Health Care Access and Sexually Transmitted Infection Screening Frequency Among At-Risk Massachusetts Men Who Have Sex With Men

Abstract

Clinicians need to assess sexual risk-taking behaviors and more routinely screen for STIs among sexually active men regardless of disclosure of a history of having sex with men.

Vulnerability in the context of HIV and syphilis infection in a population of men who have sex with men (MSM) in Salvador, Bahia State, Brazil

“…Some RDS studies have found fewer sexual partners than in this study 24,28,39,40 , but our findings are close to other results of RDS studies with MSM 6,25,27,30 . Still, such differences may be due to the lack of a standardized period for which the number of partners was computed, varying widely in the literature, or to characteristics like the size of MSM social networks, age, schooling, and social class, factors that may be associated with the number of sexual partners in this sample.…”

“…Reporting a previous syphilis test was statistically associated with HIV infection and syphilis, as in other studies 24,28 , but it can also be associated with risky sexual practices for STI 24,27,28,41 .…”

“…Thus, prevention and interven- tions targeting MSM should be broad and comprehensive, including social policies aimed at reducing stigma and improving living conditions and access to health services. Among the individual vulnerability factors associated with HIV infection and a positive rapid test for syphilis, MSM in this study had an average age of 25 years old, close to that of the MSM in the ten Brazilian cities study (27.5 years) 3 , but they were younger when compared to MSM in RDS studies in other countries, where the mean age ranged from 30 to 41 years 2,4,25,28,30,31 . This could be considered a recruitment bias in our study, but it might also reflect aspects of the male population in Salvador, with a high proportion in the 15 to 39-year age group according to the 2010 Population Census 32 .…”

“…The percentage of participants that reported a previous HIV test (37%) was close to that of Brazil's general population (36.5%) 33 and higher than the country's male population (27%) 33 , but some 50% lower than in a population of black and Latino MSM in the United States 24,41 , or among MSM with high-risk practices for HIV infection 28 . It was also lower than the results presented in the last report of the Joint United Nations Programme on HIV/AIDS (UNAIDS) (42%) 12 and in the Brazilian multicenter study (49%) 3 and other populations of MSM 42 .…”

“…Meanwhile, these estimates are high compared to the prevalence rates in the overall male population in Brazil (HIV: 0.8%; syphilis: 1.3%) 4,20 , male industrial workers (HIV: 1.7%; syphilis: 1.9%) 21 , military conscripts (HIV: 0.1%; syphilis: 0.5%) 22 , and in the Bela Vista Project with MSM (HIV: 2.1%; syphilis: 13.5%) 23 . Recent studies that also used the RDS methodology among MSM in different countries showed HIV infection prevalence rates greater than 10% 6,24,25,26 , and some studies have shown prevalence rates greater than 30% 27,28,29 .…”