Background: HIV transmission among men who have sex with men has become a major concern recently in China. However, little is known about HIV transmission among male sex workers (MSWs). This study aimed to investigate HIV infection prevalence and risk factors among MSWs in Shenzhen, China.
Materials and Methods: Following formative research, a cross-sectional study was conducted using time-location sampling (TLS) among MSWs in Shenzhen, from April to July, 2008. Behavioral and serologic data on HIV and syphilis were collected. The risk factors for HIV infection were analyzed using a logistic regression model.
Results: In total, 394 male sex workers were recruited for the survey. The prevalence of HIV and syphilis among these workers was 5.3% and 14.3%, respectively. Only a quarter of the MSWs self-identified as homosexual. More than 70% had sex with both men and women. HIV-related knowledge levels were high regardless of HIV sero-status. Consistent condom use was low (37.1%) and varied by type of sexual partner. Factors including more non-commercial male partners, working in small home-based family clubs, being drunk prior to sexual intercourse, having a history of HIV tests, syphilis infection and short period of residence in Shenzhen were associated with an increased risk of HIV infection.
Conclusions: High-risk sexual practices were common among male sex workers regardless of their high level of HIV awareness. The working venues were associated with HIV infection and a recent test for HIV was a potential predictor for HIV infection. The TLS method was found to be an appropriate way of recruiting male sex workers for this study, especially those without fixed working places.