Abstract:Young men who have sex with men (MSM) are at risk for HIV infection. We investigated inconsistent condom use among 827 sexually active young MSM (15-24 years), enrolled using venue-day-time sampling in Bangkok, Chiang Mai and Phuket, Thailand. Data was collected using palmtop computer-assisted self-interviewing. Of participants, 33.1% were regular MSM, 37.7% were male sex workers (MSWs) and 29.1% were transgenders (TGs). Of MSM, 46.7%, of MSWs, 34.9% and of TGs, 52.3% reported recent inconsistent condom use. I… Show more
“…Most (60%) MSM who sold sex in our sample experienced forced sex; these men had almost three times the odds of experiencing forced sex relative to MSM who did not sell sex. Our findings corroborate studies in other contexts that report elevated risks for experiencing sexual and other physical violence among MSM who sell sex [1,2,4,7,36]. This prevalence of forced sex is very high, particularly in comparison to data from other low- and middle-income countries which show prevalence ranging from 6.5 to 40.5% [1,64].…”
Section: Discussionsupporting
confidence: 89%
“…Associations between inconsistent condom use and some of these factors (e.g. economic insecurity, low educational attainment) have been identified in other studies with MSM who sell sex globally [21,36]. Thus, as suggested by Newman and colleagues in studies of MSM who sell sex in other low- and middle-income countries [25], interventions predicated on individual level factors, such as HIV knowledge, condom negotiation and safer sex self-efficacy, would likely be more effective if paired with interventions to increase condom access and address economic security among MSM who sell sex.Figure 1.Conceptual model of social ecological factors associated with selling sex among men who have sex with men in Jamaica (n = 556).
…”
Section: Discussionmentioning
confidence: 91%
“…age [22], education [22]), individual risk factors (e.g. condomless anal intercourse [4,22,36], HIV knowledge [22], sexually transmitted infections (STI) history [52,53], higher number of sexual partners [1,2], substance use [54]), and social level factors (e.g., forced sex, harassment and violence [1,2,4,36]). Alternately, social cohesion among MSM who sell sex has been identified as a protective factor [3].…”
Background: Globally, men who have sex with men (MSM) experience social marginalization and criminalization that increase HIV vulnerability by constraining access to HIV prevention and care. People who sell sex also experience criminalization, rights violations, and violence, which elevate HIV exposure. MSM who sell sex may experience intersectional stigma and intensified social marginalization, yet have largely been overlooked in epidemiological and social HIV research. In Jamaica, where same sex practices and sex work are criminalized, scant research has investigated sex selling among MSM, including associations with HIV vulnerability.
Objective: We aimed to examine social ecological factors associated with selling sex among MSM in Jamaica, including exchanging sex for money, shelter, food, transportation, or drugs/alcohol (past 12 months).
Methods: We conducted a cross-sectional survey with a peer-driven sample of MSM in Kingston, Ocho Rios, and Montego Bay. Multivariable logistic regression analyses were conducted to estimate intrapersonal/individual, interpersonal/social, and structural factors associated with selling sex.
Results: Among 556 MSM, one-third (n = 182; 32.7%) reported selling sex. In the final multivariable model, correlates of selling sex included: individual/intrapersonal (lower safer sex self-efficacy [AOR: 0.85, 95% CI: 0.77, 0.94]), interpersonal/social (concurrent partnerships [AOR: 5.52, 95% CI: 1.56, 19.53], a higher need for social support [AOR: 1.08, 95% CI: 1.03, 1.12], lifetime forced sex [AOR: 2.74, 95% 1.65, 4.55]) and structural-level factors (sexual stigma [AOR: 1.09, 95% CI: 1.04, 1.15], food insecurity [AOR: 2.38, 95% CI: 1.41, 4.02], housing insecurity [AOR: 1.94, 95% CI: 1.16, 3.26], no regular healthcare provider [AOR: 2.72, 95% CI: 1.60, 4.64]).
Conclusions: This study highlights social ecological correlates of selling sex among MSM in Jamaica, in particular elevated stigma and economic insecurity. Findings suggest that MSM in Jamaica who sell sex experience intensified social and structural HIV vulnerabilities that should be addressed in multi-level interventions to promote health and human rights.
“…Most (60%) MSM who sold sex in our sample experienced forced sex; these men had almost three times the odds of experiencing forced sex relative to MSM who did not sell sex. Our findings corroborate studies in other contexts that report elevated risks for experiencing sexual and other physical violence among MSM who sell sex [1,2,4,7,36]. This prevalence of forced sex is very high, particularly in comparison to data from other low- and middle-income countries which show prevalence ranging from 6.5 to 40.5% [1,64].…”
Section: Discussionsupporting
confidence: 89%
“…Associations between inconsistent condom use and some of these factors (e.g. economic insecurity, low educational attainment) have been identified in other studies with MSM who sell sex globally [21,36]. Thus, as suggested by Newman and colleagues in studies of MSM who sell sex in other low- and middle-income countries [25], interventions predicated on individual level factors, such as HIV knowledge, condom negotiation and safer sex self-efficacy, would likely be more effective if paired with interventions to increase condom access and address economic security among MSM who sell sex.Figure 1.Conceptual model of social ecological factors associated with selling sex among men who have sex with men in Jamaica (n = 556).
…”
Section: Discussionmentioning
confidence: 91%
“…age [22], education [22]), individual risk factors (e.g. condomless anal intercourse [4,22,36], HIV knowledge [22], sexually transmitted infections (STI) history [52,53], higher number of sexual partners [1,2], substance use [54]), and social level factors (e.g., forced sex, harassment and violence [1,2,4,36]). Alternately, social cohesion among MSM who sell sex has been identified as a protective factor [3].…”
Background: Globally, men who have sex with men (MSM) experience social marginalization and criminalization that increase HIV vulnerability by constraining access to HIV prevention and care. People who sell sex also experience criminalization, rights violations, and violence, which elevate HIV exposure. MSM who sell sex may experience intersectional stigma and intensified social marginalization, yet have largely been overlooked in epidemiological and social HIV research. In Jamaica, where same sex practices and sex work are criminalized, scant research has investigated sex selling among MSM, including associations with HIV vulnerability.
Objective: We aimed to examine social ecological factors associated with selling sex among MSM in Jamaica, including exchanging sex for money, shelter, food, transportation, or drugs/alcohol (past 12 months).
Methods: We conducted a cross-sectional survey with a peer-driven sample of MSM in Kingston, Ocho Rios, and Montego Bay. Multivariable logistic regression analyses were conducted to estimate intrapersonal/individual, interpersonal/social, and structural factors associated with selling sex.
Results: Among 556 MSM, one-third (n = 182; 32.7%) reported selling sex. In the final multivariable model, correlates of selling sex included: individual/intrapersonal (lower safer sex self-efficacy [AOR: 0.85, 95% CI: 0.77, 0.94]), interpersonal/social (concurrent partnerships [AOR: 5.52, 95% CI: 1.56, 19.53], a higher need for social support [AOR: 1.08, 95% CI: 1.03, 1.12], lifetime forced sex [AOR: 2.74, 95% 1.65, 4.55]) and structural-level factors (sexual stigma [AOR: 1.09, 95% CI: 1.04, 1.15], food insecurity [AOR: 2.38, 95% CI: 1.41, 4.02], housing insecurity [AOR: 1.94, 95% CI: 1.16, 3.26], no regular healthcare provider [AOR: 2.72, 95% CI: 1.60, 4.64]).
Conclusions: This study highlights social ecological correlates of selling sex among MSM in Jamaica, in particular elevated stigma and economic insecurity. Findings suggest that MSM in Jamaica who sell sex experience intensified social and structural HIV vulnerabilities that should be addressed in multi-level interventions to promote health and human rights.
“…While behaviorally homosexual and bisexual men had the lowest levels of CCU, the overall level of CCU was low across the sample-and lower than has been reported for similar populations in Thailand (Chemnasiri et al, 2010;Li et al, 2009a). The comparison of levels of CCU between Lao PDR and Thailand is important given cultural similarities between the two countries.…”
Men who have sex with both men and women (behaviorally bisexual men) may be at increased risk of HIV acquisition and transmission due to risky sexual behaviors. We recruited a sexual network comprised of behaviorally bisexual men and their sexual partners in Vientiane, Lao PDR in 2010 to inform our understanding of the potential for HIV transmission among heterosexual, homosexual, and bisexual networks. Participants completed a sexual behavior questionnaire and referred < 5 sexual partners. A total of 298 people were recruited, including 63 behaviorally bisexual men. Behaviorally bisexual men reported riskier sexual behaviors (number of sexual partners in the previous 12 months and consistent condom use) than behaviorally homosexual and heterosexual men. Using social network diagrammatic representation, heterosexual, homosexual, and bisexual networks are shown to be interlinked. This study demonstrates that behaviorally bisexual men are potential key drivers of HIV epidemics and require a targeted approach to sexual health promotion.Men who have sex with both men and women are an important population group for the control of HIV and other sexually transmitted infections (STIs) in Southeast Asia. Men who have sexual contact with both men and women may sexually link populations that are traditionally considered at high risk for HIV and STIs (such as homosexual or transgendered populations) and low risk populations (such as heterosexual women), and it is hypothesised that HIV and STIs may be transmitted during unprotected sexual contact. Men who have sex with both men and women
“…On the other hand, defining an encounter as sex work may be protective: Chemnasiri et al (50) noted that male sex workers in three cities in Thailand were significantly less likely to report inconsistent condom use than men who have non-commercial sex with men.…”
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