Luís Augusto Vasconcelos da Silva

A cibersexualidade e a pesquisa online: algumas reflexões sobre o conceito de barebacking

Este artigo e decorrente de uma pesquisa online sobre aspectos da sexualidade masculina, mais precisamente sobre as interacoes masculinas em novos contextos da epidemia de HIV/Aids. Busca discutir as possibilidades da internet como campo de pesquisa, considerando os aspectos socioculturais abertos pelas novas tecnologias de informacao. Este e o caso das praticas de barebacking, geralmente definido como sexo anal desprotegido de forma intencional. Mais especificamente, neste artigo, serao problematizadas algumas tensoes e ambiguidades conceituais do barebacking, sobretudo no que diz respeito ao sexo desprotegido entre parceiros fixos e entre parceiros ocasionais, de acordo com a discussao desenvolvida por alguns usuarios das comunidades do Orkut, no contexto brasileiro. Finalmente, destaca-se que os atores que se dizem barebackers nao sao, necessariamente, mais os mesmos, tampouco entendem o conceito da mesma forma, o que exige uma reflexao mais ampla sobre seus distintos usuarios e contextos de uso.

Barriers Along the Care Cascade of HIV-infected Men in a Large Urban Center of Brazil

Global and national HIV/AIDS policies utilize the care cascade to emphasize the importance of continued engagement in HIV services from diagnosis to viral suppression. Several studies have documented barriers that men experience in accessing services at specific stages of care, but few have analyzed how these barriers operate along the care cascade. Brazil offers a unique setting for analyzing barriers to HIV care because it is a middle-income country with a large HIV epidemic and free, universal access to HIV/AIDS services. Semi-structured interviews were conducted in 2011 with HIV-infected men (n = 25) receiving care at the only HIV/AIDS state reference center in Salvador, Brazil, the third largest city in the country. Interviews were transcribed and coded for analysis. Researchers identified barriers to services along the care cascade: health service-related obstacles (poor-quality care, lengthy wait times, and drug supply problems); psychosocial and emotional challenges (fear of disclosure and difficulty accepting HIV diagnosis); indirect costs (transportation and absenteeism at work or school); low perceived risk of HIV; and toxicity and complexity of antiretroviral drug (ARV) regimens. The stages of the care cascade interrupted by each barrier were also identified. Most barriers affected multiple, and often all, stages of care, while toxicity and complexity of ARV regimens was only present at a single care stage. Efforts to eliminate more prevalent barriers have the potential to improve care continuity at multiple stages. Going forward, assessing the relative impact of barriers along ones entire care trajectory can help tailor improvements in service provision, facilitate achievement of viral suppression, and improve access to life-saving testing, treatment, and care.

The meanings and practices of barebacking among Brazilian internet users

This article originates from an online ethnography on barebacking (intentional unprotected anal sex) in Brazil, between the years 2004 and 2008. More specifically, some elements or conceptual dimensions present in discussions on barebacking will be examined. Based on internet discussion forums and 23 open online interviews, using the Windows Live Messenger program, it was possible to organise the practice of barebacking into two principal modalities: more extensive and involving greater contact and partial or involving reduced risks. The individuals who practise bareback sex may experience situations that include various forms of barebacking during their lives, such as the men who contract HIV and try to develop strategies to reduce the risks in their sexual interactions by, for example, avoiding ejaculating inside their partner or trying to establish sexual relationships with men of the same serological status. Therefore, in general, the different motivations for barebacking constitute a frontier region (of tension) between the pleasure of sensory contact and the risk of infection. Beyond producing a dichotomy between pleasure and risk, the various meanings described by the potential barebackers must be taken into account.

Redução de riscos na perspectiva dos praticantes de barebacking: possibilidades e desafios

Este artigo discute uma modalidade de barebacking (sexo anal desprotegido) denominada de parcial ou com reducao de riscos. Esta discussao e decorrente de uma etnografia online sobre os sentidos e praticas de barebacking, no contexto brasileiro, entre os anos de 2004 a 2007. Entretanto, ao focalizar a reducao de riscos no barebacking, este artigo traz outras formas, praticas, possibilidades eroticas de realizacao e entendimento do mesmo. E o caso, por exemplo, quando alguns praticantes evitam ejacular dentro ou receber o esperma do parceiro, buscam ser mais receptivos ou insertivos ou manter relacoes sexuais desprotegidas com parceiros do mesmo status sorologico. Nessa direcao, torna-se importante discutir as possibilidades e limites de modelos alternativos de prevencao utilizados no cotidiano de diferentes pessoas, levando-se em consideracao as preferencias sexuais, dinâmica dos relacionamentos, crencas, discursos, experiencias e contextos interativos.

Práticas e sentidos do barebacking entre homens que vivem com HIV e fazem sexo com homens

Este artigo e decorrente de uma etnografia online sobre o barebacking (sexo anal desprotegido de forma intencional) no cenario brasileiro, entre os anos de 2004 e 2007. Mais especificamente, busca discutir a pratica e sentidos do barebacking entre homens soropositivos que fazem sexo com homens, considerando as implicacoes e conflitos vividos por eles a partir do momento em que se descobrem soropositivos apos o engajamento no sexo bareback. Para tal, utilizamos relatos produzidos em entrevistas abertas no MSN messenger, apos a criacao de uma pagina no orkut e participacao em suas comunidades sobre o barebacking. Apresentamos historias de tres homens, de diferentes regioes do pais, que praticavam o barebacking e passaram pelo processo da soroconversao. Nessas breves historias, destacamos algumas tensoes ou ambiguidades diante dos prazeres e das proibicoes ligados ao sexo sem camisinha, incluindo a culpa pelo engajamento no sexo desprotegido e o sentimento de liberdade produzido pelo mesmo.

Gender-based discrimination and unprotected receptive anal intercourse among transgender women in Brazil: A mixed methods study.

Introduction Discrimination related to gender identity may directly influence vulnerability to HIV through increased exposure to unprotected receptive anal intercourse (URAI). Little is known about the relationship between gender-based discrimination (GBD) and URAI with stable partners among transgender women. Methods This mixed-methods research began with a cross-sectional survey conducted between 2014 and 2016 with transgender women in Salvador, the capital city in one of the poorest regions in Brazil. Respondent-driven sampling was used to recruit the study population. GBD was defined through Latent Class Analysis. Additionally, 19 semi-structured interviews with participants were transcribed and analyzed through thematic content analysis. Results URAI with stable partners was commonly reported (37.3%). GDB was positively associated with URAI among stable partners (OR = 6.47; IC 95%: 1.67–25.02). The analysis of the interviews illustrated how GBD impacted transgender women in diverse ways. Experiences with GBD perpetrated by the family often initiated a trajectory of economic vulnerability that led many to engage in survival sex work. The constant experience with GBD contributed to participants feeling an immense sense of trust with their stable partners, ultimately diminished their desire to use condoms. Further, the high frequency of GBD contributed to poor mental health overall, though some participants said engagement in transgender advocacy efforts provided a vital source of resilience and support. Conclusion Our mixed-method study capitalizes upon the strengths of diverse data sets to produce a holistic understanding of GBD and URAI with stable partners. Furthermore, by confirming the association between greater GBD and URAI, we have demonstrated how GBD can impact condom negotiation in diverse relationships.

Factors associated with self-reported discrimination against men who have sex with men in Brazil

ABSTRACT OBJECTIVE To estimate self-reported discrimination due to sexual orientation among men who have sex with men (MSM) in Brazil and to analyze associated factors. METHODS A cross-sectional study of 3,859 MSM recruited in 2008–2009 with respondent driven sampling. Data collection conducted in health centers in 10 Brazilian cities. A face-to-face questionnaire was used and rapid HIV and syphilis tests conducted. Aggregated data were weighted and adjusted odds ratio estimated to measure the association between selected factors and self-reported discrimination due to sexual orientation. RESULTS The sample was predominantly young, eight plus years of schooling, pardo (brown), single, low-income, and identified themselves as gay or homosexual. The prevalence of self-reported discrimination due to sexual orientation was 27.7% (95%CI 26.2–29.1). Discrimination was independently associated with: age < 30 years, more years of schooling, community involvement and support, history of sexual and physical violence, suicidal thoughts, and unprotected receptive anal intercourse. CONCLUSIONS The prevalence of self-reported discrimination among MSM in Brazil is high. These results challenge the assumptions that MSM-specific prevention and support programs are not required or that health professionals do not need special training to address MSM needs.

Practices and meanings of barebacking among HIV-positive men who have sex with men

Este artigo e decorrente de uma etnografia online sobre o barebacking (sexo anal desprotegido de forma intencional) no cenario brasileiro, entre os anos de 2004 e 2007. Mais especificamente, busca discutir a pratica e sentidos do barebacking entre homens soropositivos que fazem sexo com homens, considerando as implicacoes e conflitos vividos por eles a partir do momento em que se descobrem soropositivos apos o engajamento no sexo bareback. Para tal, utilizamos relatos produzidos em entrevistas abertas no MSN messenger, apos a criacao de uma pagina no orkut e participacao em suas comunidades sobre o barebacking. Apresentamos historias de tres homens, de diferentes regioes do pais, que praticavam o barebacking e passaram pelo processo da soroconversao. Nessas breves historias, destacamos algumas tensoes ou ambiguidades diante dos prazeres e das proibicoes ligados ao sexo sem camisinha, incluindo a culpa pelo engajamento no sexo desprotegido e o sentimento de liberdade produzido pelo mesmo.

Prácticas y sentidos del barebacking entre hombres que viven con HIV e hacen sexo com hombres

Este artigo e decorrente de uma etnografia online sobre o barebacking (sexo anal desprotegido de forma intencional) no cenario brasileiro, entre os anos de 2004 e 2007. Mais especificamente, busca discutir a pratica e sentidos do barebacking entre homens soropositivos que fazem sexo com homens, considerando as implicacoes e conflitos vividos por eles a partir do momento em que se descobrem soropositivos apos o engajamento no sexo bareback. Para tal, utilizamos relatos produzidos em entrevistas abertas no MSN messenger, apos a criacao de uma pagina no orkut e participacao em suas comunidades sobre o barebacking. Apresentamos historias de tres homens, de diferentes regioes do pais, que praticavam o barebacking e passaram pelo processo da soroconversao. Nessas breves historias, destacamos algumas tensoes ou ambiguidades diante dos prazeres e das proibicoes ligados ao sexo sem camisinha, incluindo a culpa pelo engajamento no sexo desprotegido e o sentimento de liberdade produzido pelo mesmo.