Article Text

Original article
HIV, syphilis, hepatitis C and risk behaviours among commercial sex male clients in Sichuan province, China
  1. Cui Yang1,
  2. Carl Latkin2,
  3. Rongsheng Luan3,
  4. Cunling Wang1,
  5. Kenrad Nelson1
  1. 1Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
  2. 2Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
  3. 3Department of Epidemiology, West China School of Public Health, Sichuan University, China
  1. Correspondence to Dr Cui Yang, Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, 2213 McElderry Street, 2nd Floor, Baltimore 21205, USA; cyang{at}


Objectives Commercial sex male clients (CSMC) are at risk of sexually transmitted infections (STI) including HIV. This study reports the prevalence of HIV, syphilis and hepatitis C virus (HCV), a history of STI and HIV-related risk behaviours in a sample of 600 CSMC in three urban areas in Sichuan province, China. The risk factors for prevalent syphilis infection are also examined.

Methods A cross-sectional survey was conducted with 600 CSMC in Sichuan province, China. Finger stick blood samples were collected for HIV, syphilis and HCV tests. Risk factors for syphilis were assessed using multivariate logistic regression by accounting for variance within and between study sites.

Results Western blot confirmatory test results indicated that HIV prevalence was 1.5% (n=9). 32 participants (5.3%) screened positive for syphilis and 52 (8.7%) positive for HCV. The overall prevalence of consistent condom use with female sex workers (FSW) was 30.5%. Multivariate logistic regression analyses revealed local household registration (AOR 0.35, 95% CI 0.25 to 0.50), having snorted heroin in the past 6 months (AOR 2.36, 95% CI 1.18 to 4.74), always washing genitals after having sex with FSW (AOR 3.04, 95% CI 1.10 to 9.12) and consistent condom use with FSW (AOR 0.67, 95% CI 0.46 to 0.98) were significant correlates of syphilis infection.

Conclusions There is a large burden of syphilis infection coupled with high-risk sexual and substance use behaviours among male clients in Sichuan province, China. The data suggest that effective and comprehensive prevention interventions to promote condom use and reduce substance use among male clients in Sichuan province are urgently needed.

  • Condoms
  • hepatitis C virus
  • HIV
  • prostitution
  • syphilis

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  • Funding This research was funded by NIAID grant no 1R21 A173259-01A2.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Ethics approval This study was conducted with the approval of the Institutional Review Boards at Johns Hopkins Bloomberg School of Public Health and Sichuan University.

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

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