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Transactional Sex and the HIV Epidemic Among Men Who have Sex with Men (MSM): Results From a Systematic Review and Meta-analysis

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Abstract

Engagement in transactional sex has been hypothesized to increase risk of HIV among MSM, however conflicting evidence exists. We conducted a systematic review and meta-analysis comparing HIV prevalence among MSM who engaged in transactional sex to those who did not (33 studies in 17 countries; n = 78,112 MSM). Overall, transactional sex was associated with a significant elevation in HIV prevalence (OR 1.34, 95 % CI 1.11–1.62). Latin America (OR 2.28, 95 % CI 1.87–2.78) and Sub-Saharan Africa (OR 1.72, 95 % CI 1.02–2.91) were the only regions where this elevation was noted. Further research is needed to understand factors associated with sex work and subsequent HIV risk in Latin America and Sub-Saharan Africa.

Resumen

La participación en el sexo transaccional ha sido un hipótesispor la cual el riesgo de VIH esta aumentado entre los HSH, sin embargo evidencia contradictoria existe. Se realizó una revisión sistemática y meta-análisis para comparar la prevalencia del VIH entre los HSH que reportaron sexo transaccional comparado a los que no lo (33 estudios en 17 países; n = 78,112 HSH). En total, el sexo transaccional fue asociado con un aumento significativo en la prevalencia del VIH (OR = 1.34; 95 % CI = 1.11-1.62). América Latina (OR = 2.28; 95 % CI = 1.87-2.78) y África Subsahariana (OR = 1,72; 95 % CI = 1.02-2.91) fueron las únicas regiones en que se observó esta elevación. Se necesitan más investigaciones para mejor entender los factores asociados con el trabajo sexual y riesgo subsiguiente para el VIH en América Latina y en África subsahariana.

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Acknowledgments

CEO is supported by a National Institute of Allergy and Infectious Disease T32 NRSA Grant (T32AI007535; PI: Seage) and a National Institute on Drug Abuse T32 NRSA Grant (T32DA013911; PI: Flanigan). APB is supported by a Eunice Kennedy Shriver National Institute of Child Health & Human Development T32 NRSA Grant (T32HD049339; PI: Nathanson). Support for this work came from the National Institutes of Health.

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Authors and Affiliations

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

    Catherine E. Oldenburg, Sari L. Reisner & Matthew J. Mimiaga

  2. Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, New York, NY, USA

    Amaya G. Perez-Brumer

  3. The Fenway Institute, Fenway Community Health, Boston, MA, USA

    Sari L. Reisner & Matthew J. Mimiaga

  4. Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA

    Matthew J. Mimiaga

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  1. Catherine E. Oldenburg
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  2. Amaya G. Perez-Brumer
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  3. Sari L. Reisner
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  4. Matthew J. Mimiaga
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Correspondence to Catherine E. Oldenburg.

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Oldenburg, C.E., Perez-Brumer, A.G., Reisner, S.L. et al. Transactional Sex and the HIV Epidemic Among Men Who have Sex with Men (MSM): Results From a Systematic Review and Meta-analysis. AIDS Behav 19, 2177–2183 (2015). https://doi.org/10.1007/s10461-015-1010-5

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