title: HIV, syphilis, hepatitis C and risk behaviours among commercial sex male clients in Sichuan province, China.
abstract: OBJECTIVE
  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&emsp14;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.
authors.affiliation: Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, 2213 McElderry Street, 2nd Floor, Baltimore 21205, USA. cyang@jhsph.edu
authors.forename: Cui
authors.initials: C
authors.lastname: Yang
authors.forename: Carl
authors.initials: C
authors.lastname: Latkin
authors.forename: Rongsheng
authors.initials: R
authors.lastname: Luan
authors.forename: Cunling
authors.initials: C
authors.lastname: Wang
authors.forename: Kenrad
authors.initials: K
authors.lastname: Nelson
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002681:China / Q000453:epidemiology; D017280:Condoms / Q000706:statistics & numerical data; D015658:HIV Infections / Q000453:epidemiology* / Q000523:psychology; D019698:Hepatitis C, Chronic / Q000453:epidemiology* / Q000523:psychology; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012307:Risk Factors; D012309:Risk-Taking; D011477:Sex Work / Q000706:statistics & numerical data*; D012747:Sexual Partners; D019966:Substance-Related Disorders / Q000453:epidemiology; D013587:Syphilis / Q000453:epidemiology* / Q000523:psychology; D047568:Unsafe Sex / Q000706:statistics & numerical data; D014504:Urban Health; D055815:Young Adult
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