Low HIV testing frequency and behavior among low-income high-risk populations, men who have sex with men (MSM) and transgender women (TW), in Lima, Peru

Background: The HIV epidemic in Peru is concentrated among MSM/TW. Among these high-risk populations, increased HIV testing frequency can lead to earlier treatment and potentially reduce HIV transmission. This study assessed HIV testing frequency, behavior and reasons for testing among MSM/TW in Lima, Peru. Methods: We analyzed baseline survey data from MSM/TW subjects enrolled in a community-based HIV prevention trial. Participants were recruited during 2008-2009 from 24 low-income neighborhoods in Lima, Peru. Results: Of the 718 participants, the median age was 29 (IQR 23-35) with a mean of 15.3 (SD 8.06) sexually active years. Overall, 79.6% reported ever testing for HIV and among ever testers, there was a median of only three lifetime tests (IQR 2-6). Among all participants, the mean number of tests per sexually active year was 0.53 (SD 0.83). Of all possible responses, the most common reasons reported for testing were to check one's health (23.3%), lack of condom use (19.7%), and free testing (14.0%). In multivariate analysis, ever testing was reported more frequently by sex-workers [APR 1.16, 95%CI (1.07-1.27)], participants reporting a prior sexually transmitted infection [APR 1.15, 95%CI (1.07-1.24)], and TW [APR 1.11, 95%CI (1.03-1.20)]. Conclusions: In this population, lifetime HIV testing was high, but testing frequency was well-below the Peruvian Ministry of Health's recommendation to test at least twice a year for MSM/TW. Additional research on testing intervals and motivations for testing would be beneficial and future counseling and interventions should emphasize routine testing.