Interest in event-driven PrEP among men who have sex with men using daily PrEP in Mexico in 2019-2020: a cross-sectional assessment in a large-scale demonstration project.

This study aimed to evaluate the interest in event-driven PrEP (ED-PrEP) among men who have sex with men (MSM) using daily PrEP in Mexico's PrEP demonstration project between 2019 and 2020. We compared participants interested or not in ED-PrEP during their first-month visit and identified associated factors. Of 1,021 MSM attending their first-month visit, 7% had previous knowledge of ED-PrEP, but 40% were interested in ED-PrEP. However, over 50% perceived the scheme as less protective than daily PrEP. Having doubts about ED-PrEP's level of protection was related to less interest in the scheme (aOR = 0.11; CI = 0.07-0.18), just like reporting perceived barriers such as having frequent sex (aOR = 0.06; CI = 0.03-0.14), unplanned sex (aOR = 0.17; CI = 0.11-0.27), forgetting the medicine (aOR = 0.06; CI = 0.03-0.12), or difficulty carrying the medicine (aOR = 0.13; CI = 0.07-0.25). Finally, reporting not taking PrEP for >20 days in the last month (aOR = 0.05; CI = 0.01-0.27) diminished interest in ED-PrEP. In conclusion, few MSM daily PrEP users knew about ED-PrEP yet many were interested in it, suggesting the importance of awareness campaigns regarding ED-PrEP's effectiveness. The lack of interest in ED-PrEP among participants with poor adherence to daily PrEP indicates that they might prefer long-acting PrEP or HIV prevention strategies without medication.

Condom Failure Among HIV-Negative Men in Serodiscordant Relationships in Australia, Brazil, and Thailand.

Condoms continue to be used by many gay, bisexual, and other men who have sex with men (GBM) to reduce the risk of HIV transmission. However this is impacted by condom failure events, defined here as condom breakage and slippage. In a prospective, observational cohort study of 343 HIV serodiscordant male couples recruited through high HIV caseload clinics and hospitals between 2012 and 2016 in Australia, Brazil, and Thailand, condom failure rates and associated factors were analysed, including with the study partner versus other sexual partners. There were 717 reported instances of condom failure from an estimated total of 25,831 sex acts with condoms, from over 588.4 participant years of follow up. Of the HIV-negative partners (n = 343) in the study, more than a third (n = 117, 36.7%) reported at least one instance of condom failure with any partner type during study follow-up. Condom failure with their study partner was reported by 91/343 (26.5%) HIV-negative partners, compared with 43/343 (12.5%) who reported condom failure with other partners. In total, there were 86 events where the HIV-negative partner experienced ano-receptive condom failure with ejaculation, representing 12.0% of all failure events. In multivariable analysis, compared to Australia, HIV-negative men in Brazil reported a higher incidence risk rate of condom failure (IRR = 1.64, 95%CI 1.01-2.68, p = 0.046) and HIV-negative men who reported anal sex with other partners reported an increased risk of condom failure compared with men who only had sex with their study partner (IRR = 1.89, 95%CI 1.08-3.33, p = 0.025). Although at least one event of condom failure was reported by a significant proportion of participants, overall condom failure events represented a small proportion of the total condom protected sex acts.

The Homophobia Course in the Life of Older Gay Men in Brazil: Their Social Representations.

This study aims at understanding the social representations of homophobia among older gay men. A number of 20 older gay men aged between 60 and 75 years old participated of the study; the average age was 63.25 years old (SD = 3.58). In the data collection, a semi-structured interview about homophobia was used; they were analyzed on IRAMUTEQ, which compiles the descendant hierarchical classification. The corpus was divided into three classes of social representations. The first representation comprises images of prejudice within society. The second one presents social representations involving reports of internalized homophobia and the experiencing of prejudice. The third one shows social representations about physical and identity violations. The social representations of homophobia show how the participants lead their actions in society, being based upon risk and protection issues to face the objective and subjective difficulties present in their social representations.

Acceso y adhesión a proceso de intervención psicosocial diferenciado para los servicios y sistemas de salud en varones gay adultos viviendo con el VIH, Paraguay, 2022 / Access and adherence to a differentiated psychosocial intervention process for health services and systems in adult gay men living with HIV, Paraguay, 2022

Introducción: el acceso a los servicios de salud en Paraguay, está determinado por varios tipos de barreras. Por ello, es preciso describir el impacto que tienen las políticas públicas y sus implicancias en la mitigación de las mismas. Objetivo: describir el acompañamiento diferenciado y su contribución al apoyo socio emocional, adhesión al tratamiento y acceso a servicios de salud en el área de atención a personas varones que viven con el VIH. Metodología: estudio de carácter cualitativo, descriptivo, con entrevistas semi estructuradas y muestra no probabilística, dirigida e intencional; Resultados: este estudio cualitativo exploró las experiencias de personas viviendo con VIH que recibieron acompañamiento psicosocial diferenciado en un servicio de atención integral. Los participantes destacaron la importancia del acompañamiento para afrontar la crisis posterior al diagnóstico. La orientación presencial, escucha empática y seguimiento facilitaron la vinculación y adherencia al servicio de salud y al tratamiento antirretroviral. El apoyo psicosocial fue clave para desmitificar ideas erróneas sobre el VIH/SIDA, empoderarse sobre su estado serológico y mejorar la calidad de vida. Se enfatizó el rol de los grupos de pares para brindar contención. Algunos participantes reportaron experiencias previas de revelación no consentida y vulneración de confidencialidad. El acompañamiento psicosocial diferenciado resultó fundamental para facilitar la inserción y permanencia de las personas con VIH en los servicios de atención integral (adhesión al tratamiento). Conclusiones: el acompañamiento psicosocial diferenciado resultó clave para facilitar la vinculación y adherencia en personas con VIH. La atención integral requiere identificar situaciones particulares, establecer relaciones de confianza y comunicación efectiva. El apoyo inicial es fundamental brindando contención ante el impacto emocional del diagnóstico. El seguimiento continuo es esencial dada la doble discriminación. La confidencialidad y capacidad de generar vínculos empáticos son elementos centrales. Los factores mencionados favorecen la adhesión al tratamiento. Los resultados sugieren que estas prácticas psicosociales pueden optimizar modelos de atención integral a personas con VIH.

Introduction: access to healthcare services in Paraguay is influenced by various barriers. Thus, it is essential to describe the impact of public policies and their implications in mitigating these barriers. Objective: to describe the differentiated support and its contribution to socio-emotional support, therapeutic adherence, and access to healthcare services in the area of care for males living with HIV. Methodology: a qualitative, descriptive study with semi-structured interviews and a non-probabilistic, directed, and intentional sample. Results: this qualitative study explored the experiences of individuals living with HIV who received differentiated psychosocial support in an integrated care service. Participants emphasized the importance of support in coping with the post-diagnosis crisis. In-person guidance, empathetic listening, and follow-up facilitated engagement and adherence to healthcare services and antiretroviral treatment. Psychosocial support played a critical role in debunking misconceptions about HIV/AIDS, empowering individuals regarding their serostatus, and improving their quality of life. The role of peer groups in providing emotional support was emphasized. Some participants reported previous experiences of non-consensual disclosure and confidentiality breaches. Differentiated psychosocial support was essential in promoting the integration and retention of people with HIV in integrated care services (therapeutic adherence). Conclusions: differentiated psychosocial support was crucial in facilitating the engagement and adherence of individuals with HIV. Comprehensive care necessitates identifying specific situations, establishing trust-based relationships, and effective communication. Initial support is vital for providing emotional support in the face of the diagnostic impact. Ongoing follow-up is essential due to the dual discrimination faced. Confidentiality and the ability to build empathetic relationships are central elements. The aforementioned factors favor adherence to treatment. The results suggest that these psychosocial practices can enhance models of comprehensive care for people with HIV.

Agreements, Behaviour, and Change: Sex Outside the Relationship in Male HIV-negative Partners in HIV Serodiscordant Relationships in Australia, Brazil, and Thailand.

Male HIV serodiscordant couples have diverse relationship agreements regarding sex outside the relationship. We examined the relationship agreements as described by 343 male HIV-negative partners in HIV serodiscordant relationships in Australia, Brazil and Thailand participating in a multi-year cohort study. At baseline, 125 (34.1%) HIV-negative partners reported no agreement, 115 (33.5%) had a monogamous agreement, and 103 (37.9%) had an open agreement allowing sex outside the relationship. Relationship agreements were largely stable over time, with 76% of HIV-negative men reporting the same agreement across follow up, while changes were predominantly towards having an open agreement. Behaviour largely matched relationship agreements, and the predictors of breaking an agreement by having condomless anal intercourse (CLAI) with an outside partner were CLAI within the relationship (OR = 3.17, 95%CI: 1.64-6.14, p < 0.001) and PrEP use in the last three months (OR = 3.42, 95%CI: 1.48-7.92, p = 0.004). When considering HIV transmission risk for HIV-negative men in serodiscordant relationships, greater focus needs to be placed on sex that is occurring outside the relationship and the agreements that facilitate this.

HIV Disclosure Practices to Family Among Mexican and Puerto Rican Sexual Minority Men with HIV in the Continental USA: Intersections of Sexual Orientation and HIV Stigma.

Disclosing a seropositive HIV status still is a complex process of assessing the risks, benefits, and potential personal and interpersonal outcomes associated with disclosure, such as stigma, rejection, or emotional support. We examined HIV disclosure practices to family and intersectional stigma related to HIV and sexual orientation among Latino sexual minority men (LSMM) of Mexican and Puerto Rican origin with HIV in the continental USA. Guided by Framework Analysis, we present data from 54 interviews with 33 LSMM participants in HIV care engagement interventions, and 21 project staff implementing the interventions. LSMM disclosed their HIV status to family seeking support. They applied stigma management techniques to manage the information communicated to family about their HIV status, including selective disclosure to some family members, conveying strategic information about the significance of having HIV, non-disclosure, or partial disclosure, silence and deceptions. LSMM HIV disclosure practices to family encompassed appraisals of intersectional stigma related to their sexual orientation and HIV, assessing the potential outcomes of disclosure, and the preservation of family ties.

Mental Health and Life Satisfaction on Chilean Gay Men and Lesbian Women: The Role of Perceived Sexual Stigma, Internalized Homophobia, and Community Connectedness.

The Minority Stress Model has proposed that connectedness to a specific minority community may be a protective factor for stigmatized groups. This study evaluated the mediational role of connectedness with the gay men's and lesbian women's community on the relationship between two minority stressors (internalized homophobia and perceived sexual stigma) with anxiety-depressive symptomatology and life satisfaction. The sample consisted of 467 Chilean self-identified as gay men (57%) and lesbian women (43%). Results revealed that the two minority stressors were associated with anxiety-depressive symptomatology, but only internalized homophobia was associated with life satisfaction. The mediation hypothesis was partially supported by the relationship between internalized homophobia and life satisfaction. Unexpectedly, we found a negative association between connectedness with the gay men's and lesbian women's community and life satisfaction. This finding introduces a view that contrasts with the literature, which proposes that connectedness with the specific community would be a protective factor against sexual stigma.

Parenting intentions of young sexual minority men living with HIV in Mexico City, Mexico.

Young sexual minority men are disproportionately affected by HIV in Mexico. Little is known about their thoughts about childbearing, an issue complicated by sexual identity and HIV serostatus. We conducted 16 in-depth qualitative interviews to explore the parenting desires of young sexual minority men living with HIV in Mexico City. Domains of the questionnaire included (1) parenting desires, (2) preferences about different methods (e.g. adoption, in-vitro fertilisation), and (3) perceived barriers to becoming a father. A modified grounded theory approach was used for qualitative analysis. Participants ranged in age from 17 to 21 years and had been living with HIV for an average of 15 months. Most expressed the desire to have a child in the future but were uninformed as to their options for doing so. Participants largely preferred adoption, citing the perceived risk of HIV transmission as a deterrent to using assisted reproductive technologies. Some participants expressed the desire to have a child that was genetically their own, but shared doubts as to the feasibility. The majority of participants stated that the topic of childbearing had never come up during the course of their HIV care.

Characteristics of Agreements to have Condomless Anal Intercourse in the Presence of an Undetectable Viral Load Among HIV Serodiscordant Male Couples in Australia, Brazil and Thailand.

The use of undetectable viral load (VL) to negotiate condomless anal intercourse (CLAI) in HIV serodiscordant male relationships has become more common as more data regarding the effectiveness of antiretroviral treatments for the prevention of HIV transmission has been described. We examined viral load agreements (VLAs) for condomless sex in the presence of an undetectable VL in 343 HIV serodiscordant male couples in Australia, Brazil and Thailand. Factors associated with having a VLA included having agreements for the HIV-positive partner to report his VL result (p < 0.001), agreeing that VL affects agreements about sexual practice (p < 0.001), the HIV-negative partner's perception of his partner's undetectable VL (p < 0.001), the couple's belief in the efficacy of undetectable VL in preventing HIV transmission (p < 0.001), and the couple engaging in CLAI with each other (p < 0.001). Over time, these agreements became more common although 49.3% of couples in the sample never had a viral load agreement. As these agreements become more common, further education is required to support male couples in using them safely.

Violencia de parejas gays y en hombres que tienen sexo con hombres: una revisión sistemática exploratoria / Violence between Gay Couples and Men who have Sex with other Men: a Systematic Exploratory Review / Violência entre casais gays e em homens que fazem sexo com home revisão sistemática exploratória

Resumen La violencia en parejas de gays y hombres que tienen sexo con otros hombres es un problema grave que ha ido captando la atención de la comunidad científica internacional, por ello esta revisión sistemática explora las conceptualizaciones de la violencia en estas parejas, así como la prevalencia de los tipos de violencia y factores asociados en diversos estudios. Siguiendo un protocolo PRISMA se realizó una búsqueda en bases de datos como Scopus, Clarivate, EBSCO, Science Direct, Scielo y La Referencia. Del total de 292 referencias iniciales, se analizaron, mediante un proceso de depuración dividida en cuatro fases, 19 artículos que cumplieron con los criterios de inclusión (publicaciones realizadas entre 2000 y 2019, con acceso abierto y texto completo). Entre los principales resultados destacó la falta de homogeneidad en la definición de la violencia, así como sus subtipos, la mayor representación de muestras estadounidenses, que la violencia psicológica fue la más estudiada y que el análisis y detección de factores protectores fue prácticamente inexistente. Se discuten los resultados e implicaciones priorizando la necesidad de mayores estudios en la región latinoamericana.

Abstract Violence between gay couples and men who have sex with other men is a serious problem that has captured the international scientific community's attention. For this reason, this systematic exploratory review explores these couples' conceptualization of violence, as well as the prevalence of types of violence and associated factors in various studies. Databases, such as Scopus, Clarivate, EBSCO, Science Direct, Scielo and La Referencia, were searched following a PRISMA protocol. Of 292 total initial references, 19 articles, which complied with inclusion criteria (publications between 2000 and 2019 with open access and full text), were analyzed by means of a debugging process divided into four phases. Among the main results, the lack of homogeneity in definitions of violence, as well as their subtypes, higher representation of samples from the United States, the fact that psychological violence was studied most, and that protective factor analysis and detection were practically nonexistent stood out. The results and implications are discussed, prioritizing the need for more studies in Latin America.

Resumo A violência entre casais gays e homens que fazem sexo com homens é um problema grave que vem chamando a atenção da comunidade científica internacional, portanto, esta revisão sistemática explora as conceituações da violência nesses casais, bem como a prevalência de tipos de violência e fatores associados em vários estudos. Seguindo um protocolo PRISMA, foi realizada uma busca em bases de dados como Scopus, Clarivate, EBSCO, Science Direct, Scielo e La Referencia. Do total de 292 referências iniciais foram analisados19 artigos que atenderam aos critérios de inclusão (publicações realizadas entre 2000 e 2019, com acesso aberto e texto completo), após um processo de depuração dividida em quatro fases. Dentre os principais resultados, destacou-se a falta de homogeneidade na definicão da violência e seus subtipos, a maior representatividade de amostras americanas, a violência psicológica como o tipo mais estudado e a inexistência de análise e detecção de fatores de proteção. Os resultados, e implicações são discutidos, priorizando a necessidade de novos estudos na região da América Latina.

Motivaciones, significados y riesgos en los encuentros sexuales de hombres gays de La Ciudad Autónoma de Buenos Aires en el contexto del covid-19 / Motivations, meanings and risk in gay men sexual encounters in the Ciudad Autonoma de Buenos Aires in the context of covid-19 / Motivações, significados e riscos nos encontros sexuais de homens gays na Cidade Autônoma de Buenos Aires no contexto do covid-19

Resumen Se buscó identificar las motivaciones que llevan a los hombres gay del AMBA (Área Metropolitana de Buenos Aires) a romper el Aislamiento Preventivo Social Obligatorio (APSO) con fines de encuentro sexual en el contexto de la pandemia de covid-19. Se realizó un estudio cualitativo-exploratorio, con veinte entrevistas semiestructuradas a igual número de personas. La muestra fue intencional no representativa, el contacto se estableció mediante la aplicación de GRINDR y TINDER pactando las entrevistas de manera telefónica o presencial. Se encontró que los entrevistados habían roto la cuarentena motivados principalmente por "la calentura", la dificultad para mantener "la abstinencia sexual" y por las "ganas de tener sexo", en el contexto de una alta valoración personal de la libertad y de familiaridad con la clandestinidad. Algunos realizan medidas de disminución del riesgo de covid-19, como el uso de cubrebocas y alcohol en gel, otros consideran que no son población en riesgo.

Abstract We aimed to identify the motivations of gay men on the AMBA to break the governmental policy of Obligatory Preventive Social Isolation (APSO) with the purpose of sexual encounter. We designed a qualitative-exploratory study, where twenty semi-structured interviews were applied to equal number of gay men. The sample was intentional and not representative, the contact was established through the application of GRINDER and TINDER arranging the interviews by telephone or in person. We found that interviewees have broken quarantine mainly motivated by "the fever", the difficulty of keeping the "abstinence", and the "desire to have sex", in the context or a highly personal value of freedom and the familiarity with clandestine behavior. Some took measures to lower the risk of covid-19, by using covered mouths and alcohol-based gel, others mentioned that they are not part of a risk group.

Resumo Buscou-se identificar as motivações que levam homens gays da AMBA (Área Metropolitana de Buenos Aires) a romper o Isolamento Social Preventivo Obrigatório (APSO) para fins de encontros sexuais no contexto da pandemia covid-19. Realizou-se um estudo qualitativo-exploratório, com vinte entrevistas semi estruturadas com o mesmo número de pessoas. A amostra foi intencional não representativa, o contato foi estabelecido por meio dos aplicativos GRINDR e TINDER, agendando as entrevistas por telefone ou pessoalmente. Constatou-se que os entrevistados romperam a quarentena motivados principalmente pelo «tesão¼, pela dificuldade de manter a «abstinência sexual¼ e pelo «desejo de fazer sexo¼, no contexto de uma alta valorização pessoal da liberdade e de familiaridade com a clandestinidade. Alguns relataram medidas para reduzir o risco de COVID 19, como o uso de máscaras e álcool em gel, outros consideram que não são população de risco.

Do corpo do sodomita à resistência pública do prazer: um itinerário para o estudo da pegação masculina nas cidades / From the body of the sodomite to the public resistance of pleasure: an itinerary for the study of cruising gay men in cities / Del cuerpo de la sodomita a la resistencia pública del placer: un itinerário para el estudio de la práctica del cruising en las ciudades

A pegação masculina em espaços públicos da cidade é um fenômeno plural, rico em experiências instauradoras de práticas e modos de ocupar o mundo dissidentes da heteronorma. Não por acaso, foi submetido a muitos registros de infâmia. Dos antigos crimes jurídico-religiosos de sodomia forjados na Europa, que colonizaram, inclusive, os prazeres nas Américas, até sua inscrição patológico-criminal apoiada pela ciência do século XIX, a pegação tornou-se um atentado ao pudor, uma afronta à moral pública. Contudo, as figuras anônimas homoeróticas que circulam oscilantes pela urbe, instauradoras de territórios de prazer em meio ao espaço público, nos ajudam a entender, através de seus rastros, muitas vezes captados pelos aparelhos de poder, justamente suas histórias de repressão.

The cruising gay men in public spaces of the city is a plural phenomenon, rich in experiences instituting dissident practices and lifestyle of the heteronormativity. It is not by chance that this phenomenon was subjected to many registers of infamy. From the ancient juridical religious sodomy crimes established in Europe that even colonized the pleasures in the Americas to their pathological criminal inscription supported by nineteenth-century science, the cruising gay men became an indecent assault, an affront to the public moral principles. However, the anonymous homoerotic figures that circulate around the city, establishing pleasure territories in the midst of public space, help us to understand through their traces often captured by the power apparatus, precisely their stories of repression.

La práctica del cruising en los espacios públicos de la ciudad es un fenómeno plural, rico en experiencias que establecen prácticas y formas de ocupar el mundo disidentes de la heteronorma. No por casualidad, el fenómeno fue sometido a muchos registros de infamia. Desde los antiguos crimenes jurídico-religiosos de sodomía, establecidos en Europa y que incluso colonizaron los placeres en las Américas, hasta la inscripción criminal patológica apoyada por la ciencia del siglo XIX, la práctica del cruising se convirtió en un atentado contra el pudor, una afrenta a la moral pública. Sin embargo, las figuras anónimas homoeróticas que circulan alrededor de la ciudad, estableciendo territorios de placer en el espacio público, nos ayudan a comprender, a través de sus rastros, a menudo capturadas por los aparatos del poder, precisamente sus historias de represión.

Pensando a Homoparentalidade: Um Estudo Qualitativo com Jovens Adultos Portugueses sem Filhos / Considering Same-Sex Parenting: A Qualitative Study with Portuguese Childless Young Adults

Resumo: O momento atual caracteriza-se por importantes mudanças sociais e legais, com potenciais repercussões na vida de pessoas lésbicas e gays. O presente estudo teve como objetivo identificar perceções de jovens adultos portugueses sem filhos relativamente ao eventual projeto de parentalidade. Foram realizadas entrevistas a sete pessoas que se autoidentificaram como lésbicas, gays e bissexuais e que se voluntariaram para participar no estudo. As transcrições das entrevistas foram submetidas a Análise Interpretativa Fenomenológica. Os temas emergentes revelaram que o desejo e a intenção de ter filhos se associavam à ponderação de desafios ligados ao heterossexismo, mas também à reflexão sobre condições e recursos a mobilizar para o enfrentar. São apresentadas implicações com vista à otimização das experiências individuais a este nível.

Abstract: The present period is characterized by important social and legal changes with potential repercussions in the lives of lesbian and gay people. This study aimed to identify perceptions of Portuguese childless young adults regarding the possible parenthood project. Interviews were conducted with seven people who self-identified as lesbian, gay and bisexual and who volunteered to participate in the study. Interview transcripts were subjected to Interpretative Phenomenological Analysis. Emerging themes revealed that desire and intention to have children arose associated with the consideration of challenges related to heterosexism, but also associated with reflection on the conditions and resources to be mobilized to tackle it. Implications for the optimization of individual experience at this level are presented.

Strategies used by gay male HIV serodiscordant couples to reduce the risk of HIV transmission from anal intercourse in three countries.

INTRODUCTION: There are few data about the range of strategies used to prevent sexual HIV transmission within gay male serodiscordant couples. We examined HIV prevention strategies used by such couples and compared differences between countries. METHODS: Opposites Attract was a cohort study of male serodiscordant couples in Australia, Brazil and Thailand, from May 2014 (Australia) or May 2016 (Brazil/Thailand) to December 2016. At visits, HIV-positive partners had viral load (VL) tested; HIV-negative partners reported sexual behaviour and perceptions of their HIV-positive partner's VL results. Within-couple acts of condomless anal intercourse (CLAI) were categorized by strategy: condom-protected, biomedically protected (undetectable VL and/or pre-exposure prophylaxis [PrEP]), or not protected by either (HIV-negative partners engaging in insertive CLAI, receptive CLAI with withdrawal, or receptive CLAI with ejaculation). RESULTS: A total of 343 couples were included in this analysis (153 in Australia, 93 in Brazil and 97 in Thailand). Three-quarters of HIV-positive partners were consistently virally suppressed (<200 copies/mL) during follow-up, and HIV-negative partners had correct perceptions of their partner's VL result for 76.5% of tests. One-third of HIV-negative partners used daily PrEP during follow-up. Over follow-up, 73.8% of couples had CLAI. HIV-negative partners reported 31,532 acts of anal intercourse with their HIV-positive partner. Of these, 46.7% were protected by condoms, 48.6% by a biomedical strategy and 4.7% of acts were not protected by these strategies. Australian couples had fewer condom-protected acts and a higher proportion of biomedically protected acts than Brazilian and Thai couples. Of the 1473 CLAI acts where the perceived VL was detectable/unknown and were not protected by PrEP (4.7% of all acts), two-thirds (n = 983) were when the HIV-negative partner was insertive (strategic positioning). Of the 490 acts when the HIV-negative partner was receptive, 261 involved withdrawal and 280 involved ejaculation. Thus, <1% of acts were in the highest risk category of receptive CLAI with ejaculation. CONCLUSIONS: Couples used condoms, PrEP or perceived undetectable VL for prevention in the majority of anal intercourse acts. Only a very small proportion of events were not protected by these strategies. Variation between countries may reflect differences in access to HIV treatment, education, knowledge and attitudes.

Navigating stigma, survival, and sex in contexts of social inequity among young transgender women and sexually diverse men in Kingston, Jamaica.

Social inequities, including stigma, criminalisation of same-sex practices, and poverty, elevate HIV exposure among young transgender women and sexually diverse men in Jamaica. Yet the ways transgender women and sexually diverse men in Jamaica navigate sex and HIV in contexts of social inequity are underexplored. The study objective was to explore experiences and perceptions of sexual decision-making and HIV risk among young (aged 18-30) sexually diverse men and transgender women in Kingston, Jamaica. We conducted a community-based qualitative study in Kingston that involved in-depth individual interviews (transgender women: n = 20; sexually diverse men: n = 20), 2 focus groups (transgender women: n = 8; sexually diverse men: n = 10) and 13 key informant interviews. Focus groups and interviews were digitally recorded, transcribed verbatim, and analysed with a thematic approach. Findings suggest that transgender women and sexually diverse men in Kingston are aware of, and managing survival challenges and HIV risks in contexts of social inequity. Daily survival challenges include stigma and a lack of human rights protections that contributed to barriers to employment, housing, healthcare, education, and exposure to violence. Challenges maintaining sexual relationships included the need to hide for safety, often resulting in difficulties forming lasting relationships. These survival and relationship challenges converged to lower self-esteem and self-acceptance. In the face of these challenges, participants navigated sexual risk and pleasure. Findings provide insight into agency and sexual decision-making processes in contexts of social inequities. Findings can inform multi-level strategies to promote social equity, sexual health, and HIV prevention with young transgender women and sexually diverse men in Jamaica.

Violencia de pareja en hombres gay y mujeres lesbianas chilenas: Un estudio exploratorio / Intimate partner violence in chilean gay men and lesbian women: An exploratory study

La violencia en las relaciones de pareja del mismo sexo es un tema poco explorado. Históricamente, esta problemática ha sido estudiada en el marco de relaciones heterosexuales ubicando a las mujeres como víctimas y a los hombres como principales agresores. El propósito de este estudio fue describir las experiencias de violencia de pareja (VP) en una muestra de 268 hombres gay y 199 mujeres lesbianas. Se utilizó un muestreo tipo bola de nieve para reclutar la muestra en cuatro ciudades chilenas (Antofagasta, Valparaíso, Santiago y Concepción). Para la recolección de datos se aplicó un cuestionario especialmente diseñado para este estudio. Se realizaron análisis descriptivos y Chi-cuadrado para indagar posibles relaciones por sexo y características sociodemográficas. Entre los principales resultados se puede señalar que del total de la muestra (N = 467) sólo 80 personas (17.25%) reportaron haber sido receptoras de algún tipo de VP. Se encontraron diferencias estadísticamente significativas en el reporte de violencia psicológica entre hombres gay y mujeres lesbianas [χ²(1) = 6.37, p = .01, w =.64]. Los hombres gay reportaron mayor frecuencia de violencia psicológica (87.5%) en comparación con las mujeres lesbianas (65.8%). También se encontró una asociación estadísticamente significativa entre experiencias de VP y nivel educativo [χ²(3) = 10.53, p = .01, w = .51]. Las personas con mayor nivel educativo reportan frecuencias menores de VP. Finalmente, se encontró una relación estadísticamente significativa entre haber sido víctima de VP y haber sido perpetrador de VP. Los resultados son discutidos y se plantean implicaciones para futuras investigaciones.

The recognition of same-sex relationships has increased, but same-sex intimate partner violence has been less studied. Historically, this problem had been studied in heterosexual relationships, women being victims and men main aggressors. This heteronormative approach to intimate partner violence (IPV) often neglects same-sex relationships (Finneran, Chard, Sineath, Sullivan, & Stephenson, 2012; Russell, 2015). For this study, IPV is defined as every act causing psychological, physical or sexual damage, within the context of intimate relationships (Harvey et al., 2007) perceived as such. To our knowledge, there are no studies about IPV in same-sex relationships in Chile. Data about this topic is scarce in the Latin American context (Ferreira et al., 2015). Therefore, it is necessary to provide contextualized knowledge about IPV in same-sex relationships to face this psychosocial problem. The aim of this study was to describe IPV in same-sex relationships in gay men and lesbian women and its sociodemographic characteristics. In addition, results are compared to detect possible differences between groups. LGBT populations are considered a difficult-to-reach or hidden population (Paz-Bailey et al., 2013). For this reason, a snowball sampling procedure was used. The sample consists of 467 participants who identify themselves as gay men (57.4%) or lesbian women (42.6%), aging from 18 to 67 years (M = 27.9; SD = 7.9). The sample was recruited in four Chilean cities (Antofagasta, Valparaíso, Santiago, and Concepción). A specially designed questionnaire was administered to collect data for this study. Results were obtained through descriptive and comparative analyses with a Chi-square Test. Analyses indicate that 80 subjects (17.2%) had experienced some form of IPV (psychological, physical, or sexual); 87.7% of them reported psychological violence; and about half of them (47.5%) physical violence. Likewise, 19.3% respondents reported that there had been an IPV perpetrator. For group analysis, 20.1% of lesbian women and 19.3% of gay men reported some IPV experience. Statistically significant differences between gay men and lesbian women respondents were detected for psychology violence perpetrated [x²(1) = 6.37, p = .01, w = .64]. Gay men reported a higher percentage perpetrating psychological violence in their relationship (87.5%), as compared to the group of lesbian women (65.8%). Also, a statistically significant relation was found between IPV experiences and educational levels [x²(3) = 10.53, p = .01, w = .51]. Subjects with higher educational levels report less IPV frequency. Finally, a statistically significant relation was found between IPV victims and IPV perpetrators. This study represents the first approach to describe and characterize IPV in gay men and lesbian women, thus creating a baseline for making comparisons with future findings on LGBT issues in Chile and Latin America. Results support evidence concerning greater prevalence of psychological violence in both gay men and lesbian women, as compared to other types of violence such as physical and sexual (Barrett & St. Pierre, 2013; Finneran y Stephenson, 2013; Hellemans et al., 2015; Messinger, 2011). In addition, this resultis similar to those of previous studies on general population (Russell, 2015). An important result is IPV mutuality in the sample, namely, IPV occurs in two directions: persons experiencing partner violence concurrently perpetrate violence against their partners. Findings support the view that, in general, violence in same-sex relationships takes place gradually from relation al dynamics marked by violence (Barrientos, Rodríguez-Caballería, Escartín & Longares, in press). In this context, although data from this study are exploratory-descriptive, they make up a good approach to the problem since they include gay men and lesbian women from different Chilean areas of varied sociodemographic characteristics. If similar findings are reported in other studies, they could help direct psychosocial interventions, public policies, and future research. In any case, results must be carefully considered since they are non-representative samples and, in theory, not comparable with each other. Limitations and implications for future IPV research in same-sex relationships are discussed.

Identity management strategies among HIV-positive Colombian gay men in London.

This study set out to explore the social-psychological aspects of living with HIV among a group of HIV-positive Colombian gay men in London, and the strategies that they deployed to manage ensuing threats to their identities. Focus group and individual interview data were collected from 14 Colombian gay men living with HIV, and were analysed using qualitative thematic analysis and identity process theory. The following themes are discussed: (1) identity struggles and conflicts in Colombia, (2), managing multiple layers of social stigma in England, and (3) changing interpersonal and intergroup dynamics, which highlight the inter-connections between sexual prejudice, sexual risk-taking and HIV stigma. Identity may be chronically threatened due to the multiple layers of stigma, which can limit the coping strategies available to individuals. Findings strongly support the need for action and programmes to highlight and tackle both racism and HIV stigma on the gay scene and to fund more specific resources for sub-communities of gay, bisexual and other men who have sex with men, which employ appropriately trained and culturally competent staff.

A Qualitative Assessment of Alcohol Consumption and Sexual Risk Behaviors Among Men Who Have Sex With Men and Transgender Women in Peru.

BACKGROUND: Peruvian men who have sex with men (MSM) and transgender women (TGW) experience the double burden of a highly concentrated HIV epidemic with a high prevalence of alcohol use disorders (AUDs). Recent research has associated both with risky sexual behaviors, including unprotected sex, having multiple sexual partners, engaging in sex work, having recent sexually transmitted infections, and having HIV-infected partners. AUDs have also been associated in MSM/TGW with being unaware of HIV+ status. OBJECTIVES: This study aims to further examine issues associated with alcohol consumption, HIV infection, and risk behaviors in a qualitative analysis of focus groups conducted with MSM/TGW in Peru. METHODS: A total of 26 MSM/TGW participants with AUDs participated in three semi-structured focus groups in Lima, Peru. Content analysis was facilitated by software, and specific themes were elucidated. RESULTS: Participants described their drinking patterns, including the types of alcoholic drinks they consumed. They depicted drinking frequently and over multiple-day sessions. Problematic drinking behaviors were described, as well as the perceived characteristics of alcohol dependence. Interestingly, HIV-infected participants who were prescribed antiretroviral therapy did not believe that their drinking affected their medication adherence. These insights can aid in the design of future interventions aiming to reduce problematic drinking as well as HIV-related risk behaviors and, subsequently, HIV incidence. CONCLUSIONS: Peruvian MSM/TGW exhibit problematic drinking, which may be associated with risky sexual behaviors and HIV transmission. Interest in reducing alcohol consumption was high, suggesting the need for targeted behavioral and pharmacological interventions.

Very high incidence of syphilis in HIV-infected men who have sex with men in Buenos Aires city: a retrospective cohort study.

BACKGROUND: The incidence of sexually transmitted infections (STIs), particularly syphilis, is high and continues to rise among some populations, especially among men who have sex with men (MSM). Furthermore, a higher incidence of STIs has been reported in HIV-positive than in HIV-negative MSM. OBJECTIVE: To determine the incidence of syphilis in a cohort of men with HIV in Buenos Aires city. METHODS: Retrospective cohort study. We examined the records and visits made by men with HIV aged >18 years in our institution during a 1-year period. Venereal Disease Reference Laboratory (VDRL) results for all the men in our cohort during the study period were analysed. We considered a case of syphilis as incident if a person had a VDRL result of ≥16 DILS, provided that this was increased at least fourfold compared with a previous determination. All VDRL results ≤8 were investigated, and analysed together with the medical records, to determine if they were new cases. RESULTS: We analysed the VDRL results and the clinical records of 1150 men followed up in our centre during the study period. Mean age was 40.9 years. According to the definition used, we registered 171 new cases of syphilis-that is, an incidence of 14.9/100 patients/year (95% CI 12.9 to 17.0). No significant differences in incidence according to age group were found, but there was a trend towards a lower incidence in older men. Ten men had two new episodes during the study. CONCLUSIONS: The incidence of syphilis in this cohort of men with HIV (predominantly MSM) was very high. In addition to maintaining high surveillance for early diagnosis and treatment, it is necessary to implement newer and more effective measures to prevent syphilis and other STIs in this population.