Perception of vulnerability to HIV infection in a cohort of homosexual/bisexual men in Rio de Janeiro, Brazil

Abstract

The present study addresses sociodemographic characteristics, knowledge and attitudes regarding HIV/AIDS, as well as risk behaviour and perception of vulnerability to HIV infection, in the first 295 homosexual and bisexual volunteers (excluding male commercial sex workers and transvestites) taking part in a cohort study in Rio de Janeiro. The sample has a higher socio-economic level than the remainder of the cohort, and than comparable strata of the general population, and a sound knowledge about how to protect themselves against HIV infection. In addition, an association between perception of vulnerability to infection and the practice of unprotected anal sex was observed. An association was also observed between higher levels of formal education and perception of vulnerability; however no association was found with markers for past and recent exposure to sexually transmitted infections (hepatitis B, HbsAG and syphilis). The results of the present study suggest that knowledge and awareness of risk do not easily translate into behaviour change, since significant proportions of the cohort continue to practise unprotected sex with both principal and casual partners, despite their awareness of HIV infection risks as well as preventive measures.

Twenty-five years of the AIDS epidemic in Brazil: principal epidemiological findings, 1980-2005

“…What calls attention is the fact that around 90% of the Brazilian population spontaneously cite sexual relations as a form of HIV transmission 17 , and the use of condoms as a way of preventing the risk of acquiring HIV 17 , suggesting that knowledge and perception of risk do not necessarily translate into effective changes in behavior 56 .…”

Behavior assessment of women attending a sexually transmitted disease clinic in Vitória, Brazil

“…14 Over 90% of the Brazilian population cites sexual relations as a form of HIV transmission, and the use of condoms as a way of preventing transmission risk, suggesting that knowledge and perception of risk do not necessarily translate into effective changes in behavior. 14,17 Prevention campaigns should encourage condom use and disparage complacency about risks of spreading HIV through heterosexual intercourse because condoms are represented as a personal tool in the responsibility for safe sex. This approach needs to consider gender power relations which construct and constrain choices and decisions.…”

Distribuição social da AIDS no Brasil, segundo participação no mercado de trabalho, ocupação e status sócio-econômico dos casos de 1987 a 1998

“…A expressiva redução nas taxas de crescimento da incidência da AIDS em "profissionais liberais 'clássicos'" e "outros profissionais universitários", evidente entre os homens, talvez se deva ao fato de essas classes ocupacionais terem maior acesso à informação e apreenderem melhor os conceitos de risco e as estraté-gias de prevenção -o que contribuiria para a mudança comportamental quanto às práticas mais seguras (Souza et al, 1999) -, terem melhor acesso aos serviços de saúde, além dos efeitos supra-individuais, referentes às suas redes sociais de interação (Morris, 1997).…”