Galea Jerome T, León Segundo R, Peinado Jesús, Calvo Gino, Zamora Jonathan, Sánchez Hugo, Brown Brandon J
Department of Global Health and Social Medicine, Harvard Medical School, Boston, Massachusetts, USA.
Department of Research, Socios En Salud, Lima, Peru.
BMJ Open. 2017 Oct 24;7(10):e017338. doi: 10.1136/bmjopen-2017-017338.
The relationship between sexual practices, identity and role among Latino men who have sex with men (MSM) and HIV risk is the subject of ongoing investigation but less is known about how these aspects of sexuality relate to human papilloma-virus (HPV), an independent risk factor for HIV. This observational study investigated the relationship between HPV and sexual practices, identity and role as well as other sexually transmitted infection (STI)/HIV risk factors among HIV-negative heterosexually and homosexually identified Peruvian MSM.
Community-based clinic for MSM in Lima, Peru.
756 subjects were screened based on inclusion criteria of: born anatomically male; age ≥18 years; had any anal intercourse with a man during the previous 12 months; residing in metropolitan Lima; HIV negative; willing to commit to twice-yearly clinic visits for 24 months; had not participated in an HIV or HPV vaccine study. 600/756 participants met the inclusion criteria and were enrolled, of whom 48% (284) identified as homosexual and 10% (57) as heterosexual, the basis of the analyses performed.
Compared with homosexually identified MSM, heterosexually identified MSM had completed fewer years of formal education and were less likely to have: anogenital HPV or visible anal warts; given oral sex to a man; or used a condom with their most recent female sexual partner (all p<0.05). Conversely, heterosexually identified MSM were more likely to have: visible penile warts; used a condom during last anal intercourse; smoked cigarettes; had transactional sex; and used drugs during sex in the previous month (all p<0.01). There was no difference found between heterosexually and homosexually identified MSM by syphilis or high-risk HPV prevalence.
HPV burden, wart type (penile vs anal) and select HIV/STI risk behaviours differed between heterosexually and homosexually identified Peruvian MSM. Understanding the implications of these differences can lead to tailored HIV/STI prevention interventions for heterosexually identified MSM.
NCT01387412.
男男性行为者（MSM）的性行为、身份认同及角色与艾滋病毒感染风险之间的关系一直是研究热点，但对于性取向的这些方面如何与人类乳头瘤病毒（HPV）——一种艾滋病毒独立风险因素——相关的了解较少。本观察性研究调查了秘鲁艾滋病毒阴性、有异性恋或同性恋身份认同的男男性行为者中HPV与性行为、身份认同及角色以及其他性传播感染（STI）/艾滋病毒风险因素之间的关系。
秘鲁利马一家针对男男性行为者的社区诊所。
根据以下纳入标准筛选出756名受试者：出生时解剖学性别为男性；年龄≥18岁；在过去12个月内与男性有过肛交；居住在利马大都市区；艾滋病毒阴性；愿意承诺在24个月内每半年到诊所就诊一次；未参加过艾滋病毒或HPV疫苗研究。600/756名参与者符合纳入标准并被纳入研究，其中48%（284名）认同自己为同性恋，10%（57名）认同自己为异性恋，以此作为分析基础。
与认同自己为同性恋的男男性行为者相比，认同自己为异性恋的男男性行为者接受正规教育的年限更少，且更不可能有：肛门生殖器HPV感染或可见的肛门疣；给男性口交；或在最近与女性性伴侣发生性行为时使用避孕套（所有p<0.05）。相反，认同自己为异性恋的男男性行为者更可能有：可见的阴茎疣；在最近一次肛交时使用避孕套；吸烟；进行交易性性行为；以及在上个月性行为期间吸毒（所有p<0.01）。在梅毒或高危HPV感染率方面，认同自己为异性恋和同性恋的男男性行为者之间未发现差异。
在秘鲁认同自己为异性恋和同性恋的男男性行为者之间，HPV感染负担、疣体类型（阴茎疣与肛门疣）以及特定的艾滋病毒/性传播感染风险行为存在差异。了解这些差异的影响有助于为认同自己为异性恋的男男性行为者制定针对性的艾滋病毒/性传播感染预防干预措施。
NCT01387412。
