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Prevalence and Correlates of HIV and Sexually Transmitted Infections among Female Sex Workers and Their Non-commercial Male Partners in Two Mexico-USA Border Cities

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Abstract

Female sex workers (FSWs) acquire HIV and other sexually transmitted infections (STIs) through unprotected sex with commercial and non-commercial (intimate) male partners. Little research has focused on FSWs' intimate relationships, within which condom use is rare. We sought to determine the prevalence and correlates of HIV/STIs within FSWs' intimate relationships in Northern Mexico. From 2010 to 2011, we conducted a cross-sectional survey of FSWs and their non-commercial male partners in Tijuana and Ciudad Juárez, Mexico. Eligible FSWs and their verified male partners were aged ≥18 years; FSWs reported lifetime use of heroin, cocaine, crack, or methamphetamine and recently exchanged sex (past month). Participants completed baseline questionnaires and testing for HIV, chlamydia, gonorrhea, and syphilis. We determined the prevalence and correlates of individuals' HIV/STI positivity using bivariate probit regression. Among 212 couples (n = 424), prevalence of HIV was 2.6 % (n = 11). Forty-two (9.9 %) tested positive for any HIV/STIs, which was more prevalent among women than men (12.7 % vs. 7.1 %, p < 0.05). FSWs with regular sex work clients were less likely to test positive for HIV/STIs than those without regular clients. Similarly, male partners of FSWs who had regular clients were 9 % less likely to have HIV/STIs. Higher sexual decision-making power was protective against HIV/STIs for women. Men who recently used methamphetamine or reported perpetrating any conflict within steady relationships were more likely to test positive for HIV/STIs. Within FSWs' intimate relationships in two Mexican-US border cities, nearly one in ten partners tested positive for HIV/STIs. Couple-based prevention interventions should recognize how intimate relationship factors and social contexts influence HIV/STI vulnerability.

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Acknowledgments

Funding for this study was provided by the National Institutes of Health (NIH) grants R01DA027772, R36DA032376, T32AI007384, T32DA023356, and K01DA026307; the NIH had no further role in study design; in the collection, analysis and interpretation of data; in the writing of the report; or in the decision to submit the paper for publication. We thank the project staff and participants without whom this research would not be possible.

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Authors and Affiliations

  1. Department of Epidemiology, Harvard School of Public Health, 677 Huntington Avenue, Boston, MA, 02115, USA

    Angela M. Robertson

  2. The Fenway Institute, Fenway Health, 1340 Boylston Street, 8th Floor, Boston, MA, 02215, USA

    Angela M. Robertson

  3. Department of Anthropology, The Ohio State University, 4046 Smith Laboratory, 174 W. 18th Avenue, Columbus, OH, 43210, USA

    Jennifer L. Syvertsen

  4. Department of Psychiatry, University of California at San Diego, 9500 Gilman Drive, Mail Code 0603, La Jolla, CA, 92093-0603, USA

    Monica D. Ulibarri

  5. Department of Population Studies, El Colegio de La Frontera Norte, Carretera Escénica Tijuana-Ensenada, Km 18.5, San Antonio del Mar, 22560, Tijuana, Baja California, Mexico

    M. Gudelia Rangel

  6. Federación Mexicana de Asociaciones Privadas (FEMAP), Ave. Malecón No. 788 Col. Centro C.P., 32000, Ciudad Juárez, Chihuahua, Mexico

    Gustavo Martinez

  7. Division of Global Public Health, School of Medicine, University of California at San Diego, 9500 Gilman Drive, Mail Code 0507, La Jolla, CA, 92093-0507, USA

    Steffanie A. Strathdee

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  1. Angela M. Robertson
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Correspondence to Steffanie A. Strathdee.

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Robertson, A.M., Syvertsen, J.L., Ulibarri, M.D. et al. Prevalence and Correlates of HIV and Sexually Transmitted Infections among Female Sex Workers and Their Non-commercial Male Partners in Two Mexico-USA Border Cities. J Urban Health 91, 752–767 (2014). https://doi.org/10.1007/s11524-013-9855-2

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