Transactional sex and the challenges to safer sexual behaviors: a study among male sex workers in Chennai, India

Biello, Katie B.; Thomas, Beena; Johnson, B. C.; Closson, Elizabeth F.; Navakodi, Pandiaraja; Dhanalakshmi, A.; Menon, Sunil; Mayer, Kenneth H.; Safren, Steven A.; Mimiaga, Matthew J.

doi:10.1080/09540121.2016.1204421

Cited by 16 publications

(22 citation statements)

References 40 publications

(44 reference statements)

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“…53,54 A third factor was the precarious situation that made participants to accept the financial reward offered by clients. [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.…”

Section: Discussionsupporting

confidence: 79%

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

Ruiz-Burga

2021

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, 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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Section: Discussionsupporting

confidence: 79%

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

Ruiz-Burga

2021

F1000Res

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“…Yet, misogyny, sexual violence and physical abuse, substance abuse, financial coercion and inaccessibility of condoms may limit the ability of SWs to negotiate condom use. 101,[111][112][113][114][115] The percentage of SWs reporting condomless sex with clients or difficulty using condoms with clients ranged from 2.1% among female SWs in South Africa to 70% among male SWs in India. 101,111,112,[114][115][116][117] Drug use has been commonly described, and has been associated with greater numbers of clients, forced sex and unstable housing.…”

Section: Sex Workersmentioning

confidence: 99%

“…101,[111][112][113][114][115] The percentage of SWs reporting condomless sex with clients or difficulty using condoms with clients ranged from 2.1% among female SWs in South Africa to 70% among male SWs in India. 101,111,112,[114][115][116][117] Drug use has been commonly described, and has been associated with greater numbers of clients, forced sex and unstable housing. 118,119 Some cities have clinics dedicated to SW care; however, SWs who lack access to such clinics may face barriers to sexual health services due to lack of health insurance, mistrust of the healthcare system, local reliance on syndromic management and concern that positive tests may adversely affect their ability to work.…”

Section: Sex Workersmentioning

confidence: 99%

Epidemiology of gonorrhoea: a global perspective

et al. 2019

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Although understanding the local epidemiology of gonorrhoea is critical for local efforts, understanding the multinational epidemiology may support development of national and international prevention and control policies and strategies. In this paper, current epidemiology of gonorrhoea is reviewed through an international lens and with a focus on selected populations. The World Health Organization (WHO) estimates that ~87 million new gonococcal infections occurred among people aged 15–49 years in 2016. Gonorrhoea rates are rising in many countries. Gay, bisexual and other men who have sex with men, racial or ethnic minorities, Indigenous populations and sex workers appear to bear disproportionate burdens of gonorrhoea. International travel can facilitate spread of gonorrhoea, including resistant strains, across international borders. Critical gaps in epidemiological knowledge are highlighted, including data on gonorrhoea among transgender persons and the burden of extragenital gonorrhoea. Even as further data are gathered, action — informed by currently available data — is needed now to confront this growing international threat.

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“…Guided by empowerment theory and using motivational interviewing techniques, the intervention was designed to facilitate personal strategies and problem solving skills for sexual risk reduction. 12,13 We conducted an open pilot trial of the intervention to determine the feasibility of study procedures and participant acceptability. A major goal of this study was to further assess feasibility and acceptability and to assess preliminary efficacy for reducing condomless anal sex (CAS) acts among MSW in this setting.…”

Section: Introductionmentioning

confidence: 99%

A Pilot Randomized Controlled Trial of an Integrated In-person and Mobile Phone Delivered Counseling and Text Messaging Intervention to Reduce HIV Transmission Risk among Male Sex Workers in Chennai, India

et al. 2017

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Background Men who have sex with men (MSM) are at increased risk for HIV infection in India, particularly those who engage in transactional sex with other men (i.e., male sex workers; MSW). Despite the need, HIV prevention efforts for Indian MSW are lacking. As in other settings, MSW in India increasingly rely on the use of mobile phones for sex work solicitation. Integrating mobile phone technology into an HIV prevention intervention for Indian MSW may mitigate some of the challenges associated with face-to face approaches, such as implementation, lack of anonymity, and time consumption, while at the same time proving to be both feasible and useful. Methods This is a pilot randomized controlled trial to examine participant acceptability, feasibility of study procedures, and preliminary efficacy for reducing sexual risk for HIV. MSW (N = 100) were equally randomized to: (1) a behavioral HIV prevention intervention integrating in-person and mobile phone delivered HIV risk reduction counseling, and daily, personalized text or voice messages as motivating “cognitive restructuring” cues for reducing condomless anal sex (CAS); or (2) a standard of care (SOC) comparison condition. Both groups received HIV counseling and testing at baseline and 6-months, and completed ACASI-based, behavioral and psychosocial assessments at baseline, 3, and 6 months. Mixed-effects regression procedures specifying a Poisson distribution and log link with a random intercept and slope for month of follow-up was estimated to assess the intervention effect on the primary outcomes: 1) CAS acts with male clients who paid them for sex, and 2) non-paying sexual partners – both outcomes assessed over the past month. Results The intervention was both feasible (98% retention at 6-months) and acceptable (>96% of all interventions sessions attended); all intervention participants rated the intervention as “acceptable” or “very acceptable.” A reduction in the reported number of CAS acts with male clients who paid them for sex in the past month was seen in both study conditions. MSW in the intervention condition reported a faster rate of decline in the number of CAS acts with male clients in the past month from the baseline to both the 3-month (B=−1.20; 95% CI=−1.68, −0.73; p<0·0001) and 6-month (B=−2.44; 95% CI=−3.35, −1.53; p<0·00001) assessment visits compared to the SOC condition. Post-hoc contrasts indicated that, at 3 months, participants in the intervention condition reported 1.43 (SD=0.29) CAS acts with male clients in the past month compared to 4.85 (SD=0.87) in the control condition (p=0.0003). Furthermore, at 6 months, the intervention condition participants reported 0.24 (SD=0.09) CAS acts with male clients in the past month compared to 2.79 (SD=0.79) in the control condition (p<0·0001). Conclusions Findings are encouraging and provide evidence of feasibility and acceptability, and demonstrate initial efficacy (for reducing sexual risk for HIV) of a behavioral HIV prevention intervention for Indian MSW that combines daily, personaliz...

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Transactional sex and the challenges to safer sexual behaviors: a study among male sex workers in Chennai, India

Cited by 16 publications

References 40 publications

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

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

Epidemiology of gonorrhoea: a global perspective

A Pilot Randomized Controlled Trial of an Integrated In-person and Mobile Phone Delivered Counseling and Text Messaging Intervention to Reduce HIV Transmission Risk among Male Sex Workers in Chennai, India

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