Partner-Level Factors Associated with Insertive and Receptive Condomless Anal Intercourse Among Transgender Women in Lima, Peru

Abstract

Condomless anal intercourse among transgender women (TW) in Peru has been shown to vary by the type of partner involved (e.g. primary vs. casual vs. transactional sex partner), but no previous studies have explored variations in partner-level patterns of condom use according to type of anal intercourse. We evaluated the relationship between partnership characteristics and condom use during insertive (IAI) versus receptive anal intercourse (RAI) among TW with recent, non-female partners. Condomless IAI was more common with transactional and casual sex partners and by TW who self-reported HIV-uninfected serostatus (p < 0.05), alcohol use disorders, or substance use before sex. Condomless RAI was more common with primary partners and by TW who described their HIV serostatus as unknown (p < 0.05). Examining partner-level differences between condomless IAI and RAI reveals distinct patterns of HIV/STI risk among TW, suggesting a need for HIV prevention strategies tailored to the specific contexts of partners, practices, and networks.

Resumen

Las investigaciones sobre mujeres trans en Perú han encontrado una asociación entre el tipo de pareja y el sexo anal sin condón, pero aún no se han investigado los patrones del uso del condón entre parejas según tipos específicos de sexo anal. Evaluamos la asociación entre las características de las parejas masculinas de mujeres trans y el uso del condón durante sexo anal insertivo y receptivo. El sexo anal insertivo sin condón fue más común con parejas casuales y comerciales, y también entre mujeres trans que reportaron estatus VIH-negativo (p < 0.05), trastornos de uso de alcohol, y uso de alcohol y drogas previos al acto sexual. El sexo anal receptivo sin condón fue más común con parejas estables y entre mujeres trans que no sabían su estatus de VIH (p < 0.05). La investigación diferenciada según uso de condón durante el sexo anal insertivo y receptivo muestra patrones distintos del riesgo de VIH/ITS entre mujeres trans que sugieren la necesidad de desarrollar estrategias distintas de prevención que sean específicas para sus parejas, practicas, redes y contextos sexuales.

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Acknowledgments

We would like to express gratitude to the study participants, peer recruiters, and staff of the Asociación Civil Impacta Salud y Educación, particularly Jessica Rios, for their contributions to this study. Without their involvement, this study would not have been possible. Milan F. Satcher received funding from the UCLA South American Program in HIV Prevention Research (SAPHIR; NIH R25 MH087222). The primary research for this secondary data analysis was funded by the NIH/NIMH (NIH R21 MH092232 and K23 MH084611).

Funding

This study was funded by NIMH (K23 MH084611, NIH R21 MH092232) and NIH (NIH R25 MH087222).

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Correspondence to Milan F. Satcher.

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Conflict of Interest

Milan Satcher declares that she has no conflict of interest. Eddy Segura declares that he has no conflict of interest. Alfonso Silva-Santisteban declares that he has no conflict of interest. Jorge Sanchez declares that he has no conflict of interest. Javier Lama declares that he has no conflict of interest. Jesse Clark declares that he has no conflict of interest.

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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.

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Informed consent was obtained from all individual participants included in the study.

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Satcher, M.F., Segura, E.R., Silva-Santisteban, A. et al. Partner-Level Factors Associated with Insertive and Receptive Condomless Anal Intercourse Among Transgender Women in Lima, Peru. AIDS Behav 21, 2439–2451 (2017). https://doi.org/10.1007/s10461-016-1503-x

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Keywords

  • Transgender women
  • HIV
  • Sexual partnerships
  • Condomless anal intercourse
  • Peru

Palabras clave

  • Mujeres trans
  • VIH
  • Parejas sexuales
  • Sexo anal sin condón
  • Perú