title: Male sex workers: practices, contexts, and vulnerabilities for HIV acquisition and transmission.
abstract: Male sex workers who sell or exchange sex for money or goods encompass a very diverse population across and within countries worldwide. Information characterising their practices, contexts where they live, and their needs is limited, because these individuals are generally included as a subset of larger studies focused on gay men and other men who have sex with men (MSM) or even female sex workers. Male sex workers, irrespective of their sexual orientation, mostly offer sex to men and rarely identify as sex workers, using local or international terms instead. Growing evidence indicates a sustained or increasing burden of HIV among some male sex workers within the context of the slowing global HIV pandemic. Several synergistic facilitators could be potentiating HIV acquisition and transmission among male sex workers, including biological, behavioural, and structural determinants. Criminalisation and intersectional stigmas of same-sex practices, commercial sex, and HIV all augment risk for HIV and sexually transmitted infections among male sex workers and reduce the likelihood of these people accessing essential services. These contexts, taken together with complex sexual networks among male sex workers, define this group as a key population underserved by current HIV prevention, treatment, and care services. Dedicated efforts are needed to make those services available for the sake of both public health and human rights. Evidence-based and human rights-affirming services dedicated specifically to male sex workers are needed to improve health outcomes for these men and the people within their sexual networks.
authors: Department of Epidemiology, Johns Hopkins School of Public Health, Baltimore, MD, USA. Electronic address: sbaral@jhu.edu.
authors: Stefan David
authors: SD
authors: Baral
authors: Department of Infectious Diseases and Microbiology, University of Pittsburgh, Pittsburgh, PA, USA.
authors: M Reuel
authors: MR
authors: Friedman
authors: Population Council, Washington, DC, USA.
authors: Scott
authors: S
authors: Geibel
authors: Anova Health Institute, Health4Men, Cape Town, South Africa.
authors: Kevin
authors: K
authors: Rebe
authors: STAR-STAR, Skopje, Macedonia.
authors: Borche
authors: B
authors: Bozhinov
authors: Enda Santé, Dakar, Senegal.
authors: Daouda
authors: D
authors: Diouf
authors: Epidemiology, UNAIDS, Geneva, Switzerland.
authors: Keith
authors: K
authors: Sabin
authors: Department of Epidemiology, Johns Hopkins School of Public Health, Baltimore, MD, USA.
authors: Claire E
authors: CE
authors: Holland
authors: National Skin Center, Singapore.
authors: Roy
authors: R
authors: Chan
authors: Cayetano Heredia University, Lima, Peru.
authors: Carlos F
authors: CF
authors: Cáceres
mesh_terms: D017280:Condoms / Q000706:statistics & numerical data*; D015658:HIV Infections / Q000453:epidemiology / Q000635:transmission*; D006297:Health Services Accessibility / Q000706:statistics & numerical data; D018451:Homosexuality, Male; D006801:Humans; D008297:Male; D012307:Risk Factors; D012309:Risk-Taking; D011477:Sex Work / Q000331:legislation & jurisprudence / Q000706:statistics & numerical data*; D060386:Sex Workers / Q000331:legislation & jurisprudence / Q000706:statistics & numerical data*; D057545:Social Stigma; D047568:Unsafe Sex / Q000706:statistics & numerical data*