Men who have sex with men (MSM) and male-to-female
transgender women (TW) are at increased risk of HIV and sexually transmitted
infections (STIs). We evaluated factors associated with incidence of HIV,
HSV-2, and chlamydia and gonorrhea (anal and pharyngeal).
We used data from the Comunidades Positivas trial with
MSM/TW who have sex with men in Lima, Peru. Participants were asked about
sexual risk behaviors and underwent HIV/STI testing at baseline and 9- and
18-month follow-ups. We used discrete time proportional hazards regression to
calculate hazard ratios for variables associated with incidence of each STI.
- Among 718 MSM/TW, HIV incidence was 3.6 cases per 100 person-years.
- HIV incidence was associated with having an incident STI adjusted hazard ratio (aHR) of 3.73.
- Unprotected receptive anal intercourse was associated with incident anal chlamydia (aHR 2.20).
- An increased number of sexual partners increased incident HSV-2 .
- The risk of anal gonorrhea decreased with each sexually active year (aHR 0.94) and increased for unprotected compensated sex (aHR 2.36).
- The risk of pharyngeal gonorrhea also decreased with each year since sexual debut (aHR 0.95).
- The risk of anal chlamydia decreased with each sexually active year (aHR 0.96); the risk increased with reports of unprotected sex work (aHR 1.61) and unprotected receptive anal sex (aHR 2.63).
- All aHRs have P values <0.05.
MSM/TW experience high incidence of HIV. Up-to-date
prevalence and incidence information and identifying factors associated with
infection can help develop a more effective combination prevention response.
Via: http://ht.ly/SOpDt Purchase
full article at: http://goo.gl/qAK2J0
By:
- 1*School of Medicine, Stanford University, Stanford, CA; †Unit of Health, Sexuality and Human Development, Universidad Peruana Cayetano Heredia, Lima, Peru; and ‡Department of Medicine, Division of Infectious Diseases, University of California, Los Angeles, Los Angeles, CA.
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