Despite efforts to stop HIV epidemic in Latin America, new HIV cases continue to increase in the region especially among young MSM (YMSM). This study aims to assess social-economic and behavioral factors associated with HIV self-reported prevalence among YMSM participating in a survey conducted in Brazil, Mexico and Peru.
Through March to May, 2018, MSM were recruited to complete a web-based survey through advertisements on geosocial network (GSN) dating apps (Grindr and Hornet) and Facebook. Inclusion criteria were cisgender men, ≥18 years, living in Brazil, Mexico or Peru. For this analysis, we included YMSM aged 18-24 years who self-reported their HIV status (negative/positive). Multivariable logistic regression models assessed factors associated with HIV self-reported prevalence among YMSM for each country. The models were adjusted for geographical region within each country, race (only Brazil and Peru: white vs. non-white), monthly income (low vs. middle/high, according to countries definition), schooling (>secondary school vs. ≤), steady partner (yes/no), sexual attraction (men, women or both) and time since last HIV testing (≤1 year vs. >1 year).
Among 43,687 MSM that started the questionnaire, 27,475 (62.9%) reported their HIV status; 7,055 (25.7%) were YMSM and were included in the analysis. The majority of YMSM (83.1%) were recruited on GSN apps. Most (83.3%) reported an HIV test in the past year, and 15.3% reported HIV positive status in Peru, 8.4% in Mexico and 7.7% in Brazil. Among YMSM, low-income was associated with higher odds of HIV self-reported prevalence in Brazil (aOR=1.31, 95%CI:1.00-1.74) and Peru (aOR=1.59, 95%CI:1.04-2.48) but not in Mexico (aOR=0.81, 95%CI:0.56-1.18). Lower education was also associated with higher odds of HIV self-reported prevalence in Brazil (aOR=1.34, 95%CI:1.03-1.76) but not in Mexico nor in Peru. YMSM from the three countries sexually attracted to men had at least twice higher odds of HIV self-reported prevalence than those preferring women or both (Table 1).
In this large, cross-country study, HIV prevalence among YMSM was high. Social-economic disparities were associated with higher odds of HIV self-reported prevalence. Interventions to increase awareness to prevention technologies including PrEP targeting socio-economic disadvantaged YMSM are urgent in Latin America.