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Setting: Mexico-U.S. border

Incidence and predictors of HIV and sexually transmitted infections among high risk couples in Northern Mexico: a prospective, multilevel study .

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Setting: Mexico-U.S. border

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  1. Incidence and predictors of HIV and sexually transmitted infections among high risk couples in Northern Mexico: a prospective, multilevel study Angela M Robertson, Gudelia Rangel,Gustavo Martinez, Monica D Ulibarri, Jennifer L Syvertsen, Samuel A Bazzi, Scott Roesch, Heather A Pines, and Steffanie A Strathdee IAS 2014, Melbourne, Australia Funding: National Institutes of Health (NIH) grants R01 DA027772, R36 DA032376, T32 AI007384, T32 DA023356, K01 DA026307, and P30 AI060354-10 . Contact: sstrathdee@ucsd.edu

  2. Setting: Mexico-U.S. border • Sex work is socially tolerated and quasi legal in many Mexican border cities; high HIV/STI risk among sex workers/clients

  3. Cohort of Sex Workers & Intimate Partners • Proyecto Parejas: prospective mixed methods study of HIV/STIs among 214 sex workers & their 214 intimate male partners (n=428) in Tijuana & Ciudad Juarez, Mexico • Most couples always had unprotected sex together; condoms used for sex work • Heavy current drug use (62% heroin, 54% stimulants, 62% injected any drugs)

  4. Findings Highlight Social/Economic Contexts of Risk Incidence of all STIs  among FSWsthan their male partners Female Sex Workers • Time-varying predictors of new STIs (w/o HIV): • Recent stimulant use (meth, crack, cocaine) increases women’s risk (aOR: 2.13; CI: 1.07–4.28) • Women having regular sex work clients decreased their male partners’ risk (aOR: 0.38; CI: 0.14–1.03) Intimate Male Partners • Women who reported physically assaulting partners also had decreased risk (aOR: 0.44; CI: 0.22–0.86)

  5. CONCLUSIONS Couple interventions to promote communication and reduce conflict are needed Interventions that increase empowerment of sex workers (i.e., choice of clients, ability to avoid violence) may reduce their own HIV/STI incidence and that of their intimate male partners. More research is needed to understand how conflict and sex work earnings impact couples’ risk

  6. THANK YOU!Acknowledgements: Proyecto Parejas study participants & staff; NIH grants R01DA027772, R36DA032376, T32AI007384, T32DA023356, K01 DA026307, and P30 AI060354-10 Contact: Steffanie A Strathdee, PhD: sstrathdee@ucsd.edu Photos: O Loza, A Robertson, J Syvertsen, C Bava

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