Analytical analysis

Bivariate evaluations utilizing Fisher’s real and Chi-Square exams for categorical variables (where appropriate) and t-tests for steady variables contrasted traits between individuals exactly who explained more than one of these final three associates as female (i.e., MSMW) and players stating best male couples (in other words., MSMO). All individuals reporting often: 1) just male lovers; or 2) Both men and cisgender female associates had been included in the multivariate assessment. Due to the small number of transgender ladies lovers reported, TW partners are omitted using this analysis. The multivariable generalized estimating formula (GEE) product examined participant- and partnership-level faculties involving women in comparison with male couples into the three newest partnerships. Changeable choices for multivariable product put theoretic thought and substantive information based on readily available literature 3,4,5,6, 14, 16, 21, 23. Moreover, QIC subset investigations to assess better suit was performed 24. The GEE unit is a binomial circulation and record connect, with a sandwich estimator with the difference. All analyses were executed in Stata 12.0 (StataCorp, college or university place, TX).

Qualitative evaluation

Interviews (letter = 30) comprise performed after finishing the quantitative survey in Spanish by a native Spanish -speaking interviewer, and sound taped and transcribed verbatim. Led by immersion crystallization, a qualitative means that emphasizes both examining facts and showing on the experience of getting immersed inside information comparison, transcripts are assessed based on an inductive and deductive method to identify themes and relationships between design. Original units of themes are alone examined by two members of the research group which subsequently fulfilled examine themes, examine and reconcile any variations, and improve some requirements in addition to their meanings. An organized codebook originated transforming the motifs into rules. The programming program had been put on a short transcript by two members of the group, and any differences are talked about with a 3rd member of the qualitative evaluation people. All qualitative analysis got performed using Dedoose Version 5.0.11 (Socio Cultural Study Experts, LLC, dedoose. Whenever qualitative data is presented in outcomes, associate ID (PTID), self-reported HIV position, and sexual orientation tend to be reported.

Outcomes

Mixed-methods results are driven from 332 players just who complete the bio-behavioral study and the narratives of a subset of 30 players. For quantitative information, 13.9per cent of 332 players (letter = 46) reported intercourse with at least one female spouse and were classified as MSMW. MSMW typically endorsed a bisexual (45.4per cent) or heterosexual (43.2%) identification, and reported a mean of 3.5 couples (SD = 4.5) before a few months. More MSMO defined as homosexual or homosexual (84.3percent) and reported a mean of 4.6 lovers (SD = 9.7) in past times a couple of months. Over fifty percent of MSMO within our sample comprise lately diagnosed with HIV (51.4per cent), compared to 23.9% of MSMW (read desk 1).

The quantitative review furthermore assessed collaboration -specific characteristics for the last three sexual partners of each participant. Of 1073 intimate partnerships reported, 8.0% (letter = 86) had been with female partners. Across participants, boys reporting feminine couples were more likely to submit any unprotected insertive intercourse as compared to those reporting only male partners in the past a few months: 77.9per cent versus 43.1% (p desk 2 Behavioral points involving female partnerships among MSMO and MSMW in Lima (N = 227; 601 partnerships)

Specified to MSMW, anxiety about disclosure encompassed yet another dimensions of homophobia. Eg, when speaking about precisely why he would maybe not divulge to his feminine lover, one person reported, “for your anxiety that she will say, ‘Preciselywhat are you doing with boys?” (PTID #71, HIV-positive, heterosexual). Another mentioned, “because she’d ask me personally exactly who I would become with and I could not determine the girl” (PTID #81, HIV-uninfected, bisexual). Notably, these sentiments comprise echoed by MSMO at the same time, whom observed pervading stigma grounded on homophobia when you look at the belief of gay people as high-risk for HIV and other STIs, as stated: “A lot of heterosexuals genuinely believe that best everyone gays bring bacterial infections and that is a lie. They, those who are bisexual, have sexual intercourse with both men and women. That’s ladies are additionally contaminated” (PTID#17, HIV-negative, gay).