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331152
Does Having an Alcohol Use Disorder Impact Sexual Behavior or Sexually Transmitted Infection (STI) Prevalence among Men Who Have Sex with Men (MSM) and Transgender Women (TW) in Lima, Peru?


Tuesday, November 3, 2015 : 1:09 p.m. - 1:22 p.m.

Maria Christina Herrera, MD, Division of Infectious Diseases, UCLA David Geffen School of Medicine, Los Angeles, CA
Kelika Konda, MHS, PhD, Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA
Segundo Leon, MT, ID, Unit of Health, Sexuality and Human Development, School of Public Health, Universidad Peruana Cayetano Heredia, Lima, Peru
Robert Deiss, MD, Division of Global Public Health Department of Medicine, University of California, La Jolla, CA
Brandon Brown, MPH, PhD, Department of Population Health and Disease Prevention, Program in Public Health, University of California, Irvine, Irvine, CA
Carlos Caceres, MD, PhD, Unit of Health, Sexuality and Human Development, School of Public Health, Universidad Peruana Cayetano Heredia, Lima, Peru
Jeffrey Klausner, MD, MPH, Infectious Diseases, David Geffen School of Medicine at UCLA, Los Angeles, CA
Gino Calvo, BA, Epicentro
  
Alcohol use disorders (AUDs) including alcohol abuse and alcohol dependence may enhance the likelihood of risky sexual behaviors and STI acquisition. Associations between AUDs with condomless anal intercourse (CAI) and recent STI/HIV prevalence were assessed among MSM and TW in Lima, Peru.

High-risk MSM and TW recruited from STI clinics completed a survey on CAI and number of sex partners in the past 3 months, and alcohol use. An AUDIT score ≥8 determined AUD presence. Recent STI diagnosis included rectal gonorrhea/chlamydia (NAAT), syphilis (RPR titer≥1:16), and/or new HIV infection within 6 months. Prevalence ratios (PR) were calculated using Poisson regression.

Among 312 MSM and 89 TW, the median age was 30 years (IQR 18-58) and 45% of participants (181/401) had an AUD. Among those with an AUD, 164 (91%) were hazardous or harmful drinkers, and 17 (9%) had alcohol dependence.  Higher CAI was reported by participants with an AUD vs. without (84% vs. 73%, p=0.007). There was no difference in recent STI/HIV among participants by AUD status (32%, p=0.961). CAI was associated with having an AUD (aPR=1.13), self-report of bi-or heterosexual (aPR=1.13), and having ≥6 sex partners (aPR=1.22) in multivariable regression (all p-values<0.05). Recent STI/HIV infection was associated with being receptive (aPR=1.81) or both receptive and insertive (aPR=2.35) during anal sex (p-values<0.05).

Although AUDs were associated with CAI, there was no association of AUD with recent STI/HIV in our sample. This may suggest that STI prevalence within this key population confers greater risk than individual risk behaviors, necessitating population-level interventions.

Learning Areas:

Epidemiology
Planning of health education strategies, interventions, and programs
Social and behavioral sciences

Learning Objectives:
Describe alcohol use disorders (AUD) among men who have sex with men and transgender women in Lima, Peru based on the World Health Organization AUD severity categories. Describe the association of having an AUD with high risk sexual behaviors among men who have sex with men and transgender women in Lima, Peru. Describe the association of having an AUD with recent acquisition of a sexually transmitted infection among men who have sex with men and transgender women in Lima, Peru.

Keyword(s): Alcohol Use, STDs/STI

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: For the last 6 months I have been working as a research fellow between my third and fourth years of medical school in UCLA’s NIH-funded 11-month training program in HIV prevention research in Latin America. As a member of the project team for the ongoing cohort study that supplied the data for this abstract, I have conducted statistical analyses and assisted with data management and refinement of study procedures in the field.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

Back to: 4238.0: HIV/AIDS