Division of Global Public Health, Department of Medicine, University of California at San Diego, La Jolla, CA, USA.
Health Place. 2011 May;17(3):748-56. doi: 10.1016/j.healthplace.2011.01.012. Epub 2011 Mar 10.
In 2008, 400 males ≥18 years old who paid or traded for sex with a female sex worker (FSW) in Tijuana, Mexico, in the past 4 months completed surveys and HIV/STI testing; 30 also completed qualitative interviews. To analyze environmental sources of HIV vulnerability among male clients of FSWs in Tijuana, we used mixed methods to investigate correlates of clients who met FSWs in nightlife venues and clients' perspectives on venue-based HIV risk. Logistic regression identified micro-level correlates of meeting FSWs in nightlife venues, which were triangulated with clients' narratives regarding macro-level influences. In a multivariate model, offering increased pay for unprotected sex and binge drinking were micro-level factors that were independently associated with meeting FSWs in nightlife venues versus other places. In qualitative interviews, clients characterized nightlife venues as high risk due to the following macro-level features: social norms dictating heavy alcohol consumption; economic exploitation by establishment owners; and poor enforcement of sex work regulations in nightlife venues. Structural interventions in nightlife venues are needed to address venue-based risks.
2008 年，400 名年龄在 18 岁及以上的男性在墨西哥提华纳付费或与性工作者（FSW）发生过性行为，在过去 4 个月内完成了调查和 HIV/性传播感染（STI）检测；其中 30 人还完成了定性访谈。为了分析提华纳 FSW 男性客户的 HIV 脆弱性的环境来源，我们使用混合方法调查了在夜生活场所与 FSW 见面的客户的相关因素以及客户对基于场所的 HIV 风险的看法。逻辑回归确定了在夜生活场所与 FSW 见面的微观层面相关因素，并与客户关于宏观层面影响的叙述进行了三角剖分。在多变量模型中，提供更多的无保护性行为报酬和狂饮是与在夜生活场所而不是其他地方与 FSW 见面相关的独立微观层面因素。在定性访谈中，客户将夜生活场所描述为高风险，原因包括以下宏观层面特征：社会规范规定大量饮酒；场所所有者的经济剥削；以及夜生活场所性工作法规执行不力。需要在夜生活场所进行结构性干预，以解决基于场所的风险。
