International AIDS Society


HIV-1 Infections among Men who have Sex with Men (MSM) in Ecuador: Does oral sex play a role?

O Montoya1, S M Montano2, J C Vieira3, E Soria1, A Esparza1, C T Bautista4, G Chauca2, A Laguna2, J K Carr5, J L Sanchez4, J G Olson2
1Fundación Ecuatoriana Equidad, Quito, Ecuador; 2U.S. Naval Medical Research Center Detachment (NMRCD), Lima, Peru; 3Laboratorio de Investigaciones Clínicas. Hospital Vozandes, Quito, Ecuador; 4U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Rockville, Maryland, United States; 5Henry M Jackson Foundation, Rockville, Maryland, United States

BACKGROUND: This study was conducted to estimate the HIV prevalence in MSM, determine genetic variations of HIV-1 strains, and to identify risk factors for HIV infection in this high-risk group.

METHODS: We conducted a cross-sectional seroprevalence study among MSM in 4 major cities of Ecuador, Quito, Guayaquil, Portoviejo and Chone in 2001. After obtaining written informed consent, an anonymous demographic and epidemiologic risk factor questionnaire was administered to volunteers. Blood samples were collected for HIV-1 antibody testing by enzyme-linked immunosorbent assay (ELISA) and Western blot (WB) confirmatory testing. DNA was obtained from peripheral blood mononuclear cells as well as blood spots on filter paper. HIV envelope genotypes were initially determined by Heteroduplex Mobility Assay (HMA) and confirmatory DNA sequencing was performed on a subset of HIV-positive strains.

RESULTS: A total of 284 individuals were surveyed and the HIV prevalence was 11.6% (95% CI=0%-24.7%). The highest prevalence was found in Guayaquil (24.7%). No significant differences in prevalence were observed between the capital of Quito (13.2%) and other port cities (11.7%). A total of 20 samples were assayed by HMA for genotype, all were subtype B. Older age ( > 26 years) was an important risk factor for infection (AOR=2.3, 95%CI=1.1-4.8, P=0.034). Other risk factors included residing in Guayaquil (AOR=8.7, 95%CI=3.6-21.1, P < 0.001), identifying oneself as being gay (AOR=6.6, 95%CI=2.6-17.2, P < 0.001), and always practicing oral sex (AOR=4.6, 95%CI=2.0-10.8, P < 0.001). Other important factors, such as level of education, drug use, sex with foreigners/military, frequency or types of sexual contact and condom use were not associated with infection.

CONCLUSION: The HIV epidemic in Ecuador continues to be mostly restricted to MSM groups and is caused by subtype B. It is possible that oral sex may play an important role in HIV transmission among MSM and deserves further study.

The XV International AIDS Conference
Abstract no. WePeC6159

Suggested Citation
" O Montoya , , et al. HIV-1 Infections among Men who have Sex with Men (MSM) in Ecuador: Does oral sex play a role? . Poster Exhibition: The XV International AIDS Conference: Abstract no. WePeC6159"