Risk Factors for HIV Infection at a Gay Men's Community Health Center in Lima, Peru

Background: In Peru, the Human Immunodeficiency Virus (HIV) epidemic is highly concentrated among men who have sex with men (MSM) and transgender women (TGW), with 56% of new infections occurring in this population. In spite of this, there is a lack of prevention services tailored to these groups. Epicentro is the first and only gay men’s community health center in Lima and provides HIV/STI testing to MSM/TGW, and this is the first report of HIV testing results at the institution.

Methods: HIV testing services at Epicentro were paired with a simple survey including demographics and sexual behaviors. A statistical analysis using bi-directional stepwise logistic regression was conducted to determine risk factors associated with HIV prevalence. 

Results: Of 466 participants who received an HIV test result, 97 were positive (20.9%). Compared to participants who reported an “activo” (insertive) role in sexual partnerships, those who reported a “pasivo” (receptive) or “moderno” (versatile) role were significantly more likely to test positive (OR=6.3 and 6.5, respectively, p=0.003). Those who reported their last partner was a casual partner were also more likely to test positive compared to a stable partner (OR=2.2, p=0.021). Subjects reporting genital warts were significantly more likely to receive a positive test result compared to those without warts (OR=2.8, p=0.021). 

Conclusions: HIV prevalence in this sample is higher than the national population estimate (0.04%) and estimates from other studies with MSM in Peru (ranging from 11-23%). Sexual role, partner type during last sex act, and report of genital warts in the past 6 months were significantly associated with a positive test result. The high HIV prevalence at Epicentro suggests the need to utilize community centers to reach individuals at highest risk who face stigma in standard health facilities and may otherwise remain unaware of their HIV status.