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Sexual Violence Against Men Who Have Sex with Men in Brazil: A Respondent-Driven Sampling Survey

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Abstract

We estimated the prevalence of sexual violence (SV) experience among men who have sex with men (MSM) in Brazil and identified its associated risk factors. We recruited 3859 MSM through respondent driven sampling. A multivariable hierarchical analysis was performed using an ecological model. The prevalence of having ever experienced SV was 15.9 % (95 % confidence interval [CI] 14.7–17.1). SV experience was independently associated with discrimination due to sexual orientation (odds ratio [OR] 3.05; 95 % CI 2.10–4.42), prior HIV testing (OR 1.81; 95 % CI 1.25–2.63), ≤14 years at first sex (OR 1.86; 95 % CI 1.28–2.71), first sex with a man (OR 1.89; 95 % CI 1.28–2.79), presenting STI symptoms (last year) (OR 1.66; 95 % CI 1.12–2.47), and having suicidal ideas (last 6 months) (OR 2.08; 95 % CI 1.30–3.35). The high levels of SV against MSM in Brazil place them at a markedly higher risk of SV than the general population. Homophobic prejudice is the strongest determinant of SV and urgently needs to be included at the forefront of the national response to SV.

Resumen

Se estimó la prevalencia de haber experimentado violencia sexual (VS) entre hombres que tienen sexo con hombres (HSH) en Brasil y se identificó sus factores de riesgo. Se reclutó 3859 HSH mediante respondent driven sampling. Se realizó un análisis multivariado hierárquico usando un modelo ecológico. La prevalencia de experiencia de VS alguna vez fue 15.9 % (Intervalo de confianza [IC] 95 % 14.7–17.1). Los factores asociados independientemente con haber sufrido VS alguna vez fueron discriminación debida a orientación sexual (odds ratio [OR] 3.05; 95 % CI 2.10–4.42), haber realizado la prueba del VIH (OR 1.81; 95 % CI 1.25–2.63), ≤14 años de edad en la primera relación sexual (OR 1.86; 95 % CI 1.28–2.71), primera relación sexual con un hombre (OR 1.89; 95 % CI 1.28–2.79), presentar síntomas de ITS durante el último año (OR 1.66; 95 % CI 1.12–2.47), y tener ideas suicidas durante los últimos 6 meses (OR 2.08; 95 % CI 1.30–3.35). Los altos niveles de VS contra los HSH en Brasil sitúan este grupo ante un riesgo de VS superior que la población general. La homofobia es el determinante más importante y debe de encabezar urgentemente la respuesta nacional ante la VS.

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Acknowledgments

This work was supported by the National Department on STD, AIDS, and Viral Hepatitis of the Ministry of Health through a Grant (CSV 234/07). The study site in Manaus received additional funding from the Joint United Nations Programme on HIV/AIDS (UNAIDS) in Brazil. Dr. Kerr thanks the Institute for Global Health of the University of San Francisco California where the original Project was conceived. Dr. Sabidó has a fellowship as a visiting senior researcher at the Fundação de Medicina Tropical. Dr. Heitor Vieira Dourado that is funded by the Foundation for Research Support of the Amazonas State (FAPEAM) through the Strategic Programme in Science, Technology & Innovation in Health Foundations (PECTI/AM SAÚDE).

Conflict of interest

The authors declare that they have no competing interest.

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Authors and Affiliations

  1. Fundação de Medicina Tropical Doutor Heitor Vieira Dourado (FMT-HVD), Avenida Pedro Teixeira 25, Manaus, AM, CEP: 69040-000, Brazil

    Meritxell Sabidó

  2. TransLab. Department of Medical Sciences, Universitat de Girona, Girona, Catalunya, Spain

    Meritxell Sabidó

  3. Departamento de Saúde Comunitária, Universidade Federal do Ceará, Fortaleza, Brazil

    Ligia Regina Franco Sansigolo Kerr

  4. Departamento de Estatística e Matemática Aplicada, Universidade Federal do Ceará, Fortaleza, Brazil

    Rosa Salani Mota

  5. Fundação Alfredo da Mata, Manaus, Brazil

    Adele Schwartz Benzaken

  6. Departamento de DST, Aids e Hepatites Virais, Secretaria de Vigilância em Saúde, Ministério da Saúde, Brasília, Brazil

    Adele Schwartz Benzaken

  7. Escola Nacional de Saúde Pública, Fundação Oswaldo Cruz (FIOCRUZ), Rio De Janeiro, Brazil

    Adriana de A. Pinho

  8. Departamento de Medicina Preventiva e Social, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil

    Mark D. C. Guimaraes

  9. Instituto de Saúde Coletiva, Universidade Federal da Bahia, São Salvador, Brazil

    Ines Dourado

  10. Departamento de Saúde Coletiva, Universidade de Brasília, Brasília, Brazil

    Edgar Merchan-Hamman

  11. Department of Global Community Health and Behavioral Sciences, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, USA

    Carl Kendall

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  1. Meritxell Sabidó
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Correspondence to Meritxell Sabidó.

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Sabidó, M., Kerr, L.R.F.S., Mota, R.S. et al. Sexual Violence Against Men Who Have Sex with Men in Brazil: A Respondent-Driven Sampling Survey. AIDS Behav 19, 1630–1641 (2015). https://doi.org/10.1007/s10461-015-1016-z

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