Risk Behaviors and STI Prevalence Among People with HIV in El Salvador

摘要

To date, there are no studies from El Salvador among people with HIV to inform prevention programs. Weconducted a study in El Salvador in 2008 among people with HIV using audio computer-assisted interviews on riskbehaviors and access to health care. Blood was tested for syphilis and herpes simplex type 2 (HSV-2). Active syphilis wasdefined as RPR titer ≥1:8. Genital specimens were tested for other sexually transmitted infections (STI) by PCR. Weevaluated factors associated with unprotected sex with last stable partner of HIV-negative or unknown status among thosereporting a stable partner. A total of 811 HIV-positive individuals participated: 413 men and 398 women. Prevalence ofChlamydia and gonorrhea was low (≤1%), while prevalence of other STI was high: Mycoplasma genitalium (14%),syphilis (15% seropositivity, active syphilis 3%) and HSV-2 (85%). In multivariate analysis, disclosing HIV status topartner (OR 0.2, 95% CI: 0.1-0.3, p<0.001), participation in HIV support groups (OR 0.3, 95% CI: 0.1-0.8, p=0.01), easyaccess to condoms (OR 0.4, 95% CI: 0.2-0.9, p=0.04) were protective factors for unprotected sex. Reporting a casualpartner in the last 12 months (OR 3.6, 95% CI: 1.5-8.5, p=0.004). and having an STI (OR 2.6, 95% CI:1.3-5.5, p=0.02)were associated with an increased odds of unprotected sex. Prevention interventions among HIV-positives in El Salvadorshould focus on increasing condom access, promoting HIV disclosure and couples testing and reducing the number ofpartners. The positive role of support groups should be used to enhance behavioral change.