Using representative data from the 2019 National Health Survey (PNS-2019), we aim to investigate whether violent physical and sexual victimization differs by sexual orientation in Brazil. This was a cross-sectional study using data from a nationwide household-based survey. The PNS sample was selected with a three-stage cluster sampling. Prevalence of individuals aged 18 to 64 years who had suffered physical violence in the previous 12 months and 95% confidence intervals (CI) were estimated according to sex and sexual orientation. Multivariate logistic regression models were used with physical violence in the previous 12 months as the outcome and self-declared sexual orientation, sociodemographic characteristics, and age of sexual initiation as independent variables. Odds-ratios (OR) were estimated to test associations with the independent variables. The same statistical procedures were used for analyzing lifetime sexual violence. Among the 70,361 participants, 2.2% of men and 2.0% of women self-declared to be homosexual/bisexual. Among homosexual/bisexual men and women, 13% and 16%, respectively, have suffered physical violence in the previous 12 months. Regarding lifetime sexual violence, prevalence was 6.4% among homosexual/bisexual men, with OR = 9.1 (95% CI [5.7, 14.4]) in comparison to heterosexual men. Among homosexual/bisexual women, prevalence reached 11.5%, with OR = 2.4 (95% CI [1.7, 3.4]) in comparison to heterosexual women. After controlling for sexual orientation, the greatest odds of suffering physical violence in the previous 12 months were found among young people, non-white, starting sexual activity <15 years old, and poor education. The risk of women suffering lifetime sexual violence was seven times greater than that of men (OR = 7.30; 95% CI [6.05, 8.80]). The findings indicate a complex scenario in which sex, sexual orientation, skin color, and poor education interact in violent victimization and highlights the insufficiency of public policies in implementing effective actions focused on overcoming the homophobic prejudice that persists in Brazilian society.
