ObjectiveTo understand the factors associated with the practice of chemsex among MSM in Brazil, especially during the Mpox health crisis, and to design effective prevention and intervention strategies specifically for this population.DesignA cross-sectional and analytical study using an electronic survey, conducted from September to December 2022, during the peak of the Mpox outbreak in Brazil.SampleA total of 1452 MSM aged 18 and older.MeasurementsData were collected via the REDCap platform through a survey with 46 questions. These addressed demographic data, sexual affiliations, practices, experiences with Mpox, healthcare service usage, and stigma or fear related to Mpox.ResultsThe prevalence of chemsex was 19.42% (n = 282). Multivariate Poisson modeling indicated a high incidence of chemsex among those diagnosed with Mpox and those involved in high-risk behaviors. The practice of chemsex was six times higher among those diagnosed with Mpox (95% CI: 4.73-9.10). MSM who engage in bugchasing had a prevalence twice that of the main outcome (95% CI: 1.31-3.16).ConclusionThere is a significant need for targeted interventions for MSM in Brazil, especially given the Mpox outbreak. This study highlights the strong relationships between chemsex, experiences with Mpox, and various sexual behaviors, underscoring the importance of effective public health initiatives.

Background: Pre-exposure prophylaxis (PrEP) is a valuable tool in the response to the HIV epidemic, recommended for groups with a higher risk of HIV infection, such as men who have sex with men (MSM), particularly in the context of high-risk sexual behavior such as chemsex. Purpose: This study aimed 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 was a cross-sectional study of a secondary dataset from a larger study conducted between January 2020 and May 2021 throughout Brazil and Portugal involving 1852 MSM who engage in chemsex. An initial descriptive analysis was performed to calculate the absolute and relative frequencies of independent variables related to the intention to use PrEP among MSM. A multivariate regression model was developed to identify factors independently associated with the intention to use PrEP. Results: Although a high level of PrEP knowledge (85.75%) was observed among MSM who engage in chemsex, the prevalence of intention to use PrEP was only 59.07%. Five variables were associated with a higher prevalence of intention to use PrEP [engaging in double penetration – adjusted prevalence ratio (aPR): 1.56, 95% CI: 1.44–1.69; being assigned female sex at birth – aPR: 1.34, 95% CI: 1.12–1.61; cruising – aPR: 1.21, 95% CI: 1.06–1.38; not using condoms – aPR: 1.20, 95% CI: 1.05–1.36; and being an immigrant – aPR: 1.16; 95% CI: 1.07–1.25], while having knowledge of postexposure prophylaxis (aPR: 0.91; 95% CI: 0.84–0.98), having a casual sexual partner (aPR: 0.86 and 0.85; 95% CI: 0.74–0.99 and 0.74–0.98), and engaging in group sex (aPR: 0.81; 95% CI: 0.73–0.90) were associated with a lower intention to use PrEP. Conclusion: The intention to use PrEP among MSM who engage in chemsex was high, and several factors were associated with this intention. Understanding the factors associated with the intention to use PrEP among MSM practicing chemsex is crucial for developing targeted interventions to increase PrEP uptake in this population. The results of this study suggest that tailored approaches are necessary to promote PrEP use in this population.

The aim of the study was to assess the impact of the COVID-19 pandemic on the notification of new VL cases in Brazil in 2020. It is an ecological and time-series study (2015–2020) with spatial analysis techniques, whose units of analysis were the 5570 Brazilian municipalities. The study population consisted of all new cases of VL recorded between 2015 and 2020. The P-score was calculated to estimate the percentage variation in new VL cases. Global and local univariate Moran’s Indices and retrospective space–time scan statistics were used in spatial and space–time analyses, respectively. It was expected that there would be 3627 new cases of VL in Brazil in 2020, but 1932 cases were reported (−46.73%). All Brazilian regions presented a negative percentage variation in the registration of new VL cases, with the Southeast (−54.70%), North (−49.97%), and Northeast (−44.22%) standing out. There was spatial dependence of the disease nationwide in both periods, before and during the first year of the COVID-19 pandemic. There was a significant reduction in the incidence of new VL cases in Brazil during the first year of the COVID-19 pandemic. These findings reinforce the need for better preparedness of the health system, especially in situations of new epidemics.

Background: Vaccine hesitancy is a complex challenge that demands a comprehensive approach, one that not only acknowledges legitimate concerns within communities but also actively confronts misinformation. In this context, this study aimed to investigate the prevalence of belief in conspiracy theories about COVID-19 vaccines among Brazilians, seeking to understand the factors associated with this behavior. Method: Utilizing a national online survey conducted between May and August 2020, with a sample of 4247 participants, we conducted multivariate analysis to identify the independent determinants of this adherence, calculating adjusted prevalence ratios (APRs) and their 95% confidence intervals. Results: It was revealed that 27.7% of participants believed in at least one conspiracy theory. Factors associated with a higher level of adherence included agreement with at least one piece of COVID-19 misinformation on social media (APR: 3.65; 95% CI: 3.07–4.34), lack of difficulty accessing leisure activities during the pandemic (APR: 3.11; 95% CI: 1.85–5.24), age 50 years or older (APR: 1.70; 95% CI: 1.49–1.94), absence of difficulty accessing protective measures (APR: 1.47; 95% CI: 1.26–1.72), use of face masks (APR: 1.62; 95% CI: 1.33–1.97), non-use of at least one traditional media source for information (APR: 1.47; 95% CI: 1.26–1.72), female gender (APR: 1.41; 95% CI: 1.25–1.60), and age between 30 and 49 years (APR: 1.35; 95% CI: 1.19–1.52). Conclusions: Our findings highlight that it is crucial to recognize that vaccine hesitancy is not merely an isolated phenomenon but often rooted in a complex interplay of social, cultural, psychological, and political factors. There is a need for multifaceted strategies to combat vaccine hesitancy, effectively address conspiracy theories, and consider the various factors associated with their prevalence.

Background: Mpox is a viral zoonosis that has gained increased attention due to a global outbreak in 2022, significantly impacting men who have sex with men (MSM). Vaccination for this disease poses a public health challenge; because it carries a strong stigma, there may be greater hesitancy in vulnerable groups. Objectives: This study aimed to determine the prevalence and factors associated with Mpox vaccine hesitancy among Brazilian MSM. Methods: A cross-sectional study was conducted between September and December 2022 using an online survey targeted at MSM. Recruitment was carried out through social media and dating apps. The sample consisted of 1449 participants and the analysis involved bivariate logistic regression. Results: The prevalence of Mpox vaccine hesitancy was 7.57%. The significant factors associated with hesitancy were primarily related to sexual practices and attitudes towards Mpox exposure and diagnosis, such as not using “glory holes” (aOR: 19.82; 95% CI: 1.60–245.69), reluctance to undergo pre- and post-exposure testing for Mpox (aOR: 9.54; 95% CI: 5.52–16.48), and not knowing close contacts diagnosed with Mpox (aOR: 4.09; 95% CI: 1.72–9.73). Participants who would not take precautions after diagnosis (aOR: 3.00; 95% CI: 1.27–7.07) and those who would not disclose their serological status (aOR: 1.93; 95% CI: 1.13–3.30) also showed a higher likelihood of vaccine hesitancy. Conclusion: Public health strategies should address these factors to expand knowledge about vaccination barriers, plan educational campaigns with targeted messaging for the MSM population, and provide inclusive healthcare environments to increase vaccine acceptance and reduce Mpox transmission in vulnerable groups.

Background: In Brazil, men who have sex with men (MSM) are disproportionately affected by the HIV epidemic, mirroring global trends. Despite advancements in HIV prevention, such as pre-exposure prophylaxis (PrEP), uptake remains uneven among different MSM age groups, influenced by various sexual behaviors, risk perceptions, and social stigmas. Objective: This study aimed to investigate factors associated with PrEP intentions among Brazilian MSM across different age groups. Methods: A cross-sectional electronic survey was conducted with Brazilian MSM aged 18 years and above. Results: PrEP intentions were expressed by 55.1% (2390/4341) of participants. Among those under 25 years old, frequent barebacking was associated with a 25.4-fold higher prevalence of PrEP intentions (95% CI 18.18‐35.48). Conversely, having one or more casual sexual partners in the last 30 days (2164/3838) was associated with a 22% lower frequency of PrEP intentions (95% CI 0.72‐0.85). The practice of chemsex was also associated with a lower prevalence of PrEP intentions (adjusted prevalence ratio [aPR] 0.96; 95% CI 0.94‐0.98). Among individuals aged 25‐49 years, the practice of double penetration was associated with a higher prevalence of PrEP intentions (aPR 1.22; 95% CI .13‐1.32), as was being a receptive or versatile partner (aPR 1.27; 95% CI 1.04‐1.55 and aPR 1.23; 95% CI 1.01‐1.49). In addition, within this age range, a higher prevalence of PrEP intentions (over 10% 258/429]) was found among those with specific characteristics, such as a previous diagnosis of syphilis (aPR 1.12; 95% CI 1.03‐1.22). However, being single (aPR 0.90; 95% CI 0.83‐0.97) and having a partner who used PrEP (aPR 0.82; 95% CI 0.72‐0.93) were associated with a lower prevalence of PrEP intentions. For MSM aged ≥50 years, a higher prevalence of PrEP intentions was associated with the practice of double penetration (aPR 1.31; 95% CI 1.20‐1.43), as well as being a receptive (aPR 1.27; 95% CI 1.04‐1.55) or versatile partner (aPR 1.23; 95% CI 1.01‐1.50). The practice of group sex was independently associated with a lower prevalence of PrEP intentions exclusively among MSM aged ≥50 years (aPR 0.82; 95% CI 0.75‐0.89). Conclusions: The study highlights significant generational differences in factors influencing PrEP intentions among Brazilian MSM. It underscores the need for tailored HIV prevention strategies that consider the unique behaviors and perceptions of different age groups. By addressing these nuances, public health initiatives can more effectively promote PrEP use, catering to the diverse needs of the MSM community and contributing to the reduction of HIV infection rates.