Observational studyBMC infectious diseases2019
Links between transactional sex and HIV/STI-risk and substance use among a large sample of European men who have sex with men.
Observational study in BMC infectious diseases, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers.
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Who cites it
22 citing papers in PubMed, 37 citations in OpenAlex.
- Review
- Identifying sexual health concerns, risk-taking and violence using the newly developed SEXIT Adult tool in a Swedish public outpatient sample.BMC public health · 2026Article
- Work, Sex, and Substances: Differences in Self-Reported Chemsex Behaviors Between MSM Sex Workers and Digital Content Creators.Sexuality research & social policy : journal of NSRC : SR & SP · 2026Article
- When context matters: Multilevel determinants of self-reported sexually transmitted infections symptoms among men engaged in transactional sex in 26 Sub-Saharan African countries.BMC public health · 2026Article
- Prevalence and associated factors of selling sex among men who have sex with men (MSM) in Latin America: results from the Latin American MSM Internet Survey in 18 countries (LAMIS-2018).BMJ global health · 2025Article
- Substance Use Classes Among YMSM in an HIV Digital Health Intervention Program: Implications for Acceptability, Engagement, and Health Outcomes.AIDS and behavior · 2025Article
- Multiple Behaviors Associated with HIV Risk Among Female Sex Workers and Men who have Sex with Men: Results from Pooled Respondent-driven Sampling (RDS) Surveys - Uganda, 2021-2023.AIDS and behavior · 2025Article
- Prevalence and Factors Associated with Probable Alcohol Use Disorder Among Men at Higher Risk of HIV Enrolled in the HIV Pre-Exposure Prophylaxis Program in Tanga, Tanzania. A Call for Integrated Care.Substance abuse and rehabilitation · 2025Article
- HIV Incidence and Transactional Sex Among Men Who Have Sex With Men in Ningbo, China: Prospective Cohort Study Using a WeChat-Based Platform.JMIR public health and surveillance · 2024Article
- Sexual Health Needs Among Men Who Engage in Transactional Sex with Men in the UK.Archives of sexual behavior · 2024Article
- Transactional sex among adults accessing sexual health services in Alabama, 2008-2022: Prevalence, associated risk factors, and associations with HIV, HCV, and STI diagnosis.Annals of epidemiology · 2024Article
- Sexual network characteristics and partnership types among men who have sex with men diagnosed with syphilis, gonorrhoea and/or chlamydia in Lima, Peru.Sexually transmitted infections · 2024Article
- Sexually transmitted infections amongst men who have sex with men (MSM) in South Africa.PLOS global public health · 2023Article
- Prevalence and risk factors for transactional sex among Swedish-born and foreign-born MSM in Sweden.BMC public health · 2022Article
- Social and behavioural determinants of syphilis: Modelling based on repeated cross-sectional surveys from 2010 and 2017 among 278,256 men who have sex with men in 31 European countries.The Lancet regional health. Europe · 2022Article
- Barriers and facilitators to utilisation of public sexual healthcare services for male sex workers who have sex with men (MSW-MSM) in The Netherlands: a qualitative study.BMC public health · 2022Article
- Risk Behaviors Associated with Patterns of Sexualized Stimulant and Alcohol Use among Men Who Have Sex with Men: a Latent Class Analysis.Journal of urban health : bulletin of the New York Academy of Medicine · 2022Article
- Opioid use disorder: a neglected human immunodeficiency virus risk in American adolescents.AIDS (London, England) · 2021Article
- Leveraging Social Media Activity and Machine Learning for HIV and Substance Abuse Risk Assessment: Development and Validation Study.Journal of medical Internet research · 2021Article
- Neural sensitivity to risk in adults with co-occurring HIV infection and cocaine use disorder.Cognitive, affective & behavioral neuroscience · 2020Article
Corrections and comments
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Authors and funding
4 authors at 3 institutions in 4 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundIn Europe, the highest proportion of HIV diagnoses are in gay men and other men who have sex with men (MSM). Globally, HIV prevalence is particularly high among males who report selling sex, but rates among men who buy sex from other men are less clear. This study analyzed the association of transactional sex (TS) and HIV diagnosis, sexually transmitted infection (STI) diagnoses, and various drug use; and examined the variations in TS by payment direction.
methodsWe conducted a cross-sectional, non-randomized, observational study. This European MSM Internet Survey recruited MSM from 38 European countries. For descriptive purposes we stratified according to TS behavior (frequently selling sex, frequently buying sex, neither frequently selling nor buying sex in the previous 12 months), and we constructed separate multivariable logistic regression models to investigate whether engaging in TS accounted for some of the HIV- and STI diagnoses and drug use in this population.
resultsOf almost 161,000 sexually active MSM, 12.2% engaged in TS. The multivariable logistic regression results showed that relative to not frequently engaging in TS, frequently selling sex was independently associated with a higher odds of reporting diagnosed HIV (ever, adjusted odds ratio [aOR] 1.60, confidence interval [CI] 95% 1.39 to 1.85), bacterial STIs (past 12 months, aOR 1.75 CI 95% 1.54 to 2.00), using heroin or crack cocaine or injecting drugs (aOR 3.17, CI 95% 2.70 to 3.73), and using benzodiazepines (aOR 2.13, CI 95% 1.88 to 2.41). Compared to men not engaging in frequent TS, frequently buying sex was associated with a higher odds of using benzodiazepines (aOR 2.13, CI 95% 1.88 to 2.41).
conclusionsMSM who frequently sell sex suffer greater sexual- and substance use risks than other MSM, but both men who frequently sell and those who buy sex are more likely to use benzodiazepines. MSM who sell sex to other men constitute an important at-risk population who must be offered targeted health services.
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