title: Transactional sex among men who have sex with men in Latin America: economic, sociodemographic, and psychosocial factors.
abstract: OBJECTIVE
  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 interactions with other men in Latin America.
  
  
  METHODS
  We constructed multilevel logistic regression models to analyze factors associated with engagement in transactional sex in 17 Latin American countries in 2012.
  
  
  RESULTS
  Of 24 051 respondents, 1732 (7.2%) reported being paid for sexual intercourse in the past 12 months. In a multivariable model, higher country-level unemployment was associated with increased odds of transactional sex (adjusted odds ratio [AOR] = 1.07 per 1% increase in unemployment; 95% confidence interval [CI] = 1.00, 1.13). Individual or interpersonal factors associated with increased odds of engagement in transactional sex included self-reported HIV (AOR = 1.33; 95% CI = 1.04, 1.69) or sexually transmitted infection (AOR = 1.33; 95% CI = 1.11, 1.59), childhood sexual abuse history (AOR = 1.75; 95% CI = 1.48, 2.06), intimate partner violence (past 5 years, AOR = 1.68; 95% CI = 1.45, 1.95), and sexual compulsivity (AOR = 1.77; 95% CI = 1.49, 2.11).
  
  
  CONCLUSIONS
  Structural-level economic interventions and those that address individual and interpersonal factors may improve HIV prevention efforts among men who have sex with men who engage in transactional sex.
authors: Catherine E. Oldenburg is with the Department of Epidemiology, Harvard School of Public Health, Boston, MA. Amaya G. Perez-Brumer is with the Department of Sociomedical Sciences, Columbia University, New York, NY. Katie B. Biello and Kenneth H. Mayer are with the Fenway Institute, Fenway Health, Boston, MA. Stewart J. Landers is with John Snow, Inc., Boston, MA. Joshua G. Rosenberger is with the Department of Global and Community Health, George Mason University, Fairfax, VA. David S. Novak is with the OLB Research Institute, Online Buddies, Inc., Cambridge, MA. Matthew J. Mimiaga is with the Department of Psychiatry, Massachusetts General Hospital, Boston.
authors: Catherine E
authors: CE
authors: Oldenburg
authors: Amaya G
authors: AG
authors: Perez-Brumer
authors: Katie B
authors: KB
authors: Biello
authors: Stewart J
authors: SJ
authors: Landers
authors: Joshua G
authors: JG
authors: Rosenberger
authors: David S
authors: DS
authors: Novak
authors: Kenneth H
authors: KH
authors: Mayer
authors: Matthew J
authors: MJ
authors: Mimiaga
mesh_terms: D000328:Adult; D054523:Adult Survivors of Child Abuse / Q000706:statistics & numerical data; D000367:Age Factors; D015658:HIV Infections / Q000175:diagnosis / Q000453:epidemiology; D018451:Homosexuality, Male / Q000706:statistics & numerical data*; D006801:Humans; D020407:Internet; D007398:Interpersonal Relations; D007843:Latin America / Q000453:epidemiology; D008297:Male; D012111:Residence Characteristics / Q000706:statistics & numerical data; D012725:Sexual Behavior / Q000706:statistics & numerical data; D012749:Sexually Transmitted Diseases / Q000175:diagnosis / Q000453:epidemiology*; D012959:Socioeconomic Factors; D014505:Urban Population / Q000706:statistics & numerical data