Factors associated to HIV prevalence among adolescent men who have sex with men in Salvador, Bahia State, Brazil: baseline data from the PrEP1519 cohort

Adolescent men who have sex with men (AMSM) are at a heightened vulnerability for human immunodeficiency virus (HIV). This study aimed to estimate the prevalence of HIV and associated individual, social, and programmatic factors among AMSM in Salvador, Bahia State, Brazil. This is a cross-sectional study which analyzed baseline data from the PrEP1519 cohort in Salvador. Descriptive, bivariate, and multivariate analyses were conducted using the dimensions of vulnerability to HIV as hierarchical levels of analysis. Logistic regression models were used to estimate the odds ratios (OR) of the association between predictor variables and HIV infection. The prevalence of HIV infection among the 288 AMSM recruited to the project was 5.9% (95%CI: 3.7-9.3). Adjusted analysis showed a statistically significant association between self-identifying as a sex worker (OR = 3.74, 95%CI: 1.03-13.60) and HIV infection. Other associations with borderline statistical significance were the use of application programs to find sexual partners (OR = 3.30, 95%CI: 0.98-11.04), low schooling level (OR = 3.59, 95%CI: 0.96-13.41), failing to be hired or being dismissed from a job because of sexual orientation (OR = 2.88, 95%CI: 0.89-9.28), and not using health services as a usual source of care (OR = 3.14, 95%CI: 0.97-10.17). We found a high HIV prevalence among AMSM in Salvador. Furthermore, our study found that individual, social, and programmatic factors were associated with HIV infection among these AMSM. We recommend intensifying HIV combined-prevention activities for AMSM.

男男性行为青少年（Adolescent men who have sex with men, AMSM）感染人类免疫缺陷病毒（Human Immunodeficiency Virus, HIV）的风险显著升高。本研究旨在评估巴西巴伊亚州萨尔瓦多市男男性行为青少年的HIV感染率及其相关的个体、社会与规划层面因素。本研究为横断面研究，分析了巴西萨尔瓦多市PrEP1519队列的基线数据。研究以HIV感染易感性维度作为分层分析依据，开展了描述性、双变量及多变量分析。本研究采用logistic回归模型估算预测变量与HIV感染之间关联的比值比（Odds Ratio, OR）。本研究纳入的288名男男性行为青少年中，HIV感染率为5.9%（95%置信区间：3.7%~9.3%）。校正后分析显示，自称为性工作者与HIV感染存在统计学显著关联（OR=3.74，95%置信区间：1.03~13.60）。其余具有临界统计学意义的关联包括：通过应用程序结识性伴侣（OR=3.30，95%置信区间：0.98~11.04）、受教育程度较低（OR=3.59，95%置信区间：0.96~13.41）、因性取向被拒绝聘用或解雇（OR=2.88，95%置信区间：0.89~9.28），以及未将医疗服务作为常规就诊途径（OR=3.14，95%置信区间：0.97~10.17）。本研究发现萨尔瓦多市男男性行为青少年群体的HIV感染率处于较高水平。此外，本研究证实个体、社会与规划层面的多种因素与该群体的HIV感染存在关联。研究建议强化针对男男性行为青少年的HIV综合预防干预措施。