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Mother-to-child transmission of HIV (MTCT) accounts for a significant proportion of new HIV infections in Peru. The purpose of this case-control study was to examine maternal and infant factors associated with MTCT in Peru from 2015 to 2016. For each biologically confirmed case infant, we randomly selected four birth year- and birth hospital-matched controls from five hospitals in Lima-Callao. Maternal and infant information were gathered from medical records. Simple conditional logistic regression was utilized to examine possible maternal and infant characteristics associated with MTCT. The rate of MTCT was 6.9% in 2015 and 2.7% in 2016. A total of 63 matched controls were identified for 18 cases. Protective factors included higher number of prenatal visits (odds ratio [OR]: 0.72; 95% confidence interval [CI]: 0.55-0.94, p = 0.012) and having more children (OR: 0.10, 95% CI: 0.01-0.79, p = 0.029). Risk factors included later maternal diagnosis (OR: 1.19; 95% CI: 1.06-1.34; p = 0.001) and greater viral load at the time of maternal diagnosis (OR: 1.05; 95% CI: 1.01-1.10; p = 0.022). Our study highlights the importance of targeting early and continued prenatal care as specific areas to target to prevent gaps in the HIV treatment cascade for pregnant HIV-infected women. These strategies can ensure early screening and initiation of antiretroviral therapy to reduce MTCT rates. [ABSTRACT FROM AUTHOR]

In Peru, a significant proportion of people tested for HIV and syphilis do not receive timely results. Our objective was to assess the institutional feasibility of implementing simultaneous HIV/syphilis point-of-care tests and client perceptions regarding these point-of-care tests. Point-of-care tests were implemented in a hospital consultation room in a marginalised zone of Lima. A time-series design was used to compare the proportion of tested clients who received timely results, with and without the point-of-care test intervention. Experience and satisfaction with point-of-care tests was evaluated with 149 people. In the 6 months without intervention, 69% and 61% of clients tested for HIV and syphilis, respectively, received their results within the required 45-minute window. During the 2-month point-of-care test intervention, all clients tested for HIV (n = 387) and syphilis (n = 398) received their results within 45 minutes. All clients surveyed were completely satisfied (52%) or satisfied (48%) with the simultaneous HIV/syphilis point-of-care test screening process. Additionally, 73% strongly agreed with the statement ‘I feel satisfied with the rapid testing process.’ Screening using point-of-care tests represents an important opportunity to reduce the time, resource and cost burden for users and institutions and increase the proportion of users receiving their test results in a timely manner. [ABSTRACT FROM AUTHOR]

Peru’s approach to its 5.7 million 10- to 19-year-olds has shifted toward positive youth development. Following that trend, our objective was to facilitate Peruvian adolescents’ use of photovoice to better understand the factors affecting their health, well-being, and sexuality and to work with adolescents to present policy and programmatic recommendations. Photovoice sessions were carried out with low-income 12- to 16-year-olds (n = 13) from Lima. Sessions included basic photography and ethics, photo taking, and descriptions and discussions using the SHOWeD (What do you See here? What is really Happening? How does this relate to Our lives? Why does this problem or strength exist? What can we Do about it?) method. Participants grouped their photos into a “photo story.” Each section of the story consisted of a message and 4 to 10 photos. Each photo had a caption that answered the SHOWeD questions. Messages were (a) “health and well-being in danger of extinction,” (b) “with some signs of hope,” (c) “innocence in spite of everything,” (d) “what we as adolescents have,” and (e) “but we lack opportunities to live a better life and a responsible sexuality.” Participants presented the photo story to program planners, policy makers, and community members. Results underscore the value of including adolescents in program and policy planning and affirm that photovoice can achieve such inclusion. Photovoice provides a concrete method for adolescents to speak their mind through image and word. [ABSTRACT FROM PUBLISHER]

In Peru, there are few studies on male sex workers (MSWs), and existing studies explore limited subgroups or offer limited information about MSWs’ perspectives. This study provides in-depth perspectives from 40 MSWs who work in downtown Lima (Cercado) and in surrounding urban neighborhoods (non-Cercado) through interviews on their identities, lives, and HIV/STI (sexually transmitted infection) risks and vulnerabilities. Findings are that entry into sex work links economy and affection, particularly among Cercado MSWs. Continued sex work cements this link, making it difficult to exit sex work and establish goals. Ties between economics and affections influence MSWs’ perceived HIV/STI risks, vulnerabilities, and prevention practices. Although Cercado MSWs report higher HIV/STI risks and vulnerabilities than non-Cercado peers, they report fewer prevention practices given inability to buy condoms and acceptance of client offers of higher payment, especially clients they feel affection for. MSWs need support to strengthen their self-perceptions and define and pursue their goals in order to improve their HIV/STI prevention practices, health, and well-being. [ABSTRACT FROM PUBLISHER]