title: "We Might Get Some Free Beers": Experience and Motivation for Transactional Sex Among Behaviorally Bisexual Men in Vientiane, Laos.
abstract: People engaging in transactional sex are considered a key population for HIV prevention. Prior quantitative surveys demonstrated that behaviorally bisexual men in Vientiane, Laos commonly transact sex. In 2013, we conducted a qualitative study to explore behaviorally bisexual men's experience, motivations, and perceptions related to transactional sex in Vientiane. Behaviorally bisexual men were recruited from bars, nightclubs, and dormitories for five focus group discussions (FGDs) and 11 in-depth interviews (n = 31). Additionally, young women were recruited from a university, garment factory, and nightclub for four FGDs (n = 22). Transcripts were translated and thematically coded. Bisexual male participants most commonly described being paid for sex by male-to-female transgender people and buying sex from women. Both male and female participants reported that older, single women pay younger men for sex. Negotiation and direction of sexual transactions are influenced by age, attraction, and wealth. Common motivations for selling sex included the need for money to support family or fund school fees, material gain, or physical pleasure. Transactional sex was often opportunistic. Some behaviorally bisexual men reported selling sex in order to pay another more desirable sex partner or to buy gifts for their regular sex partner. Participants perceived high risk associated with intercourse with female sex workers but not with other transactional sex partners. Health interventions are needed to improve knowledge, risk perception, and health behaviors, but must recognize the diversity of transactional sex in Vientiane. Both physical and virtual settings may be appropriate for reaching behaviorally bisexual men and their partners.
authors.affiliation: Centre for Population Health, Burnet Institute, 85 Commercial Rd., Melbourne, VIC, 3004, Australia. annab@burnet.edu.au.|Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia. annab@burnet.edu.au.
authors.forename: Anna L
authors.initials: AL
authors.lastname: Bowring
authors.affiliation: Burnet Institute, Vientiane, Lao PDR.
authors.forename: Nakhornphet
authors.initials: N
authors.lastname: Pasomsouk
authors.affiliation: Centre for International Health, Burnet Institute, Melbourne, Australia.
authors.forename: Chad
authors.initials: C
authors.lastname: Hughes
authors.affiliation: Centre for Population Health, Burnet Institute, 85 Commercial Rd., Melbourne, VIC, 3004, Australia.|Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia.
authors.forename: Caroline
authors.initials: C
authors.lastname: van Gemert
authors.affiliation: Centre for Population Health, Burnet Institute, 85 Commercial Rd., Melbourne, VIC, 3004, Australia.|Faculty of Health Sciences, National Drug Research Institute, Curtin University, Fitzroy, Melbourne, Australia.
authors.forename: Peter
authors.initials: P
authors.lastname: Higgs
authors.affiliation: Faculty of Postgraduate Studies, University of Health Sciences, Vientiane, Lao PDR.
authors.forename: Vanphanom
authors.initials: V
authors.lastname: Sychareun
authors.affiliation: Centre for Population Health, Burnet Institute, 85 Commercial Rd., Melbourne, VIC, 3004, Australia.|Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia.
authors.forename: Margaret
authors.initials: M
authors.lastname: Hellard
authors.affiliation: Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia.|Centre for International Health, Burnet Institute, Melbourne, Australia.|Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia.
authors.forename: Robert
authors.initials: R
authors.lastname: Power
mesh_terms: D000293:Adolescent; D000328:Adult; D001727:Bisexuality / Q000523:psychology / Q000706:statistics & numerical data; D006801:Humans; D007812:Laos / Q000453:epidemiology; D008297:Male; D009042:Motivation; D060386:Sex Workers / Q000523:psychology / Q000706:statistics & numerical data; D012725:Sexual Behavior / Q000523:psychology / Q000706:statistics & numerical data; D055815:Young Adult
keywords: Bisexuality; HIV prevention; Laos; Men who have sex with men; Sexual behavior; Transactional sex