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HIV prevalence and related risk factors among male sex workers in Shenzhen, China: results from a time–location sampling survey
  1. Wen-De Cai1,
  2. Jin Zhao1,2,
  3. Jin-Kou Zhao3,
  4. H F Raymond4,
  5. Yu-Ji Feng1,
  6. Jie Liu5,
  7. Willi McFarland4,
  8. Yong-Xia Gan1,
  9. Zheng-Rong Yang1,
  10. Yan Zhang1,
  11. Jing-Guang Tan1,
  12. Xiao-Rong Wang2,
  13. Ming-Liang He2,6,
  14. Jin-Quan Cheng1,
  15. Lin Chen1
  1. 1Shenzhen Center for Disease Control and Prevention, Shenzhen, China
  2. 2School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
  3. 3Jiangsu Provincial Center for Disease Control and Prevention, Jiangsu, China
  4. 4San Francisco Department of Public health, San Francisco, California, USA
  5. 5Association of Schools of Public Health, Atlanta, Georgia, USA
  6. 6Li Ka Shing Institute of Health Sciences, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
  1. Correspondence to Dr Jin-Quan Cheng, Shenzhen Center for Disease Control and Prevention, No 21, Tianbei 1st Road, Shenzhen 518020, China; cjinquan{at}


Background HIV transmission among men who have sex with men has recently become a major concern in China. Little is known, however, about HIV transmission among male sex workers (MSW). This study aimed to investigate HIV infection prevalence and risk factors among MSW in Shenzhen, China.

Materials and methods Following formative research, a cross-sectional study was conducted using time–location sampling among MSW in Shenzhen, from April to July 2008. Behavioural and serological data on HIV and syphilis were collected. The risk factors for HIV infection were analysed using a logistic regression model.

Results In total, 394 MSW 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 MSW self-identified as homosexual. More than 70% had sex with both men and women. HIV-related knowledge levels were high regardless of HIV serostatus. 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 before sexual intercourse, having a history of HIV tests, syphilis infection and a short period of residence in Shenzhen were associated with an increased risk of HIV infection.

Conclusions High-risk sexual practices were common among MSW 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 of HIV infection. The time–location sampling method was found to be an appropriate way of recruiting MSW for this study, especially those without fixed working places.

  • Epidemiology
  • gay men
  • HIV-1
  • male sex workers
  • Shenzhen
  • syphilis
  • time–location sampling

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  • W-DC and JZ contributed equally to this manuscript.

  • Funding This study was partly supported by a grant from the Medical Research Fund of Guangdong Province (A2007587), a grant from Shenzhen Technology and Research Fund (200902082) and a special grant from the Medical Key Laboratory of Shenzhen.

  • Competing interests None.

  • Ethics approval This study was conducted with the approval of the Medical Ethics Committee of Shenzhen Centers for Disease Control and Prevention.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.