Sex purchasing and associations with HIV/STI among a clinic-based sample of US men

Michele R. Decker, Anita Raj, Jhumka Gupta, Jay G. Silverman

Research output: Contribution to journalArticle


BACKGROUND: Despite high rates of human immunodeficiency virus/sexually transmitted infection (HIV/STI) among commercial sex workers and international concern that male clients may constitute a critical bridge population for HIV/STI transmission, little empirical data exist within the United States to characterize men who purchase sex or to assess their sexual risk and HIV/STI infection. METHODS: The study involves the analysis of a community-based survey of men aged 18-35 years attending urban health centers (n = 1515) to assess the prevalence of engagement in sex purchasing during the past year and to evaluate relations with self-reported HIV/STI diagnosis and symptoms across this same period. RESULTS: More than 1 in 12 (8.7%) men reported exchanging drugs, money, or a place to stay for sex with a female partner in the past year. Such behavior was associated with additional sexual risk taking and emerged as an independent predictor of self-reported HIV/STI diagnosis [adjusted odds ratio (ORadj) = 2.99; 95% confidence interval (CI): 1.51 to 5.94] and STI symptoms (ORadj = 2.57; 95% CI: 1.57 to 4.22) in the past year in analyses adjusted for alternate HIV/STI risk sources. CONCLUSIONS: Sex purchasing is a common form of HIV/STI risk among the population sampled. Men engaging in such behavior are more likely to be HIV/STI infected and, thus, represent a risk to the sexual health of both commercial and noncommercial sex partners. Further research is needed to inform interventions targeted toward male clients of prostituted women.

Original languageEnglish (US)
Pages (from-to)355-359
Number of pages5
JournalJournal of Acquired Immune Deficiency Syndromes
Issue number3
StatePublished - Jul 1 2008
Externally publishedYes


  • HIV
  • Prostitution
  • Sexually transmitted disease

ASJC Scopus subject areas

  • Infectious Diseases
  • Pharmacology (medical)

Fingerprint Dive into the research topics of 'Sex purchasing and associations with HIV/STI among a clinic-based sample of US men'. Together they form a unique fingerprint.

  • Cite this