Table 1. Characteristics of MSM who completed the online surveys in each Brazilian city. 2016-2018
|
N
(%)
|
Male pop. (≥18 years)a
|
Estimated MSM pop.
(≥18 years)b
|
% resp.c
|
Age (years)
|
Race
|
Income (minimum wage)
|
Schooling (years)
|
Median
(IQR)
|
18-24
|
25-29
|
30-34
|
35+
|
White/ Asian
|
Black
|
Mix black/ Native
|
≤1
|
>1-3
|
>3-10
|
>10
|
<10
|
10-12
|
13-16
|
>16
|
North
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Manaus
|
297
(1.8)
|
569,834
|
19,944
|
1.5
|
25
(22-30)
|
138
(46.5)
|
78
(26.3)
|
37
(12.5)
|
44
(14.8)
|
98
(33.8)
|
30
(10.3)
|
162
(55.9)
|
57
(19.2)
|
126
(42.4)
|
85
(28.6)
|
29
(9.8)
|
14
(4.8)
|
145
(49.5)
|
67
(22.9)
|
67
(22.9)
|
Belém
|
290
(1.7)
|
457,322
|
16,006
|
1.8
|
26
(22-32)
|
125
(43.1)
|
64
(22.1)
|
51
(17.6)
|
50
(17.2)
|
112
(39.0)
|
43
(15.0)
|
132
(46.0)
|
35
(12.1)
|
103
(35.5)
|
111
(38.3)
|
41
(14.1)
|
7
(2.4)
|
116
(40.3)
|
101
(35.1)
|
64
(22.2)
|
Porto Velho
|
37
(0.2)
|
146,727
|
5,135
|
0.7
|
25
(22-30)
|
17
(45.9)
|
10
(27.0)
|
7
(18.9)
|
3
(8.1)
|
16
(43.2)
|
3
(8.1)
|
18
(48.6)
|
4
(10.8)
|
12
(32.4)
|
18
(48.6)
|
3
(8.1)
|
1
(2.7)
|
13
(37.1)
|
13
(37.1)
|
8
(22.9)
|
Palmas
|
34
(0.2)
|
75,543
|
2,644
|
1.3
|
27.5
(24-32.7)
|
11
(32.4)
|
9
(26.5)
|
6
(17.6)
|
8
(23.5)
|
15
(44.1)
|
5
(14.7)
|
14
(41.2)
|
4
(11.8)
|
9
(26.5)
|
18
(52.9)
|
3
(8.8)
|
0
(0.0)
|
12
(35.3)
|
11
(32.4)
|
11
(32.4)
|
Boa Vista
|
31
(0.2)
|
89,030
|
3,116
|
1.0
|
30
(24.5-37.5)
|
8
(25.8)
|
6
(19.4)
|
8
(25.8)
|
9
(29.0)
|
5
(16.1)
|
2
(6.5)
|
24
(77.4)
|
3
(9.7)
|
12
(38.7)
|
12
(38.7)
|
4
(12.9)
|
0
(0.0)
|
8
(25.8)
|
13
(41.9)
|
10
(32.3)
|
Rio Branco
|
23
(0.1)
|
103,808
|
3,633
|
0.6
|
28
(24.5-32)
|
6
(26.1)
|
9
(39.1)
|
5
(21.7)
|
3
(13.0)
|
7
(30.4)
|
2
(8.7)
|
14
(60.9)
|
5
(21.7)
|
6
(26.1)
|
9
(39.1)
|
3
(13.0)
|
0
(0.0)
|
8
(34.8)
|
9
(39.1)
|
6
(26.1)
|
Macapá
|
18
(0.1)
|
120,180
|
4,206
|
0.4
|
27
(22.5-30.7)
|
7
(38.9)
|
5
(27.8)
|
3
(16.7)
|
3
(16.7)
|
9
(50.0)
|
3
(16.7)
|
6
(33.3)
|
3
(16.7)
|
8
(44.4)
|
4
(22.2)
|
3
(16.7)
|
1
(5.6)
|
4
(23.5)
|
8
(47.1)
|
4
(23.5)
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Northeast
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Recife
|
636
(3.8)
|
508,405
|
17,794
|
3.6
|
29
(24-36)
|
183
(28.8)
|
160
(25.2)
|
113
(17.8)
|
180
(28.3)
|
283
(45.4)
|
87
(13.9)
|
254
(40.7)
|
82
(12.9)
|
239
(37.6)
|
223
(35.1)
|
92
(14.5)
|
17
(2.7)
|
232
(36.7)
|
207
(32.8)
|
176
(27.8)
|
Salvador
|
628
(3.8)
|
904,397
|
31,654
|
2.0
|
29
(24-35)
|
168
(26.8)
|
162
(25.8)
|
120
(19.1)
|
178
(28.3)
|
182
(29.4)
|
190
(30.7)
|
247
(39.9)
|
83
(13.2)
|
224
(35.7)
|
216
(34.4)
|
105
(16.7)
|
16
(2.6)
|
213
(34.0)
|
230
(36.7)
|
168
(26.8)
|
Fortaleza
|
418
(2.5)
|
800,792
|
28,028
|
1.5
|
28
(23-34)
|
131
(31.3)
|
115
(27.5)
|
80
(19.1)
|
92
(22.0)
|
157
(38.2)
|
55
(13.4)
|
199
(48.4)
|
69
(16.5)
|
160
(38.3)
|
145
(34.7)
|
44
(10.5)
|
7
(1.7)
|
170
(41.6)
|
139
(34.0)
|
93
(22.7)
|
Natal
|
171
(1.0)
|
268,193
|
9,387
|
1.8
|
28
(24-34)
|
48
(28.1)
|
51
(29.8)
|
31
(18.1)
|
41
(24.0)
|
91
(53.5)
|
22
(12.9)
|
57
(33.5)
|
13
(7.6)
|
68
(39.8)
|
62
(36.3)
|
28
(16.4)
|
6
(3.5)
|
61
(35.9)
|
55
(32.4)
|
48
(28.2)
|
Joao Pessoa
|
115
(0.7)
|
237,865
|
8,325
|
1.4
|
29
(24-34)
|
31
(27.0)
|
27
(23.5)
|
29
(25.2)
|
28
(24.3)
|
44
(38.3)
|
12
(10.4)
|
59
(51.3)
|
18
(15.7)
|
47
(40.9)
|
37
(32.2)
|
13
(11.3)
|
4
(3.5)
|
35
(30.4)
|
52
(45.2)
|
24
(20.9)
|
Aracaju
|
108
(0.6)
|
185,953
|
6,508
|
1.7
|
25
(21-29)
|
46
(42.6)
|
36
(33.3)
|
10
(9.3)
|
16
(14.8)
|
48
(45.7)
|
17
(16.2)
|
40
(38.1)
|
19
(17.6)
|
53
(49.1)
|
26
(24.1)
|
10
(9.3)
|
1
(0.9)
|
51
(47.2)
|
34
(31.5)
|
22
(20.4)
|
Teresina
|
100
(0.6)
|
262,763
|
9,197
|
1.1
|
27
(22-31.2)
|
39
(39.0)
|
25
(25.0)
|
18
(18.0)
|
18
(18.0)
|
27
(27.3)
|
18
(18.2)
|
54
(54.5)
|
20
(20.0)
|
37
(37.0)
|
38
(38.0)
|
5
(5.0)
|
2
(2.0)
|
34
(35.4)
|
33
(34.4)
|
27
(28.1)
|
Maceió
|
91
(0.5)
|
292,718
|
10,245
|
0.9
|
27
(23-33)
|
37
(40.7)
|
20
(22.0)
|
15
(16.5)
|
19
(20.9)
|
33
(36.7)
|
17
(18.9)
|
40
(44.4)
|
14
(15.4)
|
28
(30.8)
|
36
(39.6)
|
13
(14.3)
|
1
(1.1)
|
35
(38.9)
|
29
(32.2)
|
25
(27.8)
|
São Luís
|
53
(0.3)
|
326,863
|
11,440
|
0.5
|
25
(23-30)
|
26
(49.1)
|
10
(18.9)
|
7
(13.2)
|
10
(18.9)
|
20
(37.7)
|
11
(20.8)
|
22
(41.5)
|
5
(9.4)
|
28
(52.8)
|
17
(32.1)
|
3
(5.7)
|
1
(1.9)
|
24
(45.3)
|
17
(32.1)
|
11
(20.8)
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Central-west
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Brasília
|
890
(5.3)
|
855,306
|
29,936
|
3.0
|
30
(25-38)
|
219
(24.6)
|
209
(23.5)
|
170
(19.1)
|
292
(32.8)
|
460
(52.8)
|
88
(10.1)
|
324
(37.2)
|
46
(5.2)
|
199
(22.4)
|
341
(38.3)
|
304
(34.2)
|
12
(1.4)
|
261
(29.4)
|
293
(33.0)
|
322
(36.3)
|
Goiânia
|
570
(3.4)
|
450,221
|
15,758
|
3.6
|
28
(23-33)
|
169
(29.6)
|
174
(30.5)
|
113
(19.8)
|
114
(20.0)
|
287
(51.0)
|
61
(10.8)
|
215
(38.2)
|
64
(11.2)
|
201
(35.3)
|
227
(39.8)
|
78
(13.7)
|
32
(5.7)
|
222
(39.2)
|
167
(29.5)
|
146
(25.7)
|
Cuiabá
|
119
(0.7)
|
190,291
|
6,660
|
1.8
|
27
(23-33)
|
43
(36.1)
|
34
(28.6)
|
20
(16.8)
|
22
(18.5)
|
42
(35.9)
|
30
(25.6)
|
45
(38.5)
|
9
(7.6)
|
46
(38.7)
|
48
(40.3)
|
16
(13.4)
|
4
(3.4)
|
39
(33.6)
|
44
(37.9)
|
29
(25.0)
|
Campo Grande
|
115
(0.7)
|
270,346
|
9,462
|
1.2
|
28
(23-33)
|
42
(36.5)
|
28
(24.3)
|
24
(20.9)
|
21
(18.3)
|
58
(50.9)
|
19
(16.7)
|
37
(32.5)
|
8
(7.0)
|
41
(35.7)
|
50
(43.5)
|
16
(13.9)
|
4
(3.5)
|
45
(39.5)
|
36
(31.6)
|
29
(25.4)
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Southeast
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
São Paulo
|
5764
(34.6)
|
3,889,290
|
136,125
|
4.2
|
30
(25-36)
|
1393
(24.2)
|
1382
(24.0)
|
1187
(20.6)
|
1801
(31.3)
|
3885
(68.1)
|
476
(8.3)
|
1342
(23.5)
|
396
(6.9)
|
1596
(27.7)
|
2566
(44.5)
|
1206
(20.9)
|
214
(3.7)
|
1966
(34.2)
|
2147
(37.4)
|
1421
(24.7)
|
Rio de Janeiro
|
3166
(19.0)
|
2,198,018
|
76,931
|
4.1
|
30
(24-37)
|
803
(25.4)
|
757
(23.9)
|
602
(19.0)
|
1004
(31.7)
|
1791
(57.1)
|
415
(13.2)
|
931
(29.7)
|
293
(9.3)
|
996
(31.5)
|
1285
(40.6)
|
592
(18.7)
|
150
(4.8)
|
1293
(41.0)
|
878
(27.8)
|
836
(26.5)
|
Belo Horizonte
|
967
(5.8)
|
831,360
|
29,098
|
3.3
|
29
(24-35)
|
260
(26.9)
|
262
(27.1)
|
176
(18.2)
|
269
(27.8)
|
468
(48.8)
|
138
(14.4)
|
353
(36.8)
|
97
(10.0)
|
328
(33.9)
|
429
(44.4)
|
113
(11.7)
|
42
(4.4)
|
361
(37.6)
|
309
(32.2)
|
248
(25.8)
|
Campinas
|
260
(1.6)
|
389,948
|
13,648
|
1.9
|
29
(25-38)
|
60
(23.1)
|
72
(27.7)
|
48
(18.5)
|
80
(30.8)
|
165
(63.7)
|
25
(9.7)
|
69
(26.6)
|
19
(7.3)
|
82
(31.5)
|
129
(49.6)
|
30
(11.5)
|
16
(6.2)
|
99
(38.1)
|
75
(28.8)
|
70
(26.9)
|
Vitória
|
160
(1.0)
|
114,835
|
4,019
|
4.0
|
29
(24.7-34)
|
40
(25.0)
|
43
(26.9)
|
43
(26.9)
|
34
(21.3)
|
76
(48.1)
|
20
(12.7)
|
62
(39.2)
|
18
(11.3)
|
67
(41.9)
|
64
(40.0)
|
11
(6.9)
|
4
(2.6)
|
60
(37.7)
|
55
(34.6)
|
40
(25.2)
|
Santos
|
101
(0.6)
|
148,026
|
5,181
|
1.9
|
31
(26-40)
|
16
(15.8)
|
26
(25.7)
|
24
(23.8)
|
35
(34.7)
|
68
(67.3)
|
7
(6.9)
|
26
(25.7)
|
7
(6.9)
|
29
(28.7)
|
50
(49.5)
|
15
(14.9)
|
2
(2.0)
|
27
(26.7)
|
46
(45.5)
|
26
(25.7)
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
South
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Porto Alegre
|
648
(3.9)
|
489,677
|
17,139
|
3.8
|
30
(25-37)
|
150
(23.1)
|
149
(23.0)
|
134
(20.7)
|
215
(33.2)
|
526
(82.0)
|
30
(4.7)
|
85
(13.3)
|
29
(4.5)
|
196
(30.2)
|
303
(46.3)
|
120
(18.5)
|
20
(3.1)
|
242
(37.5)
|
203
(31.4)
|
181
(28.0)
|
Curitiba
|
499
(3.0)
|
615,841
|
21,554
|
2.3
|
30
(25-36)
|
122
(24.4)
|
118
(23.6)
|
115
(23.0)
|
144
(28.9)
|
347
(70.4)
|
32
(6.5)
|
114
(23.1)
|
28
(5.6)
|
147
(29.5)
|
248
(49.7)
|
76
(15.2)
|
16
(3.2)
|
169
(34.0)
|
161
(32.4)
|
151
(30.4)
|
Florianópolis
|
358
(2.1)
|
155,364
|
5,438
|
6.6
|
29
(25-34)
|
88
(24.6)
|
100
(27.9)
|
85
(23.7)
|
85
(23.7)
|
259
(73.2)
|
26
(7.3)
|
69
(19.5)
|
15
(4.2)
|
132
(36.9)
|
153
(42.7)
|
58
(16.2)
|
18
(5.0)
|
147
(41.1)
|
107
(29.9)
|
86
(24.0)
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Total
|
16,667
(100.0)
|
15,948,916
|
558,212
|
3.0
|
29
(24-36)
|
4426
(26.6)
|
4141
(24.8)
|
3281
(19.7)
|
4818
(28.9)
|
9579
(58.1)
|
1884
(11.4)
|
5014
(30.4)
|
1463
(8.7)
|
5220
(31.3)
|
6950
(41.7)
|
3034
(18.2)
|
612
(3.7)
|
6092
(36.7)
|
5539
(33.4)
|
4349
(26.2)
|
Missing (participant did not want to answer or did not know): age=1; race=190; schooling=75; sexual orientation=86; steady partner=76; test lifetime=51.
a According to Brazilian CENSO 2010 (https://sidra.ibge.gov.br/tabela/1209); b Considering the proportion of MSM among Brazilian male population between 15-64 years (3.5%) (http://www.aids.gov.br/pt-br/pub/2016/pesquisa-de-conhecimentos-atitudes-e-praticas-na-populacao-brasileira-pcap-2013); c Proportion of MSM who completed the web-based surveys in relation to estimated MSM population.
Table 2. Sexual orientation, steady partner and behaviors of MSM who completed the online surveys in each Brazilian city. 2016-2018
|
Total
|
Sexual Orientation (Gay or homosexual)
|
Steady partner
|
Binge drinkinga
|
Use of Stimulants a, b
|
STIa, c
|
HIV testing (never)
|
Sex with >5 mena
|
Condomless receptive anal sexa
|
The HIV Incidence Risk Index for MSM
(HIRI-MSM)d
|
HIV perceived riske
|
|
|
|
|
|
|
Low Risk
|
High risk
|
No risk
|
Low risk
|
High risk
|
North
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Manaus
|
297
|
242 (83.2)
|
72 (24.2)
|
191 (64.3)
|
30 (10.1)
|
32 (10.9)
|
75 (25.5)
|
114 (38.4)
|
118 (39.9)
|
120 (40.4)
|
177 (59.6)
|
59 (21.5)
|
134 (48.9)
|
81 (29.6)
|
Belém
|
290
|
240 (83.9)
|
56 (19.5)
|
203 (70.0)
|
31 (10.7)
|
32 (11.1)
|
76 (26.5)
|
105 (36.2)
|
122 (42.2)
|
116 (40.0)
|
174 (60.0)
|
64 (23.5)
|
144 (52.9)
|
64 (23.5)
|
Porto Velho
|
37
|
31 (83.8)
|
6 (16.7)
|
28 (75.7)
|
5 (13.5)
|
4 (10.8)
|
7 (19.4)
|
13 (35.1)
|
19 (52.8)
|
9 (24.3)
|
28 (75.7)
|
3 (8.6)
|
19 (54.3)
|
13 (37.1)
|
Palmas
|
34
|
29 (85.3)
|
9 (26.5)
|
25 (73.5)
|
3 (8.8)
|
6 (17.6)
|
5 (15.2)
|
9 (26.5)
|
17 (50.0)
|
11 (32.4)
|
23 (67.6)
|
4 (11.8)
|
16 (47.1)
|
14 (41.2)
|
Boa Vista
|
31
|
27 (87.1)
|
10 (32.3)
|
22 (71.0)
|
6 (19.4)
|
6 (19.4)
|
1 (3.2)
|
12 (38.7)
|
13 (41.9)
|
12 (38.7)
|
19 (61.3)
|
7 (22.6)
|
18 (58.1)
|
6 (19.4)
|
Rio Branco
|
23
|
23 (100.0)
|
7 (31.8)
|
18 (78.3)
|
3 (13.0)
|
7 (30.4)
|
3 (13.0)
|
11 (47.8)
|
10 (43.5)
|
8 (34.8)
|
15 (65.2)
|
3 (13.0)
|
15 (65.2)
|
5 (21.7)
|
Macapá
|
18
|
13 (72.2)
|
6 (33.3)
|
10 (55.6)
|
3 (16.7)
|
3 (17.6)
|
3 (16.7)
|
7 (38.9)
|
9 (50.0)
|
7 (38.9)
|
11 (61.1)
|
3 (16.7)
|
6 (33.3)
|
9 (50.0)
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Northeast
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Recife
|
636
|
550 (87.0)
|
173 (27.3)
|
437 (68.8)
|
81 (12.7)
|
64 (10.2)
|
130 (20.4)
|
251 (39.5)
|
255 (40.3)
|
253 (39.8)
|
383 (60.2)
|
121 (20.2)
|
329 (54.9)
|
149 (24.9)
|
Salvador
|
628
|
555 (88.8)
|
147 (23.6)
|
451 (71.8)
|
113 (18.0)
|
73 (11.8)
|
106 (17.0)
|
277 (44.1)
|
251 (40.2)
|
241 (38.4)
|
387 (61.6)
|
119 (20.2)
|
312 (53.1)
|
157 (26.7)
|
Fortaleza
|
418
|
391 (93.8)
|
94 (22.7)
|
288 (68.9)
|
56 (13.4)
|
46 (11.2)
|
103 (25.0)
|
151 (36.1)
|
158 (38.3)
|
173 (41.4)
|
245 (58.6)
|
70 (17.6)
|
214 (53.8)
|
114 (28.6)
|
Natal
|
171
|
155 (91.2)
|
33 (19.5)
|
118 (69.0)
|
19 (11.1)
|
23 (13.5)
|
43 (25.3)
|
66 (38.6)
|
76 (45.0)
|
67 (39.2)
|
104 (60.8)
|
22 (13.2)
|
96 (57.5)
|
49 (29.3)
|
Joao Pessoa
|
115
|
106 (93.0)
|
30 (26.1)
|
75 (65.2)
|
17 (14.8)
|
14 (12.3)
|
18 (15.8)
|
52 (45.2)
|
44 (38.3)
|
46 (40.0)
|
69 (60.0)
|
16 (14.7)
|
55 (50.5)
|
38 (34.9)
|
Aracaju
|
108
|
93 (86.1)
|
20 (18.7)
|
77 (71.3)
|
12 (11.1)
|
10 (9.3)
|
36 (33.6)
|
34 (31.5)
|
39 (36.4)
|
49 (45.4)
|
59 (54.6)
|
24 (23.3)
|
53 (51.5)
|
26 (25.2)
|
Teresina
|
100
|
84 (85.7)
|
25 (26.0)
|
63 (63.0)
|
6 (6.0)
|
9 (9.4)
|
26 (27.1)
|
35 (35.0)
|
37 (37.4)
|
43 (43.0)
|
57 (57.0)
|
18 (18.9)
|
42 (44.2)
|
35 (36.8)
|
Maceió
|
91
|
79 (86.8)
|
26 (29.2)
|
65 (71.4)
|
11 (12.1)
|
6 (6.9)
|
20 (22.2)
|
33 (36.3)
|
35 (38.5)
|
35 (38.5)
|
56 (61.5)
|
15 (17.9)
|
54 (64.3)
|
15 (17.9)
|
São Luís
|
53
|
50 (94.3)
|
10 (18.9)
|
33 (62.3)
|
5 (9.4)
|
9 (17.0)
|
18 (34.0)
|
21 (39.6)
|
22 (41.5)
|
21 (39.6)
|
32 (60.4)
|
9 (19.1)
|
22 (46.8)
|
16 (34.0)
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Central-west
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Brasília
|
890
|
795 (89.6)
|
250 (28.2)
|
632 (71.1)
|
206 (23.1)
|
110 (12.5)
|
113 (12.7)
|
399 (44.8)
|
359 (40.5)
|
322 (36.2)
|
568 (63.8)
|
133 (15.8)
|
481 (57)
|
230 (27.3)
|
Goiânia
|
570
|
509 (89.9)
|
123 (21.7)
|
405 (71.3)
|
103 (18.1)
|
89 (16.1)
|
126 (22.1)
|
230 (40.4)
|
227 (40.0)
|
213 (37.4)
|
357 (62.6)
|
104 (19.7)
|
267 (50.7)
|
156 (29.6)
|
Cuiabá
|
119
|
102 (86.4)
|
22 (18.6)
|
84 (70.6)
|
19 (16.0)
|
19 (16.4)
|
22 (18.6)
|
52 (43.7)
|
53 (45.3)
|
36 (30.3)
|
83 (69.7)
|
15 (13.5)
|
56 (50.5)
|
40 (36.0)
|
Campo Grande
|
115
|
98 (85.2)
|
19 (16.5)
|
80 (69.6)
|
25 (21.7)
|
20 (17.9)
|
22 (19.1)
|
44 (38.3)
|
50 (44.2)
|
40 (34.8)
|
75 (65.2)
|
16 (14.3)
|
60 (53.6)
|
36 (32.1)
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Southeast
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
São Paulo
|
5764
|
5201 (90.6)
|
1341 (23.3)
|
4005 (69.6)
|
1421 (24.7)
|
763 (13.4)
|
790 (13.7)
|
2664 (46.2)
|
2375 (41.4)
|
1951 (33.8)
|
3813 (66.2)
|
911 (16.8)
|
3033 (55.9)
|
1484 (27.3)
|
Rio de Janeiro
|
3166
|
2820 (89.6)
|
775 (24.6)
|
2287 (72.3)
|
624 (19.8)
|
398 (12.7)
|
541 (17.1)
|
1438 (45.4)
|
1331 (42.1)
|
1104 (34.9)
|
2062 (65.1)
|
499 (16.9)
|
1640 (55.6)
|
810 (27.5)
|
Belo Horizonte
|
967
|
881 (91.3)
|
227 (23.6)
|
693 (71.7)
|
180 (18.6)
|
123 (13.0)
|
177 (18.3)
|
386 (39.9)
|
392 (40.9)
|
362 (37.4)
|
605 (62.6)
|
134 (14.5)
|
504 (54.7)
|
283 (30.7)
|
Campinas
|
260
|
235 (91.1)
|
56 (21.6)
|
173 (66.5)
|
59 (22.7)
|
31 (12.1)
|
47 (18.1)
|
97 (37.3)
|
115 (45.3)
|
102 (39.2)
|
158 (60.8)
|
35 (14.2)
|
137 (55.5)
|
75 (30.4)
|
Vitória
|
160
|
148 (94.9)
|
34 (21.5)
|
115 (71.9)
|
36 (22.5)
|
21 (13.4)
|
22 (13.8)
|
58 (36.2)
|
72 (46.2)
|
44 (27.5)
|
116 (72.5)
|
22 (14.9)
|
83 (56.1)
|
43 (29.1)
|
Santos
|
101
|
92 (91.1)
|
28 (27.7)
|
68 (67.3)
|
14 (13.9)
|
16 (16.0)
|
12 (11.9)
|
38 (37.6)
|
39 (39.0)
|
41 (40.6)
|
60 (59.4)
|
21 (22.1)
|
46 (48.4)
|
28 (29.5)
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
South
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Porto Alegre
|
648
|
555 (88.8)
|
167 (25.9)
|
441 (68.2)
|
129 (20.0)
|
77 (12.1)
|
93 (14.4)
|
295 (45.5)
|
274 (42.3)
|
238 (36.7)
|
410 (63.3)
|
89 (14.6)
|
361 (59.2)
|
160 (26.2)
|
Curitiba
|
499
|
455 (91.5)
|
110 (22.2)
|
335 (67.1)
|
102 (20.4)
|
68 (13.9)
|
63 (12.7)
|
217 (43.5)
|
197 (39.6)
|
170 (34.1)
|
329 (65.9)
|
70 (14.8)
|
255 (53.9)
|
148 (31.3)
|
Florianópolis
|
358
|
324 (90.8)
|
79 (22.1)
|
262 (73.2)
|
82 (22.9)
|
66 (18.6)
|
56 (15.7)
|
160 (44.7)
|
156 (43.7)
|
111 (31.0)
|
247 (69.0)
|
59 (17.4)
|
177 (52.2)
|
103 (30.4)
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Total
|
16667
|
14909 (89.9)
|
3955 (23.8)
|
11684 (70.2)
|
3401 (20.4)
|
2145 (13.1)
|
2754 (16.6)
|
7269 (43.6)
|
6865 (41.4)
|
5945 (35.7)
|
10722 (64.3)
|
2665 (17.0)
|
8629 (55.0)
|
4387 (28.0)
|
a During the previous 6 months; b Cocaine, poppers, crack, or amphetamines; c Syphilis, gonorrhea, or rectal chlamydia; d The HIRI-MSM was calculated based on sexual behavior in the previous six months (number of partners, condomless receptive anal intercourse, sex with HIV-positive partner), age and use of stimulants, being stratified in low risk (< 10 points) and high risk (≥10 points; PrEP is recommended). “Unknown” answers scored 0 points on the HIRI-MSM; e In the next 12 months.
Table 3. Association between HIV risk behavior and HIV perceived risk among MSM who completed the online surveys in Brazil.
|
HIV Perceived riska
|
High HIV perceived risk
OR (95%CI)
|
Low
|
High
|
The HIV Incidence Risk Index for MSMb
|
|
|
|
Low
|
4860 (86.1)
|
784 (13.9)
|
Ref.
|
High
|
6434 (64.1)
|
3603 (35.9)
|
3.47 (3.19-3.78)
|
Condomless receptive anal sexc
|
|
|
|
No
|
7400 (80.3)
|
1811 (19.7)
|
Ref.
|
Yes
|
3847 (60.1)
|
2552 (39.9)
|
2.71 (2.52-2.91)
|
Number of male partnersc
|
|
|
|
≤5
|
7213 (81.2)
|
1671 (18.8)
|
Ref.
|
>5
|
4081 (60.0)
|
2716 (40.0)
|
2.87 (2.67-3.09)
|
a In the next 12 months; bThe HIRI-MSM was calculated based on sexual behavior in the previous six months (number of partners, condomless receptive anal intercourse, sex with HIV-positive partner), age and use of stimulants, being stratified in low risk (< 10 points) and high risk (≥10 points; PrEP is recommended).“Unknown” answers scored 0 points on the HIRI-MSM; c During the previous 6 months.
Table 4: HIV risk behavior vs. HIV perceived risk among MSM from 11 cities in Brazil.
|
HIV risk behaviora
|
HIV perceived risk b
|
|
Low
|
High
|
|
North
|
|
|
|
|
Manaus
|
Low
|
99(85.3)
|
17(14.7)
|
|
High
|
94(59.5)
|
64(40.5)
|
|
Belém
|
Low
|
102(89.5)
|
12(10.5)
|
|
High
|
106(67.1)
|
52(32.9)
|
|
|
|
|
|
|
Northeast
|
|
|
|
|
Recife
|
Low
|
203(84.9)
|
36(15.1)
|
|
High
|
247(68.6)
|
113(31.4)
|
|
Salvador
|
Low
|
198(85.3)
|
34(14.7)
|
|
High
|
233(65.4)
|
123(34.6)
|
|
|
|
|
|
|
Central-west
|
|
|
|
|
Brasília
|
Low
|
268(86.7)
|
41(13.3)
|
|
High
|
346(64.7)
|
189(35.3)
|
|
Goiânia
|
Low
|
166(83.4)
|
33(16.6)
|
|
High
|
205(62.5)
|
123(37.5)
|
|
|
|
|
|
|
Southeast
|
|
|
|
|
São Paulo
|
Low
|
1604(86.9)
|
241(13.1)
|
|
High
|
2340(65.3)
|
1243(34.7)
|
|
Rio de Janeiro
|
Low
|
910(87.8)
|
126(12.2)
|
|
High
|
1229(64.2)
|
684(35.8)
|
|
Belo Horizonte
|
Low
|
287(83.2)
|
58(16.8)
|
|
High
|
351(60.9)
|
225(39.1)
|
|
|
|
|
|
|
South
|
|
|
|
|
Porto Alegre
|
Low
|
198(87.2)
|
29(12.8)
|
|
High
|
252(65.8)
|
131(34.2)
|
|
Curitiba
|
Low
|
137(84.0)
|
26(16.0)
|
|
High
|
188(60.6)
|
122(39.4)
|
|
|
|
|
|
|
Brazil
|
Low
|
4860 (86.1)
|
784 (13.9)
|
|
High
|
6434 (64.1)
|
3603 (35.9)
|
|
a measured by the HIRI-MSM, which was calculated based on sexual behavior in the previous six months (number of partners, condomless receptive anal intercourse, sex with HIV-positive partner), age and use of stimulants, being stratified in low risk (< 10 points) and high risk (≥10 points; PrEP is recommended); b HIV perceived risk (in the next 12 months) was dichotomized in low (no/low) and high risk.
Table 5: Condomless receptive anal sex vs. HIV perceived risk among MSM from 11 cities in Brazil.
|
Condomless receptive anal sex a
|
HIV perceived risk b
|
|
Low
|
High
|
|
North
|
|
|
|
|
Manaus
|
No
|
133(79.6)
|
34(20.4)
|
|
Yes
|
60(56.6)
|
46(43.4)
|
|
Belém
|
No
|
137(85.6)
|
23(14.4)
|
|
Yes
|
71(64.0)
|
40(36.0)
|
|
|
|
|
|
|
Northeast
|
|
|
|
|
Recife
|
No
|
295(82.4)
|
63(17.6)
|
|
Yes
|
153(64.3)
|
85(35.7)
|
|
Salvador
|
No
|
292(81.3)
|
67(18.7)
|
|
Yes
|
138(60.8)
|
89(39.2)
|
|
|
|
|
|
|
Central-west
|
|
|
|
|
Brasília
|
No
|
400(79.4)
|
104(20.6)
|
|
Yes
|
212(62.9)
|
125(37.1)
|
|
Goiânia
|
No
|
247(77.9)
|
70(22.1)
|
|
Yes
|
123(59.1)
|
85(40.9)
|
|
|
|
|
|
|
Southeast
|
|
|
|
|
São Paulo
|
No
|
2592(81.5)
|
590(18.5)
|
|
Yes
|
1334(60.0)
|
889(40.0)
|
|
Rio de Janeiro
|
No
|
1397(81.6)
|
314(18.4)
|
|
Yes
|
741(60.0)
|
494(40.0)
|
|
Belo Horizonte
|
No
|
414(76.4)
|
128(23.6)
|
|
Yes
|
218(58.6)
|
154(41.4)
|
|
|
|
|
|
|
South
|
|
|
|
|
Porto Alegre
|
No
|
290(81.5)
|
66(18.5)
|
|
Yes
|
160(63.2)
|
93(36.8)
|
|
Curitiba
|
No
|
221(76.5)
|
68(23.5)
|
|
Yes
|
103(56.3)
|
80(43.7)
|
|
|
|
|
|
|
Brazil
|
No
|
7400 (80.3)
|
1811 (19.7)
|
|
Yes
|
3847 (60.1)
|
2552 (39.9)
|
|
a During the previous 6 months; b HIV perceived risk (in the next 12 months) was dichotomized in low (no/low) and high risk.
Table 6. Association, measured by the adjusted odds ratios (aOR, 95% confidence interval) between MSM characteristics and high-risk behavior as measured by the HIV Incidence Risk Index for MSM (HIRI-MSM), by city, 2016-2018.
|
Total
|
Young age: 18-24 years
(ref: >24 years
|
Black/mixed-black
(ref: white/Asian)
|
≤ 3 MW income
(ref: >3 MW)
|
≤ 12 years of Schooling
(ref: >12 years)
|
Gay or homosexual (ref: Other than gay)
|
Steady partner
(ref: no)
|
Binge drinkinga
(ref: no)
|
STIa, c
(ref: no)
|
Ever HIV testing (ref: never)
|
North
|
|
|
|
|
|
|
|
|
|
|
Manaus
|
297
|
1.20(0.67-2.18)
|
1.48(0.86-2.55)
|
0.78(0.44-1.37)
|
1.13(0.65-2.00)
|
0.95(0.47-1.89)
|
1.54(0.84-2.88)
|
2.15(1.27-3.64)
|
1.48(0.63-3.69)
|
2.44(1.36-4.42)
|
Belém
|
290
|
1.65(0.91-3.03)
|
1.32(0.77-2.28)
|
0.62(0.35-1.09)
|
1.11(0.60-2.02)
|
1.42(0.69-2.92)
|
0.71(0.37-1.39)
|
2.76(1.58-4.90)
|
5.35(1.93-19.12)
|
0.62(0.33-1.16)
|
|
|
|
|
|
|
|
|
|
|
|
Northeast
|
|
|
|
|
|
|
|
|
|
|
Recife
|
636
|
1.71(1.12-2.62)
|
0.81(0.57-1.13)
|
0.73(0.51-1.05)
|
1.15(0.78-1.71)
|
1.67(1.03-2.72)
|
1.19(0.82-1.73)
|
1.18(0.82-1.68)
|
1.32(0.76-2.35)
|
1.14(0.74-1.75)
|
Salvador
|
628
|
1.12(0.72-1.73)
|
0.83(0.56-1.22)
|
0.95(0.65-1.39)
|
1.40(0.90-2.17)
|
2.59(1.52-4.51)
|
1.11(0.74-1.67)
|
1.33(0.92-1.94)
|
3.82(2.01-7.93)
|
1.61(1.00-2.59)
|
|
|
|
|
|
|
|
|
|
|
|
Central-west
|
|
|
|
|
|
|
|
|
|
|
Brasília
|
890
|
1.29(0.87-1.91)
|
1.05(0.78-1.42)
|
0.86(0.60-1.24)
|
0.83(0.58-1.21)
|
2.46(1.55-3.93)
|
1.20(0.86-1.67)
|
1.84(1.34-2.53)
|
3.28(1.96-5.80)
|
1.09(0.69-1.72)
|
Goiânia
|
570
|
1.39(0.88-2.21)
|
0.93(0.64-1.35)
|
0.98(0.65-1.46)
|
1.55(1.02-2.38)
|
1.28(0.70-2.31)
|
1.72(1.10-2.74)
|
2.00(1.34-3.00)
|
2.37(1.38-4.23)
|
1.34(0.84-2.14)
|
|
|
|
|
|
|
|
|
|
|
|
Southeast
|
|
|
|
|
|
|
|
|
|
|
São Paulo
|
5764
|
1.46(1.25-1.71)
|
1.04(0.92-1.18)
|
0.90(0.79-1.03)
|
0.96(0.84-1.11)
|
2.05(1.70-2.48)
|
1.04(0.90-1.19)
|
2.08(1.84-2.34)
|
2.48(2.04-3.04)
|
1.42(2.04-3.04)
|
Rio de Janeiro
|
3166
|
1.40(1.14-1.72)
|
0.94(0.80-1.10)
|
1.09(0.92-1.30)
|
0.97(0.81-1.16)
|
1.73(1.36-2.20)
|
1.16(0.97-1.39)
|
1.69(1.43-2.00)
|
2.60(1.98-3.46)
|
1.75(1.42-2.16)
|
Belo Horizonte
|
967
|
0.93(0.67-1.31)
|
1.00(0.75-1.32)
|
1.18(0.88-1.59)
|
0.93(0.68-1.28)
|
2.17(1.35-3.51)
|
1.02(0.74-1.42)
|
1.74(1.29-2.34)
|
1.58(1.04-2.46)
|
1.09(0.76-1.57)
|
|
|
|
|
|
|
|
|
|
|
|
South
|
|
|
|
|
|
|
|
|
|
|
Porto Alegre
|
648
|
1.27(0.80-2.04)
|
0.79(0.51-1.23)
|
1.11(0.76-1.63)
|
0.94(0.63-1.40)
|
2.01(1.16-3.51)
|
1.05(0.71-1.57)
|
2.09(1.46-2.99)
|
2.49(1.39-4.74)
|
1.21(0.73-1.98)
|
Curitiba
|
499
|
1.09(0.65-1.84)
|
1.28(0.82-2.03)
|
0.90(0.58-1.42)
|
0.86(0.54-1.37)
|
2.09(1.02-4.31)
|
1.16(0.71-1.91)
|
2.12(1.40-3.21)
|
2.00(1.07-4.00)
|
1.65(0.89-3.02)
|
|
|
|
|
|
|
|
|
|
|
|
Brazil
|
16667
|
1.34(1.23-1.46)
|
0.97(0.91-1.04)
|
0.96(0.89-1.04)
|
1.00(0.93-1.09)
|
1.91(1.71-2.13)
|
1.13(1.04-1.22)
|
1.88(1.75-2.02)
|
2.30(2.06-2.59)
|
1.45(1.32-1.59)
|
MW = minimum wage
The HIRI-MSM was calculated based on sexual behavior in the previous six months (number of partners, condomless receptive anal intercourse, sex with HIV-positive partner), age and use of stimulants, being stratified in low risk (< 10 points) and high risk (≥10 points; PrEP is recommended). “Unknown” answers scored 0 points on The HIRI-MSM; a During the previous 6 months; b Cocaine, poppers, crack, or amphetamines; c Syphilis, gonorrhea, or rectal chlamydia.
Table 7. Association, measured by the adjusted odds ratios (aOR, 95% confidence interval) between MSM characteristics and high HIV perceived risk, by city, 2016-2018.
|
Total
|
Young age: 18-24 years
(ref: >24 years)
|
Black/mixed-black
(ref: white/Asian)
|
≤ 3 MW income
(ref: >3 MW)
|
≤ 12 years of Schooling
(ref: >12 years)
|
Gay or homosexual (ref: Other than gay)
|
Steady partner
(ref: no)
|
Binge drinkinga
(ref: no)
|
STIa, c
(ref: no)
|
Ever HIV testing (ref: never)
|
North
|
|
|
|
|
|
|
|
|
|
|
Manaus
|
297
|
0.94(0.49-1.80)
|
1.93(1.03-3.75)
|
1.37(0.73-2.60)
|
0.94(0.50-1.76)
|
1.56(0.72-3.63)
|
1.17(0.60-2.25)
|
1.77(0.98-3.30)
|
3.22(1.30-8.05)
|
0.88(0.45-1.74)
|
Belém
|
290
|
1.13(0.56-2.27)
|
1.61(0.84-3.16)
|
1.55(0.79-3.05)
|
1.28(0.63-2.60)
|
3.31(1.19-11.30)
|
0.59(0.23-1.38)
|
2.93(1.39-6.67)
|
6.67(2.68-17.49)
|
1.58(0.72-3.68)
|
|
|
|
|
|
|
|
|
|
|
|
Northeast
|
|
|
|
|
|
|
|
|
|
|
Recife
|
636
|
0.66(0.40-1.07)
|
1.30(0.87-1.94)
|
0.88(0.57-1.34)
|
1.39(0.88-2.19)
|
2.07(1.08-4.33)
|
0.94(0.60-1.46)
|
1.22(0.80-1.89)
|
2.44(1.37-4.31)
|
0.81(0.49-1.35)
|
Salvador
|
628
|
0.74(0.45-1.22)
|
1.07(0.69-1.67)
|
1.07(0.69-1.65)
|
0.94(0.57-1.53)
|
1.66(0.87-3.40)
|
1.06(0.67-1.64)
|
1.17(0.76-1.82)
|
3.36(1.98-5.72)
|
0.65(0.38-1.13)
|
|
|
|
|
|
|
|
|
|
|
|
Central-west
|
|
|
|
|
|
|
|
|
|
|
Brasília
|
890
|
0.47(0.30-0.75)
|
1.14(0.82-1.60)
|
1.12(0.74-1.69)
|
1.22(0.80-1.84)
|
1.25(0.71-2.28)
|
0.72(0.49-1.05)
|
1.69(1.16-2.49)
|
4.42(2.86-6.88)
|
1.13(0.66-2.03)
|
Goiânia
|
570
|
1.17(0.71-1.92)
|
0.82(0.54-1.24)
|
0.94(0.60-1.46)
|
0.94(0.59-1.50)
|
1.84(0.87-4.39)
|
0.72(0.43-1.20)
|
1.38(0.87-2.22)
|
2.55(1.53-4.27)
|
1.23(0.72-2.16)
|
|
|
|
|
|
|
|
|
|
|
|
Southeast
|
|
|
|
|
|
|
|
|
|
|
São Paulo
|
5764
|
0.81(0.68-0.96)
|
1.29(1.13-1.48)
|
0.93(0.80-1.08)
|
1.20(1.03-1.40)
|
1.64(1.29-2.11)
|
0.78(0.67-0.91)
|
1.22(1.06-1.40)
|
2.77(2.35-3.27)
|
1.24(1.01-1.52)
|
Rio de Janeiro
|
3166
|
0.82(0.65-1.02)
|
1.04(0.87-1.24)
|
1.20(0.99-1.45)
|
1.19(0.97-1.45)
|
1.75(1.28-2.42)
|
0.93(0.77-1.14)
|
1.28(1.05-1.56)
|
2.59(2.06-3.26)
|
1.12(0.88-1.44)
|
Belo Horizonte
|
967
|
0.62(0.43-0.90)
|
1.00(0.74-1.34)
|
1.18(0.86-1.62)
|
1.06(0.76-1.48)
|
1.27(0.74-2.25)
|
0.70(0.49-1.00)
|
1.18(0.85-1.64)
|
1.87(1.23-2.82)
|
1.25(0.83-1.92)
|
|
|
|
|
|
|
|
|
|
|
|
South
|
|
|
|
|
|
|
|
|
|
|
Porto Alegre
|
648
|
0.82(0.49-1.35)
|
1.02(0.61-1.66)
|
1.21(0.79-1.83)
|
1.31(0.85-2.00)
|
0.65(0.35-1.22)
|
1.16(0.75-1.78)
|
2.14(1.38-3.38)
|
2.13(1.24-3.62)
|
1.09(0.62-1.97)
|
Curitiba
|
499
|
0.46(0.26-0.79)
|
1.39(0.88-2.16)
|
1.41(0.88-2.24)
|
1.16(0.72-1.87)
|
0.95(0.42-2.28)
|
0.75(0.44-1.26)
|
1.39(0.89-2.20)
|
1.97(1.11-3.49)
|
0.78(0.40-1.53)
|
|
|
|
|
|
|
|
|
|
|
|
Brazil
|
16667
|
0.77(0.70-0.84)
|
1.17(1.08-1.26)
|
1.11(1.02-1.20)
|
1.14(1.05-1.24)
|
1.48(1.30-1.70)
|
0.83(0.76-0.91)
|
1.31(1.21-1.43)
|
2.65(2.40-2.92)
|
1.14(1.02-1.27)
|
Risk behavior d
|
|
|
|
|
|
|
|
|
|
|
Low
|
5644
|
0.78(0.62-0.97)
|
1.31(1.12-1.54)
|
1.17(0.98-1.40)
|
0.88(0.73-1.06)
|
1.14(0.90-1.45)
|
0.96(0.79-1.15)
|
1.17(1.00-1.38)
|
2.06(1.60-2.62)
|
1.31(1.04-1.64)
|
High
|
10037
|
0.70(0.63-0.78)
|
1.15(1.05-1.26)
|
1.11(1.01-1.23)
|
1.24(1.12-1.36)
|
1.35(1.14-1.60)
|
0.76(0.69-0.84)
|
1.12(1.02-1.24)
|
2.38(2.13-2.66)
|
0.96(0.85-1.09)
|
MW = minimum wage
HIV perceived risk (in the next 12 months) was dichotomized in low (no/low) and high risk;.a During the previous 6 months; b Cocaine, poppers, crack, or amphetamines; c Syphilis, gonorrhea, or rectal chlamydia; d Measured by the HIRI-MSM, which was calculated based on sexual behavior in the previous six months (number of partners, condomless receptive anal intercourse, sex with HIV-positive partner), age and use of stimulants, being stratified in low risk (< 10 points) and high risk (≥10 points; PrEP is recommended). “Unknown” answers scored 0 points on the HIRI-MSM.