Sexual risk behaviors among adolescent men who have sex with men in two Brazilian cities: findings from an RDS-based study.

OBJECTIVE

To estimate the prevalence of sexual risk behaviors among adolescent men who have sex with men and to identify factors associated with these behaviors.

METHODS

Data were collected between December 2020 and July 2022 in Fortaleza and São Paulo, Brazil, using respondent-driven sampling. Study outcomes included inconsistent condom use, multiple sexual partners, and sexualized drug use.

RESULTS

The final sample was composed of 287 adolescents. Among participants, 38.0% reported inconsistent condom use, 36.1% reported multiple sexual partners, and 23.8% reported sexualized drug use. Factors associated with inconsistent condom use were not having a steady partner (adjusted prevalence ratio (APR): 0.5), having come out to everyone or almost everyone (APR: 6.3), consuming alcohol weekly (APR: 2.9), looking for family/friends/pharmacy (APR: 0.7), or looking for the public healthcare service when sick (APR: 0.7), and having sexual intercourse with partners of unknown HIV status (APR: 1.6). Factors associated with multiple sexual partners were receiving money in exchange for sex (APR: 1.6), and having sexual intercourse with partners of unknown HIV status (APR: 2.0). Factors associated with sexualized drug use included Catholic religion (APR: 0.2), having a steady partner < 20 years old (APR: 2.0), participating in non-governmental organization activities (APR: 2.5), experiences of violence (APR: 2.7), receiving money in exchange for sex (APR: 1.7), and having sexual intercourse with partners of unknown HIV status (APR: 2.1).

CONCLUSION

These findings highlight the high prevalence of sexual risk behaviors among adolescent men who have sex with men, underscoring the need for targeted prevention strategies and youth-friendly services in diverse urban contexts.