Correlates of HIV, sexually transmitted infections, and associated high-risk behaviors among male clients of female sex workers in Tijuana, Mexico

Abstract

Objectives To determine sociodemographic and behavioral correlates of HIV infection among male clients of FSWs in Tijuana. Methods 400 men aged 18 or older who had paid or traded for sex with a FSW in Tijuana during the past 4 months were recruited in Tijuana’s “zone of tolerance,” where prostitution is practiced openly under a municipal permit system. Efforts were made to balance the sample between residents of the U.S. (San Diego County) and of Mexico (Tijuana). Participants underwent interviews and testing for HIV, syphilis, gonorrhea, and Chlamydia. Logistic regression identified correlates of HIV infection. Results Mean age was 36.6. One quarter had injected drugs within the previous 4 months. Lifetime use of heroin, cocaine and methamphetamine was 36%, 50% and 64%, respectively. Men had frequented FSWs for an average of 11 years, visiting FSWs an average of 26 times last year. In the past four months, one half reported having unprotected sex with an FSW; 46% reported frequently being high when having sex with an FSW. Prevalence of HIV, syphilis, gonorrhea, and Chlamydia was 4%, 2%, 2.5% and 7.5%; 14.2% were positive for at least one infection. Factors independently associated with HIV infection were living in Mexico, ever using methamphetamine, living alone, and testing positive for syphilis. Conclusions Male clients of FSWs in Tijuana had a high sex and drug risk profile. While STI prevalence was lower than among FSWs, HIV prevalence was comparable, suggesting the need for interventions among clients to prevent spread of HIV and STIs.

Study of HIV Status in 400 Cases of S.T.D in Shanti ID Clinic, Vadodara, Gujarat, India

“…In Belgium study there are also overlapping epidemics in men who have sex with men (MSM) where there are high number of HIV diagnose and incident STI [9]. Similar findings are reproduced in individualbased sectional studies including African American drug using women in USA on clients of female sex worker in Mexico [10,11]. Brainsttein and colleagues reviewed data of HIV incidence in subSaharan Africa 18 of 22 studies looking at impact of current or recent STI found an increased HIV risk, the highest HIV risk was found foeHSV2-seropositive [12].…”

Prevalence and Correlates of HIV and Sexually Transmitted Infections among Female Sex Workers and Their Non-commercial Male Partners in Two Mexico-USA Border Cities

“…62 Methamphetamine abuse has been linked to risky sexual behaviors in a variety of settings, 63 and has been associated with HIV/STI positivity and inconsistent condom use among FSWs and male clients in our previous research. 26,28,45,64 Our findings imply that the association between methamphetamine abuse and HIV/STIs may also hold true for FSWs' non-commercial male partners. Effective drug treatment options, including programs that focus on stimulant abuse and co-occurring conflict within relationships, are needed in these cities in addition to more comprehensive programs that recognize and address the co-occurrence of stimulant abuse, violence, and sexual risk among socially marginalized couples.…”

“…12 Nevertheless, we believe our findings underscore the need for continued prevention efforts targeting FSWs' male clients, who were found to have higher HIV prevalence than the non-commercial male partners in our sample (e.g., 4 % in Tijuana in 2008 vs. 1 % in our study). 45 We found that testing positive for HIV/STIs was associated with several individual and relationship factors. First, women who had regular sex work clients were less likely to test positive for HIV/STIs than women without regular clients.…”

HIV and Latino migrant workers in the USA

“…In Mexico, prostitution is legal (Patterson et al 2009). Nevertheless, human trafficking and commercial sexual exploitation place undocumented, female migrant workers along the USAÁMexico border at the highest risk for HIV infection.…”

“…Nevertheless, human trafficking and commercial sexual exploitation place undocumented, female migrant workers along the USAÁMexico border at the highest risk for HIV infection. Estimates place the HIV prevalence rate as high as four per cent among male clients of female sex workers in Tijuana (Patterson et al 2009). Stricter law enforcement of the sex trade industry at border towns and crossing sites is warranted.…”