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Incidence and predictors of HIV and sexually transmitted infections among high risk couples in Northern Mexico: a prospective, multilevel study . - PowerPoint PPT Presentation
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Incidence and predictors of HIV and sexually transmitted infections among high risk couples in Northern Mexico:
a prospective, multilevel study
Angela M Robertson, Gudelia Rangel, Gustavo Martinez, Monica D Ulibarri, Jennifer L Syvertsen, Samuel A Bazzi,
Scott Roesch, Heather A Pines, and Steffanie A Strathdee
IAS 2014, Melbourne, Australia
Funding: National Institutes of Health (NIH) grants R01 DA027772, R36 DA032376, T32 AI007384, T32 DA023356, K01 DA026307, and P30 AI060354-10 . Contact: [email protected]
Setting: Mexico-U.S. border
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Sex work is socially tolerated and quasi legal in many Mexican border cities; high HIV/STI risk among sex workers/clients
Cohort of Sex Workers & Intimate Partners• Proyecto Parejas: prospective mixed methods study of HIV/STIs
among 214 sex workers & their 214 intimate male partners (n=428) in Tijuana & Ciudad Juarez, Mexico – Most couples always had unprotected sex together; condoms used for sex work– Heavy current drug use (62% heroin, 54% stimulants, 62% injected any drugs)
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Findings Highlight Social/Economic Contexts of Risk
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Time-varying predictors of new STIs (w/o HIV):• Recent stimulant use
(meth, crack, cocaine) increases women’s risk (aOR: 2.13; CI: 1.07–4.28)
• Women having regular sex work clients decreased their male partners’ risk (aOR: 0.38; CI: 0.14–1.03)
Female Sex Workers
Intimate Male Partners
Incidence of all STIs among FSWs than their male partners
• Women who reported physically assaulting partners also had decreased risk (aOR: 0.44; CI: 0.22–0.86)
More research is needed to understand how conflict and sex work earnings impact couples’ risk
• Couple interventions to promote communication and reduce conflict are needed
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CONCLUSIONS Interventions that increase empowerment of sex workers (i.e., choice of clients, ability to avoid violence) may reduce their own HIV/STI incidence and that of their intimate male partners.
THANK YOU!
Acknowledgements: Proyecto Parejas study participants & staff; NIH grants R01DA027772, R36DA032376, T32AI007384,
T32DA023356, K01 DA026307, and P30 AI060354-10
Contact: Steffanie A Strathdee, PhD: [email protected]
Photos: O Loza, A Robertson, J Syvertsen, C Bava