Abstract
BackgroundAmong Latin America’s concentrated HIV epidemics, little is known about men who have sex with men (MSM) in Colombia, the region’s third largest country. To date, surveillance studies have been limited to Bogota, while 80% of HIV cases and deaths originate from Colombia’s other cities and departments. The extent to which interventions should prioritize MSM outside of Bogota is unknown.MethodsWe recruited 2603 MSM using respondent-driven sampling from seven of Colombia’s largest cities. HIV prevalence was estimated by site from dried blood spot samples. Behavioral data were collected through face-to-face interviews and risk factors for HIV infection analyzed using weighted, multi-level logistical regression models accounting for recruitment patterns.ResultsAcross cities, HIV prevalence averaged 15%, varied from 6% to 24% and was highest in Cali, Bogota, and Barranquilla. In the past 12 months, 65% of MSM had ≥ 5 casual male partners and 23% had a female partner. Across partnerships (i.e., casual, stable, and commercial), the proportion of MSM engaging in unprotected sex was ≥ 52% with male partners and ≥ 66% with female partners. Self-reported history of STI (24%) and past-year illicit drug use (38%) were also common. In multivariate analysis, age ≥ 35 (adjusted odds ratio [AOR], 19.2) and 25–39 (AOR, 5.6) relative to ≤ 18–24 years, identifying as homosexual relative to heterosexual (AOR 0.1), meeting casual partners on the Internet (adjusted odds ratio [AOR], 3.1) and age of sexual debut of ≤ 13 years (AOR, 3.1) predicted HIV infection. HIV testing and prevention messaging reached just 24% of MSM in the past year.ConclusionsFindings support consistently elevated HIV burden among MSM throughout Colombia’s largest cities and a need for enhanced behavioral prevention and HIV testing, emphasizing men who use the Internet as well as physical venues to meet sex partners.
Highlights
Colombia is the second most populous nation in South America after Brazil and the third largest in the Latin America region, with 48 million inhabitants [1]
Among Latin America’s concentrated HIV epidemics, little is known about men who have sex with men (MSM) in Colombia, the region’s third largest country
While in several Latin American nations men who have sex with men (MSM) have been identified as the population most central to HIV transmission [3,4,5], regular surveillance studies in Colombia have centered on women attending antenatal clinics, which have consistently demonstrated HIV prevalence below 0.5% since 1989 [6]
Summary
Colombia is the second most populous nation in South America after Brazil and the third largest in the Latin America region, with 48 million inhabitants [1]. Available data on HIV among MSM date from a single study in 2002 in Bogota, the national capital, which reported a prevalence of 20% (N = 660) [7] This was among the highest of estimates from a regional surveillance initiative in 36 South American cities. HIV mortality has increased, in contrast to trends elsewhere in the region [8], despite a national policy providing for freely available antiretroviral therapy since 1999 Amidst this expanding epidemic, male HIV mortality has consistently outpaced female mortality (8.1 vs 2.1 per 100,000 people in 2011) and 72% of HIV cases are reported among males [6], suggesting the potential importance of MSM in HIV transmission. The extent to which interventions should prioritize MSM outside of Bogota is unknown
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
