Characteristics and risk factors of male commercial sex workers

Objective: This study was performed to compare the HIV risk behaviors and predisposing, enabling and reinforcing factors in a group of young men that worked in the commercial sex industry with a cohort group of non-sex working males. Methods: Data collected from 421 males (ages 14-35) who self-identified as engaged in commercial sex work (CSW) from 2002-2005 in predominantly rural areas of Virginia gives insight to substance use, HIV risk behaviors, and HIV status of young males working in the sex trade industry. Risk assessment interviews with 269 of these males gives an in depth look at both qualitative and quantitative data on risky sexual and drug taking behaviors with both clients and recreational sex partners, as well as other risk factors, perceptions, attitudes and beliefs. T-tests were used for statistical analysis. Results: HIV incidence was 10 times higher for CSW than their cohort. Injecting drug, methamphetamine, cocaine and alcohol abuse was also significantly higher for CSW. History of mental illness and childhood sexual assault were significantly higher in CSW than their cohort. Over 35% of the men identified as heterosexual, but engaged in homosexual behavior during CSW. Conclusions: This presentation gives insight to issues surrounding this seldom-studied population, including heterosexual men who are “gay for pay” and HIV status, HIV testing history, substance abuse, mental health status and sexual practices of these young men. Successful strategies for engaging this group and interventions that proved successful in reducing risk behaviors in this group will also be discussed.