Homophobic violence and HIV risk behaviors among men who have sex with men (MSM) in Campinas, SP, Brazil
Background: Recent research has highlighted vulnerability of MSM to discrimination and homophobic violence and the association of these experiences with HIV risk behaviors. A cross-sectional survey was conducted among MSM in Campinas, Brazil to evaluate the effect of homophobic violence on risk behaviors and predictors of unprotected anal intercourse among MSM.
Methods: MSM (n=658) were recruited through respondent-driven sampling, and audio-assisted computer self-interview to obtain information on risk behaviors and experiences of anti-gay abuse. Estimates were calculated using RDSAT with 95% confidence intervals (CI). MSM who had suffered homophobic violence in the past 12 months were compared to MSM without this experience.
Results: Most respondents reported having ever suffered homophobic violence (85%; CI: 81-88), the majority in the past 12 months (70%; CI: 65-75). Psychological abuse (61%; CI: 56-67) was the most common form experienced in the past 12 months, followed by sexual harassment (31%; CI: 26-36) and physical abuse (20%; CI: 16-25). MSM who experienced psychological abuse in the past 12 months were significantly more likely to have engaged in unprotected receptive anal intercourse in the past two months than those who had not suffered psychological violence (46% vs. 30%). A higher proportion of illicit drug use was also found among MSM who experienced physical violence in the past 12 months compared to those who did not (45% vs. 27%). MSM who had suffered psychological or physical abuse in the past 12 months were also significantly more likely to engage in commercial sex (20% vs. 8% and 36% vs. 9%, respectively).
Conclusions: The astonishingly high levels of homophobia found in this study clearly support the need for policies to take strong action against discrimination and violence against MSM and for HIV prevention interventions to address issues beyond individual behavioral change, and also consider the social-cultural attitude towards homosexuality that exists in the larger society.
-Abstract available at link below-