“Amigos con beneficios”: salud sexual y estilos de apego de hombres y mujeres

Resumen Este estudio pretende analizar las variables relacionadas con la salud sexual de los individuos que pueden tener un impacto negativo en la asunción de riesgos - el uso de preservativo y el consumo de alcohol -; también pretende describir la prevalencia de infecciones de transmisión sexual y los estilos de apego que manifiestan hombres y mujeres en el marco relacional de amigos con beneficios. Para ello, se realiza un estudio transversal descriptivo. La información fue recogida mediante un cuestionario en línea y la escala de evaluación de los estilos de apego de Casullo y Fernández Liporace. En total, una muestra de 119 personas inmersas en una relación sexual casual con un amigo cumplimentaron el cuestionario. En relación a los resultados, casi el 30% de los participantes no han utilizado el preservativo en sus relaciones sexuales aduciendo razones asociadas al displacer e incomodidad; son las mujeres las que más padecen de infecciones de transmisión sexual; el consumo de alcohol ha constituido una práctica habitual en este tipo de relación. Aunque el apego seguro ha sido el más elevado, las mujeres se han mostrado temerosas. Amigos con beneficios puede entrañar graves consecuencias para la salud de los individuos y especialmente para las mujeres. Estos resultados recomiendan que desde la salud pública se preste atención a este novedoso vínculo sexual, así como la puesta en marcha de estrategias de promoción de la salud sexual dirigidas a las prácticas de riesgo de esta relación y a la mayor fragilidad afectiva y sexual de la mujer.

[Type of partner, socio-economic factors and risk practices in men who have sex with men]

OBJECTIVE

Men who have sex with men (MSM) perform risk practices that pose a challenge to prevention strategies. The aim of this study was to analyse the association between receptive and insertive unprotected anal intercourse (RUAI and IUAI) according to the type of partner and the practice of barebacking with socioeconomic factors.

METHODS

A descriptive study was conducted through a self-administered questionnaire distributed by a software tool in social networks and non-governmental organizations from June-2014 to January-2015. Participants consisted of 601 people living in Spain. Pearson's χ(2) test and logistic regression models were applied with odds ratios (OR) and 95% confidence intervals (95% CI).

RESULTS

In stable couples, the risk of RUAI increased in individuals with a medium income (OR: 1.79; 95%CI: 1.14-2.80) and in those who lived together (OR: 2.94; 95%CI: 1.74-4.98) and IUAI increased in individuals living with a partner (OR: 5.58; 95%IC: 3.24-9.59). When the partner was a friend, the risk of RUAI was higher among individuals with secondary education (OR: 2.20; 95%CI: 1.44-3.36) and those who were retired (OR: 3.6; 95%CI: 1.25-10.37), while living with a partner was a protective factor (OR: 0.56; 95%CI: 0.32-0.98). The risk of barebacking was greater in younger men (OR: 2.59; 95%CI: 1.27-5.28), in those with secondary education (OR: 1.51; 95%CI: 0.99-2.29) and in those living with a partner (OR: 3.64; 95%CI: 2.12-6.24).

DISCUSSION

There is a need to reduce vulnerability due to socioeconomic factors that influence engagement in risk practices and to highlight the importance of barebacking, mainly in young MSM. Partner-based interventions and harm reduction strategies should be incorporated into preventive strategies.

[Explanation of risky sexual behaviors in men who have sex with men]

OBJECTIVE

To explore views about risky sexual behaviors and perceptions of HIV, and to propose interventions for preventing HIV infections in a group of men who have sex with men.

METHODS

We performed a qualitative study in a sample of 13 men who have sex with men, who were participating in an HIV-seronegative cohort, and who we contacted via saunas for the gay community in Barcelona (Spain). We performed in-depth semi-structured interviews, followed by content analysis.

RESULTS

Risky sexual behaviors were associated with masculinity related to strong sexual needs, certain sexual exchange venues (such as saunas, private parties and clubs), drug use, and a desire to experiment with risk and one's own sexuality. HIV infection was perceived as a normalized disease, although becoming infected was still associated with shame and guilt. Proposed interventions included raising awareness of what it is like to live with HIV, generating greater social alarm, incorporating new technologies in prevention, and intensifying activity at gay venues.

CONCLUSIONS

The concept of masculinity plays a fundamental role in sexual practices among men who have sex with men. We suggest renewed innovation in preventive programs and incorporating the perception of risk and HIV infection from a gender perspective.