{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T18:16:07Z","timestamp":1790705767701,"version":"4.1.0"},"reference-count":28,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2025,12,12]],"date-time":"2025-12-12T00:00:00Z","timestamp":1765497600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Office of Research and Graduate Studies (Propp) at the Federal University of Mato Grosso do Sul (UFMS)\u2014Finance Code 001","award":["376\/2025"],"award-info":[{"award-number":["376\/2025"]}]},{"DOI":"10.13039\/501100002322","name":"Coordena\u00e7\u00e3o de Aperfei\u00e7oamento de Pessoal de N\u00edvel Superior\u2014Brazil","doi-asserted-by":"crossref","award":["001"],"award-info":[{"award-number":["001"]}],"id":[{"id":"10.13039\/501100002322","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Infectious Disease Reports"],"abstract":"<jats:p>Background: Men who have sex with men (MSM) in Brazil remain disproportionately affected by HIV. Combination prevention strategies, including Pre-Exposure Prophylaxis (PrEP), are critical, yet adherence remains a challenge. This study aimed to identify factors associated with the simultaneous practice of condomless anal sex and non-use of PrEP among Brazilian MSM. Methods: A national cross-sectional study was conducted in 2020 via an online questionnaire disseminated on social media and dating apps. The outcome was defined as reporting condomless anal sex and no PrEP use in the previous year. Bivariate and multivariate logistic regression analyses were performed. Results: Among 1357 MSM participants, a high proportion (69.4%) reported condomless anal sex without PrEP use. Factors significantly associated with this behavior included being younger (18\u201328 years; AOR: 2.59), identifying as homosexual (AOR: 6.04), bisexual (AOR: 5.30), or pansexual (AOR: 8.67), having a steady partner (AOR: 4.57), engaging primarily in receptive or insertive anal sex, and having a prior STI diagnosis (AOR: 1.49). Conclusions: The confluence of condomless sex and PrEP non-use reveals a significant vulnerability profile among young MSM in Brazil, even within steady relationships. These findings highlight the originality of examining this combined behavioral outcome and underscore the urgent need for targeted, culturally sensitive prevention strategies that address risk perception and enhance PrEP uptake to meet the UNAIDS 2030 goals.<\/jats:p>","DOI":"10.3390\/idr17060149","type":"journal-article","created":{"date-parts":[[2025,12,12]],"date-time":"2025-12-12T15:27:20Z","timestamp":1765553240000},"page":"149","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Factors Associated with Condomless Anal Sex and Absence of Pre-Exposure Prophylaxis (PrEP) Use Among Brazilian Men Who Have Sex with Men: A Cross-Sectional Study"],"prefix":"10.3390","volume":"17","author":[{"given":"Laelson Rochelle Milan\u00eas","family":"Sousa","sequence":"first","affiliation":[{"name":"Nursing Course, State University of Maranh\u00e3o, Coroata 65665-000, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patr\u00edcia Thais Cardoso da","family":"Silva","sequence":"additional","affiliation":[{"name":"Nursing Course, State University of Maranh\u00e3o, Coroata 65665-000, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Allan Araujo","family":"Rodrigues","sequence":"additional","affiliation":[{"name":"Nursing Course, State University of Maranh\u00e3o, Coroata 65665-000, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M\u00e1rcio Jos\u00e9 dos Santos","family":"Silva","sequence":"additional","affiliation":[{"name":"Nursing Course, State University of Maranh\u00e3o, Coroata 65665-000, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jos\u00e9 Carlos Vin\u00edcius Jansen de","family":"Paz","sequence":"additional","affiliation":[{"name":"Nursing Course, State University of Maranh\u00e3o, Coroata 65665-000, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Breno da Silva","family":"Oliveira","sequence":"additional","affiliation":[{"name":"Department of Nursing, Federal University of Mato Grosso do Sul, Coxim 79400-000, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1709-2143","authenticated-orcid":false,"given":"Daniel de Mac\u00eado","family":"Rocha","sequence":"additional","affiliation":[{"name":"Department of Nursing, Federal University of Mato Grosso do Sul, Coxim 79400-000, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8250-3773","authenticated-orcid":false,"given":"Maria","family":"Wiklander","sequence":"additional","affiliation":[{"name":"Division of Nursing, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, 171-77 Stockholm, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elucir","family":"Gir","sequence":"additional","affiliation":[{"name":"Ribeir\u00e3o Preto College of Nursing, University of S\u00e3o Paulo, Ribeirao Preto 14040-902, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0681-4721","authenticated-orcid":false,"given":"Renata","family":"Karina Reis","sequence":"additional","affiliation":[{"name":"Ribeir\u00e3o Preto College of Nursing, University of S\u00e3o Paulo, Ribeirao Preto 14040-902, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,12,12]]},"reference":[{"key":"ref_1","first-page":"e3890","article-title":"Inconsistent use of male condoms among HIV-negative men who have sex with other men","volume":"31","author":"Sousa","year":"2023","journal-title":"Rev. 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