Sex work, discrimination, drug use and violence: a pattern for HIV risk among transgender sex workers compared to MSM sex workers and other MSM in Guatemala

Abstract

The risk of HIV infection is higher among transgender women and cisgender men who have sex with men (MSM) compared to the general population due in part to social and contextual factors. This study aimed to determine the prevalence and association of alcohol and drug abuse, discrimination and violence among transgender sex workers compared to cisgender male sex workers and cisgender men who had not received money for sex in Guatemala City. In 2010, transgender women and cisgender men who had had sex with men or transgender women were recruited into a cross-sectional behavioural survey. Among transgender women, 86% received money for sex in the past year. Transgender sex workers were more likely to use drugs and binge drink, three times as likely to be discriminated against and eight times as likely to be forced to have sex compared to non-sex worker men. Male sex workers were twice as likely to use illicit drugs or experience physical violence and six times as likely to experience forced sex compared to non-sex worker men. Transgender and male sex workers would benefit from harm reduction for substance use, violence prevention, response and strategies to mitigate discrimination.

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

“…[55][56][57][58] Similar to other studies, 55,58 physical domination and verbal violence perpetrated by clients was the other aspects facilitating condomless experience, which validates MSW's vulnerability regardless of the situation. 59 Within the context of private life, this study found that differences in the perspective of condomless sex was related to the type of non-commercial sexual partner. As such, most of participants dismissed the use of condoms with formal partners as they were emotionally attached to these relationships.…”

The Epidemiology of HIV Among Sex Workers Around the World: Implications for Research, Programmes, and Policy

“…Those who reported experiencing stigma due to sex work also reported experiencing more HIV-related stigma than those who did not [42]. In Guatemala, MSM sex workers reported higher levels of discrimination than MSM non-sex workers, and transgender sex workers reported significantly higher proportions of discrimination compared to both MSM sex workers and MSM non-sex workers, suggesting intersecting stigmas due to both gender identity and sex work [49].…”

Prostitution: a new dynamic of discrimination

“…They belong to the socially and educationally backward class (Bachhav, 2020). They experience difficulty hiding their minority status and are, therefore, subject to social stigma and discrimination based on gender identity (Miller et al , 2020). Subsequently, they experience discrimination in almost all areas of life including family, society and social services, education, employment and at the workplace.…”

“…They are omitted from familial and social life (Patil, 2020), hence, they lack family and social support. Rejection causes anxiety and depression for transgenders, which subsequently hinders them to participate in the education and the job market (Miller et al , 2020).…”

“…Gender discrimination affects educational and employment opportunities (Miller et al , 2020). Most transgenders experience constant pressure in an educational environment; hence, they tend to drop out of their respective colleges or schools, leave their families and subsequently opt to stay with small groups of their own community (Patil, 2020).…”