Correlates of condomless anal intercourse with different types of sexual partners among men who have sex with men and transgender women in Lima, Peru

ABSTRACT

In Lima, Peru, men who have sex with men (MSM) and transgender women (TW) are disproportionately affected by HIV. Patterns of sexual behavior vary by sexual partner type, which has implications for HIV prevention intervention design. We examine correlates of sex and condomless anal intercourse (CAI) with each of four types of partners among HIV-negative MSM and TW in Lima who completed monthly questionnaires about partnership types and CAI. Odds ratios were calculated using generalized estimating equations to identify correlates of being in different types of partnerships and CAI within those partnerships. Among 1,831 MSM and TW with over 14,792 study visits, CAI was most reported with main partners, followed by casual partners, one-time partners, and clients. Presence of an alcohol use disorder (AUD) significantly increased the odds of CAI with all types of partners (main: OR 1.36 (95% CI 1.17-1.57); casual: 1.49 (1.27-1.75); one-time: 1.45 (1.22-1.72); client 1.52 (1.12-2.08)); recent alcohol use increased odds of CAI with main partners. Having one main partner decreased the odds of being in casual and one-time partnerships and of CAI in all types of partnerships. Interventions targeting AUDs and individuals with multiple sexual contacts could reduce CAI and HIV risk in this population.

Clinical trial registration

The Sabes study was registered in March 2013 with the National Institutes of Health at ClinicalTrials.gov (identifier: NCT01815580).

KEYWORDS:

• HIV
• sexual behavior
• men who have sex with men
• condomless anal intercourse
• alcohol use disorder

Acknowledgements

The authors would like to thank T. Templin and A. Bui for advice and guidance on statistical methods and manuscript preparation, S. Pasalar for data management support, D. Pinto, J. Rios, and C. Bain for study management and coordination, and the study staff in Seattle and Lima who made this research possible.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Ethics approval

All procedures performed in this study involving human participants were in accordance with the ethical standards of the institutional and/or national research committees, and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. The study received ethical approval from IRBs at Associación Civil Impacta y Educación in Lima, Peru; Associación Vía Libre in Lima, Peru; and Fred Hutchinson Cancer Research Center in Seattle, Washington.

Consent to participate

Written informed consent was obtained from all individual participants included in the study.

Additional information

Funding

This study was funded by the National Institutes of Health/National Institute on Drug Abuse (R01DA032106). Funding to complete the analysis in this paper was provided by the Infectious Disease Society of America and the University of Washington School of Medicine.