Commercial Sex Work and Risk of HIV Infection Among Young Drug-Injecting Men Who Have Sex With Men in San Francisco

To investigate the relationship between sex work and HIV infection among young injection drug-using men who have sex with men (MSM-IDU), the researchers in the current study conducted a cross-sectional analysis of behavioral and serologic data from street-recruited MSM-IDU in San Francisco from January 2000 to November 2001.

Of 227 participants recruited, 68 percent reported being paid by another man for sex. Twelve percent were HIV-positive (95 percent confidence interval, 8-16 percent); 42 percent of seropositive participants were unaware of their infection. HIV was independently associated with a higher number of paying male partners and history of gonorrhea infection, and inversely associated with number of female partners, syringe sharing and education. Overall consistent condom use was 41 percent, though this varied significantly by type of partner.

"Among MSM-IDU in San Francisco, sex work with men is strongly associated with HIV infection and the prevalence of condom use is low," the authors concluded. "HIV prevention among MSM-IDU must be tailored to address the excess risk associated with sex work."

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