Condom use and reported diagnosis of STI in cisgender men, according to sexual orientation: an analysis based on the 2019 Brazilian National Health Survey

Abstract This study investigated condom use and the reported diagnosis of sexually transmitted infections (STIs) in men, aged 18 to 59 years, according their sexual orientation, based on data from the 2019 Brazilian National Health Survey (NHS). A total of 30,512 subjects were analyzed. Crude and adjusted Poisson regression models, with robust variance, were used to investigate the association between sexual orientation and condom use in the last 12 months and, during the last sexual encounter, as well as the reported diagnosis of STIs. Although in crude analyses, homosexual and bisexual men reported more condom use in the last 12 months and during the most recent sexual encounter, after adjusting for the variable of living with a partner in the models, these associations lost statistical significance. The reported STI diagnosis, however, remained more prevalent in homosexual and bisexual men, even after adjustments (aPR 4.69; 95% CI 2.76-7.99). Public policies for STI/HIV/AIDS prevention should shift from a logic of risky practices to the analysis of a broader context, including different types of relationships, their temporalities, and negotiations.