Do Receio de Existir ao Direito de Conviver: reflexões e apontamentos sobre homossexualidade masculina, geração e transformações sociais

A proposta deste trabalho consiste em investigar a maneira pela qual homens de meia-idade, residentes em São Paulo, vivenciam e percebem a própria homossexualidade frente às transformações sociais ocorridas nas três últimas décadas. Neste sentido, são avaliados vários marcos como o advento da epidemia de HIV/AIDS e os pânicos morais que a doença suscitou; o surgimento das primeiras Paradas do Orgulho LGBT no Brasil; os recentes debates públicos envolvendo a legalização das uniões homoafetivas e a criminalização da homofobia. Ao mesmo tempo, problematiza o marcador “geração” e procura entender as diferenças que estes homens apontam existirem entre eles e os “mais jovens”

Interseções entre gênero, sexualidade e curso da vida

Apresentação do dossiê "Interseções entre gênero, sexualidade e curso da vida", organizado por Raphael Bispo, Carlos Eduardo Henning e Gustavo Santa Roza Sagges

Violência sexual contra homens no Brasil: subnotificação, prevalência e fatores associados

OBJECTIVES: Identifying and mapping the literature regarding sexual violence against Brazilian boys and men, as well as describing its underreporting, prevalence, and associated factors. METHODS: We conducted a scoping review by searching PubMed, Biblioteca Digital Brasileira de Teses e Dissertações, Biblioteca Virtual em Saúde, Scopus, and Web of Science databases. The inclusion criteria were: (a) surveys including data on sexual violence; (b) inclusion of boys or men as victims of sexual violence; (c) presenting statistical data on prevalence, underreporting, and factors associated with sexual violence among Brazilian boys and men. RESULTS: We found a total of 1,481 papers. Ultimately, 53 were included and had their data extracted. Most studies are quantitative in nature (n = 48). The total number of participants across studies was 1,416,480 and the prevalence of sexual violence ranged from 0.1% to 71%. It is important to note that underreporting statistical data was cited in several studies. The group with the highest prevalences was men who have sex with men and those with sexual dysfunctions. Increased tendency to drug use, social isolation, unprotected anal sex, suicidal ideation, sexual dysfunction, and post-traumatic stress disorder were statistically significant predictors for having experienced sexual violence. CONCLUSIONS: Despite the prevalence of sexual violence being high against Brazilian boys and men, this area of is surprisingly understudied and there are few studies with this exclusive scope. Social cultural issues, such as sexism, contribute to the underreporting of sexual violence. Additionally, we identified issues related to mental, sexual and reproductive health to be associated with sexual violence. Based on our findings, we recommend the implementation and development of a structural infrastructure aimed at supporting boys and men who are victims of sexual violence, and preventing negative outcomes for this affected group.OBJETIVOS: Identificar e mapear a literatura referente à violência sexual contra meninos e homens brasileiros, bem como descrever sua subnotificação, sua prevalência e os fatores associados. MÉTODOS: Realizou-se uma de revisão de escopo com buscas nas bases de dados: PubMed, Biblioteca Digital Brasileira de Teses e Dissertações, Biblioteca Virtual em Saúde, Scopus e Web of Science. Os critérios de inclusão foram: (a) pesquisas que incluíssem dados sobre violência sexual; (b) inclusão de meninos ou homens como vítimas de violência sexual; (c) apresentassem dados sobre prevalência, subnotificação e fatores associados à violência sexual entre meninos e homens brasileiros. RESULTADOS: Foram encontrados 1.481 trabalhos. No total, 53 foram incluídos e tiveram seus dados extraídos. A maioria dos estudos é de natureza quantitativa (n = 48). O total de participantes em todos os estudos foi de 1.416.480 e a prevalência de violência sexual variou de 0.1% a 71%. A subnotificação foi um aspecto citado em vários estudos. Entre os grupos com maiores prevalências estão os homens que fazem sexo com homens e com disfunções sexuais. Maior tendência ao uso de drogas, isolamento social, sexo anal desprotegido, ideação suicida, disfunções sexuais e transtorno de estresse pós-traumático foram alguns dos fatores associados. CONCLUSÕES: A violência sexual contra meninos e homens brasileiros é pouco estudada e existem poucos estudos com esse recorte exclusivo, apesar da prevalência de a violência sexual ser alta. Questões culturais, como o machismo, contribuem para a subnotificação da violência sexual. Em relação aos fatores associados, identificamos questões relacionadas à saúde mental, sexual e reprodutiva. Recomenda-se que seja estruturado acolhimento para meninos e homens vítimas de violência sexual, prevenindo ou minimizando desfechos negativos

Between losses and gains: male homosexuality, generation and social transformation in São Paulo

Baseada em pesquisa etnográfica envolvendo observação participante e entrevistas em profundidade realizadas entre 2011 e 2013, a proposta deste trabalho consiste em investigar a maneira pela qual homens de meia-idade provenientes de camadas médias e residentes na cidade de São Paulo experimentam e percebem transformações relativas à visibilidade homossexual ao longo de suas vidas e, mais especialmente, das últimas três décadas. A partir de uma análise dos discursos, tento construir junto aos interlocutores uma dialética que leva em conta tanto a experiência subjetiva de pertencimento a um grupo tradicionalmente marginalizado quanto a posição sócio-histórica que ocupam. Aqui, entram em jogo vários marcos, como o final da ditadura militar e a abertura política do Brasil, os pânicos morais suscitados pelo advento da epidemia de HIV/AIDS em meados da década de 1980 e a participação de alguns deles em movimentos sociais. Alvo de discussões acaloradas no cenário político nacional, exploro também suas posições sobre acontecimentos mais recentes, como o surgimento das Paradas do Orgulho LGBT e os embates envolvendo o reconhecimento das uniões homoafetivas e a criminalização da homofobia no país. Ao mesmo tempo, problematizo o marcador geração e procuro entender as diferenças que apontam entre eles e os mais jovens.Drawing on ethnographic research involving participant observation and in-depth interviews conducted between 2011 and 2013, this study investigates the way by which middle-class, middle-aged men from São Paulo experience and perceive transformations of homosexual visibility throughout their lives and most especially over the last three decades. Analyzing their discourses, I try to build with interlocutors a dialectic that takes into account both the subjective experience of belonging to a traditionally marginalized group and the socio-historical position they occupy. Various landmarks come into play, such as the end of the military dictatorship and the political openness in Brazil, the moral panics brought on by the emergence of HIV/AIDS epidemic in the mid-1980s and the participation of some in social movements. Subjects of heated debates in the national political scene, I also explore their positions on more recent events such as the emergence of LGBT Pride Parades and the clashes involving the recognition of same-sex unions and the criminalization of homophobic discrimination in the country. At the same time, I question the label generation and try to understand the differences they point between themselves and the younger

Anticipated Stigma and Social Barriers to Communication Between Transgender Women Newly Diagnosed with HIV and Health Care Providers: A Mediation Analysis

Purpose: We assessed whether anticipated stigma (i.e., fear of public mistreatment due to gender identity) impacts communication between transgender women (TGW) living with HIV and health care providers. Methods: This is a secondary analysis of baseline data from Trans Amigas, a study conducted in Brazil, 2018. The study population consisted of TGW living with HIV, older than 18 years, residing in the São Paulo metropolitan area. We used multivariable logistic regression (α = 0.05), mediation, and bootstrapping for the analysis. Results: One hundred and thirteen participants completed the study. Fear of public mistreatment had an adjusted odds ratio (aOR) of 7.42 (p = 0.003) for difficulty reporting new symptoms to providers. Concerning fear of public mistreatment, we found that unemployment had an aOR of 3.62 (p = 0.036); sex work, an aOR of 2.95 (p = 0.041); and issues related to name change in documents, an aOR of 2.71 (p = 0.033). For the indirect effect on difficulty reporting new symptoms, mediated by fear of public mistreatment, unemployment had an aOR of 1.52 (confidence interval [CI] = 0.88-2.24); sex work, an aOR of 1.48 (CI = 0.81-2.52); and name change issues, an aOR of 1.47 (CI = 0.96-2.43). Conclusions: Anticipated stigma was associated with communication difficulties between TGW living with HIV and providers. Our data suggest that structural factors associated with anticipated stigma could indirectly impact on difficulty reporting new symptoms. These findings indicate the importance of considering social contexts that intersect with individual experiences when analyzing communication barriers between providers and patients, and the need to strengthen social policies for TGW in Brazil. Clinical Trial Registration number: R34MH112177

Peer Navigation to Support Transgender Women's Engagement in HIV Care: Findings from the Trans Amigas Pilot Trial in São Paulo, Brazil.

Trans women living with HIV (TWH) have suboptimal HIV care engagement. We pilot tested Trans Amigas, a theory-based, trans-specific peer navigation (PN) intervention to address barriers to care in São Paulo, Brazil. TWH were randomized to the PN intervention (n = 75) or control (n = 38) condition. Control participants were referred to trans-friendly HIV care. Intervention participants were assigned a navigator who conducted nine in-person one-on-one sessions and bi-weekly phone or text check-ins to help participants overcome barriers to care and work towards gender affirmation and healthcare goals. We followed participants for 9 months to determine intervention feasibility, acceptability, and preliminary efficacy in improving retention in care. Analyses were intention to treat (ITT). Intervention acceptability was high: at end line, 85.2% of PN participants said they would continue receiving services and 94.4% would recommend peer navigation to a friend. A priori feasibility criteria were met: 92% of eligible participants enrolled and 70% were retained at 9 months; however, only 47% achieved moderate or better adherence to both in-person and phone/text program components. Though the pilot was not powered for efficacy, ITT findings trended toward significance, with intervention participants 40% more likely to be retained in care at the end of the study. Population-specific peer programming to support care engagement is acceptable, feasible, and can improve HIV outcomes for Trans women living with HIV

Prevalence, Characteristics, and Factors Associated With Sexual Violence in Adulthood Among Brazilian MSM

Most studies of sexual violence are with women, and although men who have sex with men (MSM) is the group of the men that has been most investigated for sexual violence, there are still several questions to be answered about sexual violence and sexual revictimization among MSM. This study aimed to estimate the prevalence of sexual violence in different stages of life and identify factors associated with sexual violence in adulthood among Brazilian MSM. We conducted an analysis with data from the study conducted in 2016 with 4,176 MSM from 12 Brazilian cities recruited through respondent-driven sampling (RDS), who answered a survey to a set of questions, among which some specific about sexual violence. Most participants were under 25 years old (56.5%), with more than 12 years of schooling (71.2%), mixed race (40.8%), single (86.2%), and belonging to some religion (50.9%). The lifetime prevalence of sexual violence was 20.3%. In our analyses, having experienced sexual violence in childhood and adolescence increased the odds of experiencing sexual violence in adulthood (prevalence ratio ratios [PRR] 4.93 (95% CI [1.99, 12.21]), as did experiencing physical violence (PRR 1.99; 95% CI [1.07, 3.71]) and receiving money for sex (PRR 2.26; 95% CI [1.17, 4.36]). In addition to violence in childhood and adolescence being risk factors for sexual violence in adulthood, we also observed that half of the sample experienced sexual violence repeatedly, characterizing sexual revictimization. It is important that health services are prepared to receive boys and men victims in order to reduce the chances of revictimization and other outcomes