title: Bridging populations-sexual risk behaviors and HIV prevalence in clients and partners of female sex workers, Bangkok, Thailand 2007.
abstract: The aim of this study is to estimate HIV prevalence and assess sexual behaviors in a high-risk and difficult-to-reach population of clients of female sex workers (FSWs). A modified variation of respondent-driven sampling was conducted among FSWs in Bangkok, where FSWs recruited 3 FSW peers, 1 client, and 1 nonpaying partner. After informed consent was obtained, participants completed a questionnaire, were HIV-tested, and were asked to return for results. Analyses were weighted to control for the design of the survey. Among 540 FSWs, 188 (35%) recruited 1 client, and 88 (16%) recruited 1 nonpaying partner. Clients' median age was 38 years. HIV prevalence was 20% and was associated with younger age at first sexual experience [relative risk (RR) = 3.10, 95% confidence interval (CI) 1.16-8.24] and condom use during last sexual encounter with regular partner (RR = 3.97, 95% CI 1.09-14.61). Median age of nonpaying partners was 34 years, and HIV prevalence was 15.1%. There were 56 discordant FSW-client pairs and 14 discordant FSW-nonpaying partner pairs. Condom use was relatively high among discordant FSW-client pairs (90.1%) compared to discordant FSW-nonpaying partner pairs (18.7%). Results suggest that sexual partners of FSWs have a high HIV prevalence and can be a bridge for HIV transmission to other populations. Findings also highlight the importance of initiating surveillance and targeted programs for FSW partners, and demonstrate a recruitment method for hard-to-reach populations.
authors.affiliation: Global AIDS Program, National Center for HIV, Viral Hepatitis, STD and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA. Nshah6@cdc.gov
authors.forename: Neha S
authors.initials: NS
authors.lastname: Shah
authors.forename: Ray W
authors.initials: RW
authors.lastname: Shiraishi
authors.forename: Wonchart
authors.initials: W
authors.lastname: Subhachaturas
authors.forename: Abhijeet
authors.initials: A
authors.lastname: Anand
authors.forename: Sara J
authors.initials: SJ
authors.lastname: Whitehead
authors.forename: Suvimon
authors.initials: S
authors.lastname: Tanpradech
authors.forename: Chomnad
authors.initials: C
authors.lastname: Manopaiboon
authors.forename: Keith M
authors.initials: KM
authors.lastname: Sabin
authors.forename: Kimberley K
authors.initials: KK
authors.lastname: Fox
authors.forename: Andrea Y
authors.initials: AY
authors.lastname: Kim
mesh_terms: D015492:AIDS Serodiagnosis / Q000706:statistics & numerical data; D000328:Adult; D034201:Computers, Handheld; D017280:Condoms / Q000191:economics / Q000706:statistics & numerical data* / Q000600:supply & distribution; D005260:Female; D015658:HIV Infections / Q000453:epidemiology / Q000517:prevention & control* / Q000635:transmission; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D040242:Risk Reduction Behavior; D011477:Sex Work / Q000706:statistics & numerical data*; D012725:Sexual Behavior / Q000706:statistics & numerical data; D012747:Sexual Partners; D011795:Surveys and Questionnaires; D013785:Thailand / Q000453:epidemiology; D055815:Young Adult