HIV, STD and risk behaviors among men who have sex with men in El Salvador
J. Creswell1, M.E. Guardado2, J. Armero3, G. Paz-Bailey4
1World Health Organization, Tuberculosis, Geneva, Switzerland, 2Del Valle University of Guatemala, Center for Health Studies, Guatemala, Guatemala, 3Ministry of Health of El Salvador, San Salvador, El Salvador, 4Del Valle University of Guatemala, Guatemala, Guatemala
Background: A behavioral surveillance survey
done in 2002 in El Salvador,
surveyed a convenience sample of men who have sex with men (MSM), and reported
an HIV prevalence of 15.3%. We present findings from the second behavioral surveillance
survey done in 2008 using a different sample methodology.
Methods: We used audio computer assisted
interviews to survey MSM participants in San
Salvador. Respondent Driven Sampling (RDS) was used to
recruit participants. The target sample size was 600 MSM. Blood was tested for HIV
(Determine and Oraquick), syphilis (Rapid Plasma Reagin and Treponema
Pallidum Aglutination Particles) and herpes serology (HSV-2 Herpes Select).
Data collection was conducted from March through September 2008. The BED IgG capture-ezyme immunoassay was
used among HIV positive specimens to distinguish recent HIV infections
(infection < 6 months). Annualized HIV incidence and 95% confidence
intervals were calculated, assuming a window period for the assay of 155 days,
and was corrected for assay misclassification using a local correction factor for
derived assay misclassification from this study.
Results: We enrolled a total of 624 participants. The
HIV prevalence was 10.8% (95% CI: 7.4-14.7) among MSM. HIV incidence was 7.0%,
(95% CI: 3.7, 10.3). Active syphilis
prevalence was 6.0% (95% CI: 3.6-8.9). HSV-2 sero-prevalence was 46.8% (95% CI:
40.0-53.3). Reported condom use with last casual partner was 64.2 (95% CI: 56.8-73.3).
Conclusions: This is the first survey using RDS
and ACASI in El Salvador.
HIV prevalence was moderate. We found high rates of HSV-2 seropositivity and
active syphilis, this may increase the vulnerability of this population to HIV
in the future. New intervention strategies should include condom promotion
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