Prevalence of same-sex sexual behavior and associated characteristics among low-income urban males in Peru.
BACKGROUND
Peru has a concentrated HIV epidemic in which men who have sex with men are particularly vulnerable. We describe the lifetime prevalence of same-sex sexual contact and associated risk behaviors of men in Peru's general population, regardless of their sexual identity.


RESULTS
A probability sample of males from low-income households in three Peruvian cities completed an epidemiologic survey addressing their sexual risk behavior, including sex with other men. Serum was tested for HSV-2, HIV, and syphilis. Urine was tested for chlamydia and gonorrhea. A total of 2,271 18-30 year old men and women were contacted, of whom 1,645 (72.4%) agreed to participate in the study. Among the sexually experienced men surveyed, 15.2% (85/558, 95% CI: 12.2%-18.2%) reported a history of sex with other men. Men ever reporting sex with men (MESM) had a lower educational level, had greater numbers of sex partners, and were more likely to engage in risk behaviors including unprotected sex with casual partners, paying for or providing compensated sex, and using illegal drugs. MESM were also more likely to have had previous STI symptoms or a prior STI diagnosis, and had a greater prevalence of HSV-2 seropositivity.


CONCLUSIONS
Many low-income Peruvian men have engaged in same-sex sexual contact and maintain greater behavioral and biological risk factors for HIV/STI transmission than non-MESM. Improved surveillance strategies for HIV and STIs among MESM are necessary to better understand the epidemiology of HIV in Latin America and to prevent its further spread.
Clark
Jesse L
JL
Division of Infectious Diseases, David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, California, United States of America. jlclark@mednet.ucla.edu
Caceres
Carlos F
CF
Lescano
Andres G
AG
Konda
Kelika A
KA
Leon
Segundo R
SR
Jones
Franca R
FR
Kegeles
Susan M
SM
Klausner
Jeffrey D
JD
Coates
Thomas J
TJ
D000328:Adult; D003430:Cross-Sectional Studies; D005260:Female; D015658:HIV Infections / Q000453:epidemiology / Q000635:transmission; D018451:Homosexuality, Male / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D010568:Peru / Q000453:epidemiology; D012309:Risk-Taking; D012725:Sexual Behavior / Q000706:statistics & numerical data*; D012749:Sexually Transmitted Diseases / Q000453:epidemiology / Q000635:transmission; D012923:Social Class; D047568:Unsafe Sex; D014505:Urban Population; D055815:Young Adult
J Urban Health. 2005 Mar;82(1 Suppl 1):i26-34
15738323
Sex Transm Dis. 2005 Sep;32(9):534-41
16118601
J Acquir Immune Defic Syndr. 2005 Sep 1;40(1):57-64
16123683
Sex Transm Dis. 2006 Feb;33(2):68-76
16432476
AIDS Behav. 2005 Dec;9(4):387-402
16235135
AIDS Behav. 2005 Dec;9(4):513-23
16328712
AIDS Behav. 2005 Dec;9(4):403-8; discussion 409-13
16344920
Sex Transm Infect. 2006 Feb;82(1):86-7
16461615
Sex Transm Dis. 2006 May;33(5):307-13
16540880
Sex Transm Infect. 2006 Jun;82 Suppl 3:iii3-9
16735290
BMC Public Health. 2006;6:152
16768794
Cult Health Sex. 2005 Jul-Aug;7(4):375-87
16864210
AIDS Behav. 2006 Sep;10(5):531-9
16736111
Cad Saude Publica. 2006 Oct;22(10):2097-104
16951881
J Infect Dis. 2006 Nov 15;194(10):1459-66
17054077
J Acquir Immune Defic Syndr. 2007 Apr 15;44(5):578-85
17279049
AIDS Behav. 2008 May;12(3):483-91
17377837
AIDS Educ Prev. 2000 Aug;12(4):326-39
10982122
Am J Public Health. 2001 Jun;91(6):907-14
11392933
Am J Public Health. 2001 Jun;91(6):922-6
11392935
AIDS. 2001 Apr;15 Suppl 3:S23-32
11421179
Cult Health Sex. 1999 Jul-Sep;1(3):261-75
12322218
AIDS. 2002 Jun 14;16(9):1271-7
12045493
AIDS Educ Prev. 2002 Dec;14(6):457-71
12512847
AIDS. 2002 Dec;16 Suppl 3:S23-33
12685922
Int J Infect Dis. 2002 Dec;6(4):259-65
12718818
Int J Epidemiol. 2003 Oct;32(5):740-3
14559742
AIDS Behav. 2004 Jun;8(2):185-97
15187480
AIDS. 1995 Feb;9(2):171-6
7718188
Sex Transm Infect. 2004 Dec;80(6):498-504
15572623
J Infect Dis. 2005 Feb 1;191 Suppl 1:S147-58
15627225
AIDS. 1996 Feb;10(2):201-6
8838709