Revisiting the Use of Condoms in Brazil

ABSTRACT

Introduction:It is known that a single prevention strategy is not enough to control multiple HIV epidemics around the world and in Brazil. However, it is not only necessary to recognize the importance of condoms as part of the policy of HIV/AIDS prevention but also discuss its limits. In this article, we aim to investigate the use of condoms in Brazil, draw critical reflections, and understand how they can once again be highlighted in Brazil's prevention strategy going forward.

METHODS:

A narrative review of literature was conducted using keywords in PubMed. Reports from national surveys that guide the epidemiological and behavioral surveillance of the Brazilian Ministry of Health were also included.

RESULTS:

A total of 40 articles and 3 reports were included in the review and 11 intervention studies to promote the condom use; the main findings were as follows: 1) Despite the increase in national studies on sexual behavior, little attention is given to the role of condom use; 2) There are few studies examining the factors associated with condom use among key populations such as men who have sex with men (MSM), female sex workers (FSW), drug users (DU), and transvestites and transexuals (TT), while substantial studies focus on adolescents and women; 3) Evidence suggests that a combination of interventions is more effective.

DISCUSSION:

new prevention technologies must not lose sight of the critical importance of condoms, and efforts to reintroduce them should focus on the role of pleasure in addition to their potential to minimize the risk of HIV.

Table 2 Factors associated with condom use by different population groups. 

Fatores	General Population	MSM	Sex workers	Drug users	Teens	Women	Indians	Seniors	Conscripts
Associated with increased condom use
Male	X	X
Younger ages	X	X	X
Higher education	X
Multiple partners in the recent past	X	X	X	X
Single	X	X
With casual partners (vs. fixed or regular partners)	X
Mother's education > 8 years	X
Having or buying condoms	X	X
Already took condoms for free	X
Associated with decreased condom use
Married or in a stable relationship	X	X
Initiation of sexual activity before 14 years	X	X
Not informed about HIV/AIDS	X
Negative attitudes toward condom	X
Not knowing someone with AIDS and not engaging in gay NGOs	X
Being MSM	X
Contradictory results
Years of schooling	X
Religion	X
Socioeconomic status	X
Other factors relevant to the groups, but no quantification of the effect on condom use
Incorrect beliefs about the use of condoms and STDs	X	X
Condom use as contraceptive	X
Gender relations	X	X
Situations of violence	X

X: indicates association with the specific category; MSM: men who have sex with men.

Purchase full article at:  http://goo.gl/e7BHSo  [Article in English, Portuguese]

By:  Dourado I1, MacCarthy S2, Reddy M2, Calazans G3, Gruskin S2.

• 1Instituto de Saúde Coletiva, Universidade Federal da Bahia, Salvador, BA, Brazil.
• 2Program on Global Health and Human Rights, University of Southern California, Los Angeles, CA, USA.
• 3School of Medical Sciences, Santa Casa de São Paulo, São Paulo, SP, Brazil. 

More at:  https://twitter.com/hiv_insight

And:        http://twitter.com/Prison_Health