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Background: Men who have sex with men (MSM) and male-to-female transgender women (TW) are at increased risk of HIV infection. Although prevention strategies exist in Peru, they have not been adequately tailored to MSM/TW. As a result, high-risk MSM/TW often do not get tested for HIV with sufficient frequency, resulting in low awareness of their current HIV status, delayed diagnosis, and delayed linkage to care.
Methods: A cross-sectional, clinic-based study was conducted among MSM and TW at high-risk for HIV infection in Lima, Peru. The study included HIV testing with a 3rd generation rapid point-of-care test, a 4th generation Ag/Ab HIV EIA test and confirmation with Western blot (WB). Pre- and post-test counseling and linkage to care were provided. An interviewer-administered behavioral survey was also conducted. Statistical analysis included descriptive statistics and chi-square comparisons with Fisher’s exact as needed.
Results: Participants included 133 MSM and 38 TW, median age was 29.5 years. Most, 159 (93.0%), reported at least one previous HIV test and 26/171 (15.2%) self-reported being HIV positive. After testing, 47/171 (27.5%) were HIV-antibody positive and 41/171 (24.0%) had WB confirmed infection. Among those with confirmed HIV infection, 15/41 (34.1%) were previously unaware of their infection. Among those who reported being HIV negative but tested HIV positive, 2/15 (13.3%) reported being at high risk of contracting HIV versus 31/124 (25.0% ) who perceived high risk but were truly HIV negative (p-value 0.52).
Conclusions: Among MSM and TW in this high-risk sample, almost a third of HIV-infected participants were unaware of their infection. Moreover, almost all the MSM/TW with newly diagnosed HIV did not consider themselves to be at high risk for contracting HIV. Unawareness of HIV status and low perceived risk for HIV-infection are highly problematic and should be addressed in HIV prevention programs focused on MSM/TW.