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.