Safer Sex Intervention for Male Clients of Female Sex Workers in Tijuana, Mexico

Funded by NIDA grant R01 DA029008

PI: Thomas L. Patterson

Dr. Patterson, a Professor in the Department of Psychiatry, co-directs the Global Public Health Division’s T32 training grant with Dr. Steffanie Strathdee and collaborates closely with many investigators in the Division. This project, which commenced in 2010, studies the efficacy of a brief, single-session counseling intervention (known as Hombre Seguro, or Healthy Man) in increasing condom use, decreasing sexual risk behaviors, and reducing incident HIV and STIs among male clients of female sex workers in Tijuana, Mexico. The study will enroll 400 HIV-negative men (200 residents of San Diego County; 200 Tijuana residents) who report having unprotected sex with FSWs in the past 4 months. The theory-based, participatory Hombre Seguro intervention will be evaluated in comparison with a time- and information-equivalent didactic control condition. Participants will be recruited in Tijuana, where they will undergo a baseline CAPI-administered interview, STI testing (HIV, syphilis, gonorrhea, chlamydia), and intervention counseling, with follow-up interviews at 4, 8, and 12 months. The project is scheduled to conclude in early 2015. The objectives are as follows:

  • AIM 1: evaluate the efficacy of Hombre Seguro to increase condom use of clients with FSWs.
  • AIM 2: determine if the intervention is as efficacious among U.S. versus Mexican clients.
  • AIM 3: determine the extent to which theoretically-based components of our intervention (e.g., self-efficacy) represent underlying mechanisms of change in primary outcomes (e.g., lower HIV/STI incidence).
  • AIM 4: explore subgroup differences in efficacy of the intervention based on background characteristics (e.g., age), contextual factors (e.g., substance use before/during sex), psychosexual factors (e.g., social-sexual effectiveness), and psychosocial factors (e.g., social network influence). 
  • Goodman, D., Pitpitan, E.V., Semple, S.J., Wagner, K.D., Chavarin, C.V., Strathdee, S.A., & Patterson, T.L. (In Press) Hazardous drinking and HIV-related risk behaviour among male clients of female sex workers in Tijuana, Mexico. American Journal on Addictions.
  • Volkmann, T., Wagner, K.D., Strathdee, S.A., Semple, S.J., Ompad, D.C., Chavarin, C.V., & Patterson, T.L. (2014). Correlates of self-efficacy for condom use among male clients of female sex workers. Archives of Sexual Behavior, 43(4), 719–727.
  • Wagner, K.D., Pitpitan, E.V., Chavarin, C.V., Magis-Rodriguez, C., & Patterson, T.L. (2013) Drug-using male clients of female sex workers who report being paid for sex: HIV/sexually transmitted infection, demographic, and drug use correlates. Sexually Transmitted Diseases, 40(8), 619-623.
  • Patterson, T.L., Volkmann, T., Gallardo, M., Goldenberg, S., Lozada, R., Semple, S.J., Anderson, C.Z., & Strathdee. S.A. (2012) Identifying the HIV transmission bridge: which men are having unsafe sex with female sex workers and their own wives or steady sex partners? JAIDS, 60(4): 414-420. doi: 10.1097/QAI.0b013e31825693f2.