title: Impact of alcohol use on sexual behavior among men who have sex with men and transgender women in Lima, Peru.
abstract: BACKGROUND
  Alcohol use disorders (AUDs) may enhance the likelihood of risky sexual behaviors and the acquisition of sexually transmitted infections (STIs). Associations between AUDs with condomless anal intercourse (CAI) and STI/HIV prevalence were assessed among men who have sex with men (MSM) and transgender women (TW) in Lima, Peru.
  
  
  METHODS
  MSM and TW were eligible to participate based on a set of inclusion criteria which characterized them as high-risk. Participants completed a bio-behavioral survey. An AUDIT score ≥8 determined AUD presence. Recent STI diagnosis included rectal gonorrhea/chlamydia, syphilis, and/or new HIV infection within 6 months. Prevalence ratios (PR) were calculated using Poisson regression.
  
  
  RESULTS
  Among 312 MSM and 89 TW, 45% (181/401) had an AUD. Among those with an AUD, 164 (91%) were hazardous/harmful drinkers, and 17 (9%) had alcohol dependence. Higher CAI was reported by participants with an AUD vs. without, (82% vs. 72% albeit not significant). Reporting anal sex in two or more risky venues was associated with screening AUD positive vs. not (24% vs. 15%, p=0.001). There was no difference in recent STI/HIV prevalence by AUD status (32% overall). In multivariable analysis, screening AUD positive was not associated with CAI or recent STI/HIV infection.
  
  
  CONCLUSIONS
  In our sample AUDs were not associated with CAI or new HIV infection/recent STI. However higher prevalence of CAI, alcohol use at last sex, and anal sex in risky venues among those with AUDs suggests that interventions to reduce the harms of alcohol should be aimed toward specific contexts.
authors.affiliation: Division of Infectious Diseases, UCLA David Geffen School of Medicine, Los Angeles, CA, USA.
authors.forename: M C
authors.initials: MC
authors.lastname: Herrera
authors.affiliation: Division of Infectious Diseases, UCLA David Geffen School of Medicine, Los Angeles, CA, USA. Electronic address: kkonda@mednet.ucla.edu.
authors.forename: K A
authors.initials: KA
authors.lastname: Konda
authors.affiliation: Partners in Health, Director of Research, Lima, Peru.
authors.forename: S R
authors.initials: SR
authors.lastname: Leon
authors.affiliation: Division of Global Public Health, UCSD School of Medicine, San Diego, CA, USA.
authors.forename: R
authors.initials: R
authors.lastname: Deiss
authors.affiliation: Division of Clinical Sciences, Center for Healthy Communities, University of California, Riverside, CA, USA.
authors.forename: B
authors.initials: B
authors.lastname: Brown
authors.affiliation: Unit of Health, Sexuality and Human Development, School of Public Health, Universidad Peruana Cayetano Heredia, Lima, Peru.
authors.forename: G M
authors.initials: GM
authors.lastname: Calvo
authors.affiliation: Alberto Barton Health Center, Health Directorate of Callao, Lima, Peru.
authors.forename: H J
authors.initials: HJ
authors.lastname: Salvatierra
authors.affiliation: Unit of Health, Sexuality and Human Development, School of Public Health, Universidad Peruana Cayetano Heredia, Lima, Peru.
authors.forename: C F
authors.initials: CF
authors.lastname: Caceres
authors.affiliation: Division of Infectious Diseases, UCLA David Geffen School of Medicine, Los Angeles, CA, USA.
authors.forename: J D
authors.initials: JD
authors.lastname: Klausner
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000428:Alcohol Drinking / Q000453:epidemiology / Q000523:psychology*; D005260:Female; D015658:HIV Infections / Q000453:epidemiology*; D018451:Homosexuality, Male / Q000523:psychology* / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D010568:Peru / Q000453:epidemiology; D015995:Prevalence; D012725:Sexual Behavior / Q000523:psychology* / Q000706:statistics & numerical data; D012749:Sexually Transmitted Diseases / Q000453:epidemiology*; D011795:Surveys and Questionnaires; D063106:Transgender Persons / Q000523:psychology*; D047568:Unsafe Sex / Q000523:psychology; D055815:Young Adult
keywords: AUDIT; Alcohol use; HIV; Men who have sex with men; Peru; STI; Sexual risk behavior; Transgender women