The urgency to implement innovative prevention strategies: combining a community based participatory research approach and economic incentives with male sex workers in Mexico City
Background: Addressing health inequality is a major challenge for governments, researchers, practitioners, community leaders, and affected communities. In the field of HIV/AIDS this is no exception. In Mexico, male sex workers (MSW) have the highest rate of HIV and are yet absent in the design of specific social programmes and HIV prevention campaigns. The objective of this study is to provide an account of the social context in which MSW are immersed and to explore the feasibility to provide economic incentives in order to promote MSW participation in HIV preventive strategies. A reflection is made on the possibility to combine community based participatory approaches with the provision of economic incentives.
Methods: An in-depth study was conducted by doing observations in places were MSW meet in Mexico City and 36 in-depth interviews with MSW including travesties, transgender and transsexuals.
Results: There are scarce preventive strategies focusing on MSW. This determines, with the stigma, discrimination, marginalization and poverty, the vulnerability of MSW to HIV infection. MSW are eager to participate in preventive programs and to be part of HIV preventive strategies where their voice can be listened. There is an urgent need to address issues such as access to health care programmes, education, employment and housing. According to MSW testimonies an economic incentive of around US$ 20 per month might be enough to facilitate their participation.
Conclusions: Community based participatory research is about building partnerships between researchers, community members, organizational representatives in all aspects of the research process. The knowledge gained by the experience of MSW is central if the objective is to enhance understanding of the HIV/AIDS epidemic within this group and integrate this knowledge with action to improve the health and wellbeing of MSW in Mexico City.
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