A Qualitative Assessment of Alcohol Consumption and Sexual Risk Behaviors Among Men Who Have Sex With Men and Transgender Women in Peru

ABSTRACT

Background: Peruvian men who have sex with men (MSM) and transgender women (TGW) experience the double burden of a highly concentrated HIV epidemic with a high prevalence of alcohol use disorders (AUDs). Recent research has associated both with risky sexual behaviors, including unprotected sex, having multiple sexual partners, engaging in sex work, having recent sexually transmitted infections, and having HIV-infected partners. AUDs have also been associated in MSM/TGW with being unaware of HIV+ status. Objectives: This study aims to further examine issues associated with alcohol consumption, HIV infection, and risk behaviors in a qualitative analysis of focus groups conducted with MSM/TGW in Peru. Methods: A total of 26 MSM/TGW participants with AUDs participated in three semi-structured focus groups in Lima, Peru. Content analysis was facilitated by software, and specific themes were elucidated. Results: Participants described their drinking patterns, including the types of alcoholic drinks they consumed. They depicted drinking frequently and over multiple-day sessions. Problematic drinking behaviors were described, as well as the perceived characteristics of alcohol dependence. Interestingly, HIV-infected participants who were prescribed antiretroviral therapy did not believe that their drinking affected their medication adherence. These insights can aid in the design of future interventions aiming to reduce problematic drinking as well as HIV-related risk behaviors and, subsequently, HIV incidence. Conclusions: Peruvian MSM/TGW exhibit problematic drinking, which may be associated with risky sexual behaviors and HIV transmission. Interest in reducing alcohol consumption was high, suggesting the need for targeted behavioral and pharmacological interventions.

KEYWORDS:

• Alcohol drinking
• focus groups
• gay men
• HIV
• men who have sex with men
• MSM
• risky sex
• transgender women
• unprotected sex

Acknowledgments

The authors would like to thank the participants for their time and effort, and researchers and staff at Impacta, UCLA, and the Yale AIDS Program for their help and support.

Declaration of interest

The authors declare that they have no conflicts of interest. The authors alone are responsible for the content and writing of the article.

Funding

This work was funded by the US National Institute on Drug Abuse (NIH/NIDA) through research (R01 DA032106) and career development awards (K24 DA017072). The funding source played no role in study design, data collection, data analysis, data interpretation, writing of the manuscript, or the decision to submit the paper for publication.