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

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Abstract

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.

Resumen

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.

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Acknowledgements

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.

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Authors and Affiliations

  1. Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, RI, USA

    Pablo K. Valente, Matthew J. Mimiaga & Katie B. Biello

  2. Department of Epidemiology, Brown University School of Public Health, Providence, RI, USA

    Matthew J. Mimiaga & Katie B. Biello

  3. Center for Health Equity Research, Brown University School of Public Health, Box G-S121-8, Providence, RI, 02912, USA

    Matthew J. Mimiaga & Katie B. Biello

  4. Department of Psychiatry and Human Behavior, Brown University Alpert Medical School, Providence, RI, USA

    Matthew J. Mimiaga

  5. The Fenway Institute, Fenway Health, Boston, MA, USA

    Matthew J. Mimiaga, Kenneth H. Mayer & Katie B. Biello

  6. Department of Psychology, University of Miami, Coral Gables, FL, USA

    Steve A. Safren

  7. Division of Infectious Diseases, Beth Israel Deaconess Medical Center, Boston, MA, USA

    Kenneth H. Mayer

  8. Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA, USA

    Kenneth H. Mayer

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  1. Pablo K. Valente
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Valente, P.K., Mimiaga, M.J., Mayer, K.H. et al. Social Capital Moderates the Relationship Between Stigma and Sexual Risk Among Male Sex Workers in the US Northeast. AIDS Behav 24, 29–38 (2020). https://doi.org/10.1007/s10461-019-02692-5

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