BACKGROUND:
There is a high prevalence of HIV/syphilis among male
sex workers, but no formal study has ever been conducted focusing on male
clients of male sex workers (MCM). A detailed investigation was thus called
for, to determine the burden and sociobehavioral determinants of HIV and
syphilis among these MCM in China.
METHODS:
As part of a multicenter cross-sectional study, using
respondent-driven and snowball sampling, 2958 consenting adult men who have sex
with men (MSM) were recruited, interviewed, and tested for HIV and syphilis
between 2008 and 2009. The distributions of sociodemographic characteristics,
risk behaviors, and HIV/syphilis prevalence were determined and compared
between MCM and other MSM.
RESULTS:
Among recruited MSM, 5.0% (n = 148) were MCM. HIV
prevalences for MCM and other MSM were 7.4% and 7.7%, whereas 18.9% and 14.0%
were positive for syphilis, respectively. Condomless anal intercourse (CAI) was
reported by 59.5% of MCM and 48.2% of MSM. Multiple logistic regression revealed
that compared with other MSM, MCM were more likely to have less education, higher income (for >500 US Dollars per month), more often found partners at parks/restrooms, reported CAI,
reported a larger sexual network,
and higher odds of syphilis.
CONCLUSIONS:
The greater frequency of risk behaviors and high
prevalence of HIV and syphilis indicated that HIV/syphilis prevention programs
in China need to pay special attention to MCM as a distinct subgroup, which was
completely ignored until date.
1*Department of STI control, Guangdong Provincial Center for Skin Disease and STI Control, Guangzhou, China;†Department of Epidemiology, School of Public Health, University of California, Los Angeles, CA;‡Department of HIV and STI Prevention and Control, Jiangsu Provincial Central for Disease Prevention and Control, Nanjing, China;§University of North Carolina, Project-China, Guangzhou, China; and Monitoring and Evaluation Unit, The Global Fund to Fight AIDS, Tuberculosis and Malaria, Geneva, Switzerland.
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