title: HIV, STI and Behavioral Risk Among Men Who have Sex with Men in a Setting of Elevated HIV Prevalence Along Ecuador's Pacific Coast.
abstract: We assessed HIV and STI prevalence, risk behaviors and factors associated with HIV infection in men who have sex with men (MSM) in Guayaquil, Ecuador. Respondent-driven sampling was used to recruit 400 MSM in 2011-2012. Participants completed a computer-assisted self-interview and provided blood samples. Statistical analysis accounted for differential probability of selection and for recruitment patterns. HIV prevalence was 11.3 %, HSV-2 30.2 %, active syphilis 6.9 % and hepatitis B 1.2 %. In the previous 12 months, 84 % of MSM reported casual male sex partners and 25 % sex work. Only 48 % of MSM consistently used condoms with male partners and 54 % had ever been tested for HIV. Of 17 % of MSM reporting a female partner, consistent condom use was 6 %. HIV infection was associated with age 25 or older, active syphilis and homosexual self-identification. Findings suggest continuing HIV risk and a need to strengthen prevention and testing among MSM.
authors.affiliation: Pan American Health Organization, Quito, Ecuador, amayasgomez@gmail.com.
authors.forename: Amaya
authors.initials: A
authors.lastname: Sánchez-Gómez
authors.forename: Jerry O
authors.initials: JO
authors.lastname: Jacobson
authors.forename: Orlando
authors.initials: O
authors.lastname: Montoya
authors.forename: Demetrio
authors.initials: D
authors.lastname: Magallanes
authors.forename: Wilson
authors.initials: W
authors.lastname: Bajaña
authors.forename: Oscar
authors.initials: O
authors.lastname: Aviles
authors.forename: Tito
authors.initials: T
authors.lastname: Esparza
authors.forename: Efrain
authors.initials: E
authors.lastname: Soria
authors.forename: Manuel A
authors.initials: MA
authors.lastname: González
authors.forename: Sonia
authors.initials: S
authors.lastname: Morales-Miranda
authors.forename: Rodrigo
authors.initials: R
authors.lastname: Tobar
authors.forename: Celia
authors.initials: C
authors.lastname: Riera
mesh_terms: D000293:Adolescent; D000328:Adult; D004484:Ecuador / Q000453:epidemiology; D015658:HIV Infections / Q000453:epidemiology / Q000517:prevention & control*; D006509:Hepatitis B / Q000453:epidemiology; D006558:Herpes Genitalis / Q000453:epidemiology; D018451:Homosexuality, Male / Q000523:psychology* / Q000706:statistics & numerical data; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D015995:Prevalence; D012309:Risk-Taking; D011477:Sex Work; D012747:Sexual Partners; D012749:Sexually Transmitted Diseases / Q000453:epidemiology / Q000517:prevention & control*; D012959:Socioeconomic Factors; D013587:Syphilis / Q000453:epidemiology; D055815:Young Adult