Transactional sex and the HIV epidemic among men who have sex with men (MSM): Results from a systematic review and meta-analysis


Engagement in transactional sex has been hypothesized to increase risk of HIV among MSM, however conflicting evidence exists. We conducted a systematic review and meta-analysis comparing HIV prevalence among MSM who engaged in transactional sex to those who did not (33 studies in 17 countries; n = 78,112 MSM). Overall, transactional sex was associated with a significant elevation in HIV prevalence (OR 1.34, 95 % CI 1.11-1.62). Latin America (OR 2.28, 95 % CI 1.87-2.78) and Sub-Saharan Africa (OR 1.72, 95 % CI 1.02-2.91) were the only regions where this elevation was noted. Further research is needed to understand factors associated with sex work and subsequent HIV risk in Latin America and Sub-Saharan Africa.


Oldenburg CE, Perez-Brumer AG, Reisner SL, Mimiaga MJ.




  • Epidemiology and Determinants of Health
    • Epidemiology
  • Determinants of Health
    • Stigma/discrimination
  • Population(s)
    • Men who have sex with men
    • Sex workers


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