World Health Organization Collaborating Centre for HIV Strategic Information, University of Zagreb School of Medicine, Zagreb, Croatia.
National STD/AIDS Control Programme, Ministry of Health, Colombo, Sri Lanka.
BMC Public Health. 2020 Oct 23;20(1):1604. doi: 10.1186/s12889-020-09699-x.
There are limited data globally on HIV in men who engage in casual and transactional sex with female tourists.
In 2018 we carried out a respondent-driven sampling (RDS) survey among beach boys in Galle, Sri Lanka, to determine prevalence of HIV and other infections, HIV risk behaviours and utilisation of HIV prevention services. Eligibility criteria included men who cruise in and around beach areas and who had anal and/or vaginal sex with female or male tourists in the 12 months before the survey.
We recruited 373 beach boys. Approximately 49.6% of the participants were married, while 45.7% were single and 4.7% divorced, separated or widowed. A lower percentage of beach boys reported regular partners in the past 12 months (52.3%) compared to casual partners (95.4%). Condom use at last sex with a casual partner was higher (76.7%) compared to condom use with regular partners (58.3%). Condom use at last sex with a tourist was reported by 75.3%. Ever receiving money, goods or services in exchange for sex was reported by 39.7%. For 85.5% of beach boys who sold sex, the last paying partner was a tourist (85.5%) and a woman (82.0%). In the past 12 months before the survey, 32.3% of beach boys paid money for sex, and 99.5% did so from women. Ever been tested for HIV was reported by 35.3, and 69.1% of those were tested in the 6 months before the survey. In the adjusted multivariate analysis, significant correlates of never testing for HIV were lack of comprehensive knowledge about HIV and unprotected last sexual intercourse with tourists. The prevalent infections were: HIV, 0.3% (95% CI 0.0-0.4%); syphilis, 0.5% (0.0-1.2%); herpes virus type-2, 5.0% (2.5-7.5%).
There are low level HIV and syphilis prevalence among beach boys in Galle but a high level of sexual risk taking. Beach boys may be acting as a bridge for HIV transmission between higher-risk groups (paying female tourists, men who have sex with men) and lower-risk heterosexual female population in Sri Lanka. More research is needed in South-East Asia on men who trade sexual services to female and male tourists.
全球范围内，从事偶然和交易性行为的男性与女性游客之间的艾滋病毒感染数据有限。
2018 年，我们在斯里兰卡加勒的海滩男孩中进行了一项基于回应者驱动抽样（RDS）的调查，以确定艾滋病毒和其他感染的流行率、艾滋病毒风险行为以及艾滋病毒预防服务的利用情况。入选标准包括在调查前 12 个月内在海滩地区及其周围巡游且与女性或男性游客发生过肛门和/或阴道性行为的男性。
我们招募了 373 名海滩男孩。大约 49.6%的参与者已婚，45.7%未婚，4.7%离婚、分居或丧偶。与偶然伴侣相比，报告过去 12 个月中有固定伴侣的海滩男孩比例较低（52.3%）。与固定伴侣相比，与偶然伴侣发生性行为时使用安全套的比例较高（76.7%）。与游客发生性行为时使用安全套的比例为 75.3%。报告曾收到金钱、货物或服务以换取性的比例为 39.7%。对于 85.5%从事性交易的海滩男孩来说，最后一位付费伴侣是游客（85.5%）和女性（82.0%）。在调查前的过去 12 个月中，32.3%的海滩男孩花钱买性，其中 99.5%是向女性买性。报告曾接受过艾滋病毒检测的比例为 35.3%，其中 69.1%的人是在调查前 6 个月内接受的检测。在多变量调整分析中，从未接受过艾滋病毒检测的显著相关因素是缺乏对艾滋病毒的全面认识和与游客发生无保护性行为。流行的感染包括：艾滋病毒，0.3%（95%CI 0.0-0.4%）；梅毒，0.5%（0.0-1.2%）；疱疹病毒 2 型，5.0%（2.5-7.5%）。
加勒的海滩男孩中艾滋病毒和梅毒的流行率较低，但性风险较高。海滩男孩可能是艾滋病毒在高危人群（付费女游客、男男性行为者）和斯里兰卡低危异性恋女性人群之间传播的桥梁。在东南亚地区，需要对与女性和男性游客进行性交易的男性进行更多研究。
