Exchange Sex and HIV Risk among MSM Online

摘要 对于与从事交换性行为的男性(MSM)发生性行为的男性(即，提供性行为以换取 金钱、毒品、住所或商品)、同性恋勾搭应用程序和网站已成为常见的会面场所 客户。此外，有人认为，这些新技术使男性性工作更安全、更 在同性恋社区中匿名和正常化，从而可能使MSM的数量多样化和扩大 参与互换性行为的人。然而，这一MSM群体目前还没有很好的特征或 从公共卫生的角度来理解。这项研究的目标是调查一项非常未被研究的 人口-使用勾搭应用程序/网站寻找性交客户的男男性接触者。拟议的研究将 在更好地描述这一人群及其性行为、风险行为和风险方面具有极其重要的价值 减量策略。我们还将检查参与者的艾滋病毒和性传播感染检测行为以及他们对 准备好了。由于交换性行为在18-45岁的黑人、西班牙裔和白人MSM中最为普遍，我们将 对180名未感染艾滋病毒的MSM(60名黑人， 60名拉丁裔和60名白人参与者，其中一半年龄在18-29岁之间，另一半年龄在30-45岁之间)。为了更好地理解 与男性交换性行为中的性风险相关的因素，每项中有一半的男性 年龄和种族/民族群体将只有保护性行为(要么一贯使用避孕套，要么始终如一地使用 有一半的人会与他们的客户发生无保护的肛交(无避孕套的性行为，而不是服用PrEP) 前三个月。这项研究的目的是：1.调查参与者进入交换性行为的途径，如何 他们使用勾搭应用程序/网站来寻找并与客户谈判，以及他们如何评估不同 演员和合伙人。2.研究启发式方法和减少风险的策略--包括预防接种计划和艾滋病毒以及 性传播感染检测-参与者用来尝试管理成为艾滋病毒感染的风险及其原因 选择。3.调查参与者认为哪些类型的艾滋病毒/性传播感染和性健康干预措施有用， 他们希望如何实现这些目标，然后利用调查结果制定临时干预措施，以减少 MSM中的性危险行为，他们使用勾搭应用程序/网站寻找交换性行为的客户。

Summary For men who have sex with men (MSM) who engage in exchange sex (i.e., offering sex in exchange for money, drugs, shelter, or goods), gay hookup apps and websites have become a common venue for meeting clients. Further, it has been argued that these new technologies have made male sex work safer, more anonymous and normalized in the gay community, thus likely diversifying and expanding the number of MSM who participate in exchange sex. However, this population of MSM is currently not well characterized or understood from a public health perspective. The goal of the study is to investigate a very under-studied population—MSM who use hookup apps/websites to find clients for exchange sex. The proposed research will be extremely valuable in better characterizing this population and its sexual practices, risk behavior, and risk reduction strategies. We will also examine participants’ HIV and STI testing behavior and their attitudes toward PrEP. Because exchange sex is most prevalent among Black, Hispanic, and White MSM ages 18–45, we will conduct in-depth qualitative interviews with an ethnically diverse sample of 180 HIV-uninfected MSM (60 Black, 60 Latino, and 60 White participants, half of them ages 18–29 and half 30–45). To better understand the factors associated with sexual risk taking among men who engage in exchange sex, half of the men in each age and racial/ethnic group will have only had protected sex (either consistent condom use or consistent use of PrEP) and half will have had unprotected anal sex (condomless sex without taking PrEP) with their clients in the prior three months. The study aims are: 1. To investigate participants’ pathways into exchange sex, how they use hookup apps/websites to find and negotiate with clients, and how they evaluate the worth of different acts and partners. 2. To investigate the heuristics and risk-reduction strategies—including PrEP and HIV and STI testing—participants use to try to manage the risks of becoming HIV infected and their reasons for their choices. 3. To investigate what types of HIV/STI and sexual health interventions participants would find useful, how they would like these delivered, and then, use findings to develop a provisional intervention to reduce sexual-risk behavior among MSM who use hookup apps/websites to find clients for exchange sex.