Dinâmicas de preconceito contra a diversidade sexual no contexto da universidade / Prejudice dynamics against sexual diversity in the context of the university / Dinámicas del prejuicio contra la diversidad sexual en el contexto de la universidad

O artigo objetiva analisar experiências de preconceito contra sexualidades vivenciadas por estudantes, autodeclarados homens gays, na trajetória acadêmica. Constitui um estudo qualitativo com pressupostos metodológicos e epistemológicos feministas, no qual foram realizadas entrevistas narrativas com sete discentes, acessados por meio da técnica snowball, sendo os dados discutidos com base na análise crítica do discurso. A universidade e outros espaços (festas e repúblicas universitárias), tomados como uma extensão da instituição, são vistos como ambientes mais acolhedores e libertários para as experiências não heterossexuais, no entanto, em muitos casos, (re)produzem dinâmicas complexas de preconceito que reforçam a manutenção de tais experiências no campo do privado, colaborando para a manutenção da lógica heteronormativa. Sugere-se a criação de espaços para troca de experiências como importante ferramenta de emergência de sujeitos políticos que compreendam criticamente o contexto que os cerca e desconstruam os mecanismos de poder que produzem silenciamento e naturalizam violências

The article aims to analyze experiences of prejudice against sexualities experienced by students, self-declared gay men, in the academic trajectory. It constitutes a qualitative study with methodological and epistemological assumptions of feminist theories, in which narrative interviews were conducted with seven students, accessed through the snowball technique, and the data were discussed based on critical discourse analysis. The university and other spaces (university parties and student republics), considered as an extension of the institution, are viewed as more welcoming and libertarian environments for non-heterosexual experiences, however, in many cases, it (re) produces complex dynamics of prejudice that reinforce the maintenance of such experiences in the private fi eld, contributing to the maintenance of logic heteronormative. It is suggested the creation of spaces for the exchange of experiences as an important tool for the emergence of political subjects who critically understand the context that surrounds them and deconstruct the mechanisms of power that produce silencing and naturalize violence

El artículo tiene como objetivo analizar las experiencias de prejuicio contra las sexualidades vividas por estudiantes, hombres homosexuales autodeclarados, en la trayectoria académica. Constituye un estudio cualitativo con supuestos metodológicos y epistemológicos de las teorías feministas, en el que se realizaron entrevistas narrativas a siete estudiantes, a las que se ac-cedió mediante la técnica snowball, y se discutieron los datos con base en el análisis crítico del discurso. La universidad y otros espacios (fiestas universitarias y hermandades de estudiantes), tomados como una extensión de la institución, son vistos como ambientes más acogedores y libertarios para las experiencias no heterosexuales, sin embargo, en muchos casos, (re) produce dinámicas complejas de prejuicio que refuerzan el mantenimiento de tales experiencias en el ámbito privado, contribuyendo al mantenimiento de la lógica. heteronormativo. Se sugiere la creación de espacios para el intercambio de experiencias como una herramienta importante para el surgimiento de sujetos políticos que comprendan críticamente el contexto que los rodea y deconstruyan los mecanismos de poder que producen el silencio y naturalizan la violencia

Encuesta en línea de comportamiento sexual y prácticas de prevención del virus de inmunodeficiencia humana en varones gais y hombres que tienen sexo con hombres en Uruguay / Web-based survey on sexual behavior and HIV prevention practices in gay men and men who have sex with men in Uruguay / Pesquisa online de comportamento sexual e práticas de prevenção do Vírus da Imunodeficiência Humana em gays e homens que fazem sexo com homens no Uruguai

Resumen: Introducción: por ser los varones gais y los hombres que tienen sexo con hombres (HSH) una población con mayor incidencia de virus de inmunodeficiencia humana (VIH), ONUSIDA recomienda el monitoreo periódico mediante encuestas que releven información para reportar indicadores de prevención. La implementación de estos estudios en nuestro medio es limitada debido a la complejidad y costos de las metodologías tradicionales. Objetivo: generar información actualizada sobre prevención del VIH, con énfasis en uso de condón y realización de pruebas de tamizaje en gais/HSH de 15 a 49 años en Uruguay, implementando una estrategia metodológica innovadora. Material y método: estudio de corte transversal y analítico, en base a una encuesta online disponible entre octubre y diciembre de 2019. Resultados: se incluyeron 693 varones, 67% de Montevideo y 67% con nivel educativo terciario. Un 17% fue forzado a mantener relaciones sexuales alguna vez, 20% sufrió maltrato por su orientación y 68,4% ocultaba su orientación sexoafectiva en algún grado. Un 57,2% usó condón en la última relación sexual anal casual, observándose un descenso respecto al año 2012 (67,6%), mientras que la tendencia en la cobertura de prueba de VIH (66%) fue creciente comparada con estudios previos. La proporción de positividad de VIH fue de 13,3%. El análisis multivariado mostró que la menor probabilidad de uso de condón se asocia a: pareja estable en el último año, autoidentificación gay, prueba de VIH en el último año y vacunación para virus papiloma humano. La mayor probabilidad de uso se asoció a: participación en actividades de información, relaciones sexuales con personas con ITS/VIH. La menor probabilidad de realización de prueba de VIH se asoció con pareja estable y la mayor con el conocimiento de lugares de acceso a prueba y conocimiento de la profilaxis posexposición. Entre quienes conocían la profilaxis preexposición (375), 46,1% estaba dispuesto a recibirla y 1,3% había accedido. Conclusiones: la persistencia de situaciones de discriminación y violencia hacia varones gais/HSH necesita acciones más efectivas de promoción de derechos. Es necesario integrar innovaciones biomédicas en prevención que se complementen y potencien para el control de la epidemia. El uso de una encuesta en línea fue eficiente en el reclutamiento, aunque con sesgos en la selección, lo que desafía a mejorar esta estrategia metodológica.

Summary: Introduction: as gay men and men who have sex with men (MSM) constitute a population with a greater incidence of HIV, UNAIDS recommends regular surveillance by means of surveys that provide information that allows reporting prevention indicators. The implementation of these studies is limited in our context given the high complexity and costs of traditional methodologies. Objectives: to generate updated information about HIV prevention, with an emphasis on condom use and to implement screening tests in gay/MSM population between 15 and 49 years old in Uruguay, using an innovative methodological strategy. Method: transversal, analytical study by means of a web-based survey available between October and December 2019. Results: 693 men were included in the study, 67% from Montevideo and 67% of which had university studies. 17% of them had been forced to have sex in the past, 20% had suffered abuse because of their sexual orientation and 68.4% concealed their sex-affective orientation to some extent. 57.2% used condoms in their last casual anal sexual relationship, what evidences a decrease with regard to 2012 (67.6%), whereas a growing tendency in the HIV test coverage (66%) was observed, when compared to previous studies. HIV positivity rate was 13.3%. The multivariate analysis revealed a lower probability of condom use was associated to: a stable partner in the last year, gay self-identification, HIV test in the last year and having the HPV vaccine. The greater likelihood of use was associated to: participating in informative activities, having sex with people with STD/HIV. The lowest probability of having an HIV test was associated to a stable partner and the highest was associated to knowing where they could get tested for HIV and also knowing about the post-exposure prophylaxis. When considering those who knew about the pre-exposure prophylaxis (375), 46.1% was willing to receive it and 1.3% had agreed to it. Conclusions: the continuation of discrimination and violence towards gay men and MSM needs more effective right promoting actions. We need to integrate into prevention biomedical innovations that complement and leverage one another. The web-based survey was effective in terms of recruiting, although there were bias in the selection, what results challenging to improve the methodological strategy.

Resumo: Introdução: como gays e homens que fazem sexo com homens (HSH) são uma população com maior incidência de HIV, o UNAIDS recomenda o monitoramento regular por meio de pesquisas que coletem informações para calcular indicadores de prevenção. A implementação desses estudos em nosso ambiente é limitada devido à complexidade e custo das metodologias tradicionais. Objetivo: gerar informações atualizadas sobre prevenção do HIV, com ênfase no uso de preservativos e testes de triagem em gays/HSH de 15 a 49 anos no Uruguai, implementando uma estratégia metodológica inovadora. Método: estudo transversal e analítico, baseado em questionário online disponível entre outubro e dezembro de 2019. Resultados: foram incluídos 693 homens, 67% de Montevidéu e 67% com nível superior. 17% foram obrigados a ter relações sexuais em algum momento, 20% sofreram maus-tratos devido à sua orientação e 68,4% ocultaram sua orientação sexual-afetiva em algum grau. 57,2% usaram preservativo na última relação anal casual, mostrando um decréscimo em relação a 2012 (67,6%), enquanto a tendência da cobertura do teste anti-HIV (66%) foi de aumento em relação a estudos anteriores. A taxa de positividade do HIV foi de 13,3%. A análise multivariada mostrou menor probabilidade de uso de preservativo associado a: parceiro estável no último ano, autoidentificação gay, teste de HIV no último ano e vacinação para papiloma vírus humano. A maior probabilidade de uso esteve associada a: participação em atividades informativas, relações sexuais com pessoas com IST/HIV. A menor probabilidade de realização do teste anti-HIV foi associada ao parceiro estável e a maior ao conhecimento dos locais de acesso ao teste e conhecimento da profilaxia pós-exposição. Entre os que conheciam a profilaxia pré-exposição (375), 46,1% estavam dispostos a recebê-la, 1,3% já haviam recebido. Conclusões: a persistência de situações de discriminação e violência contra gays/HSH requer ações mais efetivas de promoção de direitos. É necessário integrar inovações biomédicas na prevenção que se complementem e se fortaleçam para o controle da epidemia. A utilização de uma pesquisa online foi eficiente no recrutamento, embora com vieses de seleção, o que desafia a melhorar essa estratégia metodológica.

Linfogranuloma venéreo genital en un hombre que tiene sexo con hombre: reporte de caso no importado en Chile / Lymphogranuloma venerous genital in men who have sex with men: a non-imported case report in Chile

Resumen El linfogranuloma venéreo (LGV) es una infección de transmisión sexual (ITS) causada por Chlamydia trachomatis. En los últimos años, ha emergido principalmente en hombres que tienen sexo con hombres (HSH). Es frecuente su asociación con otras ITS como el virus de inmunodeficiencia humana (VIH) y la sífilis. Si bien el compromiso genital es la forma de presentación clásica, el síndrome anorrectal constituye el principal cuadro clínico en la actualidad. Presentamos el caso de un HSH con infección por VIH en terapia anti-retroviral, herpes genital recurrente y sífilis latente tratada, sin viajes recientes al extranjero, con adenopatías inguinales fistulizadas a piel, asociada a una úlcera genital dolorosa, sin síntomas anorrectales ni sistémicos, refractario a múltiples tratamientos antibacterianos y antivirales. El estudio con RPC de secreción de la fístula fue positiva a C. trachomatis. Se trató con doxiciclina por seis semanas, con buena respuesta clínica, sin complicaciones.

Abstract Lymphogranuloma venereum (LGV) is a sexually transmitted infection caused by Chlamydia trachomatis bacteria. In the past years, it has emerged as a relevant infectious agent, mainly affecting men who have sex with men (MSM), frequently associated with other sexually transmitted infections as human immunodeficiency virus (HIV) and syphilis. Even though genital lesions correspond to the classical presentation of LGV, nowadays anorectal syndrome is more frequently reported. We present a MSM patient, HIV infected, being treated with antiretroviral drugs, with a history of recurrent genital herpes, also recently treated for a syphilis in a latent stage. He had no recent trips. He referred inguinal fistulized enlarged lymph nodes, associated with a painful genital ulcer, he denied anorectal or systemic symptoms. He had been treated with multiple antibiotic and antiviral drugs, with no clinical response. Molecular studies from the content of the fistulized lymph node identified C. trachomatis. The patient received doxycycline for 6 weeks, showing good clinical response.

Aislamiento de Neisseria meningitidis en muestra anorectal en hombre que tiene sexo con hombre con uretritis y sifilis primaria / Isolation of Neisseria meningitidis in anorectal specimen in a men who have sex with men with uretritis and primary syphilis

Resumen Neisseria meningitidis es una bacteria gramnegativa asociada frecuentemente a enfermedades invasoras de elevada mortalidad. Si bien su reservorio natural es la nasofaringe humana, en los últimos años han aumentado los aislamientos de este agente en la mucosa anorectal, principalmente en hombres que tienen sexo con hombres (HSH). Presentamos el caso de un HSH con infección por VIH, que consultó por un cuadro de uretritis y sifilis primaria, en el cual se aisló N. meningitidis en una muestra anorectal. Fue tratado en forma empírica con ceftriaxona y azitromicina, realizándose un cultivo de control post-tratamiento que fue negativo. A pesar del aumento de las infecciones y colonizaciones anogenitales por N. meningitidis, se desconoce su rol como patógeno genital, en la transmisión de otras infecciones y la necesidad de esquemas terapéuticos específicos.

Abstract Neisseria meningitidis is a Gram-negative bacterium frequently associated with invasive diseases with high mortality. Although its natural reservoir is the human nasopharynx, in recent years there have been increasing reports of isolation of this agent in the anorectal mucosa, mainly in men who have sex with men (MSM). We present the case of an HIV-positive MSM who consulted for urethritis and primary syphilis, in which N. meningitidis was isolated in an anorectal specimen. He was treated empirically with ceftriaxone and azithromycin, and a post-treatment control culture was negative. Despite the increase in anogenital infections and colonization by N. meningitidis, its role is unknown as a genital pathogen and in the transmission of other infections and the need for specific therapeutic regimens.

Factors influencing HIV testing and counselling services among men who have sex with men in Western China: a cross-sectional study based on Andersen's Behavioral Model

BACKGROUND@#Men who have sex with men (MSM), as a marginal population, has been largely ignored by health service projects. We assessed the utilization of HIV testing and counselling services and its influencing factors based on Andersen's Behavioral Model, so as to provide a theoretical basis for future infectious disease prevention and control strategies and health services policy formulation for these population.@*METHOD@#This was a cross-sectional study. A sample survey was conducted in Western China, and an anonymous self-administered questionnaire survey was conducted among MSM. Based on Andersen's Behavioral Model, the questionnaire divided the influencing factors into predisposing factor, enabling factor and need factor. Multivariate logistic regression analysis was used to explore the factors influencing the utilization of HIV testing and counselling.@*RESULTS@#There were 3184 valid questionnaires. In the survey of HIV health services, 82.85% MSM had HIV testing and 64.98% MSM had HIV counselling, respectively. Among the predisposing factor, age 25 years old and over was a facilitator of HIV testing and counselling, and ethnicity was a factor associated with HIV testing. Among the enabling factor, MSM living in urban were more likely to have access to testing and counselling services, and income was also linked to HIV testing. Among the need factor, a high level of HIV knowledge could promote testing and counselling, and a history of sexually transmitted diseases (STD) was a facilitator of testing.@*CONCLUSIONS@#HIV testing is widespread in Western China and higher than counselling service. MSM with high-risk characteristics should be identified as a priority in the future public health services.

Receiving Human Immunodeficiency Virus Serostatus Disclosure from Male Sexual Partners and Related Factors among Men Who Have Sex with Men Aged 50 and Above / 中国医学科学院学报

Objective To investigate the rate and correlates of receiving human immunodeficiency virus(HIV) serostatus disclosure from their most recent male sexual partners among men who have sex with men(MSM) aged 50 and above. Methods With a geosocial networking application,we recruited participants through online convenience sampling to collect the demographic variables,behavioral information,receiving HIV serostatus disclosure,etc.Univariate and multivariate analyses were performed to interpret the associated factors of receiving HIV serostatus disclosure. Results Overall,38.4%(398/1037) of participants received HIV serostatus disclosure from their most recent male sexual partners.The multivariable analysis demonstrated that the following populations were less likely to receive HIV serostatus disclosure from their most recent male sexual partners:participants with junior high school degree or below(OR=0.660,95%CI=0.473-0.922, P=0.015) compared to those with senior high school degree or above;participants unemployed(OR=0.537,95%CI=0.322-0.896, P=0.017) and employed(OR=0.663,95%CI=0.466-0.944, P=0.022) compared to those retired;participants without knowledge about HIV or acquired immune deficiency syndrome(AIDS) compared to those with knowledge about HIV/AIDS(OR=0.636,95%CI=0.466-0.868, P=0.004);participants having ≥2 male sexual partners in the last year(OR=0.433,95%CI=0.320-0.586, P<0.001) compared to those having none or one male sexual partner;participants never been tested for HIV(OR=0.544,95%CI=0.403-0.734, P<0.001) compared to those ever been tested for HIV;participants ever been diagnosed to have sexually transmitted infection(STI)(OR=0.472,95%CI=0.349-0.637, P<0.001) compared to those never diagnosed to have STI;and participants with higher level of HIV stigma(OR=0.742,95%CI=0.604-0.912, P=0.005). Conclusions Our findings indicated that the MSM aged 50 and above had low possibility of receiving HIV serostatus disclosure from the most recent male sexual partners.Education,employment status,number of sexual partners,HIV/AIDS-related knowledge,HIV testing behaviors,STI infection history,and HIV stigma contributed to this result.

Analysis on psychoactive substances use in men who have sex with men in Tianjin / 中华流行病学杂志

Objective: To understand the use of psychoactive substances and its related factors in men who have sex with men (MSM) in Tianjin. Methods: A cross-sectional survey was conducted in MSM recruited in Tianjin by snowball sampling from September 2017 to December 2020, the information about their social demographic information, use of psychoactive substances and behavioral characteristics were collected, meanwhile the blood samples were taken from them for HIV/syphilis detections. Multivariate logistic regression was used to explore related factors about psychoactive substances use. Results: A total of 9 218 MSM were included in the study, in whom 43.5% (4 013/9 218) had ever used psychoactive substances, including 92.6% (3 718/4 013)who used Rush and 17.2% (692/4 013) who used multi substances. Multivariate analysis showed that, the OR of psychoactive substances use in MSM who were in Han ethnic group was 0.68 (95%CI:0.51-0.91) compared with those who were in minor ethnic group; the OR of psychoactive substances use in MSM who were married or cohabited, divorced or widowed were 0.65 (95%CI: 0.57-0.71), 0.80 (95%CI: 0.65-0.97) respectively compared with those who were unmarried; the OR of psychoactive substances use in MSM who had the first homosexual sex at age of ≥30 years was 0.57 (95%CI: 0.44-0.74) compared with those who had the first homosexual sex at age of <30 years; the OR of psychoactive substances use in local MSM in Tianjin was 1.12 (95%CI: 1.03-1.23) compared with those who were not local residents in Tianjin; the OR of psychoactive substances use in MSM with education level of college or above was 1.29 (95%CI: 1.12-1.49) compared with those with education level of junior middle school or below; the OR of psychoactive substances use in MSM who had anal sex in the past six months was 1.93 (95%CI: 1.34-2.77) compared with those who had no anal sex; the OR of psychoactive substances use in MSM who had >2 homosexual partners in the last week was 1.62 (95%CI: 1.41-1.87) compared with those who had ≤2 homosexual partners; the OR of psychoactive substances use in MSM who had homosexual commercial sex in the past six months was 1.99 (95%CI: 1.62-2.45) compared with those who had no homosexual commercial sex; the OR of psychoactive substances use in MSM who had sexually transmitted diseases in the last year was 2.39 (95%CI: 1.82-3.12) compared with those who had no sexually transmitted diseases and the OR of psychoactive substances use in MSM who received peer education services in the last year was 1.63 (95%CI: 1.50-1.78) compared with those who received no peer education services. Conclusion: The prevalence of psychoactive substances use is high in MSM in Tianjin, and there are many influencing factors. It is necessary to conduct targeted interventions according to the influencing factors.

HIV infection status and related factors in men who have sex with men in sentinel surveillance in Shanxi province, 2010, 2015 and 2020 / 中华流行病学杂志

Objective: To understand the infection status of HIV and related factors in men who have sex with men (MSM) in Shanxi province in 2010, 2015 and 2020. Methods: According to the sentinel surveillance protocol, continuous cross-sectional survey were conducted to collect the information about basic characteristics, general demographic characteristics, AIDS knowledge awareness, high-risk sexual behavior, sexually transmitted diseases, intervention services and HIV infection rate of the MSM in Shanxi in 2010, 2015 and 2020. Results: In 2010, 2015 and 2020, a total of 2 708 MSM were included in this study. There were significant differences in HIV infection rate among three years (χ2=23.76, P<0.001) with an increasing trend with year (trend χ2 =17.34, P<0.001). The rates of anal sex, commercial sex and heterosexual behavior in the past 6 months were 77.62% (2 102/2 708), 5.91% (160/2 708) and 28.14% (762/2 708) respectively, and the rates of consistent use of condom were 52.52% (1 104/2 102), 63.13% (101/160) and 23.49%(179/762) respectively, and the rate of consistent condom use was low. Results from multivariate logistic regression analysis showed that different cities, having educational level of junior high school or below, being recruited through internet, voluntary counseling and testing, suffering from sexually transmitted diseases, occasional condom use in anal sex in the past 6 months were the correlative factors of HIV infection of MSM. Conclusions: The HIV infection rate of MSM in Shanxi increased year by year from 2010, 2015 to 2020. The HIV/AIDS-related risk behavior persisted, and the proportion of condomuse adherence was low, and the HIV detection rate was low in the MSM, so targeted and effective measures should be taken to promote the condom use adherence and regular HIV testing in MSM.

Analysis of HIV-1 genetic subtype and pretreatment drug resistance among men who have sex with men infected with HIV-1 from 19 cities of 6 provinces in China / 中华流行病学杂志

Objective: To investigate the distribution of HIV-1 genetic subtypes and pretreatment drug resistance (PDR) among men who have sex with men (MSM) from 19 cities of 6 provinces in China. Methods: From April to November 2019, 574 plasma samples of ART-naive HIV-1 infected MSM were collected from 19 cities in Hebei, Shandong, Jiangsu, Zhejiang, Fujian, and Guangdong provinces, total ribonucleic acid (RNA) was extracted and amplified the HIV-1 pol gene region by nested polymerase chain reaction (PCR) after reverse transcription. Then sequences were used to construct a phylogenetic tree to determine genetic subtypes and submitted to the Stanford drug resistance database for drug resistance analysis. Results: A total of 479 samples were successfully amplified by PCR. The HIV-1 genetic subtypes included CRF01_AE, CRF07_BC, B, CRF55_01B, CRF59_01B, CRF65_cpx, CRF103_01B, CRF67_01B, CRF68_01B and unrecognized subtype, which accounted for 43.4%, 36.3%, 6.3%, 5.9%, 0.8%, 0.8%, 0.4%, 0.4%, 0.2% and 5.5%, respectively. The distribution of genetic subtypes among provinces is statistically different (χ2=44.141, P<0.001). The overall PDR rate was 4.6% (22/479), the drug resistance rate of non-nucleoside reverse transcriptase inhibitors, nucleoside reverse transcriptase inhibitors, and protease inhibitors were 3.5% (17/479), 0.8% (4/479) and 0.2% (1/479), respectively. The PDR rate of recent infections was significantly higher than that of long-term infections (χ2=4.634, P=0.031). Conclusions: The HIV-1 genetic subtypes among MSM infected with HIV-1 from 19 cities of 6 provinces in China are diverse, and the distribution of subtypes is different among provinces. The overall PDR rate is low, while the PDR rate of recent infections was significantly higher than that of long-term infections, suggesting the surveillance of PDR in recent infections should be strengthened.

Evaluation of China Comprehensive AIDS Response Program in 2020 / 中华流行病学杂志

Objective: To analyze the work indicators of China Comprehensive AIDS Response Program (China CARES) and provide reference for future work of the program. Methods: The scores of each indicator were calculated, and different scores among different types of program areas were compared. The M(Q1,Q3) was used to describe the score of each indicator. The entropy weight method was used to calculate the composite score of each indicator and the composite score was translated into a 100-point system and compared among indicators. Results: In terms of the first-level indicators, organizational leadership and management (96.0 points), publicity and education (94.0 points), and innovative strategies and measures (98.0 points) got relatively high scores; while comprehensive social governance of AIDS prevention (72.0 points) was with the lowest score. The scores of publicity and education and comprehensive intervention in county-level program areas were significantly lower than those in urban areas. For secondary indicators, the indicator with relatively lower scores included "condom use among female sex workers last time" (70.0 points)", "at least one local key population has an increase in the number of people receiving HIV testing compared with the previous year" (70.0 points)", "colleges and occupational schools set up AIDS-related self-service facilities" (65.0 points), "HIV testing among the arrested people suspected of prostitution, adultery, drug users and traffickers" (55.0 points) and "condom use among men who have sex with men during last episode" (50.0 points). The "indicator 3 comprehensive intervention" contributed most to the evaluation, while "indicator 7 innovation strategies and measures" played a minor role in the evaluation results. Conclusions: The overall situation of AIDS Response Program in 2020 was good, but the progress in different word areas was not yet balanced. The two areas of comprehensive intervention and comprehensive social governance of AIDS prevention should be strengthened. It is also suggested that relevant indicators be adjusted appropriately to improve evaluation indicators system and comprehensively promote the program.

Correlation between HIV infection, club drug use and anal canal human papillomavirus infection in men who have sex with men in Taizhou / 中华流行病学杂志

Objective: To explore the correlation between club drug use and anal canal human papillomavirus (HPV) infection in HIV-negative and HIV-positive men who have sex with men (MSM) in Taizhou. Methods: A cross-sectional survey was conducted in Taizhou. HIV-negative MSM were recruited by convenient sampling in voluntary counseling and testing clinics of Taizhou prefectural CDC from August 2016 to October 2017, and HIV-positive MSM were recruited through the routine follow-up and management by Taizhou prefectural CDC from August 2016 to June 2019. A face-to-face questionnaire interview was conducted to collect the information about the socio-demographic characteristics, sexual orientation, sexual behavior, club drug use and other information of the participants. Anal canal swabs were collected for HPV genotyping. The correlation between club drug use and the prevalence of HPV infection were evaluated with χ2 test and logistic regression analysis. Results: A total of 69 HIV-negative and 345 HIV-infected MSM were included. The prevalence of any type of anal canal HPV infection in HIV-negative MSM (27.5%, 19/69) was lower than that in HIV-positive MSM (66.4%, 229/345) (χ2=36.114,P<0.001). The prevalence of self-reported club drug use in HIV-negative MSM was higher (17.4%, 12/69) than that in HIV-positive MSM (7.0%, 24/345) (χ2=7.886, P=0.005). For HIV-negative MSM, the prevalence of club drug use was higher in MSM who had homosexual group sex (P=0.036); the prevalence of HPV infection was 50.0% (6/12) in club drug users and 22.8% (13/57) in non-club drug users (χ2=3.674, P=0.055). For HIV-positive MSM, the prevalence of HPV infection was 70.8% (17/24) in club drug users and 66.0% (212/321) in non-club drug users (χ2=0.230, P=0.632). Multivariable logistic regression model showed that HPV infection in MSM was positively correlated with HIV infection (OR=5.42, 95%CI: 2.92-10.06), and the association between HPV infection and club drug use (OR=1.66, 95%CI: 0.75-3.71) was not significant. Conclusions: HIV infection was positively correlated with anal canal HPV infection in MSM in Taizhou. Club drug use was positively correlated with high-risk sexual behaviors, while its association with HPV infection needs further study.

HIV infection status in male outpatients in sexually transmitted disease clinics in Tianjin, 2016-2020 / 中华流行病学杂志

Objective: To understand the HIV infection status in male outpatients in sexually transmitted disease (STD) clinics in Tianjin from 2016 to 2020. Methods: According to the sentinel surveillance protocol, continuous cross-sectional studies were conducted between April and June during 2016-2020 to collect the information about the awareness of AIDS related knowledge, related sex behaviors, HIV infection, syphilis prevalence and HCV infection of male STD outpatients in Tianjin with a sample seize of 400 in each sentinel clinic. Results: From 2016 to 2020, a total of 4 000 male STD outpatients were surveyed. The HIV positive rate increased from 1.13% (9/800) to 2.25% (18/800) (trend χ2=14.22, P<0.001), the positive rate of syphilis increased from 9.38% (75/800) to 13.00% (104/800) (trend χ2=7.30, P=0.007) in this population during this period. The overall HCV positive rate was 0.45% (18/4 000). Multivariate logistic regression analysis showed that compared with those who were unmarried, had registered residence in Tianjin, had no temporary sexual behavior in the past 3 months, had no anal sex and had negative syphilis test result, the risk factors of HIV infection in the male STD outpatients included cohabitation (aOR=7.53, 95%CI:2.13-26.62), being from other provinces (aOR=3.64,95%CI:1.58-8.38), having temporary sexual behavior in the past 3 months (aOR=2.24,95%CI:1.03-4.89), having homosexual anal sex (aOR=85.99,95%CI:38.76-190.74) and suffering from syphilis (aOR=6.06,95%CI:3.18-11.56). Conclusion: The detection rates of HIV infection and syphilis in male STD outpatients in Tianjin showed upward trends from 2016 to 2020. Having temporary sexual behavior and anal sex, and suffering from syphilis were the main risk factors of HIV infection in male STD outpatients.

Application of limiting antigen avidity enzyme immunoassay for estimating HIV-1 incidence in men who have sex with men / 中华流行病学杂志

Objective: To estimate the incidence of HIV-1 infection in men who have sex with men (MSM) in key areas of China through HIV-1 limiting antigen avidity enzyme immunoassay (LAg-Avidity EIA), analyze the deviation from the actual results and identify influencing factors, and provided reference for improving the accuracy of estimation results. Methods: Based on the principle of the cohort randomized study design, 20 cities were selected in China based on population size and the number of HIV-positive MSM. The sample size was estimated to be 700 according to the HIV-1 infection rate in MSM. MSM mobile phone app. was used to establish a detection appointment and questionnaire system, and the baseline cross-sectional survey was conducted from April to November 2019. LAg-Avidity EIA was used to identify the recent infected samples. The incidence of HIV-1 infection was calculated and then adjusted based on the estimation formula designed by WHO. The influencing factors were identified by analyzing the sample collection and detection processes. Results: Among the 10 650 blood samples from the participants, 799 were HIV-positive in initial screening, in which 198 samples (24.78%) missed during confirmation test. Only 621 samples were received by the laboratory. After excluding misreported samples, 520 samples were qualified for testing. A total of 155 samples were eventually determined as recent infection through LAg-Avidity EIA; Based on the estimation formula , the incidence of HIV-1 infection in MSM in 20 cities was 4.06% (95%CI:3.27%-4.85%), it increased to 5.53% (95%CI: 4.45%-6.60%)after the adjusting for sample missing rate. When the sample missing rate and misreporting rate were both adjusted, the incidence of HIV-1 infection in the MSM increased to 5.66% (95%CI:4.67%-6.65%). The actual incidence of HIV-1 infection in MSM in the 20 cities might be between 4.06% and 5.66%. Conclusions: Sample missing and misreporting might cause the deviation of the estimation of HIV-1 infection incidence. It is important to ensure the sample source and the quality of sample collection and detection to reduce the deviation in the estimation of HIV-1 infection incidence.

Meta analysis on acceptance rate of HIV pre-exposure prophylaxis among men who have sex with men in China / 中华预防医学杂志

Objective: To systematically evaluate the acceptance of pre-exposure prophylaxis (PrEP)among men who have sex with men (MSM) in China, so as to provide reference for the promotion of preventive drug use before human immunodeficiency virus exposure in China. Methods: By searching the databases of China national knowledge infrastructure, VIP database, Wanfan knowledge service platform, PubMed, Web of Science, Embase and The Cochrane Library with key words of "men who have sex with men" "pre-exposure prophylaxis" "PrEP" and "MSM". The literature on the willingness of Chinese MSM population to accept PrEP was systematically collected, and the data of the literature meeting the inclusion criteria were extracted for Meta analysis. Results: A total of 12 articles were selected in this study, including 6 articles in English and 6 in Chinese. The score of bias risk assessment of eligible articles was 14-18, which was more than 70% of the total score. The total number of samples was 11 269. The overall acceptance rate of PrEP was 0.77(95%CI:0.71-0.82). In subgroup analysis, the acceptance rates of different nationalities, marriage, household registration, age, education background, income, sexual orientation, sexual behavior and awareness of PrEP were statistically significant. Conclusion: In general, the acceptance rate of PrEP in MSM population is higher, but the awareness rate is low. There are differences in the acceptance rate among different groups.

Condom stigma among men who have sex with men population: Concept synthesis / 中南大学学报(医学版)

OBJECTIVES@#The epidemic of acquired immune deficiency syndrome (AIDS) among men who have sex with men (MSM) is severe in China. And MSM has now become a key population for the infection and transmission of AIDS. At present, the bottleneck of AIDS prevention and control among MSM population is low rate of continuous condom use and high incidence of unsafe sexual behavior. Inductive summarization of the literature revealed that the most critical reason for low rate of continuous condom use among the MSM population was condom-related stigma. Although many studies mentioned condom-related stigma among MSM populations, there has been no any definition of MSM-related condom stigma and no measurement for it. Therefore, the paper aims to explore barriers to condom use among MSM, then construct the conceptual and operational definition of "MSM-related condom stigma" through Meta synthesis and concept synthesis, and provide a new perspective for AIDS prevention and control among MSM.@*METHODS@#Based on evidence-based method, "PICoS" framework and Meta-synthesis was used to include the literatures. Then, we used synthesized qualitative evidence from included studies to construct the concept and operational definition of MSM-related condom stigma by the means of thematic analysis and concept synthesis.@*RESULTS@#According to the results of the concept synthesis, MSM-related condom stigma refers to any taboos or misbeliefs about condom use or feeling ashamed or embarrassed to talk about using condoms which perceived by individuals at the individual, interpersonal, and social levels.It was demonstrated through 4 sub-themes at operational level: a symbol of distrust, a symbol of HIV/sexual transmitted infections (STIs) prevention, a symbol of an embarrassing topic, and a symbol of violating the traditional cognition of sexual intercourse. According to the Social-ecological Model (SEM), a symbol of distrust refers to that the MSM population believes that not using condoms represents mutual trust between sexual partners, while using condoms is difficult to express intimacy, trust and loyalty between sexual partners. A symbol of HIV/STIs prevention at the interpersonal level refers to that the MSM population believes that condom use is a "symbol" for the prevention or infection of AIDS; on the one hand, if someone proposes to use condoms, he may be considered infected with HIV or have unsafe sex experiences, thus, making it difficult to propose condom use; on the other hand, if they believe that sexual partners are "AIDS free" (often a wrong perception, such as sexual partners may have the risk of AIDS infection although they do not have AIDS), it is considered that condom use is completely unnecessary. The environmental level includes a symbol of an embarrassing topic and a symbol of violating the traditional cognition of sexual intercourse. A symbol of an embarrassing topic refers to the MSM population feels shame about topics related to sexual behavior and is embarrassed to carry/buy/propose condom use or be ashamed to engage in conversations about whether to use condoms during sexual behavior. And a symbol of violating the traditional cognition of sexual intercourse: The MSM population have limitations in their perception of "sex" or "sexual behavior" and believe that real sex (behavior) is unobstructed contact between the bodies and exchange between all body fluids.@*CONCLUSIONS@#The concept of MSM-related condom stigma is proposed for the first time, and its operational definition is given. The concept includes 3 levels and 4 dimensions. It is helpful to understand MSM people's attitude and cognition towards condoms, and adds indicators with cultural sensitivity and behavioral sensitivity to the behavioral intervention for AIDS in the future.

Masculinidades no voleibol: precarização, agência e resistência em narrativas de jovens atletas / Masculinidades en voleibol: precariedad, agencia y resistencia en narrativas de jóvenes atletas / Masculinities in volleyball: precariousness, agency and resistance in narratives of young athletes

Resumo: Discutem-se neste artigo os processos de identificação e significação das masculinidades nas experiências narradas de jovens atletas de voleibol. Para isso, mobilizam-se as teorizações de Jacques Derrida, Judith Butler e Leonor Arfuch para produção e problematização de narrativas. Os relatos de dois sujeitos que se identificavam como homossexuais apontaram para a negação da orientação sexual e regulação de suas performatizações de masculinidade nos espaços de desenvolvimento do esporte. Ainda que apreendidos numa condição alta de precariedade, resistiam por agenciamentos diversos aos processos segregatórios que vivienciavam cotidianamente nos clubes.

Resumen: Este artículo discute los procesos de identificación y significación de las masculinidades en las experiencias narradas de jóvenes atletas de voleibol. Para eso, se movilizan las teorías de Jacques Derrida, Judith Butler y Leonor Arfuch para la producción y problematización de narrativas. Los relatos de dos sujetos que se identificaron como homosexuales señalaron la negación de la orientación sexual y la regulación de sus performatizaciones de masculinidad en los espacios de desarrollo deportivo. Aunque aprehendidos en una alta condición de precariedad, resistieron por varias agencias a los procesos de segregación que vivían a diario en los clubes.

Abstract: This article discusses the processes of identification and meaning of masculinities in the narrated experiences of young volleyball athletes. For this, the theories of Jacques Derrida, Judith Butler and Leonor Arfuch are mobilized for the production and problematization of narratives. The reports of two subjects who identified themselves as homosexuals pointed to the denial of sexual orientation and the regulation of their masculinity performances in the spaces of sport development. Although apprehended in a high condition of precariousness, they resisted through different agencies to the segregation processes that they experienced daily in the clubs.

Heterotopías sexuales, una localización epistemológica / Sexual heterotopies, an epistemological localization / Heterotopias sexuais, uma localização epistemológica

Resumen El presente ensayo analiza el concepto de «heterotopía¼ propuesto por Michel Foucault como una localización epistemológica a propósito de las imbricaciones existentes entre las dimensiones espaciales y sexuales. Así, el objetivo de este ensayo es trazar una asociación entre la vida urbana y aquellas libertades singulares que se pretender obtener en el imaginario de una ciudad. Para tales cometidos el texto reúne una serie de entrevistas etnográficas que engloban, por un lado, la caracterización de un desplazamiento localizado por varones homosexuales y, por el otro, un recurso epistemológico para pensar dichos movimientos espaciales.

Abstract The present essay analyzes the concept of "heterotopía" proposed by Michel Foucault as an epistemological location with regard to the imbrications existing between the spatial and sexual dimensions. Thus, the aim of this essay is to draw an association between urban life and those singular freedoms that are intended to obtain in the imaginary of a city. For such tasks the text brings together a series of ethnographic interviews that include, on the one hand, the characterization of a displacement located by homosexual men and, on the other, an epistemological resource to think about these spatial movements.

Resumo O presente ensaio analisa o conceito de "heterotopia" proposto por Michel Foucault como uma localização epistemológica em relação às imbricações existentes entre as dimensões espacial e sexual. Assim, o objetivo deste ensaio é traçar uma associação entre a vida urbana e as liberdades singulares que se pretende obter no imaginário de uma cidade. Para tais tarefas, o texto reúne uma série de entrevistas etnográficas que incluem, por um lado, a caracterização de um deslocamento localizado por homens homossexuais e, por outro, um recurso epistemológico para pensar sobre esses movimentos espaciais.

Conhecimento e práticas de risco à infecção pelo HIV na população geral, homens jovens e HSH em três municípios brasileiros em 2019 / Conocimiento y prácticas de riesgo para la infección por VIH en la población general, hombres jóvenes y HSH de tres municipios brasileños en 2019 / Knowledge and risk practices related to HIV infection in the general population, young men, and MSM in three Brazilian cities in 2019

O objetivo do estudo foi descrever o conhecimento e práticas de risco à infecção pelo HIV na amostra total de cada município, entre homens de 15 a 24 anos que vivem sem companheiro(a), e homens que fizeram sexo com homems (HSH) pelo menos uma vez na vida em três cidades brasileiras. Foi realizado estudo de corte transversal de base domiciliar com amostragem por conglomerados em três estágios (setores censitários, domicílios, indivíduos), com estratificação por sexo, faixa etária (15-24; 25-34; 35-44; 45-59) e vive com companheiro(a) na seleção do indivíduo. Estimaram-se proporções e intervalos de 95% de confiança (IC95%) de indicadores de conhecimento, testagem do HIV, comportamento sexual e autoavaliação do risco. Foram analisados 5.764 indivíduos em Campo Grande, 3.745 em Curitiba e 3.900 em Florianópolis. Baixo nível de conhecimento foi encontrado para os métodos de prevenção, sobretudo para profilaxia pré-exposição (PrEP). Práticas de sexo desprotegido foram frequentes nos três municípios. As proporções de teste de HIV na vida foram 57,2% (IC95%: 55,1-59,2) em Curitiba, 64,3% (IC95%: 62,7-66,0) em Campo Grande, e 65,9% (IC95%: 64,0-67,7) em Florianópolis. Entre homens de 15-24 anos, proporções de uso de drogas estimulantes e práticas sexuais desprotegidas foram mais altas que nos demais grupos etários. Entre os HSH, as proporções de teste de HIV na vida foram superiores a 80%. Mais de 30% foram parceiros receptivos no sexo anal sem uso de preservativo, e menos de 5% avaliam seu risco como alto. É preciso adotar estratégias de comunicação mais eficazes sobre a prevenção da infecção do HIV, incluindo a ampliação de conhecimentos que poderiam motivar práticas sexuais mais seguras.

El objetivo fue describir el conocimiento y prácticas de riesgo para la infección por el HIV en la muestra total de cada municipio, entre hombres de 15 a 24 años que viven sin compañero(a), y hombres que practicaron sexo con hombres (HSH) por lo menos una vez en la vida en tres ciudades brasileñas. Se trata de un estudio de corte transversal con base domiciliaria, con una muestra por conglomerados en tres fases (sectores censales, domicilios, individuos), con estratificación por sexo, franja de edad (15-24; 25-34; 35-44; 45-59) y vive con compañero(a) en la selección del individuo. Se estimaron las proporciones e intervalos de 95% de confianza (IC95%) de indicadores de conocimiento, testeo del VIH, comportamiento sexual y autoevaluación del riesgo. Se analizaron a 5.764 individuos en Campo Grande, 3.745 en Curitiba y 3.900 en Florianópolis. Se encontró un bajo nivel de conocimiento respecto a los métodos de prevención, sobre todo para PrEP. Fueron frecuentes las prácticas de sexo desprotegido en los tres municipios. Las proporciones de tests de VIH en la vida fueron 57,2% (IC95%: 55,1-59,2) en Curitiba, 64,3% (IC95%: 62,7-66,0) en Campo Grande, y 65,9% (IC95%: 64,0-67,7) en Florianópolis. Entre hombres de 15-24 años, las proporciones de uso de drogas estimulantes y prácticas sexuales desprotegidas fueron más altas que en los demás grupos de edad. Entre los HSH, las proporciones de test de VIH en la vida fueron superiores a 80%. Más de un 30% fueron parejas receptivas en el sexo anal, sin uso de preservativo, y menos de un 5% evalúan su riesgo como alto. Es necesario adoptar estrategias de comunicación más eficaces sobre la prevención de la infección contra el VIH, incluyendo la ampliación de conocimientos que podrían motivar prácticas sexuales más seguras.

The study aimed to describe knowledge and risk practices related to HIV infection in three Brazilian cities in the general population, men 15 to 24 years of age living without a partner, and men that reported sex with other men (MSM) at least once in life. This was a cross-sectional household-based study with three-stage cluster sampling (census tracts, households, individuals) stratified by sex, age group (15-24; 25-34; 35-44; 45-59), and conjugal status in the individual selection. We estimated the proportions and 95% confidence intervals (95%CI) of indicators of knowledge, HIV testing, sexual behavior, and self-rated risk. We analyzed 5,764 individuals in Campo Grande, 3,745 in Curitiba, and 3,900 in Florianópolis. Low levels of knowledge were found for preventive methods, especially PrEP. Unprotected sex practices were frequent in the three municipalities. Lifetime HIV test rates were 57.2% (95%CI: 55.1-59.2) in Curitiba, 64.3% (95%CI: 62.7-66.0) in Campo Grande, and 65.9% (95%CI: 64.0-67.7) in Florianópolis. Among men 15-24 years of age, the proportions of stimulant drug use and unprotected sexual practices were higher than in the other age groups. Lifetime HIV test rates exceeded 80% in MSM. More than 30% of MSM were receptive partners in anal sex without condoms, and fewer than 5% assessed their risk as high. More effective communication strategies are needed on prevention of HIV infection, including increased knowledge that could motivate safer sexual practices.

Perception of discrimination due to sexual orientation and associated factors among men who have sex with men in 12 Brazilian cities / Percepção de discriminação com base na orientação sexual e fatores associados entre homens que fazem sexo com homens em 12 cidades brasileiras / Percepción de discriminación debido a la orientación sexual y factores asociados entre hombres que tienen sexo con hombres en 12 ciudades brasileñas

Discrimination due to sexual orientation (DDSO) has an important association with health outcomes among men who have sex with men (MSM). This study aimed to analyze factors associated with DDSO among MSM in 12 Brazilian cities. This is a cross-sectional study with 4,176 MSM participants recruited in 2016 which used a respondent-driven sampling method in 12 Brazilian cities. DDSO levels were previously identified by a latent class analysis based on 13 variables from the discrimination section. An ordinal logistic regression was used to assess associations with these DDSO levels, and weighted ordinal odds ratios (OR) and their respective 95% confidence intervals (95%CI) were estimated using Gile's estimator. Most participants were young (< 25 years old) black or of mixed-race (pardo), single individuals who had a religious affiliation, primary or incomplete secondary education, and a high and average socioeconomic status. More than half (65%) reported DDSO in the 12 months prior to this study. We observed an independent association among the four latent DDSO classes and the following variables: age < 25 years old (OR = 1.66; 95%CI: 1.21-2.27), white skin color (OR = 1.43; 95%CI: 1.02-2.01), history of sexual (OR = 2.33; 95%CI: 1.58-3.43) and physical violence (OR = 3.08; 95%CI: 2.11-4.49), disclosure of their sexual orientation as MSM to their fathers (OR = 2.00; 95%CI: 1.47-2.72), experienced suicidal ideation in the two weeks prior to this study (OR = 2.09; 95%CI: 1.46-2.98), and use of any illicit drugs in the last six months (OR = 1.61; 95%CI: 1.19-2.18). Our results indicate that contextual factors may contribute to high DDSO levels among MSM in Brazil. Public health policies toward human rights surveillance and protection among MSM must be urgently addressed.

A discriminação com base na orientação sexual mostra uma associação forte com desfechos de saúde entre homens que fazem sexo com homens (HSH). O estudo buscou analisar fatores associados com a discriminação por orientação sexual entre HSH em 12 cidades brasileiras. Um estudo transversal recrutou 4.176 HSH em 2016, usando o método respondent-driven sampling em 12 cidades brasileiras. Os níveis de discriminação por orientação sexual foram identificados previamente por análise de classes latentes, com base em 13 variáveis do capítulo sobre discriminação. Foi usada regressão logística ordinal para avaliar as associações com esses níveis de discriminação por orientação sexual, e o estimador de Gile foi utilizado para estimar as razões de chances ordinais ponderadas (OR) e os respectivos intervalos de 95% de confiança (IC95%). Os participantes eram majoritariamente jovens (< 25 anos), solteiros, com filiação religiosa, com escolaridade primária ou Ensino Médio incompleto, pretos ou pardos e com nível socioeconômico alto ou médio. Mais da metade relatava discriminação por orientação sexual nos últimos 12 meses (65%). Observamos uma associação independente entre as quatro classes latentes de discriminação por orientação sexual e as seguintes variáveis: idade < 25 anos (OR = 1,66; IC95%: 1,21-2,27), cor branca (OR = 1,43; IC95%: 1,02-2,01), história de violência sexual (OR = 2,33; IC95%: 1,58-3,43) e física (OR = 3,08; IC95%: 2,11-4,49), ter divulgado ao pai a orientação sexual enquanto HSH (OR = 2,00; IC95%: 1,47-2,72), relato de ideação suicida nas últimas duas semanas (OR = 2,09; IC95%: 1,46-2,98) e uso de qualquer droga ilícita nos últimos seis meses (OR = 1,61; IC95%: 1,19-2,18). Nossos resultados indicam que fatores contextuais podem contribuir para os altos níveis de discriminação contra HSH no Brasil. São urgentes políticas de saúde pública voltadas para a vigilância e proteção dos direitos humanos dos HSH.

La discriminación debida a la orientación sexual (DDSO, por sus siglas en inglés) tiene una asociación importante con los resultados de salud entre los hombres que tienen sexo con hombres (HSH). El objetivo de este estudio fue analizar factores asociados con DDSO entre HSH en 12 ciudades brasileñas. Un estudio trasversal con 4.176 participantes HSH reclutados en 2016, usando un método de muestreo basado en los encuestados de 12 ciudades brasileñas. Los niveles de DDSO se identificaron previamente mediante un análisis de clase latente, basado en 13 variables desde la sección de discriminación. Se utilizó una regresión logística ordinal para evaluar las asociaciones con estos niveles de DDSO y se estimaron las razones de posibilidades ponderadas ordinales (OR) y su respectivo intervalo de 95% de confianza (IC95%) usando el estimador de Gile. La mayoría de los participantes eran jóvenes (< 25 años de edad), solteros, tenían filiación religiosa, una escolaridad primaria o secundaria incompleta, eran negros o mestizos (pardos) y tenían un elevado promedio socioeconómico. Más de la mitad informaron DDSO en los 12 meses previos (65%). Observamos una asociación independiente entre las cuatro clases latentes de DDSO y las siguientes variables: edad < 25 años (OR = 1,66; IC95%: 1,21-2,27), color de piel blanca (OR = 1,43; IC95%: 1,02-2,01), historia de violencia sexual (OR = 2,33; IC95%: 1,58-3,43) y violencia física (OR = 3,08; IC95%: 2,11-4,49), revelaron al padre su orientación sexual como HSH (OR = 2,00; IC95%: 1,47-2,72), tuvieron ideas suicidas durante las dos semanas previas (OR = 2,09; IC95%: 1,46-2,98) y consumieron alguna droga ilícita en los últimos seis meses (OR = 1,61; IC95%: 1,19-2,18). Nuestros resultados indican que los factores contextuales podrían haber contribuido a los altos niveles de DDSO entre HSH en Brasil. Se deben dirigir urgentemente políticas públicas de salud orientadas a la vigilancia y protección de los derechos humanos entre HSH.

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.