Alcohol, Tobacco, and Illicit Drug Use as Risk Factors for Onward HIV Transmission Among Men Who Have Sex with Men & Transgender Women in Lima, Peru

In 2016, there were about 70,000 (55,00–94,000) people living with HIV in Peru, with a prevalence of 16.4% among men who have sex with men (MSM) and 18.5% among transgender people.1 The aim of this study was to assess the association of heavy drinking, AUDIT score, tobacco use, and illicit drug use as independent risk factors for onward HIV transmission among MSM and transgender women in Lima, Peru. We identified 201 participants with incident HIV and used multivariate logistic regression to compare the association of each risk factor with onward HIV transmission (cluster membership assessed by phylogenetic analysis). Participants who reported heavy drinking (aOR: 1.51; 95% CI: 0.70-3.28) or had an AUDIT score ≥20 (aOR: 1.30; 95% CI: 0.47-3.65) had similar but not significantly higher odds of clustering. Current smoking status (aOR: 0.41; 95% CI: 0.10-1.73) or illicit drug use (aOR: 0.53; 95% CI: 0.19-1.49) were not associated with cluster membership. Our study findings suggest that there is a great need to focus on identifying other potential risk factors for onward HIV transmission.