Exchange Sex and HIV Risk among MSM Online

总结 对于从事交换性行为的男性（MSM）（即，提供性服务以换取 钱、毒品、住所或商品），同性恋勾搭应用程序和网站已经成为一个常见的聚会场所， 客户.此外，有人认为，这些新技术使男性性工作更安全， 匿名和正常化的同性恋社区，从而可能多样化和扩大数量的男男性接触者 参与交换性行为的人然而，这一人群的男男性接触者目前还没有得到很好的表征， 从公共卫生的角度来理解。这项研究的目的是调查一个研究不足的 人口-MSM谁使用连接应用程序/网站，以寻找客户交换性。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是非常有价值的。 减少战略。我们还将检查参与者的艾滋病毒和性病检测行为，以及他们对艾滋病毒和性病的态度。 制备型因为交换性行为在18-45岁的黑人、西班牙裔和白色男男性行为者中最为普遍，我们将 对180名未感染艾滋病毒的男男性行为者（60名黑人， 60名拉丁裔和60名白色参与者，其中一半年龄在18-29岁之间，另一半年龄在30-45岁之间）。更好地了解 与从事交换性行为的男性中的性风险相关的因素， 年龄和种族/族裔群体将只进行有保护的性行为（无论是持续使用避孕套还是持续使用 PrEP）和一半的人将与他们的客户进行无保护的肛交（没有采取PrEP的无避孕套性行为）， 前三个月本研究的目的是：1.为了调查参与者交换性行为的途径， 他们使用连接应用程序/网站来寻找和与客户谈判，以及他们如何评估不同的价值。 行为和合作伙伴。2.研究预防和降低风险的策略，包括PrEP和HIV， 性传播感染测试-参与者使用尝试管理成为艾滋病毒感染的风险和他们的原因， 选择. 3.为了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， 他们希望如何提供这些服务，然后利用调查结果制定临时干预措施， 男男性行为者中的性风险行为，他们使用连接应用程序/网站来寻找客户进行交换性行为。

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.