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Background

Being Unaware of Being HIV-Infected is Associated with Alcohol Use Disorders and High-Risk Sexual Risk Behaviors Among MSM in Peru. Vagenas P , Ludford , KT, Gonzales P, Peinado P; Cabezas C; Gonzales F; Lama JR, Sanchez J, Altice FL. Background. Peru Middle income country

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Background

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  1. Being Unaware of Being HIV-Infected is Associated with Alcohol Use Disorders and High-Risk Sexual Risk Behaviors Among MSM in Peru VagenasP, Ludford, KT, GonzalesP, PeinadoP; CabezasC; Gonzales F; Lama JR, Sanchez J, Altice FL

  2. Background Peru • Middle income country • Low HIV prevalence: 0.2% in general population1 • Men who have sex with men (MSM) are disproportionately affected • HIV prevalence (Lima): 18.5 – 22.3%2-4 • HIV epidemic concentrated among MSM, in Lima 1. Garcia PJ et al. Lancet 2012. 2. Sanchez Jet al.. JAIDS. 2007. 3. Tabet S et al. AIDS.2002. 4. Silva-Santisteban A, et al. Int AIDS Conf2010:Abstr# A-240-0123-13697.

  3. Other Findings from this Sample Alcohol Use Disorders (AUDs) are significantly and independently associated with: • Unprotected sex • >5 partners in last 3 months • STI in last 6 months • Sex work in last 6 months • Sex with HIV+ partner in last 6 months LudfordKT et al., POSTER #WEPE554, Wed 12.30pm

  4. Methods • Bio-behavioral cross-sectional surveillance study (May-Oct, 2011) • 5,148 biological men who reported sex with another male enrolled (convenience sampling), completed survey • Lima (66%) + 4 representative provincial cities (Ica, Piura, Iquitos, Pucallpa) • AUDs assessed using AUDIT (Alcohol Use Disorders Identification Test – developed by the W.H.O.) • Testing for HIV • Survey question: ‘have you ever tested positive for HIV?’

  5. Methods LAB TEST SELF-REPORT LAB TEST SELF-REPORT + + - + OLD/KNOWN NEW/UNKNOWN

  6. Relevant Characteristics • 63% of participants had an AUD • Median Age: 27 ± 9 • Transgender: 14% • Education • Primary or less: 16% • Some secondary: 48% • Some tertiary: 35% • Self reported sexuality • Gay: 57% • Bisexual: 30% • Straight: 13% No AUD AUD

  7. Results • Overall, 8% were HIV+ (n=420) • 89% of the 420 HIV+ men were UNAWARE of their HIV status

  8. Correlates of Being Unaware of HIV+ Status: Risk Behaviors

  9. Correlates of Being Unaware of HIV+ Status: Other Factors

  10. Conclusions • AUDs are highly prevalent among MSM • Most HIV+ MSM had not been previously HIV tested • Having an AUD and reporting unprotected sex with the last sexual partners are independently correlated with being HIV+ and unaware of their HIV+ status

  11. Recommendations • Expansion of HIV testing and treatment strategies are urgently needed among MSM – especially given the low prevalence of previous HIV testing and high risk behaviors among those without previously undiagnosed HIV infection • Further research into temporal relationship between AUDs and risky sexual behaviors • Treatment for AUDs • PrEP

  12. Acknowledgements Peruvian Authorities • EstrategiaNacional de Control de VIH/SIDA • Dirección General de Epidemiologia • InstitutoNacionalde Salud del Peru Epicentro • Hugo Sanchez • Associación Civil ImpactaSalud y Educación • AnabeliTataje (Study Coordinator) • Patricia Segura: Recruitment & Retention Coordinator • Carmela Ganoza (Lab Director) • Cecilia Chang (Lab Supervisor) • Ricardo Alfaro (Lab Manager) • Robert de la Grecca (Program Manager) • Lourdes Kusunoki (Independent Researcher) • The Participants!!

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