Mentored Scientist Award

HIV and STI prevention practices among in-person and digital male sex workers who have sex with men (MSMSW) in the United States

Headshot of Kristopher Jackson, PhD, RN
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Award amount - Direct


Male sex workers who have sex with men (MSMSW) are under-represented in most contemporary HIV prevention research efforts. While MSMSW face unique challenges and occupational risk factors as a result of their work, there is a dearth of current literature describing the uptake of HIV and STI prevention services in the form of HIV pre-exposure prophylaxis (PrEP) and/or STI chemoprophylaxis (e.g., DoxyPEP/DoxyPrEP) among MSMSW. Further, MSMSW are not a monolithic group. While the archetypal sex worker typically provides in-person sexual companionship, digital sex work is now a multi-billion-dollar global industry. While some digital sex workers sell subscribers images or videos of themselves involved in solo sex acts, others engage in live sex acts with partners. Among U.S. MSM, patterns of PrEP uptake are impacted by a variety of factors, including: sociodemographic factors, geography, and provider availability and/or willingness. It is possible these patterns may extend to MSMSW, but there have been no large-scale studies describing PrEP and/or DoxyPEP/DoxyPrEP uptake among in-person nor digital MSMSW. This pilot study, as proposed, will address a significant gap in the contemporary HIV prevention literature. The aims of the study are to: 1) elucidate between group difference(s) in the use of PrEP and STI chemoprophylaxis among MSM who engage in in-person sex work and digital sex work in the U.S. and 2) describe the association between sociodemographic factors and effects of stigma (e.g. perceived PrEP stigma, sexual behavior stigma) and PrEP use among U.S. MSM who engage in inperson sex work and digital sex work. Understanding the needs of the MSMSW community is crucial to understanding the nuanced dynamics influencing HIV transmission and the uptake of HIV/STI prevention among in-person and digital sex workers. This study has the potential to inform future intervention trials aimed at increasing HIV/STI prevention measures among vulnerable populations of MSMSW.