Bridging Populations—Sexual Risk Behaviors and HIV Prevalence in Clients and Partners of Female Sex Workers, Bangkok, Thailand 2007

• Published in: Journal of urban health Vol. 88; no. 3; pp. 533 - 544
• Main Authors: Shah, Neha S., Shiraishi, Ray W., Subhachaturas, Wonchart, Anand, Abhijeet, Whitehead, Sara J., Tanpradech, Suvimon, Manopaiboon, Chomnad, Sabin, Keith M., Fox, Kimberley K., Kim, Andrea Y.
• Format: Journal Article
• Language: English
• Published: Boston Springer US 01.06.2011; Springer Nature B.V
• Subjects: Adult; AIDS Serodiagnosis - statistics & numerical data; Computers, Handheld; Condoms - economics; Condoms - supply & distribution; Condoms - utilization; Disease transmission; Epidemiology; Female; Health Informatics; HIV; HIV Infections - epidemiology; HIV Infections - prevention & control; HIV Infections - transmission; Human immunodeficiency virus; Humans; Interviews as Topic; Male; Medicine; Medicine & Public Health; Prostitution; Public Health; Risk factors; Risk Reduction Behavior; Risk taking; Sex Work - statistics & numerical data; Sexual behavior; Sexual Behavior - statistics & numerical data; Sexual Partners; Sexually transmitted diseases; STD; Surveys and Questionnaires; Thailand - epidemiology; Young Adult; Thailand; Thailand, Chacoengsao Prov., Bangkok; Female sex workers; HIV; Thailand; Bridge population; Male clients
• ISSN: 1099-3460; 1468-2869
• DOI: 10.1007/s11524-010-9542-5

The aim of this study is to estimate HIV prevalence and assess sexual behaviors in a high-risk and difficult-to-reach population of clients of female sex workers (FSWs). A modified variation of respondent-driven sampling was conducted among FSWs in Bangkok, where FSWs recruited 3 FSW peers, 1 client, and 1 nonpaying partner. After informed consent was obtained, participants completed a questionnaire, were HIV-tested, and were asked to return for results. Analyses were weighted to control for the design of the survey. Among 540 FSWs, 188 (35%) recruited 1 client, and 88 (16%) recruited 1 nonpaying partner. Clients’ median age was 38 years. HIV prevalence was 20% and was associated with younger age at first sexual experience [relative risk (RR) = 3.10, 95% confidence interval (CI) 1.16–8.24] and condom use during last sexual encounter with regular partner (RR = 3.97, 95% CI 1.09–14.61). Median age of nonpaying partners was 34 years, and HIV prevalence was 15.1%. There were 56 discordant FSW–client pairs and 14 discordant FSW–nonpaying partner pairs. Condom use was relatively high among discordant FSW–client pairs (90.1%) compared to discordant FSW–nonpaying partner pairs (18.7%). Results suggest that sexual partners of FSWs have a high HIV prevalence and can be a bridge for HIV transmission to other populations. Findings also highlight the importance of initiating surveillance and targeted programs for FSW partners, and demonstrate a recruitment method for hard-to-reach populations.