Bridging Populations—Sexual Risk Behaviors and HIV Prevalence in Clients and Partners of Female Sex Workers, Bangkok, Thailand 2007

Artcile in the Journal of Urban Health: Bulletin of the New York Academy of Medicine, Vol. 88, No. 3.
 
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. Clientsmedian 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) 1.168.24] and condom use during last sexual encounter with regular partner (RR=3.97, 95% CI 1.0914.61). Median age of nonpaying partners was 34 years, and HIV prevalence was 15.1%. There were 56 discordant FSWclient pairs and 14 discordant FSWnon-paying partner pairs. Condom use was relatively high among discordant FSWclient pairs (90.1%) compared to discordant FSWnonpaying 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.
 
(abstract authors' own)
Year of publication: 
2011
Theme: 
Health and HIV
Author: 
Neha S. Shah, Ray W. Shiraishi, Wonchart Subhachaturas, Abhijeet Anand, Sara J. Whitehead, Suvimon Tanpradech, Chomnad Manopaiboon, Keith M. Sabin, Kimberley K. Fox and Andrea Y. Kim