The HIV epidemic among men who have sex with men (MSM) in China is becoming very serious. Unprotected anal intercourse (UAI) among MSM during cross-boundary commercial sex spread HIV across geographic areas. This study interviewed 186 Chinese male sex workers (MSW) in Shenzhen, China,
serving cross-boundary Hong Kong male clients; 49.5% had had UAI with their Hong Kong male clients (last six months) and 24.2% intended to do so (future six months). Multivariate analyses showed that perceived efficacy of condom use for HIV prevention, perceived prevalence of HIV among Hong
Kong MSM (>4%), and perceived ability to convince Hong Kong male clients to use condoms during anal sex were associated with lower likelihoods of UAI with such clients (OR = 0.04–0.09); the reverse was true for those who left the decision of condom use to their Hong Kong male clients
(OR = 6.44). Perceived condom efficacy, self-efficacy in protection against HIV infection, and perceived control over condom use were associated with an intention for UAI (OR = 0.06–80.44). Adjusting for background variables, the scales representing contextual (Clients Characteristics,
Substance Use, or Environmental Influences) and affective factors (Fear of Diseases) were associated with UAI (adjusted OR = 0.44–32.61). Except the Fear of Diseases scale, other scales were associated with an intention for UAI (adjusted OR = 4.59–43.32). MSW are at high risk of
HIV transmission. Various factors are associated with UAI with male cross-boundary clients; these factors and the context of sex work need to be considered when designing HIV prevention programs.
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Chinese male sex workers;
unprotected anal intercourse
Document Type: Research Article
Centre for Health Behaviors Research, School of Public Health and Primary Care,The Chinese University of Hong Kong, Hong Kong, China
Shenzhen Center for Disease Control and Prevention, Guangdong, China
Department of Medical Statistics and Epidemiology, School of Public Health,Sun Yat-sen University, Guangzhou, China
Publication date: 2012-01-01
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