AIDS and Behavior

, Volume 24, Issue 1, pp 29–38 | Cite as

Social Capital Moderates the Relationship Between Stigma and Sexual Risk Among Male Sex Workers in the US Northeast

  • Pablo K. Valente
  • Matthew J. Mimiaga
  • Kenneth H. Mayer
  • Steve A. Safren
  • Katie B. BielloEmail author
Original Paper


Stigma contributes to elevated HIV incidence among male sex workers (MSW). Social capital (i.e., resources accessed through one’s social relationships) may act as a buffer between stigma and sexual risk behaviors and HIV acquisition. Using negative binomial regression, we examined the association between both sex work-related stigma and social capital with respect to number of condomless sex acts among 98 MSW living in the US Northeast. In models adjusted for sociodemographic characteristics, sex work-related stigma was associated with number of condomless sex acts with any non-paying partner (i.e., male and female) (aIRR = 1.25, p < 0.001) and male non-paying partners (aIRR = 1.27, p = 0.09) among individuals with low social capital, not among those with high social capital. Sex work-related stigma was not associated with number of condomless anal sex acts with male paying clients at any level of social capital. Future HIV prevention interventions should consider promoting social capital among MSW.


HIV/AIDS Male sex workers Men who have sex with men Social capital Stigma 


El estigma contribuye al gran número de casos de VIH entre hombres trabajadores sexuales (HTS). El capital social (es decir, los recursos disponibles a través de relaciones sociales) puede actuar como un moderador de la asociación entre el estigma y comportamientos de riesgo sexual y transmisión del VIH. Utilizamos regresión binomial negativa para examinar las asociaciónes entre el estigma asociado al trabajo sexual, y el capital social, con la cantidad de actos sexuales sin condón entre 98 HTS en el Nordeste de Estados Unidos. En nuestros modelos ajustados por variables socioeconómicas y demográficas, el estigma asociado al trabajo sexual era asociado al número de actos sexuales sin condón con parejas no comerciales femeninas o masculinas (tasa de incidencia ajustada, TIa = 1.25, p < 0.001) y con parejas no comerciales masculinas (TIa = 1.27, p = 0.09) solamente entre las personas con bajo capital social, pero no entre aquellos con alto capital social. El estigma asociado al trabajo sexual no era asociado con el número de actos sexuales sin condón con parejas pagantes a cualquier nivel de capital social. Futuras intervenciones de prevención del VIH deben promover el capital social entre los HTS.

Palabras clave

VIH Hombres trabajadores sexuales Hombres que tienen sexo con hombres Capital social Estigma 



The authors would like to thank the participants and research staff for their contribution to this study and Alberto Edeza and Naiane Lomes for translating the abstract into Spanish. This work was supported by the National Institute on Drug Abuse of the National Institutes of Health (R21DA035113; PI: Biello/Mimiaga). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. The work described in this manuscript was presented at the AIDSImpact conference in London, UK, July 29–31, 2019. This manuscript has not been published previously, nor is it being considered for publication elsewhere.

Compliance with Ethical Standards

Conflict of Interest

The authors declare that they have no conflict of interest.

Ethical Approval

The Institutional Review Boards at Fenway Health approved the study.

Informed Consent

All participants underwent informed consent process. Written informed consent was obtained from all participants.


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Authors and Affiliations

  1. 1.Department of Behavioral and Social SciencesBrown University School of Public HealthProvidenceUSA
  2. 2.Department of EpidemiologyBrown University School of Public HealthProvidenceUSA
  3. 3.Center for Health Equity ResearchBrown University School of Public HealthProvidenceUSA
  4. 4.Department of Psychiatry and Human BehaviorBrown University Alpert Medical SchoolProvidenceUSA
  5. 5.The Fenway InstituteFenway HealthBostonUSA
  6. 6.Department of PsychologyUniversity of MiamiCoral GablesUSA
  7. 7.Division of Infectious DiseasesBeth Israel Deaconess Medical CenterBostonUSA
  8. 8.Department of Global Health and PopulationHarvard T.H. Chan School of Public HealthBostonUSA

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