This study aims to investigate factors associated with a history of purchasing sex services by men in Saint Petersburg and Leningrad Oblast, Russian Federation. Data were collected as part of a cross-sectional study offering free anonymous rapid HIV testing in Saint Petersburg and Leningrad Oblast in 2014; in total, 3565 men aged 18 years and older provided information about their behaviors associated with risk of acquiring HIV during face-to-face interviews.
Prevalence of CSW use in our study was 23.9 %. Multivariable analyses using log-binomial regression were stratified by self-reported HIV testing during the 12 months preceding the study interview. In both strata, older age, multiple sex partners, and a history of sex with an injection drug user (IDU) were associated with an elevated prevalence ratio (PR) for history of purchasing sex services, although the strength of the association differed by strata. Among men who reported recent HIV testing, condom use was associated with a history of purchasing sex services, and among men who did not report recent HIV testing, having a consistent sex partner was associated with purchasing sex services.
The high prevalence of CSW service use and associations found in this study raise serious concerns about potential for sexual HIV transmission and should be investigated more closely.
TABLE 1
Characteristics of the study population by experience of purchasing sex services (N = 3565)
| Characteristic | No history of purchasing sex servicesa 2713 (76.1 %) | History of purchasing sex servicesa 852 (23.9 %) | p value |
|---|---|---|---|
| Age category | <0.0001 | ||
| 29 years and younger | 1039 (38.3 %) | 216 (25.0 %) | |
| 30–36 years | 777 (28.7 %) | 368 (43.8 %) | |
| 37 years and older | 896 (33.0 %) | 268 (31.2 %) | |
| Education | 0.653 | ||
| Unfinished high school | 26 (3.0 %) | 88 (2.5 %) | |
| High school | 187 (22.0 %) | 543 (15.2 %) | |
| Some college | 410 (48.1 %) | 1351 (49.9 %) | |
| Post-college education | 229 (26.9 %) | 730 (26.9 %) | |
| Consistent sex partner | 1684 (62.2 %) | 544 (63.9 %) | 0.373 |
| History of injection drug use | 903 (33.3 %) | 352 (41.3 %) | <0.0001 |
| History of sex with injection drug user | 288 (10.6 %) | 210 (24.7 %) | <0.0001 |
| History of sex work | 14 (0.5 %) | 4 (0.5 %) | 0.867 |
| History of sex with a man | 57 (2.1 %) | 36 (4.2 %) | 0.0007 |
| Condom use during last sexual intercourse | 925 (34.1 %) | 359 (42.1 %) | <0.0001 |
| Number of sex partners during last 12 months | <0.0001 | ||
| 1 and fewer | 1800 (66.3 %) | 311 (36.6 %) | |
| 2–3 | 144 (5.3 %) | 69 (8.1 %) | |
| 4 and more | 769 (28.4 %) | 472 (55.4 %) | |
| Tested for HIV during last 12 months | 372 (13.7 %) | 162 (19.1 %) | 0.0002 |
aAll values are presented as n (%)
By:
- 1Department of Epidemiology and Biostatistics, School of Public Health, University at Albany, State University of New York, One University Place, Room 131, Rensselaer, NY, 12144-3456, USA.
- 2New York State International Training and Research Program, New York, NY, USA.
- 3Global Institute of Public Health, New York University, New York, NY, USA.
- 4Center for Drug Use and HIV Research, New York University, New York, NY, USA.
- 5Center for Health, Identity, Behavior, and Prevention Studies, New York University, New York, NY, USA.
- 6Department of Epidemiology and Biostatistics, School of Public Health, University at Albany, State University of New York, One University Place, Room 131, Rensselaer, NY, 12144-3456, USA.
- 7New York State International Training and Research Program, New York, NY, USA.
- 8Department of Internal Medicine #1, Dietrich-Bonhoeffer-Klinikum Neubrandenburg, Neubrandenburg, Germany.
- 9Fund for Social and Medical Programs Humanitarian Action, Saint Petersburg, Russian Federation.
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