History Of Sex Work Research Articles

Emotion regulation reduces victim blaming of vulnerable sex trafficking survivors.

This research applied emotion regulation to negative emotions felt toward a sex trafficking victim so that judgments were made to offer her services rather than to favor her arrest for prostitution. We predicted that participants would favor police not arresting a trafficking survivor for prostitution when she was vulnerable (Hypothesis 1) or she showed no sex work history (Hypothesis 2). We predicted a moderated mediation model (Hypothesis 3), in which emotion regulation training to reduce feelings of contempt, anger, and disgust (CAD) toward the survivor interacted with vulnerability and prior sex work such that the effects of the latter two manipulations were the strongest in the successful emotion regulation conditions (i.e., cognitive reappraisal and cognitive reappraisal with motivation), with CAD emotions mediating those relationships. Participants (N = 421, 54% women, Mage = 42.63 years, 75% White) read a modified version of a sex trafficking case and decided whether the police should arrest the survivor for prostitution. Each participant was randomly assigned to one of 16 conditions in a 4 (emotion regulation: control vs. cognitive reappraisal vs. motivation vs. cognitive reappraisal plus motivation) × 2 (vulnerability: vulnerable background vs. nonvulnerable background) × 2 (prior prostitution history: engaged in prostitution before the trafficking incident vs. not engaged in prostitution before the incident) factorial design. Participants with cognitive reappraisal training, but not controls, who read about a vulnerable survivor were less likely to favor arrest. Moreover, those who trained with cognitive reappraisal plus motivation to decrease their CAD emotions, compared with the controls, showed weaker CAD feelings toward the vulnerable survivor, which in turn predicted a lower probability of favoring arrest. Reducing CAD emotions through emotion regulation supported the impact of emotions on culpability judgments and showed how emotion regulation can be used to support a victim-centered approach to fighting sex trafficking. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Judgments of sex trafficked women: The role of emotions.

This study examined how incidental emotions influence decisions to arrest or release sex trafficking survivors. Community members (N = 984) completed an autobiographical memory task invoking disgust, sympathy, or no emotion and read case facts from United States v. Bell (2014) varying whether the survivor had a prior history of sex work and whether she came from a vulnerable or nonvulnerable background. Participants in the vulnerable condition believed that the survivor was less able to resist the trafficker's proposal. Furthermore, women but not men made to feel disgust believed that she should have resisted. Regarding arresting the survivor for prostitution versus releasing her for services, invoking either incidental disgust or sympathy, but especially disgust, triggered feelings of disgust, which in turn predicted an arrest decision. Finally, our data supported a moderated mediation model in which the belief that the survivor should have been able to resist the trafficker predicted a greater probability of an arrest judgment. Furthermore, participants in the vulnerable condition believed that the survivor had less ability to resist, and they disfavored her arrest. However, this was only true when we invoked no emotion. When we invoked disgust, vulnerability ceased to have this moderation effect. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Differences in socio-demographics status, risk behaviours, healthcare uptake and HIV/ sexually transmitted infections (STIs) between brothel-based and street-based female sex workers in Yunnan, China.

Heterosexual contact is the primary mode of HIV transmission in China and commercial sex is thought to play a crucial role in China's epidemic. Female sex workers (FSWs) in China tend to be either brothel-based (BSWs) or street-based (SSWs), but few studies have investigated the differences between these important segments of this difficult-to-reach, high-risk population. Our aim was to explore the differences between SSWs and BSWs in terms of socio-demographic characteristics, sexual and risky practices, HIV/STI-related knowledge, health services, HIV/STI prevalence and other aspects. A cross-sectional survey was conducted in Yunnan Province of China in partnership with a local FSW-friendly non-governmental organization. Face-to-face interviews using a structured questionnaire were conducted to collect data on socio-demographic characteristics, sex work history, sexual behaviours, HIV/STI-related knowledge, HIV testing history, and healthcare services uptake. Blood samples were taken for HIV and syphilis testing, and urine samples for gonorrhea and chlamydia testing. Descriptive statistics were used to evaluate differences between SSWs and BSWs. A total of 185 BSWs and 129 SSWs were included in the study. SSWs were older and less educated, had more dependents and more clients, lower condom use and accessed fewer healthcare services. Moreover, 37.2% of SSWs and 24.9% of BSWs were found to have HIV/STI infection. Unfortunately, the awareness related to STIs was relatively low in both groups, especially SSWs. Our study provides evidence that confirms the disproportionately high vulnerability of SSWs to HIV and other STIs, underscoring the urgent need for the Chinese health and public health sectors to prioritize outreach to SSWs. Awareness and educational programs, condom distribution, testing and health check-ups should be included in a comprehensive strategy for HIV/STI prevention in this high-risk population.

Food Insecurity Is High in a Multi-Site Cohort of Transgender Women Vulnerable to or Living with HIV in the Eastern and Southern United States: Baseline Findings from the LITE Cohort.

The prevalence and correlates of food insecurity-the unavailability of food and limited access to it-have not been adequately considered among transgender women (TW), particularly alongside other health-related conditions burdening this population, such as HIV infection. This study examined the prevalence and correlates of food insecurity among TW. Between 2018 and 2020, 1590 TW in the Eastern and Southern U.S. completed a multi-site baseline assessment (socio-behavioral survey and HIV testing). Descriptive statistics were calculated and multivariable Poisson models with robust error variance were used to estimate prevalence ratios and 95% confidence intervals for correlates of food insecurity (dichotomized as sometimes-to-always vs. seldom-to-never running out of food). Eighteen percent of TW were living with HIV and nearly half of participants (44%) reported food insecurity. Correlates of food insecurity included being Black, multiracial, or another race/ethnicity; having < college education, low income, unstable housing, and high anticipated discrimination; and a history of sex work and sexual violence (all p < 0.05). Food insecurity was highly prevalent among TW. Current programs to provide food support do not adequately meet the needs of TW. HIV pr evention and care programs may benefit from addressing food insecurity.

High prevalence of hepatitis B virus among MSM living with HIV in India.

People living with HIV (PWH) have been shown to bear a higher burden of hepatitis B virus (HBV) due to shared routes and risk factors for transmission. Populations such as men who have sex with men (MSM) are at an increased risk of both being infected with HBV and HIV, that places them at higher risk of hepatocellular carcinoma. Using weighted and adjusted multilevel logistic regression, we characterized the prevalence and correlates of hepatitis B surface antigen (HBsAg) among MSM living with HIV across 12 Indian cities from 2012 to 2013. Overall, the prevalence of HBsAg was 8% (range across cities: 0.5%-19%). Being between the ages of 25-34, and 35-44 increased the odds of having chronic HBV infection compared to MSM 24 years or younger. Daily or seasonal employment and being unemployed increased the odds of HBsAg prevalence compared to those with monthly or weekly wages. Sexual risk behaviours such as having had sex with both men and women in the prior 6 months and history of sex work increased the odds of having HBV. Ever having insertive sex with a man or hijra (assigned male at birth, currently identifies as female/nonbinary) was negatively associated with HBV. Despite the existence of efficacious vaccines, HBV continues to have high prevalence among PWHs. Programmes to increase early screening, vaccinations and HBV literacy are urgently needed. Integrating HBV and HIV programmes for MSM populations could be critical in addressing this dual burden and improving outcomes for both infections.

Sex Work and Health Problems in the Sexual and Gender Minority Population: Analysis of a Population Survey in Peru

Background. Sexual and gender minorities (SGM) who perform sex work are susceptible to sexually transmitted infections and substance abuse that can lead to chronic diseases, as well as discrimination and violence that deteriorate their mental health. Aim. To evaluate the association between a history of sex work and health problems in the sexual and gender minority population from Peru. Methods. A cross-sectional study was conducted based on the data of the first virtual survey for LGBTI people in Peru in 2017. The prevalence of self-reported chronic diseases, infectious diseases, and mental health problems in the last 12 months and their association with the history of sex work were evaluated. Adjusted prevalence ratios (APR) with 95% confidence intervals were calculated using Poisson regression with robust variance. Results. We analyzed data from 10629 people, of which 7.0% performed sex work. The prevalence of chronic diseases, infectious diseases, and mental health problems was 13.0%, 10.4%, and 23.7%, respectively. A significant association was found between a history of sex work with chronic diseases (APR: 1.25, 95% CI: 1.04–1.50), infectious diseases (APR: 2.11, 95% CI: 1.86–2.41), and mental health problems (APR: 1.27, 95% CI, 1.12–1.45). Conclusion. We found evidence that chronic diseases, infectious diseases, and mental health problems are associated with sex work history among the SGM population in Peru. There is a need to provide health interventions focused on disease prevention and control for this population.

Bodies of desire: use of nonprescribed hormones among transgender women and travestis in five Brazilian capitals (2019-2021).

To analyze the experiences of transgender women and travestis regarding the use of hormones for body changes without a medical prescription. This is a cross-sectional, quantitative and qualitative study, using data from "TransOdara", which estimated the prevalence of Sexually Transmitted Infections in transgender women and travestis recruited through Respondent-Driven Sampling, between December 2019 and July 2021, in São Paulo, Campo Grande, Manaus, Porto Alegre, and Salvador, Brazil. The main outcome was: use of hormones without medical prescription and associated risk factors. Descriptive analysis, mixed univariate logistic regression models, and semi-structured interviews were carried out. Of the 1,317 recruited participants, 85.9% had already used hormones. The current use of hormones was reported by 40.7% (536) of them. Of those who were able to inform the place where they obtained them, 72.6% (381/525) used them without a medical prescription. The variables associated with the outcome were: current full-time sex work (OR 4.59; 95%CI 1.90-11.06) or in the past (OR 1.92; 95%CI 1.10-3.34), not having changed their name (OR 3.59; 95%CI 2.23-5.76), not currently studying (OR 1.83; 95%CI 1.07-3.13), being younger (OR 2.16; 95%CI 1.31-3.56), and having suffered discrimination at some point in life for being a transgender women and travestis (OR 0.40; 95%CI 0.20-0.81). The use of nonprescribed hormones is high among transgender women and travestis, especially among those who are younger, did not study, have not changed their name, and with a history of sex work. This use is related to the urgency for gender transition, with excessive use and damage to health.

Self-reported intimate partner violence among men who have sex with men at an urban Australian sexual health clinic.

In Australia, 17% of women and 6% of men have experienced intimate partner violence (IPV). Although most IPV research has focused on heterosexual partnerships, studies suggest that men who have sex with men (MSM) may experience IPV at similar or higher rates than those documented among women. IPV may also take different forms among MSM and have different health and social impacts. This study aims to assess the utility of a screening tool for identifying and responding to IPV among MSM attending a sexual health clinic in Sydney, Australia. Between 1 June 2020 and 30 June 2022, MSM clients were screened using standardised questions to identify IPV experienced within the preceding 12months. Answers to the screening questions were correlated with data collected routinely at the initial clinic visit, including age, employment, country of birth, drug and alcohol use, sexual partner numbers, and any history of sex work, pre-exposure prophylaxis use and HIV status, as well as any bacterial STI diagnosed at the initial visit. There were 2410 eligible clients and of these, 2167 (89.9%) were screened during the study period. A total of 64 men (3.0%) (95% CI 2.3-3.8%) reported experiencing physical violence or intimidation in the past 12months. Controlling for age, men who were born in Australia were 2.03 (95% CI: 1.04-3.01) times more likely to report IPV, and men who had Medicare were 2.43 (95% CI: 0.95-3.90) times more likely to report IPV than those who did not. Those who had ever injected drugs were 5.8 (95% CI: 1.87-9.73) times more likely to report IPV, and men with sexualised drug use were 4.11 (95% CI: 2.03-6.19) times more likely. Those that were employed or studying were 72% (95%CI: 0.13-0.42) less likely to report IPV. The prevalence of reported IPV in our study was lower than that reported by others, which may be due to differences in recruitment methods and questions asked. Associations between IPV in MSM and injecting drug use and sexualised drug use highlight that clinicians should be aware of the impact and potential for IPV particularly in those with risk factors.

Sexually transmitted infections among patients attending a sexual assault centre: a cohort study from Oslo, Norway

ObjectivesWe estimate the prevalence of sexually transmitted infection (STI) among patients after sexual assault, assess the possible value of azithromycin prophylaxis, and identify risk factors for assault-related STI and for...

History of Sex Work Is Associated with Increased Risk of Adverse Mental Health and Substance Use Outcomes in Transgender Adults

Understanding factors influencing mental health and substance use in transgender and gender diverse people is critical to reducing disparities in this population. We sought to investigate whether a history of sex work was associated with increased prevalence of poor mental health, substance use, and a negative experience within drug and alcohol treatment facilities. We conducted a secondary analysis of the data of 25,204 transgender respondents of the 2015 United States Transgender Survey. We estimated multiple logistic regressions to assess the association between a history of sex work and adverse mental health and substance use outcomes. We then estimated mean prevalence of adverse outcomes by type of sex work. Finally, we performed chi-square analysis to explore differences in mistreatment at drug and alcohol treatment facilities. Respondents with a history of sex work were significantly more likely to have poorer psychological health, suicidality, and substance use after adjusting for covariates. Among those who visited drug and alcohol treatment facilities, those with a history of sex work were significantly more likely to report adverse experiences (26.34% vs. 11.63%). Our findings highlight the increased risk of adverse outcomes in transgender sex workers and emphasize the need for interventions targeting this subgroup of transgender people.

"If I'm at home, I do it at home": Qualitative study on HIV self-testing among transgender women in Argentina.

Evidence among key populations supports acceptability of HIV self-testing (HIVST) due to its privacy and convenience. However, insufficient research has been done among transgender women (TGW), especially in Latin America. Consequently, the aim of this study was to explore the acceptability, perceptions and recommendations for HIVST implementation among TGW in Buenos Aires. A focus group was conducted in July 2019. Particpants were invited to touch and learn about a displayed HIVST kit. The following main topics were explored: acceptability, reasons for seeking self-testing, preferences for training, distribution, periodicity and recommendations for HIVST implementation. The sample consisted of 12 TGWs; mean age of 26 years (IQR = 22-28); 66% had history of sex-work. The main motivations for seeking HIVST were convenience, privacy, and usage to reduce stigma and discrimination by health-care providers. Recommendations for HIVST were: distribution from primary health centers and trans-sensitive centers; affordable price; assistance by peer health promoters; and the provision of clear written and video instructions. Tailored implementation of HIVST can increase HIV testing rates, early detection, and linkage to HIV-care in this high-prevalence group. This study provided community-driven suggestions to inform and adapt an HIVST feasibility pilot study and future implementation in Argentina.

Persistent disparities in COVID-19-associated impacts on HIV prevention and care among a global sample of sexual and gender minority individuals

ABSTRACT As COVID-19 continues to persist, there is a need to examine its impact among sexual and gender minority individuals, especially those with intersecting vulnerabilities. We conducted a cross-sectional survey with a global sample of sexual and gender minority individuals (n = 21,795) from October 25, 2020 to November 19, 2020, through a social networking app. We characterised the HIV prevention and HIV treatment impacts of COVID-19 and the COVID-19 mitigation response and examined whether subgroups of our study population are disproportionately impacted by COVID-19. Many sexual and gender minority individuals reported interruptions to HIV prevention and HIV care and treatment services. These consequences were significantly greater among people living with HIV, racial/ethnic minorities, immigrants, individuals with a history of sex work, and socio-economically disadvantaged groups. These findings highlight the urgent need to mitigate the negative impacts of COVID-19 among sexual and gender minority individuals.

Experiences and factors associated with transphobic hate crimes among transgender women in the San Francisco Bay Area: comparisons across race

BackgroundTrans women experience high rates of gender-based violence (GBV)—a risk factor for adverse health outcomes. Transphobic hate crimes are one such form of GBV that affect trans women. However, little is understood about factors that shape transphobic hate crimes and racial/ethnic variation in these experiences. To contextualize GBV risk and police reporting, we examined self-reported types and correlates of transphobic hate crimes by racial/ethnic group of trans women in the San Francisco Bay Area.MethodsFrom 2016 to 2018, trans women participated in a longitudinal cohort study of HIV. Secondary data analyses (N = 629) examined self-reported experiences of transphobic hate crimes (i.e., robbery, physical assault, sexual assault, and battery with weapon) by race/ethnicity, and whether hate crimes were reported to the police. Chi-square tests and simple logistic regression examined demographic, sociocultural, and gender identity factors associated with transphobic violence experiences and police reporting.ResultsAbout half (45.8%) of participants reported ever experiencing a transphobic hate crime; only 51.1% of these were reported to the police. Among those who reported a hate crime experience, Black (47.9%) and Latina (49.0%) trans women reported a higher prevalence of battery with a weapon; White (26.7%) and trans women of “other” race/ethnicities (25.0%) reported a higher prevalence of sexual assault (p = 0.001). Having one’s gender questioned, history of sex work, homelessness as a child and adult, and a history incarceration were associated with higher odds of experiencing a transphobic hate crime. Trans women who felt their gender identity questioned had lower odds of reporting a hate crime to the police compared to those did not feel questioned.ConclusionsA high proportion of trans women experienced a transphobic hate crime, with significant socio-structural risk factors and racial differences by crime type. However, crimes were underreported to the police. Interventions that address structural factors, especially among trans women of color, can yield violence prevention benefits.

Linkage to care after HIV diagnosis among men who have sex with men and transgender women in Lima, Peru

ABSTRACT In Lima, Perú, HIV prevalence is estimated to be 15% among men who have sex with men (MSM) and 30% among transgender women (TW). We investigated timely linkage of MSM and TW to HIV care, as linkage to antiretroviral therapy (ART) is critical to protect the health of those living with HIV and to prevent onward transmission. We investigated linkage within 90 days of HIV diagnosis by matching data from two studies conducted in Lima between 2013 and 2015 to national ART program records. We used generalized linear modeling to assess predictors of timely linkage and late presentation to care. Of 487 newly-diagnosed MSM and TW, only 44% presented for care at an HIV clinic within 90 days. Timely linkage was less common among TW (aPR 0.7, 95% CI 0.5–1.0), those younger than 24 (aPR 0.8, 95% CI 0.6–1.0), and those reporting a history of sex work (aPR 0.7, 95% CI 0.6–0.9). Proximity to an ART program clinic was not associated with linkage; most participants linked to clinics offering “LGBTQ-friendly” care. The pattern of clinics selected by participants suggests the importance of concerns about confidentiality and stigma in decision-making about where to link to care.

Sex Work and High-Risk Anal Human Papillomavirus Infection Among Transgender Women: The Condesa Study.

Purpose: The prevalence of high-risk human papillomavirus (hrHPV) infection among transgender women has been reported to be very high and sexually transmitted infection (STI) prevention strategies have focused on transgender women who engage in sex work. The purpose of our study was to describe hrHPV infection prevalence among a group of transgender women and to explore the differences according to sex work history (SW). Methods: The Condesa Study, an HPV vaccine, and screening study, recruited 207 transgender women without previous HPV vaccination, ages 18-60, from two clinics in Mexico City that provide HIV and transgender health care (May 2018-December 2019). At enrollment, they completed a questionnaire on sociodemographic and sexual behavior data. The hrHPV DNA genotyping was done on self-collected anal samples. Factors associated with hrHPV, stratified by presence or absence of SW, were assessed with multiple logistic regression. Results: A total of 43.5% of participants reported a history of SW. Anal hrHPV prevalence was 62.0% among participants with a history of SW and 52.0% among those without. Overall, 1 in 4 (26.6%) participants were living with HIV. Independent risk factors associated with hrHPV among transgender women with a history of SW were younger age, younger age at first anal intercourse (15-17 years), and greater number of sexual partners in the last 3 months. Among transgender women who had not done SW, greater number of sexual partners in the last 3 months and self-reported STIs were associated with hrHPV. Conclusions: Prevalence of anal infection with hrHPV was high among transgender women. Our results support that other sexual behaviors different from participating in SW contribute to the high prevalence of HPV and that there is an urgent need to include all transgender women in prevention programs for HPV and associated cancers, regardless of SW.

Association of Documentation of Legal Residency Status with Nonprescribed Hormone Use Among Hispanic/Latina Trans Women in San Francisco.

Undocumented immigrant trans Latinas face significant barriers to attaining gender-affirming health care and may use nonprescribed feminizing hormones. Without medical supervision, nonprescribed hormone use may lead to adverse health outcomes. This study aimed to determine if a history of being an undocumented immigrant was associated with nonprescribed hormone use among trans Latinas. We conducted a secondary analysis using baseline data from the 2016 Trans National study done in the San Francisco Bay Area. Two hundred five trans Latinas participated in the study, of whom 75 (37%) reported a history of being undocumented. We fitted a multivariable logistic regression model to determine whether having a history of being an undocumented immigrant was associated with nonprescribed hormone use while controlling for age, income, time living in San Francisco, history of sex work, and history of problems with accessing health care. The prevalence of nonprescribed hormone use was 55.9% among trans Latinas overall; however, for trans Latinas with a history of undocumented immigration status, the prevalence was 68%. There was a significant, independent association between nonprescribed hormone use and undocumented status (adjusted odds ratio [aOR]=3.20; 95% confidence interval [CI]=1.47–6.97). We also found that having a history of sex work was associated with nonprescribed hormone use (aOR=5.72; 95% CI=2.69–12.18). The prevalence of nonprescribed hormone use among trans Latinas was high and is associated with a history of undocumented status and sex work. These associations may indicate health care avoidance related to concerns of being criminalized due to their documentation status or source of income (i.e., sex work) among trans Latinas. These findings underscore the need to reduce barriers in gender-affirming care to increase access to medically supervised hormone use, particularly among individuals with a history of undocumented status and engaged in sex work.

Correlates of alcohol and illicit drug use before commercial sex among transgender women with a history of sex work in China.

Complete survey data were analysed from 397 transgender female sex workers recruited from three of the largest cities in China: Shenyang, Shanghai and Guangzhou. Information was collected about demographics, alcohol or illicit drug use, alone or in combination, and their psychosocial correlates using structured questionnaires. Multinomial logistic regression models were used to examine the association between substance use and its correlates. Before commercial sex, approximately one-third of the sample reported exclusive alcohol use (28.5%), 9.3% reported exclusive drug use and 7.3% reported combined use of alcohol and drugs. Before commercial sex, participants with low self-esteem had twice the odds of using alcohol exclusively (adjusted odds ratio (aOR) 2.05; 95% confidence interval (CI) 1.01-4.17), those with higher levels of loneliness had almost threefold the odds of exclusive drug use (aOR 2.92; 95% CI 1.21-7.07) and those with depression (aOR 2.97; 95% CI 1.11-7.96) and unknown HIV status (aOR 3.00; 95% CI 1.02-8.87) had threefold the odds of combined use of alcohol and drugs. Programs aimed at reducing alcohol or drug use among transgender female sex workers in China may consider adding components that help support mental health and encouraging HIV screening.

Sex Worker Resistance in the Neoliberal Creative City: An auto/ethnography

Sex workers are subjects of intrigue in urban and creative economies. Tours of active, deteriorating, or defunct red-light districts draw thousands of tourists every year in multiple municipalities around the world. When cities celebrate significant anniversaries in their histories, local sex worker narratives are often included in arts-based public offerings. When sex workers take up urban space in their day-to-day lives, however, they are criminalised. Urban developers often view sex workers as existing serviceably only as legend. A history of sex work will add allure to an up-and-coming neighbourhood, lending purpose to its reformation into a more appropriately productive space, but the material presence of sex workers in these neighbourhoods is seen as a threat to community wellbeing and property values. This paper considers how sex workers, continuously displaced from environments they have carved out as workspaces, may use the arts to draw attention to these ongoing contradictions. It investigates how sex workers may make visible the idiosyncratic state of providing vitality to a city’s history while simultaneously being excluded from its living present. Most critically, it suggests ways in which sex workers may encourage those involved as producers and consumers of neoliberal urban revitalisation projects to connect these often fatal paradoxes to the laws that criminalise their labour.

1295. Advancing the PrEP Continuum: A Novel Collaboration Between a Public Health Department and a Federally Qualified Healthcare Center in the Southern United States

BackgroundWhile pre-exposure prophylaxis (PrEP) is a promising strategy for HIV prevention, some high-risk persons have limited access to care, particularly Black and Latino men who have sex with men (MSM). Disparities also exist by region: the Southern United States accounts for over half of new HIV diagnoses but only a third of PrEP prescriptions. We evaluated a novel PrEP program based on a collaboration between a local department of public health (DPH) and a federally qualified health center (FQHC) providing care to underserved racial/ethnic minorities in Durham, North Carolina.MethodsIn May 2015, the Durham County DPH and Lincoln Community Health Center, an FQHC, developed a program to offer PrEP services using existing resources. The model included initial no-cost screening for sexually transmitted infections (STIs), hepatitis B/C, and HIV at the DPH STI clinic, followed by referral to the FQHC for PrEP services. We profiled the PrEP continuum for patients starting at program initiation until March 2018. For PrEP initiators and non-initiators, comparisons were made using Wilcoxon rank-sum test for continuous variables, and Chi-square or FisherÕs exact tests as indicated for categorical variables.ResultsOf 196 unique patients evaluated in the STI clinic and referred to the FQHC, 117 (60%) persons attended their initial PrEP appointments. Among these, 84 (43%) filled a PrEP prescription, 69 (35%) persisted in care for at least three months, and 58 (30%) reported >90% adherence at follow-up (see figure). Among those presenting for initial appointments (n = 117), more than half were Black (n = 62, 53%) and 21 (18%) were Latino. Most were MSM (n = 95, 81%) and 9 were transgender. Almost half (n = 55, 47%) were uninsured. We found statistically significant differences between PrEP initiators vs. noninitiators based on race/ethnicity (P = 0.02), insurance status (P = 0.05), and history of sex work (P = 0.05).ConclusionA collaborative model of PrEP care between a DPH and an FQHC in the Southern United States was able to reach predominantly Black and Latino MSM at high-risk for HIV. Although this program is sustainable, efforts to improve steps along the PrEP care continuum are still needed in this population. Disclosures A. Sena, Gilead: Grant Investigator, Research grant.

From Ying Nakhon Sopheni to Sao Borikan: Banality and Originality in the Development of Prostitution in Thailand

Since prostitution for Thai has been much less studied that sex tourism, this article propose a brief history of sex work in Thailand, from the kingdom of Ayutthaya (14th-18th century) to the present time. The aim is first to highlight—as all over the world—the foremost prominence of the commercial aspect, prostitution being a trading exchange of a sexual service against payment. However, in present-day Thailand, and, at least for the last half-century, money is just like the true god (ngoen khue prachao) and the prospect to obtain more money tolerates any behavior and any corruption. Still to comprehend better the unusual development of prostitution in Thailand it is necessary to unveil the socio-cultural fertilizers. One of them could be the peculiar situation of the mae may, a term inappropriately translated by widow in bilingual dictionaries, following the first lexicographers of the Thai who were all Christian missionaries.