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HIV, syphilis and heterosexual bridging among Peruvian men who have sex with men
Stephen Tabet1, Jorge Sanchez, Javier Lama
1Department of Medicine, University of Washington, Seattle, Washington, USA.
Objectives:
To determine prevalence of and risk factors associated with HIV and syphilis seropositivity and estimate incidence of HIV infection among Peruvian men who have sex with men (MSM) and characterize behaviors of men who report sex with both men and women ('bridgers').
Design:
Cross-sectional study of MSM in Lima, Peru.
Methods:
Four-hundred and fifty-one MSM (of whom 442 responded to the question regarding sexual orientation) recruited through street outreach. Each was interviewed and underwent serologic testing for syphilis and HIV, including the less sensitive enzyme immunoassay test to estimate HIV incidence.
Results:
Overall, HIV and syphilis prevalence were 18.5% and 16.0%, respectively, with highest prevalence among cross-dressers (33.3% and 51.1%, respectively). The estimated overall HIV seroincidence was 11.2% per year (95% confidence interval, 4.8-23.6). Overall, 47.1% of men reported ever having sex with a woman: 78.6% of men self-identifying as heterosexuals, 85.1% of bisexuals, 35.5% of homosexuals, and 12.5% of cross-dressers. Of these, 26.5% were 'bridgers', of whom 55% reported two or more female partners during the last year. 'Bridgers' were less likely to have always used condoms during the past year for vaginal sex (17%) than for insertive anal sex with men (25.5%).
Conclusions:
Among MSM in Peru, HIV and syphilis prevalence and HIV incidence were high, especially among cross-dressers. The high prevalence of bisexuality and low rates of consistent condom use, especially with female sexual partners indicates potential HIV transmission into the heterosexual population.
Insights
High rates of HIV and syphilis were found among men who have sex with men (MSM) in Peru, particularly in cross-dressers. Low condom use with female partners suggests potential HIV transmission to the heterosexual population.
Area of Science:
- Public Health
- Epidemiology
- Infectious Diseases
Background:
- Men who have sex with men (MSM) are a key population for HIV and syphilis surveillance.
- Understanding behavioral patterns and seroprevalence is crucial for targeted interventions.
Purpose of the Study:
- To determine HIV and syphilis prevalence and risk factors among Peruvian MSM.
- To estimate HIV incidence in this population.
- To characterize sexual behaviors of men reporting sex with men and women ('bridgers').
Main Methods:
- A cross-sectional study involving 451 MSM in Lima, Peru.
- Interviews and serologic testing for HIV and syphilis.
- HIV incidence estimation using enzyme immunoassay.
Main Results:
- HIV prevalence was 18.5% and syphilis prevalence was 16.0%.
- Cross-dressers showed the highest prevalence (HIV 33.3%, syphilis 51.1%).
- Estimated HIV incidence was 11.2% per year; 'bridgers' reported lower consistent condom use with female partners.
Conclusions:
- HIV and syphilis prevalence and HIV incidence are high among Peruvian MSM, especially cross-dressers.
- High rates of bisexuality and inconsistent condom use with female partners pose a risk for HIV transmission into the heterosexual population.
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