Havana stands out as the province with the highest prevalence of transactional sex among men who have sex with men (MSM) and transgender women, while also recording the lowest consistent condom usage. This alarming trend increases exposure to HIV and other sexually transmitted infections (STIs). These findings were unveiled in the 2022-2023 Biobehavioral Survey released on Tuesday by the National Office of Statistics and Information (ONEI) on their Facebook profile.
The report highlights that transactional sex often involves multiple partners and can be driven by financial incentives, gifts, or other benefits. The combination of these practices with inconsistent condom usage significantly elevates the risk of infection. According to the study, 18% of MSM in the capital reported engaging in transactional sex in the past 12 months. This figure is double and even six times higher than those recorded in other cities included in the study: Cienfuegos at just 2.7% and Bayamo at 8.6%.
Examining only men who had casual relationships during this period, the disparity is even greater: in Havana, 23.6% engaged in transactional sex compared to 6.6% in Cienfuegos and 9.9% in Bayamo. The extensive document, spanning over 100 pages, warns of a high-risk pattern in the capital: consistent condom use among those practicing transactional sex remains very low. Only 27.8% of Havana's MSM reported always using condoms, while 69.5% admitted to using them only "occasionally."
In contrast, protection is much higher in provinces like Cienfuegos, where 90.1% claimed to use condoms consistently, or Bayamo, with 77.6%. The survey also revealed concerning results among Havana's transgender women. More than half (52.5%) confessed to engaging in transactional sex in the past year, often with multiple sexual partners. However, only 41.4% assured they always used condoms in these encounters, while 51.3% did so sporadically, and 7.3% admitted to never using them.
When asked about their most recent transactional sexual encounter, condom use increased in both groups: 75.9% among MSM and 80% among transgender women. Nonetheless, the overall figures indicate low consistent use and prevailing irregularities in protection, placing the capital in a particularly vulnerable position regarding HIV and other STIs.
Furthermore, researchers in Havana identified that some respondents admitted to having sexual relations in exchange for drugs or favors, expanding the spectrum of vulnerability. Beyond the numbers, the study warns that low condom utilization is linked to structural and gender barriers that limit access to healthcare services. These include discrimination against key populations, the lack of condom availability in pharmacies and clinics, and a lack of awareness about preventive alternatives such as pre-exposure prophylaxis (PrEP).
The Biobehavioral Survey recommends accelerating access to precise combination prevention, which includes promoting condom use, PrEP, and timely treatment for people with HIV. "Condom use is vital for disease prevention," emphasized the ONEI in their publication, noting that the capital has the highest risk levels due to the frequent practice of transactional sex and inconsistent protection.
However, the report does not address the current shortage of condoms in state pharmacies and the high cost on the informal market. The results of this report confirm that, while transactional sex is not a widespread phenomenon in Cuba, in areas like Havana it reaches significant proportions and poses urgent public health challenges.
Understanding the Risks and Barriers in Havana's Sexual Health Landscape
Why is transactional sex more prevalent in Havana compared to other cities?
Transactional sex is more prevalent in Havana due to factors like economic incentives, gifts, and other benefits that drive individuals to engage in these activities at higher rates compared to other cities.
What are the main barriers to consistent condom usage in Havana?
Key barriers include structural and gender-related obstacles, such as discrimination towards key populations, limited availability of condoms in pharmacies and clinics, and a lack of knowledge about preventive options like PrEP.
How does the low usage of condoms impact public health in Havana?
The low consistent use of condoms contributes to higher risks of HIV and other STIs, creating significant public health challenges in Havana, as the city records high levels of transactional sex and irregular protection.