Division of Global Public Health, Department of Medicine, University of California San Diego, School of Medicine, 9500 Gilman Drive, MC 0507, La Jolla, CA, 92093-0507, USA,
AIDS Behav. 2013 Oct;17(8):2577-87. doi: 10.1007/s10461-013-0491-3.
Tijuana is situated on Mexico's northern border with the U.S., where sex work is quasi-legal. Whereas previous work has focused on the risk behaviors of female sex workers (FSWs), less is known about the risk behaviors of their male clients. Further, research has not examined structural factors as moderators of the association between substance use and condom use, including the contexts in which sex takes place. The purpose of the current study is to examine whether having sex with FSWs in a bar moderates the link between alcohol intoxication during sex and condom use. We recruited 375 male clients of FSWs in Tijuana, Mexico from San Diego, California and Tijuana. Using computer assisted interviewing, we surveyed participants on their alcohol use, condom use, and physical contexts of sex with FSWs in the past 4 months. Results showed that more frequent intoxication during sex with FSWs is associated with more unprotected sex, but only among clients having sex with FSWs in a bar context. Results point to potential reasons for inconsistent condom use with FSWs in this context, including lower risk perceptions of sex with FSWs in bars. Future research should examine structural factors that underlie clients' risk behavior in bars in order to inform structural-level HIV prevention interventions.
蒂华纳位于墨西哥与美国的北部边境，性工作在那里是准合法的。虽然之前的研究主要集中在女性性工作者（FSW）的风险行为上，但对于她们的男性客户的风险行为却知之甚少。此外，研究还没有探讨结构因素作为物质使用和 condom 使用之间关联的调节因素，包括性行为发生的背景。本研究的目的是检验在酒吧与 FSW 发生性关系是否会调节性高潮期间饮酒与 condom 使用之间的联系。我们从加利福尼亚州圣地亚哥和墨西哥蒂华纳招募了 375 名 FSW 的男性客户。使用计算机辅助访谈，我们调查了参与者在过去 4 个月中与 FSW 的性行为中饮酒、 condom 使用和身体环境的情况。结果表明，与 FSW 发生性关系时更频繁的醉酒与无保护性行为有关，但仅在与酒吧环境中的 FSW 发生性关系的客户中有关。研究结果指出了在这种情况下与 FSW 不一致使用 condom 的潜在原因，包括对酒吧中与 FSW 发生性行为的风险认知较低。未来的研究应该探讨客户在酒吧中风险行为的结构因素，以便为基于结构层面的 HIV 预防干预提供信息。
