Determinants of sexual exposure to HIV in Portuguese and Brazilian adolescents: a path analysis

Abstract

Objective: to analyze the direct and indirect effects of determinants of sexual exposure to the human immunodeficiency virus among male adolescents who have sex with men and the implications for nursing care. Method: cross-sectional study carried out with 578 Portuguese and Brazilian adolescents aged 18 and 19. Interrelationships of conjugal status, use of dating apps, practice of chemsex, unawareness, partner credibility, challenging sexual practices and ineffective forms of protection against sexual exposure to the human immunodeficiency virus were evaluated using the Path Analysis technique. Results: significant direct effect on sexual exposure to the human immunodeficiency virus: conjugal status (β=-0.16), use of apps (β=-0.30), challenging sexual practices (β=0.48) and ineffective forms of protection (β=0.35). Indirect paths: partner credibility influenced ineffective forms of protection (β=0.77); having a steady/polyamorous relationship influenced the use of dating apps (β=-0.46); chemsex, mediated by challenging sexual practices (β=0.67), determined greater sexual exposure. Conclusion: adolescent sexual behaviors and forms of amorous/sexual relationship must be considered in nursing care planning to reduce sexual exposure to the human immunodeficiency virus.

Sexual exposure to HIV in Angolan men who have sex with men immigrants: A cross-sectional study in Portugal and Brazil

“…This can be attributed to a mistaken notion of security that a stable or repeated partnership can present. 12,27,28 The emergence of new risk behaviors for acquiring HIV confirms current evidence that condom use among MSM is decreasing in both rich and developing countries, indicating that prevention strategies are not working satisfactorily. Some reasons for this include optimism regarding antiretroviral treatment, the emergence of the internet as a risky environment, and structural deficiencies in providing specific services for MSM, particularly immigrants.…”

“…This method was crucial for reaching individuals located in non-metropolitan areas, considering Brazil’s vast size. 12…”

“…This is an analytical and cross-sectional study, carried out throughout Brazil and Portugal with men who have sex with men, from January 2020 to May 2021, as part of the "In_PrEP" project. 11,12…”

Adherence to Pre-Exposure Prophylaxis (PrEP) among Men Who Have Sex with Men (MSM) in Portuguese-Speaking Countries

“…Aspects linked to disclosing one’s HIV serology or not knowing the partner’s HIV serology also influenced the adherence to PrEP. This finding is reinforced by the literature [ 49 , 50 ], which points out that having a steady partner, claiming/appearing not to have STIs and having been recently tested are associated with a certain credibility that leads to waiving condom use, which can lead the participants to seek additional prevention through PrEP [ 50 , 51 , 52 ].…”

Sexual Practices and Predisposition to PrEP Use Among Men Ages 50 Years and Older Who Have Sex With Men: A Cross-Sectional Study

“…In the subsequent sections, we examined variables pertaining to sexual practices, encompassing the following aspects: preventive measures against HIV during sex, engaging in sexual activity with a partner living with HIV, involvement in group sex (three or more people simultaneously), subjective self-assessment of HIV infection risk, preferred sexual positioning, engaging in receptive anal intercourse without a condom, recent participation in unprotected sex, drug use during sexual encounters or engaging in sex under the influence of drugs in the past six months, engaging in sexual activity at gay saunas, adult cinemas, gay bars, or other venues, engaging in bareback sex (unprotected anal intercourse), double penetration, or fisting, as well as the frequency of seeking health care services. We provided clear and accessible explanations for uncommon or potentially unfamiliar terms such as “cruising” (Gama et al, 2017), “double penetration (DP)” (Sousa, Lima et al, 2023; Teixeira et al, 2022), “chemsex” (Chone et al, 2021; Sousa, Camargo et al, 2023), and “gouinage” (Sousa, et al, 2019) to ensure participant comprehension.…”