Logie Carmen H, Lacombe-Duncan Ashley, Kenny Kathleen S, Levermore Kandasi, Jones Nicolette, Baral Stefan D, Wang Ying, Marshall Annecka, Newman Peter A
a Factor-Inwentash Faculty of Social Work , University of Toronto , Toronto , ON , Canada.
b Women's College Research Institute , Women's College Hospital , Toronto , ON , Canada.
Glob Health Action. 2018;11(1):1424614. doi: 10.1080/16549716.2018.1424614.
Globally, men who have sex with men (MSM) experience social marginalization and criminalization that increase HIV vulnerability by constraining access to HIV prevention and care. People who sell sex also experience criminalization, rights violations, and violence, which elevate HIV exposure. MSM who sell sex may experience intersectional stigma and intensified social marginalization, yet have largely been overlooked in epidemiological and social HIV research. In Jamaica, where same sex practices and sex work are criminalized, scant research has investigated sex selling among MSM, including associations with HIV vulnerability.
We aimed to examine social ecological factors associated with selling sex among MSM in Jamaica, including exchanging sex for money, shelter, food, transportation, or drugs/alcohol (past 12 months).
We conducted a cross-sectional survey with a peer-driven sample of MSM in Kingston, Ocho Rios, and Montego Bay. Multivariable logistic regression analyses were conducted to estimate intrapersonal/individual, interpersonal/social, and structural factors associated with selling sex.
Among 556 MSM, one-third (n = 182; 32.7%) reported selling sex. In the final multivariable model, correlates of selling sex included: individual/intrapersonal (lower safer sex self-efficacy [AOR: 0.85, 95% CI: 0.77, 0.94]), interpersonal/social (concurrent partnerships [AOR: 5.52, 95% CI: 1.56, 19.53], a higher need for social support [AOR: 1.08, 95% CI: 1.03, 1.12], lifetime forced sex [AOR: 2.74, 95% 1.65, 4.55]) and structural-level factors (sexual stigma [AOR: 1.09, 95% CI: 1.04, 1.15], food insecurity [AOR: 2.38, 95% CI: 1.41, 4.02], housing insecurity [AOR: 1.94, 95% CI: 1.16, 3.26], no regular healthcare provider [AOR: 2.72, 95% CI: 1.60, 4.64]).
This study highlights social ecological correlates of selling sex among MSM in Jamaica, in particular elevated stigma and economic insecurity. Findings suggest that MSM in Jamaica who sell sex experience intensified social and structural HIV vulnerabilities that should be addressed in multi-level interventions to promote health and human rights.
在全球范围内，男男性行为者（MSM）面临社会边缘化和刑事定罪，这通过限制获得艾滋病毒预防和护理的机会增加了他们感染艾滋病毒的易感性。从事性交易的人也面临刑事定罪、权利侵犯和暴力，这增加了他们接触艾滋病毒的风险。从事性交易的男男性行为者可能会经历交叉污名化和加剧的社会边缘化，但在艾滋病毒流行病学和社会研究中基本上被忽视。在牙买加，同性行为和性工作被定为犯罪，很少有研究调查男男性行为者中的性交易情况，包括与感染艾滋病毒易感性的关联。
我们旨在研究与牙买加男男性行为者中从事性交易相关的社会生态因素，包括为金钱、住所、食物、交通或毒品/酒精而进行性交易（过去12个月内）。
我们对金斯敦、奥乔里奥斯和蒙特哥贝的男男性行为者进行了一项由同伴驱动的横断面调查。进行多变量逻辑回归分析以估计与性交易相关的个人/个体、人际/社会和结构因素。
在556名男男性行为者中，三分之一（n = 182；32.7%）报告从事过性交易。在最终的多变量模型中，性交易的相关因素包括：个人/个体（较低的安全性行为自我效能感[AOR：0.85，95%CI：0.77，0.94]）、人际/社会（同时存在的性伴侣关系[AOR：5.52，95%CI：1.56，19.53]、对社会支持的更高需求[AOR：1.08，95%CI：1.03，1.12]、终身被迫性行为[AOR：2.74，95% 1.65，4.55]）和结构层面因素（性污名[AOR：1.09，95%CI：1.0
