Male Sex Workers Research Articles

Transactional Desire: Exploring Male Student Sex Workers in China

ABSTRACT This paper presents a descriptive study of Chinese male student sex workers through a grounded theory analysis of 25 semi-structured one-to-one online interviews. We found that the internet and introductions by peers were the two primary channels for Chinese male students to enter the sex industry. Most students were motivated to be involved in commercial sex by a mixture of consumption and sexual desires. Student sex workers motivated mainly by sexual desire often selected clients and considered commercial sex as “transactional hookups.” Student sex workers used strategies, including concealing, separating sex and love, simulating boyfriend experiences, and terminating romantic relationships, to deal with the stigmas they encountered. Sexual health and sexually transmitted disease prevention-oriented sexuality education in China had positive impacts on male student sex workers, but we also found the need for more comprehensive sexuality education. As emerging adults, college students are in a life stage distinct from adolescents and adults. We believe student sex work, as well as emerging adult sex work in general, needs to be differentiated from voluntary adult sex work in both scholarly research and public discussions of the legal status of sex work, especially in cases where students are not informed about the risks of engaging in commercial sex.

Knowledge of Human Mpox (Monkeypox) and Attitude towards Mpox Vaccination among Male Sex Workers in China: A Cross-Sectional Study.

Re-emerging human mpox (previously known as monkeypox) is spreading around the world. According to existing studies, the current mpox pandemic mainly affects men who have sex with men (MSM), including male sex workers (MSW). Our study aimed to assess mpox knowledge and attitude towards mpox vaccination among MSW in China. A web-based, cross-sectional survey was conducted in August 2022. We collected participants' socio-demographic characteristics and knowledge with 15 knowledge items related to mpox. Modified Bloom's cut-off points of 80% (total score > 12) was used to indicate good knowledge. Multivariable regression analysis was used to assess factors of mpox knowledge and attitude towards mpox vaccination. A total of 154 MSW were recruited (age: median = 22, interquartile range, IQR = 12). Of the 154 MSW, 49.4% had good knowledge of mpox, and 63.0% were willing to be vaccinated against mpox. We found that good knowledge was associated with being single [adjusted odds ratio (AOR) = 2.46, 95% confident interval (CI) (1.22-4.87)], being unemployed [5.01, 1.21-20.70] and willingness to be vaccinated [2.51, 1.14-5.54]. Willingness to get vaccinated was related to age [1.06, 1.00-1.12], chronic diseases history [8.53, 1.01-71.68], and agreement with "priority for high-risk groups if mpox vaccine is in short supply" [2.57, 1.01-6.54]. We found that MSW had suboptimal mpox knowledge and a high willingness to be vaccinated against mpox. MSW who are single and willing to be vaccinated may have good knowledge of mpox. These findings underscore the necessity of providing health education on mpox among MSW. When the mpox vaccine is in short supply, priority should be given to high-risk groups, such as MSW.

Results of community-based TB and HIV screening among transgender women and male sex workers in Pakistan.

In Pakistan and globally, a large proportion of people with TB who are not receiving treatment are key populations with poor access to diagnosis and care. Transgender women and male sex workers (MSW) are heavily stigmatized and marginalized groups. While HIV rates are well documented among these key populations, little such data exists for TB. We engaged local organizations working with transgender women and MSW communities in Karachi and five urban cities in Sindh Province. People from the communities served as screening facilitators and treatment supporters. Verbal screening was followed by testing with Xpert MTB/RIF and HIV testing was offered. People with TB were supported through treatment. We screened 18,272 transgender women and 24,253 MSW. 8,921 (21.0%) individuals had presumptive TB and 7,472 (83.8%) provided sputum samples. We detected 438 (5.9%) people with positive results including 140 transgender women and 298 MSW. Including people diagnosed clinically, 625 people with TB were identified and 98.1% initiated treatment. Overall, 1.5% of people screened had TB, 1.7% among MSW and 1.1% among transgender women. Of 1,508 people tested for HIV, 243 had HIV infection (HIV+). The rates of TB among HIV+ transgender women (8.8%) were slightly lower than among MSW (10.3%). Previously, few attempts have been made to address TB in transgender women and MSW. Our work shows that these groups carry a significant burden of both TB and HIV in Pakistan and do not regularly access services. Effective interventions should include the engagement of community leaders and peers.

Scenario of HIV infection in Pakistan

Human immunodeficiency virus (HIV) infection, which was previously lethal, has evolved into a chronic disease that may be treated and well-managed. HIV levels in the bloodstream may become undetectable with antiretroviral therapy (ART). All those providing care for people living with HIV should be aware of the risk factors, transmission, diagnosis, and treatment, acute HIV infection, possible opportunistic infections, and malignancies. Preexposure and postexposure prophylaxis regimens allow for preventive treatment. Home healthcare specialists can help people follow their drug schedules, assess the effectiveness of their treatments, and identify HIV problems and ART side effects. The ability to support, inform, and counsel people living with HIV and their families is most crucial [1].
 Approximately 38.9 million people worldwide were living with HIV, 25.4 million had access to antiretroviral therapy (ART), 1.7 million had just recently contracted the virus, and 690,000 had passed away from AIDS-related illnesses, according to a Joint United Nations Program on HIV/AIDS 2020 report. Although Pakistan's national HIV/AIDS control program was established in 1987, the number of new HIV/AIDS cases has been rising quickly ever since. In Pakistan, 160,000 people were living with HIV/AIDS as of 2018, yet only 10% of them were receiving ART. 3 Increasing people with HIV/AIDS' access to ART has a number of positive effects, including delaying the advancement of the disease, extending life expectancy, and enhancing people's quality of life and mental health [2].
 "More than 1,000 new HIV cases are reported each month from all four provinces, including the capitol city Islamabad, Azad Kashmir, and Gilgit Baltistan. This demonstrates unequivocally that homosexuals, persons who inject drugs, male, female, and transgender sex workers, and other critical demographics are now spreading HIV to the broader community. During the final 10 months of 2022, 9,773 people in Pakistan had HIV tests that were positive, casting significant doubt on HIV preventive and control initiatives and amply demonstrating the spread of HIV from important populations to the general public. New HIV infections account for a sizable portion of low-risk males, females, and clients of critical communities, showing an increase in HIV transmission to bridging populations [3].
 The increased rate of HIV in Pakistan pose a risk to a healthy population, blood recipients etc. Therefore, surrounding communities should also be checked for HIV. The government should direct public education campaigns in coordination with NGOs. To prevent any future epidemics, barbers and unlicensed health professionals in remote regions should receive training.

Vendere virilità virtuale. Il corpo nel sex work on-line tra uomini

This contribution intends to study the theme of the body in online male sex work starting from the analysis of an in-depth interview carried out with an italian university student who plays the role of cash master for a male clientele. The body of the sex worker and that of the client are involved in an exclusively visual erotic game in which the masculinity of both becomes a conscious performance and, at the same time, the instrument and effect of a construction of models - normative and/or transgressive - of gender. The epistemological approach adopted is based on Simon and Gagnon's theory of "sexual scripts" that, by allowing us to examine the ways in which individuals organise and construct their sexual meanings, appears to be a privileged theoretical tool in the reading of the socio-sexual dimension of the body. This exquisitely pedagogical theme of investigation shows the plural dynamics of the formation (and reconstruction) of masculinity, not only in adolescence (as we have by now learnt to recognise) but also in adulthood, proposing, moreover, a theoretical challenge to the concept of the body itself, whose boundaries, ramifications and virtual hybridisations are explored.

Chaperos, Rent Boys, and Sex Workers: Translating Attitudes Towards Male Sex Work in the Spanish Dubbing of the US TV Series Looking

Chaperos, Rent Boys, and Sex Workers: Translating Attitudes Towards Male Sex Work in the Spanish Dubbing of the US TV Series Looking

Poly-drug use among female and male commercial sex workers visiting a drop in centre in Mombasa County, Kenya.

The relationship between commercial sex work and drug use is complex and the two exacerbate each other. In Kenya, Mombasa County has one of the highest populations of drug users and commercial sex workers. Despite documentation of drug use among sex workers, most of the studies are based on self-reported history which is prone to social desirability and memory recall biases. It is in this context that we sought to establish actual drug use is this sub-population. A cross-sectional study was conducted to determine self-reported and confirmed drug use among 224 commercial sex workers accessing services at Mvita Drop-in. Actual drug use was determined qualitatively using 6 panel plus alcohol Saliva Test kit. The overall prevalence of self-reported and confirmed current use for at least one drug was 98% and 99% respectively. Regardless of the technique used, alcohol and tobacco products were the most consumed substances. Alcohol use increased significantly with age (P = 0.03). Risk of cigarette use and testing positive for cotinine was higher among those age 18 to 35 years compared to >35years at P = 0.001 and P = 0.002 respectively. Poly-drug use was common with 98% testing positive for more than one drug. The reason for drug use was sex work related pressure (88%) with 60% of the respondents reporting they cannot transact this business without drugs. Almost every commercial sex worker is a poly-drug user. We recommend targeted interventions for commercial sex workers.

EBV+/HHV-8+/HIV+ high grade T Cell Lymphoma in the stomach

Abstract Introduction/Objective T-cell Lymphoma is overly aggressive. T cells overgrow triggered by aberrant T-cell signaling and transform into a lymphoma. Virus infection contributes to the transformation, for example, EBV (Epstein Barr Virus) virus is associated with Extranodal NK/T-cell lymphoma, Angioimmunoblastic T-cell lymphoma, and peripheral T-cell lymphoma, HHV-8 is associated with Primary Effusion Lymphoma, Kaposi sarcoma, and very rarely associated with T cell lymphoma. The HIV (Human Immunodeficiency Virus) virus is associated with Burkitt lymphoma, Plasmablastic lymphoma et al. Among these lymphomas, only Primary Effusion lymphoma is associated with all three virus infections and is a B cell lymphoma. T cell lymphoma with all three infections has not been reported. Since most patients are diagnosed with advanced disease. So early diagnosis of this disease is especially important. Methods/Case Report An HIV+ 38-year-old male with no significant medical history complained of weakness, dizziness, and presenting with lower extremities swelling, and anemia for the last 2 weeks. The patient had a history of an unsafe sexual encounter with male sex workers but denies iv. drug use and blood transfusion. The screen before endoscopy reveals active, acute Hepatitis B Virus infection. Endoscopy findings show gastritis. The biopsy specimen shows mucosa is diffusely infiltrated by atypical plasmablastic cells. Immunostaining reveals they are positive for CD3, CD7, CD30, MUM1, CD43, and HHV8, but negative for Cd2, Cd4, Cd5, Cd8, Cd10, Cd21, Cd23, Cd25, Cd34, Cd56, Cd138, CD19, CD20, CD79a, PAX5, CD45, CD57, P53, CyclinD1, BCL6, BCL2, ALK, c-MYC, TdT, Granzyme B, TIA, S-100, Pancytokeratin. In situ hybridization for EBER is positive, but negative for Kappa and Lambda. The proliferative index (Ki-67) is high (99%). The morphologic and immunophenotypic features are consistent with an EBV CD30+ high-grade lymphoma. The sequencing from OnkoSightTM Advanced Chronic Lymphoid NGS Report shows a BCL-6 and EP300 mutation that has not been reported in a publicly available database (COSMIC; gnomAD). Results (if a Case Study enter NA) N/A. Conclusion To our knowledge, this is the first reported case of EBV+/HHV-8+/HIV+ high grade T Cell Lymphoma in the stomach. This type of lymphoma is extremely aggressive, and the early diagnosis is particularly important for prognosis.

Advanced HIV disease and associated attrition after re-engagement in HIV care in Myanmar from 2003 to 2019: a retrospective cohort study.

The burden of advanced HIV disease (AHD) and predictors of outcomes among people living with HIV (PLHIV) re-engaging in care are not well known. We conducted a retrospective cohort study of PLHIV who re-engaged in care after being lost to follow-up (LFU), from 2003 to 2019, in Myanmar. We calculated the incidence rates of attrition after re-engagement and performed Cox regression to identify risk factors for attrition. Of 44 131 PLHIV who started antiretroviral treatment, 12 338 (28.0%) were LFU at least once: 7608 (61.6%) re-engaged in care, 4672 (61.4%) with AHD at re-engagement. The death and LFU rates were 2.21-fold (95% CI 1.82 to 2.67) and 1.46-fold (95% CI 1.33 to 1.61) higher among patients who re-engaged with AHD (p>0.001). Death in patients who re-engaged with AHD was associated with male sex (adjusted HR [aHR] 2.63; 95% CI 1.31 to 5.26; p=0.006), TB coinfection (aHR 2.26; 95% CI 1.23 to 4.14; p=0.008) and sex work (aHR 7.49, 95% CI 2.29 to 22.52; p<0.001). History of intravenous drug use was identified as a predictor of being LFU. Re-engagement in HIV care in Myanmar is frequent and those who re-engage carry a high burden of AHD. As AHD at re-engagement is associated with higher attrition rates, implementation of differentiated interventions that enable earlier linkage to care and prompt identification and management of AHD in this population is necessary.

HIV prevalence among men who have sex with men, transgender women and cisgender male sex workers in sub-Saharan Africa: a systematic review and meta-analysis.

Developing effective targets, policies and services for key populations requires estimations of population sizes and HIV prevalence across countries and regions. We estimated the relative and absolute HIV prevalence among men who have sex with men (MSM), transgender women and men, and male and transgender sex workers (MSW and TGSW) in sub-Saharan African countries using peer-reviewed literature. We performed a systematic review of peer-reviewed studies assessing HIV prevalence in MSM, transgender women and men, MSW and TGSW in sub-Saharan Africa between 2010 and 2021, following PRISMA guidelines. We searched Embase, Medline Epub, Africa Index Medicus, Africa Journal Online, Web of Science and Google Scholar. We calculated HIV prevalence ratios (PRs) between the study prevalence, and the geospatial-, sex, time and age-matched general population prevalence. We extrapolated results for MSM and transgender women to estimate HIV prevalence and the number living with HIV for each country in sub-Saharan Africa using pooled review results, and regression approximations for countries with no peer-reviewed data. We found 44 articles assessing HIV prevalence in MSM, 10 in transgender women, five in MSW and zero in transgender men and TGSW. Prevalence among MSM and transgender women was significantly higher compared to the general population: PRs of 11.3 [CI: 9.9-12.9] for MSM and 8.1 [CI: 6.9-9.6] for transgender women in Western and Central Africa, and, respectively, 1.9 [CI: 1.7-2.0] and 2.1 [CI: 1.9-2.4] in Eastern and Southern Africa. Prevalence among MSW was significantly higher in both Nigeria (PR: 12.4 [CI: 7.3-21.0]) and Kenya (PR: 8.6 [CI: 4.6-15.6]). Extrapolating our findings for MSM and transgender women resulted in an estimated HIV prevalence of 15% or higher for about 60% of all sub-Saharan African countries for MSM, and for all but two countries for transgender women. HIV prevalence among MSM and transgender women throughout sub-Saharan Africa is alarmingly high. This high prevalence, coupled with the specific risks and vulnerabilities faced by these populations, highlights the urgent need for risk-group-tailored prevention and treatment interventions across the sub-continent. There is a clear gap in knowledge on HIV prevalence among transgender men, MSW and TGSW in sub-Saharan Africa.

Factors associated with complications from COVID-19 in hospital workers: A retrospective cohort study.

SARS-CoV-2 infection in healthcare professionals represents a threat to the healthcare system. To identify factors associated with complications from COVID-19 in healthcare workers infected by SARS-CoV-2, in a specialized national hospital level III in Peru in 2020. This is a retrospective cohort study. Health personnel who were working at Instituto Nacional Materno Perinatal of Peru participated. The clinical and epidemiological characteristics and results of the Reverse Transcriptase Polymerase Chain Reaction (RT-PCR) test were collected from the medical records and epidemiological files. Simple and multiple regression models were used to estimate the risk factors of complications due to COVID-19. We found 1048 suspected cases, and 26.2% had a confirmed SARS-CoV-2 infection. Of those infected, 20.8% had comorbidity, and 55% reported contact with COVID-19 patients in health care settings. Moreover, 27.4% of infected workers were administrative personnel, 24.1% were nursing technicians, 18.3% were nurses, and 13.1% were physicians. We also found that 24.1% presented complications from COVID-19, and three workers died. In a multiple regression, the risk factors for complications due to COVID-19 were the presence of comorbidity (risk ratio: 2.94; 95% confidence interval: 1.95 to 4.42), 30 years or older (1.28; 0.6 to 2.75), 60 years or older (2.04; 0.88 to 4.74), male sex (1.1; 0.71 to 1.7) and care work area (1.02; 0.06 to 2.62). The findings in the present study show an association between the presence of comorbidities and an increased risk of presenting complications due to COVID-19 in healthcare workers, regardless of age, sex and area of work.

Online Male Sex Work in Kazakhstan: A Distinct Market?

Abstract In this article, I explore male sex-work in Kazakhstan and show that unlike male sex work around the world, the Kazakhstani market appears to be overwhelmingly heterosexual. Based on a sample of 200 online advertisements, this paper generates original data by providing an overview of male sex work in Kazakhstan’s two largest cities, Almaty and Nur-Sultan. This data is analyzed through a gender lens that acknowledges a shift in local gender roles and expectations and I argue that a desire for sexual emancipation, which is constrained by conservative views surrounding female sexuality explains this particular phenomenon. More precisely, I suggest that women are likely to have discreet sex with anonymous professionals rather than indulge in casual sex with strangers or acquaintances to maintain their reputation. While most gender research in Central Asia focuses on issues of re-traditionalization, this article investigates women’s sexuality and desires in Kazakhstan outside of the re-traditionalization paradigm.

Validating a measure of anticipated sex work-related stigma among male and female sex workers in Kenya

ABSTRACT Sex workers face different types of sex work-related stigma, which may include anticipated, perceived, experienced, or internalized stigma. Sex work stigma can discourage health care seeking and hamper STI and HIV prevention and treatment efforts. There is a paucity of validated sex work-related stigma measures, and this limits the ability to study the stigma associated with sex work. A cross-sectional survey was conducted that measured anticipated sex work-related stigma among male and female sex workers in Kenya (N = 729). We examined the construct validity and reliability of the anticipated stigma items to establish a conceptually and statistically valid scale. Our analysis supported a 15-item scale measuring five anticipated sex work stigma domains: gossip and verbal abuse from family; gossip and verbal abuse from healthcare workers; gossip and verbal abuse from friends and community; physical abuse; and exclusion. The scale demonstrated good face, content, and construct validity. Reliability was good for all subscales and the overall scale. The scale demonstrated good model fit statistics and good standardized factor loadings. The availability of valid and reliable stigma measures will enhance efforts to characterize and address stigma among sex workers and ultimately support the protection, health and well-being of this vulnerable population.

General Health Care Utilization in the Past 3 Months Increased Recent and Routine HIV and STI Testing Among Male Sex Workers in Chennai, India.

In India, male sex workers (MSW) are among the most vulnerable populations at higher risk for HIV and other sexually transmitted infections (STIs) and may seek health care services less frequently. A community-based sample of 100 MSW in Chennai, India, completed a baseline assessment as part of a behavioral intervention to reduce the acquisition and transmission of HIV. MSW reported an average of 12.2 (SD = 17.7) condomless anal sex acts with male clients in the past month, yet only 48% accessed health care services in the past 3 months. In a multivariable model adjusted for relevant covariates, MSW who accessed health care services in the past 3 months were more likely to be tested for HIV/STIs and report routine HIV testing over the past 12 months. Future HIV prevention efforts among MSW in India should incorporate referrals for accessing general health care services and identify specific barriers to health care engagement among this group.

Using Economic Diaries in an Ethnographic Study: What They Can Tell About the Financial and Daily Lives of Male and Female Sex Workers in Mombasa

This article has two objectives: first, to contribute to the academic understanding of the relationship of money with sex work by going beyond purely instrumentalist conceptualizations; and second, to inform interventions aiming to empower sex workers’ economically. Qualitative research was conducted to better understand the financial lives of sex workers in Mombasa, Kenya. The article draws largely on a participatory method using 12 economic diaries accompanied by 30 informal discussions. We complement the economic diaries with 24 in-depth interviews, key informant interviews and participant observations conducted between 2014 and 2017. We found that sex workers’ savings, spending, and earning practices were highly influenced by stigma, mobility and economic insecurity. We also found that sex workers gave substantial meaning to the idea of ‘quick money’, which reflected their daily financial strategies. The likelihood for development interventions to succeed will increase when sex workers are directly involved and not just recipients in programmes; furthermore, that programmes adequately recognize and address the needs and desires of sex workers and understand the socio-economic dynamics shaping sex work. In this article, these socio-economic factors revealed through the process and method of participants’ writing economic diaries.

Sexual Behavior Transition and Acute and Early HIV Infection Among Men Who Have Sex With Men: Evidence from an Open Cohort in China, 2011-2019.

The present study examined how sexual behaviors transit over time among men who have sex with men (MSM) and whether these transitions were associated with acute and early HIV (AEH) infection. An open cohort study was conducted using snowball sampling to recruit MSM via physical venues and Internet venues from 2011 to 2019, in China. Cox models were used to estimate the correlates of risk factors and AEH infection. We used Latent Transition Analysis (LTA) to describe behavioral profile and explore latent behavioral "trans-phenotypes," then examined the effect between different "trans-phenotypes" and AEH infection risk and explored the effect of characteristics as possible predictors of sexual behavior transition. Of 6502 MSM, a total of 1974 individuals with negative human immunodeficiency virus (HIV) tests at baseline and at least 2 visit records were included in the final analysis from 2011 to 2019. During an average 1.84years of follow-up, 64 AEH infections were documented. In the multivariable Cox model, the association between condom use in last anal sex (HR: 0.095, 0.038-0.205), fewer sexual partners (HR: 0.375, 0.205-0.712), low frequency of condom use (HR: 3.592, 1.186-11.272), and AEH acquisition were found. The percentage of MSM with "maintain/develop safety-profile," "consistent risky-profile," and "safety-profile to risky-profile" were 52.48, 40.17, and 7.35%, respectively. Compared with "maintain\develop safety-profile," "consistent or develop risky-profile" had an increasing likelihood of AEH infection. Meanwhile, male sex workers (MSWs) or older MSM were more likely to consist or transit in "risky-profile." Having middle education is a risk factor to transit in "risky-profile" for MSM with "safety-profile" at baseline. In addition, MSM who accept health services in the past year engaged in higher proportion of developing safety-profile. Approximately half of MSM maintain or develop risky behavior with the increasing likelihood of AEH acquisition in China, which suggested that targeted and intensive interventions should be prioritized to maintain safety-profile. Clinical Trial Number: ChiCTR2000039500.

Barriers and facilitators to utilisation of public sexual healthcare services for male sex workers who have sex with men (MSW-MSM) in The Netherlands: a qualitative study

BackgroundMale sex workers who have sex with men (MSW-MSM) are a high-risk group for sexually transmitted infections (STI) including human immunodeficiency virus (HIV). Provision of sexual services by MSW-MSM has shifted to the internet. Consequently, MSW-MSM have become hidden to care for providers of sexual healthcare services (SHS). The aim of this study was to 1) assess characteristics of the MSW-MSM population and 2) assess MSW-MSM’s perceived barriers and facilitators to utilise SHS provided free and anonymously by the public health STI clinic in The Netherlands.MethodsFor this qualitative study, semi-structured individual in-depth interviews were conducted with 20 MSW-MSM who worked home-based in the Dutch province of Limburg. Participants were recruited from November 2018 to June 2019 by purposive sampling until saturation was reached via 1) five websites and smartphone applications commonly used by MSW-MSM, 2) STI clinic, 3) two gay saunas. A theory-informed interview guide was developed including themes such as sexuality, sex work, SHS and barriers and facilitators to SHS utilisation. The interviews’ recordings were transcribed verbatim and thematically analysed by inductive and deductive coding with Atlas.ti 8.ResultsThe interviewed MSW-MSM were diverse in age (range: 18 – 66; median: 39.5) and mostly western European (85%). Identified barriers to SHS utilisation were lack of self-identification as homosexual and sex worker, perceived stigma on sex work and MSM, the lack of awareness of SHS and a low STI risk perception. Identified facilitators were trust in and positive attitude towards SHS, awareness of SHS’s anonymous, confidential and free-of-charge nature, high STI risk perception and knowledgeable about STI/HIV. MSW-MSM-identified implications for SHS-providers were promotion of SHS on online MSW-MSM and general platforms (e.g. Facebook), offering one-on-one online and informal communication with an SHS-provider (e.g. STI clinic nurse) and providing STI (testing) information.ConclusionThe MSW-MSM population’s diversity and identified barriers, facilitators and implications should be taken into account to optimize accessibility and utilisation of SHS for MSW-MSM in Western Europe. SHS-providers could facilitate sex work disclosure by personally asking patients about sex in exchange for money or goods in a non-judgmental manner and explaining the medical relevance of disclosure.

Differences in HIV, STI and Other Risk Factors Among Younger and Older Male Sex Workers Who Have Sex With Men in Nairobi, Kenya.

IntroductionPrevious surveys of male sex workers (MSW) in sub-Saharan Africa have not fully documented the HIV and sexually transmitted infections (STIs) rates and vulnerabilities by age category.MethodsThe bio-behavioral survey of MSW in Nairobi, Kenya, utilized respondent-driven sampling to recruit MSW. Structured interviews captured MSW's behavioral aspects, and biological tests for HIV and other STIs.ResultsAnalysis of the two age categories, 18–24 years (younger MSW) and 25 years and above (older MSW), shows that of all participants, a significantly higher proportion of younger MSW (59.6% crude, 69.6% RDS-adjusted) were recruited compared to older MSW (40.4% crude, 30.4% RDS-adjusted, P < 0.001). Young male sex workers were more likely to report multiple sexual partnerships in the last 12 months and had multiple receptive anal intercourses (RAI) acts in the last 30 days than older MSW: 0–2 RAI acts (20.6 vs. 8.6%, P = 0.0300), 3–5 RAI acts (26.3 vs. 11.5, P < 0.001), and >5 RAI acts (26.3 vs. 11.5%, P < 0.01). Furthermore, younger MSW were significantly more likely to have 3–5 insertive anal intercourse (IAI) with a regular male sex partner in the last 30 days than older MSW (24.3 vs. 8.0%, P < 0.01). Younger MSW were also more likely to report other STIs [28.5% (95% CI: 19.1–40.4%)] than older MSW [19.0% (95% CI: 7.7–29.2%)]. However, older MSWs were more likely to be infected with HIV than younger MSW (32.3 vs. 9.9 %, P < 0.01).ConclusionsOwing to the high risk sexual behaviors, HIV and STIs risks among younger and older MSW, intensified and targeted efforts are needed on risk reduction campaigns and expanded access to services.

Social Representations of LGBT Old Age and Sex Workers in Brazilian Adults

Background: The number of elderly people in the world is growing significantly, so there is an urgent need to ensure that this population can live a full life, especially taking into account the current COVID-19 pandemic scenario. Objective: To analyze the social representations of LGBT old age for male and female sex workers through the pandemic. Method: A qualitative, descriptive, and exploratory research conducted with 10 male and 10 female sex workers aged between 18 and 48. Sociodemographic questionnaires and semi-structured interviews were administered using Google Forms and then analyzed by descending hierarchical classification through the IRaMuTeQ software. Results: The analysis showed three classes: (1) «Social understanding of the topic LGBT old age,» (2) «Stigma of genders and sexual orientations,» and (3) «Physical transformations and their accompanying obstacles». Conclusions: The representations are associated with the difficulties that elderly people have with aging in society, as well as debating LGBT old age. There are also greater obstacles regarding aging of female sex workers. In this way, the study seeks to contribute to broaden the knowledge of the psychosocial aspects of LGBT aging and old age, especially those of sex workers.

The COVID-19 pandemic and male sex workers who have sex with men: associations between age and race and advertising for work in 2019–2021

Despite government-mandated restrictions on business and social activities worldwide, some sex workers continued to see clients in person throughout the COVID-19 pandemic. To better understand this behaviour, we compiled publicly available data from Internet advertisements posted on a popular website before and during the pandemic by male sex workers providing services to men. We first collected data in March 2019 from 172 advertisements – the complete number available at that time – posted by male sex workers advertising services in the Atlanta region. We then assessed whether these same sex workers continued to advertise their availability at three subsequent points during the COVID-19 pandemic: April 2020, January 2021 and February 2021. We also determined whether age and race were associated with advertising presence at each time point. While advertising rates declined among sex workers in all race categories (Black, White and ‘other’), results from our mixed effects logistic regression model show that the odds of older male sex workers continuing to advertise were greater than the odds for their younger counterparts. Further, the predicted probability of continued advertising was highest for White male sex workers. Our findings provide additional insights into male sex work during a global pandemic.