Sexually-transmitted infections: prevalence and risk behavior in a Peruvian uniformed population
S.M. Montano1, E. Soto2, N. Mori3, M. Villaran1, J. Veliz4, R. Guerra5, J. Flores6, M. Nieto1, H. Quijandria7, J. Perez1, O. Palacios6, A. Paredes2, Z. Varas4, C. Olazabal7, J. Garcia1, E. Halsey1, R. Maves1, T. Kochel1, H. Chun8
1U.S. Naval Medical Research Center Detachment - Lima, Lima, Peru, 2Comité de Prevención y Control VIH/SIDA de las Fuerzas Armadas y Policia Nacional del Perú, Lima, Peru, 3Universidad Nacional Mayor de San Marcos, Lima, Peru, 4Sanidad Ejercito Peruano, Lima, Peru, 5Sanidad Naval, Lima, Peru, 6Sanidad de La Policia Nacional, Lima, Peru, 7Sanidad de la Fuerza Aérea, Lima, Peru, 8Department of Defense HIV/AIDS Program, Naval Health Research Center, San Diego, United States
Background: Sexually-transmitted infections (STIs), including human immunodeficiency virus (HIV), remain a threat to uniformed personnel worldwide. As part of an ongoing STI/HIV prevention program in Peru, we sought to determine the prevalence and risk factors associated with STIs and HIV infection among military and police personnel in Peru.
Methods: A cross-sectional study was conducted among active-duty service members in the Peruvian Armed Forces and National Police from August-October 2009 in 5 cities in Peru: Abancay, Andahuaylas, Cuzco, Tarapoto, and Madre de Dios. Following oral informed consent, volunteers provided blood samples which were tested for HIV, syphilis, HTLV I/II, hepatitis B, and HSV-2. Risk factors and demographics were assessed via a standardized questionnaire. Risks were evaluated using an unmatched case-control study design. Testing results with appropriate counseling were given to participants in person by the study personnel.
Results: A total of 2,435 participants were evaluated. Only one case of HIV infection was identified (0.04%). A similarly low prevalence of HTLV I/II (14 cases, 0.6%) and hepatitis B (20 cases. 0.8%) was detected. Rates of syphilis 24 (1%) and anti-HSV-2 IgG (23.5%) were higher and varied by region. The overall STI seroprevalence was 25.9% (554 men and 53 women). Men reported younger ages at first sexual intercourse than women (16.4 vs. 17.6 years, p< 0.0001). 42.4% reported inconsistent use of condoms. By logistic regression analysis, age ≥35 years (AOR = 3.13), ≥2 sexual partners in the last year (AOR = 1.43), and intercourse after alcohol consumption (AOR = 2.66) were significant predictors of STI among military personnel.
Conclusions: Overall prevalence of these STIs is low in this Peruvian uniformed population. High-risk sexual behavior is common, emphasizing the need for continued STI preventive strategies in these groups. The impact of comprehensive STI prevention programs should be evaluated to determine their utility in these groups.
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