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Risk factors for the spread of HIV and other sexually transmitted infections among men who have sex with men infected with HIV in Lima, Peru
  1. J L Clark1,
  2. K A Konda1,
  3. E R Segura2,
  4. H J Salvatierra2,
  5. S R Leon2,
  6. E R Hall3,
  7. C F Caceres2,
  8. J D Klausner4,
  9. T J Coates1
  1. 1
    Division of Infectious Diseases and Program in Global Health, David Geffen School of Medicine at UCLA, Los Angeles, California, USA
  2. 2
    Unidad de Salud, Sexualidad y Desarrollo Humano, Universidad Peruana Cayetano Heredia, Lima, Peru
  3. 3
    US Naval Medical Research Center Detachment, Lima, Peru
  4. 4
    San Francisco Department of Public Health, San Francisco, California, USA
  1. Jesse L Clark, David Geffen School of Medicine at UCLA, Department of Medicine, Division of Infectious Diseases, 10833 Leconte Avenue, CHS 37-121, Los Angeles, CA 90095 USA; jlclark{at}


Objectives: To assess the prevalence of sexually transmitted infections (STIs), the frequency of sexual risk behaviours, and the relation between knowledge of HIV infection status and sexual risk behaviour among men who have sex with men (MSM) infected with HIV attending an STI clinic in Peru.

Methods: We recruited a convenience sample of 559 MSM from a municipal STI clinic in Lima, Peru. Participants completed a survey and provided blood for HIV, syphilis and HSV-2 antibody testing, and urine for gonorrhoea and chlamydia nucleic acid testing.

Results: Among 124 MSM with HIV, 72.6% were aware that they were infected with HIV. Active syphilis (RPR⩾1:8) was diagnosed in 21.0% of men infected with HIV, HSV-2 in 79.8%, urethral gonorrhoea in 1.6% and chlamydia in 1.6%. Among 41 participants reporting insertive anal intercourse with their last sex partner, 34.2% did not use a condom. Of the 86 participants reporting receptive anal intercourse, 25.6% did not use a condom. At least one episode of insertive unprotected anal intercourse (UAI) with a partner uninfected with HIV during the past 6 months was reported by 33.6% (35/104) of participants, and receptive UAI with a partner uninfected by HIV was reported by 44.6% (45/101). There was no difference in frequency of UAI with partners infected or uninfected with HIV observed between men who knew their serostatus compared with those who were previously undiagnosed (all p values >0.05).

Conclusions: MSM with HIV in Peru engaged in high-risk behaviours for spreading HIV and STIs. Knowledge of whether someone was infected with HIV was not associated with a decreased frequency of UAI. Additional efforts to reduce risk behaviour after the diagnosis of HIV infection are necessary.

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  • Funding: JLC is supported by NIMH T32 MH080634-01A1.

  • Competing interests: None.

  • Ethics approval: The study protocol was approved by the Committee of Human Subjects Research of the University of California at Los Angeles, the San Francisco Department of Public Health, the Universidad Peruana Cayetano Heredia and the US Naval Medical Research Center Detachment in Lima, Peru, in compliance with all federal regulations regarding the protection of human subjects.

  • Contributors: Study concept and design was provided by JLC, KAK and HJS under the guidance of CFC, JDK and TJC. Data collection was coordinated by ERS with the participation of JLC, HJS and SRL. Laboratory analysis of specimens was managed by SRL and ERH. Data analysis was completed by JLC and KAK. JLC took primary responsibility for drafting the manuscript, with the contribution and final approval of all of the authors.

  • The views expressed in this article are those of the author and do not necessarily reflect the official policy or position of the Department of the Navy, Department of Defense nor the US Government.

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