High-Risk Sexual Behavior, Binge Drinking and Use of Stimulants are Key Experiences on the Pathway to High Perceived HIV Risk Among Men Who Have Sex with Men in Brazil

Luz, Paula M.; Torres, Thiago Silva; Almeida-Brasil, Celline Cardoso; Marins, Luana M. S.; Veloso, Valdiléa G.; Grinsztejn, Beatriz; Cox, Joseph; Moodie, Erica E. M.

doi:10.1007/s10461-020-03035-5

Cited by 21 publications

(23 citation statements)

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“…In Mexico, a national representative survey among MSM not stratified by age showed that lower education was associated with a positive HIV test result [11]. Socioeconomic disparities add to other vulnerabilities commonly observed among YMSM such as mental health disorders [30], low HIV risk perception [28,38], riskier sexual practices [28] and lower knowledge of prevention technologies, such as PrEP [23]. YMSM sexual attracted to men had higher odds of self-reported HIV positive status than those preferring both men and women.…”

Section: Discussionmentioning

confidence: 99%

“…Income was stratified in “low”, “middle” and “high” according to each country definition, which considered the minimum wage value per month in June 2018 (Brazil: 954 BRL or 250 USD; Mexico: 2686 MXN or 141 USD; Peru: 850 PEN or 265 USD). For Brazil, participants were stratified in “low” if the family monthly income was equivalent or inferior to three times the minimum wage (≤ 750 USD); in “middle” if between three and ten times the minimum wage (751–2500 USD); in “high” if superior to ten times the minimum wage (> 2500 USD) [ 20 , 38 , 39 ]. For Mexico, participants were stratified in “low” if individual monthly income was less than three times the minimum wage (< 423 USD); “middle” if between three and five times the minimum wage (423–704 USD); and high if equivalent or superior to five times the minimum wage (750 USD) [ 27 , 40 ].…”

Section: Methodsmentioning

confidence: 99%

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Low socioeconomic status is associated with self-reported HIV positive status among young MSM in Brazil and Peru

et al. 2021

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Background Despite efforts to stop HIV epidemic in Latin America, new HIV cases continue to increase in the region especially among young MSM (YMSM). This study aims to assess if sociodemographic characteristics are associated with self-reported HIV positive status among YMSM from three Latin American countries. Methods Cross-sectional web-based survey advertised on dating apps (Grindr and Hornet) and Facebook in Brazil, Mexico and Peru. For this analysis, we included YMSM aged 18–24 years who self-reported their HIV status. We used multivariable logistic regression models for each country separately to verify if sociodemographic characteristics (race, education and income) were associated with HIV self-reported status after adjusting for behavior characteristics (sexual attraction and steady partner). Results Among 43,687 MSM who initiated the questionnaire, 27,318 (62.5%) reported their HIV status; 7001 (25.6%) of whom were YMSM. Most YMSM (83.4%) reported an HIV test in the past year, and 15.7% reported an HIV positive status in Peru, 8.4% in Mexico and 7.7% in Brazil. In adjusted models, low-income was associated with higher odds of self-reported HIV positive status in Brazil (aOR = 1.33, 95%CI: 1.01–1.75) and Peru (aOR = 1.56, 95%CI: 1.02–2.40), but not in Mexico. Lower education was associated with higher odds of self-reported HIV positive status only in Brazil (aOR = 1.35, 95%CI: 1.05–1.75). Conclusions In this large, cross-country study, self-reported HIV positive status among YMSM was high. Lower socioeconomic status was associated with higher odds of self-reported HIV positive status in Brazil and Peru. There is an urgent need for HIV prevention interventions targeting YMSM, and efforts to address low-income YMSM are especially needed in Peru and Brazil.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Low socioeconomic status is associated with self-reported HIV positive status among young MSM in Brazil and Peru

et al. 2021

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“…The HIRI-MSM score is dependent on the respondent's age, the number of male sex partners in the last 6 months, the number of times the respondent had receptive anal sex with another male in the last 6 months, the number of HIV positive male sex partners, the number of times the participant had insertive anal sex with another PLOS ONE male in the last 6 months, methamphetamine use in the last 6 months, and use of poppers in the last 6 months. Cocaine was used in addition to methamphetamine as methamphetamine use was virtually non-existent in our study population [29,30,[35][36][37][38][39][40]. The HIRI-MSM score has been previously used by the Unite States Center for Disease Control and Prevention (CDC) and New York State Department of Health as a tool to identify eligible candidates for PrEP [30,41].…”

Section: Variable Definitions and Categorizationmentioning

confidence: 99%

Are men who have sex with men at higher risk for HIV in Latin America more aware of PrEP?

Assaf

Konda²,

Torres

et al. 2021

PLoS ONE

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Introduction PrEP awareness in Latin America has been poorly characterized, with studies in Brazil, Mexico, and Peru highlighting awareness of 65% among gay, bisexual and other men who have sex with men (MSM). We assessed the association between higher risk of HIV infection, indicative of PrEP eligibility, and PrEP awareness among MSM from these countries. Methods This was a secondary analysis of a web-based survey advertised on social media platforms from March-June 2018 in Brazil, Mexico and Peru. Eligible individuals were cisgender MSM, ≥18 years old, HIV negative or of unknown status, who lived in these countries, and provided informed consent. Higher risk of HIV infection was defined as having 10 or more points in the HIV Risk Index for MSM (HIRI-MSM). We used multivariable Poisson regression models to calculate adjusted prevalence ratios (aPR) testing the association between higher risk for HIV and PrEP awareness. Results After exclusions, 19,457 MSM were included in this analysis. In Brazil, 53.8% were classified as higher risk for HIV, 51.9% in Mexico, and 54.2% in Peru. Higher risk for HIV was minimally associated with PrEP awareness among those in Brazil (aPR 1.04, 95% CI 1.01, 1.06), but no such association was observed in Mexico or Peru. Having more than a high school education, high income, daily use of geosocial networking (GSN) applications, and substance use were associated with PrEP awareness. Conclusion Higher risk of HIV infection was associated with increased PrEP awareness in Brazil. However, this association was weak indicating that PrEP awareness could be strengthened with further prevention efforts. In the remaining countries, results were non-conclusive between risk and awareness. Interventions to increase PrEP awareness are paramount to increase PrEP willingness and uptake and in turn prevent new HIV infections. Social media platforms could play an important role to achieve this goal.

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“…", with possible answers: no, low, moderate, high, 100% sure and I don't want to answer/I don't know (considered missing for this analysis; N = 175, 4.5%). Due to the low sample size of some categories and following previous studies [29,31] Participants answered about PrEP awareness ("Before today, have you ever heard about PrEP? ", yes/no).…”

Section: Covariablesmentioning

confidence: 99%

High Rates of Sexualized Drug Use or Chemsex among Brazilian Transgender Women and Young Sexual and Gender Minorities

Jalil

Torres

Pereira

et al. 2022

IJERPH

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(1) Background: We aimed to estimate sexualized drug use (SDU) prevalence and its predictors among sexual and gender minorities. (2) Methods: We used an online and on-site survey to enroll sexual/gender minorities people between October–December/2020, and multivariate logistic regression to obtain SDU correlates. (3) Results: We enrolled 3924 individuals (280 transgender women [TGW], 3553 men who have sex with men [MSM], and 91 non-binary), 29.0% currently on pre-exposure prophylaxis (PrEP). SDU prevalence was 28.8% (95% confidence interval [CI] 27.4–30.2). TGW had 2.44-times increased odds (95%CI 1.75–3.39) of engaging in SDU compared to MSM, regardless of PrEP use. PrEP use (aOR 1.19, 95%CI 1.00–1.41), South/Southeast region (aOR 1.26, 95%CI 1.04–1.53), younger age (18–24 years: aOR 1.41, 95%CI 1.10–1.81; 25–35 years: aOR 1.24, 95%CI 1.04–1.53), white race/color (aOR 1.21, 95%CI 1.02–1.42), high income (aOR 1.32, 95%CI 1.05–1.67), binge drinking (aOR 2.66, 95%CI 2.25–3.14), >5 sexual partners (aOR 1.88, 95%CI 1.61–2.21), condomless anal sex (aOR 1.49, 95%CI 1.25–1.79), self-reported sexually transmitted infection (aOR 1.40, 95%CI 1.14–1.71), and higher perceived HIV-risk (aOR 1.37, 95%CI 1.14–1.64) were associated with SDU. (4) Conclusions: TGW had the highest SDU odds. SDU may impact HIV vulnerability among key populations and should be addressed in HIV prevention approaches.

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High-Risk Sexual Behavior, Binge Drinking and Use of Stimulants are Key Experiences on the Pathway to High Perceived HIV Risk Among Men Who Have Sex with Men in Brazil

Cited by 21 publications

References 54 publications

Low socioeconomic status is associated with self-reported HIV positive status among young MSM in Brazil and Peru

Low socioeconomic status is associated with self-reported HIV positive status among young MSM in Brazil and Peru

Are men who have sex with men at higher risk for HIV in Latin America more aware of PrEP?

High Rates of Sexualized Drug Use or Chemsex among Brazilian Transgender Women and Young Sexual and Gender Minorities

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