Vulnerability and sexual risks:Vagosandvaguitasin a low income town in Perú

Abstract

Young people constitute a priority for sexual health research, policy and planning. Many studies, however, regard youth as a homogeneous group defined by developmental stages and their problems as inherent rather than factors resulting from structural vulnerability. Ethnographic data from this study provided strong evidence of the inappropriateness, in prevention interventions, of the concept of 'young people' as a group defined only by age and gender. When incorporating social resources and support into the analysis, specific segments of youth with diverse sexual practices and health seeking behaviours emerge. Thus, although most young people in urban areas show a similar level of HIV/STI knowledge, their exposure to risk varies according to their living conditions. Two population segments - "street guys" and "fast girls" - identified as vulnerable for sexual risk, are characterized. Both groups hang out on the streets, and most are involved in using alcohol and drugs, and/or practicing transactional sex. This study provided evidence for the need of various approaches according to level of poverty and social vulnerability in order to develop more effective HIV/AIDS and STI prevention programs to meet the needs of young men and women in low-income areas.

High Rates of Sex with Men among High-Risk, Heterosexually-Identified Men in Low-Income, Coastal Peru

“…The esquineros also report substantial rates of compensated sex, which from previous ethnographic work appears to occur primarily with men (Salazar et al, 2005) likening some of the men in this population to "hustlers" described in the United States (Rietmeijer, Wolitski, Fishbein, Corby, & Cohn, 1998;Simon, Morse, Balson, Osofsky, & Gaumer, 1993;Sullivan, 1996). Although concentrated groups of high-risk male populations with bisexual behavior and heterosexual identity have not been identified in many cultures and communities, they are known to exist.…”

“…Esquineros are found primarily on street corners, in parks or soccer fields, and are also referred to as 'vagos' (bums). Although they were self and community identified as heterosexual, previous studies using ethnographic methods, including in-depth interviews, focus groups, and participant observation, found that some of these men have sex with other men, often in exchange for clothes, food, or money (Salazar et al, 2005). Given these behavioral and socio-cultural characteristics, we considered the esquineros as at potentially high-risk for HIV/STI and decided to include them in the epidemiologic study described in this paper.…”

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

“…Previous ethnographic work, (Rosasco et al 2004;Salazar et al 2005) helped to identify three high-risk groups found in the barrios, members of these three sub-populations spent time and interacted in the micro-venues. From the information collected regarding their sexual risk behaviors, it was hypothesized that their risk for HIV/STI infection would be higher than that of the general population in these barrios.…”

“…The formative ethnography conducted in the same time period, provided evidence for sexual risk behaviors and sexual risk networks among these communities. This evidence was used to identify specific sub-populations potentially at increased risk of HIV/STI infection due to their sexual risk behaviors which differentiated them from the general population in these neighborhoods (Rosasco et al 2004;Salazar et al 2005). …”

Implementation and evaluation of an HIV/STD intervention in Peru

“…Based on data from previous studies (Cáceres et al,1997;Cáceres et al,1999;Tabet et al, 2002;Altamirano et al,2003) and our own epidemiological and formative ethnographic research (Konda et al,2005;Salazar et al,2005;Salazar et al, in press), this trial targets men and women belonging to three poor and marginalized population segments at greatest risk for HIV and STDs 1 . These segments are:…”