THAD0501 - Oral Abstract Session
HIV-positive gay and bisexual men in Peru: sexuality, disclosure and the disconnect between sexual health needs and access
Presented by Miguel Angel Ceccarelli (Peru).
C.F. Caceres1, X. Salazar1, M.A. Ceccarelli1, P. Anamaria2, P. Prada2, J. Villayzan3, P. Bracamonte4
1Cayetano Heredia University School of Public Health, Institute of Health, Sexuality and Human Development, Lima, Peru, 2Peruanos Positivos, Lima, Peru, 3Red Peru Trans, Lima, Peru, 4ONUSIDA, Lima, Peru
70000 people are living with HIV (PLH) in Peru. Over half live in Lima-Callao
and one half are gay/bisexual men and transgender people. While they are the
focus of care and prevention services, not much is known about their
sexuality, sexual and reproductive health (SRH) needs and access. A
community-based collaborative study involving the Peru Positive Network took
place to assess sexuality and SRH status and access of PLH in Peru.
PLH volunteers in Lima-Callao and 6 inner cities conducted 814 structured
interviews in 2011 (48.7% in Lima-Callao, 72% biological males). This analysis
focuses on 273 males reporting being gay and bisexual (40.8%) and compares
Lima-Callao (n=134) with other cities (n=139).
in Lima-Callao were slightly older; 40% in Lima-Callao and 60% elsewhere lacked
health insurance. Overall 32% had regular partners - in Lima-Callao 95% of partners
were men, while elsewhere 21% of those were women and 17% trans; 42% of regular
partners were seropositive, but serostatus of another 20% was reported as
unknown outside Lima. Participants had disclosed serostatus to 82% in
Lima-Callao but 60% elsewhere. 88% reported penetrative sex in last 6 months -
up to 40% unprotected outside Lima; condom use was unrelated to partner
serostatus. Among those with only casual partners, 28% reported unprotected sex
in prior month; disclosure was negligible. Participants recognized a shared
responsibility in prevention, including through treatment adherence. 21% and 8% had heard
about barebacking and serosorting, respectively, but few had practiced them.
15% had been diagnosed STIs in prior year, primarily herpes and syphilis. Sexual
health advice received by participants often encouraged abstinence (30%).
gay/bisexual men in Peru remain sexually active; serostatus disclosure is
limited, particularly with casual partners; unprotected sex and STIs are
common. Often sexual health services inappropriately advise abstinence and insufficiently
address prevention and disclosure.
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