Is Intimate Partner and Client Violence Associated with Condomless Anal Intercourse and HIV Among Male Sex Workers in Lima, Peru?

Abstract

Violence experience can increase HIV risk behaviors; however, literature is scarce on violence among male sex workers (MSWs) globally. In 2014, 210 Peruvian MSWs (median age 24.9) were interviewed about their experience of physical, emotional, and sexual violence and condom use with non-paying intimate partners and clients and were tested for HIV. Multivariable models examined relationships between violence in the past 6 months, condomless anal intercourse (CLAI) in the past 3 months and HIV infection. HIV infection (24 %), CLAI (43 %), being a violence victim (42 %) and perpetrator (39 %) were common. In separate multivariable models, being a violence victim [adjusted prevalence ratio aPR = 1.49 (95 % CI 1.09-2.03)] and perpetrator [aPR = 1.39 (1.03-1.87)] were associated with CLAI. Further, being a victim [aPR = 1.65 (1.04-2.62)] was associated with HIV infection. Violence, which was significantly associated with CLAI and HIV infection, is common among Peruvian MSWs, reinforcing the importance of violence awareness and prevention as HIV risk-reduction strategies.

Keywords: Client violence; HIV; Intimate partner violence; Lima, Peru; Male sex work.

Figure 1

Figure 1 shows the identity of the other person involved in the physical, emotional, or sexual violence, as a percent of the total cohort. The top panel shows how frequently MSWs were victims of violence and who committed the violence against MSWs. For example, 11% of MSWs were victims of emotional violence by male intimate partners. The bottom panel shows how frequently MSWs were perpetrators of violence and against whom the MSWs committed violence. For example, 10% of MSWs were perpetrators of emotional violence against male intimate partners. *please include Figure 1 in color if possible.