HIV-1, sexually transmitted infections, and sexual behavior trends among men who have sex with men in Lima, Peru

J Acquir Immune Defic Syndr. 2007 Apr 15;44(5):578-85. doi: 10.1097/QAI.0b013e318033ff82.


Objective: To assess and estimate trends in HIV, sexually transmitted infections (STIs), and sexual behavior among men who have sex with men (MSM) in Lima, Peru.

Design: Second-generation HIV sentinel surveillance surveys conducted in 1996, 1998, 2000, and 2002.

Methods: Adult men reporting sex with at least 1 man during the previous year were eligible to participate. Sexual behavior and serum HIV-1 and syphilis antibodies were assessed. HIV seroincidence was estimated by a sensitive/less-sensitive enzyme immunoassay strategy. Rectal and pharyngeal swabs for Neisseria gonorrhoeae culture and a first-void urine sample for urethral leukocytes for presumptive diagnosis of urethritis were obtained. Herpes simplex virus 2 (HSV-2) antibodies were measured in 2002.

Results: Although HIV prevalence increased from 18.5% to 22.3% from 1996 through 2002, bacterial prevalence declined significantly for syphilis (16.0% to 12.4%), early syphilis (8.6% to 3.4%), and rectal gonorrhea (5.1% to 0.2%). High HIV seroincidence was estimated, with the lowest (4.8%) incidence in 1998. In 2002, HSV-2 seroprevalence was 51.0%. After adjustment for age, education, and self-reported sexual identity, our data suggest that a yearly increase by 6% in the prevalence of HIV occurred among MSM in Lima, with a corresponding decline in syphilis (by 9%), early syphilis (by 18%), and rectal gonorrhea (by 64%). Condom use during last sexual intercourse increased by 26% each year with the most recent male steady partner and, among non-sex workers, by 11% with the most recent casual partner.

Conclusions: HIV continued to spread among MSM in Lima even when a decline in bacterial STIs and increase in condom use were estimated to occur. Intensification of medical and behavior prevention interventions is warranted for MSM in Peru.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Adolescent
  • Adult
  • Condoms / statistics & numerical data
  • HIV Infections / epidemiology
  • HIV Infections / prevention & control
  • HIV Infections / transmission*
  • HIV-1
  • Homosexuality, Male*
  • Humans
  • Male
  • Peru / epidemiology
  • Sexual Behavior
  • Sexually Transmitted Diseases / epidemiology
  • Unsafe Sex / prevention & control