HIV, sexually transmitted infections, and risk behaviours in male commercial sex workers in Sydney

• Published in: Sexually transmitted infections Vol. 76; no. 4; pp. 294 - 298
• Main Authors: Estcourt, Claudia S, Marks, Caron, Rohrsheim, Richard, Johnson, Anne M., Donovan, Basil, Mindel, Adrian
• Format: Journal Article
• Language: English
• Published: London BMJ Publishing Group Ltd 01.08.2000; BMJ; BMJ Publishing Group LTD; BMJ Group
• Subjects: Adolescent; Adult; Aged; Aged, 80 and over; AIDS/HIV; Australia - epidemiology; Biological and medical sciences; Chlamydia; Cross-Sectional Studies; Female; General aspects; Gonorrhea; Health services; Hepatitis; HIV; HIV - isolation & purification; HIV Infections - epidemiology; Homosexuality, Male - statistics & numerical data; Human immunodeficiency virus; Human infectious diseases. Experimental studies and models; Humans; Infections; Infectious diseases; Male; male commercial sex workers; Medical sciences; Middle Aged; Original; Prevalence; prostitutes; Residence Characteristics; Retrospective Studies; Risk Factors; Serology; Sex industry; Sex Work - statistics & numerical data; Sexual health; Sexually transmitted diseases; Sexually Transmitted Diseases - epidemiology; sexually transmitted infections; STD; Syphilis; Warts; Women; Australia; Oceania; Infection; Immunopathology; Prostitution; Sexually transmitted disease; Prevalence; Viral disease; Sexual behavior; Risk factor; Male; AIDS; Immune deficiency; Epidemiology
• ISSN: 1368-4973; 1472-3263
• DOI: 10.1136/sti.76.4.294

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.