HIV-1, sexually transmitted infections, and sexual behavior trends among men who have sex with men in Lima, Peru.
OBJECTIVE
To assess and estimate trends in HIV, sexually transmitted infections (STIs), and sexual behavior among men who have sex with men (MSM) in Lima, Peru.


METHODS
Second-generation HIV sentinel surveillance surveys conducted in 1996, 1998, 2000, and 2002.


METHODS
Adult men reporting sex with at least 1 man during the previous year were eligible to participate. Sexual behavior and serum HIV-1 and syphilis antibodies were assessed. HIV seroincidence was estimated by a sensitive/less-sensitive enzyme immunoassay strategy. Rectal and pharyngeal swabs for Neisseria gonorrhoeae culture and a first-void urine sample for urethral leukocytes for presumptive diagnosis of urethritis were obtained. Herpes simplex virus 2 (HSV-2) antibodies were measured in 2002.


RESULTS
Although HIV prevalence increased from 18.5% to 22.3% from 1996 through 2002, bacterial prevalence declined significantly for syphilis (16.0% to 12.4%), early syphilis (8.6% to 3.4%), and rectal gonorrhea (5.1% to 0.2%). High HIV seroincidence was estimated, with the lowest (4.8%) incidence in 1998. In 2002, HSV-2 seroprevalence was 51.0%. After adjustment for age, education, and self-reported sexual identity, our data suggest that a yearly increase by 6% in the prevalence of HIV occurred among MSM in Lima, with a corresponding decline in syphilis (by 9%), early syphilis (by 18%), and rectal gonorrhea (by 64%). Condom use during last sexual intercourse increased by 26% each year with the most recent male steady partner and, among non-sex workers, by 11% with the most recent casual partner.


CONCLUSIONS
HIV continued to spread among MSM in Lima even when a decline in bacterial STIs and increase in condom use were estimated to occur. Intensification of medical and behavior prevention interventions is warranted for MSM in Peru.
Sanchez
Jorge
J
Asociation Civil Impacta Salud y Educacion, Av. Grimaldo Del Solar 805, Lima 18, Peru. jsanchez@impactaperu.org
Lama
Javier R
JR
Kusunoki
Lourdes
L
Manrique
Hugo
H
Goicochea
Pedro
P
Lucchetti
Aldo
A
Rouillon
Manuel
M
Pun
Monica
M
Suarez
Luis
L
Montano
Silvia
S
Sanchez
Jose L
JL
Tabet
Stephen
S
Hughes
James P
JP
Celum
Connie
C
D000293:Adolescent; D000328:Adult; D017280:Condoms / Q000706:statistics & numerical data; D015658:HIV Infections / Q000453:epidemiology / Q000517:prevention & control / Q000635:transmission*; D015497:HIV-1; D018451:Homosexuality, Male; D006801:Humans; D008297:Male; D010568:Peru / Q000453:epidemiology; D012725:Sexual Behavior; D012749:Sexually Transmitted Diseases / Q000453:epidemiology; D047568:Unsafe Sex / Q000517:prevention & control