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Knowledge, attitudes, sexual practices and STI/HIV prevalence in male sex workers and other men who have sex in Tel Aviv, Israel: a cross-sectional study
  1. Zohar Mor1,2,
  2. Michael Dan2,3,4
  1. 1Ramla Department of Health, Ramla, Israel
  2. 2Levinsky STI Clinic, Tel Aviv Department of Health, Tel Aviv, Israel
  3. 3Infectious Disease Unit, Wolfson Medical Centre, Holon, Israel
  4. 4Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
  1. Correspondence to Dr Zohar Mor, 3 Danny Mass St., Ramla 72100, Israel; zohar.mor{at}


Objective To explore knowledge, attitudes and sexual practices of male sex workers (MSW) in Tel Aviv in comparison with men who have sex with men (MSM) classified by their risk behaviours and to outline attributes related to sexually transmitted infections (STI)/HIV prevalence.

Methods MSW were recruited for this cross-sectional study from designated street venues and gay-dating internet site. MSM were recruited from gay-related venues and divided into high-risk MSM (HRMSM) if they performed unprotected anal intercourse in the last 6 months with an HIV-discordant/unknown partner and to low-risk MSM (LRMSM). Each participant completed a questionnaire and was tested for STI/HIV.

Results Of 87 MSW and 635 MSM approached, 53 (60.9%) and 235 (37.0%) participated, respectively. Street-MSW (N=32) had more female sex partners and were more drug dependent than internet-MSW (N=21). No differences were found in their knowledge regarding STI/HIV transmission, practices and STI/HIV burden. Compared with HRMSM, MSW had different demographic attributes and demonstrated more realistic perception regarding the risk to getting STI/HIV, while no differences were found in their knowledge and sexual practices. STI burden among MSW, HRMSM (N=119) and LRMSM (N=116) were 28.3%, 23.5% and 10.3% (p=0.009) and HIV burden among MSW, HRMSM and LRMSM were 5.6%, 9.2% and 0%, (p=0.001), respectively. Multivariate models evaluating attributes associated with HIV/STI diagnosis did not find sex work to be significant if the variable used was MSW versus HRMSM, regardless of the adjustments performed. However, when MSW versus LRMSM was used in the model, sex work was associated with STI/HIV diagnosis.

Conclusions Street-MSW and internet-MSW, similar to all MSW and HRMSM, had comparable sexual practices and had no difference in their STI/HIV prevalence.

  • HIV
  • Israel
  • male sex workers
  • men who have sex with men
  • sexual behaviour
  • AIDS
  • sexual behaviour
  • gay men
  • vaginal infections
  • UTI
  • infectious disease
  • vulvovaginitis
  • vaginal candida

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  • Funding This study was financially supported in part by a grant from the Institute of International Education, Washington, DC, USA.

  • Competing interests None.

  • Patient consent Obtained.

  • Ethics approval Ethics approval was provided by the Wolfson Hospital, Holon, Israel.

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