Transactional sex, HIV and health among young cisgender men and transgender women who have sex with men in Thailand

• Type of Material: Article
• Authors: Patrick Sullivan, Emory University; BW Weir, Johns Hopkins Bloomberg School of Public Health; C Dun, Johns Hopkins Bloomberg School of Public Health; AL Wirtz, Johns Hopkins Bloomberg School of Public Health; SHH Mon, Johns Hopkins Bloomberg School of Public Health; N Qaragholi, Johns Hopkins Bloomberg School of Public Health; T Chemnasiri, Centers for Disease Control and Prevention, Atlanta; S Pattanasin, Centers for Disease Control and Prevention, Atlanta; W Sukwicha, Centers for Disease Control and Prevention, Atlanta; A Varangrat, Centers for Disease Control and Prevention, Atlanta; EF Dunne, Centers for Disease Control and Prevention, Atlanta; TH Holtz, Centers for Disease Control and Prevention, Atlanta; S Janyam, Service Workers in Group Foundation (SWING); H Jin, Johns Hopkins Bloomberg School of Public Health; D Linjongrat, Rainbow Sky Association of Thailand (RSAT); PA Mock, Thailand Ministry of Public Health-U.S. Centers for Disease Control and Prevention Collaboration; MC Thigpen, US Ctr Dis Control & Prevent; JF Rooney, Gilead Sciences; AC Hickey, U.S. Centers for Disease Control and Prevention, Atlanta; P Sirivongrangson, Thailand Ministry of Public Health-U.S. Centers for Disease Control and Prevention Collaboration; C Beyrer, Johns Hopkins Bloomberg School of Public Health
• Language: English
• Date: 2022-05-25
• Publisher: ELSEVIER SCIENCE INC
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: © 2022 The Author(s). Published by Elsevier Inc.
• License: Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.1016/j.annepidem.2022.03.012
• Title of Journal or Parent Work: ANNALS OF EPIDEMIOLOGY
• Volume: 72
• Start Page: 1
• End Page: 8
• Keywords: MSM; COHORT; BRIEF SCREEN; Global Health; Thailand; Life Sciences & Biomedicine; Public health; Transgender persons; Public, Environmental & Occupational Health; HIV; BANGKOK; Prevention; Science & Technology; Epidemiology; Pre-Exposure Prophylaxis; RISK; Sex work

Abstract

PURPOSE: To examine how recent sex work is identified and the HIV risk factors and service needs among Thai cisgender men who have sex with men (MSM) and transgender women (TGW) who exchange sex. METHODS: MSM and TGW in Bangkok and Pattaya who exchanged sex in the last year (n = 890) were recruited through social media, outreach, and word-of-mouth. Recent sex exchange was based on the primary question, "In the last 30 days, have you sold or traded sex"; secondary questions (regarding income source and client encounters) were also investigated. RESULTS: Overall, 436 (48%) participants engaged in sex work in the last 30 days; among those, 270 (62%) reported exchanging sex by the primary question, and 160 (37%) based on secondary questions only. Recent sex exchange was associated with gonorrhea, syphilis, discussing PrEP with others, and using condoms, alcohol, methamphetamine, amyl nitrate, and Viagra. Exchanging sex based on secondary questions only was associated with being in a relationship, social media recruitment, less recent anal intercourse, and not discussing PrEP. CONCLUSIONS: Thai MSM and TGW who exchange sex need regular access to HIV/STI prevention, testing, and treatment services, and multiple approaches to assessing sex work will help identify and serve this diverse and dynamic population.