5A 2 Lack of HIV Serostatus Awareness Among High-Risk MSM in Lima, Peru. 2013

Thursday, June 12, 2014: 8:10 AM
Dogwood B
Lottie Romero, MD1, Kelika Konda, PhD2, Segundo Leon, ME&ID3, Silver K Vargas Rivera, BS4, Jeffrey Klausner, MD, MPH5 and Carlos F Caceres, MD, MPH, PhD1, 1Universidad Peruana Cayetano Heredia, Lima, Peru, 2University of California Los Angeles, 3Global Health Department, University of Washington, Laboratory of Sexual Health, LID, UPCH, Lima, 31, Peru, 4Unit of Health, Sexuality and Human Development, and Laboratory of Sexual Health, Universidad Peruana Cayetano Heredia, Lima, Peru, 5Division of Infectious Diseases and Program in Global Health, David Geffen School of Medicine and Fielding School of Public Health, Los Angeles, CA

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.