{"doi":"10.1525/agh.2025.2484577","title":"Perspectives of hygiene-based practices, preferred intervention modalities, and “¡Lubricarte, Liberarte, Lavarte+!” or L3+ for HIV/STI risk reduction in Peru","abstract":"Hygiene-based practices of lubrication, genital cleansing, postcoital urination, and rectal douching are common behaviors among populations at higher risk of human immunodeficiency virus (HIV)/sexually transmitted infections (STI). Yet, the role these behaviors have on HIV/STI risk has not been well elucidated, especially among transgender women (TW) and gay, bisexual, and other men who have sex with men (GBMSM). Unfortunately, many individuals also do not benefit equally from barrier (condoms) and biomedical preventative strategies, which strengthens the need for more sustainable methods. This study explored the knowledge, attitudes, and behaviors of hygiene-based practices, proven preventative methods, and preferred intervention methods among Peruvian TW and GBMSM. Thirty interviews and 50 questionnaires were conducted with TW (N = 35), GBMSM (N = 35), health-care providers (N = 5), and key community informants (N = 5). Participants perceived hygiene-based practices as a significant aspect of sexual well-being. Despite potential rural and literacy limitations, educational materials utilizing social media and in-person events were also viewed favorably. Several barriers to autonomy surfaced, most notably systemic disparities in adequate HIV/STI services and top versus bottom social dynamics. Additionally, 78% of survey participants reported never taking pre-exposure prophylaxis. Most participants found condoms and hygiene-based practices to be acceptable and feasible to adhere to. Participants also shared significant usability with douching, despite many sharing unawareness or misinformation about its potential harms. Additional work is needed to address the barriers to effective HIV/STI-preventative methods and improve the understanding of the risks and safest techniques of hygiene-based practices. Please refer to Supplementary Materials, Full text Spanish version, for a full text Spanish version of this article.","journal":"Advances in Global Health","year":2025,"id":578620,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":0,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9527,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2025-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":1445341,"name":"Jesus Cisneros Asca","orcid":null,"position":1,"is_corresponding":false},{"id":1488532,"name":"Carlos Cáceres","orcid":"0000-0002-2302-9602","position":2,"is_corresponding":false},{"id":61450,"name":"Shahrzad Bazargan‐Hejazi","orcid":"0000-0001-8361-5198","position":3,"is_corresponding":false},{"id":452187,"name":"Dallas Swendeman","orcid":null,"position":4,"is_corresponding":false},{"id":1488913,"name":"Ricky Timmons-Vendryes","orcid":null,"position":0,"is_corresponding":true}],"reference_count":28,"raw_metadata":null,"created_at":"2026-07-19T02:58:24.957414Z","pmid":null,"pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}