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Characterizing Men Who Have Sex with Transgender Women in Lima, Peru: Sexual Behavior and Partnership Profiles

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Abstract

HIV prevalence is high among transgender women (TW), but how HIV is transmitted to this population is not well understood. This analysis aims to characterize sexual partners of TW (PTW) to understand how their behavior contributes to HIV risk among TW. We examined baseline data from TW, PTW, and men who have sex with men (MSM) from a treatment-as-prevention study in Lima, Peru. Individual and partnership characteristics were compared across groups, and Poisson regression was used to calculate prevalence ratios for associations between sexual concurrency and potential correlates. We found that 81% of PTW had no cisgender male partners. Prevalence of alcohol dependency, concurrency, and condomless anal intercourse was high and HIV testing was low compared to the other groups. Our results suggest that PTW are a distinct population from MSM and TW, engage in behavior associated with HIV transmission, and are likely not well reached by HIV prevention interventions.

Resumen

La prevalencia de VIH es alta entre mujeres transgénero (MT), pero se desconoce como la infección de VIH se transmite en esta población. Este análisis tiene como objetivo caracterizar a las parejas sexuales de mujeres transgénero (PMT) para entender como sus comportamientos contribuyen al riesgo de VIH entre MT. Para ello, evaluamos datos de base de MT, PMT y hombres que tienen sexo con hombres (HSH), provenientes de un estudio de tratamiento-como-prevención en Lima, Perú. Características individuales y de pareja fueron comparadas. Se usó regresión de Poisson para calcular la proporción de prevalencia para las asociaciones entre concurrencia sexual y variables correlacionadas potenciales. Encontramos que 81% de las MT no tuvieron parejas cis-hombres. La prevalencia de dependencia de alcohol, superposición de parejas y sexo anal desprotegido fue elevada y la de pruebas de VIH fue baja en comparación con otros grupos. Nuestros resultados sugieren que las PMT son una población distinta a la población de HSH y MT, se involucran en comportamientos asociados con transmisión de VIH y probablemente no son alcanzadas por programas de prevención de VIH.

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Acknowledgements

We would like to acknowledge the contribution of the Sabes Study Team: Carmela Ganoza, Ricardo Alfaro, Cecilia Correa, Karin Sosa, Jessica Rios, Manuel Villaran, and Patricia Segura.

Funding

This work was funded by the NIH National Institute on Drug Abuse, (R01 Grant DA032106 to AD) and by NIH Research Training Grant #D43 TW009345 awarded to the Northern Pacific Global Health Fellows Program by the Fogarty International Center.

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Authors and Affiliations

  1. Department of Epidemiology, University of Washington, 1959 NE Pacific Street, Health Sciences Bldg, F-262, Box 357236, Seattle, USA

    Jessica E. Long

  2. Fred Hutchinson Cancer Research Center, Seattle, WA, USA

    Angela Ulrich, Edward White, Sayan Dasgupta & Ann Duerr

  3. Department of Global Health, University of Washington, Seattle, WA, USA

    Angela Ulrich

  4. Via Libre, Lima, Peru

    Robinson Cabello

  5. Epicentro Salud, Lima, Peru

    Hugo Sanchez

  6. Asociación Civil Impacta Salud y Educación, Lima, Peru

    Javier R. Lama

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  1. Jessica E. Long
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Correspondence to Jessica E. Long.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. This article does not contain any studies with animals performed by any of the authors.

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Long, J.E., Ulrich, A., White, E. et al. Characterizing Men Who Have Sex with Transgender Women in Lima, Peru: Sexual Behavior and Partnership Profiles. AIDS Behav 24, 914–924 (2020). https://doi.org/10.1007/s10461-019-02590-w

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