Study Models Ways to Cut Mexico's HIV Rates in Male-to-Male Sex Trade
Medical Xpress
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November 21, 2014
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A model shows how incidence of HIV infection among partners of male sex workers could be reduced from the status quo of 8 percent per year by increased condom use or wider enrollments in antiretroviral therapy (ART). (Galárraga Lab/Brown University)

To address the HIV epidemic in Mexico is to address it among men who have sex with men (MSM), because they account for a large percentage of the country's new infections, says Omar Galárraga, assistant professor of health services policy and practice in the Brown University School of Public Health.

A major source of the new infections is Mexico City's male-to-male sex trade, Galárraga has found. In his research, including detailed interviews and testing with hundreds of male sex workers on the city's streets and in its clinics, his team estimates that the prevalence of the virus among them could be as high as 40 percent. Because of inconsistent condom use and high degrees of infection among many sex workers, about 8 percent of their customers and other partners become infected each year. Infection can spread further from there.

But out of such seemingly bleak knowledge, Galárraga said, there is also hope. In a new study in AIDS and Behavior, Galárraga, lead author João Filipe G. Monteiro, and colleagues project that a 10-percent increase in condom use by HIV-positive male sex workers would reduce an 8 percent annual infection rate among their partners to 5.2 percent. Meanwhile, increasing the number of HIV-positive sex workers on antiretroviral medications by 50 percent would slash the infection rate among clients to 4.4 percent. More aggressive interventions could cut the rates further.

"There is universal access to HIV treatment in Mexico, so if this is implemented, especially among these key populations, it can really make a dent in the concentrated epidemic that Mexico has," Galárraga said.

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