Optimistic perception of HIV/AIDS, unprotected sex and implications for prevention among men who have sex with men, Sao Paulo, Brazil

Background: This study examines the association between optimistic perceptions about AIDS and unprotected sex among men who have sex with men (MSM) in the city of Sao Paulo, Brazil. Methods: A cross-sectional study was carried out among MSM in leisure areas of Sao Paulo in 2003. We interviewed 161 participants aged 18-30 years. Results: Thirty-nine per cent (95% confidence interval 32-47%) reported unprotected anal sex with steady or casual partners in the previous 6 months. The optimistic perception score created for this study was associated with unprotected sex (P = 0.01) and higher education (P = 0.02). The quartile with the most optimistic perception was 1.8 times more likely to engage in unprotected anal sex compared with the quartile with the least optimistic perception. Conclusion: This study suggests that the current situation regarding AIDS, which is seemingly favourable, may create optimistic perceptions leading to unprotected sexual practices. Prevention programmes, particularly for MSM, need to take this into account. (c) 2005 Lippincott Williams & Wilkins.