Migration and Mobility: Correlates of Recent HIV Testing Among Substance Using Female Sex Workers at the Mexico\u2013Guatemala Border

Teresita Rocha-Jiménez,Shira M Goldenberg,Jay G Silverman,María Luisa Zúñiga,Sonia Morales-Miranda,Carmen Fernández-Casanueva,Kimberly C Brouwer,Noe Crespo

doi:10.1007/s10461-021-03501-8

Abstract

The goal of this paper is to determine the association between traveling to engage in sex work in another country and recent access to HIV testing among substance-using female sex workers (FSWs) in the Mexico–Guatemala border region. From 2012 to 2015, through modified time-location sampling and peer referral, 255 FSWs were recruited at Mexico’s southern border. Participants completed questionnaires on sociodemographics, migration and mobility experiences, work environment factors, and substance use. A conceptual framework, as depicted by a directed acyclic graph (DAG), guided our analysis. Crude and adjusted logistic regression models were used to evaluate the relationships between mobility experiences and HIV testing in the past year. Overall HIV testing was low (41%); after considering relevant covariates (i.e., interaction with health services and organizations, and sex work characteristics) traveling to engage in sex work in another country was found to be positively associated with HIV testing in the past year. Future efforts need to consider voluntary and non-stigmatizing prevention HIV services and focus on reaching out to less mobile women.

Highlights

Female sex workers (FSWs) are disproportionately affected by HIV and sexually transmitted infections, STI [1,2,3,4,5,6]
In the univariate analyses (Table 2), mobility was associated with increased HIV testing: 3.67 higher odds for those traveling to do sex work in another country and nearly twice the odds for recent as well as for frequent border crossers
We found that female sex workers (FSWs) who traveled to another country for sex work had higher odds of being tested for HIV in the past year compared to those who did not travel to another country to do sex work

Summary

Introduction

Female sex workers (FSWs) are disproportionately affected by HIV and sexually transmitted infections, STI [1,2,3,4,5,6]. World Health Organization (WHO) guidelines recommend that populations disproportionally affected by HIV, such as men who have sex with men (MSM) and FSW, get tested every 3–6 months [15, 16]. Many populations (e.g., FSW, MSM, migrants) in diverse settings face barriers to HIV testing due to stigma, criminalization, and limited access to health services [1, 14, 17,18,19,20]. Less is known about the possible compounding effects of migration and mobility on HIV testing access [21, 22]

Objectives

Methods

Results

Discussion

Conclusion