Abstract
BackgroundThere are limited data globally on HIV in men who engage in casual and transactional sex with female tourists.MethodsIn 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.ResultsWe 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%).ConclusionsThere 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.
Highlights
There are limited data globally on HIV in men who engage in casual and transactional sex with female tourists
From March – June 2018, we conducted the second round of an integrated bio-behavioural survey (IBBS) using respondent-driven sampling (RDS) among beach boys in Galle in order to determine the prevalence of HIV, syphilis and herpes virus type-2 (HSV-2), corresponding risk behaviours and utilization of HIV prevention services
We report on the prevalence of HIV, syphilis and HSV-2 infection, risk behaviours and correlates of HIV testing among beach boys in Galle
Summary
There are limited data globally on HIV in men who engage in casual and transactional sex with female tourists. It was estimated that 3500 [3000–4100] adults aged 15 years and above were living with HIV in Sri Lanka at the end of 2018, and HIV prevalence among adults 15–49 years old was < 0.1% [1]. National HIV Strategic Plan for Sri Lanka for 2018– 2022 identifies female sex workers (FSW), men having sex with men (MSM), transgender (TG) persons, beach boys, people who use drugs and people who inject drugs (PWID) as key populations for HIV transmission [3]. Beach boys refer to men who work or socialise on the tourist beaches or close to the beaches, and who offer sex to men and women in exchange for money or some form of gratification. Many of them work in the tourism industry, in restaurants, hotels, guest houses and boat-related tourism
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