Sexual behaviors, knowledge about STI, and health care access among young heterosexual and homosexual men
Conductas sexuales, conocimiento sobre ITS y acceso a la salud entre hombres jóvenes heterosexuales y homosexuales
Condutas sexuais, conhecimento sobre IST e acesso à saúde entre homens jovens heterossexuais e homossexuais
Vinícius Rodrigues Fernandes da Fonte; Thelma Spindola; Hugo de Andrade Peixoto; Sergio Corrêa Marques; Luciana Ramos Bernardes; Elisa da Conceição Silva Barros
Abstract
Objective to comparatively analyze sexual behaviors, knowledge about Sexually Transmitted Infections (STIs), and access to health services among young heterosexual and homosexual men.
Method a descriptive, cross-sectional, and quantitative study conducted with 200 young men aged 18 to 29 years (100 heterosexuals and 100 homosexuals) in social settings in Rio de Janeiro, Brazil. Data were collected through an anonymous questionnaire and analyzed using descriptive and inferential statistics.
Results heterosexual young men presented a lower mean age and reported a higher proportion of stable affective relationships compared to homosexual men. Conversely, homosexual men showed higher educational levels, a greater number of sexual partners, and more frequent use of alcohol and other drugs before sexual intercourse. They also demonstrated closer contact with health services, undergoing more HIV and STI testing, and seeking professional counseling more often. Regarding condom use, the practice was irregular in both groups.
Conclusion and implications for the practice the findings highlight the need for inclusive sexual education, non-stigmatizing healthcare environments, and intersectional policies that promote health equity.
Keywords
Resumen
Palabras clave
Resumo
Objetivo: analisar comparativamente as condutas sexuais, o conhecimento sobre as Infecções Sexualmente Transmissíveis (ISTs) e o acesso aos serviços de saúde entre jovens homens heterossexuais e homossexuais.
Método: estudo descritivo, transversal e quantitativo, realizado com 200 homens jovens de 18 a 29 anos (100 heterossexuais e 100 homossexuais) em locais de sociabilização na cidade do Rio de Janeiro, Brasil. Os dados foram coletados por meio de um questionário anônimo e analisados por meio de estatística descritiva e inferencial.
Resultados: os jovens heterossexuais apresentaram idade média mais baixa e relataram maior proporção de relacionamentos afetivos estáveis quando comparados aos homossexuais. Por outro lado, os homossexuais destacaram-se por apresentarem níveis mais elevados de escolaridade, maior número de parceiros sexuais e maior frequência de consumo de álcool e de outras drogas antes da relação sexual. Além disso, demonstraram maior aproximação com os serviços de saúde, realizando-se mais testagens para HIV e outras ISTs, bem como buscando-se com mais frequência o aconselhamento de profissionais. No que se refere ao uso do preservativo, observou-se que a prática se apresenta irregular em ambos os grupos.
Conclusão e implicações para a prática: os achados reforçam a necessidade de uma educação sexual inclusiva, acolhimento sem estigma e de políticas interseccionais que promovam a equidade em saúde.
Palavras-chave
Referências
1 World Health Organization. Sexually transmitted infections (STIs). Geneva: WHO; 2024 [citado 2024 nov 10]. Disponível em:
2 Gomes NL, Lopes CS. Panorama of risky sexual behaviors in the Brazilian adult population – PNS 2019. Rev Saude Publica. 2022;56:61.
3 Decreto-lei nº 12852, de 5 de agosto de 2013 (BR). Institui o Estatuto da Juventude e dispõe sobre os direitos dos jovens. Diário Oficial da União, Brasília (DF), 6 ago 2013.
4 Francisco MTR, Fonte VRF, Spindola T, Pinheiro CDP, Costa CMA, Rocha FCS. HIV testing and post-exposure prophylaxis among men who have/ do not have sex with men. Esc Anna Nery. 2021;25(3):e20200236.
5 Parmejiani EP, Queiroz ABA, Cunha MPL, Carvalho ALO, Santos GS, Bezerra JF et al. Riverside men’s knowledge and ways of acting regarding condom use. Texto Contexto Enferm. 2022;31:e20220155.
6 Fonseca BS, Rodrigues TFCS, Silva GM, Pimenta RA, Silva M, Furtado MD et al. A part of me knew this would happen one day’: experiences of young people with HIV/AIDS. Saude Debate. 2024;48(141):e8986.
7 Silva K, Brasil VP, Coelho B, Fermo VC, Amadigi FR. Ampliando horizontes na prevenção do HIV: percepções e práticas em torno da PrEP em uma capital brasileira. Interface. 2025;29:e240492.
8 Oliveira EA, Santos LA, Zucchi EM, Massa P, Grangeiro A, Couto MT. Gay and bisexual adolescents and other men who have sex with men: intersectionality and the PrEP care continuum. Rev Saude Publica. 2024;58(Suppl 1):11s.
9 Monteiro SS, Leal AF, Barbosa RM, Magno L, Neves ALM, Honorato IB et al. Sexual and reproductive health of adolescents and young people: identification of demands and experiences based on a qualitative study in communities in five Brazilian cities. Cad Saude Publica. 2025;41(4):e00047824.
10 Cegolon L, Bortolotto M, Bellizzi S, Cegolon A, Bubbico L, Pichierri G et al. Knowledge, prevention, and occurrence of sexually transmitted infections among freshmen from Italian universities. Int J Environ Res Public Health. 2022;19(2):897.
11 Guimarães MDC, Magno L, Ceccato MGB, Gomes RRFM, Leal AF, Knauth DR et al. HIV/AIDS knowledge among MSM in Brazil: a challenge for public policies. Rev Bras Epidemiol. 2019;22(22, Suppl 1):e190005.
12 Mansor N, Ahmad N, Rahman HA. Determinants of knowledge on sexually transmitted infections among students in public higher education institutions in Melaka state, Malaysia. PLoS One. 2020;15(10):e0240842.
13 Lederer AM, Vertacnik AL. Correlates of sexually transmitted infection knowledge among late adolescents. Sex Health. 2021;18(4):303-10.
14 Patel PK, Singh TB, Singh SK, Patel VS, Singh S. Awareness and knowledge of sexually transmitted infections and its associated factors among patients in Eastern Uttar Pradesh. J Biostat Epidemiol. 2024;10(2):179-91.
15 Felisbino-Mendes MS, Araújo FG, Oliveira LVA, Vasconcelos NM, Vieira MLFP, Malta DC. Sexual behaviors and condom use in the Brazilian population: National Health Survey, 2019. Rev Bras Epidemiol. 2021;24(Suppl 2):e210018.
16 Petry S, Padilha MI, Bellaguarda MLR, Vieira AN, Neves VR. The said and the unsaid in the teaching of sexually transmitted infections. Acta Paul Enferm. 2021;34:eAPE001855.
17 Ajayi AI, Ismail KO, Akpan W. Factors associated with consistent condom use: a survey in Nigerian universities. BMC Public Health. 2019;19:1207.
18 Soster AP, Souza MLA, Castro EK. Percepção de risco e comportamentos de saúde em relação ao sexo casual em universitárias. Psico-USF. 2021;26(1):117-28.
19 Monte LL, Rufino AC, Madeiro A. Prevalence and factors associated with risky sexual behavior among Brazilian school adolescents. Cien Saude Colet. 2024;29(2):e03342023.
20 Gallo MF, Nguyen NC, Luff A, Luong TN, Le VT, Casterline J et al. Effects of a novel erectogenic condom on men and women’s sexual pleasure: randomized controlled trial. J Sex Res. 2022;59(9):1133-9.
21 Noll M, Noll PRE, Gomes JM, Soares Jr JM, Silveira EA, Sorpreso ICE. Associated factors and sex differences in condom non-use among adolescents: Brazilian National School Health Survey (PeNSE). Reprod Health. 2020;17(1):139.
22 Chuy VS, Rajagopal G, Talluri R, Cheng AL, Dall L. Factors influencing contraceptive use among sexually active students U.S. Middle and High School Students, 2015 to 2019. Cureus. 2021;13(12):e20803.
23 Spindola T, Fonte VRF, Lima GSL, Moraes PC, Martins ERC, Soares BGS. Young male university students and condom use. Enferm Glob. 2022;21(67):185-220.
24 Chapin-Bardales J, Rosenberg ES, Sullivan PS, Jenness SM, Paz-Bailey G. Trends in number and composition of sex partners among men who have sex with men in the united states, national hiv behavioral surveillance, 2008-2014. J Acquir Immune Defic Syndr. 2019;81(3):257-65.
25 Aung ET, Chow EPF, Fairley CK, Hocking JS, Bradshaw CS, Williamson DA et al. International travel as risk factor for Chlamydia trachomatis infections among young heterosexuals attending a sexual health clinic in Melbourne, Australia, 2007 to 2017. Euro Surveill. 2019;24(44):1900219.
26 Damacena GN, Szwarcwald CL, Motta LR, Kato SK, Adami AG, Paganella MP et al. A portrait of risk behavior towards HIV infection among Brazilian Army conscripts by geographic regions, 2016. Rev Bras Epidemiol. 2019;22(22, Suppl 1):e190009.
27 Tavares MKB, Melo RLP, Evangelista DR, Silva JBNF. Sex education and vulnerability of application users, comparisons based on sexual orientation. Acta Paul Enferm. 2022;35:eAPE01397.
28 Castoldi L, Berengan MM, Both NS, Fortes VS, Pinheiro TV. HIV post-exposure prophylaxis in vulnerable populations: a retrospective longitudinal study in a public health outpatient clinic in Rio Grande do Sul, Brazil, 2015-2018. Epidemiol Serv Saude. 2021;30(2):e2020646.
29 Zeggagh J, Bauer R, Delaugerre C, Carette D, Fressard L, Charreau I et al. Incidence and risk factors for recurrent sexually transmitted infections among MSM on HIV pre-exposure prophylaxis. AIDS. 2022;36(8):1129-34.
30 Damacena GN, Cruz MM, Cota VL, Souza Jr PRB, Szwarcwald CL. Knowledge and risk practices related to HIV infection in the general population, young men, and MSM in three Brazilian cities in 2019. Cad Saude Publica. 2022;38(4):PT155821.
31 Ayhan CHB, Bilgin H, Uluman OT, Sukut O, Yilmaz S, Buzlu S. A Systematic Review of the Discrimination Against Sexual and Gender Minority in Health Care Settings. Int J Health Serv. 2020;50(1):44-61.
32 Ferreira BO, Bonan C. Opening the closets of access and quality: an integrative review on the health of LGBTT populations. Cien Saude Colet. 2020;25(5):1765-78.
33 Bay MB, Freitas MR, Lucas MCV, Souza ECF, Roncalli AG. HIV testing and HIV knowledge among men who have sex with men in Natal, Northeast Brazil. Braz J Infect Dis. 2019;23(1):2-7.
34 Zhou J, Yang L, Ma J, Jiang S, Liu Y, Sun Z. Factors associated with HIV testing among MSM in Guilin, China: results from a cross-sectional study. Int J Public Health. 2022;67:1604612.
35 Chaves AFL, Tavares TT, Costa EC, Maciel NS, Ferreira DS, Martins FVA et al. Knowledge, attitude and practice of African university exchange students about Sexually Transmitted Infections. Esc Anna Nery. 2022;26:e20210455.
36 Paganella MP, Motta LR, Adami AG, Sperhacke RD, Kato SK, Pereira GFM. Knowledge about sexually transmitted infections among young men presenting to the Brazilian Army, 2016. Medicine. 2021;100(22):e26060.
37 Visalli G, Cosenza B, Mazzù F, Bertuccio MP, Spataro P, Pellicanò GF et al. Knowledge of sexually transmitted infections and risky behaviours: a survey among high school and university students. J Prev Med Hyg. 2019;60(2):E84-92.
38 Werneck J. Racismo institucional e saúde da população negra. Saude Soc. 2016;25(3):535-49.
39 Galvão ALM, Oliveira E, Germani ACCG, Luiz OC. Determinantes estruturais da saúde, raça, gênero e classe social: uma revisão de escopo. Saude Soc. 2021;30(2):e200743.
40 Meyer IH. Prejudice, social stress, and mental health in lesbian, gay, and bisexual populations: conceptual issues and research evidence. Psychol Bull. 2003;129(5):674-97.
Aceito em:
05/03/2026

)