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, said assistant professor Mark Padilla of the University of Michigan 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 said. However, Padilla's 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.
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. That population of male prostitutes grows larger as the traditional, agricultural jobs dry up. 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. Most male sex tourists in the study were from North America and Europe, Padilla said. The local men who served these tourists also had sexual encounters with female tourists, but Padilla's study did not directly examine that issue.
"Many men are unemployed from rural areas, and they immigrate to tourism areas," Padilla said. "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.