Background: Published literature on MSM has linked unsafe sexual behavior with certain sex venues. For sex venues previously described and frequently reported by high-risk MSM in Lima, Peru, we explored whether participants reporting anal sex at these venues also engage more frequently in recent unprotected anal intercourse (UAI).
Methods: MSM and male-to-female transwomen (TW), 18 years or older and at high-risk for syphilis, were recruited for a clinic-based study. The interview-administered survey collected socio-demographics and recent sexual behavior, including reported anal sex at particular venues: saunas, disco/club, public places (i.e. public bathrooms/parks), and hair salons. Poisson regression was used to calculate prevalence ratios (PRs), adjusted for age and gender identity (MSM vs. TW), between anal sex at venues and reporting UAI in the past 3 months (labeled as “recent UAI”). Due to collinearity between sex venues, separate models were created for each.
Results: Of the 175 participants, 38 (22%) were TW and mean age (+/- standard deviation) was 31.1±10.4 years; 91 (52%) reported recent UAI. Of the 37 (21%) reporting anal sex in public places, 26 (70%) reported recent UAI. Of the 29 (17%) reporting anal sex in saunas, 20 (69%) reported recent UAI. Of the 27 (15%) reporting anal sex at discos/clubs, 17 (63%) reported recent UAI. Of the 15 (9%) reporting anal sex in hair salons, 8 (53%) reported recent UAI. Participants reporting recent anal sex in public places were more likely to report recent UAI than participants who didn’t report anal sex in public places (aPR 1.71, 95% CI: 1.32, 2.22).
Conclusions: High-risk MSM and TW in Lima, Peru, reporting anal sex in public places are also more likely to report recent UAI. HIV/STI prevention efforts for MSM and TW in Lima should target public places, such as public bathrooms or parks, with sex education and screening activities.