Network-Level Correlates of Sexual Risk Among Male Sex Workers in the United States: A Dyadic Analysis
Year: 2020
Type: article
Study design: Observational Study
Abstract: BACKGROUND: Male sex workers (MSWs) are at increased risk of HIV infection in the United States. Research is limited on sexual and drug use network characteristics of MSWs. SETTING: Community-based organization and health center in 2 US Northeast cities. METHODS: One hundred MSWs completed a behavioral assessment and sexual and drug network inventory. Using dyadic analyses, we assessed whether network characteristics, including sex worker-male client age, race, and HIV status homophily and risk multiplexity (ie, overlap in drug-use and sex networks), were associated with condom use. RESULTS: MSW participants' mean age was 33.6. Two-thirds identified as Black or Latino, 12% identified as heterosexual, and 90% reported recent drug use. Participants reported an average of 5.3 male clients in the past month (SD = 3.4), and having anal sex with 74% of these clients, at a rate of 2.2 times per month (SD = 4.6). Participants reported inconsistent condom use during anal sex with 53% of clients. In multivariable models, inconsistent condom use was more common in relationships with presumed HIV status homophily [odds ratio (OR): 1.25; 95% confidence interval (CI): 1.07 to 1.46] and sexual and drug network multiplexity (OR: 1.19; 95% CI: 1.09 to 1.30); and less common within relationships where the client is older than the MSW participant (OR: 0.83; 95% CI: 0.74 to 0.93). Number of multiplex relationships was positively associated with number of condomless anal sex acts with male clients (incidence rate ratio: 1.35; 95% CI: 1.19 to 1.54). CONCLUSIONS: Network characteristics may contribute to disproportionate HIV risk among MSWs. Modeling studies should include network characteristics when simulating HIV transmission, and future HIV interventions should address the role of networks.
Language: English
Topic: Sex work and related issues
Subfield: Sociology and Political Science
Field: Social Sciences
Domain: Social Sciences
Open Access status: green
Awards: Mobile Adaptation and Testing of a Uniquely Targeted HIV Intervention for Young Transgender Women, Optimizing PrEP uptake & Adherence among MSWs using a 2-stage randomization design, HIV Risk for MSM Sex Workers: A Social, Sexual, & Drug Network Simulation Study, Highly Adaptive Epidemic Control Strategies for HIV Prevention in Drug Users, Los Angeles CRS for the MACS/WIHS Combined Cohort Study, Brown University Community and Clinical Research Training Program
OpenAlex ID: W3000596373