title: Moderno love: sexual role-based identities and HIV/STI prevention among men who have sex with men in Lima, Peru.
abstract: Role-based sexual identities structure male same-sex partnerships and influence HIV/STI epidemiology among MSM in Latin America. We explored shifting relationships between sexual roles, identities and practices among MSM in Lima, Peru, and implications for HIV/STI prevention. Patterns of HIV/STI epidemiology reflected differential risks for transmission within role-based partnerships with relatively low prevalences of HIV, syphilis, and HSV-2 but higher prevalences of urethral gonorrhea/chlamydia among activo MSM compared with moderno and pasivo participants. Qualitative analysis of how MSM in Peru integrate sexual identities, roles, and practices identified four key themes: pasivo role as a gay approximation of cultural femininity; activo role as a heterosexual consolidation of masculinity; moderno role as a masculine reconceptualization of gay identity; and role-based identities as social determinants of partnership, network, and community formation. The concept of role-based sexual identities provides a framework for HIV prevention for Latin American MSM that integrates sexual identities, practices, partnerships, and networks.
authors.affiliation: Program in Global Health, Division of Infectious Diseases, Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, 10833 Leconte Avenue, CHS 37-121, Los Angeles, CA 90095, USA. jlclark@mednet.ucla.edu
authors.forename: Jesse
authors.initials: J
authors.lastname: Clark
authors.forename: Javier
authors.initials: J
authors.lastname: Salvatierra
authors.forename: Eddy
authors.initials: E
authors.lastname: Segura
authors.forename: Ximena
authors.initials: X
authors.lastname: Salazar
authors.forename: Kelika
authors.initials: K
authors.lastname: Konda
authors.forename: Amaya
authors.initials: A
authors.lastname: Perez-Brumer
authors.forename: Eric
authors.initials: E
authors.lastname: Hall
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Klausner
authors.forename: Carlos
authors.initials: C
authors.lastname: Caceres
authors.forename: Thomas
authors.initials: T
authors.lastname: Coates
mesh_terms: D000328:Adult; D005260:Female; D017144:Focus Groups; D005783:Gender Identity; D015658:HIV Infections / Q000453:epidemiology* / Q000517:prevention & control* / Q000635:transmission; D018451:Homosexuality, Male / Q000523:psychology*; D006801:Humans; D007407:Interviews as Topic; D008149:Love; D008297:Male; D010568:Peru / Q000453:epidemiology; D015995:Prevalence; D036301:Qualitative Research; D012307:Risk Factors; D012309:Risk-Taking; D012747:Sexual Partners; D012749:Sexually Transmitted Diseases / Q000453:epidemiology* / Q000517:prevention & control* / Q000635:transmission; D047568:Unsafe Sex / Q000517:prevention & control; D055815:Young Adult