Highlighting risk contexts differences among male, female and transgender sex workers: evidence from Mexico
Background: Sex work is widespread and diverse in Mexico. HIV prevalence varies greatly between male (15.1%) and female sex workers (1.0%)(Gayet-et-al.,2007), there is no data available for transgender sex workers in Mexico. Despite these differences, there is a lack of comparative studies about different categories of sex workers: female (FSW), male (MSW) and transgender sex workers (TSW). This study aims to identify the risk contexts for each category of sex workers, which impede them to have protected sexual practices. The findings will guide the design of more targeted prevention strategies.
Methods: From January to May 2007 six triads were conducted with FSW, 15 semi-structured interviews with 15 MSW, and 15 interviews with TSW in Mexico City. Topics included life conditions, discrimination experiences, social capital, attitudes toward HIV, and health needs. A content analysis was developed. Emerging topics were trajectories in commercial sex, steady partners’ relationships and familiar background.
Results: Common barriers to condom use among all groups were low self esteem, lack of social networks, drug use and poverty. There were unique barriers identified for each category of sex worker: for FSW, a perception of not having control of their lives; for MSW keeping their sex work secret; and for TSW, recurrent discrimination experiences. These factors and negative experiences in clinics and hospitals generate among sex workers a perception of distrust and uselessness of institutionalized services, impeding sex workers’ search for information about HIV-STI and access to health care.
Conclusions: These findings demonstrate the need to design more targeted campaigns for different categories of sex workers. In order to maximize campaign effectiveness for FSW, messages should focus on autonomy and control over their bodies. MSW programs should provide personalized support to guarantee confidentiality. TSW interventions should attempt to reduce the experience of discrimination in health services and to promote specialized services according to their specific needs.
-Abstract available at link below-