Alcohol abuse and increased prevalence of sexual risk behaviors among men who have sex with men (MSM) in Lima, Peru

BACKGROUND: Alcohol abuse is an important but understudied HIV risk factor among men who have sex with men (MSM), particularly in Latin America. We studied the relationship between alcohol abuse and sexual risk among MSM in Lima, Peru. METHODS: We recruited 718 participants from 24 neighborhoods for a study on sexually transmitted infections and community-building among MSM. Alcohol abuse was defined using the CAGE screening tool. Bivariate analysis was used to compare alcohol abusers with non-abusers. RESULTS: Of 718 participants, 58% met criteria for alcohol abuse. Alcohol abusers were significantly more likely to report failing to always use condoms (66% vs 58%, OR 1.4, 95%CI 1.04-1.9) and were also significantly more likely to use alcohol (OR 2.0, 95%CI 1.5-2.8) or drugs (OR 2.5, 95%CI 1.3-5.0) prior to their most recent sexual encounter. In the last year, abusers were significantly more likely to receive compensation (OR 1.9, 95%CI 1.4,2.6) or pay (OR 1.7, 95%CI 1.2-2.4) for sex and were significantly more likely than non-abusers to ever have been coerced into sex (OR 2.3, 95%CI 1.6-3.2). Alcohol abusers also reported a significantly higher median number of lifetime sexual partners (100, IQR 20,500) and partners within the last six months (6, IQR 2,20) when compared with non-abusers (40, IQR 15,200) and (4, IQR 2,10), respectively (p<0.01). CONCLUSIONS: We found a high prevalence of alcohol abuse among MSM in Lima, Peru, which was associated with increased sexual risk in our study. Further studies and targeted interventions to reduce alcohol abuse among MSM are warranted.