Abstract
BackgroundThe 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.MethodsA 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.ResultsHIV 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.ConclusionInternet-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.
Highlights
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 %)
HIV prevalence and testing history The overall HIV prevalence for MSM among this study population was 18.3 %, but varied by sub-group: 15.9 % for MSM who found out about Epicentro by word of mouth, 23.2 % for MSM who learned about Epicentro online, and 19.3 % for sex workers
The distribution of sexual roles was similar for the in-person and online groups: penetrative (29.0 % vs. 22.2 %), receptive (21.7 % vs. 20.5 %), and both (47.7 % vs. 56.3 %)
Summary
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. Diagnosis is the critical first step in getting infected individuals into HIV care, but less than 50 % of MSM in Lima have been tested for HIV [7]. Among those who do present for testing, as few as 59 % attend a follow-up visit to receive their test results [8]. Reported reasons for low testing levels include fear of receiving a positive diagnosis, resulting in lifelong dependency on HIV treatment, drastic lifestyle changes, and even death [7, 10]
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