title: Partner-Level Factors Associated with Insertive and Receptive Condomless Anal Intercourse Among Transgender Women in Lima, Peru.
abstract: Condomless anal intercourse among transgender women (TW) in Peru has been shown to vary by the type of partner involved (e.g. primary vs. casual vs. transactional sex partner), but no previous studies have explored variations in partner-level patterns of condom use according to type of anal intercourse. We evaluated the relationship between partnership characteristics and condom use during insertive (IAI) versus receptive anal intercourse (RAI) among TW with recent, non-female partners. Condomless IAI was more common with transactional and casual sex partners and by TW who self-reported HIV-uninfected serostatus (p < 0.05), alcohol use disorders, or substance use before sex. Condomless RAI was more common with primary partners and by TW who described their HIV serostatus as unknown (p < 0.05). Examining partner-level differences between condomless IAI and RAI reveals distinct patterns of HIV/STI risk among TW, suggesting a need for HIV prevention strategies tailored to the specific contexts of partners, practices, and networks.
authors.affiliation: Division of Infectious Disease, Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, CA, USA. mfsatcher@gmail.com.|Department of Family Medicine, Boston University School of Medicine / Boston Medical Center, Boston, MA, USA. mfsatcher@gmail.com.
authors.forename: Milan F
authors.initials: MF
authors.lastname: Satcher
authors.affiliation: Division of Infectious Disease, Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, CA, USA.
authors.forename: Eddy R
authors.initials: ER
authors.lastname: Segura
authors.affiliation: Unit of Health, Sexuality and Human Development, Cayetano Heredia University School of Public Health, Lima, Peru.
authors.forename: Alfonso
authors.initials: A
authors.lastname: Silva-Santisteban
authors.affiliation: Asociación Civil Impacta Salud y Educación, Lima, Peru.
authors.forename: Jorge
authors.initials: J
authors.lastname: Sanchez
authors.affiliation: Asociación Civil Impacta Salud y Educación, Lima, Peru.
authors.forename: Javier R
authors.initials: JR
authors.lastname: Lama
authors.affiliation: Division of Infectious Disease, Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, CA, USA.
authors.forename: Jesse L
authors.initials: JL
authors.lastname: Clark
mesh_terms: D000328:Adult; D005260:Female; D015658:HIV Infections / Q000517:prevention & control*; D006801:Humans; D008297:Male; D010568:Peru; D021841:Safe Sex; D012725:Sexual Behavior / Q000706:statistics & numerical data; D012747:Sexual Partners; D063106:Transgender Persons; D047568:Unsafe Sex / Q000706:statistics & numerical data*; D055815:Young Adult
keywords: Condomless anal intercourse; HIV; Peru; Sexual partnerships; Transgender women