title: Aphrodisiac use associated with HIV infection in elderly male clients of low-cost commercial sex venues in Guangxi, China: a matched case-control study.
abstract: BACKGROUND
  Rising HIV infection rates have been observed among elderly people in Guangxi, China. Inexpensive aphrodisiacs are available for purchase in suburban and rural areas. This study aims to investigate the association between aphrodisiac use and increased HIV risk for middle-aged and elderly men in Guangxi.
  
  
  METHODS
  A matched case-control study of aphrodisiac use-associated HIV infection was performed among male subjects over 50 years old who were clients of low-cost commercial sex venues in Guangxi. The cases were defined as clients who were HIV-positive and two controls were selected for each case. The cases and the controls were matched on the visited sex venue, age (±3 years), number of years of purchasing sex (±3 years), and educational attainment. Subjects were interviewed and tested for HIV. Paired t-test or McNemar Chi-squared test were used to compare the characteristics between the cases and controls. A stepwise conditional logistic regression was used to identify risk factors associated with HIV infection.
  
  
  RESULTS
  This study enrolled 103 cases and 206 controls. Aphrodisiac use (P = 0.02, odds ratio (OR) = 1.81, 95% CI = 1.08-3.04), never using condom during commercial sex encounter (P = 0.03, odds ratio (OR) = 1.82, 95% CI = 1.08-3.07), and lacking a stable partner (P = 0.03, odds ratio (OR) = 1.76, 95% CI = 1.05-2.98) were found to be risk factors for HIV infection among the study groups. For subjects reporting aphrodisiac use, the frequency of purchasing sex was positively correlated with the frequency of aphrodisiac use (r = 0.3; p = 0.02).
  
  
  CONCLUSIONS
  Aphrodisiac use was significantly associated with increased HIV infection risk in men over 50 years old who purchased commercial sex in the suburban and rural areas of Guangxi. Further research and interventions should address the links between aphrodisiac use, commercial sex work, condom use, and increased HIV transmission.
authors.affiliation: Guangxi Zhuang Autonomous Region Center for Disease Control and Prevention, Nanning, Guangxi, China.
authors.forename: Zhenzhu
authors.initials: Z
authors.lastname: Tang
authors.affiliation: Department of HIV/AIDS Control and Prevention, Guangxi Zhuang Autonomous Region Center for Disease Control and Prevention, Nanning, Guangxi, China.
authors.forename: Xinghua
authors.initials: X
authors.lastname: Wu
authors.affiliation: Guangxi Zhuang Autonomous Region Center for Disease Control and Prevention, Nanning, Guangxi, China.
authors.forename: Guojian
authors.initials: G
authors.lastname: Li
authors.affiliation: Department of HIV/AIDS Control and Prevention, Guangxi Zhuang Autonomous Region Center for Disease Control and Prevention, Nanning, Guangxi, China.
authors.forename: Zhiyong
authors.initials: Z
authors.lastname: Shen
authors.affiliation: Department of HIV/AIDS Control and Prevention, Guangxi Zhuang Autonomous Region Center for Disease Control and Prevention, Nanning, Guangxi, China.
authors.forename: Hongman
authors.initials: H
authors.lastname: Zhang
authors.affiliation: Department of HIV/AIDS Control and Prevention, Guangxi Zhuang Autonomous Region Center for Disease Control and Prevention, Nanning, Guangxi, China.
authors.forename: Guanghua
authors.initials: G
authors.lastname: Lan
authors.affiliation: Department of HIV/AIDS Control and Prevention, Guangxi Zhuang Autonomous Region Center for Disease Control and Prevention, Nanning, Guangxi, China; Department of Pharmaceutical Systems and Policy, West Virginia University, Morgantown, West Virginia, United States of America.
authors.forename: Xue
authors.initials: X
authors.lastname: Feng
authors.affiliation: Department of HIV/AIDS Control and Prevention, Guangxi Zhuang Autonomous Region Center for Disease Control and Prevention, Nanning, Guangxi, China.
authors.forename: Rui
authors.initials: R
authors.lastname: Lin
authors.affiliation: Department of Medicine, Boston University School of Medicine, Boston, Massachusetts, United States of America, and School of Public Health, Guangxi Medical University, Nanning, China.
authors.forename: Abu S
authors.initials: AS
authors.lastname: Abdullah
authors.affiliation: National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China.
authors.forename: Zunyou
authors.initials: Z
authors.lastname: Wu
authors.affiliation: Chinese Center for Disease Control and Prevention, Beijing, China, and School of Public Health, Harvard University, Boston, Massachusetts, United States of America.
authors.forename: Cynthia X
authors.initials: CX
authors.lastname: Shi
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001046:Aphrodisiacs / Q000494:pharmacology*; D016022:Case-Control Studies; D002681:China / Q000453:epidemiology; D003365:Costs and Cost Analysis; D015658:HIV Infections / Q000453:epidemiology* / Q000635:transmission; D006801:Humans; D008297:Male; D008875:Middle Aged; D012306:Risk; D011477:Sex Work
chemical_list: D001046:Aphrodisiacs