Presentación realizada en AIDS Impact Conference, Santa Fe, Nuevo México, USA (12 al 15 de septiembre de 2011).
Abstract #123 - Identidades de la diversidad sexual, parejas y conductas sexuales de riesgo entre MSM en Buenos Aires
Presenting Author: Dr. Ivan Balan - New York State Psychiatric Institute/Columbia University Additional Authors: Dr. Alex Carballo-Dieguez, Lic. Ruben Marone, Lic. Victoria Barreda, Dr. Curtis Dolezal, Dr. Maria Pando, Dr. Maria Avila
To assess the sexual risk behavior and prevalence of HIV and other sexually transmitted infections among a diverse group of MSM from the Buenos Aires metropolitan area.
Method / Issue:
Respondent driven sampling (RDS) was used to recruit 500 MSM from the greater Buenos Aires area who completed a self-administered web-based survey inquiring about their sexual risk behavior during the prior two months. They also underwent testing for sexually transmitted infections, included HIV. Consistent with RDS procedures, data were weighted based on the network size of the participant.
Results / Comments:
The mean participant age was 30.5 (SD=11.5) and 66% had less than complete high school education. Only 26% of participants identified as gay; 37% as bisexual, 23% as heterosexual, and 13.7% were grouped as “Other.” Among gay-identified men 88% reported having sex only with men during the past two months. Among bisexually-identified men 36% reported having sex with men and women, while 37% reported having sex with men, women, and male-to-female transvestites. And, 21% of heterosexually identified men reported having sex with men and women, while 52% reported having sex with men, women, and transvestites—rates similar to those reported by participants in the Other category. Approximately one-third of the total sample reported having male, female, and transvestite sexual partners. In terms of sexual risk behavior, over two-thirds of the men reported having unprotected sex during the prior two months, with 88% of participants reporting more than one sexual partner, with a median of 5.8 (standard deviation [SD]=13.13) occasions of unprotected anal or vaginal intercourse (range 0-200). Insertive unprotected anal intercourse with a man during the past two months was reported by 52% of the men who reported only having sex with men, 28% of the men who reported having sex with men and women, and 48% of the men who reported having sex with men, women, and transvestites. Receptive unprotected anal intercourse with a man during the past two months was reported by 51% of the men who reported only having sex with men, 7% of the men who reported having sex with men and women, and 9% of the men who reported having sex with men, women, and transvestites. Overall prevalence of HIV was 17%, and ranged from 10% for men in the Other category to 31% for gay-identified men. Prevalence of Hepatitis B and Syphilis were 23% and 21% respectively, and were highest among gay-identified men, at 39% and 33%, respectively.
The term MSM includes considerable diversity in relation to sexual identity, partners, and sexual risk behavior. Rates of HIV are significantly higher in this sample than among the general population in Argentina, and rates among gay-identified men are strikingly high. The multiple types of partners and inconsistent condom use seen within the non-gay identified men is particularly concerning given their position as a high-risk bridge population to broader segments of the Argentine population. Findings also highlight the need for HIV prevention interventions and campaigns to be tailored to MSM subgroups to be most effective in reducing HIV risk behavior.