Henrique Pereira, Ines Goncalves, Isabel Borges, Justino Filho, Natalia Cerqueira and Maria Eugenia Saraiva
Background: HIV transmission among men who have sex with men (MSM) is a major concern in Portugal. Little is known, however, about HIV transmission among male sex workers (MSW) who have sex with male clients. This study aimed to investigate the prevalence of HIV infection and risk behaviors among MSW in Lisbon, Portugal. Materials and Methods: A cross-sectional study was conducted using outreach sampling among MSW in Lisbon. Behavioral and serological data on HIV was collected. Results: In total, 143 MSW were recruited for the survey (mean age=28.26, SD=5.96). The prevalence of HIV among these workers was 8.4%. 86% of the MSW self-identified as gay or bisexual. More than 75% were Brazilian immigrants, and 94.4% worked indoors (apartments). Consistent condom use was high (95%) for anal sex with clients, but much lower (63.6%) for anal sex with partners. In addition, 21.7% had not been tested for HIV in the previous year. Self-identified gay MSW had been tested for HIV more often in the previous year than self-identified bisexual or heterosexual MSW (p=0.020). This was also the case with MSW who said that they were versatile (p=0.026), when compared with men who said that they had receptive or insertive anal intercourse. The data suggests that the most salient risks for MSW include professional isolation, inconsistent HIV testing, limited perceived HIV risk, and suboptimal levels of condom use in sexual relationships with partners.
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