‘Just getting by’: a cross-sectional study of male sex workers as a key population for HIV/STIs among men who have sex with men in Peru

Abstract

Objectives To describe the socio-demographic and sex work characteristics, recent sexual practices, HIV risk perception and testing history, and HIV and syphilis prevalences of Cercado (downtown) and non-Cercado (close urban) male sex workers (MSWs) in Lima, Peru. Methods Eighty-nine MSWs completed a self-administered survey and participated in HIV and syphilis testing. Results Cercado MSWs had significantly lower median weekly earnings than non-Cercado MSWs (US $43 versus $72, p=0.04). Most non-Cercado MSWs (81%) reported only insertive anal intercourse with male/transgender partners, while Cercado MSWs primarily reported only insertive (52%) or both insertive and receptive (45%) anal intercourse (p=0.03). Consistent condom use was low with insertive and receptive anal intercourse in both sub-groups. Among MSWs with recent female partners, condom use with the last partner was lower among Cercado versus non-Cercado MSWs for vaginal sex (37% versus 65%, p=0.04) and anal sex (27% versus 80%, p=0.01). More Cercado than non-Cercado MSWs (57% versus 42%) perceived high HIV risk (p=0.05) and Cercado MSWs had a much higher prevalence than non-Cercado MSWs of HIV [23% versus 4% (p = 0.04)] and syphilis [22% versus 0% (p = 0.02)] infections. Conclusion MSWs in Lima are diverse and Cercado MSWs are “just getting by,” engaging in more risk behaviors, and more likely to have HIV/STIs. Future research should identify, describe and HIV/STI test broader groups of MSWs and their client and non-client partners. Prevention efforts should provide HIV/STI risk reduction education for MSWs and related sub-groups who are currently not targeted such as female partners.

Health-information needs of HIV-positive adults in Latin America and the Caribbean: an integrative review of the literature

“…Women and MSM were both noted to have distinct information needs from heterosexual men, a finding that may be related to gender roles and stigma in particular cultural settings (Zunzunegui, Alvarado, Béland, & Vissandjee, 2009). Information needs of other groups that have been identified as high risk in LAC, such as transgender women, intravenous drug users, male and female sex workers, and married women (Bayer et al, 2014; De Boni et al, 2014; García et al, 2014), were not specifically addressed in the included studies. Because differences in health-information needs were evident across subgroups, additional research focusing on these specific high-risk individuals is warranted.…”

Is Intimate Partner and Client Violence Associated with Condomless Anal Intercourse and HIV Among Male Sex Workers in Lima, Peru?

“…(3,4) Existing yet limited HIV prevention efforts in Peru have focused on MSWs, who have specific social, cultural, and behavioral characteristics that place them at high risk for acquisition and transmission of HIV and sexually transmitted infections (STIs). (5)…”

“…(6) Globally, MSWs have been shown to have numerous (7) and diverse sexual contacts, (8) high rates of sex without a condom, high prevalence of STIs, (5) and high rates of substance abuse. (9) In Peru, existing research shows additional factors that place MSM and MSWs at high risk of HIV acquisition, including work location, (10) sexual role, (11) and high risk sexual networks.…”

The Changing face of HIV in Latin America and the Caribbean

“…A small study that compare 89 Cercado (downtown) and non-Cercado (close urban) MSM sex workers. found much higher HIV prevalence among the Cercado (23%) versus non-Cercado sex workers (4%) (29). No data are available for Venezuela.…”