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

Shah, Neha; Shiraishi, Ray W.; Subhachaturas, W; Anand, Abhijeet; Whitehead, Sara J.; Tanpradech, Suvimon; Manopaiboon, Chomnad; Sabin, Keith; Fox, Kimberley; Kim, Andrea Y.

doi:10.1007/s11524-010-9542-5

Cited by 21 publications

(15 citation statements)

References 30 publications

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“…Furthermore, respondents with early sexual debut were more likely to have paid someone for sexual activity. This is particularly worrisome because individuals who pay for sex are considered to be a bridging population for STIs/HIV, as their paid partners are often individuals at higher STIs/HIV risk [23, 24]. …”

Section: Discussionmentioning

confidence: 99%

Early Sexual Debut: A Risk Factor for STIs/HIV Acquisition Among a Nationally Representative Sample of Adults in Nepal

2015

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While early sexual debut is highly prevalent in Nepal, its link to sexually transmitted infections (STIs/ HIV) risk factors has not been explored at a national level. The objective of this study was to assess potential association between early sexual debut and risk factors for STIs/ HIV acquisition, including sexual risk behaviors, sexual violence, and teenage pregnancy among adults in Nepal. Data were taken from the nationally representative Nepal Demographic Health Survey (2011), which employed a two-stage complex design to collect data. A sample of 12,756 adults (ages 15–49 years) were included. Multivariate logistic models were conducted, adjusted for demographic characteristics, to assess the association between early sexual debut and STIs/HIV-related risk factors. The prevalence of early sexual debut in this sample was 39.2 %, with a mean age of coital debut at 17.9 years. After adjusting for potential confounders, individuals with early sexual debut were significantly more likely to report a history of STIs (aOR 1.19; 95 % CI 1.06–1.35) and had a significantly higher risk profile, including having multiple sex partner (aOR 2.14; 95 % CI 1.86–2.47), inconsistent condom use (aOR 0.72; 95 % CI 0.61–0.86), paid for sex (aOR 1.61; 95 % CI 1.14–2.27), a history of sexual violence (aOR 1.99; 95 % CI 1.63–2.43), and teenage pregnancy (aOR 12.87; 95 % CI 11.62–14.26). Individuals who have early sexual debut are more likely to engage in risk behaviors that place them at increased risk of STIs/ HIV acquisition. STIs/HIV prevention strategies should aim at delaying sexual debut to decrease the disproportionate burden of adverse health outcomes, including STIs/ HIV, among individuals in Nepal.

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Section: Discussionmentioning

confidence: 99%

Early Sexual Debut: A Risk Factor for STIs/HIV Acquisition Among a Nationally Representative Sample of Adults in Nepal

2015

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“…Findings from a study in Bangkok, Thailand reported that 20% (95% CI 12.1–31.2%) of male clients were infected with HIV, and similar prevalence was found among FSW with whom they had sex. Almost 25% of these male clients were married and more than 85% reported more than one sexual partner in the past month [11]. Findings from Yunnan, China, on the border with Vietnam, showed HIV prevalence among male clients to be 9.2% and to be most associated with injecting drug use and co-infection with herpes simplex virus type 2 (HSV-2) [10].…”

Section: Introductionmentioning

confidence: 99%

High HIV Prevalence and Risk Among Male Clients of Female Sex Workers in Hanoi and Ho Chi Minh City, Vietnam

Nadol¹,

Hoang

Le³

et al. 2017

AIDS Behav

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In Vietnam’s concentrated HIV epidemic, female sex workers (FSWs) are at increased risk for acquiring and transmitting HIV, largely through their male clients. A high proportion of males in Vietnam report being clients of FSWs. Studying HIV-related risk factors and prevalence among male clients is important, particularly given the potential for male clients to be a ‘bridge’ of HIV transmission to the more general population or to sex workers. Time-location sampling was used to identify FSW in Hanoi and Ho Chi Minh City, Vietnam’s largest cities, in 2013–2014. Recruited FSWs were asked to refer one male client to the study. Demographic and risk behavior data were collected from FSWs and male clients by administered questionnaires. Biologic specimens collected from male clients were tested for HIV and opiates. Sampling weights, calculated based on the FSWs probability of being selected for enrolment, were applied to prevalence estimates for both FSWs and male clients. Logistic regression models were developed to obtain odds ratios for HIV infection among male clients. A total of 804 male clients were enrolled. Overall, HIV prevalence among male clients was 10.2%; HIV prevalence was 20.7% (95% confidence interval (CI) 15.0–27.9%) among those reporting a history of illegal drug use and 32.4% (95% CI 20.2–47.7%) among those with opioids detected in urine. HIV prevalence among male clients did not differ across ‘bridging’ categories defined by condom use with FSWs and regular partners over the previous 6 months. HIV among male clients was associated with a reported history of illegal drug use (OR 3.76; 95% CI 1.87–7.56), current opioid use (OR 2.55; 95% CI 1.02–6.36), and being referred by an FSW who self-reported as HIV-positive (OR 5.37; 95% CI 1.46–19.75). Self-reported HIV prevalence among enrolled FSWs was 2.8%. Based on HIV test results of male clients and self-reported status from FSWs, an estimated 12.1% of male client-FSW pairs were sero-discordant. These results indicate high HIV prevalence among male clients of FSWs, particularly among those with a history of drug use. Programs to expand HIV testing, drug-use harm reduction, and HIV treatment for HIV-infected male clients of FSWs should be considered as key interventions for controlling the HIV epidemic in Vietnam.

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“…Studies from Thailand and elsewhere suggest that clients of sexual workers may serve as a bridge for transmitting HIV from high-risk populations to the general population 11 12. Many male clients of HSWs in Pakistan are married or have girlfriends, and they may also have FSW contacts.…”

Section: Introductionmentioning

confidence: 99%

Condom use during commercial sex among clients of Hijra sex workers in Karachi, Pakistan (cross-sectional study)

et al. 2011

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ObjectiveTo describe the prevalence and predictors of condom use and sexual risk in the male clients of Hijra sex workers (HSWs) in Karachi, Pakistan.DesignCross-sectional study.SettingKarachi, Pakistan.ParticipantsClients of HSWs were recruited with assistance from HSWs and a non-governmental organisation (NGO) focused on men who have sex with men (MSM) during October–November 2010.MeasurementsThe interviewer administered the questionnaire to each participant to solicit information on demographics, HIV/AIDS knowledge/attitudes and sexual risk behaviours/practices, including condom use in the last sexual act with the HSW.ResultsOf the 203 participants, 42.4% reported that they used condoms during their last sexual act with HSW, 40% were married, 18% had ever used drugs or alcohol, and 52% reported also engaging with female sex workers in the last month. Casual HSW clients were more likely to use condoms than regular clients (adjusted OR (AOR), 2.50; 95% CI 1.34 to 4.65), as were persons with a higher education level (AOR 5.8; 95% CI 1.6 to 20.3). Drug/alcohol users and non-users were equally likely to use condoms (AOR 1.11; 95% CI 0.51 to 2.24).ConclusionClients of HSWs in Pakistan are at risk of acquiring HIV/STI infections. Concerted efforts are needed to increase condom use in this key bridge population to curtail the spread of HIV in the general population.

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

Cited by 21 publications

References 30 publications

Early Sexual Debut: A Risk Factor for STIs/HIV Acquisition Among a Nationally Representative Sample of Adults in Nepal

Early Sexual Debut: A Risk Factor for STIs/HIV Acquisition Among a Nationally Representative Sample of Adults in Nepal

High HIV Prevalence and Risk Among Male Clients of Female Sex Workers in Hanoi and Ho Chi Minh City, Vietnam

Condom use during commercial sex among clients of Hijra sex workers in Karachi, Pakistan (cross-sectional study)

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