Objectives: To determine sociodemographic and behavioral correlates of HIV infection among male clients of female sex workers (FSWs) in Tijuana.
Methods: Four hundred men aged 18 years or older who had paid or traded for sex with a FSW in Tijuana during the past 4 months were recruited in Tijuana's ‘zone of tolerance,’ where prostitution is practiced openly under a municipal permit system. Efforts were made to balance the sample between residents of the United States (San Diego County) and of Mexico (Tijuana). Participants underwent interviews and testing for HIV, syphilis, gonorrhea, and Chlamydia. Logistic regression identified correlates of HIV infection.
Results: Mean age was 36.6 years. One-quarter had injected drugs within the previous 4 months. Lifetime use of heroin, cocaine, and methamphetamine was 36, 50, and 64%, respectively. Men had frequented FSWs for an average of 11 years, visiting FSWs an average of 26 times last year. In the past 4 months, one-half reported having unprotected sex with a FSW; 46% reported being high fairly or very often when having sex with a FSW. Prevalence of HIV, syphilis, gonorrhea, and Chlamydia was 4, 2, 2.5, and 7.5%; 14.2% were positive for at least one infection. Factors independently associated with HIV infection were living in Mexico, ever using methamphetamine, living alone, and testing positive for syphilis.
Conclusion: Male clients of FSWs in Tijuana had a high sex and drug risk profile. Although sexually transmitted infection prevalence was lower than among FSWs, HIV prevalence was comparable suggesting the need for interventions among clients to prevent spread of HIV and sexually transmitted infections.
aDepartment of Psychiatry, University of California, USA
bMental Illness Research, Education, and Clinical Care Program (MIRECC), San Diego Veterans Administration Healthcare System, USA
cJoint Doctoral Program in Public Health, San Diego State University and University of California, San Diego, California, USA
dPatronato Pro-COMUSIDA, Tijuana, Mexico
eDepartment of Psychiatry, USA
fDivision of Global Public Health, Department of Medicine, University of California, San Diego, La Jolla, California, USA.
Received 8 May, 2009
Revised 3 June, 2009
Accepted 4 June, 2009
Correspondence to Professor Thomas L. Patterson, PhD, Department of Psychiatry, University of California, 9500 Gilman Drive, La Jolla, CA 92093-0680, USA. Tel: +1 858 534 3354; fax: +1 858 534 7723; e-mail: firstname.lastname@example.org