title: Anonymous partnerships among MSM and transgender women (TW) recently diagnosed with HIV and other STIs in Lima, Peru: an individual-level and dyad-level analysis.
abstract: OBJECTIVE
  Partner notification (PN) following sexually transmitted disease (STI) diagnosis is a key strategy for controlling HIV/STI transmission. Anonymous partnerships are an important barrier to PN and often associated with high-risk sexual behaviour. Limited research has examined the profile of men who have sex with men (MSM) and transgender women (TW) who engage in anonymous sex. To better understand anonymous partnership practices in Lima, Peru, we assessed participant-level and partnership-level characteristics associated with anonymous sex among a sample of MSM and TW recently diagnosed with HIV/STI.
  
  
  METHODS
  MSM and TW diagnosed with HIV/STI within the past month completed a cross-sectional survey regarding anticipated PN practices. Participants reported sexual partnership types and characteristics of up to three of their most recent partners. Using a Poisson generalised estimating equation model, we assessed participant-level and partnership-level characteristics associated with anonymous partnerships.
  
  
  RESULTS
  Among 395 MSM and TW with HIV/STI, 36.0% reported at least one anonymous sexual partner in the past 3 months (mean of 8.6 anonymous partners per participant; SD 17.0). Of the 971 partnerships reported, 118 (12.2%) were anonymous and the majority (84.8%) were with male partners, followed by 11.0% with female partners and 4.2% with transgender/travestipartners. Partner-level characteristics associated with increased likelihood of having an anonymous partner included female (adjusted prevalence ratio (aPR) 2.28, 95% CI 1.05 to 4.95, p=0.04) or transgender/travesti(aPR 4.03, 95% CI 1.51 to 10.78, p=0.006) partner gender.
  
  
  CONCLUSIONS
  By assessing both individual-level and dyadic-level factors, these results represent an important step in understanding the complexity of partnership interactions and developing alternative PN strategies for Latin America.
authors.affiliation: Department of Sociomedical Sciences, Columbia Mailman School of Public Health, New York, USA.|Department of Medicine and Program in Global Health, David Geffen School of Medicine at UCLA, Los Angeles, USA.
authors.forename: Amaya G
authors.initials: AG
authors.lastname: Perez-Brumer
authors.affiliation: Department of Epidemiology, Harvard School of Public Health, Boston, USA.
authors.forename: Catherine E
authors.initials: CE
authors.lastname: Oldenburg
authors.affiliation: Department of Medicine and Program in Global Health, David Geffen School of Medicine at UCLA, Los Angeles, USA.
authors.forename: Eddy R
authors.initials: ER
authors.lastname: Segura
authors.affiliation: Asociación Civil Impacta Salud y Educación, Lima, Peru.|Department of Global Health, University of Washington, Seattle, USA.
authors.forename: Jorge
authors.initials: J
authors.lastname: Sanchez
authors.affiliation: Asociación Civil Impacta Salud y Educación, Lima, Peru.|Department of Global Health, University of Washington, Seattle, USA.
authors.forename: Javier R
authors.initials: JR
authors.lastname: Lama
authors.affiliation: Department of Medicine and Program in Global Health, David Geffen School of Medicine at UCLA, Los Angeles, USA.
authors.forename: Jesse L
authors.identifier: http://orcid.org/0000-0001-5862-6530
authors.initials: JL
authors.lastname: Clark
keywords: HIV; INFECTIOUS DISEASES; LATIN AMERICA; MEN; PARTNER NOTIFICATION