HIV prevalence and risk behaviors among male clients of female sex workers in Yunnan, China

Xia Jin, Kumi Smith, Ray Y. Chen, Guowei Ding, Yan Yao, Haibo Wang, Han Zhu Qian, Dongfang Chang, Guixiang Wang, Ning Wang

Research output: Contribution to journalArticlepeer-review

55 Scopus citations


OBJECTIVES: To assess the prevalence and risk factors of HIV among male clients of female sex workers (FSWs) in China. METHODS: Convenience sampling methods were used to recruit 315 clients using FSW-client and client-client networks. Subjects provided information on sociodemographic characteristics and sexual and drug behavior patterns. Blood samples were collected for HIV testing and urine samples for opiate testing. RESULTS: Overall HIV prevalence was 6.0%; among drug users, it was 30.8%. 33.7% of respondents reported that they always use condoms in commercial sex and 63.5% that they used a condom in the last commercial sex episode. Drug use (OR: 6.1; 95% CI: 1.7 to 21.4) and lack of a regular sexual partner (OR: 6.3; 95% CI: 1.8 to 21.9) were significantly associated with HIV infection. CONCLUSIONS: Clients of FSWs serve as potential bridges for HIV transmission from the high-risk FSWs to the low-risk general population, making them a key target for intervention. High HIV prevalence rates among clients in Kaiyuan is particularly alarming given their risk behavior patterns including high rates of partner exchange, low condom use rates, and drug-using behaviors. Innovative interventions are needed to reduce the risk of HIV among clients and reduce the bridge of transmission to the general population.

Original languageEnglish (US)
Pages (from-to)131-135
Number of pages5
JournalJournal of Acquired Immune Deficiency Syndromes
Issue number1
StatePublished - Jan 2010


  • China
  • Clients of female sex workers
  • Commercial sex
  • Condom use
  • HIV


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