Risk behavior score: a practical approach for assessing risk among men who have sex with men in Brazil

Abstract

HIV/AIDS epidemic is not well controlled, and multiple sexual behavior factors help explainhigh rates of HIV infection among men who have sex with men (MSM). This article proposesto exam the use of a potential risk behavior score for HIV infection, based on the type andnumber of sexual partners, and condom use, and their associated factors in a sample ofMSM in Brazil. A cross sectional RDS (Respondent Driven Sampling) study was performedamong 3738 MSM aged 18+ years old from ten Brazilian cities. The risk behavior score wascomposed by the number of male partners and anal condom use in the last year with steady,casual, and commercial partners. Most participants were 25+ years old (58.1%), non-white(83.1%), and single (84.9%). Final weighted ordinal logistic model showed that age ≤ 25 yearsold (p = 0.037), homosexual or bisexual identity (p < 0.001), sexual initiation before 15-year-old(p < 0.001), having sex with men only in the last 12 months (p < 0.001), frequent alcohol andillicit drug use (p < 0.001), and use of local sites to meet sexual partners in the last month wereindependently associated with higher scores of risky behavior. Specific strategies shouldbe developed aimed at the MSM population. Additionally, pre-exposed prophylaxis (Prep)should be considered for those at higher score as a strategy for reducing risk for HIV infectionin this population.