Correlates of condomless anal intercourse with different types of sexual partners among men who have sex with men and transgender women in Lima, Peru

In Lima, Peru, men who have sex with men (MSM) and transgender women (TW) are disproportionately affected by HIV. Patterns of sexual behavior vary by type of sexual partner, which has implications for the design of interventions to reduce HIV transmission within these groups. Among this population, we examine correlates of sex with each of four types of partners (main, casual, one-time, client) and condomless anal intercourse (CAI) with those partners. HIV-negative MSM and TW in Lima completed monthly questionnaires to indicate whether they had any of the four types of partners and whether they had CAI with those partners. Odds ratios were calculated using generalized estimating equations to identify correlates of being in different types of partnerships and CAI within those partnerships. In multivariate analysis of data from 1,831 MSM and TW over 14,792 study visits, CAI was most commonly reported with main partners, followed by casual partners, one-time partners, and clients. Presence of an alcohol use disorder (AUD) significantly increased the odds of CAI with all types of partners (main: OR 1.36 (95% CI 1.17–1.57); casual: 1.49 (1.27–1.75); one-time: 1.45 (1.22–1.72); client 1.52 (1.12–2.08)), while alcohol use in the last 30 days only increased the odds of CAI with main partners. Having one main partner decreased the odds of being in casual and one-time partnerships and of CAI in all types of partnerships. Interventions targeting AUDs and individuals with multiple sexual contacts could reduce CAI and HIV risk in this population.