Abstract

HIV, STI and risk behaviors among men who have sex with men and female sex workers in El Salvador

J. Creswell¹, M.E. Guardado¹, J. Armero², E. Monterroso³, G. Paz-Bailey<sup>1

1</sup>Collaboration Universidad del Valle de Guatemala and Centers for Disease Control and Prevention, Guatemala, Guatemala, ²Ministry of Health, San Salvador, El Salvador, ³US Centers for Disease Control and Prevention, Atlanta, United States

Background: A behavioral and sexually transmitted infections (STI) surveillance survey was completed in 2008 in El Salvador. The survey objectives were to estimate the prevalence of HIV, other STIs and risk behaviors among female sex workers (FSW) and men who have sex with men (MSM) and to identify interventions.
Methods: We used audio computer assisted interviews to survey MSM and FSW in three cities. Respondent Driven Sampling (RDS) was used to recruit participants. Blood was tested for HIV (Determine and Oraquick) and syphilis (Rapid Plasma Reagin and Treponema Pallidum Aglutination Particles). Data was collected from March through September 2008 and was analyzed using RDSAT 6.01, a program specifically designed to be used with RDS.
Results: We enrolled 663 FSW participants and 624 MSM. The HIV prevalence was 5.7% (3.5-7.9) among FSW and 10.8% (7.4-14.7) among MSM. Active syphilis prevalence was 6.3% (3.9-9.1) for FSW and 9.0% (5.2-13) for MSM. Reported condom use by FSW during the last sexual encounter was 74.5% while 81.7% reported using a condom with the last frequent client and 90.3% with the last new client. A total of 53.7% found clients in brothels or nightclubs. For MSM, 46.1% self identified as gay or homosexual. About a third (30.4%) reported a stable partner in the last 12 months, while only 34.6% reported consistent condom use with that partner. Consistent condom use with female partners was 4.9% during the last 12 months.
Conclusions: Intervention strategies should include condom promotion among MSM and FSW, expanding HIV counseling and testing services and education programs on HIV transmission and prevention. To have a greater impact, these interventions should be targeted at to MSM and FSW and not at the general population.