Exposição ao risco de infecção por Hiv/Aids : fatores associados à intenção de não usar preservativo em homens que fazem sexo com homens

Abstract

This study aims to identify and analyze contextual and psychosocial variables associated with the non-use of condoms among men who have sex with men (MSM) in Porto Alegre. Participants in this study are MSM, users of a Testing and Counseling Center (CTA), who goes to the health service to perform the HIV rapid test. Through three studies, this research verified: understanding how risk management related to the non-use of condoms in anal sex, happens in the relationships between MSM; adapt cross-culturally to Portuguese the Cuestionario de Investigación sobre Prácticas Sexuales de Hombres que hacen Sexo com Hombres (CIPRASEX MSM); and to analyze the psychometric characteristics of the questionnaire. The CIPRASEX MSM, conceived based on the Theory of Planned Behavior, presents the following dimensions: the attitudinal factor, subjective norm and perceived control over behavior, and aims to identify the factors associated with the intention to do not use condoms among MSM. This is a mixed study involving men over 18 years old. In an exploratory, qualitative study, 20 MSM participated and the material from semi-structured interviews was analyzed from the perspective of discursive analysis. The psychometric validation and adaptation studies of CIPRASEX MSM included 249 participants. As a result, the qualitative study showed that the negotiation process has the influence of the good appearance of the partner, social class to which he belongs, and relations with bigger exclusivity and reliability. Still, self-esteem, desire for romantic relationship, serological control, family support and historical social context are factors that impact the establishment of preventive strategies, related to the constitution of risk management. In the adaptation study, good conceptual and semantic equivalence was found between the last version in Portuguese and the original in Spanish, as well as the innovative characteristic of the instrument in the Brazilian context. The final version of CIPRASEX MSM has good psychometric characteristics and the results confirm the association between its dimensions and the intention related to the use of condoms among MSM. CIPRASEX MSM is a current instrument that can be applied in future studies and may also contribute to the development of interventions that consider the specificities of MSM.