Behavioral surveillance surveys of the male clients of female sex workers in Hong Kong: results of three population-based surveys

BACKGROUND: Male clients of female sex workers (FSWs) are an important group vulnerable to HIV infection. GOALS: The goal was to administer and assess behavioral surveillance surveys of male clients of FSWs in Hong Kong. STUDY DESIGN: Three population-based telephone surveys of males aged 18 to 60 were conducted from 1998 to 2001 (n=5159). RESULTS: Of all respondents, about 10.8% to 14% had patronized FSWs in the previous 6 months. Among male clients of FSWs, about 25% did not always use condoms, 4% to 6% had contracted a sexually transmitted disease, 16% had undergone HIV antibody testing, and 20% or more reported having four or more sex partners in the previous 6 months. There was no improvement in condom use over time. Cross-border (from Hong Kong to mainland China) commercial sex was common. CONCLUSION: The level of risk behaviors associated with male clients of FSWs remained substantial. The overall effectiveness and coverage of relevant prevention programs were questioned.