title: HIV prevalence and risk behaviors among male clients of female sex workers in Yunnan, China.
abstract: OBJECTIVE
  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.
authors.affiliation: Department of Epidemiology, National Center for AIDS/sexually transmitted diseases Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China.
authors.forename: Xia
authors.initials: X
authors.lastname: Jin
authors.forename: Kumi
authors.initials: K
authors.lastname: Smith
authors.forename: Ray Y
authors.initials: RY
authors.lastname: Chen
authors.forename: Guowei
authors.initials: G
authors.lastname: Ding
authors.forename: Yan
authors.initials: Y
authors.lastname: Yao
authors.forename: Haibo
authors.initials: H
authors.lastname: Wang
authors.forename: Han-Zhu
authors.initials: HZ
authors.lastname: Qian
authors.forename: Dongfang
authors.initials: D
authors.lastname: Chang
authors.forename: Guixiang
authors.initials: G
authors.lastname: Wang
authors.forename: Ning
authors.initials: N
authors.lastname: Wang
mesh_terms: D000293:Adolescent; D000328:Adult; D002681:China / Q000453:epidemiology; D017280:Condoms / Q000706:statistics & numerical data / Q000821:virology; D003430:Cross-Sectional Studies; D005260:Female; D015658:HIV Infections / Q000453:epidemiology* / Q000635:transmission*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D018570:Risk Assessment / Q000706:statistics & numerical data; D012307:Risk Factors; D012309:Risk-Taking; D012747:Sexual Partners; D015819:Substance Abuse, Intravenous / Q000453:epidemiology* / Q000821:virology; D011795:Surveys and Questionnaires; D047568:Unsafe Sex / Q000706:statistics & numerical data; D055815:Young Adult