Commercial sex work and risk of HIV infection among young drug-injecting men who have sex with men in San Francisco.
OBJECTIVE
The objective of this study was to investigate the relationship between sex work and HIV infection among young injection drug-using men who have sex with men (MSM-IDU).


METHODS
This study was a cross-sectional analysis of behavioral and serologic data collected from 227 street-recruited MSM-IDU in San Francisco, California, between January 2000 and November 2001.


RESULTS
Sixty-eight percent of participants reported being paid by another man for sex. HIV prevalence was 12% (95% confidence interval, 8-16%); 42% of seropositive participants were unaware of their infection. HIV was independently associated with higher number of paying male partners and history of gonorrhea and inversely associated with number of female partners, education, and syringe-sharing. Consistent condom use overall was 41%, but varied significantly by type of partner.


CONCLUSIONS
Among MSM-IDU in San Francisco, sex work with men is strongly associated with HIV infection and the prevalence of condom use is low. HIV prevention among MSM-IDU must be tailored to address the excess risk associated with sex work.
Center for AIDS Prevention Studies, Department of Medicine, University of California San Francisco,and the Positive Health Program, Department of Medicine, San Francisco General Hospital, California 94105, USA.
Oliver
O
Bacon
Paula
P
Lum
Judith
J
Hahn
Jennifer
J
Evans
Peter
P
Davidson
Andrew
A
Moss
Kimberly
K
Page-Shafer
D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D003430:Cross-Sectional Studies; D018562:Disease Transmission, Infectious / Q000517:prevention & control; D015658:HIV Infections / Q000453:epidemiology* / Q000209:etiology / Q000517:prevention & control* / Q000635:transmission; D018451:Homosexuality, Male; D006801:Humans; D008297:Male; D015995:Prevalence; D012307:Risk Factors; D012495:San Francisco / Q000453:epidemiology; D011477:Sex Work / Q000706:statistics & numerical data*; D012725:Sexual Behavior / Q000706:statistics & numerical data*; D015819:Substance Abuse, Intravenous / Q000453:epidemiology*