Correlates of viral suppression among HIV-infected men who have sex with men and transgender women in Lima, Peru

ABSTRACT

In Peru, HIV is concentrated among men who have sex with men (MSM) and transgender women (TGW). Between June 2015 and August 2016, 591 HIV-positive MSM and TGW were recruited at five clinical care sites in Lima, Peru. We found that 82.4% of the participants had achieved viral suppression (VS; VL < 200) and 73.6% had achieved maximal viral suppression (MVS; VL < 50). Multivariable modeling indicated that patients reporting transportation as a barrier to HIV care were less likely to achieve VS (aOR = 0.47; 95% CI = 0.30–0.75) and MVS (aOR = 0.56; 95% CI = 0.37–0.84). Alcohol use disorders were negatively associated with MVS (aOR = 0.62; 95% CI = 0.30–0.75) and age was positively associated with achieving MVS (aOR = 1.29; 95% CI = 1.04–1.59). These findings underscore the need for more accessible HIV care with integrated behavioral health services in Lima, Peru.

KEYWORDS:

• HIV
• viral suppression
• Latin America
• men who have sex with men
• transgender women

Acknowledgments

The authors gratefully acknowledge the individuals who gave their time to participate in this study; the medical and research personnel at IMPACTA Peru, Via Libre, Hospital Nacional Dos de Mayo, and Hospital Nacional Arzobispo Loayza; and the research personnel at the Yale AIDS Program for their continued support of this study.

Disclosure statement

Dr. Atlice receives grant support from NIH, NIDA, SAMHSA, HRSA, Gilead Foundation, Merk. Dr. Atlice is on the Speakers Bureau for Gilead Sciences, Merk, Clinical Care Options, and Practice Point Communications. All other authors have no disclosures.

ORCID

Katherine M. Rich http://orcid.org/0000-0002-2767-2355

Jaime Soria http://orcid.org/0000-0002-5863-0502

Frederick L. Altice http://orcid.org/0000-0002-7860-693X

Additional information

Funding

This research was made possible by generous financial support from the National Institute on Drug Abuse (K24 DA017072) and from Yale University with the following student fellowships: The Charles P. Howland Fellowship, the Overlook International Foundation, The Downs International Health Student Travel Fellowship, The Latin American and Iberian Studies Travel Award, The Yale Global Health Field Experience Award, the Yale College Fellowship for Juniors, the Global Health Seed Funding Fellowship.