Lau Joseph T, Tang Amy S, Tsui H Y
Centre for Clinical Trials and Epidemiological Research, Faculty of Medicine, the Chinese University of Hong Kong, Hong Kong, ROC.
AIDS. 2003 Jan 3;17(1):105-12. doi: 10.1097/00002030-200301030-00014.
This study investigated the consistency of condom use and the prevalence of self-reported sexually transmitted diseases (STD) among male Hong Kong commercial sex clients with respect to the geographical location of these transactions.
Male clients were identified via three independent, population-based surveys conducted in 1998, 1999, and 2001. A unique confidential telephone system was used to collect sensitive information.
Respondents patronizing female sex workers (FSW) in 'mainland China only' or in 'mainland China and other places' were more likely to be inconsistent condom users (28 and 34%) than those patronizing FSW in 'Hong Kong only' (9.1%). A similar pattern was found for self-reported STD in the past 6 months (10.1, 8.1 and 1.0%, respectively). Patronizing FSW in mainland China was associated with a higher prevalence of self-reported STD (adjusted OR 4.16), independent of consistent condom use and other potential confounding factors, including calendar year of survey, age, educational attainment, HIV-related knowledge, perceived efficacy of condom use for HIV/AIDS prevention, number of female sex partners, and the presence of a regular female sex partner in the past 6 months. Clients who had commercial sex both in mainland China and Hong Kong were more likely to use condoms in Hong Kong than in mainland China (paired OR 4.67, < 0.05).
The geographical location of commercial sexual activity is related to the consistency of condom use, irrespective of the clients engaged in such activity. Prevention programmes need to be aware of how risk behaviour is dependent on local contexts.
本研究调查了香港男性商业性性交易客户在不同交易地理位置下避孕套使用的一致性以及自我报告的性传播疾病（STD）患病率。
通过1998年、1999年和2001年进行的三项独立的基于人群的调查确定男性客户。使用独特的保密电话系统收集敏感信息。
仅在内地或在内地及其他地方光顾女性性工作者（FSW）的受访者比仅在香港光顾FSW的受访者更有可能不一致地使用避孕套（分别为28%和34%），而后者为9.1%。在过去6个月中自我报告的性传播疾病方面也发现了类似模式（分别为10.1%、8.1%和1.0%）。在内地光顾FSW与自我报告的性传播疾病患病率较高相关（调整后的比值比为4.16），与是否一致使用避孕套以及其他潜在混杂因素无关，这些因素包括调查年份、年龄、教育程度、与艾滋病毒相关的知识、认为避孕套对预防艾滋病毒/艾滋病的有效性、女性性伴侣数量以及过去6个月中是否有固定的女性性伴侣。在中国大陆和香港都有商业性性交易的客户在香港比在中国大陆更有可能使用避孕套（配对比值比为4.67，<0.05）。
商业性性活动的地理位置与避孕套使用的一致性有关，无论从事此类活动的客户如何。预防计划需要了解风险行为如何依赖于当地情况。
