New Populations at High Risk of HIV/STIs in Low-income, Urban Coastal Peru

Cáceres, Carlos; Konda, Kelika A.; Salazar, Ximena; León, Segundo R.; Klausner, Jeffrey D.; Lescano, Andrés G.; Maiorana, André; Kegeles, Susan M.; Jones, Franca R.; Coates, Thomas J.; Trial, Std Collaborative Intervention

doi:10.1007/s10461-007-9348-y

Cited by 36 publications

(34 citation statements)

References 22 publications

(25 reference statements)

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“…Our findings of the high baseline prevalence and incidence rates of the STIs measured are supported by previous high prevalence findings in other studies 4,5,23,24 . This provides further validation of Lima’s lower-income MSM and TW as populations at the heart of a concentrated and active HIV epidemic and at high-risk for other STIs.…”

Section: Discussionsupporting

confidence: 91%

HIV and Sexually Transmitted Infection Incidence and Associated Risk Factors Among High-Risk MSM and Male-to-Female Transgender Women in Lima, Peru

Castillo

Konda

León

et al. 2015

JAIDS Journal of Acquired Immune Deficiency Syndromes

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Background Men who have sex with men (MSM) and male-to-female transgender women (TW) are at increased risk of HIV and sexually transmitted infections (STIs). We evaluated factors associated with incidence of HIV, HSV-2, and chlamydia and gonorrhea (anal and pharyngeal). Methods We used data from the Comunidades Positivas trial with MSM/TW who have sex with men in Lima, Peru. Participants were asked about sexual risk behaviors and underwent HIV/STI testing at baseline and 9- and 18-month follow-ups. We used discrete time proportional hazards regression to calculate hazard ratios (HRs) for variables associated with incidence of each STI. Results Among 718 MSM/TW, HIV incidence was 3.6 cases per 100 person-years. HIV incidence was associated with having an incident STI (aHR 3.73). Unprotected receptive anal intercourse was associated with incident anal chlamydia (aHR 2.20). An increased number of sexual partners increased incident HSV-2 (aHR 3.15 for 6–14 partners and 3.97 for 15–46 partners compared to 0–2 partners). Risk of anal gonorrhea decreased with each sexually active year (aHR 0.94) and increased for unprotected compensated sex (aHR 2.36). Risk of pharyngeal gonorrhea also decreased with each year since sexual debut (aHR 0.95). Risk of anal chlamydia decreased with each sexually active year (aHR 0.96), risk increased with reports of unprotected sex work (aHR 1.61), and unprotected receptive anal sex (aHR 2.63). All aHRs have p-values < 0.05. Conclusion MSM/TW experience high incidence of HIV. Up-to-date prevalence and incidence information and identifying factors associated with infection can help develop a more effective combination prevention response.

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Section: Discussionsupporting

confidence: 91%

HIV and Sexually Transmitted Infection Incidence and Associated Risk Factors Among High-Risk MSM and Male-to-Female Transgender Women in Lima, Peru

Castillo

Konda

León

et al. 2015

JAIDS Journal of Acquired Immune Deficiency Syndromes

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“…Poverty and socioeconomic marginalisation of MSM leads many to engage in compensated sex for economic survival 30. A high baseline prevalence of STIs heightens the risk for the continued spread of HIV and STIs in the community 31. Deficiencies in public health resources limit access to diagnosis, treatment and public health services (such as third-party partner notification and expedited partner treatment) that could reduce the spread of HIV and other STIs in the population 32.…”

Section: Discussionmentioning

confidence: 99%

Risk factors for the spread of HIV and other sexually transmitted infections among men who have sex with men infected with HIV in Lima, Peru

Clark

Konda

Segura

et al. 2008

Sexually Transmitted Infections

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Objectives-To assess the prevalence of sexually transmitted infections (STIs), frequency of sexual risk behaviors, and relationship between knowledge of HIV infection status and sexual risk behavior among HIV-infected men who have sex with men (MSM) attending an STI clinic in Peru.Methods-We recruited a convenience sample of 559 MSM from a municipal STI clinic in Lima, Peru. Participants completed a survey and provided blood for HIV, Syphilis, and HSV-2 antibody testing, and urine for gonorrhea and chlamydia nucleic acid testing.Results-Among 124 HIV-infected MSM, 72.6% were aware of their HIV-infected status. Active syphilis (RPR≥1:8) was diagnosed in 21.0% of HIV-infected participants, HSV-2 in 79.8%, urethral gonorrhea in 1.6%, and chlamydia in 1.6%. Among 41 participants reporting insertive anal intercourse with their last sex partner, 34.2% did not use a condom. Of 86 participants reporting receptive anal intercourse, 25.6% did not use a condom. At least one episode of insertive unprotected anal intercourse (UAI) with an HIV-uninfected partner during the previous six months was reported by 33.6% (35/104) of participants, and receptive UAI with an HIV-uninfected partner by 44.6% Key Statements: Many HIV-infected MSM in Peru engage in sexual practices that carry a high risk of HIV transmission to uninfected partners. In a sample of MSM with previously diagnosed HIV infection, no evidence of serosorting or seropositioning harm reduction strategies was observed. No difference in the prevalence of high-risk sexual behavior was seen when comparing men with newly diagnosed HIV infection from those who were aware of their HIV infection status.

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“…Other Peruvian studies have shown that people who use substances before sex are at particularly high risk of either having sex with another man, having unprotected sex with a casual partner, or having had an STD [16][17][18]. Similarly, heavy drinking significantly increases the risk of having multiple sexual partners, having had sex with a casual partner in the last year, and acquiring an STD [14,19,20].…”

Section: Overview Of Alcohol-illicit Drug Use and Associated Risky Bementioning

confidence: 96%

The Relationship between Substance Use and HIV Transmission in Peru

Massa¹

2012

J Addict Res Ther

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Objectives-The primary aim of this article is to review literature regarding the relationship between substance use and HIV transmission in Peru.Methods-Detailed search of published literature completed in PubMed and Google-Scholar and other local Peruvian publications. Mesh words: "Peru"; "substance-related-disorders"; "HIV"; "sexual-behavior" and their combinations. From 3921 articles, 150 were chosen for more careful review and only 26 were used for the review. No date limit was used in this review.Results-Peruvian HIV epidemic is limited to MSM and its prevalence goes up to 33% in certain MSM-subpopulations. Transmission is mainly through sexual contact. Drug use doubled the risk for casual sex, decreased by half the chances of using condoms, increased the number of partners per year and the risk for STD's. Peruvian HIV-positive populations have higher rates drug use and using drugs have been associated with a higher prevalence of being HIV-positive. This may be also true for other populations such as pregnant women in which there is an association between drug use and HIV.Conclusions-Although the amount of Peruvian research in this area limits the review, there seems to be a relationship between using drugs, having risky-sexual-behaviors and being HIV positive in Peru. HIV-prevention strategies for Peruvians must address the link between sex and substance use.

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New Populations at High Risk of HIV/STIs in Low-income, Urban Coastal Peru

Cited by 36 publications

References 22 publications

HIV and Sexually Transmitted Infection Incidence and Associated Risk Factors Among High-Risk MSM and Male-to-Female Transgender Women in Lima, Peru

HIV and Sexually Transmitted Infection Incidence and Associated Risk Factors Among High-Risk MSM and Male-to-Female Transgender Women in Lima, Peru

Risk factors for the spread of HIV and other sexually transmitted infections among men who have sex with men infected with HIV in Lima, Peru

The Relationship between Substance Use and HIV Transmission in Peru

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