Sexual behavior in travelers visiting Cuzco.

BACKGROUND In South America, little is known about sexual behavior and risk factors for acquiring sexually transmitted diseases (STDs) among travelers and among local people sexually interacting with travelers. There is evidence that, in Peru, significant sexual interaction between these groups exists. METHOD An anonymous written questionnaire was administered to travelers in the airport and bus stations before they left Cuzco. RESULTS Of the travelers,5.6% engaged in sexual activity with a new partner during their stay in Cuzco. Sexual intercourse with other travelers was most common (76/140, 54.3%), followed by sex with local partners (57/140, 40.7%), and with commercial sex workers (3/140, 2.15%). Consistent condom use was reported by 97/140 (69.3%). In the multivariate analysis, the following variables were independently associated with casual sex: male gender, single marital status, age between 15 and 35 years, non-United States travelers (NUSTs), traveling alone or with friends, length of stay more than 30 days, homosexual or bisexual orientation, and expectation of having sex before traveling. Homosexual and bisexual travelers had 3 or more new sexual partners more frequently than heterosexual travelers (4/8, 18/129, OR=6.17 (1.16<OR<33.5)). NUSTs received more pretravel advice (698/1587, 210/718, OR=1.86 (1.54<OR<2.24)) and engaged in more sexual activity (100/1,587, 25/722, OR=1.86 (1.20<OR<2.93)) than United States travelers (USTs). CONCLUSION Travelers visiting Cuzco engage in sexual activities that put them at risk of acquiring STD and transmitting it, both in their home country and in Peru. We recommend the inclusion of Peru and possibly other Latin American countries in the list of destinations where there is substantial risk of transmission of STD and the provision of pretravel advice regarding this issue to travelers to Peru.

[1]  P. Garred Chemokine-receptor polymorphisms: clarity or confusion for HIV-1 prognosis? , 1998, The Lancet.

[2]  D. Freedman,et al.  Strongyloides stercoralis hyperinfection associated with human T cell lymphotropic virus type-1 infection in Peru. , 1999, The American journal of tropical medicine and hygiene.

[3]  C. Cl.,et al.  Global risk of sexually transmitted diseases. , 1999 .

[4]  J. Echevarria,et al.  Sexual Behavior of International Travelers Visiting Peru , 2002, Sexually transmitted diseases.

[5]  K. Holmes,et al.  Gender differences in sexual practices and sexually transmitted infections among adults in Lima, Peru. , 1996, American journal of public health.

[6]  R. de Graaf,et al.  Underlying reasons for sexual conduct and condom use among expatriates posted in AIDS endemic areas. , 1998, AIDS care.

[7]  G. Hart,et al.  Travel, migration and HIV. , 1993, AIDS care.

[8]  J. Rowley,et al.  Global epidemiology of sexually transmitted diseases , 1998, The Lancet.

[9]  E. Gotuzzo,et al.  Prevalence of human retroviral infection in Quillabamba and Cuzco, Peru: a new endemic area for human T cell lymphotropic virus type 1. , 1997, The American journal of tropical medicine and hygiene.

[10]  J. Mullins,et al.  Emerging genetic diversity of HIV-1 in South America , 2000, AIDS.

[11]  K. Holmes,et al.  Sexually Transmitted Infections in Female Sex Workers: Reduced by Condom Use But Not by a Limited Periodic Examination Program , 1998, Sexually transmitted diseases.

[12]  E. Gotuzzo,et al.  Sexual practices and prevalence of HIV, HTLV-I/II, and Treponema pallidum among clandestine female sex workers in Lima, Peru. , 1999, Sexually transmitted diseases.

[13]  E. Hagelberg,et al.  Evidence for a post-Columbian introduction of human T-cell lymphotropic virus [type I] [corrected] in Latin America. , 1998, The Journal of general virology.

[14]  C. Bangham HTLV-1 infections , 2000, Journal of clinical pathology.

[15]  K. Hyams,et al.  Sexual transmission of human T‐lymphotropic virus type I in Peruvian prostitutes , 1992, Journal of medical virology.

[16]  G. Hart,et al.  The sexual health of travelers. , 1998, Infectious disease clinics of North America.

[17]  S. Macintyre,et al.  The sexual behaviour of international travellers at two Glasgow GUM clinics , 1997, International journal of STD & AIDS.