Jackson Kristopher J, Sullivan Tadhg, Howell Sean, Garner Alex, Santos Glenn-Milo
UCSF Center for AIDS Prevention Studies, University of California, 550 16th Street, 3rd Floor, San Francisco, CA, 94158, USA.
Division of Infection, University College London Hospitals NHS Foundation Trust, London, UK.
Arch Sex Behav. 2025 Feb;54(2):827-839. doi: 10.1007/s10508-024-03027-9. Epub 2024 Nov 5.
This study examined the association between self-identification as a sex worker (SW) and perceived access to pharmacologic and non-pharmacologic HIV prevention methods among MSM in France, Russia, and Türkiye amidst the COVID-19 pandemic. Globally, 17,250 MSM recruited through a geosocial networking smartphone application completed the COVID-19 disparities survey, which was administered between October and November 2020. Approximately 38% of survey respondents were identified as living in France (n = 1269), Russia (n = 3882), and Türkiye (n = 3141) at the time of survey completion. Given the diverse sociodemographic factors and attitudes toward both MSM behavior and commercial sex work in these countries, we conducted a secondary analysis of survey data exploring the relationship between SW status and perceived access to pharmacologic and non-pharmacologic HIV prevention methods during the COVID-19 pandemic. Among respondents in Russia and France, MSM SW status was associated with a reduction in perceived access to condoms/lubricants (p = .001 in Russia, p < .001 in France). MSM SW in France were less likely to report never using PrEP as compared to non-SW peers (RR = 0.40, p = .005). Our findings highlight the disparities in access to HIV prevention for MSM SW living in these three countries during the COVID-19 pandemic. Based on our findings, COVID-19 may have exacerbated pre-existing inequities in HIV prevention among populations experiencing intersecting stigmas.
本研究调查了在新冠疫情期间，法国、俄罗斯和土耳其的男男性行为者（MSM）中，自我认同为性工作者（SW）与获得药物和非药物HIV预防方法的认知之间的关联。在全球范围内，通过一款基于地理位置社交网络的智能手机应用程序招募的17250名男男性行为者完成了2020年10月至11月期间进行的新冠疫情差异调查。在调查完成时，约38%的受访者被确定居住在法国（n = 1269）、俄罗斯（n = 3882）和土耳其（n = 3141）。鉴于这些国家存在多样的社会人口因素以及对男男性行为和商业性工作的不同态度，我们对调查数据进行了二次分析，以探究在新冠疫情期间，性工作者身份与获得药物和非药物HIV预防方法的认知之间的关系。在俄罗斯和法国的受访者中，男男性行为者的性工作者身份与获得避孕套/润滑剂的认知减少有关（在俄罗斯p = 0.001，在法国p < 0.001）。与非性工作者的男男性行为者同伴相比，法国的男男性行为者性工作者报告从未使用暴露前预防（PrEP）的可能性较小（相对风险RR = 0.40，p = 0.005）。我们的研究结果凸显了在新冠疫情期间，这三个国家的男男性行为者性工作者在获得HIV预防方面的差异。基于我们的研究结果，新冠疫情可能加剧了遭受多重耻辱的人群中原本就存在的HIV预防不平等现象。
