STD antecedents, use of health services and counseling in men who have sex with men (MSM) in Brazil
F.S. Lima1, M. Urdaneta2, E. Merchan-Hamann2, X. Diaz-Bermudez2, M.J. Silva1, L.R.S. Kerr3, A.S. Benzaken4, A.M. de Brito5, M.I.C. Dourado6, M.D.C. Guimarães7, S.M. Batista da Silva8, F. Abreu9, L.C. Oliveira10, A.D.S. Morais11, G.M.B. de Freitas12, C. Kendall13, W. McFarland14, G.W. Rutherford14, A. Pinho15, M.B. Mello15
1ESCS, Brasilia, Brazil, 2Universidade de Brasilia, Brasilia, Brazil, 3Universidade Federal do Ceará, Fortaleza, Brazil, 4Universidade Federal do Amazonas, Manaus, Brazil, 5Centro de Pesquisas Aggeu Magalhães/ Fiocruz, Recife, Brazil, 6Universidade Federal da Bahia, Salvador, Brazil, 7Universidade Federal de Minas Gerais, Belo Horizonte, Brazil, 8Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil, 9Secretaria Municipal de Saúde, Santos, Brazil, 10Secretaria Municipal de Saúde, Curitiba, Brazil, 11Secretaria Municipal de Saúde, Itajaí, Brazil, 12Secretaria Municipal de Saúde, Campo Grande, Brazil, 13Tulane University, Tulane, United States, 14University of California, San Francisco, United States, 15FIOCRUZ, Rio de Janeiro, Brazil
Background: A nation-wide cross sectional study was conducted in Brazil in order to estimate the HIV prevalence and sexual behavior among MSM. In this abstract we focus on STD history, use of health services and counseling.
Methods: 3,858 interviews were carried out with MSM recruited by RDS method in ten Brazilian cities. Basic descriptive analyses with no adjustments are shown.
Results: Age varied from 18 to 70 (median=25). 21% defined themselves as “gays”, 29% as bisexuals, 27% as homosexual, 7.5% as heterosexuals, and 11% as MSM. 66% had up to 11 years of school education. 8.3% had been tested for HIV and were positive before the study. Life-time syphilis was reported by 6%. In the last year 8% reported sores/ulcers in penis or anus, 6.2% reported blisters, 4,5% warts, 6% purulent secretion. 13,9% referred seeking health care, and among these, 71.6% sought public health services; 19,1% private clinics, 6% pharmacies; and 4.2% others. Counseling with recommendation of using condom was provided in 80.8%, whereas 71.5% recommended telling to their partners, 65% HIV serological testing, and 57.4% syphilis testing. Drugs were prescribed in 85.9% of cases. 34.5% reported not having cured. Among those who referred possible STD problems, a significant proportion received counseling for HIV serological testing in public health services as compared with other facilities (89.73% vs 51.0%; X2=84.7, p< 0.0001). No differences were observed between facilities with respect to the proportion of cure (X2=0.34, p< 0.5).
Conclusions: Public health services demonstrated to be the most important health facility sought by MSM who referred STD signs/symptoms. Apparently, they supply adequate counseling. High rates for informal attendance at pharmacies and other non health related facilities were identified (~10%). Preliminary results point out for the need of strengthening information coverage targeting this specific group and health professionals.
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