Abstract
Objectives: To assess prevalence of HIV and sexually transmitted infections (STIs), risk behaviours, and demographics in male commercial sex workers (CSWs)/prostitutes in Sydney.
Methods: Retrospective, cross sectional study with two comparison groups. Demographic, behavioural, and morbidity data were analysed from standardised medical records of patients attending a public STI and HIV service in Sydney between January 1991 and March 1998. Two comparison groups were used: female CSWs and non-CSW working homosexual men who attended over the same time.
Results: 94 male CSWs, 1671 female CSWs, and 3541 non-CSW working homosexual men were included. The prevalence of HIV in male CSWs tested (6.5%) was significantly greater than in female CSWs (0.4%, p=0.0001), but less than in non-CSW homosexual men (23.9%, p<0.0001). Genital warts occurred significantly more frequently in male CSWs than in comparison groups. Prevalence of other STIs was similar in all groups. Male CSWs saw significantly fewer clients per week than female CSWs and male and female CSWs used condoms with almost all clients. Male CSWs reported significantly more non-work sexual partners than female CSWs and non-CSW homosexual men and were significantly more likely to have unprotected penetrative sex with their non-work partners than non-CSW homosexual men. Injecting drug use was significantly more frequent in male CSWs than in both comparison groups.
Conclusions: Although male CSWs use condoms with clients, they are more likely to practise unsafe sex with non-work partners (especially women) and inject drugs than female CSWs and non-CSW homosexual men. Some men with HIV are working within the commercial sex industry. Targeted health education to encourage safer drug use and safer sex outside work is needed.
Key Words: male commercial sex workers; prostitutes; HIV; sexually transmitted infections
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Selected References
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- Browne J., Minichiello V. The social meanings behind male sex work: implications for sexual interactions. Br J Sociol. 1995 Dec;46(4):598–622. [PubMed] [Google Scholar]
- Coutinho R. A., van Andel R. L., Rijsdijk T. J. Role of male prostitutes in spread of sexually transmitted diseases and human immunodeficiency virus. Genitourin Med. 1988 Jun;64(3):207–208. doi: 10.1136/sti.64.3.207. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Crofts N., Marcus L., Meade J., Sattler G., Wallace J., Sharp R. Determinants of HIV risk among men who have homosexual sex and inject drugs. AIDS Care. 1995;7(5):647–655. doi: 10.1080/09540129550126290. [DOI] [PubMed] [Google Scholar]
- Day S., Ward H. Sex workers and the control of sexually transmitted disease. Genitourin Med. 1997 Jun;73(3):161–168. doi: 10.1136/sti.73.3.161. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Elifson K. W., Boles J., Sweat M. Risk factors associated with HIV infection among male prostitutes. Am J Public Health. 1993 Jan;83(1):79–83. doi: 10.2105/ajph.83.1.79. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Kunawararak P., Beyrer C., Natpratan C., Feng W., Celentano D. D., de Boer M., Nelson K. E., Khamboonruang C. The epidemiology of HIV and syphilis among male commercial sex workers in northern Thailand. AIDS. 1995 May;9(5):517–521. [PubMed] [Google Scholar]
- McKeganey N. P. Prostitution and HIV: what do we know and where might research be targeted in the future? AIDS. 1994 Sep;8(9):1215–1226. doi: 10.1097/00002030-199409000-00002. [DOI] [PubMed] [Google Scholar]
- Morse E. V., Simon P. M., Osofsky H. J., Balson P. M., Gaumer H. R. The male street prostitute: a vector for transmission of HIV infection into the heterosexual world. Soc Sci Med. 1991;32(5):535–539. doi: 10.1016/0277-9536(91)90287-m. [DOI] [PubMed] [Google Scholar]
- O'Connor C. C., Berry G., Rohrsheim R., Donovan B. Sexual health and use of condoms among local and international sex workers in Sydney. Genitourin Med. 1996 Feb;72(1):47–51. doi: 10.1136/sti.72.1.47. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Simon P. M., Morse E. V., Balson P. M., Osofsky H. J., Gaumer H. R. Barriers to human immunodeficiency virus related risk reduction among male street prostitutes. Health Educ Q. 1993 Summer;20(2):261–273. doi: 10.1177/109019819302000216. [DOI] [PubMed] [Google Scholar]
- Tomlinson D. R., Hillman R. J., Harris J. R., Taylor-Robinson D. Screening for sexually transmitted disease in London-based male prostitutes. Genitourin Med. 1991 Apr;67(2):103–106. doi: 10.1136/sti.67.2.103. [DOI] [PMC free article] [PubMed] [Google Scholar]