title: HIV-1, sexually transmitted infections, and sexual behavior trends among men who have sex with men in Lima, Peru.
abstract: 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.
authors.affiliation: Asociation Civil Impacta Salud y Educacion, Av. Grimaldo Del Solar 805, Lima 18, Peru. jsanchez@impactaperu.org
authors.forename: Jorge
authors.initials: J
authors.lastname: Sanchez
authors.forename: Javier R
authors.initials: JR
authors.lastname: Lama
authors.forename: Lourdes
authors.initials: L
authors.lastname: Kusunoki
authors.forename: Hugo
authors.initials: H
authors.lastname: Manrique
authors.forename: Pedro
authors.initials: P
authors.lastname: Goicochea
authors.forename: Aldo
authors.initials: A
authors.lastname: Lucchetti
authors.forename: Manuel
authors.initials: M
authors.lastname: Rouillon
authors.forename: Monica
authors.initials: M
authors.lastname: Pun
authors.forename: Luis
authors.initials: L
authors.lastname: Suarez
authors.forename: Silvia
authors.initials: S
authors.lastname: Montano
authors.forename: Jose L
authors.initials: JL
authors.lastname: Sanchez
authors.forename: Stephen
authors.initials: S
authors.lastname: Tabet
authors.forename: James P
authors.initials: JP
authors.lastname: Hughes
authors.forename: Connie
authors.initials: C
authors.lastname: Celum
mesh_terms: 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