Characterizing Men Who Have Sex with Transgender Women in Lima, Peru: Sexual Behavior and Partnership Profiles

  • Jessica E. LongEmail author
  • Angela Ulrich
  • Edward White
  • Sayan Dasgupta
  • Robinson Cabello
  • Hugo Sanchez
  • Javier R. Lama
  • Ann Duerr
Original Paper


HIV prevalence is high among transgender women (TW), but how HIV is transmitted to this population is not well understood. This analysis aims to characterize sexual partners of TW (PTW) to understand how their behavior contributes to HIV risk among TW. We examined baseline data from TW, PTW, and men who have sex with men (MSM) from a treatment-as-prevention study in Lima, Peru. Individual and partnership characteristics were compared across groups, and Poisson regression was used to calculate prevalence ratios for associations between sexual concurrency and potential correlates. We found that 81% of PTW had no cisgender male partners. Prevalence of alcohol dependency, concurrency, and condomless anal intercourse was high and HIV testing was low compared to the other groups. Our results suggest that PTW are a distinct population from MSM and TW, engage in behavior associated with HIV transmission, and are likely not well reached by HIV prevention interventions.


HIV Peru Transgender women Concurrency Sexual networks 


La prevalencia de VIH es alta entre mujeres transgénero (MT), pero se desconoce como la infección de VIH se transmite en esta población. Este análisis tiene como objetivo caracterizar a las parejas sexuales de mujeres transgénero (PMT) para entender como sus comportamientos contribuyen al riesgo de VIH entre MT. Para ello, evaluamos datos de base de MT, PMT y hombres que tienen sexo con hombres (HSH), provenientes de un estudio de tratamiento-como-prevención en Lima, Perú. Características individuales y de pareja fueron comparadas. Se usó regresión de Poisson para calcular la proporción de prevalencia para las asociaciones entre concurrencia sexual y variables correlacionadas potenciales. Encontramos que 81% de las MT no tuvieron parejas cis-hombres. La prevalencia de dependencia de alcohol, superposición de parejas y sexo anal desprotegido fue elevada y la de pruebas de VIH fue baja en comparación con otros grupos. Nuestros resultados sugieren que las PMT son una población distinta a la población de HSH y MT, se involucran en comportamientos asociados con transmisión de VIH y probablemente no son alcanzadas por programas de prevención de VIH.



We would like to acknowledge the contribution of the Sabes Study Team: Carmela Ganoza, Ricardo Alfaro, Cecilia Correa, Karin Sosa, Jessica Rios, Manuel Villaran, and Patricia Segura.


This work was funded by the NIH National Institute on Drug Abuse, (R01 Grant DA032106 to AD) and by NIH Research Training Grant #D43 TW009345 awarded to the Northern Pacific Global Health Fellows Program by the Fogarty International Center.

Compliance with Ethical Standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical Approval

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. This article does not contain any studies with animals performed by any of the authors.

Informed Consent

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

Supplementary material

10461_2019_2590_MOESM1_ESM.docx (49 kb)
Supplementary material 1 (DOCX 48 kb)


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of EpidemiologyUniversity of WashingtonSeattleUSA
  2. 2.Fred Hutchinson Cancer Research CenterSeattleUSA
  3. 3.Department of Global HealthUniversity of WashingtonSeattleUSA
  4. 4.Via LibreLimaPeru
  5. 5.Epicentro SaludLimaPeru
  6. 6.Asociación Civil Impacta Salud y EducaciónLimaPeru

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