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In the United States young men who have sex with men have higher rates of substance use, higher HIV incidence, and less frequent HIV testing than their heterosexual counterparts and older MSM. Less is known about comparable populations in Latin America. As part of an epidemiological study, MSM were recruited through Respondent Driven Sampling in the metropolitan area of Buenos Aires, Argentina and answered a computerized behavioral survey. From the total of 500 MSM enrolled, a sub-sample of 233 aged 18?25 was analyzed. The sample was concentrated among lower socioeconomic strata, and only 16% identified as gay. Nearly half reported male, female, and transvestite sexual partners. Reported substance use was widespread ranging from 61% for marijuana to 20% for pasta base (cocaine sulfate). Seventy percent of the sample had never been tested for HIV infection; 3% tested positive for HIV and 8% for syphilis during the study. En los Estados Unidos, los hombres jóvenes que tienen sexo con hombres (JHSH) tienen tasas de uso de sustancias más altas de los HSH de mayor edad y de sus pares heterosexuales, además de una mayor incidencia del VIH y menor frecuencia de hacerse el examen del VIH. De las poblaciones comparables en América Latina, se conoce menos. Como parte de un estudio epidemiológico, 500 HSH fueron reclutados a través del método de Muestreo Dirigido por los Participantes (en inglés RDS) en el área metropolitano de Buenos Aires, Argentina y contestaron una encuesta conductual computarizada. Una submuestra de 233 hombres de 18 a 25 años de edad fue analisada. Se concentró en estratos socioeconómicos más bajos y sólo el 16% se identificaron como gay. Casi la mitad de la submuestra reportó haber tenido parejas sexuales masculinas, femeninas y travestíes. El uso de sustancias fue común, desde 61% consumidores de marihuana hasta 20% sulfato de cocaína (pasta base). El 70% de la muestra nunca se había hecho una prueba para el VIH: 3% resultaron positivos para VIH y 8% para sífilis en el transcurso del estudio. Fil: Balán, Iván C.. New York State Psychiatric Institute; Estados Unidos. Columbia University; Estados Unidos Fil: Frasca, Timothy. New York State Psychiatric Institute; Estados Unidos Fil: Pando, María de los Ángeles. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto de Investigaciones Biomédicas en Retrovirus y Sida. Universidad de Buenos Aires. Facultad de Medicina. Instituto de Investigaciones Biomédicas en Retrovirus y Sida; Argentina Fil: Marone, Ruben. Nexo Asociación Civil; Argentina Fil: Barreda, Victoria. Nexo Asociación Civil; Argentina Fil: Dolezal, Curtis. New York State Psychiatric Institute; Estados Unidos. Columbia University; Estados Unidos Fil: Carballo Diéguez, Alex. New York State Psychiatric Institute; Estados Unidos. Columbia University; Estados Unidos Fil: Ávila, María Mercedes. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto de Investigaciones Biomédicas en Retrovirus y Sida. Universidad de Buenos Aires. Facultad de Medicina. Instituto de Investigaciones Biomédicas en Retrovirus y Sida; Argentina

Venue-based HIV prevention interventions, especially in sex on premise venues, can disrupt high-risk sexual networks. However, prior to intervening, it is essential to understand the person-venue dynamics that contribute to HIV risk. As such, we conducted five ethnographic observations at each of six venues where alcohol is sold and sex occurs onsite (2 each porn theaters, sex clubs, and dance clubs) frequented by gay and other men who have sex with men (G&MSM) in the Buenos Aires metropolitan area. Alcohol use, sexual behavior, and person-venue dynamics differed markedly across venue types. In dance clubs, substantial alcohol consumption often preceded visits to the darkroom for sex which, at times, included unprotected anal and vaginal intercourse. Condoms, although available, were not easily accessible. HIV prevention messaging was generally non-existent. These venues are in critical need of interventions to reduce HIV transmission risk.

This study sought to describe childhood sexual experiences with older partners (CSEOP) among men who have sex with men (MSM) in Buenos Aires, Argentina. MSM were recruited through respondent driven sampling. They responded to a computer administered self-interview with questions on CSEOP, operationalized as manual, oral, genital, or anal contact prior to age 13 with a partner at least 4 years older. Of the 500 respondents, only 25% identified as gay. Eighteen percent of the respondents reported CSEOP, the majority of whom did not feel they were hurt by the experience and did not consider it to be childhood sexual abuse (CSA). Over two-thirds of MSM who reported CSEOP said that their older partner was a female. Only 4% of those with a female partner felt their experience was CSA compared to 44% of those who had a male partner. Among all men reporting CSEOP, those who felt sexually abused were more likely to have been physically forced or threatened, physically hurt, and emotionally hurt than those who did not feel sexually abused. Having CSEOP, being hurt by the experiences, and perceiving the experiences as sexual abuse were not associated with current HIV sexual risk or substance use behavior. In this sample of MSM in Argentina, a substantial minority reported CSEOP. Those who felt they had been sexually abused were much more likely to have had an older male partner than an older female partner, and were more likely to report having been physically forced and threatened by their older partner. Fil: Dolezal, Curtis. Columbia University; Estados Unidos Fil: Carballo Diéguez, A.. Columbia University; Estados Unidos Fil: Balán, Iván C.. Columbia University; Estados Unidos Fil: Pando, María de los Ángeles. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto de Investigaciones Biomédicas en Retrovirus y Sida. Universidad de Buenos Aires. Facultad de Medicina. Instituto de Investigaciones Biomédicas en Retrovirus y Sida; Argentina Fil: Mabragaña, Marina. Columbia University; Estados Unidos Fil: Marone, Ruben. Nexo Asociación Civil; Argentina Fil: Barreda, Victoria. Nexo Asociación Civil; Argentina Fil: Ávila, María Mercedes. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto de Investigaciones Biomédicas en Retrovirus y Sida. Universidad de Buenos Aires. Facultad de Medicina. Instituto de Investigaciones Biomédicas en Retrovirus y Sida; Argentina

The objective of the study was to explore HIV-testing practices among men who have sex with men (MSM) in Buenos Aires, Argentina, in light of current international health guidelines that recommend frequent HIV testing for MSM who engage in high-risk behavior. Participants, who were recruited using respondent-driven sampling (RDS), were 500 mostly young, nongay-identified MSM of low socioeconomic status, high levels of unemployment, living mainly in the less-affluent areas surrounding Buenos Aires, and lacking health insurance. They provided blood samples for HIV testing and responded to a Computer Assisted Self Interview. Fifty-two percent had never been tested for HIV, and 20% had been tested only once; 17% were found to be HIV infected, of whom almost half were unaware of their status. Main reasons for never having tested previously were: not feeling at risk, fear of finding out results, and not knowing where to get tested. Among those previously tested, men had been tested a median of 2 times with their most recent test having occurred a median of 2.7 years prior to study enrollment. Of those who had not tested positive before entering the study, only 41% returned for their results. HIV testing was infrequent and insufficient for early detection of infection, entry into treatment, and protection of sexual partners. This was particularly the case among nongay-identified MSM. Testing campaigns should aim to help MSM become aware of their risk behavior, decrease fear of testing by explaining available treatment resources and decreasing the stigma associated with HIV, and by publicizing information about free and confidential testing locations. Rapid HIV testing should be made available to eliminate the need for a return visit and make results immediately available to individuals who are tested. Fil: Carballo Diéguez, Alex. Columbia University; Estados Unidos Fil: Balán, Iván C.. Columbia University; Estados Unidos Fil: Dolezal, Curtis. Columbia University; Estados Unidos Fil: Pando, María de los Ángeles. Universidad de Buenos Aires. Facultad de Medicina. Departamento de Microbiología. Centro Nacional de Referencia para el Sida; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto de Investigaciones Biomédicas en Retrovirus y Sida. Universidad de Buenos Aires. Facultad de Medicina. Instituto de Investigaciones Biomédicas en Retrovirus y Sida; Argentina Fil: Marone, Ruben. Nexo Asociación Civil; Argentina Fil: Barreda, Victoria. Nexo Asociación Civil; Argentina Fil: Ávila, María Mercedes. Universidad de Buenos Aires. Facultad de Medicina. Departamento de Microbiología. Centro Nacional de Referencia para el Sida; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto de Investigaciones Biomédicas en Retrovirus y Sida. Universidad de Buenos Aires. Facultad de Medicina. Instituto de Investigaciones Biomédicas en Retrovirus y Sida; Argentina

The objective of this study was to explore the acceptability of rapid HIV self-testing (RHST)among men who have sex with men (MSM).MethodsDuring 2006±2009, a sample of 500 MSM was recruited through Respondent Driven Samplingfor an HIV prevalence/incidence study. Attitude toward RHST was explored amongHIV negative MSM. Data were weighted prior to analyses.ResultsParticipants reported they were likely to buy RHST (74%), test themselves more frequentlythan they currently do (77%), and that the procedure would simplify testing (70%). Furthermore,71% reported they would probably use it alone, 66% would use it with a steady partner,and 56% with a friend/partner. While a majority acknowledged that RHST use woulddeprive them of receiving counseling (61%), 74% declared they would go for help if theytested positive; 57% would use an RHST in order to avoid condoms. Probability of use surpassed70% among gay and non-gay identified MSM as well as those with and without aprevious HIV test. Those likely to buy RHST were older (p = 0.025) and more likely to identifyas gay (p = 0.036). A total of 17% said they would think about killing themselves and 9%would attempt suicide if they tested positive. These MSM were more likely to be younger(p

Five hundred men who have sex with men (MSM), recruited through respondent driven sampling in Buenos Aires, Argentina, were interviewed in order to assess knowledge and beliefs about HIV infection. The mean proportion of HIV correct knowledge answers was 62 %; however participants whose sexual partners in the prior year included women (MSM&W) had lower frequencies of correct answers than participants with no women partners. Men with previous HIV testing experience and those who were HIV positive had higher HIV knowledge. In relation to HIV beliefs, less than half of participants responded correctly to each of the scenarios presented. Accurate answers for all items were more likely among those who only have sex with men. Men have basic HIV knowledge but also many misconceptions about transmission and prevention. Furthermore, MSM&W have less information than those who are exclusively MSM, probably related to the fact that information campaigns specifically targeted gay identified men. Un total de 500 hombres que tienen sexo con hombres (HSH), reclutados utilizando el muestreo RDS en Buenos Aires, Argentina, fueron encuestados a fin de conocer su conocimiento y creencias sobre la transmisión del VIH. La proporción de respuestas correctas sobre conocimiento en VIH fue del 62 %. Sin embargo, los participantes que reportaron tener parejas sexuales mujeres (HSH&M) en el último año tuvieron menos frecuencias correctas que los participantes que no tenían parejas mujeres. Los hombres que se habían realizado un diagnóstico previo de VIH y aquellos que eran VIH positivos tenían mayor conocimiento sobre el virus. En relación a las creencias sobre VIH, menos de la mitad de los participantes respondieron correctamente a cada uno de los escenarios presentados. Los HSH que no tenían parejas mujeres respondieron más correctamente. Este estudio revela que los HSH tienen conocimientos básicos sobre VIH pero también muchos errores sobre transmisión y prevención. Además, los HSH&M tienen menos información que los HSH (mayormente identificados como gay), probablemente relacionado con el hecho de que las campañas previas se han dirigido específicamente a hombres identificados como gay. Fil: Pando, Maria de Los Angeles. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto de Investigaciones Biomédicas en Retrovirus y Sida; Argentina. Universidad de Buenos Aires. Facultad de Medicina; Argentina Fil: Balan, Ivan. Columbia University; Estados Unidos Fil: Marone, Ruben. Nexo Asociación Civil; Argentina Fil: Dolezal, Curtis. Columbia University; Estados Unidos Fil: Barreda, Victoria. Nexo Asociación Civil; Argentina Fil: Carballo Dieguez, Alex. Columbia University; Estados Unidos Fil: Avila, Maria Mercedes. Universidad de Buenos Aires. Facultad de Medicina; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto de Investigaciones Biomédicas en Retrovirus y Sida; Argentina

El uso del diagnóstico rápido para HIV en Argentina, así como otros países de Latinoamérica, ha sido limitado hasta el momento. Este trabajo reporta los resultados provenientes de un estudio cualitativo realizado entre hombres gays y otros hombres que tienen sexo con hombres (GHSH) de la Ciudad de Buenos Aires, Argentina. El objetivo principal del mismo fue conocer las ventajas y desventajas que los hombres GHSH perciben en relación al diagnóstico rápido casero para HIV. Se realizaron ocho grupos focales con 73 participantes en los cuales se discutió acerca de las ventajas y desventajas del uso de los diagnósticos rápidos. Las respuestas fueron codificadas utilizando un programa para análisis de datos cualitativos (NVivo) y analizadas temáticamente. Los participantes describieron numerosas ventajas sobre el uso del diagnóstico rápido casero, aunque algunos reportaron importantes preocupaciones dentro de las cuales se destaca la posibilidad de impulsos suicidas si alguien recibe un resultado positivo estando solo. En términos generales se observó una gran aceptabilidad para el uso del diagnóstico rápido si el mismo es realizado por personal de salud en lugares acondicionados para este fin.

Five hundred men who have sex with men were recruited in Buenos Aires using respondent driven sampling. Of them, 46 respondents (24 of them not gay identified) who were HIV infected were asked questions on serodisclosure. The sample was characterized by indicators of low socioeconomic status. Most of the respondents reported being in good to excellent health despite 42% of them having been diagnosed with AIDS. Only 10% of respondents had not disclosed their serostatus to at least one person. Coworkers and lovers or main sexual partners were those most likely to know the respondents’ serostatus. Reactions to disclosure were for the most part supportive. Those who had not disclosed anticipated less favorable reactions than those who had disclosed. No significant differences were observed between gay and non-gay identified respondents. The progressive social environment of Argentina that includes federal laws recognizing gay marriage may contribute to create a climate favorable for serostatus disclosure. Fil: Carballo Diéguez, Alex. HIV Center for Clinical and Behavioral Studies; Estados Unidos de América; Fil: Balan, Iván C.. HIV Center for Clinical and Behavioral Studies; Estados Unidos de América; Fil: Dolezal, Curtis. HIV Center for Clinical and Behavioral Studies; Estados Unidos de América; Fil: Ibitoye, Mobolaji. HIV Center for Clinical and Behavioral Studies; Estados Unidos de América; Fil: Pando, Maria de Los Angeles. Universidad de Buenos Aires. Facultad de Medicina. Departamento de Microbiología. Centro Nacional de Referencia del Sida; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay; Argentina Fil: Marone, Ruben. Universidad de Buenos Aires. Facultad de Medicina. Departamento de Microbiología. Centro Nacional de Referencia del Sida; Argentina. Nexo Asociación Civil; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay; Argentina Fil: Barreda, Victoria. Nexo Asociación Civil; Argentina Fil: Avila, Maria Mercedes. Universidad de Buenos Aires. Facultad de Medicina. Departamento de Microbiología. Centro Nacional de Referencia del Sida; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay; Argentina

Objective: The aims of this study were to investigate the frequency of male circumcision among men who have sex with men (MSM) in Buenos Aires, Argentina; the association between circumcision and sexually transmitted infections (STIs); and, among those uncircumcised, the willingness to be circumcised. Methods: A cross-sectional study was conducted among 500 MSM recruited through the respondent-driven sampling (RDS) technique. Participants underwent a consent process, responded to a Web-based survey that included questions on demographic information, sexual behaviour, and circumcision and provided biological samples. HIV, hepatitis B virus (HBV), hepatitis C virus (HCV), Treponema pallidum, and human papiloma virus (HPV) diagnoses were performed using standard methodologies. For all analyses, data were weighted based on participants’ network size. Results: Only 64 (13%) of the 500 MSM in our study reported being circumcised. Among uncircumcised men (n=418), 302 (70.4%) said that they would not be willing to get circumcised even if the procedure could reduce the risk of HIV infection. When considering all participants, circumcision status was not significantly associated with HIV, HBV, HCV, T. pallidum or HPV infections. However, when we restricted the sample to men who do not practice receptive anal intercourse (RAI) and compared circumcised to uncircumcised men, the former (N=33) had no cases of HIV infection, while 34 of 231 (14.8%) uncircumcised men were HIV positive (p=0.020). Regarding HPV, uncircumcised men had a significantly larger number of different HPV types compared with circumcised men (mean 1.83 vs. 1.09, p

Quinientos hombres gay y otros hombre que tienen sexo con hombres (G&HSH) de Buenos Aires, Argentina, completaron un cuestionario sobre consumo de sustancias y comportamiento sexual. Durante los últimos dos meses, 78 % de participantes consumieron alcohol y 61 % drogas. Mas del 20 % de los participantes que reportaron usar alcohol, marihuana, pasta base o tranquilizantes, lo hizo diariamente. El consumo excesivo de alcohol fue mas probable entre participantes con mas reactividad en el estado de ánimo (AOR = 1.64) y menos probable entre los que se identifican como gay (AOR = 0.38). El uso semanal de drogas fue menos probable entre participantes mayores (AOR = 0.98), y los que se identifican como gay (AOR = 0.50) pero mas probable entre los que tienen mas reactividad en el estado de ánimo (AOR = 1.49). El uso de drogas se correlacionó con las relaciones sexuales anales y vaginales no protegidas con hombres, mujeres y travestis entre los participantes no identificados como gay (r = 0.22). Los hallazgos del estudio resaltan la necesidad de reducir el uso de sustancias y las prácticas sexuales de riesgo en esta población. Five hundred gay and other men who have sex with men (G&MSM) from Buenos Aires, Argentina completed an assessment regarding substance use and sexual behavior. During the past 2 months, 78 % of participants consumed alcohol and 61 % drugs. Over 20 % of participants reporting alcohol, marijuana, cocaine sulfate, or tranquilizer use, did so daily. Heavy alcohol use was more likely among participants with greater mood reactivity (AOR = 1.64) and less likely among those who identified as gay (AOR = 0.38). Weekly drug use was less likely among older (AOR = 0.98), and gay-identified participants (AOR = 0.50), but more likely among participants with greater mood reactivity (AOR = 1.49). Drug use was correlated with unprotected anal and vaginal intercourse with men, women, and transvestites among non-gay identified participants (r = 0.22). Findings highlight the need to reduce substance use and sexual risk behavior in this population. Fil: Balan, Iván C.. Columbia University. HIV Center for Clinical and Behavioral Studies; Estados Unidos de América; Fil: Carballo Diéguez, Alex. Columbia University. HIV Center for Clinical and Behavioral Studies; Estados Unidos de América; Fil: Dolezal, Curtis. Columbia University. HIV Center for Clinical and Behavioral Studies; Estados Unidos de América; Fil: Marone, Ruben. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto de Investigaciones Biomédicas en Retrovirus y Sida; Argentina; Nexo Asociación Civil; Argentina; Fil: Pando, Maria de Los Angeles. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto de Investigaciones Biomédicas en Retrovirus y Sida; Argentina; Fil: Barreda, Victoria. Nexo Asociación Civil; Argentina; Fil: Avila, Maria Mercedes. Universidad de Buenos Aires. Facultad de Medicina. Departamento de Microbiología. Cátedra de Microbiología, Parasitología e Inmunología; Argentina

BACKGROUND The aim of this study was to estimate the prevalence of HIV and other STIs, among MSM from Buenos Aires (2007-2009). METHODS Responding Driven Sampling was used for recruitment of MSM. Participants completed a structured web-based survey and provided biological samples. RESULTS A total of 496 MSM were studied for HIV, HBV, HCV, and T pallidum infections. Chlamydia and HPV diagnoses were only performed in 98 and 109 participants, respectively. Prevalence of HIV was 17.3%, HBV 22.9%, HCV 7.5%, T pallidum 20.5%, HPV 83.5%, and C trachomatis 1.7%. In the year prior to the evaluation, 71% of the participants had had sex with men and/or trans and women (MMW) while 29% had not had sex with women (MM). Comparing MM to MMW, prevalence of HIV (30.7% vs. 11.9%, p

Background Prior research focusing on men who have sex with men (MSM) conducted in Buenos Aires, Argentina, used convenience samples that included mainly gay identified men. To increase MSM sample representativeness, we used Respondent Driven Sampling (RDS) for the first time in Argentina. Using RDS, under certain specified conditions, the observed estimates for the percentage of the population with a specific trait are asymptotically unbiased. We describe, the diversity of the recruited sample, from the point of view of sexual orientation, and contrast the different subgroups in terms of their HIV sexual risk behavior. Methodology 500 MSM were recruited using RDS. Behavioral data were collected through face-to-face interviews and Web-based CASI. Conclusion In contrast with prior studies, RDS generated a very diverse sample of MSM from a sexual identity perspective. Only 24.5% of participants identified as gay; 36.2% identified as bisexual, 21.9% as heterosexual, and 17.4% were grouped as “other.” Gay and non-gay identified MSM differed significantly in their sexual behavior, the former having higher numbers of partners, more frequent sexual contacts and less frequency of condom use. One third of the men (gay, 3%; bisexual, 34%, heterosexual, 51%; other, 49%) reported having had sex with men, women and transvestites in the two months prior to the interview. This population requires further study and, potentially, HIV prevention strategies tailored to such diversity of partnerships. Our results highlight the potential effectiveness of using RDS to reach non-gay identified MSM. They also present lessons learned in the implementation of RDS to recruit MSM concerning both the importance and limitations of formative work, the need to tailor incentives to circumstances of the less affluent potential participants, the need to prevent masking, and the challenge of assessing network size.

A partir de un relevamiento de tipo etnográfico, este artículo describe prácticas sexuales y lugares de encuentro de HSH (Hombres que tienen Sexo con Hombres) en la ciudad de Buenos Aires. Tales espacios, así como las características que asumen en ellos los encuentros sexuales, delinean obstáculos específicos en la adopción de comportamientos preventivos, y generan nuevos desafíos para las actividades de prevención. Se plantean además dificultades y debates conceptuales que la categoría HSH presenta, y sus consecuencias en el abordaje preventivo y teórico-metodológico para las ciencias sociales. Se proponen asimismo nuevos interrogantes acerca de los alcances y las limitaciones del modelo preventivo del VIH/Sida para HSH.