HIV Prevention Needs Among Street-Based Male Sex Workers in Providence,Rhode Island

We examined data derived from a needs assessment of the personal and social characteristics and HIV risk behavior of street-based male sex workers, in Providence, Rhode Island, who engage in transactional sexual intercourse with other men. Substance use, injected drugs, needle sharing, and psychosocial distress were highly prevalent among the sample. History of physical, sexual, and emotional abuse was associated with increased risk of condomless anal sexual intercourse with paying male clients.In the United States, studies show that male sex workers (MSWs) engage in sexual and drug-using risk behaviors that put themselves and their partners at risk for HIV acquisition. Male sex workers have a significantly higher HIV prevalence (7.3% vs 1.1%) and incidence (4.7% vs 0.9%) than do men who have sex with men but who do not engage in transactional sexual intercourse.1–6 Street-based MSWs have been shown to have the highest rates of HIV risk behavior both with clients and nontransactional partners.5,7 Several psychosocial factors, including sexual abuse, homelessness, and substance use (particularly injecting), are known to heighten sexual risk behavior among street-based MSWs.8–13Given the clandestine nature of sex work, there are limited surveillance data on MSWs in the United States. Project Weber (http://www.projectweber.org), a nonprofit health service organization serving MSWs in Providence, Rhode Island, estimates that there are between 300 and 500 street-based MSWs in the city. Collected by Project Weber as part of a needs assessment of street-based MSWs in Providence, the data reported here detail the personal and social characteristics and HIV risk behavior among this group.