广东省深圳地区MSM并行性多性伴的影响因素

目的了解广东省深圳地区男男性行为人群（MSM）的并行性多性伴的特征,分析其影响因素。方法采用同伴推动抽样方法进行抽样调查,收集MSM人口学、HIV知识、风险感知、安全套使用及并行性多性伴行为等资料。应用RDSAT 5.6和SAS 9.2软件进行统计分析。结果共访谈351名MSM。最近6个月内,208人（59.3%）有并行性多性伴,其中60.6%仅有男性性伴,39.4%有双性性伴。与无并行性多性伴的MSM相比,有并行性多性伴的MSM多在娱乐场所工作,艾滋病知识水平较低,最近6个月不使用安全套的比例较高;与仅有男性并行性多性伴的MSM相比,有双性并行性多性伴的MSM年龄较大。多因素Logistic回归分析结果表明,HIV知识得分越高,MSM发生并行性多性伴行为的风险越小。结论相当比例的MSM有并行性多性伴行为,应制订有针对性的干预计划,以阻断艾滋病病毒（HIV）由MSM向普通人群传播。     

山东省1378名男男性行为人群艾滋病感染状况及相关因素调查

目的了解男男性行为人群艾滋病感染状况,分析其影响L犬j素,为开展男男性行为人群艾滋病防治工作提供依据。方法使用同伴推动抽样法招募研究对象,南经过专门培训的人员进行问卷调查,使用酶联免疫吸附试验进行艾滋病病毒抗体筛查,使用蛋白印迹试验进行艾滋病病毒确证,使用EpiData3．2建立数据库,采用SPSS17．0进行统计分析。结果调查对象艾滋病防治知识知晓率为81．86％;63．93％男男性行为人群通过网络寻找性伴;最近6个月发生过肛交性行为的占81．57％,通过付钱的方式得到过男性提供的性服务的占3．48％,为了得到钱为男性提供过性服务的占6．53％,与女性发生过性关系的占27．36％,有过吸毒行为的占0．73％;最近1年…现过性病相关症状的占6．75％;艾滋病、梅毒和丙肝的感染率分别为2．18％、6．75％和1．23％。结论男男性行为人群普遍存在高危行为;艾滋病感染率旱逐年上升的趋势;多性伴等不安全性行为是性病、艾滋病感染的主要影响因素。     

婚姻状况对男男性行为者的艾滋病高危性行为影响研究

目的 探讨中国男男性行为者(MSM)中,在婚与非在婚亚人群艾滋病高危性行为状况.方法 采用定向抽样方法,对9个城市2 250名MSM进行匿名问卷调查,比较在婚与非在婚亚人群的高危行为.结果 在婚组累计同性性伴数、同性口交性伴数、同性肛交性伴数、近1年内向男性"买"性次数,均明显高于非在婚组(P均＜0.01);在婚组与男女性交及最近1次与女性性交时安全套使用率、近6个月内"买"性时安全套使用频率,明显低于非在婚组(P＜0.05或0.01);在婚组近6个月内在男同性爱者活动场所与陌生男性性交、最近1次与不熟悉或陌生男性性交、曾经向男性"买"性及有过肛交行为的百分率,明显高于非在婚组(P＜0.05或0.01);在婚组近6个月女性性伴数、是男性性工作者、最近1次与男性性工作者性交、有固定的男性伴侣、近1年内性交时曾出血、近1年内在外地与男性性交的百分率,明显低于非在婚组(P＜0.05或0.01).结论 MSM中,在婚与非在婚亚人群的高危行为存在诸多差异,婚姻不能制约其高危性行为,为有效阻断艾滋病病毒的传播,应对不同的MSM亚人群选择不同的艾滋病干预措施.     

深圳地区MSM性伴数量及影响因素分析

目的了解深圳地区男男性行为人群（MSM）性伴数量,分析其影响因素。方法应用同伴推动抽样（RDS）法进行抽样调查,收集MsM人群人口学和性伴数等资料。用SAS软件对数据进行Poisson回归分析。结果共抽样调查351例MSM。最近半年,仅31．4％MSM没有肛交性伴或保持单一性伴,25．9％没有口交性伴或保持单一性伴：28．5％有女性性伴,其中11．4％有多个女性性伴。职业为娱乐场所从业人员和曾做过男男性工作者（MB）,是MSM肛交性伴数和口交性伴数的共同危险因素。除此之外,HIV风险感知越高,艾滋病知识得分越高,MSM口交性伴数越多。结论对该人群有针对性的干预行动已刻不容缓,以有效阻断HIV传播和蔓延。     

凉山彝族地区门诊就诊者艾滋病知识态度行为调查

目的了解凉山彝族地区门诊就诊者对艾滋病的相关知识、态度、行为及影响因素,为提高少数民族艾滋病相关知识知晓率和促进其行为改变提出策略建议。方法采用横断面现况调查方法,在凉山地区的四所医院,通过问卷调查门诊就诊者的艾滋病相关知识、态度和行为。结果共调查413名对象,其艾滋病相关知识的平均知晓率为53.5%(221/413)。性别、文化水平、收入水平、是否接受过艾滋病相关宣传教育,对艾滋病相关知识知晓率有影响。调查对象对"四免一关怀政策"了解率较低。调查对象中有68.0%(281/413)表示会远离艾滋病感染者及病人。少数调查对象有吸毒、多性伴和商业性行为。结论对文化水平较低、收入较低、农村人群的宣传教育应加强,如何在民族地区推广使用安全套,预防艾滋病的传播是一个亟待解决的问题。     

MSM人群艾滋病感染状况及影响因素研究

目的了解男男性行为人群(Men who have sex with men,MSM)艾滋病病毒(Human immunodeficiencyvirus,HIV)感染状况,并分析其影响因素,为开展高危性行为干预工作提供依据。方法采用同伴推动抽样法招募研究对象,由经过专门培训的人员进行问卷调查和实验室检测,使用Epi Data 3.2建立数据库,采用SPSS 17.0进行统计分析。结果在过去12个月做过HIV抗体检测的占26.2%(126/474),其中知道检测结果的99.2%(125/126)。首次性行为平均年龄为22.5岁,近6个月平均性伴数为4.5个。最近6个月,7.2%(341/474)的人曾通过付钱的方式得到过男性提供的性服务,10.3%(49/474)的人为了得到钱为男性提供过性服务;31.4%(149/474)的人与女性发生过性关系。男性性伴数是无保护性行为的主要危险因素(P=0.000,OR=5.642)。艾滋病、梅毒和丙型肝炎的感染率分别为2.5%(12/474)、8.0%(38/474)、0.8%(4/474),其中艾滋病和梅毒共患率为0.6%(3/474)。结论 MSM人群普遍存在高危性行为,HIV感染率呈逐年上升的趋势,多性伴等不安全性行为是性病艾滋病感染的主要因素;应进一步加大MSM人群干预的力度,预防和控制艾滋病的传播和蔓延。     

黑龙江省四市MSM人群艾滋病相关高危行为及其影响因素分析

目的了解黑龙江省四市男男性行为人群（MsM）艾滋病相关高危行为及其影响因素,为制定针对性干预策略提供建议。方法采用同伴推动法和分类滚雪球抽样法招募MSM,进行一对一问卷调查,并采血检测艾滋病病毒（HIV）、梅毒、丙型肝炎病毒（HCV）抗体。以不安全性行为为应变量,人口学特征、艾滋病知识知晓情况、干预服务覆盖情况、高危性行为情况等因素为自变量,进行多因素逐步向前Logistic回归分析。结果共调查1353名MSM。最近6个月,83．8％的MSM与男性发生过肛交性行为,56．7％有2个以上男性伴,无保护肛交率55．4％;7．5％发生过商业性行为,无保护肛交率44．7％;22．1％与女性发生过性行为,无保护率70．2％。最近1年干预服务覆盖率80．6％。月收入高于2000元、从浴池、公园类场所寻找性伴、艾滋病知识不知晓、首次与男性性行为年龄小于25岁,是发生多男性伴行为的危险因素;月收入低于2000元、干预未覆盖、首次与男性发生性行为年龄小于18岁、浴池、公园类场所寻找性伴,是与男性发生无保护肛交行为的危险因素;初中及以下低文化、非同性恋取向、艾滋病知识不知晓、有多男性伴行为,是与男性发生商业性行为的危险因素;已婚、与男性有无保护肛交行为是与女性发生无保护性行为的危险因素。结论四市MsM人群干预覆盖率低,促成HIV传播的高危性行为情况较严重,急需在相关方面加强。四市目前所开展的干预服务促进了男男性行为的安全套使用,但使用水平较低,且对多男性伴行为、商业性性行为、与女性性行为的安全性均无明显影响,需要在干预的有效性上下功夫,在干预内容上加以完善。     

武汉市男男性接触者艾滋病知信行现状初报

目的了解武汉市男男性接触者(MSM)艾滋病相关知识、信念及行为(KAP)现状,为制定该人群预防艾滋病干预措施提供支撑材料。方法通过MSM志愿者,采用横断面方法对武汉市307位出入同性恋酒吧的MSM进行匿名问卷调查。结果①调查对象受教育程度普遍较高,职业与年龄宽泛,以性活跃期的中青年为主,最大者90岁。②艾滋病(AIDS)知识掌握不全面,存在理解偏差和知识-行为分离现象。③同性、异性和双性多元生活方式并存,多性伴和无保护性肛交等高危性行为普遍存在,38.26%的人拥有6个以上的同性伴,而68.79%的人与异性有过或保持性接触。66.67%的人知道自己的性伴另有性伴。④近一半的人认为自己很有可能感染艾滋病病毒(HIV),3/4的人担心感染HIV,4/5的人愿意进行HIV抗体检测。结论采取合适方式,加强社区内针对性的健康教育和行为干预,阻截HIV经由MSM人群扩散到普通人群已迫在眉睫。     

我国部分地区艾滋病非婚异性性传播病例感染方式构成及特征分析北大核心

目的了解调查地区艾滋病经非婚异性性行为传播的主要方式,为艾滋病经性传播的控制提供线索。方法通过横断面调查,了解新发现经性传播病例的既往性接触史,比较不同人群经性途径感染艾滋病病毒(HIV)的主要方式。结果 2014年1-6月,完成了对3257例经非婚异性性行为途径感染HIV病例的调查,男性2586人,女性671人。男性和女性感染HIV的方式有显著差异,男性以商业异性性行为为主(77.8%),其次为临时异性性伴传播(15.5%);女性中,商业性伴、临时性伴和固定性伴传播各占1/3。男性感染方式在不同年龄、文化程度、婚姻状况分组中情况不同,女性则差异不显著。结论艾滋病经性传播方式复杂、多样,各地区差异较大。应深入了解各地区艾滋病经性传播方式,以便制定有针对性的艾滋病防治策略。     

中国男男性接触者和STD/AIDS防治

世界上首例艾滋病(AIDS)是在男性同性恋人群中发现,并首先在该人群中传播。随着相关调查的开展,人们认识到AIDS在该人群的传播是由于男性与男性间的多性伴及无保护肛交行为造成的,男男性接触者(men who have sex withmen,MSM)是传播AIDS的高危人群。目前,世界上5%~10%的艾滋病病毒(HIV)感染的病例是由于男男性行为传播的。尽管不同的国家所占比例不同,但在世界一些地区男男性行为已经成为HIV主要的传播途径[1]。作为AIDS感染高危人群之一的MSM人群,目前在中国引起特别的关注。中国的MSM人数究竟有多少,至今还没有可靠的数据。…     

HIV risk among female sex workers with different patterns of drug use behaviors in Southwest China: a cross-sectional study

Although many researchers found that drug use behaviors significantly increased HIV risk, few of them investigated the association between HIV risk and different drug use behaviors among female sex workers (FSWs) in China. The current study examines demographic and behavioral risk factors as well as the infections of HIV, syphilis, and among a subgroup of FSWs who are injection drug users (IDU) or noninjection drug users (NIDU) in comparison to Hepatitis C Virus (HCV) nondrug users (non-DU). We conducted secondary analysis of the 2010 National Sentinel Surveillance (NSS) data from Guangxi China. A self-administered, standard behavioral surveillance survey was completed by a total of 12,622 FSWs recruited from Guangxi, China. The Guangxi 2010 NSS sample included 2.6% NIDU and 0.5% IDU. Compared to non-DU, IDU were more likely to report no condom use in the last sex act (aOR = 3.25, 95%CI = 1.65, 6.40), inconsistent condom use in the past month (aOR = 4.88, 95%CI = 2.66, 8.96), having an HIV testing (aOR = 2.48, 95%CI = 1.34, 4.58), infections of HIV (aOR = 42.60, 95%CI = 9.45, 192.06), syphilis (aOR = 4.13, 95%CI = 1.86, 9.16), and HCV (aOR = 74.54, 95%CI = 30.26, 183.61). NIDU had 2.89 times higher than non-DU to report a history of sexually transmitted disease and 26% less likely to report inconsistent condom use in the past month (p < 0.05). We called for tailored, accessible, and nonjudgmental drug treatments coupled with effective sexual risk reduction interventions to help FSWs with various drug use problems to reduce their vulnerability and susceptibility of HIV risk in China as well as other cultural settings.     

常德市武陵区2010年暗娼人群艾滋病哨点监测分析

目的了解武陵区暗娼人群艾滋病相关知识、行为现状及艾滋病、梅毒、丙型肝炎(丙肝)的感染状况,为干预工作提供依据。方法按照《全国艾滋病哨点监测实施方案(试行)》(2010年版)要求,抽查辖区内暗娼人群进行问卷调查和艾滋病病毒(Human immunodeficiency virus,HIV)、梅毒、丙肝病毒(Hepatitis C virus,HCV)抗体的检测。结果共调查400名暗娼,年龄中位数26岁,25～47岁占55.00%,本省户籍占90.00%,初中及以下文化占79.00%,有过婚史或有固定性伴者占58.00%。艾滋病知识知晓率为80.00%,最近1次与客人发生性行为时使用安全套的比例,最近1个月与客人发生性行为时坚持使用安全套的比例,分别为94.00%和77.50%。最近一年做过HIV检测并知晓检测结果的占34.50%,HIV、梅毒、HCV抗体阳性检出率分别为0.25%(1/400)、3.25%(13/400)、1.25%(5/400),HIV确认阳性率为0.25%。对HIV感染者追踪调查发现,第二代和第三代HIV感染者各1例。结论低档次的本土暗娼是该区性服务场所的"主力军",尽管目前HIV、梅毒、HCV的感染率较低,但传播风险不容忽视,控制传播是现阶段艾滋病性病防控工作的重点。     

Epidemiology of sexually transmitted infections, HIV, and related high-risk behaviors among female sex workers in Guangxi Autonomous Region, China

This study assessed the epidemiology of sexually transmitted infections (STIs), HIV, and associated risk factors among female sex workers (FSWs) in Guangxi autonomous region, China. A cross-sectional study of 488 FSWs was conducted using a structured questionnaire to collect sociodemographic and behavioral information. Biological specimens from subjects were sampled to detect various STIs and HIV infection. Among FSWs, the prevalence rates of syphilis, Neisseria gonorrhoeae, Chlamydia trachomatis, genital herpes, condyloma acuminate, and HIV were 7.2%, 1.8%, 18.2%, 0.4%, 2.3%, and 0.8%, respectively. The prevalence rates of single, double, and triple infections were 22.3%, 3.9%, and 0.20%, respectively. Multivariate analysis indicated that STIs and HIV infection was independently related to low education level (OR = 7.244; 95% CI = 3.031-17.213; P < 0.001), low knowledge of STIs/HIV (OR = 0.191; 95% CI = 0.108-0.337; P < 0.001), low-grade working place (OR = 1.64; 95%CI = 1.016-2.648; P = 0.046), and no condom use during the last sexual intercourse (OR = 0.199; 95% CI = 0.113-0.350; P < 0.001). The prevalence of STIs is high among FSWs in Guangxi, is accompanied by a 0.8% HIV-positive rate, and may be largely related to high-risk sexual behaviors. Future interventions should be focused on the reduction of risk factors, including promotion of condom use and improvement of knowledge of STIs and HIV among FSWs.     

Male condom use,multiple sexual partners and HIV: a prospective case-control study in Kinshasa (DRC)

In the Democratic Republic of Congo no previous studies have assessed the factors associated with different patterns of condom use and with multiple sexual partners, and the association between condom use simultaneously taking into account multiple sexual partnerships, and HIV infection. We carried out a prospective case–control study. From December 2010 until June 2012, 1630 participants aged 15–49 getting HIV Voluntary Counseling and Testing in a hospital in Kinshasa were selected. Cases were new HIV diagnosis and controls were HIV-negative participants detected along the study period. We recruited 274 cases and 1340 controls that were interviewed about HIV-related knowledge, attitudes and behaviours. Among cases there was a high prevalence of multiple lifetime and concurrent sexual partnerships (89.8% and 20.4%, respectively) and most cases never used condoms with only 1.5% using them consistently. Condom use and multiple partnerships were associated with male, single and high-educated participants. An association was found between multiple lifetime partners and ‘any condom use’ (OR?=?2.99; 95%CI: 2.14–4.19) but not with consistent use. Both having two or more multiple concurrent sexual partners or not using condoms were variables similarly and highly associated to HIV risk. The association found between having two or more concurrent sexual partners and HIV was slightly higher (OR?=?3.58, 95%CI:2.31–5.56) than the association found between never condom use and HIV (OR?=?3.38, 95%CI:1.15–9.93). We found a high prevalence of multiple lifetime sexual partners and an extremely high prevalence of inconsistent condom use, both strongly associated with HIV seropositivity. Local programmes would benefit from comprehensive interventions targeting all behavioural and sociocultural determinants.     

青岛市社区吸食新型毒品者的吸毒行为特征及安全套使用情况

目的了解青岛市社区吸食新型毒品者的人口学特征、吸毒行为、安全套使用,以及艾滋病病毒(HIV)、梅毒和丙型肝炎病毒(HCV)的感染情况,为开展行为干预提供依据。方法采取同伴推动抽样(RDS)方法进行横断面调查,问卷包括人口学特征、吸毒行为、安全套使用情况,采集血液标本检测HIV、HCV和梅毒抗体。结果共招募吸食新型毒品者324人,男性为主,文化程度较低。61.1%的吸食新型毒品者是3~5人聚集到一起吸毒,吸毒的场所以朋友或自己家里为主(占70.2%)。40.3%的吸毒者曾同时与多人发生过性行为,59.5%的吸毒者从来不使用安全套,每次都使用且一人一套的只有8人,占4.7%。Logistic回归分析显示:每周吸毒3次者安全套使用率明显低于每周吸毒3次者(OR=0.3;95%CI:0.1~0.7),做过HIV检测者安全套使用率明显高于未做过检测者(OR=5.5;95%CI:2.1~14.7)。结论青岛市社区吸食新型毒品者吸毒场所隐蔽,群体吸食后发生高危性行为的概率及梅毒感染率较高,但安全套使用率极低。需要多部门联合,全社会参与,共同应对新型毒品的流行。     

Demographic and behavioral correlates of HIV/STI among Vietnamese female sex workers in southwest China

Previous literature has suggested high rates of HIV/STIs among Chinese FSWs. However, limited data were available regarding HIV-related risks among Vietnamese FSWs – a rapidly increasing, vulnerable population in southwest China. The current study examined the demographic and behavioral factors associated with the infection rates of HIV, syphilis, and Hepatitis C (HCV) among Vietnamese FSWs in Guangxi, China. We conducted a secondary data analysis of a cumulative sample of 1026 Vietnamese FSWs (aged 14–66) recruited over five years (2010–2014) from 35 National Sentinel Surveillance sites in Guangxi. Analyses included Fisher’s exact chi-square test, t-test, and binary logistic regression. The overall prevalence of HIV, syphilis, and HCV infections among the cross-border women were 3.2%, 6.9%, and 2.6%, respectively. Multivariate analysis showed that greater lengths of sex work and low paying work venues were significant risk factors for HIV infection; for syphilis infection, older age, drug use experience, and forgoing condom use were significant risk factors; for HCV infection, drug use experience was the only significant risk factor. Our findings suggest that elevated HIV-related risks among the Vietnamese FSWs are closely related to their financial disadvantages and that drug use is a prominent risk factor for cross-border women in the sex trade. Furthermore, culturally tailored and linguistically accessible HIV prevention and intervention initiatives that target cross-border FSWs, with a close international collaboration between China and Vietnam, are urgently needed.     

HIV awareness and condom use among female sex workers in Afghanistan: implications for intervention

There is little information about HIV awareness or condom use among female sex workers (FSWs) in Afghanistan. The purpose of this cross-sectional study was to assess HIV awareness, knowledge, and condom use among FSWs in three Afghan cities. FSWs residing in Jalalabad, Kabul, and Mazar-i-Sharif were recruited through outreach programs and completed an interviewer-administered questionnaire and rapid tests for hepatitis B surface antigen, HIV, syphilis, and hepatitis C virus. Logistic regression identified factors associated with HIV awareness, comprehensive HIV knowledge (knowledge that HIV cannot be detected by sight, that condoms prevent HIV, and rejection of local misconceptions about HIV transmission), and consistent condom use (use with every sex act) with clients in the last six months. Of 520 participants, 76.9% had no formal education and 37.7% lived outside Afghanistan in the last five years. Nearly half (44.2%) were aware of HIV but, of these, only 17.4% (N = 40) had comprehensive HIV knowledge. There were significant differences by site; FSWs in Jalalabad were more likely to be aware of HIV but FSWs in Kabul were more likely to have correct HIV knowledge and use condoms consistently with clients. Consistent client condom use was reported by 11.5% (N = 60) and was independently associated with having more clients per month (AOR = 1.99, 95% CI: 1.04-3.81). In conclusion, comprehensive HIV knowledge and consistent condom use with clients are low among Afghan FSWs in these cities. Efforts to reach this population should focus on relaying accurate information and expanding condom use with clients.     

Bias in Self-Reported Condom Use: Association Between Over-Reported Condom Use and Syphilis in a Three-Site Study in China

This study examined over-reporting bias in self-reported condom use and assessed its association with syphilis. A survey was conducted among 1245 female sex workers (FSWs) in three cities in China. Respondent’s over-reported condom use was defined as reporting no unprotected sex for the past 24 h but testing positive for prostate specific antigen. The proportion of prevalent syphilis and active syphilis was 23 and 10 % respectively among FSWs. The proportion of over-reported condom use with sex clients only was 27–45 % among the three study sites. The proportion of over-reported condom use with all sex partners (clients, husbands, or boyfriends) was 26–46 %. FSWs who had active or prevalent syphilis were more likely to over report condom use. Self-reported condom use may not be a valid tool to measure the efficacy of HIV/STI intervention because the bias is associated with the outcome measure, i.e., syphilis.     

HIV seroprevalence and high-risk sexual behavior among female sex workers in Central Brazil

Female sex workers (FSWs) are considered a high-risk group for human immunodeficiency virus (HIV) infection due to their social vulnerability and factors associated with their work. We estimated the prevalence of HIV, and identified viral subtypes and risk factors among FSWs. A cross-sectional study using respondent-driven sampling (RDS) method was conducted among 402 FSWs in Campo Grande city, Brazil, from 2009 to 2011. Participants were interviewed using a standardized questionnaire about sociodemograpic characteristics and risk behavior. Blood samples were collected for serological testing of HIV. Of the 402 FSWs, median age and age of initiating sex work were 25 years (Interquartile range [IQR]: 9) and 20 years (IQR: 6), respectively. The majority reported use of alcohol (88.5%), had 5–9 years (median: 9; IQR: 3) of schooling (54.5%), 68.6% had tattoos/body piercings, and 45.1% had more than seven clients per week (median: 7; IQR: 10). Only 32.9% of FSW reported using a condom with nonpaying partners in the last sexual contact. Prevalence of HIV infection was 1.0% (95% CI: 0.1–2.6%). Genotyping for HIV-1 performed on three samples detected subtypes B, C, and F1. Sex work in the Midwestern region of Brazil is characterized by reduced education, large numbers of clients per week, and inconsistent condom use, mainly with nonpaying partners. Although prevalence of HIV infection is currently low, elevated levels of high-risk sexual behavior confirm a need to implement prevention measures. Specific interventions targeting FSWs must emphasize the risk associated with both clients and nonpaying partners while providing knowledge about HIV prevention.     

Clients of Female Sex Workers as a Bridging Population in Vietnam

Understanding bridging behaviors of clients of female sex workers (FSWs) is important for projecting and intervening in the spread of sexually transmitted infections in Vietnam. The goals of the study were to determine HIV/STI prevalence amongst different bridging groups, identify factors associated with being potential and active bridgers, and assess the association of drug use and unsafe sex with HIV and/or STI prevalence. In April, 2007, 292 clients were anonymously interviewed at sex venues in a two-stage time-location cluster sampling survey, followed by HIV, syphilis, and HSV-2 testing. Based on condom use with both high-risk (FSWs) and low-risk (wives/girlfriends) sexual partners, clients were classified as unlikely, potential, or active bridgers. The majority of clients were potential or active bridgers (55.8%) who had a significantly higher prevalence of herpes simplex type 2 (HSV-2) (21% and 33%, respectively) than unlikely bridgers (8.7%). HIV seropositivity was 4.4-fold (95% CI 1.1-17.1) higher among those who were HSV-2-positive. Clients of FSWs may be playing a major bridging role in transmitting HIV and sexually transmitted infections (STIs) in Vietnam. An observed synergistic interaction between drug use and condom slippage/breakage emphasizes the importance of proper condom use, particularly among drug users.