Among gay men in Peru,

“Among gay men in Peru, HIV and syphilis prevalence and HIV incidence were high, especially among cross-dressers. The high prevalence of bisexuality and low rates of consistent condom use, especially with female sexual partners indicates potential HIV transmission into the heterosexual population.”
‘HIV, syphilis and heterosexual bridging among Peruvian men who have sex with men’
Official Journal of the International AIDS Society
14 June 2002
http://journals.lww.com/aidsonline/Abstract/2002/06140/HIV,_syphilis_and_heterosexual_bridging_among.10.aspx

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