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AIDS and Behavior

, Volume 6, Issue 2, pp 173–181 | Cite as

Reducing AIDS Risk Among Men Who Have Sex with Men in Salvador, Brazil

  • Marcia Sampaio
  • Carlos Brites
  • Ron Stall
  • Esther S. Hudes
  • Norman Hearst
Article

Abstract

Even though men who have sex with men (MSM) continue to account for a high proportion of AIDS cases in Brazil, relatively few prevention programs have been designed for them. We developed, implemented, and measured the impact of such a program in Salvador, Bahia, Brazil. This prospective cohort study used pre–post comparison to evaluate the impact of an intervention. We interviewed a cohort of 227 men recruited through snowball sampling before and up to 6 months after participating in brief AIDS prevention interventions. Knowledge and attitudes measures of HIV/AIDS and safer sex practices were raised and reported AIDS sexual risk behaviors declined after the intervention (all p values <.001). The proportion of men reporting unprotected anal intercourse in the prior month fell from 19% before the intervention to 1% after it. This study suggests that AIDS prevention activities designed for MSM in similar settings can be feasible and effective. More such prevention programs are urgently needed for MSM in developing countries such as Brazil.

AIDS Brazil homosexual men human immunodeficiency virus Latin America 

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REFERENCES

  1. Adib, S. M., Joseph, J. G., Ostrow, D. G., Tal, M., and Schwartz, S. A. (1991). Relapse in sexual behavior among homosexual men: A 2-year follow-up from the Chicago MACS/CCS. AIDS, 5, 757-760.Google Scholar
  2. Bhave, G., Lindan, C. P., Hudes, E. S., Desai, S., Wagle, U., Tripathi, S. P., and Mandel, J. S. (1995). Impact of an intervention on HIV, sexually transmitted diseases, and condom use among sex workers in Bombay, India. AIDS, 9 (Supplement 1), S21-S30.Google Scholar
  3. Carne, C. A., Johnson, A. M., Pearce, F., Smith, A., Tedder, R. S., Weller, I. V. D., Loveday, C., Hawkins, P., Williams, P., and Adler, M. W. (1987). Prevalence of antibodies to human immunodeficiency virus, gonorrhea rates, and changed sexual behavior in homosexual men in London. Lancet, 1, 1429-1430.Google Scholar
  4. Centers for Disease Control (1985). Self-reported behavioral changes among homosexual and bisexual men. Journal of the American Medical Association, 254, 2537-2538.Google Scholar
  5. Centers for Disease Control (1999). Increases in unsafe and rectal gonorrhea among men who have sex with men-San Francisco, California, 1994-1997. Morbidity and Mortality Weekly Report, 3, 48.Google Scholar
  6. Cerqueira, M., and Mott, L. (2000). Roteiro tur´ýstico e cultural dos locais, datas e assuntos de maior interesse na Bahia, Alagoas,Pernambuco, Cear´a, Rio Grande do Norte e Sergipe para o publico GLS. Guia gay da Bahia 2000-2001 [Tourist and cultural guide to places, dates, and points of interest in Bahia, Alagoas,Pernambuco, Cear´a, Rio Grande do Norte and Sergipe for the gay and lesbian public. Gay guide to Bahia 2000-2001]. Salvador, Brazil: Grupo Gay da Bahia.Google Scholar
  7. Choi, K.-H., Lew, S., Vittinghoff, E., Catania, J. A., Barret, D. C., and Coates, T. J. (1996). The efficacy of brief group counseling in HIV risk reduction among homosexual Asian and Pacific Islander men. AIDS, 10, 81-88.Google Scholar
  8. Coates, T., Furlonge, C., Mwakagile, D., Kamenga, C., Schachter, J., and Gregorich, S. (1998, July). Validation of self-reported sexual risk behavior with STD incident rates: Results from the voluntary HIV counseling and testing study [Abstract 14107]. Presented at the 12th World AIDS Conference, Geneva, Switzerland.Google Scholar
  9. Dean, A. G., Dean, J. A., Coulombier, D., Burton, A. H., Brendel, K. A., Smith, D. C., Dicker, R. C., Sullivan, K. M., and Fagan, R. F. (1994). Epi Info, Version 6: A word processing, database, and statistics program for epidemiology on microcomputers. Atlanta, GA: Centers for Disease Control and Prevention.Google Scholar
  10. De Souza, C. T. V., Bastos, F. I., Lowndes, C. M., Szwarcwald, C. L., Santos, E. M., Castilho, E. A., and Sutmoller, F. (1999). Perception of vulnerability to HIV infection in a cohort of homosexual/bisexual men in Rio de Janeiro, Brazil. AIDS Care, 11, 567-579.Google Scholar
  11. De Wit, J. B., van Griensven, G. J., Kok, G., and Sandfort, T. G. (1993).Why do homosexual men relapse into unsafe sex? Predictors of resumption of unprotected anogenital intercourse with casual partners. AIDS, 7, 1113-1118.Google Scholar
  12. Ekstrand, M. L., and Coates, T. J. (1990). Maintenance of safer sexual behaviors and predictors of risky sex: The San Francisco Men's Health Study. American Journal of Public Health, 80, 973-977.Google Scholar
  13. Ekstrand, M. L., Stall, R. S., Paul, J. P., Osmond, D. H., and Coates, T. J. (1999). Gay men report high rates of unprotected anal sex with partners of unknown or discordant HIV status. AIDS, 13, 1525-1533.Google Scholar
  14. Hospers, H. J., and Kok, G. (1995). Determinants of safe and risk taking sexual behavior among gay men: A review. AIDS Education and Prevention, 7, 74-94.Google Scholar
  15. Imrie, J. C. G., and Stephenson, J. (1996, July). Is group work based intervention within a STD clinic a feasible and appropriate intervention for high-risk gay men? [Abstract Th. C. 213]. Presented at the XI International Conference on AIDS, Vancouver, Canada.Google Scholar
  16. Joseph, J. G., Montgomery, S. B., Emmons, C. A., Kessler, R. C., Ostrow, D. G., Wortman, C. B., O'Brien, K., Eller, M. E., and Eshleman, S. (1987). Magnitude and determinants of behavioral risk reduction: Longitudinal analysis of a cohort at risk for AIDS. Psychology and Health, 1, 73-95.Google Scholar
  17. Kegeles, S. M., and Hart, G. J. (1998). Recent HIV-prevention interventions for gay men: Individual, small group and community based studies. AIDS, 12(Supplement A), S209-S215.Google Scholar
  18. Kelly, J. A., St. Lawrence, J. S., and Brasfield, T. L. (1991). Predictors of vulnerability to AIDS risk behavior relapse. Journal of Consulting and Clinical Psychology, 59, 163-166.Google Scholar
  19. Kelly, J. A., Kalichman, S. C., and Rompa, D. J. (1996, July). Outcomes of a randomized intervention trial to promote HIV risk reduction behavior change maintenance in an ethnically diverse cohort of gay and bisexual men [Abstract We. C. 3497]. Presented at the XI International Conference on AIDS, Vancouver, Canada.Google Scholar
  20. Kerr-Pontes, L. R. S., Gondim, R., Mota, R. S., Martins, T. A., and Wypij, D. (1999). Self-reported sexual behavior and HIV risk taking among men who have sex with men in Fortaleza, Brazil. AIDS, 13, 709-717.Google Scholar
  21. Leigh, B., and Stall, R. (1993). Substance use and risky sexual behavior for exposure to HIV: Issues in methodology, interpretation and prevention. American Psychologist, 48, 1035-1045.Google Scholar
  22. Martin, J. L. (1987). The impact of AIDS on gay male sexual behavior patterns in New York City. American Journal of Public Health, 77, 578-581.Google Scholar
  23. McKusick, L., Wiley, J. A., Coates, T. J., Stall, R., Saika, G., Morin, S., Charles, K., Horstman, W., and Conant, M. A. (1985). Reported changes in the sexual behavior of men at risk for AIDS. San Francisco, 1982-1984-The AIDS Behavioral Research Project. Public Health Reports, 100, 622-629.Google Scholar
  24. McKusick, L. M., Coates, T. J., Morin, S. F., Pollack, L., and Hoff, C. (1990). Longitudinal predictors of reductions in unprotected anal intercourse among gay men in San Francisco: The AIDS behavioral research project. American Journal of Public Health, 80, 978-983.Google Scholar
  25. Ministerio da Saude do Brasil: National Coordinator for the Control of Sexually Transmitted Diseases and AIDS (2000). Epidemiological Bulletin on AIDS, XIII (03).Google Scholar
  26. Mott, L. (1986). Epidemic of hate: Violations of the human rights of gay men, lesbians and transvestites in Brazil. San Francisco: The International Gay and Lesbian Human Rights Commission.Google Scholar
  27. Parker, R. (1999). Beneath the equator: Cultures of desire, male homosexuality and emerging gay communities in Brazil. New York: Routledge.Google Scholar
  28. Peterson, J. L., Coates, T. J., Catania, J., Hauck, W. W., Acree, M., Daigle, D., Hillard, B., Middleton, L., and Hearst, N. (1996). Evaluation of an HIV risk reduction intervention among African-American homosexual and bisexual men. AIDS, 10, 319-325.Google Scholar
  29. Schechter, M. T., Craib, K. J. P., Math, M., Willoughby, B., Douglas, B., McLeod, A., Maynard, M., Constance, P., and O'Shaughnessy, M. (1988). Patterns of sexual behavior and condom use in a cohort of homosexual men. American Journal of Public Health, 78, 1535-1538.Google Scholar
  30. Stall, R. D., Hays, R. B., Waldo, C. R., Ekstrand, M., and McFarland, W. (2000). The gay '90's. A review of research in the 1990's on sexual behavior and HIV risk among men who have sex with men. AIDS, 14(Supplement 3), S1-S14.Google Scholar
  31. Stall, R. S., Ekstrand, M., Pollack, L., McKusick, L., and Coates, T. J. (1990). Relapse from safer sex: The next challenge for AIDS prevention efforts. Journal of Acquired Immune Deficiency Syndrome, 3, 1181-1187.Google Scholar
  32. Stata Corporation. (2001). Stata Statistical Software: Release 7.0. College Station, TX: Author.Google Scholar
  33. Van de Ven, P., Prestage, G., French, J., Knox, S., and Kippax, S. (1998). Increase in unprotected anal intercourse with casual partners among Sydney gay men in 1996-1998. Australian and New Zealand Journal of Public Health, 22, 814-818.Google Scholar
  34. Winkelstein, W., Samuel, M., Padian, N. S., Wiley, J. A., Lang, W., Anderson, R. E., and Levy, J. A. (1987). The San Francisco Men's Health Study: III. Reduction in human immunodeficiency virus transmission among homosexual/bisexual men, 1982-86. American Journal of Public Health, 77, 685-689.Google Scholar

Copyright information

© Plenum Publishing Corporation 2002

Authors and Affiliations

  • Marcia Sampaio
    • 1
  • Carlos Brites
    • 2
  • Ron Stall
    • 3
  • Esther S. Hudes
    • 3
  • Norman Hearst
    • 3
  1. 1.STD/AIDS Program, Secretariat of Health of the State of BahiaSalvador, BahiaBrazil
  2. 2.Federal University of BahiaSalvador, BahiaBrazil
  3. 3.University of CaliforniaSan Francisco

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