Testing for HIV and sexually transmitted infections among men who have sex with men (MSM) in Lima, Peru: Opportunities for treatment and risk modification

BACKGROUND: The HIV/AIDS epidemic in Peru is largely concentrated among men who have sex with men (MSM). We studied patterns/frequency of HIV testing and association with sexual risk behavior among MSM in Lima, Peru. METHODS: We recruited 718 MSM from 24 neighborhoods for a study on sexually transmitted infections (STIs) and community-building. Individuals who had never been tested for HIV were compared with individuals with at least one prior test. RESULTS: Of 718 participants, 77% had previously been tested for HIV (median 3 tests, IQR 2,6). Overall, HIV prevalence was 16% and did not differ between individuals with or without prior HIV testing (17% vs 14%, p=0.34). MSM with a history of testing were significantly more likely than others to report a prior STI diagnosis (35% vs 16%, p<0.01), abuse alcohol as defined by the CAGE questionnaire (62% vs 53%, p<0.05) and receive compensation for sex (59% vs 39%, p<0.01). MSM previously tested also reported a significantly (p<0.01) higher median number of lifetime partners (85, IQR 25,500) and partners over the past six months (6, IQR 2,20) when compared with other participants (30, IQR 10,100) and (3, IQR 2,9), respectively. Excluding participants who reported prior diagnosis of HIV (n=41), our study results did not change appreciably. CONCLUSIONS: We found a high prevalence of sexual risk behaviors among individuals tested previously for HIV, and testing did not appear to impact the behavior of high-risk MSM. Interventions to reduce sexual risk behaviors among high-risk MSM within STI testing/treatment programs are urgently needed.