Reisner Sari L, Mimiaga Matthew J, Mayer Kenneth H, Tinsley Jake P, Safren Steven A
The Fenway Institute, Fenway Health, Boston, MA 02215, USA.
J LGBT Health Res. 2008;4(4):195-209. doi: 10.1080/15574090903114739.
Sex work is a significant risk for HIV and sexually transmitted infection (STI) among men who have sex with men (MSM); however, there is a dearth of knowledge about how to reduce risk in this group. MSM sex workers (N = 32) completed a semistructured qualitative interview and a close-ended quantitative assessment. Analyses focused on themes relevant to intervention development. Participants reported an average of 46 male sex partners in the prior 12 months; 31% of participants were HIV-infected. Male sex workers frequently used substances during sex and had elevated levels of psychological distress. Qualitative findings suggest that trauma-informed mental health and substance abuse treatment, ready access to HIV/STI testing and treatment and condoms/informational materials, support groups to address isolation/loneliness, skill-building for risk reduction with sex partners, and paid incentives as add-ons to effective behavior change interventions may be valuable intervention components. Targeting consumers of paid/exchanged sex may assist with changing community norms regarding the practice of transactional sex. Multipronged interventions to decrease sexual risk taking among male sex workers would also benefit from addressing the unique socioeconomic and legal needs of this population.
性工作是男男性行为者（MSM）感染艾滋病毒和性传播感染（STI）的重大风险因素；然而，对于如何降低该群体的风险，我们知之甚少。男男性行为性工作者（N = 32）完成了一次半结构化定性访谈和一次封闭式定量评估。分析聚焦于与干预措施制定相关的主题。参与者报告称，在过去12个月里平均有46名男性性伴侣；31%的参与者感染了艾滋病毒。男男性行为性工作者在性行为期间经常使用毒品，心理困扰程度较高。定性研究结果表明，创伤知情的心理健康和药物滥用治疗、随时可获得艾滋病毒/性传播感染检测与治疗以及避孕套/信息材料、解决孤独感的支持小组、与性伴侣进行降低风险的技能培训，以及作为有效行为改变干预措施附加内容的付费激励措施，可能是有价值的干预组成部分。针对付费/交换性行为的消费者开展工作，可能有助于改变关于交易性行为的社区规范。减少男男性行为性工作者性风险行为的多方面干预措施，若能满足该群体独特的社会经济和法律需求，也将从中受益。
