Abstract
BackgroundMale clients of female sex workers (FSWs) are at risk of HIV and other sexually transmitted infections (STIs). We conducted a two-arm randomized controlled trial to test the efficacy of a sexual risk reduction intervention for male clients of FSWs in Tijuana, Mexico.Methods/DesignMale clients of FSWs who were at least 18, were HIV-negative at baseline, and reported recent unprotected sex with FSWs were randomized to the Hombre Seguro sexual risk reduction intervention, or a time-attention didactic control condition. Each condition lasted approximately one hour. Participants underwent interviewer-administered surveys and testing for HIV and other STIs at baseline, and at 4, 8, and 12 month follow-ups. Combined HIV/STI incidence and unprotected vaginal and anal sex acts with FSWs were the primary outcomes.DiscussionA total of 400 participants were randomized to one of the two conditions. Analyses indicated that randomization was successful; there were no significant differences between the participants in the two conditions at baseline. Average follow-up was 84% across both conditions. This is the first study to test the efficacy of a sexual risk reduction intervention for male clients of FSWs using the rigor of a randomized controlled trial.Trial registrationNCT01280838, Date of registration: January 19, 2011.
Highlights
Male clients of female sex workers (FSWs) are at risk of HIV and other sexually transmitted infections (STIs)
Average follow-up was 84% across both conditions. This is the first study to test the efficacy of a sexual risk reduction intervention for male clients of FSWs using the rigor of a randomized controlled trial
We successfully randomized participants to conditions, as there were no significant differences between clients in the Hombre Seguro and control conditions
Summary
Male clients of female sex workers (FSWs) are at risk of HIV and other sexually transmitted infections (STIs). HIV behavioral and intervention development research is necessarily directed at groups that engage in high HIV transmission risk behavior, including female sex workers (FSWs). San Diego, California and Tijuana, Baja California abut one another along the extreme western end of the U.S.– Mexico border. Together, these two cities form the world’s largest binational metropolis and share its busiest land border crossing [22]. These two cities form the world’s largest binational metropolis and share its busiest land border crossing [22] In both cities, FSWs offer sexual services to men from Mexico and the U.S Estimates of the number of FSWs in Tijuana range from 6000 to 10,000 [23]. Since ~60% of the U.S Hispanic population is of Mexican origin, and 42,000
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