Discrepancy between behavioral-indicated and perceived candidacy for HIV pre-exposure prophylaxis among men who have sex with men in Chengdu, China / 北京大学学报(医学版)

OBJECTIVE@#To explore the discrepancy between behavioral-indicated candidacy and perceived candidacy (behavioral-perceived gap) and its associated factors of human immunodeficiency virus (HIV) pre-exposure prophylaxis (PrEP) among men who have sex with men (MSM), so as to identify the focus population of PrEP interventions and to design and implement targeted interventions.@*METHODS@#We recruited a sample of 622 HIV-negative MSM who were regular clients of a community-based organization located in Chengdu, China, from November to December 2021. A cross-sectional questionnaire was used to collect the participants' information on social demographics, PrEP-related knowledge and cognitions, and risk behaviors. In this study, behaviorally eligible for PrEP was defined as performing at least one type of high-risk behavior in the past six months, including inconsistent condom use, sex with an HIV-positive partner, confirmed sexual transmitted infections (STI) diagnosis, substance use, and post-exposure prophylaxis (PEP) experience. Logistic regression models were fitted, and multivariate analyses were adjusted for social demographics.@*RESULTS@#Among the 622 eligible participants, 52.6% (327/622) were classified as behaviorally eligible for PrEP. Only 37.9% (124/327) of the participants perceived themselves as appropriate candidates for PrEP and 62.1% (203/207) had discrepancy between behavioral-indicated and perceived candidacy. 85.9% (281/327) had heard of PrEP, and 14.2% (40/281) accessed PrEP information through health care providers. Of the 327 participants eligible for behavior-indicated PrEP use, about half (47.1%) knew how to obtain PrEP medication and 33.0% had a professional PrEP counseling experience. The majority (93.3%) had no or few friends using PrEP. 54.1% scored eight or above in PrEP knowledge level. 66.7% reported having two or more sexual partners in the past six months. After adjusting for age and recruitment channel, we found six factors that were associated with perceived candidacy for PrEP, including PEP use [adjusted odds ratio (ORA)=2.20; 95% confidence interval (CI): 1.33-3.63], PrEP availability (ORA=1.69; 95%CI: 1.06-2.68), a greater number of PrEP-using friends (ORA=4.92; 95%CI: 1.77-13.65), PrEP know-ledge (ORA=2.21; 95%CI: 1.38-3.56), multiple sexual partnership (ORA=1.77; 95%CI: 1.07-2.94), and perceiving a higher risk of HIV infection (ORA=4.02; 95%CI: 1.73-9.32). Substance use during sex and PrEP information channel were not statistically associated with this beha-vioral-perceived gap.@*CONCLUSION@#We observed a high discrepancy between behavioral-indicated and perceived candidacy for PrEP among Chengdu MSM in China. Future PrEP implementation efforts should be made in skills training in assessing HIV infection risk, increasing PrEP knowledge, providing professional PrEP counselling, and fostering PrEP support environment.

Funcionalidad familiar: hombres que tienen sexo con hombres y sexo solo con mujeres / Family functionality: men who have sex with men and men who only have sex with women / Funcionalidade familiar: homens que fazem sexo com homens e sexo apenas com mulheres

Resumen (analítico) Los hombres que tienen sexo con hombres se caracterizan por recibir expresiones de rechazo y estigmatización, ante el ideal heteronormativo de los hombres que tienen sexo solo con mujeres, circunstancias que propician la aparición de problemas en el grupo familiar. Se realizó un estudio cuantitativo con el objetivo de comparar la funcionalidad familiar desde la perspectiva de los hombres que tienen sexo con hombres frente a los hombres que tienen sexo solo con mujeres, con un muestreo no probabilístico por bola de nieve. Los resultados indican mayores porcentajes de disfuncionalidad familiar entre los hombres que tienen sexo con hombres, en contraste a la funcionalidad moderada y normo-funcionalidad de los hombres que tienen sexo solo con mujeres, con diferencias estadísticamente significativas (p=.001). Se recomienda generar mayores evidencias al fondo común del conocimiento, a fin de derribar prejuicios, visibilizar la demanda de cuidado y promover la formulación de estrategias en atención a las necesidades de este grupo vulnerable.

Abstract (analytical) Men who have sex with men are characterized by receiving rejection and stigmatization based on the heteronormative ideal of men who only have sex with women. These circumstances can lead to problems in family groups. A quantitative study was carried out with the objective of comparing the family functionality based on the perspectives of men who have sex with men with men who only have sex with women and using non-probability snowball sampling. The results indicate higher percentages of family dysfunction among men who have sex with men, in contrast to the moderate functionality and normo-functionality of men who only have sex with women, and with statistically significant differences (p=.001). It is recommended to generate more knowledge in this area to challenge prejudices, highlights the need for assistance and to promote the design of assistance strategies that meet the needs of this vulnerable group.

Resumo (analítico) Homens que fazem sexo com homens se caracterizam por receber expressões de rejeição e estigmatização, dado o ideal heteronormativo de homens que fazem sexo apenas com mulheres, circunstâncias que levam ao surgimento de problemas no grupo familiar. Um estudo quantitativo foi realizado, com o objetivo de comparar a funcionalidade familiar na perspectiva de homens que fazem sexo com homens com homens que fazem sexo apenas com mulheres, amostragem não probabilística por bola de neve. Os resultados indicam percentuais mais elevados de disfunção familiar entre os homens que fazem sexo com homens, em contraste com a funcionalidade moderada e normofuncionalidade dos homens que fazem sexo apenas com mulheres com diferenças estatisticamente significativas (p=.001). Recomendase gerar mais evidências para o fundo comum de conhecimento, a fim de demolir preconceitos, visibilizar a demanda de cuidados e promover a formulação de estratégias para atender às necessidades desse grupo vulnerável.

HIV, syphilis, hepatitis B and C in key populations: results of a 10-year cross-sectional study, Southern Brazil

ABSTRACT Objective: Although the development of prevention and treatment strategies for sexually transmitted infections in key groups has improved over the years, they still remain a challenge for health systems worldwide. In this context, the objective of this study is to assess the seroprevalence in the tested population, with an emphasis on key populations, aiming at identifying the participants' profile and consequently the development of testing strategies. Methods: The present study analyzed the seroprevalence of HIV, syphilis, and hepatitis B and C, and the epidemiological profiles of key and general populations tested at a reference public health facility for sexually transmitted infections testing and counseling in the city of Curitiba, Southern Brazil. A cross-sectional study was conducted to report data from 2010 to 2019. Results: A total of 67,448 samples were analyzed, 9,086 of these tested positive, 3,633 (56%) for HIV, 4,978 (77%) for syphilis, 340 (5%) for hepatitis C virus (HCV), and 135 (2%) for hepatitis B virus (HBV). Overall, most of the participants were men (79 to 87%), and predominantly white. For HIV and syphilis, the predominant age groups were 21-30 years old (48 and 50%), HBV 21-40 years old (31%), and HCV 41-60 years old (25%). A high seroprevalence of HIV and syphilis was observed in the investigated key populations with a higher frequency in sex workers, men who have sex with men, and transgender. Conclusion: The progressive increase in syphilis cases emphasizes the need for effective interventions to enhance adherence to the use of condoms, and to expand diagnosis and treatment for these key populations.

Hombres homosexuales: conocimiento sobre el VIH y respuestas ante su situación de diagnóstico / Homosexual men: knowledge about HIV and responses to their diagnosis situation / Homens homossexuais: conhecimento sobre o HIV e respostas à sua situação de diagnóstico

RESUMENObjetivo: identificar en un grupo de hombres homosexuales el conocimiento que tienen sobre el VIH y los tipos de respuesta ante su situación de diagnóstico.Método:estudio cualitativo y descriptivo. Los participantes fueron seleccionados mediante muestreo bola denieve. La recolección de datos se realizó mediante entrevistas semiestructuradas aplicadas en un consultorio particular durante febrero y mayo de 2021 en la ciudad de Puebla, México, las cualesfueron grabadas y transcritas en su totalidad. El análisis sedesarrolló a través del programa MAXQDA a partir de las seis fases propuestas por Braun y Clarke, apegándose a los principios de bioética y a los criterios de calidad establecidos para investigaciones de esta índole. Resultados:se realizaron cinco entrevistas a HSH autoidentificados como homosexuales con un promedio de edad de 27,4 años. Como resultado del análisis de contenido se encontraron cinco categorías periféricas alrededor de una categoría central denominada 'HSH con VIH': conocimiento acerca del VIH,proceso adaptativo, comportamiento sexual, redes de apoyo y discriminación percibida. Conclusión: se observan conductas sexuales de riesgo, falta de apego al tratamiento, así como conocimientos y creencias erróneas acerca del VIH. Adicionalmente, se implementan intervenciones dirigidas a los profesionales de la salud.

ABSTRACTObjective:to identify the knowledge about HIV a group of homosexual men has and the types of response facing theirdiagnosis situation. Method:descriptive qualitative study. The participants were selected by snowball sampling, the collection was through semi-structured interviews applied in a private office between February and May 2021 in the city of Puebla, Mexico,which were entirely recorded and transcribed. The analysis was developed through the MAXQDA program based on the six phases proposed by Braun and Clarke, adhering to the principles of bioethics and the quality criteria established for this type of research. Results:five interviews were conducted with MSM self-identified as homosexual with an average age of 27,4 years. As a result of the content analysis, five peripheral categories were found around a central category called 'MSM with HIV': knowledge aboutHIV, adaptive process, sexual behavior, support networks and perceived discrimination. Conclusion:risky sexual behaviors, lack of adherence to treatment, as well as erroneous knowledge and beliefs about HIV are observed, in addition to implementing interventions aimed at health professionals.

RESUMOObjetivo:identificar como é o conhecimento sobre o HIV e os tipos de resposta que um grupo de homens homossexuais tem dado a sua situação diagnóstica. Método:estudo qualitativo e descritivo. Os participantes foram selecionados por amostragem em bola de neve. A coleta se deu por meio de entrevistas semiestruturadas, aplicadas em consultório particular, durante os meses de fevereiro e maio de 2021 na cidade de Puebla, México, as quais foram gravadas e transcritas na íntegra. A análise se deu por meio do programa MAXQDA e das seis fases propostas por Braun e Clarke. Respeitou os princípios da bioética e os critérios de qualidade estabelecidos para esse tipode pesquisa. Resultados:foram realizadas cinco entrevistas com HSH autoidentificados como homossexuais com média de idade de 27,4 anos. Como resultado da análise de conteúdo, foram encontradas cinco categorias periféricas: conhecimento sobre o HIV, processo adaptativo, comportamento sexual, redes de apoio e discriminação percebida, em torno de uma categoria central denominada HSH com HIV. Conclusão:observam-se comportamentos sexuais de risco, falta de adesão ao tratamento, conhecimento e crenças errôneassobre o HIV. Além de implementar intervenções direcionadas aos profissionais de saúde.

Barreiras de acesso para Homens que fazem Sexo com Homens à testagem e tratamento do HIV no município de Curitiba (PR) / Access barriers for Men who have Sex with Men for HIV testing and treatment in Curitiba (PR)

RESUMO Mais da metade das novas infecções por HIV em 2018 ocorreu entre populações-chave, incluindo homens gays e outros Homens que fazem Sexo com Homens (HSH). O estigma pode trazer uma série de consequências comportamentais, refletindo negativamente na vida dos indivíduos, e pode ser traduzido em barreiras para o acesso aos serviços públicos de saúde. O objetivo deste artigo é o de analisar as principais barreiras para o acesso à testagem do HIV em um Centro de Orientação e Aconselhamento de Curitiba e a vinculação dos homens gays e outros HSH ao serviço de saúde para o tratamento precoce. Realizou-se a coleta de dados primários seguindo método qualitativo, triangulando as técnicas de observações de campo, análise documental e entrevistas. Os resultados revelam falta de profissionais capacitados, dificuldade de acolhimento nos serviços de saúde, aceitação da sexualidade, medo do resultado e falta de informação como principais barreiras para se testar. Dificuldade na aceitação do diagnóstico, preconceito e discriminação foram algumas barreiras encontradas para o início do tratamento. Pode-se concluir que a ampliação do acesso para a garantia dos direitos daqueles que efetivamente têm mais dificuldade de entrada nos serviços de saúde do Sistema Único de Saúde (SUS) permanece um grande desafio.

ABSTRACT More than half of new HIV infections in 2018 were among key populations, including gay men and other Men who have Sex with Men (MSM). Stigma can have several behavioral consequences, adversely reflecting on the lives of individuals and can be translated into barriers to access to public health services. This paper aimed to analyze the main barriers to accessing HIV testing at a Curitiba Testing and Counseling Center and the linkage of gay men and other MSM with the health service for early HIV treatment. Primary data were collected following the qualitative method, triangulating field observations, document analysis, and interviews. The results pointed to the lack of trained professionals, difficulty receiving health services, acceptance of sexuality, fear of results, and lack of information as the main barriers to testing. Difficulty in accepting the diagnosis, prejudice, and discrimination were some barriers identified to start treatment. We can conclude that the expansion of access to guarantee the rights of those who have more difficulty entering the Unified Health System (SUS) is still a significant challenge.

Voluntary counseling and testing among young students in Hangzhou City during 2016-2020 / 中国学校卫生

Objective@#To analyze the characteristics of young students inquiry to voluntary counseling and testing (VCT) clinics, and to provide reference for AIDS prevention and control effectiveness of local schools.@*Methods@#A total of 1 223 students aged 7-28 years were collected and characterized through HIV Testing Consulting Information Management System in Shangcheng VCT clinics during 2016-2020. The epidemic characteristics were analyzed by cross sectional studies.@*Results@#Young students accounted for 25.21%(1 223/4 852) of the total counseling population in VCT clinics from 2016 to 2020. The main reason for counseling was non high risk (28.29%, 346 cases), followed by MSM (26.41%, 323 cases) and non commercial non fixed heterosexual behavior(25.92%, 317 cases). The counseling proportion of non commercial non fixed heterosexual behavior and commercial heterosexual sex behavior declined with time( χ 2 trend =-6.04, -3.59, P <0.01). The average of HIV positive detection rate among young students was 3.03%(37 cases), which increased with time( χ 2 trend=2.45, P <0.01).@*Conclusion@#Sex education and HIV/AIDS knowledge education are necessary in primary and secondary schools. Targeted strategies are in great need in terms of MSM behavior intervention.

Recreational new drug use and influencing factors among young men who have sex with men in Tianjin / 中国学校卫生

Objective@#To understand the basic characteristics, sexual behavior and the use of recreational new drugs of young men who have sex with men (MSM) in Tianjin, and to explore the characteristics of young MSM who use recreational drugs, so as to provide reference for the policy making of HIV/AIDS prevention and control in universities.@*Methods@#From January 1, 2018, solstice to December 31, 2018, participants were recruited in the bathrooms, bars and social network sites in Tianjin by snowball sampling. The basic demographic information, sexual behavior and recreational drug use of the participants were collected through face to face interviews and questionnaires. Logistic regression was used to analyzed the characteristic differences drug users and non users among young MSM.@*Results@#A total of 826 young MSM were included in the study, 32 were infected with HIV, and the overall prevalence rate was 3.87 %. Totally 371 (44.92%) were drug users. Rush Poppers were the most common used drug ( 98.65 %). Of the young MSM using new drugs, 306 (82.48%) multiple drugs were used, 65 people ( 17.52 %) only one drug has been used. Among new drug users, multiple drug users had higher HIV prevalence rate (16.92%) than single drug users (4.57%). There were statistically significant differences between drug users and non users in age, age of first sexual behavior, household registration, sexual orientation, education level, sexual partners seeking routes, unprotected anal intercourse and HIV testing history( OR=3.70，5.51，0.51，0.60，4.64，0.40，0.52，1.98，2.29，P <0.05).@*Conclusion@#The utilization rate of recreational drugs among young MSM in Tianjin was high. Relevant departments should strengthen the propaganda of recreational drugs and HIV prevention among college students, improve the sexual health awareness of young MSM, and establish a long term HIV and recreational drug prevention system.

Factors influencing HIV infection among college students who are young men who have sex with men in Tianjin / 中国学校卫生

Objective@#To analyze associated factors of HIV infection among college students who are young men and have sex with men (YMSM) in Tianjin, providing reference for HIV prevention and control among YMSM college students.@*Methods@#During Aug. 1st, 2018 to Dec. 31st, 2018, SHENLAN recruited college students who were YMSM aged 18-24 years from gay baths, gay bars, QQ, WeChat and gay dating app BLUED. HIV infection status and associated factors (general demographic characteristics, unsafe sexual behaviors, addictive substance using, basic knowledge of HIV) was collected and analyzed.@*Results@#A total of 470 college students, including 21 HIV infected (4.47%), were enrolled in this study. Univariate Logistic regression analyses indicated that age, age at first sex behavior, HIV related knowledge, tobacco use, recreational drug usage, syphilis infection was associated with HIV infection among YMSM students (P<0.05). Multivariate analysis found age of first sex (OR=21.20，95%CI=3.09-145.43), recreational drug use (OR=5.07，95%CI=1.77-14.48), lack of HIV related knowledge (OR=3.38，95%CI=1.33-8.63)were associated with HIV infection (P<0.05).@*Conclusion@#College students who are YMSM in Tianjin have a high rate of HIV infection, who deserves further attention. Targeted campus HIV/AIDS prevention program should be developed combined with specific characteristics of this population.

Social network characteristics of gay men college students in Tianjin seeking sex partners / 中国学校卫生

Objective@#Based on the MSM college students in Tianjin, this study aims to explore the demographic and behavioral characteristics of MSM with different sexual partners, and to provide evidence and information for intervention in combination with social networks.@*Methods@#According to the source and access of seeking sexual partners, 546 MSM of Tianjin college students aged 18-24 in 2018 Jan. and 2019 Dec. were divided into internet-based MSM (396) and traditional MSM (150). Chi-square test and rank-sum test were used to compare the demographic information, sexual behavior characteristics, HIV prevention and testing awareness, and psychoactive substance use of the two MSMs, and Logistic regression was used to explore factors affecting college students use of the Internet for sexual partners.@*Results@#Internet-based MSM has advantages in receiving HIV testing and safety consulting services, AIDS knowledge level, and peer education in the past year (P<0.05). The psychoactive substance use of the survey population reached more than 40%, and the awareness rates of pre-exposure prophylaxis and post-exposure prophylaxis were 32.98% and 55.32%, respectively. After multivariate Logistic regression analysis, MSM students who had received condom distribution, AIDS counseling and peer education (OR=2.16, 1.98, P<0.01) were more inclined to use the Internet for sexual partners.@*Conclusion@#Relevant departments can use the Internet to intervene in the prevention and control of MSM in colleges and universities in terms of AIDS-related knowledge, HIV testing, and mental substances.

Association between the characteristics of sexual partners and substance use before sexual behavior in young male students who have sex with men / 中国学校卫生

Objective@#To understand the characteristics of sexual partners and the influence of having multiple sexual partners on substance use among young male students man who have sex with men (MSM) in China, and to provide scientific basis for the prevention and control of HIV/AIDS among young MSM students.@*Methods@#A mixed recruitment method of snowball sampling and respondent driven sampling was used to recruit young MSM students in Beijing and Tianjin, and a questionnaire survey was conducted among 220 participants from November to December 2019. Chi-square test and generalized linear model multi-factor Logistic regression were used to analyze the influencing factors of substance use before sexual behavior.@*Results@#The average age of them was (22.39±2.57) years old, 84.5% of them were students, the average age of first sexual behavior was (18.83±2.45) years old, 44.1% of them had two or more sexual partners (including fixed sexual partners, temporary sexual partners and commercial sexual partners), 22.7% had more than one male fixed partner. After adjusting for age and education, having multiple sexual partners was risk factor for drinking alcohol before sex (aOR=2.97) or substance abuse (aOR=2.39). Having male temporary sexual partner was an risk factor in substance use before sexual behavior(OR=4.10).@*Conclusion@#The characteristics of sexual partners among young MSM students are complex, and the proportion of multiple sexual partners is high. Having fixed single sexual partner can reduce the risk of substance use before sexual behavior. AIDS prevention education for young MSM students should be further strengthened.

Depressive symptoms and associated factors of men who have sex with men (MSM) among young people/students in a city / 中国学校卫生

Objective@#To understand HIV status and depressive symptoms among men who have sex with men (MSM) in the HIV-infected young people/social network.@*Methods@#Intervention network of local CDC was used to recruit HIV-infected young people/students in the city. A mixed recruitment method of snowball sampling and respondent driven sampling method. A MSM young people/students with HIV infection. A total of 201 valid questionnaires were collected.@*Results@#Among them, 132(65.7%) were students, 121(60.2%) were HIV-positive, 108(53.7%) had depressive symptoms. The awareness rate was 92.0%(185). Binary-Logistic regression analysis showed that HIV infection(aOR=4.06,95%CI=2.13-7.72), living alone (aOR=2.93, 95%CI=1.31-6.52) and having sex before the age of 18 (aOR=4.13, 95%CI=1.32-12.96) were significantly associated with depression, moreover, HIV knowledge was a protective factor that help to resist depression in young MSM(aOR=0.30, 95%CI=0.13-0.69)(P<0.01).@*Conclusion@#Depressive symptoms are prevalent among HIV-infected MSM young people. It s cost-effective to promote a multiple biomedical package of increasing HIV/AIDS awareness, reducing HIV infection and transmission to protect young people/students from depression.

Effect of peer intervention by popular opinion leaders among young students who have sex with men / 中国学校卫生

Objective@#The proposal of this study is to determine the feasibility of using online social software to guide popular opinion leaders(POLs) among young students MSM (men who have sex with men, MSM) carrying out comprehensive AIDS prevention in young students MSM.@*Methods@#From November to December 2019 in Tianjin, 22 POLs who had previously experienced AIDS prevention education and training foucus on life skills were recruited. Though snowball sampling method, 100 POLs partners (friends, sexual partners, classmates, etc) were invited into the study. From January to March 2020, regular posters will be sent through the WeChat platform to guide POL to intervene their partners/sexual partners. The questionnaire surveys were conducted before and after the intervention.@*Results@#After the intervention, both the proportion of young students MSM had sex and with multiple sex partners decreased(χ2=12.12, 5.94, P<0.05). The comprehensive ability of AIDS prevention has improved significantly, the "National Eight Items" correct rate has risen from 90.0% to 99.0%(χ2=5.82, 7.56, P<0.05), and the "Youth Eight Items" correct rate has increased from 86.0% to 98.0%(P<0.01). Knowledge score increased from(11.08±1.89) to (11.84±1.27); Attitude score increased from (54.29±4.01) to (56.06±3.75), the behavior score increased from (52.12±4.78) to (55.08±4.25), skill score increased from (51.96±4.75) to (54.67±5.04), The comprehensive prevention ability score (percent) increased from (87.30±6.95) to (91.86±5.42)(t=-4.21, -3.51, -5.32, -5.16, -6.45, P<0.01).@*Conclusion@#Using Wechat platform to guide POL carrying out comprehensive AIDS prevention is effective for improving the comprehensive AIDS prevention ability of young students MSM.

Association between ego-centric social network and HIV status of MSM young students / 中国学校卫生

Objective@#To identify the characteristics of social network and the association between ego-centric network and HIV status among young MSM Chinese students.@*Methods@#The cross-sectional study was conducted in Chongqing, Tianjin, Harbin and Xi an city from April to December 2017 and from March to May 2018. A mixed recruitment method of snowball sampling and RDS approach was used to recruit participants who reported information on social network and received HIV test. The Multiple Regression Analysis method was used to for the analysis of association between ego-centric social network and HIV status of men who have sex with men (MSM) among young students.@*Results@#The sample included 547 participants who nominated 1 088 social partners in total with average age of 13 to 60 years old. The MSM with different sexual orientation from their social members (aOR=0.38), embedded in a large network (aOR=0.63), with a high individual betweenness centrality (aOR=0.27) were at lower risk of HIV-positive status; while MSM who differed greatly in education level with their social members(aOR=1.60), existed in sexual networks(aOR=1.41), existed in the “risky networks” (aOR=1.88) , with high network density (aOR=1.91) and a high individual degree (aOR=4.10) had higher risk of HIV-positive status(P<0.05).@*Conclusion@#MSM with great difference in education level from social members, existed in sexual networks, with a large network density and a high degree were exposed to higher risk of HIV-positive status.

Suspected COVID-19 flu-like syndrome in men who have sex with men and have been involved in casual sex / Síndrome gripal sospecha de COVID-19 en hombres que tienen sexo con hombres y se envolvieron en sexo ocasional / Síndrome gripal suspeita de COVID-19 em homens que fazem sexo com homens e se envolveram em sexo casual

ABSTRACT Objective: To evaluate the presence of flu-like syndrome suggestive of COVID-19 in men who have sex with men (MSM) and engaged in casual sex during a period of social isolation. Method: National epidemiological survey, applied in April and May 2020, by adaptation of Respondent Drive Sampling. Results: 1,337 MSM participated in the survey, of which 514 (38.4%) had fever associated with another sign or symptom of flu-like syndrome. Social, demographic characteristics, sexual practices and activities during the period of social isolation were statistically associated with the presence of flu-like syndrome. There was a statistical difference (p < 0.001) in the average of partners between those who had signs and symptoms of flu-like syndrome (3.5) and those who did not (1.7). Conclusion: Evidence of signs and symptoms indicative of flu-like syndrome suggestive of COVID 19 in Brazilian MSM who were involved in casual sex during the period of social isolation.

RESUMEN Objetivo: Evaluar la presencia de síndrome gripal sospecha de COVID-19 en hombres que tienen sexo con hombres (HSH) y se envolvieron en sexo con pareja ocasional durante distanciamiento social. Método: Averiguación epidemiológica, de abarcamiento nacional, aplicado en abril y mayo de 2020, por adaptación del Respondent Drive Sampling. Resultados: 1.337 HSHs participaron de la investigación, de los cuales 514 (38,4%) tuvieron fiebre relacionada a otra señal o síntoma de síndrome gripal. Características sociales, demográficas, prácticas y actividades sexuales durante el distanciamiento social han estáticamente relacionadas a la presencia de síndrome gripal. Hubo diferencia estadística (p < 0,001) en la media de parejas entre aquellos que tuvieron señales y síntomas de síndrome gripal (3,5) y aquellos que no los tuvieron (1,7). Conclusión: Se evidencia ocurrencia de señales y síntomas indicativos de síndrome gripal sugestivo de COVID-19 en HSHs brasileños que se envolvieron en sexo ocasional durante el período del distanciamiento social.

RESUMO Objetivo: Avaliar a presença de síndrome gripal suspeita de COVID-19 em homens que fazem sexo com homens (HSH) e se envolveram em sexo com parceiro casual durante período de distanciamento social. Método: Inquérito epidemiológico, de abrangência nacional, aplicado em abril e maio de 2020, por adaptação do Respondent Drive Sampling. Resultados: 1.337 HSHs participaram da pesquisa, dos quais 514 (38,4%) tiveram febre associada a outro sinal ou sintoma de síndrome gripal. Características sociais, demográficas, práticas e atividades sexuais durante o período de distanciamento social foram estaticamente associadas à presença de síndrome gripal. Houve diferença estatística (p < 0,001) na média de parceiros entre aqueles que tiveram sinais e sintomas de síndrome gripal (3,5) e aqueles que não os tiveram (1,7). Conclusão: Evidencia-se ocorrência de sinais e sintomas indicativos de síndrome gripal sugestiva de COVID19 em HSHs brasileiros que se envolveram em sexo casual durante o período do distanciamento social.

Comprehensive AIDS prevention ability of young students who is men have sex with men and associated factors / 中国学校卫生

Objective@#To understand the characteristics of KAP (knowledge, attitude and practice) related to the prevention of AIDS among young male MSM (man sex with man) in China, and to evaluate the comprehensive ability of AIDS prevention and associated factors to provide a scientific basis for the development of MSM AIDS prevention and control.@*Methods@#From November to December 2019, sampling was recruited by using snowball sampling methods centered on Beijing and Tianjin. A cross-sectional survey of 222 young students MSM was conducted through an online questionnaire with information of general demographic characteristics, sexual behavior and HIV testing, psychological status and comprehensive ability to prevent AIDS.@*Results@#Average score on comprehensive AIDS prevention knowledge was (87.64±6.41),with knowledge,attitude,and behavior score of (11.32±1.67)(54.87±3.36) and (52.18±4.30) respectively.The pass rate of knowledge, attitude, practice related to AIDS prevention were respectively 95.5%, 56.3%, and 27.0%. The separation rate of knowledge from belief was 42.8%, the separation rate of knowledge from behavior was 71.2%, and the separation rate of faith from information was 48.2%. Whether have received AIDS prevention education was related to knowledge qualification rate (P<0.01).@*Conclusion@#Current AIDS education is associated with the knowledge level of AIDS prevention among young MSM groups, but it is not enough to improve their attitudes and behaviors. The comprehensive ability of MSM in preventing AIDS among young students is still not optimistic. Intervention measures need to be further strengthened to improve the comprehensive ability of young students MSM group to prevent AIDS.

Prevalence and associated factors of seeking casual male sexual partners among men who have sex with men students in Guangzhou / 中国学校卫生

Objective@#To examine the prevalence and associated factors of seeking casual male sexual partners among men who have sex with men (MSM) students in Guangzhou, and to provide a reference for health education and intervention.@*Methods@#A cross-sectional study was conducted to recruit 189 MSM students aged 18 and 28 via voluntary counseling and testing (VCT) clinics, Lingnan partners and Zhitong charity from May 2017 to April 2018. An anonymous electronic questionnaire was administrated to collect information on sociodemographic and sexual behavior characteristics. Chi-square test and non-conditional Logistic regression analysis were performed to explore the associated factors of casual homosexual behavior among MSM students.@*Results@#In the past 6 months, 63.49% (120/189) of them reported casual male partners, and the rate of consistent condom use was 61.67%(74/120). Multivariate Logistic regression analysis showed that participants who had multiple sex partners in the past 6 months were more likely to seek male casual partners(aOR=9.13, 95%CI=4.27-19.53). Individuals who used recreational drugs before sex were at a higher risk of having casual sex behaviors(aOR=3.06, 95%CI=1.08-8.62). MSM students who had steady homosexual partners had a lower risk to seek casual sex(aOR=0.43, 95%CI=0.19-0.98).@*Conclusion@#The proportion of seeking casual male sexual partners among MSM students in Guangzhou was relatively high. The publicity and education should be strengthened among those who had multiple sex partners, with no steady homosexual partners and used recreational drugs before sex, to reduce the casual sex behaviors.

Infecções sexualmente transmissíveis e fatores associados ao uso do preservativo em usuários de aplicativos de encontro no Brasil / Infecciones de transmisión sexual y factores asociados al uso del preservativo en usuarios de aplicaciones de citas en Brasil / Sexually transmitted infections and factors associated with condom use in dating app users in Brazil

Resumo Objetivos Caracterizar os usuários brasileiros de aplicativos de encontro baseados em geolocalização, estimar a prevalência de Infecções Sexualmente Transmissíveis (ISTs) e fatores associados ao uso do preservativo. Métodos Estudo descritivo, transversal, com amostra de 2.250 homens que fazem sexo com homens (HSH) de todo o Brasil. Utilizou-se da rede social Facebook® para a coleta e divulgação da pesquisa, por meio de uma postagem impulsionada semanalmente, de novembro de 2016 a janeiro de 2017. Os dados foram analisados de forma uni e bivariada com o auxílio do software SPSS. Resultados Houve a predominância de participantes jovens (25 anos), com ensino superior completo (57,8%) e homossexuais (75,7%), que conheceram os seus parceiros através de aplicativos (64,1%), utilizando, principalmente, o Tinder ® (57,3%) e Grindr® (53,3%) para fins sexuais (69,7%). A prevalência de ISTs foi de 11,1%, sendo 7,1 de HIV. Foram fatores associados ao uso de preservativos: conhecer o parceiro pelo app (p=0,003), utilizar o Grindr ® (p=0,002), Scruff ® (p=0,027) ou Hornet ® (p<0,001), usar os apps para amizade (p<0,001), sexo (p<0,001) ou relacionamento (p<0,001), frequência de uso do aplicativo (p<0,001) e utilizar os apps durante à noite (p=0,003). Conclusão Os usuários são jovens, com alto nível educacional e que demonstram familiaridade com os apps pelo tempo de uso. A prevalência de ISTs foi elevada, sobretudo da infecção pelo HIV. Características sociodemográficas e particularidades do uso e consumo dos apps estão associadas a utilização consistente do preservativo, principalmente o motivo de uso, frequência, horário e aplicativo utilizado.

Resumen Objetivos caracterizar a los usuarios brasileños de aplicaciones de citas basadas en geolocalización, estimar la prevalencia de infecciones de transmisión sexual (ITS) y factores asociados al uso del preservativo. Métodos estudio descriptivo, transversal, con muestra de 2.250 hombres que tienen sexo con hombres (HSH) de todo Brasil. Se utilizó la red social Facebook® para la recolección y difusión de la investigación, por medio de una publicación impulsada semanalmente, de noviembre de 2016 a enero de 2017. Los datos fueron analizados de forma uni y bivariada con la ayuda del software SPSS. Resultados hubo un predominio de participantes jóvenes (25 años), con educación superior completa (57,8%) y homosexuales (75,7%), que conocieron a sus parejas a través de aplicaciones (64,1%), utilizando principalmente Tinder ® (57,3%) y Grindr® (53,3%) para fines sexuales (69,7%). La prevalencia de ITS fue de 11,1%, siendo 7,1 de VIH. Los factores asociados al uso de preservativos fueron: conocer a la pareja a través de la app (p=0,003), utilizar Grindr ® (p=0,002), Scruff ® (p=0,027) o Hornet ® (p<0,001), usar las apps para amistad (p<0,001), sexo (p<0,001) o relaciones (p<0,001), frecuencia de uso de la aplicación (p<0,001) y utilizar las apps durante la noche (p=0,003). Conclusión los usuarios son jóvenes, con alto nivel educativo y que demuestran familiaridad con las apps por el tiempo de uso. La prevalencia de ITS fue elevada, sobre todo de la infección por el VIH. Características sociodemográficas y particularidades del uso y consumo de las aplicaciones están asociadas a la utilización consistente del preservativo, principalmente el motivo de uso, frecuencia, horario y aplicación utilizada.

Abstract Objectives To establish the characteristics of Brazilian geosocial dating app users, estimate the prevalence of sexually transmitted infections (STIs) and factors associated with condom use. Methods This was a cross-sectional descriptive study with a sample of 2,250 men who have sex with men (MSM) from across Brazil. The social network Facebook® was used to disseminate and collect data for the survey, through a post boosted weekly, between November 2016 and January 2017. The data were submitted to univariate and bivariate analysis with the help of SPSS software. Results Most participants were young (25 years old), had a university degree (57.8%), were homosexual (75.7%), and had met their partners on dating apps (64.1%), especially Tinder ® (57.3%) and Grindr ® (53.3%), for sexual purposes (69.7%). The prevalence of STIs was 11.1%, and 7.1% were HIV+. Factors associated with condom use were: meeting partners on app (p=0.003), using Grindr ® (p=0.002), Scruff ® (p=0.027) or Hornet ® (p<0.001), using apps to find friends (p<0.001), sex (p<0.001) or relationships (p<0.001), frequency of app use (p<0.001) and using apps at night (p=0.003). Conclusion App users are young, with high education levels and are familiar with the apps due to time of use. The prevalence of STIs was high, especially HIV. The sociodemographic characteristics and particularities of the use and consumption of app were associated with consistent condom use, especially reason for use, frequency, time of day, and app used.

Respuesta familiar ante la revelación de la orientación sexual, desde el discurso de hombres homosexuales / Family response to the revelation of the sexual orientation, from the discourse of homosexual men / Resposta familiar perante à revelação da orientação sexual, desde o discurso de homens homossexuais

Resumen Introducción La homosexualidad representa fragmentar las normas establecidas socialmente, provenientes de una sociedad sectorizada, que adopta un patrón de obligatoriedad heteronormativa, por lo que una orientación sexual disidente conlleva enfrentar un sinfín de prejuicios, con afecciones significativas en el entorno familiar. Objetivo Conocer la respuesta del entorno familiar ante la revelación de la orientación sexual, desde el discurso de hombres homosexuales. Métodos Estudio cualitativo descriptivo, en el que se realizaron entrevistas semiestructuradas y observación participante a cinco hombres homosexuales de 19 a 36 años de edad de la ciudad de Puebla, México, a través de un muestreo teórico y el empleo de participantes clave para el acceso a los informantes. Resultados Los hallazgos se estructuraron en torno a una categoría central: respuesta familiar ante un integrante homosexual, de la cual se desprenden tres subcategorías: creencia familiar, conflicto familiar y proceso de pérdida familiar a la heteronormatividad, la cual se encuentra integrada por la agrupación de múltiples códigos, clasificados de acuerdo a las cinco etapas del proceso de pérdida, propuestas por Kübler-Ross. Discusión Las respuestas familiares ante la homosexualidad son dinámicas, sumergidas en un proceso de negación que con el tiempo puede llegar a la aceptación. Conclusiones Las respuestas familiares desencadenadas por la homosexualidad se expresan de forma multifacética y a manera de proceso; el conocimiento de éstas puede ayudar a guiar el actuar de enfermería y del equipo de salud, para planear actividades y estrategias ante el proceso de pérdida familiar de la heteronormatividad.

Abstract Introduction Homosexuality represents a deviation from the social norms established by a sectorial society which imposes having a mandatory heterosexual pattern. Because of this, having a different sexual orientation implies facing prejudices which have diverse impacts on the family environment. Objective To know the response of the family environment towards the revelation of the sexual orientation from the perspective of homosexual males. Methods This is a qualitative and descriptive study with theoretical sampling and key informing, which used semi-structured interviews and observations on five homosexual males from the city of Puebla, Mexico, whose ages ranged from 19 to 36 years old. Results: The findings clustered around a central category: the family response towards having a homosexual member, from which three subcategories emerged: family beliefs, family conflict, and the loss of the heterosexual normativity, reflected by multiple codes classified in the five stages of the process of a loss proposed by Kübler-Ross. Discussion: The family responses towards homosexuality are dynamic and framed by a denial process which eventually can lead to the acceptance. Conclusions: The family responses towards having a member being homosexual are multiple; thus, an understanding of these responses can help nurses and other health professionals to plan activities and strategies aimed at addressing the process of the family loss of the heterosexual normativity.

Resumo Introdução A homossexualidade representa fragmentar as normas estabelecidas socialmente, provenientes de uma sociedade setorizada, que adopta um padrão de obrigatoriedade heteronormativa, pelo que uma orientação sexual dissidente faz enfrentar uma infinidade de preconceitos, com afecções significativas no entorno familiar. Objetivo Conhecer a resposta do entorno familiar perante a revelação da orientação sexual, desde o discurso de homens homossexuais. Métodos Estudo qualitativo descritivo, no qual se realizaram entrevistas semiestruturadas e observação participante a cinco homens homossexuais de 19 a 36 anos de idade da cidade de Puebla, México, a través de uma amostragem teórica e o emprego de participantes chave para o acesso aos informantes. Resultados Os achados estruturaram-se em volta de uma categoria central: resposta familiar frente a um integrante homossexual, da qual se desprendem três subcategorias: crença familiar, conflito familiar e processo de perda familiar à heteronormatividade, a qual se encontra integrada pela agrupação de múltiplos códigos, classificados de acordo com as cinco etapas do processo de perda, propostas por Kübler-Ross. Discussão As respostas familiares diante da homossexualidade são dinâmicas, submersas em um processo de negação que com o tempo pode chegar à aceitação. Conclusões As respostas familiares desatadas pela homossexualidade expressam-se de forma multifacetada e em forma de processo; o conhecimento destas pode ajudar a guiar o agir da enfermagem e da equipe de saúde, para planejar atividades e estratégias frente ao processo de perda familiar da heteronormatividade.

Analysis of HIV infection status and the related factors among male students who have sex with men from voluntary counseling and testing clinics by classification tree model in Changzhou City, Jiangsu Province / 中华预防医学杂志

Objective@#To analysis the status of HIV infection and the related factors among students of men who have sex with men (MSM) from voluntary counseling and testing (VCT) clinics in Changzhoucity Jiangsu province.@*Methods@#A total of 236 subjects with previous male sexual history, 16-25 years of age and less than 3 months of confirmation time of HIV positive infection were recruited in Changzhou from January 2014 to December 2017. Questionnaires were conducted and plasma samples were collected for selenium and HIV antibody testing. The relevant factors of HIV infection among MSM were screened by classification tree model. The model was evaluated using cross validation and receiver operating characteristic (ROC) curve.@*Results@#The age of subjects was (20.76±1.97) years old. The age of the first sex with men was (19.14±1.85) years old and the plasma selenium content was (82.59±11.99) ng/ml. Of the 236 subjects, 74.58% (176 cases) were college students or undergraduates; 8.90% (21 cases) were diagnosed with venereal diseases in the last year; 80.93% (191 cases) received health services in the last year, and the positive rate of HIV antibody was 25.00% (59 cases). Four relevant factors were screened by the classification tree model, including the diagnosis of sexual transmitted diseases (STDs) in the last year, health services in the last year, plasma selenium level and education level. The most important factor was whether STDs were diagnosed in the last year. The estimate of re-substitution and cross-validation of the classification tree model was 0.186 and 0.195, and the standard error was 0.025 and 0.026, respectively. The area under the ROC was 0.706 (P<0.001).@*Conclusion@#The MSM HIV antibody positive rate of VCT students in Changzhou City, Jiangsu Province was 25.0%. The diagnosis of STDs in the last year, receiving health services in the last year, plasma selenium level and education level were relevant factors of HIV infection.

Rush poppers use and risks of human papillomavirus infection among men who have sex with men in Urumqi: mediation effect through high-risk sexual behaviors / 中华预防医学杂志

Objective@#To study the prevalence of rush poppers use among men who have sex with men (MSM) in Urumqi and to analyze the mediating effect of high-risk sexual behavior between the use of rush poppers and human papillomavirus (HPV) infection.@*Methods@#From January to June 2018, 651 MSM were recruited through network and publicity. Data was collected by using online questionnaire and anal swab were collected from them for HPV genotyping. According to Baron and Kenny's criterion, multivariate logistic regression models was used to analyze the mediation effect of high-risks sexual behaviors (multiple sexual partners, anal intercourse condom use) between rush poppers use and HPV infection.@*Results@#A total of 651 subjects were (32.0±8.0) years old, and 174 subjects (26.7%) had ever used rush poppers in the past 6 months, while 350 subjects (46.9%) had more than 2 sexual partners and 188 subjects (28.9%) did not use anal condom. After adjusting age and marital status, rush poppers use was associated with HPV infection (OR (95%CI) was 2.34 (1.63-3.36), P<0.05), and sexual partners in the past 6 months (OR (95%CI) was 2.72 (1.89-3.93), P<0.05).After adjustment for age, marital status, sexual partners in the past 6 months, and anal condom use, rush poppers use was still associated with HPV infection (OR (95%CI) was 2.21 (1.53-3.19), P<0.05).After adjustment and adjustment of age, marital status, rush poppers use and anal sex condom use, the number of sexual partners at nearly 6 months was still associated with HPV infection (OR (95%CI) was 1.46 (1.05-2.04), P<0.05).@*Conclusion@#Sexual partners in the past 6 months have a mediation effect between rush poppers use and HPV infection in Urumqi. For the prevention of sexually transmitted diseases, we should focus on rush poppers use.