Tucker Joan S, Wenzel Suzanne L, Kennedy David P, Golinelli Daniela, Ewing Brett
RAND Corporation, 1776 Main St., Santa Monica, CA, 90407-2138, USA,
Arch Sex Behav. 2013 Nov;42(8):1535-44. doi: 10.1007/s10508-013-0122-0. Epub 2013 May 30.
Sex trade behavior is fairly common among homeless adults and may contribute to higher rates of HIV/AIDS in this population. This study provides a detailed examination of the sex trade-related attitudes and behaviors of homeless men by: (1) determining the prevalence of sex trade-related behaviors, including sex with female sex workers (FSWs); (2) identifying risk factors for having sex with FSWs; and (3) comparing men's relationships with FSWs and non-FSWs in terms of relationship qualities and HIV-related risk behaviors, such as condom use. Structured interviews were conducted with a probability sample of 305 heterosexually active homeless men recruited from meal lines in Los Angeles. Recent sex with a FSW was reported by 26 % of men, and more likely among those who were older, used crack cocaine, had more sex partners, believed that sometimes men just need to have sex no matter what, and were embedded in networks that were denser and where risky sex was more normative. Compared to non-FSW partners, men with FSW partners felt less emotionally close to them, were more likely to believe the partner had never been tested for HIV, and were more likely to have sex with them under the influence of drugs or alcohol; however, they were not more likely to talk about using condoms or to use condoms with FSWs. Whether the relationship was considered "serious" was a stronger correlate of condom use than whether the partner was a FSW. Implications of these findings for HIV prevention efforts among homeless adults are discussed.
性交易行为在无家可归的成年人中相当普遍，这可能导致该人群中艾滋病毒/艾滋病的高感染率。本研究通过以下方式详细考察了无家可归男性与性交易相关的态度和行为：（1）确定与性交易相关行为的流行情况，包括与女性性工作者（FSW）发生性行为；（2）识别与FSW发生性行为的风险因素；（3）比较男性与FSW及非FSW在关系质量和与艾滋病毒相关的风险行为（如使用避孕套）方面的关系。对从洛杉矶施粥处招募的305名有异性性行为的无家可归男性进行了概率抽样的结构化访谈。26%的男性报告最近与FSW发生过性行为，年龄较大、使用快克可卡因、性伴侣较多、认为有时男人无论如何都需要性行为，以及置身于更密集且危险性行为更为常见的社交网络中的男性更有可能如此。与非FSW伴侣相比，有FSW伴侣的男性感觉与她们在情感上不那么亲近，更有可能认为伴侣从未接受过艾滋病毒检测，并且更有可能在药物或酒精影响下与她们发生性行为；然而，他们谈论使用避孕套或与FSW使用避孕套的可能性并不更高。关系是否被视为“认真”比伴侣是否为FSW更能影响避孕套的使用。讨论了这些发现对无家可归成年人艾滋病毒预防工作的启示。
