Rich Rivka, Leventhal Alex, Sheffer Rivka, Mor Zohar
School of Public Health, Hebrew University, Jerusalem, Israel.
Ministry of Health, Public Health Services, Jerusalem, Israel.
Isr J Health Policy Res. 2018 Jun 27;7(1):19. doi: 10.1186/s13584-018-0213-4.
Commercial sex shares a role in HIV and sexually transmitted infections (STI) transmission. Men who pay for sex (MPS) may transmit HIV/STI to other populations which are low-risk. This study aimed to test our hypothesis that MPS engage in high-risk sexual behaviors associated with HIV/STI transmission more so than non-MPS.
This cross-sectional study included heterosexual men who attended an STI clinic between 2003 and 2010. Demographic, clinical, behavioral and laboratory data were compared between MPS and non-MPS to identify factors associated with high-risk sexual behavior and STI-burden.
Of the first visits of 6156 heterosexual men who attended the STI-clinic during the study period, 1649 (26.7%) were MPS. MPS were more commonly older, married and non-Israeli born compared with non-MPS. MPS were more likely to engage in risk-behaviors associated with HIV/STI-transmission, including a greater number of lifetime sexual partners, substance use and previous STI diagnoses. Determinants associated with STI-diagnoses at the current visit included being non-Israeli born, presenting with STI symptoms, reporting a greater number of lifetime sexual partners and having sexual encounters with non-Israeli individuals.
Approximately 25% of all men who attended the clinic were MPS. They were more likely to engage in risk-behaviors associated with HIV/STI transmission compared to non-MPS. These findings highlight the need to establish interventions for MPS that both continue to encourage condom use and address the potential perils pertaining to risky sexual behaviors.
商业性行为在艾滋病毒和性传播感染（STI）的传播中起到一定作用。购买性服务的男性（MPS）可能会将艾滋病毒/性传播感染传播给其他低风险人群。本研究旨在验证我们的假设，即与非购买性服务的男性相比，购买性服务的男性更易出现与艾滋病毒/性传播感染传播相关的高风险性行为。
这项横断面研究纳入了2003年至2010年间在性传播感染诊所就诊的异性恋男性。比较了购买性服务的男性和非购买性服务的男性在人口统计学、临床、行为和实验室数据方面的差异，以确定与高风险性行为和性传播感染负担相关的因素。
在研究期间到性传播感染诊所就诊的6156名异性恋男性中，首次就诊时1649名（26.7%）为购买性服务的男性。与非购买性服务的男性相比，购买性服务的男性年龄更大、已婚且非以色列出生的情况更为常见。购买性服务的男性更有可能从事与艾滋病毒/性传播感染传播相关的风险行为，包括一生中拥有更多性伴侣、使用毒品和既往有性传播感染诊断史。本次就诊时与性传播感染诊断相关的决定因素包括非以色列出生、出现性传播感染症状、报告一生中拥有更多性伴侣以及与非以色列人发生性行为。
到诊所就诊的所有男性中约25%为购买性服务的男性。与非购买性服务的男性相比，他们更有可能从事与艾滋病毒/性传播感染传播相关的风险行为。这些发现凸显了有必要为购买性服务的男性制定干预措施，既要继续鼓励使用避孕套，并应对与高风险性行为相关的潜在危险。
