Peru's HIV care continuum among men who have sex with men and transgender women: opportunities to optimize treatment and prevention

The HIV epidemic in Peru is concentrated in men who have sex with men (MSM) and transgender women (TW), who have an estimated prevalence > 10%, while the overall population prevalence remains < 1%. Because MSM and TW account for >60% of new infections, it is crucial to understand the full HIV continuum of care for these key populations. We performed a review of the peer-reviewed scientific and grey literature to determine the proportion of HIV-infected MSM and TW in Peru who are diagnosed, linked to and retained in care, are taking antiretroviral therapy (ART), and who have attained virologic suppression. Of the estimated 613,080 MSM and TW in Peru in 2015, approximately 63,981 are HIV-infected. Only 24.0% of HIV-infected MSM and TW are aware of their diagnosis, 15.6% are retained in care, 13.6% are on ART, and 12.0% have achieved adequate virologic control. The largest drop-off in the HIV care continuum occurs at the first step: diagnosis of HIV. Improving HIV serostatus awareness among MSM and TW is crucial to controlling Peru’s HIV epidemic. In the era of ‘treatment as prevention’, understanding the full HIV care continuum may help guide efforts to curb transmission and reduce HIV-related morbidity and mortality.