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Factors associated with previously undiagnosed human immunodeficiency virus infection in a population of men who have sex with men and male-to-female transgender women in Lima, Peru

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dc.contributor.author Billings, Joshua-D.
dc.contributor.author Joseph-Davey, Dvora-L.
dc.contributor.author Konda, Kelika-A.
dc.contributor.author Bristow, Claire-C.
dc.contributor.author Chow, Jeremy
dc.contributor.author Klausner, Jeffrey-D.
dc.contributor.author Caceres, Carlos-F.
dc.date.accessioned 2019-02-06T14:51:17Z
dc.date.available 2019-02-06T14:51:17Z
dc.date.issued 2016
dc.identifier.uri https://hdl.handle.net/20.500.12866/5191
dc.description.abstract The aim of the study was to identify factors associated with undiagnosed human immunodeficiency virus (HIV) infection among men who have sex with men (MSM) and male-to-female transgender women in Lima, Peru. We analyzed characteristics of 378 MSM and transgender women recruited from 2 sexually transmitted infection (STI) clinics in Lima, Peru. Descriptive analyses compared: (A) HIV-uninfected, (B) previously undiagnosed HIV-infected, and (C) previously diagnosed HIV-infected participants. Multivariable logistic regression models identified: (1) correlates of previously undiagnosed HIV-infection among participants thought to be HIV-uninfected (B vs A); and (2) correlates of previously undiagnosed HIV-infection among HIV-infected participants (B vs C). Subanalysis identified correlates of frequent HIV testing among participants thought to be HIV-uninfected. Among participants, 31.0% were HIV-infected; of those, 35.0% were previously undiagnosed. Among participants thought to be HIV-uninfected (model 1), recent condomless receptive anal intercourse and last HIV test being over 1-year ago (compared to within the last 6-months) were associated with increased odds of being previously undiagnosed HIV-infected (adjusted odds ratio [aOR] = 2.43, 95% confidence interval [95%CI] = 1.10–5.36; aOR = 2.87, 95%CI = 1.10–7.53, respectively). Among HIV-infected participants (model 2), recent condomless receptive anal intercourse was again associated with previously undiagnosed HIV-infection (aOR = 2.54, 95%CI = 1.04–6.23). Achieving post-secondary education and prior syphilis infection were associated with lower odds of having previously undiagnosed HIV-infection (aOR = 0.35, 95%CI = 0.15–0.81; aOR = 0.32, 95%CI = 0.14–0.75, respectively). Reporting semiannual testing was associated with higher educational attainment, identifying as a transgender woman, or reporting a history of syphilis (aOR = 1.94, 95%CI = 1.11–3.37; aOR = 2.40, 95%CI = 1.23–4.70; aOR = 2.76, 95%CI = 1.62–4.71, respectively). Lower odds of semiannual testing were associated with recent condomless insertive anal intercourse or reporting a moderate or high self-perceived risk of acquiring HIV (aOR = 0.56, 95%CI = 0.33–0.96; aOR = 0.32, 95%CI = 0.18–0.59 and aOR = 0.43, 95%CI = 0.21–0.86, respectively). In our study, undiagnosed HIV-infection was associated with recent condomless receptive anal intercourse, infrequent HIV testing, lower education, and absence of prior syphilis diagnosis. Infrequent HIV testing was associated with lower education, not identifying as transgender, recent condomless insertive anal intercourse, absence of prior syphilis diagnosis, and higher self-perceived risk of HIV. Further efforts to decrease HIV transmission and increase HIV-serostatus awareness should be directed towards effectively promoting condom use and frequent HIV testing, integrated with STI management. en_US
dc.language.iso eng
dc.publisher Wolters Kluwer Health
dc.relation.ispartof urn:issn:1648-9144
dc.rights info:eu-repo/semantics/restrictedAccess
dc.rights.uri https://creativecommons.org/licenses/by-nc-nd/4.0/deed.es
dc.subject Diagnostic Errors en_US
dc.subject HIV en_US
dc.subject Homosexuality, Male en_US
dc.subject Transgender Persons en_US
dc.subject Adult en_US
dc.subject Female en_US
dc.subject HIV Infections/diagnosis/epidemiology en_US
dc.subject Humans en_US
dc.subject Male en_US
dc.subject Peru/epidemiology en_US
dc.subject Prevalence en_US
dc.subject Risk Factors en_US
dc.subject Sexual Behavior en_US
dc.subject Sexually Transmitted Diseases/diagnosis/epidemiology en_US
dc.subject Unsafe Sex en_US
dc.subject Young Adult en_US
dc.title Factors associated with previously undiagnosed human immunodeficiency virus infection in a population of men who have sex with men and male-to-female transgender women in Lima, Peru en_US
dc.type info:eu-repo/semantics/article
dc.identifier.doi https://doi.org/10.1097/MD.0000000000005147
dc.subject.ocde https://purl.org/pe-repo/ocde/ford#3.02.00 es_PE
dc.subject.ocde https://purl.org/pe-repo/ocde/ford#3.02.00


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