Experiences of Stealth Breeding and Associated Factors to HIV Post-Exposure Prophylaxis Seek Among Gay Men in Brazil.

Objectives: Stealth breeding is the act in which a man, without the consent of their partner, removes the condom during sexual intercourse, breaking the previously established agreement and configuring an unprotected sexual relationship. The evolution of cases of infection by the Human Immunodeficiency Virus (HIV) remains worrying for public health, with prevention considered the only strategy for its control, especially with emphasis on Post-Exposure Prophylaxis (PEP) after an episode of sexual violence. Our goal was to analyze the stealth breeding experiences from the victims' perspectives and the associated factors with seeking PEP among gay men who experienced stealth breeding in Brazil. Methods: This quantitative study followed the conceptual references of intersectionality, health care, and masculinities. In total, a diverse sample of 601 gay cisgender men, all of whom suffered from a stealth breeding experience, from all regions of Brazil, aged between 18 and 61 years, responded to an online survey in 2023. Results: From this sample, 421 sought PEP after the experience, and 180 did not; Over 50% reported becoming infected with an STI. A multinomial logistic regression revealed that those who were victimized by a casual sex partner and those who disclosed the experience to others showed higher odds of seeking PEP in the aftermath of the stealth breeding. Conclusions: We concluded that stealth breeding is a reality in Brazil among gay men, which should generate more discussions about sexual violence among gay men and reduce the overall societal stigma that prevents them from seeking help and more emotional support, as well as seeking PEP after an episode of sexual violence.