Male prostitutes and safe sex: different settings, different risks.

Twenty-seven male prostitutes were interviewed extensively about their work and considerations relating to safe sex with clients. Important differences were found between street prostitutes and those working at home. Street-workers were more likely to be using hard drugs, to have a heterosexual preference, to have no other occupation, to have more clients, but less steady ones, and to have a more negative working attitude. Sexual techniques most often practised were manual and oral contact; however, most prostitutes also practised either insertive or receptive anal intercourse. Homosexual male prostitutes reported more receptive anal intercourse than did their heterosexual male colleagues; but no such differences were found in insertive anal intercourse. Prostitutes were most likely to have had anal intercourse with steady clients, with clients whom they trusted regarding condom use, or with clients they felt sexually attracted to; and also when in dire need of drugs. Of those who had practised anal intercourse in the previous year, a minority had not consistently used condoms. The same factors that encourage anal intercourse also appear conducive to unprotected intercourse.