High Rates of Unprotected Receptive Anal Intercourse and Their Correlates Among Young and Older MSM in Brazil

Department of Surveillance, Prevention and Control of Sexually Transmitted Infections, HIV/AIDS and Viral Hepatitis, of the Secretariat for Health Surveillance of the Brazilian Ministry of Health Universidade Federal de S?o Jo?o del-Rei. Divinopolis, MG, Brazil. Universidade Federal de Minas Gerais. Departamento de Medicina Preventiva e Social. Belo Horizonte, MG, Brazil. Fundacao Oswaldo Cruz. Instituto Aggeu Magalhaes. Recife, PE, Brazil. Universidade Federal da Bahia. Instituto de Sa?de Coletiva. Salvador, BA, Brasil. Faculdade de Ci?ncias Medicas Santa Casa de S?o Paulo. S?o Paulo, SP, Brazil. Tulane University. School of Public Health and Tropical Medicine. New Orleans, LA, USA / Universidade Federal do Ceara. Dept Community Hlth. Fortaleza, CE, Brazil. Universidade Federal do Ceara. Dept Community Hlth. Fortaleza, CE, Brazil. Universidade Federal do Rio de Janeiro. Rio de Janeiro, RJ, Brasil. Funda??o Alfredo Mata. Manaus, AM, Brazil. Funda??o Oswaldo Cruz. Recife, PE, Brazil. Funda??o Oswaldo Cruz. Recife, PE, Brazil. Funda??o Oswaldo Cruz. Campo Grande, MS, Brazil / Universidade Federal de Mato Grosso do Sul. Campo Grande, MS, Brazil. Universidade Federal do Rio Grande do Sul. Porto Alegre, RS, Brazil. Universidade Federal do Rio Grande do Sul. Porto Alegre, RS, Brazil. Universidade de Brasilia. Brasilia, DF, Brazil. Universidade de Brasilia. Brasilia, DF, Brazil. Faculdade de Ci?ncias Medicas Santa Casa de S?o Paulo. S?o Paulo, SP, Brazil. Universidade Federal da Bahia. Salvador, BA, Brasil. Universidade Federal do Ceara. Project PI. Fortaleza, CE, Brazil. Centro Universit?rio Aut?nomo do Brasil. Curitiba, PR, Brazil. Universidade Federal de Minas Gerais. Belo Horizonte, MG, Brazil. Universidade Federal do Ceara. Fortaleza, CE, Brazil. Universidade Federal do Ceara. Fortaleza, CE, Brazil. Secretaria Sa?de Cear?. Fortaleza, CE, Brazil. Tulane University. New Orleans, LA, USA / Universidade Federal do Ceara. Fortaleza, CE, Brazil. University of California San Francisco. San Francisco, CA, USA. University of California San Francisco. San Francisco, CA, USA. Minist?rio da Sa?de. Departamento de Vigil?ncia, Preven??o e Controle das IST, do HIV/Aids e das Hepatites Virais. Brasilia, DF, Brazil. Minist?rio da Sa?de. Departamento de Vigil?ncia, Preven??o e Controle das IST, do HIV/Aids e das Hepatites Virais. Brasilia, DF, Brazil. Minist?rio da Sa?de. Departamento de Vigil?ncia, Preven??o e Controle das IST, do HIV/Aids e das Hepatites Virais. Brasilia, DF, Brazil. Universidade do Estado Bahia. Departamento de Ci?ncias da Vida. Salvador, BA, Brazil. 16IEC The aim of this study was to estimate the prevalence and factors associated with unprotected receptive anal intercourse (URAI), stratified by age (18-24 or 25 + years old), in a sample of 4,129 MSM recruited by respondent driven sampling in 12 Brazilian cities in 2016. The prevalence of URAI was higher among younger MSM (41.9% vs 29.7%) (p < 0.01). Multivariate analysis indicated that perception of risk, sexual identity, self-rated health status, and having commercial sex were associated with URAI among younger MSM. History of sexual violence, sex with younger partners, having 6 + partners and unprotected sexual debut were associated with URAI among older MSM. Marital status, having stable partner, and reporting sex with men only were associated with URAI in both groups. Despite access to condoms and lubricants, preventive efforts may not be reaching MSM effectively. Age specific intervention approaches, including stigma, discrimination, and perception of risk must be considered.