High Rates of Sexualized Drug Use or Chemsex among Brazilian Transgender Women and Young Sexual and Gender Minorities
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Design
2.2. Outcome
2.3. Primary Exposure Variable
2.4. Covariables
2.5. Statistical Methods
3. Results
3.1. Study Population
3.2. Prevalence of SDU and Associated Factors among Sexual and Gender Minorities
4. Discussion
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
- Giorgetti, R.; Tagliabracci, A.; Schifano, F.; Zaami, S.; Marinelli, E.; Busardò, F.P. When “Chems” Meet Sex: A Rising Phenomenon Called “ChemSex”. CN 2017, 15, 762–770. [Google Scholar] [CrossRef] [PubMed]
- Edmundson, C.; Heinsbroek, E.; Glass, R.; Hope, V.; Mohammed, H.; White, M.; Desai, M. Sexualised drug use in the United Kingdom (UK): A review of the literature. Int. J. Drug Policy 2018, 55, 131–148. [Google Scholar] [CrossRef] [PubMed]
- Schmidt, A.J.; Bourne, A.; Weatherburn, P.; Reid, D.; Marcus, U.; Hickson, F. Illicit drug use among gay and bisexual men in 44 cities: Findings from the European MSM Internet Survey (EMIS). Int. J. Drug Policy 2016, 38, 4–12. [Google Scholar] [CrossRef] [PubMed]
- Maxwell, S.; Shahmanesh, M.; Gafos, M. Chemsex behaviours among men who have sex with men: A systematic review of the literature. Int. J. Drug Policy 2019, 63, 74–89. [Google Scholar] [CrossRef]
- Tomkins, A.; George, R.; Kliner, M. Sexualised drug taking among men who have sex with men: A systematic review. Perspect Public Health 2019, 139, 23–33. [Google Scholar] [CrossRef]
- Torres, T.S.; Bastos, L.S.; Kamel, L.; Bezerra, D.R.B.; Fernandes, N.M.; Moreira, R.I.; Garner, A.; Veloso, V.G.; Grinsztejn, B.; De Boni, R.B. Do men who have sex with men who report alcohol and illicit drug use before/during sex (chemsex) present moderate/high risk for substance use disorders? Drug Alcohol Depend. 2020, 209, 107908. [Google Scholar] [CrossRef]
- Blair, K.J.; Segura, E.R.; Garner, A.; Lai, J.; Ritterbusch, A.; Leon-Giraldo, S.; Guilamo-Ramos, V.; Lake, J.E.; Clark, J.; Holloway, I.W. PrEP Awareness, Use, Intention to Use, and Information Source Among Geosocial Networking Application Users in Mexico in 2018–2019. AIDS Behav. 2021, 25, 2743–2754. [Google Scholar] [CrossRef]
- Fan, X.; Lau, J.T.F.; Cai, Y.; Li, J.; Ma, T.; Gu, J.; Wang, Z. Prevalence and associated factors of sexualized drug use in sex work among transgender women sex workers in China. AIDS Care 2021, 33, 1098–1106. [Google Scholar] [CrossRef]
- UNAIDS 2020 Global AIDS Report. 2020. Available online: https://www.unaids.org/sites/default/files/media_asset/2020_global-aids-report_en.pdf (accessed on 15 December 2021).
- BRAZIL Boletim Epidemiológico HIV/AIDS 2020. 2020. Available online: http://www.aids.gov.br/pt-br/pub/2020/boletim-epidemiologico-hivaids-2020 (accessed on 15 December 2021).
- Kerr, L.; Kendall, C.; Guimarães, M.D.C.; Salani Mota, R.; Veras, M.A.; Dourado, I.; Maria de Brito, A.; Merchan-Hamann, E.; Pontes, A.K.; Leal, A.F.; et al. HIV prevalence among men who have sex with men in Brazil: Results of the 2nd national survey using respondent-driven sampling. Medicine 2018, 97, S9–S15. [Google Scholar] [CrossRef]
- Grinsztejn, B.; Jalil, E.M.; Monteiro, L.; Velasque, L.; Moreira, R.I.; Garcia, A.C.F.; Castro, C.V.; Krüger, A.; Luz, P.M.; Liu, A.Y.; et al. Unveiling of HIV dynamics among transgender women: A respondent-driven sampling study in Rio de Janeiro, Brazil. Lancet HIV 2017, 4, e169–e176. [Google Scholar] [CrossRef][Green Version]
- Bastos, F.I.; Bastos, L.S.; Coutinho, C.; Toledo, L.; Mota, J.C.; Velasco-de-Castro, C.A.; Sperandei, S.; Brignol, S.; Travassos, T.S.; dos Santos, C.M.; et al. HIV, HCV, HBV, and syphilis among transgender women from Brazil: Assessing different methods to adjust infection rates of a hard-to-reach, sparse population. Medicine 2018, 97, S16–S24. [Google Scholar] [CrossRef] [PubMed]
- Guimarães, M.D.C.; Kendall, C.; Magno, L.; Rocha, G.M.; Knauth, D.R.; Leal, A.F.; Dourado, I.; Veras, M.A.; de Brito, A.M.; Kerr, L.R.F.S. Comparing HIV risk-related behaviors between 2 RDS national samples of MSM in Brazil, 2009 and 2016. Medicine 2018, 97, S62–S68. [Google Scholar] [CrossRef] [PubMed]
- Wilson, E.C.; Jalil, E.M.; Moreira, R.I.; Velasque, L.; Castro, C.V.; Monteiro, L.; Veloso, V.G.; Grinsztejn, B. High risk and low HIV prevention behaviours in a new generation of young trans women in Brazil. AIDS Care 2020, 33, 997–1001. [Google Scholar] [CrossRef] [PubMed]
- Grant, R.M.; Lama, J.R.; Anderson, P.L.; McMahan, V.; Liu, A.Y.; Vargas, L.; Goicochea, P.; Casapía, M.; Guanira-Carranza, J.V.; Ramirez-Cardich, M.E.; et al. Preexposure Chemoprophylaxis for HIV Prevention in Men Who Have Sex with Men. N. Engl. J. Med. 2010, 363, 2587–2599. [Google Scholar] [CrossRef] [PubMed][Green Version]
- BraZil. Protocolo Clínico e Diretrizes Terapêuticas para Profilaxia Pré-Exposição (PrEP) de Risco à Infecção pelo HIV. 2017. Available online: http://www.aids.gov.br/system/tdf/pub/2017/64510/pcdt_prep_12_2017.pdf?file=1&type=node&id=64510&force=1 (accessed on 15 December 2021).
- Kennedy, R.; Murira, J.; Foster, K.; Heinsbroek, E.; Keane, F.; Pal, N.; Chalmers, L.; Sinka, K. Sexualized drug use and specialist service experience among MSM attending urban and rural sexual health clinics in England and Scotland. Int. J. STD AIDS 2021, 32, 1338–1346. [Google Scholar] [CrossRef]
- Guerra, F.M.; Salway, T.J.; Beckett, R.; Friedman, L.; Buchan, S.A. Review of sexualized drug use associated with sexually transmitted and blood-borne infections in gay, bisexual and other men who have sex with men. Drug Alcohol Depend. 2020, 216, 108237. [Google Scholar] [CrossRef]
- Ottaway, Z.; Finnerty, F.; Amlani, A.; Pinto-Sander, N.; Szanyi, J.; Richardson, D. Men who have sex with men diagnosed with a sexually transmitted infection are significantly more likely to engage in sexualised drug use. Int. J. STD AIDS 2017, 28, 91–93. [Google Scholar] [CrossRef]
- Allen, J.L.; Mowbray, O. Sexual orientation, treatment utilization, and barriers for alcohol related problems: Findings from a nationally representative sample. Drug Alcohol Depend. 2016, 161, 323–330. [Google Scholar] [CrossRef]
- Boyd, C.J.; Veliz, P.T.; Stephenson, R.; Hughes, T.L.; McCabe, S.E. Severity of Alcohol, Tobacco, and Drug Use Disorders Among Sexual Minority Individuals and Their “Not Sure” Counterparts. LGBT Health 2019, 6, 15–22. [Google Scholar] [CrossRef]
- Evans-Polce, R.J.; Veliz, P.T.; Boyd, C.J.; Hughes, T.L.; McCabe, S.E. Associations between sexual orientation discrimination and substance use disorders: Differences by age in US adults. Soc. Psychiatry Psychiatr. Epidemiol. 2020, 55, 101–110. [Google Scholar] [CrossRef]
- Kerridge, B.T.; Pickering, R.P.; Saha, T.D.; Ruan, W.J.; Chou, S.P.; Zhang, H.; Jung, J.; Hasin, D.S. Prevalence, sociodemographic correlates and DSM-5 substance use disorders and other psychiatric disorders among sexual minorities in the United States. Drug Alcohol Depend. 2017, 170, 82–92. [Google Scholar] [CrossRef] [PubMed]
- McCabe, S.E.; Hughes, T.L.; West, B.T.; Veliz, P.; Boyd, C.J. DSM-5 Alcohol Use Disorder Severity as a Function of Sexual Orientation Discrimination: A National Study. Alcohol. Clin. Exp. Re. 2019, 43, 497–508. [Google Scholar] [CrossRef] [PubMed]
- Flores Anato, J.L.; Panagiotoglou, D.; Greenwald, Z.R.; Trottier, C.; Vaziri, M.; Thomas, R.; Maheu-Giroux, M. Chemsex practices and pre-exposure prophylaxis (PrEP) trajectories among individuals consulting for PrEP at a large sexual health clinic in Montréal, Canada (2013-2020). Drug and Alcohol Dependence 2021, 226, 108875. [Google Scholar] [CrossRef] [PubMed]
- Torres, T.S.; Konda, K.; Vega-Ramirez, E.H.; Elorreaga Reyes, O.A.; Diaz-Sosa, D.; Hoagland, B.; Diaz, S.; Pimenta, C.; Bennedeti, M.; Lopez-Gatell, H.; et al. Awareness and factors associated with willingness to use Pre-exposure prophylaxis (PrEP) in Brazil, Mexico and Peru: An online survey among men who have sex with men (MSM) (Preprint). JMIR Public Health Surveill. 2019, 5, e13771. [Google Scholar] [CrossRef] [PubMed]
- De Aguiar Pereira, C.C.; Torres, T.S.; Luz, P.M.; Hoagland, B.; Farias, A.; Brito, J.D.U.; Guimarães Lacerda, M.V.; da Silva, D.A.R.; Benedetti, M.; Pimenta, M.C.; et al. Preferences for pre-exposure prophylaxis (PrEP) among men who have sex with men and transgender women at risk of HIV infection: A multicentre protocol for a discrete choice experiment in Brazil. BMJ Open 2021, 11, e049011. [Google Scholar] [CrossRef]
- Torres, T.S.; Marins, L.M.S.; Veloso, V.G.; Grinsztejn, B.; Luz, P.M. How heterogeneous are MSM from Brazilian cities? An analysis of sexual behavior and perceived risk and a description of trends in awareness and willingness to use pre-exposure prophylaxis. BMC Infect. Dis. 2019, 19, 1067. [Google Scholar] [CrossRef][Green Version]
- National Institute on Alcohol Abuse and Alcoholism (NIAAA) NIAAA Council Approves Definition of Binge Drinking. 2004. Available online: https://pubs.niaaa.nih.gov/publications/Newsletter/winter2004/Newsletter_Number3.pdf (accessed on 20 February 2019).
- Luz, P.M.; Torres, T.S.; Almeida-Brasil, C.C.; Marins, L.M.S.; Veloso, V.G.; Grinsztejn, B.; Cox, J.; Moodie, E.E.M. High-Risk Sexual Behavior, Binge Drinking and Use of Stimulants are Key Experiences on the Pathway to High Perceived HIV Risk Among Men Who Have Sex with Men in Brazil. AIDS Behav. 2021, 25, 748–757. [Google Scholar] [CrossRef]
- For the PrEP Brasil Study Team; Hoagland, B.; De Boni, R.B.; Moreira, R.I.; Madruga, J.V.; Kallas, E.G.; Goulart, S.P.; Cerqueira, N.; Torres, T.S.; Luz, P.M.; et al. Awareness and Willingness to Use Pre-exposure Prophylaxis (PrEP) Among Men Who Have Sex with Men and Transgender Women in Brazil. AIDS Behav. 2017, 21, 1278–1287. [Google Scholar] [CrossRef]
- Jalil, E.M.; Grinsztejn, B.; Velasque, L.; Ramos Makkeda, A.; Luz, P.M.; Moreira, R.I.; Kamel, L.; Fernandes, N.M.; Ferreira, A.C.G.; Hoagland, B.; et al. Awareness, Willingness, and PrEP Eligibility Among Transgender Women in Rio de Janeiro, Brazil. JAIDS J. Acquir. Immune Defic. Syndr. 2018, 79, 445–452. [Google Scholar] [CrossRef]
- Martins, T.A.; Kerr, L.R.F.S.; Macena, R.H.M.; Mota, R.S.; Carneiro, K.L.; Gondim, R.C.; Kendall, C. “Travestis”, an unexplored population at risk of HIV in a large metropolis of northeast Brazil: A respondent-driven sampling survey. AIDS Care 2013, 25, 606–612. [Google Scholar] [CrossRef]
- Benevides, G.B.; Nogueira, S.N.B. Dossiê dos Assassinatos e da Violência Contra Travestis e Transexuais Brasileiras em 2020; Expressão Popular, ANTRA, IBTE: São Paulo, Brazil, 2021; ISBN 9786558910138. [Google Scholar]
- TGEU. TMM Update Trans Day of Remembrance 2020. Transrespect versus Transphobia World Wide. GLS Bank, BIC/SWIFT: GENODEM1GLS, IBAN: DE 66 4306 0967 1153 7962 00, subject line: “TvT Project”. 2020. Available online: https://transrespect.org/en/) (accessed on 20 December 2021).
- Baral, S.D.; Poteat, T.; Strömdahl, S.; Wirtz, A.L.; Guadamuz, T.E.; Beyrer, C. Worldwide burden of HIV in transgender women: A systematic review and meta-analysis. Lancet Infect. Dis. 2013, 13, 214–222. [Google Scholar] [CrossRef]
- Teixeira, S.L.; Jalil, C.M.; Jalil, E.M.; Nazer, S.C.; Silva, S.D.C.C.; Veloso, V.G.; Luz, P.M.; Grinsztejn, B. Evidence of an untamed HIV epidemic among MSM and TGW in Rio de Janeiro, Brazil: A 2018 to 2020 cross-sectional study using recent infection testing. J. Int. AIDS Soc. 2021, 24, e25743. [Google Scholar] [CrossRef] [PubMed]
- Veloso, V.G. ImPrEP project overview and selected results. 11th IAS Conference on HIV Science. 2021. Available online: https://theprogramme.ias2021.org/Programme/Session/227 (accessed on 20 December 2021).
- Brazil. Painel PrEP 2021. Available online: http://www.aids.gov.br/pt-br/painel-prep (accessed on 15 December 2021).
- Weissman, A.; Ngak, S.; Srean, C.; Sansothy, N.; Mills, S.; Ferradini, L. HIV Prevalence and Risks Associated with HIV Infection among Transgender Individuals in Cambodia. PLoS ONE 2016, 11, e0152906. [Google Scholar] [CrossRef] [PubMed][Green Version]
- Nemoto, T.; Operario, D.; Keatley, J.; Han, L.; Soma, T. HIV Risk Behaviors Among Male-to-Female Transgender Persons of Color in San Francisco. Am. J. Public Health 2004, 94, 1193–1199. [Google Scholar] [CrossRef]
- BRAZIL Boletim Epidemiológico—HIV/AIDS 2018. 2018. Available online: http://www.aids.gov.br/pt-br/pub/2018/boletim-epidemiologico-hivaids-2018 (accessed on 15 December 2021).
- Coelho, L.E.; Torres, T.S.; Veloso, V.G.; Grinsztejn, B.; Jalil, E.M.; Wilson, E.C.; McFarland, W. The Prevalence of HIV Among Men Who Have Sex With Men (MSM) and Young MSM in Latin America and the Caribbean: A Systematic Review. AIDS Behav. 2021, 25, 3223–3237. [Google Scholar] [CrossRef]
- Caceres, C.F.; Konda, K.A.; Moreira, R.; Leite, I.; Cunha, M.; Hoagland, B.; Guanira, J.V.; Vermandere, H.; Vega, H.; Grinsztejn, B.; et al. Early predictors of seroconversion among enrolees in a PrEP programme in Brazil, Mexico and Peru—The IMPREP Demonstration study. J. Int. AIDS Soc. 2021, 24, 32–34. [Google Scholar]
- Fritz, K.; Morojele, N.; Kalichman, S. Alcohol: The forgotten drug in HIV/AIDS. Lancet 2010, 376, 398–400. [Google Scholar] [CrossRef][Green Version]
- Bezerra, D.R.B.; Torres, T.; Coelho, L.; Jalil, C.; Carvalheira, E.; Granjeiro, J.R.; Araujo, T.; Freitas, J.; Cerqueira, C.; Monteiro, L.; et al. Online and venue-based recruitment strategies are complementary to reach high risk MSM for a large PrEP service in Rio de Janeiro, Brazil. 2020. Available online: https://www.abstract-archive.org/Abstract/Share/81633 (accessed on 15 December 2021).
Current PrEP Use | Cramer’s V Coefficient 3 | p-Value | ||
---|---|---|---|---|
No | Yes | |||
N = 2785 | N = 1139 | |||
Gender | 0.01 | 0.834 | ||
Cisgender men | 2521 (90.5) | 1032 (90.6) | ||
Transgender women | 197 (7.1) | 83 (7.3) | ||
Non binary | 67 (2.4) | 24 (2.1) | ||
Recruitment | 0.25 | <0.001 | ||
On site | 516 (18.5) | 485 (42.6) | ||
Online | 2269 (81.5) | 654 (57.4) | ||
Geographic region | 0.19 | <0.001 | ||
North | 55 (2.0) | 108 (9.5) | ||
Northeast | 326 (11.7) | 73 (6.4) | ||
Central-west | 247 (8.9) | 78 (6.8) | ||
Southeast | 1825 (65.5) | 775 (68) | ||
South | 332 (11.9) | 105 (9.2) | ||
Age | ||||
Median (IQR) | 31 (26,37) | 32 (27,38) | 0.001 | |
18–24 | 505 (18.1) | 165 (14.5) | 0.053 | 0.004 |
25–35 | 1420 (51.0) | 574 (50.4) | ||
>35 | 860 (30.9) | 400 (35.1) | ||
Race/color | 0.006 | 0.932 | ||
White/Asian | 1539 (56.0) | 624 (55.6) | ||
Pardo/Indigenous | 767 (27.9) | 313 (27.9) | ||
Black | 442 (16.1) | 186 (16.6) | ||
Completed schooling | 0.042 | 0.035 | ||
Elementary | 179 (6.5) | 50 (4.4) | ||
Secondary | 782 (28.2) | 341 (30.0) | ||
Post-secondary | 1812 (65.3) | 744 (65.6) | ||
Family monthly income | 0.017 | 0.566 | ||
Low | 916 (34.2) | 351 (32.4) | ||
Middle | 1085 (40.5) | 453 (41.8) | ||
High | 679 (25.3) | 280 (25.8) | ||
Sexual Orientation | 0.031 | 0.053 | ||
Gay or homosexual | 2185 (78.5) | 925 (81.2) | ||
Other | 600 (21.5) | 214 (18.8) | ||
Any illicit drug use 1 | 1118 (40.1) | 533 (46.8) | 0.061 | <0.001 |
Tobacco use 1 | 903 (32.4) | 351 (30.8) | 0.016 | 0.327 |
Marijuana use 1 | 884 (31.7) | 405 (35.6) | 0.037 | 0.021 |
Stimulant drug use 1 | 591 (21.2) | 323 (28.4) | 0.077 | <0.001 |
Binge drinking 1 | 1603 (57.6) | 677 (59.4) | 0.279 | |
Number of sexual partners 1 | ||||
Median (IQR) | 4 (2,10) | 7 (3,15) | <0.001 | |
≤5 | 1828 (65.6) | 535 (47) | 0.173 | <0.001 |
>5 | 957 (34.4) | 604 (53.0) | 0.017 | |
Condomless anal sex 1 | 1765 (63.4) | 923 (81.0) | 0.173 | <0.001 |
Condomless receptive anal sex 1 | 1230 (44.2) | 718 (63.0) | 0.171 | <0.001 |
Steady partner 1 | 960 (34.5) | 491 (43.1) | 0.081 | <0.001 |
Reported STI 1 | 370 (13.3) | 265 (23.3) | 0.123 | <0.001 |
HIV perceived risk 2 (N = 3749) | 0.171 | <0.001 | ||
No/Low | 1909 (72.2) | 973 (88.1) | ||
Moderate/High/100% sure | 735 (27.8) | 132 (11.9) |
Overall Sample (N = 3924) | Current PrEP Use | |||||
---|---|---|---|---|---|---|
No (N = 2785) | Yes (N = 1139) | |||||
Sexualized drug use (SDU) | No 2794 (71.2) | Yes 1130 (28.8) | No 2039 (73.2) | Yes 746 (26.8) | No 755 (66.3) | Yes 384 (33.7) |
Current PrEP use | ||||||
No | 2039 (73.2) | 746 (26.8) | NA | NA | NA | NA |
Yes | 755 (66.3) | 384 (33.7) | NA | NA | NA | NA |
Gender | ||||||
Cisgender men | 2567 (72.2) | 986 (27.8) | 1880 (74.6) | 641 (25.4) | 687 (66.6) | 345 (33.4) |
Transgender women | 166 (59.3) | 114 (40.7) | 115 (58.4) | 82 (41.6) | 51 (61.4) | 32 (38.6) |
Non-binary | 61 (67) | 30 (33) | 44 (65.7) | 23 (34.3) | 17 (70.8) | 7 (29.2) |
Geographical region | ||||||
North/Northeast/Central-west | 652 (73.5) | 235 (26.5) | 459 (73.1) | 169 (26.9) | 193 (74.5) | 66 (25.5) |
South/Southeast | 2142 (70.5) | 895 (29.5) | 1580 (73.2) | 577 (26.8) | 562 (63.9) | 318 (36.1) |
Age (years) | ||||||
18–24 | 461 (68.8) | 209 (31.2) | 348 (68.9) | 157 (31.1) | 113 (68.5) | 52 (31.5) |
25–35 | 1386 (69.5) | 608 (30.5) | 1028 (72.4) | 392 (27.6) | 358 (62.4) | 216 (37.6) |
>35 | 947 (75.2) | 313 (24.8) | 663 (77.1) | 197 (22.9) | 284 (71.0) | 116 (29.0) |
Race | ||||||
White/Asian | 1532 (55.5) | 631 (56.7) | 906 (73.1) | 334 (26.9) | 356 (69.3) | 158 (30.7) |
Black/Pardo/Indigenous | 1226 (44.5) | 482 (43.3) | 1107 (73.4) | 401 (26.6) | 389 (63.9) | 220 (36.1) |
Completed schooling | ||||||
Elementary | 152 (66.4) | 77 (33.6) | 117 (65.4) | 62 (34.6) | 35 (70) | 15 (30) |
Secondary | 797 (71) | 326 (29) | 565 (72.3) | 217 (27.7) | 232 (68) | 109 (32) |
Post-secondary | 1835 (71.8) | 721 (28.2) | 1351 (74.6) | 461 (25.4) | 484 (65.1) | 260 (34.9) |
Family monthly income | ||||||
Low | 900 (71) | 367 (29) | 660 (72.1) | 256 (27.9) | 240 (68.4) | 111 (31.6) |
Middle | 1120 (72.8) | 418 (27.2) | 812 (74.8) | 273 (25.2) | 308 (68) | 145 (32.0) |
High | 663 (69.1) | 296 (30.9) | 489 (72) | 190 (28) | 174 (62.1) | 106 (37.9) |
Binge drinking | ||||||
No | 1354 (82.4) | 290 (17.6) | 990 (83.8) | 192 (16.2) | 364 (78.8) | 98 (21.2) |
Yes | 1440 (63.2) | 840 (36.8) | 1049 (65.4) | 554 (34.6) | 391 (57.8) | 286 (42.2) |
Number of partners | ||||||
≤5 | 1833 (77.6) | 530 (22.4) | 1432 (78.3) | 396 (21.7) | 401 (75) | 134 (25) |
>5 | 961 (61.6) | 600 (38.4) | 607 (63.4) | 350 (36.6) | 354 (58.6) | 250 (41.4) |
Condomless anal sex1 | ||||||
No | 975 (78.9) | 261 (21.1) | 818 (80.2) | 202 (19.8) | 157 (72.7) | 59 (27.3) |
Yes | 1819 (67.7) | 869 (32.3) | 1221 (69.2) | 544 (30.8) | 598 (64.8) | 325 (35.2) |
STI | ||||||
No | 2400 (73.0) | 889 (27.0) | 1796 (74.4) | 619 (25.6) | 604 (69.1) | 270 (30.9) |
Yes | 394 (62.0) | 241 (38.0) | 243 (65.7) | 127 (34.3) | 151 (57) | 114 (43) |
Steady partner | ||||||
No | 1769 (71.5) | 704 (28.5) | 1342 (73.5) | 483 (26.5) | 427 (65.9) | 221 (34.1) |
Yes | 1025 (70.6) | 426 (29.4) | 697 (72.6) | 263 (27.4) | 328 (66.8) | 163 (33.2) |
HIV perceived risk | ||||||
No/Low | 2096 (72.7) | 786 (27.3) | 1452 (76.1) | 457 (23.9) | 644 (66.2) | 329 (33.8) |
Moderate/High/100% sure | 560 (64.6) | 307 (35.4) | 476 (64.8) | 259 (35.2) | 84 (63.6) | 48 (36.4) |
Current PrEP Use | ||||||
---|---|---|---|---|---|---|
All (N = 3924) | No (N = 2785) | Yes (N = 1139) | ||||
OR (95% CI) | aOR (95% CI) | OR (95%CI) | aOR (95% CI) | OR (95%CI) | aOR (95% CI) | |
Current PrEP use | ||||||
No | Ref. | Ref. | NA | NA | NA | NA |
Yes | 1.39 (1.20–1.61) *** | 1.19 (1.00–1.41) * | NA | NA | NA | NA |
Recruitment | ||||||
On site | 0.99 (0.84–1.16) | NA | NA | NA | NA | NA |
Online | Ref. | NA | NA | NA | NA | NA |
Gender | ||||||
Cisgender men | Ref. | Ref. | Ref. | Ref. | Ref. | Ref. |
Transgender women | 1.79 (1.39–2.29) *** | 2.44 (1.75–3.39) *** | 2.09 (1.55–2.81) *** | 2.54 (1.71–3.77) *** | 1.25 (0.78–1.97) | 2.11 (1.13–3.92) * |
Non-binary | 1.28 (0.81–1.98) | 1.52 (0.92–2.46) | 1.53 (0.90–2.53) | 1.85 (1.04–3.21) * | 0.82 (0.31–1.92) | 0.87 (0.30–2.34) |
Geographical region | ||||||
North/Northeast/Central-west | Ref. | Ref. | Ref. | Ref. | Ref. | Ref. |
South/Southeast | 1.16 (0.98–1.37) | 1.26 (1.04–1.53) * | 0.99 (0.81–1.21) | 1.13 (0.90–1.43) | 1.65 (1.22–2.27) ** | 1.64 (1.16–2.34) ** |
Age (years) | ||||||
18–24 | 1.37 (1.11–1.69) ** | 1.41 (1.10–1.81) ** | 1.52 (1.19–1.94) *** | 1.42 (1.06–1.89) * | 1.12 (0.76–1.66) | 1.32 (0.82–2.13) |
25–35 | 1.33 (1.13–1.56) *** | 1.24 (1.04–1.53) * | 1.28 (1.05–1.56) * | 1.13 (0.91–1.41) | 1.48 (1.12–1.95) ** | 1.54 (1.12–2.13) ** |
>35 | Ref. | Ref. | Ref. | Ref. | Ref. | Ref. |
Race/color | ||||||
White/Asian | 1.05 (0.91–1.21) | 1.21 (1.02–1.42) * | 0.96 (0.81–1.14) | 1.21 (0.99–1.48) | 1.28 (0.99–1.64) | 1.20 (0.89–1.62) |
Black/Pardo/Indigenous | Ref. | Ref. | Ref. | Ref. | Ref. | Ref. |
Completed schooling | ||||||
Elementary | Ref. | Ref. | Ref. | Ref. | Ref. | Ref. |
Secondary | 0.81 (0.60–1.10) | 1.00 (0.69–1.46) | 0.72 (0.51–1.03) | 0.99 (0.65–1.52) | 1.10 (0.58–2.15) | 1.20 (0.55–2.72) |
Post-secondary | 0.78 (0.58–1.04) | 1.10 (0.75–1.63) | 0.64 (0.47–0.90) ** | 1.01 (0.66–1.58) | 1.25 (0.68–2.40) | 1.49 (0.66–3.50) |
Family monthly income | ||||||
Low | Ref. | Ref. | Ref. | Ref. | Ref. | Ref. |
Middle | 0.92 (0.78–1.08) | 1.06 (0.87–1.30) | 0.87 (0.71–1.06) | 1.08 (0.85–1.38) | 1.02 (0.76–1.37) | 1.01 (0.70–1.47) |
High | 1.09 (0.91–1.31) | 1.32 (1.05–1.67) * | 1.00 (0.80–1.25) | 1.29 (0.98–1.71) | 1.32 (0.95–1.83) | 1.42 (0.91–2.21) |
Binge drinking | ||||||
No | Ref. | Ref. | Ref. | Ref. | Ref. | Ref. |
Yes | 2.72 (2.34–3.18) *** | 2.66 (2.25–3.14) *** | 2.72 (2.27–3.28) *** | 2.56 (2.10–3.14) *** | 2.72 (2.08–3.57) *** | 2.85 (2.12–3.86) *** |
Number of partners | ||||||
≤5 | Ref. | Ref. | Ref. | Ref. | Ref. | Ref. |
>5 | 2.16 (1.88–2.49) *** | 1.88 (1.61–2.21) *** | 2.09 (1.76–2.48) *** | 1.86 (1.53–2.25) *** | 2.11 (1.64–2.73) *** | 1.93 (1.45–2.57) *** |
Condomless anal sex | ||||||
No | Ref. | Ref. | Ref. | Ref. | Ref. | Ref. |
Yes | 1.78 (1.52–2.09) *** | 1.49 (1.25–1.79) *** | 1.80 (1.50–2.17) *** | 1.63 (1.33–2.01) *** | 1.45 (1.05–2.02) * | 1.18 (0.82–1.71 |
Reported STI | ||||||
No | Ref. | Ref. | Ref. | Ref. | Ref. | Ref. |
Yes | 1.65 (1.38–1.97) *** | 1.40 (1.14–1.71) ** | 1.52 (1.20–1.91) *** | 1.27 (0.97–1.65) | 1.69 (1.27–2.24) *** | 1.53 (1.11–2.09) ** |
Steady partner | ||||||
No | Ref. | NA | NA | NA | NA | NA |
Yes | 1.04 (0.91–1.20) | NA | NA | NA | NA | NA |
HIV perceived risk | ||||||
No/Low | Ref. | Ref. | Ref. | Ref. | Ref. | Ref. |
Moderate/High/100% sure | 1.46 (1.24–1.72) *** | 1.37 (1.14–1.64) ** | 1.73 (1.44–2.08) *** | 1.38 (1.13–1.70) ** | 1.12 (0.76–1.63) | 1.35 (0.89–2.05) |
Publisher’s Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affiliations. |
© 2022 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
Share and Cite
Jalil, E.M.; Torres, T.S.; de A. Pereira, C.C.; Farias, A.; Brito, J.D.U.; Lacerda, M.; da Silva, D.A.R.; Wallys, N.; Ribeiro, G.; Gomes, J.; et al. High Rates of Sexualized Drug Use or Chemsex among Brazilian Transgender Women and Young Sexual and Gender Minorities. Int. J. Environ. Res. Public Health 2022, 19, 1704. https://doi.org/10.3390/ijerph19031704
Jalil EM, Torres TS, de A. Pereira CC, Farias A, Brito JDU, Lacerda M, da Silva DAR, Wallys N, Ribeiro G, Gomes J, et al. High Rates of Sexualized Drug Use or Chemsex among Brazilian Transgender Women and Young Sexual and Gender Minorities. International Journal of Environmental Research and Public Health. 2022; 19(3):1704. https://doi.org/10.3390/ijerph19031704
Chicago/Turabian StyleJalil, Emilia M., Thiago S. Torres, Claudia C. de A. Pereira, Alessandro Farias, Jose D. U. Brito, Marcus Lacerda, Daila A. R. da Silva, Nickols Wallys, Gabriela Ribeiro, Joyce Gomes, and et al. 2022. "High Rates of Sexualized Drug Use or Chemsex among Brazilian Transgender Women and Young Sexual and Gender Minorities" International Journal of Environmental Research and Public Health 19, no. 3: 1704. https://doi.org/10.3390/ijerph19031704