Unpacking “High-Risk”: A Latent Class Analysis of Sexual Partnership Patterns and HIV Transmission Risk Among Gay, Bisexual, and other Men who have Sex with Men in Perú
Reni Forer, Jesse L. Clark, Jessica Gutierrez, Eddy Segura, Rolando Valladares, Jose Luis Castro, Narendar Kumar, Jordan E. Lake, Robinson Cabello, Cheríe S. BlairBackground:
Gay, bisexual, and other men who have sex with men (GBMSM) are often considered a homogenous “high-risk” group. We aimed to differentiate subgroups based on participants’ last sexual partner (LSP) and explore associations with HIV transmission risk factors.
Setting:
We utilized cross-sectional data (06/2022-03/2023) from “high-risk” GBMSM in Lima, Perú.
Methods:
Participants included cisgender men and gender non-conforming adults assigned male at birth reporting condomless anal sex (CAS) with ≥1 serodiscordant or unknown serostatus cisgender man or transgender woman in the past 6 months. Latent class analysis was performed using LSP characteristics, including partner type, sexual role, and CAS position. Multinomial logistic regression examined HIV risk factors associated with latent classes, including drug use, transactional sex, STI diagnosis, sexual identity, hazardous alcohol use, and number of anonymous partners.
Results:
From 2,119 participants (47.1% living with HIV [LWH]), five latent classes were identified:
Conclusion:
Our findings demonstrate that GBMSM in Lima represent a behaviorally diverse population whose HIV risk is shaped by sexual roles, partnership types, and network structures. Culturally informed prevention strategies that incorporate these dynamics—such as role-specific partner notification methods—are essential to more effectively address HIV transmission in the region.