HIV, STI and Behavioral Risk Among Men Who have Sex with Men in a Setting of Elevated HIV Prevalence Along Ecuador's Pacific Coast.

We assessed HIV and STI prevalence, risk behaviors and factors associated with HIV infection in men who have sex with men (MSM) in Guayaquil, Ecuador. Respondent-driven sampling was used to recruit 400 MSM in 2011-2012. Participants completed a computer-assisted self-interview and provided blood samples. Statistical analysis accounted for differential probability of selection and for recruitment patterns. HIV prevalence was 11.3 %, HSV-2 30.2 %, active syphilis 6.9 % and hepatitis B 1.2 %. In the previous 12 months, 84 % of MSM reported casual male sex partners and 25 % sex work. Only 48 % of MSM consistently used condoms with male partners and 54 % had ever been tested for HIV. Of 17 % of MSM reporting a female partner, consistent condom use was 6 %. HIV infection was associated with age 25 or older, active syphilis and homosexual self-identification. Findings suggest continuing HIV risk and a need to strengthen prevention and testing among MSM.

A continuing HIV epidemic and differential patterns of HIV-STI risk among MSM in Quito, Ecuador: an urgent need to scale up HIV testing and prevention.

This study characterized the HIV epidemic among men who have sex with men (MSM) in Quito, Ecuador and contrasted risk patterns with other STI's. 416 MSM ages 15 years and older were recruited using respondent-driven sampling in 2010-2011. Biological testing and a self-interview survey assessed HIV and STI infections and risk behaviors. Analysis incorporated recruiter-level variables and clustering adjustments to control for recruitment patterns. We identify high levels of HIV (11 %), HSV-2 (14 %) and active syphilis (5.5 %) infections, low levels of lifetime HIV testing (57 %), limited knowledge of HIV and STI's (<48 %) and limited consistent condom use independent of partner type (<40 %). Sex work was associated with all infections while associations with residential location, how casual partners are met and other variables, varied. Scale-up of behavioral prevention and HIV testing is urgently needed. Interventions should target male sex workers and exploit differential patterns of HIV-STI risk to stay ahead of the epidemic.

Seroprevalencia de infección por vih en grupos de riesgo en Ecuador / Seroprevalencia of infection by vih in groups of risk in cellular and tumorlike Kinetic Ecuador

La infección por el Virus de la Inmunodeficiencia Humana (VIH) está distribuida en todo el mundo y el número de casos se incrementa de una manera dramática. En el Ecuador, muy pocos estudios relacionados a la prevalencia real de la infección se hallan disponibles, la mayoría de ellos provienen de datos derivados de instituciones privadas y organizaciones no gubernamentales con enfoques a la educación, diagnóstico, tratamiento y monitoreo de la infección por VIH. Dentro de la red de vigilancia creada en ocho países de América del Sur, en nuestro laboratorio analizamos 403 muestras de suero de personas de un grupo de riesgo (HSH=hombres sexo hombres) de Quito, Guayaquil y Portoviejo. Se utilizaron pruebas de tamizaje...