The disproportionate burden of HIV and STIs among male sex workers in Mexico City and the rationale for economic incentives to reduce risks

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dc.contributor.authorGalárraga, Omar
dc.contributor.authorSosa-Rubí, Sandra G
dc.contributor.authorGonzález, Andrea
dc.contributor.authorBadial-Hernández, Florentino
dc.contributor.authorConde-Glez, Carlos J
dc.contributor.authorJuárez-Figueroa, Luis
dc.contributor.authorBautista-Arredondo, Sergio
dc.contributor.authorKuo, Caroline
dc.contributor.authorOperario, Don
dc.contributor.authorMayer, Kenneth H
dc.date.accessioned2021-10-08T07:08:16Z
dc.date.available2021-10-08T07:08:16Z
dc.date.issued2014
dc.description.abstractIntroductionThe objective of this article is to present the rationale and baseline results for a randomized controlled pilot trial using economic incentives to reduce HIV and sexually transmitted infection (STI) risk among male sex workers (MSWs) in Mexico City.MethodsParticipants (n=267) were tested and treated for STIs (chlamydia, gonorrhoea, syphilis and HIV) and viral hepatitis (hepatitis B and C), received HIV and STI prevention education and were randomized into four groups: (1) control, (2) medium conditional incentive ($50/six months), (3) high conditional incentive ($75/six months) and (4) unconditional incentive ($50/six months). In the conditional arms, incentives were contingent upon testing free of new curable STIs (chlamydia, gonorrhoea and syphilis) at follow-up assessments.ResultsParticipants’ mean age was 25 years; 8% were homeless or lived in a shelter, 16% were unemployed and 21% lived in Mexico City less than 5 years. At baseline, 38% were living with HIV, and 32% tested positive for viral hepatitis or at least one STI (other than HIV). Participants had a mean of five male clients in the previous week; 18% reported condomless sex with their last client. For 37%, sex work was their main occupation and was conducted mainly on the streets (51%) or in bars/discotheques (24%) and hotels (24%). The average price for a sex transaction was $25 with a 35% higher payment for condomless sex.ConclusionsThe findings suggest that economic incentives are a relevant approach for HIV prevention among MSWs, given the market-based inducements for unprotected sex. This type of targeted intervention seems to be justified and should continue to be explored in the context of combination prevention efforts.
dc.identifier.apacitationGalárraga, O., Sosa-Rubí, S. G., González, A., Badial-Hernández, F., Conde-Glez, C. J., Juárez-Figueroa, L., ... Mayer, K. H. (2014). The disproportionate burden of HIV and STIs among male sex workers in Mexico City and the rationale for economic incentives to reduce risks. <i>Journal of the International AIDS Society</i>, 17(1), 19218 - 177. http://hdl.handle.net/11427/34539en_ZA
dc.identifier.chicagocitationGalárraga, Omar, Sandra G Sosa-Rubí, Andrea González, Florentino Badial-Hernández, Carlos J Conde-Glez, Luis Juárez-Figueroa, Sergio Bautista-Arredondo, Caroline Kuo, Don Operario, and Kenneth H Mayer "The disproportionate burden of HIV and STIs among male sex workers in Mexico City and the rationale for economic incentives to reduce risks." <i>Journal of the International AIDS Society</i> 17, 1. (2014): 19218 - 177. http://hdl.handle.net/11427/34539en_ZA
dc.identifier.citationGalárraga, O., Sosa-Rubí, S.G., González, A., Badial-Hernández, F., Conde-Glez, C.J., Juárez-Figueroa, L., Bautista-Arredondo, S. & Kuo, C. et al. 2014. The disproportionate burden of HIV and STIs among male sex workers in Mexico City and the rationale for economic incentives to reduce risks. <i>Journal of the International AIDS Society.</i> 17(1):19218 - 177. http://hdl.handle.net/11427/34539en_ZA
dc.identifier.issn1758-2652
dc.identifier.ris TY - Journal Article AU - Galárraga, Omar AU - Sosa-Rubí, Sandra G AU - González, Andrea AU - Badial-Hernández, Florentino AU - Conde-Glez, Carlos J AU - Juárez-Figueroa, Luis AU - Bautista-Arredondo, Sergio AU - Kuo, Caroline AU - Operario, Don AU - Mayer, Kenneth H AB - IntroductionThe objective of this article is to present the rationale and baseline results for a randomized controlled pilot trial using economic incentives to reduce HIV and sexually transmitted infection (STI) risk among male sex workers (MSWs) in Mexico City.MethodsParticipants (n=267) were tested and treated for STIs (chlamydia, gonorrhoea, syphilis and HIV) and viral hepatitis (hepatitis B and C), received HIV and STI prevention education and were randomized into four groups: (1) control, (2) medium conditional incentive ($50/six months), (3) high conditional incentive ($75/six months) and (4) unconditional incentive ($50/six months). In the conditional arms, incentives were contingent upon testing free of new curable STIs (chlamydia, gonorrhoea and syphilis) at follow-up assessments.ResultsParticipants’ mean age was 25 years; 8% were homeless or lived in a shelter, 16% were unemployed and 21% lived in Mexico City less than 5 years. At baseline, 38% were living with HIV, and 32% tested positive for viral hepatitis or at least one STI (other than HIV). Participants had a mean of five male clients in the previous week; 18% reported condomless sex with their last client. For 37%, sex work was their main occupation and was conducted mainly on the streets (51%) or in bars/discotheques (24%) and hotels (24%). The average price for a sex transaction was $25 with a 35% higher payment for condomless sex.ConclusionsThe findings suggest that economic incentives are a relevant approach for HIV prevention among MSWs, given the market-based inducements for unprotected sex. This type of targeted intervention seems to be justified and should continue to be explored in the context of combination prevention efforts. DA - 2014 DB - OpenUCT DP - University of Cape Town IS - 1 J1 - Journal of the International AIDS Society LK - https://open.uct.ac.za PY - 2014 SM - 1758-2652 T1 - The disproportionate burden of HIV and STIs among male sex workers in Mexico City and the rationale for economic incentives to reduce risks TI - The disproportionate burden of HIV and STIs among male sex workers in Mexico City and the rationale for economic incentives to reduce risks UR - http://hdl.handle.net/11427/34539 ER - en_ZA
dc.identifier.urihttp://hdl.handle.net/11427/34539
dc.identifier.vancouvercitationGalárraga O, Sosa-Rubí SG, González A, Badial-Hernández F, Conde-Glez CJ, Juárez-Figueroa L, et al. The disproportionate burden of HIV and STIs among male sex workers in Mexico City and the rationale for economic incentives to reduce risks. Journal of the International AIDS Society. 2014;17(1):19218 - 177. http://hdl.handle.net/11427/34539.en_ZA
dc.language.isoeng
dc.publisher.departmentDepartment of Psychiatry and Mental Health
dc.publisher.facultyFaculty of Health Sciences
dc.sourceJournal of the International AIDS Society
dc.source.journalissue1
dc.source.journalvolume17
dc.source.pagination19218 - 177
dc.source.urihttps://dx.doi.org/10.7448/IAS.17.1.19218
dc.subject.otherHIV/STI prevention
dc.subject.otherMexico
dc.subject.othercompensating differential
dc.subject.otherconditional cash transfer
dc.subject.otherconditional economic incentives
dc.subject.othermale sex workers
dc.subject.othermen who have sex with men
dc.subject.otherrisk premium
dc.subject.otherAdolescent
dc.subject.otherAdult
dc.subject.otherDisease Transmission, Infectious
dc.subject.otherHumans
dc.subject.otherMale
dc.subject.otherMexico
dc.subject.otherMotivation
dc.subject.otherRisk Assessment
dc.subject.otherRisk Reduction Behavior
dc.subject.otherSex Workers
dc.subject.otherSexually Transmitted Diseases
dc.subject.otherYoung Adult
dc.titleThe disproportionate burden of HIV and STIs among male sex workers in Mexico City and the rationale for economic incentives to reduce risks
dc.typeJournal Article
uct.type.publicationResearch
uct.type.resourceJournal Article
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