XVIII International AIDS Conference


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Social constructions of gender, sexual identity and sex role among MSM in urban Peru: a qualitative analysis

J. Clark1, X. Salazar2, A. Bayer1, E. Segura2, K. Konda1, J. Salvatierra2, T. Coates1, C. Caceres2

1David Geffen School of Medicine at UCLA, Department of Medicine, Division of Infectious Diseases and Program in Global Health, Los Angeles, United States, 2Universidad Peruana Cayetano Heredia, Instituto de Salud Sexual y Derechos Humanos, Lima, Peru

Background: Social and cultural constructions of gender and sexuality are important influences of sexual behavior and determinants of vulnerability to HIV and STI transmission among MSM. We used qualitative methods to explore the meanings of sexual identities, roles, and practices among MSM in urban Peru.
Methods: We recruited a community-based sample of 36 MSM with a range of sexual identities (heterosexual, bisexual, gay, and transgender) and sex roles (activo/insertive, pasivo/receptive, moderno/versatile) for participation in individual interviews (n=8) or one of four focus groups. Interviews and focus group discussions were recorded, transcribed, and analyzed for content using a grounded theory approach.
Results: MSM interviewed often assumed sexual identities, roles, and practices according to a masculine/feminine, heterosexual/homosexual, activo/pasivo dichotomy. Men who reported a pasivo sex role usually identified as gay or transgender and, while considering themselves as anatomically distinct from women, often described themselves as “approximating” femininity through the deployment of “feminine” gender practices and assumption of the “female” role during intercourse. MSM who reported an activo sex role frequently assumed an unmarked (hetero)sexual identity unifying their public presentation of gender, sexuality, and sex role as “hombre.” For these men, to be penetrated during intercourse would be to sacrifice their masculine identity and become, “almost gay.” These sex roles frequently extend to interpersonal power dynamics in which the activo partner, “controls the situation.” Moderno sex roles were recognized only by gay- and bisexual-identified MSM and described by most as a simple mechanical alternation of sexual positions but by some as a re-articulation of intercourse between men through which two men, “share, in some way, the homosexuality,” while maintaining their masculine gender identity.
Conclusions: Deeper understanding of the interdependent meanings of sexual identities, roles, and practices as articulated by MSM in Peru is necessary for the development of effective, culturally-informed HIV/STI prevention interventions.

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