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Does knowledge mean effective prevention? The assessment of knowledge about HIV prevention and serostatus among Andean high risk men who have sex with men
J. Guanira1,2, J.R. Lama1,2, P. Goicochea1, P. Segura1, O. Montoya3, S. Montano4, T. Kochel5, R. Grant6, J. Sanchez1,2, The Peruvian HIV Sentinel Surveillance Working Group
1Investigaciones Medicas en Salud, Lima, Peru, 2Asociación Civil Impacta Salud y Educación, Lima, Peru, 3Fundación Ecuatoriana Equidad, Guayaquil, Ecuador, 4US Naval Medical Research Center Detachment, Virology Laboratory, Lima, Peru, 5US Naval Medical Research Center Detachment, Virology Program, Lima, Peru, 6Gladstone Instituteof Virology and Inmunology, Univerity of California San Francisco, San Francisco, United States
Background: In 2001, the United Nations General Assembly Special Session (UNGASS) Declaration of Commitment on HIV/AIDS established a set of five questions to assess the knowledge about HIV prevention as an indicator about prevention and to monitor the responses to epidemic in certain populations.
Methods: In 2006, during a proposed third generation sentinel surveillance survey conducted in the Andean Region among high risk MSM to estimate the HIV incidence. The inclusion criteria were not knowing their HIV serostatus or not having a HIV test during the previous twelve months. We assessed UNGASS questions using a behavioral computer assisted self-interview. Answering the five questions correctly was considered adequate. HIV (Determine HIV 1/2 rapid test & Western Blot), early syphilis (RPR>1:8 & positive MHTP) and HSV-2 (Herpes ELISA with an OD≥3.5) seroestatus were determined in all participants.
Results: A total of 1586 persons in Lima and 541 in Guayaquil participated in the study. Median age was 25 years, 53.5% had less than high school education, 44.6% referred to have had >5 male sexual partners during the last 3 months[JRL1] . A total of 272 (12.9%) were diagnosed with HIV infection, 179 (8.5%) with early syphilis and 428 (37.4%) with HSV-2 infection. The proportion of answering correctly to each question ranges from 65.2% to 88.7%. Only 43.6% of participants correctly answered all the five questions. In the multivariate analysis, neither an adequate response to the UNGASS indicator nor the number of correct answers were associated with HIV infection after controlling for demographic, behavioral covariates, early syphilis and HSV-2.
Conclusions: Using knowledge of HIV prevention to assess the efforts to control the epidemic do not correlates with HIV prevalence and these indicators should be reviewed to appropriately guide public health programs in developing settings.
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