HIV Insight: Sex with Sex Workers among Latino Day Laborers in Suburban Maryland

Using the structural-environmental conceptual framework, this study employed mixed methods to address the question of whether sex with female sex workers contributes to HIV risk among male immigrant Latino day laborers in suburban Maryland. Because contextual factors can greatly affect HIV risk for both sex workers and their clients, this study investigated the organizational structure of sex work, factors that predicted men’s hiring of sex workers, sexual behaviors performed with sex workers, and the use of condoms.

Qualitative research was conducted to inform the development of a quantitative survey, but also provided crucial descriptions about the motivations, locations, arrangements, and sexual activities related to sex work. Key informant interviews (N= 10), in-depth interviews with day laborers (N= 10) and Latina female sex workers (N = 4), and two focus groups with day laborers (N= 11) were conducted, and a quantitative survey administered via Audio-enhanced Computer-assisted Self-interviewing (N = 174).

Condom use was nearly universal in encounters with female sex workers, thus indicating that the sex workers were not an important source of HIV transmission in this context. Logistic regression was performed to test a model predicting sex with sex workers. Latino day laborers who reported more immigrant stress and who did not have a partner in the U.S. were more likely to have had sex with a sex worker, as were men who reported binge drinking. Structural and social conditions influenced the hiring of sex workers.

Further research is warranted to better understand the interrelationships among these circumstances and to inform the development of programs to address them.

Experiences of Latino day laborers with sex workers

	Percent
Ways men find sex workers (N= 174)
Sex workers give out business cards	59.2
Friends tell each other	50.6
Pimp approaches potential clients	33.3
Internet	18.4
Sex workers are in public places (e.g., street corner)	14.9
Locations where men have sex with sex workers (N= 174)
House or apartment (“delivery”)	58.1
Brothel (“casa de sitas”)	36.8
Hotel or motel	28.7
Street, car, or park	19.0
Bar, discotheque, restaurant	16.7
Reasons participants had sex with sex workers (N= 52)
Lack of companionship	65.4
Relief from sexual urges	55.8
No commitment	51.9
Only sex available	40.4
Fun and pleasure	36.5
Distraction from problems	17.3
Sexual behaviors participants performed with sex workers (N= 52)
Vaginal intercourse	76.9
Oral sex on the participant	59.6
Manual stimulation of penis	34.6
Anal intercourse	9.6
Oral sex on the woman	3.9