Religious Affiliation, Internalized Homonegativity and Depressive Symptoms: Unveiling Mental Health Inequalities among Brazilian Gay Men.

INTRODUCTION: Different religious narratives associate same-sex sexuality, in its various manifestations, with moral deviation or sin. Gay men who are socialized in more religious communities appear to experience and internalize greater levels of homonegativity, as well as to present greater indicators of depressive symptoms. The purpose of this study was to evaluate indicators of perceived homonegativity in the community and internalized, and signs/symptoms of depression reported by Brazilian gay men with a nominal religion and compare them to those reported by Atheists or Agnostics. METHOD: Our sample comprised 194 Brazilian gay men, distributed into three groups: Christians (Protestants and Catholics, n = 71; 36.6%); Spiritualists (Kardecists or religions of African origin, n = 52; 26.8%) and Atheists or Agnostics (n = 71; 36.6%). The following measurement instruments were used: sociodemographic questionnaire, Internalized Homophobia Scale and Beck Depression Scale. RESULTS: High mean scores of depression were verified in all groups, and 60% of the sample presented some level of depression. There was a higher level of self-reported homonegativity among Christians and Spiritualists compared to that reported by Atheists or Agnostics, with the differences between the groups being significant. The regression analysis indicated a significant effect of religion on homonegativity, but not on depression. CONCLUSION: Our results suggest that gay men's chronic exposure to non-affirming religious affiliation contexts may harm the construction of a positive gay identity and should be taken into consideration when addressing mental health inequalities of sexual minorities.

Examining the Fraternal Birth Order Effect and Sexual Orientation: Insights from an East European Population.

The development of human sexual orientation remains a complex and multifaceted subject. It is often studied but its origins continue to elude us. In this preregistered study, our primary objective was to demonstrate the fraternal birth order effect (FBOE), which assumes a higher prevalence of older brothers in gay men than in their straight counterparts and which has also been recently recorded in lesbian women. Our second aim was to explore any potential impact of the FBOE on anal-erotic role orientation (AERO), both in gay and straight men. Our study sample included 693 gay men, 843 straight men, 265 lesbian women, and 331 straight women from Czechia and Slovakia. Employing a conventionally parameterized logistic regression model, we substantiated the FBOE among both gay men (OR = 1.35 for maternal older brothers) and lesbian women (OR = 1.71). These outcomes were confirmed by a more nuanced parameterization recently proposed by Blanchard (2022). Nonmaternal older brothers did not exhibit a significant influence on their younger brothers' sexual orientation. Contrary to some earlier reports, however, our data did not establish the FBOE as exclusive to gay men with the receptive AERO. Furthermore, our observations indicated a lower offspring count for mothers of gay men compared to mothers of straight men. Emphasizing the positive FBOE outcomes, we acknowledge the need for caution regarding the various options that can be used to estimate the familial influences on sexual orientation.

Comparison of the burden of self-reported bacterial sexually transmitted infections among men having sex with men across 68 countries on four continents.

BACKGROUND: Men who have sex with men (MSM) are in general more vulnerable to sexually transmitted infections (STIs) than the heterosexual men population. However, surveillance data on STI diagnoses lack comparability across countries due to differential identification of MSM, diagnostic standards and methods, and screening guidelines for asymptomatic infections. METHODS: We compared self-reported overall diagnostic rates for syphilis, gonorrhea, and chlamydia infections, and diagnostic rates for infections that were classified to be symptomatic in the previous 12 months from two online surveys. They had a shared methodology, were conducted in 68 countries across four continents between October 2017 and May 2018 and had 202,013 participants. RESULTS: Using multivariable multilevel regression analysis, we identified age, settlement size, number of sexual partners, condom use for anal intercourse, testing frequency, sampling rectal mucosa for extragenital testing, HIV diagnosis, and pre-exposure prophylaxis use as individual-level explanatory variables. The national proportions of respondents screened and diagnosed who notified some or all of their sexual partners were used as country-level explanatory variables. Combined, these factors helped to explain differences in self-reported diagnosis rates between countries. The following differences were not explained by the above factors: self-reported syphilis diagnoses were higher in Latin America compared with Europe, Canada, Israel, Lebanon, and the Philippines (aORs 2.30 - 3.71 for symptomatic syphilis compared to Central-West Europe); self-reported gonorrhea diagnoses were lower in Eastern Europe and in Latin America compared with all other regions (aORs 0.17-0.55 and 0.34 - 0.62 for symptomatic gonorrhea compared to Central-West Europe); and self-reported chlamydia diagnoses were lower in Central East and Southeast Europe, South and Central America, and the Philippines (aORs 0.25 - 0.39 for symptomatic chlamydia for Latin American subregions compared to Central West Europe). CONCLUSIONS: Possible reasons for differences in self-reported STI diagnosis prevalence likely include different background prevalence for syphilis and syndromic management without proper diagnosis, and different diagnostic approaches for gonorrhea and chlamydia.

The relationship between acceptance of illness and quality of life among men who have sex with men living with human immunodeficiency virus: A cross-sectional study.

Objectives: To explore the relationship between acceptance of illness and quality of life (QOL), and factors associated with acceptance of illness among men who have sex with men (MSM) living with human immunodeficiency virus (HIV). Methods: Three hundred and one MSM were recruited from an HIV clinic between August and December 2018. The battery of measurements consisted of the Acceptance of Illness Scale, World Health Organization Quality of Life Questionnaire for HIV brief version, HIV Cognitive Appraisal Scale and a self-designed questionnaire used to collect general information. Pearson correlation test was used to examine the relationship between acceptance of illness and QOL. Univariate and multivariate ordinal logistic regression analyses were used to examine whether the general data (demographic and HIV-related clinical data) and HIV cognitive appraisal were associated with acceptance of illness levels. Results: Descriptive analysis showed the acceptance level among MSM living with HIV was moderate (Mean = 26.29, SD = 5.28). Those with a better acceptance of illness had a better QOL (r = 0.69, P < 0.01). In the multivariate ordinal logistic regression model, education level, threat appraisals (OR:1.09; 95%CI [1.06-1.13]), and controllability appraisals (OR: 0.82; 95%CI [0.71-0.94]) were significantly associated with acceptance of illness. Conclusions: Results showed acceptance level was moderate and had a positive correlation with QOL. High level of education, low threat appraisals and high controllability appraisals were related to high illness acceptance. This finding highlights the importance of focusing on HIV-infected MSM with low education and on their perceptions of threat and controllability about HIV-related issues when designing interventions to promote illness acceptance in this vulnerable population.

Estratégia de linkagem e vulnerabilidades nas barreiras ao tratamento de HIV/Aids para homens que fazem sexo com homens / Linkage strategy and vulnerabilities in the barriers to HIV/AIDS treatment for men who have sex with men

Resumo Este estudo tem por objetivo analisar a vinculação ao tratamento de HIV/Aids de Homens que fazem Sexo com Homens (HSH) no Projeto A Hora é Agora, na cidade de Curitiba, Paraná. O conceito de vulnerabilidade com seus três eixos: individual, social e programático foi considerado o marco teórico. Realizou-se levantamento das barreiras enfrentadas pelos sujeitos da testagem até o início do tratamento, por meio de registro da linkagem e atas das reuniões de supervisão. Os dados revelaram que, no plano individual, os HSH tiveram dificuldade em aceitar o diagnóstico de HIV, além de problemas psicológicos que podem ter acarretado na demora de início do tratamento. No eixo social, o estigma/discriminação foi identificado no atendimento nas Unidades Básicas de Saúde e na família, protelando a revelação da sorologia. Por fim, no eixo programático, os HSH encontraram entraves no acesso aos serviços de saúde em função: dos pedidos para repetirem o teste de HIV; mudança de médico pelo mau atendimento; e obstáculos na realização de outros exames, refletindo negativamente no cuidado da saúde. Para a superação dessas barreiras recomenda-se uma atuação não apenas macroestrutural frente a esse grupo, mas um investimento na micropolítica, possibilitando uma mudança real de atitude, cuidado contínuo e postura frente a abordagem do cuidador e a defesa da vida.

Abstract This study aims to analyze the linkage to HIV/AIDS treatment among Men who have Sex with Men (MSM) of the project "A Hora é Agora" in Curitiba, Paraná, Brazil. The concept of vulnerability with its three axes, namely, the individual, social, and programmatic, was the theoretical framework. The barriers from testing up to the onset of the treatment were mapped through linkage registration and minutes from supervisory meetings. In the individual axis, the data revealed that the MSM struggled to address the HIV diagnosis, besides psychological problems that could cause the delay in starting treatment. Considering the social axis, stigma/discrimination was identified in the service at the Basic Health Care Network and within the families, delaying the disclosure of serology. Lastly, in the programmatic axis, the MSM found barriers in accessing the health services due to requests to repeat the HIV test, changing doctors due to poor service, and difficulties in conducting further tests, which adversely reflected on health care. In order to overcome these barriers, it is recommended not only a macro-structural work within this group, but also an investment in the micropolitics, which will enable a real change of attitude, continued care, and a stance related to approaches of care and the defense of life.

Topology of the Closet.

Despite the closet's centrality to queer culture and theory, the metaphor's various meanings have yet to be disaggregated and defined. Following Eve Kosofsky Sedgwick's identification of the closet with a "crisis of homo/heterosexual definition, indicatively male, dating from the end of the nineteenth century," the present article uses an array of late-Victorian sources-especially The Memoirs of John Addington Symonds and Teleny, a pornographic novel sometimes attributed to Oscar Wilde-to describe and distinguish: (1) so-called latent homosexuality ("the unconscious closet"); (2) deliberate strategies of suppression, abstention, and reformation ("the conscious closet"); (3) clandestine pursuits of gay sex and sociability ("the double life"); and (4) performances of a heterosexual persona ("the mask"). This article's sources further attest to the late-Victorian advent of "closet consciousness"-a recognition among certain homosexually-inclined men that the closet's multiple modalities, for all their variety, are phenomenologically and ideologically linked.

To What Extent are Prenatal Androgens Involved in the Development of Male Homosexuality in Humans?

Endocrine variations, including possibly reduced exposure to androgens, may contribute to the development of male homosexuality, with animal models demonstrating same-sex mate preference with altered exposure during prenatal or early postnatal development. As similar studies in humans are impossible, indirect physical and cognitive measures of androgen exposure are used. Some studies suggest that physical measures affected by prenatal androgens, including the index-to-ring finger ratio, growth indices, and facial structure, are more "feminine" in gay men. Gay men also exhibit significant childhood gender non-conformity and a "feminized" anatomical and functional brain pattern in sexual arousal, as well as domains such as language, visuospatial skills and hemispheric relationships. However, many of these results are equivocal and may be confounded by other factors. Research has also been hampered by inconsistencies in the reporting of sexual orientation and the potentially unrepresentative populations of gay men studied, while additional complexities pertaining to gender conformity and sexual role may also influence results.

Considerações sobre a busca por muscularidade entre homens gays / Considerations about drive for muscularity among gay men

Apresenta-se um manuscrito no formato de "carta ao editor", em que é abordada a busca por muscularidade por homens gays e suas possíveis funções, como reparação da autoestima danificada por exposição crônica a experiências de homofobia, necessidade ou desejo de uma aparência mais masculina, sensação de força e capacidade de autoproteção e evitação da constatação da própria fragilidade psíquica. São apresentadas indicações a profissionais de saúde mental que cuidam dessa população. Alguns fragmentos da experiência clínica do primeiro autor são apresentados a título de ilustração. (AU)

A manuscript in the form of a "letter to the editor" is presented, in which the search for muscularity by gay men and its possible functions is addressed, such as repairing self-esteem damaged by chronic exposure to experiences of homophobia, need or desire for a more masculine appearance, feeling of self-confidence and capacity for self-protection and avoidance of the realization of one's own psychic fragility. Indications are presented to mental health professionals who care for this population. Some fragments of the first author's clinical experience are presented by way of illustration.(AU)

Se presenta un manuscrito en forma de "carta al editor", en el que se aborda la búsqueda de la musculatura por parte de los hombres homosexuales y sus posibles funciones, como reparar la autoestima dañada por la exposición crónica a experiencias de homofobia, necesidad o deseo de apariencia más masculina, sentimiento de fortaleza y capacidad de autoprotección y evitación de la realización de la propia fragilidad psíquica. Se presentan indicaciones a los profesionales de la salud mental que atienden a esta población. A modo de ilustración se presentan algunos fragmentos de la experiencia clínica del primer autor.(AU)

Quantifying Sexual Constitution: Abraham Myerson's Endocrine Study of Male Homosexuality, 1938-1942.

Using the new medical science of endocrinology, scientific sex researchers in the 1920s and 1930s began studying sex hormone excretion as a means to search for the biological basis of human sexuality. One of these researchers was Abraham Myerson, a leading psychiatrist and researcher from Boston who conducted a series of innovative endocrine experiments between 1938 and 1942 in an effort to establish a relationship between sex hormone excretion patterns and homosexuality in men. While prevailing cultural models of heteronormativity identified male homosexuality as an abnormal case of biological femininity in men, Myerson's framework and experimental research transcended this limiting duality of sexual biology. Adopting the theory of bisexuality, he argued that all men possessed a natural variability of masculine and feminine traits in their biological, social, and sexual characteristics, and that the disparity among these traits could be quantified and understood using sex hormones. In reconstructing Myerson's research methods and data analysis, this paper uncovers how he established a distinctive diagnostic method and classification system for male homosexuality and illuminates how he conceptualized and categorized male sexuality as quantifiable and independent of personality.

Análise da implementação das estratégias de comunicação para as ações de testagem e sua vinculação ao tratamento de HIV/aids em homens que fazem sexo com homens em Curitiba / Analysis of the implementation of the communication strategies for men who have sex with men to be tested for HIV and aids and test connection with their treatment in Curitiba, Brazil / Análisis de la implementación de las estrategias de comunicación para las acciones de prueba y su vinculación al tratamiento del VIH/Sida en hombres que tienen sexo con otros hombres en Curitiba, Brasil

Há barreiras de acesso enfrentadas por homens gays e homens que fazem sexo com outros homens (HSH) à testagem e ao tratamento de HIV/aids devido a fatores estruturais e simbólicos. Daí, o objetivo do estudo que fundamenta este artigo é analisar a implementação das estratégias de comunicação para ampliar a testagem e vincular seu resultado ao tratamento de HIV/aids, em Curitiba (PR), pelo projeto A Hora é Agora (AHA), realizado de dezembro de 2014 a setembro de 2017, visando à maior aproximação dos que o executam com homens gays e HSH e ao desenvolvimento de meios mais efetivos de comunicação, identificando facilidades e dificuldades. Utilizou-se abordagem qualitativa por meio da análise documental do plano de comunicação e dos relatórios de atividades. As lições aprendidas foram a boa aceitação das campanhas 'corpo a corpo' feitas por educadores de pares nos espaços públicos, sobretudo em festas gays, e a necessidade de desenvolver estratégias específicas para HSH que não se identificam como gay.

There are access barriers faced by gay men and men who have sex with men (MSM) to be tested for HIV/ Aids and their treatment due to structural and symbolic factors. Hence, the objective of the study that underlies this article is to analyze the implementation of the communication strategies for expanding the testing and to link its result to treatment for HIV/Aids in Curitiba, Paraná, Brazil, by the project A Hora é Agora (AHA), implemented from December 2014 to September 2017, with the aim of coming closer to gay men and MSM and developing more effective means of communication, identifying facilities and difficulties. A qualitative approach by means of the documental analysis of the communication plan and activity reports was developed. The lessons learned were the good acceptance of the 'face to face' campaigns made by peer educators in public spaces, especially at gay parties, and the need to develop specific strategies for MSM who do not identify themselves as being gay.

Los hombres homosexuales y los hombres que tienen sexo con hombres (HSH) enfrentan barreras de acceso a las pruebas y al tratamiento del VIH/Sida provocadas por factores estructurales y simbólicos. De ahí que el objetivo del estudio presentado en este artículo sea analizar la implementación de estrategias de comunicación para ampliar las pruebas y las vincular al tratamiento del VIH/Sida en Curitiba, Paraná, Brasil, practicada por el proyecto A Hora é Agora (AHA), realizado desde diciembre de 2014 hasta septiembre de 2017, con el objetivo de acercarse más a los hombres homosexuales y HSH y desarrollar medios de comunicación más efectivos, identificando facilidades y dificultades. Se utilizó un enfoque cualitativo por medio del análisis documental del plan de comunicación e informes de actividad. Las lecciones aprendidas fueron la buena aceptación de las campañas "mano a mano" realizadas por los educadores de pares en los espacios públicos, especialmente en las fiestas gay, y la necesidad de desarrollar estrategias específicas para los HSH que no se identifican como gay.

Homosexualidad masculina y lesbianismo en la psicología china: revisión sistemática entre 2012 y 2016 / Male homosexuality and lesbianism in Chinese psychology: systematic review between 2012 and 2016

Resumen Para identificar el estudio y enfoque que la psicología de China realiza sobre la homosexualidad y el lesbianismo se realizó una revisión sistemática de la bibliografía publicada entre 2012-2016. Se realizó la búsqueda en seis bases de datos: BVS, Dialnet, PsycINFO (PsycNET), Scopus, Web of Science y CNKI (中国知网). Como resultado, se encontraron 240 artículos: 202 de la China continental, 30 de Hong Kong y 12 de Taiwan. Se analizaron los idiomas utilizados, cantidad de publicación en cada año, las áreas de psicología en que se publican y los temas de los artículos publicados se han organizado en doce categorías. A partir de los resultados, presentamos una discusión sobre la patologización construida de la población homosexual, la invisibilidad de la población homosexual femenina, la hegemonía de la lengua inglesa y el efecto de la censura de la publicación científica.

Abstract To identify the study and the approach Chinese psychology takes on homosexuality and lesbianism, a systematic review of the bibliography published between 2012 and 2016 was conducted. The search was made in six databases: BVS, Dialnet, PsycINFO (PsycNET), Scopus, Web of Science and CNKI (中国知网). As result, 240 articles were found: 202 from mainland China, 30 from Hong Kong, and 12 from Taiwan. We analyzed the languages used, amount of publication in each year, the areas of psychology in which they were published and the topics of the published articles have been organized into 12 categories. Based on the results, we present a discussion on the constructed pathologization of the homosexual population, the invisibility of the female homosexual population, the hegemony of the English language and the effect of censorship of scientific publication.

The Interactions Among Sexual Orientation, Masculine and Feminine Gender Role Orientation, and Facets of Sociosexuality in Young Heterosexual and Homosexual Men.

The present study investigated the functional relationships among sexual orientation, masculine and feminine gender role orientation, and sociosexual orientation in 282 heterosexual and 282 homosexual young men. Homosexual men reported significantly more pronounced sociosexual behavior (d = 0.65) and desire (d = 0.31). Furthermore, homosexual men were characterized by lower masculine (d =-0.26) and higher feminine (d = 0.38) gender role orientation. Latent variable analyses revealed that homosexual men as well as more masculine men, irrespective of their sexual orientation, had more uncommitted sexual relations and more unrestricted sociosexual attitudes. A similar pattern could be identified for sociosexual desire. While homosexual men were more unrestricted in their sociosexual desire, this also held for more feminine men in general. Overall, findings indicated that homosexual orientation is positively associated with sociosexual orientation. In addition, masculine/feminine gender role orientations exert differential influences on the three facets of sociosexuality independent of sexual orientation.

Sexual practices and the risk of Hepatitis A in men who have sex with men in Spain.

AIM: To determine the frequency of and identify risk factors associated with sexual practices leading to hepatitis A infection in the population of men who have sex with men in Spain. BACKGROUND: The increased incidence of hepatitis A as a result of sexual contact among this population is a public health concern and a challenge in controlling sexually transmitted infections. METHODS: This cross-sectional, online survey-based study included 881 men who have sex with men. Unprotected oro-anal and insertive-anal sex are considered to be unsafe sexual practices associated with hepatitis A infection. RESULTS: Of all respondents, 83.4% engaged in insertive-anal sex and 71.3% in unprotected oro-anal sex during the previous 12 months. An association was found with sociodemographic factors [living alone (OR = 2; 95%CI = 1.13-3.35)] and contextual factors of sexual behaviour [previous diagnosis of sexually transmitted infection(s) (OR = 1.74; 95%CI = 1.15-2.61) and participating in 'chemsex' (OR = 5.15; 95%CI = 1.05-25.15)]. CONCLUSION: The frequency of unsafe sexual practices associated with hepatitis A among men who have sex with men in Spain is high. Interventions based on sociodemographic and contextual factors of sexual behaviour should be implemented. IMPLICATIONS FOR NURSING MANAGEMENT: Nurse managers should update and incorporate the support needs of men who have sex with men and take advantage of the opportunity to implement harm reduction strategies.

On the Mathematics of the Fraternal Birth Order Effect and the Genetics of Homosexuality.

Mathematicians have always been attracted to the field of genetics. The mathematical aspects of research on homosexuality are especially interesting. Certain studies show that male homosexuality may have a genetic component that is correlated with female fertility. Other studies show the existence of the fraternal birth order effect, that is, the correlation of homosexuality with the number of older brothers. This article is devoted to the mathematical aspects of how these two phenomena are interconnected. In particular, we show that the fraternal birth order effect implies a correlation between homosexuality and maternal fecundity. Vice versa, we show that the correlation between homosexuality and female fecundity implies the increase in the probability of the younger brothers being homosexual.

Family relationships in the social network for young male homosexuals / Relaciones familiares de la red social de jóvenes homosexuales masculinos / Relações familiares da rede social de jovens homossexuais masculinos

ABSTRACT Objective: To evaluate the family relationships in the social network for young male homosexuals. Methods: this is a qualitative, descriptive, exploratory study anchored in the theoretical framework Social Network and including 20 male homosexuals selected by the Snowball technique through semi-structured script interview. The IRaMuTeQ software was analyzed by Similitude Analysis. Results: the primary social network was configured in the elements: 1 - Family affective ties: the center of the social network, 2 - Binding family relationship and religiosity. Final considerations: it was evaluated that the primary social network has been rooted to fragile relationships of socialization and solidarity, and that the social dimension is also rooted on conservatism, sexism/bigotry, and violence. When it comes to address this issue creates the contribution to the visibility of the homosexual youth family dynamics, since it represents the central core and first learning experience that will determine the development and ability to deal with adversities.

RESUMEN Objetivo: Evaluar las relaciones familiares de la red social de jóvenes homosexuales masculinos. Método: Se trata de estudio cualitativo, descriptivo, exploratorio, basado en el referencial teórico Red Social, con 20 homosexuales masculinos, seleccionados por medio de la técnica Snowball, mediante entrevista con guión semiestructurado. Se ha realizado el análisis de los datos por el software IRaMuTeQ, por el análisis de similitud. Resultados: Se ha configurado la red social primaria en los elementos: 1) Vínculos afectivos familiares: el centro de la red social; 2) Relación vinculante de la familia y religiosidad. Consideraciones finales: Se evaluó que la red social primaria está basada a las relaciones de socialización y solidaridad debilitadas; y que dimensión social está basada al conservadurismo, sexismo y violencia. Al tratarse de este tema, se contribuye con la visibilidad de la dinámica familiar de los jóvenes homosexuales, puesto que representa el núcleo central y primera experiencia interpersonal para aprendizaje que determinarán el desarrollo y capacidad de lidiar con las adversidades.

RESUMO Objetivo: Avaliar as relações familiares da rede social de jovens homossexuais masculinos. Método: Trata-se de estudo qualitativo, descritivo, exploratório, ancorado no referencial teórico Rede Social, com 20 homossexuais masculinos, selecionados por meio da técnica Snowball, mediante entrevista com roteiro semiestruturado. Realizou-se a análise dos dados pelo software IRaMuTeQ, pela análise de similitude. Resultados: Configurou-se a rede social primária nos elementos: 1) Laços afetivos familiares: o centro da rede social; 2) Relação vinculativa da família e religiosidade. Considerações finais: Avaliou-se que a rede social primária está ancorada às relações de socialização e solidariedade fragilizadas; e que dimensão social está alicerçada ao conservadorismo, sexismo e violência. Ao se tratar deste tema, contribui-se com a visibilidade da dinâmica familiar dos jovens homossexuais, visto que representa o núcleo central e primeira experiência interpessoal para aprendizagem que determinarão o desenvolvimento e capacidade de lidar com as adversidades.

Access to the Unified Health System in the perspective of male homosexuals / Acceso al Sistema de Salud Unificado en la perspectiva de los homosexuals masculinos / O acesso ao Sistema Único de Saúde na percepção de homossexuais masculinos

ABSTRACT Objectives: To analyze the perception of male homosexuals regarding the access to the Unified Health System. Methods: A qualitative study with male homosexuals in a city in the Northeast Brazil. Eight subjects participated, a socioeconomic questionnaire was used for data collection and a focal group was carried out, in which the narratives were recorded and later transcribed. For the analysis of the speeches, the analysis of thematic content was used. Results: The analysis revealed five thematic categories that express the limitations on humanization and reception, as well as in the quality of health care offered to subjects, disregarding the psychosocial and lifestyle-related demands. Final considerations: It was emphasized that the focus group technique contributed to the approach of the research with the perception of male homosexuals marked by prejudice and discrimination, reflecting the subjects' dissatisfaction with the care received in the health services.

RESUMEN Objetivos: Analizar la percepción de los hombres homosexuales sobre el acceso al Sistema Único de Salud. Métodos: Un estudio cualitativo con hombres homosexuales en una ciudad en el noreste de Brasil. Participaron ocho sujetos, se utilizó un cuestionario socioeconómico para la recolección de datos y se llevó a cabo un grupo focal, en el que se registraron las narrativas y luego se transcribieron. Para el análisis de los discursos, se utilizó el análisis de contenido temático. Resultados: El análisis reveló cinco categorías temáticas que expresan las limitaciones en la humanización y la recepción, así como en la calidad de la atención médica que se ofrece a los sujetos, sin tener en cuenta las demandas psicosociales y relacionadas con el estilo de vida. Consideraciones finales: Se destacó que la técnica del grupo focal contribuyó al enfoque de la investigación con la percepción de los homosexuales masculinos marcados por el prejuicio y la discriminación, lo que refleja la insatisfacción de los sujetos con la atención recibida en los servicios de salud.

RESUMO Objetivos: Analisar a percepção de homossexuais masculinos a respeito do acesso ao Sistema Único de Saúde. Métodos: Estudo qualitativo realizado com homossexuais masculinos em uma cidade do Nordeste do Brasil. Participaram oito sujeitos, sendo utilizado para coleta de dados um questionário socioeconômico e realizado um grupo focal, no qual as narrativas foram gravadas e posteriormente transcritas. Para análise das falas empregou-se a análise de conteúdo temática. Resultados: A análise revelou cinco categorias temáticas que expressam as limitações na humanização e no acolhimento, bem como na qualidade do atendimento à saúde oferecido aos sujeitos, desconsiderando as demandas psicossociais e relacionadas ao estilo de vida. Considerações finais: Destaca-se que a técnica do grupo focal contribuiu para a aproximação da pesquisa com a percepção dos homossexuais masculinos marcada por preconceito e discriminação, refletindo a insatisfação dos sujeitos com o atendimento recebido nos serviços de saúde.

Access to the Unified Health System in the perspective of male homosexuals / Acceso al Sistema de Salud Unificado en la perspectiva de los homosexuals masculinos / O acesso ao Sistema Único de Saúde na percepção de homossexuais masculinos

ABSTRACT Objectives: To analyze the perception of male homosexuals regarding the access to the Unified Health System. Methods: A qualitative study with male homosexuals in a city in the Northeast Brazil. Eight subjects participated, a socioeconomic questionnaire was used for data collection and a focal group was carried out, in which the narratives were recorded and later transcribed. For the analysis of the speeches, the analysis of thematic content was used. Results: The analysis revealed five thematic categories that express the limitations on humanization and reception, as well as in the quality of health care offered to subjects, disregarding the psychosocial and lifestyle-related demands. Final considerations: It was emphasized that the focus group technique contributed to the approach of the research with the perception of male homosexuals marked by prejudice and discrimination, reflecting the subjects' dissatisfaction with the care received in the health services.

RESUMEN Objetivos: Analizar la percepción de los hombres homosexuales sobre el acceso al Sistema Único de Salud. Métodos: Un estudio cualitativo con hombres homosexuales en una ciudad en el noreste de Brasil. Participaron ocho sujetos, se utilizó un cuestionario socioeconómico para la recolección de datos y se llevó a cabo un grupo focal, en el que se registraron las narrativas y luego se transcribieron. Para el análisis de los discursos, se utilizó el análisis de contenido temático. Resultados: El análisis reveló cinco categorías temáticas que expresan las limitaciones en la humanización y la recepción, así como en la calidad de la atención médica que se ofrece a los sujetos, sin tener en cuenta las demandas psicosociales y relacionadas con el estilo de vida. Consideraciones finales: Se destacó que la técnica del grupo focal contribuyó al enfoque de la investigación con la percepción de los homosexuales masculinos marcados por el prejuicio y la discriminación, lo que refleja la insatisfacción de los sujetos con la atención recibida en los servicios de salud.

RESUMO Objetivos: Analisar a percepção de homossexuais masculinos a respeito do acesso ao Sistema Único de Saúde. Métodos: Estudo qualitativo realizado com homossexuais masculinos em uma cidade do Nordeste do Brasil. Participaram oito sujeitos, sendo utilizado para coleta de dados um questionário socioeconômico e realizado um grupo focal, no qual as narrativas foram gravadas e posteriormente transcritas. Para análise das falas empregou-se a análise de conteúdo temática. Resultados: A análise revelou cinco categorias temáticas que expressam as limitações na humanização e no acolhimento, bem como na qualidade do atendimento à saúde oferecido aos sujeitos, desconsiderando as demandas psicossociais e relacionadas ao estilo de vida. Considerações finais: Destaca-se que a técnica do grupo focal contribuiu para a aproximação da pesquisa com a percepção dos homossexuais masculinos marcada por preconceito e discriminação, refletindo a insatisfação dos sujeitos com o atendimento recebido nos serviços de saúde.

Narrativas fora do armário: a identidade sexual de homens gays na cidade / Narratives out of the closet: the sexual identity of gay men in the city / Narrativas fuera del armario: la identidad sexual de hombres gays en la ciudad / Récits hors du placard: l'identité sexuelle des hommes homosexuels chez les villes

Este estudo visa a investigar os processos de reconhecimento da identidade gay em uma capital brasileira a partir de entrevistas narrativas com quatro participantes entre 21 e 42 anos. As entrevistas foram analisadas de acordo com a teoria de interpretação e narratividade de Ricoeur. Em comum com outros estudos, as histórias desses participantes colocam processos de identificação de uma orientação sexual "diferente" na infância, sua elaboração como identidade sexual e pessoal na adolescência e, ao final, a "saída do armário" como autorrevelação para outras pessoas. Além das semelhanças, esta pesquisa mostra as singularidades do "sair do armário": cada trajetória implica processos de reconhecimento subjetivo e intersubjetivo em diferentes matizes, que interagem com fatores contextuais para produzir bem-estar ou sofrimento psíquico.

This study aims to investigate the processes of recognition of gay identity in a Brazilian capital through narrative interviews with four participants between 21 and 42 years old. The interviews were analyzed according to Ricoeur's theory of interpretation and narration. In common with other studies, the stories of these participants place processes of identifying a "different" sexual orientation in childhood, their elaboration as sexual and personal identity in adolescence, and ultimately "out of the closet" as self-disclosure to others. In addition to the similarities, this research shows the singularities of "coming out of the closet": each trajectory implies processes of subjective and inter-subjective recognition in different shades, which interact with contextual factors to produce well-being or psychological distress.

Este trabajo tiene el objetivo de investigar los procesos de reconocimiento de la identidad gay en una capital brasileña a partir de entrevistas narrativas con cuatro participantes entre 21 y 42 años. Las entrevistas fueron analizadas de acuerdo con la teoría de interpretación y narrativa de Ricoeur. En común con otros estudios, las historias de estos participantes ponen procesos de identificación de una orientación sexual "diferente" en la infancia, su elaboración como identidad sexual y personal en la adolescencia y, al final, la "salida del armario" como autorrevelación para otras personas. Además de las similitudes, esta investigación muestra las singularidades del "salir del armario": cada trayectoria implica procesos de reconocimiento subjetivo e intersubjetivo en distintos matices, que interactúan con factores contextuales para producir bien-estar o sufrimiento psíquico.

Cette étude a pour objectif d'étudier les processus de reconnaissance de l'identité homosexuelle dans une capitale brésilienne à travers des entretiens narratifs avec quatre participants âgés de 21 à 42 ans. Les entretiens ont été analysés selon la théorie de l'interprétation et de la narrativité de Ricoeur. À l'instar d'autres études, les récits de ces participants décrivent des processus d'identification d'une orientation sexuelle «différente¼ dans l'enfance, leur élaboration en tant qu'identité sexuelle et personnelle à l'adolescence et, finalement, la «sortie du placard¼ comme une révélation personnelle aux autres. Cette recherche montre aussi les singularités de la «sortie du placard¼: chaque trajectoire implique des processus de reconnaissance subjective et inter-subjective dans différentes nuances, qui interagissent avec des facteurs contextuels pour produire du bien-être ou une détresse psychologique.

Imagem, corpo e linguagem em usos do aplicativo Grindr / Image, corps et langage dans utilisations de l'application Grindr / Image, cuerpo y lenguaje en usos de la aplicación Grindr / Image, body, and language in the usage of Grindr

Resumo O presente artigo aborda o aplicativo de busca por parceiros entre homens Grindr, em seus aspectos linguísticos e semióticos, enfatizando as produções imagéticas e discursivas de seus usuários, concebidas enquanto performatividades. Foram entrevistados onze homens que utilizam a rede social, com foco em suas composições fotográficas e interações textuais com outros membros do aplicativo, analisadas posteriormente a partir das perspectivas butlerianas e barthesianas sobre a linguagem e sua interface com a imagem. Constatou-se a composição de uma "gramática" produzida no interior do aplicativo, com significação particular de palavras e imagens e direcionamento comercial e midiático. Além disso, técnicas de composição e manipulação de fotografias, modulações do corpo e associação de práticas travadas no aplicativo a uma dimensão política foram abordadas pelos entrevistados. Desta forma, foi possível entender o Grindr como um "sistema de significação", no qual tais dinâmicas são produzidas, negociadas e disputadas no seu próprio uso.

Résumé Le présent travail discute l'application de recontres pour hommes Grindr, dans ses aspects linguistique et sémiotique, en mettant l'accent sur les productions imaginaires et linguistiques de ses utilisateurs, conçues comme des performativités. Onze hommes qui utilisent ce réseau social ont été interviewés, en se concentrant sur leurs compositions photographiques et leurs interactions textuelles avec les autres membres, analysées par la suite dans les cadres des perspectives butlerienne et barthesiennes sur la langue et sa relation avec l'image. On a identifié la composition d'une "grammaire" produite à l'intérieur de l'application, avec une signification particulière des mots et des images, avec ciblage commercial et médiatique. En outre, les interviewés ont abordé les techniques de composition et de manipulation des photographies, les modulations corporelles et l'association de pratiques enfermées dans l'application à une dimension politique. Ainsi, il a été possible de comprendre le Grindr comme un "système de signification" où ces dynamiques sont produites, négociées et contestées dans leur propre usage.

Resumen El presente artículo discute la aplicación de citas entre hombres Grindr, en sus aspectos linguísticos y semióticos, enfatizando las producciones de imágenes y lenguaje de sus usuarios, comprendidas como performatividades. Once hombres usuarios de Grindr fueron entrevistados, con foco en sus composiciones fotográficas y interacciones textuales con otros miembros de la red social, posteriormente analizadas a partir de las perspectivas butlerianas y barthesianas sobre el lenguaje y sus relaciones con la imagen. Se constató la producción de una "gramática" en el interior de la aplicación, con la significación particular de palabras y imágenes com dirección comercial y mediatica. Además, técnicas de composición y manipulación de fotografías, modulaciones del cuerpo y la asociación entre prácticas en la aplicación a cuestiones políticas fueron abordadas por los entrevistados. De esta manera, fue posible comprender Grindr como un "sistema de significación", dónde estas dinámicas son producidas, negociadas y disputadas en sus usos.

Abstract In our study we discuss the gay dating app Grindr, considering its linguistic and semiotic aspects, emphasizing its users' imagery and linguistic productions, conceived as performativities. Eleven users of this social network were interviewed, focusing on their photographic compositions and textual interactions with other members, subsequently analyzed under Butlerian and Barthesian perspectives on language and its relation to image. A "grammar" with particular meanings of words and images with commercial and mediatic target was found out to be used within the application. Furthermore, techniques of photography, body improvement, and associations between practices and political issues were addressed by the interviewees. Therefore, we could understand Grindr as a "meaning system", where such dynamics are produced, negotiated and disputed in its uses.

Performance of rapid tests compared to conventional tests used for HIV diagnosis / Desempenho dos testes rápidos em relação aos testes convencionais utilizados no diagnóstico de HIV

ABSTRACT Introduction: Early diagnosis is an important tool for strategies to fight human immunodeficiency virus (HIV) infection. Objective: The main objective of this study is to evaluate the comparability of the results of rapid tests (RT) used for the HIV diagnosis in relation to conventional molecular and serological tests in blood samples from a population of men who have sex with men (MSM), from 12 Brazilian capitals. Material and methods: 591 HIV-1 reactive test samples from 4176 MSM participants were submitted to Instituto Adolfo Lutz (IAL) for evaluation by conventional laboratory tests. From these samples with at least one RT reagent, 522 samples were analyzed, and in 493 (94.4%) the HIV positivity was confirmed, with 33% HIV-1 viral load above 5,000 copies/mL and 67% by the serological tests. A total of 336 (10%) samples with a non-reactive RT result were evaluated by standard serology, four (1.2%) tested positive for HIV. Results and conclusion: The results showed a high percentage of samples with confirmed HIV positivity in the conventional laboratory tests, as well as some non-reactive results that were confirmed positive, indicating some limitations of the RT single-step method. Therefore, the serological tests had a fundamental role in clarifying the diagnosis.

RESUMO Introdução: O diagnóstico precoce é um importante instrumento para estratégias de combate à infecção pelo vírus da imunodeficiência humana (HIV). Objetivo: O objetivo principal deste trabalho foi avaliar a comparabilidade do resultado de testes rápidos (TR) utilizados para o diagnóstico de HIV em relação a testes moleculares e sorológicos convencionais em amostras de sangue de população de homens que fazem sexo com homens (HSH) de 12 capitais brasileiras. Material e métodos: Foram encaminhadas ao Instituto Adolfo Lutz (IAL), 591 amostras com resultado reagente no TR HIV dos 4176 HSH participantes para serem avaliadas pelos testes laboratoriais convencionais. Dessas amostras com pelo menos um TR reagente, 522 amostras foram analisadas e em 493 (94,4%) confirmou-se a positividade para HIV, sendo 33% pela carga viral HIV-1 acima de 5.000 cópias/ml e 67% pelos testes sorológicos. Foram avaliadas pela sorologia convencional, 336 (10%) amostras com resultado de TR não reagente; quatro (1,2%) apresentaram-se reagentes para HIV. Resultados e conclusão: Os resultados mostraram elevado percentual de amostras com a positividade confirmada para HIV nos testes laboratoriais convencionais, bem como alguns resultados negativos que se confirmaram positivos, mostrando algumas limitações do método único do TR, destacando-se aos exames sorológicos papel fundamental à elucidação do diagnóstico.