"Massive Increase of HIV Cases in Brazil in Young People"

[mvan1]

Headline from today's article - 

Massive Increase of HIV Cases in Brazil in Young People

https://riotimesonline.com/brazil-news/rio-politics/society/massive-increase-of-hiv-cases-in-brazil-in-people-between-15-and-24-years/

[docbr]

It’s a sad situation for gay youth in Brazil. With testing/treatment universal and free in Brazil, the image reported by media (conventional and new social media influencers) that HIV-infection is no more than a nuisance for the patient (often compared to hipertension or diabetes) and the late “conservative family-oriented” political turn over we are seeing fewer public policies to protect the youth from HIV and those skyrocket in numbers.

Folha de São Paulo newspaper cited a Health Minister survey that states that 1:4 (25%) of the “male who have sex with male” at 19-24 years old have HIV infection in São Paulo. 

These numbers are in hand with epidemiological reports that shows majority of new cases of hiv infection being gay males now in Brazil (heterossexual males where majority before, considering they outnumber gays by like 9:1).

When I open Grindr here everybody says it’s on PreP, but I think that’s hard to believe... Seems to me more a lure to bareback sex. 

On a side note, got two Garotos at the saunas this month being very insistent in having bareback sex... I always thought that the sauna garotos were more careful about HIV/STD than the average gay dude, most of being “heterossexual” and having families. Another change perhaps ? 

Edited May 10, 2019 by docbr
Typo

[rgb23]

This is happening in the states, too. When I'm topping, guys sometimes ask me to take off the condom. Yesterday a "straight" young man I met online said he wanted to feel me cum inside him... In the heat of the moment I gave him what he asked for, but he was taking a stupid risk for a reason I honestly don't understand. Maybe it's because these 20-somethings didn't watch half their friends sicken and die of AIDS back in the 90s.

[AdamSmith]

11 hours ago, rgb23 said:

This is happening in the states, too. When I'm topping, guys sometimes ask me to take off the condom. Yesterday a "straight" young man I met online said he wanted to feel me cum inside him... In the heat of the moment I gave him what he asked for, but he was taking a stupid risk for a reason I honestly don't understand. Maybe it's because these 20-somethings didn't watch half their friends sicken and die of AIDS back in the 90s.

I have done the very same thing. I knew I was negative, but he did not, and could not have. Very selfious to reinforce his dangerous delusional notions & instincts. 

[CaliPexx]

23 hours ago, docbr said:

When I open Grindr here everybody says it’s on PreP, but I think that’s hard to believe... Seems to me more a lure to bareback sex. 

That is indeed hard to believe. According to an article in the illustrious medical journal , Guia Gay São Paulo, even though PrEP has been offered by SUS (the Brazilian National Health Service) for people at risk since 2017, as of summer 2018 only 2,748 Brazilians had initiated PrEP, at least PrEP that is dispensed by the SUS. The SUS had sufficient supplies for another 4,200 to start PrEP. I doubt that many Brazilian MSM are obtaining PrEP through sources other than the SUS, because they would then have to pay the high retail cost of Truvada out-of-pocket.

23 hours ago, docbr said:

On a side note, got two Garotos at the saunas this month being very insistent in having bareback sex... I always thought that the sauna garotos were more careful about HIV/STD than the average gay dude, most of being “heterossexual” and having families. Another change perhaps ? 

That's a worrisome observation. As a confirmed passivo (bottom) who wishes to maintain his HIV negative status, I am keenly aware of the point during sex at which garotos don their camisinhas (condoms). Truth be told, I have never been with a GP who has not used a condom. And I've never had to ask him to do so. If the mores of condom use are, in fact, changing among the sauna boys in Brazil, as you imply is happening among Brazilian MSM in general, that would be concerning indeed.

[Walker]

I have been to a few sex clubs and sex parties in Brazil recently, I see a lot of barebacks.  I bet some people think HIV is no longer a life threatening disease.  Although it is  not curable, it can be treated as a long term disease, much like diabetes.  Personally I wouldn't take any risk, but some people have different views.

[likeohmygod]

On 5/11/2019 at 7:10 AM, CaliPexx said:

That is indeed hard to believe. According to an article in the illustrious medical journal , Guia Gay São Paulo, even though PrEP has been offered by SUS (the Brazilian National Health Service) for people at risk since 2017, as of summer 2018 only 2,748 Brazilians had initiated PrEP, at least PrEP that is dispensed by the SUS. The SUS had sufficient supplies for another 4,200 to start PrEP. I doubt that many Brazilian MSM are obtaining PrEP through sources other than the SUS, because they would then have to pay the high retail cost of Truvada out-of-pocket.

That's a worrisome observation. As a confirmed passivo (bottom) who wishes to maintain his HIV negative status, I am keenly aware of the point during sex at which garotos don their camisinhas (condoms). Truth be told, I have never been with a GP who has not used a condom. And I've never had to ask him to do so. If the mores of condom use are, in fact, changing among the sauna boys in Brazil, as you imply is happening among Brazilian MSM in general, that would be concerning indeed.

I think that the statistics is talking only about the free of cost PrEP therapy. It's not free for everyone, the cost depends on the income you have, and even in the worst case, is no more expensive than Paracetamol. I saw many friends of me in Brazil and even some GPs taking PrEP.

At the same time, there's a lot of people who don't take it and there's a lot of BB sex going on.

[Badboy81]

On 5/10/2019 at 10:34 AM, rgb23 said:

In the heat of the moment I gave him what he asked for, but he was taking a stupid risk for a reason I honestly don't understand.

But shouldn't you have known better being somebody that did watch your friends die from AIDS related complications?

If they are so eager to have you do that with them, assume you arent the only one....

[Badboy81]

On 5/10/2019 at 1:32 AM, docbr said:

On a side note, got two Garotos at the saunas this month being very insistent in having bareback sex... I always thought that the sauna garotos were more careful about HIV/STD than the average gay dude, most of being “heterossexual” and having families. Another change perhaps ? 

That is very strange and would automatically make me not want to deal with said sauna worker...if they are out here risking their own lives, that means they are also willing to risk the lives of others....

[asdsrfr]

Well I always use condoms --100%.   Recently two friends who are on PREP were in Rio and they really wanted to have bareback sex and they had a hard time finding garotos who were in to that--and their impression was that all the garotos played with condoms only. I guess it depends on the night, the client , and the $$.

 

[Tomcal]

2 hours ago, asdsrfr said:

Well I always use condoms --100%.   Recently two friends who are on PREP were in Rio and they really wanted to have bareback sex and they had a hard time finding garotos who were in to that--and their impression was that all the garotos played with condoms only. I guess it depends on the night, the client , and the $$.

 

I think it depends more on how well they know the client. For the last 2 or 3 years I have been offered bareback sex by sauna guys who regularly work Pointe and 117 and I am not asking, I would estimate 75% of the time! I say no that's ok let's use them, but I don't get into to conversations about as to why they are offering.  Also better then 1/2 the 3 and 4 ways when they are doing each other it is usually condomless! So the old adage "being forwarned is being forwarded" or something like that! (The guys in Mexico have also gotten very free about condomless sex)

[likeohmygod]

Can quote tomcal 100%. BB sex between Garotos in "x-ways" is common, the guys know and trust each other.

Many guys once they know you and if they like you (physically), will offer BB sex. Just decline the offer if you're not into it.

As I said, I have personally seen many of the regulars I am spending time with in RJ or SP, taking prep. The percentage increases between the guys who are openly gay or bisexual.

For sure, I wanna add something obvious... having BB sex with a sex worker that you don't know while you are not taking prep and testing regularly is a very stupid thing.

I can also tell you that in Bogotá and Medellín I was offered BB sex from the 95% of the guys.

Edited May 13, 2019 by likeohmygod

[Riobard]

Just a small request, please. This discussion is very interesting, but I can understand the trends (eg anecdotal reports here) better if reference is made to when the BB offer or proposal from the Brasileiro is receptive anal (he bottoms), insertive anal (he tops), or perhaps reciprocal. 

————-

Most ‘garotos’ I select identify as ‘ativo’ exclusively but I am flexible about ‘versatil’ role. I always at some point put on a condom because “you never know” if they will accept receptive, as long as they do not have to explicitly verbally agree. It is fascinating to witness the reactions. Usually they freak out and I have to calm down the drama. What is particularly amusing is the idea that I could subdue and pin down any of these guys. I assume their vehement protest is related to my apparent bold assumption they “look” or “behave” gay enough to take it up the ass after all.

However, some will go down on it, with the condom on me, although that had not been part of the sealed deal.

A renowned exclusive top at 117 I have gone with for a few years recently shocked me by allowing me to frottage between his perfect butt cheeks with his face smooshed down on the mattress, with me wearing a condom. Sometimes edging a little beyond the forbidden is half the fun. 

——-

More on topic, I have had no BB offers among any of encounters now having reached 3 figures.

PrEP uptake that is governmentally financed is a huge hurdle among the “straight” working guys. They are required to go to the relevant health station and declare that they are either having sex with men or are doing commercial sex work presumably with male clientele. There is no face-saving box to tick off, ie, “just a gigolo”. 

Edited May 13, 2019 by Riobard

[rgb23]

20 hours ago, Badboy81 said:

shouldn't you have known better being somebody that did watch your friends die from AIDS related complications?

Yes. I do know better. I've used rubbers religiously for decades. He was so hot and I was halfway to the finish line when he asked me to lose the rubber. I'm an old man and not used to being desired like that these days. Scary how easily I lost control...

[Badboy81]

44 minutes ago, rgb23 said:

Yes. I do know better. I've used rubbers religiously for decades. He was so hot and I was halfway to the finish line when he asked me to lose the rubber. I'm an old man and not used to being desired like that these days. Scary how easily I lost control...

Not judging YOU but there is a saying..."There is no fool like an old fool..."

[Riobard]

At the decision juncture, then, it is proverbially the elder who apparently should know better and be expected to model prudence by explicitly, politely, calmly, verbally, taking a pass on the offer or request; taciturn seamless condom application as though this is the most natural acceptable norm and not up for discussion; or attempting to engage in an instructive dialogue about risk and safety.

This third option reminds me of the proverb: *Fools rush in where angels fear to tread.* It is a challenge because many younger people know everything whilst not knowing what they don’t know. 

I believe on-the-spot HIV test kits are available in Brazil. I suggest scooping up a supply so that if any one ‘garoto de programa’ importunes for bareback, the client shove one in his face saying “you will be needing this”. Or alternatively, “your choice buddy ... condom or needle prick, unless you plan to be among the 15,000 AIDS deaths in Brazil during some future calendar year”. 

Who is in the best position, holding the money and power, to add STD awareness and openness to education as an added precondition for playcheque?

Public health campaigns are obviously failing and brothel owners be like honey badger don’t give a shit.

[mvan1]

14 minutes ago, Riobard said:

At the decision juncture, then, it is proverbially the elder who apparently should know better and be expected to model prudence by explicitly, politely, calmly, verbally, taking a pass on the offer or request; taciturn seamless condom application as though this is the most natural acceptable norm and not up for discussion; or attempting to engage in an instructive dialogue about risk and safety.

This third option reminds me of the proverb: *Fools rush in where angels fear to tread.* It is a challenge because many younger people know everything whilst not knowing what they don’t know. 

I believe on-the-spot HIV test kits are available in Brazil. I suggest scooping up a supply so that if any one ‘garoto de programa’ importunes for bareback, the client shove one in his face saying “you will be needing this”. Or alternatively, “your choice buddy ... condom or needle prick, unless you plan to be among the 15,000 AIDS deaths in Brazil during some future calendar year”. 

Who is in the best position, holding the money and power, to add STD awareness and openness to education as an added precondition for playcheque?

Public health campaigns are obviously failing and brothel owners be like honey badger don’t give a shit.

You are a bright guy and probably nice on top of that. 

However, your writing is unnecessarily difficult to read.  

By way of example in the first paragraph of your post that I quoted above YOU HAVE 64 WORDS in the first paragraph. 

Not even a textbook would contain 64 words in a paragraph.  

If you want most others to understand your input, you should shorten your paragraphs by not including several different subjects and thoughts.   Sixty-four words in a casual paragraph are unreasonable.   

Please do not feel offended by my observation and suggestion. 

If you want people to understand your posts, you should break each thought and/or subject into a separate paragraph.  

[Riobard]

I no longer work with Microsoft Word program, so I do not run my pieces through Flesch-Kincaid reading grade level.

The first paragraph is actually one sentence with three points separated by semi-colons.

If it were PowerPoint, they would likely be presented as three bullet points. 

I am going to leave it up to the reader to mentally organize the structure for their consumption, should they choose to accept the mission.

Interestingly, this thread contains information about research studies.

I can assure you that research summary abstracts, including all of my several publications in peer-reviewed journals, contain well beyond 64 words.

As you know, the abstract sentences are often clustered together.

Sometimes the meat, potatoes and veggie sides are separated out on the plate, typically four headings but nevertheless usually single-spaced.

Each periodical conforms to one of a handful of stylistic preferences. 

I often take the time to read entire journal articles that are referenced here on the Board, beyond the news summaries.

I usually do not distract myself with word count. 

Such reading requires more than the average 64-second attention span, a liberal estimate, that is today's trend in focused attention to written material.

The 64-dollar question is: how does one package content to everyone's penultimate satisfaction? 

The answer is simple.

One cannot.

Edited May 14, 2019 by Riobard

[SolaceSoul]

The saying that should be repeated here is, “those who know better, do better.”

If you are a man of a certain age from a first- or second-world developed country, and you also have the means and ability to travel abroad, then you damn.well should already know about the risks of transmission from bareback sex of not only HIV, but other potentially deadly or chronic STDs (whether treatable or not — are we just going to forget about the rise in the USA in STD transmission since the use of PreP — some of which are becoming resistant to antibiotics?). There’s been a recent explosion in meningitis cases in men who have sex with men.

https://www.vox.com/platform/amp/science-and-health/2018/5/22/17376742/truvada-prep-hiv-stds

I’ve had several Brazilian garotos and non-garoto (and in other countries) dates offer me bareback during the “heat of passion”, which I always refuse. If I had to estimate, the percentage who have offered it is maybe 10% — still too high (even one is too high). I’m 48, and started going out to gay clubs in the 80s — so, I’m old enough to remember watching men drop like flies weekly, but still young enough to be considered like an uncle or older brother to some of these brasileiros. So, it isn’t that hard for me to sit one down after he offers me bareback to tell him to be careful about doing that with someone, just because you think they’re “clean” because of how they look or because of what first-world country they are from. 

I made it through the Plague Period without ever seroconverting to HIV+ status (fortunately, and probably because back then, I wasn’t having any intercourse with men, which probably saved my life) , but I saw enough death and tragedy from friends and clubgoer colleagues who did — and at the time, it WAS considered a “death sentence”. So, I’ll be damned if after making it through that dark period unscathed, that I do something (or allow someone to do something) that is high-risk behavior for me or themselves. 

The harsh truth is that while some here are demonizing the garotos for unsafe sex practices, some of the clients and tourists participate in riskier sex than the garotos — and this is how HIV and other STDs are transmitted. As “hot” as the garoto you’re with may be to you, he’s also been with quite a few of those same clients that you’d rather not fuck. That mental image right there is enough to sober me up. 

Edited May 14, 2019 by SolaceSoul

[BlkSuperman]

@SolaceSoul, you hit the nail right on the head with this response.  Weve had garatos tell us that because they really like my husband and myself, they would have sex with us bareback. We were shocked considering the amount of men they sleep with in a day, week or month. Weve visited last year in June of 2018 and about 2 of the guys we saw when we were there in March of 2019 look sickly and frail. One guy, a favorite of mine, I didnt even recognize at the sauna in March. 

[SolaceSoul]

6 minutes ago, BlkSuperman said:

Weve visited last year in June of 2018 and about 2 of the guys we saw when we were there in March of 2019 look sickly and frail. One guy, a favorite of mine, I didnt even recognize at the sauna in March. 

If you think that’s gross, take a look at some of the clients or customers. 

[Riobard]

Viral hepatitis infection likely accounts for a significant proportion of the health decline features such as the wasting among known guys described here.

The infection rates, for HBV for example, are high among MSM in Brazil, and follow-through for inoculation series beyond the initial vaccination dose is very poor.

This is particularly disturbing because it is one of the few potentially serious sexually transmitted diseases that is medically preventable. 

[CaliPexx]

An interesting report about HIV among Brazilian men who have sex with men (MSM) appeared in June 2018 in Folha de São Paulo about a paper that had just been published in a peer-reviewed medical journal, International Medicine. The study included 4,176 MSM from all social strata and age brackets in 11 Brazilian capitals. Each participant had two interviews and HIV tests and half of the participants reported that this was the first HIV test they had ever received. 83.1% of the considered themselves gay, 12.9% heterosexual or bisexual and 4% "others". Of the total, 75% were having sex only with men.

3,958 of the participants agreed to be tested and, taking all of the participants in the Brazilian cities as an aggregate, 18.4% were HIV-positive compared to 12.1% in a study set up in the same way in 2009. Of all of the Brazilian capitals in the study, São Paulo ranked first, with 1 in 4 MSM HIV-positive. Rio de Janeiro had an HIV-infection rate near the middle of the pack at 15.3%. Among MSM 15-19 years old, the rate of HIV infection had tripled since 2009, going from 2.4 to 6.7 per 100K inhabitants. Among MSM age 20-24, the rate had doubled from 15.9 to 33.1 cases per 100K inhabitants.

The authors wrote that Brazilian MSM are experiencing a "second wave" of the HIV/AIDS epidemic. The factors they hypothesized for this increase included:

• The reduction of HIV prevention campaigns in Brazil related to the economic crisis.
• The anti-sexuality instruction in schools movement of the Brazilian extreme-right [and this was even before Jair Bolsonaro became president and, as one of his first policies in office, acted to remove sex and diversity education in Brazilian schools].
• The rise of social media, giving MSM the ability to have many more sexual encounters.
• The fact that young MSM don't remember what the worst years of the AIDS epidemic were like and never met anyone seriously ill with complications of HIV/AIDS.
• The [false] notion that HIV has been cured by current medications, losing the fear of death has led to a "relaxation of preventive measures".

They provide this telling quote: "Young [Brazilian] men think of themselves as supermen, who'll never get sick, and so they don't seek out health care services."

[Riobard]

Thanks ... the journal is simply Medicine (pub Wolters Kluwer Health), not International Medicine, for those digging for it.

[Riobard]

The published article is bothering me because there are dozens of researchers collaborating and not one of them, or the periodical's peer reviewers, caught the error in the Introduction, in which their incorrectly provided (or typed erroneously in the manuscript submission) figures suggesting that the 'stable, contained' prevalence in the Brasilian general population is greater than 10 times that of young men, and greater than 50 times that of male youth (late teens). By extension, the error puts the subgroup-specific by general population prevalence rates at about .037% and .0074% respectively. These would be considered puny stats outside of wildfire Ebola or SARS. 

In any case, a government sycophant in the current political climate with half a brain can spin the data just as easily, or capitalize on the errors and inconsistencies, promoting a dismissive attitude about increased infection rates in tandem with gay-'blashming'.

Moreover, some of the references do not seem to fit the content. This is sometimes more often the case when a 'reference manager' program or OCD human editor is not utilized for numbered references as opposed to alphabetical by first author. 

Oh well, maybe the report will yield some heightened awareness and action.