title: Seroprevalence of and risk factors for HIV-1 infection among South American men who have sex with men.
abstract: OBJECTIVE
  Sex among men constitutes an important route of transmission for HIV type 1 (HIV-1) in Latin America. Seeking better understanding of risk behaviours in this region, we determined the seroprevalence, potential risk factors, and geographic distribution of HIV-1 among groups of men who have sex with men (MSM).
  
  
  METHODS
  Seroepidemiological, cross sectional studies of 13,847 MSM were conducted in seven countries of South America during the years 1999-2002. Volunteers were recruited in city venues and streets where anonymous questionnaires and blood samples were obtained. HIV-1 infection was determined by enzyme linked immunosorbent assay (ELISA) screening and western blot (WB) confirmatory tests.
  
  
  RESULTS
  HIV-1 seroprevalence varied widely (overall 12.3%, range 11.0%-20.6%). The highest HIV-1 seroprevalence was noted in Bolivia (20.6%) and the lowest in Peru (11.0%). Predictors of HIV-1 infection varied among countries; however, a history of previous sexually transmitted disease (STD) was associated with a consistent increased risk (ORs=1.9-2.9, AORs=1.8-2.7). Multiple weekly sexual contacts was found to represent a secondary risk factor in Ecuador, Peru, and Argentina (ORs=1.6-2.9, AORs=1.6-3.1), whereas use of drugs such as cocaine was found to increase risk in Bolivia, Uruguay, and Paraguay (ORs=2.5-6.5, AORs=2.6-6.1).
  
  
  CONCLUSIONS
  The results of this study illustrate an elevated HIV-1 seroprevalence among MSM participants from Andean countries. A previous STD history and multiple partners predicted HIV-1 infection in the seven countries of South America. In Southern Cone countries, HIV-1 infection was also associated with use of illegal drugs such as cocaine.
authors.affiliation: US Military HIV Research Program and Henry M Jackson Foundation, 1 Taft Court, Suite 250, Rockville, MD 20850, USA. cbautista@hivresearch.org
authors.forename: C T
authors.initials: CT
authors.lastname: Bautista
authors.forename: J L
authors.initials: JL
authors.lastname: Sanchez
authors.forename: S M
authors.initials: SM
authors.lastname: Montano
authors.forename: V A
authors.initials: VA
authors.lastname: Laguna-Torres
authors.forename: J R
authors.initials: JR
authors.lastname: Lama
authors.forename: J L
authors.initials: JL
authors.lastname: Sanchez
authors.forename: L
authors.initials: L
authors.lastname: Kusunoki
authors.forename: H
authors.initials: H
authors.lastname: Manrique
authors.forename: J
authors.initials: J
authors.lastname: Acosta
authors.forename: O
authors.initials: O
authors.lastname: Montoya
authors.forename: A M
authors.initials: AM
authors.lastname: Tambare
authors.forename: M M
authors.initials: MM
authors.lastname: Avila
authors.forename: J
authors.initials: J
authors.lastname: Viñoles
authors.forename: N
authors.initials: N
authors.lastname: Aguayo
authors.forename: J G
authors.initials: JG
authors.lastname: Olson
authors.forename: J K
authors.initials: JK
authors.lastname: Carr
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D015658:HIV Infections / Q000453:epidemiology*; D015528:HIV Seroprevalence; D015497:HIV-1; D018451:Homosexuality, Male / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D012307:Risk Factors; D012747:Sexual Partners; D013020:South America / Q000453:epidemiology; D019966:Substance-Related Disorders / Q000453:epidemiology; D047568:Unsafe Sex / Q000706:statistics & numerical data; D014504:Urban Health