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Sex and the Internet: an online survey among HIV-Positive men who have sex with men in Lima, Peru
I.E. Alva1,2,3, M.M. Blas1,2,3, E.R. Orellana4, J.C. Bartolo2, R. Cabello2, J. Salvatierra5, C. Carcamo1, S.M. Montano6, J.R. Zunt3
1Universidad Peruana Cayetano Heredia, Lima, Peru, 2Via Libre, Lima, Peru, 3University of Washington, Seattle, United States, 4Columbia University, New York, United States, 5Centro de Salud Alberto Barton, Callao, Peru, 6Naval Medical Research Center Detachment, Lima, Peru
Background: Seeking sex over the internet among men who have sex with men (MSM) has been widely reported in many countries, including Peru. Information about sexual behavior of HIV-positive MSM seeking partners over the Internet is limited, especially in resource-constrained settings.
Methods: An online survey was conducted from December 2007 to February 2009 to assess online sex seeking and harm reduction strategies among HIV-positive MSM attending two HIV clinics in Lima, Peru.
Results: Ninety-four HIV-positive MSM completed the survey. Average age was 35 years (range: 19-66 years). Overall, 68.5% sought partners online and 54.4% had sex with partners met online; 19.2% met their most recent sexual partner online. Of the respondents who had sex with partners met online, 95.2% did not disclose their HIV status to their partner, 31.3% reported unprotected anal sex, and 22.2% did not use condoms during their last sexual intercourse. Twelve (12.8%) participants reported their last sexual encounter was with an HIV-positive partner; only one (1.1%) of them reported having unprotected anal sex (serosorting). Seventy-one (75.5%) participants reported their last sexual encounter was with an HIV-negative/unknown partner; four reported strategic positioning to reduce chances of HIV transmission. Compared to sex with a known HIV-positive partner, any (protected or unprotected) receptive oral sex and unprotected insertive oral sex were more common with the last HIV-negative/unknown partner (p=0.04, p=0.03). Insertive anal sex was more common with the last HIV-positive partner (p=0.002).
Conclusions: The Internet is a widely used tool for HIV-positive MSM seeking sex partners in Lima. Of concern is the low rate of HIV status disclosure. HIV-positive MSM seeking sex via the Internet did report more receptive sex with HIV-negative/unknown partners. Additional innovative internet-based risk reduction interventions for HIV-positive MSM in Peru are needed.
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