Intenção de usar PrEP entre homens que fazem sexo com homens praticantes de chemsex: um survey eletrônico internacional

Abstract

Introduction: pre-exposure prophylaxis (PrEP) is an essential tool in the fight against HIV, particularly recommended for vulnerable groups such as men who have sex with men (MSM), especially in the context of high-risk behaviors like chemsex, which involves the use of psychoactive substances during sexual activities. Objective: to analyze the prevalence and factors associated with the intention to use PrEP among MSM who engage in chemsex in Brazil and Portugal. Methods: this cross-sectional and analytical study was conducted between January 2020 and May 2021. Data collection employed a snowball sampling technique through two dating apps targeting the MSM population. Bivariate analysis was performed using Pearson’s Chi-squared test, followed by multivariate analysis for variables with p<0.20. Prevalence ratios (PRs) and 95% confidence intervals (95% CI) were calculated to measure the strength and direction of associations. Results: data were collected from 1,852 participants. The prevalence of intention to use PrEP was 59.07% (n=1,094). The final model included eight variables, five of which were associated with a higher intention to use PrEP: engaging in double penetration (aPR: 1.56), being assigned female sex at birth (aPR: 1.34), practicing cruising (aPR: 1.21), not using condoms (aPR:1.20), and being an immigrant (aPR: 1.16). Conversely, knowledge about PEP (aPR: 0.91), having casual sexual partners (aPRs: 0.86 and 0.85), and engaging in group sex (aPR: 0.81) were associated with lower intention to use PrEP. Conclusion: the intention to use PrEP among MSM who engage in chemsex was relatively low, highlighting the need for tailored strategies to promote its adoption in this population.