Urban gentrification and declining access to HIV/STI,sexual health,and outreach services amongst women sex workers between 2010-2014: Results of a community-based longitudinal cohort

Despite increasing gentrification across North American cities, little is known about impacts on work and living environments and health access for marginalized women. Drawing upon prospective cohort and external spatial data, we examined changes in land use and sex workers’ work/living environments in relation to gentrification exposure in Metro Vancouver (2010–2014), and modeled independent effects of gentrification exposure on reduced utilization of HIV/STI testing, sexual health, and sex worker support services. These decreases occurred despite efforts to scale-up HIV services for marginalized populations. Planning of healthcare, housing, and other support services should be responsive to shifting urban landscapes for marginalized women.     

Sexual identities and sexual health within the Celtic nations: An exploratory study of men who have sex with men recruited through social media

ABSTRACT

Associations of sexual identity with a range of sexual and sexual health behaviours were investigated amongst men who have sex with men (MSM). Data from 1816 MSM recruited from 4 Celtic nations (Scotland, Wales, Northern Ireland and the Republic of Ireland) were collected via a cross-sectional online survey advertised via social media. About 18.3% were non-gay identified MSM (NGI-MSM). In the last year, 30% of NGI-MSM reported high-risk unprotected anal intercourse and 45% reported never having had an sexually transmitted infection (STI) test. When compared to MSM who were gay identified (GI-MSM), NGI-MSM were more likely to be older, have a female partner, fewer sex partners, fewer anal sex partners, STI diagnoses and less likely to be HIV positive, more likely to never use the gay scene and be geographically further from a gay venue. NGI-MSM were also less likely to report STI and HIV testing behaviours. The findings highlight variations in risk by sexual identities, and unmet sexual health needs amongst NGI-MSM across Celtic nations. Innovative research is required regarding the utility of social media for reaching populations of MSM and developing interventions which target the heterogeneity of MSM and their specific sexual health needs.     

Sexual HIV risk among gay,bisexual and queer transgender men: findings from interviews in Vancouver,Canada

Abstract

Gay, bisexual, queer and other men who have sex with men are disproportionately affected by HIV in Canada. While up to 63% of transgender men identify as gay, bisexual or queer and report a variety of HIV sexual risk behaviours, transgender men are often overlooked within epidemiological HIV surveillance and research. While a growing body of research has begun to examine sexual risk for transgender gay, bisexual and queer men, most studies have been conducted in the USA. This study explored sexual HIV risk for this population in the Canadian context, specifically in British Columbia, in an environment of publically funded universal access to healthcare, including HIV testing and treatment. We conducted interviews with 11 gay, bisexual and queer transgender men. Participants’ narratives suggest that HIV risk for these transgender men is shaped by a diversity of sexual behaviours, including inconsistent condom use, seeking partners online for greater safety and accessing HIV/STI testing and other healthcare services despite facing transition-related barriers. Public health prevention and health education must recognise the presence of transgender men and ensure health services and broader population health promotion meet the unique sexual health needs of this sub-population of gay, bisexual and queer men.     

基于结构方程模型的男男性行为人群HIV检测行为影响因素研究

目的 分析MSM人群HIV检测行为的影响因素,为制定促进该人群检测HIV的干预措施提供依据。方法 2018年4-6月,通过滚雪球的方法在江苏省无锡市招募MSM研究对象。采取面对面问卷调查的方式,收集研究对象的人口学信息、性行为特征、接受干预服务情况、心理状态和HIV检测情况等。利用结构方程模型对数据进行拟合并对拟合后的模型进行修正,分析各变量间的关系和影响程度。结果 共招募研究对象MSM 410人,认为自己有必要检测HIV占72.9%（299/410）,最近1年HIV检测占69.0%（283/410）。修正后的结构方程模型拟合较好,拟合指数主要结果分别为近似误差均方根（RMSEA）=0.065、规范拟合指数（NFI）=0.946、相对拟合指数（RFI）=0.922、Tucker-Lewis指数（TLI）=0.968、比较拟合指数（CFI）=0.952。模型拟合结果显示,对MSM人群HIV检测行为标准化总效应最高的变量为干预服务,路径系数为0.57;而在干预服务中,HIV检测提醒的因子载荷最大,为0.88。心理状态评分对MSM人群HIV检测行为的标准化总效应呈负向关系,路径系数为-0.33。结论 MSM人群HIV检测意识和检测率有待进一步提高,在采取有效措施促进MSM进行检测的同时,应关注MSM人群心理健康问题。     

Estimating the Number of Men Who Have Sex with Men by Race/Ethnicity at the County Level in Texas

This analysis presents a method for estimating the population of men who have sex with men (MSM) at the county and metropolitan area level in Texas. Surveillance data consistently demonstrate that MSM experience a high burden of HIV and other sexually transmitted infections (STIs). Numerous studies have shown that MSM are also vulnerable to many other health concerns such as suicide, substance abuse, domestic violence and assault, homelessness, and mental illness. However, compilation of rates of HIV, STIs, and other health issues is dependent on estimation of population denominators. In the absence of systematic, consistent, and direct assessment of sexual orientation and gender identity in national surveys, it is difficult to estimate the size of at-risk populations. Previous estimates at the national and state level have been calculated using varied methodologies. However, to date, statewide estimates at the county level have only been produced for the state of Florida. County-level and metropolitan area estimates of MSM population were produced using three modified models developed by Lieb et al. These models used data on population and same-sex households from the US Census, along with estimates of sexual behavior from the National Survey on Family Growth. These models produce an estimate of 599,683 MSM in Texas (6.4 % of the adult male population). Metropolitan areas with the highest percentage of MSM population include Dallas and Austin (10.3 and 9.8 %, respectively). County-level estimates of MSM population range from 1.0 to 12.9 %. These local estimates are critical to targeting vulnerable populations and effective allocation of resources for prevention and treatment programs.     

An integrated model of care to counter high incidence of HIV and sexually transmitted diseases in men who have sex with men – initial analysis of service utilizers in Zurich

Background  

As other countries, Switzerland experiences a high or even rising incidence of HIV and sexually transmitted infections (STI) among men who have sex with men (MSM). An outpatient clinic for gay men (" Checkpoint ") was opened in 2006 in Zurich (Switzerland) in order to provide sexual health services. The clinic provides counselling, testing, medical treatment and follow-up at one location under an "open-door-policy" and with a high level of personal continuity. We describe first experiences with the new service and report the characteristics of the population that utilized it.     

Five-year monitoring of a gay-friendly voluntary counselling and testing facility in Switzerland: who got tested and why?

ABSTRACT: BACKGROUND: An increase in new HIV cases among men who have sex with men (MSM) has been reported in Switzerland since 2001. A rapid result HIV testing for MSM through voluntary counselling and testing (VCT) facility ("Checkpoint") was opened in Geneva in 2005. This gay-friendly facility, the first to open in Switzerland, provides testing for sexually transmitted infections (STI) and rapid result HIV testing and counselling. Our objective was to analyze Checkpoint's activity over its first five years of activity and its ability to attract at-risk MSM. METHOD: S We used routine data collected anonymously about the facility activity (number of clients, number of tests, and test results) and about the characteristics of the clientele (sociodemographic data, sexual risk behaviour, and reasons for testing) from 2005 to 2009. RESULTS: The yearly number of HIV tests performed increased from 249 in 2005 to 561 in 2009. The annual proportion of positive tests among tests performed varied between 2% and 3%. Among MSM clients, the median annual number of anal intercourse (AI) partners was three. Roughly 30% of all MSM clients had at least one unprotected anal intercourse (UAI) experience in the previous 12 months with a partner of different/unknown HIV status. The main reason for testing in 2007, 2008, and 2009 was "sexual risk exposure" (~40%), followed by "routine" testing (~30%) and "condom stopping in the beginning of a new steady relationship" (~10%). Clients who came to the facility after a sexual risk exposure, compared to clients who came for other reasons, had the highest number of AI partners in the previous 12 months, were more likely to have had UAI with a partner of different/unknown HIV status in the previous 12 months (57.3%), more likely to have had an STI diagnosed in the past (41.6%), and more likely to report recent feelings of sadness or depression (42.6%). CONCLUSION: Many of Checkpoint's clients reported elevated sexual risk exposure and risk factors, and a noticeable proportion of new HIV cases among MSM living in Geneva were identified by the facility. This VCT facility attracts the intended population and appears to be a useful tool contributing to the fight against the HIV epidemic among MSM in Switzerland.     

HIV/AIDS in Vancouver, British Columbia: a growing epidemic

The prevalence of HIV in Vancouver, British Columbia was subject to two distinct periods of rapid increase. The first occurred in the 1980s due to high incidence among men who have sex with men (MSM), and the second occurred in the 1990s due to high incidence among injection drug users (IDU). The purpose of this study was to estimate and model the trends in HIV prevalence in Vancouver from 1980 to 2006. HIV prevalence data were entered into the UNAIDS/WHO Estimation and Projection Package (EPP) where prevalence trends were estimated by fitting an epidemiological model to the data. Epidemic curves were fit for IDU, MSM, street-based female sex trade workers (FSW), and the general population. Using EPP, these curves were then aggregated to produce a model of Vancouver's overall HIV prevalence. Of the 505 000 people over the age of 15 that reside in Vancouver, 6108 (ranging from 4979 to 7237) were living with HIV in the year 2006, giving an overall prevalence of 1.21 percent (ranging from 0.99 to 1.43 percent). The subgroups of IDU and MSM account for the greatest proportion of HIV infections. Our model estimates that the prevalence of HIV in Vancouver is greater than one percent, roughly 6 times higher than Canada's national prevalence. These results suggest that HIV infection is having a relatively large impact in Vancouver and that evidence-based prevention and harm reduction strategies should be expanded.     

Disparities in Sexually Transmitted Infection/HIV Testing,Contraception, and Emergency Contraception Care Among Adolescent Sexual Minority Women Who Are Racial/Ethnic Minorities

PurposeSexual minority women and racial/ethnic minority women in the United States are at increased risk for sexually transmitted infections (STIs) and unintended pregnancy. Yet, we know little about STI/HIV testing and contraceptive care among women who have sex with women only and women who have sex with both women and men, and who are racial/ethnic minorities. This study examined receipt of STI/HIV testing and contraceptive care among sexually active adolescent women by sex of sexual contact(s) and race/ethnicity.MethodsOur sample included 2,149 sexually active adolescent women from the National Survey of Family Growth (2011–2019). We examined receipt of sexual and reproductive health (SRH) services by sex of sexual contact(s) and race/ethnicity: STI and HIV testing, contraceptive counseling, contraceptive method, emergency contraception (EC) counseling, and EC method.ResultsService receipt was low for all adolescent women, with disparities by sex of sexual contact(s) and by race/ethnicity. Women who have sex with women only had the lowest rates across all services; women who have sex with both women and men had higher rates of STI and HIV testing and EC counseling than women who have sex with men only. Non-Hispanic Black women had higher rates of STI and HIV testing than non-Hispanic White peers, and non-Hispanic Black and Hispanic women had lower rates of contraception method receipt than their non-Hispanic White peers. Racial/ethnic disparities persisted when results were stratified by sex of sexual contact(s).DiscussionThere is an unmet need for improved SRH service delivery for all adolescent women and for services that are not biased by sex of sexual contact(s) and race/ethnicity.     

不同性传播感染MSM艾滋病高危行为对比分析

目的探讨男男性行为者(MSM)中近1年内曾患性传播感染(STI)者与未患STI者的艾滋病(AIDS)高危行为状况。方法采用滚雪球法进行横断面调查;应用SPSS 13.0软件对9个城市2 134名MSM进行匿名问卷分析,比较患STI者与未患STI者AIDS高危行为差异。结果患STI者中累计同性肛交性伴数、近6个月同性肛交性伴数中位数分别为20、3个,均高于未患STI者的7、 2个;近1年内,患STI者中有28.8%(95/330)曾参加群交,24.7%(81/328)向同性买性,44.1%(146/331)性交时出血,均高于未患STI者的17.0%(289/1 697)、11.4%(189/1 657)、24.4%(417/1 706)(P=0.000);患STI者中有67.3%(181/269)近1次同性肛交时使用安全套,低于未患STI者的76.9%(964/1 253)(χ²=11.065,P=0.001);患STI者艾滋病病毒(HIV)感染率为4.03%(14/347),明显高于未患STI者的1.96%(35/1 787)(χ²=5.582,P=0.018)。结论MSM中患STI者具有更多的AIDS高危行为,需加强对其进行健康干预。     

广西南宁市男男性接触者艾滋病相关知识及行为学特征调查

目的了解南宁市男男性行为（MSM）人群的行为学特征，掌握艾滋病／性病在MSM人群中的流行情况，为南宁市MSM人群艾滋病／性病的健康促进工作提供科学依据。方法采取“滚雪球”方式进行调查，问卷采取匿名的方式，由培训后的工作人员询问情况后当场填写，问卷当场收回，同时采集3～5ml静脉血。结果452名被调查对象艾滋病相关知识知晓率普遍较高，“输入带有艾滋病病毒感染者的血液或血液制品会不会感染艾滋病病毒”这条正确率达到98．45％，总体知识知晓率为92．86％。最近一次与男性肛交安全套使用率为64．43％，最近6个月与男性发生肛交行为时安全套从不使用和每次均用的比率分别为10．95％和34．83％。获得预防艾滋病服务前3位分别是艾滋病/性病宣传材料（67．92％）、安全套发放（62．61％）、润滑剂发放（57．30％）。艾滋病病毒抗体阳性率为199％，梅毒阳性率为8．85％。结论南宁市MSM中的危险行为仍普遍存在，仅靠艾滋病知识的宣传很难促成行为的改变，应进一步采取多元化的艾滋病预防策略遏制男男性行为人群中的艾滋病流行。     

Project HOPE: Online Social Network Changes in an HIV Prevention Randomized Controlled Trial for African American and Latino Men Who Have Sex With Men

Objectives. We examined whether and how an HIV prevention diffusion-based intervention spread throughout participants’ online social networks and whether changes in social network ties were associated with increased HIV prevention and testing behaviors.Methods. We randomly assigned 112 primarily racial/ethnic minority men who have sex with men (MSM) to receive peer-delivered HIV (intervention) or general health (control) information over 12 weeks through closed Facebook groups. We recorded participants’ public Facebook friend networks at baseline (September 2010) and follow-up (February 2011), and assessed whether changes in network growth were associated with changes in health engagement and HIV testing.Results. Within-group ties increased in both conditions from baseline to follow-up. Among the intervention group, we found a significant positive relation between increased network ties and using social media to discuss sexual behaviors. We found a positive trending relationship between increased network ties and likelihood of HIV testing, follow-up for test results, and participation in online community discussions. No significant differences were seen within control groups.Conclusions. Among high-risk MSM, peer-led social media HIV prevention interventions can increase community cohesion. These changes appear to be associated with increased HIV prevention and testing behaviors.African American and Latino individuals are at high risk for contracting HIV.1 In Los Angeles County, California, most of these cases are attributable to men who have sex with men (MSM), who currently account for more than 75% of all HIV cases.2,3 Researchers, and MSM themselves, have suggested use of novel approaches to increase HIV prevention and testing among at-risk populations.4,5Peer leader interventions, based on diffusion theories, are community-based interventions that train community peers to spread HIV prevention information and change HIV prevention-related social norms.6–9 Successful peer-led interventions have resulted in decreasing anal intercourse up to 25% and increasing condom use up to 16%, with sustained behavior change up to 3 years later.10–12 Peer-delivered interventions have been found to be acceptable among MSM populations.13 Social network interventions have shown that information can rapidly diffuse throughout social networks to change health behaviors,14,15 suggesting that peer-delivered HIV interventions also might diffuse throughout social networks.Growth in social media allows these technologies to be used for peer-led HIV testing interventions,4 and research supports that peer-led interventions delivered via social media can increase HIV testing.16 Social networking technologies, such as Facebook, allow users to connect and communicate with other network users by sharing pictures, messages, Web site links, and other multimedia information.17 High rates of online social networking, especially among groups disproportionately affected by HIV (e.g., MSM),18 make it important to evaluate whether and how interventions might diffuse throughout online social networks. Although social media can be used to increase HIV prevention,16,19,20a and health behaviors of (offline) social ties influence our own health behaviors20b, no known research has studied changes in social network ties during the course of an online social media community HIV intervention or whether and how HIV prevention information and behaviors might spread among group participants in a social media–based HIV testing intervention that is designed for network diffusion.The Harnessing Online Peer Education (HOPE) intervention was a 12-week randomized controlled HIV prevention intervention designed to use peer-led Facebook groups to diffuse HIV information to increase testing among African American and Latino MSM. The study found that participants in the HIV intervention groups were more likely to request an HIV test than were those in the control groups,16 but whether changes in social network ties (i.e., participants within each group becoming Facebook friends with one another) played a role in these effects among intervention group participants is unknown. The current study used data from the HOPE study and was designed to evaluate the association between changes in online social network structure and HIV prevention and testing among HOPE network participants. Specifically, we have (1) described the change from baseline to follow-up in network ties among HOPE participants as a result of the intervention, (2) presented network visualizations to illustrate changes in network connections among intervention and control group participants, and (3) determined whether changes in social network ties from baseline to follow-up were associated with online community engagement, discussions about HIV prevention, and rates of HIV testing.     

Seeking sexual partners on the internet: a marker for risky sexual behaviour in men who have sex with men

OBJECTIVE: In order to generate a generalizable estimate regarding risk for STI and HIV acquisition in men who have sex with men (MSM) who seek partners on the internet, we examined the sexual practices of MSM who seek partners on the internet compared to MSM who do not, using a community-based sample of MSM from British Columbia. METHODS: 'Sex Now', a questionnaire that was developed to examine trends in sexual behaviour in gay men, was offered to men attending Gay Pride events throughout the province of British Columbia, Canada between May and August 2004. Logistic regression analysis was used to model the association between seeking sexual partners online and other variables of interest, using odds ratio as the measure of association. RESULTS: Of the 2,312 MSM who completed the survey, 766 (33.1%) had used the internet to find a partner in the past year. In logistic regression analyses, MSM who found partners on the internet were more likely to have had more than 10 sexual partners in the past year (overall, insertive and receptive), and to engage in sexual activities in public venues. They were also more likely to agree with the statement "I think most guys in relationships have condom-free sex." MSM who sought partners on the net were more likely to be from specific geographic regions, including non-urban regions. Demographic characteristics, HIV status, and use of drugs were not significantly different between men who found partners on the internet and those who did not in multivariable modeling. DISCUSSION: MSM who sought to meet partners online had significantly more sexual partners, were more likely to be from specific geographic regions of the province and to have participated in seeking sexual partners in venues known to be associated with HIV and STI acquisition. This study confirms from a community-based sample of MSM that programming for prevention and treatment of HIV and STI need to be available and offered in the cyber setting, to ensure effective messaging and interventions reach this population.     

The development of an innovative,theory-driven,psychoeducational HIV/STI prevention intervention for heterosexually active black adolescents with mental illnesses

Sexually transmitted infections (STIs), including human immunodeficiency virus (HIV), continue to disproportionately affect Black adolescents. Those experiencing the psychological sequelae of mental illnesses are at increased risk. Here, we outline the development of an HIV/STI prevention intervention for heterosexually active Black adolescents with mental illnesses. This research was guided by a psychosocial expansion of the Theory of Planned Behavior, nested within a broader social determinants of health framework. A youth community advisory board provided study oversight. Heterosexually active Black adolescents aged 14–17 were recruited from community-based outpatient mental health providers for focus groups, surveys and two ‘dress rehearsals’ of the intervention protocol (N = 68). The qualitative and quantitative findings indicated that knowledge, attitudes and skills related to consistent condom use, reduced number of sexual partners, routine HIV/STI testing, abstinence and emotion regulation were important areas to target. These elicitation data provided insight into the context of HIV/STI risk for the study population, and were used to develop the intervention content. ‘Project GOLD: We are Kings and Queens’ was designed to be delivered over two days (3 hours per day), with eight, 45-min modules. The activities address behaviors, as well as cognitive, emotional, psychological and social processes associated with HIV/STI risk. Alongside evidence-based HIV/STI prevention strategies (e.g. sexual partner communication skills), the intervention activities are rooted in principles of Cognitive Behavioral Therapy. Dress rehearsal participants were in favor of the intervention and provided feedback on activity length, gender and cultural relevance and strategies to sustain attention; this information was used to finalize the curriculum. In partnership with the community, we developed a theoretically driven, gender and culturally relevant, developmentally and psychologically appropriate HIV/STI prevention program. Our ultimate goal is to standardize sexual health assessment and intervention in outpatient mental health treatment settings to meet sexual health needs in this underserved population.     

Temporal Trends in Population Level Impacts of Risk Factors for Sexually Transmitted Infections Among Men Who Have Sex with Men,Heterosexual Men,and Women: Disparities by Sexual Identity (1998–2013)

Sexually transmitted infections (STIs) remain a significant public health problem worldwide. We aimed to describe the temporal trends and relative contributions of established risk factors to STIs among sexual health center attendees. This retrospective study included more than 90,000 individuals who attended a sexual health center in Sydney, Australia, during the period 1998–2013. Multivariable logistic regression models were used to identify the correlates of STI diagnoses for three groups: men who have sex with men (MSM), heterosexual men, and women separately. Trends in population attributable risk percentages (PAR%) were estimated to assess the relative contributions of the risk factors on STI diagnosis. STI diagnosis rates among sexual health clinic attendees increased by 75% from 16 to 28% among MSM and more than doubled among heterosexual men and women (7–15 and 5–12%, respectively). Inconsistent condom use, three or more sex partners, sex overseas, past STI diagnosis, and contact with an STI case collectively contributed 61, 74 and 55% of the STI diagnoses among MSM, heterosexual men and women, respectively. Increase in STI diagnosis associated with temporal trends in combined risk factors including condomless sex, multiple sex partners, past STI diagnosis, and contact with an STI case. Although the majority of the factors considered in this study have been significantly associated with STI positivity in all three groups, their overall population level contributions to the epidemic have changed substantially. Our results indicated significant disparities between the MSM and heterosexual men and women as well as sex-specific differences in terms of sexual behaviors.     

A qualitative assessment of health seeking practices among and provision practices for men who have sex with men in Malawi

Background

In the context of a generalized epidemic and criminalization of homosexuality, men who have sex with men (MSM) in Malawi have a disproportionate burden of HIV compared to other adults. Past research has documented low uptake of HIV prevention and health services among MSM, self-reported fear of seeking health services, and concerns of disclosure of sexual orientation and discrimination in health settings. Qualitative research was conducted among MSM and health service providers in Blantyre, Malawi to understand underlying factors related to disclosure and health seeking behaviors and inform the development of a community-based comprehensive HIV prevention intervention.

Methods

Using peer recruitment, eight MSM participants representing a range of ages, orientations, and social and behavioral characteristics were enrolled for in-depth interviews. Five service providers were recruited from the district hospital, local health and STI clinics, and a HIV prevention service organization. We use the Health Belief Model as a framework to interpret the influential factors on 1) health seeking and uptake among MSM, and 2) influences on provision of services by healthcare providers for MSM.

Results

Results highlight disclosure fears among MSM and, among providers, a lack of awareness and self-efficacy to provide care in the face of limited information and political support. Service providers reported concerns of adverse repercussions related to the provision of services to men in same sex sexual relationships. Some MSM demonstrated awareness of HIV risk but believed that within the wider MSM community, there was a general lack of HIV information for MSM, low awareness of appropriate prevention, and low perception of risks related to HIV infection.

Conclusions

Qualitative research highlights the need for appropriate information on both HIV risks and acceptable, effective HIV prevention options for MSM. Information and educational opportunities should be available to the wider MSM community and the health sector. Health sector interventions may serve to increase cultural and clinical competency to address health problems experienced by MSM. To ensure availability and use of services in light of the criminalization and stigmatization of same sex practices, there is need to increase the safety of uptake and provision of these services for MSM.

     

Health Care Services for men who have sex with men in different Australian states and territories since the emergence of HIV

The purpose of this article is to describe sexual health services available in Australia across the different states and territories for gay men and men who have sex with men (MSM) and their utilisation. An assessment of services available in different states is made, then the evidence about how MSM and people living with HIV/AIDS access health care in Australia is presented. This demonstrates that the number and location of sexual health services has changed over time. It also demonstrates that services available differ by state and territory. The availability of non-occupational post-exposure prophylaxis for HIV infection has been different in each state and territory, as has its utilisation. The majority of care for sexual health-related issues and for MSM and people living with HIV/AIDS is delivered in general practice settings in Australia, with hospital outpatient settings, including sexual health clinics, utilised commonly.     

河北省廊坊市男男性行为人群艾滋病/性传播疾病危险行为与感染率现况调查

目的 了解廊坊市区男男性行为(MSM)人群人口学和行为学特征及HIV与梅毒感染率.方法 2007年10-11月间在廊坊市、MSM场所和网络共招募MSM 118人,采用面对面访谈的方式完成问卷106份,调查收集了同性关系、异性关系、性接触方式以及HIV和梅毒的感染信息.结果 不同方式招募的MSM在年龄、婚姻状况和职业特征上存在差别(P＜0.05).约90.0%的人认同自己的同性性取向,82.1%的人保持着与男性的性接触,50.4%的人和女性保持着性关系.该人群性接触方式的比例由高到低依次为肛交(87.7%)、口交(58.5%)、吻肛(32.1%)、拳交(15.1%)和群交(8.5%).17.0%的人表示曾经发生过性交出血的情况.在HIV防范意识方面,仅有31.1%的人意识到自己有感染HIV的风险,23.6%的人曾经做过HIV检测.参加检测的84名MSM中HIV感染率为4.8%,梅毒抗体携带率为22.6%.结论 MSM人群艾滋病/性传播疾病防治意识较为薄弱,HIV和梅毒的感染率较高,亟需通过多种方式在该人群中开展针对性干预工作.     

Condoms and sexual health education as evidence: impact of criminalization of in-call venues and managers on migrant sex workers access to HIV/STI prevention in a Canadian setting

Background

Despite a large body of evidence globally demonstrating that the criminalization of sex workers increases HIV/STI risks, we know far less about the impact of criminalization and policing of managers and in-call establishments on HIV/STI prevention among sex workers, and even less so among migrant sex workers.

Methods

Analysis draws on ethnographic fieldwork and 46 qualitative interviews with migrant sex workers, managers and business owners of in-call sex work venues in Metro Vancouver, Canada.

Results

The criminalization of in-call venues and third parties explicitly limits sex workers’ access to HIV/STI prevention, including manager restrictions on condoms and limited onsite access to sexual health information and HIV/STI testing. With limited labour protections and socio-cultural barriers, criminalization and policing undermine the health and human rights of migrant sex workers working in –call venues.

Conclusions

This research supports growing evidence-based calls for decriminalization of sex work, including the removal of criminal sanctions targeting third parties and in-call venues, alongside programs and policies that better protect the working conditions of migrant sex workers as critical to HIV/STI prevention and human rights.