Sexual Practices and HIV Risk Perception Among Men Who Have Sex with Men in Brazil

Objectives: To investigate sexual practices and HIV risk perception among MSM, identifying associated risk factors and determinants. Methods: A cross-sectional epidemiological study was conducted with 144 MSM in Teresina, Piauí, Brazil, using the snowball sampling technique. Participants were recruited via snowball sampling and underwent rapid HIV testing, in addition to completing questionnaires on sexual practices, risk perception, and illicit drug use. Results: The majority of participants showed an unsatisfactory perception of HIV risk. Factors associated with this perception include non-penetrative sex as an HIV preventive measure, which increased the chances of having an unsatisfactory risk perception by 1.45 times (P = .04), engaging with known HIV-positive individuals without knowledge of their viral load (ORa = 2.70; P = .043), and using illicit drugs before/during sex (ORa = 0.29; P = .048). Conclusions: The results indicate a high prevalence of risky sexual practices and an unsatisfactory HIV risk perception among the MSM studied. Plain Language Summary HIV Risk and Sexual Practices Among Men Who Have Sex with Men in Brazil This study examines sexual practices and perceptions of HIV risk among men who have sex with men (MSM) in Teresina, Brazil. MSM are significantly more likely to contract HIV compared to the general population, with various factors influencing their risk. Despite this high vulnerability, many MSM do not perceive themselves to be at significant risk of HIV infection. Researchers surveyed 144 MSM to understand their sexual behaviors and how they perceive the risk of HIV. The study found that many MSM engage in risky sexual practices, such as not using condoms during oral sex, even though most use them during anal sex. Additionally, the study revealed that MSM often has a false sense of security when having sex with steady partners compared to casual partners. Key factors associated with a poor perception of HIV risk included low family income, engaging in non-penetrative sex as a preventive measure, having sexual relations with known HIV-positive individuals without knowing their viral load, and using illicit drugs during sexual activity. For instance, using illicit drugs, known as “chemsex,” significantly increases risky behaviors, leading to a higher chance of HIV transmission. The study emphasizes the need for targeted health education and interventions for MSM. It suggests promoting regular condom use, better understanding o