High HIV and syphilis prevalence among male commercial sex workers from the Peruvian Amazon
Background: Although the HIV epidemic in Latin America is concentrated in men who have sex with men, there is limited information about the practices and STD/HIV status of male commercial sex workers (MCSW) in urban settings.
Methods: As part of a venue-based survey, from March 2006 to March 2007 we administered standardized questionnaires as well as tested for HIV and syphilis to MCSW from 10 Peruvian cites with populations above 50,000.
Results: We enrolled 1206 participants who had an average age of 26.6 years. MCSW reported having an average number of 11.5 male sex partners during the 3 months prior to the interview, while 21.3% referred having had sex with a female partner in the same period. The frequency of condom use with the last client was 54.4%, and 42.7% did not receive condoms from governmental or non-governmental organizations during the year prior to the interview. Overall, 41.8% had never been previously tested for HIV infection. HIV prevalence was highest for jungle cities (13.9%), intermediate in coastal cities (9.1%), and lowest for cities in the Andes (4.1%). Similarly, syphilis was more prevalent in cities in the Amazon region (35.1%) than in the coast (13.7%) or the highlands (5.6%).
Conclusions: HIV and syphilis prevalences have reached substantial levels among MCSW in Peru, particularly in cities located in the Amazon basin. This study remarks the relevance of this group in the dissemination of HIV and STI into the general population due to the high frequency of unprotected sex and sex with women. Risk reduction programs targeting this group need to be implemented.
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