be explained by the fact that youth have difficulties in negotiating condom use with partners in the beginning of their sexual life. Thus, the urgency of having new experiences might lead them to higher risk sexual behaviors and the spontaneity or unplanned sexual intercourse encounters are generally associated with the lack of condom use.…”

Comparison of HIV Risk Behaviors Between Clinical Trials and Observational Cohorts in Uganda

“…A higher score indicates higher risk components. We used the difference in this composite score between baseline and end of follow up (12 months) as a measure of change in risk components [29], where a positive value indicates an increase in high-risk behavior.…”

“…Composite sets of HIV risk components have been previously used in cohorts of serodiscordant couples in seven African countries [26] and Men who have sex with men in China [27], Kenya [28] and Brazil [29], to generate HIV risk scores. In these studies, a lower risk score was associated with 20 to 85% [26,29] lower HIV incidence. The composite score allowed for more precise predictive capability of risk on HIV incidence, than individual predictors [26].…”