Abstract
Introduction: Male sex workers are at high-risk for acquisition of sexually transmitted infections, including human immunodeficiency virus. We quantified incidence rates of sexually transmitted infections and identified their time-varying predictors among male sex workers in Mexico City.
Methods: Male sex workers recruited from the largest human immunodeficiency virus clinic and community sites in Mexico City were tested for chlamydia, gonorrhea, syphilis, hepatitis, and human immunodeficiency virus at baseline, 6-months, and 12-months. Incidence rates with 95% bootstrapped confidence limits were calculated. We examined potential time-varying predictors using generalized estimating equations for a population averaged model. Results and Discussion: Among 227 male sex workers, median age was 24 and baseline human immunodeficiency virus prevalence was 32%. Incidence rates (per 100 person-years) were as follows: human immunodeficiency virus (5.23; 95% confidence interval [CI]: 2.15, 10.31), chlamydia (5.15; 95% CI: 2.58, 9.34), gonorrhea (3.93; 95% CI: 1.88, 7.83), syphilis (13.04; 95% CI: 8.24, 19.94), hepatitis B (2.11; 95% CI: 0.53, 4.89), hepatitis C (0.95; 95% CI: 0.00, 3.16), any sexually transmitted infection except human immunodeficiency virus (30.99; 95% CI: 21.73, 40.26), and any sexually transmitted infection including human immunodeficiency virus (50.08; 95% CI: 37.60, 62.55). In the multivariable-adjusted model, incident sexually transmitted infections (excluding human immunodeficiency virus) were lower among those who reported consistently using condoms during anal and vaginal intercourse (odds ratio = 0.03, 95% 0.00, 0.68) compared to those who reported inconsistently using condoms during anal and vaginal intercourse. Conclusions: Incidence of sexually transmitted infections is high among male sex workers in Mexico City. Consistent condom use is an important protective factor for sexually transmitted infections, and should be an important component of interventions to prevent incident infections.
Focused Peer-Mediated Educational Programs Among Female Sex Workers To Reduce Sexually Transmitted Disease And Human Immunodeficiency Virus Transmission In Kenya And Zimbabwe