Role versatility among men who have sex with men in Urban Peru

Role versatility refers to the practice in which individual men who have sex with men (MSM) play both insertive and receptive sexual roles over time. Versatility has been thought to be relatively uncommon among Latin American MSM but possibly is rising. Versatility also has been shown to be a potentially large population-level risk factor for HIV infection. In this study we examine the correlates of versatile behavior and identity among 2,655 MSM in 6 Peruvian cities. Versatile behavior with recent male partners was found in 9% of men, and versatile (moderno) identity was reported by 16%. Significant predictors included high education, white-collar occupation, sex work, and residence in Lima. Age was not significant in any analysis. Since sex work is correlated negatively with other predictors, versatile men appear to comprise two distinct subpopulations. Insertive-only men appear to play a strong role in bridging the HIV epidemic between MSM and women.