The Risk of Stable Partnerships: Associations between Partnership Characteristics and Unprotected Anal Intercourse among Men Who Have Sex with Men and Transgender Women Recently Diagnosed with HIV and/or STI in Lima, Peru

Abstract

BackgroundPartnership type is an important factor associated with unprotected anal intercourse (UAI) and subsequent risk for HIV and sexually transmitted infections (STI). We examined the association of partnership type with UAI among men who have sex with men (MSM) and male-to-female transgender women (TGW) in Lima, Peru, recently diagnosed with HIV and/or STI.MethodsWe report data from a cross-sectional analysis of MSM and TGW recently diagnosed with HIV and/or STI in Lima, Peru between 2011 and 2012. We surveyed participants regarding UAI with up to their three most recent sexual partners according to partner type. Multivariable Generalized Estimate Equating (GEE) models with Poisson distribution were used to estimate prevalence ratios (PR) for UAI according to partner type.ResultsAmong 339 MSM and TGW recently diagnosed with HIV and/or STI (mean age: 30.6 years, SD 9.0), 65.5% self-identified as homosexual/gay, 16.0% as bisexual, 15.2% as male-to-female transgender, and 3.3% as heterosexual. Participants provided information on 893 recent male or TGW partners with whom they had engaged in insertive or receptive anal intercourse: 28.9% stable partners, 56.4% non-stable/non-transactional partners (i.e. casual or anonymous), and 14.7% transactional partners (i.e. transactional sex client or sex worker). Unprotected anal intercourse was reported with 41.3% of all partners. In multivariable analysis, factors associated with UAI included partnership type (non-stable/non-transactional partner APR 0.73, [95% CI 0.59–0.91], transactional partner APR 0.53 [0.36–0.78], p<0.05) and the number of previous sexual encounters with the partner (>10 encounters APR 1.43 [1.06–1.92], p<0.05).ConclusionUAI was more commonly reported for stable partners and in partnerships with >10 sexual encounters, suggesting UAI is more prevalent in partnerships with a greater degree of interpersonal commitment. Further research assessing partner-level factors and behavior is critical for improving HIV and/or STI prevention efforts among Peruvian MSM and TGW.

Partner-Level Factors Associated with Insertive and Receptive Condomless Anal Intercourse Among Transgender Women in Lima, Peru

“…Condom use patterns for RAI in our sample paralleled previous findings of a higher prevalence of overall CAI within the primary partnerships of MSM and TW in Peru [1, 27] and TW in the US [24, 26, 28, 42]. The approximation of condomless RAI to overall CAI in our analysis raises concerns that factors associated with composite CAI may be driven by our sample’s predominant sexual behavior (RAI) and therefore may mask important distinctions between specific sexual behaviors.…”

Sexually transmitted infections associated with alcohol use and HIV infection among men who have sex with men in Kampala, Uganda

“…It is possible that MSM recognise higher infection risk with anonymous partners and are more likely to practice preventive behaviours with these partners, such as using condoms. 20 However, risk behaviours have also been found to be associated with having anonymous partners. 21 Our study may have been limited in assessing confounders in the relationship between STI and having anonymous sex partners.…”

Sexual Health and Socioeconomic-Related Factors Among HIV-Positive Men Who Have Sex with Men in Puerto Rico

“…This finding was significant after comparing to HIV-positive MSM with seroconcordant partners. It might be considered that these HIV-positive MSM are engaging in more frequent condom use when engaging in sexual intercourse with casual/non-primary sexual partners; a practice that has been documented among other samples of HIV-positive MSM (Cambou et al, 2014; Niderost, Gredig, Roulin, & Rickenbach 2011). Considering the study limitations, this might suggest protective sexual practices that can be reinforced and encouraged.…”