AIDS and Behavior

, Volume 23, Issue 4, pp 813–819 | Cite as

Venue-Based HIV-Testing: An Effective Screening Strategy for High-Risk Populations in Lima, Peru

  • Lao-Tzu Allan-BlitzEmail author
  • M. Christina Herrera
  • Gino M. Calvo
  • Silver K. Vargas
  • Carlos F. Caceres
  • Jeffrey D. Klausner
  • Kelika A. KondaEmail author
Original Paper


Venue-based testing may improve screening efforts for HIV and syphilis, thereby reducing transmission. We offered onsite rapid dual HIV and syphilis testing at venues popular among MSM and/or transgender women in Lima, Peru. We used Poisson regression to calculate adjusted prevalence ratios (aPRs) for factors associated with each infection. Most (90.4%) of the 303 participants would test more frequently if testing was available at alternative venues. New cases of HIV (69) and syphilis infection (84) were identified. HIV was associated with recent sex work (aPR 1.11; 95% CI 1.02–1.22), sex with a partner of unknown serostatus (aPR 1.18; 95% CI 1.09–1.27), exclusively receptive anal sex role (aPR 1.16; 95% CI 1.03–1.30) or versatile sex role (aPR 1.17; 95% CI 1.06–1.30) compared to insertive. Syphilis was associated with reporting role versatility (aPR = 2.69; 95% CI 1.52–5.74). Sex work venues had higher syphilis prevalence 47% versus 28% in other venues, p value = 0.012. Venue-based testing may improve case finding.


HIV Latin America Syphilis MSM Transgender women 


Realizar pruebas en lugares de encuentro puede mejorar la detección del VIH y sífilis, llegando a reducir transmisión. Ofrecíamos pruebas rápidas para sífilis y VIH en lugares populares entre HSH y/o mujeres transgénero en Lima, Perú. Calculamos razones de prevalencia ajustados (aRP) para factores asociados con cada infección usando regresión de Poisson. La mayoría (90.4%) de los 303 participantes realizarían pruebas más frecuentemente si estuvieran disponibles en lugares alternativos. Se identificaron nuevos casos de VIH (69) y sífilis (84). VIH fue asociado con trabajo sexual (aPR = 1.11; IC95% 1.02-1.22), tener una pareja de seroestatus desconocido (aPR = 1.18; IC95% 1.09-1.27), sexo anal exclusivamente receptiva (aPR = 1.16; IC95% 1.03-1.30) o rol sexual versátil (aPR = 1.17; 95% CI 1.06-1.30) en comparación con insertivo. Sífilis fue asociado con versatilidad de rol (aPR = 2.69; IC95% 1.52-5.74). Los lugares de trabajo sexual tuvieron una mayor prevalencia de sífilis 47% en comparación con 28% en otros, valor-p = 0.012. Pruebas en lugares de encuentro pueden mejorar la búsqueda de casos.



This research was supported by the University of California, Los Angeles Center for AIDS Research #AI028697 as well as the South American Program in HIV Prevention Research NIH/NIMH R25MH087222. The dual rapid tests were donated by Standard Diagnostics, Incorporated.

Compliance with Ethical Standards

Conflict of interest

The authors have no conflicts of interest.

Ethical Approval

This article does not contain any studies with animals performed by any of the authors. All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Informed Consent

Informed consent was obtained from all individual participants included in the study.


  1. 1.
    UNAIDS. Report on the global AIDS epidemic. Geneva: UNAIDS; 2008.Google Scholar
  2. 2.
    Galea JT, Kinsler JJ, Salazar X, et al. Acceptability of pre-exposure prophylaxis as an HIV prevention strategy: barriers and facilitators to pre-exposure prophylaxis uptake among at-risk Peruvian populations. Int J STD AIDS. 2011;22(5):256–62.CrossRefGoogle Scholar
  3. 3.
    Hayes R, Sabapathy K, Fidler S. Universal testing and treatment as an HIV prevention strategy: research questions and methods. Curr HIV Res. 2011;9(6):429–45.CrossRefGoogle Scholar
  4. 4.
    Directiva Sanitaria Para la atención médica periódica a las/os trabajadoras/es sexuales y HSH. Lima, Peru: Ministerio de Salud; 2009.Google Scholar
  5. 5.
    Pinkerton SD, Holtgrave DR, Galletly CL. Infections prevented by increasing HIV serostatus awareness in the United States, 2001 to 2004. J Acquir Immune Defic Syndr. 2008;47(3):354–7.CrossRefGoogle Scholar
  6. 6.
    Marks G, Crepaz N, Janssen RS. Estimating sexual transmission of HIV from persons aware and unaware that they are infected with the virus in the USA. AIDS. 2006;20(10):1447–50.CrossRefGoogle Scholar
  7. 7.
    Lee SW, Deiss RG, Segura ER, et al. A cross-sectional study of low HIV testing frequency and high-risk behaviour among men who have sex with men and transgender women in Lima, Peru. BMC Public Health. 2015;15:408.CrossRefGoogle Scholar
  8. 8.
    Golub SA, Gamarel KE. The impact of anticipated HIV stigma on delays in HIV testing behaviors: findings from a community-based sample of men who have sex with men and transgender women in New York City. AIDS Patient Care STDS. 2013;27(11):621–7.CrossRefGoogle Scholar
  9. 9.
    Lipsitz MC, Segura ER, Castro JL, et al. Bringing testing to the people - benefits of mobile unit HIV/syphilis testing in Lima, Peru, 2007-2009. Int J STD AIDS. 2014;25(5):325–31.CrossRefGoogle Scholar
  10. 10.
    Kahn RH, Moseley KE, Thilges JN, Johnson G, Farley TA. Community-based screening and treatment for STDs: results from a mobile clinic initiative. Sex Transm Dis. 2003;30(8):654–8.CrossRefGoogle Scholar
  11. 11.
    Khumalo-Sakutukwa G, Morin SF, Fritz K, et al. Project Accept (HPTN 043): a community-based intervention to reduce HIV incidence in populations at risk for HIV in sub-Saharan Africa and Thailand. J Acquir Immune Defic Syndr. 2008;49(4):422–31.CrossRefGoogle Scholar
  12. 12.
    Ellen JM, Bonu S, Arruda JS, Ward MA, Vogel R. Comparison of clients of a mobile health van and a traditional STD clinic. J Acquir Immune Defic Syndr. 2003;32(4):388–93.CrossRefGoogle Scholar
  13. 13.
    Clark JL, Konda KA, Silva-Santisteban A, et al. Sampling methodologies for epidemiologic surveillance of men who have sex with men and transgender women in Latin America: an empiric comparison of convenience sampling, time space sampling, and respondent driven sampling. AIDS Behav. 2014;18(12):2338–48.CrossRefGoogle Scholar
  14. 14.
    Vanden Berghe W, Nostlinger C, Buve A, Beelaert G, Fransen K, Laga M. A venue-based HIV prevalence and behavioural study among men who have sex with men in Antwerp and Ghent, Flanders, Belgium, October 2009 to March 2010. Euro Surveill. 2011;16:28.Google Scholar
  15. 15.
    Perez-Brumer AG, Konda KA, Salvatierra HJ, et al. Prevalence of HIV, STIs, and risk behaviors in a cross-sectional community- and clinic-based sample of men who have sex with men (MSM) in Lima, Peru. PLoS ONE. 2013;8(4):e59072.CrossRefGoogle Scholar
  16. 16.
    Snowden JM, Konda KA, Leon SR, et al. Recent syphilis infection prevalence and risk factors among male low-income populations in coastal Peruvian cities. Sex Transm Dis. 2010;37(2):75–80.CrossRefGoogle Scholar
  17. 17.
    Lama JR, Lucchetti A, Suarez L, et al. Association of herpes simplex virus type 2 infection and syphilis with human immunodeficiency virus infection among men who have sex with men in Peru. J Infect Dis. 2006;194(10):1459–66.CrossRefGoogle Scholar
  18. 18.
    Sanchez J, Lama JR, Kusunoki L, et al. HIV-1, sexually transmitted infections, and sexual behavior trends among men who have sex with men in Lima, Peru. J Acquir Immune Defic Syndr. 2007;44(5):578–85.CrossRefGoogle Scholar
  19. 19.
    Clark J, Salvatierra J, Segura E, et al. Moderno love: sexual role-based identities and HIV/STI prevention among men who have sex with men in Lima, Peru. AIDS Behav. 2013;17(4):1313–28.CrossRefGoogle Scholar
  20. 20.
    Allan-Blitz L, Konda KA, Vargas SK, Wang X, Segury ER, Fazio BM, Calvo GM, Caceres CF, Klausner JD. The development of an online risk calculator for the prediction of future syphilis among a high-risk cohort of men who have sex with men and transgender women in Lima, Peru. Sexual Health. 2017;15:261–8.CrossRefGoogle Scholar
  21. 21.
    Fox J, Fidler S. Sexual transmission of HIV-1. Antiviral Res. 2010;85(1):276–85.CrossRefGoogle Scholar
  22. 22.
    Bernstein KT, Marcus JL, Nieri G, Philip SS, Klausner JD. Rectal gonorrhea and chlamydia reinfection is associated with increased risk of HIV seroconversion. J Acquir Immune Defic Syndr. 2010;53(4):537–43.CrossRefGoogle Scholar
  23. 23.
    Zetola NM, Bernstein KT, Wong E, Louie B, Klausner JD. Exploring the relationship between sexually transmitted diseases and HIV acquisition by using different study designs. J Acquir Immune Defic Syndr. 2009;50(5):546–51.CrossRefGoogle Scholar
  24. 24.
    Beck EC, Birkett M, Armbruster B, Mustanski B. A data-driven simulation of hiv spread among young men who have sex with men: role of age and race mixing and STIs. J Acquir Immune Defic Syndr. 2015;70(2):186–94.CrossRefGoogle Scholar
  25. 25.
    Kelley CF, Vaughan AS, Luisi N, et al. The effect of high rates of bacterial sexually transmitted infections on HIV incidence in a cohort of black and white men who have sex with men in Atlanta, Georgia. AIDS Res Hum Retroviruses. 2015;31(6):587–92.CrossRefGoogle Scholar
  26. 26.
    Allan-Blitz LT, Leon SR, Bristow CC, et al. High prevalence of extra-genital chlamydial or gonococcal infections among men who have sex with men and transgender women in Lima, Peru. Int J STD AIDS. 2016;29:568–76.CrossRefGoogle Scholar
  27. 27.
    Castillo R, Konda KA, Leon SR, et al. HIV and sexually transmitted infection incidence and associated risk factors among high-risk MSM and male-to-female transgender women in Lima, Peru. J Acquir Immune Defic Syndr. 2015;69(5):567–75.CrossRefGoogle Scholar
  28. 28.
    Perez-Brumer AG, Konda KA, Salvatierra HJ, et al. Prevalence of HIV, STIs, and risk behaviors in a cross-sectional community- and clinic-based sample of men who have sex with men (MSM) in Lima, Peru. PLoS ONE. 2013. Scholar
  29. 29.
    Fernandez-Davila P, Salazar X, Caceres CF, et al. Compensated sex and sexual risk: sexual, social and economic interactions between homosexually- and heterosexually-identified men of low income in two cities of Peru. Sexualities. 2008;11(3):352–74.CrossRefGoogle Scholar
  30. 30.
    Simoni JM, Pantalone DW. Secrets and safety in the age of AIDS: does HIV disclosure lead to safer sex? Top HIV Med. 2004;12(4):109–18.Google Scholar
  31. 31.
    Golden MR, Brewer DD, Kurth A, Holmes KK, Handsfield HH. Importance of sex partner HIV status in HIV risk assessment among men who have sex with men. J Acquir Immune Defic Syndr. 2004;36(2):734–42.CrossRefGoogle Scholar
  32. 32.
    Wei C, Raymond HF, Guadamuz TE, et al. Racial/Ethnic differences in seroadaptive and serodisclosure behaviors among men who have sex with men. AIDS Behav. 2011;15(1):22–9.CrossRefGoogle Scholar
  33. 33.
    Parsons JT, Schrimshaw EW, Wolitski RJ, et al. Sexual harm reduction practices of HIV-seropositive gay and bisexual men: serosorting, strategic positioning, and withdrawal before ejaculation. AIDS. 2005;19(Suppl 1):S13–25.CrossRefGoogle Scholar
  34. 34.
    Silva-Santisteban A, Raymond HF, Salazar X, et al. Understanding the HIV/AIDS epidemic in transgender women of Lima, Peru: results from a sero-epidemiologic study using respondent driven sampling. AIDS Behav. 2012;16(4):872–81.CrossRefGoogle Scholar
  35. 35.
    Kesler MA, Kaul R, Liu J, Loutfy M, et al. Actual sexual risk and perceived risk of HIV acquisition among HIV-negative men who have sex with men in Toronto, Canada. BMC Public Health. 2016;16:254.CrossRefGoogle Scholar
  36. 36.
    Stephenson R, White D, Darbes L, Hoff C, Sullivan P. HIV testing behaviors and perceptions of risk of HIV infection among MSM with main partners. AIDS Behav. 2015;19(3):553–60.CrossRefGoogle Scholar
  37. 37.
    Musyoki H, Kellogg TA, Geibel S, et al. Prevalence of HIV, sexually transmitted infections, and risk behaviours among female sex workers in Nairobi, Kenya: results of a respondent driven sampling study. AIDS Behav. 2015;19(Suppl 1):S46–58.CrossRefGoogle Scholar
  38. 38.
    Volk JE, Lippman SA, Grinsztejn B, et al. Acceptability and feasibility of HIV self-testing among men who have sex with men in Peru and Brazil. Int J STD AIDS. 2016;27(7):531–6.CrossRefGoogle Scholar
  39. 39.
    Bustamante MJ, Konda KA, Joseph Davey D, et al. 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. Int J STD AIDS. 2016;28:133–7.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  1. 1.David Geffen School of MedicineUniversity of CaliforniaLos AngelesUSA
  2. 2.Division of Infectious Diseases, Department of Medicine, David Geffen School of MedicineUniversity of CaliforniaLos AngelesUSA
  3. 3.Center for Interdisciplinary Investigation in Sexuality, AIDS, and Society and Laboratory of Sexual HealthUniversidad Peruana Cayetano HerediaLimaPeru
  4. 4.Fielding School of Public HealthUniversity of CaliforniaLos AngelesUSA

Personalised recommendations