Transactional Sex, HIV, and Bacterial STIs Among U.S. Men Who have Sex with Men.

IF 4.3 2区医学 Q1 MEDICINE, GENERAL & INTERNAL

American Journal of Preventive Medicine Pub Date : 2024-07-11 DOI:10.1016/j.amepre.2024.07.002

Kaitlyn Atkins, John M Wiginton, Thomas Carpino, Travis H Sanchez, Sarah M Murray, Stefan D Baral

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引用次数: 0

Abstract

Introduction: Men who have sex with men (MSM) and are engaged in transactional sex (MSM-TS) experience complex social and structural vulnerabilities that increase their HIV risk. This study aimed to estimate the prevalence of TS and associations between TS and sexually transmitted infection (STI) outcomes among cisgender MSM in the U.S.

Methods: Using 2017-2021 data from an online survey of U.S. MSM, characteristics of MSM-TS were summarized, and adjusted prevalence ratios (aPRs) calculated for the associations between past-year TS and bacterial STI diagnosis, HIV status, and either antiretroviral or pre-exposure prophylaxis use. Analyses were conducted in 2023.

Results: TS prevalence was 3.7% (n=1,848/49,539). Compared to other MSM, MSM-TS more commonly reported homelessness, being uninsured, condomless anal sex with partners of any HIV status and condomless anal sex with serodifferent partners, and illicit drug use. TS was associated with increased HIV (aPR 1.44, 95% CI 1.25-1.66) and bacterial STI prevalence (aPR 2.40, 95% CI=2.09-2.52) and lower antiretroviral therapy use (among MSM living with HIV; PR 0.92, 95% CI=0.87-0.97).

Conclusions: Structural and behavioral risks converged among U.S. MSM engaging in TS leading to greater HIV and bacterial STI prevalence in this group. HIV interventions for U.S. MSM-TS should address individual as well as structural risks, including poverty and housing instability.

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美国男男性行为者中的性交易、艾滋病毒和细菌性性传播感染。

导言：男男性行为者（MSM）和从事性交易的男性（MSM-TS）经历了复杂的社会和结构脆弱性，这增加了他们感染 HIV 的风险。本研究旨在估算美国顺性别 MSM 中交易性行为的发生率以及交易性行为与性传播感染（STI）结果之间的关联：利用美国 MSM 在线调查的 2017-2021 年数据，总结了 MSM-TS 的特征，并计算了上一年 TS 与细菌性 STI 诊断、HIV 感染状况以及抗逆转录病毒疗法或暴露前预防疗法 (PrEP) 使用之间的调整患病率比 (aPR)。分析于 2023 年进行：TS 患病率为 3.7%（n=1,848/49,539）。与其他 MSM 相比，MSM-TS 更常报告无家可归、无保险、与任何 HIV 感染状况的伴侣进行无套肛交 (CAS)、与血清不同的伴侣进行 CAS 以及使用非法药物。TS 与 HIV 感染率（aPR 1.44，95% CI 1.25-1.66）和细菌性 STI 感染率（aPR 2.40，95% CI=2.09-2.52）增加以及抗逆转录病毒疗法使用率降低（在感染 HIV 的 MSM 中；PR 0.92，95% CI=0.87-0.97）有关：从事性传播感染的美国男男性行为者的结构性风险和行为风险趋于一致，导致该群体中艾滋病毒和细菌性传播感染的发病率更高。针对美国 MSM-TS 的 HIV 干预措施应解决个人和结构性风险，包括贫困和住房不稳定。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

American Journal of Preventive Medicine 医学-公共卫生、环境卫生与职业卫生

CiteScore

8.60

自引率

1.80%

发文量

395

审稿时长

32 days

期刊介绍： The American Journal of Preventive Medicine is the official journal of the American College of Preventive Medicine and the Association for Prevention Teaching and Research. It publishes articles in the areas of prevention research, teaching, practice and policy. Original research is published on interventions aimed at the prevention of chronic and acute disease and the promotion of individual and community health. Of particular emphasis are papers that address the primary and secondary prevention of important clinical, behavioral and public health issues such as injury and violence, infectious disease, women''s health, smoking, sedentary behaviors and physical activity, nutrition, diabetes, obesity, and substance use disorders. Papers also address educational initiatives aimed at improving the ability of health professionals to provide effective clinical prevention and public health services. Papers on health services research pertinent to prevention and public health are also published. The journal also publishes official policy statements from the two co-sponsoring organizations, review articles, media reviews, and editorials. Finally, the journal periodically publishes supplements and special theme issues devoted to areas of current interest to the prevention community.