title: Prevalence of HIV, STIs, and risk behaviors in a cross-sectional community- and clinic-based sample of men who have sex with men (MSM) in Lima, Peru.
abstract: BACKGROUND
  Further research is necessary to understand the factors contributing to the high prevalence of HIV/STIs among men who have sex with men (MSM) in Peru. We compared HIV/STI prevalence and risk factors between two non-probability samples of MSM, one passively enrolled from an STI clinic and the other actively enrolled from community venues surrounding the clinic in Lima, Peru.
  
  
  METHODS
  A total of 560 self-identified MSM were enrolled between May-December, 2007. 438 subjects enrolled from a municipal STI clinic and 122 subjects enrolled during community outreach visits. All participants underwent screening for HIV, syphilis, HSV-2, gonorrhoea, and chlamydia and completed a survey assessing their history of HIV/STIs, prior HIV testing, and sexual behavior.
  
  
  RESULTS
  HIV prevalence was significantly higher among MSM enrolled from the clinic, with previously undiagnosed HIV identified in 9.1% compared with 2.6% of community participants. 15.4 % of all MSM screened were infected with ≥ 1 curable STI, 7.4% with early syphilis (RPR ≥ 1:16) and 5.5% with urethral gonorrhoea and/or chlamydia. No significant differences between populations were reported in prevalence of STIs, number of male sex partners, history of unprotected anal intercourse, or alcohol and/or drug use prior to sex. Exchange of sex for money or goods was reported by 33.5% of MSM enrolled from the clinic and 21.2% of MSM from the community (p = 0.01).
  
  
  CONCLUSIONS
  Our data demonstrate that the prevalence of HIV and STIs, including syphilis, gonorrhoea, and chlamydia are extremely high among MSM enrolled from both clinic and community venues in urban Peru. New strategies are needed to address differences in HIV/STI epidemiology between clinic- and community-enrolled samples of MSM.
authors: Department of Medicine, Division of Infectious Diseases and Center for World Health, David Geffen School of Medicine at University of California at Los Angeles, Los Angeles, California, United States of America. aperezbr@hsph.harvard.edu
authors: Amaya G
authors: AG
authors: Perez-Brumer
authors: Kelika A
authors: KA
authors: Konda
authors: H Javier
authors: HJ
authors: Salvatierra
authors: Eddy R
authors: ER
authors: Segura
authors: Eric R
authors: ER
authors: Hall
authors: Silvia M
authors: SM
authors: Montano
authors: Thomas J
authors: TJ
authors: Coates
authors: Jeff D
authors: JD
authors: Klausner
authors: Carlos F
authors: CF
authors: Caceres
authors: Jesse L
authors: JL
authors: Clark
mesh_terms: D000328:Adult; D000554:Ambulatory Care Facilities / Q000706:statistics & numerical data*; D003430:Cross-Sectional Studies; D005260:Female; D015658:HIV Infections / Q000453:epidemiology*; D018451:Homosexuality, Male; D006801:Humans; D008297:Male; D010568:Peru / Q000453:epidemiology; D015995:Prevalence; D012111:Residence Characteristics / Q000706:statistics & numerical data*; D012309:Risk-Taking; D055815:Young Adult
references: Sex Transm Infect. 2007 Apr;83(2):120-5; discussion 125
references: 17090569
references: J Acquir Immune Defic Syndr. 2003 Apr 1;32(4):388-93
references: 12640196
references: Sex Transm Infect. 2004 Jun;80(3):236-40
references: 15170012
references: Sex Transm Dis. 2010 Feb;37(2):75-80
references: 19940809
references: Sex Transm Dis. 2005 Sep;32(9):534-41
references: 16118601
references: AIDS. 1996 Sep;10(10):1141-5
references: 8874632
references: PLoS One. 2007 Aug 22;2(8):e778
references: 17712426
references: J Infect Dis. 2006 Nov 15;194(10):1459-66
references: 17054077
references: Sex Transm Infect. 2004 Dec;80(6):498-504
references: 15572623
references: J Acquir Immune Defic Syndr. 2007 Apr 15;44(5):578-85
references: 17279049
references: J Infect Dis. 2001 Apr 1;183(7):1087-92
references: 11237834
references: J Acquir Immune Defic Syndr. 2009 May 1;51 Suppl 1:S47-51
references: 19384102
references: J Acquir Immune Defic Syndr. 2004 Aug 15;36(5):1057-66
references: 15247559