Social, Epidemiological, and Virological Characteristics from Peruvian Subjects Living with HIV-1/AIDS with Different Sexual Risk Behavior.

HIV-1 genetic diversity and resistance profile might change according to the risky sexual behavior of the host. To show this, we recruited 134 individuals between the years 2015 and 2017 identified as transgender women sex workers (TWSW, n = 73) and Heterosexual Military Officers (HET-MO, n = 61). After obtaining informed consent, we collected a blood sample to perform the HIV genotyping, CD4 cell count, and viral load. We used bioinformatics approaches for detecting resistance mutations and recombination events. Epidemiological data showed that both groups reported sexually transmitted diseases and they were widespread among TWSW, especially syphilis and herpes virus (35.6%). Illegal drugs consumption was higher among TWSW (71.2%), whereas condom use was inconsistent for both HET-MO (57.4%) and TWSW (74.0%). TWSW showed the shortest time exposition to antiretroviral therapy (ART) (3.5 years) and the lowest access to ART (34.2%) that conducted treatment failure (>4 logs). HIV-1 sequences from TWSW and HET-MO were analyzed to determine the genetic diversity and antiretroviral drug resistance. Phylogeny analysis revealed 125 (93%) cases of subtype B, 01 subtype A (0.76%), 07 (5.30%) BF recombinants, and 01 (0.76%) AG recombinant. Also, TWSW showed a higher recombination index (9.5%, 7/73) than HET-MO (1.5%, 1/68). HET-MO only showed acquired resistance (26.23%, 16/61), whereas TWSW showed both acquired as transmitted resistance (9.59% for each). In conclusion, TWSW and HET-MO showed significant differences considering the epidemiological characteristics, genetic diversity, recombination events, and HIV resistance profile.

HIV self-testing in Peru: questionable availability, high acceptability but potential low linkage to care among men who have sex with men and transgender women.

HIV status awareness is key to prevention, linkage-to-care and treatment. Our study evaluated the accessibility and potential willingness of HIV self-testing among men who have sex with men (MSM) and transgender women in Peru. We surveyed four pharmacy chains in Peru to ascertain the commercial availability of the oral HIV self-test. The pharmacies surveyed confirmed that HIV self-test kits were available; however, those available were not intended for individual use, but for clinician use. We interviewed 147 MSM and 45 transgender women; nearly all (82%) reported willingness to perform the oral HIV self-test. However, only 55% of participants would definitely seek a confirmatory test in a clinic after an HIV-positive test result. Further, price may be a barrier, as HIV self-test kits were available for 18 USD, and MSM and transgender women were only willing to pay an average of 5 USD. HIV self-testing may facilitate increased access to HIV testing among some MSM/transgender women in Peru. However, price may prevent use, and poor uptake of confirmatory testing may limit linkage to HIV treatment and care.

Moderno love: sexual role-based identities and HIV/STI prevention among men who have sex with men in Lima, Peru.

Role-based sexual identities structure male same-sex partnerships and influence HIV/STI epidemiology among MSM in Latin America. We explored shifting relationships between sexual roles, identities and practices among MSM in Lima, Peru, and implications for HIV/STI prevention. Patterns of HIV/STI epidemiology reflected differential risks for transmission within role-based partnerships with relatively low prevalences of HIV, syphilis, and HSV-2 but higher prevalences of urethral gonorrhea/chlamydia among activo MSM compared with moderno and pasivo participants. Qualitative analysis of how MSM in Peru integrate sexual identities, roles, and practices identified four key themes: pasivo role as a gay approximation of cultural femininity; activo role as a heterosexual consolidation of masculinity; moderno role as a masculine reconceptualization of gay identity; and role-based identities as social determinants of partnership, network, and community formation. The concept of role-based sexual identities provides a framework for HIV prevention for Latin American MSM that integrates sexual identities, practices, partnerships, and networks.

Human papillomavirus infection in men who have sex with men in Lima, Peru.

Human papillomavirus (HPV) infection among men who have sex with men (MSM) is the primary risk factor for anal cancer. Of 105 Peruvian MSM examined, 77.1% were infected with HPV; of these 79.0% were coinfected with two or more types and 47.3% were infected by a carcinogenic type. HPV types 53, 6, 16, and 58 were the most frequent HPV infections detected. High-risk HPV type infection was associated with sex work, HIV status, and having rectal chlamydial or gonorrheal infection. These findings support broadening HPV vaccine coverage and increasing surveillance for the development of cancer in MSM infected with HPV.

Polymorphism, recombination, and mutations in HIV type 1 gag-infecting Peruvian male sex workers.

HIV genetic diversity in female sex workers (FSW) has been previously described in Peru; however this information is not yet available for male sex workers (MSW). Therefore, purified peripheral blood mononuclear cell DNA from 147 HIV-infected subjects identified as MSW and FSW was used to amplify a 460-bp fragment corresponding to the p24-p7 region of the gag gene. The PCR product was digested with restriction enzymes to identify genetic polymorphism. Later, a random group of samples (n = 19) was sequenced to perform phylogenetic analysis, intragenic recombination analysis, and deleterious mutations leading to a nonfunctional protein in conservative regions of the Gag protein. RFLP analysis revealed 11 genetic variants for AluI and five for MspI. A group of nonsex workers (NSW) used for comparison showed different RFLP genetic variant distributions. Of interest, nine cases of mixed genetic variants were observed for MSW, one case for FSW, and none for NSW. Phylogenetic analysis revealed that all HIV-1 species were subtype B. Intragenic recombination analysis showed a B/C recombination case from an FSW (boostrap = 1000; p value < 0.05). Of interest, deleterious mutations were observed in three cases of conservative D2 zinc domains for Gag 3/19 and one case of the high homology region (1/19). This study shows that gag of HIV circulating from MSW has high genetic polymorphism involving deleterious mutations in conserved domains from the p24-p7 gag region.

Cultivo de gonococo positivo en gonorrea según género y localización anatómica en el Centro de Referencia para ETS Alberto Barton / Positive culture of gonococcus in gonorrhea by sex and anatomic localization at STD Alberto BartonÆs Reference Center

Introducción: En el Centro de Referencia para ETS Alberto Barton del Callao, Perú, se realiza búsqueda activa de casos de gonorrea en trabajadores sexuales hombres y mujeres. También se realiza cultivo en personas que acuden con síntomas relacionados a la gonorrea como son la descarga uretral y proctitis en hombres y mujeres no trabajadoras sexuales que acuden por flujo vaginal. Objetivos: Hallar la cantidad de cultivos positivos en ambos grupos de cultivos de personas que acudieron asintomáticas ó sintomáticas y correlacionarlos con las cantidades de cultivos positivos esperados según estadísticas nacionales e internacionales. Material y métodos: Se hizo un estudio retrospectivo en búsqueda en los archivos e historias clínicas, de la cantidad de cultivos tomados en el Centro de Referencia para ETS Alberto Barton, entre enero del año 2000 a agosto del año 2003. Resultados: Se halló una cantidad de 26150 cultivos tomados de los cuales solamente 43 resultaron ser positivos. De los 43 cultivos positivos, 33 correspondieron a hombres que tienen sexo con otros hombres con descarga uretral, 7 correspondieron a hombres heterosexuales con descarga uretral, un cultivo positivo correspondió a un hombre con proctitis que tiene sexo con otros hombres, uno correspondió a una trabajadora sexual asintomática y un cultivo positivo correspondió a una mujer no trabajadora sexual que acudió con flujo vaginal y contacto de un hombre con descarga uretral con cultivo positivo para gonococo. Conclusiones: Se halló una cantidad de cultivos positivos para gonococo, menor a la esperada y por tanto mencionamos la necesidad de hacer un nuevo estudio sobre la utilidad del cultivo de gonococo en gonorrea como ôprueba de oroõ (ôgold standardõ), que sugiere que sean pruebas basadas en amplificación de ácido nucleico sea PCR ó Lifasa Chain Reaction(LCR).

Introduction: At STD Alberto BartonÆs Reference Center in Callao, Peru, an active search of gonorrhea cases is performed in male and females sexual workers . Also culture is made in no sexual workers males with urethral discharge or proctitis and in no sexual workers females with proctitis or vaginal discharge Objectives: To find out the amount of positive cultures in both groups of symptomatic and asymptomatic persons and compare it with the national and international statistics number of cases. Material and methods: A retrospective study was made searching cultures in clinical records and archives of STD Alberto BartonÆs Reference Center between January 2000 and August 2003 RESULTS: Of 26 150 cultures only 43 were positives; of these 33 belonged to men with urethral discharge that have sex with other men, 7 belonged to heterosexual men with urethral discharge, one to a man with proctitis that have sexual relations with men, one to a asymptomatic female sexual worker and one to a no sexual worker woman who had vaginal discharge and sexual relation with a man with urethral discharge and positive culture for gonococcus. CONCLUSIONS: We found few than hoped positive cultures and we mentioned the necessity of make a new study about the utility of culture of gonococcus in gonorrhea like a gold standard, and suggest that is better a gold standard test based on nucleic acid amplification like PCR or LCR.