Sexual Orientation and Gender Identity Associated with Sexual Practices, Psychoactive Substance Use and Sexually Transmitted Infections Among HIV PrEP Users
Abstract
1. Introduction
2. Materials and Methods
3. Results
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
Abbreviations
AIDS | Acquired Immunodeficiency Syndrome |
ART | Antiretroviral Therapy |
CAPES | Coordenação de Aperfeiçoamento de Pessoal de Nível Superior |
CI | Confidence Interval |
FAPESP | Fundação de Amparo à Pesquisa do Estado de São Paulo |
GHB | Gamma-Hydroxybutyric Acid |
HIV | Human Immunodeficiency Virus |
U = U | Undetectable = Untransmittable |
LGBT | Lesbian, Gay, Bisexual and Transgender |
MSM | Men who have Sex with Men |
OR | Odds Ratio |
PAS | Psychoactive Substances |
PrEP | Pre-Exposure Prophylaxis |
SD | Standard Deviation |
STI | Sexually Transmitted Infection |
SUS | Sistema Único de Saúde |
USA | United States of America |
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Variables | Gender Identity | p-Value | Sexual Orientation | p-Value | ||||
---|---|---|---|---|---|---|---|---|
Cisgender Men N/% | Cisgender Women N/% | Transgender Women N/% | Homosexuals/ Gays/Lesbians N/% | Bisexuals N/% | Heterosexuals N/% | |||
Race/Skin colour | <0.001 b | 0.002 a | ||||||
Asian | 17/2.5 | 0/0.0 | 0/0.0 | 15/2.4 | 2/2.6 | 0/0.0 | ||
White | 494/71.3 | 11/52.4 | 6/27.3 | 449/71.6 | 47/61.8 | 15/45.5 | ||
Indigenous | 4/0.6 | 0/0.0 | 1/4.6 | 4/0.6 | 0/0.0 | 1/3.0 | ||
Brown | 132/19.0 | 9/42.9 | 14/63.6 | 120/19.1 | 18/23.7 | 17/51.5 | ||
Black | 46/6.6 | 1/4.8 | 1/4.5 | 39/6.2 | 9/11.8 | 0/0.0 | ||
Total | 693/100 | 21/100 | 22/100 | 623/100 | 76/100 | 33/100 | ||
Schooling | <0.001 b | <0.001 b | ||||||
No studies | 1/0.1 | 0/0.0 | 0/0.0 | 0/0.0 | 1/1.3 | 0/0.0 | ||
4–7 years | 6/0.9 | 2/9.5 | 5/22.7 | 6/1.0 | 2/2.6 | 5/15.2 | ||
8–11 years | 91/13.1 | 5/23.8 | 9/40.9 | 75/12.0 | 21/27.6 | 9/27.3 | ||
12+ years | 595/85.9 | 14/66.7 | 8/36.4 | 546/87.1 | 52/68.4 | 19/57.6 | ||
Total | 693/100 | 21/100 | 22/100 | 627/100 | 76/100 | 33/100 | ||
Sex with people living with HIV | 0.456 a | 0.742 a | ||||||
No | 196/28.5 | 5/23.8 | 9/40.9 | 177/28.4 | 22/29.3 | 11/33.3 | ||
Don’t know | 322/46.8 | 11/52.4 | 11/50.0 | 290/46.6 | 39/52.0 | 15/45.5 | ||
Yes | 170/24.7 | 5/23.8 | 2/9.1 | 156/25.0 | 14/18.7 | 7/21.2 | ||
Total | 688/100 | 21/100 | 22/100 | 623/100 | 75/100 | 33/100 | ||
Exchanging sex for money | 0.001 a | 0.001 a | ||||||
No | 595/86.1 | 8/38.1 | 6/27.3 | 550/88.0 | 47/61.8 | 12/36.4 | ||
Yes | 96/13.9 | 13/61.9 | 16/72.7 | 75/12.0 | 29/38.2 | 21/63.6 | ||
Total | 691/100 | 21/100 | 22/100 | 625/100 | 76/100 | 33/100 | ||
Condomless sex | 0.017 b | 0.413 b | ||||||
No | 7/1.1 | 2/10.0 | 1/5.6 | 8/1.4 | 1/1.5 | 1/3.6 | ||
Yes | 605/98.9 | 18/90.0 | 17/94.4 | 546/98.6 | 67/98.5 | 27/96.4 | ||
Total | 612/100 | 20/100 | 18/100 | 554/100 | 68/100 | 28/100 | ||
Syphilis diagnosis | 0.336 b | 0.988 a | ||||||
No | 64/49.6 | 2/50.0 | 0/0.0 | 54/48.2 | 10/50.0 | 2/50.0 | ||
Yes | 65/50.4 | 2/50.0 | 3/100.0 | 58/51.8 | 10/50.0 | 2/50.0 | ||
Total | 129/100 | 4/100 | 3/100 | 112/100 | 20/100 | 4/100 | ||
Rectal gonorrhoea and/or chlamydia | 0.795 b | 0.648 b | ||||||
No | 100/77.5 | 4/100.0 | 3/100.0 | 88/78.6 | 15/75.0 | 4/100.0 | ||
Yes | 29/22.5 | 0/0.0 | 0/0.0 | 24/21.4 | 5/25.0 | 0/0.0 | ||
Total | 129/100 | 4/100) | 3/100 | 112/100 | 20/100 | 4/100 | ||
Any substance use | 0.838 a | 0.716 a | ||||||
Total | 680/100 | 20/100 | 22/100 | 615/100 | 75/100 | 32/100 | ||
No | 304/44.7 | 10/50.0 | 9/40.9 | 279/45.4 | 31/41.3 | 13/40.6 | ||
Yes | 376/55.3 | 10/50.0 | 13/59.1 | 336/54.6 | 44/58.7 | 19/59.4 | ||
Alcohol | 18/58.1 | 0/-- | 1/100.0 | 1.000 b | 17/60.7 | 1/33.3 | 1/100.0 | 0.737 b |
Poppers | 106/28.2 | 1/10.0 | 1/7.7 | 0.124 a | 97/28.9 | 10/22.7 | 1/5.3 | 0.063 a |
Cocaine | 106/28.2 | 3/30.0 | 7/53.9 | 0.135 a | 96/28.6 | 10/22.7 | 10/52.6 | 0.050 a |
Crack | 4/1.1 | 1/10.0 | 1/7.7 | 0.041 b | 4/1.2 | 0/0.0 | 2/10.5 | 0.048 b |
Cannabis | 233/62.0 | 8/80.0 | 9/69.2 | 0.450 a | 211/62.8 | 26/59.1 | 13/68.4 | 0.775 a |
Club drugs | 164/43.6 | 1/10.0 | 4/30.8 | 0.073 a | 143/42.6 | 20/45.5 | 6/31.6 | 0.583 a |
Erectile stimulants | 159/42.3 | 1/10.0 | 0/0.0 | 0.001 b | 140/41.7 | 20/45.5 | 0/0.0 | 0.001 b |
Solvents | 33/8.8 | 0/0.0 | 3/23.1 | 0.150 b | 25/7.4 | 8/18.2 | 3/15.8 | 0.038 a |
Age (years old): Mean 34.9 (SD = 9.1) |
Variables | Gender Identity | Sexual Orientation | ||||
---|---|---|---|---|---|---|
Cisgender Men (Ref) | Cisgender Women (OR 95%CI) | Transgender Women (OR 95%CI) | Heterosexuals (Ref) | Homosexuals/ Gays/Lesbians (OR 95%CI) | Bisexuals (OR 95%CI) | |
Exchanging sex for money | Ref | 9.8 (3.5–27.3) | 15.6 (5.3–46.1) | Ref | 0.1 (0.0–0.2) | 0.4 (0.2–1.0) |
Condomless sex | Ref | 0.1 (0.0–0.5) | 0.1 (0.0–1.2) | Ref | 0.1 (0.0–0.6) | 0.1 (0.0–2.7) |
Syphilis diagnosis | Ref | 1.0 (0.10–9.4) | 6.9 (0.1–339) | Ref | 29.0 (1.1–762) | 34.6 (1.2–960) |
Crack use | Ref | 13.1 (1.31–130) | 9.9 (1.0–94.7) | - | - | - |
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Silva, M.M.S.; Santos, L.C.d.; Almeida, M.M.S.d.; Nichiata, L.Y.I. Sexual Orientation and Gender Identity Associated with Sexual Practices, Psychoactive Substance Use and Sexually Transmitted Infections Among HIV PrEP Users. Healthcare 2025, 13, 1841. https://doi.org/10.3390/healthcare13151841
Silva MMS, Santos LCd, Almeida MMSd, Nichiata LYI. Sexual Orientation and Gender Identity Associated with Sexual Practices, Psychoactive Substance Use and Sexually Transmitted Infections Among HIV PrEP Users. Healthcare. 2025; 13(15):1841. https://doi.org/10.3390/healthcare13151841
Chicago/Turabian StyleSilva, Marcos Morais Santos, Lucas Cardoso dos Santos, Mayara Maria Souza de Almeida, and Lucia Yasuko Izumi Nichiata. 2025. "Sexual Orientation and Gender Identity Associated with Sexual Practices, Psychoactive Substance Use and Sexually Transmitted Infections Among HIV PrEP Users" Healthcare 13, no. 15: 1841. https://doi.org/10.3390/healthcare13151841
APA StyleSilva, M. M. S., Santos, L. C. d., Almeida, M. M. S. d., & Nichiata, L. Y. I. (2025). Sexual Orientation and Gender Identity Associated with Sexual Practices, Psychoactive Substance Use and Sexually Transmitted Infections Among HIV PrEP Users. Healthcare, 13(15), 1841. https://doi.org/10.3390/healthcare13151841