HIV and other sexually transmitted infections were common among Mexican male sex workers, according to recent data.
Omar Galárraga, PhD, of Brown University School of Public Health, and colleagues conducted interviews and infection tests with 267 male sex workers who had enrolled at Clínica Especializada Condesa in Mexico City. Participants (mean age, 25 years) reported primarily having sex with other men. Thirty-seven percent of the cohort reported that legal sex work was their primary occupation, 16% were unemployed, and 8% were homeless or lived in a shelter.
At study enrollment, 38% of participants tested positive for HIV, 21% had syphilis, 10% chlamydia, 3% active hepatitis B virus, 2% gonorrhea, and 1% had hepatitis C virus. Fourteen percent were unaware of their HIV status, 11% said they did not have HIV, and 16% were unwilling to disclose their previous HIV status.
Participants reported having sex with an average of five male clients in the previous week, and 18% said they did not use a condom with their last client. The average price for a sex transaction was $25, but increased by 35% when condoms were not used.
Using this data, the researchers began an incentive-based study to reduce risky behavior. The participants were randomly assigned into four groups: control, a medium condition incentive of $50 in food vouchers every 6 months for being free of new STIs, high conditional incentive of $75 every 6 months infection-free, and unconditional incentive of $50 every 6 months. Trial results are pending.
“The findings suggest that economic incentives are a relevant approach for HIV prevention among [male sex workers], given the market-based inducements for unprotected sex,” the researchers wrote. “This type of targeted intervention seems to be justified and should continue to be explored in the context of combination prevention efforts.”
Disclosure: The researchers report no relevant financial disclosures.