Barriers to Pre-Exposure Prophylaxis Uptake Among Online Male Sex Workers in the US

Sundelson, Anne E.; Meunier, Étienne; Schrimshaw, Eric W.; Siegel, Karolynn

doi:10.1007/s10461-021-03510-7

Cited by 8 publications

(2 citation statements)

References 57 publications

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“…In addition to the Dutch PrEP eligibility criteria, certain sexual behaviors are associated with an increased risk of engaging in condomless anal sex and acquiring an HIV infection, which include having multiple partners [ 4 ], chemsex [ 5 ], group sex [ 6 ], and sex work [ 7 , 8 ]. Previous studies have shown that chemsex [ 9 ] and sex work [ 10 ] are also associated with lower PrEP uptake; as are certain sociodemographic characteristics, such as younger age (i.e., <30 or <35), living in a non-urban area, lower education level (i.e., no post-secondary education), or having a migration background from an HIV/STI endemic area [ 11 – 13 ]. Such behaviors and characteristics can help more effectively recognize PrEP need and prioritize individuals for the NPP beyond the current eligibility criteria.…”

Section: Introductionmentioning

confidence: 99%

Characterizing subgroups of sexual behaviors among men who have sex with men eligible for, but not using, PrEP in the Netherlands

et al. 2023

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This study identified subgroups of sexual behaviors associated with increased STI/HIV risk among those eligible for but not using pre-exposure prophylaxis (PrEP) in order to improve PrEP uptake and prioritization in the context of restricted capacity. We used data from sexual health centers (SHCs) in the Netherlands, including all visits of eligible but non-PrEP using men who have sex with men (MSM), men who have sex with men and women (MSMW) and transgender persons between July 2019 (start of the Dutch national PrEP pilot (NPP)) and June 2021. Using latent class analysis (LCA), we identified classes of sexual behaviors (number of partners, chemsex, group sex and sex work) and explored whether these classes were associated with STI diagnosis and sociodemographics. Across 45,582 visits of 14,588 eligible non-PrEP using individuals, the best fitting LCA model contained three classes of sexual behaviors. Classes were distinguished by seldomly reported sexual behaviors (class 1; 53.5%, n = 24,383), the highest proportions of ≥6 partners and group sex (class 2; 29.8%, n = 13,596), and the highest proportions of chemsex and sex work (class 3; 16.7% of visits, n = 7,603). Visits in classes 2 and 3 (vs. class 1) were significantly more often with individuals who were diagnosed with an STI, older (≥36 vs. ≤35 years), MSMW (vs. MSM), and visiting an urban (vs. non-urban) SHC; while these visits were significantly less often with individuals from an STI/HIV endemic area. The percentage of visits at which an STI was diagnosed was 17.07% (n = 4,163) in class 1, 19.53% (n = 2,655) in class 2 and 25.25% (n = 1,920) in class 3. The highest risk of STI, and thereby HIV, was in those engaging in specific subgroups of sexual behavior characterized by frequently reporting multiple partners, group sex, sex work or chemsex. PrEP uptake should be encouraged and prioritized for these individuals.

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Section: Introductionmentioning

confidence: 99%

Characterizing subgroups of sexual behaviors among men who have sex with men eligible for, but not using, PrEP in the Netherlands

et al. 2023

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“…22 It has been estimated that an increase in condomless sex and increase of sexual partners can substantially demean the effect of the interventions. 23,24 Further, some studies reported lack of awareness and knowledge about these treatments among MSW, 25,26 whereas others reported potential side effects, 7 perceived risk, and practical and logistical barriers to access 26,27 as main barriers for their use among MSW. In this way, authors have highlighted the need to address these issues to enhance their effect on HIV prevention.…”

Section: Introductionmentioning

confidence: 99%

Perceived risk and condomless sex practice with commercial and non-commercial sexual partners of male migrant sex workers in London, UK

Ruiz-Burga

2023

F1000Res

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Background: Since the emergence of HIV and the AIDS pandemic, the majority of risk-reduction interventions have been centred on the use of condoms in sex workers. Methods: This qualitative study recruited 25 male migrant sex workers in London to understand their risk perception and condomless sex experiences within the context of sex work and private life. The data was collected using face-to-face interviews, analysed using thematic analysis, and the findings interpreted through the theory of planned behaviour. Results: The themes explain that condomless sex with clients occurred when participants consciously accepted to perform this service deploying a risk assessment of clients, faulty strategies, and sexual practices to reduce their risk; or when they lost control because of recreational drugs, feeling attraction to clients, were in precarious circumstances, or were victims of violence. Conversely, condomless sex with non-commercial partners occurred according to the type of relationship, with formal partners it was rationalised through emotional aspects attached to this kind of relationship, while with casual partners it was connected to sexual arousal and the use of alcohol and drugs. Conclusions: Reinforce educational interventions to deliver STI-HIV information, enhance the use of condoms, and to address specific contextual factors that facilitate condomless practice with commercial and non-commercial sexual partners.

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Type of Exchange Sex and Associated Behaviors and Outcomes Among Cisgender Men and Women at Increased Risk for HIV via Heterosexual Transmission in Six U.S. Metropolitan Areas

Lipira,

Glick,

German

et al. 2023

Arch Sex Behav

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Barriers to Pre-Exposure Prophylaxis Uptake Among Online Male Sex Workers in the US

Cited by 8 publications

References 57 publications

Characterizing subgroups of sexual behaviors among men who have sex with men eligible for, but not using, PrEP in the Netherlands

Characterizing subgroups of sexual behaviors among men who have sex with men eligible for, but not using, PrEP in the Netherlands

Perceived risk and condomless sex practice with commercial and non-commercial sexual partners of male migrant sex workers in London, UK

Type of Exchange Sex and Associated Behaviors and Outcomes Among Cisgender Men and Women at Increased Risk for HIV via Heterosexual Transmission in Six U.S. Metropolitan Areas

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