title: Association between sexual role and HIV status among Peruvian men who have sex with men seeking an HIV test: a cross-sectional analysis.
abstract: In Latin America, sexual role, sexual identity and sexual practices are intricately related; the roles activo, pasivo and moderno often encompass sexual identity and sexual practices. We aimed to understand the association between sexual role and HIV status in Peruvian men who have sex with men. HIV-testing services at Epicentro Salud, a Peruvian gay men's health centre, were paired with clinic data on demographics and sexual behaviour. Bidirectional stepwise logistic regression was conducted to determine associations between sexual role and HIV status. Of 366 clients who underwent HIV testing, 86 (23.5%) tested positive. There was a strong association between sexual role ('activo' or typically insertive, 'pasivo' or typically receptive, 'moderno' or typically versatile) and a positive HIV test (p = 0.002). Compared to clients with an activo role, those who reported a pasivo (OR = 6.14) and moderno (OR = 6.26) role were more likely to test positive for HIV. Sexual role was associated with sexual identity (gay, straight and bisexual) and gender of partners in the past six months. Self-reported pasivo and moderno sexual roles were strongly associated with a positive HIV test result. Further research should examine differences in sexual practices between sexual role groups.
authors.affiliation: Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London, UK.
authors.forename: Sarah A
authors.initials: SA
authors.lastname: McLean
authors.affiliation: Epicentro Salud, Lima, Peru Socios En Salud, Lima Peru.
authors.forename: Jerome T
authors.initials: JT
authors.lastname: Galea
authors.affiliation: Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London, UK.
authors.forename: Holly J
authors.initials: HJ
authors.lastname: Prudden
authors.affiliation: Epicentro Salud, Lima, Peru.
authors.forename: Gino
authors.initials: G
authors.lastname: Calvo
authors.affiliation: Epicentro Salud, Lima, Peru.
authors.forename: Hugo
authors.initials: H
authors.lastname: Sánchez
authors.affiliation: University of California Riverside, Riverside, CA, USA brandon.brown@ucr.edu.
authors.forename: Brandon
authors.initials: B
authors.lastname: Brown
mesh_terms: D000293:Adolescent; D000328:Adult; D017280:Condoms / Q000706:statistics & numerical data*; D003430:Cross-Sectional Studies; D005783:Gender Identity; D015658:HIV Infections / Q000453:epidemiology / Q000517:prevention & control* / Q000635:transmission; D018451:Homosexuality, Male / Q000208:ethnology / Q000523:psychology*; D006801:Humans; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D010568:Peru / Q000453:epidemiology; D015995:Prevalence; D012189:Retrospective Studies; D012309:Risk-Taking; D012725:Sexual Behavior; D012747:Sexual Partners; D047568:Unsafe Sex / Q000517:prevention & control*; D055815:Young Adult
keywords: AIDS; HIV; MSM; Peru; homosexual; insertive anal sex; men; men who have sex with men; receptive anal sex; sexual identity; sexual role