title: Drug-using male clients of female sex workers who report being paid for sex: HIV/sexually transmitted infection, demographic, and drug use correlates.
abstract: BACKGROUND
  Research has focused on male clients of female sex workers (FSWs) and their risk for HIV/sexually transmitted infections (STIs). However, it is unclear whether the commercial sex behaviors of these men are limited to paying for sex or whether they may also be paid for sex themselves.
  
  
  METHODS
  We analyzed the interview data and HIV/STI test results from 170 drug-using male clients of FSWs in Tijuana, Mexico, to determine the extent to which these men report being paid for sex and the association with positive HIV/STI results.
  
  
  RESULTS
  More than one quarter of men reported having been paid for sex in the past 4 months. In a multivariate logistic regression model, reporting having been paid for sex was significantly associated with testing positive for any HIV/STI (adjusted odds ratio [AdjOR], 3.53; 95% confidence interval [CI], 1.33-9.35), being bisexual (AdjOR, 15.59; 95% CI, 4.81-50.53), injection drug use in the past 4 months (AdjOR, 2.65; 95% CI, 1.16-6.03), and cocaine use in the past 4 months (AdjOR, 2.93; 95% CI, 1.22-7.01).
  
  
  CONCLUSIONS
  Findings suggest that drug-using male clients of FSWs may be characterized by unique risk profiles that require tailored HIV prevention interventions.
authors.affiliation: Division of Global Public Health, Department of Medicine, University of California San Diego, La Jolla, CA 92093-0849, USA. kdwagner@ucsd.edu
authors.forename: Karla D
authors.initials: KD
authors.lastname: Wagner
authors.forename: Eileen V
authors.initials: EV
authors.lastname: Pitpitan
authors.forename: Claudia V
authors.initials: CV
authors.lastname: Chavarin
authors.forename: Carlos
authors.initials: C
authors.lastname: Magis-Rodriguez
authors.forename: Thomas L
authors.initials: TL
authors.lastname: Patterson
mesh_terms: D000328:Adult; D002690:Chlamydia Infections / Q000453:epidemiology* / Q000517:prevention & control; D017280:Condoms / Q000706:statistics & numerical data; D003430:Cross-Sectional Studies; D005260:Female; D006069:Gonorrhea / Q000453:epidemiology* / Q000517:prevention & control; D015658:HIV Infections / Q000453:epidemiology* / Q000517:prevention & control; D006801:Humans; D008297:Male; D008800:Mexico / Q000453:epidemiology; D015995:Prevalence; D012307:Risk Factors; D012309:Risk-Taking; D060386:Sex Workers; D012725:Sexual Behavior; D012747:Sexual Partners; D012959:Socioeconomic Factors; D015819:Substance Abuse, Intravenous / Q000453:epidemiology* / Q000517:prevention & control; D013587:Syphilis / Q000453:epidemiology* / Q000517:prevention & control