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Alcohol Use, HIV Unawareness, and Risky Behaviors Among MSM in Peru

Study on HIV prevalence and associated behaviors among MSM in Peru, revealing high rates of alcohol use disorders and risky sexual behaviors leading to HIV infection. Urges for expanded testing and treatment strategies.

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Alcohol Use, HIV Unawareness, and Risky Behaviors Among MSM in Peru

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  1. Being Unaware of Being HIV-Infected is Associated with Alcohol Use Disorders and High-Risk Sexual Risk Behaviors Among MSM in Peru VagenasP, Ludford, KT, GonzalesP, PeinadoP; CabezasC; Gonzales F; Lama JR, Sanchez J, Altice FL

  2. Background Peru • Middle income country • Low HIV prevalence: 0.2% in general population1 • Men who have sex with men (MSM) are disproportionately affected • HIV prevalence (Lima): 18.5 – 22.3%2-4 • HIV epidemic concentrated among MSM, in Lima 1. Garcia PJ et al. Lancet 2012. 2. Sanchez Jet al.. JAIDS. 2007. 3. Tabet S et al. AIDS.2002. 4. Silva-Santisteban A, et al. Int AIDS Conf2010:Abstr# A-240-0123-13697.

  3. Other Findings from this Sample Alcohol Use Disorders (AUDs) are significantly and independently associated with: • Unprotected sex • >5 partners in last 3 months • STI in last 6 months • Sex work in last 6 months • Sex with HIV+ partner in last 6 months LudfordKT et al., POSTER #WEPE554, Wed 12.30pm

  4. Methods • Bio-behavioral cross-sectional surveillance study (May-Oct, 2011) • 5,148 biological men who reported sex with another male enrolled (convenience sampling), completed survey • Lima (66%) + 4 representative provincial cities (Ica, Piura, Iquitos, Pucallpa) • AUDs assessed using AUDIT (Alcohol Use Disorders Identification Test – developed by the W.H.O.) • Testing for HIV • Survey question: ‘have you ever tested positive for HIV?’

  5. Methods LAB TEST SELF-REPORT LAB TEST SELF-REPORT + + - + OLD/KNOWN NEW/UNKNOWN

  6. Relevant Characteristics • 63% of participants had an AUD • Median Age: 27 ± 9 • Transgender: 14% • Education • Primary or less: 16% • Some secondary: 48% • Some tertiary: 35% • Self reported sexuality • Gay: 57% • Bisexual: 30% • Straight: 13% No AUD AUD

  7. Results • Overall, 8% were HIV+ (n=420) • 89% of the 420 HIV+ men were UNAWARE of their HIV status

  8. Correlates of Being Unaware of HIV+ Status: Risk Behaviors

  9. Correlates of Being Unaware of HIV+ Status: Other Factors

  10. Conclusions • AUDs are highly prevalent among MSM • Most HIV+ MSM had not been previously HIV tested • Having an AUD and reporting unprotected sex with the last sexual partners are independently correlated with being HIV+ and unaware of their HIV+ status

  11. Recommendations • Expansion of HIV testing and treatment strategies are urgently needed among MSM – especially given the low prevalence of previous HIV testing and high risk behaviors among those without previously undiagnosed HIV infection • Further research into temporal relationship between AUDs and risky sexual behaviors • Treatment for AUDs • PrEP

  12. Acknowledgements Peruvian Authorities • EstrategiaNacional de Control de VIH/SIDA • Dirección General de Epidemiologia • InstitutoNacionalde Salud del Peru Epicentro • Hugo Sanchez • Associación Civil ImpactaSalud y Educación • AnabeliTataje (Study Coordinator) • Patricia Segura: Recruitment & Retention Coordinator • Carmela Ganoza (Lab Director) • Cecilia Chang (Lab Supervisor) • Ricardo Alfaro (Lab Manager) • Robert de la Grecca (Program Manager) • Lourdes Kusunoki (Independent Researcher) • The Participants!!

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