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Is Intimate Partner and Client Violence Associated with Condomless Anal Intercourse and HIV Among Male Sex Workers in Lima, Peru?

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Abstract

Violence experience can increase HIV risk behaviors; however, literature is scarce on violence among male sex workers (MSWs) globally. In 2014, 210 Peruvian MSWs (median age 24.9) were interviewed about their experience of physical, emotional, and sexual violence and condom use with non-paying intimate partners and clients and were tested for HIV. Multivariable models examined relationships between violence in the past 6 months, condomless anal intercourse (CLAI) in the past 3 months and HIV infection. HIV infection (24 %), CLAI (43 %), being a violence victim (42 %) and perpetrator (39 %) were common. In separate multivariable models, being a violence victim [adjusted prevalence ratio aPR = 1.49 (95 % CI 1.09–2.03)] and perpetrator [aPR = 1.39 (1.03–1.87)] were associated with CLAI. Further, being a victim [aPR = 1.65 (1.04–2.62)] was associated with HIV infection. Violence, which was significantly associated with CLAI and HIV infection, is common among Peruvian MSWs, reinforcing the importance of violence awareness and prevention as HIV risk-reduction strategies.

Resumen

Experimentar violencia aumenta los comportamientos sexuales de riesgo; sin embargo, existe poca literatura sobre violencia entre trabajadores sexuales masculinos (TSM). En 2014, se realizaron entrevistas a 210 TSM peruanos (edad mediana 24,9) acerca de su experiencia con violencia física, emocional y sexual y el uso de preservativo con sus parejas íntimas y sus clientes. Además se les tomaron pruebas de VIH. Mediante modelos multivariables se examinaron las relaciones entre violencia en los últimos seis meses, sexo anal sin preservativo en los últimos tres meses, e infección por VIH. Fue común tener una infección por VIH (24 %), reportar sexo sin preservativo (43 %), y ser víctima (42 %) o perpetrador (39 %) de violencia. En modelos multivariables, el ser víctima (razón de prevalencia ajustada RPa = 1.49 (IC 95 %: 1.09-2.03)) y ser perpetrador (RPa = 1.39 (1.03-1.87)) de violencia estuvieron asociados con sexo sin preservativo. Ser víctima (RPa = 1.65 (1.04-2.62)) también estuvo asociado con infección por VIH. La violencia, que se asocia con sexo sin preservativo e infección con VIH, es común entre TSM peruanos, lo cual demuestra la importancia de la toma de consciencia y la prevención de violencia como estrategias para reducir el riesgo de VIH.

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Acknowledgments

The authors would like to acknowledge and thank all of the study participants and staff without whom this analysis would not have been possible. PEG would also like to acknowledge and thank Drs. Jesse Clark, Jordan Lake, Eddy Segura and Kelika Konda for their guidance and support throughout the research process. The pilot skills building intervention was supported by two grants from the National Institute of Health (K01TW009206, R21MH098982). PEG was supported by the University of California, Los Angeles South American Program in HIV Prevention Research (SAPHIR, NIH R25 MH 087222). The funding sources played no role in study design, data collection, analysis, and interpretation, writing of the manuscript or the decision to submit the paper for publication.

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Authors and Affiliations

  1. Division of Infectious Diseases, David Geffen School of Medicine, University of California, Los Angeles, 10833 LeConte Ave., CHS 12-105, Los Angeles, CA, 90095, USA

    Paul E. George, Angela M. Bayer, Thomas J. Coates & Pamina M. Gorbach

  2. Washington University in St. Louis School of Medicine, St. Louis, MO, USA

    Paul E. George

  3. Epidemiology, STD, and HIV Unit, School of Public Health and Administration, Universidad Peruana Cayetano Heredia, Lima, Peru

    Angela M. Bayer, Patricia J. Garcia & Jose E. Perez-Lu

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

    Patricia J. Garcia

  5. Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA

    Jessica G. Burke

  6. Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, CA, USA

    Pamina M. Gorbach

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  1. Paul E. George
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Correspondence to Paul E. George.

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George, P.E., Bayer, A.M., Garcia, P.J. et al. Is Intimate Partner and Client Violence Associated with Condomless Anal Intercourse and HIV Among Male Sex Workers in Lima, Peru?. AIDS Behav 20, 2078–2089 (2016). https://doi.org/10.1007/s10461-016-1327-8

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