AEGiS-15IAC: Increasing prevalence of female commercial sex contacts among men in Britain: Implications for HIV transmission.

15th International AIDS Conference

Bangkok, Thailand - July 11-16, 2004

Increasing prevalence of female commercial sex contacts among men in Britain: Implications for HIV transmission.

Int Conf AIDS 2004 Jul 11-16; 15:(abstract no. TuOrC1201)

Johnson AM, Mercer CH, Ward H, Wellings K, Fenton KA, Erens B
University College, London, United Kingdom

BACKGROUND: High-risk sexual behaviour, STI incidence and heterosexually acquired diagnosed HIV infections are increasing in Britain. Women sex workers have been the focus of HIV prevention initiatives, and their risk currently remains low. However, little attention has focussed on clients. We examined the epidemiology of female commercial sex contacts reported by men in 1990 and 2000.

METHODS: National probability sample surveys of sexual attitudes and lifestyles ('Natsal') of men aged 16-44 resident in Britain in 1990 (n=6000) and 2000 (n=4762). Data collected by combination of face-to face and self-completion interviews.

RESULTS: The proportion of men reporting paying for sex with women (clients) in last 5 years increased from 2.0% in 1990 to 4.2% in 2000 (OR 2.09, 95% CI 1.61-2.73). In 2000, the prevalence of paying for sex was highest among men aged 25-34 (5.4% cf. 3.4% of men 16-24; 3.6% of men 35-44; p=.014); among previously/unmarried men (5.7% cf. 3.1% of married/cohabiting men; p=.0001); and men living in London (8.6% cf. 3.5% men living in rest of Britain; p<.0001); but was not associated with ethnicity or social class. Clients had similar prevalence of homosexual contact (2.9%) but higher prevalence of injecting drug use (2.7%) as men who did not pay for sex (1.2%, p=.048). Clients reported more partners (36.5% 10+ partners cf. 8.1% in non-clients, p<.0001), more new partners abroad (55% cf. 12.3% in non-clients, p<.0001), and more STIs (9% cf. 3%, p<.0001) in last 5 years, but only 15% had an HIV test cf. 8.8% in non-clients (p=.004). 35% of clients in the last year reported no condom use in that time. Conclusion The proportion of men who have paid for heterosexual sex has increased, and these men have more partners and more partners abroad. Their higher rates of STI and low level of |HIV testing emphasise the need for prevention interventions for clients as well as sex workers.

Keywords: AEGIS, Prevalence, HIV, Acquired Immunodeficiency Syndrome, HIV Seropositivity, Sexual Behavior, HIV Infections, Prostitution, Safe Sex, Heterosexuality, Incidence, Coitus, Interviews, Data Collection, London, Female, Humans, Male, transmission, epidemiology

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