Transactional Sex & Prevalence of STIs: A Cross-Sectional Study of MSM & Transwomen Screened for an HIV Prevention Trial

Few studies have characterised the degree of engagement in transactional sex among men and transgender women who have sex with men and explored its association with sexually transmitted infections and human immunodeficiency virus in Ecuador.

We screened 642 men who have sex with men and transgender women for a pre-exposure prophylaxis clinical trial (iPrEx) in Guayaquil, Ecuador, 2007-2009. We analysed the association of degree of engagement in transactional sex and prevalence of sexually transmitted infections including human immunodeficiency virus using chi-square and analysis of variance tests. 

• Although just 6.2% of those who screened self-identified as sex workers, 52.1% reported having engaged in transactional sex. 
• Compared to those who had never been paid for sex, those who had been paid were more likely to have a sexually transmitted infection (56.6% vs. 45.0%) and trended towards a higher HIV prevalence (16.6% vs. 10.4%) at screening. 
• Transgender women compared to other men who have sex with men were more likely to have STIs diagnosed at screening (75.6% vs. 50.0%).

 Transactional sex is practiced widely but occasionally among the men who have sex with men and transgender women in Guayaquil who screened for the iPrEx study; however, engaging in transactional sex may not lead to a sex worker self-identification. Both transactional sex and being a transgender woman are associated with sexually transmitted infections prevalence.

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By: Solomon MM1, Nureña CR2, Tanur JM3, Montoya O4, Grant RM5, Jeff McConnell J6.

• 1Department of Medicine, University of California, CA, USA Gladstone Institutes, CA, USA marc.solomon@ucsf.edu.
• 2Escuela de Antropología, Universidad Nacional Mayor de San Marcos, Perú
• 3Department of Sociology, Stony Brook University, Stony Brook, NY, USA.
• 4Fundación Ecuatoriana Equidad, Ecuador.
• 5Department of Medicine, University of California, CA, USA Gladstone Institutes, CA, USA.
• 6Gladstone Institutes, CA, USA. 

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