High rates of unprotected receptive anal sex and vulnerabilities to HIV infection among Brazilian men who have sex with men

Abstract

This study aimed to evaluate unprotected receptive anal sex intercourse (URAI) rates and vulnerabilities to HIV infection among men who have sex with men (MSM) that use geosocial networking dating apps in Brazil. An online, analytical, cross-sectional study was carried out with 2,250 MSM. The analyzed variables were grouped according to domains of vulnerability and analyzed by bi and multivariate statistics to calculate the Adjusted Odds Ratios (aOR). The prevalence of self-reported HIV was 7.1%; and of URAI, 23.4%. The studied variables that increased the chances of engaging in URAI were: identifying as homosexual (aOR = 8.30; 95%CI = 5.68:12.04), pansexual (aOR = 5.01; 95%CI = 2.04:12.38), or bisexual (aOR = 3.14; 95%CI = 2.03:4.80), using apps for obtaining sex (aOR = 1.3; 95%CI = 1.0:1.5), engaging in group sex (aOR = 1.6; 95%CI = 1.3:2.0), and reporting chemsex (aOR = 1.5; 95%CI = 1.1:2.0). Self-reported positive HIV status was associated with: less than a minimum wage income (aOR = 1.78; 95%CI = 1.22:2.58), lower education (aOR = 1.86; 95%CI = 1.31 CI; 2,64), not knowing the partner’s HIV status (aOR = 1.84; 95%CI = 1.06:3.19), practicing group sex (aOR = 1.67; 95%CI = 1.04; 2.68), and chemsex (aOR = 2.03; 95%CI =1.06:3.19). The applications interaction is shaped by their own users to better meet their desires and needs. However, this behavior exposes individuals to HIV vulnerabilities.

Sexual Exposure to HIV Infection during the COVID-19 Pandemic in Men Who Have Sex with Men (MSM): A Multicentric Study

“…Our findings showed that at-risk sexual exposure to HIV infection was present in 30.6% of the residents in Brazil and in 24.4% of the residents in Portugal, high prevalence values when compared to studies who used similar methodology prior to the pandemic [ 28 , 30 , 31 ]. Particularly, the MSM living in Brazil presented almost twice the chances of at-risk sexual exposure to HIV infection when compared to those living in Portugal.…”

“…We noticed that practices classically associated with greater chances of engaging in at-risk sexual exposure to HIV infection in MSM, such as having had multiple partners [ 33 ], group sex [ 34 ], not knowing the partner’s serological status [ 28 ] and practicing chemsex [ 35 ] were also determining factors when we consider the COVID-19 pandemic scenario, although a reduction in part of these behaviors could be expected following the promotion of social distancing and isolation.…”

“…Each seed received a link to the research and was instructed to invite at least 5 MSM from their social network until a significant sample was obtained within two months. To identify the seeds, we used the time location sampling (TLS) technique, changing the location to have access to the seeds [ 28 , 29 ]. The two most popular geographic location-based dating apps (Grindr ® and Hornet ® ) [ 30 ] were used, and a direct approach through chat with online users who met the inclusion criteria and sample diversification was implemented.…”

“…The two most popular geographic location-based dating apps (Grindr ® and Hornet ® ) [ 30 ] were used, and a direct approach through chat with online users who met the inclusion criteria and sample diversification was implemented. The first individuals who were available online in each one of the two apps and who met the inclusion criteria were included, according to what is recommended in previous studies [ 28 , 29 ].…”

Factors associated with chemsex in Portugal during the COVID-19 pandemic

“…The form was content validated ( 25 ) by three expert/specialist in the topic and was divided into four sections with 46 questions, most were multiple-choice questions, and some were mandatory; without answering those questions, the participant could not proceed with the questionnaire. The questions addressed social and demographic information (age, education, gender identity, housing and type of relationships, according to prior studies) ( 10 - 11 , 26 - 27 ) , mental health (self-perception of stress and strategies to cope with the pandemic), behaviors adopted to protect against the pandemic (social distancing, protective measures against the COVID-19 and level of adherence) and sexual behavior during the social distancing, isolation or quarantine (casual sex, adoption of protective measures against the COVID-19 and sexually transmissible infections [STIs], and type and number of sexual partners) and in the period immediately before the emergence of the pandemic (strategies to find partners, type and number of partners and preventive measures against STIs).…”