Aphrodisiac Use and Associated Factors Among Older Male Clients of Low-Cost Female Sex Workers in Southwestern Rural Areas of China

This is the first study focusing on the use of non-prescribed aphrodisiacs by older male clients of FSWs in southwestern rural areas of Guangxi China. A cross-sectional survey was performed in low-cost commercial sex venues in 13 regions in Guangxi. Structured interviews collected data about demographics, general health status, commercial sex and aphrodisiac use behaviors, the awareness of HIV and the diagnostic services. Blood assays were conducted to test for HIV and syphilis infections. A sample of 3485 male clients from 50 to 92 years old were recruited, among which 1040 (29.8 %) were aphrodisiac users. HIV prevalence was 3.0 % (4.3 % among aphrodisiac users and 2.4 % among non-aphrodisiac users). Factors independently associated with aphrodisiac use included older age, ethnic minorities, low level of education, infected by HIV, having chronic disease, and not using condoms every time in commercial sex with FSWs. Aphrodisiacs were reported to improve sexual function by older male clients, and thereby unsafe commercial sex among them was facilitated. Aphrodisiac use can be viewed as a marker of a high-risk behavioral pattern for HIV transmission and infection in such a population.