Abstract
Engagement in transactional sex has been hypothesized to increase risk of HIV among MSM, however conflicting evidence exists. We conducted a systematic review and meta-analysis comparing HIV prevalence among MSM who engaged in transactional sex to those who did not (33 studies in 17 countries; n=78,112 MSM). Overall, transactional sex was associated with a significant elevation in HIV prevalence (OR1.34, 95% CI1.11-1.62). Latin America (OR2.28, 95% CI1.87-2.78) and Sub-Saharan Africa (OR1.72, 95% CI1.02-2.91) were the only regions where this elevation was noted. Further research is needed to understand factors associated with sex work and subsequent HIV risk in Latin America and Sub-Saharan Africa.
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