HIV Testing Among Middle-Aged and Older Men Who Have Sex With Men (MSM): A Blind Spot?

Abstract

Middle-aged and older men who have sex with men (MSM) are one of the most underestimated populations with regard to HIV/AIDS infection, despite the worldwide trend of increasing prevalence in recent years. This population also has low rates of testing, although rare studies are done exclusively with middle-aged and older MSM assessing the factors associated with this prevalence. Thus, based on data from an exclusive online survey with middle-aged and older MSM who use geolocation-based dating applications, the purpose of the study was to analyze factors associated with not taking the HIV test among middle-aged (50 years old) and older MSM in Brazil. Using a modification of time-location sampling adapted to virtual reality, 412 volunteers were approached in Grindr®, Hornet®, SCRUFF®, and Daddyhunt®. The multivariate logistic regression model was adopted to produce adjusted odds ratios (ORa), considering a significance level at .05. There were factors associated with not taking the test: being in a relationship (ORa: 0.24; 95% CI [0.10, 0.53]); knowing partner through the applications (ORa: 1.84; 95% CI [1.07, 3.15]); not knowing the serological status (ORa: 5.07; 95% CI [1.88, 13.67]); ejaculating outside of anal cavity (ORa: 1.79; 95% CI [1.04, 3.05]); practicing sex without penetration (ORa: 2.30; 95% CI [1.17, 4.50]); not taking the test as a form of prevention (ORa: 2.83; 95% CI [1.05, 7.68]); and rarely using Viagra in sexual intercourse (ORa: 1.91; 95% CI [1.20, 3.65]). There is a blind spot in the prevalence of HIV testing in older MSM because this population is not being covered by services, which compromises the overall response to HIV, the goals set for universal health coverage.

Suspected COVID-19 flu-like syndrome in men who have sex with men and have been involved in casual sex

“…We were also struck by the fact that the data were collected during the period of the pandemic when the COVID-19 case curve in Brazil was on the rise and, as a result, there were a high number of new cases and deaths. However, the data revealed a scenario of continued sexual practices (casual, drug-using, unprotected, group sex) by MSM at levels similar to those recorded in studies slightly prior to the pandemic (21)(22)(23) , suggesting that this scenario may have worsened in subsequent months.…”

The care provided to the sexual partners of people living with the human immunodeficiency virus

“…O fornecimento de informações sobre HIV é uma ação importante a ser realizada pelos serviços especializados, seja com parcerias heterossexuais, não heterossexuais, soroconcordantes ou discordantes. O empoderamento do usuário do serviço de saúde contribui para mudanças no quadro epidemiológico da atual situação global dessa infecção, principalmente para que se possa atingir a meta 90-90-90 estipulada pelo UNAIDS (3,10) .…”

“…O principal objetivo proposto pelo Programa Conjunto das Nações Unidas sobre HIV/Aids é que, até 2020, os países diagnostiquem 90% das pessoas com esse vírus, que 90% delas iniciem o tratamento precocemente, e 90% delas atinjam níveis de supressão, gerando uma redução na transmissão do HIV (3) .…”

The HIV prevalence in older men who have sex with men in Western & Central Europe and North America—a meta-analysis

“…A study focusing on the older MSM who use dating application has reported that the testing rate in older MSM was only 47%. 36 In the future, widely-covered HIV care and special program on older MSM should be promoted by the government and public health agencies to reach, educate, and help older MSM. Increasing the attention on older MSM is necessary in the implement of “90–90-90” AIDS ending plan.…”