Population Of Peru Research Articles

Perceived Barriers and Facilitators to Integrating HIV Prevention and Treatment with Cross-Sex Hormone Therapy for Transgender Women in Lima, Peru.

Transgender women (TW) represent a vulnerable population at increased risk for HIV infection in Peru. A mixed-methods study with 48 TW and 19 healthcare professionals was conducted between January and February 2015 to explore barriers and facilitators to implementing a model of care that integrates HIV services with gender-affirmative medical care (i.e., hormone therapy) in Lima, Peru. Perceived acceptability of the integrated care model was high among TW and healthcare professionals alike. Barriers included stigma, lack of provider training or Peruvian guidelines regarding optimal TW care, and service delivery obstacles (e.g., legal documents, spatial placement of clinics, hours of operation). The hiring of TW staff was identified as a key facilitator for engagement in health care. Working in partnership with local TW and healthcare provider organizations is critical to overcoming existing barriers to successful implementation of an integrated HIV services and gender-affirmative medical care model for this key population in Peru.

Smoking and heavy drinking patterns in rural, urban and rural-to-urban migrants: the PERU MIGRANT Study

BackgroundPrevious studies have found mixed results about cigarette and alcohol consumption patterns among rural-to-urban migrants. Moreover, there are limited longitudinal data about consumption patterns in this population. As such, this study aimed to compare the smoking and heavy drinking prevalence among rural, urban, and rural-to-urban migrants in Peru, as well as the smoking and heavy drinking incidence in a 5-year follow-up.MethodsWe analyzed the PERU MIGRANT Study data from rural, urban, and rural-to-urban migrant populations in Peru. The baseline study was carried out in 2006–2007 and follow-up was performed five years later. For the baseline data analysis, the prevalence of lifetime smoking, current smokers, and heavy drinking was compared by population group using prevalence ratios (PR) and 95% confidence intervals (95% CI). For the longitudinal analysis, the incidence of smoking and heavy drinking was compared by population group with risk ratios (RR) and 95% CI. Poisson regression with robust variance was used to calculate both PRs and RRs.ResultsWe analyzed data from 988 participants: 200 rural dwellers, 589 migrants, and 199 urban dwellers. Compared with migrants, lifetime smoking prevalence was higher in the urban group (PR = 2.29, 95% CI = 1.64–3.20), but lower in the rural group (PR = 0.55, 95% CI = 0.31–0.99). Compared with migrants, the urban group had a higher current smoking prevalence (PR = 2.29, 95% CI = 1.26–4.16), and a higher smoking incidence (RR = 2.75, 95% CI = 1.03–7.34). Current smoking prevalence and smoking incidence showed no significant difference between rural and migrant groups. The prevalence and incidence of heavy drinking was similar across the three population groups.ConclusionsOur results show a trend in lifetime smoking prevalence (urban > migrant > rural), while smoking incidence was similar between migrant and rural groups, but higher in the urban group. In addition, our results suggest that different definitions of smoking status could lead to different smoking rates and potentially different measures of association. The prevalence and incidence of heavy drinking were similar between the three population groups.

Talking about digital inclusion in rural sector

Given the existence palpable of digital divide in the Latin American rural sector, the authors intend to formalize this document online conversation initiated under the auspices Anilla Cultural Uruguay, which focuses on understanding the situation of the rural population in Uruguay, Peru and Colombia, as well as digital inclusion processes, developed in them from the state initiative, thinking that camp residents to access, use and appropriation ICT in their activities, especially given school as a bridge. Considering the respect that should be borne by the diversity and the need for digital inclusion projects are with, by and for rural communities, the paper ends with a summary description of a proposal basics for future initiatives.Keywords: digital divide; digital inclusion; rural sector; diversity.

A DNA barcoding approach for identifying species in Amazonian traditional medicine: The case of Piri-Piri

The progressive loss of knowledge about the use of plants in traditional medicine practices is an issue of major concern with social, economic, and health implications for local communities, especially in developing countries. The Peruvian Amazon is one of the principal scenarios where this phenomenon is occurring at a growing rate. We investigated the case of Piri-Piri (Cyperus articulatus L.), a species of sedge used by native populations of Peru as an antiemetic, an anti-diarrheal, a sedative, an anti-venom, and to treat other symptoms or to conduct ritual practices. In this study, we collected 19 samples of Piri-Piri from different natives' familiar nuclei in four Amazonian villages, and we used the molecular tool DNA barcoding to verify the corrected species identification. The identification performances of four barcode loci (rbcL, matK, trnH-psbA and ITS) were evaluated. RbcL and matK were not able to univocally identify the Piri-Piri samples; however, they indicated that one sample did not match with the expected C. articulatus (local misidentification). This finding was further confirmed at both trnH-psbA and ITS regions. These two loci designated the remaining 18 samples to the correct species, C. articulatus. Based on our results, we propose DNA barcoding as a reliable tool for preserving the genetic identity and the exploitation of Piri-Piri by the local traditional medicine. This universal and fast molecular characterization method should be included in Internet-based Automated Identification Technology systems to enhance the spread of traditional medicine and prevent the erosion of ancient traditional knowledge.

Phylogeny and biogeography of the most diverse clade of South American gymnophthalmid lizards (Squamata, Gymnophthalmidae, Cercosaurinae)

Nearly 50% of the diversity of the speciose Neotropical lizard clade Gymnophthalmidae is nested within the subclade Cercosaurinae. The taxonomy of Cercosaurinae lizards has been historically confusing because many diagnostic characters of those clades traditionally ranked as genera do not represent true diagnostic apomorphies. Even though molecular phylogenies of several ‘genera’ have been presented in the last few years, some of them remain poorly sampled (e.g., Anadia, Echinosaura, Potamites, Riama). In this paper we present a more comprehensive phylogeny of Cercosaurinae lizards with emphasis on Andean taxa from Ecuador and Peru, as well as a time-calibrated phylogeny with reconstruction of ancestral areas. Our analysis includes 52% of all recognized species of Cercosaurinae (67 species) and 1914 characters including three mitochondrial and one nuclear gene. We find that Anadia, Echinosaura, Euspondylus, Potamites, Proctoporus, and Riama are not monophyletic: the Tepuian Anadia mcdiarmidi is not sister to Andean species of Anadia; Echinosaura sulcarostrum is not included in the same clade formed by other species of Echinosaura and their more recent common ancestor; Teuchocercus is nested within Echinosaura; species of Euspondylus included in this study are nested within Proctoporus; Riama laudahnae is included in Proctoporus; and Potamites is paraphyletic and split in two separate clades, one of which we name Gelanesaurus, also a new genus-group name. Within Potamites, P. ecpleopus is paraphyletic, and P. strangulatus strangulatus and P. strangulatus trachodus are recognized as two distinct species. We also identify three unnamed clades (i.e., not nested within any of the recognized ‘genera’) from Andean populations in Ecuador and Peru. The estimated age of the clade Cercosaurinae (∼60Ma) corresponds to the early stages of the northern Andes. Even though the distribution of the most recent common ancestor of Cercosaurinae remains equivocal, our analysis shows that these lizards colonized and radiated along the northern Andes before reaching the central Andes in Peru. Finally, we present phylogenetic definitions for some of the recovered clades to promote a clear and precise classification of Cercosaurinae lizards.

The challenge of improving boiling: lessons learned from a randomized controlled trial of water pasteurization and safe storage in Peru.

Boiling is the most common method of household water treatment in developing countries; however, it is not always effectively practised. We conducted a randomized controlled trial among 210 households to assess the effectiveness of water pasteurization and safe-storage interventions in reducing Escherichia coli contamination of household drinking water in a water-boiling population in rural Peru. Households were randomized to receive either a safe-storage container or a safe-storage container plus water pasteurization indicator or to a control group. During a 13-week follow-up period, households that received a safe-storage container and water pasteurization indicator did not have a significantly different prevalence of stored drinking-water contamination relative to the control group [prevalence ratio (PR) 1·18, 95% confidence interval (CI) 0·92-1·52]. Similarly, receipt of a safe-storage container alone had no effect on prevalence of contamination (PR 1·02, 95% CI 0·79-1·31). Although use of water pasteurization indicators and locally available storage containers did not increase the safety of household drinking water in this study, future research could illuminate factors that facilitate the effective use of these interventions to improve water quality and reduce the risk of waterborne disease in populations that boil drinking water.

Disease prevalence in a rural Andean population of central Peru: a focus on autoimmune and allergic diseases.

Introduction The hygiene hypothesis, formulated to explain the increased incidence of allergic and autoimmune diseases observed in industrialized countries, remains controversial. We reflected upon this hypothesis during a medical mission to rural and impoverished villages of central Peru.Materials and methods The mission was carried out in July 2015 to aid three Andean villages located near Cusco, and comprised 10 American physicians, 4 nurses, and 24 students. After recording the vital signs, patients were triaged by nurses based on the major complaint, visited by physicians, and prescribed medications. Physicians wrote their notes on a one-page form and established diagnoses purely on clinical grounds, without laboratory or imaging testing. Physician notes were then analyzed retrospectively in a de-identified and double-blinded fashion.ResultsA total of 1075 patients (357 men and 718 women) were visited during 5 consecutive clinic days, 840 being adults and 235 <18 years of age. The most common complaints were back pain, stomach pain, headache, and vision loss. Osteoarthritis, gastritis, visual disturbances, and parasitic infections dominated the diagnostic categories. Thirty-seven patients (3 %) were diagnosed with an allergic or autoimmune disease, mainly represented by asthma, rheumatoid arthritis, and Hashimoto’s thyroiditis, a prevalence that was not significantly lower than that reported in industrialized countries.ConclusionsAlthough a study of this nature cannot definitively support or refute the hygiene hypothesis, it does provide a novel snapshot of disease prevalence in rural Andean villages of central Peru. The study could serve as a basis to implement basic public health interventions and prepare for future missions to the same or comparable regions.Electronic supplementary materialThe online version of this article (doi:10.1007/s13317-016-0076-z) contains supplementary material, which is available to authorized users.

Interacting Effects of Newcastle Disease Transmission and Illegal Trade on a Wild Population of White-Winged Parakeets in Peru: A Modeling Approach.

Illegal wildlife-pet trade can threaten wildlife populations directly from overharvest, but also indirectly as a pathway for introduction of infectious diseases. This study evaluated consequences of a hypothetical introduction of Newcastle disease (ND) into a wild population of Peru’s most trafficked psittacine, the white-winged parakeet (Brotogeris versicolurus), through release of infected confiscated individuals. We developed two mathematical models that describe ND transmission and the influence of illegal harvest in a homogeneous (model 1) and age-structured population of parakeets (model 2). Infection transmission dynamics and harvest were consistent for all individuals in model 1, which rendered it mathematically more tractable compared to the more complex, age-structured model 2 that separated the host population into juveniles and adults. We evaluated the interaction of ND transmission and harvest through changes in the basic reproduction number (R0) and short-term host population dynamics. Our findings demonstrated that ND introduction would likely provoke considerable disease-related mortality, up to 24% population decline in two years, but high harvest rates would dampen the magnitude of the outbreak. Model 2 produced moderate differences in disease dynamics compared to model 1 (R0 = 3.63 and 2.66, respectively), but highlighted the importance of adult disease dynamics in diminishing the epidemic potential. Therefore, we suggest that future studies should use a more realistic, age-structured model. Finally, for the presumptive risk that illegal trade of white-winged parakeets could introduce ND into wild populations, our results suggest that while high harvest rates may have a protective effect on the population by reducing virus transmission, the combined effects of high harvest and disease-induced mortality may threaten population survival. These results capture the complexity and consequences of the interaction between ND transmission and harvest in a wild parrot population and highlight the importance of preventing illegal trade.

Advocacy Interventions to Reduce or Eliminate Violence and Promote the Physical and Psychosocial Well‐Being of Women who Experience Intimate Partner Abuse: A Systematic Review

Advocacy Interventions to Reduce or Eliminate Violence and Promote the Physical and Psychosocial Well‐Being of Women who Experience Intimate Partner Abuse: A Systematic Review

Estudio transversal de uso de servicios de salud mental en cinco ciudades del Perú

Resumen Antecedentes. La primera causa de carga de enfermedad en el Perú son las enfermedades neuropsiquiátricas. Objetivo. El objetivo del presente estudio fue generar información acerca del uso de 12 meses de servicios de salud mental en la población adulta urbana de Perú. Método. El Estudio Mundial de Salud Mental(EMSM)se desarrolló con una muestra probabilística y multietápica de 3930 participantes de 18 a 65 años de edad en Lima, Arequipa, Huancayo, Iquitos y Tacna entre julio del 2004 y diciembre del 2005. Utilizó la Entrevista Diagnóstica Internacional Compuesta, que proporciona diagnósticos de acuerdo con el DSM-IV y el CIE-10. Resultados. Sólo una de cada cinco personas que presentaron algún trastorno durante los últimos 12 meses recibió tratamiento durante ese período. En promedio, durante este tiempo recibieron tres atenciones. Sólo 9.7% de las personas con cualquier trastorno durante los últimos 12 meses recibió un tratamiento adecuado. Las personas con bajo nivel de educación tuvieron menor acceso a tratamiento mínimamente adecuado (OR=0.1; 95% CI=0.0, 0.5). El grupo con trastornos de uso de sustancias presentó menor acceso a tratamiento en los últimos 12 meses (12.7%). Discusión y conclusión. En el Perú existe una brecha de atención de salud mental. Las personas de menor educación y las personas con trastorno de abuso de sustancias son el grupo de menor acceso a cualquier tipo de tratamiento adecuado. La brecha de atención pone en evidencia la urgente necesidad de dirigir atención y recursos hacia la detección y tratamiento oportuno de las enfermedades mentales en el Perú.

Soil-Transmitted Helminth Infections Are Associated With an Increase in Human Papillomavirus Prevalence and a T-Helper Type 2 Cytokine Signature in Cervical Fluids.

An ecological correlation between invasive cervical cancer incidence and burden of soil-transmitted helminths (STH) is hypothesized to explain the excess in detectable human papillomavirus (HPV) infection in Latin America, via a global T-helper type 2 (Th2)-biased mucosal immune response secondary to STH infection. The association between current STH infection and HPV prevalence was compared in regions of Peru where STH is or is not endemic. Adjusted prevalence ratios (PRs) with robust variance were estimated as an effect measure of STH infection on HPV prevalence in each study site. Soluble immune marker profiles in STH-infected and STH-uninfected women were compared using Spearman rank correlation with the Sidak correction. Among women in the helminth-endemic region of the Peruvian Amazon, those with STH infection women had a 60% higher prevalence of HPV, compared with those without STH infection (PR, 1.6; 95% confidence interval, 1.0-2.7). Non-STH parasitic/protozoal infections in the non-STH-endemic population of Peru were not associated with HPV prevalence. In Iquitos, A Th2 immune profile was observed in cervical fluid from helminth-infected women but not helminth-uninfected women. A proportion of the increased HPV prevalence at older ages observed in Latin America may be due to a population-level difference in the efficiency of immunological control of HPV across the lifespan due to endemic STH infection.

Prevalence of diabetes and impaired fasting glucose in Peru: report from PERUDIAB, a national urban population-based longitudinal study

ObjectivesWe aimed to estimate the prevalences of diabetes and impaired fasting glucose (IFG) in a national sample in Peru and assess the relationships with selected sociodemographic variables.MethodsWe estimated prevalence in...

P11.22 Hepatitis c infections among high-risk men who have sex with men and transgender women in lima, peru

Introduction Disparate findings persist in the literature regarding the sexual transmission of hepatitis C virus (HCV) and the role of HIV/other STIs. Therefore we analysed the epidemiology and risk factors for HCV infection among a non-intravenous drug using, sexually active population in Peru. Methods High-risk men who have sex with men (MSM) and transwomen (TW) recruited from two STI clinics completed a behavioural survey on substance use and sexual risk taking in the last 3 months. Hepatitis C diagnosis was determined by detection of Anti-HCV antibodies using EIA UMELISA PLUS (Specificity: 99.93% Sensitivity: 100% Tecnosuma, Cuba). In addition to HIV testing, STI screening included rectal gonorrhoea/chlamydia (NAAT) and syphilis (RPR titer ≥1:16). Chi-square tests were used to compare differences in characteristics between HCV-infected and negative individuals. Results Among 310 MSM and 89 TW (median age30 years, IQR: 18–58), 4% (15/399) were HCV-infected. Recent condomless anal intercourse was reported by 76% of the sample (292/393). Although more condomless anal intercourse was reported among HCV-infected vs. negative individuals (93% vs.74%) the difference was not significant (p = 0.107). Illicit substance use for the cohort was low with 13% reporting recent cocaine use, which also was not significantly different among HCV-infected vs. negative individuals (27% vs. 13%, p = 0.120). HIV positivity was 31% for the sample (124/401) and was associated with HCV infection vs. non-infection (53% vs. 30%, p = 0.054). When comparing HCV-infected to negative individuals, neither rectal STI diagnosis (27% vs. 20%, p = 0.55) nor recent syphilis diagnosis (47% vs. 36%, p = 0.41) were significantly associated. Conclusion The findings for this cohort in Peru did uncover an association between HCV infection and concurrent HIV infection however such associations for sexual risk behaviours and other STI diagnoses were not found. Prospective data documenting HCV seroconversion among a larger sample is needed to better understand the contribution of sexual transmission to HCV infection. Disclosure of interest statement This data for this abstract was obtained from an NIH-funded study (1R01AI099727). Hepatitis tests were donated however the donating company did not contribute to the conception of this study or participate in the analysis/interpretation of the data in this abstract.

P11.21 Characterising the epidemiology of active hepatitis b virus infection among high-risk men who have sex with men and transgender women in lima, peru

Introduction Hepatitis B (HBV) infection is a major cause of chronic liver disease, which is a leading cause of death worldwide. Despite differing epidemiology, HBV infection shares routes of transmission with HIV infection. Therefore we explored factors associated with those infections among high-risk populations in Peru. Methods Men who have sex with men (MSM) and transwomen (TW) recruited from two STI clinics completed a behavioural survey on alcohol use and sexual risk-taking in the last 3 months and received HIV testing. An AUDIT score ≥17 determined the presence of a severe alcohol use disorder. Active hepatitis B infection was determined by detection of HBsAg using EIA UMELISA and HBsAg confirmatory testing (Tecnosuma, Cuba). Self-collected rectal swabs were used to diagnose gonorrhoea/chlamydia by NAAT. Prevalence ratios (PR) were calculated using Poisson regression. Results Among 310 MSM and 89 TW (median age 30 years, IQR: 18–58), 5% (20/399) had active HBV infection. Of the 20 participants with active HBV infection, 50% were HIV co-infected which was significantly more than the HIV prevalence among HBsAg negatives (30%, p-value = 0.053). Rates of recent condomless anal intercourse were similar by HBV infection status (68% among those with active infection vs. 74% among HBsAg negatives p = 0.557). Rectal STI prevalence was 40% among participants with active HBV infection vs. 20% among HBsAg negative participants. (p-value = 0.034). In multivariable regression active HBV infection was associated with severe alcohol use disorders (aPR = 2.54, p-value = 0.008) and HIV diagnosis (aPR = 2.56, p-value = 0.009). Conclusions In the context of South America’s low carrier rate, the prevalence of active HBV infection among this Peruvian sample is high. Our findings emphasise the importance of revising national HBV screening and vaccination guidelines to include HIV-infected individuals and heavy drinkers since both conditions may accelerate liver disease. Educational campaigns to encourage transmission prevention are also needed since condomless anal intercourse was common in this cohort. Disclosure of interest statement This data for this abstract was obtained from an NIH-funded study (1R01AI099727). Hepatitis tests were donated however the donating company did not contribute to the conception of this study or participate in the analysis/interpretation of the data in this abstract.

Morphology of the oxyurid nematodes Trypanoxyuris (T.) cacajao n. sp. and T. (T.) ucayalii n. sp. from the red uakari monkey Cacajao calvus ucayalii in the Peruvian Amazon.

Cacajao calvus ucayalii (Thomas, 1928) (Primates: Pitheciidae), a subspecies endemic to the Peruvian Amazon, occurs in patchy and sometimes isolated populations in north-eastern Peru and is in a vulnerable situation, mainly due to habitat loss and hunting. This rareness and remote distribution means that, until now, parasitical studies have been limited. Based on optical and scanning electron microscopy of specimens of both sexes, we report two new species of Trypanoxyuris pinworms occurring in the large intestine of the Peruvian red uakari, namely Trypanoxyuris (Trypanoxyuris) cacajao and Trypanoxyuris (Trypanoxyuris) ucayalii. Both species showed a distinct morphology of the lips and cephalic structure. Sexual dimorphism in the lateral alae was observed in both male and the female worms, with ventral ornamentation being shown in the oesophageal teeth. The finding of these new pinworm species highlights the possibility of discovering other species.

Ethical problems in health research with indigenous or originary peoples in Peru.

The varied, abrupt and amazing geography of the land of Peru is home of one of the major concentrations of indigenous peoples in the world. The asymmetry of power, however, in their relationship with the rest of society and the State is still very evident in their social exclusion, their gap in social and economic development, barriers in their access to health services as well as their marginalization and exploitation as subjects of health research. In this paper, we analyse two cases of research on indigenous populations in Peru, discuss them from the point of view of bioethics and reflect on important issues for researchers, research participants and the society, such as the need to respect different cultures, the need that the research being done is relevant to the needs of the population in which it is conducted and the necessity to empower indigenous communities in participatory research, to strengthen the institutions and to protect human rights, namely through ethics committees for research and the free, informed and meaningful informed consent. This approach should foster quality research, while at the same time fully respecting human rights and bioethics. We cannot forget that advancements in genetics, throughout the world, are very much in debt to indigenous populations.

La situación demográfica del Perú

Si bien, dentro de lo que a los participantes a estas Jornadas de Población, pueda interesar, este es sólo un enfoque parcial del llamado problema de la población, resulta también ser condición básica el conocimiento científico de la población del Perú, dentro del contexto netamente demográfico. Es así que cualquier conjunto de medidas tendientes a influir sobre el comportamiento de las variables demográficas, la fecundidad, la mortalidad, la migración, deberá partir de este conocimiento. Quienes concurrieron a las reuniones de Población en Tarma, realizadas en junio pasado, han tenido la oportunidad de escuchar que los demógrafos peruanos hemos sido objeto de críticas por parte de profesionales de otras disciplinas, por no haber dado a las cuestiones demográficas su verdadera dimensión, y por no haber sido tal vez lo suficientemente influyentes para una toma de conciencia de los problemas de Población.

Curva de trabajo de parto normal en mujeres peruanas

De acuerdo a los criterios que se señalan, se transcribieron 875 curvas de trabajo de parto, para la obtención de la curva de trabajo de parto en general. 400 eran primerizas y 475 multíparas. Con otros requisitos adicionales, se seleccionaron 463 casos, para la elaboración de la curva de trabajo de parto ideal. 164 eran primerizas y 299 multíparas. La curva de trabajo de parto obtenida, permite objetivar fácilmente la presencia de una Fase Latente y una Fase Activa, ésta última conformada por las subfases de Aceleración, Máxima Aceleración y Desceleración. La suma de la Fase Latente con la Activa, constituyen el 1er. Período. El 2do. Período, lo constituye el clásico período expulsivo. Las curvas de trabajo de parto de las primerizas en general, primerizas ideales, multíparas en general y multíparas ideales son distintas entre sí, pero considerando la calidad de los grupos, se prefieren las curvas de trabajo de parto ideal, como representativas de la Curva de Trabajo de Parto de la población peruana. De acuerdo a los resultados, el diagnóstico de Trabajo de parto prolongado, se presenta cuando la duración del mismo ha sobrepasado 20 horas en las primerizas o 15 horas en las multíparas. Con igual sentido se introducen conceptos como: Fase Latente prolongada, Fase Activa prolongada, Velocidad de Dilatación Infranormal, etc. Que se estiman en gran utilidad para el correcto manejo de un trabajo de parto.

Hemoglobin and Lipid Assessment of Children in Iquitos, Peru*

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The HOPE social media intervention for global HIV prevention in Peru: a cluster randomised controlled trial

Social media technologies offer new approaches to HIV prevention and promotion of testing. We examined the efficacy of the Harnessing Online Peer Education (HOPE) social media intervention to increase HIV testing among men who have sex with men (MSM) in Peru. In this cluster randomised controlled trial, Peruvian MSM from Greater Lima (including Callao) who had sex with a man in the past 12 months, were 18 years of age or older, were HIV negative or serostatus unknown, and had a Facebook account or were willing to create one (N=556) were randomly assigned (1:1) by concealed allocation to join intervention or control groups on Facebook for 12 weeks. For the intervention, Peruvian MSM were trained and assigned to be HIV prevention mentors (peer-leaders) to participants in Facebook groups. The interventions period lasted 12 weeks. Participants in control groups received an enhanced standard of care, including standard offline HIV prevention available in Peru and participation in Facebook groups (without peer leaders) that provided study updates and HIV testing information. After accepting a request to join the groups, continued participation was voluntary. Participants also completed questionnaires on HIV risk behaviours and social media use at baseline and 12 week follow-up. The primary outcome was the number of participants who received a free HIV test at a local community clinic. The facebook groups were analysed as clusters to account for intracluster correlations. This trial is registered with ClinicalTrials.gov, number NCT01701206. Of 49 peer-leaders recruited, 34 completed training and were assigned at random to the intervention Facebook groups. Between March 19, 2012, and June 11, 2012, and Sept 26, 2012, and Dec 19, 2012, 556 participants were randomly assigned to intervention groups (N=278) or control groups (N=278); we analyse data for 252 and 246. 43 participants (17%) in the intervention group and 16 (7%) in the control groups got tested for HIV (adjusted odds ratio 2·61, 95% CI 1·55–4·38). No adverse events were reported. Development of peer-mentored social media communities seemed to be an efficacious method to increase HIV testing among high-risk populations in Peru. Results suggest that the HOPE social media intervention could improve HIV testing rates among MSM in Peru. National Institute of Mental Health.