HIV-positive gay and bisexual men in Peru: Sexuality, disclosure and the disconnect between sexual health needs and access

Areas of concern Access to Sexual and Reproductive Health services and supplies Pleasurable experience of the sexuality of PLH The Peruvian Strategic Plan for HIV ( ) did not include PLH within its priority populations

Health, Dignity and Prevention Highlights gaps and needs on prevention Where are the links between human rights, prevention, care and disclosure?

QuantitativeSurvey 814 PLH (332 MSM) Qualitative In depth interviews and focus groups 190 PLH METHODS

RESULTS Average age: 37 years in Lima / Callao, compared to 32 years in other cities. A quarter earn less than the national minimum wage (about 240 dollars). More than a half do not have health insurance. Most educated population In Lima / Callao (38% with complete higher education).

EXPERIENCE OF SEXUALITY AND SEXUAL PRACTICES Diagnosis and experience of sexuality LIMA/CALLAOOTHER CITIES

EXPERIENCE OF SEXUALITY AND SEXUAL PRACTICES Sex life is restricted - self-questioning on sexual behavior. Undeserved sense of diagnosis “Traumatic abstinence”: Sexuality is put aside on their way to adapt themselves to the condition Less traumatic attitude: “life changes but we have to go on”

“They actually made me feel bad, the psychologist who was there at that time and gave me this advice... She said "you know what? have to limit yourself because you will not have any new relationships, you can not do this, you can not do that... " (Focus group gay / bisexual men, Tumbes)

Percentage of participants with steady partners Heterosexual men Gay and bisexual men Women Trans women Lima/Callao Other cities

Serological status of the steady partner related to partner awareness of the diagnosis of the participant

Unprotected sex with steady partner in the last month LIMA/CALLAO OTHER CITIES

Reported prevention strategies from participants

Information received from Health Providers

Sexual and reproductive services offered LIMA/CALLAOOTHER CITIES

CONCLUSIONS Despite ART program provided by Peruvian MoH, whose great contribution continues to be recognized, there is still stigma and discrimination and its effects. Health providers do violent their own patients sexual rights, without providing social support and without offering usual sexual health services, such as anal and prostate exams.

CONCLUSIONS Supporting patients for disclosure to partners is not effectively encouraged. There no alternatives for PLH who are not able to discuss their serostatus to partners, neither notification strategies for casual partners.