Transactional sex, condomless anal sex, and HIV risk among men who have sex with men

Abstract

To understand the HIV epidemic among men who have sex with men who engage in transactional sex (MSM-TS) in Paris, France, we sought to examine the association between engagement in transactional sex and HIV risk behaviors among MSM in Paris, France. Users of a geosocial-networking application in Paris were provided an anonymous web-based survey ( N = 580), which included questions about transactional sex and behavioral risk factors for HIV along with sexually transmitted infection (STI)/HIV status. Multivariate analyses showed that engagement in transactional sex was associated with condomless receptive and insertive anal intercourse (adjusted relative risk [aRR] = 1.34, 95% confidence interval [CI] = 1.04–1.72 and aRR = 1.41, 95% CI = 1.04–1.91, respectively). MSM-TS were more likely to have engaged in substance use before or during sex (aRR = 1.35, 95% CI = 1.13–1.62), to have participated in group sex (aRR = 1.37, CI = 1.13–1.62), and to have had an STI during the last year (aRR = 1.68, 95% CI = 1.16–2.45). Transactional sex was not associated with HIV status. MSM-TS in Paris engaged in higher HIV risk behaviors, however, did not have higher rates of HIV infection. Sexual health interventions should continue to target MSM-TS; however, future studies should characterize the social, cultural, and structural factors that interact with individual behaviors to elevate HIV risk for MSM-TS.

Sexual (Risk) Behavior and Risk-Reduction Strategies of Home-Based Male Sex Workers Who Have Sex with Men (MSW–MSM) in The Netherlands: A Qualitative Study

“…Comparable to the results of the current study, quantitative and qualitative studies among MSM and MSW-MSM in the USA reported awareness and usage of both PEP and PrEP being low but the interest being high as well as willingness to disclose their sexual behavior to obtain PrEP (Dolezal et al, 2015;Underhill et al, 2015;Walters et al, 2017). While the majority of MSW-MSM in France were aware of PrEP and likely to use it, the actual PrEP use was low and may signify issues with access to sexual healthcare services (SHS) (Mgbako et al, 2019a(Mgbako et al, , 2019b.…”

“…Furthermore, MSW-MSM seem to be more likely to display sexual risk behavior compared to MSM and FSW. Substance use before/during sex is reported to be higher among MSW-MSM compared to MSM and FSW (Berg et al, 2019;Drückler et al, 2020;Mgbako et al, 2019aMgbako et al, , 2019bWeber et al, 2001). A systematic review also indicated that 23% of the internet-based MSW-MSM who engaged in anal sex reported condomless sex (Passos & Almeida-Santos, 2020).…”

Transactional sex among young people in Switzerland: a cross-sectional study

“…Mgbako et al (26) found that, among men having sex with men (MSM), 24% of those aged 18-24 years practiced transactional sex. Berg et al (1), in their study in different European countries, found that 12% of MSM had engaged in transactional sex in the previous year.…”

Syndemic Health Disparities and Sexually Transmitted Infection Burden Among Black Men Who Have Sex with Men Engaged in Sex Work in the U.S.

“…The comparative odds ratios for depression, physical violence, intimate partner violence, and polydrug use describe a group of BMSM-SW at the center of a syndemic requiring action. While some studies have noted that MSM-SW have elevated STI rates compared to other MSM (dos Ramos Farías et al, 2011;Mgbako et al, 2019;Muraguri et al, 2015;Patel et al, 2016), this study used a syndemic framework to contextualize the relationship between sex work engagement and STI burden.…”