Factors associated with self-reported discrimination against men who have sex with men in Brazil.

Laio Magno,Carl Kendall,Mark Drew Crosland Guimarães,Adele Benzaken,Ligia Regina Franco Sansigolo Kerr,Sandra Brignol,Inês Dourado,Luís Augusto V Da Silva,Ana Maria De Brito,Adriana De A Pinho

doi:10.11606/s1518-8787.2017051000016

Abstract

ABSTRACTOBJECTIVE To estimate self-reported discrimination due to sexual orientation among men who have sex with men (MSM) in Brazil and to analyze associated factors.METHODS A cross-sectional study of 3,859 MSM recruited in 2008–2009 with respondent driven sampling. Data collection conducted in health centers in 10 Brazilian cities. A face-to-face questionnaire was used and rapid HIV and syphilis tests conducted. Aggregated data were weighted and adjusted odds ratio estimated to measure the association between selected factors and self-reported discrimination due to sexual orientation.RESULTS The sample was predominantly young, eight plus years of schooling, pardo (brown), single, low-income, and identified themselves as gay or homosexual. The prevalence of self-reported discrimination due to sexual orientation was 27.7% (95%CI 26.2–29.1). Discrimination was independently associated with: age < 30 years, more years of schooling, community involvement and support, history of sexual and physical violence, suicidal thoughts, and unprotected receptive anal intercourse.CONCLUSIONS The prevalence of self-reported discrimination among MSM in Brazil is high. These results challenge the assumptions that MSM-specific prevention and support programs are not required or that health professionals do not need special training to address MSM needs.

Highlights

The prevalence of HIV infections among men who have sex with men (MSM) in various countries is disproportionately high[1]
A sample of 4,048 MSM were initially recruited in 10 Brazilian cities – 188 (4.46%) were considered ineligible and one refused to participate, for a total of 3,859 participants
This is similar to findings such as the study cited above in the USA, where the chance of suffering verbal abuse and physical violence was greater among MSM younger than 21 years of age, in comparison to older MSM16

Summary

Introduction

The prevalence of HIV infections among men who have sex with men (MSM) in various countries is disproportionately high[1]. In Brazil, the estimated prevalence of HIV infection between MSM above 18 years of age is around 14.2% (95%CI 12.1–16.6)[2]. Studies have underlined that stigma and discrimination are among the main contributing factors to the continuation of the epidemic among MSM, often creating barriers to prevention, testing, and treatment services for HIV5. Another aggravating factor is that homoerotic practices are deemed illegal in 78 countries in the world and, in five countries, are punishable by death[6]. In Brazil, according to the Secretary of Human Rights of the Presidency of the Republic, in 2012, there were around 27 notifications per day of homophobic incidents – and this is assumed to be underreported[8]

Methods

Results

Conclusion