title: High HIV prevalence and the internet as a source of HIV-related service information at a community-based organization in Peru: a cross-sectional study of men who have sex with men.
abstract: The HIV prevalence among men who have sex with men (MSM) in Peru (12.4 %) is 30 times higher than in the general adult population (0.4 %). It is critical for community-based organizations to understand how to provide HIV services to MSM while maximizing limited resources. This study describes the HIV prevalence and risk profiles of MSM seeking HIV services at a community-based organization in Lima, Peru. It then compares HIV prevalence between those who found out about the HIV services through different sources.
  
  
  
  A cross-sectional study of MSM seeking HIV services at Epicentro Salud in Lima, Peru for the first time between April 2012 and October 2013. We compared HIV prevalence among MSM who found out about Epicentro via online sources of information (N = 419), those using in-person sources (friends, partners) (N = 907), and sex workers (N = 140) using multivariable logistic regression models.
  
  
  
  HIV prevalence was 18.3 % overall: 23.2 % among MSM using online sources, 19.3 % among sex workers, and 15.9 % among MSM using in-person sources. However, when compared to the in-person group, sexual risk behaviors were not statistically higher among MSM using online sources. For the sex worker group, some behaviors were more common, while others were less. After adjusting for confounders, the odds of having HIV was higher for the online group (Odds Ratio = 1.61; 95 % Confidence Interval: 1.19-2.18), but not for the sex worker group (OR = 1.12; 95 % CI: 0.68-1.86), compared to the in-person group.
  
  
  
  Internet-based promotion appears to successfully reach MSM at high risk of HIV in Peru. Outreach via this medium can facilitate HIV diagnosis, which is the critical first step in getting infected individuals into HIV care. For community-based organizations working in resource-limited settings, this may be an effective strategy for engaging a subset of high-risk persons in HIV care.
authors.affiliation: Vanderbilt Institute for Global Health, Vanderbilt University, Nashville, TN, USA.
authors.forename: R Colby
authors.initials: RC
authors.lastname: Passaro
authors.affiliation: Vanderbilt Institute for Global Health, Vanderbilt University, Nashville, TN, USA.|Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA.
authors.forename: Connie A
authors.initials: CA
authors.lastname: Haley
authors.affiliation: Epicentro Salud, Lima, Peru.
authors.forename: Hugo
authors.initials: H
authors.lastname: Sanchez
authors.affiliation: Vanderbilt Institute for Global Health, Vanderbilt University, Nashville, TN, USA.|Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN, USA.
authors.forename: Sten H
authors.initials: SH
authors.lastname: Vermund
authors.affiliation: Vanderbilt Institute for Global Health, Vanderbilt University, Nashville, TN, USA. aaron.kipp@vanderbilt.edu.|Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA. aaron.kipp@vanderbilt.edu.|Institute for Medicine and Public Health, 2525 West End Ave., Suite 614, Nashville, TN, USA. aaron.kipp@vanderbilt.edu.
authors.forename: Aaron M
authors.initials: AM
authors.lastname: Kipp
mesh_terms: D000328:Adult; D003153:Community Health Services; D003430:Cross-Sectional Studies; D015658:HIV Infections / Q000453:epidemiology*; D018451:Homosexuality, Male; D006801:Humans; D057226:Information Seeking Behavior; D007255:Information Services; D020407:Internet; D016015:Logistic Models; D008297:Male; D008389:Marketing of Health Services; D016017:Odds Ratio; D010342:Patient Acceptance of Health Care; D010379:Peer Group; D010568:Peru / Q000453:epidemiology; D015995:Prevalence; D012309:Risk-Taking; D060386:Sex Workers; D012725:Sexual Behavior; D012747:Sexual Partners; D055815:Young Adult
keywords: Community organizations; Education and outreach; HIV; Marginalized populations; Public health; Resource-limited; Testing