| Autor: |
Sönmez I; Centre d'Estudis Epidemiològics sobre les ITS i Sida de Catalunya (CEEISCAT), Badalona, Spain; and Germans Trias i Pujol Research Institute (IGTP), Badalona, Spain., Lorente N; Centre d'Estudis Epidemiològics sobre les ITS i Sida de Catalunya (CEEISCAT), Badalona, Spain; and Community-Based Research Laboratory, Coalition PLUS, Pantin, France; and CIBER Epidemiologia y Salud Pública (CIBERESP), Madrid, Spain., Mesías-Gazmuri J; Centre d'Estudis Epidemiològics sobre les ITS i Sida de Catalunya (CEEISCAT), Badalona, Spain; and Germans Trias i Pujol Research Institute (IGTP), Badalona, Spain; and Doctorat Metodologia de la Recerca Biomèdica i Salut Publica, Universitat Autònoma de Barcelona, Bellaterra, Spain., Schmidt AJ; Sigma Research, Department of Public Health, Environments and Society, London School of Hygiene and Tropical Medicine, London, UK., Jonas KJ; Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, The Netherlands., Stuardo Avila V; Institute of Public Health, Universidad Andrés Bello, Santiago de Chile, Chile., Marcus U; Robert Koch Institut, Berlin, Germany., Veras MA; Santa Casa de São Paulo School of Medical Sciences, São Paulo, Brazil., Casabona Barbarà J; Centre d'Estudis Epidemiològics sobre les ITS i Sida de Catalunya (CEEISCAT), Badalona, Spain; and Germans Trias i Pujol Research Institute (IGTP), Badalona, Spain., Folch C; Centre d'Estudis Epidemiològics sobre les ITS i Sida de Catalunya (CEEISCAT), Badalona, Spain; and Germans Trias i Pujol Research Institute (IGTP), Badalona, Spain; and CIBER Epidemiologia y Salud Pública (CIBERESP), Madrid, Spain. |
| Abstrakt: |
Background In Latin American countries and Suriname, sexual transmission is one of the most common modes of HIV transmission, and men who have sex with men (MSM) who engage in sex work constitute a key population. Methods In a sample of MSM (N =53,166) from the Latin American Internet Survey (2018) across 18 countries, we examined how sex work engagement is associated with syndemic conditions (multidrug use, homophobic abuse, depression/anxiety, alcohol dependency (CAGE alcohol questionnaire) and internalised homonegativity) and condomless anal intercourse with non-steady male partners using separate logistic regressions. We then used a structural equation model to determine if and how syndemic conditions mediate the relationship between sex work engagement and non-steady male partners. Results We found that getting paid for sex was associated with less condom use for anal intercourse with non-steady male partners and particular syndemic conditions, such as multidrug use, homophobic abuse and alcohol dependency. In our structural equation model, the results showed that the direct relationship between sex work engagement and non-steady male partners was positive and significant, and syndemic conditions partially mediated this relationship. Conclusion Our results highlight the continuing need for including MSM who engage in sex work and those who experience syndemic conditions in the prevention strategies targeted to MSM in Latin America and Suriname, to prevent the transmission of HIV. |
