title: Acceptability of oral versus rectal HIV preexposure prophylaxis among men who have sex with men and transgender women in Peru.
abstract: OBJECTIVE
  Oral preexposure prophylaxis (PrEP) with antiretrovirals (ARVs) is at the forefront of biomedical HIV prevention research, and ARVs are also being tested for rectal administration to target people practicing unprotected receptive anal intercourse (URAI) and at risk of HIV infection. This study assessed the acceptability of daily oral PrEP and rectal PrEP during URAI among men who have sex with men (MSM) and transgender women (TGW) in Peru.
  
  
  METHODS
  During the 2008 HIV sentinel surveillance survey conducted in 3 Peruvian cities (Lima, Iquitos, and Pucallpa), MSM and TGW reported being "versatile," "most of the time receptive," and "exclusively receptive" during anal sex behavior where surveyed on their acceptability of oral and rectal PrEP.
  
  
  RESULTS
  Among 532 individuals, high acceptance of either oral (96.2%) or rectal (91.7%) PrEP products was reported. If both products were efficacious/available, 28.6% would prefer a pill, 57.3% a rectal lubricant, and 14.1% either. A trend toward higher acceptance was observed as receptive anal sex behavior exclusivity rose (P = .013). Being receptive most of the time (adjusted odds ratio [aOR]: 9.1, P = .01) and exclusively receptive (aOR: 7.5, P = .01), compared to being versatile, were independently associated with oral PrEP acceptability. A similar association was found with the acceptability of rectal formulations (aOR: 2.3, P = .07; and aOR: 2.5, P = .02; respectively).
  
  
  CONCLUSIONS
  Oral and rectal PrEP were highly acceptable among Peruvian MSM and TGW, particularly among those at the highest HIV infection risk. These data can guide the implementation of PrEP programs in Peru and similar settings and populations.
authors: Asociación Civil Impacta Salud y Educación, Lima, Peru.
authors: Jesus
authors: J
authors: Peinado
authors: Javier R
authors: JR
authors: Lama
authors: Jerome T
authors: JT
authors: Galea
authors: Patricia
authors: P
authors: Segura
authors: Martin
authors: M
authors: Casapia
authors: Abner
authors: A
authors: Ortiz
authors: Silvia M
authors: SM
authors: Montano
authors: Tadeusz
authors: T
authors: Kochel
authors: Jorge
authors: J
authors: Sánchez
mesh_terms: D000284:Administration, Oral; D000328:Adult; D044966:Anti-Retroviral Agents / Q000008:administration & dosage* / Q000032:analysis; D005260:Female; D015658:HIV Infections / Q000517:prevention & control*; D018451:Homosexuality, Male; D006801:Humans; D054327:Lubricants / Q000737:chemistry; D008297:Male; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D010568:Peru; D012007:Rectum; D018571:Sentinel Surveillance; D063106:Transgender Persons; D055815:Young Adult
chemical_list: D044966:Anti-Retroviral Agents; D054327:Lubricants
keywords: HIV-1; Peru; high-risk; homosexual men; preexposure prophylaxis; rectal microbicides; transgender women