TY - JOUR
T1 - Pre-exposure prophylaxis among Brazilian men who have sex with men
T2 - a comparative study between migrants and non-migrants
AU - Sousa, Álvaro Francisco Lopes
AU - Lima, Shirley Verônica Melo Almeida
AU - Ribeiro, Caíque Jordan Nunes
AU - de Sousa, Anderson Reis
AU - Camargo, Emerson Lucas Silva
AU - de Oliveira, Layze Braz
AU - Neto, João Cruz
AU - Fronteira, Inês
AU - Mendes, Isabel Amélia Costa
N1 - Funding Information:
This work was supported by National Research Council–CNPq Process: 159908/2019-1. The funders had no role in the study design; in data collection, analyses, or interpretation; in writing of the manuscript; or in the decision to publish the results.
Publisher Copyright:
Copyright © 2023 Sousa, Lima, Ribeiro, Sousa, Camargo, de Oliveira, Neto, Fronteira and Mendes.
PY - 2023
Y1 - 2023
N2 - Introduction: Investigating the use and adherence to pre-exposure prophylaxis (PrEP) in MSM is a global health priority in the fight against HIV. Strategies must be capable of increasing usage and reaching not only the population living in the country but also those who immigrate, who face additional vulnerabilities. Based on this, in this observational, cross-sectional, and analytical study, our aim is to analyze the use of PrEP among Brazilian men who have sex with men, whether they are migrants or not. We aim to highlight preventive opportunities and strategies for the global health scenario. Methods: We utilized a sample of Brazilians living in the country and Brazilian immigrants residing in Portugal, one of the main destinations for Brazilians in recent years. To estimate the prevalence ratio (PR) of PrEP use, we employed the Poisson regression model with robust variance estimation using a covariance matrix. Results: A total of 1,117 Brazilian MSM PrEP users participated in this study, with 788 residing in Brazil and 328 in Portugal. Multivariate analysis was conducted in three stages: overall, and for subgroups of residents in Brazil and immigrants in Portugal. We identified four convergent factors that increased the prevalence of PrEP use in Brazilians regardless of migration status: having two or more casual sexual partners per month, engaging in challenging sexual practices as the receptive partner, disclosing serological status on apps, and being single. Among native Brazilians, four unique factors stood out: being in a polyamorous relationship, having sexual relations with unknown casual partners, and having higher levels of education. Discussion: This study highlights the need to implement strategies to strengthen PrEP adherence in Brazil and create international programs that facilitate its usage among populations migrating between these two countries.
AB - Introduction: Investigating the use and adherence to pre-exposure prophylaxis (PrEP) in MSM is a global health priority in the fight against HIV. Strategies must be capable of increasing usage and reaching not only the population living in the country but also those who immigrate, who face additional vulnerabilities. Based on this, in this observational, cross-sectional, and analytical study, our aim is to analyze the use of PrEP among Brazilian men who have sex with men, whether they are migrants or not. We aim to highlight preventive opportunities and strategies for the global health scenario. Methods: We utilized a sample of Brazilians living in the country and Brazilian immigrants residing in Portugal, one of the main destinations for Brazilians in recent years. To estimate the prevalence ratio (PR) of PrEP use, we employed the Poisson regression model with robust variance estimation using a covariance matrix. Results: A total of 1,117 Brazilian MSM PrEP users participated in this study, with 788 residing in Brazil and 328 in Portugal. Multivariate analysis was conducted in three stages: overall, and for subgroups of residents in Brazil and immigrants in Portugal. We identified four convergent factors that increased the prevalence of PrEP use in Brazilians regardless of migration status: having two or more casual sexual partners per month, engaging in challenging sexual practices as the receptive partner, disclosing serological status on apps, and being single. Among native Brazilians, four unique factors stood out: being in a polyamorous relationship, having sexual relations with unknown casual partners, and having higher levels of education. Discussion: This study highlights the need to implement strategies to strengthen PrEP adherence in Brazil and create international programs that facilitate its usage among populations migrating between these two countries.
KW - global health
KW - HIV
KW - international migration
KW - migrant populations
KW - MSM
KW - PrEP
KW - sexual behavior
UR - http://www.scopus.com/inward/record.url?scp=85169576418&partnerID=8YFLogxK
U2 - 10.3389/fpubh.2023.1198339
DO - 10.3389/fpubh.2023.1198339
M3 - Article
C2 - 37663850
AN - SCOPUS:85169576418
SN - 2296-2565
VL - 11
JO - Frontiers in public health
JF - Frontiers in public health
M1 - 1198339
ER -
