This study compared the correlates of HIV risk among men who have sex with men (MSM) with newly diagnosed versus previously known HIV infection among 5,148 MSM recruited using modified snowball sampling in 5 Peruvian cities. Participants, if age C18 years and reporting sex with a male in the previous 12 months, underwent standardized computer-assisted risk assessments and HIV and syphilis testing. Overall, 420 (8.2 %) participants tested HIV seropositive, most of whom (89.8 %) were unaware of their HIV status. Compared to those who knew themselves to be HIV-infected, multivariate logistic regression demonstrated that unprotected anal intercourse at last encounter [AOR = 2.84 (95 % CI 1.09-7.40)] and having an alcohol use disorder (AUD) [AOR = 2.14 (95 % CI 1.01-5.54)] were independently associated with a newly diagnosed HIV infection. Being unaware of being HIVinfected was associated with high-risk sexual behaviors and AUDs, both of which are amenable to behavioral and medication-assisted therapy interventions.
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Acknowledgments The authors would like to acknowledge the subjects who participated in this study; all the medical and research personnel at Impacta, Peru; Dr. Jeffrey Wickersham at the Yale AIDS Program and the Yale University StatLab for their help and advice with the statistical analyses; Enrico Ferro at Yale College; Paula Dellamura and Ruthanne Marcus at the Yale AIDS Program for their continued support of this project. This research was funded by The Global Fund to Fight AIDS, Tuberculosis and Malaria Grants PER-506-G03-H and PER-607-G05-H awarded to CARE PERU; unrestricted discretionary core funds from Asociacion Civil Impacta Ed-ucacion y Salud; and from the National Institute on Drug Abuse through research (R01 DA032106) and career development awards (K24 DA017072) to FLA. The funding sources played no role in study design, data collection, data analysis, data interpretation, writing of the manuscript or the decision to submit the paper for publication.
- Alcohol use disorders
- Extended-release naltrexone
- HIV infection
- Male homosexuality
- Medication-assisted therapies
- Sexual risk