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A Continuing HIV Epidemic and Differential Patterns of HIV-STI Risk among MSM in Quito, Ecuador: An Urgent Need to Scale Up HIV Testing and Prevention

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Abstract

This study characterized the HIV epidemic among men who have sex with men (MSM) in Quito, Ecuador and contrasted risk patterns with other STI’s. 416 MSM ages 15 years and older were recruited using respondent-driven sampling in 2010–2011. Biological testing and a self-interview survey assessed HIV and STI infections and risk behaviors. Analysis incorporated recruiter-level variables and clustering adjustments to control for recruitment patterns. We identify high levels of HIV (11 %), HSV-2 (14 %) and active syphilis (5.5 %) infections, low levels of lifetime HIV testing (57 %), limited knowledge of HIV and STI’s (<48 %) and limited consistent condom use independent of partner type (<40 %). Sex work was associated with all infections while associations with residential location, how casual partners are met and other variables, varied. Scale-up of behavioral prevention and HIV testing is urgently needed. Interventions should target male sex workers and exploit differential patterns of HIV-STI risk to stay ahead of the epidemic.

Resumen

Este estudio caracteriza la epidemia de VIH en hombres que tienen sexo con hombres (HSH) en Quito, Ecuador y contrasta los patrones de riesgo con otras ITS. En 2010–2011, se reclutaron 416 HSH mayores de 14 años utilizando muestreo dirigido por participantes. Se evaluó la prevalencia de VIH e ITS y los comportamientos de riesgo a través de serología y entrevista auto-administrada. Para controlar los patrones de reclutamiento se incorporaron variables a nivel del reclutador y ajustes por conglomerados. Se identificaron niveles elevados de VIH (11 %), VHS-2 (14 %) y sífilis activa (5.5 %) y niveles bajos de uso de la prueba del VIH (57 %), conocimiento de VIH-ITS (<48 %) y uso consistente del condón independientemente del tipo de pareja (<40 %). El trabajo sexual se asoció con todas las infecciones, mientras que variaron las asociaciones con lugar de residencia, manera de conocer parejas ocasionales y otras variables. Ampliar las estrategias de prevención y testeo son medidas urgentemente necesarias. Las intervenciones deben dirigirse a los trabajadores sexuales masculinos y aprovechar los patrones diferenciales de riego de VIH-ITS para mantenerse al frente de la epidemia.

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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, the United Nations Development Programme through a grant from Agencia Española de Cooperación Internacional para el Desarrollo, and EQUIDAD.

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The findings and conclusions in this paper are those of the authors and do not necessarily represent those of the Pan American Health Organization.

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Authors and Affiliations

  1. Pan American Health Organization, Bogota, Colombia

    Jerry O. Jacobson & Bertha Gómez

  2. Pan American Health Organization, Quito, Ecuador

    Amaya Sánchez-Gómez & Celia Riera

  3. Ecuadorian Foundation EQUIDAD, Quito, Ecuador

    Orlando Montoya & Efrain Soria

  4. Facultad de Ciencias de la Salud Eugenio Espejo, Universidad Tecnológica Equinoccial, Quito, Ecuador

    Wilmer Tarupi

  5. Instituto Nacional de Higiene y Medicina Tropical, Quito, Ecuador

    Marcelo Chiriboga Urquizo & Eliana Champutiz Ortiz

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

    Sonia Morales Miranda

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

    Rodrigo Tobar

Authors
  1. Jerry O. Jacobson
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  2. Amaya Sánchez-Gómez
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  3. Orlando Montoya
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  10. Bertha Gómez
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  11. Celia Riera
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Corresponding author

Correspondence to Jerry O. Jacobson.

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Jacobson, J.O., Sánchez-Gómez, A., Montoya, O. et al. A Continuing HIV Epidemic and Differential Patterns of HIV-STI Risk among MSM in Quito, Ecuador: An Urgent Need to Scale Up HIV Testing and Prevention. AIDS Behav 18, 88–98 (2014). https://doi.org/10.1007/s10461-013-0478-0

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  • DOI: https://doi.org/10.1007/s10461-013-0478-0

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