ABSTRACT
The practice of sex with casual partners without the use of adequate prevention in the period of social distancing due to the COVID-19 pandemic among men who have sex with men (MSM) can expose them to the risk of infection by the HIV virus. To assess this, we conducted an online survey in April and May 2020 in the entire national territory of Brazil and Portugal. We used the snowball technique for sampling, associated with circulation in social networks, totaling 2934 participants. Bivariate and multivariate logistic regression was used to produce the adjusted Odds Ratio (aOR). Eight-hundred-and-forty-two (28.7%) MSM presented at-risk sexual exposure in this period. In general, the types of sexual practices that most increased the chances of sexual exposure were having multiple partners (aOR:14.045); having practiced chemsex (aOR:2.246) and group sex (aOR:2.431), as well as presenting a history of at-risk sexual exposure (aOR:5.136). When we consider each country separately, the chances are increased in Brazil since the probability of the outcome was increased in those who practiced group sex (aOR:5.928), had multiple partners (aOR:19.132), and reported a sexual history of at-risk exposure (aOR:8.861). Our findings indicate that practices that are classically associated with greater chances of engaging in risky sexual exposure to HIV infection were the factors that most increased the chances of acquiring the virus in the pandemic context.
Subject(s)
COVID-19 , HIV Infections , Sexual and Gender Minorities , Cross-Sectional Studies , HIV Infections/epidemiology , Homosexuality, Male , Humans , Male , Pandemics , SARS-CoV-2 , Sexual Behavior , Sexual PartnersABSTRACT
OBJECTIVES: We investigated the extent to which Brazilian and Portuguese Men Who Have Sex with Men (MSM) had casual sex partners outside their homes during the period of sheltering in place for the COVID-19 pandemic. METHODS: An online survey was conducted in Brazil and Portugal in April, during the period of social isolation for COVID-19, with a sample of 2361 MSMs. Recruitment was done through meeting apps and Facebook. RESULTS: Most of the sample (53.0%) had casual sex partners during sheltering. Factors that increased the odds of engaging in casual sex in Brazil were having group sex (aOR 2.1, 95% CI 1.3-3.4), living in an urban area (aOR 1.6, 95% CI 1.1-2.2), feeling that sheltering had a high impact on daily life (aOR 3.0, 95% CI 1.1-8.3), having casual instead of steady partners (aOR 2.5, 95% CI 1.8-3.5), and not decreasing the number of partners (aOR 6.5, 95% CI 4.2-10.0). In Portugal, the odds of engaging in casual sex increased with using Facebook to find partners (aOR 4.6, 95% CI 3.0-7.2), not decreasing the number of partners (aOR 3.8, 95% CI 2.9-5.9), usually finding partners in physical venues (pre-COVID-19) (aOR 5.4, 95% CI 3.2-8.9), feeling that the isolation had a high impact on daily life (aOR 3.0, 95% CI 1.3-6.7), and HIV-positive serostatus (aOR 11.7, 95% CI 4.7-29.2). Taking PrEP/Truvada to prevent COVID-19 was reported by 12.7% of MSM. CONCLUSIONS: The pandemic has not stopped most of our MSM sample from finding sexual partners, with high-risk sexual behaviors continuing.
Subject(s)
COVID-19 , HIV Infections , Sexual and Gender Minorities , Brazil , Cross-Sectional Studies , HIV Infections/epidemiology , HIV Infections/prevention & control , Homosexuality, Male , Humans , Male , Pandemics , Portugal , Risk-Taking , SARS-CoV-2 , Sexual Behavior , Sexual Partners , Surveys and QuestionnairesABSTRACT
The aim of this study was to investigate factors associated with sex practice under the effect of drugs (chemsex) among men who have sex with men (MSM) during the period of social isolation in the context of the COVID-19 pandemic. A multicenter online survey was applied to Brazil and Portugal in April 2020 when the two countries were under restrictive health measures due to the pandemic. Participants were recruited with an adaptation of the respondent driven sampling (RDS) method in the online environment. Data were collected using social networks and dating apps for MSM. We used bivariate and multivariate logistic regression to produce crude (OR) and adjusted odds ratios (aOR). In a universe of 2,361 subjects, 920 (38.9%) reported engaging in chemsex practice, which involved casual partners in 95% of the cases. Higher OR of engaging in chemsex were associated with Brazil (aOR = 15.4; 95%CI: 10.7-22.1), not being in social isolation (aOR = 4.9; 95%CI: 2.2-10.9), engaging in casual sex during social distancing (aOR = 52.4; 95%CI: 33.8-81.4), group sex (aOR = 2.9; 95%CI: 2.0-4.4), not presenting any symptom of COVID-19 (aOR = 1.3; 95%CI: 1.1-1.8), not living with the sex partner (aOR = 1.8; 95%CI: 1.2-2.6), and using pre-exposure prophylaxis (aOR = 2.6; 95%CI: 1.8-3.7). The occurrence of chemsex was high, especially in Brazil, where the proposed social distancing did not gain adherence by MSM.
Investigar os fatores associados à prática do sexo sob o efeito de drogas (chemsex) entre homens que fazem sexo com homens (HSH) durante período de isolamento social, no contexto da pandemia da COVID-19. Inquérito multicêntrico online, aplicado aos territórios de Brasil e Portugal em abril de 2020, enquanto os dois países vivenciavam medidas sanitárias restritivas para a doença. Os participantes foram recrutados valendo-se de uma adaptação do método respondent driven sampling (RDS) ao ambiente virtual. Os dados foram coletados usando redes sociais e aplicativos de encontro voltados a HSH. Utilizamos regressão logística bivariada e multivariada para a produção das odds bruto (OR) e ajustado (ORa). Em um universo de 2.361 sujeitos, 920 (38,9%) realizaram a prática do chemsex, que, em 95% dos casos, foi realizada com parceiro casual. Aumentaram as chances de se envolver em chemsex: morar no Brasil (ORa = 15,4; IC95%: 10,7-22,1); não estar em isolamento social (ORa = 4,9; IC95%: 2,2-10,9); fazer sexo casual durante o distanciamento social (ORa = 52,4; IC95%: 33,8-81,4); fazer sexo grupal (ORa = 2,9; IC95%: 2,0-4,4); não apresentar nenhum tipo de sintoma para a COVID-19 (ORa = 1,3; IC95%: 1,1-1,8); não residir com o parceiro (ORa = 1,8; IC95%: 1,2-2,6) e estar em uso da profilaxia pré-exposição (ORa = 2,6; IC95%: 1,8-3,7). A ocorrência de chemsex foi elevada, sobretudo no Brasil, onde o isolamento social proposto não sensibilizou os HSH à adesão.
El objetivo fue investigar los factores asociados a la práctica del sexo bajo el efecto de drogas (chemsex), entre hombres que practican sexo con hombres (HSH) durante el período de aislamiento social en el contexto de la pandemia de la COVID-19. Se realizó una encuesta multicéntrica en línea, aplicada al territorio de Brasil y Portugal en abril de 2020, mientras los dos países vivían medidas sanitarias restrictivas por la COVID-19. Los participantes se reclutaron mediante una adaptación del método respondent driven sampling (RDS) al ambiente virtual. Los datos fueron recabados usando redes sociales y aplicaciones de encuentros dirigidos a HSH. Utilizamos la regresión logística bivariada y multivariada para la producción de las odds ratio brutas (OR) y ajustadas (ORa). En un universo de 2.361 sujetos, 920 (38,9%) realizaron la práctica del chemsex, que en el 95% de los casos se realizó con una pareja casual. Aumentaron las oportunidades de implicarse en chemsex: vivir en Brasil (ORa = 15,4; IC95%: 10,7-22,1); no estar en aislamiento social (ORa: = 4,9; IC95%: 2,2-10,9); practicar sexo casual durante el distanciamiento social (ORa = 52,4; IC95%: 33,8-81,4); practicar sexo grupal (ORa = 2,9; IC95%: 2,0-4,4); no presentar ningún tipo de síntoma de COVID-19 (ORa = 1,3; IC95%: 1.1-1.8); no residir con la pareja (ORa = 1,8; IC95%: 1,2-2,6) y estar usando la profilaxis previa a la exposición (ORa = 2,6; IC95%: 1,8-3,7). La ocurrencia de chemsex fue elevada, sobre todo en Brasil, donde el aislamiento social propuesto no sensibilizó a los HSH a la adhesión.
Subject(s)
COVID-19 , HIV Infections , Sexual and Gender Minorities , Brazil , Cross-Sectional Studies , HIV Infections/epidemiology , Homosexuality, Male , Humans , Male , Pandemics , Portugal , SARS-CoV-2 , Sexual Behavior , Social Isolation , Surveys and QuestionnairesABSTRACT
Investigar os fatores associados à prática do sexo sob o efeito de drogas (chemsex) entre homens que fazem sexo com homens (HSH) durante período de isolamento social, no contexto da pandemia da COVID-19. Inquérito multicêntrico online, aplicado aos territórios de Brasil e Portugal em abril de 2020, enquanto os dois países vivenciavam medidas sanitárias restritivas para a doença. Os participantes foram recrutados valendo-se de uma adaptação do método respondent driven sampling (RDS) ao ambiente virtual. Os dados foram coletados usando redes sociais e aplicativos de encontro voltados a HSH. Utilizamos regressão logística bivariada e multivariada para a produção das odds bruto (OR) e ajustado (ORa). Em um universo de 2.361 sujeitos, 920 (38,9%) realizaram a prática do chemsex, que, em 95% dos casos, foi realizada com parceiro casual. Aumentaram as chances de se envolver em chemsex: morar no Brasil (ORa = 15,4;IC95%: 10,7-22,1);não estar em isolamento social (ORa = 4,9;IC95%: 2,2-10,9);fazer sexo casual durante o distanciamento social (ORa = 52,4;IC95%: 33,8-81,4);fazer sexo grupal (ORa = 2,9;IC95%: 2,0-4,4);não apresentar nenhum tipo de sintoma para a COVID-19 (ORa = 1,3;IC95%: 1,1-1,8);não residir com o parceiro (ORa = 1,8;IC95%: 1,2-2,6) e estar em uso da profilaxia pré-exposição (ORa = 2,6;IC95%: 1,8-3,7). A ocorrência de chemsex foi elevada, sobretudo no Brasil, onde o isolamento social proposto não sensibilizou os HSH à adesão. El objetivo fue investigar los factores asociados a la práctica del sexo bajo el efecto de drogas (chemsex), entre hombres que practican sexo con hombres (HSH) durante el período de aislamiento social en el contexto de la pandemia de la COVID-19. Se realizó una encuesta multicéntrica en línea, aplicada al territorio de Brasil y Portugal en abril de 2020, mientras los dos países vivían medidas sanitarias restrictivas por la COVID-19. Los participantes se reclutaron mediante una adaptación del método respondent driven sampling (RDS) al ambiente virtual. Los datos fueron recabados usando redes sociales y aplicaciones de encuentros dirigidos a HSH. Utilizamos la regresión logística bivariada y multivariada para la producción de las odds ratio brutas (OR) y ajustadas (ORa). En un universo de 2.361 sujetos, 920 (38,9%) realizaron la práctica del chemsex, que en el 95% de los casos se realizó con una pareja casual. Aumentaron las oportunidades de implicarse en chemsex: vivir en Brasil (ORa = 15,4;IC95%: 10,7-22,1);no estar en aislamiento social (ORa: = 4,9;IC95%: 2,2-10,9);practicar sexo casual durante el distanciamiento social (ORa = 52,4;IC95%: 33,8-81,4);practicar sexo grupal (ORa = 2,9;IC95%: 2,0-4,4);no presentar ningún tipo de síntoma de COVID-19 (ORa = 1,3;IC95%: 1.1-1.8);no residir con la pareja (ORa = 1,8;IC95%: 1,2-2,6) y estar usando la profilaxis previa a la exposición (ORa = 2,6;IC95%: 1,8-3,7). La ocurrencia de chemsex fue elevada, sobre todo en Brasil, donde el aislamiento social propuesto no sensibilizó a los HSH a la adhesión. The aim of this study was to investigate factors associated with sex practice under the effect of drugs (chemsex) among men who have sex with men (MSM) during the period of social isolation in the context of the COVID-19 pandemic. A multicenter online survey was applied to Brazil and Portugal in April 2020 when the two countries were under restrictive health measures due to the pandemic. Participants were recruited with an adaptation of the respondent driven sampling (RDS) method in the online environment. Data were collected using social networks and dating apps for MSM. We used bivariate and multivariate logistic regression to produce crude (OR) and adjusted odds ratios (aOR). In a universe of 2,361 subjects, 920 (38.9%) reported engaging in chemsex practice, which involved casual partners in 95% of the cases. Higher OR of engaging in chemsex were associated with Brazil (aOR = 15.4;95%CI: 10.7-22.1), not being in social isolation (aOR = 4.9;95%CI: 2.2-10.9), engaging in casual sex during social distancing (aOR = 52.4;95%CI: 33.8-81.4), group sex (aOR = 2.9;95%CI: 2.0-4.4), not presenting any symptom of COVID-19 (aOR = 1.3;95%CI: 1.1-1.8), not living with the sex partner (aOR = 1.8;95%CI: 1.2-2.6), and using pre-exposure prophylaxis (aOR = 2.6;95%CI: 1.8-3.7). The occurrence of chemsex was high, especially in Brazil, where the proposed social distancing did not gain adherence by MSM.