HIV and STI Co-infection and Migration-Related Social Vulnerability among Venezuelan Gay and Bisexual Migrants in Lima, Peru

Abstract

BACKGROUND: This study examined HIV, bacterial STI co-infection, and migration-related vulnerability among Venezuelan gay, bisexual, and other men who have sex with men (GBM) in Lima, Peru. METHODS: A total of 306 Venezuelan GBM of any serostatus living in Lima, Peru, were recruited between June and October 2024 for a cross-sectional biobehavioural survey with laboratory-based testing for HIV, chlamydia and syphilis. Poisson regression models with robust standard errors were used to estimate the association between HIV status, migration context, and STI positivity. RESULTS: The median age of participants was 32 years, and 59% had been living in Peru since 2018 or earlier. Overall, 152 GBM were living with HIV, of whom 70 were diagnosed with HIV in Venezuela, 65 after leaving, and 17 newly diagnosed through the study. Almost all (99%) GBM living with HIV who knew their status reported being on ART. The most common STI was syphilis (19%), followed by gonorrhea (12%) and chlamydia (10%). Compared to HIV negative GBM, those diagnosed with HIV in Venezuela (PR=2.29 95% CI: 1.39-3.79) and after leaving Venezuela (PR=22.29 95% CI: 1.47-3.56) were more likely to test positive for an STI. CONCLUSIONS: Venezuelan GBM migrants in Lima experience both high HIV care engagement and an ongoing burden of STIs within a broader context of migration-related social vulnerability. While Peru's HIV infrastructure demonstrates capacity for post-migration linkage to care, persistent STI co-infection and migration-related treatment disruptions highlight the need for more integrated and sustained HIV-STI prevention, sexual health services, and resettlement support.