Risk Factors for HIV Infection in the MSM Population in the Metropolitan Area of Campinas City, Brazil, Using Respondent-driven Sampling
Council research aims to contribute to the reduction of HIV in the population of men who have sex with men in Brazil by establishing subgroups who are at greatest risk for HIV infection and understanding the sociodemographic, behavioral, and environmental factors associated with such high risks.
Data regarding the sociodemographic, behavioral, and environmental factors associated with risk for HIV are particularly urgent for populations in Brazil in which the HIV epidemic continues to grow, including men who have sex with men (MSM). Population Council researchers from the Horizons program conducted pioneering research with MSM, collecting information that was used to associate behavioral data with biological markers using respondent-driven sampling. The overall goal of this research was to contribute to the reduction of HIV among MSM by establishing which subgroups are at greatest risk for HIV infection and understanding the sociodemographic, behavioral, and environmental factors associated with such high risks. The results will inform future HIV planning, intervention, and treatment programs.
This study involved a sample of 800 MSM in a large metropolitan area of southeastern Brazil. A cross-sectional study design was used. Data collection consisted of interviews and biological specimen collection (at the same time point) to determine sociodemographic, behavioral, and environmental predictors of risk for HIV; syphilis was used as a biomarker.
Key findings include:
- Multivariate analysis revealed that ever having suffered homophobic psychological abuse was an important predictor of unprotected receptive anal intercourse in the past two months along with having a greater number of sexual partners, lower education, and living with a male or transvestite partner.
- HIV seroprevalence is 7 percent among MSM in the metropolitan area of Campinas. An important finding of this study was the high percentage of MSM who did not know their HIV status, with 70 percent of those who tested HIV-positive being unaware of their infection.
- Forty-two percent of all MSM had never been tested for HIV. Sixty-two percent of MSM aged 14–19 years had never been tested for HIV, and 46 percent of these individuals had unprotected receptive anal intercourse in the past two months.
- MSM who engage in commercial sex work also were identified as a high-risk group in this study. Approximately 15 percent of MSM reported having received payment (money, drugs, or gifts) in exchange for sex in the past two months, and approximately 8 percent identified themselves as commercial sex workers.
- A high proportion of MSM reported having suffered homophobic violence at least once in their lifetime (85 percent), as well as in the past 12 months (70 percent).
The findings from this study clearly indicate the importance of the population of MSM in the HIV epidemic and the need for targeted interventions, particularly for the risky subpopulations in Campinas. Progress is being made in this area. The Brazilian government has made MSM a key target group in the fight against HIV, as highlighted by the high priority given to young MSM during the official 2007 AIDS Day prevention campaign. Together these are important steps toward comprehensive coverage of MSM and their subgroups with HIV prevention programs. Lastly, the implementation of this study contributed substantially to the development of the guidelines for the implementation of the national HIV surveillance in high-risk populations.
Assessment of risk factors for HIV infection among men who have sex with men in the metropolitan area of Campinas City, Brazil, using respondent-driven sampling (PDF)
de Mello,Maeve; de Araujo Pinho,Adriana; Chinaglia,Magda; Tun,Waimar; Barbosa Junior,Aristides; Ilario,Maria Cristina F.J.; Reis,Paulo; Salles,Regina C.S.; Westman,Suzanne; Diaz,Juan
Horizons Final Report
Publication date: 2008
Sexual risk behaviours and HIV seroprevalence among male sex workers who have sex with men and non-sex workers in Campinas, Brazil (abstract)
Tun,Waimar; de Mello,Maeve; Pinho,Adriana A.; Chinaglia,Magda; Diaz,Juan
Sexually Transmitted Infections 84(6): 455-457
Publication date: 2008
Project Stats
Location: Brazil (metropolitan area of Campinas, SP, comprising 19 neighboring municipalities)
Program(s):
HIV and AIDS
Topic(s):
Behavior change
HIV prevention
Men who have sex with men
Stigma and discrimination
Duration: 6/2005 - 6/2007
Population Council researchers:
Waimar Tun
Non-Council collaborators:
Aristides Barbosa Jr. (National Program of STD/AIDS, Ministry of Health, Brazil)
Francisco Hideo Aoki (Faculty of Medical Sciences, State University of Campinas, Brazil)
Suzanne Westman (Centers for Disease Control and Prevention/Brazil)
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