HIV prevalence and prevention behaviors among immigrant men who have sex with men in Brazil and Portugal.

Abstract

BackgroundThis study aimed to assess HIV prevalence and associated sexual behaviors among immigrant men who have sex with men (MSM) in Brazil and Portugal, recognizing the elevated vulnerability of this population due to sociocultural and structural barriers.MethodsA cross-sectional online survey was conducted between January 2020 and May 2021 with 2033 immigrant MSM. Participants were recruited using snowball sampling through dating applications. Data were self-reported and analyzed to identify associations between sexual behaviors and HIV status.ResultsThe overall HIV prevalence was 11.7%. Higher-risk sexual practices were frequent, including receptive anal intercourse and having multiple sexual partners. Conversely, low adoption of preventive behaviors such as sexual abstinence and non-penetrative sex was observed. Condomless sex was commonly justified by trust in partners or recent negative HIV test results. Factors independently associated with unprotected sex included being versatile or receptive in anal sex and not disclosing HIV status on dating apps. Gaps in HIV prevention knowledge and engagement were also identified.ConclusionsImmigrant MSM in Brazil and Portugal experience a high burden of HIV and engage in behaviors that increase their risk of infection. Cultural and structural barriers-such as language difficulties, limited healthcare access, and stigma-contribute to inadequate prevention practices. These findings highlight the urgent need for targeted, culturally competent public health interventions to expand access to HIV prevention strategies and reduce transmission risk in this underserved population.