XIX International AIDS Conference


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THAD0501 - Oral Abstract

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

Background: Approximately 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.
Methods: Trained 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).
Results: Participants 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%).
Conclusions: HIV+ 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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