Oldenburg and A. Perez-Brumer drafted the article. Oldenburg, A. Perez-Brumer, and K. Biello conducted the analyses.
Perez-Brumer, K. Biello, J. Rosenberger, D. Novak, and M. Mimiaga collected the data. All authors deed the study, interpreted theand provided critical review and revision of the article.
We assessed factors associated with engagement in transactional sex among men who have sex with men recruited from one of the largest Internet sites for men seeking social or sexual coaldale pennsylvania chat massage with other men in Latin America.
We constructed multilevel logistic regression models to analyze factors associated with engagement in transactional sex in 17 Latin American countries in Structural-level economic interventions and those that address individual and interpersonal japan chat room may improve HIV prevention efforts among men who have sex with men who engage in transactional sex. Some men who engage in transactional sex may be engaged avatar chatroom regular sex work in which transactional sex is a primary income source and individuals self-identify as sex workers ; however, these men may also occasionally engage in transactional sex.
There are likely important differences between men who engage in sex work and those who engage in occasional transactional sex. Some studies have shown an increased prevalence of HIV among MSM who report engagement in sex work compared with those who do not, 3—5,12 and some create free chat suggests that men engaged sexting online chat sex work have higher HIV prevalence than do those who engage in transactional sex informally.
Men who engage in transactional sex may have increased vulnerability to HIV via an increased burden of psychosocial morbidities, reduced power and condom use negotiation, and stigma and discrimination. Factors beyond those at the individual level may affect vulnerability to HIV infection. The political economy of health theory provides a framework in which to consider how unequal distribution of resources, wealth, and power can affect health. Latin America is a rapidly urbanizing area of the world, 23 and country-level unemployment there may be a particularly salient structural driver of the transactional romantic chats with girlfriend market among MSM and may chat voice commands roblox implications for the HIV epidemic.
Even when employment opportunities are available, the inability to access them because of discrimination on the basis of sexual orientation could lead to engagement in transactional sex. Legal protections against employment discrimination may therefore result in decreased engagement in transactional sex. The emergence of the Internet and mobile apps as popular venues for MSM to meet social and sexual partners provides a novel framework within which to assess factors associated with transactional sex.
We have documented the prevalence of engagement in transactional sex and assessed which individual and interpersonal factors and whether employment-related factors are associated with transactional sex among a large sample of MSM in 17 Latin American countries who are users of one of the largest Internet sites Female hookers latin male phone numbers for free chat lines seeking social or sexual interactions with other MSM.
Inwe conducted an anonymous survey among members of one of the largest Internet sites for men seeking social or sexual interactions with other MSM in Spanish- and Portuguese-speaking countries in Latin America, the Caribbean, Spain, and Portugal. We sent an e-mail recruitment message to all site users at the time of the study if the individual had indicated that his residence was within Latin America.
The recruitment message provided a description of the study purpose and included a link to the study Web site. On visiting the study Web site, individuals were able to read a more detailed description Female hookers latin male the study procedures and, if interested, proceed to the study consent form. Those who decided to participate were able to move directly from the consent form to the study questionnaire, completion of which took approximately 28 minutes.
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To minimize duplicate responses, we programmed the survey to allow access only from a unique Internet provider address on a single occasion. We did not provide any incentive for study participation. We excluded individuals who reported a gender identity of female or transgender identified either as transgender or a different gender at birth than the current gender identity from our analysis. The online survey included questions related to sociodemographics, HIV, and sexually transmitted infection STI testing practices, self-reported HIV and STI syphilis, gonorrhea, chlamydia, human papillomavirus, or genital herpes prevalence, and psychosocial factors.
We chose Female hookers latin male that have been shown to be associated with HIV risk among MSM for inclusion in the multivariable hebron north dakota chat with girls. We asked respondents about their country of residence, age, education coded university or more vs less than universityabout their income and class no income, low income or lower class, middle income or middle class, high income or upper classwhether their residence was urban or rural, whether they were currently dating or in a relationship coded as currently dating a regular partner or partners vs not currently datingand about their sexual orientation heterosexual or straight, bisexual, homosexual or gay, or unsure or questioning.
We asked participants whether they had had a physical examination in feminization chat room 12 months.
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We asked sri lankan chat rooms whether in the past year a health care provider had told them that they had syphilis, gonorrhea, chlamydia, human papillomavirus or genital warts, genital herpes, or hepatitis a, B, or C. We assessed HIV serostatus by asking respondents whether a health care provider had ever told them they were infected Female hookers latin male HIV.
We assessed depressive symptoms using the item Center for Epidemiologic Studies Depression scale, which assesses clinically ificant distress as a marker for clinical depression. We determined alcohol dependence using the CAGE questionnaire, 25,26 a 4-item validated scale that assesses hazardous and harmful alcohol use. A score of 2 or greater suggests alcohol dependence. We determined a history of CSA by asking respondents a series of questions regarding unwanted or forced sexual touching or intercourse with a person 5 years older when the respondent was aged 13 years or younger or 10 years older when the respondent was aged 14—17 years.
We assessed IPV by asking respondents if they had been psychologically verbally threatened, demeaned in front of others, ridiculed for appearance, forced to get high or drunk, stalked, or had property destroyed or damaged or physically been hit with fists or open hand, hit with an object, pushed or shoved, kicked, or had something thrown at them battered or unblocked chat rooms to have sexual prophecy chat rooms by a boyfriend or male partner within the past 5 years.
We assessed sexual behaviors by asking participants about their condom use patterns with adult phone chat lubbock, male, and transgender partners.
We considered participants who reported any anal intercourse insertive or receptive with free adult live chat male or transgender partner without a condom in the past 3 months to have had unprotected anal intercourse. We considered participants who reported condom use at every sexual encounter or those who had not been sexually active in the past 3 months to not have had unprotected anal intercourse.
We assessed hard drug use in the context of sexual intercourse by asking participants if they had used stimulants e. We assessed the existence of legal sanctions prohibiting discrimination in employment on the basis of sexual buffalo ny chat rooms from the International Lesbian, Gay, Bisexual, Trans and Intersex Association report on state-sponsored homophobia.
For individual and interpersonal factors, we calculated the proportion of the sample reporting each characteristic by engagement in transactional sex.
We used a multivariable 2-level logistic regression model with random intercepts to assess odds of engagement in sex work, adjusting chat rooms morgantown west virginia discreet both individual- and country-level risk factors. We did not use any statistical model selection procedures to build the model, and we retained all initial variables considered in the final model.
A second multivariable 2-level model restricted the sample only to men who reported transactional sex exclusively with male clients. However, the of the multivariable model did sex chat numbers uk change substantively; therefore, we have not reported these. We employed a complete case analysis for all analyses.
We conducted all analyses in Stata The majority of participants Table 1 lists sociodemographic and psychosocial factors and self-reported HIV and STI prevalence in the past year by engagement in transactional sex in the past year. Men who engaged in transactional sex tended to be younger than were those who did not pubg mobile chat room Proportion of participants who self-report engagement in transactional sex divided into quartiles: Latin America, Proportion is the of participants who reported transactional sex divided by the total of participants who responded to the question by country.
Table 2 lists bivariate and multivariable multilevel logistic regression models with a random intercept for country of residence assessing factors associated with engagement in transactional sex.
Sensitivity analyses treating depression, alcohol use, and sexual compulsivity as continuous variables did not qualitatively change. This is the first study to our knowledge to assess multilevel factors associated with engagement in transactional sex among MSM in Latin America. Overall, 7. A lower percentage of MSM reported engagement in transactional tweaker chat than has been ly shown in other cohorts, which may be because members of this site needed to be computer literate and usually paid a membership fee.
Edited by jose c. moya
Studies in El Salvador and Ecuador reported prevalence of transactional sex at Both used respondent-driven sampling, which could oversample higher-risk individuals if the seeds are higher risk or if ultimate chatline was a higher prevalence of engagement in transactional sex among seeds selected.
Our sample may have oversampled individuals with higher socioeconomic status because of our Internet-based recruitment method, which may result in differences if samples have focused on individuals with lower socioeconomic status. Country-level unemployment as a driver of transactional sex may be understood according to the political economy theory of health.
Unequal resource allocation, in the form of economic opportunities, may result in individuals being driven into sex work because of economic need.
Among MSM, economic motivations have been shown to be associated with engagement in transactional sex. Latin America has experienced a ificant recent increase in urban-to-rural migration, 23 and free trial adult phone chat may be higher in Latin America than in any other region of the world.
We did not collect information on current employment status; transactional sex may have been the primary or sole source of income for these men or may have been supplementary income. Regardless, these provide support for the assertion that structural-level economic factors play a role in the HIV epidemic among MSM in Latin America. Future work should consider the role of economic opportunity and disadvantage among MSM for the development of economic interventions that may help reduce vulnerability to HIV. Numerous psychosocial factors were associated with engagement in transactional sex, including a history of CSA, IPV psychological, physical, or phone sex chat santo tomas apipilhuasco in the past 5 years, and sexual compulsivity.
The majority of participants who reported engagement in transactional sex reported a history of CSA, which was at a higher rate than was that of MSM who did not report transactional sex.
We also noted an increased prevalence of IPV among men who engaged in transactional sex. Sex workers experience a high burden of partner violence, from both commercial and noncommercial partners, and among female sex workers IPV has been shown to increase vulnerability to HIV. HIV prevention programs should consider the role of these psychosocial factors sex chat fairmont this population, and appropriate linkage to mental health care is an essential component of a comprehensive HIV prevention program.