title: HPV and genital warts among Peruvian men who have sex with men and transgender people: knowledge, attitudes and treatment experiences.
abstract: BACKGROUND
  Several studies have assessed the epidemiology of HPV infection among MSM, but no qualitative studies have specifically assessed how HPV and genital warts (GW) affect South American men who have sex with men (MSM) and male-to-female transgendered women (TG). This study explored the knowledge, attitudes and experiences of Peruvian MSM and TG regarding HPV and GW.
  
  
  METHODS
  We performed a qualitative study consisting of fifteen in-depth interviews and three focus groups carried out in Lima, Peru with diverse MSM and TG groups, including sex workers. Resulting data were analyzed by applying a systematic comparative and descriptive content analysis.
  
  
  RESULTS
  While knowledge of HPV was limited, awareness of GW was common, particularly among TG persons and sex workers. Still, few participants recognized that GW are sexually transmitted, and many had problems differentiating between GW and other STI/anogenital conditions. Stigmatizing experiences were common during sexual encounters with people who had visible GW. Shame, emotional and physical troubles, and embarrassing sexual experiences were reported by individuals with GW. Search for treatment was mediated by peers, but stigma and apparent health services' inability to deal with GW limited the access to effective medical care.
  
  
  CONCLUSIONS
  In Peru, public health interventions should strengthen services for HPV/GW management and increase accurate knowledge of the transmission, treatment, and sequelae of HPV/GW in MSM and TG populations.
authors.affiliation: Escuela de Antropología, Universidad Nacional Mayor de San Marcos, Lima, Peru.
authors.forename: César R
authors.initials: CR
authors.lastname: Nureña
authors.forename: Brandon
authors.initials: B
authors.lastname: Brown
authors.forename: Jerome T
authors.initials: JT
authors.lastname: Galea
authors.forename: Hugo
authors.initials: H
authors.lastname: Sánchez
authors.forename: Magaly M
authors.initials: MM
authors.lastname: Blas
mesh_terms: D000293:Adolescent; D000328:Adult; D003218:Condylomata Acuminata / Q000453:epidemiology* / Q000628:therapy*; D005260:Female; D017144:Focus Groups; D007722:Health Knowledge, Attitudes, Practice; D018451:Homosexuality, Male; D006801:Humans; D008297:Male; D027383:Papillomaviridae; D010568:Peru / Q000453:epidemiology; D012725:Sexual Behavior; D063106:Transgender Persons; D055815:Young Adult