Trends in HIV, sexually transmitted infections and risk behaviors among men who have sex with men in Lima, Peru
Background: In 1996, Peru started a second generation of HIV and sexually transmitted infections (STI) sentinel surveillance as an effective way to monitor the HIV epidemic.
Methods: Cross-sectional studies of HIV and STI were carried-out in men who have sex with men (MSM) in Lima during 1996, 1998, 2000 and 2002. Peer-educators referred participants to attend specialized centers. Adult men reporting at least one male sex partner during the last year were considerable eligible. Demographics and behavioral data were obtained. Serum samples were tested for antibodies against HIV-1 (ELISA and confirmatory WB), Treponema pallidum (RPR and confirmatory MHA-TP). A first-void urine sample was requested to rule out urethritis, except in 1996. Attempts to isolate Neisseria gonorrhoeae from pharynx and rectum by culture were done, except in 2002. Participants received pre- and post-test counseling, free condoms and lubricants, and received appropriate management according to results.
Results: HIV prevalences were 18.3% (444 people tested in 1996), 17.5% (1,231 in 1998), 19.7% (1,357 in 2000) and 22.3% (1,358 in 2002). Over time, early syphilis (RPR > 1:8 and confirmatory MHA-TP) had decreased (8.6%, 6.9%, 3.0% and 3.1%), but asymptomatic urethritis had increased (6.2%, 7.4%, and 10.6%). Rectal gonorrhea prevalence decreased (5.0%, 0.5%, and 0.2%), whereas pharyngeal gonorrhea remained stable (less than 1.5%). Excluding participants with previous HIV diagnosis, prevalence of new diagnosed cases had remained stable in Lima (17.4%, 13.5%, 13.7%, and 14.2%). Between 1996 and 2000, reported condom use in the last intercourse with a steady partner had risen in MSM with previous HIV diagnosis (17.1%, 29.8% and 49.4%), with ‘new’ HIV diagnosis (50.0%, 57.9% and 67.3%), and with non-HIV diagnosis (25.7%, 32.2%, and 40.9%), but dropped in 2002 (to 25.3%, 26.6%, and 31.5% respectively), after a disruption of the MoH condom promotion system.
Conclusions: This approach has showed to be useful to estimate STI prevalences, but needs to be compared with population based surveys.
The XV International AIDS Conference
" J Lama , , et al.
Trends in HIV, sexually transmitted infections and risk behaviors among men who have sex with men in Lima, Peru.
The XV International AIDS Conference: