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A Mixed Methods Analysis of the Venue-Related Social and Structural Context of Drug Use During Sex Among Male Clients of Female Sex Workers in Tijuana, Mexico

Abstract

Drug use during sex increases risks for HIV acquisition. Male clients of female sex workers (FSW) represent both a key population at risk for HIV as well as a transmission bridge population. In Tijuana, Mexico, drug use is prevalent and there is a need to understand male clients’ drug use during sex with FSW. Characteristics of sex work venues may confer higher risks for drug use, risky sex, and HIV/STI. It is essential to understand the venue-related social and structural factors associated with drug use during sex in order to inform HIV prevention interventions with male clients in this region. We used a Mixed-Methods Sequential Explanatory Design to conduct an enriched examination of drug use during sex among male clients of FSW in Tijuana. Findings from logistic regression analysis showed that drug use during sex was significantly correlated with police harassment (AOR = 4.06, p < .001) and methamphetamine use (AOR = 33.77, p < .001). In-depth interview data provided rich meaning behind and context around the quantitative associations. Social and structural interventions to reduce police harassment, methamphetamine use, and promote condom availability are needed to reduce risks for HIV among male clients of FSW in Tijuana.

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Funding

This work was supported by a Mentored Career Development Award from the National Institute on Drug Abuse awarded to the first author (Grant No. K01DA036447).

Author information

Correspondence to Eileen V. Pitpitan.

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Conflicts of interest

All authors have no conflicts of interest to declare.

Ethical Approval

All procedures were in accordance with the ethical standards of the institutional review board at UCSD and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Pitpitan, E.V., Rocha-Jimenez, T., Salazar, M. et al. A Mixed Methods Analysis of the Venue-Related Social and Structural Context of Drug Use During Sex Among Male Clients of Female Sex Workers in Tijuana, Mexico. AIDS Behav 24, 724–737 (2020). https://doi.org/10.1007/s10461-019-02519-3

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Keywords

  • Male clients
  • FSW
  • HIV risk
  • Drug use
  • Sexual risk behavior
  • Venues