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HIV, STI and Behavioral Risk Among Men Who have Sex with Men in a Setting of Elevated HIV Prevalence Along Ecuador’s Pacific Coast

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Abstract

We assessed HIV and STI prevalence, risk behaviors and factors associated with HIV infection in men who have sex with men (MSM) in Guayaquil, Ecuador. Respondent-driven sampling was used to recruit 400 MSM in 2011–2012. Participants completed a computer-assisted self-interview and provided blood samples. Statistical analysis accounted for differential probability of selection and for recruitment patterns. HIV prevalence was 11.3 %, HSV-2 30.2 %, active syphilis 6.9 % and hepatitis B 1.2 %. In the previous 12 months, 84 % of MSM reported casual male sex partners and 25 % sex work. Only 48 % of MSM consistently used condoms with male partners and 54 % had ever been tested for HIV. Of 17 % of MSM reporting a female partner, consistent condom use was 6 %. HIV infection was associated with age 25 or older, active syphilis and homosexual self-identification. Findings suggest continuing HIV risk and a need to strengthen prevention and testing among MSM.

Resumen

Este estudio evaluó la prevalencia del VIH y otras ITS, los comportamientos de riesgo y los factores asociados a la infección por VIH en la población de hombres que tienen sexo con hombres (HSH) en Guayaquil, Ecuador. Se empleó el muestreo dirigido por participantes para reclutar a 400 HSH en 2011–2012. Los participantes completaron una entrevista auto-administrada asistida por computadora y aportaron muestras de sangre. El análisis estadístico tuvo en cuenta la probabilidad diferencial de selección y los patrones de reclutamiento. La prevalencia del VIH fue 11,3 %, VHS-2 30,2 %, sífilis activa 6,9 % y hepatitis B 1,2 %. En los últimos 12 meses, 84 % de los HSH refirieron parejas ocasionales hombres y 25 % haber ejercido trabajo sexual. Solo el 48 % usó el condón de manera consistente con sus parejas masculinas y el 54 % se había realizado la prueba del VIH alguna vez en la vida. Del 17 % que refirió haber tenido una pareja mujer, el uso consistente del condón fue del 6 %. La infección por el VIH se asoció con edad igual o mayor a 25 años, sífilis activa y auto-identificación como homosexual. Los resultados sugieren un riesgo continuado y la necesidad de fortalecer la prevención y el testeo entre HSH en la costa pacífica de Ecuador.

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Acknowledgments

Funding for this study was provided by Ecuador’s National Ministry of Public Health, the United Nations Joint Programme on HIV/AIDS, the Pan American Health Organization and Fundación Ecuatoriana Equidad.

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Authors and Affiliations

  1. Pan American Health Organization, Quito, Ecuador

    Amaya Sánchez-Gómez & Celia Riera

  2. Pan American Health Organization, Bogota, Colombia

    Jerry O. Jacobson

  3. Ecuadorian Foundation Equidad, Quito, Ecuador

    Orlando Montoya, Demetrio Magallanes, Wilson Bajaña, Oscar Aviles, Tito Esparza & Efrain Soria

  4. National Institute of Hygiene and Tropical Medicine, Guayaquil, Ecuador

    Manuel A. González

  5. Centro de Estudios en Salud, Universidad del Valle de Guatemala, Guatemala City, Guatemala

    Sonia Morales-Miranda

  6. National STI/HIV-AIDS Program, Ministry of Public Health, Quito, Ecuador

    Rodrigo Tobar

  7. C/Clara Del Rey 47, escalera izquierda 3º Derecha, 28002, Madrid, Spain

    Amaya Sánchez-Gómez

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  1. Amaya Sánchez-Gómez
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  2. Jerry O. Jacobson
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  3. Orlando Montoya
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Correspondence to Amaya Sánchez-Gómez.

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Sánchez-Gómez, A., Jacobson, J.O., Montoya, O. et al. HIV, STI and Behavioral Risk Among Men Who have Sex with Men in a Setting of Elevated HIV Prevalence Along Ecuador’s Pacific Coast. AIDS Behav 19, 1609–1618 (2015). https://doi.org/10.1007/s10461-014-0956-z

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  • DOI: https://doi.org/10.1007/s10461-014-0956-z

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