Abstract

OBJECTIVE--to assess whether male prostitution is an independent risk factor for HIV infection among male (intravenous and nonintravenous) drug users. DESIGN--a cross-sectional study. SETTING--various low-threshold methadone clinics and the sexually transmitted diseases clinic of the Municipal Health Service in Amsterdam and a drug-treatment centre in The Hague. PARTICIPANTS--343 male intravenous drug users and 106 male non-intravenous drug users. MAIN OUTCOME MEASURES--characteristics concerning drug use behaviour, sexual behaviour, and sociodemography, related to prostitution and HIV-antibodies. RESULTS--of the 449 study participants, 88 (20%) reported a history of prostitution; no differences were found between intravenous and non-intravenous drug users. Younger age, West German nationality, and having had private homosexual sex contacts, were independent predictors of a history of prostitution. Independent predictors of HIV infection were (1) longer residency in Amsterdam; (2) having had predominantly homosexual private sex contacts; (3) longer duration of intravenous drug use; and (4) frequent needle sharing. CONCLUSION--no evidence was found to suggest that male prostitution in itself contributed to the risk of HIV infection.