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Original article
Individual-level characteristics associated with oral HIV test acceptability among Peruvian men who have sex with men and transgender women: a cross-sectional study
  1. Juan A Flores1,2,
  2. Brandon Brown3,
  3. Segundo R León2,
  4. Hugo Sánchez4,
  5. Jerome T Galea2,4,5
  1. 1 Facultad de Salud Pública, Universidad Peruana Cayetano Heredia, Lima, Perú
  2. 2 Socios En Salud Sucursal Perú, Lima, Perú
  3. 3 Department of Social Medicine and Population Health, Center for Healthy Communities, University of California, Riverside, California, USA
  4. 4 Epicentro Salud, Lima, Perú
  5. 5 Department of Global Health and Social Medicine, Harvard Medical School, Boston, Massachusetts, USA
  1. Correspondence to Dr Jerome T Galea, Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA 02115, USA; jerome_galea{at}hms.harvard.edu

Abstract

Objectives Peruvian men who have sex with men (MSM) and transgender women (TGW) are highly vulnerable to HIV infection (HIV), but stigma, access issues and fear of venipuncture hamper testing. The oral HIV test—which uses oral fluids and provides results in 20 minutes—could reduce these barriers. The objective of this study was to determine the acceptability of the oral HIV test and the individual-level factors associated with its acceptability among MSM and TGW.

Methods We conducted a cross-sectional secondary analysis among Peruvian MSM and TGW attending a community-based health centre between February 2012 and February 2013 to determine the individual-level factors associated with oral HIV test acceptability.

Results Of 334 participants, 88% were MSM and 12% TGW. Overall, 85% of participants indicated their acceptability of the oral HIV test. Acceptability was higher in MSM than TGW (85.7% vs 80.0%) but this difference was not significant. Factors associated with acceptability in MSM were: tertiary or higher education (prevalence ratio (PR)=1.18, 95% CI 1.06 to 1.32 and PR=1.16, 95% CI 1.03 to 1.30, respectively); sex with drug use (PR=1.19, 95% CI 1.05 to 1.36); believing that HIV is transmitted by saliva (PR=1.20, 95% CI 1.08 to 1.33); and potential use of the oral test at home (PR=1.56, 95% CI 1.32 to 1.85). The only factor associated with lower acceptability was having had first anal intercourse between 14 and 19 years of age (PR=0.89, 95% CI 0.80 to 0.98).

Conclusions We identified the individual factors associated with oral HIV test acceptability among Peruvian MSM and TGW. Expanded use of the oral HIV test to increase testing rates among Peruvian MSM and TGW is recommended.

Trial registration number NCT01387412, post-results.

  • point-of-careTesting
  • men who have sex with men
  • transgender
  • primary prevention
  • HIV
  • saliva

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Footnotes

  • Handling editor Stefan Baral

  • Contributors BJB and JTG are the principal investigators who conceived the study design, supervised the study and provided critical revision of this manuscript. JAF wrote the first draft, and performed the statistical analyses. SRL provided revision of the manuscript. HS helped coordinate study at the community-based health centre ‘Epicentro’. All authors contributed to interpretation of the results and the revision of the manuscript, and all approved the final draft.

  • Funding Supported in part, by the research grant 39619 from the Merck Investigator–Initiated Studies Program of Merck & Co, Inc. Additional funding by National Institutes of Health Grant T32 MH080634. Juan A. Flores is a doctoral student studying Epidemiological Research at Universidad Peruana Cayetano Heredia under FONDECYT/CIENCIACTIVA scholarship EF033-235-2015.

  • Disclaimer The opinions expressed in this study are those of the authors and do not necessarily represent those of Merck & Co, Inc.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Ethics approval Institutional Review Boards at the University of California, Los Angeles, USA (approval number: 11-003060) and the Asociación Civil Impacta Salud y Educación in Lima, Peru (approval number: 00183-2011) reviewed and approved all study procedures and documents prior to implementation and all participants provided written informed consent prior to study participation.

  • Provenance and peer review Not commissioned; externally peer reviewed.