Lack of HIV prevention for male sex workers in the Caribbean
adds to growing epidemic
Male sex tourists, largely from the United States and Europe, may be fueling an HIV/AIDS epidemic in the Caribbean, and efforts to stop the epidemic will be severely hampered unless HIV prevention dollars are diverted to help male prostitutes, a new study suggests.
Additionally, the study should serve as call to action for the tourism industry to implement HIV/AIDS prevention programs for tourists and tourism employees, says assistant professor Mark Padilla of the School of Public Health.
The Caribbean is second only to sub-Saharan Africa in HIV/AIDS cases. The disease has been described as primarily heterosexual, Padilla says. However, Padilla's new book shows that sexual contact between Caribbean male sex workers and male tourists may be a much larger contributor to the HIV/AIDS epidemic there than previously thought.
Padilla's book "Caribbean Pleasure Industry: Tourism, Sexuality, and HIV/AIDS in the Dominican Republic," is the largest known study of male sex workers in the Caribbean and how their bisexual behavior impacts the spread of HIV. During the study, Padilla interviewed 298 bisexually behaving men over the course of three years.
Currently prevention dollars in the Caribbean serve primarily heterosexuals, and this particular population of male sex workers who have sex with tourists is largely neglected. Funding comes from a variety of sources: governments, multilateral organizations such as the World Health Organization and private foundations.
The Caribbean has become increasingly dependent on money from tourism, and young men have fewer options for making a living. That population of male prostitutes grows larger as the traditional, agricultural jobs dry up. Most male sex tourists in the study were from North America and Europe, Padilla says.
"Many men are unemployed from rural areas, and they immigrate to tourism areas," Padilla says. "Very few identify themselves as sex workers, and most have other income from tourism. Because of social stigma, these men often do not communicate with female partners about their involvement in sex work," which means the risk for HIV may be high among women.
Padilla says the tourism industry needs to be held at least partly responsible for providing a safer environment. Many of those tourism companies are based in the United States, he says.