Male clients of female commercial sex workers: HIV, STDs and risk behaviour

Social stigma and taboo limit current understanding of sexual behaviours and epidemiology of sexually transmitted infections (STIs) in clients of commercial sex workers/prostitutes. We designed a study to determine risk behaviours and prevalence of STIs in a group of sexual health clinic attending male clients of female commercial sex workers (FCSWs) in Sydney, and to compare these characteristics with men who denied any commercial sexual contact. Eight hundred and ninety cases and 2670 controls were included. Clients of FCSWs were older, more likely to be married and of non-English speaking background than controls. Clients had more sexual partners but reported more condom usage than controls. Prevalence of STIs at presentation was lower in clients than controls but clients were more likely to report STIs in the past than controls. HIV prevalence was low in both groups.