Sexual communication with partners informs risk assessment and sexual practices. We evaluated participant, partner, and network factors associated with communication about condom use and HIV serostatus and explored their relationships with condomless anal intercourse (CAI) among 446 men who have sex with men (MSM) and 122 transgender women (TW) in Lima, Peru. Generalized estimating equations assessed contextual influences on communication and practices with recent sexual partners. More frequent HIV communication was reported by MSM who: identified as heterosexual, compared to bisexual or gay; characterized partnerships as stable, compared to casual, anonymous, or commercial; or discussed HIV/STIs with close social contacts (p < 0.05). TW in concurrent partnerships discussed condom use more frequently than those in monogamous relationships (p < 0.05). Condom use discussions and alcohol use among MSM were associated with CAI (p < 0.05). Findings highlight complexity in sexual decision-making and call for further study of conversation content and practices to inform HIV prevention messaging.

与伴侣的性交流为风险评估和性行为提供信息。我们评估了与安全套使用和 HIV 血清状况交流相关的参与者、伴侣和网络因素，并在利马的 446 名男男性行为者 (MSM) 和 122 名跨性别女性 (TW) 中探讨了他们与无安全套肛交 (CAI) 的关系，秘鲁。广义估计方程评估了情境对与近期性伴侣的交流和实践的影响。MSM 报告了更频繁的 HIV 传播，他们： 与双性恋或同性恋相比，被认为是异性恋；与随意的、匿名的或商业的相比，将伙伴关系描述为稳定的；或与密切的社会接触者讨论 HIV/STIs (p < 0.05)。处于并发伴侣关系中的 TW 比处于一夫一妻制关系中的 TW 更频繁地讨论安全套的使用 (p < 0.05)。MSM 中关于安全套使用的讨论和饮酒与 CAI 相关 (p < 0.05)。调查结果突出了性决策的复杂性，并呼吁进一步研究对话内容和做法，以告知 HIV 预防信息。