AIDS and Behavior

, Volume 17, Issue 4, pp 1313–1328 | Cite as

Moderno Love: Sexual Role-Based Identities and HIV/STI Prevention Among Men Who Have Sex with Men in Lima, Peru

  • Jesse Clark
  • Javier Salvatierra
  • Eddy Segura
  • Ximena Salazar
  • Kelika Konda
  • Amaya Perez-Brumer
  • Eric Hall
  • Jeffrey Klausner
  • Carlos Caceres
  • Thomas Coates
Original Paper

Abstract

Role-based sexual identities structure male same-sex partnerships and influence HIV/STI epidemiology among MSM in Latin America. We explored shifting relationships between sexual roles, identities and practices among MSM in Lima, Peru, and implications for HIV/STI prevention. Patterns of HIV/STI epidemiology reflected differential risks for transmission within role-based partnerships with relatively low prevalences of HIV, syphilis, and HSV-2 but higher prevalences of urethral gonorrhea/chlamydia among activo MSM compared with moderno and pasivo participants. Qualitative analysis of how MSM in Peru integrate sexual identities, roles, and practices identified four key themes: pasivo role as a gay approximation of cultural femininity; activo role as a heterosexual consolidation of masculinity; moderno role as a masculine reconceptualization of gay identity; and role-based identities as social determinants of partnership, network, and community formation. The concept of role-based sexual identities provides a framework for HIV prevention for Latin American MSM that integrates sexual identities, practices, partnerships, and networks.

Keywords

HIV STI MSM Sexual role Peru 

Resumen

Las identidades basadas en roles sexuales forman la estructura de las relaciones de pareja e influyen en la epidemiología del VIH/ITS entre HSH en América Latina. Se exploró la relación cambiante entre roles, identidades, y practicas sexuales en HSH en Lima, Perú y las implicaciones para la prevención del VIH. Los patrones epidemiológicos del VIH/ITS mostraron diferencias en riesgos de transmisión en parejas definidas por roles sexuales con una prevalencia relativamente baja de VIH, sífilis, y HSV-2, pero una prevalencia alta de gonorrea/clamidia uretral en HSH activos en comparación a modernos y pasivos. El análisis cualitativo de como los HSH en el Perú integran sus identidades, roles y practicas identificó cuatro ejes temáticos: El rol pasivo como una aproximación gay de la feminidad cultural; el rol activo como una consolidación heterosexual de la masculinidad; el rol moderno como una reconceptualización masculina de la identidad gay; y las identidades basadas en roles sexuales como determinantes de la formación de parejas, redes, y comunidades. El concepto de identidades sexuales basadas en roles sexuales ofrece un marco analítico para la prevención del VIH entre HSH Latinoamericanos que puede integrar las identidades, prácticas, parejas, y redes sexuales.

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Copyright information

© Springer Science+Business Media, LLC 2012

Authors and Affiliations

  • Jesse Clark
    • 1
  • Javier Salvatierra
    • 2
  • Eddy Segura
    • 1
  • Ximena Salazar
    • 2
  • Kelika Konda
    • 1
  • Amaya Perez-Brumer
    • 1
  • Eric Hall
    • 3
  • Jeffrey Klausner
    • 1
  • Carlos Caceres
    • 2
  • Thomas Coates
    • 1
  1. 1.Program in Global Health, Division of Infectious Diseases, Department of Medicine, David Geffen School of MedicineUniversity of California, Los AngelesLos AngelesUSA
  2. 2.Instituto de Estudios en Salud, Sexualidad y Desarollo HumanoUniversidad Peruana Cayetano HerediaLimaPeru
  3. 3.U.S. Naval Medical Research CenterBethesdaUSA

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