title: Being unaware of being HIV-infected is associated with alcohol use disorders and high-risk sexual behaviors among men who have sex with men in Peru.
abstract: This study compared the correlates of HIV risk among men who have sex with men (MSM) with newly diagnosed versus previously known HIV infection among 5,148 MSM recruited using modified snowball sampling in 5 Peruvian cities. Participants, if age ≥18 years and reporting sex with a male in the previous 12 months, underwent standardized computer-assisted risk assessments and HIV and syphilis testing. Overall, 420 (8.2 %) participants tested HIV seropositive, most of whom (89.8 %) were unaware of their HIV status. Compared to those who knew themselves to be HIV-infected, multivariate logistic regression demonstrated that unprotected anal intercourse at last encounter [AOR = 2.84 (95 % CI 1.09-7.40)] and having an alcohol use disorder (AUD) [AOR = 2.14 (95 % CI 1.01-5.54)] were independently associated with a newly diagnosed HIV infection. Being unaware of being HIV-infected was associated with high-risk sexual behaviors and AUDs, both of which are amenable to behavioral and medication-assisted therapy interventions.
authors.affiliation: Section of Infectious Diseases, Department of Internal Medicine, Yale School of Medicine, Yale University AIDS Program, 135 College Street, Suite 323, New Haven, CT, 06510, USA, panagiotis.vagenas@yale.edu.
authors.forename: Panagiotis
authors.initials: P
authors.lastname: Vagenas
authors.forename: Kaysia T
authors.initials: KT
authors.lastname: Ludford
authors.forename: Pedro
authors.initials: P
authors.lastname: Gonzales
authors.forename: Jesus
authors.initials: J
authors.lastname: Peinado
authors.forename: Cesar
authors.initials: C
authors.lastname: Cabezas
authors.forename: Fernando
authors.initials: F
authors.lastname: Gonzales
authors.forename: Javier R
authors.initials: JR
authors.lastname: Lama
authors.forename: Jorge
authors.initials: J
authors.lastname: Sanchez
authors.forename: Frederick L
authors.initials: FL
authors.lastname: Altice
mesh_terms: D000437:Alcoholism / Q000453:epidemiology; D003376:Counseling; D003430:Cross-Sectional Studies; D015658:HIV Infections / Q000175:diagnosis / Q000453:epidemiology* / Q000517:prevention & control; D006679:HIV Seropositivity / Q000523:psychology*; D006293:Health Promotion / Q000379:methods*; D006306:Health Surveys; D018451:Homosexuality, Male / Q000523:psychology*; D006801:Humans; D008297:Male; D010568:Peru / Q000453:epidemiology; D011159:Population Surveillance; D012307:Risk Factors; D012725:Sexual Behavior / Q000706:statistics & numerical data; D012749:Sexually Transmitted Diseases; D013587:Syphilis / Q000175:diagnosis / Q000453:epidemiology / Q000517:prevention & control